2013-07-02T16:21:29-05:00 2012-12-31 593070669 MOORE STEPHENS LOVELACE PA 311 PARK PLACE BLVD SUITE 100 CLEARWATER FL 33759 990 2012-01-01 591031820 PLYMOUTH HARBOR INC PLYM 9413652600 700 JOHN RINGLING BLVD SARASOTA FL 34236 GARRY H JACKSON 9413652600 2013-07-02 1 MELANIE A MCPEAK P01346034 7275314477 2012 2016-02-24 21:20:13Z HARRY E HOBSON 700 JOHN RINGLING BLVD SARASOTA FL 34236 18939718 0 X WWW.PLYMOUTHHARBOR.ORG X 1961 FL PLYMOUTH HARBOR IS A CHURCH-SPONSORED, NOT-FOR-PROFIT COMMUNITY OF DISTINCTION FOR OLDER ADULTS COMMITTED TO PROVIDING THE MOST POSITIVE AGING EXPERIENCE POSSIBLE FOR ITS RESIDENTS. 16 16 270 30 0 0 114106 262059 20295191 18350807 -184065 270642 69509 56210 20294741 18939718 0 0 0 0 8911081 8823980 0 0 0 9969113 10915640 18880194 19739620 1414547 -799902 49451005 56538100 41760351 49621299 7690654 6916801 X PLYMOUTH HARBOR IS A CHURCH-SPONSORED NOT-FOR-PROFIT COMMUNITY OF DISTINCTION FOR OLDER ADULTS COMMITTED TO PROVIDING THE MOST POSITIVE AGING EXPERIENCE POSSIBLE FOR ITS RESIDENTS. 0 0 8225420 11234558 SENIOR ADULT LIVING SERVICE - CARING FOR SENIOR ADULTS THROUGH THE OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF APPROXIMATELY 208 INDEPENDENT APARTMENT UNITS AND 10 ASSISTED LIVING APARTMENT UNITS. 4185911 4454331 SENIOR ADULT HEALTH CARE CENTER SERVICE - PROVIDES SKILLED NURSING SERVICES TO THE ELDERLY IN ITS 60 BED SKILLED NURSING CENTER. 2591468 2253973 SENIOR ADULT DIETARY SERVICE - SERVICING THE DIETARY NEEDS OF SENIOR ADULTS AT THE CONTINUING CARE RETIREMENT COMMUNITY. 745224 464155 HOME HEALTH AGENCY - A LICENSED HOME HEALTH AGENCY THAT SERVICES SENIOR ADULTS IN THEIR OWN HOME. 745224 464155 15748023 1 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 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 1 1 1 0 0 1 56 0 1 270 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X GARRY JACKSON 9413652600 700 RINGLING BLVD SARASOTA FL 34236 F THOMAS HOPKINS 1.00 2.00 X X 0 0 0 JOSEPH HUDGINS 1.00 2.00 X X 0 0 0 WILLIAM R JOHNSTON 1.00 2.00 X X 0 0 0 JOHN M STRICKLAND 1.00 2.00 X X 0 0 0 LEE BYRON 1.00 2.00 X 0 0 0 DUNCAN FINLAY 1.00 2.00 X 0 0 0 LARRY COFFEY 1.00 2.00 X 0 0 0 WILLIAM KENNEDY MD 1.00 2.00 X 0 0 0 ELLEN HARRISON 1.00 2.00 X 0 0 0 ROBERT T MITCHELL 1.00 2.00 X 0 0 0 RANDALL NATHERSON 1.00 2.00 X 0 0 0 WILLIAM YOUNG 1.00 2.00 X 0 0 0 SARAH PAPPAS 1.00 2.00 X 0 0 0 GEORGE PETERS 1.00 2.00 X 0 0 0 RICHARD BAUM 1.00 2.00 X 0 0 0 DAVE KUHN 1.00 2.00 X 0 0 0 NANCY COOK 1.00 2.00 X 0 0 0 HARRY E HOBSON 38.00 2.00 X 226421 0 243513 GARRY H JACKSON 38.00 2.00 X 142161 0 5988 GORDON OKAWA 40.00 X 102475 0 4687 471057 0 254188 3 0 1 0 ANNE FOLSOM SMITH 330 SOUTH PINEAPPLE AVE SARASOTA FL 34236 INTERIOR DESIGN CONTRACTING 785861 FUNCTIONAL PATHWAYS OF TENNESSEE PO BOX 102426 ATLANTA GA 30368 THERAPY SERVICE 342356 TAKE CARE SARASOTA 3982 BEE RIDGE ROAD SARASOTA FL 34233 NURSING SERVICE 119803 NURSECORE PO BOX 21925 ARLINGTON TX 76006 NURSING SERVICE 107189 4 262059 262059 MONTHLY SERVICE FEES 623000 14024483 14024483 ENTRANCE FEES 623000 4326324 4326324 18350807 166158 166158 102414 2070 0 0 102414 2070 104484 104484 CAPITAL REIMBURSEMENTS 623000 56210 56210 56210 