2018-01-29T16:50:28-06:00 2017-03-31 420714325 RSM US LLP 201 FIRST ST SE SUITE 800 CEDAR RAPIDS IA 52401 990 2016-04-01 420838541 THE METH-WICK COMMUNITY INC METH 3193659171 1224 13TH STREET NW CEDAR RAPIDS IA 524052404 ROBIN MIXDORF PRESIDENT 3193659171 2018-01-25 1 SHAWNA HULS P01315330 3192985333 108.171.131.189 2018-01-25 12:30:40 CS P 99601D3132F1E31F6862A7C077C0948039A20E61 63F0EEB24C910906BC6653715CD0B4582F1A1648 2016 2021-01-29 14:40:06Z ROBIN MIXDORF PRESIDENT 1224 13TH STREET NW CEDAR RAPIDS IA 524052404 17025410 0 X WWW.METHWICK.ORG X 1959 IA CONTINUING CARE RETIREMENT COMMUNITY 20 20 269 125 41556 34234 1171810 601531 14321491 14962676 126871 248456 39096 42206 15659268 15854869 0 0 0 0 6890445 7482147 63771 21257 21257 7671464 8395149 14625680 15898553 1033588 -43684 33311542 35897673 16156289 18481432 17155253 17416241 X OUR MISSION IS TO PROVIDE A SECURE AND CARING LIVING ENVIRONMENT TO THOSE WE SERVE, ALLOWING THEM TO MAINTAIN THEIR DIGNITY AND TO ENRICH THE QUALITY OF THEIR LIVES AS THEY AGE. 0 0 6034918 6326864 NURSING HOME- OPERATED A 65 BED NURSING HOME FACILITY WHICHPROVIDED 22,006 RESIDENT DAYS OF CARE FOR RESIDENTS TRANSFERRINGFROM OTHER SERVICE LEVELS WITHIN THE METH-WICK COMMUNITY ANDFROM THE SURROUNDING AREA. FREE AND DISCOUNTED CARE IS PROVIDEDTO ANY RESIDENT WHO IS UNABLE TO PAY FOR THE SERVICES THEY NEED.17 RESIDENTS RECEIVED SUCH ASSISTANCE IN THE 2016-17 FISCAL YEAR. 2987756 2860815 INDEPENDENT LIVING - PROVIDED 157 INDEPENDENT LIVING UNITS WHICHALLOW THE RESIDENTS THE OPPORTUNITY TO LIVE INDEPENDENTLY WHILEHAVING ACCESS TO ALL HEALTH, WELLNESS AND RECREATIONAL SERVICESAVAILABLE ON OUR CAMPUS. ADDITIONALLY, INDEPENDENT LIVING RESIDENTSMAY ADD SERVICES OR TRANSITION TO ANY OTHER LEVEL OF LIVING/CAREPROVIDED ON OUR CAMPUS WHEN NECESSARY TO MEET THEIR NEEDS. 2138016 2217758 SUPPORTED LIVING - PROVIDE 73 SUPPORTED LIVING UNITS TO CAREFOR RESIDENTS TRANSFERRING FROM OTHER SERVICES LEVELSWITH THE METH-WICK COMMUNITY AND FROM THE SURROUNDING AREA.FREE AND DISCOUNTED CARE IS PROVIDED TO ANY RESIDENT WHO ISUNABLE TO PAY FOR THE SERVICES THEY NEED. 2 RESIDENTS HAVERECEIVED SUCH ASSISTANCE IN THE 2016-17 FISCAL YEAR. 2649416 3163987 ASSISTED LIVING- OPERATED TWO 32 ROOM ASSISTED LIVING UNITS WHICHPROVIDED 19,581 RESIDENT DAYS OF CARE FOR RESIDENTS TRANSFERRINGFROM OTHER SERVICE LEVELS WITHIN THE METH-WICK COMMUNITY ANDTHE SURROUNDING AREA. FREE AND DISCOUNTED CARE IS PROVIDEDTO ANY RESIDENT WHO IS UNABLE TO PAY FOR THE SERVICES THEY NEED.4 RESIDENTS RECEIVED SUCH ASSISTANCE IN THE 2016-17 FISCAL YEAR. 771937 393247 COMMUNITY CARE, BEAUTY SHOP, ESTATE COUNSELING, RENTAL OF ROOF SPACE 3421353 3557234 14582043 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 18 0 1 269 1 1 1 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X ROBIN MIXDORF 3192978601 1224 13TH STREET NW CEDAR RAPIDS IA 524052404 GARY ERNST CHAIRPERSON 1.00 X X 0 0 0 RICHARD JOHNSON VICE-CHAIRPERSON 1.00 X X 0 0 0 DIANNE AUSTAD SECRETARY 1.00 X X 0 0 0 DOUG ALLEMANG TREASURER 1.00 X X 0 0 0 DEBORAH GERTSEN BOARD MEMBER 1.00 X 0 0 0 ARLON BERKHOF BOARD MEMBER 1.00 X 0 0 