CLINTON CONVALESCENT CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CLINTON CONVALESCENT CENTER INC (EIN 43-0911676)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-02-17
- IRS object ID
- 202210489349300326
- Schema version
- 2020v4.2
- 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 | 2022-02-17T11:41:51-06:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470698853 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLAND & ASSOCIATES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 450 REGENCY PARKWAY | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68114 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430911676 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLINTON CONVALESCENT CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLIN | BusinessNameControlTxt |
| Phone | 8165392128 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 247 | AddressLine1Txt |
| City | PLATTSBURG | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 644770247 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | COREY STRIDER | PersonNm |
| Person Title | VICE PRESIDENT | PersonTitleTxt |
| Phone | 8165392128 | PhoneNum |
| Signature | 2022-02-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | COREY | PersonFirstNm |
| Person Last | STRIDER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NICOLE SNOW | PreparerPersonNm |
| PTIN | P01392174 | PTIN |
| Phone | 4023978822 | PhoneNum |
| Preparation | 2022-02-17 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAKRIDGE OF PLATTSBURG | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | COREY STRIDER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 EAST CLAY AVENUE | AddressLine1Txt |
| City | PLATTSBURG | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 644770247 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,362,749 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OAKRIDGEOFPLATTSBURG.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | OAKRIDGE OF PLATTSBURG WILL PROVIDE A NURTURING ENVIRONMENT FOR ITS RESIDENTS AND STAFF, SO THAT ALL MAY EXPERIENCE INDIVIDUAL RESPECT, CARING AND SUPPORT WHILE LIVING OR WORKING WITHIN THESE WALLS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 92 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $423,016 | PYContributionsGrantsAmt |
| CY Contributions Grants | $886,797 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,558,063 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,458,777 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,333 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,884 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,653 | PYOtherRevenueAmt |
| CY Other Revenue | $6,291 | CYOtherRevenueAmt |
| PY Total Revenue | $3,998,065 | PYTotalRevenueAmt |
| CY Total Revenue | $4,362,749 | 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 | $2,255,602 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,578,232 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,261,544 | PYOtherExpensesAmt |
| CY Other Expenses | $1,588,045 | CYOtherExpensesAmt |
| PY Total Expenses | $3,517,146 | PYTotalExpensesAmt |
| CY Total Expenses | $4,166,277 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $480,919 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $196,472 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,545,047 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,423,656 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $549,744 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $231,881 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,995,303 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,191,775 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OAKRIDGE OF PLATTSBURG WILL PROVIDE A NURTURING ENVIRONMENT FOR ITS RESIDENTS AND STAFF, SO THAT ALL MAY EXPERIENCE INDIVIDUAL RESPECT, CARING AND SUPPORT WHILE LIVING OR WORKING WITHIN THESE WALLS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,494,071 | ExpenseAmt |
| Revenue | $3,465,068 | RevenueAmt |
| Desc | LONG TERM CARE SKILLED NURSING FACILITY | Desc |
| Total Program Service Expenses | $3,494,071 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 92 | 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 |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | 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 | BOBBY SWYMELER | PersonNm |
| Phone | 8165392128 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 EAST CLAY AVENUE | AddressLine1Txt |
| City | PLATTSBURG | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64477 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| TOM DECKER | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| COREY STRIDER | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PATTI GEORGE | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JIM PATRICO | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CRAIG EVANS | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAN O'CONNOR III | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GENICE READ | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JORDAN ROTH | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAULETTE TAYLOR | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BOBBY SWYMELER | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $135,162 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $135,162 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | 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 | REHABCARE GROUP INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7733 FORSYTH BLVD SUITE 1700 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | THERAPY | ServicesDesc |
| Compensation | $215,938 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $886,797 | GovernmentGrantsAmt |
| Total Contributions | $886,797 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 623000 | $1,476,286 | $1,476,286 |
| PRIVATE REVENUE | 623000 | $1,341,893 | $1,341,893 |
| MEDICARE | 623000 | $640,598 | $640,598 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,458,777 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,884 | TotalRevenueColumnAmt |
| Exclusion | $10,884 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $6,291 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,291 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,291 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,362,749 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,465,068 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,884 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,209,266 | TotalAmt |
| Program Services | $2,032,525 | ProgramServicesAmt |
| Management And General | $176,741 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,528 | TotalAmt |
| Program Services | $26,246 | ProgramServicesAmt |
| Management And General | $2,282 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,263 | TotalAmt |
| Program Services | $164,002 | ProgramServicesAmt |
| Management And General | $14,261 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,175 | TotalAmt |
| Program Services | $149,201 | ProgramServicesAmt |
| Management And General | $12,974 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,945 | TotalAmt |
| Management And General | $15,945 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,947 | TotalAmt |
| Management And General | $9,947 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,171 | TotalAmt |
| Management And General | $14,171 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,465 | TotalAmt |
