2024-05-15T10:26:13-05:00 2023-06-30 593070669 MSL PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2022-07-01 591837338 SUSANNA WESLEY HEALTH CENTER INC SUSA 3055563500 5345 WEST 18TH AVENUE HIALEAH FL 33012 REV RUBEN VELASCO CHAIR 3055563500 2024-05-15 1 REV RUBEN VELASCO 999009999 1 HARRY E HARP CPA P00176471 4077405400 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z REV RUBEN VELASCO 5345 WEST 18TH AVENUE HIALEAH FL 33012 22387995 0 X WWW.EPWORTHVILLAGERC.COM X 1978 FL PROVIDE ELDERLY AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES DESIGNED TO MEET THEIR NEEDS. X 8 5 0 7 0 0 90000 0 1304052 1087607 625 16661649 0 0 1394677 17749256 0 0 0 0 40000 0 0 0 0 1440936 1923394 1480936 1923394 -86259 15825862 6170411 1778513 10852044 18500 -4681633 1760013 THE ORGANIZATION PROVIDES ELDERLY PERSONS AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES ESPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS THROUGH THE LEASE OF A SKILLED NURSING FACILITY TO ITS SUPPORTED 501(C)(3) TAX-EXEMPT AFFILIATE. 0 0 1197148 1087607 THE ORGANIZATION LEASES A FACILITY USED AS A SKILLED CARE NURSING HOME FOR THE HOUSING AND CARE OF THE ELDERLY AND SUPPORTS THE LESSEE IN OPERATING THE FACILITY IN A CHARITABLE MANNER. 1197148 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 1 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X CHANTAL FALBY 3055563500 5345 WEST 18TH AVENUE HIALEAH FL 33012 MADELYN SIMON LOZANO EXECUTIVE DIRECTOR 10.00 30.00 X X 0 40000 0 REV RUBEN VELASCO VICE-CHAIR 5.00 10.00 X X 0 0 0 MICHELLE DUNAJ LUCKING DIRECTOR 5.00 10.00 X 0 0 0 JUDITH PIERRE-OKERSON DIRECTOR 5.00 10.00 X 0 0 0 GERTRUDE STEWART DIRECTOR 5.00 10.00 X 0 0 0 BELINDA BACON CHAIR 5.00 10.00 X X 0 0 0 DR DIANE NETTO DIRECTOR 5.00 10.00 X 0 0 0 REV CYNTHIA WEEMS DIRECTOR 5.00 10.00 X 0 0 0 0 40000 0 0 0 0 0 0 RENTAL INCOME FROM AFFILIATE 531110 978039 978039 OTHER PROGRAM REVENUE 531110 109568 109568 1087607 1654 1654 21298734 4638739 16659995 16659995 16659995 17749256 1087607 0 16661649 58719 58719 40700 40700 80450 80450 726 726 183907 183907 330790 330790 327083 297636 29447 248991 59072 189919 MISCELLANEOUS 326285 326285 PREPAYMENT EXPENSE 325743 325743 1923394 1197148 726246 0 106090 943668 194345 136277 0 4714495 1213549 640500 6170411 1778513 59739 18500 10778007 14298 0 10852044 18500 X -4681633 1760013 -4681633 1760013 6170411 1778513 X 15825862 -9384216 X X 0 1 X 1 1 1 X X 1 ALDERSGATE HEALTHCARE INC 161676092 10 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 SCHEDULE A, PART I, LINE 12, COLUMN (VI) THE FILING ORGANIZATION SUPPORTS IT SUPPORTED ORGANIZATION THROUGH THE PROVISION AND LEASE TO ITS SUPPORTED ORGANIZATION OF LAND, BUILDINGS, AND PERSONAL PROPERTY THAT CONSTITUTES THE SKILLED NURSING FACILITY OPERATED BY ITS SUPPORTED ORGANIZATION. THE FILING ORGANIZATION AND ITS SUPPORTED ORGANIZATION ARE RELATED TAX-EXEMPT ORGANIZATIONS. SCHEDULE A, PART IV, SECTION A, LINE 1 THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION STATE THAT SUSANNA WESLEY HEALTH CENTER, INC. IS ORGANIZED TO PROVIDE ELDERLY PERSONS AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES ESPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS. IN ACCORDANCE WITH ITS CHARITABLE PURPOSE, THE FILING ORGANIZATION LEASES REAL AND PERSONAL PROPERTY THAT CONSTITUTES A SKILLED NURSING FACILITY TO ALDERSGATE HEALTHCARE, INC., A RELATED 501(C)(3) ORGANIZATION, THAT OPERATES THE FACILITY. SCHEDULE A, PART IV, SECTION D, LINE 3 THE FILING ORGANIZATION SUPPORTS ALDERSGATE HEALTHCARE, INC. (THE SUPPORTED ORGANIZATION). THE PRIMARY ACTIVITY OF THE FILING ORGANIZATION IS TO OWN REAL AND PERSONAL PROPERTY THAT CONSTITUTES A SKILLED NURSING FACILITY AND LEASE SUCH PROPERTY TO THE SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. THE SUPPORTED ORGANIZATION HAS A SIGNIFICANT VOICE IN DIRECTING THE USE OF THE FILING ORGANIZATION'S ASSETS THROUGH THE OVERLAP OF THE EXECUTIVE DIRECTOR AND CERTAIN BOARD MEMBERS THAT PARTICIPATE IN THE GOVERNANCE OF BOTH ORGANIZATIONS. AS PRESCRIBED IN THE LEASE AGREEMENT PERTAINING TO THE SKILLED NURSING FACILITY, THE FILING ORGANIZATION IS RESPONSIVE TO THE NEEDS OF ITS SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. SCHEDULE A, PART IV, SECTION E, LINE 2A THE FILING ORGANIZATION