PACE NEBRASKA: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PACE NEBRASKA (EIN 27-3635416)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-04-20
- IRS object ID
- 202231109349300903
- 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 | 2022-04-20T08:18:28-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 476097913 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEIM JOHNSON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT STREET SUITE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273635416 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PACE NEBRASKA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PACE | BusinessNameControlTxt |
| Phone | 4028292900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1044 NORTH 115TH STREET NO 500 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68154 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT BEAR | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 4028292900 | PhoneNum |
| Signature | 2022-04-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SCOTT | PersonFirstNm |
| Person Last | BEAR | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY R COOLEY | PreparerPersonNm |
| PTIN | P01523804 | PTIN |
| Phone | 4023302660 | 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 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IMMANUEL PATHWAYS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SCOTT BEAR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1044 NORTH 115TH STREET NO 500 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68154 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,840,358 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IMMANUEL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE IN-HOME, RESIDENTIAL AND COMMUNITY-BASED HEALTH CARE AND RELATED SERVICES TO THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 37 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,100 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,833,091 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,827,168 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$3,781 | PYInvestmentIncomeAmt |
| CY Investment Income | -$3,538 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $20,829,310 | PYTotalRevenueAmt |
| CY Total Revenue | $21,836,730 | 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 | $5,050,566 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,913,108 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,394,913 | PYOtherExpensesAmt |
| CY Other Expenses | $16,013,838 | CYOtherExpensesAmt |
| PY Total Expenses | $19,445,479 | PYTotalExpensesAmt |
| CY Total Expenses | $20,926,946 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,383,831 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $909,784 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,441,325 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,312,717 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,915,676 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,877,284 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,525,649 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,435,433 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CHRIST-CENTERED SERVICE TO SENIORS, EACH OTHER AND THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,971,062 | ExpenseAmt |
| Revenue | $21,827,168 | RevenueAmt |
| Desc | "PACE" STANDS FOR PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY. PACE PROGRAMS COORDINATE AND PROVIDE ALL NEEDED PREVENTIVE, PRIMARY, ACUTE AND LONG-TERM CARE SERVICES SO THAT OLDER INDIVIDUALS CAN CONTINUE LIVING IN THEIR HOMES AND COMMUNITIES. | Desc |
| Total Program Service Expenses | $18,971,062 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 84 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 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 | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KELLE SCOTT CONTROLLER | PersonNm |
| Phone | 4028292933 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1044 NORTH 115TH STREET SUITE 500 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68154 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JANE TONNIGES | ||||||||
