2019-06-28T11:32:56-05:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2018-01-01 237302390 KANSAS CITY UNITED METHODIST RETIREMENT HOME INC D/B/A KINGSWOOD KANS 8169420994 10000 WORNALL ROAD KANSAS CITY MO 64114 JOANNE KELLEY SECRETARY 8169420994 2019-06-25 1 JEFF PARKER P00970069 3149254300 67.137.57.251 2019-06-25 09:54:44 CD P AE419FF41DEE4B5733E7E5F8E31ABE2574D75352 DBE5E9100BD705C5801F05FB9419F1388E8E9FDA 2018 2019-02-21 02:37:17Z MATT PHIPPS 10000 WORNALL ROAD KANSAS CITY MO 64114 15552927 0 X WWW.KINGSWOODRETIREMENTLIVING.COM X 1972 MO TO PROVIDE RESIDENTAL AND HEALTH CARE FACILITIES, SERVICES AND OPPORTUNITIES FOR OLDER ADULTS AND DISABLED PERSONS. 11 11 418 100 0 0 140902 126889 12891919 14735117 192652 282805 290688 405070 13516161 15549881 450 0 0 0 7452434 8335861 0 0 0 10863054 13463383 18315938 21799244 -4799777 -6249363 62824604 56291039 86143360 86256953 -23318756 -29965914 KINGSWOOD'S MISSION IS TO WELCOME OLDER ADULTS AND DISABLED PERSONS WITH OPPORTUNITIES TO ENRICH THEIR LIVES WITH EXCELLENT RESIDENTIAL AND HEALTHCARE SERVICES OFFERED IN A SAFE, LOVING AND CARING COMMUNITY. A MINISTRY OF THE UNITED METHODIST CHURCH. 0 0 18463945 15001739 KINGSWOOD, A MINISTRY OF THE UNITED METHODIST CHURCH, MAINTAINS 137 INDEPENDENT LIVING APARTMENTS, 82 BEDS IN THE HEALTH CENTER, 34 ASSISTED LIVING APARTMENTS, 23 MEMORY CARE BEDS, AND 65 VILLA HOMES. THE HEALTH CENTER IS LICENSED BY THE STATE OF MISSOURI AS A SKILLED NURSING FACILITY. KINGSWOOD AVERAGES AROUND 300 RESIDENTS ON THE 33 ACRE CAMPUS. SERVICES PROVIDED BY KINGSWOOD INCLUDE MEALS, HOUSEKEEPING, LAUNDRY, UTILITIES, MAINTENANCE, LIGHTED PARKING, RELIGIOUS/SOCIAL PROGRAMMING, SECURITY, ADMINISTRATIVE SERVICES, LOUNGES, CRAFT AREAS, TRANSPORTATION, PERSONAL CARE ASSISTANCE, REHABILITATITVE THERAPY, A CHAPEL, A LIBRARY, A COMPUTER LAB, BEAUTY AND BARBER SALON, GIFT SHOP, OUTDOOR PATIOS AND WALKING AREAS. 18463945 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 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 1 1 0 0 1 58 0 418 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CONNIE CARGIN 8164423255 10000 WORNALL ROAD KANSAS CITY MO 64114 X RICHARD LANE CHAIR 0.50 0.50 X X 0 0 0 KELLY SIZEMORE VICE CHAIR 1.00 X X 0 0 0 JOANNE KELLEY SECRETARY 1.00 X X 0 0 0 ROSS MARINE TREASURER 1.00 X X 0 0 0 FRED WIMAN PAST CHAIR 1.00 X X 0 0 0 ROBERT ADAMS DIRECTOR 0.50 0.50 X 0 0 0 SCOTT CORBIN DIRECTOR 1.00 X 0 0 0 ELVA NEEDLES DIRECTOR 1.00 X 0 0 0 RUTHANNE PHILLIPS DIRECTOR 0.50 0.50 X 0 0 0 GARLAND RICHARDSON DIRECTOR 1.00 X 0 0 0 GARY WARRINER DIRECTOR 1.00 X 0 0 0 SALLY FIRESTONE DIRECTOR (TERM ENDED) 1.00 X 0 0 0 MATT PHIPPS EXECUTIVE DIRECTOR 40.00 X 0 0 0 MIKE DIRLAM ASSOCIATE EXECUTIVE DIRECTOR 40.00 X 0 0 0 KRISTEN