0 ROBERT J BUNTZ BOARD MEMBER 1.00 X 0 0 0 LAVERNE FLAGEL BOARD MEMBER 1.00 X 0 0 0 LEN HADLEY BOARD MEMBER 1.00 X 0 0 0 RUTH NEBERGALL BOARD MEMBER 1.00 X 0 0 0 SCOTT OLSON BOARD MEMBER 1.00 X 0 0 0 MARY ANN OSBORN BOARD MEMBER 1.00 X 0 0 0 JAMES RUSSELL BOARD MEMBER 1.00 X 0 0 0 ERICA YODER BOARD MEMBER 1.00 X 0 0 0 DARA SCHMIDT BOARD MEMBER 1.00 X 0 0 0 DR JOHN HERRING BOARD MEMBER 1.00 X 0 0 0 JAN HANDLER BOARD MEMBER 1.00 X 0 0 0 PAUL DRAPER BOARD MEMBER 1.00 X 0 0 0 TERRI DAVIS BOARD MEMBER 1.00 X 0 0 0 ERIK MADSEN BOARD MEMBER EFF. 06/2016 1.00 X 0 0 0 ROBIN MIXDORF PRESIDENT 48.00 X 204060 0 16100 RON JAEGER CHIEF FINANCIAL OFFICERR 40.00 X 104346 0 29062 308406 0 45162 2 0 1 0 PRIMUS CONSTRUCTION 401 8TH AVE SE CEDAR RAPIDS IA 52401 CONSTRUCTION CONTRACTOR 2560038 SODEXO INC PO BOX 360170 PITTSBURG PA 15251 FOOD SERVICE PROVIDER 1906157 MILLENNIUM REHAB & CONSULTING INC 4725 MERLE HAY ROAD DES MOINES IA 50322 THERAPY PROVIDER 314636 JW MORTON AND ASSOCIATES 1924 ST ANDREWS CT NE CEDAR RAPIDS IA 52402 ADVERTISING 202551 APPLEBY AND HORN TILE CO 128 31ST ST NE CEDAR RAPIDS IA 52402 FLOORING VENDOR 196472 8 601531 17427 601531 HEALTHCARE FEES 623000 7834785 7834785 RESIDENT FEES 623000 5816348 5816348 ENTRANCE FEES 623000 1311543 1311543 14962676 176455 176455 650 0 650 650 650 1236558 5984 1165136 5405 71422 579 72001 72001 ROOF LICENSE-ANTENNA 517000 41556 41556 41556 15854869 14962676 41556 249106 322842 64568 258274 5435697 5151806 283891 137307 121612 15695 1171963 1094129 77834 414338 380385 33953 23385 23385 50950 9450 41500 21257 21257 36295 36295 163134 163134 225118 225118 489374 415689 73685 909617 873759 35858 29905 25650 4255 47629 32991 14638 9124 9124 2796121 2700005 96116 228232 209973 18259 RESIDENT MEALS 1879146 1865467 13679 THERAPY & OUTSIDE SVCS 698807 448788 250019 REPAIRS & MAINTENANCE 446218 444386 1832 INCOME TAX - UBIT 9400 9400 352694 346009 6685 15898553 14582043 1295253 21257 1071792 3272652 1033187 622300 1429443 759805 536683 535785 222196 201071 69532505 45440209 22938754 24092296 6079487 6413764 33311542 35897673 1221356 1441680 10166264 11076446 4344715 5433631 423954 529675 16156289 18481432 X 7348270 7715948 8841182 8734492 965801 965801 17155253 17416241 33311542 35897673 -43684 304672 0 X 0 1 X 1 0 X 303356 1165620 3128998 1171810 601531 6371315 303356 1165620 3128998 1171810 601531 6371315 2552422 3818893 134700 169987 204112 201770 177105 887674 13272 15145 15641 32726 35234 112018 1151 1151 7372158 70035146 0.51800 0.52380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5378426 81227 521968 143325 38934 5799362 5401462 267983 -111942 138789 40288 5378426 5094066 121954 361670 136645 39583 5401462 4073433 767934 505594 108154 144741 5094066 3675334 218990 336213 109219 47885 4073433 0.41160 0.16650 0.42190 0 0 1616065 1616065 62832322 41228498 21603824 5084118 4211711 872407 24092296 APPLICANTS' DEPOSITS 529675 529675 X 16159541 304672 304672 15854869 0 15854869 15898553 0 15898553 0 15898553 PART V, LINE 4: THE ENDOWMENT FUNDS PROVIDE A SOURCE FOR FURNISHING FREE AND DISCOUNTED CARE TO RESIDENTS OF THE METH-WICK