2015-08-14T15:21:48-05:00 2014-12-31 593070669 MOORE STEPHENS LOVELACE PA 311 PARK PLACE BLVD SUITE 100 CLEARWATER FL 33759 990 2014-01-01 593474336 LCPS MANAGEMENT INC LCPS 9042731701 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 D BRUCE JONES CHIEF EXECUTIVE OFFICER 9042731701 2015-08-14 1 KURT A ALTER CPA P00059492 7275314477 2014 2016-03-07 17:11:31Z D BRUCE JONES 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 1353093 0 X N/A X 1997 FL TO PROVIDE A FULL RANGE OF OPERATIONAL MANAGEMENT SERVICES TO ORGANIZATIONS OPERATING CONTINUING CARE RETIREMENT COMMUNITIES AND OTHER ORGANIZATIONS PROVIDING LONG-TERM CARE. 8 8 6 6 0 0 0 0 1010915 1352965 118 128 0 0 1011033 1353093 0 884983 0 0 812510 665345 0 0 0 125241 161573 937751 1711901 73282 -358808 636334 234439 84048 40961 552286 193478 TO PROVIDE A FULL RANGE OF OPERATIONAL MANAGEMENT SERVICES TO ORGANIZATIONS OPERATING CONTINUING CARE RETIREMENT COMMUNITIES AND OTHER ORGANIZATIONS PROVIDING LONG-TERM CARE. 0 0 1332505 884983 1352965 MANAGEMENT SUPPORT SERVICES PROVIDED TO AFFILIATED ORGANIZATIONS: LIFE CARE PONTE VEDRA, INC. AND LIFE CARE ST JOHNS, INC. 1332505 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 6 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X D BRUCE JONES 9042731701 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 MARGARET ARROWSMITH BOARD CHAIR 1.00 1.00 X X 0 0 0 GEORGE FETHERSTON VICE CHAIR 1.00 7.00 X X 0 0 0 BRUCE VORSANGER BOARD CHAIR 2.00 6.00 X X 0 0 0 GERALD REYNOLDS BOARD MEMBER 1.00 1.00 X 0 0 0 FREDRICK ISAAC BOARD MEMBER 1.00 7.00 X 0 0 0 WILLIAM J MURDOCK III BOARD MEMBER 1.00 7.00 X 0 0 0 MARK BONNER BOARD MEMBER 1.00 5.00 X 0 0 0 JOHN STROM BOARD MEMBER 1.00 3.00 X 0 0 0 MICHAEL HARVICK BOARD MEMBER 1.00 2.00 X 0 0 0 RODNEY BRACE BOARD MEMBER 1.00 5.00 X 0 0 0 D BRUCE JONES CHIEF EXECUTIVE OFFICER 10.00 30.00 X 168196 0 23707 CANDACE BOWLING CHIEF FINANCIAL OFFICER 4.00 36.00 X 100264 0 13384 DALE PIRKLE CHIEF OPERATING OFFICER 1.00 40.00 X 123056 0 8347 391516 0 45438 3 0 1 0 0 MANAGEMENT CONTRACT 623000 1325000 1325000 APPLICATION FEES 623000 16450 16450 MANAGEMENT FEES 623000 11515 11515 1352965 128 128 1353093 1352965 0 128 884983 884983 436954 161653 275301 142428 142428 15787 15787 29161 29161 41015 23789 17226 84251 84251 3304 686 2618 9508 9508 WALLER FUND SPENDING 48615 48615 EMPLOYEE RELATIONS 8095 8095 COMMUNITY EVENTS 7800 7800 1711901 1332505 379396 0 189947 227089 772 7349 0 443248 2367 1 636334 234439 83521 38130 527 2831 84048 40961 X 552286 135322 58156 552286 193478 636334 234439 -358808 0 X 0 0 0 X X X 2 LIFE CARE PONTE VEDRA INC 592555812 9 1 0 0 LIFE CARE ST JOHNS INC 593474627 9 1 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 PART IV, SECTION E, LINE 2A: LCPS MANAGEMENT, INC. PROVIDED A FULL RANGE OF MANAGEMENT SERVICES TO LIFE CARE PONTE VEDRA, INC. D/B/A VICAR'S LANDING (EIN: 59-2555812) AND LIFE CARE ST. JOHNS, INC. (EIN: 59-3474627), WHICH ASSISTED THOSE ORGANIZATIONS IN PROVIDING FOR THE HOUSING, PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, HEALTH CARE AND FINANCIAL SECURITY NEEDS OF THE RESIDENTS OF VICAR'S LANDING AND LIFE CARE ST. JOHNS. PART IV, SECTION E, LINE 