2014-09-04T09:02:12-05:00 2013-12-31 410746749 CLIFTONLARSONALLEN LLP 610 WGERMANTOWN PIKE STE400 PLYMOUTH MEETING PA 19462 990 2013-01-01 521761391 KESWICK PINES INC KESW 7328490400 509 ROUTE 530 WHITING NJ 08759 GEORGINA BAVAIS CHIEF FINANCIAL OFFICER 7328490400 2014-09-02 1 JAMES D WATSON P01450300 2156433900 2013 2015-11-30 17:44:51Z THE PINES AT WHITING ERIC GHAUL 509 ROUTE 530 WHITING NJ 08759 33804852 0 X WWW.THEPINESATWHITING.ORG X 1989 NJ SERVES THE ELDERLY THROUGH APARTMENT LIVING, ASSITED LIVING, AND NURSING HOME CARE. 8 8 327 137 0 0 153813 81740 16588823 15797874 371932 368786 512739 528527 17627307 16776927 20237 13815 0 0 8366399 8237342 0 0 0 7849142 8103849 16235778 16355006 1391529 421921 34285023 32023070 38567312 44305768 -4282289 -12282698 X GUIDED BY CHRISTIAN PRINCIPLES, THE PINES AT WHITING SEEKS TO BUILD A CARING AND RESPECTFUL COMMUNITY OF TRUSTEES, RESIDENTS AND STAFF THAT SERVES THE PHYSICAL, SOCIAL, EMOTIONAL AND SPIRITUAL NEEDS OF SENIOR ADULTS THROUGH RESIDENTIAL LIVING AND HEALTH CARE 0 0 14649056 13815 16319162 THE PINES AT WHITING OFFERS INDEPENDENT LIVING APARTMENTS WITH 24 HOUR EMERGENCY CALL SERVICE AND HOME CARE SUPPORTIVE SERVICES AS WELL AS HEALTH CARE SERVICES INCLUDING: ASSISTED LIVING, MEMORY SUPPORT, SKILLED NURSING/REHABILITATION AND LONG TERM CARE PROGRAMS.DURING 2013, THE PINES MADE A SUBSTANTIAL CONTRIBUTION TO THE GREATER WHITING AREA COMMUNITY. THESE COMMUNITY OUTREACH ACTIVITIES RANGED FROM: 1) CAREGIVER VOLUNTEERS LUNCHEON2) HOSTED STOP HUNGER INITIATIVE WORKING WITH LOCAL ORGANIZATIONS IN AN EFFORT TO HELP THOSE IN NEED3) VARIOUS PRESENTATIONS BY THE FITNESS DIRECTOR TO LIBRARIES, COMMUNITIES ETC.4) FRESH PRESENTATION BY DIRECTOR OF ENRICHMENT TO FIVE BRANCHES OF THE OCEAN COUNTY LIBRARY5) HOSTED "TAKE CONTROL OF YOUR HEALTH" PROGRAM AT THE PINES6) DIRECTOR OF ENRICHMENT LED SOME "TAKE CONTROL OF YOUR HEALTH" PROGRAMS FOR OTHER VENUES TO SUB FOR OTHER LEADERS7) HOSTED CAREGIVERS "SENSITIVITY TRAINING" FOR CAREGIVER KIDS PROGRAMS8) DONATED COOKIES TO MANCHESTER TOWNSHIP TREE LIGHTING SERVICE9) SPONSORED CAREGIVER VOLUNTEERS IN THEIR WINE TASTING EVENT10) FOOD DRIVE FOR MANCHESTER TOWNSHIP11) DONATION TO AMERICA'S KESWICK12) HOSTED AND MADE A DONATION TO CENTRAL JERSEY CHORAL SOCIETY13) HOSTED HOME SCHOOLED CHILDREN FOR INTERGENERATIONAL EDUCATIONAL PROGRAMS ONCE EACH MONTH FROM JANUARY THROUGH MAY14) HOSTED MOCAP MEETING15) HOSTED VOLUNTEERS LUNCHEON TO HONOR VOLUNTEERS HERE AND IN THE OUTSIDE COMMUNITY16) HOSTED VETERAN'S LUNCHEON TO HONOR VETERANS17) HOSTED SCHOLARSHIP AWARDS CEREMONY DONATING TO EMPLOYEES IN COLLEGE18) HOSTED AMERICAN RED CROSS BLOOD DRIVE19) ALZHEIMER'S