2012-05-04T08:17:54-05:00 2011-09-30 GENE R SOLOMON CPA 1342 COLONIAL BLVD STE B-11 FORT MYERS FL 33907 990 2010-10-01 650610085 CYPRESS COVE AT HEALTHPARK FLORIDA INC CYPR 2394890023 9800 S HEALTHPARK DRIVE SUITE 350 FT MYERS FL 33908 JOHN A NOLAND 2394890023 2012-05-02 1 GENE R SOLOMON CPA 2399395303 2012-05-02 X 2010 2016-02-24 21:20:13Z JOHN A NOLAND 1715 MONROE ST FORT MYERS FL 33901 25051663 0 X CYPRESSCOVELIVING.ORG X 1995 FL TO PROVIDE OUR RESIDENTS WITH RETIREMENT OR ASSISTED LIVING AND SKILLED NURSING SERVICES THAT MEETS THEIR NEEDS. 14 14 334 140 0 0 0 28679 25301387 23899402 1265321 413401 569173 710181 27135881 25051663 0 0 0 0 9022744 8904743 0 0 127440 19501812 19802359 28524556 28707102 -1388675 -3655439 98720575 94495403 112917186 112347453 -14196611 -17852050 X TO CREATE AND SUSTAIN A LIFECARE RETIREMENT COMMUNITY AT HEALTHPARK, FL AT A REASONABLE COST; AN ENVIRONMENT OF VITALITY WHILE COMFORTABLE AND SECURE. CYPRESS COVE OFFERS THE SECURITY OF LIFE CARE, WHEREBY RESIDENTS WHO HAVE QUALIFIED BOTH FINANCIALLY AND PHYSICALLY, CAN LIVE WITHIN THE COMMUNITY AND, IF NEEDED, RECEIVE ASSISTED LIVING AND SKILLED CARE FOR THE CONTRACTUAL MONTHLY FEE FOR THE DURATION OF THEIR LIVES. CYPRESS COVE WILL NOT DISMISS OR TERMINATE THE RESIDENT SOLELY BECAUSE OF FINANCIAL INABILITY TO PAY ALL OR A PART OF THE CONTRACTED MONTHLY SERVICE FEE. RESIDENTS CONTINUE THEIR ACTIVE AND INDEPENDENT LIFESTYLES, AGING WITH DIGNITY AND ADDED PEACE OF MIND. 0 0 16643911 17595198 PROVIDING A LIFE CARE COMMUNITY INCLUDING 332 INDEPENDENT LIVING APARTMENTS AND 30 VILLAS, TOGETHER WITH APPROPRIATE COMMON AND AMENITY AREAS SITUATED ON 48 ACRES OF THE HEALTHPARK FLORIDA CAMPUS, LOCATED IN LEE COUNTY, FL. WE OFFER A HOLISTIC APPROACH TO LIFE BY PROVIDING AN ACTIVITIES DEPARTMENT AND WELLNESS CENTER PLACING STRONG EMPHASIS ON PREVENTIVE CARE AND MAINTAINING GOOD HEALTH. A PERSONAL TRAINER AND ACTIVITIES COORDINATOR ARE ALL INCLUDED. WE FULFIL OUR MISSION BY 1) CREATING A LIFE CARE COMMUNITY THAT ENCOURAGES ACTIVITY AND PERSONAL GROWTH. 2) PROVIDING DINING SERVICES OFFERING A BROAD, SATISFYING, AND NUTRITIOUS ARRAY OF CHOICES EVERY DAY. 3) BY PROVIDING HOUSEKEEPING AND TRANSPORTION, FREEING RESIDENT'S TIME AND ENERGY. 4) DEVELOPING A NEIGHBORHOOD WHICH FOSTERS NEW FRIENDSHIPS. 5) PROVIDING GOOD BUSINESS PRACTICES. 6) EXCEEDING RESIDENT EXPECTATIONS WHILE ATTENDING TO THEIR EMOTIONAL AND SPIRITUAL NEEDS. 7133105 7427786 PRESENTING 44 ASSISTED LIVING UNITS AND A FACILITY OFFERING 64 BED NURSING. PROVIDING ON CAMPUS AND ON STAFF A MEDICAL DIRECTOR AND NURSING SERVICES INCLUDING REHABILITATIVE AND SKILLED NURSING TO LIFE CARE RESIDENTS FOR AS LONG AS REQUIRED. WE FULFIL OUR MISSION BY 1) MAINTAINING A HIGH QUALITY LIFECARE PROGRAM WITH PROVISIONS FOR ASSISTED LIVING AND NURSING CARE AS IS APPROPRIATE, CONSIDERING THE NEEDS OF THE INDIVIDUAL RESIDENT. 2) OFFERING AN ENVIRONMENT WHERE RESIDENTS ARE RESPONSIBLE FOR ORGANIZING THEIR OWN LIVES, YET KNOW THAT SHOULD THEY NEED IT, SUPPORT IS AVAILABLE. 