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SUSANNA WESLEY HEALTH CENTER INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
SUSANNA WESLEY HEALTH CENTER INC (EIN 59-1837338)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-03-10
IRS object ID
202220699349300202
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

FieldValueIRS element (for citing)
Return2022-03-10T06:49:56-06:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN593070669PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MSL PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 E BROWARD BLVD SUITE 1550AddressLine1Txt
CityFORT LAUDERDALECityNm
State AbbreviationFLStateAbbreviationCd
ZIP33394ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN591837338EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SUSANNA WESLEY HEALTH CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSUSABusinessNameControlTxt
Phone3055563500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15345 WEST 18TH AVENUEAddressLine1Txt
CityHIALEAHCityNm
State AbbreviationFLStateAbbreviationCd
ZIP33012ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMADELYN SIMON LOZANOPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3055563500PhoneNum
Signature2022-03-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMADELYNPersonFirstNm
Person LastSIMON LOZANOPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHARRY E HARP CPAPreparerPersonNm
PTINP00176471PTIN
Phone9548478910PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMADELYN SIMON LOZANOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15345 WEST 18TH AVENUEAddressLine1Txt
CityHIALEAHCityNm
State AbbreviationFLStateAbbreviationCd
ZIP33012ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,304,995GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EPWORTHVILLAGERC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionPROVIDE ELDERLY AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES DESIGNED TO MEET THEIR NEEDS.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$500,000PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$1,274,052PYProgramServiceRevenueAmt
CY Program Service Revenue$1,304,052CYProgramServiceRevenueAmt
PY Investment Income$2,829PYInvestmentIncomeAmt
CY Investment Income$943CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,776,881PYTotalRevenueAmt
CY Total Revenue$1,304,995CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$40,000PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$40,000CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,162,949PYOtherExpensesAmt
CY Other Expenses$1,280,027CYOtherExpensesAmt
PY Total Expenses$1,202,949PYTotalExpensesAmt
CY Total Expenses$1,320,027CYTotalExpensesAmt
PY Revenues Less Expenses$573,932PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$15,032CYRevenuesLessExpensesAmt
Total Assets BOY$6,770,265TotalAssetsBOYAmt
Total Assets EOY$6,508,923TotalAssetsEOYAmt
Total Liabilities BOY$11,350,607TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,104,297TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$4,580,342NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$4,595,374NetAssetsOrFundBalancesEOYAmt
MissionTHE ORGANIZATION PROVIDES ELDERLY PERSONS AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES ESPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS THROUGH THE LEASE OF A SKILLED NURSING FACILITY TO ITS SUPPORTED 501(C)(3) TAX-EXEMPT AFFILIATE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,041,499ExpenseAmt
Revenue$1,304,052RevenueAmt
DescTHE ORGANIZATION LEASES A FACILITY USED AS A SKILLED CARE NURSING HOME FOR THE HOUSING AND CARE OF THE ELDERLY AND SUPPORTS THE LESSEE IN OPERATING THE FACILITY IN A CHARITABLE MANNER.Desc
Total Program Service Expenses$1,041,499TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHANTAL FALBYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3055563500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15345 WEST 18TH AVENUEAddressLine1Txt
CityHIALEAHCityNm
State AbbreviationFLStateAbbreviationCd
ZIP33012ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MADELYN SIMON LOZANO
EXECUTIVE DIRECTOR10.0030.00Yes (X)Yes (X)$0$0$0
BELINDA BACON
CHAIR5.0010.00Yes (X)Yes (X)$0$0$0
REV RUBEN VELASCO
VICE-CHAIR5.0010.00Yes (X)Yes (X)$0$0$0
GEORGE PEDLAR
SECRETARY/TREASURER5.0010.00Yes (X)Yes (X)$0$0$0
REV CYNTHIA WEEMS
DIRECTOR5.0010.00Yes (X)$0$0$0
REV DANILO QUEVEDO
DIRECTOR5.0010.00Yes (X)$0$0$0
JUDITH PIERRE-OKERSON
DIRECTOR5.0010.00Yes (X)$0$0$0
ROBERT LADNER
DIRECTOR5.0010.00Yes (X)$0$0$0
GERTRUDE STEWART
DIRECTOR5.0010.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
TURNER CONSTRUCTION COMPANY
7235 CORPORATE CENTER DRIVE SUITEMIAMIFL33126RENOVATION SERVICES$134,628
AIRSTRON INC
1559 SW 21 AVENUEFT LAUDERDALEFL33312MAINTENANCE SERVICES$110,028
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRENTAL INCOME FROM AFFILIATEDesc
Business531110BusinessCd
Total Revenue Column$1,304,052TotalRevenueColumnAmt