COMMUNITY WHO HAVE SUBSTANTIALLY DEPLETED THEIR RESOURCES. THE BOARD OF DIRECTORS FOLLOW THE POLICY OF RETAINING A SET PERCENTAGE OF THE INTEREST INCOME EARNED ON THE FUNDS AND USING THE REMAINDER FOR RESIDENT CARE. PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RECOGNIZED THE ORGANIZATION AS EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS SUBJECT TO FEDERAL AND STATE INCOME TAXES ON UNRELATED BUSINESS INCOME. THE ORGANIZATION FOLLOWS THE ACCOUNTING GUIDANCE RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. IN ACCORDANCE WITH THAT GUIDANCE, MANAGEMENT HAS EVALUATED THEIR MATERIAL TAX POSITIONS AND DETERMINED THERE IS NO LIABILITY TO RECORD. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE MARCH 31, 2014. THE ORGANIZATION HAS NOT BEEN NOTIFIED OF ANY IMPENDING EXAMINATION BY TAX AUTHORITIES AND NO EXAMINATIONS ARE IN PROCESS. X X X 1 AMPERAGE 6711 CHANCELLOR DR CEDAR FALLS IA 50613 FUNDRAISING CAMPAIGN ADVISOR 0 390162 21257 368905 390162 21257 368905 AZ DE IL IN IA KS LA MI MN MO MT NE NY SD TN TX VT WI WY X X X 0 0 0 0 0 0 0 0 0 ROBIN MIXDORF PRESIDENT 159560 0 44500 0 0 0 6231 0 9869 0 220160 0 0 0 A CITY OF ROBINS IOWA 420887558 NONEAVAIL 2009-08-12 3038887 AMEND 8/16/99 BOND ISSUE (BLDG) 0 0 0 B LINN COUNTY IOWA 426004338 NONEAVAIL 2009-09-29 4100000 CONSTRUCTION-TOWN CENTER ADDITION 0 0 0 A 2173832 3038887 28661 3010226 2000 1 0 1 1 B 1115186 4100000 60000 4040000 2010 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 0 B 0 FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF EXECUTIVE WILL SIGN AND CERTIFY THAT THE IRS FORM 990 IS ACCURATE AND COMPLETE. THE FINANCE COMMITTEE WILL REVIEW AND APPROVE THE IRS FORM 990 ANNUAL TAX FILING PRIOR TO SUBMISSION, AND THE FULL BOARD SHALL RECEIVE A COPY OF THE IRS FORM 990 IMMEDIATELY PRIOR TO THE DATE OF SUBMISSION FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THIS STATEMENT WILL ALLOW THE METH-WICK COMMUNITY, INC. TO IDENTIFY ANY CORPORATE, MEMBERSHIP OR OTHER RELATIONSHIPS OF THE INDIVIDUAL WHICH COULD BENEFIT THE PRIVATE INTEREST OF SUCH INDIVIDUAL OR RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. THE COMPLETED CONFLICT OF INTEREST DISCLOSURE STATEMENT IS REVIEWED BY THE CHAIR OF THE CORPORATION AND INSURANCE COMMITTEE. THE CHAIR WILL REPORT ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST TO THE BOARD OF DIRECTORS WITH THE INDIVIDUAL IN QUESTION GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS REGARDING THE POSSIBLE CONFLICT. THE BOARD WILL THEN DECIDE IF A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15A EXECUTIVE COMPENSATION POLICY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF THE METH-WICK COMMUNITY, INC. HAS GENERAL OVERSIGHT OF THE YEARLY EVALUATION OF THE CHIEF EXECUTIVE OF THE ORGANIZATION AND IS THE AUTHORIZED BODY TO DETERMINE COMPENSATION ARRANGEMENTS FOR THE CHIEF EXECUTIVE. THE CHAIRPERSON OF THE BOARD WILL NOTIFY THE BOARD OF DIRECTORS OF THE ANNUAL EVALUATION AND SEEK THEIR INPUT ALONG WITH INPUT FROM THE SENIOR MANAGEMENT STAFF AND SELECTED RESIDENT REPRESENTATIVES. THE EVALUATION WILL BE CONDUCTED ON A TIMELY BASIS