2016-08-15T10:03:36-05:00 2015-09-30 271728945 PKF O'CONNOR DAVIES LLP 665 FIFTH AVENUE NEW YORK NY 10022 990 2014-10-01 066077232 BISHOP WICKE HEALTH AND REHABILITATION CENTER INC BISH 2039448285 580 LONG HILL AVENUE SHELTON CT 06484 GARY J MAGLIO CORPORATE CONTROLLER 2039448285 2016-08-10 1 GARRETT M HIGGINS P00543209 2122862600 2016-08-10 2014 2016-12-15 16:53:06Z GARY J MAGLIO 580 LONG HILL AVENUE SHELTON CT 06484 14640518 0 X UMH.ORG X 1968 CT TO PROVIDE NURSING CARE AND ACCOMODATIONS TO THOSE IN NEED. 5 0 259 42 0 0 0 0 14793246 14610890 654 1080 23947 28548 14817847 14640518 0 0 0 0 9360331 9797961 0 0 0 6029429 5847709 15389760 15645670 -571913 -1005152 9512441 8470978 12307943 12271632 -2795502 -3800654 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 14038626 14610890 BISHOP WICKE IS AN AWARD-WINNING HEALTH AND REHABILITATION FACILITY THAT PROVIDES SHORT-TERM REHABILITATION, SKILLLED NURSING CARE, AND LONG-TERM, DEMENTIA, AND HOSPICE CARE. 14038626 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 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 10 0 259 1 0 0 0 0 0 0 0 0 0 0 X 5 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X GARY J MAGLIO 2039448285 580 LONG HILL AVENUE SHELTON CT 06484 X DAVID M LAWLOR PRESIDENT/CHAIRMAN 1.00 46.00 X X 0 342813 66745 PETER BELVAL DIRECTOR/VICE PRESIDENT 0.50 40.50 X X 0 126766 45340 VICTORIA DOMPIERRE DIRECTOR/SECRETARY 0.50 43.00 X X 0 64335 8529 GARY J MAGLIO DIRECTOR/TREASURER 1.00 46.00 X X 0 149297 33912 FAITH WADJOWICZ DIRECTOR/DIRECTOR OF NURSING 40.00 0.50 X X 136519 0 53858 DEBRA SAMORAJCZYK ADMINISTRATOR 40.00 0.00 X 107350 0 10458 ROBERT L CLAPP FORMER DIRECTOR/CHAIRMAN 0.00 X 0 180000 0 243869 863211 218842 2 1 1 0 0 NET RESIDENT REVENUE 623000 14491016 14491016 OUTPATIENT THERAPY 623000 114792 114792 OTHER PROGRAM FEES 623000 5082 5082 14610890 1080 1080 1800 0 1800 1800 1800 MISCELLANEOUS 900099 26748 26748 26748 14640518 14610890 0 29628 X 327372 287278 40094 6650503 6216190 434313 1041154 972084 69070 933047 870351 62696 845885 748933 96952 586252 586252 6592 6592 32220 32220 2242053 2181149 60904 3610 629 2981 355302 249901 105401 792118 776276 15842 31 31 7005 7005 280111 274509 5602 108118 27029 81089 PROVIDER TAX EXPENSE 539163 539163 DIETARY SUPPLIES 486307 486307 NURSING SUPPLIES 327337 327337 THERAPIES SUPPLIES 73128 73128 8362 8362 15645670 14038626 1607044 0 455 419476 479404 2155251 1680247 17863 18660 121894 120931 9676440 5946473 3911050 3729967 2886452 2441769 9512441 8470978 3073665 3277139 101023 61469 9133255 8933024 12307943 12271632 X -3706502 -4711654 911000 911000 -2795502 -3800654 9512441 8470978 -1005152 0 X X 0 1 X 1 1 1 X 13927532 14080582 13338888 14793246 14610890 70751138 13927532 14080582 13338888 14793246 14610890 70751138 0 0 0 70751138 326 135 1476 654 2880 5471 326 135 1476 654 2880 5471 23947 26748 50695 13927858 14080717 13340364 14817847 14640518 70807304 0.99920 0.99960 0.00010 X 0 1 X 911000 911000 911000 40868 40868 911000 3722421 366213 3177634 911000 3181850 540571 3722421 1.00000 0 1 1 24213 24213 7380936 3947154 3433782 2271291 1999319 271972 3729967 DEFERRED FINANCING, NET 129081 DUE FROM AFFILIATE 883984 RESTRICTED DEPOSITS AND