Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 750,957 | 759,022 | 752,328 | 839,421 | 926,192 | 4,027,920 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 13,751 | 12,144 | 17,409 | 23,287 | 1,796 | 68,387 |
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 764,708 | 771,166 | 769,737 | 862,708 | 927,988 | 4,096,307 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 384,630 | 293,433 | 362,801 | 385,601 | 383,703 | 1,810,168 |
| c | Add lines 7a and 7b.. | 384,630 | 293,433 | 362,801 | 385,601 | 383,703 | 1,810,168 |
| 8 | Public support. (Subtract line 7c from line 6.) | 2,286,139 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 764,708 | 771,166 | 769,737 | 862,708 | 927,988 | 4,096,307 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 3,416 | 3,259 | 2,382 | 1,701 | 1,464 | 12,222 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 3,416 | 3,259 | 2,382 | 1,701 | 1,464 | 12,222 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 768,124 | 774,425 | 772,119 | 864,409 | 929,452 | 4,108,529 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | WELSEY MANOR RETIREMENT COMMUNITY, INC. IS A 60-UNIT APARTMENT FACILITY FOR THE ELDERLY OR DISABLED. THE RETIREMENT LIVING APARTMENTS AT WESLY MANOR ARE PERFECT FOR THOSE WITH AN ACTIVE LIFESTYLE OR THOSE WHO ARE LOOKING TO SCALE BACK. NESTLED AMONG THE WHISPERING PINES SO ABUNDANT TO THE AREA, WESLEY MANOR RETIREMENT COMMUNITY IS LOCATED IN HATTIESBURG, A CERTIFIED RETIREMENT COMMUNITY RECOGNIZED AS ONE OF THE "TOP 100 RETIREMENT TOWNS IN AMERICA" BY WHERE TO RETIRE MAGAZINE AND "BEST PLACES TO RETIRE" BY DAVID SAVAGEAU. EASY RETIREMENT LIVING IN A CITY RECOGNIZED FOR ITS SERVICES TO SENIORS IS READILY FOUND AT WESLEY MANOR. COMFORT, CONVENIENCE AND AFFORDABILITY MAKE WESLEY MANOR AN APPEALING OPTION FOR RETIREES WHO WANT A FRIENDLY ENVIRONMENT FOR THEIR ACTIVE, INDEPENDENT LIFESTYLE. RETIREMENT LIVING HERE AFFORDS RESIDENTS THE OPPORTUNITY TO BECOME INVOLVED IN PROGRAMS, BOTH EDUCATIONAL AND ENTERTAINING, THROUGH THE UNIVERSITY OF SOUTHERN MISSISSIPPI AND WILLIAM AND CAREY UNIVERSITY WHO CALL HATTIESBURG HOME. WESLEY MANOR IS MUCH MORE THAN A PLCAE TO RETIRE. IT OFFERS RESIDENTS AFFORDABLE, CLEAN, ATTRACTIVE SURROUNDINGS. THE KIND, ATTENTIVE STAFF STRIVE TO CREATE A WARM, FAMILY ATMOSPHERE. NUMEROUS PORCHES AND MANICURED GROUNDS INVITE SEASONAL OUTDOOR RELAXATION. GROCERIES, SHOPPING MALLS, AND MEDICAL FACILITIES ARE JUST MINUTES AWAY, OR RESIDENTS CAN RELAX RIGHT AT HOME WITH DAILY SOCIAL ACTIVITIES, IN-HOUSE MOVIES AT THE TOM THUMB THEATER, AND WEEKLY WORSHIP SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 3 | THE ORGANIZATION'S PARENT ORGANIZATION, MISSISSIPPI METHODIST SENIOR SERVICES, INC., PROVIDES OVERALL MANAGEMENT SERVICES INCLUDING OPERATIONAL MANAGEMENT SUPERVISION, DEVELOPMENT AND MARKETING, HUMAN RESOURCES MANAGEMENT LEGAL, AND RISK MANAGEMENT SERVICES, AND FINANCIAL AND ACCOUNTING MANAGEMENT, FOR WHICH IT IS PAID A MANAGEMENT FEE. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE CORPORATION HAS ONE MEMBER, MISSISSIPPI METHODIST SENIOR SERVICES, INC. (MMSS), A NON-STOCK, NONPROFIT CORPORATION, EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE BOARD OF DIRECTORS OF MMSS SHALL VOTE THE MEMBERSHIP INTEREST OF MMSS IN THE CORPORATION. IN ALL MEETINGS OF THE MEMBERSHIP, THE MEMBER, MMSS, SHALL BE ENTITLED TO ONE VOTE, WHICH VOTE SHALL CONSTITUTE THE ACTION OF THE MEMBERSHIP. THE BOARD OF DIRECTORS OF MMSS, AT ANY DULY HELD MEETING OF DIRECTORS, SHALL HAVE THE AUTHORITY TO VOTE THE MEMBERSHIP INTEREST OF MMSS IN THE CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE CORPORATION'S NOMINATING COMMITTEE SHALL MAKE RECOMMENDATIONS TO THE MMSS NOMINATING COMMITTEE FOR PERSONS TO SERVE ON THE CORPORATION'S BOARD OF DIRECTORS. NOMINATIONS FOR PERSONS TO SERVE ON THE CORPORATION'S BOARD OF DIRECTORS SHALL BE MADE BY THE MMSS NOMINATING COMMITTEE. NOMINATIONS MAY ALSO BE MADE BY THE MEMBERSHIP. ANY VACANCY IN THE BOARD OF DIRECTORS SHALL BE FILLED FOR THE UNEXPIRED TERM BY THE MEMBERSHIP, IN CONSULTATION WITH THE CORPORATION'S BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE BOARD OF DIRECTORS OF THE CORPORATION SHALL ADOPT, AND KEEP CURRENT, A STATEMENT OF THE CORPORATION'S PURPOSE AND MAJOR POLICIES WHICH SHALL BE FORWARDED TO THE MMSS BOARD OF DIRECTORS FOR APPROVAL AND MODIFICATION. IN ADDITION, THE BOARD OF DIRECTORS MAY HAVE DELEGATED TO IT OR RESCINDED FROM IT BY THE MMSS BOARD OF DIRECTORS SOME OR ALL OF THE FOLLOWING DUTIES, RESPONSIBILITIES, AND POWERS: (A) MAKE PROVISION FOR QUALITY RESIDENTIAL, LONG-TERM HEALTH CARE COMMENSURATE WITH COMMUNITY NEEDS AND RESOURCES. (B) RECOMMEND AND IMPLEMENT BOARD APPROVED CHANGES IN BYLAWS, POLICIES AND PROCEDURES, FOR THE OPERATION OF THE CORPORATION'S FACILITIES AND SERVICES. (C) PROVIDE FOR THE PREPARATION OF AN ANNUAL OPERATING AND A THREE-YEAR CAPITAL BUDGET TO BE APPROVED BY THE MMSS BOARD OF DIRECTORS AND REGULARLY REVIEW FINANCIAL BUDGET PERFORMANCE. (D) WORK COOPERATIVELY WITH LOCAL CHURCHES, SOCIAL WELFARE AND CIVIC AGENCIES, AND THE COMMUNITY AT LARGE TO ADDRESS THE PROBLEMS OF THE AGING. (E) PROVIDE FOR THE DEVELOPMENT, REVIEW AND UPDATING OF LONG-RANGE PLAN RELATING TO NEEDS OF THE ELDERLY WITHIN THE AREA OF SERVICE. (F) ADOPT AND IMPLEMENT A COMMUNITY RELATIONS AND DEVELOPMENT PROGRAM COMPATIBLE WITH LOCAL NEEDS AND RESOURCES TO BROADEN THE LOCAL SUPPORT AND FINANCIAL BASE OF THE CORPORATION. (G) SUBMIT TO THE MMSS BOARD OF DIRECTORS SUCH RECOMMENDATIONS AND COMMENTS AS ARE APPROPRIATE REGARDING THE CORPORATION, IN SUPPORT OF QUALITY SERVICES FOR THE ELDERLY IN THE LOCAL COMMUNITY. (H) PARTICIPATE IN THE PROCESS OF SELECTION, REVIEW AND RETENTION OF THE EXECUTIVE DIRECTOR. (I) WORK COOPERATIVELY WITH MMSS AND ITS OTHER AFFILIATES, SHARING RESPONSIBILITY FOR THE WELFARE OF THE WHOLE. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 AND SUPPORTING SCHEDULES ARE AVAILABLE TO ALL BOARD MEMBERS THROUGH THEIR ACCESS TO THE ORGANIZATION'S INTRANET POSTING. MMSS ALSO REVIEWS ONE FORM IN ONE AUDIT COMMITTEE MEETING EACH YEAR. |
| FORM 990, PAGE 6, PART VI, LINE 12C | A FORM IS COMPLETED ANNUALLY BY OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES THAT DISCLOSES INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THESE FORMS ARE THEN REVIEWED BY A COMPLIANCE OFFICER. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE ORGANIZATION DOES NOT COMPENSATE ANY OFFICERS OR EMPLOYEES. ALL COMPENSATION IS PAID BY THE ORGANIZATION'S PARENT, MISSISSIPPI METHODIST SENIOR SERVICES, INC. |
| FORM 990, PAGE 6, PART VI, LINE 19 | UPON REQUEST |
| FORM 990, PART IX, LINE 11G | OTHER FEES 176,617 1,114 0 |
| FORM 990, PART XI, LINE 9 | DESIGNATED GIFT TRANSFERS 0 ROUNDING 0 CAPITAL TRANSFERS -1,447 TOTAL -1,447 |
| Software ID: | |
| Software Version: |