2014-11-13T14:31:24-06:00 2013-12-31 410746749 CliftonLarsonAllenLLP 5001 Spring Valley Road Suite 600W Dallas TX 75244 990 2013-01-01 510190369 Presbyterian Village North PRES 2143559001 8600 Skyline Drive Dallas TX 75243 Steve Kearney CFO 2143559001 2014-11-12 1 Michael Siegel P01587323 9723835700 2013 2015-11-30 17:44:51Z Godwin Dixon 6100 Colwell Blvd Irving TX 75039 38728711 0 X www.presbyterianvillagenorth.org X 1980 TX Presbyterian Village North (PVN), as a member of the Presbyterian Communities and Services family of non-profit organizations, pledges to enrich the lives of those it serves by providing exceptional care and services in a faith-based culture. PVN, a continuing care retirement community founded in 1980 and located on 63 beautiful, garden-like acres, provides a full range of residential choices and care options, including residential living, assisted living, skilled nursing, rehabilitation, and Alzheimer's, dementia, and other long-term care. 5 5 660 267 0 0 1706467 1792367 33622231 36436690 87954 -931114 1183444 393575 36600096 37691518 663229 509401 0 0 18658859 21165652 0 0 0 13848134 14387953 33170222 36063006 3429874 1628512 85378962 90518336 29082003 28640889 56296959 61877447 X Presbyterian Village North (PVN), as a member of the Presbyterian Communities and Services family of non-profit organizations, pledges to enrich the lives of those it serves by providing exceptional care and services in a faith-based culture. PVN, a continuing care retirement community founded in 1980 and located on 63 beautiful, garden-like acres, provides a full range of residential choices and care options, including residential living, assisted living, skilled nursing, rehabilitation, and Alzheimer's, dementia, and other long-term care. 0 0 19179639 340952 24686097 Provide skilled nursing, alzheimer's and dementia care to our community residents and Medicare patients. We served about 914 unduplicated patients in 2013. 5705916 7746458 Retirement and other related services in 2013. 2290347 168449 4004135 Provide assisted living services to 104 unduplicated residents in 2013. 27175902 1 1 0 0 0 0 0 1 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 164 0 660 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Earnshaw 2144131540 6100 Colwell Blvd STE 225 Irving TX 75039 Cynthia Hudgins Chairperson 1.00 1.00 X X 0 0 0 Dr Lisa Clark Vice Chairperson 1.00 1.00 X X 0 0 0 Al Cloud Secretary 1.00 X X 0 0 0 Phil Wentworth Trustee 1.00 1.00 X 0 0 0 Bruce Jamieson Trustee 1.00 X 0 0 0 Godwin Dixon President/CEO 10.00 30.00 X 0 324624 42026 Brenda Terry VP of Operations 10.00 30.00 X 0 187513 28327 Ron Kelly Executive Director 40.00 X 161254 0 22417 Steve Kearney CFO 10.00 30.00 X 0 50292 2169 Kliff Rodgers Past CFO 10.00 30.00 X 0 169387 35000 Mary Bean Administrator-Health Servi 40.00 X 118097 0 7412 279351 731816 137351 2 0 1 0 Cardinal Health 411 Inc PO Box 847384 Dallas TX 75284 Medications/Pharmacy 1466566 Olicon Inc 1801 Royal Ln Suite 700 Dallas TX 75229 Construction Contractor 1158092 Pi Architects Inc 3500 Jefferson St 303 Austin TX 78731 Architect 1118495 Salus Solutions LLC 7330 Fern Ave Suite 502 Shreveport LA 71105 Contract Labor 1000463 US Foodservices Inc PO Box 843202 Dallas TX 75243 Food 637735 20 1772807 19560 1792367 Resident Revenue 623000 36436690 36436690 36436690 106079 106079 1037193 -1037193 -1037193 -1037193 Insurance Settlement 900099 393575 393575 393575 37691518 36436690 0 -537539 509401 509401 161254 161254 17252788 13341003 3911785 122439 94678 27761 2366613 1830023 536590 1262558 976294 286264 2234183 2234183 42914 42914 20500 20500 1290360 1290360 15120 11692 3428 81479 63005 18474 83640 64676 18964 1498423 1498423 16730 12937 3793 27239 21063 6176 101906 101906 2734824 2114748 620076 266763 266763 Medical 1682963 1301379 381584 Food 1425615 1425615 Supplies 1034508 799950 234558 Outside Services 865174 669010 196164 965612 884882 80730 36063006 27175902 8887104 0 -261491 -159634 14456169 11464613 2738823 3495045 281064 254113 123201 108133 75139506 48746338 25746073 26393168 42295123 48962898 85378962 90518336 2431123 2459063 13689343 13181505 12220000 12220000 741537 780321 29082003 28640889 X 19454043 22648640 32395057 34780948 4447859 4447859 56296959 61877447 85378962 90518336 1628512 3951976 0 X X 0 1 X 1 0 X 896235 971478 1386682 1706467 1792367 6753229 30655785 32237121 31991712 33622231 36436690 164943539 31552020 33208599 33378394 35328698 38229057 171696768 0 0 0 171696768 140738 159274 84751 87254 106079 578096 140738 159274 84751 87254 106079 578096 556573 -36027 1183444 393575 2097565 31692758 33924446 33427118 36599396 38728711 174372429 0.98470 0.98450 0.00330 0.00510 X Schedule A, Part III, Line 12, Explanation of Other Income: Insurance Settlements / Other Income - 2010 Amount: $ 556,573. 