| CHAIR | 0.30 | 2.80 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CINDY ALLOWAY | ||||||||
| VICE CHAIR | 0.30 | 2.80 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CLARENCE NICHOLS | ||||||||
| SECRETARY/TREASURER | 0.30 | 2.80 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GEORGE GRIEB | ||||||||
| MEMBER | 0.30 | 2.80 | Yes (X) | $0 | $0 | $0 | ||
| BRUCE PLATH | ||||||||
| MEMBER | 0.30 | 2.80 | Yes (X) | $0 | $0 | $0 | ||
| BISHOP BRIAN MAAS | ||||||||
| MEMBER | 0.30 | 3.10 | Yes (X) | $0 | $0 | $0 | ||
| DELIGHT WREED BYRD | ||||||||
| MEMBER | 0.30 | 3.10 | Yes (X) | $0 | $0 | $0 | ||
| REV E JON BENSON | ||||||||
| MEMBER | 0.30 | 2.80 | Yes (X) | $0 | $0 | $0 | ||
| KRISTEN HOFFMAN MD | ||||||||
| MEMBER | 0.30 | 3.10 | Yes (X) | $0 | $0 | $0 | ||
| RANDAL BURNS | ||||||||
| MEMBER | 0.30 | 3.10 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT HOWERTER | ||||||||
| MEMBER | 0.30 | 2.80 | Yes (X) | $0 | $0 | $0 | ||
| JILL POWERS | ||||||||
| MEMBER | 0.30 | 3.40 | Yes (X) | $0 | $0 | $0 | ||
| ANDREA SKOLKIN | ||||||||
| MEMBER | 0.30 | 2.80 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN OGBORN | ||||||||
| MEMBER | 0.30 | 2.80 | Yes (X) | $0 | $0 | $0 | ||
| STEVEN BULLOCK | ||||||||
| MEMBER | 0.30 | 2.80 | Yes (X) | $0 | $0 | $0 | ||
| DAN FRIEDLUND | ||||||||
| MEMBER | 0.30 | 3.10 | Yes (X) | $0 | $0 | $0 | ||
| ERIC N GURLEY | ||||||||
| PRESIDENT & CEO | 2.00 | 46.00 | Yes (X) | $0 | $531,151 | $230,812 | ||
| JULIE PALADINO-KAMINSKI | ||||||||
| SENIOR VP/COO | 6.00 | 42.00 | Yes (X) | $0 | $259,681 | $30,473 | ||
| SCOTT BEAR | ||||||||
| VP & CFO | 3.00 | 45.00 | Yes (X) | $0 | $242,758 | $57,880 | ||
| TAMMY SEALER | ||||||||
| SENIOR VP/CAO | 2.00 | 46.00 | Yes (X) | $0 | $257,477 | $28,292 | ||
| ADAM VOSSEN MD | ||||||||
| PHYSICIAN | 14.00 | 34.00 | $0 | $307,060 | $37,711 | Yes (X) | ||
| MARIA CHONG-RAMASUTE MD | ||||||||
| PHYSICIAN | 20.00 | 20.00 | $0 | $221,843 | $57,007 | Yes (X) | ||
| RHONDA DISTEFANO | ||||||||
| VP OF CONSTRUCTION, FACILITIES MGMT | 2.00 | 46.00 | $0 | $196,606 | $17,095 | Yes (X) | ||
| JENNIFER KNECHT | ||||||||
| VP OF MARKETING AND COMMUNICATIONS | 2.00 | 46.00 | $0 | $193,103 | $12,875 | Yes (X) | ||
| DEVIN FOX MD | ||||||||
| MEDICAL DIRECTOR | 4.00 | 44.00 | $0 | $261,436 | $5,851 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,471,115 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $477,996 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FLORENCE HOME FOR THE AGED | |||||
| 7915 N 30TH ST | OMAHA | NE | 68112 | MEDICAL SERVICES | $2,013,068 |
| CHI HEALTH IMMANUEL | |||||
| PO BOX 776215 | CHICAGO | IL | 606776215 | MEDICAL SERVICES | $998,238 |
| MAPLE CREST HEALTH CENTER | |||||
| 2824 N 66TH AVE | OMAHA | NE | 68104 | MEDICAL SERVICES | $536,338 |
| SOUTHVIEW HEIGHTS | |||||
| 5110 SOUTH 49TH ST | OMAHA | NE | 68117 | MEDICAL SERVICES | $270,403 |
| VISITING NURSE HEALTH SERVICES | |||||
| 12565 W CENTER ROAD SUITE 100 | OMAHA | NE | 68144 | HOME SERVICES | $265,801 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $13,100 | GovernmentGrantsAmt |
| Total Contributions | $13,100 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 623000 | $10,908,125 | $10,908,125 |
| MEDICARE | 623000 | $10,036,918 | $10,036,918 |
| SENIOR SERVICE | 623000 | $882,125 | $882,125 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,827,168 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90 | TotalRevenueColumnAmt |
| Exclusion | $90 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,628 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$3,628 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,628 | TotalRevenueColumnAmt |
| Exclusion | -$3,628 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,836,730 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,827,168 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$3,538 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,920,835 | TotalAmt |
