2015-11-12T16:16:08-06:00 2014-12-31 461497033 EKS&H LLLP 7979 E TUFTS AVENUVE 400 DENVER CO 80237 990 2014-01-01 840438016 SUNNY VISTA LIVING CENTER SUNN 7194718700 2445 E CACHE LA POUDRE COLORADO SPRINGS CO 80909 JANET BURNS CEO 7194718700 2015-11-12 1 DORI J EGGETT P00645252 3037409400 2014 2016-04-25 22:37:26Z JANET BURNS 2445 E CACHE LA POUDRE COLORADO SPRINGS CO 80909 13188490 0 X WWW.SUNNYVISTA.ORG X 1911 CO PROVIDES A HOMELIKE ENVIRONMENT THROUGH A CONTINUUM OF CARE THAT ALLOWS PEOPLE TO AGE WITH DIGNITY. 10 10 251 27 0 0 65102 17417 13007914 13015950 64166 79065 7207 62732 13144389 13175164 0 0 0 0 6779923 6929574 0 0 0 6540670 6452741 13320593 13382315 -176204 -207151 24255085 24099709 17551431 17335304 6703654 6764405 WE EXIST TO ENSURE THE ELDERLY OF OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC STATUS, HAVE DIGNIFIED ACCESS TO AFFORDABLE LONG-TERM CARE AS WELL AS SHORT TERM REHABILITATIVE HEALTH CARE SERVICES IN A COMFORTABLE AND SAFE ENVIRONMENT. 0 0 12125977 13027347 SUNNY VISTA LIVING CENTER PROVIDES SKILLED NURSING CARE FOR ELDERS; BOTH FOR LONG TERM CARE AND SHORT-TERM REHABILITATION. WE PROVIDE CARE TO MEDICAID RESIDENTS (A PROGRAM THAT SUPPORTS PEOPLE WHO ARE NOT ABLE TO PAY FOR SKILLED NURSING). THESE NEEDS OF ALL RESIDENTS ARE PROVIDED FOR: HEALTH CARE, ACTIVITIES, SOCIAL SERVICES AND DINING SERVICES. THIS GROUP GENERALLY STAYS IN OUR COMMUNITY UNTIL THEIR DEATH. WE ALSO PROVIDE MEDICARE REHABILITATION. THESE RESIDENTS WORK WITH OUR THERAPISTS FOR A SHORT TIME TO ALLOW THEM TO RETURN HOME WELL AND STRONG. WE ALSO PROVIDE HOSPICE CARE THAT PROVIDES COMFORT SERVICES TO THOSE NEEDING END OF LIFE CARE. FINALLY, WE PROVIDE PRIVATE PAY RESIDENTS WHO ARE GENERALLY HERE FOR REGULAR SKILLED NURSING CARE AND HAVE THE ABILITY TO PAY FOR THAT CARE. 12125977 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 16 0 1 251 1 0 0 0 0 0 1 1 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X JANET BURNS 7194718700 2445 E CACHE LA POUDRE COLORADO SPRINGS CO 80909 GEORGE SANCHEZ PRESIDENT 2.00 0.50 X X 0 0 0 GEORGE WAY IMMEDIATE PAST PRESDIENT 2.00 0.50 X X 0 0 0 WALT MOORE VP ADMINISTRATION TERM END 03/2014 1.00 0.30 X X 0 0 0 DICK EITEL VP ADMINISTRATION TERM BEGIN 04/2014 1.00 0.30 X X 0 0 0 PAT ELLIS VP FINANCE 0.50 0.30 X X 0 0 0 DR SCOT SICKBERT TRUSTEE 0.50 0.30 X 0 0 0 LAURA MUIR SECRETARY 1.00 0.30 X X 0 0 0 TOM DECOTIIS TRUSTEE 0.50 0.30 X 0 0 0 TOM CONE TRUSTEE 0.50 0.30 X 0 0 0 JONATHAN SHANKLAND TRUSTEE 0.50 0.30 X 0 0 0 NICOLE RIVET TRUSTEE 0.50 0.30 X 0 0 0 JANET BURNS CEO 38.00 2.00 X 192635 0 6610 192635 0 6610 1 0 1 0 INFINITY REHAB 25117 SW PARKWAY SUITE D WILSONVILLE OR 97070 REHAB SERVICES 1264558 SCHRYVER MEDICAL 12075 E 45TH AVE 600 DENVER CO 80239 LABS/RADIOLOGY 307211 2 17407 10 17417 PATIENT REVENUE 623000 13015950 13015950 13015950 79065 79065 3070 17407 13326 -10256 -10256 REBATE 900099 51359 51359 MISCELLANEOUS REVENUE 900099 11397 11397 CAFETERIA REVENUE 722514 10232 10232 72988 