2011-09-12T09:06:23-05:00 2010-12-31 Moore Stephens Lovelace PA 311 Park Place Blvd Suite 100 Clearwater FL 33759 990 2010-01-01 592347336 Carpenter's Home Estates Inc CARP 8638583847 1001 Carpenters Way Lakeland FL 33809 Lou McCraney 8638583847 2011-09-12 1 Karin E Vickers 7275314477 2010 2016-02-24 21:20:13Z Lou McCraney 1001 Carpenters Way Lakeland FL 33809 16449513 0 X N/A X 1989 FL See Schedule O.The Estates at Carpenter's is a not-for-profit Continuing Care Retirement Community as defined in Florida Statute 651 and is dedicated to providing nursing and personal services to meet the spritual, social, emotional, physical and health needs of the residents and the community we serve. We strive to promote and enhance an environment that encourages dignity, personal growth, happiness and self-esteem while valuing a sense of purpose and independence, and we do this at the lowest possible cost to the resident. 7 7 379 92 0 0 17913 31217 16535199 16274003 886169 144293 0 0 17439281 16449513 6335 25031 0 0 7366191 8349439 0 0 0 7711420 7463433 15083946 15837903 2355335 611610 44353185 44365546 41018239 40418990 3334946 3946556 X The Estates at Carpenter's is a not-for-profit Continuing Care Retirement Community as defined in Florida Statute 651 and is dedicated to providing nursing and personal services to meet the spiritual, social, emotional, physical, and health needs of the residents and community we serve. We strive to promote and enhance an environment that encourages dignity, personal growth, happiness and self-esteem while valuing a sense of purpose and independence, and we do this at the lowest possible cost to the resident. 0 0 3778686 4264209 See Schedule O.Carpenter's Home Estates, Inc. ("the Estates") operates a 72 bed skilled nursing facility and participates in the Medicare and Medicaid programs. In 2010, 59% of the total patient days served in the nursing home were receiving lifecare benefits. Through their resident agreement, these residents receive a guarantee for the provision of services regardless of their ability to pay, as long as they have not disposed of their assets at less than fair market value. In addition, the Estates demonstrates commitment to the service and support of the indigent elderly population of the local community. In 2010, 15% of the total patient days in the skilled nursing component were for care provided to residents covered by the Medicaid program. In the Estates 25 year history, no resident has ever been asked to leave due to their inability to meet their financial obligations to the organization. 1059675 1195833 See Schedule O.Carpenter's Home Estates, Inc. operates a 49 unit assisted living facility with a licensed occupancy of 52 residents. The facility holds an extended congregate care license to allow for the provision of nursing services to the residents. This specialty license allows the facility to expand the number and types of services provided to the residents with the intent of allowing them to "age in place." This license and staffing pattern, which includes 24-hour a day nursing coverage, permits the residents to age with dignity and postpones their transfer to skilled nursing, which has a higher cost than assisted living. In 2010, 93% of the residents served in the assisted living facility were receiving lifecare benefits. Through their resident agreement, these residents receive a guarantee for the provision of services and support regardless of their ability to pay, as long as they have not disposed of their assets at less than fair market value. In the Estates 25 year history, no resident has ever been asked to leave due to their inability to meet their financial obligations to the organization. 9275179 31217 10466945 See Schedule O.Carpenter's Home Estates, Inc. operates 372 independent living apartments as part of the continuing care retirement community. The independent living apartments provide financial support to the operating activities of the skilled nursing facility and the assisted living facility. The Estates operates a Wellness Clinic staffed by licensed nurses to provide oversight of resident health concerns, communicate with medical providers to improve care and minimize waste, and to assist in the coordination of outside medical services. The resident agreement executed at admission to the community provides residents with a sense of security and peace of mind by guaranteeing the provisions of services and support for the rest of their lives and regardless of their ability to pay, as long as they have not disposed of their assets at less than fair market value. In the Estates 25 year history, no resident has ever been asked to leave due to their inability to meet their financial obligations to the organization. 14113540 1 1 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 27 0 1 379 1 0 0 0 0 0 0 0 0 0 0 X 7 7 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X John Thompson 8638583847 1001 Carpenters Way Lakeland FL 33809 Mallory Johnson 3.00 X X 0 0 0 Rev Dwight Edwards 3.00 X 0 0 0 Lou McCraney 3.00 X X 0 0 0 Dr Riley Short 3.00 X 0 0 0 Leo Gillman 3.00 X X 0 0 0 Lynne Breidenbach 3.00 X 0 0 0 Sammy Taylor 3.00 X 0 0 0 Brian Robare 40.00 X 123573 0 40255 John Thompson 40.00 X 126606 0 11316 250179 0 51571 2 0 1 0 Great West Health Care 1511 N Westshore Blvd 700 Tampa FL 33607 Health Insurance Provider 1079579 HMS of Lakeland Inc 1009 Carpenters Way Lakeland FL 33809 Management Services 663725 US Food Service Inc PO Box 281841 Atlanta GA 30384 Food Vendor 411526 Sysco Food Services 200 West Story Road Ocoee FL 34761 Food Vendor 316145 Pharmerica 735B West Highway 434 Longwood FL 32750 Pharmacy Supplies 212187 12 31217 31217 Assisted Living Revenu 623000 14364857 14364857 Medicare/Medicaid Paym 623000 1562130 1562130 Beauty Shop Income 900099 190397 190397 Resident Services 623000 156619 156619 16274003 144293 144293 16449513 15926987 0 491309 25031 25031 301750 301750 6449941 6251972 197969 57524 42572 14952 1004634 990230 14404 535590 464169 71421 539316 194154 345162 46296 35761 10535 32045 32045 98349 1952 96397 912237 850654 61583 36602 23085 13517 38390 19494 18896 1545694 1545694 1758017 1758017 375093 125453 249640 Dietary Food and Suppli 1358878 1305734 53144 Utilities 206105 206105 Charitable Care 135524 86386 49138 Postage and Freight 68253 3749 64504 Miscellaneous 55009 1668 53341 257625 181660 75965 15837903 14113540 1724363 0 215730 66398 5889727 7343778 575182 681583 270111 351741 46615 58276 354554 472365 47962827 20213141 28484690 27749686 8516576 7641719 44353185 44365546 1678390 1468998 13411223 13238004 24855000 24855000 1073626 856988 41018239 40418990 X 3334946 3946556 3334946 3946556 44353185 44365546 611610 0 X X 0 1 1 X 0 X 230209 190614 22977 17913 31217 492930 14760154 15503198 16834865 16593075 16261646 79952938 14990363 15693812 16857842 16610988 16292863 80445868 0 7373 7373 7373 7373 80438495 391417 442447 443917 886169 144292 2308242 391417 442447 443917 886169 144292 2308242 15381780 16136259 17301759 17497157 16437155 82754110 0.97200 0.96940 0.02790 0.03050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1775399 1775399 41669446 17252993 24416453 2659924 1749644 910280 1858058 1210504 647554 27749686 Deferred Financing Costs 664039 Investments Whose Use Is Limited 6896565 Utility Deposits 81115 7641719 Entrance Fee Deposits 246248 Refundable Entrance Fees 610740 856988 16449513 15837903 611610 0 611610 16453213 3700 3700 16449513 0 16449513 15837903 0 15837903 0 15837903 1 X Employee Emergency Assistance 40 25031 Amounts paid directly to creditors and other vendors on behalf of employees. Form 990, Schedule I, Part 1, Line 2: Grant Monitoring: The board is responsible for approving, monitoring and evaluating the payment of all grants and other assistance. The use of the grant funds are monitored by the organization making payments directly to creditors and vendors on behalf of the grant recipients. X X X X X 0 0 0 0 0 0 0 0 0 Brian Robare 123573 0 0 0 0 0 0 0 40255 0 163828 0 0 0 City of Lakeland Rev and Ref Bonds 2008 596000354 511727AH2 2008-05-01 26555000 See continuation statement below 0 0 0 1700000 26544437 2189838 1545694 13660414 762333 6686158 2009 0 1 1 1 0 1 0 0 0 0.00050 0.00050 1 0 0 0 0 0 0 Schedule K, Part I(f) Purpose of Series 2008 Bonds: The proceeds from the Series 2008 Bonds were used to finance certain expansions to the facilities on Carpenter's Home Estate's campus, advance refund the Series 1998 Bonds, and pay certain expenses related to the financing of the Series 2008 Bonds. Schedule K Additional Information Related to Bond Issuance: In April 2008, the Estates issued the City of Lakeland, Florida, Retirement Community First Mortgage Revenue and Refunding Bonds, Series 2008 (the "Series 2008 Bonds"), with yearly principal payments due in varying increasing installments in the amount of $550,000 beginning January 1, 2012, to $2,735,000 in January 1, 2043. The Series 2008 Bonds were issued to refinance the existing Series 1998 Bonds, construct and equip an additional 32 independent living units, and pay the cost of issuing the Series 2008 Bonds. The 32 independent living units were completed during the year ended December 31, 2009. Schedule K, Part I(C) Information pertaining to CUSIP of 2008 Series Bond Issue: The Series 2008 Bond Issue Consists of the Following: CUSIP No. 511727AH2, $8,555,000 5.875% Term Bonds Due January 1, 2019 CUSIP No. 511727AJ8, $3,630,000 6.25% Term Bonds Due January 1, 2028 CUSIP No. 511727AK5, $14,370,000 6.375% Term Bonds Due January 1, 2043 Schedule K, Part II, Line 3 Additional Information Related to Bond Issuance: The total proceeds for series 2008 bond issue are not identical to the issue price listed in Part I, Column (e), the difference is a underwriters discount of $10,563. HMS of Lakeland Inc Management Company 663725 Mgt. fee HMS provides operational management services to the organization. It is owned 75% by the organization's Executive Director, Health Care Administrator and Director of Operations. 0 Form 990, Part VI, Section A, line 2 John Thompson is the Executive Director and Matthew Thompson is the Health Center Administrator. They have a direct family relationship as father and son. In addition, they are both part owners of the Management Company, HMS of Lakeland. John Thompson, Matthew Thompson and Brian Robare are business partners through their ownership in the Management Company, HMS of Lakeland. Form 990, Part VI, Section A, line 3 The organization delegates control over management duties that are customarily performed by or under the direct supervision of officers, directors, trustees or key employees to HMS of Lakeland, Inc. The organization's Executive Director, Director of Operations and Administrator are three of the four owners of HMS. The Board of Directors believes that the management fee is reasonable based on the duties that are performed by the management company. The Board of Directors also believes that the management fee does not result in private inurement or an excess benefit transaction. Form 990, Part VI, Section B, line 11 The return is sent to the entire Board via email, comments are taken into consideration and the return is modified as necessary. A copy of the final return is provided to all of the voting members of organization's Board before it is filed with the IRS. Form 990, Part VI, Section B, line 12c The conflict of interest policy is reviewed with the Board of Directors and key employees on an annual basis. At this time, individuals are requested to declare areas of potential conflict. If any potential conflicts are identified, the Board approved policy is followed. Form 990, Part VI, Section B, line 15a The compensation of the Executive Director is reviewed and approved by the Executive & Finance Committees of the Board of Directors, which are made up of independent persons. The compensation is set based upon comparable data available from other similar organizations and online resources, such as Guidestar. The organization has contemporaneous documentation of the deliberation and decision to pay the compensation. Form 990, Part VI, Section C, line 19 The unaudited monthly financial statements are provided to our Board of Directors, the President of the resident association (CHERA), and two resident representatives to our Board of Directors. The unaudited quarterly and annual financial statements are provided to all existing residents of the community, posted quarterly on Municipal Securities Rulemaking Board (MSRB) website, and posted on the Florida Office of Insurance Regulation website. The audited annual financial statements are filed with the MSRB and the Florida Department of Insurance. A copy of the audited annual financial statements is provided to each Board member, the two resident representatives to the Board and the President of the CHERA. In addition, a summary of the annual financial statements is posted on our bulletin board and a copy is available in the business for inspection by the general public upon request. The governing documents and conflict of interest policy are available to the general public at our business location upon request. Oversight of Audit Form 990, Part XII, Line 2c The Audit Committee of the Board of Directors has responsibility for oversight of audit and selection of an independent accountant. The process has not changed from the prior year.