ASHLEY HOUSE: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ASHLEY HOUSE (EIN 94-3080307)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202203159349306005
- Schema version
- 2021v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T14:33:00-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911623649 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON STONE & PAGANO PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1501 REGENTS BLVD SUITE 100 | AddressLine1Txt |
| City | FIRCREST | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98466 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 943080307 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLEY HOUSE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ASHL | BusinessNameControlTxt |
| Phone | 2535339050 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 33811 9TH AVE S | AddressLine1Txt |
| City | FEDERAL WAY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98003 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN L FREEBORN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 2535339050 | PhoneNum |
| Signature | 2022-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEPHEN | PersonFirstNm |
| Person Last | FREEBORN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CORA P THORDARSON | PreparerPersonNm |
| PTIN | P01332199 | PTIN |
| Phone | 2535667070 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHEN L FREEBORN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 33811 9TH AVE S | AddressLine1Txt |
| City | FEDERAL WAY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98003 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,161,851 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AH-NW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | ASHLEY HOUSE PROVIDES COMPREHENSIVE, COST EFFECTIVE, QUALITY CARE TO MEDICALLY FRAGILE CHILDREN AND YOUNG ADULTS IN A HOME-LIKE SETTING. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 177 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $346,287 | PYContributionsGrantsAmt |
| CY Contributions Grants | $224,805 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,158,182 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,631,259 | CYProgramServiceRevenueAmt |
| PY Investment Income | $105,335 | PYInvestmentIncomeAmt |
| CY Investment Income | $318,104 | CYInvestmentIncomeAmt |
| PY Other Revenue | $36,289 | PYOtherRevenueAmt |
| CY Other Revenue | $11,276 | CYOtherRevenueAmt |
| PY Total Revenue | $9,646,093 | PYTotalRevenueAmt |
| CY Total Revenue | $10,185,444 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $185,898 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $135,218 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,653,867 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,144,060 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $795,408 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,246,048 | PYOtherExpensesAmt |
| CY Other Expenses | $1,787,216 | CYOtherExpensesAmt |
| PY Total Expenses | $9,085,813 | PYTotalExpensesAmt |
| CY Total Expenses | $10,066,494 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $560,280 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $118,950 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,301,517 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,832,773 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,164,145 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,555,612 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,137,372 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,277,161 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE ARE DEDICATED TO PROVIDING EDUCATION TO FAMILIES AND CAREGIVERS, BUILDING SUPPORT SYSTEMS, COORDINATING SERVICES AND NURTURING THE DEVELOPMENT OF EACH INDIVIDUAL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,662,414 | ExpenseAmt |
| Grant | $135,218 | GrantAmt |
| Revenue | $7,416,721 | RevenueAmt |
| Desc | ASHLEY HOUSE PROVIDED TRANSITIONAL NURSING CARE SERVICES, HOSPICE SERVICES, CASE MANAGEMENT AND SOCIAL SERVICES TO 27 MEDICALLY FRAGILE CHILDREN IN 2021. FREE SERVICES WERE PROVIDED TO NEEDY CHILDREN IN 2021 VALUED AT APPROXIMATELY $135,218. ASHLEY HOUSE PROVIDES THESE SERVICES IN FIVE GROUP HOMES, IN FAMILY-LIKE SETTINGS. THE HOMES ARE STAFFED 24 HOURS A DAY WITH NURSES AND CNA'S. ADDITIONAL STAFF ARE UTILIZED TO TAKE CHILDREN TO MEDICAL APPOINTMENTS, AND ON OUTINGS. OUR SPECIFIC OBJECTIVE IS TO ENABLE CHILDREN TO BE RETURNED TO THEIR OWN HOME, OR TO SEEK ADOPTION OR FOSTER CARE. HENCE, WE ARE A SETTING FOR TRANSITIONAL CARE UNTIL PERMANENCY IS OBTAINED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,975,903 | ExpenseAmt |
| Revenue | $2,225,814 | RevenueAmt |