| Program Services | $3,556,973 | ProgramServicesAmt |
| Management And General | $363,862 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,530 | TotalAmt |
| Program Services | $135,913 | ProgramServicesAmt |
| Management And General | $12,617 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $568,815 | TotalAmt |
| Program Services | $507,305 | ProgramServicesAmt |
| Management And General | $61,510 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,928 | TotalAmt |
| Program Services | $252,015 | ProgramServicesAmt |
| Management And General | $22,913 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,091,579 | TotalAmt |
| Management And General | $1,091,579 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,876 | TotalAmt |
| Management And General | $18,876 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $990,137 | TotalAmt |
| Program Services | $802,128 | ProgramServicesAmt |
| Management And General | $188,009 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,639 | TotalAmt |
| Program Services | $11,639 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,719 | TotalAmt |
| Program Services | $123,498 | ProgramServicesAmt |
| Management And General | $33,221 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,751 | TotalAmt |
| Management And General | $2,751 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,954 | TotalAmt |
| Program Services | $163,954 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,568 | TotalAmt |
| Program Services | $208,949 | ProgramServicesAmt |
| Management And General | $619 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $471,236 | TotalAmt |
| Program Services | $471,236 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,778 | TotalAmt |
| Program Services | $73,576 | ProgramServicesAmt |
| Management And General | $18,202 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SERVICES | $12,080,033 | $12,080,033 | |
| MEDICAL SUPPLIES | $354,468 | $354,468 | |
| COVID-19 RELATED EXPENS | $195,553 | $116,039 | $79,514 |
| FOOD | $116,707 | $109,545 | $7,162 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,840 | TotalAmt |
| Program Services | $3,791 | ProgramServicesAmt |
| Management And General | $55,049 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,926,946 | TotalAmt |
| Program Services | $18,971,062 | ProgramServicesAmt |
| Management And General | $1,955,884 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,209 | BOYAmt |
| EOY | $150,387 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,416 | BOYAmt |
| EOY | $297,490 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,468 | BOYAmt |
| EOY | $11,815 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,533,927 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,560,463 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,369,597 | BOYAmt |
| EOY | $973,464 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,440,635 | BOYAmt |
| EOY | $4,879,561 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,441,325 | BOYAmt |
| EOY | $6,312,717 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,620,576 | BOYAmt |
| EOY | $1,877,284 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,100 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,915,676 | BOYAmt |
| EOY | $1,877,284 | 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 | $3,525,649 | BOYAmt |
| EOY | $4,435,433 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,525,649 | BOYAmt |
| EOY | $4,435,433 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,441,325 | BOYAmt |
| EOY | $6,312,717 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $909,784 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $13,100 | CurrentTaxYearAmt |
| Total | $13,100 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,709,707 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,910,171 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,813,048 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,833,091 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,827,168 | CurrentTaxYearAmt |
| Total | $92,093,185 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,709,707 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,910,171 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,813,048 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,833,091 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,840,268 | CurrentTaxYearAmt |
| Total | $92,106,285 | 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 | $92,106,285 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $421 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $527 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $519 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $448 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $90 | CurrentTaxYearAmt |
| Total | $2,005 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $421 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $527 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $519 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $448 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $90 | CurrentTaxYearAmt |
| Total | $2,005 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,710,128 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,910,698 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,813,567 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,833,539 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,840,358 | CurrentTaxYearAmt |
| Total | $92,108,290 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,296,005 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,847,712 | DepreciationAmt |
| Book Value | $448,293 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,180,585 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,684,465 | DepreciationAmt |
| Book Value | $496,120 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,337 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,286 | DepreciationAmt |
| Book Value | $29,051 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $973,464 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM IMMANUEL HOME AND COMMUNITY RESOURCES | $4,816,761 |
| THIRD PARTY PAYOR SETTLEMENTS | $62,800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,879,561 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,835,026 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,835,026 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,704 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,704 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,836,730 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,925,242 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,925,242 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,704 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,704 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,926,946 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE COMPANY IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. THE COMPANY ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE COMPANY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2021, THE COMPANY HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,704. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,704. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ERIC N GURLEY | ||||||||||||||
| PRESIDENT & CEO | $0 | $418,187 | $0 | $100,517 | $0 | $12,447 | $0 | $210,078 | $0 | $20,734 | $0 | $761,963 | $0 | $0 |
| ADAM VOSSEN MD | ||||||||||||||
| PHYSICIAN | $0 | $306,657 | $0 | $77 | $0 | $326 | $0 | $18,196 | $0 | $19,515 | $0 | $344,771 | $0 | $0 |
| SCOTT BEAR | ||||||||||||||
| VP & CFO | $0 | $188,644 | $0 | $46,734 | $0 | $7,380 | $0 | $13,300 | $0 | $44,580 | $0 | $300,638 | $0 | $0 |
| JULIE PALADINO-KAMINSKI | ||||||||||||||
| SENIOR VP/COO | $0 | $200,901 | $0 | $51,134 | $0 | $7,646 | $0 | $15,740 | $0 | $14,733 | $0 | $290,154 | $0 | $0 |
| TAMMY SEALER | ||||||||||||||
| SENIOR VP/CAO | $0 | $200,947 | $0 | $48,887 | $0 | $7,643 | $0 | $15,529 | $0 | $12,763 | $0 | $285,769 | $0 | $0 |
| MARIA CHONG-RAMASUTE MD | ||||||||||||||
