2012-11-14T12:57:15-06:00 2011-12-31 751386677 BROWN GRAHAM & COMPANY 9005 MOUNTAIN RIDGE RD SUITE 240 AUSTIN TX 78759 990 2011-01-01 741459599 WESLEYAN HOMES INC WESL 5128681205 PO BOX 486 GEORGETOWN TX 78627 JOHN KLUBERG 5128681205 2012-11-14 1 SHANNON ANDRE P00288382 5122578078 2012-11-14 2011 2016-02-24 21:20:13Z JOHN KLUBERG PO BOX 486 GEORGETOWN TX 78627 18116037 0 X WWW.WESLEYANHOMES.ORG X 1955 TX TO PROVIDE RETIREMENT, ASSISTED LIVING AND NURSING HOME ACCOMMODATIONS TO RESIDENTS. 32 31 497 215 0 0 96282 167702 17231204 17774272 7398 14765 332434 159298 17667318 18116037 0 0 0 0 10799691 10743251 0 0 211000 6352477 7222925 17152168 17966176 515150 149861 35438566 36226024 24708697 25361589 10729869 10864435 X TO BE THE PREMIER PROVIDER OF SUPPORTIVE CARE AND SERVICES IN CENTRAL TEXAS, OPEN TO ALL SENIOR ADULTS. THE ORGANIZATION VALUES FAITH, COMPASSION, WELLNESS, AFFORDABILITY, EXCELLENCE, PROFESSIONALISM AND CHOICE. THE VISION OF WESLEYAN HOMES, INC. IS TO BE A FAITH-BASED MINISTRY PROVIDING COMFORT AND CARE FOR RESIDENTS AND THEIR FAMILIES IN A PLACE CALLED HOME. 0 0 17038902 17774272 PROFESSIONAL PATIENT CARE AND BENEFITS REGARDLESS OF FINANCIAL CONSIDERATIONS AND QUALIFICATIONS. THE RETIREMENT AND NURSING HOME WERE HOME TO 633 OLDER ADULTS IN 2011. 17038902 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 67 0 1 497 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 32 31 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 X JOHN KLUBERG 5128681205 1811 NORTH AUSTIN AVE STE 201 GEORGETOWN TX 78626 BISHOP MIKE LOWRY 1.00 X 0 0 0 DR BOB SOULEN 1.00 X 0 0 0 DR DOUG BENOLD 1.00 X 0 0 0 DR ERIC MCKINNEY 1.00 X 0 0 0 MR STEVE MCIVER 1.00 X 0 0 0 MR BILL CONNOR 1.00 X 5064 0 0 MR ED KOMANDOSKY 1.00 X 0 0 0 MR ERROL WENDLAND 1.00 X 0 0 0 MR GEORGE BRIGHTWELL 1.00 X 0 0 0 MR PAT STROMAN 1.00 X 0 0 0 MR TOM FORBES 1.00 X 0 0 0 MRS JACKIE RANDALL 1.00 X 0 0 0 MRS JEANNINE FAIRBURN 1.00 X 0 0 0 MRS LINDA GUSNOWSKI 1.00 X 0 0 0 MRS PATTY LEE 1.00 X 0 0 0 MS CYNTHIA RIVES 1.00 X 0 0 0 MS DORRIS ROSS 1.00 X 0 0 0 REV ARCYNTHIA LOUIE 1.00 X 0 0 0 REV DEBRA CRUMPTON 1.00 X 0 0 0 REV JIM CHANDLER 1.00 X 0 0 0 REV LARA WHITLEY 1.00 X 0 0 0 REV NANCY WOODS 1.00 X 0 0 0 REV RANKIN KOCH 1.00 X 0 0 0 REV TRAVIS FRANKLIN 1.00 X 0 0 0 MS CORLISS MCBRIDE 1.00 X 0 0 0 REV STEPHEN SCHMIDT 1.00 X 0 0 0 REV RON BELLOMY 1.00 X 0 0 0 DR STEVE LANGFORD 1.00 X 0 0 0 DR DALE SCHULTZ 1.00 X 0 0 0 MR JOHN KLUBERG 40.00 X 100481 0 13700 MR GENE LAWHON 1.00 X 0 0 0 MR BILL BOOTH 1.00 X 0 0 0 MR CHRIS SPENCE 40.00 X 161914 0 21518 MRS NANCY BENOLD 1.00 X 0 0 0 MR TIMOTHY STUTEVILLE 40.00 X 102286 0 14048 369745 0 49266 3 0 1 0 VRW CONSTRUCTION CO INC PO BOX 150369 AUSTIN TX 78715 ASSISTED LIVING CONSTRUCTION 1533000 SELECT REHABILITATION INC 550 FRONTAGE RD STE 2415 NORTHFIELD IL 60093 OCCUPATION, SPEECH AND PHYSICAL THERAPY 895181 US FOODSERVICE INC 979 SPRINGDALE ROAD AUSTIN TX 78702 FOOD 680896 MEDLINE INDUSTRIES INC PO BOX 121080 DALLAS TX 75312 MEDICAL SUPPLIES 239974 COMMUNITIES OF FAITH RRG 1800 SECOND