| Desc | ASHLEY HOUSE YOUNG ADULT RESIDENTIAL GROUP HOME ACCEPTS UP TO 6 YOUNG ADULTS (18-30 YEARS OLD) WITH MEDICAL COMPLEXITY TO LIVE IN A HOME-LIKE SETTING (SHORT OR LONG TERM). THESE MEDICALLY FRAGILE YOUNG ADULTS ARE OFTEN INDIVIDUALS WITH COMPLICATED MEDICAL HISTORIES, SUCH AS ORGAN TRANSPLANTATION, VENTILATOR DEPENDENCY OR TRAUMATIC BRAIN INJURY AND EXPERIENCE LENGTHY HOSPITALIZATIONS, NEED SPECIALIZED CAREGIVER TRAINING, AND HAVE EQUIPMENT OR NURSING NEEDS THAT MAY EXCEED WHAT CAN BE PROVIDED IN THEIR FAMILY HOMES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,638,317 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 177 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEN MAAZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2535339050 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 33811 9TH AVE S | AddressLine1Txt |
| City | FEDERAL WAY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98003 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| TOM VERTETIS | |||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN L FREEBORN | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CINDY GRADY | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DAN BOGART | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KAREN QUANDT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BETH KAUKL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIE FOLEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KEN MAAZ | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $169,988 | $0 | $12,176 | Yes (X) | ||
| ERICA PERNELA | |||||||
| DIRECTOR OF CLINICAL SERVI | 40.00 | $132,326 | $0 | $18,852 | Yes (X) | ||
| MARK SCHINDLER | |||||||
| DIRECTOR OF HUMAN RESOURCE | 40.00 | $124,054 | $0 | $18,428 | Yes (X) | ||
| SARA EDWARDS | |||||||
| CONTROLLER | 40.00 | $109,378 | $0 | $17,694 | Yes (X) | ||
| MICHAELA GOULD | |||||||
| DEVELOPEMENT LIASON | 40.00 | $149,932 | $0 | $19,513 | Yes (X) | ||
| MICHAEL PUGSLEY | |||||||
| DIRECTOR OF DEVELOPMENT | 40.00 | $144,056 | $0 | $19,476 | Yes (X) | ||
| KRISTINE SPENCER | |||||||
| LPN | 40.00 | $104,980 | $0 | $15,395 | Yes (X) | ||
| CAROL JACKSON | |||||||
| REGISTERED NURSE | 40.00 | $100,465 | $0 | $14,999 | Yes (X) | ||
| JENIFFER STONE | |||||||
| REGISTERED NURSE | 40.00 | $102,148 | $0 | $14,702 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,137,327 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $151,235 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | 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 |
|---|---|---|---|---|---|
| SQUARE PEG CONSTRUCTION LLC | |||||
| PO BOX 77570 | SEATTLE | WA | 98177 | CONTRACTOR FOR NEW SHORELINE BUILDING | $1,935,962 |
| KUKULU LLC | |||||
| 812 E MAIN ST SUITE 201 | PUYALLUP | WA | 98372 | CONTRACTOR FOR REMODELING OLYMPIA HOUSE | $363,743 |
| CROWN BUILDING CO | |||||
| 705 10TH AVE | MILTON | WA | 98354 | CONTRACTOR FOR REMODELING BROWNS POINT H | $297,355 |
| SWINERTON BUILDERS | |||||
| 2001 CLAYTON ROAD 7TH FL | CONCORD | CA | 94520 | CONTRACTOR FOR REMODELING SPOKANE HOUSE | $251,858 |
| TURK SCHACHLE | |||||
| 6605 86TH ST CT NW | GIG HARBOR | WA | 98332 | INTEREST PAYMENTS ON SHORT TERM LOAN | $126,875 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $224,805 | AllOtherContributionsAmt |
| Noncash Contributions | $120,418 | NoncashContributionsAmt |
| Total Contributions | $224,805 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INSURANCE | 623000 | $5,530,665 | $5,530,665 |
| MEDICAID: STATE FEE FOR SERVICE P | 623000 | $4,100,594 | $4,100,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,631,259 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,750 | TotalRevenueColumnAmt |
| Exclusion | $44,750 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,248,761 | SecuritiesAmt |
| Other | $1,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $976,407 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $272,354 | SecuritiesAmt |
| Other | $1,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $273,354 | TotalRevenueColumnAmt |
| Exclusion | $273,354 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $11,276 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,276 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $11,276 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,185,444 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,642,535 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $318,104 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,218 | TotalAmt |
| Program Services | $135,218 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602,896 | TotalAmt |
| Program Services | $490,844 | ProgramServicesAmt |
| Management And General | $84,859 | ManagementAndGeneralAmt |
