2013-07-24T09:04:08-05:00 2012-12-31 420732909 RYUN GIVENS & COMPANY PLC 2900 100TH STREET SUITE 301 URBANDALE IA 50322 990 2012-01-01 420713662 THE UNITED PRESBYTERIAN HOME OF WASHINGTON IOWA UNIT 3196535473 1203 EAST WASHINGTON STREET WASHINGTON IA 523532198 MICHAEL D MOORE 3196535473 2013-07-11 1 CURTIS E BRAND CPA P00299230 5152253141 2012 2016-02-24 21:20:13Z MICHAEL D MOORE 1203 EAST WASHINGTON STREET WASHINGTON IA 523532198 7748488 0 X UPHOME.ORG X 1947 IA THE MISSION OF UNITED PRESBYTERIAN HOME, GUIDED BY CHRISTIAN COMPASSION, CONCERN AND STEWARDSHIP, IS TO PROVIDE SENIORS WITH QUALITY SERVICES, CARE AND HOUSING. 16 16 124 118 1507 0 152344 1868173 5862083 5852604 23309 24097 -542 0 6037194 7744874 0 0 0 0 3211866 3413913 0 0 0 2621658 3285215 5833524 6699128 203670 1045746 11858866 12875444 8872287 8802532 2986579 4072912 THE MISSION OF UNITED PRESBYTERIAN HOME, GUIDED BY CHRISTIAN COMPASSION, CONCERN AND STEWARDSHIP, IS TO PROVIDE SENIORS WITH QUALITY SERVICES, CARE AND HOUSING. 0 0 5822410 5640883 HOLISTIC APPROACH TO LONG-TERM CARE FOR THE ELDERLY TO MAINTAIN INDIVIDUAL AT HIGHEST PRACTICAL LEVEL OF FUNCTIONING. PROVIDED HOUSING AND NURSING CARE PATIENT DAYS: ICF 8,758, SKILLED 1,449, MEDICAID 7,630, ASSISTED LIVING AND RESIDENTIAL 48,370 FOR A TOTAL OF 65,907 PATIENT DAYS. 5822410 1 1 0 0 0 0 0 0 0 1 1 1 0 0 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 0 0 0 0 0 1 11 0 1 124 1 1 1 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IA X X MICHAEL D MOORE 3196535473 1203 EAST WASHINGTON STREET WASHINGTON IA 523532198 JAMES E LLOYD 2.00 X X 0 0 0 ROBERT G HUBER 2.00 X X 0 0 0 JIM CUDDEBACK 2.00 X X 0 0 0 DEBORAH SCHOENFELDER 2.00 X 0 0 0 REV FORREST KRUMMEL 2.00 X 0 0 0 CHARLES E POLAND 2.00 X 0 0 0 DAVID MAUPIN 2.00 X 0 0 0 RICHARD K SCHMIDT 2.00 X 0 0 0 SANDY DUNLAP 2.00 X 0 0 0 JEAN ROBERTSON 2.00 X 0 0 0 BILL STEWART 2.00 X 0 0 0 BRUCE WALKER 2.00 X 0 0 0 JOANN TORPEY 2.00 X 0 0 0 NANCY ROSS 2.00 X 0 0 0 JOHN THORNE 2.00 X 0 0 0 JOHN STALEY 2.00 X 0 0 0 MICHAEL D MOORE 50.00 X 136271 0 2414 ERIN DRAHOTA 45.00 X 44941 0 11424 181212 0 13838 1 0 0 0 MORRISON MANAGEMENT SPECIALIST 5801 PEACHTREE DUNWOODY RD ATLANTA GA 30342 FOOD MANAGEMENT CONTRACTOR 688080 AEGIS THERAPIES INC 7160 DALLAS PARKWAY STE 400 PLANO TX 75024 THERAPY CONTRACTOR 327154 SHAW ELECTRIC INC 930 EAST RIVER DRIVE DAVENPORT IA 52803 GENERAL CONTRACTOR 157771 STATLER CONSTRUCTION 1655 HWY 1 WASHINGTON IA 52353 CONSTRUCTION CONTRACTOR 113673 4 1868173 18221 1868173 RESIDENT SERVICES 623000 3313754 3313754 MEDICAID/MEDICARE PAYM 623000 2327129 2327129 DAY CARE 623000 107351 107351 MEALS 623000 104370 104370 5852604 22590 22590 5121 3614 1507 1507 1507 7744874 5640883 1507 234311 181212 181212 2774044 2651706 122338 63021 56506 6515 167464 156284 11180 228172 208497 19675 16360 16360 5529 5529 21453 5412 16041 48826 12663 36163 999097 929827 69270 4491 4491 6533 6533 656308 656308 36392 36392 MEDICARE COSTS 427625 427625 LOSS ON BOND REFINANCE 363491 363491 FOOD AND SUPPLEMENTS 287830 287830 SUPPLIES AND EQUIPMENT 277883 277883 133397 103415 29982 6699128 5822410 876718 0 23394 26441 155434 1184388 403889 334457 31857 31742 7158 207 23095382 13148717 9025419 9946665 1148461 799168 1063254 552376 11858866 12875444 464900 419521 4327944 4445618 3865000 3787912 137255 77337 77188 