2013-05-10T15:11:27-05:00 2012-06-30 COHNREZNICK LLP 500 EAST PRATT STREET SUITE 200 BALTIMORE MD 212023100 990 2011-07-01 621486858 CLAREMONT HEALTH SYSTEM INC % JOHN GILLMOR CLAR 6152522305 1600 Division St Suite 700 Nashville TN 37203 JOHN GILMOR 2013-05-10 true PHILIP H CORNBLATT CPA 4107834900 2011 2016-02-24 21:20:13Z John Gillmor 1600 Division St Suite 700 Nashville TN 37203 9316153 false 5138 X N/A X 1992 NJ THE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY. 6 0 140 0 0 0 9975631 9312489 2022 3664 0 0 9977653 9316153 0 0 0 0 5306327 5101245 0 0 0 4517038 4017029 9823365 9118274 154288 197879 7926393 7977648 7803431 7656807 122962 320841 THE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY. false false 8874522 9312489 OPERATED INTERMEDIATE AND SKILLED-CARE NURSING HOME FACILITIES FOR THE CARE OF ELDERLY PATIENTS. The organization has 118 beds in its nursing home facility. 8874522 true false false false false false false false false true false false true true true true false false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 0 0 true 140 true false false false false false false false false false false X 6 0 true false false false false false false true true false false true true true true true true true true false X JOHN GILLMOR 6152522305 1600 DIVISION ST SUITE 700 Nashville TN 37203 X BRUCE P HUTSON 0.4 X X 0 55500 0 STEPHEN F WOOD Sr 1.0 X X 244000 JOHN G FOOS 0.1 X X 55500 JOHN E GILLMOR 0.2 X X 70878 DOUGLASS SMITH 0.1 X JO ANN CORBITT 0.1 X STEPHEN F WOOD JR 0.1 X CYNTHIA WOOD 0.48 X 21000 LEWIS F WOOD JR X 548713 0 995591 0 0 true true false GENESIS ELDERCARE NETWORK SERVICES 101 E STATE STREET KENNETT SQUARE PA 19348 MANAGEMENT FEES 6066722 GENESIS REHABILITATION SERVICES 101 E STATE STREET KENNETT SQUARE PA 19348 REHAB THERAPIES 634671 OMNICARE 2100 QUAKER POINTE DRIVE QUAKERTOWN PA 18981 PHARMACEUTICALS 173717 3 0 PROGRAM SVC REV 623000 9312489 9312489 9312489 3664 3664 0 0 0 0 0 0 0 9316153 9312489 3664 0 0 0 0 0 0 4342728 4342728 0 340022 340022 418495 418495 533447 533447 13869 13869 0 0 26850 26850 0 0 0 0 6609 6609 0 0 0 0 0 0 0 414623 414623 0 394546 394546 174007 174007 BAD DEBTS 35323 35323 0 0 ADMINISTRATIVE 216902 0 216902 0 UTILITIES 172618 172618 0 0 SUPPLIES 141279 141279 0 0 1886956 1886956 9118274 8874522 243752 0 998968 1448820 0 0 0 0 820485 878485 0 0 0 0 0 0 34531 25467 901687 868186 10322705 6144492 4567891 4178213 0 0 0 0 0 0 0 0 602831 578477 7926393 7977648 344175 379590 0 0 84057 55052 0 0 0 0 0 0 7302938 7183147 0 0 72261 39018 7803431 7656807 X 122962 320841 0 0 0 0 122962 320841 7926393 7977648 197879 X false true true X true true X false false false 9431036 9864762 10250312 9975621 9312489 48834220 9431036 9864762 10250312 9975621 9312489 48834220 48834220 12920 6518 3223 2022 3664 28347 12920 6518 3223 2022 3664 28347 9443956 9871280 10253535 9977643 9316153 48862567 0.99942 0.99903 0.00058 0.00097 X 750000 750000 7629311 4684952 2944359 1710849 1278132 432717 232545 181408 51137 4178213 FINANCING FEES, NET OF AMORT 578477 578477 0 OTHER LIABILITY 39018 39018 9316153 9118274 197879 197879 9316153 9316153 9316153 9118274 9118274 9118274 FIN 48 PART X LINE 2 The Company has applied for and received a determination letter from the Internal Revenue Service (IRS) to be treated as a tax-exempt entity pursuant to Section 501(c)(3) of the Internal Revenue Code and did not have any unrelated business income for the year ended June 30, 2012. Due to