FURP.ORG / PUBLIC DATA EXPLORER

CUMBERLAND VALLEY MANOR: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
CUMBERLAND VALLEY MANOR (EIN 61-0913814)
Tax period
2022-10-01 to 2023-09-30
Filed
2024-04-11
IRS object ID
202441029349300009
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-04-11T07:59:07-05:00ReturnTs
Tax Period End2023-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12650 EASTPOINT PKWY SUITE 300AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN610913814EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CUMBERLAND VALLEY MANORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCUMBBusinessNameControlTxt
Phone2708644315PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 438AddressLine1Txt
CityBURKESVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42717ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICK NEIKIRKPersonNm
Person TitleMANAGING DIRECTORPersonTitleTxt
Phone2708644315PhoneNum
Signature2024-03-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstRICKPersonFirstNm
Person LastNEIKIRKPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEMILIE M KNIERIEM CPAPreparerPersonNm
PTINP01330194PTIN
Phone5029923500PhoneNum
Preparation2024-03-21PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDR ROBERT FLOWERS SRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 438AddressLine1Txt
CityBURKESVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42717ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,098,701GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1975FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionPROVIDE PERSONAL AND INTERMEDIATE CARE TO RESIDENTS.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee167TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$155,558PYContributionsGrantsAmt
CY Contributions Grants$428,581CYContributionsGrantsAmt
PY Program Service Revenue$6,277,586PYProgramServiceRevenueAmt
CY Program Service Revenue$2,958,686CYProgramServiceRevenueAmt
PY Investment Income$8,537PYInvestmentIncomeAmt
CY Investment Income$775,024CYInvestmentIncomeAmt
PY Other Revenue$2,600PYOtherRevenueAmt
CY Other Revenue$918CYOtherRevenueAmt
PY Total Revenue$6,444,281PYTotalRevenueAmt
CY Total Revenue$4,163,209CYTotalRevenueAmt
PY Grants And Similar Paid$200PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,134,619PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,770,946CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,109,513PYOtherExpensesAmt
CY Other Expenses$2,190,780CYOtherExpensesAmt
PY Total Expenses$6,244,332PYTotalExpensesAmt
CY Total Expenses$3,961,726CYTotalExpensesAmt
PY Revenues Less Expenses$199,949PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$201,483CYRevenuesLessExpensesAmt
Total Assets BOY$4,137,611TotalAssetsBOYAmt
Total Assets EOY$3,622,516TotalAssetsEOYAmt
Total Liabilities BOY$747,964TotalLiabilitiesBOYAmt
Total Liabilities EOY$31,386TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,389,647NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,591,130NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE PERSONAL, INTERMEDIATE, AND SKILLED CARE TO RESIDENTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,451,317ExpenseAmt
Grant$0GrantAmt
Revenue$2,958,686RevenueAmt
DescPATIENT RELATED SERVICES - PERSONAL, INTERMEDIATE, AND SKILLED CARE.Desc
Total Program Service Expenses$3,451,317TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document45IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee167EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldKYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CUMBERLAND VALLEY MANOR MANAGEMENTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2708644315PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 438AddressLine1Txt
CityBURKSVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42717ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DR ROBERT FLOWERS SR
CHAIRMAN1.0040.00Yes (X)Yes (X)$12,000$640,366$17,046
JUDY FREDERICK
VICE CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
MATTHEW HURT
TREASURER1.00Yes (X)Yes (X)$0$0$0
MARIE ROWE
SECRETARY1.00Yes (X)Yes (X)$0$0$0
RICHARD NEIKIRK
BOARD MEMBER1.0040.00Yes (X)$0$267,991$24,561
DR ROBERT FLOWERS JR
BOARD MEMBER1.0040.00Yes (X)$0$481,210$9,037
VICKIE DYER
BOARD MEMBER1.00Yes (X)$0$0$0
THOMAS BAKER
BOARD MEMBER1.00Yes (X)$0$0$0
MIKE MOSBY
BOARD MEMBER1.00Yes (X)$0$0$0
RICHIE CAPPS
CFO CCHA1.0040.00Yes (X)$0$220,424$15,597
MARIBETH SHELTON
ADMINISTRATION40.00$109,080$0$16,466Yes (X)
NATALIE CRAFT
DIRECTOR OF NURSING40.00$100,511$0$11,333Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$221,591TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,609,991TotReportableCompRltdOrgAmt
Total Other Compensation$94,040TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SELECT REHABILITATIONBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 71985AddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP606941985ZIPCd
FieldValueIRS element (for citing)
ServicesMEDICAL PAYMENTSServicesDesc
Compensation$506,526CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$428,581GovernmentGrantsAmt
Total Contributions$428,581TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business623110BusinessCd
Total Revenue Column$2,958,686TotalRevenueColumnAmt
Related Or Exempt Func Income$2,958,686RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,958,686TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$72,899TotalRevenueColumnAmt
Exclusion$72,899ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$1,637,617OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$935,492OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$702,125OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$702,125TotalRevenueColumnAmt
Exclusion$702,125ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescVENDING INCOMEDesc
Business722515BusinessCd
Total Revenue Column$918TotalRevenueColumnAmt
Exclusion$918ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$918OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,163,209TotalRevenueColumnAmt
Related Or Exempt Func Income$2,958,686RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$775,942ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$12,000TotalAmt
Program Services$9,674ProgramServicesAmt
Management And General$2,326ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,686,587TotalAmt
Program Services$1,359,603ProgramServicesAmt
Management And General$326,984ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$12,917TotalAmt
Program Services$10,413ProgramServicesAmt
Management And General$2,504ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$728TotalAmt
Program Services$587ProgramServicesAmt
Management And General$141ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$58,714TotalAmt