| PHYSICIAN | $0 | $219,598 | $0 | $1,750 | $0 | $495 | $0 | $13,738 | $0 | $43,269 | $0 | $278,850 | $0 | $0 |
| DEVIN FOX MD | ||||||||||||||
| MEDICAL DIRECTOR | $0 | $241,092 | $0 | $20,000 | $0 | $344 | $0 | $0 | $0 | $5,851 | $0 | $267,287 | $0 | $0 |
| RHONDA DISTEFANO | ||||||||||||||
| VP OF CONSTRUCTION, FACILITIES MGMT | $0 | $162,321 | $0 | $33,358 | $0 | $927 | $0 | $10,951 | $0 | $6,144 | $0 | $213,701 | $0 | $0 |
| JENNIFER KNECHT | ||||||||||||||
| VP OF MARKETING AND COMMUNICATIONS | $0 | $158,795 | $0 | $34,177 | $0 | $131 | $0 | $11,554 | $0 | $1,321 | $0 | $205,978 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE COMPENSATED OFFICERS ARE EMPLOYEES OF IMMANUEL, A RELATED ENTITY. THE BOARD'S EXECUTIVE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE TO REVIEW AND APPROVE THE TOTAL COMPENSATION FOR ERIC GURLEY, AND TO APPROVE THE BONUS PLAN AND PAYOUT OF BONUSES TO THE LEADERSHIP TEAM. THE COMPENSATION COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP SET SALARIES AND BENEFITS. A WRITTEN EMPLOYMENT CONTRACT IS USED FOR ERIC GURLEY. |
| PART I, LINE 4B | ERIC N. GURLEY, PRESIDENT AND CEO, IS A PARTICIPANT IN AN ENDORSEMENT SPLIT-DOLLAR LIFE INSURANCE PLAN AND A DEFERRED COMPENSATION PLAN WHICH IS INTENDED TO MEET THE REQUIREMENTS OF SECTIONS 409A AND 457(F). BOTH PLANS ARE SPONSORED BY IMMANUEL, MR. GURLEY'S EMPLOYER. AS OF DECEMBER 31, 2020, MR. GURLEY'S DEFERRED COMPENSATION ACCOUNT WAS CREDITED WITH $188,528. PREMIUMS OF $157,474 WERE PAID FOR THE ENDORSEMENT SPLIT-DOLLAR LIFE INSURANCE PLAN POLICY. UNDER THE PLAN, IMMANUEL ENDORSES TO MR. GURLEY THE RIGHT TO DESIGNATE A BENEFICIARY FOR THE PORTION OF THE DEATH BENEFIT IN EXCESS OF THE GREATER OF THE CASH SURRENDER VALUE OR PREMIUMS PAID. THE VALUE OF THAT RIGHT, WHICH WAS INCLUDED IN MR. GURLEY'S REPORTABLE COMPENSATION, WAS $3,441. AS OF JUNE 30, 2021, THE DEATH BENEFIT IN EXCESS OF PREMIUMS PAID WAS $2,840,477. |
| PART I, LINE 6 | THE ORGANIZATION DOES NOT PAY OR ACCRUE ANY COMPENSATION BASED ON THE REVENUES OR THE NET EARNINGS OF THE ORGANIZATION OR ANY RELATED ORGANIZATION. HOWEVER, A SMALL PERCENTAGE (LESS THAN 10%) OF THE BONUSES PAID TO ERIC GURLEY, ADAM VOSSEN, M.D., SCOTT BEAR, JULIE PALADINO-KAMINSKI, TAMMY SEALER, MARIA CHONG-RAMASUTE, M.D., DEVIN FOX, M.D., RHONDA DISTEFANO AND JENNIFER KNECHT IS BASED ON AN OPERATING MARGIN CALCULATION OF IMMANUEL AND RELATED TAX-EXEMPT ORGANIZATIONS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 2A: | INDIVIDUALS PERFORMING SERVICES FOR PACE NEBRASKA ARE EMPLOYEES OF IMMANUEL, A RELATED ENTITY. THEREFORE, IMMANUEL ISSUES THE FORM W-2 FOR THESE EMPLOYEES. BECAUSE PACE NEBRASKA REIMBURSES IMMANUEL FOR THE SALARIES AND BENEFITS OF THESE EMPLOYEES, THE EXPENSES FOR THEIR SALARIES AND BENEFITS ARE REFLECTED ON THIS RETURN IN PART IX, STATEMENT OF FUNCTIONAL EXPENSES. |
| FORM 990, PART VI, SECTION A, LINE 2 | ERIC N. GURLEY IS THE PRESIDENT AND CEO OF IMMANUEL, A SUPPORTING ORGANIZATION OF IMMANUEL HOME AND COMMUNITY RESOURCES, THE SOLE MEMBER OF PACE NEBRASKA. ALL COMPENSATED BOARD MEMBERS, OFFICERS AND EMPLOYEES ARE EMPLOYEES OF IMMANUEL. |
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT SERVICES ARE PROVIDED BY IMMANUEL HOME & COMMUNITY RESOURCES, THE ORGANIZATION'S SOLE MEMBER. MANAGEMENT AND DEVELOPMENT FEES ARE PAID TO IMMANUEL HOME & COMMUNITY RESOURCES BASED ON CONTRACTUAL AGREEMENT. |
| FORM 990, PART VI, SECTION A, LINE 6 | PACE NEBRASKA HAS ONE MEMBER, IMMANUEL HOME AND COMMUNITY RESOURCES. |
| FORM 990, PART VI, SECTION A, LINE 7A | IMMANUEL HOME AND COMMUNITY RESOURCES, PACE NEBRASKA'S SOLE MEMBER, HAS THE RIGHT TO APPOINT AND REMOVE DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | IMMANUEL HOME AND COMMUNITY RESOURCES, PACE NEBRASKA'S SOLE MEMBER, MUST APPROVE ANY AMENDMENT AND INITIATE OR ADOPT AMENDMENTS TO THE ARTICLES OR BYLAWS OF PACE NEBRASKA. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM WITH THE ASSISTANCE OF THE CONTROLLER, AND IS THEN REVIEWED BY THE CFO AND THE CONTROLLER. COPIES OF THE REVIEWED RETURN ARE PROVIDED TO THE BOARD MEMBERS PRIOR TO FILING WITH IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | PACE NEBRASKA USES THE SAME POLICY AS IMMANUEL, A RELATED ORGANIZATION. THE POLICY STATES THAT THE BOARD OF DIRECTORS MUST SIGN THE CONFLICT OF INTEREST POLICY AND DISCLOSE ALL CONFLICTS ANNUALLY. THE GOVERNANCE COMMITTEE SHALL DECIDE WHAT ACTIONS NEED TO BE TAKEN CONCERNING ANY CONFLICTS. THE BOARD MEMBER IS PROHIBITED FROM VOTING ON ANY BUSINESS RELATED TO ANY CONFLICT THE GOVERNANCE COMMITTEE HAS IDENTIFIED. |
