2011-05-13T09:26:55-05:00 2010-09-30 Gene R Solomon CPA 1342 Colonial Blvd Ste B-11 Fort Myers FL 33907 990 2009-10-01 650610085 Cypress Cove at HealthPark Florida Inc CYPR 2394890023 10200 Cypress Cove Drive Ft Myers FL 33908 JOHN A NOLAND 2394890023 2011-05-10 1 Gene R Solomon CPA 2399395303 2011-05-05 X 2009 2016-02-24 21:20:13Z JOHN A NOLAND 1715 MONROE ST FORT MYERS FL 33901 27135881 0 X cypresscoveliving.org X 1995 FL TO PROVIDE OUR RESIDENTS WITH RETIREMENT OR ASSISTED LIVING AND SKILLED NURSING SERVICES THAT MEETS THEIR NEEDS. 10 10 365 140 0 0 0 25721880 25301387 1323442 1265321 485930 569173 27531252 27135881 0 0 8678959 9022744 0 0 19173652 19501812 27852611 28524556 -321359 -1388675 103207068 98720575 116015004 112917186 -12807936 -14196611 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 19276490 20541457 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. 6087313 6594424 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. 25363803 1 0 0 0 0 0 0 0 0 1 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 1 54 0 365 1 0 0 0 0 0 0 0 0 0 0 0 10 10 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 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 X 0 0 0 JOHN A NOLAND 3.00 X X 0 0 0 DAVID G ROBINSON PHD 1.00 X 0 0 0 E BRUCE STRAYHORN 2.00 X X 0 0 0 JO ELLEN BEAUVOIS 1.00 X 0 0 0 CARL A BARRACO 1.00 X 0 0 0 CHARLES EDWARDS SR 1.00 X 0 0 0 JOSEPH CATTI 1.00 X 0 0 0 Timothy D Ficker 45.00 X X X 174424 0 0 Jay A GROESSER 45.00 X 126742 0 28329 Kevin Mannix 45.00 X 102310 0 27384 SANDRA D REGAL 45.00 X 102160 0 22532 Edward KUNZWEILER 45.00 X 163179 0 18915 668815 0 97160 5 1 1 0 LEE FP INC 9800 S HEALTHPARK DRIVE STE 350 FORT MYERS FL 33908 MANAGEMENT FEE 601375 SELECT MEDICAL REHABILITATION SVCS PO BOX 643920 PITTSBURGH PA 15264 THERAPY: PHYSICAL, SPEECH, OCCUPATIONAL 539170 LEE FP INC 9800 S HEALTHPARK DRIVE STE 350 fORT MYERS FL 33908 Marketing Employee Costs 406648 CLA Landscaping Inc 5685 YOUNGQUIST RD FORT MYERS FL 33912 LANDSCAPING 344873 Rxperts Pharmacy Services 4032 N 29th AVe Hollywood FL 33020 pharmacy services 167171 5 MONTHLY SERVICE 900099 12208104 12208104 ASSIST. LVG & NURSING 900099 6594423 6594423 MEMBERSHIP 900099 6498860 6498860 25301387 673508 673508 591813 591813 591813 591813 Unrealized Gain on Inv 900099 410249 410249 MISCELLANEOUS 900099 158924 158924 569173 27135881 27135881 0 0 168331 168331 7356086 6843120 512966 175590 175590 732039 732039 590698 492650 98048 76647 76647 47700 47700 128502 128502 986036 986036 72206 29541 42665 132297 11990 120307 3885910 3885910 34405 5979 28426 4697819 4697819 3316740 3316740 1424635 1423555 1080 DINING SERVICES 1368972 1368972 NURSING SERVICES 1360946 1360946 GENERAL & ADMINISTRATIV 1028452 1028452 GROUND LEASE 914256 914256 RESIDENT SERVICES 26289 26289 28524556 25363803 3160753 0 6297798 4210600 660793 675914 1212950 1376043 83898 87121 440001 893911 96677263 28500695 70312428 68176568 17191474 16903665 6895614 6182329 112112 214424 103207068 98720575 5033413 3523732 65153957 62935477 3370000 2571553 42457634 43886424 116015004 112917186 X -12807936 -14196611 -12807936 -14196611 103207068 98720575 X 0 1 1 X 0 X 7973713 7766648 7002220 6548267 6498860 35789708 17411196 18301075 18248819 18740987 18802527 91504604 25384909 26067723 25251039 25289254 25301387 127294312 0 0 0 127294312 1376655 2107131 1134324 734808 673508 6026426 1376655 2107131 1134324 734808 673508 6026426 519023 511453 587796 1507190 1160986 4286448 27280587 28686307 26973159 27531252 27135881 137607186 0.92510 0.92760 0.04380 0.04610 X 1313786 1313786 87930369 22519626 65410743 7433108 5981069 1452039 68176568 ASSETS WHOSE USE IS LIMITED - BOND INDENTURE 10247458 F ASSETS WHOSE USE IS LIMITED - CONTINUING CARE 6656207 F 16903665 GROUND LEASE PAYABLE 7264341 UNEARNED ENTRANCE FEES 36622083 43886424 27135881 28524556 -1388675 0 -1388675 27135881 0 27135881 0 27135881 28524556 0 28524556 0 28524556 Part X, Line 2 - FIN 48 footnote disclosure: During fiscal year 2010, Cypress Cove was required to implement Accounting Standards Codification (ASC) 740-10, Income Taxes as it relates to uncertain tax positions for the year ended September 30, 2010 and has evaluated its tax positions taken for all open tax years. Based on an evaluation of Cypress Coves 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, 2010. X X X X X 0 0 0 0 0 1 0 0 0 Timothy D Ficker 174424 0 0 0 0 0 0 0 0 0 174424 0 0 0 Jay A GROESSER 123992 0 2750 0 0 0 13937 0 14392 0 155071 0 0 0 Edward KUNZWEILER 112476 0 50703 0 0 0 9791 0 9124 0 182094 0 0 0 Part I, Line 6 A bonus plan was available to the extent if there was a positive variance in the net operating income used to calculate the Net Operating Margin Ratio-CCAC above the approved 2010 budget. If this objective was met, a maximum percentage of 3% of salary was available for improving occupancy and a maximum percentage of 3% of salary for meeting department quality improvement goals. An additional maximum $3,000 was available for improving resident and employee satisfaction. 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. 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 compensation committee consisting of the CEO and the CFO from the oversight management company (Lee FP, Inc) and the board president which 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. Form 990, Part XI, Line 2c: Audit Oversight Committee and selection of independent accountant: 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 SUPPORTS LEE MEMORAL HEALTH SYSTEM AND ITS PUBLIC HOSPITAL FUNCTIONS. FL 501(c)(3) 509(a)(3) N/A 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 1 0 LEE MEMORIAL HOSP INC DBA LEE HEALTHCARE RESOURCES (LHR)-GROUND LS PAY E 7264341 LEE HEALTH VENTURE INC (LHV) BOND PURCHASE AGRMT - 2 E 430000 LHR - RENT J 914256 LEE FP INC - MANAGEMENT FEES L 601375 LHR - PLEDGE FEE L 18750 LEE FP INC - MARKETING SERVICES & EMPLOYEE COSTS L 406648 LHR - MAINTENANCE FEES ON MEDICAL PLAZE ONE BLDG P 14025 LHV BOND PURCHASE AGRMT - 2 Q 1070000 LHV BOND PURCHASE AGRMT - 1 Q 375000