WALK - FUNDRAISERS - FOR ALZHEIMER'S - YARD SALE, DRESS DOWN FRIDAYS FOR STAFF20) PARTNERSHIP WITH VARIOUS GIRL SCOUT TROUPES TO SUPPORT OUR SOLDIERS21) THE PINES ALSO PROVIDED SUBSIDY FOR 9 RESIDENTS IN THE PINES COMMUNITY WHO COULD NOT AFFORD TO PAY THE FULL RATE FOR SERVICES. FOR THE YEAR 2013, THE TOTAL AMOUNT OF FORGIVEN REVENUE WAS $135,258.OVERALL, THE PINES PROGRAM TO SERVE OTHERS BENEFITTED SENIORS, COMMUNITY MEMBERS AND STUDENTS BY SUPPORTING THEIR TALENTS, GIVING INFORMATION TO IMPROVE THE QUALITY OF LIFE AND HELPING PEOPLE TO BETTER UNDERSTAND AND APPRECIATE SENIOR ADULTS. 14649056 1 1 0 1 0 0 1 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 17 0 327 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 0 1 1 0 NJ X GEORGINA BAVAIS CFO 7328490400 509 ROUTE 530 WHITING NJ 08759 JAY B KATZ CHAIRPERSON 2.00 0.00 X X 0 0 0 MARK KOLCHIN VICE CHAIRMAN 2.00 0.00 X X 0 0 0 DOUGLAS J BAUERBAND TREASURER 2.00 0.00 X X 0 0 0 ALAN R DINKFELT DIRECTOR 2.00 0.00 X 0 0 0 MARY JANE OUSLEY RESIDENT REPRESENTATIVE 2.00 0.00 X 0 0 0 JOHN R HOLLAND DIRECTOR 2.00 0.00 X 0 0 0 WILLIAM COOK DIRECTOR 2.00 0.00 X 0 0 0 CAROLYN HIBBARD RESIDENT REPRESENTATIVE 2.00 0.00 X 0 0 0 WILLIAM JANSON PRESIDENT 40.00 0.00 X 220045 0 31832 GEORGINA BAVAIS CHIEF FINACIAL OFFICER 40.00 0.00 X 113111 0 29068 PATRICIA POLCHAK ADMINISTRATOR 40.00 0.00 X 122840 0 23002 455996 0 83902 3 0 1 0 SODEXO INC & AFFLIATES PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE 1331374 US FOOD SERVICE INC PO BOX 33101 NEWARK NJ 071880101 FOOD SUPPLIER 475529 MANCHESTER WINDOW AND DOOR CO LIC 1981 BROOKLYN AVE WHITING NJ 08759 CONSTRUCTION CONTRACTOR 303488 JW FINLEY INC 310 MAIN ST TOMS RIVER NJ 08753 HEATING & CARPETING 239606 LOVE & COMPANY 1209 N EAST ST FREDERICK MD 21701 MARKETING 138459 7 81740 81740 RESIDENT MONTHLY FEES 623990 6674387 6674387 PRIVATE PAY 623990 4567081 4567081 MEDICAID AND MEDICARE REVENUE 623990 3189748 3189748 ENTRANCE FEES REVENUE 623990 1366658 1366658 15797874 258796 258796 18546 9390 9156 9156 9156 17128525 17018535 109990 109990 109990 ANCILLARY SERVICES 623000 313759 313759 FOOD SERVICES 623000 107048 107048 BARBER AND BEAUTY 623000 91601 91601 6963 8880 -1917 519371 16776927 16319162 0 376025 5000 5000 8815 8815 394057 339854 54203 6330703 5459903 870800 73227 55373 17854 1439355 1264088 175267 290172 290172 24848 24848 36792 36792 243698 237165 6533 386868 385898 970 270322 234749 35573 80693 16440 64253 1698375 1614945 83430 23291 22736 555 1278016 1278016 1957102 1683108 273994 342000 314353 27647 FOOD SERVICES 1016444 1013473 2971 MEDICAL EXPENSES 227642 227642 MISCELLANEOUS EXPENSES 141362 111102 