FAIRBURY ASSISTED LIVING FACILITY: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: FAIRBURY ASSISTED LIVING FACILITY (EIN 47-0841274)
Tax period: 2021-10-01 to 2022-09-30
Filed: 2023-08-14
IRS object ID: 202322269349301502
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-08-14T10:38:02-05:00	ReturnTs
Tax Period End	2022-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450250958	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	EIDE BAILLY LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	18081 BURT ST STE 200	AddressLine1Txt
City	OMAHA	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	680224722	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	470841274	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FAIRBURY ASSISTED LIVING FACILITY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	FAIR	BusinessNameControlTxt
Phone	4027296100	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	828 22ND STREET	AddressLine1Txt
City	FAIRBURY	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68352	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CHANCE KLASEK	PersonNm
Person Title	SECRETARY	PersonTitleTxt
Phone	4027293351	PhoneNum
Signature	2023-07-31	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	CHANCE	PersonFirstNm
Person Last	KLASEK	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MEGAN L KOZIOL CPA	PreparerPersonNm
PTIN	P01544037	PTIN
Phone	4023302660	PhoneNum
Preparation	2023-07-31	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	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	CEDARWOOD	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	CHANCE KLASEK	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2200 H STREET PO BOX 277	AddressLine1Txt
City	FAIRBURY	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68352	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$2,003,558	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTPS://WWW.CEDARWOODAL.ORG/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2001	FormationYr
Legal Domicile State	NE	LegalDomicileStateCd
Activity Or Mission	CEDARWOOD STRIVES TO PROVIDE THE HIGHEST QUALITY OF HOSPITALITY, SERVICES, ACTIVITIES, SECURITY, COMPANIONSHIP AND FREEDOM TO TENANTS IN A CARING AND LOVING ENVIRONMENT THAT THE TENANTS ARE PROUD TO CALL THEIR HOME. CEDARWOOD'S SERVICES ARE PROVIDED TO THE RESIDENTS OF JEFFERSON COUNTY.	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	41	TotalEmployeeCnt
Total Volunteers	6	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$254,486	PYContributionsGrantsAmt
CY Contributions Grants	$12,430	CYContributionsGrantsAmt
PY Program Service Revenue	$1,862,862	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,942,841	CYProgramServiceRevenueAmt
PY Investment Income	$24,233	PYInvestmentIncomeAmt
CY Investment Income	$44,641	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$3,646	CYOtherRevenueAmt
PY Total Revenue	$2,141,581	PYTotalRevenueAmt
CY Total Revenue	$2,003,558	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	$739,211	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$910,177	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$960,321	PYOtherExpensesAmt
CY Other Expenses	$1,135,101	CYOtherExpensesAmt
PY Total Expenses	$1,699,532	PYTotalExpensesAmt
CY Total Expenses	$2,045,278	CYTotalExpensesAmt
PY Revenues Less Expenses	$442,049	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$41,720	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,727,943	TotalAssetsBOYAmt
Total Assets EOY	$2,570,376	TotalAssetsEOYAmt
Total Liabilities BOY	$210,172	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$307,356	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,517,771	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,263,020	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE THE HIGHEST QUALITY OF HOSPITALITY, SERVICES, ACTIVITIES, SECURITY, COMPANIONSHIP AND FREEDOM TO TENANTS IN A CARING AND LOVING ENVIRONMENT THEY ARE PROUD TO CALL HOME.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$1,775,512	ExpenseAmt
Revenue	$1,942,841	RevenueAmt
Desc	CEDARWOOD ASSISTED LIVING FACILITY WAS CONSTRUCTED ADJACENT TO JEFFERSON COMMUNITY HEALTH CENTER, INC. (JCHC), A NEBRASKA NON-PROFIT HOSPITAL EXEMPT FROM INCOME TAXES UNDER I.R.C. 501(C)(3). THE PURPOSE OF THE 50-UNIT FACILITY IS TO MEET AN IDENTIFIABLE COMMUNITY NEED IN THE FAIRBURY AREA, AND TO DEVELOP A MORE COMPREHENSIVE CONTINUUM OF HEALTH CARE THAT COMPLEMENTS THE HEALTH CARE SERVICES ALREADY AVAILABLE ON THE CAMPUS OF JCHC. SIXTY-THREE RESIDENTS WERE SERVED FROM OCTOBER 2021 THROUGH SEPTEMBER 2022. TWELVE OF THESE RESIDENTS QUALIFIED UNDER THE MEDICAID WAIVER PROGRAM. TOTAL DAYS OF CARE PROVIDED WERE 16,082.	Desc
Total Program Service Expenses	$1,775,512	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	0	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	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	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	0	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	0	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
