2022-11-01T15:24:16-05:00 2021-12-31 621657946 CANNON WRIGHT BLOUNT PLLC 756 RIDGE LAKE BLVD SUITE 100 MEMPHIS TN 38120 990 2021-01-01 620589737 THE KING'S DAUGHTERS AND SONS HOME KING 9012727405 3568 APPLING ROAD BARTLETT TN 38133 NICOLE WILES ADMINISTRATOR/EXECUTIVE DIRECTOR 9012727405 2022-11-01 1 NICOLE WILES 999009999 STEPHANIE L LIVINGSTON CPA P00235829 9016857500 2022-10-31 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z NICOLE WILES 3568 APPLING ROAD BARTLETT TN 38133 10359674 0 X N/A X BRANCH OF THE INTERNATIONAL ORDER OF KING'S DAUGHTERS AND SONS 1908 TN NURSING CARE 7 7 199 66 0 0 2954179 1099593 10030175 9249023 9503 11058 0 0 12993857 10359674 0 0 0 0 6198373 5745197 0 0 0 4992126 5046712 11190499 10791909 1803358 -432235 21272026 20930838 6086981 5736961 15185045 15193877 PROVIDE NURSING CARE TO THE SICK AND ELDERLY. 0 0 9238878 9249023 INTERMEDIATE AND SKILLED HEALTH AND NURSING CARE 108 LICENSED BEDS AVAILABLE 9238878 1 1 0 0 0 0 0 0 0 0 1 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 0 0 1 0 0 0 1 12 0 1 199 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 0 1 1 0 X NICOLE WILES 9012727405 3568 APPLING ROAD BARTLETT TN 38133 NICOLE WILES EXECUTIVE DIRECTOR 40.00 X X 136225 0 0 DELIA WAGES DIRECTOR 0.50 X 0 0 0 STELLA THOMASON DIRECTOR 0.50 X 0 0 0 BABS LUSK DIRECTOR 0.50 X 0 0 0 CAROLYN SKAGGS PRESIDENT 1.00 X X 0 0 0 JEAN BEDWELL TREASURER 0.50 X X 0 0 0 GAYLE TEMPLETON CORRESPONDING SECRETARY 0.50 X X 0 0 0 DEBRA BALL RECORDING SECRETARY 0.50 X X 0 0 0 JIMMY WILLIAMS LPN, INFECTION PREVENTIONIST 40.00 X 105900 0 0 MIA POTT OT, DIRECTOR OF REHABILITATION 40.00 X 102258 0 0 344383 0 0 3 0 0 0 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 CONTRACTED DIETARY, LAUNDRY AND HOUSEKEE 1333747 TWOMAGNETS INC (CLIPBOARD HEALTH) 340 S LEMON AVENUE 5028 WALNUT CA 91789 CONTRACT RNS, LPNS, CNAS 156742 2 267 480000 507298 112028 1099593 INTERMEDIATE & SKILLED NURSING HO 623000 9249023 9249023 9249023 9074 9074 1984 0 1984 1984 1984 10359674 9249023 0 11058 X 136225 123284 12941 4734945 4285988 448957 513299 464627 48672 360728 328954 31774 6268 6268 46581 46581 1944559 1895179 49380 146819 146819 576657 537322 39335 156002 145361 10641 324544 302805 21739 318186 296482 21704 SPECIAL LICENSE FEE 498827 498827 PATIENT ACTIVITIES 433374 433374 MEDICAL SUPPLIES 424715 255322 169393 BAD DEBTS 170180 170180 10791909 9238878 1553031 0 371946 392395 3141137 2815084 887946 747311 194443 156821 26335 20331 11060478 5670281 5717276 5390197 10821686 11306385 111257 102314 21272026 20930838 647759 754491 5163667 4869667 275555 112803 6086981 5736961 X 15047945 15034697 137100 159180 15185045 15193877 21272026 20930838 X -432235 -164420 605487 X 0 1 X 0 0 X 544381 581852 1111962 1553279 1099593 4891067 9612454 9906727 10373269 10030175 9249023 49171648 10156835 10488579 11485231 11583454 10348616 54062715 0 0 0 54062715 1278 1863 4096 9503 9074 25814 1278 1863 4096 9503 9074 25814 10158113 10490442 11489327 11592957 10357690 54088529 0.99950 0.99970 0.00050 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 469659 469659 8132389 3583607 4548782 2458430 2086674 371756 0 5390197 BENEFICIAL INTEREST IN KING'S DAUGHTERS AND SONS HOME FOUNDATION,INC. 10939608 F INVESTMENTS - HOME 366777 F 11306385 DERIVATIVE - INTEREST RATE SWAP 112803 112803 10794982 605488 605488 10189494 170180 170180 10359674 10621729 0 10621729 170180 170180 10791909 PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST IN HOME FOUNDATION 411,693. CHANGE IN VALUE OF INTEREST IN HOME INVESTMENTS 73,006. CHANGE IN VALUE OF DERIVATIVE FINANCIAL INSTRUMENT 120,789. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 170,180. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 170,180. A THE HEALTH EDUCATIONAL AND HOUSING FAC BD OF THE COUNTY OF SHELBY TENNESSEE 521283414 821697VH9 2003-06-05 8200000 CONSTRUCTION OF NURSING FACILITY 0 0 0 A 8200000 161000 64554 7974446 2004 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 1 1 REGIONS BANK 10.000000000000 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 6 THE KING'S DAUGHTERS AND SONS HOME IS UNDER THE AUSPICES OF THE TENNESSEE BRANCH OF THE INTERNATIONAL ORDER OF KING'S DAUGHTERS AND SONS. MEMBERSHIP IN THE INTERNATIONAL ORDER OF KING'S DAUGHTERS AND SONS IS AVAILABLE TO INDIVIDUALS DESIRING TO COMPLY WITH THE REQUIREMENTS OF THE ORDER AND SERVE ITS MISSION. MEMBERS ARE ORGANIZED IN CIRCLES AT A LOCAL LEVEL TO CARRY ON THE MISSION OF THE ORDER. FORM 990, PART VI, SECTION A, LINE 7A THE KING'S DAUGHTERS AND SONS HOME (THE HOME) IS UNDER THE AUSPICES OF THE TENNESSEE BRANCH OF THE INTERNATIONAL ORDER OF KING'S DAUGHTERS AND SONS. MEMBERSHIP IN THE INTERNATIONAL ORDER OF KING'S DAUGHTERS AND SONS IS AVAILABLE TO INDIVIDUALS DESIRING TO COMPLY WITH THE REQUIREMENTS OF THE ORDER AND SERVE ITS MISSION. MEMBERS ARE ORGANIZED IN CIRCLES AT A LOCAL LEVEL TO CARRY ON THE MISSION OF THE ORDER. MEMBERS OF THE LOCAL CIRCLES ELECT THE BOARD OF DIRECTORS (THE GOVERNING BODY) OF THE HOME. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF THE KING'S DAUGHTERS AND SONS HOME AND ANY CHANGES AND/OR AMENDMENTS MUST BE APPROVED BY THE MEMBERS FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND IS REVIEWED BY THE EXECUTIVE DIRECTOR BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C BYLAWS AND ANY CHANGES AND AMENDMENTS WHICH REFERENCE THESE ISSUES ARE PROVIDED TO ALL MEMBERS. WRITTEN CORPORATE COMPLIANCE PROGRAM PLANS WHICH REFERENCE THESE ISSUES ARE PROVIDED TO EMPLOYEES. AN EMPLOYEE ATTESTATION STATEMENT IS SIGNED BY THE EMPLOYEE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS MEET EVERY MONTH TO REVIEW OPERATIONAL AND FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,895,179. MANAGEMENT AND GENERAL EXPENSES 49,380. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,944,559. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST IN HOME FOUNDATION 411,692. CHANGE IN VALUE OF INTEREST IN HOME INVESTMENTS 73,006. CHANGE IN VALUE OF DERIVATIVE FINANCIAL INSTRUMENT 120,789. THE KING'S DAUGHTERS AND SONS HOME FOUNDATION INC 3568 APPLING ROAD BARTLETT TN 38133 621818785 SUPPORTING ORGANIZATION TN 501(C)(3) LINE 12D, III-O N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 THE KING'S DAUGHTERS AND SONS HOME FOUNDATION INC C 480000