NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED (EIN 35-1282401)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-02-01
- IRS object ID
- 202300339349300400
- Schema version
- 2021v4.2
- 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 | 2023-02-01T23:07:00-06:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351282401 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATIONAL FELLOWSHIP BRETHREN RETIREMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NATI | BusinessNameControlTxt |
| Phone | 5743726200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 337 GRACE VILLAGE DR | AddressLine1Txt |
| City | WINONA LAKE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46590 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUSTIN KIMBRELL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5743726200 | PhoneNum |
| Signature | 2023-01-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JUSTIN | PersonFirstNm |
| Person Last | KIMBRELL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA N CRAWFORD CPA | PreparerPersonNm |
| PTIN | P00573197 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2023-01-29 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-03-07 01:45:13Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE VILLAGE RETIREMENT COMMUNITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JUSTIN KIMBRELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 337 GRACE VILLAGE DR | AddressLine1Txt |
| City | WINONA LAKE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46590 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,180,961 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | GRACEVILLAGE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | GRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 27 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $80,937 | PYContributionsGrantsAmt |
| CY Contributions Grants | $301,122 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,008,832 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,365,601 | CYProgramServiceRevenueAmt |
| PY Investment Income | $145,234 | PYInvestmentIncomeAmt |
| CY Investment Income | $118,233 | CYInvestmentIncomeAmt |
| PY Other Revenue | $192,718 | PYOtherRevenueAmt |
| CY Other Revenue | $5,660 | CYOtherRevenueAmt |
| PY Total Revenue | $3,427,721 | PYTotalRevenueAmt |
| CY Total Revenue | $3,790,616 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $935,857 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $608,755 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $27,448 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,626,792 | PYOtherExpensesAmt |
| CY Other Expenses | $1,409,373 | CYOtherExpensesAmt |
| PY Total Expenses | $2,562,649 | PYTotalExpensesAmt |
| CY Total Expenses | $2,018,128 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $865,072 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,772,488 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,579,802 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,170,280 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,119,856 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,845,670 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $459,946 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,324,610 | NetAssetsOrFundBalancesEOYAmt |
| Mission | GRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY. GRACE VILLAGE OFFERS INDEPENDENT LIVING OPTIONS THAT INCLUDE MEALS AND NURSING SERVICES WHEN NEEDED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,302,188 | ExpenseAmt |
| Revenue | $3,365,601 | RevenueAmt |
| Desc | GRACE VILLAGE OFFERS INDPENDENT LIVING OPTIONS THAT INCLUDE MEALS AND NURSING SERVICES WHEN NEEDED. GRACE VILLAGE ALSO OFFERS THERAPY SERVICES AND IN HOME NON-MEDICAL SERVICES AS NEEDED. | Desc |
| Total Program Service Expenses | $1,302,188 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 27 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SONDREA HAMILTON VP AND CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5743726200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 337 GRACE VILLAGE DR | AddressLine1Txt |
| City | WINONA LAKE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46590 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| CHAD HUMMEL | ||||||||
| VICE CHAIR | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ADAM LENON | ||||||||
| SECRETARY & TREASURER | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DENNIS DUNCAN | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| GLENN HALL | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| CHUCK JOSEY | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DAVID KOONTZ | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DAN LEININGER | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| MARK MCCOLLOM | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| NATHAN MUELLER | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER PIERCE | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DALE ROBBINS | ||||||||
| BOARD MEMBER | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JUSTIN KIMBRELL | ||||||||
| CEO | 28.00 | 12.00 | Yes (X) | $0 | $195,462 | $6,189 | ||
| SONDREA HAMILTON | ||||||||
| CFO | 28.00 | 12.00 | Yes (X) | $0 | $129,508 | $15,728 | ||
| JEFFRY CARROLL | ||||||||
| FORMER CEO | 0.00 | 0.00 | $0 | $253,332 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $578,302 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $21,917 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $221,462 | GovernmentGrantsAmt |
| All Other Contributions | $79,660 | AllOtherContributionsAmt |
| Total Contributions | $301,122 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT AND RESIDE | 623000 | $2,380,180 | $2,380,180 |
| DEFERRED LIFE LEASE | 623000 | $685,421 | $685,421 |
| RENT INCOME FROM GRACE | 623000 | $300,000 | $300,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,365,601 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,543 | TotalRevenueColumnAmt |
| Exclusion | $19,543 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $256,346 | SecuritiesAmt |
| Other | $232,689 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $258,724 | SecuritiesAmt |