Related Or Exempt Func Income$1,304,052RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,304,052TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$943TotalRevenueColumnAmt
Exclusion$943ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,304,995TotalRevenueColumnAmt
Related Or Exempt Func Income$1,304,052RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$943ExclusionAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$40,000TotalAmt
Management And General$40,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$43,650TotalAmt
Management And General$43,650ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,150TotalAmt
Management And General$4,150ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,873TotalAmt
Management And General$2,873ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$150,950TotalAmt
Program Services$150,950ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$412,747TotalAmt
Program Services$412,747ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$421,201TotalAmt
Program Services$403,949ProgramServicesAmt
Management And General$17,252ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$244,456TotalAmt
Program Services$73,853ProgramServicesAmt
Management And General$170,603ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,320,027TotalAmt
Program Services$1,041,499ProgramServicesAmt
Management And General$278,528ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$100,092BOYAmt
EOY$364,016EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$196,515BOYAmt
EOY$139,226EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$13,351,948LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,243,899LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,316,030BOYAmt
EOY$5,108,049EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,157,628BOYAmt
EOY$897,632EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,770,265BOYAmt
EOY$6,508,923EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$46,190BOYAmt
EOY$54,826EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$11,190,386BOYAmt
EOY$10,988,494EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$114,031BOYAmt
EOY$60,977EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,350,607BOYAmt
EOY$11,104,297EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$4,580,342BOYAmt
EOY-$4,595,374EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$4,580,342BOYAmt
EOY-$4,595,374EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,770,265BOYAmt
EOY$6,508,923EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$15,032ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ALDERSGATE HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN161676092EIN
Organization Type10OrganizationTypeCd
Governing Document Listed0GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing Doc0ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

FieldValueIRS element (for citing)
Timely Provided DocumentsYes (1)TimelyProvidedDocumentsInd
Officers Close RelationshipYes (1)OfficersCloseRelationshipInd
Supported Org Voice InvestmentYes (1)SupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

FieldValueIRS element (for citing)
Activities TestYes (X)ActivitiesTestInd
Activities Further Exempt PrpsYes (1)ActivitiesFurtherExemptPrpsInd
Activities Engaged Org InvlmntYes (1)ActivitiesEngagedOrgInvlmntInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE A, PART I, LINE 12, COLUMN (VI)THE FILING ORGANIZATION SUPPORTS IT SUPPORTED ORGANIZATION THROUGH THE PROVISION AND LEASE TO ITS SUPPORTED ORGANIZATION OF LAND, BUILDINGS, AND PERSONAL PROPERTY THAT CONSTITUTES THE SKILLED NURSING FACILITY OPERATED BY ITS SUPPORTED ORGANIZATION. THE FILING ORGANIZATION AND ITS SUPPORTED ORGANIZATION ARE RELATED TAX-EXEMPT ORGANIZATIONS.
SCHEDULE A, PART IV, SECTION A, LINE 1THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION STATE THAT SUSANNA WESLEY HEALTH CENTER, INC. IS ORGANIZED TO PROVIDE ELDERLY PERSONS AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES ESPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS. IN ACCORDANCE WITH ITS CHARITABLE PURPOSE, THE FILING ORGANIZATION LEASES REAL AND PERSONAL PROPERTY THAT CONSTITUTES A SKILLED NURSING FACILITY TO ALDERSGATE HEALTHCARE, INC., A RELATED 501(C)(3) ORGANIZATION, THAT OPERATES THE FACILITY.
SCHEDULE A, PART IV, SECTION D, LINE 3THE FILING ORGANIZATION SUPPORTS ALDERSGATE HEALTHCARE, INC. (THE SUPPORTED ORGANIZATION). THE PRIMARY ACTIVITY OF THE FILING ORGANIZATION IS TO OWN REAL AND PERSONAL PROPERTY THAT CONSTITUTES A SKILLED NURSING FACILITY AND LEASE SUCH PROPERTY TO THE SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. THE SUPPORTED ORGANIZATION HAS A SIGNIFICANT VOICE IN DIRECTING THE USE OF THE FILING ORGANIZATION'S ASSETS THROUGH THE OVERLAP OF THE EXECUTIVE DIRECTOR AND CERTAIN BOARD MEMBERS THAT PARTICIPATE IN THE GOVERNANCE OF BOTH ORGANIZATIONS. AS PRESCRIBED IN THE LEASE AGREEMENT PERTAINING TO THE SKILLED NURSING FACILITY, THE FILING ORGANIZATION IS RESPONSIVE TO THE NEEDS OF ITS SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY.
