2011-05-16T14:01:33-05:00 2010-12-31 LARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2010-01-01 237302390 KANSAS CITY UNITED METHODIST RETIREMENT HOME INC D/B/A KINGSWOOD KANS 8169420994 10000 WORNALL ROAD KANSAS CITY MO 64114 MIKE DIRLAM 8169420994 2011-05-10 1 3149254300 2010 2016-02-24 21:20:13Z MIKE DIRLAM 10000 WORNALL ROAD KANSAS CITY MO 64114 15082237 0 X WWW.KINGSWOODATHOME.ORG X 1972 MO KINGSWOODS' MISSION IS TO PROVIDE RESIDENTAL AND HEALTH CARE FACILITIES, SERVICES AND OPPORTUNITIES FOR OLDER ADULTS. KINGSWOOD, A MINISTRY OF THE UNITED METHODIST CHURCH. 14 14 289 107 0 0 348301 151090 13562820 14225617 129669 151791 534935 548013 14575725 15076511 0 6198 0 0 6346566 6221605 0 0 0 8973255 9051496 15319821 15279299 -744096 -202788 38390101 36726889 51594835 49958968 -13204734 -13232079 KINGSWOODS' MISSION IS TO PROVIDE RESIDENTAL AND HEALTH CARE FACILITIES, SERVICES AND OPPORTUNITIES FOR OLDER ADULTS. KINGSWOOD IS A MINISTRY OF THE UNITED METHODIST CHURCH. 0 0 13383285 14225617 KINGSWOODS' MISSION IS TO PROVIDE RESIDENTIAL AND HEALTH CARE FACILITIES, SERVICES AND OPPORTUNITIES FOR OLDER ADULTS. KINGSWOOD, A MINISTRY OF THE UNITED METHODIST CHURCH, MAINTAINS 201 APARTMENTS, 82 BEDS IN THE HEALTH CENTER, 17 ASSISTED LIVING APARTMENTS, AND 54 VILLA HOMES. THE HEALTH CENTER IS LICENSED BY THE STATE OF MISSOURI AS A SKILLED NURSING FACILITY. KINGSWOOD AVERAGES AROUND 300 RESIDENTS ON THE 32 ACRE CAMPUS. SERVICES PROVIDED BY KINGSWOOD INCLUDE MEALS, HOUSEKEEPING, LAUNDRY, UTILITIES, MAINTENANCE, LIGHTED PARKING, RELIGIOUS/SOCIAL PROGRAMMING, SECURITY, ADMINISTRATIVE SERVICES, LOUNGES, CRAFT AREAS, TRANSPORTATION, PERSONAL CARE ASSISTANCE, REHABILITATITVE THERAPY, A CHAPEL, A LIBRARY, A COMPUTER LAB, BEAUTY AND BARBER SALON, GIFT SHOP, OUTDOOR PATIOS AND WALKING AREAS. 13383285 1 1 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 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 1 0 0 0 0 1 47 0 1 289 1 0 0 0 0 0 0 1 1 0 0 0 0 0 X 14 14 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CONNIE CARGIN 8164423255 10000 WORNALL ROAD KANSAS CITY MO 64114 ROBERT ADAMS 1.00 X X 0 0 0 DAVID CARNES 1.00 X 0 0 0 SALLY FIRESTONE 1.00 X 0 0 0 DR HEATHER ANDERSON 1.00 X 0 0 0 GEORGE HEYMACH 1.00 X 0 0 0 JOHN YOUNGER 1.00 X 0 0 0 JOANNE KELLEY 1.00 X 0 0 0 EVELYN CRAIG 1.00 X 0 0 0 RICHARD LANE 1.00 X 0 0 0 JAMES MORDY 1.00 X X 0 0 0 FRED WIMAN 1.00 X X 0 0 0 VICKIE WOLGAST 1.00 X 0 0 0 JANICE WOLLARD 1.00 X 0 0 0 JOELLEN WURTH 1.00 X 0 0 0 MILTON ADAMS 1.00 X 0 0 0 WILLIAM FRANKLIN 1.00 X 0 0 0 RUTH KINTIGH 1.00 X 0 0 0 RUSSELL LYTLE 1.00 X 0 0 0 JEFFREY HARKINS 40.00 X 0 163491 0 0 163491 0 0 0 1 0 REHAB CHOICE 2127 INNERBELT BUS CENTER DR ST LOUIS MO 63110 THERAPY PROVIDER 931555 