2011-08-24T16:32:02-05:00 2010-12-31 BROWN GRAHAM & COMPANY 9005 MOUNTAIN RIDGE RD SUITE 240 AUSTIN TX 78759 990 2010-01-01 741459599 WESLEYAN HOMES INC WESL 5128681205 PO BOX 486 GEORGETOWN TX 78627 JOHN KLUBERG 5128681205 2011-08-24 1 SHANNON ANDRE 5122578078 2011-08-15 2010 2016-02-24 21:20:13Z JOHN KLUBERG PO BOX 486 GEORGETOWN TX 78627 17680585 0 X WWW.WESLEYANHOMES.ORG X 1955 TX TO PROVIDE RETIREMENT, ASSISTED LIVING AND NURSING HOME ACCOMMODATIONS TO RESIDENTS. 34 33 400 148 0 0 65686 96282 16499379 17231204 33462 7398 477731 332434 17076258 17667318 0 0 0 0 10536104 10799691 0 0 299565 7471096 6352477 18007200 17152168 -930942 515150 27758785 35438566 18360417 24708697 9398368 10729869 X TO BE THE PREMIER PROVIDER OF SUPPORTIVE CARE AND SERVICES IN CENTRAL TEXAS, OPEN TO ALL SENIOR ADULTS. THE ORGANIZATION VALUES FAITH, COMPASSION, WELLNESS, AFFORDABILITY, EXCELLENCE, PROFESSIONALISM AND CHOICE. THE VISION OF WESLEYAN HOMES, INC. IS TO BE A FAITH-BASED MINISTRY PROVIDING COMFORT AND CARE FOR RESIDENTS AND THEIR FAMILIES IN A PLACE CALLED HOME. 0 0 16068916 17314219 PROFESSIONAL PATIENT CARE AND BENEFITS REGARDLESS OF FINANCIAL CONSIDERATIONS AND QUALIFICATIONS. THE RETIREMENT AND NURSING HOME WERE HOME TO 561 OLDER ADULTS IN 2010. 16068916 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 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 0 0 0 0 1 45 0 400 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 34 33 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 X JOHN KLUBERG 5128681205 1811 NORTH AUSTIN AVE STE 201 GEORGETOWN TX 78626 DR DOUG BENOLD 1.00 X 0 0 0 MS CATHY BRYANT 1.00 X 0 0 0 MR BILL CONNOR 1.00 X 16975 0 0 MRS JEANNINE FAIRBURN 1.00 X 0 0 0 MR TOM FORBES 1.00 X 0 0 0 MRS LINDA GUSNOWSKI 1.00 X 0 0 0 MS DORRIS ROSS 1.00 X 0 0 0 MR PAT STROMAN 1.00 X 0 0 0 MR ERROL WENDLAND 1.00 X 0 0 0 REV JOHN AYMOND 1.00 X 0 0 0 REV JIM CHANDLER 1.00 X 0 0 0 REV NANCY WOODS 1.00 X 0 0 0 REV RANKIN KOCH 1.00 X 0 0 0 MR ED KOMANDOSKY 1.00 X 0 0 0 DR KENT MARRS 1.00 X 0 0 0 DR JAMES PORTER 1.00 X 0 0 0 MR DAVID HAYS 1.00 X 0 0 0 REV TRAVIS FRANKLIN 1.00 X 0 0 0 DR ERIC MCKINNEY 1.00 X 0 0 0 REV LARA WHITLEY 1.00 X 0 0 0 REV DEBRA CRUMPTON 1.00 X 0 0 0 MRS PATTY LEE 1.00 X 0 0 0 REV ARCYNTHIA LOUIE 1.00 X 0 0 0 BISHOP MIKE LOWREY 1.00 X 0 0 0 MR GENE LAWHON 1.00 X 0 0 0 MRS JACKIE RANDALL 1.00 X 0 0 0 DR BOB SOULEN 1.00 X 0 0 0 REV CHRIS HAYES 1.00 X 0 0 0 MR STEVE MCIVER 1.00 X 0 0 0 MS CYNTHIA RIVES 1.00 X 0 0 0 MRS NANCY BENOLD 1.00 X 0 0 0 MR GEORGE BRIGHTWELL 1.00 X 0 0 0 DR DALE SCHULTZ 1.00 X 0 0 0 MR BILL BOOTH 1.00 X 0 0 0 MR CHRIS SPENCE 40.00 X 151591 0 17633 JOHN KLUBERG 40.00 X 94153 0 12788 262719 0 30421 1 0 1 0 VRW CONSTRUCTION CO INC PO BOX 150369 AUSTIN TX 78715 ASSISTED LIVING CONSTRUCTION 6010469 SELECT REHABILITATION INC 550 FRONTAGE RD STE 2415 NORTHFIELD IL 60093 PHYSICAL THERAPY 991768 US FOODSERVICE INC 979 SPRINGDALE ROAD AUSTIN TX 78702 FOOD 609467 LEAH W VON KAENEL INC 336 S CONGRESS AVE STE 165 AUSTIN TX 78704 ASSISTED LIVING DESIGN AND FURNISHINGS 516926 COMMUNITIES OF FAITH RRG 1800 SECOND STREET STE 909E SARASOTA FL 34236 INSURANCE 221398 5 96282 96282 ROUTINE PATIENT CARE