2013-10-23T13:14:54-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 610 WEST GERMANTOWN PIKE SUITE 400 PLYMOUTH MEETING PA 19462 990 2012-01-01 521761391 KESWICK PINES INC KESW 7328490400 509 ROUTE 530 WHITING NJ 08759 WILLIAM A JANSON 7328490400 2013-10-22 1 JAMES D WATSON P01450300 2156433900 2012 2016-02-24 21:20:13Z THE PINES AT WHITING WILLIAM A JANSON 509 ROUTE 530 WHITING NJ 08759 21843626 0 X WWW.THEPINESATWHITING.ORG X 1989 NJ SERVES THE ELDERLY THROUGH APARTMENT LIVING, ASSITED LIVING, AND NURSING HOME CARE. 10 10 353 110 0 0 108384 153813 16358083 16588823 -1857649 371932 513525 512739 15122343 17627307 24775 20237 0 0 8001702 8366399 0 0 0 7962005 7849142 15988482 16235778 -866139 1391529 35282194 34285023 41619194 38567312 -6337000 -4282289 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 14369175 20237 17018322 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 2012, THE PINES MADE A SUBSTANTIAL CONTRIBUTION TO THE GREATER WHITING AREA COMMUNITY BY PARTICIPATING IN APPROXIMATELY 40 COMMUNITY EVENTS. THESE ACTIVITIES RANGED FROM: 1) OFFERING A VARIETY OF LECTURES ON AGING, MAINTAINING PHYSICAL WELL-BEING, MANAGING PARKINSON'S DISEASE ON-SITE AND AS PART OF A COMMUNITY LIBRARY PROGRAM. 2) THE ORGANIZATION HOSTED MANY EVENTS INCLUDING: INTERGENERATIONAL CONCERTS WITH THE HIGH SCHOOL CHORUS; SPECIAL CULTURAL EVENTS FOR THE LOCAL ELEMENTARY SCHOOL; THE GARDEN CLUB; CAMERA CLUB; CAREGIVER'S OF WHITING; A PUMPKIN DECORATING CONTEST AND A RED CROSS BLOOD DRIVE. 3) THE PINES ALSO RAISED FUNDS FOR: FOOD DONATIONS TO SUPPORT SEVERAL LOCAL FOOD BANKS; ALZHEIMER'S MEMORY WALK; CROP WALK AND COLLEGE SCHOLARSHIPS FOR LOCAL STUDENTS. DONATIONS WERE MADE TO: AMERICA'S KESWICK, THE POLICE, FIRE FIGHTERS, AND CAREGIVERS VOLUNTEERS. 4) AS A PROVIDER OF HEALTH CARE SERVICES IN OCEAN COUNTY, THE PINES OFFERED AN EDUCATIONAL SEMINAR FOR ACTIVITY PROFESSIONALS. 5) THE CEO AND THE PINES RECEIVED A SPECIAL AWARD FOR DISTINGUISH SERVICE TO OCEAN COUNTY SENIORS LEADING AGE OF NEW JERSEY.6) THE CHAPLAIN OF THE PINES SERVES AS POLICE CHAPLAIN FOR TWO OCEAN COUNTY MUNICIPALITIES.7) THE PINES PROVIDED APARTMENTS TO 4 SENIOR HOUSEHOLDS DISPLACED BY HURRICANE SANDY AND RAISED MONEY AND FOOD DONATIONS TO SUPPORT OTHER VICTIMS AND EMPLOYEES.8) THE PINES ALSO PROVIDED SUBSIDY FOR SIX RESIDENTS IN THE PINES COMMUNITY WHO COULD NOT AFFORD TO PAY THE FULL RATE FOR SERVICES. FOR THE YEAR 2012, THE TOTAL AMOUNT OF FORGIVEN REVENUE WAS $65,000. OVERALL, THE PINES PROGRAM TO SERVE OTHERS BENEFITTED MORE THAN 2000 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. 14369175 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 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 24 0 353 1 0 0 0 0 0 0 0 0 0 0 X 10 10 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 8666225037 509 ROUTE 530 WHITING NJ 08759 JAY B KATZ 2.00 X X 0 0 0 MARK KOLCHIN 2.00 X X 0 0 0 DOUGLAS J BAUERBAND 2.00 X X 0 0 0 ALAN R DINKFELT 2.00 X 0 0 0 NEIL ERIKSEN 2.00 X X 0 0 0 JOHN R HOLLAND 2.00 X 0 0 0 CHARITY ROSZEL 2.00 X 0 0 0 WILLIAM COOK 2.00 X 0 0 0 CAROLYN HIBBARD 2.00 X 0 0 0 JOHN BHATT 2.00 X 0 0 0 WILLIAM JANSON 40.00 X 254679 0 10591 GEORGINA BAVAIS 40.00 X 132995 0 11742 PATRICIA POLCHAK 40.00 X 134896 0 7974 ADRIANNE SOBOCINSKI 40.00 X 111714 0 11109 634284 0 41416 4 0 1 0 SODEXO OPERATIONS PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE 948986 MANCHESTER WINDOW AND DOOR CO LIC 1981 BROOKLYN AVE WHITING NJ 08759 CONSTRUCTION CONTRACTOR 322774 AOD SOFTWARE 11575 HERON BAY BLVD STE 200 CORAL SPRINGS FL 33076 SOFTWARE COMPANY 196165 BUSINESS FLOORING 9105 E WHISKEY BOTTOM RD LAUREL MD 20723 CARPET AND FLOORING 172858 JW FINLEY INC 310 MAIN ST TOMS RIVER NJ 08753 HEATING CONTRACTOR 144129 10 153813 153813 RESIDENT MONTHLY FEES 623990 6589332 6589332 PRIVATE PAY 623990 5028744 5028744 MEDICAID AND MEDICARE REVENUE 623990 3000825 3000825 ENTRANCE FEES REVENUE 623990 1865036 1865036 RECOVERY OF DOUBTFUL ACCOUNTS 623990 104886 