2020-08-17T16:10:30-05:00 2019-09-30 271728945 PKF O'CONNOR DAVIES LLP 665 FIFTH AVENUE NEW YORK NY 10022 990 2018-10-01 066077232 BISHOP WICKE HEALTH AND REHABILITATION CENTER INC BISH 2039448285 580 LONG HILL AVENUE SHELTON CT 06484 ZVONIMIR JUKIC TREASURER 2039448285 2020-08-17 1 GARRETT M HIGGINS P00543209 2122862600 2020-08-10 66.108.235.87 2020-08-17 14:03:40 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 8B9532C6912B3E39A4E7E5ED0BE6E8176682D039 2018 2020-09-22 18:59:49Z ZVONIMIR JUKIC 580 LONG HILL AVENUE SHELTON CT 06484 14518385 0 X UMH.ORG X 1968 CT TO PROVIDE NURSING CARE AND ACCOMMODATIONS TO THOSE IN NEED. 5 0 269 30 0 0 0 0 14763342 14513214 49775 5171 0 0 14813117 14518385 0 0 0 0 9081115 9059954 0 0 0 6042271 5793518 15123386 14853472 -310269 -335087 7493969 7565551 12786774 13167963 -5292805 -5602412 TO PROVIDE A CONTINUUM OF SERVICES THAT SUPPORTS HEALTH, INDEPENDENCE, AND DIGNITY. WE BUILD THIS CONTINUUM ON THE BELIEF THAT A RELATIONSHIP-CENTERED PHILOSOPHY BEST SUSTAINS BODY, MIND, AND SPIRIT. 0 0 13720205 14513214 BISHOP WICKE IS AN AWARD-WINNING HEALTH AND REHABILITATION FACILITY LOCATED IN SHELTON, CONNECTICUT THAT PROVIDES SHORT-TERM REHABILITATION, SKILLED NURSING CARE, AND LONG-TERM, DEMENTIA, AND HOSPICE CARE. 13720205 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 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 1 0 0 0 1 X 22 0 269 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X ZVONIMIR JUKIC 2039448276 580 LONG HILL AVENUE SHELTON CT 06484 X DAVID M LAWLOR PRESIDENT/CHAIRMAN 1.00 46.00 X X 0 423024 28143 VICTORIA DOMPIERRE DIRECTOR/SECRETARY 0.50 43.00 X X 0 70219 3604 ZVONIMIR JUKIC DIRECTOR/TREASURER 1.00 46.00 X X 0 145065 14375 FAITH WADJOWICZ - DIRECTOR VICE PRESIDENT OF CLINICAL SERVICES 40.00 0.50 X X 148965 0 25579 DEBRA SAMORAJCZYK DIRECTOR/ADMINISTRATOR 40.00 0.00 X X 120219 0 24035 269184 638308 95736 2 0 1 0 UNITEX TEXTILE RENTAL SERVICES 401 SOUTH MACQUESTEN PARKWAY MOUNT VERNON NY 10550 LINEN SUPPLIES 188050 1 NET RESIDENT REVENUE 623000 14511414 14511414 RENTAL INCOME-SPACE 623000 1800 1800 14513214 5171 5171 14518385 14513214 0 5171 351776 314717 37059 6878858 6664351 214507 168690 167693 997 860124 830038 30086 800506 773112 27394 580568 580568 2017 2017 38085 38085 1239016 1181746 57270 6963 6963 129255 116743 12512 1481893 1421786 60107 496 479 17 5098 4924 174 270873 265456 5417 132498 127964 4534 NURSING SUPPLIES 581296 581296 DIETARY SUPPLIES 521395 521395 BAD DEBT 412323 350475 61848 LAUNDRY/HOUSEKEEPING 292665 292665 99077 98402 675 14853472 13720205 1133267 0 500 500 220035 678466 2370869 1894802 14383 16298 107737 130112 10018514 6987101 3105539 3031413 1674906 1813960 7493969 7565551 1438877 1239556 74998 85062 8180781 7957812 3092118 3885533 12786774 13167963 X -6203805 -6513412 911000 911000 -5292805 -5602412 7493969 7565551 -335087 25480 0 X X 0 1 X 1 1 1 X 190200 190200 14610890 14669078 14924403 14763342 14513214 73480927 14610890 14859278 14924403 14763342 14513214 73671127 0 0 0 73671127 2880 722 2394 49775 5171 60942 2880 722 2394 49775 5171 60942 26748 26748 14640518 14860000 14926797 14813117 14518385 73758817 0.99880 0.99860 0.00080 0.00080 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 26,748. 