2011-08-12T17:57:35-07:00 2010-09-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2009-10-01 593759049 Wuesthoff Assisted Living at IRCC Inc WUES 3216372606 1116 Geiger Street Rockledge FL 32955 Johnette Gindling 3216372606 2011-08-10 1 KPMG LLP 3362753394 2011-08-10 2009 2016-02-24 21:20:13Z X Johnette Gindling 1116 Geiger Street Rockledge FL 32955 3783997 0 X X 2001 FL Provide assisted living for the elderly. 15 15 0 15 0 0 0 580 4350666 3770892 375 144 0 12381 4351041 3783997 0 0 0 0 1802740 1674600 0 0 0 2416873 2359396 4219613 4033996 131428 -249999 2295776 2141271 1015665 1111157 1280111 1030114 THE ORGANIZATION WILL PROVIDE QUALITY COMPREHENSIVE AND ACCESSIBLE HEALTHCARE SERVICES IN A COST-EFFECTIVE MANNER TO THE COMMUNITY WE SERVE. 0 0 3899004 0 3783997 PROVISION OF HOUSING AND CARE TO ELDERLY RESIDENTS 0 0 0 3899004 1 0 0 0 0 0 0 0 0 1 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 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X JOHNETTE GINDLING 3216372696 110 Longwood Avenue Rockledge FL 32956 RONALD BURK MD 2 X 0 0 0 FRAN PICKETT 2 X 0 0 0 LARRY SHULTZ 2 X 0 0 0 HOMI COOPER 2 X 0 0 0 JAMES DWIGHT 2 X 0 0 0 JEFFREY SHUMAN 2 X 0 0 0 JOHN BANKS 2 X 0 0 0 EUGENE JOHNSON 2 X 0 0 0 KENNETH KOREY 2 X 0 0 0 MAXWELL KING 2 X 0 0 0 REBEKAH DAVIS 2 X 0 0 0 ROBERT ANDERSON 2 X 0 0 0 STEVEN PHELPS 2 X 0 0 0 VALERIE BROWN KRIMSLEY 2 X 0 0 0 WILLIAM P BANCROFT 2 X 0 0 0 EMIL MILLER 2 X 0 642191 34655 GEORGE FAYER 2 X 0 439275 32891 DEBORALEE DAVIS 40 X 124150 0 9387 BRIAN BODI 2 X 0 169790 27907 JOHNETTE GINDLING 2 X 0 209619 27341 MARCHITA MARINO 2 X 0 259038 26281 KELLY SULLIVAN 2 X 0 217919 11686 DOREEN WOODS 2 X X 0 74559 10024 KAREN DAVILA 2 X X 0 6092 687 124150 2018483 180859 1 1 1 0 CROTHALL 955 CHESTERBROOK BLVD WAYNE PA 19087 CLEANING SERVICES 112744 1 0 0 0 0 0 580 0 580 RENT FROM RESIDENTS 623990 3770892 3770892 0 0 0 0 0 0 3770892 144 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 INCOME FROM OTHER MISC REVENUE 900099 12381 12381 0 0 0 0 0 0 12381 3783997 3783273 0 144 134992 134992 0 0 0 0 0 1277192 1277192 0 0 0 0 0 165856 165856 0 0 96560 96560 0 0 391919 391919 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24457 24457 0 0 335487 335487 0 0 0 0 0 0 0 0 0 0 1292615 1292615 0 0 1070 1070 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51816 51816 0 0 0 0 0 0 875 875 0 0 CONTRACT SERVICES 297564 297564 0 0 DUES & SUBSCRIBTION 2808 2808 0 0 RECRUITING EXPENSE 2269 2269 0 0 TAXES & LICENSES EXP -49003 -49003 0 0 CONTRACT LABOR 7519 7519 0 0 4033996 3899004 134992 0 758779 644352 1373663 1438532 28109 19097 101047 4962 0 0 0 0 34178 34328 2295776 2141271 272359 620306 9325 6251 733981 484600 1015665 1111157 X 1280111 1030114 0 0 0 0 1280111 1030114 2295776 2141271 X 0 1 1 X 0 X 0 0 0 0 580 580 3750226 3846759 4204615 4350666 3783853 19936119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3750226 3846759 4204615 4350666 3784433 19936699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19936699 936 1053 769 375 144 3277 0 0 0 0 0 0 936 1053 769 375 144 3277 0 0 0 0 0 0 0 0 0 0 0 0 3751162 3847812 4205384 4351041 3784577 19939976 0.99984 0.99984 0.00016 0.00016 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PROFESSIONAL LIABILITY CD 34328 34328 0 ACCRUE PROFESSIONAL LIAB 484600 484600 3783997 4033996 -249999 0 0 0 0 0 0 -249999 3771472 0 0 0 0 0 3771472 0 12525 12525 3783997 4033996 0 0 0 0 0 4033996 0 0 0 4033996 SchD_P10_S00_L00 Schedule D, Part X Professional liability CD SchD_P12_S00_L04b Schedule D, Part XII, Line 4b REVENUE FROM BEAUTY SHOP AND OTHER MISC RENTS 1 0 0 0 0 0 0 0 0 EMIL MILLER 0 521201 0 13886 0 107104 0 8250 0 26405 0 676846 0 0 GEORGE FAYER 0 288802 0 65682 0 84790 0 5305 0 27587 0 472166 0 0 BRIAN BODI 0 150244 0 0 0 19545 0 3134 0 24773 0 197696 0 0 KELLY SULLIVAN 0 181379 0 0 0 36540 0 715 0 10970 0 229604 0 0 JOHNETTE GINDLING 0 165219 0 17784 0 26615 0 3406 0 23935 0 236959 0 0 MARCHITA MARINO 0 169543 0 20790 0 68706 0 3982 0 22299 0 285320 0 0 DEBORALEE DAVIS 88949 0 0 0 35202 0 0 0 9386 0 133537 0 0 0 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 During 2009, Wuesthoff paid Karen Davila, Senior Vice-President, a severance payment of $6,092.16 for her years of service to the Wuesthoff Health Systems and its affiliates. F990_P06_S0B_L11 Form 990, Part VI, Section B, Line 11 Prior to filing the Form 990, management and accounting staff reviewed the draft. CFO, management and accounting provided comments. Based upon feedback received prior to finalization, revisions were made to the return. The board of directors received a final copy prior to filing. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c Wuesthoff Health Systems, Inc. and affiliates (referred to as "Wuesthoff") has established a Conflict of Interest policy which requires all board members and officers to affirm adherence to our conflict of interest policy and to disclose all related party transactions. The conflict of interest policy has been reviewed and approved by the Board of Directors. Wuesthoff's policy requires certain individuals to disclose participation in activities or circumstances that may present a conflict of interest on an annual basis or if at any time such individual becomes aware of circumstances that may present a conflict of interest. These disclosures are reviewed as necessary. The board of director reviews all potential transactions with related parties. The board of directors approves a transaction between Wuesthoff and a related party only when such transaction is determined to be in the best interests of Wuesthoff F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 A third party administrator (Hay Group) on behalf of the Executive/Compensation Committee of the Board of Directors annually conducts an independent review of the competitiveness of compensation for the executive team. The process includes documentation review to re-familiarize themselves with the organization to ensure a good understanding of the environment in which Wuesthoff operates. Each executive's role is assessed based on position, size and complexity. Compensation structure and each executive's placement in a salary grade are reviewed. A market analysis is done to determine base salary and total cash compensation ranges for each individual position. Recommendations for potential changes to salaries are then made to the Executive/Compensation Committee of the Board of directors for their review and implementation is necessary. The last review was done in August of 2009 of the following positions: Chief Executive Officer Chief Financial Officer Chief Operating Officer - Melbourne Chief Operating Officer - Rockledge Senior Vice President - Human Resources Senior Vice President - Chief Legal Senior Vice President - Marketing Vice President - Medical Affairs Vice President - Nursing Rockledge Vice President - Nursing Melbourne Vice President - Health Services President - Foundation Corporate Controller Vice President - Quality Assurance Vice President - Managed Service Organization Vice President - Support Services F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Wuesthoff does not make its governing documents or conflict of interest policy available to the public. Wuesthoff's Articles of Incorporation are available on www.sunbiz.org. The form 990 is based on the audited financial statements of Wuesthoff. F990_P07_S0A_L01a Form 990, Part VII, Section A, Line 1a OFFICERS AND KEY EMPLOYEES COMPENSATED BY RELATED ORGANIZATIONS WORK 40 HOURS PER WEEK. Wuesthoff Memorial Hospital Inc PO BOX 5655002 ROCKLEDGE FL 32955 590688798 HOSPITAL FL 501 (c) (3) exempt Line 3 Wuesthoff Health Systems Foundation Inc PO BOX 5655002 ROCKLEDGE FL 32955 593226582 FOUNDATION FL 501 (c) (3) exempt Line 7 Wuesthoff Health Services Inc PO BOX 5655002 ROCKLEDGE FL 32955 592432321 HOSPITAL SUPPORT SERVICES FL 501 (c) (3) exempt Line 3 Wuesthoff Progressive Care Center Inc PO BOX 5655002 ROCKLEDGE FL 32955 593759051 REHAB/NURSING HOME FL 501 (c) (3) exempt Line 9 WUESTHOFF HEALTH SYSTEMS INC PO BOX 5655002 ROCKLEDGE FL 32955 592432318 HOME OFFICE FL 501 (c) (3) exempt Line 11 Type 1 BREVARD CARDIOLOGY GROUP 1116 GEIGER ST ROCKLEDGE FL 32955 650732075 CARDIOLOGY PHYSICIANS FL N/A WUESTHOFF FAMILY PHYSICIANS 1116 GEIGER ST ROCKELDGE FL 32955 593398532 PHYSICIANS FL N/A WUESTHOFF HEALTH SYSTEM AUXILIARY 1116 GEIGER ST ROCKELDGE FL 32955 591008664 HOSPITAL AUXILIANS FL N/A SUNTREE DIAGNOSTIC CENTER 1116 GEIGER ST ROCKLEDGE FL 32955 593048318 DIAGNOSTIC SERVICES FL WUESTHOFF HEALTH SERVICES Related CARESPAN INC 1116 GEIGER ST ROCKLEDGE FL 32955 593401464 MANAGING SERVICE FL WUESTHOFF HEALTH SYSTEMS C 34576 2833959 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 WUESTHOFF HEALTH SYSTEMS INC o 146721 Wuesthoff Health Services Inc o 1468 Wuesthoff Memorial Hospital Inc p 73206 Wuesthoff Health Systems Foundation Inc p 2580 Wuesthoff Progressive Care Center Inc p 605