2011 Amount: $ -36,027. 2012 Amount: $ 1,183,444. 2013 Amount: $ 393,575. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 153370 X X 0 3255723 3255723 42520299 22418717 20101582 5271693 4982206 289487 19993793 17614267 2379526 4097998 3731148 366850 26393168 Deposits 1039 Due from Related Parties 7124717 CIP 2849819 Collections of Art 153370 Interest in PVN Foundation 38501633 Interest in Texas Health Presbyterian Foundation 112795 Interest in PC&S Foundation 219525 48962898 Asset Retirement Obligation 669358 Security Deposits 110963 780321 X Part III, Line 4: Collection of Porcelain Figurines - Birds. As a retirement and nursing community, these items enrich the lives of those we serve. They were donated to exhibit for their beauty and to improve the environment our residents live in. Part X, Line 2: The Organization's income tax returns are subject to review and examination by federal, state, and local authorities. The Organization is not aware of any activities that would jeopardize its tax-exempt status. The Organization reports any activities that are subject to tax on unrelated business income or excise or other taxes and files all proper returns related to these activities. The information tax returns for the years 2010 to 2013 are open to examination by federal, state, and local authorities. 1 Supplemental Assistance 16 509401 Part I, Line 2: The organization provides assistance to residents of its CCRC campus who reach financial hardship and are unable to pay a portion of their monthly fees. An application for assistance is completed and submitted to the Executive Director and committee for review and approval prior to providing assistance. The resident's financial circumstances are periodically reviewed to determine if the resident still qualifies for assistance. X X X 0 0 0 0 0 0 0 0 0 Godwin Dixon President/CEO 0 324624 0 0 0 0 0 18308 0 23718 0 366650 0 0 Brenda Terry VP of Operations 0 187513 0 0 0 0 0 12915 0 15412 0 215840 0 0 Ron Kelly Executive Director 161254 0 0 0 0 0 0 0 22417 0 183671 0 0 0 Kliff Rodgers Past CFO 0 169387 0 0 0 0 0 35000 0 0 0 204387 0 0 Form 990, Part VI, Section A, line 3 On 5/1/2008, Presbyterian Communities & Services was formed to provide management and shared services to Presbyterian Village North and other affiliated organizations. Form 990, Part VI, Section B, line 11 The 990 is reviewed by management to review and correct prior to submitting to the Finance Committee of the Board for review. Management meets with the Finance Committee, along with the outside preparer, to discuss the 990 return and recommends changes, if any. After the 990 has been finalized and approved by the Finance Committee, it is submitted to the Board of Directors for their review prior to sending to the IRS. Form 990, Part VI, Section B, line 12c We have a compliance officer (CO) who review all transactions of the organization that may result in a conflict of interest. The CO determines if the transaction would result in undue influence as a result of the relationship and not be pursued. The CO reports all conflicts of interest to the Board of Directors. Form 990, Part VI, Section B, line 15 The Board has a compensation committee that reviews the current compensation compared to like entities and makes recommendations to the Board for changes in compensation. The Board also uses an outside consultatnt to review compensation, independent of the compensation committee. Form 990, Part VI, Section C, line 19 These documents are available at the site, based on written request. Form 990, Part XII, Line 2c The organization does have a committee that assumes responsibility for oversight of the audit, and the neither the oversight process nor the selection process has changed during the filing year. Presbyterian Village North Foundation 8600 Skyline Drive Dallas TX 75243 752022746 Foundation for PVN TX 501(c)(3) PF N/A 0 Presbyterian Communities and Services 6100 Colwell Blvd Ste 225 Irving TX 75039 261459224 Shared Services/Management TX 501(c)(3) Line 11b, II N/A 0 Grace Presbyterian Ministries 550 E Ann Arbor Ave Dallas TX 75216 751094140 CCRC TX 501(c)(3) Line 9 Presbyterian Communities & Services 0 Presbyterian Communities and Services Foundation 6100 Colwell Blvd Ste 225 Irving TX 75039 751910084 Foundation for Affiliates TX 501(c)(3) Line 7 Presbyterian Communities & Services 0 Faith Presbyterian Providers Inc 4350 Sigma Rd Suite 400 Dallas TX 75244 383800779 Pallative/Hospice Services TX 501(c)(3) Line 9 Presbyterian Communities & Services 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0