2013-11-13T08:47:21-06:00 2012-12-31 310210560 BATTELLE & BATTELLE LLP 2000 WEST DOROTHY LANE DAYTON OH 45439 990 2012-01-01 310641121 WIDOWS HOME OF DAYTON OHIO WIDO 9372521661 50 SOUTH FINDLAY STREET DAYTON OH 45403 NANCY HINES 9372521661 2013-10-01 1 KAREN O CRIM P00368385 9372980201 2012 2016-02-25 16:41:14Z NANCY HINES 50 SOUTH FINDLAY STREET DAYTON OH 45403 5456913 0 X WWW.WIDOWSHOME.ORG X 1961 OH THE PURPOSE OF THE WIDOWS HOME IS TO PROVIDE LONG-TERM CARE SERVICES TO ELDERLY INDIVIDUALS. 10 10 171 180 0 0 0 0 5739765 5453503 -470 -1099 1150 3410 5740445 5455814 0 0 0 0 2721822 2559740 0 0 0 2914089 2890539 5635911 5450279 104534 5535 7485759 7465982 8417215 8339303 -931456 -873321 THE PURPOSE OF THE WIDOWS HOME IS TO PROVIDE LONG-TERM CARE SERVICES TO ELDERLY INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. 0 0 4509030 5452404 THE WIDOWS HOME OF DAYTON, OHIO PROVIDES LONG-TERM NURSING AND RESIDENTIAL CARE, SHORT-TERM REHABILITATION, AND ADULT DAY PROGRAMS TO ELDERLY INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THE HOME IS AN INNER-CITY FACILITY WITH 75 LICENSED BEDS. 4509030 1 0 0 1 0 0 0 0 1 0 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 0 0 0 1 0 0 171 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 1 0 0 0 OH X KRISTINA DIXON 9372521661 50 SOUTH FINDLAY STREET DAYTON OH 45403 NANCY HINES 0.50 X X 0 0 0 ROBERT PROPHATER 0.50 X X 0 0 0 MARILYN HOBACK 0.50 X X 0 0 0 JOAN FRANKS 0.50 X X 0 0 0 ROBERT APPLEBAUM 0.50 X 0 0 0 JANE CLIFTON 0.50 X 0 0 0 LINDA ROEPKEN 0.50 X 0 0 0 JEFF SORRELL 0.50 X 0 0 0 KEITH VALIQUETTE 0.50 X 0 0 0 ROSE WILDENHAUS 0.50 X 0 0 0 KRISTINA DIXON 32.00 X 87831 0 0 87831 0 0 0 0 0 0 ALPHA & OMEGA STAFFING SOLUTIONS 6276 PLATTSBURG ROAD S CHARLESTON OH 45368 THERAPY SERVICES 471944 UNITED CHURCH HOMES MANAGEMENT PO BOX 1806 MARION OH 433011806 MANAGEMENT SERVICES 260250 BEEBER PHARMACIES 600 UNION BLVD ENGLEWOOD OH 45322 PHARMACY SERVICES 166924 3 MEDICARE/MEDICAID PAYM 623000 4418617 4418617 PRIVATE PAY RESIDENTS 623000 543779 543779 HOSPICE CARE RESIDENTS 623000 470366 470366 SENIOR ADULT DAY CARE 623000 20741 20741 5453503 1099 -1099 -1099 -1099 OTHER INCOME 900099 3410 3410 3410 5455814 5452404 0 3410 87831 87831 1748481 1680524 67957 162000 153752 8248 561428 524229 37199 166610 166610 800 800 9600 9600 14387 14387 267040 267040 379164 379164 HEALTH SERVICES 1165041 1165041 BED TAX 319122 319122 ADMINISTRATION 187394 187394 DIETARY 164399 164399 216982 174881 42101 5450279 4509030 941249 0 79547 277235 779394 895918 4339 5744 44407 42354 10872213 4662325 6572991 6209888 5081 34843 7485759 7465982 452572 599139 4250348 3943457 17833 19085 3696462 3777622 8417215 8339303 X -931456 -873321 -931456 -873321 7485759 7465982 X 5535 52598 X X 0 1 X 1 0 X 4420400 5677102 5768165 5689985 5432762 26988414 4420400 5677102 5768165 5689985 5432762 26988414 0 0 0 26988414 47293 48939 49778 49778 20741 216529 47293 48939 49778 49778 20741 216529 4467693 5726041 5817943 5739763 5453503 27204943 0.99200 0.99030 0.00800 0.00970 X 0 0 0 0 0 0 0 0 1 0 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A SMALL PORTION OF THE ORGANIZATION'S DUES PAID TO LEADINGAGE OHIO (FKA AOPHA) IS ALLOCABLE TO LOBBYING. 