COUNTRY HEALTH INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- COUNTRY HEALTH INC (EIN 37-6064916)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-05-28
- IRS object ID
- 202411499349301361
- Schema version
- 2023v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-28T17:28:55-04:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 371074029 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCK CPAS & ADVISORS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 202 N PROSPECT ROAD SUITE 206 | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61704 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 376064916 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTRY HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COUN | BusinessNameControlTxt |
| Phone | 2175687362 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2304 CR 3000N | AddressLine1Txt |
| City | GIFFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61847 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEANNA OSTERBUR | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 2175687362 | PhoneNum |
| Signature | 2024-05-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DEANNA | PersonFirstNm |
| Person Last | OSTERBUR | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RENEE S BRUCKER | PreparerPersonNm |
| PTIN | P01417594 | PTIN |
| Phone | 3098286071 | PhoneNum |
| Preparation | 2024-05-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEANNA OSTERBUR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2304 CR 3000N | AddressLine1Txt |
| City | GIFFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61847 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,029,385 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HERITAGEOFCARE.COM/GIFFORD | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | OPERATE AN 89-BED LONG-TERM CARE FACILITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 155 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $757,483 | PYContributionsGrantsAmt |
| CY Contributions Grants | $170,056 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,504,609 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,838,857 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,567 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,145 | CYInvestmentIncomeAmt |
| PY Other Revenue | $12,270 | PYOtherRevenueAmt |
| CY Other Revenue | $15,327 | CYOtherRevenueAmt |
| PY Total Revenue | $8,279,929 | PYTotalRevenueAmt |
| CY Total Revenue | $9,029,385 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,743,268 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,995,354 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,244,724 | PYOtherExpensesAmt |
| CY Other Expenses | $3,487,812 | CYOtherExpensesAmt |
| PY Total Expenses | $8,987,992 | PYTotalExpensesAmt |
| CY Total Expenses | $9,483,166 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$708,063 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$453,781 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,825,746 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,535,741 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,271,855 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,435,631 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,553,891 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,100,110 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OPERATE AN 89-BED LONG-TERM CARE FACILITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,536,960 | ExpenseAmt |
| Revenue | $8,838,857 | RevenueAmt |
| Desc | RESIDENT INTERMEDIATE AND SKILLED CARE NURSING FACILITY. | Desc |
| Total Program Service Expenses | $8,536,960 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 155 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERITAGE OPERATIONS GROUP LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3098284361 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 WEST JEFFERSON | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| SHYVONNE SMITH | ||||||||
| LPN | 40.00 | Yes (X) | $135,297 | $0 | $0 | |||
| TINA LAWSON | ||||||||
| MDS COORDINA | 40.00 | Yes (X) | $125,839 | $0 | $0 | |||
| DIANA SWISHER | ||||||||
| RN | 40.00 | Yes (X) | $102,221 | $0 | $0 | |||
| MICHAEL BABB | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| JAMIE DORSEY | ||||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | Yes (X) | |
| MOLLY FLESNER | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| JACKIE HARRIS | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| CELIA HETHKE | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| TANNER MCLAIN | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| DEANNA OSTERBUR | ||||||||
| PRESIDENT | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | Yes (X) | |
| ROD OSTERBUR | ||||||||
| VICE PRESIDE | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | Yes (X) | |
| KOLEEN ROSEMAN | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $363,357 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HERITAGE OPERATIONS GROUP LLC | |||||
| 115 WEST JEFFERSON ST | BLOOMINGTON | IL | 61701 | MANAGEMENT | $442,113 |
| GRAPETREE MEDICAL STAFFING LLC | |||||
| PO BOX 5340 | SIOUX FALLS | SD | 57117 | NURSING | $366,574 |
| SELECT REHABILITATION LLC | |||||
| PO BOX 71985 | CHICAGO | IL | 60694 | THERAPY | $201,591 |
| PRIME TIME HEALTHCARE LLC | |||||
| PO BOX 3544 | OMAHA | NE | 68103 | NURSING | $159,632 |
| SHIFTKEY LLC | |||||
| PO BOX 735913 | DALLAS | TX | 75373 | NURSING | $128,933 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $154,593 | GovernmentGrantsAmt |
| All Other Contributions | $15,463 | AllOtherContributionsAmt |
| Total Contributions | $170,056 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NURSING/RELATED CARE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $8,838,857 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,838,857 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,838,857 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,145 | TotalRevenueColumnAmt |
| Exclusion | $5,145 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Total Revenue Column | $15,327 | TotalRevenueColumnAmt |
| Exclusion | $15,327 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $15,327 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,029,385 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,838,857 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $20,472 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,115,928 | TotalAmt |
| Program Services | $4,673,859 | ProgramServicesAmt |
| Management And General | $442,069 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $538,510 | TotalAmt |
| Program Services | $484,659 | ProgramServicesAmt |
| Management And General | $53,851 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,916 | TotalAmt |
| Program Services | $306,824 | ProgramServicesAmt |
| Management And General | $34,092 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,113 | TotalAmt |
| Program Services | $221,057 | ProgramServicesAmt |
| Management And General | $221,056 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,775 | TotalAmt |
| Program Services | $5,775 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,620 | TotalAmt |
| Program Services | $7,114 | ProgramServicesAmt |
| Management And General | $2,506 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,667 | TotalAmt |
| Program Services | $9,667 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,423 | TotalAmt |
| Program Services | $39,981 | ProgramServicesAmt |
| Management And General | $4,442 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,261 | TotalAmt |
| Program Services | $9,235 | ProgramServicesAmt |
| Management And General | $1,026 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,622 | TotalAmt |
| Program Services | $249,622 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $903 | TotalAmt |
| Program Services | $813 | ProgramServicesAmt |
| Management And General | $90 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61 | TotalAmt |
| Program Services | $55 | ProgramServicesAmt |
| Management And General | $6 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,452 | TotalAmt |