TO COINCIDE WITH THE ANNUAL BUDGETING PROCESS. THE EXECUTIVE COMMITTEE WILL: -ENSURE THAT THE COMPENSATION ARRANGEMENT IS APPROVED BY A COMMITTEE COMPOSED ENTIRELY OF INDIVIDUALS WHO HAVE NO CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT. -OBTAIN APPROPRIATE DATA AS TO SALARY COMPARABILITY TO BE USED IN THE DECISION MAKING PROCESS. -ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION OF THE COMPENSATION PACKAGE. APPROPRIATE DATA FOR COMPARABILITY WILL INCLUDE COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS, FOR FUNCTIONALLY COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICE IN THE GEOGRAPHIC AREA OF THE ORGANIZATION; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE PERSON. THE COMMITTEE WILL MEET INDEPENDENT OF THE CHIEF EXECUTIVE TO DISCUSS PERFORMANCE RELATIVE TO THE POSITION DESCRIPTION AND IDENTIFIED PERFORMANCE GOALS. ONCE CONSENSUS IS REACHED REGARDING PERFORMANCE, A SIMILAR DISCUSSION IS HELD CONCERNING COMPENSATION RELATIVE TO THE ESTABLISHED OBJECTIVES. THE COMMITTEE AND/OR THE BOARD CHAIR WILL MEET WITH THE CHIEF EXECUTIVE TO DISCUSS AND DOCUMENT STRENGTHS, WEAKNESSES AND GOALS FOR THE UPCOMING YEAR. COMPENSATION FOR THE UPCOMING YEAR IS TO BE DISCUSSED AND DOCUMENTED AS WELL. THE COMMITTEE WILL PRESENT ITS FINDINGS AND RESULTING EXECUTIVE COMPENSATION PACKAGE TO THE FULL BOARD IN AN EXECUTIVE SESSION WITHOUT THE CHIEF EXECUTIVE PRESENT. SENIOR MANAGEMENT STAFF COMPENSATION PROCEDURE THE CHIEF EXECUTIVE OF THE METH-WICK COMMUNITY, INC. HAS GENERAL OVERSIGHT OF THE YEARLY EVALUATION OF THE SENIOR MANAGEMENT STAFF OF THE ORGANIZATION AND IS THE AUTHORIZED BODY TO DETERMINE COMPENSATION ARRANGEMENTS FOR THE SENIOR MANAGEMENT STAFF. THE DIRECTOR OF HUMAN RESOURCES OF THE METH-WICK COMMUNITY WILL NOTIFY THE CHIEF EXECUTIVE OF THE NECESSARY ANNUAL EVALUATIONS. THE EVALUATIONS WILL BE CONDUCTED ON A TIMELY BASIS TO COINCIDE WITH THE ANNUAL BUDGETING PROCESS. THE CHIEF EXECUTIVE WILL: -ENSURE THAT THERE IS NO CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT. -OBTAIN APPROPRIATE DATA AS TO SALARY COMPARABILITY TO BE USED IN THE DECISION MAKING PROCESS. -ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION OF THE COMPENSATION PACKAGE. APPROPRIATE DATA FOR COMPARABILITY WILL INCLUDE COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS, FOR FUNCTIONALLY COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICE IN THE GEOGRAPHIC AREA OF THE ORGANIZATION; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE PERSON. THE CHIEF EXECUTIVE WILL MEET WITH THE SENIOR EXECUTIVE STAFF TO DISCUSS AND DOCUMENT STRENGTHS, WEAKNESSES AND GOALS FOR THE UPCOMING YEAR. COMPENSATION FOR THE UPCOMING YEAR IS TO BE DISCUSSED AND DOCUMENTED AS WELL. FORM 990, PART VI, SECTION C, LINE 19 THE CHIEF EXECUTIVE OF THE METH-WICK COMMUNITY, INC. IS RESPONSIBLE FOR MAKING THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. THE GENERAL PUBLIC CAN REQUEST COPIES OF THESE DOCUMENTS BY CONTACTING THE CHIEF EXECUTIVE AT THE METH-WICK COMMUNITY, INC., 1224 13TH STREET NW, CEDAR RAPIDS, IA 52405. THE REQUEST CAN BE MADE IN PERSON OR IN WRITING.