HUGHSON SAMARITAN VILLAGE: Form 990PF, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HUGHSON SAMARITAN VILLAGE (EIN 46-0469127)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-01-24
- IRS object ID
- 202220249349100422
- Schema version
- 2020v4.1
- 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-PF
- Depreciation Schedule
- General Explanation Attachment
- Investments Corp Stock Schedule
- Land Etc Schedule2
- Other Assets Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Liabilities Schedule
- Transfers Frm Controlled Entities
- Transfers To Controlled Entities
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-01-24T17:56:53-06:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 941239084 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATHERTON & ASSOCIATES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4339 | AddressLine1Txt |
| City | MODESTO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 953524339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460469127 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUGHSON SAMARITAN VILLAGE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HUGH | BusinessNameControlTxt |
| Phone | 2098833000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7700 FOX ROAD | AddressLine1Txt |
| City | HUGHSON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 953261090 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM RAEBER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2098833000 | PhoneNum |
| Signature | 2022-01-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | WILLIAM | PersonFirstNm |
| Person Last | RAEBER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELYN HOWELL | PreparerPersonNm |
| PTIN | P01327223 | PTIN |
| Phone | 2095774800 | PhoneNum |
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-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $28,127,334 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $20,704 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $20,704 | InterestOnSavNetInvstIncmAmt |
| Interest On Savings Adj Net Incm | $20,704 | InterestOnSavingsAdjNetIncmAmt |
| Gross Rents Rev And Expnss | $8,455,939 | GrossRentsRevAndExpnssAmt |
| Gross Rents Adj Net Incm | $8,455,939 | GrossRentsAdjNetIncmAmt |
| Net Rental Income Or Loss | $8,455,939 | NetRentalIncomeOrLossAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Other Income Rev And Expnss | $2,123,388 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $0 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $2,123,388 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $10,600,031 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $20,704 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $10,600,031 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $478,922 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $422,412 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $56,510 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $4,333,833 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $3,822,466 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $511,367 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $631,763 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $557,218 | PensionEmplBnftAdjNetIncmAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $74,545 | PensionEmplBnftDsbrsChrtblAmt |
| Interest Rev And Expnss | $882,336 | InterestRevAndExpnssAmt |
| Interest Net Invst Incm | $0 | InterestNetInvstIncmAmt |
| Interest Adj Net Incm | $778,226 | InterestAdjNetIncmAmt |
| Interest Dsbrs Chrtbl | $104,110 | InterestDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $1,790,408 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $1,579,150 | DeprecAndDpltnAdjNetIncmAmt |
| Trav Conf Meeting Rev And Expnss | $941 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $830 | TravConfMeetingAdjNetIncmAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $111 | TravConfMeetingDsbrsChrtblAmt |
| Printing And Pub Rev And Expnss | $11,653 | PrintingAndPubRevAndExpnssAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $10,278 | PrintingAndPubAdjNetIncmAmt |
