If you have further questions about this matter please do not hesitate to call.

Transcription

1 Senior Care Living V, LLC (Inspired Living at Windermere,FL) 8380 Bay Pines Blvd., 3'"^ Floor St. Petersburg, PL December 27, 2016 RE: Officers Certificate for Senior Care Living V, LLC (Inspired Living at Windermere, FL) Relating to the Monthly Reports-After the Issuance of a Certificate of Occupancy Issues Including: None I hereby certify that the unaudited financial reports filed on constitutes the monthly financial information required by the Continuing Disclosure Agreement. I further certify that the information complies with the Continuing Disclosure Agreement and the Rule as required. DAC shall be entitled to rely on this certificate. If you have further questions about this matter please do not hesitate to call. Mark Bouldin President Senior Care Living II, Inc.- Manager

2 CASH Balance Current Period Cash - Operating 397, TOTAL CASH 397, ACCOUNTS RECEIVABLE - RESIDENTS A/R - Resident 43, TOTAL ACCOUNTS RECEIVABLE - RESIDENTS 43, DUE TO/FROM Due to/from Senior Living I, LLC (IRL) Due to/from Senior Living III SRQ, LLC (ILS) Due to/from Senior Living IV Sun City, LLC (ILSC) Due to/from Senior Living VI Lakewood Ranch, LLC (ILLW Due to/from Senior Living VII Tampa, LLC (ILT) Due to/from Community Payroll, LLC 5, Due to/from Senior Living VIII Bonita Springs (ILBS) TOTAL DUE TO/FROM 7, PREPAID EXPENSES AND OTHER ASSETS Inventory 4, Inventory Emergency - Food 1, Prepaid AHCA 10, Prepaid Insurance Business 22, Prepaid Other 27, Prepaid Background Checks 2, TOTAL PREPAID EXPENSES AND OTHER ASSETS 69, RESTRICTED CASH Utility Deposits 2, TOTAL RESTRICTED CASH 2, FIXED ASSETS Land Improvements 18, Building 1, Furniture & Fixtures 38, Equipment 174, Vehicles 40, Computer Hardware 10, Computer Software 6, TOTAL FIXED ASSETS 290, TOTAL ASSETS 809, LIABILITIES & CAPITAL LIABILITIES Balance Sheet (With Period Change) ACCOUNTS PAYABLE Period = Jan 2016-Nov 2016 Book = Accrual ; Tree = ysi_bs Accounts Payable 58, Accrued Accounts Payable 46,256 12/27/2016 8:38 AM Page 1 of 2

3 Balance Sheet (With Period Change) Period = Jan 2016-Nov 2016 Book = Accrual ; Tree = ysi_bs Balance Current Period TOTAL ACCOUNTS PAYABLE 104, ACCRUED WAGES & BENEFITS Accrued Wages 168, Commissions Payable 40, Accrued Vacation 7, Employee Voluntary Life Insurance Short Term/Long Term Disability Vision / Dental HSA 1, TOTAL ACCRUED WAGES & BENEFITS 217, ACCRUED EXPENSES Accrued Workers Comp - IBNR 12, Prepaid Rent 170, Sales Tax Payable Other Accrued Expenses Deferred Forever Revenue 5, TOTAL ACCRUED EXPENSES 187, ACCRUED PROPERTY TAXES Accrued Property Taxes (1,328) TOTAL ACCRUED PROPERTY TAXES (1,328) ACCOUNTS PAYABLE-RELATED PARTY Due to/from Members 1,587, TOTAL ACCOUNTS PAYABLE-RELATED PARTY 1,587, TOTAL CURRENT LIABILITIES 2,096, MEMBERS EQUITY Retained Earnings, Current (1,286,296) TOTAL MEMBERS EQUITY (1,286,296) TOTAL LIABILITIES & CAPITAL 809,846 12/27/2016 8:38 AM Page 2 of 2