18939718 18407017 0 270642 618083 618083 6147718 5226836 920882 130607 92026 38581 1409425 1230154 179271 518147 417394 100753 40377 40377 51595 51595 26526 26526 1467019 781820 685199 206893 94673 112220 268077 143508 124569 2400 2400 1404542 1404542 38278 8336 29942 280712 280663 49 4097887 3269243 828644 700664 558981 141683 FOOD & FOOD PRODUCTS 806459 806459 MEDICAL, OXYGEN & DRUGS 538478 538478 SUPPLIES 428803 399002 29801 REPAIRS & MAINTENANCE 146948 138658 8290 409982 357250 52732 19739620 15748023 3991597 0 164724 1790105 42697 28335 1019564 3645725 65585 63448 252568 381539 80031182 37839435 41308143 42191747 6537187 8384059 60537 53142 49451005 56538100 1883437 1341613 34576475 42915400 4471976 4312247 828463 1052039 41760351 49621299 X 7560225 6714859 130429 201942 7690654 6916801 49451005 56538100 X -799902 51795 -25746 X X 0 1 X 1 0 X 918708 693695 565881 114106 262059 2554449 16494092 16999433 19010775 20364700 18407017 91276017 17412800 17693128 19576656 20478806 18669076 93830466 0 0 0 93830466 377892 259155 449252 81689 166158 1334146 377892 259155 449252 81689 166158 1334146 17790692 17952283 20025908 20560495 18835234 95164612 0.98600 0.98320 0.01400 0.01680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 890 282 1172 0 9459414 419981 995208 350000 52597 10472006 8705989 209791 580017 36383 9459414 8569657 428376 129249 350000 71293 8705989 8024973 73014 1146043 600000 74373 8569657 11300666 300240 -2739909 750000 86024 8024973 1.00000 0 1 1 273228 273228 75045280 33277281 41767999 633343 482823 150520 4079331 4079331 0 42191747 CASH AND CASH EQUIVALENTS 2707879 F ACCURED INTEREST 24419 F CORPORATE BONDS 1308895 F FOREIGN CORPORATE BONDS 1187247 F U.S. GOVERNMENT OBLIGATIONS 2744995 F FOREIGN GOVERNMENT OBLIGATIONS 188794 F MUTUAL FUNDS 221830 F 8384059 DEPOSITS 205000 INTEREST RATE SWAP 625209 EMPLOYEE BENEFIT LIABILITY 221830 1052039 18965767 51795 -25746 26049 18939718 0 18939718 19739620 0 19739620 0 19739620 PART IV, LINE 1B: PLYMOUTH HARBOR, INC. OFFERS A CASH MANAGEMENT SERVICE TO ITS HEALTHCARE RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF EACH RESPECTIVE RESIDENT. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUND IS HELD BY THE RELATED ORGANIZATION PLYMOUTH HARBOR ENDOWMENT FUND. THE BOARD OF TRUSTEES, WHICH SERVE BOTH THE FILING ORGANIZATION AND THE ENDOWMENT FUND, MAY DISTRIBUTE CORPUS OF THESE FUNDS AT ITS SOLE DISCRETION. THE INTENDED USE OF THE ENDOWMENT FUND MONIES IS EXCLUSIVELY FOR CHARITABLE ACTIVITIES CONDUCTED BY THE FILING ORGANIZATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF SWAP AGREEMENT X 1 1 X X X X 0 1 0 0 0 0 0 0 0 HARRY E HOBSON 226421 0 0 0 0 0 228937 0 14576 0 469934 0 0 0 PART I, LINE 4B PLYMOUTH HARBOR, INC. HAS AN EMPLOYEE DEFERRED COMPENSATION PLAN OPEN TO CERTAIN KEY EMPLOYEES UNDER INTERNAL SECTION 457(F) THAT IS A NON-TAX QUALIFIED RETIREMENT PLAN. THESE FUNDS REMAIN THE PROPERTY OF PLYMOUTH HARBOR, INC. THE ORGANIZATION HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. KEY EXECUTIVE (HARRY HOBSON, CEO) PARTICIPATES IN THE DEFERRED COMPENSATION PLAN UNDER IRC SEC. 457(F); HOWEVER, HE DID NOT RECEIVE ANY CURRENT YEAR