2B: LIFE CARE PONTE VEDRA, INC D/B/A VICAR'S LANDING (EIN: 59-2555812) AND LIFE CARE ST. JOHNS, INC (EIN: 59-3474627) WOULD BE ENGAGED IN THE ACTIVITIES OF PROVIDING FOR THE HOUSING, PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, HEALTH CARE AND FINANCIAL SECURITY NEEDS OF THEIR RESIDENTS BUT FOR THE INVOLVMENT OF LCPS MANAGEMENT, INC. LCPS MANAGEMENT, INC PROVIDES MANAGEMENT SERVICES, THAT COULD BE PROVIDED INTERNALLY BY LIFE CARE PONTE VEDRA, INC D/B/A VICAR'S LANDING AND LIFE CARE ST. JOHNS, INC OR FROM A THIRD PARTY, UNRELATED TO LIFE CARE PONTE VEDRA, INC D/B/A VICAR'S LANDING AND LIFE CARE ST. JOHNS, INC. 0 DUE TO/DUE FROM VICAR'S LANDING 2831 2831 0 LIFE CARE ST JOHNS INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593474627 501(C)(3) 443248 COST LAND AS PART OF GLENMOOR'S 2014 RESTRUCTURING, LCPS MANAGEMENT DONATED THIS LAND TO LIFE CARE ST. JOHNS, INC TO USE AS COLLATERAL FOR FINANCING. LIFE CARE ST JOHNS INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593474627 501(C)(3) 425000 LCPS MANAGEMENT WOULD NORMALLY CHARGE LIFE CARE ST. JOHNS, INC A FEE THAT REPRESENTS 5% OF OPERATING REVENUE. BOND DOCUMENTS RESTRICT AMOUNT TO $100K ANNUALLY. RECORDED ENTRY AS $525K MANAGEMENT FEE AND AN OFFSETTING $425K CONTRIBUTION BACK TO LIFE CARE ST. JOHNS, INC. LIFE CARE PONTE VEDRA INC DBA VICAR'S LANDING 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 592555812 501(C)(3) 16735 TO ESTABLISH AN "EMPLOYEE EMERGENCY FUND" ON THE VICAR'S LANDING BOOKS. 3 0 X 0 0 0 0 0 0 0 0 0 D BRUCE JONES CHIEF EXECUTIVE OFFICER 168196 0 0 0 0 0 0 0 23707 0 191903 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS LIFE CARE PASTORAL SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATION'S SOLE MEMBER, LIFE CARE PASTORAL SERVICES, INC., HAS THE POWER TO ELECT ALL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL OF THE SOLE MEMBER, LIFE CARE PASTORAL SERVICES, INC., SHALL BE REQUIRED FOR A NUMBER OF ACTIONS BY THE BOARD, AS WRITTEN WITHIN THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY VIA EMAIL FOR REVIEW PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THERE IS A YEARLY REVIEW AT THE BOARD LEVEL WHERE EACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST POLICY AND DECLARES ANY CONFLICT. ADDITIONALLY, THERE IS A CONFLICT OF INTEREST POLICY IN THE EMPLOYEE HANDBOOK, AND IT IS REVIEWED WITH THE DEPATRTMENT HEADS ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD REVIEWS ACCOMPLISHMENTS AGAINST OBJECTIVES AND DETERMINES THE COMPENSATION OF EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIALS & KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. LIFE CARE PONTE VEDRA INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 592555812 CONTINUING CARE RETIREMENT COMMUNITY FL 501(C)(3) LINE 9 LIFE CARE PASTORAL SERVICES 1 LIFE CARE ST JOHNS INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593474627 CONTINUING CARE RETIREMENT COMMUNITY FL 501(C)(3) LINE 9 LIFE CARE PASTORAL SERVICES 1 LIFE CARE PASTORAL SERVICES INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593480191 HOLDING COMPANY FL 501(C)(3) LINE 11A, I N/A 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0