2016-05-13T16:40:07-05:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2015-01-01 237302390 KANSAS CITY UNITED METHODIST RETIREMENT HOME INC D/B/A KINGSWOOD KANS 8169420994 10000 WORNALL ROAD KANSAS CITY MO 64114 JOANNE KELLEY SECRETARY 8169420994 2016-05-13 1 JEFF PARKER P00970069 3149254300 2015 2016-12-15 16:53:06Z TERRI MOORE 10000 WORNALL ROAD KANSAS CITY MO 64114 14036138 0 X WWW.KINGSWOODATHOME.ORG X 1972 MO KINGSWOOD'S MISSION IS TO PROVIDE RESIDENTAL AND HEALTH CARE FACILITIES, SERVICES AND OPPORTUNITIES FOR OLDER ADULTS. 12 12 302 113 0 0 277268 202775 13742036 13270926 13492 -368418 457345 426567 14490141 13531850 0 0 0 0 6642421 6673905 0 0 0 8444682 8481293 15087103 15155198 -596962 -1623348 32178169 30298496 47518937 47332313 -15340768 -17033817 X KINGSWOOD'S MISSION IS TO PROVIDE RESIDENTAL AND HEALTH CARE FACILITIES, SERVICES AND OPPORTUNITIES FOR OLDER ADULTS. 0 0 12632505 13442750 KINGSWOODS' MISSION IS TO WELCOME OLDER ADULTS WITH OPPORTUNITIES TO ENRICH THEIR LIVES WITH EXCELLENT RESIDENTIAL AND HEALTHCARE SERVICES OFFERED IN A SAFE, LOVING, AND CARING COMMUNITY. KINGSWOOD, A MINISTRY OF THE UNITED METHODIST CHURCH, 82 BEDS IN THE HEALTH CENTER, 14 ASSISTED LIVING APARTMENTS, 201 INDEPENDENT LIVING APARTMENTS AND 54 VILLA HOMES. THE HEALTH CENTER IS LICENSED BY THE STATE OF MISSOURI AS A SKILLED NURSING FACILITY. KINGSWOOD AVERAGES AROUND 300 RESIDENTS ON THE 32 ACRE CAMPUS. SERVICES PROVIDED BY KINGSWOOD INCLUDE MEALS, HOUSEKEEPING, LAUNDRY, UTILITIES, MAINTENANCE, LIGHTED PARKING, RELIGIOUS/SOCIAL PROGRAMMING, SECURITY, ADMINISTRATIVE SERVICES, LOUNGES, CRAFT AREAS, TRANSPORTATION, PERSONAL CARE ASSISTANCE, REHABILITATITVE THERAPY, A CHAPEL, A LIBRARY, A COMPUTER LAB, BEAUTY AND BARBER SALON, GIFT SHOP, OUTDOOR PATIOS AND WALKING AREAS. 12632505 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 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 1 1 1 0 0 1 63 0 302 1 0 0 0 0 0 0 0 0 0 1 0 X 12 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CONNIE CARGIN 8164423255 10000 WORNALL ROAD KANSAS CITY MO 64114 X ROBERT ADAMS DIRECTOR 0.50 0.50 X 0 0 0 SALLY FIRESTONE DIRECTOR 1.00 X 0 0 0 JOANNE KELLEY SECRETARY 1.00 X X 0 0 0 RICHARD LANE VICE CHAIRMAN/TREASURER 0.50 0.50 X X 0 0 0 FRED WIMAN CHARIMAN/DIRECTOR 0.50 0.50 X X 0 0 0 JANICE WOLLARD DIRECTOR 1.00 X 0 0 0 SCOTT CORBIN DIRECTOR 1.00 X 0 0 0 DR JAMES DALEY DIRECTOR 1.00 X 0 0 0 EVELYN CRAIG DIRECTOR 0.50 0.50 X 0 0 0 GARLAND RICHARDSON DIRECTOR 1.00 X 0 0 0 ELLEN JOY DIRECTOR 1.00 X 0 0 0 SALLY HAYNES DIRECTOR 1.00 X 0 0 0 TERRI MOORE CEO 40.00 X 0 0 0 CONNIE CARGIN DIRECTOR OF FINANCE 40.00 X 103812 0 4531 103812 0 4531 1 0 0 0 LIFE CARE SERVICES 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT COMPANY 729558 REHABCARE GROUP 7733 FORSYTH BLVD STE 2300 ST