| Program Services | $19,515 | ProgramServicesAmt |
| Management And General | $26,950 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,618 | TotalAmt |
| Management And General | $74,618 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,368 | TotalAmt |
| Management And General | $1,368 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,925 | TotalAmt |
| Program Services | $100,925 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,396 | TotalAmt |
| Management And General | $122,396 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| NFRA/NFAC FEES | $272,725 | $220,907 | $51,818 |
| MEDICAL EXPENSES | $258,950 | $238,234 | $20,716 |
| SUPPLIES | $251,768 | $203,932 | $47,836 |
| COVID TESTING | $214,110 | $173,429 | $40,681 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,657 | TotalAmt |
| Program Services | $165,155 | ProgramServicesAmt |
| Management And General | $39,502 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,166,277 | TotalAmt |
| Program Services | $3,494,071 | ProgramServicesAmt |
| Management And General | $672,206 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,438 | BOYAmt |
| EOY | $171,077 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,440,786 | BOYAmt |
| EOY | $1,250,850 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,516 | BOYAmt |
| EOY | $132,888 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,695 | BOYAmt |
| EOY | $5,335 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,289 | BOYAmt |
| EOY | $15,667 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,681,456 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,849,109 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $869,027 | BOYAmt |
| EOY | $832,347 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,296 | BOYAmt |
| EOY | $15,492 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,545,047 | BOYAmt |
| EOY | $2,423,656 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,283 | BOYAmt |
| EOY | $231,881 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,461 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $549,744 | BOYAmt |
| EOY | $231,881 | 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 | $1,937,156 | BOYAmt |
| EOY | $2,133,221 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,147 | BOYAmt |
| EOY | $58,554 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,995,303 | BOYAmt |
| EOY | $2,191,775 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,545,047 | BOYAmt |
| EOY | $2,423,656 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $196,472 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| 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 | $195 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,112 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,047 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $423,016 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $886,797 | CurrentTaxYearAmt |
| Total | $1,326,167 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,073,292 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,602,944 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,623,293 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,558,063 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,458,777 | CurrentTaxYearAmt |
| Total | $17,316,369 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,073,487 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,617,056 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,625,340 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,981,079 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,345,574 | CurrentTaxYearAmt |
| Total | $18,642,536 | 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 | $18,642,536 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,684 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,223 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,887 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,333 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,884 | CurrentTaxYearAmt |
| Total | $46,011 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,684 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,223 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,887 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,333 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,884 | CurrentTaxYearAmt |
| Total | $46,011 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,806 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,116 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,282 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,653 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,291 | CurrentTaxYearAmt |
| Total | $66,148 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,093,977 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,648,395 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,651,509 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,998,065 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,362,749 | CurrentTaxYearAmt |
| Total | $18,754,695 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99400 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99420 | PublicSupportPY509Pct |
| Investment Income CY | 0.00250 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00210 | 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 | $65,693 | OtherCostOrOtherBasisAmt |
| Book Value | $65,693 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,667,742 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,188,847 | DepreciationAmt |
| Book Value | $478,895 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $878,699 | OtherCostOrOtherBasisAmt |
| Depreciation | $622,456 | DepreciationAmt |
| Book Value | $256,243 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $69,322 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,806 | DepreciationAmt |
| Book Value | $31,516 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $832,347 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE NURSING FACILITY FILES FEDERAL INCOME TAX RETURNS. THE NURSING FACILITY IS NO LONGER SUBJECT TO FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE SEPTEMBER 30, 2015. THE NURSING FACILITY FOLLOWS THE PROVISIONS OF UNCERTAIN TAX POSITIONS AS ADDRESSED IN FASB ACCOUNTING STANDARDS CODIFICATION 740-10-65-1. THE NURSING FACILITY RECOGNIZED NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS AT SEPTEMBER 30, 2021, 2020, 2019, 2018, 2017 AND 2016. IF APPLICABLE, THE NURSING FACILITY RECOGNIZES INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN OPERATING EXPENSES. NO SUCH INTEREST OR PENALTIES WERE RECOGNIZED DURING THE PERIODS PRESENTED. THE NURSING FACILITY HAD NO ACCRUALS FOR INTEREST OR PENALTIES AT SEPTEMBER 30, 2021, 2020, 2019, 2018, 2017 AND 2016. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | BOARD OF DIRECTORS ARE ELECTED FROM MEMBERSHIP OF ORIGINAL BOND HOLDERS (ALL BONDS RETIRED) OR A MEMBERSHIP OF HONORARY MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | BOARD OF DIRECTORS ANNUALLY ELECTED BY MEMBERSHIP BALLOTS PROVIDED TO MEMBERS AND HONORARY MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ADMINISTRATOR AND THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE SUBMITTING TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE COMPENSATION FOR THE ORGANIZATION'S ADMINISTRATOR IS SET BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
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