0 1 X 131650 131650 8937837 3714794 5223043 1802726 947531 855195 6209888 ACCRUED EXPENSES 353883 DEFERRED COST OF INTEREST RATE SWAP 284015 FUNDS ADVANCED FROM WIDOWS HOME FOUNDATION - RELATED ORGANIZATION 3139724 3777622 X PART IV, LINE 2B: RESIDENT SAVINGS ACCOUNTS ARE HELD IN A SEPARATE BANK ACCOUNT. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOME AND THE FOUNDATION QUALIFY AS TAX-EXEMPT NON-PROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAX IS REQUIRED. MANAGEMENT EVALUATED THE HOME AND THE FOUNDATION'S TAX POSITIONS AS OF DECEMBER 31, 2012 AND 2011 AND CONCLUDED THAT THEY HAVE TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS. IN GENERAL, THE HOME AND FOUNDATION ARE NO LONGER SUBJECT TO FEDERAL, STATE, OR LOCAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009. A CITY OF RIVERSIDE 316000133 2006-12-29 2500000 25 BED EXPANSION 0 0 0 A 2500000 2008 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 UNITED CHURCH HOMES MANAGEMENT, INC. PROVIDES MANAGEMENT AND CONSULTING SERVICES, FINANCIAL MANAGEMENT, HUMAN RESOURCES, CENSUS AND BUSINESS DEVELOPMENT, MEDICARE BILLING SERVICES, AND SIMILAR MANAGEMENT SERVICES TO THE WIDOWS HOME OF DAYTON. THE ADMINISTRATOR OF THE WIDOWS HOME IS EMPLOYED BY UNITED CHURCH HOMES MANAGEMENT, INC. AND RECEIVES SALARY AND BENEFITS FROM THAT ORGANIZATION. THERE IS NO OWNERSHIP INTEREST IN UNITED CHURCH HOMES MANAGEMENT, INC. BY THE WIDOWS HOME OF DAYTON OR ANY OFFICERS OR BOARD MEMBERS OF THE WIDOWS HOME. THE MANAGEMENT CONTRACT WITH UNITED CHURCH HOMES MANAGEMENT, INC. WAS TERMINATED ON DECEMBER 31, 2012. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEE MEETING MINUTES WERE NOT TAKEN. HOWEVER, THE DISCUSSIONS DURING COMMITTEE MEETINGS ARE REPORTED AT BOARD MEETINGS AND ARE DOCUMENTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE PROVIDED TO BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS PROVIDE SELF-DISCLOSURE OF CONFLICTS OF INTEREST. 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP OBLIGATION 52,487. CHANGE IN CASH SURRENDER VALUE OF RESIDENT LIFE INSURANCE 111. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS HAS NOT CHANGED THAT PROCESS FROM THE PRIOR YEAR. THE FINANCIAL STATEMENTS ARE CONSOLIDATED WITH THE WIDOWS HOME FOUNDATION, A PUBLIC CHARITY WHOSE PURPOSE IS TO CONDUCT FUNDRAISING ACTIVITIES AND MANAGE THE ENDOWMENT FUNDS FOR THE BENEFIT OF THE WIDOWS HOME OF DAYTON. WIDOWS HOME FOUNDATION 50 SOUTH FINDLAY STREET DAYTON OH 45403 311584036 TO CONDUCT FUNDRAISING ACTIVITIES AND MANAGE ENDOWMENT FUNDS. OH 501(C)(3) LINE 7 N/A 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WIDOWS HOME FOUNDATION E 3139724 FAIR MARKET VALUE