SUPPORTS ALDERSGATE HEALTHCARE, INC. (THE SUPPORTED ORGANIZATION). THE SOLE ACTIVITY OF THE FILING ORGANIZATION IS THE LEASE OF REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY TO THE SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. THE ACTIVITY OF HOLDING TITLE TO AND LEASING THE SKILLED NURSING FACILITY TO THE SUPPORTED ORGANIZATION IS A DIRECT FURTHERANCE ACTIVITY AS THE FILING ORGANIZATION'S ASSETS ARE USED IN CARRYING OUT THE EXEMPT PURPOSE OF PROVIDING HOUSING AND SERVICES TO ELDERLY PERSONS AND HANDICAPPED PERSONS. PLEASE SEE OUR RESPONSE FOR SCHEDULE A, PART IV, SECTION D, QUESTION 3 REGARDING HOW THE FILING ORGANIZATION IS RESPONSIVE TO THE NEEDS AND DEMANDS OF THE SUPPORTED ORGANIZATION. SCHEDULE A, PART IV, SECTION E, LINE 2B THE ACTIVITY OF OWNING TITLE TO AND LEASING REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY TO ITS SUPPORTED ORGANIZATION IS AN ACTIVITY THAT, BUT FOR THE INVOLVEMENT OF THE FILING ORGANIZATION, THE SUPPORTED ORGANIZATION WOULD BE REQUIRED TO ENGAGE IN. WERE IT NOT FOR THE FILING ORGANIZATION, THE SUPPORTED ORGANIZATION WOULD EITHER BE REQUIRED TO PURCHASE THE REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY OR LEASE SUITABLE PROPERTY IN ORDER TO CONDUCT ITS BUSINESS OF OPERATING A SKILLED NURSING FACILITY AND PROVIDING THESE NECESSARY SERVICES TO THE COMMUNITY. 0 ESCROW RECEIVABLE 640500 640500 X 8365040 -9384216 -9384216 17749256 0 17749256 1923394 0 1923394 0 1923394 PART X, LINE 2: THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES, AS IT IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: TRANSFER OF NET ASSETS -9,384,216. MSL PUBLIC RELATIONS LLC ENTITY MORE THAN 35% OWNED BY MADELYN SIMON LOZANO, EXECUTIVE DIRECTOR 40000 INDEPENDENT CONTRACTOR COMPENSATION 0 THE ORGANIZATION TRANSFERRED FUNDS TO EPWORTH VILLAGE, INC. THAT WERE OBTAINED FROM THE SALE OF THE FACILITIES DURING THE YEAR ENDED JUNE 30, 2023. THESE FUNDS BEAR NO REPAYMENT REQUIREMENTS TO THE COMPANY AND ARE UNRESTRICTED. 2023-04-30 9384216 FAIR MARKET VALUE 590589990 EPWORTH VILLAGE INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 501(C)(3) 1 1 0 0 PART II, LINE 2E: PERSON(S) INVOLVED: MADELYN SIMON LOZANO, ELVIRA MOUNTAIN, REV. RUBEN VELASCO, JUDITH PIERRE-OKERSON, GERTRUDE STEWART, MICHELLE DUNAJ LUCKING, CHANTAL FALBY, PAUL MOSKOWITZ. PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: THE ORGANIZATION SHARES BOARD MEMBERS WITH EPWORTH VILLAGE, INC.MSL PUBLIC RELATIONS, LLC , AN ENTITY MORE THAN 35% OWNED BY MADELYN SIMON LOZANO, EXECUTIVE DIRECTOR, PROVIDES PROFESSIONAL SERVICES TO SUSANNA WESLEY HEALTH CENTER, INC.SUSANNA WESLEY HEALTH CENTER TRANSFERRED FUNDS TO EPWORTH VILLAGE WEST IN THE AMOUNT OF $9,384,216 THAT WERE OBTAINED FROM THE SALE OF THE NURSING HOME DURING THE YEAR ENDED JUNE 30, 2023. THESE FUNDS BEAR NO REPAYMENT REQUIREMENTS TO THE COMPANY AND ARE UNRESTRICTED.SUSANNA WESLEY HEALTH CENTER WILL NOT BE FULLY DISSOLVED UNTIL ALL ESCROW ACTIVITIES FROM THE SALE AND PAYMENTS OF ALL LIABILITIES HAVE BEEN COMPLETED. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR. A COPY OF THE FORM 990 IS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS BEFORE ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE ANNUAL DISCLOSURE PROCESS AND PROHIBITS OFFICERS AND DIRECTORS FROM VOTING ON MATTERS WHERE ACTUAL CONFLICTS OF INTEREST EXIST. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS COMPENSATED AS AN INDEPENDENT CONTRACTOR AS APPROVED BY THE BOARD OF DIRECTORS. SEE SCHEDULE L, PART IV FOR FURTHER INFORMATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER -9,384,216. FORM 990, PART XII, LINE 2C THE FINANCIAL COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGNT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. EPWORTH VILLAGE INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 590589990 FUND RAISING FOR RELATED TAX-EXEMPT ORGANIZATIONS FL 501(C)(3) LINE 12B, II N/A 0 EPWORTH VILLAGE WEST INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 591920293 LEASE OF RETIREMENT LIVING FACILITY TO RELATED ORGANIZATION FL 501(C)(3) LINE 12C, III-FI N/A 0 ALDERSGATE HEALTHCARE INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 161676092 OPERATES SKILLED NURSING FACILITY FL 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0