WALTERS ADMINISTRATOR 40.00 X 0 0 0 TERRI MOORE PAST EXECUTIVE DIRECTOR 40.00 X 0 0 0 CONNIE CARGIN DIRECTOR OF FINANCE 40.00 X 103523 0 7701 103523 0 7701 1 0 0 0 REHAB CARE PO BOX 503534 ST LOUIS MO 63150 THERAPY 797996 PARIC CORP PO BOX 790100 ST LOUIS MO 63179 CONSTRUCTION 723607 SQUIRES CONSTRUCTION 23230 NW PINK HILL ROAD BLUE SPRINGS MO 64015 CONSTRUCTION 554802 GLYNNDEVINS 8880 WARD PARKWAY KANSAS CITY MO 64114 MARKETING SOLUTIONS 442428 LIFE CARE SERVICES 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT/DEVELOPMENT 381900 15 126889 126889 RESIDENT REVENUE 623000 14735117 14735117 14735117 228718 228718 57133 57133 3046 -3046 -3046 -3046 8658 0 8658 8658 NFRA REVENUE 623000 266622 266622 DINING SERVICES 623000 89651 89651 TRANSPORTATION 623000 33291 33291 6848 6848 396412 15549881 15001739 0 421253 298552 298552 6641009 5904348 736661 7855 5245 2610 877770 794164 83606 510675 449097 61578 401781 401781 228390 228390 57686 57686 1241070 1184241 56829 832952 832952 727767 665241 62526 225421 225421 1344939 1301381 43558 70640 57797 12843 3158299 3056012 102287 2772458 2682667 89791 205549 198892 6657 FOOD 948927 948927 MAINTENANCE 642246 621446 20800 DUES, LICENSE, FEES 297941 288122 9819 ANCILLARY EXPENSE 184894 184894 122423 121471 952 21799244 18463945 3335299 0 2250210 431790 4866995 1888094 332513 521562 51077 56433 119327 127869 81805546 36196962 47415247 45608584 6531596 6476605 1113023 1035486 144616 144616 62824604 56291039 6376490 5611244 3442533 3236091 49882081 49472388 26442256 27937230 86143360 86256953 X -27632548 -34104835 2418466 2233595 1895326 1905326 -23318756 -29965914 62824604 56291039 -6249363 -397795 0 X X 0 1 X 1 0 X 277268 202778 197089 140902 126889 944926 13742036 13270926 12913761 12891919 14735117 67553759 8658 8658 14019304 13473704 13110850 13032821 14870664 68507343 5000 5000 0 5000 5000 68502343 39892 135870 106540 192652 285850 760804 39892 135870 106540 192652 285850 760804 430945 426567 283854 290688 396412 1828466 14490141 14036141 13501244 13516161 15552926 71096613 0.96350 0.96210 0.01070 0.00760 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: DINING SERVICES - 2014 AMOUNT: $ 75,102. 2015 AMOUNT: $ 70,957. 2016 AMOUNT: $ 70,399. 2017 AMOUNT: $ 85,824. 2018 AMOUNT: $ 89,651. GIFT SHOP - 2014 AMOUNT: $ 20,993. 2015 AMOUNT: $ 20,107. 2016 AMOUNT: $ 13,669. 2017 AMOUNT: $ 7,558. BEAUTY SHOP - 2014 AMOUNT: $ 83,798. 2015 AMOUNT: $ 77,708. 2016 AMOUNT: $ 66,987. 2017 AMOUNT: $ 31,257. 2018 AMOUNT: $ 3,003. MISCELLANEOUS - 2015 AMOUNT: $ 9,745. 2016 AMOUNT: $ 2,763. TRANSPORTATION - 2014 AMOUNT: $ 41,228. 2015 AMOUNT: $ 43,401. 2016 AMOUNT: $ 34,305. 2017 AMOUNT: $ 26,363. 2018 AMOUNT: $ 33,291. GUEST ROOM - 2014 AMOUNT: $ 25,335. 2015 AMOUNT: $ 32,825. 