2013-04-10T18:50:42-05:00 2012-06-30 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2011-07-01 310544277 MAPLE KNOLL COMMUNITIES INC MAPL 5137822400 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 KENNETH W HUFF 5137822400 2013-04-04 1 BERNIE OSTROWSKI P00366367 6148493000 2011 2016-02-25 16:41:14Z SEE SCHEDULE O JAMES FORMAL 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 53372118 0 X WWW.MKCOMMUNITIES.ORG X 1934 OH MAPLE KNOLL COMMUNITIES, INC. IS A NOT-FOR-PROFIT CORPORATION WHICH PROVIDES HOUSING, HEALTH CARE AND OTHER RELATED SERVICES AND ACTIVITIES FOR THE BENEFIT OF THE ELDERLY. MAPLE KNOLL COMMUNITIES OWNS AND OPERATES TWO CONTINUING CARE RETIREMENT COMMUNITIES (CCRC) LOCATED IN CINCINNATI, OHIO AND OXFORD, OHIO. 15 15 982 515 -24075 -24075 1284385 1494981 42801931 41652581 1582273 669466 1382566 552209 47051155 44369237 510146 520849 0 0 22624404 21853822 0 0 1001508 24557588 23839169 47692138 46213840 -640983 -1844603 142251569 135836869 109899067 106718912 32352502 29117957 X THE MISSION OF MAPLE KNOLL COMMUNITIES, INC. IS TO BE A GROWING PROVIDER OF OUTSTANDING FACILITIES AND SERVICES FOR THE AGING WITHIN THE TRISTATE AREA WHICH ALLOWS THOSE WE SERVE TO THRIVE IN A SAFE, STIMULATING, AND DIGNIFIED ENVIRONMENT. THIS WILL BE ACCOMPLISHED THROUGH THE PRACTICE OF RESPONSIBLE FISCAL STEWARDSHIP. 0 0 25875917 520849 29353126 "MAPLE KNOLL VILLAGE" - MAPLE KNOLL VILLAGE IS A NON-PROFIT CONTINUING CARE RETIREMENT COMMUNITY WITH A HISTORY OF MORE THAN 160 YEARS. LOCATED ON A BEAUTIFUL 54-ACRE CAMPUS, OUR COMMUNITY OFFERS 279 VILLAS AND APARTMENTS, 60 ASSISTED LIVING APARTMENTS AND A 186-BED NURSING FACILITY. THE COMMUNITY IS RECOGNIZED AS A TEACHING FACILITY FOR FUTURE GERIATRICIANS THROUGH THE UNIVERSITY OF CINCINNATI. THE GERIATRIC EVALUATION CENTER, A CLINICAL SERVICE OF THE UNIVERSITY FAMILY PHYSICIANS, INC. IS LOCATED ON THIS CAMPUS. THE QUALITY OF THE VILLAGE'S RESIDENTIAL HEALTH CARE SERVICES AND PROGRAMS ARE ATTESTED TO BY A LONG LIST OF ACCREDITATIONS AND CITATIONS, INCLUDING THE CONTINUING CARE ACCREDITATION COMMISSION (CCAC). 12262425 0 10159499 "THE KNOLLS OF OXFORD" - THE KNOLLS OF OXFORD IS A NON-PROFIT CONTINUING CARE RETIREMENT COMMUNITY WITH CULTURE AND CHARM. LOCATED ON A BEAUTIFUL 85-ACRE CAMPUS, THE COMMUNITY OFFERS 94 VILLAS, 28 ASSISTED LIVING APARTMENTS AND A 62-BED SKILLED NURSING FACILITY AND REHABILITATION CENTER. THE COMMUNITY BOASTS OF A UNIQUE AFFILIATION WITH MIAMI UNIVERSITY. THIS AGREEMENT OFFERS MULTIPLE OPPORTUNITIES FOR MIAMI STUDENTS, BUT IS ALSO A TREMENDOUS BENEFIT FOR KNOLLS RESIDENTS AS WELL. THE QUALITY OF SERVICES AND OPPORTUNITIES AT THE KNOLLS OF OXFORD IS REINFORCED BY ITS ACCREDITATION THROUGH THE CONTINUING CARE ACCREDITATION COMMISSION (CCAC). 1609031 0 1598389 "MAPLE KNOLL HOME HEALTH SERVICES" - THE MISSION OF MAPLE KNOLL HOME HEALTH SERVICES IS TO HELP OLDER ADULTS LIVE TO THEIR HIGHEST POTENTIAL AS INDIVIDUALS WHO SEEK INDEPENDENCE, GOOD HEALTH AND PERSONAL FULFILLMENT. WE STRIVE TO PROVIDE THE HIGHEST QUALITY OF MEDICAL CARE AND SUPPORT IN THE HOME WITH COMPASSION AND RESPECT FOR EACH PERSON. MAPLE KNOLL HOME HEALTH SERVICES OFFERS A FULL RANGE OF HOME HEALTH SERVICES THAT ENABLE INDIVIDUALS TO RECUPERATE SAFELY IN THEIR HOME. NURSES, THERAPISTS AND AIDES PROVIDED A TOTAL OF NEARLY 16,000 VISITS THE PAST YEAR IN FIVE OHIO COUNTIES (HAMILTON, BUTLER, WARREN, CLERMONT AND PREBLE). 