LOUIS MO 63105 THERAPY PROVIDER 468357 AG ARCHITECTURE 1414 UNDERWOOD AVENUE SUITE 301 WAUWATOSA WI 53213 ARCHITECTURE 443159 SQUIRES CONSTRUCTION 23230 PINK HILL ROAD BLUE SPRINGS MO 64015 CONSTRUCTION 227827 ZILLNER 8725 ROSEHILLD RD 200 LENEXA KS 66215 MARKETING 199645 10 186094 16681 202775 RESIDENT REVENUE 623000 13270926 13270926 13270926 135870 135870 504288 -504288 -504288 -504288 NFRA REVENUE 623000 171824 171824 BEAUTY SHOP 623000 77708 77708 DINING SERVICES 623000 70957 70957 106078 106078 426567 13531850 13442750 0 -113675 233845 233845 5269339 4694184 575155 771970 671545 100425 398751 353123 45628 400245 400245 247027 247027 48662 48662 818673 799668 19005 396067 396067 635817 582767 53050 180603 180603 902446 873219 29227 78607 60061 18546 1015219 982339 32880 1424878 1378731 46147 158405 153275 5130 FOOD 911084 911084 MAINTENANCE 603515 583969 19546 DUES, LICENSE, FEES 312208 296053 16155 ANCILLARY SERVICES 244740 244740 103097 47747 55350 15155198 12632505 2522693 0 1001107 350103 2224434 2054230 510888 642048 50176 50946 101737 99411 50191815 30803437 19807226 19388378 7250976 5931002 884959 938282 346666 844096 32178169 30298496 4358914 5081728 3736734 3660469 15949786 15261167 1016491 508246 22457012 22820703 47518937 47332313 X -18753993 -20526547 1561250 1639055 1851975 1853675 -15340768 -17033817 32178169 30298496 -1623348 -69701 0 X X 0 1 X 1 0 X 372962 169279 290233 277268 202778 1312520 14098864 13604155 13587315 13742036 13270926 68303296 14471826 13773434 13877548 14019304 13473704 69615816 0 0 0 69615816 98747 50881 56589 39892 135870 381979 98747 50881 56589 39892 135870 381979 446102 436695 688314 430945 426567 2428623 15016675 14261010 14622451 14490141 14036141 72426418 0.96120 0.95990 0.00530 0.00560 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: DINING SERVICES - 2011 AMOUNT: $ 76,631. 2012 AMOUNT: $ 85,646. 2013 AMOUNT: $ 80,337. 2014 AMOUNT: $ 75,102. 2015 AMOUNT: $ 70,957. GIFT SHOP - 2011 AMOUNT: $ 20,388. 2012 AMOUNT: $ 25,490. 2013 AMOUNT: $ 26,287. 2014 AMOUNT: $ 20,993. 2015 AMOUNT: $ 20,107. BEAUTY SHOP - 2011 AMOUNT: $ 97,057. 2012 AMOUNT: $ 99,081. 2013 AMOUNT: $ 91,231. 2014 AMOUNT: $ 83,798. 2015 AMOUNT: $ 77,708. MISCELLANEOUS - 2011 AMOUNT: $ 252,026. 2012 AMOUNT: $ 174,340. 2013 AMOUNT: $ 432,247. 2015 AMOUNT: $ 9,745. TRANSPORTATION - 2012 AMOUNT: $ 36,825. 2013 AMOUNT: $ 37,616. 2014 AMOUNT: $ 41,228. 2015 AMOUNT: $ 43,401. GUEST ROOM - 2012 AMOUNT: $ 15,313. 2013 AMOUNT: $ 20,596. 2014 AMOUNT: $ 25,335. 2015 AMOUNT: $ 32,825. NFRA REVENUE - 2014 AMOUNT: $ 184,489. 2015 AMOUNT: $ 171,824. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2618506 33357 28818 25326 2655355 2460121 25818 157417 24850 2618506 2081657 27732 377512 26780 2460121 1842813 30396 238844 30396 2081657 1930509 26488 -5536 108648 1842813 0.00000 0.91700 0.08300 0 1 1 1609385 1609385 41343000 27211884 14131116 3204551 1163412 2041139 2720776 2428141 292635 1314103 1314103 19388378 RESIDENT DEPOSITS 137081 REFUNDABLE ENTRANCE FEES 22683622 22820703 X PART V, LINE 4: KINGSWOOD MAINTAINS A WESLEY ENDOWMENT FUND. THE FUNDS ARE USED FOR FINANCIAL ASSISTANCE FOR THE RESIDENTS. PART X, LINE 2: KINGSWOOD AND THE FOUNDATION ARE NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IT IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAX EXCEPT FOR THOSE THAT ARE ALREADY REPORTED ANNUALLY. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS A MANAGEMENT AGREEMENT WITH LIFE CARE SERVICES, LLC (LCS). UNDER THE AGREEMENT, LCS PROVIDES AN EXECUTIVE DIRECTOR AND IS APPOINTED MANAGER OF THE ORGANIZATION'S OPERATIONS AND REAL ESTATE. THE AGREEMENT HAS A 60-MONTH TERM ENDING SEPTEMBER 30, 2019 AND INCLUDES CERTAIN PROVISIONS FOR TERMINATION. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED 990 WILL BE E-MAILED TO BOARD MEMBERS PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED ANNUALLY TO REVIEW THE CONFLICT OF INTEREST POLICY AND SIGN THAT THEY WILL COMPLY WITH THE POLICY. IF AND WHEN A CONFLICT ARISES, THE BOARD MEMBER IS ASKED TO DISCLOSE MATERIAL FACTS AND LEAVE THE MEETING. A DETRMINATION IS MADE BY THE REMAINING BOARD MEMBERS WHETHER OR NOT A CONFLICT OF INTEREST EXIST. IF A CONFLICT EXIST, THE BOARD MEMBER IS REQUESTED TO LEAVE THE MEETING DURING THE DISCUSSION AND THEN THE REST OF THE BOARD VOTES ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS AN EMPLOYEE OF LIFE CARE SERVICES, THE MANAGEMENT COMPANY, AND RECEIVED COMPENSATION OF APPROXIMATELY $233,845. COMPARATIVE INFORMATION ON OTHER DIRECTOR'S COMPENSATION IS AVAILABLE THROUGH LIFE CARE SERVICES. A PERFORMANCE REVIEW IS COMPLETED BY THE EMPLOYEE AND THE CEO. COMPARATIVE INFORMATION ON SIMILAR POSITIONS ARE AVAILABLE THROUGH LIFE CARE SERVICES. THIS PROCESS WAS LAST UNDERTAKEN IN 2014. 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 PAGE 12, PART XII, LINE 2C THE POLICY FOR REVIEWING THE FINANCIAL STATEMENT REMAINS UNCHANGED FROM THE PRIOR YEAR FORM 990, SCHEDULE R, PART III, COLUMN A THE PARTNERSHIPS ARE RELATED AS THERE IS COMMON CONTROL WHEREAS BOARD MEMBERS OF THE FILING ORGANIZATION OWN A VOTING MAJORITY OF THESE PARTNERSHIPS. KINGSWOOD SENIOR LIVING COMMUNITY FOUNDATION 10000 WORNALL ROAD KANSAS CITY MO 64114 200639597 PROVIDES SUPPORT FOR KANSAS CITY UNITED METHODIST RETIREMENT HOME, INC. MO 501 (C)(3) LINE 11A, TYPE I KANSAS CITY UNITED METHODIST RETIREMENT HOME INC DBA KINGSWOOD 1 457 WEST 100TH TERRACE LLC 10000 WORNALL ROAD KANSAS CITY MO 64114 274598541 REAL ESTATE MO N/A 0 0 1 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 0 KINGSWOOD SENIOR LIVING COMMUNITY FOUNDATION C 186094 FMV