2017-08-28T15:33:20-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2016-01-01 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 2017-08-21 1 JEFF PARKER P00970069 3149254300 67.137.57.251 2017-08-21 17:19:44 CD P 2FD9AEF635F49284691F87E9FE125090855B27AB 5C592A38642564D958275A63599AC7915113978F 2016 2021-01-29 14:40:06Z TERRI MOORE 10000 WORNALL ROAD KANSAS CITY MO 64114 13511244 0 X WWW.KINGSWOODRETIREMENTLIVING.COM X 1972 MO KINGSWOOD'S MISSION IS TO PROVIDE RESIDENTAL AND HEALTH CARE FACILITIES, SERVICES AND OPPORTUNITIES FOR OLDER ADULTS AND DISABLED PERSONS. 12 12 325 100 0 0 202775 197089 13270926 12913761 -368418 112084 426567 283854 13531850 13506788 0 0 0 0 6673905 6845449 0 0 0 8481293 8656740 15155198 15502189 -1623348 -1995401 30298496 65893931 47332313 84879686 -17033817 -18985755 KINGSWOODS' 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 12314105 12981103 KINGSWOOD, A MINISTRY OF THE UNITED METHODIST CHURCH, MAINTAINS 152 APARTMENTS, 82 BEDS IN THE HEALTH CENTER, 57 ASSISTED LIVING APARTMENTS, AND 54 VILLA HOMES. THE HEALTH CENTER IS LICENSED BY THE STATE OF MISSOURI AS A SKILLED NURSING FACILITY. KINGSWOOD AVERAGES AROUND 300 RESIDENTS ON THE 32 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. 12314105 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 61 0 325 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 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 ROBERT ADAMS DIRECTOR 1.00 X 0 0 0 SALLY FIRESTONE DIRECTOR 1.00 X 0 0 0 JOANNE KELLEY SECRETARY 1.00 X X 0 0 0 RICHARD LANE VICE CHAIRMAN/TREASURER 0.50 0.50 X X 0 0 0 FRED WIMAN CHARIMAN/DIRECTOR 0.50 0.50 X X 0 0 0 SCOTT CORBIN DIRECTOR 1.00 X 0 0 0 DR JAMES DALEY DIRECTOR 1.00 X 0 0 0 GARLAND RICHARDSON DIRECTOR 1.00 X 0 0 0 SALLY HAYNES DIRECTOR 0.50 0.50 X 0 0 0 ELVA NEEDLES DIRECTOR 0.50 0.50 X 0 0 0 RUTHANNE PHILLIPS DIRECTOR 1.00 X 0 0 0 KELLY SIZEMORE DIRECTOR 1.00 X 0 0 0 TERRI MOORE EXECUTIVE DIRECTOR 40.00 X 0 0 0 MIKE DIRLAM ASSOCIATE EXECUTIVE DIRECTOR 40.00 X 80624 0 0 CONNIE CARGIN DIRECTOR OF FINANCE 40.00 X 105964 0 6545 186588 0 6545 1 0 0 0 PARIC CORP PO BOX 790100 ST LOUIS MO 63179 CONSTRUCTION 10837231 LIFE CARE SERVICES 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT/DEVELOPMENT 2139834 SPELLMAN BRADY 8251 MARYLAND AVENUE SUITE 300 ST LOUIS MO 63105 INTERIOR DESIGN 903259 AG ARCHITECTURE 1414 UNDERWOOD AVENUE SUITE 301 WAUWATOSA WI 53213 ARCHITECTURE 730322 SYSCO 1915 KANSAS CITY ROAD PO BOX 820 OLATHE KS 66061 FOOD SERVICE 648949 14 149450 47639 197089 RESIDENT REVENUE 623000 12913761 12913761 12913761 106540 106540 10000 4456 5544 5544 5544 DINING SERVICES 623000 70399 70399 NFRA REVENUE 623000 67342 67342 BEAUTY SHOP 623000 66987 66987 79126 79126 283854 13506788 12981103 0 328596 362985 362985 5340549 4747976 592573 725463 642545 82918 416452 367341 49111 391825 391825 248454 248454 51977 51977 935697 910794 24903 438860 438860 610134 532029 78105 198629 198629 945236 914623 30613 72573 56200 16373 949217 918475 30742 1248665 1208225 40440 159419 154256 5163 FOOD 852084 852084 MAINTENANCE 508330 491867 16463 RETIREMENT OF DEBT 446424 446424 DUES, LICENSE, FEES 308243 291924 16319 290973 225766 65207 15502189 12314105 3188084 0 350103 2730512 2054230 5549218 642048 662469 50946 52519 99411 100238 69882007 31697688 19388378 38184319 5931002 17494603 938282 1000337 844096 119716 30298496 65893931 5081728 6618867 3660469 3282046 15261167 49941545 508246 0 