3) PROMOTING INNOVATIVE PROGRAMS AND SERVICES, WELLNESS, HEALTHFUL LIVING AND THE OPPORTUNITY FOR RESIDENTS TO LIVE LONGER, HEALTHIER AND MORE FULFILLING LIVES. 23777016 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 60 0 1 334 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 FL X TERRENCE HIDUKE 2394890023 9800 S HEALTHPARK DR STE 350 FORT MYERS FL 33908 JOHN A NOLAND 3.00 X X 0 0 0 CARL A BARRACO 2.00 X X 0 0 0 E BRUCE STRAYHORN 2.00 X X 0 0 0 GARRETT H REASONER 2.00 X X 0 0 0 ALBERT B WINCHELL 1.00 X 0 0 0 DANIEL F ADAMS 2.00 X 0 0 0 DAVID G ROBINSON PHD 1.00 X 0 0 0 JO ELLEN BEAUVOIS 1.00 X 0 0 0 CHARLES B EDWARDS SR 1.00 X 0 0 0 JOSEPH CATTI 1.00 X 0 0 0 CHRIS GAIR 1.00 X 0 0 0 ROBBIE BRIGGS ROEPSTORFF 1.00 X 0 0 0 RONALD EUGENE INGE 1.00 X 0 0 0 DAWSON MCDANIEL 1.00 X 0 0 0 TIMOTHY D FICKER 45.00 X X X 205427 0 17779 JAY A GROESSER 45.00 X 123771 0 17375 KEVIN MANNIX 45.00 X 100010 0 12884 DRUMMOND CAMEL 45.00 X 88111 0 14071 SANDRA D REGAL 45.00 X 88321 0 12466 429208 0 48038 3 0 1 0 LEE FP INC 9800 S HEALTHPARK DRIVE STE 350 FORT MYERS FL 33908 MANAGEMENT FEE 876808 SELECT MEDICAL REHABILITATION SVCS PO BOX 643920 PITTSBURGH PA 15264 THERAPY: PHYSICAL, SPEECH, OCCUPATIONAL 520599 DECO TILE & MARBLE INC 3113 21ST ST W LEHIGH ACRES FL 33971 TILE INSTALLATION 264103 MARTINO & BINZER 270 FARMINGTON AVE STE 128 FARMINGTON CT 06032 MARKETING 219653 BENTLEY ELECTRIC CO OF NAPLES 4406 ENTERPRISE AVE NAPLES FL 33104 ELCTRICIAN 212370 5 28679 28679 MONTHLY SERVICE 900099 11579139 11579139 ASSIST. LVG & NURSING 900099 7427786 7427786 MEMBERSHIP 900099 4892477 4892477 23899402 413401 413401 REALIZED GAIN ON INVES 900099 568993 568993 MISCELLANEOUS 900099 525477 525477 UNREALIZED GAIN ON INV 900099 -384289 -384289 710181 25051663 25022984 0 0 207499 207499 7774602 6962338 751991 60273 189439 189439 133873 133873 599330 497576 97384 4370 126357 126357 66647 66647 822283 769731 52552 875267 875267 91053 37288 47494 6271 164842 2962 161880 3572146 3572146 59013 20723 36347 1943 4573051 4573051 3127043 3127043 1274228 1272943 1215 70 GENERAL & ADMINISTRATIV 2212789 2212789 DINING SERVICES 1436394 1436394 NURSING SERVICES 1378853 1378853 RESIDENT SERVICES 20432 20432 PHILANTHROPY 1961 1961 28707102 23777016 4802646 127440 4210600 3586102 675914 653724 1376043 579464 87121 89276 893911 835908 97217892 31114486 68176568 66103406 0 16903665 16764022 6182329 5669078 214424 214423 98720575 94495403 3523732 3715908 62935477 62416343 2571553 1425838 43886424 44789364 112917186 112347453 X -14196611 -17852050 -14196611 -17852050 98720575 94495403 -3655439 0 X X 0 1 1 X 0 X 7766648 7002220 6548267 6498860 11607818 39423813 18301075 18248819 18740987 18802527 12320263 86413671 26067723 25251039 25289254 25301387 23928081 125837484 0 0 0 125837484 2107131 1134324 734808 673508 413401 5063172 2107131 1134324 734808 673508 413401 5063172 511453 587796 1507190 1160986 710181 4477606 28686307 26973159 27531252 27135881 25051663 135378262 0.92950 0.92510 0.03740 