| Printing And Pub Dsbrs Chrtbl | $1,375 | PrintingAndPubDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $3,863,516 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $3,407,642 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $453,382 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $11,993,372 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $10,578,222 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $1,201,400 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $1,250 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $1,250 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $11,994,622 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $10,578,222 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $1,202,650 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$1,394,591 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $20,704 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $21,809 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $1,807,935 | CashBOYAmt |
| Cash EOY | $1,503,063 | CashEOYAmt |
| Cash EOYFMV | $1,503,063 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $1,520,516 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $1,527,016 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $1,527,016 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl | $99,600 | AcctRcvblAmt |
| Acct Rcvbl BOY | $110,937 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $99,600 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $99,600 | AcctRcvblEOYFMVAmt |
| Inventories BOY | $25,870 | InventoriesBOYAmt |
| Inventories EOY | $34,908 | InventoriesEOYAmt |
| Inventories EOYFMV | $34,908 | InventoriesEOYFMVAmt |
| Prepaid Expenses BOY | $230,382 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $268,657 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $268,657 | PrepaidExpensesEOYFMVAmt |
| Corporate Stock BOY | $1,248,898 | CorporateStockBOYAmt |
| Corporate Stock EOY | $1,324,757 | CorporateStockEOYAmt |
| Corporate Stock EOYFMV | $1,776,829 | CorporateStockEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $50,774,842 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,330,449 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $22,871,640 | LandBOYAmt |
| Land EOY | $21,444,393 | LandEOYAmt |
| Land EOYFMV | $21,444,393 | LandEOYFMVAmt |
| Other Assets BOY | $1,420,285 | OtherAssetsBOYAmt |
| Other Assets EOY | $1,472,868 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $1,472,868 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $29,236,463 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,675,262 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $28,127,334 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $594,199 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $694,064 | AccountsPayableEOYAmt |
| Deferred Revenue BOY | $26,232 | DeferredRevenueBOYAmt |
| Deferred Revenue EOY | $19,743 | DeferredRevenueEOYAmt |
| Other Liabilities BOY | $20,613,600 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $20,353,614 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $21,234,031 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,067,421 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $8,002,432 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $6,607,841 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $8,002,432 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $6,607,841 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $29,236,463 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $27,675,262 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $8,002,432 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$1,394,591 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $6,607,841 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $6,607,841 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $288 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $288 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $288 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $288 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | 0 | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | CA | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (1) | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | Yes (1) | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | WWW.SVLIVING.ORG | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLIAM N RAEBER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2098833000 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7700 FOX ROAD | AddressLine1Txt |
