2012-11-15T10:27:42-06:00 2011-12-31 202122306 GBQ PARTNERS LLC 230 WEST STREET SUITE 700 COLUMBUS OH 432152663 990 2011-01-01 311468043 NATIONAL CHURCH RESIDENCES DBA TRADITIONS AT CHILLICOTHE INC NATI 6144512151 2335 NORTH BANK DRIVE COLUMBUS OH 43220 JUDITH NADERHOFF 6144512151 2012-11-13 1 GBQ PARTNERS LLC P00631697 6142211120 2011 2016-02-24 21:20:13Z JOSEPH KUYOTH 2335 NORTH BANK DRIVE COLUMBUS OH 43220 10943696 0 5048 X WWW.NATIONALCHURCHRESIDENCES.ORG X 1996 OH PROVIDE HOUSING FOR LOW AND MODERATE INCOME FAMILIES. 3 3 242 141 0 0 5564 6538 9491403 10933624 5098 3534 0 0 9502065 10943696 0 0 0 0 4630172 5201204 0 0 0 4573443 4771253 9203615 9972457 298450 971239 17719657 17957312 17310792 16690018 408865 1267294 X THE MISSION OF NATIONAL CHURCH RESIDENCES IS TO PROVIDE QUALITY HOUSING AND CARE AT AFFORDABLE PRICES IN COMMUNITIES OF CARING PERSONS. OUR MINISTRY IS NATIONAL IN SCOPE AND ORIGINATES FROM A CHRISTIAN COMMITMENT OF SERVICE TO OLDER ADULTS, WHICH BEGAN IN 1961. WHILE OUR MINISTRY HAS BEEN TARGETED PRIMARILY TOWARD OLDER ADULTS, WE HAVE SPECIAL CONCERN FOR LOW- AND MODERATE-INCOME SENIORS, PERSONS WITH DISABILITIES, AND LOW- AND MODERATE-INCOME FAMILIES. WE ARE COMMITTED TO EXPANDING AND FUNDING SERVICES IN ASSISTED LIVING, NURSING HOMES, AND FULL-SERVICE RETIREMENT COMMUNITIES. WE ALSO PLAN FOR THOUGHTFUL GROWTH IN AFFORDABLE FAMILY HOUSING. WE ARE COMMITTED TO PROFESSIONALISM IN THE MANAGEMENT OF PROPERTY, PROGRAMS, AND HUMAN RESOURCES AND EQUALLY COMMITTED TO COMPASSION FOR THE PEOPLE WE SERVE. 0 0 8950627 10933624 PROVIDE LONG TERM HEALTH CARE FACILITIES FOR THE ELDERLY IN THE FORM OF A MULTI-BED NURSING HOME. IN 2011 THE ORGANIZATION PROVIDED 100 LICENSED RESIDENTIAL CARE FACILITY BEDS, 47 INDEPENDENT LIVING UNITS, 80 LICENSED NURSING FACILITY BEDS AND 50 LICENSED RESIDENTIAL CARE UNITS. 8950627 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 1 0 0 0 1 27 0 1 242 1 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X X JOE KASBERG 6144512151 2335 NORTH BANK DRIVE COLUMBUS OH 43220 RONALD ADAMS 1.00 X 0 0 0 FLOYD JONES 1.00 X 0 0 0 UDY STOVER 1.00 X 0 0 0 JOSEPH KUYOTH 1.00 X 0 253704 33964 JUDITH NADERHOFF 1.00 X 0 193651 38480 JOSEPH R KASBERG 1.00 X 0 333984 48253 KAREN STEINBROOK 40.00 X 105005 0 18757 MATTHEW GEISE 40.00 X 100942 0 22281 205947 781339 161735 2 0 1 0 SYSCO PO BOX 62066 CINCINNATI OH 45262 FOOD/DIETARY SUPPLIES 358255 PHARMACIA PO BOX 409251 ATLANTA GA 30384 PHARMACY 204072 DIRECT SUPPLY PO BOX 88201 MILWAUKEE WI 53288 MEDICAL EQUIPMENT 199796 3 6538 6538 RESIDENT SERVICE FEES 623000 10933624 10933624 10933624 3534 3534 10943696 10933624 0 3534 4005162 4005162 24208 24208 775501 775501 396333 396333 998943 14012 984931 7354 7354 29545 29545 45354 45354 48014 48014 81282 81282 60986 60986 412595 412595 21748 21748 486021 486021 366500 366500 778309 778309 103256 103256 PROGRAM SUPPLIES AND DR 462123 462123 PATIENT MEALS 371238 371238 EQUIPMENT AND MAINTENAN 157080 157080 TAXES AND FILING FEES 137563 137563 203342 203342 9972457 8950627 1021830 0 151701 647153 516543 677399 50024 52128 19857684 5438695 14444426 14418989 449992 2556963 1711651 17719657 17957312 981719 769639 14715000 14085000 1614073 1835379 17310792 16690018 X 408865 1267294 408865 1267294 17719657 17957312 X 971239 -112810 X X 0 1 1 X 0 X 101000 1082588 5564 6538 1195690 6837344 9266337 9563881 9491403 10933624 46092589 6938344 9266337 10646469 9496967 10940162 47288279 0 0 0 47288279 49815 5070 13295 5098 3534 76812 49815 5070 13295 5098 3534 76812 6988159 9271407 10659764 9502065 10943696 47365091 0.99840 0.99460 0.00160 0.00540 X 474269 474269 16713534 4135016 12578518 297173 89358 207815 2327422 1172429 1154993 45286 41892 3394 14418989 RESERVES FOR REPLACEMENT 1437064 FINANCING COSTS, NET 274587 1711651 DEPOSITS 189698 OBLIGATION ON FINANCIAL INSTRUMENT 946685 OBLIGATION ON