S 623000 17231204 17231204 17231204 20665 20665 13267 -13267 -13267 -13267 BARBER/BEAUTY SHOP 812900 131709 131709 GAIN-INVEST INSURANCE 900099 125405 125405 OTHER SERVICES 812900 75320 75320 332434 17667318 17217937 0 353099 276165 276165 8595862 8204082 289278 102502 251281 242091 6590 2600 1028519 897293 29332 101894 647864 613522 30015 4327 26132 4915 21217 34550 34550 1180615 1173733 5506 1376 34918 23407 1038 10473 211829 134734 25092 52003 818539 755695 50898 11946 48223 36354 1074 10795 441516 441516 914982 914982 245679 243608 2071 DIETARY 966369 966369 NURSING DEPT AND THERAP 666798 666798 REPAIRS & MAINTENANCE 288981 270623 17961 397 HOUSEKEEPING 221582 221582 OTHER 167991 141386 26515 90 83773 81676 935 1162 17152168 16068916 783687 299565 415139 612638 68671 69062 2331340 3003357 78469 34572 34268017 6225574 21332980 28042443 274444 2575088 2498641 449167 402967 507931 500442 27758785 35438566 262623 414752 16551297 22315838 1546497 1978107 18360417 24708697 X 9398368 10729869 9398368 10729869 27758785 35438566 X 515150 816351 X X 0 1 1 X 0 X 1455000 230000 65686 96282 1846968 13001517 14608395 16510003 16489480 17314219 77923614 14456517 14608395 16740003 16555166 17410501 79770582 0 0 0 79770582 777068 3278900 792649 521092 1421150 6790859 777068 3278900 792649 521092 1421150 6790859 15233585 17887295 17532652 17076258 18831651 86561441 0.92150 0.93050 0.07850 0.06950 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1074000 10068 102728 10937 1175859 888965 36257 153305 4527 1074000 1320680 28913 -441512 19116 888965 0.96000 0.03000 0.01000 0 1 1 2027969 2027969 21049965 4770987 16278978 2689595 1454587 1235008 8500488 8500488 28042443 INVESTMENT IN RRG 1422314 C INVESTMENTS & RESTR CASH 1076327 F 2498641 ACCRUED COMPENSATION & EMPLOYEE BENEFITS 729693 ACCRUED INTEREST 38766 ACCOUNTS PAYABLE - CONSTRUCTION 1198248 COMMUNITY FEE DEPOSIT 11400 1978107 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE BENEVOLENT ENDOWMENT FUND COMPOSES APPROXIMATELY 77% OF THE ENDOWMENT BALANCE AND IS INTENDED TO GENERATE INCOME TO HELP COVER THE ACTUAL COSTS OF CARE FOR CERTAIN RESIDENTS IN EXCESS OF THEIR MEDICAID REIMBURSEMENT OR PERSONAL ABILITY TO PAY. THE REMAINING ENDOWMENT BALANCE IS IN A GENERAL ENDOWMENT FUND INTENDED TO GENERATE INCOME TO SUPPORT CHARITABLE CARE, CAPITAL IMPROVEMENTS, SERVICES, AND PROGRAMMING OF THE ORGANIZATION. X X 0 0 0 0 0 0 0 1 0 MR CHRIS SPENCE 135724 0 6000 0 9867 0 9123 0 8510 0 169224 0 163984 0 PART I, LINE 7 DISCRETIONARY CHRISTMAS BONUSES WERE PAID TO ALL EMPLOYEES. HFDC OF CENTRAL TEXAS INC 371453424 NONEGIVEN 2009-10-07 25462000 SEE PART V 0 0 0 22315838 66948 424339 6400166 15424385 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 SCH K, PART I A (F) DESCRIPTION OF PURPOSE THE PURPOSE OF THE PROMISSORY NOTE (WESLEYAN HOMES, INC.) SERIES 2009A AND SERIES 2009B IS (1) TO REFUND WITHIN 90 DAYS OF ISSUANCE DATE, THE GEORGETOWN HEALTH FACILITIES DEVELOPMENT CORPORATION REVENUE BONDS (WESLEYAN HOMES, INC PROJECT) SERIES 1998 AND SERIES 2006, (2) TO FINANCE THE ACQUISITION AND CONSTRUCTION OF AN ASSISTED LIVING FACILITY CONSISTING OF 60 ASSISTED LIVING UNITS OF WHICH 20 UNITS ARE FOR MEMORY CARE AS WELL AS COMMON AREAS, AND (3) TO PROVIDE FUNDS TO PAY ALL OR A PORTION OF THE COSTS OF ISSUANCE OF THE NOTES. FORM 990, PART VI, SECTION A, LINE 2 THE CHAIRWOMAN, NANCY BENOLD, IS THE DAUGHTER-IN-LAW OF DR. DOUG BENOLD, LAITY MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE BOARD, CEO AND CFO PRIOR TO FILING. THE RETURN IS REVIEWED FOR ACCURACY WITH ANY CHANGES BEING DISCUSSED AND SUBMITTED TO BROWN, GRAHAM & COMPANY. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS AND OFFICERS OF THE BOARD OF TRUSTEES AS WELL AS KEY MANAGEMENT EMPLOYEES. UPON DATE OF EMPLOYMENT OR APPOINTMENT ONTO BOARD, THESE INDIVIDUALS MUST SIGN A CONFLICT OF INTEREST STATEMENT STATING THAT THEY HAVE READ AND ARE FAMILIAR WITH THE BYLAWS AND, IN PARTICULAR, ARTICLE 6.6 REGARDING CONFLICT OF INTEREST, AND THAT THEY WILL COMPLY WITH REQUIREMENT TO REPORT, IN WRITING, ANY APPARENT CONFLICT OF INTEREST TO THE BOARD CHAIR. THE BOARD CHAIR IN CONSULTATION WITH APPROPRIATE BOARD MEMBERS AND KEY MANAGEMENT WILL DETERMINE IF A CONFLICT EXISTS AND DETERMINE APPROPRIATE RESTRICTIONS ON A CASE-BY-CASE BASIS FOR AN INDIVIDUAL WITH A CONFLICT OF INTEREST. THE CONFLICT OF INTEREST POLICY WAS REVIEWED AND UPDATED STATEMENTS WERE SIGNED BY ALL BOARD MEMBERS DURING A 2010 BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE SALARIES FOR THE CEO AND OTHER KEY EMPLOYEES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD EACH OCTOBER FOR THE FOLLOWING YEAR. EACH COMMITTEE MEMBER IS PROVIDED WITH THE SALARY HISTORY OF EACH OF THESE EMPLOYEES SINCE HIS/HER EMPLOYMENT DATE. THE HUMAN RESOURCE MANAGER PARTICIPATES EACH YEAR IN THE SALARY SURVEYS FOR AAHSA AND TAHSA ( AMERICAN ASSOC. OF HOMES AND SERVICE FOR THE AGING, AND THE TEXAS ASSOCIATION OF HOMES AND SERVICES FOR THE AGING). THE RESULTS OF THESE SURVEYS ARE PROVIDED TO THE CEO TO PRESENT TO THE EXECUTIVE COMMITTEE. THE CEO DISCUSSES EACH EMPLOYEE'S STRENGTHS, WEAKNESSES, ACCOMPLISHMENTS, AND OVERALL PERFORMANCE WITH THIS COMMITTEE. THE COMMITTEE TAKES ALL OF THIS INFORMATION, ALONG WITH THEIR PERCEPTION OF THE EMPLOYEE BASED ON THEIR OWN INTERACTIONS, AND DETERMINES, BY EMPLOYEE, THE SALARY ADJUSTMENT TO BE MADE. THEN, THE CEO LEAVES THE MEETING, AND THE COMMITTEE GOES THROUGH THE SAME PROCEDURE TO EVALUATE HIM. THE BOARD CHAIR GATHERS ALL OF THE INFORMATION ON RAISES AND SIGNS OFF. THE DOCUMENTATION IS THEN FORWARDED TO THE CFO FOR PROCESSING AFTER THE LAST PAYROLL OF THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC ON REQUEST FROM MANAGEMENT. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 20,912. PRIOR PERIOD ADJUSTMENTS: 795,439. OVERSIGHT OF THE AUDIT FORM 990, PART XIII,LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. WESLEYAN HOMES PROPERTIES PO BOX 486 GEORGETOWN TX 78627 900085004 ACQUIRING, HOLDING TITLE TO, CONSTRUCTING & MAINTAINING REAL PROPERTY TX 501(C)(3) LINE 11A, I WESLEYAN HOMES INC 0 WESLEYAN HOMES FOUNDATION PO BOX 486 GEORGETOWN TX 78627 900085021 PROVIDE SUPPORT FOR WESLEYAN HOMES INC TX 501(C)(3) LINE 11A, I WESLEYAN HOMES INC 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WESLEYAN HOMES FOUNDATION C 96282 GRANT-CHARITABLE CARE PROVIDED