72144 8872287 8802532 X 1999191 3098763 405598 392359 581790 581790 2986579 4072912 11858866 12875444 X 1045746 49576 -8989 X X 0 1 X 1 0 X 110061 123143 109473 152344 1868173 2363194 4566071 4694260 5075565 5685851 5640884 25662631 168798 167584 176232 211721 724335 4676132 4986201 5352622 6014427 7720778 28750160 76984 27906 49835 56425 211150 0 76984 27906 49835 56425 211150 28539010 14669 9932 11093 23309 22590 81593 14669 9932 11093 23309 22590 81593 4690801 4996133 5363715 6037736 7743368 28831753 0.98980 0.99010 0.00280 0.00400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 575819 6389 418 581790 581790 -5554 417 575819 575607 14163 7980 581790 493511 82531 435 575607 603879 -108424 1944 493511 1.00000 1 0 116913 116913 20536979 11683696 8853283 2441490 1465021 976469 9946665 PROJECT FUND 189172 F BENEVOLENT FUND 171387 F PERMANENTLY RESTRICTED FUNDS 388331 F TEMPORARILY RESTRICTED FUNDS 50278 F 799168 REFUNDABLE ENDOWMENTS LIABILITY 14298 RESIDENT LOANS PAYABLE 57846 72144 7785461 49576 -8989 40587 7744874 0 7744874 6699128 0 6699128 0 6699128 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS ARE TO BE USED FOR BENEVOLENT AND CHARITABLE CARE FOR RESIDENTS, EMPLOYEE RECOGNITION AND EDUCATION, AND OPERATIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN VALUE OF CHARITABLE REMAINDER TRUSTS -8,989. FORM 990, PART VI, SECTION B, LINE 11 THE POLICY OF THE BOARD OF DIRECTORS IS TO PRESENT THE FORM 990 TO THE FULL BOARD OF DIRECTORS INCLUDING SIGNIFICANT SCHEDULES. EACH MEMBER OF THE BOARD OF DIRECTORS WILL RECEIVE A COPY OF THE FORM 990 PRIOR TO SUBMISSION OF THE FORM TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO READ AND UNDERSTAND THE CONFLICTS OF INTEREST POLICY, AND ALL BOARD MEMBERS ARE REQUIRED, ON AN ANNUAL BASIS, TO COMPLETE AND SIGN AN ANNUAL STATEMENT OF COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 WHEN HIRING THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES, AND THEREAFTER ON AN ANNUAL BASIS, THE BOARD WILL PERFORM A THOROUGH REVIEW TO DETERMINE SUITABLE COMPENSATION. THE PROCESS INCLUDES A REVIEW OF COMPARABILITY DATA BY THE BOARD OF DIRECTORS OR AN INDEPENDENT COMPENSATION CONSULTANT. EACH YEAR THE BOARD WILL REVIEW THE COST OF LIVING INDEX, LEADINGAGE IOWA WAGE AND BENEFITS SURVEY, YEARS OF SERVICE AND THE LEADINGAGE NATIONAL WAGE AND BENEFIT SURVEY. THE BOARD WILL RETAIN DOCUMENTATION OF THE DELIBERATION AND FINAL DECISION. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 AND FORM 1023 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. COPIES WILL BE PROVIDED IMMEDIATELY IN THE CASE OF IN-PERSON REQUESTS. REQUESTS RECEIVED BY WRITTEN, PHONE, FAX OR EMAIL MEANS WILL BE HONORED BY DIRECTING THE REQUESTORS TO OUR WEBSITE. THE CURRENT FORM 990, EXCLUDING SCHEDULE B, AND FORM 1023 CAN BE FOUND ON THE ORGANIZATION'S WEBSITE IN ADOBE FORMAT. 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 AT ITS OFFICE IN WASHINGTON, IOWA. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF CHARITABLE TRUST RECEIVABLE -8,989. OVERSIGHT OF FINANCIAL STATEMENT AUDIT FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT RELATING TO THE AUDIT OF THE FINANCIAL STATEMENTS. THE BOARD OF DIRECTORS IS ALSO RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THERE HAS BEEN NO CHANGE IN THE PROCESS FROM THE PRIOR YEAR.