| Other | $131,621 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$2,378 | SecuritiesAmt |
| Other | $101,068 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,690 | TotalRevenueColumnAmt |
| Exclusion | $98,690 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,660 | TotalRevenueColumnAmt |
| Exclusion | $5,660 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,660 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,790,616 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,365,601 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $123,893 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,634 | TotalAmt |
| Program Services | $300,923 | ProgramServicesAmt |
| Management And General | $137,711 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,500 | TotalAmt |
| Program Services | $8,576 | ProgramServicesAmt |
| Management And General | $3,924 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,068 | TotalAmt |
| Program Services | $74,140 | ProgramServicesAmt |
| Management And General | $33,928 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,553 | TotalAmt |
| Program Services | $33,996 | ProgramServicesAmt |
| Management And General | $15,557 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,505 | TotalAmt |
| Management And General | $30,505 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,628 | TotalAmt |
| Program Services | $5,885 | ProgramServicesAmt |
| Management And General | $64,295 | ManagementAndGeneralAmt |
| Fundraising | $27,448 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,850 | TotalAmt |
| Management And General | $5,850 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,222 | TotalAmt |
| Program Services | $42,647 | ProgramServicesAmt |
| Management And General | $17,575 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $459,825 | TotalAmt |
| Program Services | $414,508 | ProgramServicesAmt |
| Management And General | $45,317 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286 | TotalAmt |
| Program Services | $286 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305 | TotalAmt |
| Management And General | $305 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,196 | TotalAmt |
| Program Services | $160,376 | ProgramServicesAmt |
| Management And General | $17,820 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,002 | TotalAmt |
| Program Services | $667,802 | ProgramServicesAmt |
| Management And General | $74,200 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,068 | TotalAmt |
| Management And General | $105,068 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| DUES & SUBSCRIPTIONS | $8,845 | $8,845 | |
| ALLOCATED EXPENSE | -$412,952 | -$412,952 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,593 | TotalAmt |
| Program Services | $6,001 | ProgramServicesAmt |
| Management And General | $127,592 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,018,128 | TotalAmt |
| Program Services | $1,302,188 | ProgramServicesAmt |
| Management And General | $688,492 | ManagementAndGeneralAmt |
| Fundraising | $27,448 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,550,356 | BOYAmt |
| EOY | $1,624,551 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,660 | BOYAmt |
| EOY | $1,539,217 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,000 | BOYAmt |
| EOY | $3,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $313,612 | BOYAmt |
| EOY | $13,343 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,374 | BOYAmt |
| EOY | $15,413 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,279 | BOYAmt |
| EOY | $9,099 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,654,948 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,825,014 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,310,807 | BOYAmt |
| EOY | $7,829,934 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $252,714 | BOYAmt |
| EOY | $1,106,339 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $29,384 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,579,802 | BOYAmt |
| EOY | $12,170,280 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,283 | BOYAmt |
| EOY | $178,077 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,863,540 | BOYAmt |
| EOY | $6,208,704 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,758,444 | BOYAmt |
| EOY | $3,384,893 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $364,589 | BOYAmt |
| EOY | $73,996 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,119,856 | BOYAmt |
| EOY | $9,845,670 | 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 | $453,972 | BOYAmt |
| EOY | $2,319,472 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,974 | BOYAmt |
| EOY | $5,138 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,946 | BOYAmt |
| EOY | $2,324,610 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,579,802 | BOYAmt |
| EOY | $12,170,280 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,772,488 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$142,105 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $234,281 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 | $34,431 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,045 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $77,706 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $80,937 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $301,122 | CurrentTaxYearAmt |
| Total | $522,241 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,141,982 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,267,431 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,303,708 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,008,832 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,365,601 | CurrentTaxYearAmt |
| Total | $16,087,554 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,176,413 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,295,476 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,381,414 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,089,769 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,666,723 | CurrentTaxYearAmt |