its tax-exempt status, the Company is not subject to income taxes. The Company is required to file and does file tax returns with the IRS and other taxing authorities. Accordingly, these financial statements do not reflect a provision for income taxes and the Company has no other tax positions which must be considered for disclosure. Open tax years for the Company are 2009, 2010 and 2011. X X X X false false false false false false false false false STEPHEN F WOOD Sr 244000 244000 LEWIS F WOOD JR 548713 548713 GOVERNANCE, MANAGEMENT & DISCLOSURE PART VI, SECTION A, LINE 2 RELATIONSHIP SCHEDULE --------------------- NAME OF OFFICER, DIRECTOR, ETC: Stephen Wood NAME OF RELATED ENTITY: LEWIS F. WOOD, JR CYNTHIA WOOD Stephen Wood, JR TITLE OR ROLE: CEO/TREASURER RELATIONSHIP: BROTHER/SISTER-IN-LAW/son NAME OF OFFICER, DIRECTOR, ETC: LEWIS F. WOOD, JR NAME OF RELATED ENTITY: CYNTHIA WOOD STEPHEN WOOD stephen wood, jr TITLE OR ROLE: Former officer RELATIONSHIP: WIFE/BROTHER/nephew NAME OF OFFICER, DIRECTOR, ETC: CYNTHIA WOOD NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD Stephen wood, jr TITLE OR ROLE: Asst Secretary RELATIONSHIP: HUSBAND/BROTHER-IN-LAW/nephew NAME OF OFFICER, DIRECTOR, ETC: Stephen Wood Jr NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD Cynthia Wood TITLE OR ROLE: director RELATIONSHIP: uncle/father/uncle GOVERNANCE, MANAGEMENT & DISCLOSURE PART VI, SECTION A, LINES 11 A DRAFT OF FORM 990 IS REVIEWED & AUTHORIZED BY A MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. GOVERNANCE, MANAGEMENT & DISCLOSURE PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON AN INDEPENDENT COMPENSATION STUDY, AND INCREASES ARE BASED ON THE CPI (ALL CONSUMERS MARKET BASKET) AND THE DISCRETION OF THE BOARD. GOVERNANCE, MANAGEMENT & DISCLOSURE PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ORGANIZATION'S OFFICE DURING REGULAR BUSINESS HOURS UPON REQUEST. COMPENSATION OF OFFICERS PART VII, SECTION A, AVERAGE HOURS PER WEEK THE OFFICERS AND DIRECTORS DO NOT KEEP DETAILED TIME RECORDS OF HOURS SPENT FOR THIS AND RELATED ENTITIES. HOWEVER, THROUGH DISCUSSIONS WITH EACH, AN ESTIMATE HAS BEEN MADE OF THE TIME THEY SPENT ON MATTERS OF THIS ENTITY AND ITS RELATED CHARITABLE ENTITIES. THERE ARE twelve RELATED CHARITABLE ENTITIES FOR WHICH THE OFFICERS AND DIRECTORS PROVIDE SERVICES. OFTEN BOARD MEETINGS AND OTHER WORK INVOLVES MATTERS FOR SEVERAL OR ALL OF THESE ENTITIES. GOVERNANCE, MANAGEMENT & DISCLOSURE Part VI Section B Line 12 The Board members annually certify that they are aware of the conflict of interest policy and have no conflicts of interest. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRUCE P. HUTSON TITLE:PRESIDENT HOURS:8 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEPHEN F. WOOD, Sr. TITLE:CEO/VP/TREASURER HOURS:29 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN G. FOOS TITLE:VP/asst. TREASURER HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN E. GILLMOR TITLE:VP/SECRETARY HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DOUGLASS SMITH TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JO ANN CORBITT TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEPHEN F. WOOD, JR TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CYNTHIA WOOD TITLE:ASSISTANT SECRETARY HOURS:4 OTHER EXPENSES FORM 990 PART IX DESCRIPTION:CONTRACTS TOTAL EXPENSES:10924 PROGRAM SERVICES:10924 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:TRASH REMOVAL TOTAL