30260 PROVISION FOR DOUBTFUL 86224 86224 16355006 14649056 1705950 0 1565 1565 1327919 1489294 716522 446212 18325 307375 213716 49662696 30128488 20516050 19534208 10705670 9981487 691597 356588 34285023 32023070 2145357 1463485 12075822 20112656 23666571 22246250 629619 430838 49943 52539 38567312 44305768 X -4357923 -12320419 75634 37721 -4282289 -12282698 34285023 32023070 X 421921 425142 -8835278 -12194 X X 0 1 X 1 0 X 143349 173475 108384 153813 81740 660761 16448865 16897260 16875886 16328552 16316358 82866921 16592214 17070735 16984270 16482365 16398098 83527682 120 120 0 120 120 83527562 425376 380428 336953 277342 377942 1798041 425376 380428 336953 277342 377942 1798041 17017590 17451163 17321223 16759707 16776040 85325723 0.97890 0.97610 0.02110 0.02390 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 481 481 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO LEADING AGE, NEW JERSEY. A PERCENTAGE OF THOSE DUES ARE USED BY LEADING AGE, NEW JERSEY FOR LOBBYING PURPOSES. THE AMOUNT OF LOBBYING EXPENSES REPORTED ARE THE PERCENTAGE OF THE ORGANIZATION'S DUES USED BY LEADING AGE, NEW JERSEY FOR LOBBYING. X X X 1 1 1 0.00 0 0 1 X 2748541 2748541 37867217 28037659 9829558 8718731 1937870 6780861 328207 152959 175248 19534208 CHARITBLE GIFT ANNUITIES 52539 52539 X 17199265 425142 -2804 422338 16776927 0 16776927 16364396 9390 9390 16355006 0 16355006 PART II, LINE 9: THE DEPARTMENT OF ENVIRONMENTAL PROTECTION HAS PROVIDED SIGNAGE THAT HAS BEEN PUT IN PLACE, ACCOMPANIED BY A LISTING OF APPROVED USES OF THE SITE AND ANY RESTRICTIONS. PART IV, LINE 2B: AMOUNTS HELD IN ESCROW REPRESENT CASH DEPOSITS MADE BY PROSPECTIVE RESIDENTS OF INDEPENDENT LIVING UNITS. THE CASH HAS BEEN DEPOSITED INTO A SAVINGS ACCOUNT. IF THE PROSPECTIVE RESIDENT(S) SHOULD DECIDE NOT TO FULFILL THE CONTRACT THE DEPOSITS ARE REFUNDABLE. IN ADDITION, ENTRANCE FEES RECEIVED FROM RESIDENTS HAVE BEEN REPORTED AS A LONG-TERM LIABILITY. REFUNDABLE PORTIONS OF ENTRANCE FEES ARE FULLY REFUNDABLE TO THE RESIDENT(S), LESS CERTAIN COSTS OR CHARGES INCURRED. IF THE RESIDENT(S) TERMINATE(S) THE CONTRACT AFTER THE FIRST 120 DAYS OF OCCUPANCY, THE REFUNDABLE PORTION OF ENTRANCE FEES IS REFUNDABLE PENDING REOCCUPANCY OF THE UNIT. PART X, LINE 2: KESWICK HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. KESWICK FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON KESWICK'S FINANCIAL STATEMENTS. KESWICK'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN THE VALUE OF ANNUITY -12,194. OCCUPANCY COSTS 9,390. PART XII, LINE 2D - OTHER ADJUSTMENTS: OCCUPANCY COSTS 9,390. 