1410765 0 1044415 "SYCAMORE SENIOR CENTER" - SYCAMORE SENIOR CENTER PROVIDES NEEDED OUTREACH TO THE COMMUNITY. THIS PAST YEAR, THE CENTER SERVED 94,018 HOME DELIVERED MEALS. THE CENTER PROVIDED 11,086 TRIPS TO HOSPITALS, DOCTORS' OFFICES , THERAPY AND REHAB CENTERS, GROCERY STORES AND THE SENIOR CENTER. WITH MORE THAN 1,800 MEMBERS, THE CENTER HAS SERVED 16,100 CONGREGATE MEALS DEMOSTRATING THE IMPORTANCE OF A HOT MEAL, GOOD FRIENDS AND GREAT CONVERSATION. 1410765 1044415 41158138 1 1 0 1 0 0 0 1 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 100 0 1 982 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 15 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X KENNETH W HUFF 5137822550 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 STEVEN L BRASH 1.00 X X 0 0 0 STEVEN A WILSON 1.00 X X 0 0 0 WILLIAM B BROWN 1.00 X X 0 0 0 GARY T HUFFMAN 1.00 X X 0 0 0 RONALD L WILEY 1.00 X X 0 0 0 RONALD A BEYMER 1.00 X 0 0 0 JOHN C BLOOMSTROM 1.00 X 0 0 0 THOMAS E DEWEY 1.00 X 0 0 0 DIANE Y DUMBALD 1.00 X 0 0 0 ANNE G FEUER 1.00 X 0 0 0 JEANE GOINGS 1.00 X 0 0 0 ANN HUFFMAN 1.00 X 0 0 0 MARILYN P KREMZAR 1.00 X 0 0 0 RICHARD M NORMAN 1.00 X 0 0 0 WILLIAM S OSTRANDER 1.00 X 0 0 0 JAMES FORMAL 45.00 X 327411 0 50769 KENNETH W HUFF 45.00 X 201575 0 34064 ROSE DENMAN 45.00 X 109515 0 15849 TIMOTHY MCGOWAN 45.00 X 130825 0 13395 769326 0 114077 4 0 1 0 EUGENE H RUECKERT 9458 FLICK ROAD CINCINNATI OH 45247 CONSTRUCTION 374758 ECS BILLING & CONSULTING PO BOX 402 TIFFIN OH 44883 BILLING 234569 D-PWER LLC 1277 ELMS COVE FAYETTEVILLE OH 45118 PAINTING 229405 JEFF HOLLMAN 27 ORCHARD STREET ST BERNARD OH 45217 PAINTING 128565 4 44241 450 1450290 1494981 ROOM AND BOARD REVENUE 623000 36481801 36481801 AMORTIZED ENTRANCE FEE 623000 2612830 2612830 COMMUNITY SERVICES 623000 2557950 2557950 41652581 709523 709523 321131 343066 -21935 -21935 2140 -24075 8565501 26844 8604306 28096 -38805 -1252 -40057 -40057 47645 450 27413 20232 20232 MISC REVENUE 900099 553912 553912 553912 44369237 42208633 -24075 689698 520849 520849 1061326 113606 817526 130194 15980964 14724170 1212728 44066 549141 505960 41667 1514 1654641 1520467 126855 7319 2607750 2402691 197869 7190 24601 979 23622 160257 58325 101932 36000 36000 126339 126339 571365 571365 557934 509904 48030 2830616 1398994 668826 762796 642754 642754 2845934 2845934 53359 52784 575 3402095 3402095 5830791 5166488 618387 45916 325546 289195 33838 2513 FOOD EXPENSE 3237796 3237796 ADMINISTRATIVE 2241409 2241409 BAD DEBTS 550231 550231 LICENSE SURCHARGE 336038 336038 66104 66104 46213840 41158138 4054194 1001508 3471835 1759688 358170 0 460962 167031 3399894 2424083 1117508 805036 379411 0 298988 771621 159102664 64175718 98391877 94926946 19995920 20832719 9734228 9295506 4642776 4854239 142251569 135836869 6639379 7599473 30697353 27320131 60563337 58706878 7210087 7756735 4788911 5335695 109899067 106718912 X 21050081 18907585 884637 299008 10417784 9911364 32352502 29117957 142251569 135836869 X -1844603 -1389940 X X 0 1 1 X 0 X 958007 792981 1348080 1266029 1229567 5594664 39564477 41509812 40380271 42795251 41196068 205445879 40522484 42302793 41728351 44061280 42425635 211040543 367438 371103 676735 333544 746619 2495439 0 