2011-07-08T11:10:20-05:00 2010-12-31 JOHNSON HICKEY & MURCHISON PC 651 E 4TH ST STE 200 CHATTANOOGA TN 37403 990 2010-01-01 581838041 THE SENIOR LIVING FOUNDATION INC SENI 7703999988 1530 DUNWOODY VILLAGE PKY NO 115 ATLANTA GA 303384138 WINSTON ALLEN PORTER III 7703999988 2011-05-23 JOEL D SUSMAN 4237560052 2010 2016-02-24 21:20:13Z X WINSTON ALLEN PORTER III DUNWOODY VILLAGE PKWY 115 ATLANTA GA 30350 9463622 0 X N/A X 2008 GA THE ORGANIZATION WAS FORMED TO PROMOTE HEALTH BY OFFERING ELDERLY CITIZENS VIABLE CHOICES IN ALTERNATE LIVING ARRANGEMENTS DESIGNED TO MEET THEIR VARIOUS LEVELS OF NEEDS. 5 0 317 76 0 0 0 9437260 175 26187 9463622 0 0 4489901 0 0 4833180 9323081 140541 16649122 16508581 140541 THE ORGANIZATION WAS FORMED TO PROMOTE HEALTH BY PROVIDING ELDERLY CITIZENS VIABLE CHOICES IN ALTERNATE LIVING ARRANGEMENTS DESIGNED TO MEET THEIR 0 0 8572184 9463447 CARE FOR THE ELDERLY WHICH INCLUDES INTERMEDIATE OR SKILLED NURSING CARE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY,AND EXTENSIVE ACTIVITIES PROGRAMMING. TOTAL PATIENT DAYS WERE 47,139 DURING THE YEAR ENDED 12/31/10. 8572184 1 0 0 0 0 0 0 0 0 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 0 1 0 0 0 1 0 0 0 0 1 1 0 0 0 0 1 14 0 317 1 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 1 0 GA X X THE SENIOR LIVING FOUNDATION INC 7703999988 1530 DUNWOODY VILLAGE PKY STE 115 ATLANTA GA 30338 WINSTON ALLEN PORTER III 12.00 X 50000 0 0 DAVID MARVIN 1.00 X 500 0 0 CHUCK POWELL 1.00 X 500 0 0 STEVE PICKIN 1.00 X 0 0 0 CHRIS MORRISON 1.00 X 500 0 0 GARY COCHRAN 40.00 X 92965 0 0 JEFF GABBERT 40.00 X 66102 0 0 LAURA GILLET RN 40.00 X 71738 0 0 CYNDY PASQUINELLY RN BSN 40.00 X 59712 0 0 51500 0 0 0 0 0 0 ENDURACARE PO BOX 53064 PHOENIX AZ 850723064 THERAPY SERVICES 628093 CENTRAL HEALTH SYSTEMS LLC 1530 DUNWOODY VILLAGE PKWY ATLANTA GA 30338 MANAGEMENT FEES 412500 TRI-MED PHARMACY PO BOX 890985 CHARLOTTE NC 282890985 PHARMACY 296426 GORDON FOOD SERVICE DEPT CH 10490 PALATINE IL 600550490 FOOD SERVICES 274419 MMS PO BOX 955588 ST LOUIS MO 631955588 MEDICAL SUPPLY 116564 5 NET PATIENT REVENUE 623000 9437260 9437260 9437260 175 175 HOME BASE REVENUE 623000 15745 15745 BEAUTY & BARBER 623000 7052 7052 MEALS 623000 2880 2880 510 510 26187 9463622 9463447 0 175 340517 131450 209067 3362331 3245497 116834 32339 29493 2846 428504 390422 38082 326210 295148 31062 412500 371250 41250 25038 22534 2504 1113243 1029976 83267 40015 40015 11567 6960 4607 212782 192532 20250 16652 14987 1665 17391 9061 8330 1087734 978961 108773 242265 218039 24226 129207 116286 12921 DRUG AND MEDICAL SUPPLI 430912 430912 LICENSES AND PERMITS 340224 340224 RAW FOOD 291548 291548 OTHER SUPPLIES 247476 209001 38475 BAD DEBT 134537 134537 80089 73351 6738 9323081 8572184 750897 0 540013 1119478 76913 6906507 235246 0 6671261 0 8241457 0 16649122 1154770 13734 10363489 350000 4468005 0 158583 0 16508581 X 0 140541 0 140541 0 16649122 140541 X 1 0 1 X 0 X 9463447 9463447 9463447 9463447 0 0 0 9463447 175 175 175 175 9463622 9463622 1.00000 0.00000 X 129651 129651 6606749 214846 6391903 170107 20400 149707 6671261 GOODWILL 8107191 NET DEFERRED FINANCING COSTS 104009 PATIENT TRUST FUNDS 30257 8241457 NOTE PAYABLE CROSSVILLE ASSOCIATES 128326 PATIENT TRUST FUNDS 30257 158583 THE HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF CROSSVILLE TN 2010-02-01 10363489 PURCHASE OF NURSING HOME 0 0 0 10363489 10363489 0 0 0 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 WINSTON PORTER OPERATIONS X 350000 350000 0 1 0 350000 CROSSVILLE ASSOCIATES LLC PART V 15000000 PURCHASE OF NURSING HOME 0 CENTRAL HEALTH SYSTEMS LLC PART V 412500 MANAGEMENT FEES 0 0 PART IV SECTION (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION WINSTON PORTER 99% OWNER IN CROSSVILLE ASSOCIATES LLC, IS THE FATHER OF THE MANAGING DIRECTOR WINSTON PORTER III. THE NURSING HOME WAS PURCHASED AT ARM'S LENGTH, INCLUDING INTEREST RATES AT OR BELOW BANKING INDUSTRY STANDARDS AND A PURCHASE PRICE THAT WAS AT OR BELOW FAIR MARKET VALUE BASED ON INDEPENDENT APPRAISALS.WINSTON PORTER OWNER OF MORE THAN 50% OF THE MANAGEMENT COMPANY IS THE FATHER OF WINSTON PORTER III WHO IS THE MANAGING DIRECTOR OF THE SENIOR LIVING FOUNDATION INC.THE MANAGEMENT COMPANY OFFERS A STANDARD CONTRACT THAT IS BE SIMILAR TO OTHERS IN THE INDUSTRY. THE PROPERTY BID OUT MANAGEMENT AGREEMENTS TO INSURE THAT ANY MANAGEMENT AGREEMENT RATE THAT THE NONPROFIT PAYS ARE KEPT AT OR BELOW FAIR MARKET VALUE FOR SUCH SERVICES FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WILL BE REVIEWED BY THE BOARD BEFORE IT IS FILED FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY THE BOARD FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. SLF NO1 LLC 456 WAYNE AVENUE CROSSVILLE TN 38555 271506824 NURSING HOME TN 9463622 16649122 THE SENIOR LIVING FOUNDATION INC SOLE MEMBER OF SLF NO1 LLC SLF NO1 LLC 456 WAYNE AVENUE CROSSVILLE TN 38555 271506824 NURSING HOME TN 501(C)3 LINE 9 THE SENIOR LIVING FOUNDATION INC SOLE MEMBER OF SLF NO1 LLC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART II SECTION (F) DIRECT CONTROLLING ENTITY THE SENIOR LIVING FOUNDATION INC. IS THE SOLE MEMBER OF SLF NO1 LLC