4 MEMORY CARE - FOREVER REVENUE Inspired Forever Program MC 189, , Deferred MC Forever Revenue (1,280) - (1,280) MEMORY CARE - FOREVER REVENUE 188, , MEMORY CARE - STANDARD REVENUE Inspired Standard Program MC - 95,682 (95,682) MEMORY CARE - STANDARD REVENUE - 95,682 (95,682) ASSISTED LIVING - FOREVER REVENUE Inspired Forever Program AL 269,582 94, , Deferred AL Forever Revenue (3,900) - (3,900) ASSISTED LIVING - FOREVER REVENUE 265,682 94, , ASSISTED LIVING -STANDARD REVENUE Level 2-7,875 (7,875) Level 3-7,875 (7,875) ASSISTED LIVING -STANDARD REVENUE - 15,750 (15,750) SECOND OCCUPANT REVENUE Second Occupant Revenue 2,518 2, SECOND OCCUPANT REVENUE 2,518 2, COMMUNITY FEES Community Fee Revenue 171,000 52, , COMMUNITY FEES 171,000 52, , CONCESSIONS Concession-Miscellaneous (22,874) - (22,874) Concession - Marketing Specials (49,279) - (49,279) CONCESSIONS (72,153) - (72,153) INCONTINENCE REVENUE Incontinence Supplies Revenue 17,609-17, INCONTINENCE REVENUE 17,609-17, ANCILLARY REVENUE Barber & Beauty Administrative Revenue Pet Service/Fee Revenue Maintenance Services Revenue (126) Transportation Revenue Gift Shop Revenue - 3,527 (3,527) Private Duty Aide - 51 (51) Furniture Purchase/Rental (126) ANCILLARY REVENUE 754 3,830 (3,076) TOTAL REVENUE 573, , , PAYROLL WAGES Director Wages 17,156 18,332 1, RN Wages 4,693 - (4,693) LPN Wages 27,078 44,039 16, Nursing Aides Wages (CNA/STNA) 29,978 24,222 (5,756) Page 1 of 10

5 Private Duty Aides (Med Tech) 5,438 - (5,438) Lead Med Tech Healthcare MC 1,579 - (1,579) Care Givers Wages 18,624 - (18,624) LPN Overtime 1,184 - (1,184) Nursing Aides Overtime 2,385 - (2,385) Med Tech and Lead Med Tech Overtime (533) Overtime Wages (240) Holiday Wages 843 2,184 1, PTO 360 3,640 3, HEALTHCARE MC LABOR 110,091 92,417 (17,674) PAYROLL WAGES Director Wages 22,721 20,668 (2,053) LPN Wages 42,750 45,507 2, Nursing Aides Wages (CNA/STNA) 11,243 - (11,243) Private Duty Aides (Med Tech) - 24,222 24, Care Givers Wages 16,899 - (16,899) LPN Overtime 1,007 - (1,007) Nursing Aides Overtime 3,009 - (3,009) Bonus 72 - (72) Holiday Wages 1,317 2,364 1, PTO 779 3,944 3, HEALTHCARE AL LABOR 99,797 96,705 (3,092) PAYROLL WAGES Program Director Wages 11,667 13,332 1, Program Coordinator Wages 5,630 8,412 2, Overtime Wages (286) Holiday Wages PTO ACTIVITIES MC LABOR 17,818 23,076 5, PAYROLL WAGES Program Director Wages 12,576 13, Program Coordinators AL 5,145 8,412 3, Overtime Wages (451) Holiday Wages PTO ACTIVITIES AL LABOR 18,300 23,076 4, PAYROLL WAGES Director Wages 2,742 18,332 15, Assistant Director Wages 10,238 - (10,238) Cooks Wages 30,874 13,488 (17,386) Chefs Wages 2,632 16,681 14, Prep Staff Wages 6,136 5,110 (1,026) Waitstaff Wages 33,461 14,679 (18,782) Page 2 of 10