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT 593423 SYSCO FOODS 1915 KANSAS CITY RD OLATHE KS 66061 FOOD SERVICE 554007 BLUE CROSS BLUE SHIELD OF KC PO BOX 219451 KANSAS CITY MO 64121 HEALTH INSURANCE 433804 KCP & L PO BOX 418679 KANSAS CITY MO 64141 ELECTRICITY 421962 17 151090 151090 RESIDENT REVENUE 623000 14225617 14225617 14225617 157517 157517 16351 16351 16351 16351 5726 -5726 -5726 -5726 MISCELLANEOUS 623000 317677 317677 DINING SERVICES 623000 113921 113921 BEAUTY SHOP 623000 92051 92051 8013 8013 531662 15076511 14225617 0 699804 6198 6198 5374399 4625128 749271 4578 3940 638 438778 377606 61172 403850 347547 56303 443770 443770 102989 102989 46943 46943 257089 219488 37601 21592 21592 69807 69807 939560 909131 30429 27189 7516 19673 1213988 1174671 39317 2192987 2121963 71024 139523 135004 4519 ANCILLARY SERVICES 1343893 1343893 FOOD 857227 857227 SUPPLIES 394129 355069 39060 MAINTENANCE 340603 329572 11031 CONTRACTED LABOR 330767 264140 66627 329440 305192 24248 15279299 13383285 1896014 0 578518 782171 1165565 2184914 47468 48836 67691 62411 50536795 25187998 27139748 25348797 9391111 8299760 38390101 36726889 4378011 3375434 4539308 4678727 18854447 18337003 3462492 3053029 20360577 20514775 51594835 49958968 X -15589945 -15849842 577937 795907 1807274 1821856 -13204734 -13232079 38390101 36726889 X -202788 175443 X X 0 1 1 X 0 X 193297 348301 151090 692688 12002926 13393751 13024580 13562820 14225617 66209694 12002926 13393751 13217877 13911121 14376707 66902382 0 0 0 66902382 315697 361940 290229 175983 168142 1311991 315697 361940 290229 175983 168142 1311991 309554 291197 447480 505982 531662 2085875 12628177 14046888 13955586 14593086 15076511 70300248 0.95170 0.93570 0.01870 0.02050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1773191 35570 172057 50309 1930509 1547455 20220 210576 5060 1773191 2016690 56415 -434368 91292 1547445 1.00000 0 1 1 1543850 1543850 46340593 22875805 23464788 2648438 2312193 336245 3914 3914 25348797 DEFERRED FINANCING COSTS 497531 INTEREST IN ASSETS OF FOUNDATION 676060 DONOR RESTRICTED FUND- PERM RESTRICTED 1763363 ACCRUED INTEREST 22 DONOR RESTRICTED FUND- TEMP RESTRICTED 167147 BOND FUNDS 5195637 8299760 RESIDENT DEPOSITS 210206 REFUNDABLE ENTRANCE FEES 20304569 20514775 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: KINGSWOOD MAINTAINS A WESLEY ENDOWMENT FUND. THE FUNDS ARE USED FOR FINANCIAL ASSISTANCE FOR THE RESIDENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATIONS FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATIONS INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE TAX RETURNS FOR THE YEARS 2007 THROUGH 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. 