EXPENSES:23625 PROGRAM SERVICES:23625 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:VEHICLE MAINTENACE TOTAL EXPENSES:17367 PROGRAM SERVICES:17367 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:MISCELLANEOUS OPERATING TOTAL EXPENSES:19663 PROGRAM SERVICES:19663 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:WORKERS COMP TOTAL EXPENSES:144594 PROGRAM SERVICES:144594 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:LICENSES & CERTIFICATION TOTAL EXPENSES:10079 PROGRAM SERVICES:10079 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:MORTGAGE INSURANCE PREMIUM TOTAL EXPENSES:36240 PROGRAM SERVICES:36240 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:AMORTIZATION EXPENSE TOTAL EXPENSES:24354 PROGRAM SERVICES:24354 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:FOOD TOTAL EXPENSES:189833 PROGRAM SERVICES:189833 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:DRUGS AND PHARM. TOTAL EXPENSES:185857 PROGRAM SERVICES:185857 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:MEDICAL SUPPLIES TOTAL EXPENSES:32647 PROGRAM SERVICES:32647 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:OTHER SERVICE EXPENSES TOTAL EXPENSES:511681 PROGRAM SERVICES:511681 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:NURSING SERVICES TOTAL EXPENSES:35432 PROGRAM SERVICES:35432 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:REHABILITATION SERVICES TOTAL EXPENSES:621162 PROGRAM SERVICES:621162 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:ACTIVITIES SERVICES TOTAL EXPENSES:23210 PROGRAM SERVICES:23210 MANAGEMENT AND GENERAL:FUNDRAISING: OTHER EXPENSES FORM 990 PART IX DESCRIPTION:MISC FINANCIAL EXPENSES TOTAL EXPENSES:288 PROGRAM SERVICES:288 MANAGEMENT AND GENERAL:FUNDRAISING: HOOSIER CARE INC 1600 Division St Suite 700 Nashville TN 37203 311262572 NURSING HOME IN 501(C)(3) 9 NA false HOOSIER CARE II INC 1600 Division St Suite 700 Nashville TN 37203 311274121 NURSING HOME IN 501(C)(3) 9 HOOSIER CARE false HOOSIER CARE III INC 1600 Division St Suite 700 Nashville TN 37203 621459304 NURSING HOME DE 501(C)(3) 9 HOOSIER CARE false HOOSIER care PROPERTIES INC 1600 Division St Suite 700 NASHVILLE TN 37203 200377349 NURSING HOME IN 501(C)(3) 9 HOOSIER CARE false VICTORIA HEALTH CORPORATION 1600 Division St Suite 700 Nashville TN 37203 621518645 NURSING HOME NJ 501(C)(3) 9 HOOSIER CARE false DELAWARE HEALTH CORPORATION 1600 Division St Suite 700 Nashville TN 37203 621548336 NURSING HOME DE 501(C)(3) 9 HOOSIER CARE false HIGHLAND HEALTH SYSTEMS INC 1600 Division St Suite 700 Nashville TN 37203 621486857 NURSING HOME PA 501(C)(3) 9 HOOSIER CARE false BIRCHWOOD SENIOR HOUSING CORPORATION 1600 Division St Suite 700 NASHVILLE TN 37203 204800428 sr housing DE 501(C)(3) 9 HOOSIER CARE false Cleveland Senior Housing Corporation 1600 Division St Suite 700 Nashville TN 37203 264739076 sr housing TN 501(C)(3) 9 HOOSIER CARE false LAURELWOOD SENIOR HOUSING CORPORATION 1600 DIVISION STREET STE 700 Nashville TN 37203 320362338 SR HOUSING TN 501(C)(3) 9 HOOSIER CARE false HEALTH & HOUSING SUPPORT SERVICES INC 1600 DIVISION STREET STE 700 NASHVILLE TN 37203 452449379 sr hsg & svcs NV 501(C)(3) 11 HOOSIER CARE false HOOSIER CARE INVESTMENTS LLC 1600 Division St Suite 700 nashville TN 37203 200479449 INVESTMENT DE HOOSIER CARE RELATED false false false false false false false false false false false false false false true false false false hoosier care investment llc o 121200 cost