6 Dishwashers Wages - 4,866 4, Staff Wages - 5,244 5, Bonus 1,000 - (1,000) Overtime Wages 14,197 - (14,197) Holiday Wages 1,487 2,652 1, PTO 633 4,420 3, DINING LABOR 103,399 85,472 (17,927) PAYROLL WAGES Housekeeper Wages 20,239 25,914 5, Overtime Wages (711) Holiday Wages PTO 116 1,244 1, HOUSEKEEPING LABOR 21,301 27,904 6, PAYROLL WAGES Director Wages 21,273 18,332 (2,941) Maintenance Wages 6,505 6,292 (213) Overtime Wages (229) Holiday Wages PTO 426 1, Jury Duty (376) MAINTENANCE LABOR 28,905 26,264 (2,641) PAYROLL WAGES Driver Wages 4,367 5,854 1, Overtime Wages 15 - (15) Holiday Wages PTO TRANSPORTATION LABOR 4,382 6,471 2, PAYROLL WAGES Director Wages 62,196 58,330 (3,866) Assistant Director Wages - 33,330 33, Move In Coordinator Wages 12,891 6,668 (6,223) Commissions 125,750 22,100 (103,650) Overtime Wages 1,112 - (1,112) Holiday Wages 120 2,308 2, PTO 726 4,810 4, SALES LABOR 202, ,546 (75,248) PAYROLL WAGES Executive Director Wages 56,795 96,870 40, Business Office Director Wages 11,432 16,902 5, HR Generalist 16,167 15,212 (955) Receptionist Wages 25,505 26,820 1, Commissions Administration 25,750 12,125 (13,625) Overtime Wages 2,158 - (2,158) Page 3 of 10

7 Holiday Wages 404 3,616 3, PTO 4,976 7,530 2, Bereavement 1,154 - (1,154) ADMINISTRATION LABOR 144, ,075 34, PAYROLL TAXES FICA Tax 8,205 7,071 (1,134) FUTA Tax (292) SUI TAX 2,246 1,564 (682) FICA Tax 7,776 7,398 (378) FUTA Tax (175) SUI TAX 2,265 1,584 (681) FICA Tax 1,316 1, FUTA Tax (59) SUI Tax (209) FICA Tax 1,395 1, FUTA Tax (74) SUI TAX (245) FICA Tax 7,709 6,539 (1,170) FUTA Tax (220) SUI TAX 1,863 1,204 (659) FICA Tax 1,617 2, FUTA Tax (62) SUI TAX (207) FICA Tax 2,197 2,009 (188) FUTA Tax (99) SUI TAX (264) FICA Tax FUTA Tax SUI TAX FICA Tax 12,167 10,261 (1,906) FUTA Tax (169) SUI TAX (401) FICA Tax 9,113 15,187 6, FUTA Tax (133) SUI TAX 1,443 1,130 (313) PAYROLL TAXES 64,583 62,738 (1,845) EMPLOYEE BENEFITS Employee Insurance (1,635) 1,374 3, Employee Hiring & Moving Uniform Expense 2,883 - (2,883) Employee Insurance (1,310) 2,202 3, Employee Hiring & Moving 155 1,250 1, Uniform Expense (101) Page 4 of 10

8 Employee Insurance (209) 1,100 1, Employee Hiring & Moving Uniform Expense (179) Employee Insurance (105) Employee Hiring & Moving Uniform Expense (221) Employee Insurance (843) 3,300 4, Employee Hiring & Moving 698 2,000 1, Uniform Expense 1,366 - (1,366) Employee Insurance (100) 1,374 1, Employee Hiring & Moving Uniform Expense 29 - (29) Employee Insurance Employee Hiring & Moving Uniform Expense (319) Employee Insurance Employee Hiring & Moving Employee Insurance (314) 3,435 3, Employee Hiring & Moving Uniform Expense (378) Employee Insurance 10,102 3,302 (6,800) Other Employee Insurance (300) Insurance - Life 32 - (32) Employee Hiring & Moving 2,522 1,000 (1,522) Uniform Expense 1,740 - (1,740) EMPLOYEE BENEFITS 17,517 25,714 8, WORKER'S COMPENSATION Worker's Compensation 17,789 34,191 16, WORKER'S COMPENSATION 17,789 34,191 16, TOTAL LABOR COST 851, ,649 (40,367) Allocation of Dining Expense (139) Contract Services 1, (893) Office Supplies Healthcare MC 5,490 - (5,490) Forms & Printing (314) Non-Billable Medical Supplies 4,569 4,134 (435) Incontinency Supplies 1,367 - (1,367) Infectious Waste Disposal (158) Equipment Rental/Purchases 3,179 - (3,179) Training & Education 1,309 - (1,309) Travel - Local Mileage/Gas (674) HEALTHCARE MC NON LABOR 18,272 4,314 (13,958) Contract Services (220) Office Supplies Healthcare AL 1,222 - (1,222) Page 5 of 10