FUNDED RESERVES 517704 DONOR RESTRICTED FUNDS HELD BY AFFILIATED FOUNDATION 911000 2441769 X 14640518 0 14640518 0 14640518 15645670 0 15645670 0 15645670 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, 2015, 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 ENDOWMENT NET ASSETS OF $7,687,344. EARNINGS OF THE AFFILIATED FOUNDATION EARMARKED FOR THE FACILITY ARE RECOGNIZED AS AN INCREASE TO 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 INCOME TAX POSITIONS 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, 2012. 0 0 0 0 0 0 0 0 0 DAVID M LAWLOR PRESIDENT/CHAIRMAN 0 342813 0 0 0 0 0 42748 0 23997 0 409558 0 0 PETER BELVAL DIRECTOR/VICE PRESIDENT 0 126766 0 0 0 0 0 23619 0 21721 0 172106 0 0 GARY J MAGLIO DIRECTOR/TREASURER 0 149297 0 0 0 0 0 16907 0 17005 0 183209 0 0 FAITH WADJOWICZ DIRECTOR/DIRECTOR OF NURSING 136519 0 0 0 0 0 37610 0 16248 0 190377 0 0 0 ROBERT L CLAPP FORMER DIRECTOR/CHAIRMAN 0 0 0 0 0 180000 0 0 0 0 0 180000 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 452. 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 B, LINE 11 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 15 COMPENSATION OF MANAGEMENT IS DETERMINED BY A COMPENSATION COMMITTEE AND/OR SENIOR MANAGEMENT, INCLUDING THE HUMAN RESOURCES DEPARTMENT. 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 IX, LINE 11G SERVICE CONTRACT FEES: PROGRAM SERVICE EXPENSES 23,326. MANAGEMENT AND GENERAL EXPENSES 34,650. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,976. NURSING FEES: PROGRAM SERVICE EXPENSES 414,660. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 414,660. THERAPIES FEES: PROGRAM SERVICE EXPENSES 1,449,410. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,449,410. OTHER RESIDENT SERVICE FEES: PROGRAM SERVICE EXPENSES 285,002. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 285,002. CONSULTING FEES: PROGRAM SERVICE EXPENSES 8,751. MANAGEMENT AND GENERAL EXPENSES 26,254. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,005. 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 9 UNITED METHODIST HOMES INC 0 CROSBY COMMONS INC 580 LONG HILL AVENUE SHELTON CT 06484 061505334 ASSISTED LIVING SERVICES CT 501(C)(3) LINE 9 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 9 UNITED METHODIST HOMES INC 0 THE UNITED METHODIST HOME OF SHARON INC 580 LONG HILL AVENUE SHELTON CT 06484 061607026 SKILLED NURSING FACILITY CT 501(C)(3) LINE 9 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 9 0 WESLEY HEIGHTS INC 580 LONG HILL AVENUE SHELTON CT 06484 066077231 SENIOR RETIREMENT HOUSING CT 501(C)(3) LINE 9 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 11B, II UNITED METHODIST HOMES INC 0 WESLEYAN HOMES OF CONNECTICUT INC 580 LONG HILL AVENUE SHELTON CT 06484 262789298 SENIOR RETIREMENT HOUSING CT 501(C)(3) LINE 9 UNITED METHODIST HOMES INC 0 WESLEYAN HOMES OF INDIANA INC 580 LONG HILL AVENUE SHELTON CT 06484 205526452 SKILLED NURSING FACILITY CT 501(C)(3) LINE 9 UNITED METHODIST HOMES INC 0 WESLEYAN HOMES OF TENNESSEE INC 580 LONG HILL AVENUE SHELTON CT 06484 203533871 SKILLED NURSING FACILITY CT 501(C)(3) LINE 9 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 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0