0.04380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1313786 1313786 88223463 24808755 63414708 7680643 6305731 1374912 66103406 ASSETS WHOSE USE IS LIMITED - BOND INDENTURE 10000815 F ASSETS WHOSE USE IS LIMITED - CONTINUING CARE 6459401 F ASSETS WHOSE USE IS LIMITED - BOARD DESIGNATED ASSETS 303806 F 16764022 GROUND LEASE PAYABLE 8494648 UNEARNED ENTRANCE FEES 36159716 PHILANTHROPY NOTE FROM LHR 135000 44789364 25051663 28707102 -3655439 0 -3655439 25051663 0 25051663 0 25051663 28707102 0 28707102 0 28707102 PART X, LINE 2 - FIN 48 FOOTNOTE DISCLOSURE: CYPRESS COVE HAS ADOPTED ACCOUNTING STANDARDS CODIFICATION (ASC) 740-10, INCOME TAXES AS IT RELATES TO UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED SEPTEMBER 30, 2011 AND 2010. CYPRESS COVE HAS EVALUATED ITS TAX POSITIONS TAKEN FOR ALL OPEN TAX YEARS. CURRENTLY, THE 2008, 2009 AND 2010 TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. HOWEVER, THE ORGANIZATION IS NOT CURRENTLY UNDER AUDIT NOR HAS THE ORGANIZATION BEEN CONTACTED BY ANY TAX JURISDICTION. THE ORGANIZATION'S SIGNIFICANT TAX POSITIONS RELATE TO ITS NOT-FOR-PROFIT STATUS AND THE POSITION NONE OF ITS INCOME IS UNRELATED BUSINESS INCOME AND SUBJECT TO TAX. BASED ON AN EVALUATION OF CYPRESS COVE'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER AN EXAMINATION. THEREFORE, NO PROVISION FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED FOR THE YEAR ENDED SEPTEMBER 30, 2011. X X X X X 0 0 0 0 0 1 0 0 0 TIMOTHY D FICKER 190969 0 14251 0 207 0 6172 0 11607 0 223206 0 0 0 PART I, LINE 6 NO BONUS PLAN WAS IN PLACE FOR THIS FISCAL YEAR ENDED SEPTEMBER 30, 2011. BONUSES INCLUDED WITHIN THIS 990 WERE FOR THE PRIOR FISCAL YEAR. DANIEL F ADAMS OFFICER AND DIRECTOR SERVES AS SECRETARY AND DIRECTOR OF LEE FP, INC., A RELATED ORGANIZATION TAXED AS A CORPORATION. 0 JOHN A NOLAND OFFICER AND DIRECTOR SERVES AS CHAIRMAN AND DIRECTOR OF LEE FP, INC., A RELATED ORGANIZATION TAXED AS A CORPORATION AND LEE HEALTHCARE RESOURCES, A RELATED NOT-FOR-PROFIT ORGANIZATION. 0 JOSEPH CATTI OFFICER AND DIRECTOR SERVES AS VICE CHAIRMAN AND IS TREASURER AND DIRECTOR OF LEE FP, INC., A RELATED ORGANIZATION TAXED AS A CORPORATION. ALSO SERVES AS DIRECTOR FOR LEE HEALTHCARE RESOURCES, A RELATED NOT-FOR-PROFIT ORGANIZATION. 0 RONALD EUGENE INGE DIRECTOR SERVES AS DIRECTOR OF LEE FP, INC., A RELATED ORGANIZATION TAXED AS A CORPORATION. 0 ROBBIE BRIGGS ROEPSTORFF DIRECTOR SERVES AS DIRECTOR OF LEE FP, INC., A RELATED ORGANIZATION TAXED AS A CORPORATION. 0 FORM 990, PART VI, SECTION A, LINE 3 MEMBERS OF THE MANAGEMENT TEAM ARE EMPLOYEES OF LEE FP, INC. - A FOR PROFIT RELATED CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD MEMBERS OF LEE MEMORIAL HOSPITAL, INC. D/B/A LEE HEALTHCARE RESOURCES (A 501(C)(3) CORPORATION) SELECT THE MEMBERS OF THE BOARD OF DIRECTORS UNDER ALL CIRCUMSTANCES INCLUDING, BUT NOT LIMITED TO: (I) THE ANNUAL ELECTION, (II) IN THE EVENT THERE IS AN INCREASES IN THE SIZE OF THE BOARD, OR (III) IN THE EVENT THERE IS A VACANCY IN THE MEMBERSHIP OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED BY OUR OUTSIDE TAX ADVISOR/CPA FROM INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF CYPRESS COVE. MANAGEMENT REVIEWS THE 990 PRIOR TO PRESENTATION IN DRAFT FORM TO THE FINANCE COMMITTEE. UPON COMMITTEE APPROVAL, THE 990 IS SENT TO ALL BOARD MEMBERS AND DISCUSSED AND APPROVED AT A BOARD MEETING PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS AND COMMITTEE MEMBERS WITH BOARD-DELEGATED POWERS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST AT THE TIME THE BOARD MAY BE CONSIDERING A RELATED TRANSACTION OR ARRANGEMENT THE INDIVIDUAL WITH THE CONFLICT IS PRECLUDED FROM VOTING ON MATTERS TO WHICH THE CONFLICT PERTAINS. IN ADDITION, ON AN ANNUAL BASIS EACH DIRECTOR IS REQUIRED TO SIGN A STATEMENT AFFIRMING THEY HAVE READ AND UNDERSTAND THE POLICY AND HAD NOT BEEN INVOLVED IN ANY CONFLICTS OF INTEREST. CYPRESS COVE ALSO PERFORMS PERIODIC REVIEWS TO ENSURE COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE DIRECTOR'S COMPENSATION REVIEW ENTAILS THE HUMAN RESOURCES DEPARTMENT GATHERING COMPARABILITY DATA FROM LIKE SIZE CONTINUING CARE RETIREMENT COMMUNITIES. THE DATA IS PRESENTED TO THE CEO AND THE OVERSIGHT MANAGEMENT COMPANY (LEE FP, INC) WHO APPROVES THE EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT THE OFFICE OF THE EXECUTIVE DIRECTOR UPON REQUEST. IN ADDITION, THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED ANNUALLY WITH THE CYPRESS COVE RESIDENT FINANCIAL COMMUNICATIONS COMMITTEE. QUARTERLY FINANCIAL UPDATES ARE ALSO PROVIDED IN PUBLIC FORUM FOR ALL RESIDENTS. AUDIT OVERSIGHT COMMITTEE AND SELECTION OF INDEPENDENT ACCOUNTANT: FORM 990, PART XII, LINE 2C: THE LEE MEMORIAL HOSPITAL, INC. D/B/A LEE HEALTHCARE RESOURCES, INC. (LHR) BOARD ADOPTED AN AUDIT CHARTER AND DELEGATED A COMMITTEE THAT IS APPOINTED ANNUALLY TO BE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND CONTROLLED ENTITIES INCLUDING CYPRESS COVE AT HEALTHPARK FLORIDA, INC. (CC) AND SELECTION OF AN INDEPENDENT AUDITOR. THE COMMITTEE ALSO MEETS WITH THE AUDITOR BEFORE AND AFTER THE AUDITS ARE COMPLETE. THE AUDITS ARE PRESENTED TO THE FULL BOARD OF DIRECTORS OF LHR AND CC BY THE AUDITOR ANNUALLY. LEE MEMORIAL HOSPITAL INC DBA LEE HEALTHCARE RESOURCES 9800 S HEALTH PARK DR FORT MYERS FL 33908 237160360 SUPPORT:1)LMHS-PUBLIC HOSPITAL FUNCTIONS 2)CYPRESS COVE-CHARITABLE FUNCTIONS FL 501(C)(3) 509(A)(3) N/A 0 LEE FP INC & SUBSIDIARIES 9800 S HEALTHPARK DR STE 350 FORT MYERS FL 33908 650184989 MANAGEMENT & DEVELOPMENT ACTIVITIES FL N/A C 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 1 0 0 LEE MEMORIAL HOSP INC DBA LEE HEALTHCARE RESOURCES (LHR)-GROUND LS PAY E 8494648 COST LEE MEMORIAL HOSP INC DBA LEE HEALTHCARE RESOURCES (LHR)-PHILANTHROPY E 135000 COST LEE HEALTH VENTURE INC (LHV) BOND PURCHASE AGRMT - 3 E 295000 COST LHR - RENT (GROUND LEASE) J 914256 COST LEE FP INC - MANAGEMENT FEES L 634771 COST LHR - PLEDGE FEE L 30000 COST LHR - MAINTENANCE FEES ON MEDICAL PLAZE ONE BLDG P 10905 COST