2019-10-04T07:19:59-05:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 610 W GERMANTOWN PIKE STE 400 PLYMOUTH MEETING PA 19462 990 2018-01-01 521761391 KESWICK PINES INC KESW 7328490400 509 ROUTE 530 WHITING NJ 08759 GEORGINA BAVAIS CHIEF FINANCIAL OFFICER 7328490400 2019-10-03 1 SETH BRODY CPA P01586423 2156433900 67.137.57.251 2019-10-03 13:34:33 ED P 73165959F041044F9DC26414D498D34F5ABB8EC7 AE419FF41DEE4B5733E7E5F8E31ABE2574D75352 2018 2020-01-14 16:20:31Z THE PINES AT WHITING ERIC GHAUL 509 ROUTE 530 WHITING NJ 08759 19424734 0 X WWW.THEPINESATWHITING.ORG X 1989 NJ SERVES THE ELDERLY THROUGH APARTMENT LIVING, ASSISTED LIVING, AND NURSING HOME CARE. 10 10 378 60 0 0 56891 145814 18254990 18317696 44029 226040 553623 569756 18909533 19259306 28787 37051 0 0 9261852 9561746 0 0 0 7433331 7048969 16723970 16647766 2185563 2611540 29467070 29424705 34258274 32130552 -4791204 -2705847 X GUIDED BY CHRISTIAN PRINCIPLES, THE PINES AT WHITING SEEKS TO BUILD A CARING AND RESPECTFUL COMMUNITY OF TRUSTEES, RESIDENTS AND STAFF THAT SERVES THE PHYSICAL, SOCIAL, EMOTIONAL AND SPIRITUAL NEEDS OF SENIOR ADULTS THROUGH RESIDENTIAL LIVING AND HEALTH CARE. 0 0 14729528 37051 18317696 THE PINES AT WHITING OFFERS INDEPENDENT LIVING APARTMENTS WITH 24 HOUR EMERGENCY CALL SERVICE AND HOME CARE SUPPORTIVE SERVICES AS WELL AS HEALTH CARE SERVICES INCLUDING: ASSISTED LIVING, MEMORY SUPPORT, SKILLED NURSING/REHABILITATION AND LONG TERM CARE PROGRAMS. DURING 2018, THE PINES MADE A SUBSTANTIAL CONTRIBUTION TO THE GREATER WHITING AREA COMMUNITY. THESE COMMUNITY OUTREACH ACTIVITIES RANGED FROM: 1.) DONATIONS TOTALLING $300 TO A RESIDENT'S CAUSE, AN ORPHANAGE IN COSTA RICA. DONATIONS FROM STAFF THROUGH DRESS DOWN DAY, E. GHAUL FROM A PERSONAL DONATION, AND FROM THE PINES.2.) $500 SPONSORSHIP OF AMERICA'S KESWICKS FREEDOM WALK3.) AMERICA'S KESWICK ANNUAL DONATION OF $2,500 4.) HELD THE MEETING FOR MONMOUTH OCEAN COUNTY ACTIVITY PROFESSIONALS AT THE PINES, COSTING $300.5.) DONATION FROM PINES EMPLOYEE ASSISTANCE FUND FOR DRESS DOWN DAYS RESULTING IN A CONTRIBUTION OF $139 TO THE WHITING VOLUNTEER FIRE DEPT.6.) HOSTED BREAKFAST MEETING FOR SOCRETES WITH 20 PARTICIPANTS.7.) VETERAN'S BENEFIT SEMINAR FOR 25 AREA SENIORS8.) VOLUNTEER APPRECIATION LUNCHEON & PRESENTATION WITH 75 PARTICIPANTS, COSTING $1,000.9.) DONATION FROM PINES EMPLOYEE ASSISTANCE FUND FOR DRESS DOWN DAYS RESULTING IN A CONTRIBUTION OF $115 FOR EMPLOYEE ASSISTANCE.10.) USE OF OUR BUS (AND DRIVER) TO TAKE 13 VOLUNTEERS TO AN APPRECIATION DINNER11.) $550 SPONSORSHIP OF HOLE AT MANCHESTER TOWNSHIP VETERANS ORGANIZATION GOLF OUTING FUNDRAISER AND PAYING FOR 5 BOARD MEMBERS TO PLAY.12.) INTERGENERTATIONAL PROGRAM WITH OUR HEALTHCARE RESIDENTS13.) $210 OF DONATIONS THROUGH EMPLOYEE DRESS DOWN DAY ON MAY 11TH AND RESIDENT FUNDRAISER.14.) $486 OF DONATIONS THROUGH OUR "CONVENIENT STORE AND THROUGH EMPLOYEE DRESS DOWN DAYS. DONATIONS COSISTED OF $280 IN FOOD, AND $206 CASH.15.) 