9 Non-Billable Medical Supplies 759 4,134 3, Incontinency Supplies 1,407 - (1,407) Equipment Rental/Purchases (146) Travel - Local Mileage/Gas (247) HEALTHCARE AL NON LABOR 4,181 4, Allocation of Dining Expense 1,081 - (1,081) Minor Furniture & Fixtures (122) Entertainers (150) Office Supplies Activities MC 217 2,645 2, Forms & Printing (124) Activities & Travel Revenue (181) Reimbursable Entertainment Exp (181) Subscriptions 10 - (10) Resident Activities (569) Equipment Rental/Purchases (798) Training & Education (323) Meetings and Conferences Activities MC (119) Travel - Meals & Entertainment 61 - (61) Travel - Local Mileage/Gas 65 - (65) Travel - Hotel (135) Resident Activity Startup Supplies 9,294 - (9,294) ACTIVITIES MC NON LABOR 13,069 2,645 (10,424) Contract Services (170) Entertainers (760) Office Supplies Activities AL - 4,134 4, Forms & Printing 66 - (66) Resident Gifts (147) Special Events (202) Subscriptions 16 - (16) Resident Activities (292) Travel - Local Mileage/Gas (421) Resident Activity Startup Supplies (630) ACTIVITIES AL NON LABOR 2,883 4,314 1, Allocation of Dining Expense (1,772) - 1, Guest Meals (1,200) - 1, Employee Meals (396) Raw Food 31,863 10,407 (21,456) Chemicals 2,464 - (2,464) Dishes / Utensils 349 1,776 1, Paper Goods 1,205 - (1,205) Inventory Change - Mth (4,523) - 4, Repairs & Maintenance Dining (698) Contract Services Page 6 of 10

10 Supplies Dining 3,016 1,457 (1,559) Office Supplies Dining (218) Forms & Printing 66 - (66) Linen Costs 1,557 - (1,557) Equipment Rental/Purchases 1,565 - (1,565) Training & Education 35 - (35) Meetings and Conferences Dining (475) Travel - Meals & Entertainment 42 - (42) Travel - Local Mileage/Gas 1,181 - (1,181) Travel - Hotel 95 - (95) DINING NON LABOR 37,292 14,440 (22,852) Housekeeping Supplies 10,487 4,090 (6,397) HOUSEKEEPING NON LABOR 10,487 4,090 (6,397) Fire Inspection & Training 579 2,400 1, Repairs & Maintenance 1,451 - (1,451) Between Tenant Renovations Minor Furniture & Fixtures 1,220 - (1,220) Pest Control 1,400 1, Contract Services 1,927 3,300 1, Supplies Maintenance 13,795 6,514 (7,281) Forms & Printing (133) Property landscaping 12,894 8,332 (4,562) Equipment Rental/Purchases 1,395 - (1,395) Travel - Meals & Entertainment 10 - (10) Travel - Local Mileage/Gas (403) Travel - Hotel (398) MAINTENANCE NON LABOR 35,604 22,546 (13,058) Auto Exp - Gas (556) Automobile Expense (Other) TRANSPORTATION NON LABOR 1, (308) Collateral Printing 11,937 - (11,937) Design Charges 8,500 - (8,500) Print Media Marketing 51,369 35,000 (16,369) Direct Mail 29,165 40,000 10, Direct Mail Postage 38,523 50,000 11, Newspaper Inserts 18,700 - (18,700) Miscellaneous Advertising - 45,000 45, Advertising Tracking (598) Digital Media Marketing 1,820 - (1,820) Promotional Items 8,176 30,000 21, Signage Marketing 3,868 - (3,868) Contract Services (830) Printing & Photography (313) Page 7 of 10