1 EMPLOYEE SCHOLARSHIPS 6 8815 PART I, LINE 2: THE PINES BUDGETS A CERTAIN DOLLAR AMOUNT EVERY YEAR TO DONATE TO THOSE WHO PROVIDE BENEFITS TO THE COMMUNITY. THE PINES MAINTAINS RECORDS OF WHERE THE DONATIONS WERE GIVEN. PART III, LINE 1 THE SCHOLARSHIP APPLICANT MUST HAVE BEEN EMPLOYED AT THE PINES AT WHITING AS A PART-TIME EMPLOYEE FOR AT LEAST ONE YEAR AND WORKED AT LEAT 300 HOURS PER YEAR. HOURS ARE BASED ON FISCAL YEAR MAY 1 - APRIL 1. THE APPLICANT MUST PRESENT A LETTER OF ACCEPTANCE FROM EITHER A COLLEGE OR SPECIALTY SCHOOL AT THE TIME OF APPLICATION. THE APPLICANT MUST SUPPLY TWO LETTERS OF REFERENCE; ONE FROM SCHOOL (GUIDANCE COUNSELOR, TEACHER, COACH, ETC.) AND THE SECOND MUST COME FROM AN INDIVIDUAL UNRELATED TO SCHOOL OR FAMILY. IN ADDITION, EACH APPLICATION IS CAREFULLY REVIEWED BY THE STUDENT'S DIRECT SUPERVISOR. THE SUPERVISOR IS TO EXAMINE SPECIFIC CRITERIA SUCH AS SAFETY AND JOB PERFORMANCE. THE SUPERVISOR WILL INCLUDE HIS/HER RELATED REMARKS, SIGN THE APPLICATION, AND FORWARD THE APPLICATION IN ITS ENTIRETY TO THE SCHOLARSHIP COMMITTEE. APPLICANTS ALREADY IN COLLEGE, WHETHER APPLYING FOR THE FIRST TIME OR FOR RENEWAL OF THE SCHOLARSHIP MUST PRESENT A TRANSCRIPT OF FULL-TIME (12 OR MORE CREDIT HOURS) OF COLLEGE GRADES. THE APPLICANT WILL THEN NOT BE REQUIRED TO SUBMIT A LETTER OF ACCEPTANCE AND TWO LETTERS OF REFERENCE; HOWEVER, BOTH FIRST TIME APPLICANTS AND APPLICANT RENEWALS WILL BE ASKED ABOUT THEIR LEVEL OF PARTICIPATION BOTH IN THEIR SCHOOL AND THEIR COMMUNITY. X 1 0 X X 0 0 0 0 0 0 0 0 0 WILLIAM JANSON PRESIDENT 199545 0 20500 0 0 0 19652 0 12180 0 251877 0 0 0 PART I, LINE 1A WILLIAM JANSON, PRESIDENT, WAS PAID $12,000 AS A TAKE HOME TAX DEFERRAL BONUS. THE PINES PAID THE TAXES ON HIS BEHALF. THIS WAS PART OF HIS APPROVED COMPENSATION PACKAGE FOR 2013 AND WAS PAID OUT IN 2014. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS, BY RESOLUTION ADOPTED BY A MAJORITY OF THE DIRECTORS THEN IN OFFICE, MAY DESIGNATE AN EXECUTIVE COMMITTEE COMPRISED OF THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER AND AN ADDITIONAL MEMBER OF THE BOARD OF DIRECTORS SELECTED BY THE CURRENT MEMBERS OF THE BOARD OF DIRECTORS IN MANAGEMENT OF THE CORPORATION, PROVIDED, THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN REFERENCE TO (A) AMENDING, ALTERING, OR REPEALING THE BYLAWS, (B) ELECTING, APPOINTING OR REMOVING ANY MEMBER OF THE EXECUTIVE COMMITTEE OR ANY DIRECTOR OR OFFICER OF THE CORPORATION, (C) AMENDING THE ARTICLES OF INCORPORATION, (D) ADOPTING A PLAN OF MERGER OR ADOPTING A PLAN OF CONSOLIDATION WITH ANOTHER CORPORATION, (E) AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION, (F) AUTHORIZING THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKING PROCEEDINGS THERFOR, (G) ADOPTING A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION, (H)AMENDING, ALTERING, OR REPEALING ANY RESOLUTION OF THE BOARD OF DIRECTORS TO ANOTHER COMMITTEE OF THE BOARD THE DESIGNATION AND APPOINTMENT OF AN EXECUTIVE COMMITTEE AND THE DELEGATION THERETO OF AUTHORITY SHALL NOT OPERATE TO RELIEVE THE BOARD OF DIRECTORS, OR ANT INDIVIDUAL DIRECTOR, OF ANY RESPONSIBILITY IMPOSED UPON IT OR HIM BY LAW. FORM 990, PART VI, SECTION B, LINE 11 THE CFO REVIEWS THE FORM 990 WITH THE FINANCE COMMITTEE AT A QUARTLERY MEETING PRIOR TO FILING WITH THE IRS. A COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD MEMBERS AND OFFICERS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST TO THE MEMBERS OF THE BOARD. BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY, WHICH ARE REVIEWED BY THE CEO. THE ORGANIZATION ALSO HAS A CONFLICT OF INTEREST SECTION IN ITS EMPLOYEE HANDBOOK WHICH ALL EMPLOYEES ARE REQUIRED TO FOLLOW AT THE APRIL QUARTERLY MEETING. ALL BOARD MEMBERS ARE TO SIGN THE CONFLICT OF INTEREST POLICY STATING THERE ARE NONE TO DECLARE OR IF THERE ARE ANY TO DECLARE. TO DATE THERE HAVE NOT BEEN ANY DECLARED.IF CONFLICTS OF INTEREST DO ARISE, THE INTERESTED PARTY OR PARTIES ARE PROHIBITED FROM VOTING ON BOARD MATTERS. FORM 990, PART VI, SECTION B, LINE 15 EVERY YEAR THE BOARD DECIDES WHAT THE CEO'S COMPENSATION WILL BE BASED ON PERFORMANCE. IT IS SUBMITTED TO THE CFO IN WRITING TO GRANT THE APPROVED THE COMPENSATION. OTHER OFFICERS OR KEY EMPLOYEES ARE REVIEWED BY THE SUPERVISOR ON THE ANNIVERSARY AND ARE APPROVED AN INCREASE IF THE JOB PERFOMANCE JUSTIFIES ONE AND THIS IS DONE WITHIN THE BUDGETED BOUNDARIES. THE LAST TIME THIS PROCESS WAS REVIEWED WAS IN DECEMBER OF 2012. 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, PART VI, LINE 14 DOCUMENT RETENTION AND DESTRUCTION POLICY: ALTHOUGH THE ORGANIZATION DOES NOT HAVE A FORMAL DOCUMENT RETENTION AND DESTRUCTION POLICY, IT FOLLOWS THE ESTABLISHED PERIOD OF RETENTION AND DESTRUCTION GUIDELINES OUTLINED IN THE PRACTICE BRIEF FROM THE AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION AND THE QUALITY ASSURANCE STANDARDS OF THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS. FORM 990, PART VI, LINE 9 MAILING ADDRESS: THE ORGANIZATION MAINTAINS A SEPARATE, OFFICIAL MAILING ADDRESS FOR EACH OF ITS BOARD OF TRUSTEES HOWEVER, ALL BOARD MEMBERS, OFFICERS AND DIRECTORS CAN ALSO BE REACHED AT THE ORGANIZATION'S MAILING ADDRESS. FORM 990, PART XI, LINE 9: CHANGE IN THE VALUE OF ANNUITY -12,194. PART VII, LINE 2C FINANCE COMMITTEE: THE OVERSIGHT AND SELECTION PROCESS USED BY THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.