| Total | $16,609,795 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $16,609,795 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,108 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,351 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,092 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,195 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,543 | CurrentTaxYearAmt |
| Total | $102,289 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,108 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,351 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,092 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,195 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,543 | CurrentTaxYearAmt |
| Total | $102,289 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,473 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,145 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,737 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $192,718 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,660 | CurrentTaxYearAmt |
| Total | $216,733 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,216,994 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,321,972 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,407,243 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,290,682 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,691,926 | CurrentTaxYearAmt |
| Total | $16,928,817 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98120 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97950 | PublicSupportPY509Pct |
| Investment Income CY | 0.00600 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00710 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $134,848 | OtherCostOrOtherBasisAmt |
| Book Value | $134,848 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,298,339 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,214,422 | DepreciationAmt |
| Book Value | $7,083,917 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,138,341 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,610,592 | DepreciationAmt |
| Book Value | $527,749 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $83,420 | OtherCostOrOtherBasisAmt |
| Book Value | $83,420 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,829,934 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| SCHWAB - LIFE LEASE ACCOUNT | $59,205 | C |
| SCHWAB - GENERAL INVESTMENT ACCOUNT | $840,104 | C |
| LCB FREEDOM CD | $207,030 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,106,339 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DEPOSITS | $22,995 |
| RENT CREDITS | $48,406 |
| LOAN INSURANCE COSTS | -$5,309 |
| DEFERRED COMPENSATION PLAN OBLIGATI | $7,904 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $73,996 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,882,792 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$142,105 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $234,281 | OtherRevenueAmt |
| Revenue Not Reported | $92,176 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,790,616 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,790,616 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,018,128 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,018,128 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,018,128 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THEIR ORGANIZATIONS AND RECOGNIZE A TAX LIABILITY IF THEY HAVE TAKEN AN UNCERTAIN 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 GRACE AND NATIONAL FELLOWSHIP AND HAS CONCLUDED THAT AS OF JUNE 30, 2022 AND 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATIONS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | GAIN/LOSS ON INTEREST RATE SWAP 234,281. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFRY CARROLL | ||||||||||||||
| FORMER CEO | $0 | $0 | $0 | $0 | $0 | $253,332 | $0 | $0 | $0 | $0 | $0 | $253,332 | $0 | $0 |
| JUSTIN KIMBRELL | ||||||||||||||
| CEO | $0 | $195,462 | $0 | $0 | $0 | $0 | $0 | $5,799 | $0 | $390 | $0 | $201,651 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | GRACE VILLAGE HEALTHCARE FACILITY, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO DETERMINE THE CEO'S COMPENSATION: -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | DURING 2021, JEFFRY CARROLL (FORMER CEO) RECEIVED A 457F PLAN PAYMENT OF $253,000. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO ASSISTS BLUE & CO., LLC IN PREPARATION OF THE 990 BEFORE IT IS FILED. THE CFO REVIEWS THE FORM 990 BEFORE IT IS FILED. BLUE & CO. FILES THE FORM 990 ONCE FINAL APPROVAL IS RECEIVED FROM THE CFO. THE CEO AND FULL BOARD ARE GIVEN A COPY OF THE FORM 990 UPON COMPLETION OF THE PREPARATION AND FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | GRACE VILLAGE TRIES TO AVOID SITUATIONS THAT COULD POTENTIALLY BE SEEN AS CONFLICTS OF INTEREST. IF A CONFLICT IS FOUND, IT IS DEALT WITH ON A CASE BY CASE BASIS, AND THE BOARD OF DIRECTORS MAKES A DECISION AS TO MATERIALITY OF THE CONFLICT, AND WHETHER TO TERMINATE TRANSACTIONS WITH PARTIES THAT HAVE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST ARE MONITORED AND DEALT WITH AT EVERY LEVEL OF THE ORGANIZATION, FROM HOURLY EMPLOYEES, TO SALARIED EMPLOYEES, TO BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S SALARY IS PAID BY A RELATED ORGANIZATION AND IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OF THAT ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST |
| FORM 990, PART XI, LINE 9: | GAIN/LOSS ON INTEREST RATE SWAP 234,281. |
| FORM 990, PART XII, LINE 2C | THE PROCESS FOR FOR SELECTION OF INDEPENDENT ACCOUNTANT AND OVERSIGHT OF SUCH PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE VILLAGE HEALTHCARE FACILITY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 337 GRACE VILLAGE DRIVE | AddressLine1Txt |
| City | WINONA LAKE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46590 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351447417 | EIN |
| Primary Activities | NURSING HOME/ASSISTED LIVING FACILITY | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| GRACE VILLAGE HEALTHCARE FACILITY INC | |
| J | $300,000 |
| GRACE VILLAGE HEALTHCARE FACILITY INC | |
| M | $600,509 |
Comments