2014-05-01T08:02:17-05:00 2013-06-30 410746749 CLIFTONLARSONALLEN LLP 610 WGERMANTOWN PIKE STE400 PLYMOUTH MEETING PA 19462 990 2012-07-01 232613942 RIDDLE VILLAGE RIDD 6108913777 1048 W BALTIMORE PIKE MEDIA PA 19063 ROBERT BERTOLETTE CEO 6108913777 2014-04-30 1 JAMES D WATSON P01450300 2156433900 2012 2015-11-30 17:44:51Z ROBERT BERTOLETTE 1048 W BALTIMORE PIKE MEDIA PA 19063 26666294 0 X WWW.RIDDLEVILLAGE.COM X 1993 PA TO ENRICH THE VALUE OF RETIREMENT LIVING FOR RESIDENTS & LIVES OF THOSE WHO SUPPORT THEM. 9 9 429 43 0 0 1138619 103398 26083204 26415152 104166 147744 0 0 27325989 26666294 0 0 0 0 10717226 11078833 0 0 0 15471960 15203117 26189186 26281950 1136803 384344 52406783 50758247 92368265 89717042 -39961482 -38958795 X TO ENRICH THE VALUE OF RETIREMENT LIVING FOR OUR RESIDENTS AND THE LIVES OF THOSE WHO SUPPORT THEM. 0 0 11817013 17277178 INDEPENDENT LIVING FACILITY - CONSISTING OF 365 UNITS, IS DESIGNED TO ALLOW EACH RESIDENT TO LIVE THEIR LIFE TO THE FULLEST WITHOUT THE CONCERNS ASSOCIATED WITH POSSIBLE FUTURE HEALTHCARE NEEDS. THE ORGANIZATION PROVIDE MEALS, HOUSEKEEPING, ACTIVITIES, WELLNESS, 24 HOUR NURSE AVAILABILITY AND A FITNESS CENTER THAT ENCOURAGES RESIDENTS TO REMAIN AS ACTIVE AS POSSIBLE. AS A CCRC, RIDDLE VILLAGE PROVIDES SUBSIDIES TO ANY RESIDENT WHO IS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS TO THE COMMUNITY. THE ORGANIZATION CURRENTLY HAS AT LEAST TWO RESIDENTS WHO ARE IN NEED OF THIS SUBSIDY WITH OTHERS REQUESTING ASSISTANCE RECENTLY DO TO THE DOWNTURN IN THE ECONOMY. RIDDLE VILLAGE HOSTS MANY COMMUNITY EVENTS, IS A VOTING CENTER DURING ELECTIONS AND SUPPORTS THE OVERALL COMMUNITY BY PARTICIPATING IN THE PAYMENT OF LOCAL, COUNTY AND SCHOOL TAXES. 3379277 5197303 PERSONAL CARE UNIT - CONSISTS OF 49 APARTMENTS BOTH STUDIO AND ONE-BEDROOMS. THERE WAS A RECENT EXPANSION AND REFURBISHING PROJECT FOR BOTH PERSONAL CARE UNIT AND SKILLED NURSING FACILITY TO ALLOW FOR A MORE HOME LIKE ENVIRONMENT, MORE GATHERING PLACES FOR RESIDENTS, FAMILY AND FRIENDS AND KITCHEN FACILITIES TO BETTER SERVE OUR RESIDENTS. IT IS OUR PHILOSOPHY THAT EACH RESIDENTS CARE, PHYSICAL AND EMOTIONAL HEALTH IS EQUALLY IMPORTANT. THIS UNIT CONSISTS OF BOTH LIFECARE RESIDENTS AND PRIVATE PAY RESIDENTS. ALL LIFECARE RESIDENTS ARE GUARANTEED CARE REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. 7167258 3940671 SKILLED NURSING FACILITY - CONSISTS OF 86 SKILLED BEDS. THE FACILITY IS DESIGNED TO PROVIDE A HOME LIKE ATMOSPHERE TO ENSURE THAT RESIDENTS ARE COMFORTABLE IN ALL STAGES OF THEIR LIFE. THIS FACILITY ALSO CARES FOR LIFECARE RESIDENTS AND PRIVATE PAY RESIDENTS. WE ALSO PROVIDE FOR MEDICARE AND OTHER THIRD PARTY BILLING RESIDENTS. ALL LIFECARE RESIDENTS ARE GUARANTEED CARE REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. 22363548 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 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 0 1 0 0 0 0 1 22 0 429 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X KIMBERLY ROGUSZEWSKI 6108913777 1048 WEST BALTIMORE PIKE MEDIA PA 19063 ARTHUR A BERNARDON 1.00 0.00 X 0 0 0 DANIEL E KENNEDY 1.00 0.00 X X 0 0 0 JOSEPH P BROOKS 1.00 0.00 X 0 0 0 JOSEPH LUNDY ESQ 1.00 0.00 X 0 0 0 ROBERT F FISCHER 1.00 0.00 X X 0 0 0 ROBERT L SUMNER 1.00 0.00 X 0 0 0 JON D HELMS 1.00 0.00 X X 0 0 0 MARIA C BUCCO 1.00 0.00 X 0 0 0 LEONARD MCCANDLESS 1.00 0.00 X 0 0 0 ROBERT G BERTOLETTE 40.00 