11 Travel - Hotel 62 - (62) MARKETING NON LABOR 173, ,000 26, Allocation of Dining Expense (590) Minor Furniture & Fixtures (803) Creative Follow-up 3,527 12,500 8, Outreach/Community Relations 3,006 12,500 9, Corporate Allocation - Sales 27,721 38,580 10, Contract Services 8,043 1,250 (6,793) Entertainers Sales - 11,250 11, Office Supplies Sales 1,069 - (1,069) Forms & Printing - Sales (587) Resident Gifts (450) Special Events 4,394 12,500 8, Subscriptions 5 - (5) Postage & Freight (297) Meals & Entertainment Sales (100) Lease Cost - Equipment 19,897 - (19,897) Training & Education (184) Meetings and Conferences Sales 1,591 - (1,591) Employee Recognition / Awards (132) Travel - Local Mileage/Gas 1,403 - (1,403) Travel - Parking Expense 6 - (6) SALES NON LABOR 73,805 88,580 14, Minor Furniture & Fixtures 5,175 1,211 (3,964) Sponsorships 3,500 - (3,500) Referrals 40,613 - (40,613) Corporate Allocation - Administration 66,070 29,480 (36,590) Payroll Processing Fees 6,148 3,000 (3,148) Contract Services 2,288 6,000 3, Barber & Beauty Revenue (1,144) - 1, Contract Services 2,268 - (2,268) Supplies Administration 7,342 - (7,342) Office Supplies Administration 5,020 5,014 (6) Forms & Printing (483) Charitable Contributions 50 - (50) BW and Color Copies Administration 3,170 - (3,170) Special Events 49,204 70,000 20, Subscriptions (796) Software Support Fees 5,594 5, Merchant Services Fees (120) Postage & Freight (226) Delivery (342) Bank Fees (506) Page 8 of 10

12 Late Fees/Penalties/Srvc Chgs (296) Licenses/Permits 2,391 1,668 (723) Meals & Entertainment 46 - (46) Unallocated Lease Cost - Equipment 1,581 - (1,581) Equipment Rental/Purchases 1,210 - (1,210) Holiday Party (843) Computer Supplies/Repairs (129) Training & Education 5,476 - (5,476) Meetings and Conferences (544) Employee Recognition / Awards 5,452 - (5,452) Travel - Meals & Entertainment (317) Travel - Local Mileage/Gas 1,931 - (1,931) Travel - Parking Expense 2 - (2) Travel - Hotel (852) Telephone - Cell 2, (2,222) Cable - 1,668 1, Internet 4,893 2,668 (2,225) Telephone 4,819 2,500 (2,319) ADMINISTRATION NON LABOR 231, ,773 (101,734) TOTAL NON LABOR COST 602, ,940 (126,253) TOTAL CONTROLLABLE COST 1,453,209 1,286,589 (166,620) UTILITIES Water & Sewer 9,926 12,500 2, Trash Removal 3,117 8,332 5, Gas 3,831 8,332 4, Electric 63,883 54,168 (9,715) UTILITIES 80,757 83,332 2, PROFESSIONAL FEES Legal Fees 1,564 - (1,564) Accounting Fees - 1,332 1, PROFESSIONAL FEES 1,564 1,332 (232) MANAGEMENT FEES Management Fee Expense 250, ,000 25, MANAGEMENT FEES 250, ,000 25, PROPERTY TAXES Taxes - Real Estate 28,863 65,000 36, PROPERTY TAXES 28,863 65,000 36, INSURANCE Insurance - Property 14,297 28,484 14, Insurance - Liability 8,723 7,828 (895) Insurance - Automobile 7,647 1,000 (6,647) Insurance - Excess Liability 6,932 20,200 13,268 Page 9 of 10

13 Insurance - Crime (272) Insurance - EPLI (460) INSURANCE 38,330 57,512 19, TOTAL NON-CONTROLLABLE COSTS 399, ,176 82, TOTAL EXPENSES 1,852,723 1,768,765 (83,958) NET OPERATING INCOME (LOSS) (1,278,933) (1,504,588) 225, NON OPERATING EXPENSES Non Operating Expenses 6,000 - (6,000) NON OPERATING EXPENSES 6,000 - (6,000) NET INCOME (LOSS) (1,284,933) (1,504,588) 219,655 Statement of Cash Flows: Net Loss (1,284,933) Increase in Current Assets (121,838) Increase in Current Liabilities 507,534 Cash used in Operations (899,237) Purchase of Fixed Assets (290,769) Borrowings on Long-term debt 1,587,243 Increase in Cash 397,237 Cash - beginning of period - Cash - end of period 397,237 Occupany as of November 30, Page 10 of 10