2022-05-13T16:51:00-05:00 2021-06-30 871438555 RYUN GIVENS & COMPANY PC 2900 100TH STREET SUITE 303 URBANDALE IA 50322 990 2020-07-01 421521198 ON WITH LIFE EXTENDED SERVICES LTD ONWI 5159651339 715 SW ANKENY RD ANKENY IA 50023 JEAN SHELTON SECRETARY 5159651339 2022-05-13 1 JEAN SHELTON 999009999 KATHY A FRENCH P02443093 5152253141 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JEAN SHELTON 715 SW ANKENY RD ANKENY IA 50023 5638047 0 X N/A X 2001 IA JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. 6 6 82 75 0 0 11967 818465 5004620 4807873 126 11709 0 0 5016713 5638047 0 0 0 0 3206828 3221414 0 0 0 1657843 1722234 4864671 4943648 152042 694399 1392627 1567844 1037602 518421 355025 1049423 JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. 0 0 3880075 4807873 PROVIDED 24-HOUR-DAY CARE IN A 32-BED SKILLED NURSING FACILITY TO INDIVIDUALS WHO HAVE EXPERIENCED TRAUMATIC BRAIN INJURY, STROKE, ANEURYSM OR OTHER BRAIN INJURY DIAGNOSES. 3880075 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 75 0 1 82 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X JEANETTE SHELTON 5152899600 715 SW ANKENY RD ANKENY IA 50023 ELI J WIRTZ PRESIDENT 0.40 X X 0 0 0 SYBIL FINKEN VICE PRESIDENT 0.40 X X 0 0 0 JEANETTE SHELTON CEO, TREASURER, AND SECY 2.00 40.00 X X 0 231739 17216 DIANA HOOGESTRAAT DIRECTOR 0.40 X 0 0 0 JOHN SNYDER DIRECTOR 0.40 X 0 0 0 KATHLEEN BENSON LARSON DIRECTOR 0.40 X 0 0 0 JAMES FOREMAN CFO 1.00 40.00 X 0 123906 4701 PATRICK STILWILL EXEC DIR OF PROGRAMS AND S 1.00 40.00 X 0 146601 5473 GARY WALTERS ANALYTICS DIRECTOR 1.00 40.00 X 0 117370 11367 0 619616 38757 0 0 1 0 MCKESSON MEDICAL 6555 STATE HWY 161 IRVING TX 75039 MEDICAL SUPPLIES 228115 GLENWOOD RESOURCE CENTER 711 S VINE ST GLENWOOD IA 51534 LEASE 215054 2 6731 811734 818465 MEDICARE/MEDICAID 623000 4809512 4809512 MISCELLANEOUS 623990 -1639 -1639 4807873 11709 11709 5638047 4807873 0 11709 X 2766610 2550121 216489 264115 236780 27335 190689 176383 14306 1006982 344738 662244 63734 63734 101648 96095 5553 24440 24440 31236 11565 19671 SUPPLIES 414778 400781 13997 OTHER 79416 39172 40244 4943648 3880075 1063573 0 45015 42940 662848 710968 86124 125311 921053 786802 152796 134251 445844 554374 1392627 1567844 326563 518421 711039 1037602 518421 X 355025 1049423 355025 1049423 1392627 1567844 694399 0 X 0 1 X 1 0 X 62000 4558 7803 7568 6730 88659 4435869 4744243 4694196 4905837 4807873 23588018 4497869 4748801 4701999 4913405 4814603 23676677 0 0 0 23676677 878 1481 3637 126 11709 17831 878 1481 3637 126 11709 17831 4498747 4750282 4705636 4913531 4826312 23694508 0.99920 0.99970 0.00080 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 921053 786802 134251 134251 INTERCOMPANY 554374 554374 X PART X, LINE 2: THE ORGANIZATION HAS ADOPTED THE ACCOUNTING STANDARD REGARDING "ACCOUNTING FOR UNCERTAIN TAX POSITIONS." THIS STANDARD PROVIDES DETAILED GUIDANCE FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, AND DISCLOSURE OF UNCERTAIN TAX POSITIONS RECOGNIZED IN THE ENTITY'S FINANCIAL STATEMENTS. IT REQUIRES AN ENTITY TO RECOGNIZE THE FINANCIAL STATEMENT BENEFIT OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THE ADOPTION OF THIS STANDARD HAD NO MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOW. X X X 0 0 0 0 0 0 0 0 0 JEANETTE SHELTON CEO, TREASURER, AND SECY 0 197936 0 26500 0 7303 0 8069 0 9147 0 248955 0 0 PATRICK STILWILL EXEC DIR OF PROGRAMS AND S 0 141350 0 750 0 4501 0 4933 0 540 0 152074 0 0 PART I, LINE 3 WAGES ARE COMPARED TO SALARIES PUBLISHED IN BUSINESS RECORD FOR SIMILAR POSITIONS. THE BOARD ALSO USES WAGE SURVEYS FROM IOWA WORKFORCE, IOWA HEALTH CARE ASSOCIATION, AND SIMILAR ASSOCIATIONS. THE EXECUTIVE COMMITTEE COMPLETES PERFORMANCE REVIEW REVIEWS AND THE FULL BOARD VOTES ON THE EXECUTIVE DIRECTOR'S SALARY. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF ON WITH LIFE EXTENDED SERVICES IS ON WITH LIFE, INC., AN IOWA CORPORATION ORGANIZED AS A 501(C)(3). FORM 990, PART VI, SECTION A, LINE 7A ON WITH LIFE, INC (SOLE MEMBER) WILL SEND ONE REPRESENTATIVE TO ATTEND ON WITH LIFE EXTENDED SERVICES MEETINGS WHENEVER A VOTE OR APPROVAL BY THE MEMBER IS REQUIRED. THE MEMBER REPRESENTATIVE WILL CAST THE VOTE ON BEHALF OF THE MEMBER BASED ON THE DECISION VOTED ON BY THE MEMBER'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B ON WITH LIFE, INC (SOLE MEMBER) WILL SEND ONE REPRESENTATIVE TO ATTEND ON WITH LIFE EXTENDED SERVICES MEETINGS WHENEVER A VOTE OR APPROVAL BY THE MEMBER IS REQUIRED. THE MEMBER REPRESENTATIVE WILL CAST THE VOTE ON BEHALF OF THE MEMBER BASED ON THE DECISION VOTED ON BY THE MEMBER'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B AN ELECTRONIC COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. ANY QUESTIONS AND CLARIFICATIONS ARE DIRECTED TO THE FINANCE COMMITTEE CHAIR. FORM 990, PART VI, SECTION B, LINE 12C EVERY BOARD MEETING BEGINS WITH A REVIEW OF THE AGENDA ITEMS, AND DIRECTORS ARE PROMPTED TO DISCLOSE ANY CONFLICTS OF INTEREST RELATED TO THOSE ITEMS. FORM 990, PART VI, SECTION C, LINE 19 THE ARTICLES OF INCORPORATION ARE PUBLISHED ON THE SECRETARY OF STATE WEBSITE. BYLAWS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. THE CONSOLIDATED FINANCIAL STATEMENT SUMMARY INCLUDED IN THE ANNUAL REPORT IS ON THE ORGANIZATION'S WEBSITE, AND THE 990 IS AVAILABLE ON GUIDESTAR. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 277,201. MANAGEMENT AND GENERAL EXPENSES 648,096. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 925,297. OTHER EMPLOYEE RELATED: PROGRAM SERVICE EXPENSES 67,537. MANAGEMENT AND GENERAL EXPENSES 14,148. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,685. ON WITH LIFE INC 715 SW ANKENY ROAD ANKENY IA 50023 421308032 PROVIDE SKILLED CARE AND REHAB SERVICES FOR INDIV LIVING WITH BRAIN INJURY IA 501(C)(3) LINE 10 0 ON WITH LIFE FOUNDATION 715 SW ANKENY ROAD ANKENY IA 50023 421399777 SUPPORT OWL AFFILIATES IN PROVIDING SERVICES TO IND LIVING W/BRAIN INJURY IA 501(C)(3) LINE 12B, II 0 ON WITH LIFE SUPPORTIVE HOUSING CORPORATION 715 SW ANKENY ROAD ANKENY IA 50023 460516882 SUBSIDIZED HOUSING FOR INDIVIDUALS WHO HAVE EXPERIENCED A BRAIN INJURY IA 501(C)(3) LINE 10 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 ON WITH LIFE FOUNDATION C 6731 ACTUAL