1 WESLEY ASSISTANCE GRANT 1 6198 OTHER INFORMATION: PART IV: THE ORGANIZATION REVIEWS ANNUALLY THE NEED BY RESIDENTS WHOSE RESOURCES ARE NOT SUFFICIENT TO PAY THEIR MONTHLY FEES. THE WESLEY ASSISTANCE FUND PROVIDES THE DIFFERENCE BETWEEN THE COST AND THE RESOURCES AVAILABLE. 0 0 0 0 0 0 0 0 0 JEFFREY HARKINS 0 163491 0 0 0 0 0 0 0 0 0 163491 0 0 FORM 990, PART VI JEFF HARKINS, CEO, WAS AN EMPLOYEE OF LIFE CARE SERVICES DURING 2010. AS A RESULT OF THIS HE WAS NOT DIRECTLY COMPENSATED THROUGH THE FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION A, LINE 2 MILTON ADAMS HAS A FAMILY RELATIONSHIP. ROBERT ADAMS HAS A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 LIFE CARE SERVICES WAS HIRED AS A MANAGEMENT COMPANY IN 2009. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED 990 WILL BE PROVIDED TO BOARD MEMBERS PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED ANNUALLY TO REVIEW THE CONFLICT OF INTEREST POLICY AND SIGN THAT THEY WILL COMPLY WITH THE POLICY. IF AND WHEN A CONFLICT ARISES, THE BOARD MEMBER IS ASKED TO DISCLOSE MATERIAL FACTS AND LEAVE THE MEETING. A DETERMINATION IS MADE BY THE REMAINING BOARD MEMBERS WHETHER OR NOT A CONFLICT OF INTEREST EXIST. IF A CONFLICT EXISTS, THE BOARD MEMBER IS REQUESTED TO LEAVE THE MEETING DURING THE DISCUSSION AND THE REST OF THE BOARD VOTES ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS AN EMPLOYEE OF LIFE CARE SERVICES, THE MANAGEMENT COMPANY. COMPARATIVE INFORMATION ON OTHER DIRECTOR'S COMPENSATION IS AVAILABLE THROUGH LIFE CARE SERVICES. A PERFORMANCE REVIEW IS COMPLETED BY THE EMPLOYEE AND THE CEO. COMPARATIVE INFORMATION ON SIMILAR POSITIONS ARE AVAILABLE THROUGH LIFE CARE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS ALSO AVAILABLE ON THE WEBSITE WWW.GUIDESTAR.ORG. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 175,443. FORM 990 PAGE 12, PART XI, LINE 2C THE POLICY FOR REVIEWING THE FINANCIAL STATEMENT REMAINS UNCHANGED FROM THE PRIOR YEAR FORM 990, SCHEDULE R, PART III, COLUMN A THE PARTNERSHIPS ARE RELATED AS THERE IS COMMON CONTROL WHERE AS BOARD MEMBERS OF THE FILING ORGANIZATION OWN A VOTING MAJORITY OF THESE PARTNERSHIPS. KINGSWOOD SENIOR LIVING COMMUNITY FOUNDATION 10000 WORNALL ROAD KANSAS CITY MO 64114 200639597 PROVIDES SUPPORT FOR KANSAS CITY UNITED METHODIST RETIREMENT HOME, INC. MO 501 (C)(3) LINE 11A, TYPE I 0 614 WEST 99TH LLC 10000 WORNALL ROAD KANSAS CITY MO 64114 203437324 REAL ESTATE MO N/A WEST 100TH TERRACE LLC 10000 WORNALL ROAD KANSAS CITY MO 64114 753134697 REAL ESTATE MO N/A LIFE CARE SERVICES 400 LOCUST SUITE 820 CAPITAL SQUARE DES MOINES IA 50309 MANAGEMENT OF COMMUNITY IA N/A N/A 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 KINGSWOOD SENIOR LIVING COMMUNITY FOUNDATION C 151090 LIFE CARE SERVICES N 593423 MANAGEMENT AGREEMENT