33 PARTICIPANTS IN A BLOOD DRIVE RAISING $10016.) LAUGHTER WORKSHOP FOR 12 PROFESSIONALS 17.) $1100 OF DONATIONS THROUGH VARIOUS FUNDRAISING EVENTS WITHIN THE COMMUNITY AND STAFF ATTENDED THE ALZHEIMER'S WALK. DONATIONS CONSISTED OF $954 CASH, AND $200 VARIOUS OTHER DONATIONS.18.) HEALTH FAIR FOR RESIDENTS AND OUTSIDE COMMUNITY MEMBERS - 50 ATTENDEES.19.) HOSTED JUNIOR IMPACT CLUB THROUGHOUT THE YEAR FOR AN INTERGENERATIONAL PROGRAM WITH HEALHCARE RESIDENTS20.) $58 OF DONATIONS THROUGH RESIDENTS FOR CROP WALK21.) $1,550 OF DONATION OF A TABLE OF TICKETS FOR CAREGIVER VOLUNTEERS OF CENTRAL JERSEY ANNUAL GALA22.) NON-PERISHABLE FOOD DONATIONS FOR SENIORS IN OCEAN COUNTY23.) $137 OF DONATIONS TRHOUGH EMPLOYEE DRESS DOWN DAYS24.) $120 OF COOKIE TRAY DONATIONSFOR THE YEAR 2018, THE TOTAL AMOUNT OF FORGIVEN REVENUE WAS $186,170.OVERALL, THE PINES PROGRAM TO SERVE OTHERS BENEFITTED SENIORS, COMMUNITY MEMBERS AND STUDENTS BY SUPPORTING THEIR TALENTS, GIVING INFORMATION TO IMPROVE THE QUALITY OF LIFE AND HELPING PEOPLE TO BETTER UNDERSTAND AND APPRECIATE SENIOR ADULTS. 0 14729528 1 1 0 1 0 0 1 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16 0 378 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X GEORGINA BAVAIS CFO 7328490400 509 ROUTE 530 WHITING NJ 08759 JAY KATZ OFFICER & MEMBER 2.00 X X 0 0 0 MARK KOLCHIN OFFICER & MEMBER 2.00 X X 0 0 0 DOUGLAS J BAUERBAND OFFICER & MEMBER 2.00 X X 0 0 0 WILLIAM COOK MEMBER 2.00 X 0 0 0 ALAN R DINKFELT DIRECTOR 2.00 X 0 0 0 CAROLYN HIBBARD MEMBER 2.00 X 0 0 0 JOHN R HOLLAND MEMBER 2.00 X 0 0 0 ROBERT HUBINGER MEMBER 2.00 X 0 0 0 OTTO C MORCH MEMBER 2.00 X 0 0 0 CHARITY ROSZEL MEMBER 2.00 X 0 0 0 ERIC J GHAUL CEO 40.00 X 195624 0 17779 GEORGINA E BAVAIS CFO 40.00 X 150916 0 37897 PATRICIA A POLCHAK HEALTHCARE ADMINISTRATOR 40.00 X 139796 0 32541 ADRIANNE M SOBOCINSKI PHYSICAL THERAPIST 40.00 X 121735 0 18260 ANN EASTON DIRECTOR OF NURSING 40.00 X 118254 0 10573 726325 0 117050 5 0 1 0 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 15251 FOOD SERVICE PROVIDER 1023821 R SOMERS CONSTRUCTION INC 3 S CHARLOTTEVILLE DR TOMS RIVER NJ 08757 CONSTRUCTION CONTRACTOR 331208 BRANDMETTLE INC 436 MAIN STREET SUITE 200 FRANKLIN TN 37064 MARKETING CONSULTANTS 227578 J W FINLEY INC P O BOX 409 TOMS RIVER NJ 08754 HEATER MAINTANENCE 193150 J&L CARPET 2 STATION RD WHITING NJ 08759 CARPET FLOORING 165803 5 145814 145814 RESIDENT MONTHLY FEES 623990 7142038 7142038 PRIVATE PAY 623990 6443169 6443169 MEDICAID AND MEDICARE REVENUE 623990 3115746 3115746 ENTRANCE FEES REVENUE 623990 1616743 1616743 18317696 189463 189463 198090 161513 36577 36577 36577 7982 3915 4067 4067 ANCILLARY SERVICES 623000 336856 336856 FOOD SERVICES 623000 135271 135271 BARBER AND BEAUTY 623000 91844 91844 1718 1718 565689 19259306 18317696 0 795796 7051 7051 30000 30000 389563 