| Program Services | $56,726 | ProgramServicesAmt |
| Management And General | $56,726 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,618 | TotalAmt |
| Program Services | $280,456 | ProgramServicesAmt |
| Management And General | $31,162 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,284 | TotalAmt |
| Program Services | $225,256 | ProgramServicesAmt |
| Management And General | $25,028 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| LICENSE AND FEES | $467,719 | $420,947 | $46,772 |
| FOOD AND DRUG PURCHASES | $440,096 | $440,096 | |
| THERAPY FEES | $359,888 | $359,888 | |
| SUPPLIES | $216,860 | $216,860 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $555,450 | TotalAmt |
| Program Services | $528,070 | ProgramServicesAmt |
| Management And General | $27,380 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,483,166 | TotalAmt |
| Program Services | $8,536,960 | ProgramServicesAmt |
| Management And General | $946,206 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350 | BOYAmt |
| EOY | $350 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $546,708 | BOYAmt |
| EOY | $694,744 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $566,463 | BOYAmt |
| EOY | $487,060 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,428 | BOYAmt |
| EOY | $30,262 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,401 | BOYAmt |
| EOY | $29,016 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,868,810 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,650,500 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,507,933 | BOYAmt |
| EOY | $7,218,310 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,463 | BOYAmt |
| EOY | $75,999 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,825,746 | BOYAmt |
| EOY | $8,535,741 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,634,608 | BOYAmt |
| EOY | $2,079,417 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,949 | BOYAmt |
| EOY | $18,769 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,628,298 | BOYAmt |
| EOY | $3,284,658 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $52,787 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,271,855 | BOYAmt |
| EOY | $5,435,631 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,453,891 | BOYAmt |
| EOY | $3,000,110 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $100,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,553,891 | BOYAmt |
| EOY | $3,100,110 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,825,746 | BOYAmt |
| EOY | $8,535,741 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$453,781 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $40,340 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $462,112 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,109,914 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $757,483 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $170,056 | CurrentTaxYearAmt |
| Total | $2,539,905 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,949,411 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,295,744 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,134,489 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,504,609 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,838,857 | CurrentTaxYearAmt |
| Total | $35,723,110 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,989,751 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,757,856 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,244,403 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,262,092 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,008,913 | CurrentTaxYearAmt |
| Total | $38,263,015 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $38,263,015 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $17,315 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,792 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,623 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,567 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,145 | CurrentTaxYearAmt |
| Total | $55,442 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $17,315 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,792 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,623 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,567 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,145 | CurrentTaxYearAmt |
| Total | $55,442 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,879 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,557 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,146 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,270 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,327 | CurrentTaxYearAmt |
| Total | $68,179 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,025,945 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,784,205 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,267,172 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,279,929 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,029,385 | CurrentTaxYearAmt |
| Total | $38,386,636 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99680 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99600 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, LINE 12 | FormAndLineReferenceDesc |
| Explanation | MEAL INCOME 68,179 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,031 | OtherCostOrOtherBasisAmt |
| Book Value | $27,031 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,574,598 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,856,155 | DepreciationAmt |
| Book Value | $6,718,443 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $653,117 | OtherCostOrOtherBasisAmt |
| Depreciation | $265,127 | DepreciationAmt |
| Book Value | $387,990 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,614,064 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,529,218 | DepreciationAmt |
| Book Value | $84,846 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,218,310 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACCOUNTS PAYABLE - AFFILATE CORP | Desc |
| Amt | $52,787 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $52,787 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $9,029,385 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $9,029,385 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $9,029,385 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,483,166 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $9,483,166 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $9,483,166 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 2, PART IV, LINE 2B | FormAndLineReferenceDesc |
| Explanation | ORGANIZATION HOLDS FUNDS ON BEHALF OF RESIDENTS THAT RESIDENTS MAY ACCESS AND USE AT THE RESIDENT'S DISCRETION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 3 | COUNTRY HEALTH, INC. HAS DELEGATED ADMINISTRATION, ACCOUNTING, PURCHASING, AND CERTAIN OTHER RELATED SERVICES TO HERITAGE OPERATIONS GROUP, LLC. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE CFO OF HERITAGE OPERATIONS GROUP, LLC, OF WHICH THE ORGANIZATION HAS DELEGATED CONTROL OVER MANAGEMENT SERVICES, REVIEWS THE 990 BEFORE IT IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS MONITORED THROUGH THE USE OF A QUESTIONNAIRE REQUIRED TO BE COMPLETED ANNUALLY AND REVIEWED BY THE BOARD OF DIRECTORS. EMPLOYEES ARE MADE AWARE OF CONFLICT OF INTEREST POLICY VIA THE EMPLOYEE HANDBOOK. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION REVIEW AND APPROVAL FOR ALL LEVELS OF STAFF ARE COMPLETED BY HERITAGE OPERATIONS GROUP, LLC, WHOM THE ORGANIZATION HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLEASANT VIEW MANOR INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2304 CR 3000N | AddressLine1Txt |
| City | GIFFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61847 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371233447 | EIN |
| Primary Activities | APARTMENTS | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501C | ExemptCodeSectionTxt |
| Public Charity Status | 10 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PLEASANT VIEW MANOR INC | ||
| J | $10 | ACTUAL CASH |
| PLEASANT VIEW MANOR INC | ||
| Q | $52,787 | ACTUAL CASH |