Employee	41	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	5	GoverningBodyVotingMembersCnt
Independent Voting Member	5	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	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	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	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	CHANCE KLASEK	PersonNm
Phone	4027296856	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2200 H STREET PO BOX 277	AddressLine1Txt
City	FAIRBURY	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68352	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
RICK STANTON
CHAIRMAN	1.00	Yes (X)	Yes (X)	$0	$0	$0
DAVID REESE
VICE CHAIRMAN	1.00	Yes (X)	Yes (X)	$0	$0	$0
CHANCE KLASEK
SECRETARY	5.00	Yes (X)	Yes (X)	$0	$0	$0
REGINA BERGH
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
PAT GANYO
MEMBER	1.00	Yes (X)		$0	$0	$0
BURKE KLINE
PRESIDENT	1.00		Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEFFERSON COMMUNITY HEALTH CENTER INC	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2200 H STREET PO BOX 277	AddressLine1Txt
City	FAIRBURY	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68352	ZIPCd

Field	Value	IRS element (for citing)
Services	CONTRACTED DIETARY, MANAGEMENT, MAINTENA	ServicesDesc
Compensation	$644,459	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Government Grants	$12,052	GovernmentGrantsAmt
All Other Contributions	$378	AllOtherContributionsAmt
Total Contributions	$12,430	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT REVENUE	623000	$1,652,308	$1,652,308
MEDICAID PAYMENTS	623000	$285,741	$285,741
RENTAL INCOME	900002	$4,792	$4,792

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,942,841	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$44,641	TotalRevenueColumnAmt
Exclusion	$44,641	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	INSURANCE PROCEEDS	Desc
Business	524298	BusinessCd
Total Revenue Column	$3,646	TotalRevenueColumnAmt
Exclusion	$3,646	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$3,646	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,003,558	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,942,841	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$48,287	ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$802,336	TotalAmt
Program Services	$674,017	ProgramServicesAmt
Management And General	$128,319	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$44,260	TotalAmt
Program Services	$37,181	ProgramServicesAmt
Management And General	$7,079	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$63,581	TotalAmt
Program Services	$53,412	ProgramServicesAmt
Management And General	$10,169	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$95,211	TotalAmt
Management And General	$95,211	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$11,150	TotalAmt
Management And General	$11,150	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$26,085	TotalAmt
Program Services	$23,101	ProgramServicesAmt
Management And General	$2,984	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$4,951	TotalAmt
Program Services	$4,896	ProgramServicesAmt
Management And General	$55	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$115,255	TotalAmt
Program Services	$104,272	ProgramServicesAmt
Management And General	$10,983	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$76,741	TotalAmt
Program Services	$75,916	ProgramServicesAmt
Management And General	$825	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$5,678	TotalAmt
Program Services	$5,628	ProgramServicesAmt
Management And General	$50	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$10,881	TotalAmt
Program Services	$10,761	ProgramServicesAmt
Management And General	$120	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$193,070	TotalAmt
Program Services	$190,940	ProgramServicesAmt
Management And General	$2,130	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$45,706	TotalAmt
Program Services	$45,202	ProgramServicesAmt
Management And General	$504	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
RESIDENT MEALS	$531,491	$531,491
DUES & SUBSCRIPTIONS	$15,060	$14,894	$166
BAD DEBT	$3,822	$3,801	$21

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,045,278	TotalAmt
Program Services	$1,775,512	ProgramServicesAmt
Management And General	$269,766	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$199,496	BOYAmt
EOY	$169,161	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$769,956	BOYAmt
EOY	$701,441	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$27,988	BOYAmt
EOY	$22,153	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,779	BOYAmt
EOY	$24,008	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$5,868,923	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$4,215,310	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,724,724	BOYAmt
EOY	$1,653,613	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,727,943	BOYAmt
EOY	$2,570,376	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$58,037	BOYAmt
EOY	$126,619	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$152,135	BOYAmt
EOY	$180,737	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$210,172	BOYAmt
EOY	$307,356	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	$2,517,771	BOYAmt
EOY	$2,263,020	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,517,771	BOYAmt
EOY	$2,263,020	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,727,943	BOYAmt
EOY	$2,570,376	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$41,720	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$213,031	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	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)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

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	$112	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$100	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$52,296	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$254,486	CurrentTaxYearMinus1YearAmt
Current Tax Year	$12,430	CurrentTaxYearAmt
Total	$319,424	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,788,255	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,942,276	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,002,218	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$1,862,862	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,942,841	CurrentTaxYearAmt
Total	$9,538,452	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,788,367	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,942,376	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,054,514	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,117,348	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,955,271	CurrentTaxYearAmt
Total	$9,857,876	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	$9,857,876	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$7,144	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$8,639	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$7,992	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$24,233	CurrentTaxYearMinus1YearAmt
Current Tax Year	$44,641	CurrentTaxYearAmt
Total	$92,649	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$7,144	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$8,639	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$7,992	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$24,233	CurrentTaxYearMinus1YearAmt
Current Tax Year	$44,641	CurrentTaxYearAmt
Total	$92,649	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$92,547	CurrentTaxYearMinus4YearsAmt
Current Tax Year	$3,646	CurrentTaxYearAmt
Total	$96,193	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,888,058	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,951,015	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,062,506	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,141,581	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,003,558	CurrentTaxYearAmt
Total	$10,046,718	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.98120	PublicSupportCY509Pct
Public Support PY509	0.98540	PublicSupportPY509Pct
Investment Income CY	0.00920	InvestmentIncomeCYPct
Investment Income PY	0.00520	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	$60,427	OtherCostOrOtherBasisAmt
Book Value	$60,427	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,433,307	OtherCostOrOtherBasisAmt
Depreciation	$3,901,580	DepreciationAmt
Book Value	$1,531,727	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$279,655	OtherCostOrOtherBasisAmt
Depreciation	$225,519	DepreciationAmt
Book Value	$54,136	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$95,534	OtherCostOrOtherBasisAmt
Depreciation	$88,211	DepreciationAmt
Book Value	$7,323	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,653,613	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
RESIDENT SECURITY DEPOSITS	$89,328
DUE TO JEFFERSON COMMUNITY HEALTH CENTER	$69,380
PREPAID RENT	$22,029

Field	Value	IRS element (for citing)
Total Liability	$180,737	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$1,786,705	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$213,031	NetUnrealizedGainsInvstAmt
Revenue Not Reported	-$213,031	RevenueNotReportedAmt
Revenue Subtotal	$1,999,736	RevenueSubtotalAmt
Other Revenues Not Included	$3,822	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$3,822	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$2,003,558	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$2,041,456	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$2,041,456	ExpensesSubtotalAmt
Other Expenses Not Included	$3,822	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$3,822	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$2,045,278	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART X, LINE 2:	CEDARWOOD ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. CEDARWOOD RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT SEPTEMBER 30, 2022 AND 2021, CEDARWOOD HAD NO UNCERTAIN TAX POSITIONS ACCRUED.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 3,822.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 3,822.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS OF THE CORPORATION ARE BRYAN HEALTH AND JEFFERSON COMMUNITY HEALTH CENTER, INC., BOTH NEBRASKA NON-PROFIT CORPORTIONS.
