2011-11-04T10:56:22-05:00 2010-12-31 SWINDOLL JANZEN HAWK & LOYD LLC 123 S MAIN PO BOX 1337 MCPHERSON KS 67460 990 2010-01-01 480643239 MEMORIAL HOME INC MEMO 6203452901 86 22ND AVE MOUNDRIDGE KS 67107 JASON T STUCKY 6203452901 2011-10-31 1 KEITH S JANZEN CPA 6202411826 2010 2016-03-07 17:11:31Z JIM HUXMAN 86 22ND AVENUE MOUNDRIDGE KS 67107 5204081 0 X WWW.MEMORIALHOME.ORG X 1958 KS TO SERVE ELDERS IN ALL LEVELS OF SERVICE FROM INDEPENDENT TO FULL SERVICE HEALTHCARE, IN A CARING, RESIDENT-CENTERED ENVIRONMENT, TO PROVIDE THE BEST QUALITY OF LIFE POSSIBLE FOR ALL RESIDENTS. 11 11 190 125 0 0 109463 103934 5552411 5043207 17876 2941 49029 47396 5728779 5197478 0 0 0 0 3459438 3259987 2530 88 70068 2334844 2255530 5796812 5515605 -68033 -318127 10802700 10280565 6890832 6686824 3911868 3593741 TO PROVIDE A CONTINUUM OF LONG-TERM CARE SERVICES FOR THE AGED AND HANDICAPPED PERSONS WHO COME TO OUR FACILITIES, AND TO DO SO WITHIN A FRAMEWORK OF CHRISTIAN CONCERN. 0 0 3706263 4059996 SKILLED NURSING-PROVIDED FULL SERVICE HEALTHCARE INCLUDING DEMENTIA CARE TO RESIDENTS IN NEED OF CARE AND SERVICES. 428235 469106 ASSISTED LIVING-PROVIDES ALL MEALS, ASSISTANCE WITH MEDICATION AND OTHER SERVICES FOR THOSE NOT NEEDING FULL HEALTHCARE. 512580 561501 INDEPENDENT LIVING-ON CAMPUS ARE 75 INDEPENDENT LIVING UNITS FROM CONGREGATE APARTMENTS TO SINGLE HOMES FOR THOSE THAT WANT SERVICES SUCH AS LAWN CARE, SNOW REMOVAL, REPAIR AND UPKEEP OR HOMES, ETC. 4647078 1 1 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 14 0 190 1 0 0 0 0 0 1 1 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 KS X JASON STUCKY 6203452901 86 22ND AVENUE MOUNDRIDGE KS 67107 STEVE KAUFMAN 1.00 X 0 0 0 KEN STUCKY 1.00 X 0 0 0 JOHN WILL 1.00 X 0 0 0 ALLEN SEEBER 1.00 X 0 0 0 JEFF KOLLER 1.00 X 0 0 0 KEN PREHEIM 1.00 X 0 0 0 LLOYD VOGT 1.00 X 0 0 0 ROBERT SWAN 1.00 X 0 0 0 MICHAEL DUNN 1.00 X 0 0 0 RUTH OLTMANNS 1.00 X 0 0 0 NADA WEDEL 1.00 X 0 0 0 JASON T STUCKY 40.00 X 62793 0 2078 JAMES N HUXMAN 40.00 X 69122 0 1610 131915 0 3688 0 0 0 0 0 103934 103934 NET RESIDENT SERVICES 900099 5043207 5043207 5043207 9144 9144 400 6603 -6203 -6203 -6203 WELLNESS CENTER 900099 18359 18359 MISCELLANEOUS INCOME 900099 10892 10892 CAFETERIA 900099 9364 9364 8781 8781 47396 5197478 5090603 0 2941 131915 131915 2590688 2436430 117892 36366 2449 1878 571 337681 306707 25206 5768 197254 176895 18004 2355 6822 6822 61839 61839 88 88 9723 9723 23626 7 23619 93706 47410 44424 1872 29086 29086 3669 3590 79 365877 287023 78854 2937 1576 1361 53254 18680 34574 129630 129630 707397 707397 125133 125133 FOOD 240383 240383 MEDICARE SERVICE EXPENS 223283 223283 SUPPLIES AND EXPENSES 179165 174583 4582 ALLOCATE FUNCTIONAL EXP 0 718917 -718917 5515605 4647078 798459 70068 865344 655445 230561 229888 319489 413059 75605 66103 17899110 8983040 9311701 8916070 10802700 10280565 282334 303666 3943792 3817021 2523469 2334900 141237 231237 6890832 6686824 X 3818711 3549694 93157 44047 3911868 3593741 10802700 10280565 -318127 0 X 0 0 0 X 121567 74642 165559 109463 103934 575165 4853589 5063047 5076973 5552411 5043208 25589228 83621 100752 57875 93811 44134 380193 5058777 5238441 5300407 5755685 5191276 26544586 0 0 0 26544586 7204 7007 4986 17876 9144 46217 7204 7007 4986 17876 9144 46217 5065981 5245448 5305393 5773561 5200420 26590803 0.99830 0.99850 0.00170 0.00150 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 929490 118845 17887 1066222 690976 161407 77107 929490 728075 97047 -134146 690976 0.03010 0.03370 0.93620 0 1 1 993715 993715 14783548 7574737 7208811 2121847 1408303 713544 8916070 DEMAND CERTIFICATES - 4.25% 231237 231237 5197478 5515605 -318127 0 -318127 5336735 11888 127369 139257 5197478 0 5197478 5518130 2525 2525 5515605 0 5515605 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TO USE THE INVESTMENT INCOME FROM ENDOWMENT FUNDS TO SUPPLEMENT THE INCOME FROM RESIDENTS AND KEEP CHARGES AFFORDABLE FOR RESIDENTS. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGES IN VALUE OF SPLIT-INTEREST AGREEMENTS PART XII, LINE 2D - OTHER ADJUSTMENTS: REVENUE FROM ENDOWMENT FUND CONSOLIDATION 127,369. PART XIII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES PAID BY ENDOWMENT FUND CONSOLIDATION 2,525. CITY OF MOUNDRIDGE KANSAS 486020221 2008-06-27 2600000 CONSTRUCTION OF NEW ASSISTED LIVING UNITS. 0 0 0 2008 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 OFFICER REVIEWS FORM 990 BEFORE BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD POLICIES AND EMPLOYEE POLICIES STATE THAT AN ANNUAL REVIEW AND SELF REPORTING OF ANY CONFLICT OF INTEREST IS REQUIRED. A CORPORATE COMPLIANCE OFFICER IS IN PLACE TO MONITOR ANY REPORTED CONFLICTS AND PRESENT THEM TO THE BOARD OF DIRECTORS IF NECESSARY. FORM 990, PART VI, SECTION C, LINE 19 PUBLIC INSPECTION OF FINANCIAL DOCUMENTS IS MADE AVAILABLE UPON REQUEST IN PERSON. MEMORIAL HOME ENDOWMENT FOUNDATION 86 22ND AVENUE MOUNDRIDGE KS 67107 481243016 ENDOWMENT KS 501(C)(3) MEMORIAL HOME INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0