STREET STE 909E SARASOTA FL 34236 INSURANCE 206006 10 167702 167702 ROUTINE PATIENT CARE S 623000 17525880 17525880 BARBER/BEAUTY SHOP 812900 133098 133098 OTHER SERVICES 812900 115294 115294 17774272 14765 14765 GAIN-INVESTMENT IN RRG 900099 159298 159298 159298 18116037 17774272 0 174063 285718 285718 8797846 8412985 264435 120426 258317 239509 15092 3716 731570 690879 38694 1997 669800 626701 36674 6425 37847 18761 19086 31208 31208 1308383 1294864 12751 768 74713 73632 170 911 311869 239398 18019 54452 783726 747796 23719 12211 29562 21317 710 7535 519466 519466 1061884 1061884 230913 230913 DIETARY 1055278 1055278 NURSING DEPT AND THERAP 697369 697369 REPAIRS & MAINTENANCE 370261 367902 1206 1153 OTHER PROGRAM EXPENSES 359560 359560 350886 349480 1406 17966176 17038902 716274 211000 612638 1046472 69062 69253 3003357 2797864 34572 32624 35850015 7199062 28042443 28650953 274444 271920 2498641 2655256 402967 356767 500442 344915 35438566 36226024 414752 455544 22315838 24020200 1978107 885845 24708697 25361589 X 10729869 10864435 10729869 10864435 35438566 36226024 X 149861 -15295 X X 0 1 1 X 0 X 230000 65686 96282 126702 518670 14608395 16510003 16489480 17314219 17686726 82608823 14608395 16740003 16555166 17410501 17813428 83127493 0 0 0 83127493 3278900 792649 521092 1421150 14765 6028556 3278900 792649 521092 1421150 14765 6028556 17887295 17532652 17076258 18831651 17828193 89156049 0.93240 0.92150 0.06760 0.07850 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1175859 10670 -500 11353 1174676 1074000 10068 102728 10937 1175859 888965 36257 153305 4527 1074000 1320680 28913 -441512 19116 888965 0.96000 0.03000 0.01000 0 1 1 2027969 2027969 30191892 5370908 24820984 3630154 1828154 1802000 28650953 INVESTMENT IN RRG 1581612 C INVESTMENTS & RESTR CASH 1073644 F 2655256 ACCRUED COMPENSATION & EMPLOYEE BENEFITS 800932 ACCRUED INTEREST 64213 COMMUNITY FEE DEPOSIT 20700 885845 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE BENEVOLENT ENDOWMENT FUND COMPOSES APPROXIMATELY 76% OF THE ENDOWMENT BALANCE AND IS INTENDED TO GENERATE INCOME TO HELP COVER THE ACTUAL COSTS OF CARE FOR CERTAIN RESIDENTS IN EXCESS OF THEIR MEDICAID REIMBURSEMENT OR PERSONAL ABILITY TO PAY. THE REMAINING ENDOWMENT BALANCE IS IN A GENERAL ENDOWMENT FUND INTENDED TO GENERATE INCOME TO SUPPORT CHARITABLE CARE, CAPITAL IMPROVEMENTS, SERVICES, AND PROGRAMMING OF THE ORGANIZATION. X X 0 0 0 0 0 0 0 1 0 MR CHRIS SPENCE 140538 0 10000 0 11376 0 10383 0 11135 0 183432 0 0 0 PART I, LINE 7 DISCRETIONARY CHRISTMAS BONUSES WERE PAID TO ALL EMPLOYEES. HFDC OF CENTRAL TEXAS INC 371453424 2009-10-07 25462000 SEE PART V 0 0 0 840765 24860965 184051 424339 8486914 15765661 601035 2011 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 SCH K, PART II, LINE 3 VARIANCE EXPLANATION THE VARIANCE OF $601,035 BETWEEN ISSUE PRICE AND TOTAL PROCEEDS OF ISSUE IS DUE TO UNSPENT FUNDS ON PROMISSORY NOTE (WESLEYAN HOMES, INC.) SERIES 2009B RELATING TO CONSTRUCTION AND OTHER ALLOWABLE COSTS FOR THE ASSISTED LIVING FACILITY. FORM 990, PART VI, SECTION A, LINE 2 THE CHAIRWOMAN, NANCY BENOLD, IS THE DAUGHTER-IN-LAW OF DR. DOUG BENOLD, LAITY MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE BOARD, CEO AND CFO PRIOR TO FILING. THE RETURN IS REVIEWED FOR ACCURACY WITH ANY CHANGES BEING DISCUSSED AND SUBMITTED TO BROWN, GRAHAM & COMPANY. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS AND OFFICERS OF THE BOARD OF TRUSTEES AS WELL AS KEY MANAGEMENT EMPLOYEES. UPON DATE OF EMPLOYMENT OR APPOINTMENT ONTO BOARD, THESE INDIVIDUALS MUST SIGN A CONFLICT OF INTEREST STATEMENT STATING THAT THEY HAVE READ AND ARE FAMILIAR WITH THE BYLAWS AND, IN PARTICULAR, ARTICLE 6.6 REGARDING CONFLICT OF INTEREST, AND THAT THEY WILL COMPLY WITH REQUIREMENT TO REPORT, IN WRITING, ANY APPARENT CONFLICT OF INTEREST TO THE BOARD CHAIR. THE BOARD CHAIR IN CONSULTATION WITH APPROPRIATE BOARD MEMBERS AND KEY MANAGEMENT WILL DETERMINE IF A CONFLICT EXISTS AND DETERMINE APPROPRIATE RESTRICTIONS ON A CASE-BY-CASE BASIS FOR AN INDIVIDUAL WITH A CONFLICT OF INTEREST. THE CONFLICT OF INTEREST POLICY WAS REVIEWED AND UPDATED STATEMENTS WERE SIGNED BY ALL BOARD MEMBERS DURING A 2011 BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE SALARIES FOR THE CEO AND OTHER KEY EMPLOYEES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD EACH OCTOBER FOR THE FOLLOWING YEAR. EACH COMMITTEE MEMBER IS PROVIDED WITH THE SALARY HISTORY OF EACH OF THESE EMPLOYEES SINCE HIS/HER EMPLOYMENT DATE. THE HUMAN RESOURCE MANAGER PARTICIPATES EACH YEAR IN THE SALARY SURVEYS FOR AAHSA AND TAHSA (AMERICAN ASSOC. OF HOMES AND SERVICE FOR THE AGING, AND THE TEXAS ASSOCIATION OF HOMES AND SERVICES FOR THE AGING). THE RESULTS OF THESE SURVEYS ARE PROVIDED TO THE CEO TO PRESENT TO THE EXECUTIVE COMMITTEE. THE CEO DISCUSSES EACH EMPLOYEE'S STRENGTHS, WEAKNESSES, ACCOMPLISHMENTS, AND OVERALL PERFORMANCE WITH THIS COMMITTEE. THE COMMITTEE TAKES ALL OF THIS INFORMATION, ALONG WITH THEIR PERCEPTION OF THE EMPLOYEE BASED ON THEIR OWN INTERACTIONS, AND DETERMINES, BY EMPLOYEE, THE SALARY ADJUSTMENT TO BE MADE. THEN, THE CEO LEAVES THE MEETING, AND THE COMMITTEE GOES THROUGH THE SAME PROCEDURE TO EVALUATE HIM. THE BOARD CHAIR GATHERS ALL OF THE INFORMATION ON RAISES AND SIGNS OFF. THE DOCUMENTATION IS THEN FORWARDED TO THE CFO FOR PROCESSING AFTER THE LAST PAYROLL OF THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FROM MANAGEMENT. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -15,295. OVERSIGHT OF THE AUDIT FORM 990, PART XIII,LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. WESLEYAN HOMES PROPERTIES PO BOX 486 GEORGETOWN TX 78627 900085004 ACQUIRING, HOLDING TITLE TO, CONSTRUCTING & MAINTAINING REAL PROPERTY TX 501(C)(3) LINE 11A, I WESLEYAN HOMES INC 0 WESLEYAN HOMES FOUNDATION PO BOX 486 GEORGETOWN TX 78627 900085021 PROVIDE SUPPORT FOR WESLEYAN HOMES INC TX 501(C)(3) LINE 11A, I WESLEYAN HOMES INC 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WESLEYAN HOMES FOUNDATION C 160914 GRANT-CHARITABLE CARE PROVIDED WESLEYAN HOMES FOUNDATION C 41000 GRANT-VAN PURCHASE