| City | HUGHSON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95326 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| JOHN ROGERS | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | CHAIRMAN | 1.00 | $0 | $0 | $0 |
| RANDALL SCHWANTES | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | SECRETARY | 1.00 | $0 | $0 | $0 |
| RAMON BAWANAN | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | VICE CHAIRMAN | 1.00 | $0 | $0 | $0 |
| WILLIAM N RAEBER | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | CFO | 40.00 | $174,595 | $6,264 | $0 |
| DAN AGUILAR | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | PRESIDENT & CEO | 40.00 | $304,327 | $6,280 | $0 |
| JUNE ROGERS | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| JANET ROGERS | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| VITO CHIESA | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| ROBERT FORESTER MD | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| PATRICIA MASON | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| WALTER SCHMIDT | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR | 1.00 | $0 | $0 | $0 |
Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee BenefitsEmployeeBenefitsAmt | Expense AccountExpenseAccountAmt |
|---|---|---|---|---|---|---|---|---|
| BETTY LOPEZ | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | ADMINISTRATOR | 40.00 | $192,300 | $417 | $0 |
| ALBERTO PEREZ | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR OF IT & SUP | 40.00 | $143,920 | $6,280 | $0 |
| RIKKI PEREZCHICA | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | ADMINISTRATOR | 40.00 | $143,846 | $6,280 | $0 |
| LORRY QUINTERO | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR OF PATIENT | 40.00 | $133,843 | $6,269 | $0 |
| PATRICK FINK | ||||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | DIRECTOR OF FOOD & B | 40.00 | $120,016 | $6,280 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Employee Paid Over50k | 10 | OtherEmployeePaidOver50kCnt |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Service TypeServiceTypeTxt | CompensationCompensationAmt |
|---|---|---|---|---|---|
| TRICOUNTY FLOORING INC | |||||
| 481 BELLEVUE ROAD | ATWATER | CA | 95301 | FLOORING | $143,485 |
| BRIGHTVIEW TREE CARE SERVICES | |||||
| PO BOX 31001-2463 | PASADENA | CA | 91110 | LANDSCAPING | $119,242 |
| MICKEY WALL PAINTING INC | |||||
| PO BOX 3302 | TURLOCK | CA | 95381 | PAINTING SERVICES | $72,102 |
| DATA PATH INC | |||||
| 318 MCHENRY AVENUE | MODESTO | CA | 95354 | COMPUTER SERVICES | $63,359 |
| REESE'S SEALCOATING INC | |||||
| PO BOX 740 | LOCKEFORD | CA | 95237 | PARKING LOT PAVING AND SEAL COATING | $59,773 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 2 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | TO MAKE DISTRIBUTIONS OF ITS INCOME AND ASSETS FOR ITS OWN CHARITABLE ACTIVITIES OR TO OTHER NONPROFIT ORGANIZATIONS. FUNDS WILL BE USED EXCLUSIVELY FOR CHARITABLE PURPOSES. | Description1Txt |
| Expenses1 | $11,994,622 | Expenses1Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $1,636,156 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $3,126,262 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $4,762,418 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $4,762,418 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $71,436 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $4,690,982 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $234,549 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $1,202,650 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $363,159 | CharitableAssetsAcquisPaidAmt |
| Qualifying Distributions | $1,565,809 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $1,565,809 | AdjustedQualifyingDistriAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Fndtn Ruling | 2002-09-05 | PrivateOperatingFndtnRulingDt |
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $21,809 | CurrentYearAmt |
| Year1 | $25,707 | Year1Amt |
| Year2 | $40,842 | Year2Amt |
| Year3 | $12,616 | Year3Amt |
| Total | $100,974 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $18,538 | CurrentYearAmt |
| Year1 | $21,851 | Year1Amt |
| Year2 | $34,716 | Year2Amt |
| Year3 | $10,724 | Year3Amt |
| Total | $85,828 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $1,565,809 | CurrentYearAmt |
| Year1 | $1,130,583 | Year1Amt |
| Year2 | $867,055 | Year2Amt |
| Year3 | $816,201 | Year3Amt |
| Total | $4,379,648 | TotalAmt |
Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $1,565,809 | CurrentYearAmt |
| Year1 | $1,130,583 | Year1Amt |
| Year2 | $867,055 | Year2Amt |
| Year3 | $816,201 | Year3Amt |
| Total | $4,379,648 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $27,675,262 | CurrentYearAmt |
| Year1 | $29,236,463 | Year1Amt |
| Year2 | $30,687,791 | Year2Amt |
| Year3 | $31,687,859 | Year3Amt |
| Total | $119,287,375 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $27,675,262 | CurrentYearAmt |
| Year1 | $29,236,463 | Year1Amt |
| Year2 | $30,687,791 | Year2Amt |
| Year3 | $31,687,859 | Year3Amt |
| Total | $119,287,375 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support TotalSupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Public Support Type PublicSupportType
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Largest Support From EO LargestSupportFromEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Investment Income GrossInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITED SAMARITANS FOUNDATION | BusinessNameLine1Txt |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S BROADWAY | AddressLine1Txt |
| City | TURLOCK | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95380 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Relationship | NONE | RecipientRelationshipTxt |
| Recipient Foundation Status | PC | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | CHARITABLE CONTRIBUTION | GrantOrContributionPurposeTxt |
| Amt | $1,250 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $1,250 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $20,704 | ExclusionAmt |
Net Rntl Incm Re Debt Fincd Prop NetRntlIncmReDebtFincdPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 30 | ExclusionCd |
| Exclusion | $8,455,939 | ExclusionAmt |
Other Revenue Described OtherRevenueDescribedGrp (2 entries)
| DescDesc | ExclusionExclusionCd | ExclusionExclusionAmt |
|---|---|---|
| OTHER REVENUE | 03 | $181,832 |
| RESIDENT CARE SERVICES | 03 | $1,941,556 |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $10,600,031 | ExclusionAmt |
| Related Or Exempt Function Incm | $0 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $10,600,031 | TotalIncomeProducingActyAmt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Depreciation Schedule DepreciationSchedule
Depreciation Property DepreciationPropertyGrp (6 entries)
| PropertyPropertyDesc | AcquiredAcquiredDt | Cost Or Other BasisCostOrOtherBasisAmt | Computation MethodComputationMethodTxt | Current Year ExpenseCurrentYearExpenseAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Prior Year DepreciationPriorYearDepreciationAmt | LifeLifeRt |
|---|---|---|---|---|---|---|---|---|
| LAND | 2001-01-01 | $627,846 | L | $0 | $0 | $0 | ||
| LAND IMPROVEMENTS | 2001-01-01 | $4,010,930 | SL | $144,325 | $0 | $144,325 | $2,346,040 | 15.000000000000 |
| BUILDINGS & IMPROVEMENTS | 2001-01-01 | $41,249,829 | SL | $1,488,994 | $0 | $1,488,994 | $21,038,960 | 39.000000000000 |
| FURNITURE AND FIXTURES | 2001-01-01 | $1,789,732 | SL | $29,485 | $0 | $29,485 | $1,616,300 | 7.000000000000 |
| EQUIPMENT | 2001-01-01 | $2,802,118 | SL | $112,182 | $0 | $112,182 | $2,314,448 | 5.000000000000 |
| VEHICLES | 2001-01-01 | $294,387 | SL | $15,422 | $0 | $15,422 | $224,293 | 5.000000000000 |
General Explanation Attachment GeneralExplanationAttachment
General Explanation GeneralExplanationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OWNERSHIP OF CONTROLLED ENTITIES | IdentifierTxt |
| Form And Line Reference | FORM 990-PF, PAGE 5, PART VII-A, LINE 11 | FormAndLineReferenceDesc |
| Medium Explanation | NAME: HUGHSON SAMARITAN VILLAGE HOLDINGS, LLCADDRESS: 7700 FOX ROAD, HUGHSON CA, 95326EIN: 90-1011736 EXCESS BUSINESS HOLDING: NONAME: HUGHSON SAMARITAN HOME CARE, LLC ADDRESS:7700 FOX ROAD, HUGHSON CA, 95326 EIN: 35-2578444 EXCESS BUSINESS HOLDING: NO | MediumExplanationTxt |
Investments Corp Stock Schedule InvestmentsCorpStockSchedule
Investments Corporate Stock InvestmentsCorporateStockGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Stock | EQUITIES & SECURITIES | StockNm |
| EOY Book Value | $1,324,757 | EOYBookValueAmt |
| EOYFMV | $1,776,829 | EOYFMVAmt |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtcGrp (5 entries)
| Category Or ItemCategoryOrItemTxt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt |
|---|---|---|---|
| BUILDINGS | $45,260,759 | $25,018,319 | $20,242,440 |