367438 371103 676735 333544 746619 2495439 208545104 1730701 1354875 1376049 1274542 1104719 6840886 1730701 1354875 1376049 1274542 1104719 6840886 1987811 1500779 1343857 1371339 407439 6611225 44240996 45158447 44448257 46707161 43937793 224492654 0.92900 0.91890 0.03050 0.03040 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 36000 0 0 0 36000 0 100000 0 2497390 2497390 127164349 48300103 78864246 12670363 4999341 7671022 16254114 10876274 5377840 516448 516448 94926946 DEBT SERVICE FUNDS 171306 C BENEFICIAL INTEREST IN IRREVOCABLE TRUST 9124200 C 9295506 PROVISIONS FOR INTEREST RATE SWAP 4884988 CHARITABLE GIFT ANNUITY 277511 OTHER LONG TERM LIABILITIES 7876 DEFERRED COMPENSATION 165320 5335695 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: MAPLE KNOLL COMMUNITIES, INC. IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STAUTS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS THE ORGANIZATION'S 2009, 2010, AND 2011 TAX RETURNS ARE OPEN FOR EXAMINATION BY THE IRS. THE ORGANIZATION CURRENTLY EVALUATES UNCERTAIN TAX POSITIONS UNDER THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS NO. 5, ACCOUNTING FOR CONTINGENCIES. THE EFFECTS OF TAX POSITIONS ARE GENERALLY RECOGNIZED IN THE FINANCIAL STATEMENTS CONSISTENT WITH AMOUNTS REFLECTED IN RETURNS FILED, OR EXPECTED TO BE FILED, WITH TAXING AUTHORITIES. FOR TAX POSITIONS THAT THE ORGANIZATION CONSIDERS TO BE UNCERTAIN, CURRENT AND DEFERRED TAX LIABILITIES ARE RECOGNIZED, OR ASSETS DERECOGNIZED, WHEN IT IS PROBABLE THAT AN INCOME TAX LIABILITY HAS BEEN INCURRED AND THE AMOUNT OF THE LIABILITY IS REASONABLY ESTIMABLE, OR WHEN IT IS PROBABLE THAT A TAX BENEFIT, SUCH AS A TAX CREDIT OR LOSS CARRYFORWARD, WILL BE DISALLOWED BY A TAXING AUTHORITY. WMKV GOLF OUTING 35750 450 35300 0 1150 9934 7816 269 12345 12345 8244 48095 450 47645 1150 9934 7816 8513 27413 20232 1 CHARITABLE ASSISTANCE - RENT 20 520849 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ASSISTANCE IS IN THE FORM OF REDUCED RENT. RECEIPIENTS MUST MEET QUALIFICATIONS FOR RENT ASSISTANCE. 1 X X X X 0 1 0 0 0 0 0 0 0 JAMES FORMAL 255011 0 49680 0 22720 0 49722 0 1047 0 378180 0 0 0 KENNETH W HUFF 162779 0 20000 0 18796 0 33017 0 1047 0 235639 0 0 0 PART I, LINE 4B THE CEO, JAMES FORMAL, AND CFO, KENNETH HUFF, HAVE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. AMOUNTS FOR 6/30/12 WERE $17,000 FOR FORMAL AND $12,000 FOR HUFF. COUNTY OF BUTLER OHIO 316000061 12354NAE6 2007-06-20 28145000 CONSTRUCTION 0 0 0 COUNTY OF BUTLER OHIO 316000061 NONEAVAIL 2010-07-28 30000000 REFUNDING BONDS 0 0 0 COUNTY OF BUTLER OHIO 316000061 12354NAL0 2002-05-01 58000000 CONSTRUCTION 0 0 0 17800000 28145000 30000000 391550 155180 27598269 2007 0 0 1 1 530000 30000000 30000000 2010 1 0 1 1 38740000 58000000 0 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 1 1 1 SEE SCH K PART V 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 FORM 990, SCHEDULE K, COLUMN B, PART II, LINE 14: THE BOND WAS ISSUED TO PARTIALLY REFUNDED THE 5/21/2002 BONDS HELD BY MAPLE KNOLL. FORM 990, SCHEDULE K, PART IV, LINE 3B: AS OF JUNE 30, 2012, MAPLE KNOLL COMMUNITIES HAD ENTERED INTO FIVE SWAP AGREEMENTS WITH AN OUTSTANDING INTEREST RATE SWAP POSITION (DERIVATIVE INSTRUMENT) AND A TOTAL NOTIONAL AMOUNT OF $49,470,000. THE SWAP AGREEMENTS HAVE SIMILAR TERMS TO