104886 16588823 333998 333998 20519 11363 9156 9156 9156 4242890 4204956 37934 37934 37934 ANCILLARY SERVICES 623000 112149 112149 FOOD SERVICES 623000 109522 109522 BARBER AND BEAUTY 623000 92748 92748 189164 207828 -18664 503583 17627307 17018322 0 455172 8237 8237 12000 12000 6803895 5852791 951104 86181 53086 33095 1476323 1281144 195179 247686 208251 39435 14884 14884 34028 34028 174564 167968 6596 214683 213297 1386 416062 368251 47811 65066 24872 40194 2988290 2788522 199768 19580 18233 1347 1867021 1624308 242713 420398 392034 28364 FOOD SERVICES 1043624 1040559 3065 MEDICAL EXPENSES 224603 224603 MISCELLANEOUS EXPENSES 118653 91019 27634 16235778 14369175 1866603 0 X 1365 1565 1083218 1327919 337434 716522 154500 18325 404357 307375 48741487 28225437 20999870 20516050 11753702 10705670 547748 691597 35282194 34285023 1558896 2145357 11963807 12075822 25085000 23666571 551800 629619 2459691 49943 41619194 38567312 X -6365827 -4357923 28827 75634 -6337000 -4282289 35282194 34285023 X 1391529 601053 62129 X X 0 1 X 1 0 X 24114 143349 173475 108384 153813 603135 16416322 16448865 16897260 16875886 17018322 83656655 16440436 16592214 17070735 16984270 17172135 84259790 0 0 0 84259790 472994 425376 380428 336953 447265 2063016 472994 425376 380428 336953 447265 2063016 16913430 17017590 17451163 17321223 17619400 86322806 0.97610 0.97440 0.02390 0.02560 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 411 411 0 EXPLANATION OF LOBBYING ACTIVITIES: 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 37464685 26407024 11057661 8202662 1674132 6528530 325599 144281 181318 20516050 CHARITBLE GIFT ANNUITIES 49943 49943 X 18185604 601053 -42756 558297 17627307 0 17627307 16130892 -104886 -104886 16235778 0 16235778 DESCRIPTION OF HOW ORGANIZATION REPORTS CONSERVATION EASEMENTS: PART II, LINE 9: THE DEPARTMENT OF ENVIRONMENTAL PROTECTION IS TO PROVIDE SIGNAGE 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 TRUST 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2009 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR (RECOVERY OF) DOUBTFUL ACCOUNTS -104,886. CHANGE IN THE VALUE OF ANNUITY 62,130. PART XII, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR (RECOVERY OF) DOUBTFUL ACCOUNTS -104,886. 0 EMPLOYEE SCHOLARSHIPS 7 12000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION DOES NOT MAINTAIN SUCH RECORDS AS IT ONLY PROVIDES SMALL DONATIONS TO OTHER CHARITABLE ORGANIZATIONS PART III, LINE 1 EMPLOYEE SCHOLARSHIPS 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 APPLICATN 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 SHE 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 1 0 0 0 WILLIAM JANSON 208659 0 40020 0 6000 0 3000 0 7591 0 265270 0 0 0 GEORGINA BAVAIS 132995 0 0 0 0 0 3989 0 7753 0 144737 0 0 0 PART I, LINE 1B THE BOARD APPROVED A "DEFERRED COMPENSATION BONUS" FOR WILLIAM JANSON, CEO. THE BENEFIT WAS INCLUDED IN TAXABLE COMPENSATION FOR THE CURRENT YEAR. PART I, LINE 6 IF THE ORGANIZATION SURPASSES THE NET EARNINGS BUDGETED, STAFF MEMBERS ARE REWARDED WITH A BONUS. THE BONUSES ARE ACCRUED. 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 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 REVIEWED WAS IN DECEMBER OF 2012. FORM 990, PART VI, SECTION C, LINE 19 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. DOCUMENT RETENTION AND DESTRUCTION POLICY FORM 990, PART VI, LINE 14 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. MAILING ADDRESS FORM 990, PART VI, LINE 9 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. INTEREST RECEIVABLE FORM 990, PART X, LINE 15 THIS IS A MUNICIPAL DERIVATIVE SETTLEMENT BETWEEN THE ATTORNEY GENERAL AND WACHOVIA BANK. THIS WAS KESWICK'S SHARE ($45,354) OF THE SETTLEMENT RESTITUTION FUND. THIS IS A PORTION OF THE 55.4 MILLION DOLLAR FUND. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN THE VALUE OF ANNUITY 62,129. FINANCE COMMITTEE PART VII, LINE 2C 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.