| FURNITURE & FIXTURES | $1,789,732 | $1,645,785 | $143,947 |
| LAND | $627,846 | $0 | $627,846 |
| MACHINERY & OTHER EQUIPMENT | $2,802,118 | $2,426,630 | $375,488 |
| TRANSPORTATION EQUIPMENT | $294,387 | $239,715 | $54,672 |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (4 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| DEPOSITS HELD WITH VENDORS | $137,996 | $114,355 | $114,355 |
| REPLACEMENT RESERVE | $1,264,984 | $1,291,779 | $1,291,779 |
| ESCROW DEPOSITS | $17,305 | $18,343 | $18,343 |
| DEPOSITS HELD WITH LENDER | $0 | $48,391 | $48,391 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (29 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| ADVERTISING | $112,803 | $0 | $99,493 | $13,310 |
| BANK AND PAYROLL CHARGES | $37,758 | $0 | $33,303 | $4,455 |
| BOOKS AND SUBSCRIPTIONS | $10,137 | $0 | $8,941 | $1,196 |
| CABLE | $30,604 | $0 | $26,993 | $3,611 |
| COMPUTER | $60,590 | $0 | $53,441 | $7,149 |
| CONTRACT SERVICES | $240,576 | $0 | $212,189 | $28,387 |
| DUES AND EVENTS | $43,705 | $0 | $38,548 | $5,157 |
| EMPLOYEE RELATED | $39,565 | $0 | $34,897 | $4,668 |
| FOOD | $612,800 | $0 | $540,493 | $72,307 |
| LIABILITY INSURANCE | $327,829 | $0 | $289,147 | $38,682 |
| LICENSES | $15,632 | $0 | $13,788 | $1,844 |
| MISCELLANEOUS | $1,661 | $0 | $1,465 | $196 |
| OFFICE SUPPLIES | $20,235 | $0 | $17,847 | $2,388 |
| POSTAGE | $4,185 | $0 | $3,691 | $494 |
| REPAIRS AND MAINTENANCE | $304,986 | $0 | $268,999 | $35,987 |
| SUPPLIES | $253,458 | $0 | $223,551 | $29,907 |
| TELEPHONE | $82,681 | $0 | $72,925 | $9,756 |
| UNIFORMS | $3,625 | $0 | $3,197 | $428 |
| UTILITIES | $761,927 | $0 | $672,024 | $89,903 |
| WORKERS' COMPENSATION INSURANCE | $258,385 | $0 | $227,897 | $30,488 |
| ACCOUNTING FEES | $60,340 | $0 | $53,220 | $7,120 |
| LEGAL FEES | $107,731 | $0 | $95,019 | $12,712 |
| CONSULTING FEES | $16,214 | $0 | $14,301 | $1,913 |
| EQUIPMENT RENTAL | $25,651 | $0 | $22,624 | $3,027 |
| EMPLOYER CONTRIBUTION | $1,035 | $0 | $913 | $122 |
| MORTGAGE INSURANCE | $101,096 | $0 | $89,167 | $11,929 |
| COVID-19 RELATED EXPENSES | $219,759 | $0 | $193,829 | $25,930 |
| BAD DEBT EXPENSE | $87,428 | $0 | $77,112 | $10,316 |
| AMORTIZATION | $21,120 | $0 | $18,628 | $0 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|
| OTHER REVENUE | $181,832 | $181,832 |
| RESIDENT CARE SERVICES | $1,941,556 | $1,941,556 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail (3 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt |
|---|---|---|
| RESIDENT DEPOSITS PAYABLE | $181,930 | $189,450 |
| LOAN PAYABLE | $20,431,670 | $20,056,614 |
| PAYABLE TO LENDER | $0 | $107,550 |
Transfers Frm Controlled Entities TransfersFrmControlledEntities
Transfers From Controlled Ent TransfersFromControlledEntGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | DescDesc | AmtAmt |
|---|---|---|---|---|---|---|
| HUGHSON SAMARITAN VILLAGE HOLDINGS LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 901011736 | REIMBURSEMENT OF AUDIT FEES FROM HUGHSON SAMARITAN VILLAGE HOLDINGS, LLC TO HUGHSON SAMARITAN VILLAG | $0 |
| HUGHSON SAMARITAN VILLAGE HOLDINGS LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 901011736 | REPLACEMENT RESERVE CHECK FROM ORIX REAL ESTATE CAPITAL, LLC | $0 |
| HUGHSON SAMARITAN HOME CARE LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 352578444 | MISCELLANEOUS INCOME | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,011 | TotalAmt |
Transfers To Controlled Entities TransfersToControlledEntities
Transfers To Controlled Ent TransfersToControlledEntGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | DescDesc | AmtAmt |
|---|---|---|---|---|---|---|
| HUGHSON SAMARITAN VILLAGE HOLDINGS LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 901011736 | PROPERTY AND EQUIPMENT LEASE INCOME | $1,794,029 |
| HUGHSON SAMARITAN VILLAGE HOLDINGS LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 901011736 | FIXED ASSET ACQUISITIONS | $340,962 |
| HUGHSON SAMARITAN VILLAGE HOLDINGS LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 901011736 | AUDIT FEES | $12,125 |
| HUGHSON SAMARITAN VILLAGE HOLDINGS LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 901011736 | TAX FEES | $1,250 |
| HUGHSON SAMARITAN HOME CARE LLC | ||||||
| 7700 FOX ROAD | HUGHSON | CA | 95326 | 352578444 | MISCELLANEOUS EXPENSES | $691,412 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,839,778 | TotalAmt |
Comments