Program Services$47,331ProgramServicesAmt
Management And General$11,383ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$5,000TotalAmt
Management And General$5,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$34,950TotalAmt
Management And General$34,950ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$380,256TotalAmt
Program Services$267,748ProgramServicesAmt
Management And General$112,508ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,868TotalAmt
Program Services$10,868ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$73,188TotalAmt
Program Services$73,188ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$15,155TotalAmt
Program Services$14,832ProgramServicesAmt
Management And General$323ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$116,042TotalAmt
Program Services$116,042ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$23,760TotalAmt
Program Services$23,760ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$149TotalAmt
Program Services$149ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$46,491TotalAmt
Program Services$38,975ProgramServicesAmt
Management And General$7,516ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$435,357TotalAmt
Program Services$435,357ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$389,213$389,213
DRUGS AND MEDICAL SUPPL$317,644$310,870$6,774
FOOD$129,228$129,228
PROVIDER TAX$103,509$103,509

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$109,970TotalAmt
Program Services$109,970ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,961,726TotalAmt
Program Services$3,451,317ProgramServicesAmt
Management And General$510,409ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$100BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,008,068BOYAmt
EOY$3,621,090EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$798,740BOYAmt
EOY$1,426EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$55,771BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$184,460BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,037,118BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$53,354BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,137,611BOYAmt
EOY$3,622,516EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$419,544BOYAmt
EOY$3,319EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$328,420BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$28,067EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$747,964BOYAmt
EOY$31,386EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,389,647BOYAmt
EOY$3,591,130EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,389,647BOYAmt
EOY$3,591,130EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,137,611BOYAmt
EOY$3,622,516EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$201,483ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$3,245CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$155,558CurrentTaxYearMinus1YearAmt
Current Tax Year$428,581CurrentTaxYearAmt
Total$587,384TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,582,679CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,539,771CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,307,348CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,277,586CurrentTaxYearMinus1YearAmt
Current Tax Year$2,958,686CurrentTaxYearAmt
Total$29,666,070TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,582,679CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,539,771CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,310,593CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,433,144CurrentTaxYearMinus1YearAmt
Current Tax Year$3,387,267CurrentTaxYearAmt
Total$30,253,454TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$30,253,454PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$818CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,934CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,363CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,537CurrentTaxYearMinus1YearAmt
Current Tax Year$72,899CurrentTaxYearAmt
Total$94,551TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$818CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,934CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,363CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,537CurrentTaxYearMinus1YearAmt
Current Tax Year$72,899CurrentTaxYearAmt
Total$94,551TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$28,092CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,957CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,738CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,600CurrentTaxYearMinus1YearAmt
Current Tax Year$918CurrentTaxYearAmt
Total$42,305TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,611,589CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,549,662CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,323,694CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,444,281CurrentTaxYearMinus1YearAmt
Current Tax Year$3,461,084CurrentTaxYearAmt
Total$30,390,310TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99550PublicSupportCY509Pct
Public Support PY5090.99800PublicSupportPY509Pct
Investment Income CY0.00310InvestmentIncomeCYPct
Investment Income PY0.00070InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM THIRD PARTY PAYORDesc
Amt$28,067Amt
FieldValueIRS element (for citing)
Total Liability$28,067TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND JUNE 30, 2022 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR ROBERT FLOWERS SR
CHAIRMAN$0$639,159$0$1,207$12,000$0$0$9,150$0$7,896$12,000$657,412$0$0
DR ROBERT FLOWERS JR
BOARD MEMBER$0$479,992$0$1,218$0$0$0$7,550$0$1,487$0$490,247$0$0
RICHARD NEIKIRK
BOARD MEMBER$0$266,763$0$1,228$0$0$0$8,327$0$16,234$0$292,552$0$0
RICHIE CAPPS
CFO CCHA$0$219,196$0$1,228$0$0$0$6,680$0$8,917$0$236,021$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2DR. ROBERT FLOWERS SR. AND DR. ROBERT FLOWERS JR. SHARE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF THE FORM 990 IS REVIEWED BY ACCOUNTING PERSONNEL AND PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CALL CONTRACTS AND OTHER AGREEMENTS ARE REVIEWED BY MANAGEMENT TO ENSURE THAT NO CONFLICTS EXIST OR HAVE THE ABILITY TO ARISE. THE BOARD OF DIRECTORS MUST VOTE ON THE POLICY IF A CONFLICTING EVENT ARISES AND A CONFLICTING BOARD MEMBER MUST ABSBTAIN FROM VOTING.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1CUMBERLAND COUNTY HOSPITAL ASSOCIATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 280AddressLine1Txt
CityBURKESVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42717ZIPCd
FieldValueIRS element (for citing)
EIN610624096EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateKYLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 3PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd