2013-06-05T08:55:36-05:00 2012-06-30 420714325 MCGLADREY LLP 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2011-07-01 364467489 FLORIDA LIVING OPTIONS INC FLOR 3093431550 851 WEST LUMSDEN ROAD BRANDON FL 33511 CHARLES D WESTBAY 3093431550 2013-06-05 1 BEN MCMAHAN P00702421 3093428026 2011 2016-03-07 17:11:31Z CHARLES D WESTBAY 851 WEST LUMSDEN ROAD BRANDON FL 33511 27731722 0 X N/A X 2001 FL TO PROVIDE & OPERATE NURSING HOMES,ASSISTED LIVING FACILITIES & RETIREMENT HOUSING FOR ELDERLY. 4 4 761 45 0 0 15769 8138 27725519 27720520 623 -23578 0 0 27741911 27705080 100 4920 0 0 13783244 13791574 0 0 0 12760933 13834648 26544277 27631142 1197634 73938 7917539 7647586 5699545 5355654 2217994 2291932 X THE MISSION OF THE ORGANIZATION IS ARTICULATED IN ITS ARTICLES OF INCORPORATION AS FOLLOWS:THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES, INCLUDING, FOR SUCH PURPOSES, THE MAKING OF DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN FURTHERANCE OF THESE PURPOSES, THE CORPORATION MAY BUILD, LEASE, ACQUIRE AND OTHERWISE OWN AND OPERATE HOUSING, NURSING FACILITIES, CONTINUOUS CARE RETIREMENT COMMUNITIES AND OTHER RELATED FACILITIES AND SERVICES FOR THE ELDERLY, MENTALLY RETARDED, MENTALLY ILL, DEVELOPMENTALLY DISABLED AND OTHER LIKE CONDITIONS WITHOUT REGARD TO RACE, RELIGION, COLOR, SEX, CREED OR NATIONAL ORIGIN OF SAID PERSONS. 0 0 25675442 4920 27720520 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING NURSING HOMES, ASSISTED LIVING FACILITIES & RETIREMENT HOUSING FOR THE ELDERLY. THE ORGANIZATION OPERATES 8 FACILITIES WITH A COMBINED TOTAL OF 688 BEDS. 25675442 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 0 0 0 0 0 1 0 0 0 0 1 1 0 0 1 0 1 29 0 1 761 1 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X X RON WILSON RFMS INC 3093431550 285 SOUTH FARMHAM STREET GALESBURG IL 61401 X CHARLES D WESTBAY 2.00 X X 1899 0 0 JOHN CROCK 2.00 X 1700 0 0 JOHN THOMPSON 2.00 X X 1700 0 0 DALE FENWICK 2.00 X 1700 0 0 RON WILSON FLASC INC 10.00 X 0 0 0 VERNON ZEGER 40.00 X 122969 0 9527 DEBRA FRANKLIN LTC SUPPORT 40.00 X 0 0 135036 129968 0 144563 1 0 0 0 QUALITY CARE REHAB INC 8477 SOUTH SUNCOAST BLVD HOMOSASSA FL 34446 PHYSICAL THERAPY SERVICES 675774 FLASC INC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 ADMINISTRATIVE SERVICES 624828 LTC SUPPORT SERVICES LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 SUPPORT SERVICES 179920 3 8138 8138 MEDICARE & MEDICAID 623000 18307582 18307582 RESIDENT PRIVATE PAY 623000 7721231 7721231 HOSPICE SERVICES 623000 1355194 1355194 GOVERNMENT VA FEES 623000 113828 113828 RESPITE SERVICES 623000 63065 63065 159620 159620 27720520 3064 3064 26642 -26642 -26642 -26642 27705080 27720520 0 -23578 4920 4920 18300 18300 11812825 11468489 344336 115286 111925 3361 852259 827416 24843 992904 963962 28942 790908 461886 329022 61402 61402 95100 95100 6041 6041 1202764 1186439 16325 109713 98742 10971 180290 143111 37179 24775 19820 4955 5208405 5054170 154235 109772 95570 14202 17195 15279 1916 7708 7708 409855 389362 20493 183559 145538 38021 SUPPLIES & SMALL EQUIP. 3040274 3040175 99 MEDICAID ASSESSMENT TAX 1274191 1274191 UNCOLLECTIBLE CHARGES 670065 670065 EQUIPMENT RENT & MAINT. 