0.00 X 267444 0 18734 KIMBERLY ROGUSZEWSKI 40.00 0.00 X 186785 0 24127 RONALD WATERMAN 40.00 0.00 X 177046 0 24127 DONNA CAHILL 40.00 0.00 X 109362 0 16568 SUZANNE CHILDS 40.00 0.00 X 106698 0 22774 847335 0 106330 5 0 1 0 REHAB CARE GROUP INC PO BOX 50534 ST LOUIS MO 63150 PHYSICAL THERAPY 972715 CS LIGA PAINTING 223 EAST SECOND STREET MEDIA PA 19063 PAINTING/REFURBISHING 504103 ELWYN PHARMACY & MED EQUIP 194 S MIDDLETOWN ROAD ELWYN PA 19063 PHARMACY 494688 CLASSIC KITCHENS 622 E GAY STREET WEST CHESTER PA 19380 APPLIANCE STORE 439541 SYSCO FOOD SERVICES PO BOX 6499 PHILADELPHIA PA 19145 RAWFOOD SUPPLIES 419903 14 103398 103398 NET PATIENT SERVICE REVENUE 623000 11900783 11900783 RESIDENT CARE 623000 9138900 9138900 EARNED ENTRANCE FEE 623000 5336247 5336247 39222 39222 26415152 147744 147744 26666294 26415152 0 147744 692876 692876 8519938 8231243 288695 1170468 1113710 56758 695551 625996 69555 30000 30000 72050 72050 269732 269732 736812 736812 2774763 2497287 277476 50599 50599 1797444 1617700 179744 4143114 3728803 414311 1027398 924658 102740 NURSING 1905933 1905933 DINING SERVICES 1509419 1509419 PLANT AND MAINTENANCE 649016 208799 440217 236837 236837 26281950 22363548 3918402 0 1032355 1187275 2110577 2239115 5673478 4105633 110956 130162 1326714 1405548 93584473 64794836 30772438 28789637 10293909 11913389 1086356 987488 52406783 50758247 1377544 1295303 38536361 37754275 48890000 47965000 1035575 973014 428571 285714 2100214 1443736 92368265 89717042 X -42079592 -41180303 691214 691214 1426896 1530294 -39961482 -38958795 52406783 50758247 X 384344 -38135 656478 X X 0 1 X 1 0 X 105972 50526 47426 1138619 103398 1445941 23164757 24321791 25513077 26083204 26415152 125497981 23270729 24372317 25560503 27221823 26518550 126943922 0 0 0 126943922 608646 297917 138153 104166 147744 1296626 608646 297917 138153 104166 147744 1296626 23879375 24670234 25698656 27325989 26666294 128240548 0.98990 0.98360 0.01010 0.01640 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1426896 103398 1530294 777704 649192 1426896 730278 47426 777704 679752 50526 730278 578173 101579 679752 0.00000 1.00000 0.00000 0 0 58076757 32789217 25287540 5897402 5600620 296782 29610314 26404999 3205315 28789637 INTEREST RATE SWAP AGREEMENT 1443736 1443736 X 27284637 -38135 656478 618343 26666294 0 26666294 26281950 0 26281950 0 26281950 PART IV, LINE 2B: THE ORGANIZATION HAS BEEN HOLDING DEPOSITS RECEIVED FROM PROSPECTIVE RESIDENTS THAT ARE FULLY REFUNDABLE UNTIL THEY SIGN A RESIDENT AGREEMENT, AT WHICH TIME THE DEPOSITS ARE APPLIED TOWARD THE RESIDENTS' ENTRANCE FEE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: FIN 48 FOOTNOTE: THE VILLAGE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REQUIRED. THE VILLAGE FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE VILLAGE BELIEVES THAT THERE IS NO UNCERTAINTY IN THE TAX POSITIONS TAKEN BY THE VILLAGE AND THESE PROVISIONS HAVE NO IMPACT ON THE VILLAGE'S FINANCIAL STATEMENTS. THE VILLAGE'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE VILLAGE IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE VILLAGE IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 656,478. X X X X 0 0 0 0 0 0 0 0 0 ROBERT G BERTOLETTE 230859 0 36585 0 0 0 0 0 18734 0 286178 0 0 0 KIMBERLY ROGUSZEWSKI 165669 0 21116 0 0 0 0 0 24127 0 210912 0 0 0 RONALD WATERMAN 156958 0 20088 0 0 0 0 0 24127 0 201173 0 0 0 A