13175164 13027347 0 130400 X 199245 179321 19924 5738491 5164642 573849 526656 473990 52666 465182 418664 46518 42953 42953 105402 15500 89902 11625 11625 2022929 2005331 17598 4742 4742 56348 7760 48588 54567 54567 382581 222524 160057 18687 18687 2271 2271 727175 727175 846931 846931 98767 88890 9877 MEDICAL SUPPLIES 999431 999431 MEDICAID PROVIDER FEE 326893 326893 RAW FOOD 267171 267171 BAD DEBT 197442 197442 286826 184312 102514 13382315 12125977 1256338 0 1349884 1310214 124174 163008 1840561 2438786 54191 80422 24384255 6084319 19002074 18299936 1432473 1490608 451728 316735 24255085 24099709 821998 1234565 15282834 14923896 1446599 1176843 17551431 17335304 X 6413654 6474405 290000 290000 6703654 6764405 24255085 24099709 X -207151 -20883 288785 X 0 1 X 1 0 X 17594 29432 69158 65102 17417 198703 8390389 8556440 10085405 13007914 13027347 53067495 21959 16354 15296 21943 10232 85784 8429942 8602226 10169859 13094959 13054996 53351982 0 31558 145480 177038 31558 145480 177038 53174944 63367 22490 42340 64166 79065 271428 63367 22490 42340 64166 79065 271428 51359 51359 8493309 8624716 10212199 13159125 13185420 53674769 0.99070 0.98890 0.00510 0.00750 X 234842 -1318 233524 209451 25391 234842 185479 23972 209451 217024 -31545 185479 229001 -11977 217024 1.00000 0 0 21791786 4518805 17272981 2313737 1476247 837490 278732 89267 189465 18299936 DEPOSITS FROM RESIDENTS 10915 CONDITIONAL ASSET RETIREMENT OBLIGATION 426833 SWAP LIABILITY 739095 1176843 X 13456392 -20883 302111 281228 13175164 0 13175164 13395641 13326 13326 13382315 0 13382315 PART V, LINE 4: THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO PROVIDE GENERAL SUPPORT TO THE ORGANIZATION AS NEEDED FROM THE EARNINGS. THE ENDOWMENT FUNDS ARE COMPRISED OF BOARD DESIGNATED AND PERMANENT ENDOWMENTS. THE BREAKOUT OF THESE FUNDS ARE AS FOLLOWS: BOARD DESIGNATED: -24.18% PERMANENT ENDOWMENT: 124.18% PART X, LINE 2: THE ORGANIZATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN; THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF DECEMBER 31, 2014 AND 2013. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS GENERAL AND ADMINISTRATIVE EXPENSES. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF DECEMBER 31, 2014 AND 2013. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF SWAP 288,785. FUNDRAISING EXPENSES 13,326. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 13,326. ART SHOW 20477 17407 3070 13326 20477 17407 3070 13326 13326 -10256 X X X X 0 0 0 0 0 0 0 0 0 JANET BURNS CEO 132635 0 60000 0 0 0 0 0 6610 0 199245 0 0 0 A COLORADO HEALTH FACILITIES AUTHORITY 840752932 2010-12-29 15795000 CONSTRUCT NEW NURSING FACILITY 0 0 0 A 15800093 151090 525793 15123210 2012 0 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 1 COMPASS BANK 6.500000000000 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PREPARED BY A THIRD PARTY AND PROVIDED TO THE BOARD FOR APPROVAL BEFORE IT IS FILED. THE CEO EXAMINES THE FORM 990 FOR ACCURACY OF FINANCIAL AND INFORMATIONAL DATA AND DISCUSSES ANY ISSUES WITH THE PREPARER. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REMINDED AT MEETINGS TO DISCLOSE ANY CONFLICT OF INTEREST THEY MAY HAVE. NO DIRECTOR OR OFFICER OF THE CORPORATION SHALL ENGAGE IN ANY COURSE OF CONDUCT WHICH MAY RESULT IN A CONFLICT OF INTEREST OR HAVE ANY FINANCIAL INTEREST IN ANY CONTRACTUAL ARRANGEMENT ENTERED INTO BY THE CORPORATION IN CONNECTION WITH THE RENDITION OF SERVICES, THE PROVISIONS OF GOODS OR SUPPLIES, MANAGEMENT OF THE FACILITY, PROCUREMENT OF FURNISHINGS OR EQUIPMENT OR OTHER MATTERS WHATSOEVER. WHEN DECISIONS ARE MADE BY THE BOARD, THE PRESIDENT OF THE BOARD WILL ASK IF ANYONE HAS A CONFLICT OF INTEREST ON THAT PARTICULAR ISSUE. IF THAT PERSON DOES, THEY ARE RECUSED FROM VOTING ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15A DURING 2013, THE ORGANIZATION ENGAGED AN OUTSIDE FIRM TO PERFORM AN EXECUTIVE COMPENSATION STUDY. A COMPENSATION COMMITTEE APPROVES COMPENSATION CHANGES AND WILL CONDUCT SEMI-ANNUAL MEASUREMENT MEETINGS WITH THE CEO. ALL DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. INTERESTED PARTIES MAY USE THE CONTACT INFORMATION LISTED ON PART VI OF FORM 990 TO REQUEST REVIEW OF THESE RECORDS. FORM 990, PART IX, LINE 11G COMMUNITY RELATIONS : PROGRAM SERVICE EXPENSES 4,017. MANAGEMENT AND GENERAL EXPENSES 4,017. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,034. CONSULTING : PROGRAM SERVICE EXPENSES 114,663. MANAGEMENT AND GENERAL EXPENSES 7,993. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 122,656. CONTRACT LABOR : PROGRAM SERVICE EXPENSES 10,202. MANAGEMENT AND GENERAL EXPENSES 5,588. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,790. DENTAL : PROGRAM SERVICE EXPENSES 1,916. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,916. LABORATORY : PROGRAM SERVICE EXPENSES 162,052. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 162,052. MEDICAL DIRECTOR : PROGRAM SERVICE EXPENSES 18,900. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,900. MEDICAL SERVICES : PROGRAM SERVICE EXPENSES 68,620. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,620. NURSING : PROGRAM SERVICE EXPENSES 111,053. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 111,053. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 578,071. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 578,071. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 610,237. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 610,237. RADIOLOGY: PROGRAM SERVICE EXPENSES 123,549. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 123,549. SPEECH THERAPY: PROGRAM SERVICE EXPENSES 202,051. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 202,051. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP 288,785. THE VILLA AT SUNNY VISTA 2480 E DALE STREET COLORADO SPRINGS CO 80909 840820082 LOW INC HOUSE CO 501(C)(3) LINE 9 SUNNY VISTA 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 THE VILLA AT SUNNY VISTA Q 89199 REIMBURSED AMOUNT