22820703 25037228 47332313 84879686 X -20526547 -22701788 1639055 1836573 1853675 1879460 -17033817 -18985755 30298496 65893931 -1995401 43463 0 X X 0 1 X 1 0 X 169279 290233 277268 202778 197089 1136647 13604155 13587315 13742036 13270926 12913761 67118193 13773434 13877548 14019304 13473704 13110850 68254840 5000 5000 0 5000 5000 68249840 50881 56589 39892 135870 106540 389772 50881 56589 39892 135870 106540 389772 436695 688314 430945 426567 283854 2266375 14261010 14622451 14490141 14036141 13501244 70910987 0.96250 0.96120 0.00550 0.00530 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: DINING SERVICES - 2012 AMOUNT: $ 85,646. 2013 AMOUNT: $ 80,337. 2014 AMOUNT: $ 75,102. 2015 AMOUNT: $ 70,957. 2016 AMOUNT: $ 70,399. GIFT SHOP - 2012 AMOUNT: $ 25,490. 2013 AMOUNT: $ 26,287. 2014 AMOUNT: $ 20,993. 2015 AMOUNT: $ 20,107. 2016 AMOUNT: $ 13,669. BEAUTY SHOP - 2012 AMOUNT: $ 99,081. 2013 AMOUNT: $ 91,231. 2014 AMOUNT: $ 83,798. 2015 AMOUNT: $ 77,708. 2016 AMOUNT: $ 66,987. MISCELLANEOUS - 2012 AMOUNT: $ 174,340. 2013 AMOUNT: $ 432,247. 2015 AMOUNT: $ 9,745. 2016 AMOUNT: $ 2,763. TRANSPORTATION - 2012 AMOUNT: $ 36,825. 2013 AMOUNT: $ 37,616. 2014 AMOUNT: $ 41,228. 2015 AMOUNT: $ 43,401. 2016 AMOUNT: $ 34,305. GUEST ROOM - 2012 AMOUNT: $ 15,313. 2013 AMOUNT: $ 20,596. 2014 AMOUNT: $ 25,335. 2015 AMOUNT: $ 32,825. 2016 AMOUNT: $ 28,389. NFRA REVENUE - 2014 AMOUNT: $ 184,489. 2015 AMOUNT: $ 171,824. 2016 AMOUNT: $ 67,342. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2655355 27350 145490 26817 2801378 2618506 33357 28818 25326 2655355 2460121 25818 157417 24850 2618506 2081657 27732 377512 26780 2460121 1842813 30396 238844 30396 2081657 0.00000 0.92100 0.07900 0 1 1 2017322 2017322 41600966 27970349 13630617 3283431 1267785 2015646 2794824 2459554 335270 20185464 20185464 38184319 RESIDENT DEPOSITS 126756 REFUNDABLE ENTRANCE FEES 24910472 25037228 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 APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. 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 51937170 3535288 1035400 20757235 13741216 12868031 2017 1 0 0 1 A 0 1 1 1 0 0.00060 0.00000 0.00060 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 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. TOTAL FEES PAID TO LCS PURSUANT TO THE AGREEMENT AMOUNTED TO APPROXIMATELY $435,000 AND $311,000 FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015, RESPECTIVELY. OTHER MISCELLANEOUS FEES PAID TO LCS FOR VARIOUS SERVICES, INCLUDING TRAVEL, TECHNOLOGY, MARKETING, AND REIMBURSABLE EXPENSES, TOTALED APPROXIMATELY $503,000 AND $387,000 FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015, 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. TERRI MOORE WAS COMPENSATED $222,358 AS EXECUTIVE DIRECTOR AND MIKE WAS COMPENSATED $59,699.58 AS ASSOCIATE EXECUTIVE DIRECTOR BY LCS . 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 EXIST. IF A CONFLICT EXIST, 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. 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 FORM 990, SCHEDULE R, PART III, COLUMN A THE PARTNERSHIPS ARE RELATED AS THERE IS COMMON CONTROL WHEREAS BOARD MEMBERS OF THE FILING ORGANIZATION OWN A VOTING MAJORITY OF THESE PARTNERSHIPS. 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 1 457 WEST 100TH TERRACE LLC 10000 WORNALL ROAD KANSAS CITY MO 64114 274598541 REAL ESTATE MO N/A 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 149450 FMV