SCHEDULE A, PART IV, SECTION E, LINE 2ATHE FILING ORGANIZATION SUPPORTS ALDERSGATE HEALTHCARE, INC. (THE SUPPORTED ORGANIZATION). THE SOLE ACTIVITY OF THE FILING ORGANIZATION IS THE LEASE OF REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY TO THE SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. THE ACTIVITY OF HOLDING TITLE TO AND LEASING THE SKILLED NURSING FACILITY TO THE SUPPORTED ORGANIZATION IS A DIRECT FURTHERANCE ACTIVITY AS THE FILING ORGANIZATION'S ASSETS ARE USED IN CARRYING OUT THE EXEMPT PURPOSE OF PROVIDING HOUSING AND SERVICES TO ELDERLY PERSONS AND HANDICAPPED PERSONS. PLEASE SEE OUR RESPONSE FOR SCHEDULE A, PART IV, SECTION D, QUESTION 3 REGARDING HOW THE FILING ORGANIZATION IS RESPONSIVE TO THE NEEDS AND DEMANDS OF THE SUPPORTED ORGANIZATION.
SCHEDULE A, PART IV, SECTION E, LINE 2BTHE ACTIVITY OF OWNING TITLE TO AND LEASING REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY TO ITS SUPPORTED ORGANIZATION IS AN ACTIVITY THAT, BUT FOR THE INVOLVEMENT OF THE FILING ORGANIZATION, THE SUPPORTED ORGANIZATION WOULD BE REQUIRED TO ENGAGE IN. WERE IT NOT FOR THE FILING ORGANIZATION, THE SUPPORTED ORGANIZATION WOULD EITHER BE REQUIRED TO PURCHASE THE REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY OR LEASE SUITABLE PROPERTY IN ORDER TO CONDUCT ITS BUSINESS OF OPERATING A SKILLED NURSING FACILITY AND PROVIDING THESE NECESSARY SERVICES TO THE COMMUNITY.

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$261,000OtherCostOrOtherBasisAmt
Book Value$261,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,128,148OtherCostOrOtherBasisAmt
Depreciation$6,516,533DepreciationAmt
Book Value$4,611,615BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,776,661OtherCostOrOtherBasisAmt
Depreciation$1,727,366DepreciationAmt
Book Value$49,295BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$186,139OtherCostOrOtherBasisAmt
Book Value$186,139BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,108,049TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescCAPITAL RESERVEDesc
Book Value$897,632BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$897,632TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$60,977Amt
FieldValueIRS element (for citing)
Total Liability$60,977TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,304,995TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$1,304,995RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,304,995TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,320,027TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$1,320,027ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,320,027TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES, AS IT IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MSL PUBLIC RELATIONS LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionENTITY MORE THAN 35% OWNED BY MADELYN SIMON LOZANO, EXECUTIVE DIRECTORRelationshipDescriptionTxt
Transaction$40,000TransactionAmt
TransactionINDEPENDENT CONTRACTOR COMPENSATIONTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR. A COPY OF THE FORM 990 IS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS BEFORE ITS FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE ANNUAL DISCLOSURE PROCESS AND PROHIBITS OFFICERS AND DIRECTORS FROM VOTING ON MATTERS WHERE ACTUAL CONFLICTS OF INTEREST EXIST.
FORM 990, PART VI, SECTION B, LINE 15ATHE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS COMPENSATED AS AN INDEPENDENT CONTRACTOR AS APPROVED BY THE BOARD OF DIRECTORS. SEE SCHEDULE L, PART IV FOR FURTHER INFORMATION.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2CTHE FINANCIAL COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGNT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
EPWORTH VILLAGE INC
5300 WEST 16TH AVENUEHIALEAHFL33012590589990FUND RAISING FOR RELATED TAX-EXEMPT ORGANIZATIONSFL501(C)(3)LINE 12B, IIN/A0
EPWORTH VILLAGE WEST INC
5300 WEST 16TH AVENUEHIALEAHFL33012591920293LEASE OF RETIREMENT LIVING FACILITY TO RELATED ORGANIZATIONFL501(C)(3)LINE 12C, III-FIN/A0
ALDERSGATE HEALTHCARE INC
5300 WEST 16TH AVENUEHIALEAHFL33012161676092OPERATES SKILLED NURSING FACILITYFL501(C)(3)LINE 10N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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