| Fundraising | $27,193 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,889,156 | TotalAmt |
| Program Services | $4,784,828 | ProgramServicesAmt |
| Management And General | $832,743 | ManagementAndGeneralAmt |
| Fundraising | $271,585 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,108,437 | TotalAmt |
| Program Services | $917,136 | ProgramServicesAmt |
| Management And General | $150,256 | ManagementAndGeneralAmt |
| Fundraising | $41,045 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $543,571 | TotalAmt |
| Program Services | $446,273 | ProgramServicesAmt |
| Management And General | $74,163 | ManagementAndGeneralAmt |
| Fundraising | $23,135 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,473 | TotalAmt |
| Management And General | $96,473 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,815 | TotalAmt |
| Management And General | $24,815 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,969 | TotalAmt |
| Management And General | $20,969 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $325,404 | TotalAmt |
| Program Services | $8,940 | ProgramServicesAmt |
| Management And General | $37,700 | ManagementAndGeneralAmt |
| Fundraising | $278,764 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,429 | TotalAmt |
| Program Services | $16,912 | ProgramServicesAmt |
| Management And General | $2,175 | ManagementAndGeneralAmt |
| Fundraising | $342 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,636 | TotalAmt |
| Program Services | $36,525 | ProgramServicesAmt |
| Management And General | $23,397 | ManagementAndGeneralAmt |
| Fundraising | $8,714 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,373 | TotalAmt |
| Management And General | $110,373 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,693 | TotalAmt |
| Program Services | $87,808 | ProgramServicesAmt |
| Management And General | $14,540 | ManagementAndGeneralAmt |
| Fundraising | $3,345 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,476 | TotalAmt |
| Program Services | $21,123 | ProgramServicesAmt |
| Management And General | $2,363 | ManagementAndGeneralAmt |
| Fundraising | $990 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,628 | TotalAmt |
| Program Services | $2,639 | ProgramServicesAmt |
| Management And General | $3,363 | ManagementAndGeneralAmt |
| Fundraising | $626 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,497 | TotalAmt |
| Program Services | $127,346 | ProgramServicesAmt |
| Management And General | $30,986 | ManagementAndGeneralAmt |
| Fundraising | $104,165 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,118 | TotalAmt |
| Program Services | $161,456 | ProgramServicesAmt |
| Management And General | $52,662 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,416 | TotalAmt |
| Program Services | $86,756 | ProgramServicesAmt |
| Management And General | $23,830 | ManagementAndGeneralAmt |
| Fundraising | $3,830 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| HOUSEHOLD, CLEANING, CH | $187,937 | $184,437 | $3,500 | |
| MISC OTHER | $99,591 | $86,274 | $1,406 | $11,911 |
| TAXES & LICENSES | $47,065 | $18,706 | $11,237 | $17,122 |
| BANK FEES | $33,600 | $30,959 | $2,641 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,096 | TotalAmt |
| Program Services | $25,096 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,066,494 | TotalAmt |
| Program Services | $7,638,317 | ProgramServicesAmt |
| Management And General | $1,632,769 | ManagementAndGeneralAmt |
| Fundraising | $795,408 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $386,192 | BOYAmt |
| EOY | $150,012 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,571 | BOYAmt |
| EOY | $79,490 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,356,998 | BOYAmt |
| EOY | $1,657,638 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,880 | BOYAmt |
| EOY | $182,852 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,890,746 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,093,541 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,950,722 | BOYAmt |
| EOY | $4,797,205 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,546,160 | BOYAmt |
| EOY | $2,366,849 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,819,994 | BOYAmt |
| EOY | $7,598,727 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,301,517 | BOYAmt |
| EOY | $16,832,773 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $994,585 | BOYAmt |
| EOY | $1,862,567 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,169,560 | BOYAmt |
| EOY | $5,693,045 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,164,145 | BOYAmt |
| EOY | $7,555,612 | 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 | $9,127,372 | BOYAmt |
