2011-11-15T15:30:36-06:00 2010-12-31 GBQ PARTNERS LLC 230 WEST STREET SUITE 700 COLUMBUS OH 432152663 990 2010-01-01 311340217 WAVERLY CARE CENTER INC WAVE 6144512151 2335 NORTH BANK DRIVE COLUMBUS OH 43220 - 6144512151 2011-11-15 1 GBQ PARTNERS LLC 6142211120 2010 2016-03-07 17:11:31Z JOE KASBERG 2335 NORTH BANK DRIVE COLUMBUS OH 43220 8951556 0 5048 X WWW.TRADITIONSHEALTHCARE.ORG X 1991 OH PROVIDE HOUSING FOR LOW AND MODERATE INCOME FAMILIES. 6 6 126 107 0 0 0 4415 8755586 8942128 -34041 5013 0 0 8721545 8951556 0 0 0 0 4826510 5002144 0 0 0 3804089 3194331 8630599 8196475 90946 755081 9058065 9637023 6437074 6300178 2620991 3336845 X THE MISSION OF NATIONAL CHURCH RESIDENCES IS TO PROVIDE QUALITY HOUSING AND CARE AT AFFORDABLE PRICES IN COMMUNITIES OF CARING PERSONS. OUR MINISTRY IS NATIONAL IN SCOPE AND ORIGINATES FROM A CHRISTIAN COMMITMENT OF SERVICE TO OLDER ADULTS, WHICH BEGAN IN 1961. WHILE OUR MINISTRY HAS BEEN TARGETED PRIMARILY TOWARD OLDER ADULTS, WE HAVE SPECIAL CONCERN FOR LOW- AND MODERATE-INCOME SENIORS, PERSONS WITH DISABILITIES, AND LOW- AND MODERATE-INCOME FAMILIES. WE ARE COMMITTED TO EXPANDING AND FUNDING SERVICES IN ASSISTED LIVING, NURSING HOMES, AND FULL-SERVICE RETIREMENT COMMUNITIES. WE ALSO PLAN FOR THOUGHTFUL GROWTH IN AFFORDABLE FAMILY HOUSING. WE ARE COMMITTED TO PROFESSIONALISM IN THE MANAGEMENT OF PROPERTY, PROGRAMS, AND HUMAN RESOURCES AND EQUALLY COMMITTED TO COMPASSION FOR THE PEOPLE WE SERVE. 0 0 7390835 8942128 PROVIDE A LONG TERM HEALTH CARE FACILITY FOR THE ELDERLY IN THE FORM OF A MULTI-BED NURSING HOME. IN 2010, THE ORGANIZATION PROVIDED 75 LICENSED NURSING FACILITY BEDS, 56 LICENSED RESIDENTIAL CARE FACILITY BEDS, AND 38 LICENSED RESIDENTIAL CARE UNITS. 7390835 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 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 1 1 0 0 0 1 16 0 1 126 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X X JOE KASBERG 6144512151 2335 NORTHBANK DR COLUMBUS OH 43220 DONALD RUSSELL 1.00 X 0 0 0 AL RUPIPER 1.00 X 0 0 0 BOB FOSTER 1.00 X 0 0 0 JOSEPH B KUYOTH 1.00 X 0 251393 33907 JUDITH NADERHOFF 1.00 X 0 142911 27277 JOSEPH R KASBERG 1.00 X 0 279646 43699 JUNE HIMES 40.00 X 81710 0 11730 MINDIE BOND 40.00 X 92740 0 9540 0 673950 104883 0 0 1 0 0 4415 4415 RESIDENT SERVICE FEES 623000 8942128 8942128 8942128 5013 5013 8951556 8942128 0 5013 3591738 3591738 1036739 1036739 373667 373667 825442 19802 805640 7428 7428 25225 25225 86776 86776 39271 39271 63375 63375 50564 50564 288672 288672 4739 4739 133456 133456 434512 434512 112176 112176 PROGRAM SUPPLIES AND DR 401574 401574 TAXES AND FILING FEES 329177 329177 PATIENT MEALS 195828 195828 EQUIPMENT AND MAINTENAN 104032 104032 BAD DEBT -18116 -18116 110200 110200 8196475 7390835 805640 0 595156 759351 588034 793294 23328 37011 10262274 3813650 6545609 6448624 1305938 1598743 9058065 9637023 732375 699002 5505000 5370000 199699 231176 6437074 6300178 X 2620991 3336845 2620991 3336845 9058065 9637023 X 755081 -39227 X X 0 1 1 X 0 X 29470 41713 937 4415 76535 7001408 7109459 8054081 8755586 8942128 39862662 7030878 7151172 8055018 8755586 8946543 39939197 0 0 0 39939197 8227 6403 5656 6882 5013 32181 8227 6403 5656 6882 5013 32181 7039105 7157575 8060674 8762468 8951556 