THEIR RELATED BONDS AND ARE USED TO MANAGE MAPLE KNOLL COMMUNITIES' INTEREST RATE RISK. MAPLE KNOLL COMMUNITIES BELIEVES THAT THE RISK OF NONPERFORMANCE BY THE OTHER PARTY IN CONJUNCTION WITH THIS ARRANGEMENT IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE FAIR VALUE OF THE INTEREST RATE SWAP AGREEMENTS WAS A LIABILITY OF $4,884,988 AND $4,389,569 AS OF JUNE 30, 2012 AND 2011 RESPECTIVELY. FORM 990, SCHEDULE K, PART IV, LINE 3C: OF THE FIVE INTEREST RATE SWAP AGREEMENTS, THE EARLIEST MATURING AGREEMENT HAS A MATURITY DATE OF AUGUST 15, 2013, THEREFORE A TERM 2.1. THE LONGEST AGREEMENT HAS A MATURITY DATE OF NOVEMBER 1, 2018, THEREFORM A TERM OF 6.3. FORM 990, SECTION C, DOING BUSINESS AS NAME: MAPLE KNOLL VILLAGE, THE KNOLLS OF OXFORD, SYCAMORE SENIOR CENTER, WMKV-FM, MAPLE KNOLL HOME HEALTH SERVICES FORM 990, PART VI, SECTION A, LINE 7A RESIDENTS ELECT ONE VOTING MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE CFO AND CONTROLLER REVIEW THE FORM 990 WITH THE FINANCE COMMITTEE BEFORE FILING, POINTING OUT ANY CHANGES FROM THE PRIOR YEAR. THE FORM 990 IS PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST POLICY IS COMPLETED ONCE A YEAR AT A BOARD MEETING BY THE BOARD OF DIRECTORS. THE POLICY ALSO COVERS KEY MEMBERS OF THE ORGANIZATION. THE BOARD DETERMINES IF A POTENTIAL CONFLICT EXISTS, REVIEWS THE FACTS AND CIRCUMSTANCES, AND VOTES ON THE FINAL DETERMINATION, EXCLUDING THE MEMBER WHO HAS THE POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 FOR THE CEO, THE COMPENSATION COMMITTEE MEETS ANNUALLY TO REVIEW THE CURRENT SALARIED COMPENSATION AND BONUS PACKAGE, BASED ON THE CONTRACTUAL AGREEMENT SIGNED IN THE CEO'S SALARY CONTRACT. AN OUTSIDE CONSULTANT IS USED IF NECESSARY. THE INCREASE IN SALARY IS BASED UPON FINANCIAL RESULTS OF THE COMPANY, FUTURE EXPECTATIONS, AND OTHER BOARD COMMENTS. THE WAGE INCREASE IS COMPARED TO INDUSTRY BENCHMARKS. COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES IS REVIEWED BY THEIR SUPERIOR OFFICER DURING THEIR ANNUAL PERFORMANCE APPRAISAL TO DETERMINE COMPENSATION AMOUNTS. THIS POLICY WAS LAST REVIEWED IN 2012. FORM 990, PART VI, SECTION C, LINE 18 FORM 1023 AND FORM 990 ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -900,705. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT 6,184. CHANGE IN VALUE OF DERIVATIVE -495,419. TOTAL TO FORM 990, PART XI, LINE 5: -1,389,940. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. MKV INC 11000 SPRINGFIELD PIKE CINCINNATI OH 45246 310914017 HUD SUBSIDIZED HOUSING OH 501(C)(3) 509(A)(2) MAPLE KNOLL COMMUNITIES INC 1 SYCAMORE-ANDERSON SENIOR HOUSING INC 11000 SPRINGFIELD PIKE CINCINNATI OH 45246 311209103 HUD SUBSIDIZED HOUSING OH 501(C)(3) 509(A)(2) MAPLE KNOLL COMMUNITIES INC 1 SYCAMORE-ANDERSON SENIOR HOUSING II INC 11000 SPRINGFIELD PIKE CINCINNATI OH 45246 311428462 HUD SUBSIDIZED HOUSING OH 501(C)(3) 509(A)(2) MAPLE KNOLL COMMUNITIES INC 1 53 PRIVATE BANK- ELIZABETH PATTERSON TRUST 5050 KINGSLEY DRIVE CINCINNATI OH 45263 TRUST OH N/A T 17790 239305 0.66000 US BANK- FLORIS SACKETT TRUST 425 WALNUT STREET 5TH FLOOR CINCINNATI OH 45202 TRUST OH N/A T 36125 333848 1.00000 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 MKV INC K 66432 GENERAL LEDGER MKV INC B 57058 GENERAL LEDGER SYCAMORE-ANDERSON SENIOR HOUSING INC K 51504 GENERAL LEDGER