OPERATING RIGHTS 680325 PENSION OBLIGATIONS 18671 1835379 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: MANAGEMENT OF THE FACILITIES ANNUALLY EVALUATES WHETHER THERE ARE ANY UNCERTAINTIES IN INCOME TAX POSITIONS THAT MAY AFFECT THEIR COMBINED FINANCIAL STATEMENTS. MANAGEMENT DETERMINED THERE WERE NO MATERIAL UNCERTAIN POSITIONS TAKEN BY THE FACILITIES IN THEIR TAX RETURNS. IRS FORM 990 FILING PERIODS FOR THE YEARS ENDED 2008 AND PRIOR ARE CLOSED. X X X X X X 0 1 0 0 0 0 0 0 0 JOSEPH KUYOTH 0 189484 0 62000 0 2220 0 31095 0 2869 0 287668 0 0 JUDITH NADERHOFF 0 158245 0 35267 0 139 0 25897 0 12583 0 232131 0 0 JOSEPH R KASBERG 0 213767 0 95000 0 25217 0 35204 0 13049 0 382237 0 0 SUPPLEMENTAL INFORMATION PART III NATIONAL CHURCH RESIDENCES, A RELATED ORGANIZATION, ESTABLISHES THE TOP MANAGEMENT OFFICIALS' COMPENSATION. THE FOLLOWING METHODS WERE USED BY NATIONAL CHURCH RESIDENCES TO ESTABLISH COMPENSATION LEVELS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FRANKLIN COUNTY OHIO 316400067 353180GT3 2005-07-14 32000000 FRANKLIN COUNTY ADJUSTABLE RATE HEALTH CARE FACILITIES REVENUE BOND 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL, AT ALL TIMES, BE NATIONAL CHURCH RESIDENCES. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR TRUSTEES SHALL HAVE THE APPROVAL OF THE BOARD OF TRUSTEES OF NATIONAL CHURCH RESIDENCES. FORM 990, PART VI, SECTION A, LINE 7B NATIONAL CHURCH RESIDENCES IS REQUIRED TO APPROVE THE SELECTION OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 THE 990 RETURN IS MADE AVAILABLE TO THE BOARD PRIOR TO FILING. AN OFFICER REVIEWS THE 990 RETURN PRIOR TO SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, EXECUTIVE OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS IS COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY PERSON COVERED UNDER THIS POLICY MUST DISCLOSE THE EXISTENCE OF A CONFLICT AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF BOARD COMMITTEES. ALL DIRECTORS AND OFFICERS SHALL ALSO REVIEW AND SIGN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT ON AN ANNUAL BASIS, IDENTIFYING FAMILY MEMBERS, POSSIBLE RELATED BUSINESSES, AND INVESTMENTS AND PROMPTLY REPORT ANY CHANGES TO THE CHAIRPERSON THAT OCCUR THROUGHOUT THE YEAR. IF A CONFLICT EXISTS, PARTICIPATION AND VOTING RIGHT RESTRICTIONS ARE IMPOSED. FORM 990, PART VI, SECTION B, LINE 15 FOLLOWING AN ESTABLISHED EXECUTIVE COMPENSATION POLICY, THE HUMAN RESOURCE COMMITTEE REVIEWS AND APPROVES SALARIES OF ALL OFFICERS AND REPORTS TO THE EXECUTIVE COMMITTEE ON THEIR ACTION. THE COMMITTEES BASE THE SALARY DECISIONS ON SURVEY DATA FROM COMPARABLE ORGANIZATIONS, USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE COMPENSATION POLICY REVIEW WAS LAST PERFORMED IN 2011. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST AND THROUGH A SECURED WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: LOSS ON OBLIGATION ON FINANCIAL INSTRUMENT -112,810. TOTAL TO FORM 990, PART XI, LINE 5: -112,810. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII JOSEPH B. KUYOTH, JR., JUDITH NADERHOFF AND JOSEPH R. KASBERG WORK AN ESTIMATED 40-50 TOTAL HOURS A WEEK ON THE SOLE MEMBER, NATIONAL CHURCH RESIDENCES, AND ITS AFFILIATES. FORM 990, SCHEDULE R, PART II THE RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION #5048. 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RENTAL ACTIVITY FOR SENIORS/FAMILIES OH N/A C WHITEHALL SENIOR HOUSING INC 851 COUNTRY CLUB RD WHITEHALL OH 432132442 311592976 RENTAL ACTIVITY FOR SENIORS/FAMILIES OH N/A C WINGATE MANAGEMENT CORP 29777 TELEGRAPH RD SUITE 2611 SOUTHFIELD MI 48034 382060029 MANAGEMENT OF RENTAL ACTIVITY MI N/A S 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 NATIONAL CHURCH RESIDENCES L 984931 FAIR MARKET VALUE NATIONAL CHURCH RESIDENCES E 548674 FAIR MARKET VALUE NATIONAL CHURCH RESIDENCES Q 366500 FAIR MARKET VALUE