59604 329959 7189446 6424102 765344 139731 98911 40820 1206244 1039172 167072 636762 555975 80787 202640 202640 33181 33181 37512 37512 36779 36779 405012 392619 12393 356269 356035 234 184301 179084 5217 128080 24112 103968 1566956 1502762 64194 17824 13545 4279 524655 524655 1649329 1473752 175577 255741 227809 27932 FOOD SERVICES 1103686 1101607 2079 SUPPLIES 245357 228238 17119 REPAIRS & MAINTENANCE 90348 90348 BAD DEBT EXPENSE 45000 45000 166299 152507 13792 16647766 14729528 1918238 0 1765 1763 2944627 3235094 492256 629878 105651 138289 56444118 38450476 17989724 17993642 7633475 7272173 299572 153866 29467070 29424705 1238162 1146477 15086988 14206308 17355921 16146269 532082 586976 45121 44522 34258274 32130552 X -4821145 -2716871 29941 11024 -4791204 -2705847 29467070 29424705 X 2611540 -512317 -13866 X 0 1 X 1 0 X 105015 164667 100137 56891 145814 572524 16838100 17237458 17534611 18265044 18317696 88192909 16943115 17402125 17634748 18321935 18463510 88765433 0 0 0 88765433 232435 158490 169766 141098 189463 891252 232435 158490 169766 141098 189463 891252 323000 22296 3967 22750 573671 945684 17498550 17582911 17808481 18485783 19226644 90602369 0.97970 0.98350 0.00980 0.01220 X 0 0 0 0 0 0 0 0 1 396 396 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO LEADING AGE, NEW JERSEY. A PERCENTAGE OF THOSE DUES ARE USED BY LEADING AGE, NEW JERSEY FOR LOBBYING PURPOSES. THE AMOUNT OF LOBBYING EXPENSES REPORTED ARE THE PERCENTAGE OF THE ORGANIZATION'S DUES USED BY LEADING AGE, NEW JERSEY FOR LOBBYING. X X X 1 0 1 1 0.00 0 0 1 X 2748541 2748541 42187860 34757343 7430517 11042327 3448941 7593386 465390 244192 221198 17993642 CHARITABLE GIFT ANNUITIES 44522 44522 X 18666344 -512317 -43866 -556183 19222527 36779 36779 19259306 16580987 0 16580987 36779 30000 66779 16647766 PART II, LINE 9: THE DEPARTMENT OF ENVIRONMENTAL PROTECTION HAS PROVIDED SIGNAGE THAT HAS BEEN PUT IN PLACE, ACCOMPANIED BY A LISTING OF APPROVED USES OF THE SITE AND ANY RESTRICTIONS. PART IV, LINE 2B: AMOUNTS HELD IN ESCROW REPRESENT CASH DEPOSITS MADE BY PROSPECTIVE RESIDENTS OF INDEPENDENT LIVING UNITS. THE CASH HAS BEEN DEPOSITED INTO A SAVINGS ACCOUNT. IF THE PROSPECTIVE RESIDENT(S) SHOULD DECIDE NOT TO FULFILL THE CONTRACT THE DEPOSITS ARE REFUNDABLE. IN ADDITION, ENTRANCE FEES RECEIVED FROM RESIDENTS HAVE BEEN REPORTED AS A LONG-TERM LIABILITY. REFUNDABLE PORTIONS OF ENTRANCE FEES ARE FULLY REFUNDABLE TO THE RESIDENT(S), LESS CERTAIN COSTS OR CHARGES INCURRED. IF THE RESIDENT(S) TERMINATE(S) THE CONTRACT, THE REFUNDABLE PORTION OF ENTRANCE FEES IS REFUNDABLE FOLLOWING THE REOCCUPANCY OF THE UNIT FOR THIRTY DAYS. PART X, LINE 2: KESWICK HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. KESWICK FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON KESWICK'S FINANCIAL STATEMENTS. KESWICK'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN THE VALUE OF ANNUITY -13,866. SCHOLARSHIP COSTS -30,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: SCHOLARSHIP COSTS 30,000. 