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBERS OF THE CORPORATION, BRYAN HEALTH, A NEBRASKA NON-PROFIT CORPORATION, AND JEFFERSON COMMUNITY HEALTH CENTER, INC., A NEBRASKA NON-PROFIT CORPORATION, HAVE THE POWER TO APPOINT 3 TRUSTEES EACH, BOTH PERIODICALLY AND AS VACANCIES ARISE.
FORM 990, PART VI, SECTION A, LINE 8B	THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B	THE BOARD WILL REVIEW THE FORM 990 AT A REGULARLY SCHEDULED BOARD MEETING, WHICH DOES NOT NECESSARILY OCCUR PRIOR TO THE FILING OF FORM 990. FORM 990 IS REVIEWED BY MR. CHANCE KLASEK, BOARD SECRETARY, PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	ON AN ANNUAL BASIS, OFFICERS AND TRUSTEES ARE REQUIRED TO SIGN THE "CONFLICT OF INTEREST STATEMENT." BY SIGNING THIS STATEMENT, THE OFFICERS AND TRUSTEES AGREE NOT TO USE HIS OR HER POSITION FOR PERSONAL PROFIT OR TO GAIN PERSONAL ADVANTAGE. THE OFFICERS AND TRUSTEES ARE REQUIRED TO DISCLOSE IN WRITING TO THE BOARD OF TRUSTEES ANY PERSON TO WHOM HE OR SHE IS CLOSELY RELATED OR ORGANIZATION WITH WHICH HE OR SHE IS AFFILIATED, WHO OR WHICH PRESENTLY TRANSACTS BUSINESS WITH THE CORPORATION OR MIGHT REASONABLY BE EXPECTED TO DO SO IN THE FUTURE. THE OFFICERS AND TRUSTEES ARE REQUIRED TO SUBMIT SUCH DISCLOSURE ON A CASE-BY-CASE BASIS. IT IS UNDERSTOOD THAT AFFILIATION WITH AN ORGANIZATION IS CONSIDERED TO EXIST WHEN AN OFFICER, TRUSTEE OR A MEMBER OF HIS OR HER IMMEDIATE FAMILY OR CLOSE RELATIVE IS AN OFFICER, DIRECTOR, PARTNER, EMPLOYEE OR AGENT OF THE ORGANIZATIONS OR OWNS 5% OF THE VOTING STOCK OR CONTROLLING INTEREST IN THE ORGANIZATION. THE OFFICERS AND TRUSTEES MUST ABSTAIN FROM VOTING ON ANY MOTION REGARDING THE DISCLOSED CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION C, LINE 19	CEDARWOOD'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII:	BURKE KLINE, PRESIDENT, AND CHANCE KLASEK, SECRETARY, ARE EMPLOYEES OF JEFFERSON COMMUNITY HEALTH CENTER, INC., AN UNRELATED ORGANIZATION THAT PROVIDES MANAGEMENT AND CLERICAL SERVICES FOR THE ORGANIZATION. THEREFORE, THE COMPENSATION IS PAID BY JEFFERSON COMMUNITY HEALTH CENTER, INC.
FORM 990, PART XII, LINE 2C:	THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON CONCLUSION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINDINGS TO THE FINANCE COMMITTEE. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART VI, SECTION B, LINE 14:	THE ORGANIZATION DOES NOT HAVE A WRITTEN POLICY, BUT IT DOES MAINTAIN DOCUMENTS IN ACCORDANCE WITH FEDERAL AND STATE LAWS.
FORM 990, PART VI, SECTION B, LINE 15:	AS NO OFFICER IS PAID BY THIS ORGANIZATION, NO INDEPENDENT REVIEW OR APPROVAL PROCESS IS CONDUCTED BY THIS ORGANIZATION.