0 1 X 911000 25480 25480 911000 990560 48834 128394 911000 911000 79560 990560 911000 911000 911000 911000 1.00000 0 1 1 24213 24213 7623412 4814800 2808612 2370889 2172301 198588 3031413 RESTRICTED DEPOSITS AND FUNDED RESERVES 902960 DONOR RESTRICTED FUNDS HELD BY AFFILIATED FOUNDATION 911000 1813960 DUE TO AFFILIATE 3885533 3885533 X 14543865 25480 25480 14518385 0 14518385 14853472 0 14853472 0 14853472 PART IV, LINE 2B: ASSETS LIMITED AS TO USE CONSIST OF CASH AND CASH EQUIVALENTS AND HAVE BEEN SET ASIDE IN ACCORDANCE WITH REGULATORY COMPLIANCE REQUIREMENTS. FOR THE TAX YEAR, CUSTODIAL LIABILITIES CONSISTED OF A SECURITY DEPOSIT FUND AND RESIDENT TRUST FUNDS. RESIDENT TRUST FUNDS: CERTAIN DEPOSITS ARE HELD IN TRUST BY THE FACILITY ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE FACILITY FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE FACILITY AT THE REQUEST OF, OR ON BEHALF OF, RESIDENTS FOR THEIR PERSONAL USE. PART V, LINE 4: DONOR RESTRICTED FUNDS HELD BY AFFILIATED FOUNDATION WESLEYAN FOUNDATION FOR HEALTH AND AGING, INC. (THE "AFFILIATED FOUNDATION") WAS FORMED TO RAISE, HOLD AND INVEST ASSETS OF UMH AND ITS AFFILIATED ENTITIES. THE AFFILIATED FOUNDATION MAINTAINS DONOR RESTRICTED CONTRIBUTIONS AND ACCUMULATED EARNINGS EARMARKED TO SUPPORT THE GENERAL OPERATIONS OF THE FACILITY. AS OF SEPTEMBER 30, 2019, THE AMOUNTS RESTRICTED FOR THE FACILITY AND THE FACILITY'S PORTION OF THE AFFILIATED FOUNDATION'S NET ASSETS, WHICH ARE PERMANENTLY RESTRICTED, TOTALED $911,000 OF THE AFFILIATED FOUNDATION'S TOTAL NET ASSETS OF $15,293,628. EARNINGS OF THE AFFILIATED FOUNDATION EARMARKED FOR THE FACILITY ARE RECOGNIZED AS AN INCREASE IN TEMPORARILY RESTRICTED NET ASSETS. WHEN THE EARMARKED EARNINGS ARE EXPENDED FOR THE STIPULATED PURPOSES, TEMPORARILY RESTRICTED NET ASSETS ARE RECLASSIFIED TO UNRESTRICTED NET ASSETS. THE ASSETS OF THE AFFILIATED FOUNDATION'S ENDOWMENT ARE CARRIED AT FAIR VALUE AND HAVE BEEN VALUED USING LEVEL 2 INPUTS. PART X, LINE 2: THE FACILITY RECOGNIZES THE EFFECT OF TAX POSITIONS ONLY WHEN THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE FACILITY HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE FACILITY IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO SEPTEMBER 30, 2016. 0 0 0 0 0 0 0 0 0 DAVID M LAWLOR PRESIDENT/CHAIRMAN 0 423024 0 0 0 0 0 27558 0 585 0 451167 0 0 ZVONIMIR JUKIC DIRECTOR/TREASURER 0 145065 0 0 0 0 0 5001 0 9374 0 159440 0 0 FAITH WADJOWICZ - DIRECTOR VICE PRESIDENT OF CLINICAL SERVICES 148965 0 0 0 0 0 6194 0 19385 0 174544 0 0 0 FORM 990, PART V, LINES 2A AND 2B: THE FILING ORGANIZATION'S EMPLOYEES ARE THE EMPLOYEES OF UNITED METHODIST HOMES, INC. ("UMH"), THE PARENT ORGANIZATION. UMH IS THE COMMON PAYMASTER. THE ORGANIZATION REIMBURSES UMH FOR PAYROLL AND RELATED EXPENSES COSTS AS REPORTED ON SCHEDULE R, PART V. ON LINE 2A OF 990, PAGE, 5, PART V, THE ORGANIZATION HAS REPORTED THE NUMBER OF EMPLOYEES ASSOCIATED WITH THE FILING ORGANIZATION DURING THE CALENDAR YEAR ENDING WITHIN ITS TAX YEAR. THE TOTAL NUMBER OF EMPLOYEES REPORTED BY UMH DURING THE CALENDAR YEAR ENDING WITHIN ITS TAX YEAR IS 474. THE FILING ORGANIZATION HAS ANSWERED YES TO LINE 2B OF 990, PAGE, 5, PART V, AS UMH HAS FILED ALL REQUIRED FEDERAL EMPLOYMENT TAX RETURNS FOR THE CALENDAR YEAR ENDING WITHIN ITS TAX YEAR. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT OF THE FACILITY IS PERFORMED BY UNITED METHODIST HOMES, INC., A RELATED PARTY. THE FACILITY IS UNDER THE DIRECT OPERATIONAL AND MANAGEMENT CONTROL OF UNITED METHODIST HOMES, INC. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS UNITED METHODIST HOMES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION HAS THE AUTHORITY TO ELECT DIRECTORS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S BYLAWS MAY BE AMENDED BY THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY OUR INDEPENDENT AUDITORS IN COORDINATION WITH THE ANNUAL AUDITS. THE FINANCE COMMITTEE REVIEWS THESE REPORTS AND PROVIDES COMMENT PRIOR TO ELECTRONIC FILING. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTERESTS IN CONNECTION TO AN OWNERSHIP, INVESTMENT OR COMPENSATION ARRANGEMENT WITH ANY INDIVIDUAL OR ORGANIZATION WITH WHICH UNITED METHODIST HOMES AND AFFILIATES HAS OR IS CONTEMPLATING A TRANSACTION WITH. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY A COMMITTEE LEAD BY THE CORPORATE COMPLIANCE OFFICER. THE COMMITTEE EVALUATES THE APPROPRIATE HANDLING OF EACH CONFLICT AND REPORTS TO THE FULL BOARD ON AN ANNUAL BASIS. A CONFLICTED PERSON MAY NOT VOTE ON OR ENTER INTO ANY TRANSACTION WITH WHICH HE HAS A CONFLICT OF INTEREST. THE BOARD MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO ANY PROPOSED CONFLICTED TRANSACTION. RECORDS AND REVIEWS OF ALL IDENTITY OF INTERESTS AND DETERMINATIONS OF POSSIBLE CONFLICTS OF INTEREST ARE RECORDED IN THE MINUTES OF ANY BOARD MEETING IN WHICH THEY ARE DISCUSSED. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION OF MANAGEMENT IS DETERMINED BY A COMPENSATION COMMITTEE AND/OR SENIOR MANAGEMENT, INCLUDING THE HUMAN RESOURCES DEPARTMENT, THROUGH A DETAILED REVIEW USING COMPARABILITY DATA, INCLUDING THE FORM 990S FROM SIMILARLY SITUATED NONPROFIT ORGANIZATIONS. CONTEMPORANEOUS DOCUMENTATION OF THE DELIBERATIONS AND DECISION MAKING IS MAINTAINED BY THE ORGANIZATION. THE PROCESS WAS LAST CONDUCTED IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, 990S AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. FORM 990, PART VII, LINE 1(B): THE LISTED BOARD MEMBERS AND OFFICERS REPORTED IN PART VII OF THIS 990 ARE COMPENSATED AS AN EMPLOYEE BY A RELATED ORGANIZATION, UNITED METHODIST HOMES, INC. (THE PARENT ORGANIZATION) OR ONE OF UNITED METHODIST HOMES' AFFILIATES. EACH EMPLOYEE'S AVERAGE HOURS PER WEEK RANGE FROM 40 TO 50. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CARELINK CORPORATION 580 LONG HILL AVENUE SHELTON CT 06484 061501849 ASSISTED LIVING SERVICES CT 501(C)(3) LINE 10 UNITED METHODIST HOMES INC 0 CROSBY COMMONS INC 580 LONG HILL AVENUE SHELTON CT 06484 061505334 ASSISTED LIVING SERVICES CT 501(C)(3) LINE 10 UNITED METHODIST HOMES INC 0 MIDDLEWOODS OF NEWINGTON INC 580 LONG HILL AVENUE SHELTON CT 06484 743080603 ASSISTED LIVING SERVICES CT 501(C)(3) LINE 10 UNITED METHODIST HOMES INC 0 THE UNITED METHODIST HOME OF SHARON INC 580 LONG HILL AVENUE SHELTON CT 06484 061607026 SUPPORT THE OPERATIONS OF UMH - DISSOLVED CT 501(C)(3) LINE 12A, I UNITED METHODIST HOMES INC 0 UNITED METHODIST HOMES INC 580 LONG HILL AVENUE SHELTON CT 06484 060987394 HEALTH CARE SERVICES CT 501(C)(3) LINE 10 N/A 0 WESLEY HEIGHTS INC 580 LONG HILL AVENUE SHELTON CT 06484 066077231 SENIOR RETIREMENT HOUSING CT 501(C)(3) LINE 10 UNITED METHODIST HOMES INC 0 WESLEYAN FOUNDATION FOR HEALTH AND AGING INC 580 LONG HILL AVENUE SHELTON CT 06484 060606530 RAISE AND DISTRIBUTE FUNDS TO AFFILIATES CT 501(C)(3) LINE 12B, II UNITED METHODIST HOMES INC 0 WESLEYAN HOMES OF TENNESSEE INC 580 LONG HILL AVENUE SHELTON CT 06484 203533871 INACTIVE - DISSOLVED CT 501(C)(3) LINE 10 UNITED METHODIST HOMES INC 0 THE LONG HILL COMPANY 580 LONG HILL AVENUE SHELTON CT 06484 061534724 SERVICE MANAGEMENT CT UNITED METHODIST HOMES INC C 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0