1 SCHOLARSHIPS 14 30000 PART I, LINE 2: THE PINES BUDGETS A CERTAIN DOLLAR AMOUNT EVERY YEAR TO DONATE TO THOSE WHO PROVIDE BENEFITS TO THE COMMUNITY. THE PINES MAINTAINS RECORDS OF WHERE THE DONATIONS WERE GIVEN. PART III, LINE 1 THE SCHOLARSHIP APPLICANT MUST HAVE BEEN EMPLOYED AT THE PINES AT WHITING AS A PART-TIME EMPLOYEE FOR AT LEAST ONE YEAR AND WORKED AT LEAST 300 HOURS PER YEAR. HOURS ARE BASED ON FISCAL YEAR MAY 1 - APRIL 1. THE APPLICANT MUST PRESENT A LETTER OF ACCEPTANCE FROM EITHER A COLLEGE OR SPECIALTY SCHOOL AT THE TIME OF APPLICATION. THE APPLICANT MUST SUPPLY TWO LETTERS OF REFERENCE; ONE FROM SCHOOL (GUIDANCE COUNSELOR, TEACHER, COACH, ETC.) AND THE SECOND MUST COME FROM AN INDIVIDUAL UNRELATED TO SCHOOL OR FAMILY. IN ADDITION, EACH APPLICATION IS CAREFULLY REVIEWED BY THE STUDENT'S DIRECT SUPERVISOR. THE SUPERVISOR IS TO EXAMINE SPECIFIC CRITERIA SUCH AS SAFETY AND JOB PERFORMANCE. THE SUPERVISOR WILL INCLUDE HIS/HER RELATED REMARKS, SIGN THE APPLICATION, AND FORWARD THE APPLICATION IN ITS ENTIRETY TO THE SCHOLARSHIP COMMITTEE. APPLICANTS ALREADY IN COLLEGE, WHETHER APPLYING FOR THE FIRST TIME OR FOR RENEWAL OF THE SCHOLARSHIP MUST PRESENT A TRANSCRIPT OF FULL-TIME (12 OR MORE CREDIT HOURS) OF COLLEGE GRADES. THE APPLICANT WILL THEN NOT BE REQUIRED TO SUBMIT A LETTER OF ACCEPTANCE AND TWO LETTERS OF REFERENCE; HOWEVER, BOTH FIRST TIME APPLICANTS AND APPLICANT RENEWALS WILL BE ASKED ABOUT THEIR LEVEL OF PARTICIPATION BOTH IN THEIR SCHOOL AND THEIR COMMUNITY. X 1 1 X 0 0 0 0 0 0 0 0 0 ERIC J GHAUL CEO 160560 0 15000 0 20064 0 6931 0 10848 0 213403 0 0 0 GEORGINA E BAVAIS CFO 132562 0 7500 0 10854 0 5724 0 32173 0 188813 0 0 0 PATRICIA A POLCHAK HEALTHCARE ADMINISTRATOR 127354 0 6000 0 6442 0 7452 0 25089 0 172337 0 0 0 PART I, LINE 1A AS PART OF HIS 2017 COMPENSATION PACKAGE; ERIC GHAUL, PRESIDENT, WAS PAID A BOARD APPROVED TAKE-HOME TAX DEFERRAL BONUS OF $10,000. THE PINES PAID THE TAXES ON HIS BEHALF. A PUBLIC FINANCE AUTHORITY 273866124 NONEAVAIL 2014-11-13 21500000 SEE PART VI 0 0 0 A 4788818 21500000 894458 429999 85517 3447116 16642910 2014 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: PUBLIC FINANCE AUTHORTIY (F) DESCRIPTION OF PURPOSE: TO REFUND THE FIRST MORTGAGE REVENUE REFUNDING BONDS, SERIES 1998 AND TO FINANCE VARIOUS CAPITAL PROJECTS AND WORKING CAPITAL. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS, BY RESOLUTION ADOPTED BY A MAJORITY OF THE DIRECTORS THEN IN OFFICE, MAY DESIGNATE AN EXECUTIVE COMMITTEE COMPRISED OF THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER AND AN ADDITIONAL MEMBER OF THE BOARD OF DIRECTORS SELECTED BY THE CURRENT MEMBERS OF THE BOARD OF DIRECTORS IN MANAGEMENT OF THE CORPORATION, PROVIDED, THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN REFERENCE TO (A) AMENDING, ALTERING, OR REPEALING THE BYLAWS, (B) ELECTING, APPOINTING OR REMOVING ANY MEMBER OF THE EXECUTIVE COMMITTEE OR ANY DIRECTOR OR OFFICER OF THE CORPORATION, (C) AMENDING THE ARTICLES OF INCORPORATION, (D) ADOPTING A PLAN OF MERGER OR ADOPTING A PLAN OF CONSOLIDATION WITH ANOTHER CORPORATION, (E) AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION, (F) AUTHORIZING THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKING PROCEEDINGS THERFORE, (G) ADOPTING A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION, (H)AMENDING, ALTERING, OR REPEALING ANY RESOLUTION OF THE BOARD OF DIRECTORS TO ANOTHER COMMITTEE OF THE BOARD THE DESIGNATION AND APPOINTMENT OF AN EXECUTIVE COMMITTEE AND THE DELEGATION THERETO OF AUTHORITY SHALL NOT OPERATE TO RELIEVE THE BOARD OF DIRECTORS, OR ANY INDIVIDUAL DIRECTOR, OF ANY RESPONSIBILITY IMPOSED UPON IT OR HIM BY LAW. FORM 990, PART VI, SECTION B, LINE 11B THE CFO REVIEWS THE FORM 990 WITH THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS. A COPY OF THE FORM 990 IS PROVIDED TO ALL MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD MEMBERS AND OFFICERS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST TO THE MEMBERS OF THE BOARD. BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY, WHICH ARE REVIEWED BY THE CEO. THE ORGANIZATION ALSO HAS A CONFLICT OF INTEREST SECTION IN ITS EMPLOYEE HANDBOOK WHICH ALL EMPLOYEES ARE REQUIRED TO FOLLOW AT THE APRIL QUARTERLY MEETING. ALL BOARD MEMBERS ARE TO SIGN THE CONFLICT OF INTEREST POLICY STATING THERE ARE NONE TO DECLARE OR IF THERE ARE ANY TO DECLARE. TO DATE THERE HAVE NOT BEEN ANY DECLARED. IF CONFLICTS OF INTEREST DO ARISE, THE INTERESTED PARTY OR PARTIES ARE PROHIBITED FROM VOTING ON BOARD MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S EXECUTIVE COMMITTEE APPROVES THE CEO'S COMPENSATION. IT IS SUBMITTED IN WRITING BY THE CHAIR OF THE BOARD TO THE CFO. COMPARABILITY DATA INCLUDED THE 2016-2017 CCRC REPORT SALARY & BENEFITS REPORT ENDORSED BY LEADING AGE PUBLISHED BY HOSPITAL & HEALTHCARE COMPENSATION SERVICE WAS USED AS A REFERENCE. THIS PROCESS IS DONE WITHIN THE BOARD APPROVED BUDGET AND WAS LAST COMPLETED IN 2015. OTHER OFFICERS ARE REVIEWED BY THE SUPERVISOR ON THE EMPLOYEE'S ANNIVERSARY AND ARE APPROVED AN INCREASE IF THE JOB PERFORMANCE JUSTIFIES AND THIS IS DONE WITHIN THE BOARD APPROVED BUDGET. COMPARABILITY DATA INCLUDED THE 2016-2017 CCRC REPORT SALARY & BENEFITS REPORT ENDORSED BY LEADING AGE PUBLISHED BY HOSPITAL & HEALTHCARE COMPENSATION SERVICE WAS USED AS A REFERENCE. THIS PROCESS OCCURS ANNUALLY. 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. THE ANNUAL DISCLOSURE STATEMENT INCLUDES THE MOST RECENT AUDITED FINANCIAL STATEMENTS. THIS IS GIVEN TO RESIDENTS AND/OR PROSPECTIVE RESIDENTS WHO INQUIRE ABOUT THE ORGANIZATION. FORM 990, PART XI, LINE 9: CHANGE IN THE VALUE OF ANNUITY -13,866.