39971378 0.99920 0.99870 0.00080 0.00130 X 88000 88000 8244179 2612251 5631928 142120 74142 67978 1787975 1127257 660718 6448624 RESERVE FOR REPLACEMENT 1431182 FINANCING COSTS, NET 167561 1598743 OBLIGATIONS ON FINANCIAL INSTRUMENT 185418 DEPOSITS 45758 231176 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FACILITIES ANNUALLY EVALUATE WHETHER THERE ARE ANY UNCERTAINTIES IN INCOME TAX POSITIONS THAT MAY AFFECT THEIR COMBINED FINANCIAL STATEMENTS. MANAGEMENT DETERMINED THERE WERE NO MATERIAL UNCERTAIN POSITIONS TAKEN BY THE FACILIITES IN THEIR TAX RETURNS. IRS FORM 990 FILING PERIOS FOR THE YEARS ENDED 2006 AND PRIOR ARE CLOSED. X X X X X X 0 1 0 0 0 0 0 0 0 JOSEPH B KUYOTH 0 183965 0 66000 0 1428 0 30154 0 3753 0 285300 0 0 JUDITH NADERHOFF 0 142794 0 0 0 117 0 14208 0 13069 0 170188 0 0 JOSEPH R KASBERG 0 199061 0 61000 0 19585 0 29647 0 14052 0 323345 0 0 FRANKLIN COUNTY OHIO 316400067 353180GT3 2005-07-14 32000000 ADJUSTABLE RATE HEALTH CARE FACILITIES REVENUE BONDS 0 0 0 PIKE COUNTY OHIO 316400084 72127PAS0 2007-10-29 2100000 SUPPLEMENTAL INDENTURE TO THE 2005 BONDS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMEBER OF THE CORPORATION SHALL, AT ALL TIMES, BE NCR. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR TRUSTEES SHALL HAVE THE APPROVAL OF THE BOARD OF TRUSTEES OF NCR. FORM 990, PART VI, SECTION A, LINE 7B NCR IS REQUIRED TO APPROVE THE SELECTION OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 THE 990 RETURN IS MADE AVAILABLE TO THE BOARD PRIOR TO FILING. AN OFFICER REVIEWS THE 990 RETURN PRIOR TO SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, EXECUTIVE OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS IS COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY PERSON COVERED UNDER THIS POLICY MUST DISCLOSE THE EXISTENCE OF A CONFLICT AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF BOARD COMMITTEES. ALL DIRECTORS AND OFFICERS SHALL ALSO REVIEW AND SIGN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT ON AN ANNUAL BASIS, IDENTIFYING FAMILY MEMBERS, POSSIBLE RELATED BUSINESSES, AND INVESTMENTS AND PROMPTLY REPORT ANY CHANGES TO THE CHAIRPERSON THAT OCCUR THROUGHOUT THE YEAR. IF A CONFLICT EXISTS, PARTICIPATION AND VOTING RIGHT RESTRICTIONS ARE IMPOSED. FORM 990, PART VI, SECTION B, LINE 15 FOLLOWING AN ESTABLISHED EXECUTIVE COMPENSATION POLICY, THE HUMAN RESOURCE COMMITTEE REVIEWS AND APPROVES SALARIES OF ALL OFFICERS AND REPORTS TO THE EXECUTIVE COMMITTEE ON THEIR ACTION. THE COMMITTEES BASE THE SALARY DECISIONS ON SURVEY DATA FROM COMPARABLE ORGANIZATIONS, USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THE COMPENSATION POLICY REVIEW WAS LAST PERFORMED IN 2010. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST AND THROUGH A SECURED WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: LOSS ON FINANCIAL OBLIGATION -39,227. TOTAL TO FORM 990, PART XI, LINE 5: -39,227. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII JOSEPH B. KUYOTH, JR., JUDITH NADERHOFF AND JOSEPH R. KASBERG WORK AN ESTIMATED 40-50 TOTAL HOURS A WEEK ON THE SOLE MEMBER, NCR, AND ITS AFFILIATES. FORM 990, SCHEDULE R, PART II THE RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION #5048. 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