| EOY | $9,217,161 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $60,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,137,372 | BOYAmt |
| EOY | $9,277,161 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,301,517 | BOYAmt |
| EOY | $16,832,773 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $118,950 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $20,839 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 Minus4 Years | $646,529 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,396 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,999 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $346,287 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $224,805 | CurrentTaxYearAmt |
| Total | $1,277,016 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,116,343 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,889,328 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,681,141 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,158,182 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,631,259 | CurrentTaxYearAmt |
| Total | $38,476,253 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,762,872 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,923,724 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,706,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,504,469 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,856,064 | CurrentTaxYearAmt |
| Total | $39,753,269 | 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 | $39,753,269 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $95,646 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $64,557 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,817 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,950 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $44,750 | CurrentTaxYearAmt |
| Total | $295,720 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $95,646 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $64,557 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,817 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,950 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $44,750 | CurrentTaxYearAmt |
| Total | $295,720 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,829 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,489 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,813 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,164 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,276 | CurrentTaxYearAmt |
| Total | $68,571 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,864,347 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,995,770 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,761,770 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,583,583 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,912,090 | CurrentTaxYearAmt |
| Total | $40,117,560 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99090 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98840 | PublicSupportPY509Pct |
| Investment Income CY | 0.00740 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00990 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III SECTION B LINE 12 OTHER INCOME | FormAndLineReferenceDesc |
| Explanation | CPR/FIRST AID FEES, REBATES, CLASS ACTION PROCEEDS FROM SECURITIES | ExplanationTxt |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | $0 | PoliticalExpendituresAmt |
| Expended527 Activities | $0 | Expended527ActivitiesAmt |
| Internal Funds Contributed | $0 | InternalFundsContributedAmt |
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $34,000 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $34,000 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | Yes (1) | NotDescribedSection501c3Ind |
| Tax4912 | $0 | Tax4912Amt |
| Managers4912 Tax | $0 | Managers4912TaxAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | ASHLEY HOUSE PAID A CONSULTANT TO LOBBY ON THEIR BEHALF FOR FUNDING TO PURCHASE AND REMODEL A HOME IN SPOKANE, WA FOR CRITICALLY ILL CHILDREN. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,176,435 | OtherCostOrOtherBasisAmt |
| Book Value | $1,176,435 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,715,201 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,359,077 | DepreciationAmt |
| Book Value | $3,356,124 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $816,377 | OtherCostOrOtherBasisAmt |
| Depreciation | $652,311 | DepreciationAmt |
| Book Value | $164,066 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $182,733 | OtherCostOrOtherBasisAmt |
| Depreciation | $82,153 | DepreciationAmt |
| Book Value | $100,580 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,797,205 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| CONSTRUCTION IN PROGRESS | $7,597,114 |