| FORM 990, PART VI, SECTION B, LINE 15 | PACE NEBRASKA DOES NOT HAVE A CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL OR ANY KEY EMPLOYEES THAT THE ORGANIZATION DIRECTLY COMPENSATES. THE ORGANIZATION REIMBURSES IMMANUEL, A RELATED ORGANIZATION, FOR PORTIONS OF THE SALARIES OF IMMANUEL EMPLOYEES WHO PROVIDE NEEDED SERVICES. THEREFORE, IT IS NOT NECESSARY TO HAVE A PROCESS TO DETERMINE COMPENSATION FOR THESE POSITIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | PACE NEBRASKA DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VII: | ALL COMPENSATION AND BENEFITS SHOWN FOR DIRECTORS ARE PAID BY IMMANUEL, THE SPONSOR ORGANIZATION, FOR SERVICES PERFORMED FOR IMMANUEL OR OTHER RELATED ENTITIES. THE COMPENSATION IS NOT PAID FOR SERVICES IN CONNECTION WITH THE POSITION OF DIRECTOR FOR PACE NEBRASKA. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS OF PACE NEBRASKA ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| IMMANUEL | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 470733774 | CORPORATE SUPPORT | NE | 501(C)(3) | LINE 12B, II | N/A | 0 | |
| IMMANUEL RETIREMENT COMMUNITIES | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 470799108 | ELDERLY HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL | |
| IMMANUEL COMMUNITY FOUNDATION | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 470624928 | FUNDRAISING | NE | 501(C)(3) | LINE 12C, III-FI | Yes (1) | SEE STATEMENT | |
| IMMANUEL HOME AND COMMUNITY RESOURCES | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 272628802 | ELDERLY SERVICES | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL | |
| PACE IOWA | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 273635343 | ELDERLY SERVICES | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL HOME & COMMUNITY RESOURCES | |
| IMMANUEL AFFORDABLE INC | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 470831041 | ELDERLY & LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL | |
| IMMANUEL AFFORDABLE II INC | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 800016829 | ELDERLY & LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL | |
| IMMANUEL TRINITY AFFORDABLE INC | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 113742894 | ELDERLY & LOW INCOME HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL | |
| IMMANUEL LONG TERM CARE | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 462582783 | LONG-TERM HEALTH CARE SERVICES | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL | |
| IMMANUEL COMMUNITY VISION FOUNDATION | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 462693844 | SUPPORT NONPROFITS WHOSE MISSIONS ALIGN WITH IMMANUEL | NE | 501(C)(3) | LINE 12B, II | Yes (1) | IMMANUEL | |
| IRC II INC | |||||||||||
| 1044 NORTH 115TH STREET SUITE 500 | OMAHA | NE | 68154 | 812697102 | ELDERLY HOUSING | NE | 501(C)(3) | LINE 10 | Yes (1) | IMMANUEL | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE R, PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS | IMMANUEL COMMUNITY FOUNDATION'S DIRECTORS ARE SELECTED BY THE BOARDS OF DIRECTORS OF THE FOUR ORGANIZATIONS IT SUPPORTS; IMMANUEL RETIREMENT COMMUNITIES, IMMANUEL HOME AND COMMUNITY RESOURCES, IMMANUEL LONG TERM CARE, AND IRC II, INC. EACH OF THESE FOUR ORGANIZATIONS IS CONTROLLED BY THEIR SOLE MEMBER, IMMANUEL. |
| SCHEDULE R, PART V, LINE 1A-S: | IMMANUEL, A RELATED ENTITY, PAYS INVOICES FOR OPERATING EXPENSES ON BEHALF OF THE CORPORATION AND THE CORPORATION REIMBURSES IMMANUEL FOR AMOUNTS INCURRED. MOST, IF NOT ALL, INTERCOMPANY TRANSACTIONS ARE A RESULT OF THIS CENTRALIZED ACCOUNTING SYSTEM. |
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