DELAWARE COUNTY AUTHORITY 231973437 245913HK7 2006-10-01 45270000 TO PROVIDE FUNDS TO MAKE THE LOAN FOR PURPOSES OF PAYING CONSTRUCTION COSTS 0 0 0 B DELAWARE COUNTY AUTHORITY 231973437 2011-10-03 30000000 TO REFINANCE THE 2005 BONDS AND PARTIAL 2006 BONDS 0 0 0 A 26365000 45270000 492581 109792 8170709 36496918 2007 1 0 1 1 B 940000 30000000 390000 29610000 2011 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 1 1 1 SOVEREIGN 10.000000000000 0 0 0 0 1 B 1 1 1 SOVEREIGN 10.000000000000 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD, TO THE EXTENT PERMITTED BY APPLICABLE LAW, BETWEEN MEETINGS OF THE BAORD. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED AT ANY TIME BY THE CHAIR OF COMMITTEE, BY THE CHAIR OF THE BOARD OR BY ANY TWO MEMBERS OF THE COMMITTEE. NOTICE OF SPECIAL MEETINGS OF THE EXECUTIVE COMMITTEE SHALL BE GIVEN AT LEAST TWO DAYS BEFORE SUCH MEETING, BUT WRITTEN NOTICE SHALL NOT BE REQUIRED. FORM 990, PART VI, SECTION A, LINE 7A ONE DIRECTOR SHALL BE NOMINATED BY THE RIDDLE HEALTH CARE FOUNDATION, AND PROVIDED THAT SUCH NOMINEE IS OTHERWISE QUALIFIED UNDER THESE BYLAWS AND APPLICABLE LAW, SUCH NOMINEE SHALL BE ELECTED BY THE BOARD TO SERVE FOR A TERM OF ONE YEAR, AND SHALL BE ELIGIBLE FOR SUCCEEDING ONE-YEAR TERMS WITHOUT LIMIT. AT ALL TIMES, A MAJORITY OF ALL OF THE DIRECTOS SHALL BE NON-RESIDENTS OF RIDDLE VILLAGE. NO DIRECTOR, EXCEPT THE DIRECTOR NOMINATED BY THE RIDDLE HEALTH CARE FOUNDATION, MAY SERVE MORE THAN TWO CONSECUTIVE FULL TERMS. FORM 990, PART VI, SECTION B, LINE 11 ALL MEMBERS OF THE BOARD REVIEW THE FORM PRIOR TO THE FILING THEREOF. FORM 990, PART VI, SECTION B, LINE 12C CURRENTLY, ALL MEMBERS OF THE BOARD REVIEW THE CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. THEY CONFIRM THAT THEY HAVE NO SUCH CONFLICT IF APPROPRIATE. IF CONFLICT WERE TO EXIST, THE BOARD AS A WHOLE WOULD REVIEW EACH POTENTIAL CONFLICT AND DETERMINE THE APPROPRIATENESS OF THE ACTION. ANY BOARD MEMBER INVOLVED IN A CONFLICT WOULD BE UNABLE TO VOTE ON ANY ACTION, PURCHASE OR DECISION BEING MADE. IN ADDITION, EACH SENIOR MANAGEMENT REPRESENTATIVE SIGNS A SIMILAR STATEMENT. DIRECTORS WITH A POTENTIAL CONFLICT ARE EXCLUDED FROM DECISION MAKING IN THAT AREA. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS MAINLY DETERMINED BASED ON EXTERNAL SALARY SURVEYS. WORK PERFORMANCE AND EXPANDED JOB RESPONSIBLITIES ARE ALSO CONSIDERED. THE PRESIDENT/CEO USES THE TOOLS MENTIONED ABOVE TO DETERMINE THE SALARIES OF KEY EMPLOYEES. THE INFORMATION IS THEN SHARED WITH THE COMPENSATION COMMITTEE FOR DISCUSSION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE ORGANIZATIONS FINANCIAL STATEMENTS ARE DISTRIBUTED TO RESIDENTS & FILED WITH THE PA INSURANCE DEPARTMENT. THEY ARE ALSO MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP AGREEMENT 656,478. / FORM 990, PART XI, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. RELATED PARTY EXPLANATION RIDDLE VILLAGE LEASES THE LAND ON WHICH THEIR FACILITY IS SITUATED FROM RIDDLE HEALTHCARE FOUNDATION. THESE ENTITIES ALSO HAVE A BOARD MEMBER IN COMMON. RIDDLE HEALTHCARE FOUNDATION DOES NOT HAVE CONTROL OR AN ABILITY TO ELECT A MAJORITY OF THE BOARD MEMBERS OF RIDDLE VILLAGE. THEREFORE, THESE TWO PARTIES ARE NOT CONSIDERED RELATED. RIDDLE VILLAGE DEVELOPMENT LLC 1048 WEST BALTIMORE PIKE MEDIA PA 19063 262397145 IMPLEMENTING DEVELOPMENT OF ADDITIONAL FACILITIES PA 0 0 RIDDLE VILLAGE