| PERSONAL FUNDS- CUSTODIAL | $1,613 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,598,727 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $10,050,096 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $20,839 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $20,839 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,029,257 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $20,969 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $135,218 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $156,187 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,185,444 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,910,307 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,910,307 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $20,969 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $135,218 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $156,187 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,066,494 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | UNCOMPENSATED CARE 135,218. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | UNCOMPENSATED CARE 135,218. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | GROUP HOME - ROOM & BOARD - UNCOMPENSATED CARE | GrantTypeTxt |
| Recipient | 12 | RecipientCnt |
| Cash Grant | $135,218 | CashGrantAmt |
| Valuation Method Used | OTHER | ValuationMethodUsedDesc |
| Non Cash Assistance | ROOM & BOARD PROVIDED AT NO COST. | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III LINE 1 | FormAndLineReferenceDesc |
| Explanation | FUNDS ARE NOT GIVEN TO ANY INDIVIDUAL. THE COST TO THE AGENCY FOR ROOM AND BOARD IS INCLUDED AS A GRANT TO INDIVIDUALS WHEN ASHLEY HOUSE DOES NOT RECEIVE ANY REIMBURSEMENT FOR THESE SERVICES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEN MAAZ | ||||||||||||||
| EXECUTIVE DIRECTOR | $169,988 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,176 | $0 | $182,164 | $0 | $0 | $0 |
| MICHAELA GOULD | ||||||||||||||
| DEVELOPEMENT LIASON | $149,932 | $0 | $0 | $0 | $0 | $0 | $7,337 | $0 | $12,176 | $0 | $169,445 | $0 | $0 | $0 |
| MICHAEL PUGSLEY | ||||||||||||||
| DIRECTOR OF DEVELOPMENT | $144,056 | $0 | $0 | $0 | $0 | $0 | $7,300 | $0 | $12,176 | $0 | $163,532 | $0 | $0 | $0 |
| ERICA PERNELA | ||||||||||||||
| DIRECTOR OF CLINICAL SERVI | $132,326 | $0 | $0 | $0 | $0 | $0 | $6,676 | $0 | $12,176 | $0 | $151,178 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | HOSPITAL EQUIPMENT | 15 | $59,976 | FMV |
| Yes (X) | MISCELLANEOUS | 0 | $49,673 | FMV |
| Yes (X) | WINDOWS PROGRAM | 3 | $10,769 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 REVIEW IS LISTED ON THE YEARLY BOARD OF DIRECTORS COMPLIANCE CALENDAR TO REMIND ALL BOARD MEMBERS OF THE REVIEW. FORM 990 IS PREPARED AFTER THE COMPLETION OF THE INDEPENDENT FINANCIAL AUDIT. A COMPLETE COPY OF THE 990 IS INDIVIDUALLY PROVIDED TO ALL BOARD MEMBERS WHO REVIEW THE RETURN PRIOR TO FILING. ANY QUESTIONS OR CONCERNS ARE COMPILED BY THE BOARD TREASURER, WHO THEN CONTACTS THE RETURN PREPARER AND/OR AUDITORS AS NECESSARY. AFTER THE BOARD HAS REVIEWED AND ACCEPTED THE RETURN, BY VOTE AT A REGULARLY SCHEDULED BOARD MEETING, IT IS SIGNED BY THE BOARD PRESIDENT AND FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD COMPLIANCE CALENDAR LISTS AS AN ITEM TO BE COMPLETED IN THE FIRST QUARTER OF THE YEAR, REVIEW THE CONFLICT OF INTEREST POLICY. IT REQUIRES ALL BOARD MEMBERS TO ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT. THE POLICY ALSO REQUIRES A DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST. IT OUTLINES PROCEDURES FOR THE BOARD TO FOLLOW IN DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AND PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST THAT MAY ARISE. ADDITIONALLY, INDEPENDENT FINANCIAL AUDITORS ANNUALLY REVIEW AND TEST THE ORGANIZATION'S RECORDS FOR POSSIBLE CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | A BOARD COMMITTEE CONDUCTS AN ANNUAL PERFORMANCE AND COMPENSATION REVIEW FOR THE EXECUTIVE DIRECTOR. THE COMMITTEE ALSO OBTAINS COMPARABLE SALARY INFORMATION FROM INDEPENDENT THIRD-PARTY SOURCES AND DETERMINES ANY RECOMMENDATION FOR SALARY ADJUSTMENT. A WRITTEN EMPLOYMENT CONTRACT IS USED TO DOCUMENT ALL TERMS OF THE EXECUTIVE DIRECTOR'S EMPLOYMENT. THE EXECUTIVE DIRECTOR COMPLETES PERFORMANCE REVIEW AND OBTAINS COMPARABLE SALARY INFORMATION FOR ALL KEY EMPLOYEES. THE FULL BOARD REVIEW AND APPROVES COMPENSATION PACKAGES FOR BOTH THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DISCLOSURE OF GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC, BUT ARE PROVIDED ON A REQUEST BASIS. |
| FORM 990 PART XII, LINE 2C | THERE HAVE BEEN NO CHANGES TO THE PROCESS FROM THE PRIOR YEAR. |
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