276482 275830 652 166149 90909 75240 27631142 25675442 1955700 0 824749 1287021 1658664 432029 3020716 3315339 350913 379302 4628984 2568725 1905961 2060259 124994 124994 31542 48642 7917539 7647586 2243971 1918252 119624 98435 3140000 3140000 195950 198967 5699545 5355654 X 2217994 2291932 2217994 2291932 7917539 7647586 73938 0 X X 0 1 1 X 0 X 168650 34685 21706 15769 8138 248948 23622158 24873087 26456682 27725519 27720520 130397966 23790808 24907772 26478388 27741288 27728658 130646914 0 0 0 130646914 3388 5265 963 623 3064 13303 3388 5265 963 623 3064 13303 23794196 24913037 26479351 27741911 27731722 130660217 0.99990 0.99990 0.00010 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6041 6041 25675442 25681483 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 3882 21663 5501 6041 37087 250000 250000 250000 250000 1000000 1500000 2301210 1285439 1015771 2160007 1124791 1035216 167767 158495 9272 2060259 RESIDENT SECURITY DEPOSITS 47375 RESIDENT TRUST LIABILITIES 48642 REFUNDABLE BALANCES 102950 198967 27705080 27631142 73938 73938 27731722 0 27731722 -26642 -26642 27705080 27657784 26642 26642 27631142 0 27631142 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2008. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON EQUIPMENT DISPOSAL -26,642. PART XIII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON EQUIPMENT DISPOSAL 26,642. LTC SUPPORT SERVICES (LTC) TWO DIRECTORS COMMON TO FLO & LTC ARE JACK CROCK & CHARLES WESTBAY. 166080 MANAGEMENT SERVICES ARE PROVIDED BY LTC SUPPORT SERVICES, LLC., AS DESCRIBED IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. JACK CROCK, WHO IS A DIRECTOR OF FLORIDA LIVING OPTIONS, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $0 FROM LTC SUPPORT SERVICES, LLC. FOR THE FISCAL YEAR ENDING JUNE 30, 2012. CHARLES WESTBAY, WHO IS ALSO A DIRECTOR OF FLORIDA LIVING OPTIONS, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $0 FROM LTC SUPPORT SERVICES, LLC. FOR THE FISCAL YEAR ENDING JUNE 30, 2012. 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION RECEIVES MANAGEMENT SERVICES FROM LTC SUPPORT SERVICES, LLC, AN UNRELATED COMPANY. THESE SERVICES INCLUDE OVERSIGHT, TRAINING, REGULATORY COMPLIANCE, QUALITY ASSURANCE PROGRAMS, HUMAN RESOURCE SUPPORT, MARKETING AND MAINTENANCE. FLORIDA LIVING OPTIONS, INC., OWNS 12.5% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 87.5% OF LTC SUPPORT SERVICES, LLC, IS OWNED BY UNRELATED EXEMPT ORGANIZATIONS. THE ORGANIZATION ALSO HAS A NEGOTIATED ARMS LENGTH ADMINISTRATIVE SERVICES CONTRACT WITH FLASC, INC., AN UNRELATED COMPANY, TO OBTAIN SERVICES SUCH AS CASH MANAGEMENT, ACCOUNTING AND FINANCIAL REPORTING, PAYROLL AND EMPLOYEE BENEFITS, INFORMATION TECHNOLOGY, REGULATORY MATTERS, AND OTHER GENERAL BUSINESS AND FINANCIAL MANAGEMENT SERVICES AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 11 EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVES A PAPER COPY OF FORM 990 FOR THEIR REVIEW AND COMMENT PRIOR TO ITS FILING. THE BOARD ALSO REVIEWS IN DETAIL EACH FORM 990 FILED BY THE ORGANIZATION AT ITS REGULARLY SCHEDULED BOARD MEETINGS. ON AN ANNUAL BASIS, EACH BOARD MEMBER ATTENDS A TRAINING SESSION THAT PROVIDES UPDATES ON CURRENT EXEMPT ORGANIZATION TAX COMPLIANCE MATTERS. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO ATTEST TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE BOARD OF DIRECTORS REVIEWS ALL COMPLETED CONFLICT OF INTEREST STATEMENTS TO DETERMINE IF ANY CONFLICTS EXIST WHICH WOULD REQUIRE RESTRICTION ON PARTICIPATION IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN ANY TRANSACTIONS INVOLVING THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 18 A PAPER COPY OF FORM 990 IS PROVIDED UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE VIA THE GUIDESTAR.ORG WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXCEPT THROUGH PUBLIC FILING REQUIREMENTS. FORM 990, PART VII, SECTION A, COLUMN F: DEBORAH FRANKLIN IS EMPLOYED BY LTC SUPPORT SERVICES, LLC, AN UNRELATED ORGANIZATION WHICH PROVIDES MANAGEMENT SERVICES TO FLORIDA LIVING OPTIONS, INC. THE TYPE OF SERVICES PROVIDED BY LTC SUPPORT SERVICES, LLC ARE DETAILED IN THE SCHEDULE O EXPLANATION ABOVE RELATIVE TO FORM 990, PART VI, SECTION A, LINE 3. DEBORAH FRANKLIN MANAGES THE OPERATIONS OF FLORIDA LIVING OPTIONS, INC. THE COMPENSATION REPORTED IN COLUMN F REPRESENTS 100% OF THE WAGES REPORTED ON HER LTC SUPPORT SERVICES, LLC FORM W-2, BOX 5 FOR CALENDAR YEAR 2011. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. FIRST FLORIDA LIVING OPTIONS LLC 851 W LUMSDEN RD BRANDON FL 33511 364467494 OPERATES A NURSING HOME & ASSISTED LIVNG FACILITY FOR THE ELDERLY. FL 10499680 2855650 N/A SECOND FLORIDA LIVING OPTIONS LLC 851 W LUMSDEN RD BRANDON FL 33511 364467496 OPERATES A NURSING HOME FOR THE ELDERLY. FL 11568620 2355810 N/A THIRD FLORIDA LIVING OPTIONS LLC 851 W LUMSDEN RD BRANDON FL 33511 364467499 OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY. FL 1850775 118210 N/A FOURTH FLORIDA LIVING OPTIONS LLC 851 W LUMSDEN RD BRANDON FL 33511 364469681 OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY. FL 2211409 234210 N/A FIFTH FLORIDA LIVING OPTIONS LLC 851 W LUMSDEN RD BRANDON FL 33511 331094306 OPERATES AN INDEPENDENT LIVING RETIREMENT CENTER FOR THE ELDERLY. FL 1574596 317579 N/A SIXTH FLORIDA LIVING OPTIONS LLC 4100 SW 33RD AVENUE OCALA FL 34474 263708014 OPERATIONS NOT COMMENCED AS OF 6/30/2012. FL 0 17215 N/A SARVOP LLC 2806 FRITZKE ROAD DOVER FL 33527 202996830 FUTURE SKILLED-CARE FACILITY CURRENTLY UNDER DEVELOPMENT. FL 0 114994 N/A SEVENTH FLORIDA LIVING OPTIONS LLC 5381 DESOTO ROAD SARASOTA FL 34243 371660137 OPERATIONS NOT COMMENCED AS OF 6/30/2012. FL 0 68264 N/A RFMS INC MEDICAL BENEFIT PLAN TRUST 285 S FARNHAM STREET GALESBURG IL 61401 367042729 MEDICAL, ST DISABILITY & DEATH BENEFITS FOR ELIGIBLE EMPLOYEES IL 501(C)(9) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RFMS INC MEDICAL BENEFIT PLAN TRUST Q 513244 COST OF PREMIUMS SCHEDULE R, PART II AND PART V: THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS A SELF-INSURED BENEFIT PROGRAM FUNDED BY THE EMPLOYERS AND PARTICIPANTS WITHIN THE PLAN. PARTICIPANTS IN THE PLAN ARE CURRENT AND FORMER EMPLOYEES OF THE FOLLOWING SPONSORS: RFMS, INC., LTC SUPPORT SERVICES, LLC, COMMUNITY RESIDENTIAL CENTERS, INC., COMMUNITY LIVING OPTIONS, INC., FRANCES HOUSE, INC., UNLIMITED DEVELOPMENT, INC., KENSINGTON OF GALESBURG, INC., ACHIEVEMENT UNLIMITED, INC., CONCEPTS PLUS, INC., PINNACLE OPPORTUNITIES, INC., PIONEER CONCEPTS, INC., RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., RESIDENTIAL ALTERNATIVES OF IOWA, DESERT HEALTHCARE FACILITIES, INC., FLORIDA LIVING OPTIONS, INC., AND HIGHLAND ESTATES RESORT, LLC. NO TRUSTEE FEES OR MANAGEMENT FEES ARE PAID BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST. THE AMOUNT OF PREMIUMS RECEIVED BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS FOR THE PLAN'S FISCAL YEAR ENDING OCTOBER 31, 2011. THE 2011 FORM 990 FOR FLORIDA LIVING OPTIONS, INC. WAS TIMELY FILED ELECTRONICALLY ON MAY 14, 2013, ON WHICH DATE IT WAS ALSO REJECTED. AFTER CONTACTING THE IRS E-FILE HELP DESK ON MAY 15, 2013, INCIDENT NUMBER #IM46203 WAS CREATED WITH THE IRS REGARDING THE E-FILE REJECTION. THE IRS REPRESENTATIVE EXPLAINED THAT THE FORM 990 COULD NOT BE SUBMITTED ELECTRONICALLY UNTIL A DATABASE WAS UPDATED WITHIN THE IRS'S E-FILE SYSTEM. THIS UPDATE WOULD NOT OCCUR UNTIL AFTER THE 10-DAY GRACE PERIOD ALLOWED TO RESOLVE E-FILE REJECTIONS. THEREFORE, THIS GRACE PERIOD WOULD BE WAIVED, AND LATE FILING PENALTIES AND INTEREST WOULD NOT BE ASSESSED SINCE THE INABILITY TO RESUBMIT THE REJECTED RETURN ELECTRONCIALLY WAS OUT OF THE ORGANIZATION'S CONTROL. THE IRS DOCUMENTATED OF ALL CORRESPONDENCE RELATED TO THIS MATTER UNDER THE ABOVE REFERENCED INCIDENT NUMBER. ON JUNE 3, 2013, AN IRS REPRESENTATIVE STATED THAT THE NECESSARY DATABASE UPDATE WAS COMPLETE AND THE RETURN CAN BE SUBMITTED ELECTRONCIALLY AFTER THAT DATE.