2016 AMOUNT: $ 28,389. 2017 AMOUNT: $ 29,055. 2018 AMOUNT: $ 3,845. NFRA REVENUE - 2014 AMOUNT: $ 184,489. 2015 AMOUNT: $ 171,824. 2016 AMOUNT: $ 67,342. 2017 AMOUNT: $ 110,631. 2018 AMOUNT: $ 266,622. 3308785 -98815 3209970 2801378 507407 3308785 2655355 27350 145490 26817 2801378 2618506 33357 28818 25326 2655355 2460121 25818 157417 24850 2618506 0.00000 0.33120 0.66880 0 1 1 3161712 3161712 70668544 31181001 39487543 3307543 1510361 1797182 4627048 3505600 1121448 40699 40699 45608584 RESIDENT DEPOSITS 189156 REFUNDABLE ENTRANCE FEES 27421494 MANAGEMENT FEE PAYABLE 326580 27937230 X PART V, LINE 4: KINGSWOOD MAINTAINS A WESLEY ENDOWMENT FUND. THE FUNDS ARE USED FOR FINANCIAL ASSISTANCE FOR THE RESIDENTS. PART X, LINE 2: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IT IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAX EXCEPT FOR THOSE THAT ARE ALREADY REPORTED ANNUALLY. A INDUSTRIAL DEVELOPMENT AUTHORIITY OF THE CITY OF KANSAS CITY MISSOURI 431157670 48504LAC7 2016-01-06 51937170 ACQUISITION OF LAND AND CONSTRUCTION ON NEW INDEPENDENT LIVING VILLAS, RENOV 0 0 0 A 715000 51937170 3535288 1035400 31553644 15812838 2017 1 0 1 1 A 0 1 1 1 0 0.00050 0.00000 0.00050 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE OF THE BOARD IS GIVEN AUTHORITY TO ACT ON THE BOARD'S BEHALF ON SPECIFIC SITUATIONS. THE COMMITTEE IS COMPRISED OF THE CHAIR, VICE CHAIR, SECRETARY, TREASURER, AND PAST CHAIR. ALL MEMBERS ARE ALSO MEMBERS OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING BOARD MEMBERS HAVE MEMBERSHIP INTEREST IN 447 WEST 99TH LLC: ROBERT M. ADAMS - MEMBERSHIP INTEREST OF 12% SALLY FIRESTONE - MEMBERSHIP INTEREST OF 24% RUTHANNE PHILLIPS - MEMBERSHIP INTEREST OF 6% FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS A MANAGEMENT AGREEMENT WITH LIFE CARE SERVICES, LLC (LCS). UNDER THE AGREEMENT, LCS PROVIDES AN EXECUTIVE DIRECTOR AND IS APPOINTED MANAGER OF THE ORGANIZATION'S OPERATIONS AND REAL ESTATE. THE AGREEMENT HAS A 60-MONTH TERM ENDING SEPTEMBER 30, 2019 AND INCLUDES CERTAIN PROVISIONS FOR TERMINATION. THE BASE MANAGEMENT FEE WILL BE THE SUM OF $5,000; PLUS, THE GREATER OF $16,000 OR AN AMOUNT EQUAL TO 2.5% OF NET OPERATING REVENUES RECEIVED BY THE ORGANIZATION DURING EACH MONTH. TOTAL FEES PAID TO LCS PURSUANT TO THE AGREEMENT AMOUNTED TO APPROXIMATELY $934,000 AND $422,000 FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017, RESPECTIVELY. OTHER MISCELLANEOUS FEES PAID TO LCS FOR VARIOUS SERVICES, INCLUDING TRAVEL, TECHNOLOGY, MARKETING, AND REIMBURSABLE EXPENSES, TOTALED APPROXIMATELY $430,368 AND $348,000 FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017, RESPECTIVELY. THE ORGANIZATION ALSO ENTERED INTO A DEVELOPMENT AGREEMENT WITH LCS DEVELOPMENT, LLC (LCS), EFFECTIVE JULY 31, 2014. UNDER THE AGREEMENT, LCS WILL EXPEDITE AND COORDINATE PLANNING AND DEVELOPMENT OF THE MASTER FACILITY RENOVATION PROJECT, ASSIST THE ORGANIZATION WITH THE IDENTIFICATION OF POTENTIAL FINANCING FOR THE PROJECT AND ASSIST WITH THE ACQUISITION OF FINANCING FOR THE MASTER FACILITY RENOVATION PROJECT, MANAGE STATE AND LOCAL REGULATORY APPROVALS, MANAGE INITIAL OCCUPANCY DEVELOPMENT, ARRANGE FOR DESIGN AND CONSTRUCTION SERVICES, AND WILL HANDLE CERTAIN BOOKKEEPING FUNCTIONS. IN 2018, THE FOLLOWING LCS EMPLOYEES WERE COMPENSATED BY LCS FOR THEIR SERVICES TO KINGSWOOD: MATT PHIPPS, EXECUTIVE DIRECTOR: $62,438 TERRI MOORE, EXECUTIVE DIRECTOR: $83,657 MIKE DIRLAM, ASSOCIATE EXECUTIVE DIRECTOR: $49,831 KRISTEN WALTERS, ADMINISTRATOR: $102,626 FORM 990, PART VI, SECTION B, LINE 11B THE COMPLETED 990 WILL BE E-MAILED TO BOARD MEMBERS PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED ANNUALLY TO REVIEW THE CONFLICT OF INTEREST POLICY AND SIGN THAT THEY WILL COMPLY WITH THE POLICY. IF AND WHEN A CONFLICT ARISES, THE BOARD MEMBER IS ASKED TO DISCLOSE MATERIAL FACTS AND LEAVE THE MEETING. A DETERMINATION IS MADE BY THE REMAINING BOARD MEMBERS WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS, THE BOARD MEMBER IS REQUESTED TO LEAVE THE MEETING DURING THE DISCUSSION AND THEN THE REST OF THE BOARD VOTES ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS AN EMPLOYEE OF LIFE CARE SERVICES, THE MANAGEMENT COMPANY. COMPARATIVE INFORMATION ON OTHER DIRECTOR'S COMPENSATION IS AVAILABLE THROUGH LIFE CARE SERVICES. A PERFORMANCE REVIEW IS COMPLETED BY THE EMPLOYEE AND THE CEO. COMPARATIVE INFORMATION ON SIMILAR POSITIONS ARE AVAILABLE THROUGH LIFE CARE SERVICES. THIS PROCESS WAS LAST COMPLETED IN 2018. THE CEO REVIEWS THE DIRECTORS BASED ON A PERFORMANCE POINT SYSTEM. THE WAGE INCREASE PERCENTAGE IS BASED ON ACCOUMULATED POINTS. A WAGE COMPARISON IS COMPLETELY ANNUALLY TO ENSURE THAT THE COMPANY REMAINS COMPETITIVE IN THE MARKET. THIS PROCESS WAS LAST COMPLETED IN 2018. 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. FORM 990 PAGE 12, PART XII, LINE 2C THE POLICY FOR REVIEWING THE FINANCIAL STATEMENT REMAINS UNCHANGED FROM THE PRIOR YEAR KINGSWOOD SENIOR LIVING COMMUNITY FOUNDATION 10000 WORNALL ROAD KANSAS CITY MO 64114 200639597 PROVIDES SUPPORT FOR KANSAS CITY UNITED METHODIST RETIREMENT HOME, INC. MO 501 (C)(3) LINE 12A, I KANSAS CITY UNITED METHODIST RETIREMENT HOME INC DBA KINGSWOOD 1 0 0 1 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 0 KINGSWOOD SENIOR LIVING COMMUNITY FOUNDATION C 126889 FMV SCHEDULE R PART III 457 WEST 100TH TERRACE LLC HAS BEEN REMOVED FROM SCHEDULE R. THE LLC FILED ARTICLES OF TERMINATION WITH THE STATE OF MISSOURI ON MARCH 9, 2016