PAYMENTS FROM THE PLAN. THE TERMS AND CONDITIONS OF THE PLAN ARE AS FOLLOWS: THE VESTED DATE SHALL BE JANUARY 1, 2018 AT WHICH TIME THE CEO CAN RECEIVE THE BENEFIT IN FULL. IF THE CEO RESIGNS OR OTHERWISE TERMINATES EMPLOYMENT PRIOR TO THE VESTING DATE, OR EMPLOYMENT IS TERMINATED BY THE EMPLOYER FOR CAUSE PRIOR TO THE VESTING DATE, THE CEO SHALL NOT BE ENTITLED TO ANY OF THE BENEFIT. IF EMPLOYMENT IS TERMINATED BY THE EMPLOYER OTHER THAN FOR CAUSE OR REASON OF DEATH OR PERMANENT DISABILITY OF THE CEO, THE CEO (OR HIS ESTATE, IN THE CASE OF DEATH) SHALL BE ENTITLED TO RECEIVE THE ENTIRE BENEFIT ACCRUED TO THE DATE OF TERMINATION. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS REVIEWED IN ITS ENTIRETY BY THE CHIEF FINANCIAL OFFICER. ANY QUESTIONS ARE RESOLVED WITH THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE RETURN. IN ADDITION, A COPY IS PROVIDED TO EACH INDEPENDENT VOTING MEMBER OF THE BOARD FOR REVIEW BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND EMPLOYEES. NEW BOARD MEMBERS COMPLETE AND SUBMIT A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT AT ORIENTATION. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND SUBMIT A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE BOARD PRESIDENT AND CHIEF EXECUTIVE OFFICER. ANY BOARD MEMBER HAVING A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS PROHIBITED FROM VOTING OR USING HIS/HER PERSONAL INFLUENCE ON THE MATTER, AND SHOULD NOT BE COUNTED AS PART OF A QUORUM FOR THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION COMMITTEE, WHICH IS INDEPENDENT WITH RESPECT TO ALL COMPENSATION DECISIONS AND CONSISTS OF SEVERAL INDEPENDENT BOARD MEMBERS, AND AN INDEPENDENT CONSULTANT EVALUATE THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER. THE CEO PERFORMS ANNUAL EVALUATIONS OF OTHER TOP MANAGEMENT OFFICIALS. THE ORGANIZATION UTILIZES COMPARABILITY SURVEYS, CONDUCTED BY THE HUMAN RESOURCES DIRECTOR, TO DETERMINE THE COMPENSATION OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE PRESIDENT OF THE BOARD OF DIRECTORS REVIEWS THE EVALUATIONS AND PROVIDES WRITTEN APPROVAL OF COMPENSATION DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AT THE FACILITY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP AGREEMENT -25,746. OVERSIGHT OF FINANCIAL STATEMENT AUDIT FORM 990, PART XII, LINE 2C THE ORGANIZATION'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE PLYMOUTH HARBOR FOUNDATION LLC 700 JOHN RINGING BLVD SARASOTA FL 34236 000000000 TO SUPPORT THE PLYMOUTH HARBOR FACILITY. FL 338823 52458 PLYMOUTH HARBOR INC PLYMOUTH HARBOR ENDOWMENT FUND 700 JOHN RINGING BLVD SARASOTA FL 34236 596231811 SUPPORT FOR PLYMOUTH HARBOR FACILITY FL 501(C)(3) LINE 11B, II PLYMOUTH HARBOR INC 1 PLYMOUTH HARBOR RESIDENTS 2003 ENDOWMENT FUND 700 JOHN RINGING BLVD SARASOTA FL 34236 306059708 SUPPORT FOR PLYMOUTH HARBOR FACILITY FL 501(C)(3) LINE 11B, II PLYMOUTH HARBOR INC 1 PLYMOUTH HARBOR POOLED INCOME FUND 700 JOHN RINGLING BLVD SARASOTA FL 34236 596749492 SUPPORT PLYMOUTH HARBOR FACILITY FL PLYMOUTH HARBOR INC T -22 3999 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PLYMOUTH HARBOR ENDOWMENT FUND C 350000 FAIR MARKET VALUE