FURP.ORG / PUBLIC DATA EXPLORER

LOUISVILLE PROTESTANT ALTENHEIM: Form 990PF, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
LOUISVILLE PROTESTANT ALTENHEIM (EIN 61-0449634)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-08
IRS object ID
202213129349101671
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-08T13:26:03-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN611064249PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DEMING MALONE LIVESAY & OSTROFF PSCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19300 SHELBYVILLE ROAD SUITE 1100AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP402225187ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN610449634EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LOUISVILLE PROTESTANT ALTENHEIMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLOUIBusinessNameControlTxt
Phone5025847417PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1936 BARRET AVENUEAddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40204ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAWN SMITHPersonNm
Person TitleADMINISTRATORPersonTitleTxt
Phone5025847417PhoneNum
Signature2022-11-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDAWNPersonFirstNm
Person LastSMITHPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMELINDA L HECKPreparerPersonNm
PTINP01392306PTIN
Phone5024269660PhoneNum
Preparation2022-11-07PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$14,881,326FMVAssetsEOYAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$1,970ContriRcvdRevAndExpnssAmt
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Dividends Rev And Expnss$182,799DividendsRevAndExpnssAmt
Dividends Net Invst Incm$182,799DividendsNetInvstIncmAmt
Dividends Adj Net Incm$182,799DividendsAdjNetIncmAmt
Net Gain Sale Ast Rev And Expnss$618,939NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$2,181,714GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$618,939CapGainNetIncmNetInvstIncmAmt
Net ST Capital Gain Adj Net Incm$52,041NetSTCapitalGainAdjNetIncmAmt
Other Income Rev And Expnss$2,927,251OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$0OtherIncomeNetInvstIncmAmt
Other Income Adj Net Incm$2,927,251OtherIncomeAdjNetIncmAmt
Total Rev And Expnss$3,730,959TotalRevAndExpnssAmt
Total Net Invst Incm$801,738TotalNetInvstIncmAmt
Total Adj Net Incm$3,162,091TotalAdjNetIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Adj Net Incm$0CompOfcrDirTrstAdjNetIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$1,119,869OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Net Invst Incm$0OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Adj Net Incm$1,119,869OthEmplSlrsWgsAdjNetIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$0OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Rev And Expnss$74,558PensionEmplBnftRevAndExpnssAmt
Pension Empl Bnft Net Invst Incm$0PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Adj Net Incm$74,558PensionEmplBnftAdjNetIncmAmt
Pension Empl Bnft Dsbrs Chrtbl$0PensionEmplBnftDsbrsChrtblAmt
Other Prof Fees Rev And Expnss$77,066OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$62,308OtherProfFeesNetInvstIncmAmt
Other Prof Fees Adj Net Incm$14,758OtherProfFeesAdjNetIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Taxes Rev And Expnss$82,329TaxesRevAndExpnssAmt
Taxes Net Invst Incm$0TaxesNetInvstIncmAmt
Taxes Adj Net Incm$82,329TaxesAdjNetIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$100,057DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$0DeprecAndDpltnNetInvstIncmAmt
Deprec And Dpltn Adj Net Incm$100,057DeprecAndDpltnAdjNetIncmAmt
Occupancy Rev And Expnss$204,078OccupancyRevAndExpnssAmt
Occupancy Net Invst Incm$0OccupancyNetInvstIncmAmt
Occupancy Adj Net Incm$204,078OccupancyAdjNetIncmAmt
Occupancy Dsbrs Chrtbl$0OccupancyDsbrsChrtblAmt
Trav Conf Meeting Rev And Expnss$8,652TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Adj Net Incm$8,652TravConfMeetingAdjNetIncmAmt
Trav Conf Meeting Dsbrs Chrtbl$0TravConfMeetingDsbrsChrtblAmt
Other Expenses Rev And Expnss$1,397,803OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$0OtherExpensesNetInvstIncmAmt
Other Expenses Adj Net Incm$1,397,803OtherExpensesAdjNetIncmAmt
Other Expenses Dsbrs Chrtbl$0OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$3,064,412TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$62,308TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$3,002,104TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$0TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$0ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$0ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$3,064,412TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$62,308TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$3,002,104TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$0TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$666,547ExcessRevenueOverExpensesAmt
Net Investment Income$739,430NetInvestmentIncomeAmt
Adjusted Net Income$159,987AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$491,653CashBOYAmt
Cash EOY$556,702CashEOYAmt
Cash EOYFMV$556,702CashEOYFMVAmt
Acct Rcvbl$60,610AcctRcvblAmt
Acct Rcvbl Allwnc Dbtfl Acct$20,000AcctRcvblAllwncDbtflAcctAmt
Acct Rcvbl BOY$53,054AcctRcvblBOYAmt
Acct Rcvbl EOY$40,610AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$40,610AcctRcvblEOYFMVAmt
Inventories BOY$9,203InventoriesBOYAmt
Inventories EOY$9,203InventoriesEOYAmt
Inventories EOYFMV$9,203InventoriesEOYFMVAmt
Prepaid Expenses BOY$10,467PrepaidExpensesBOYAmt
Prepaid Expenses EOY$45,272PrepaidExpensesEOYAmt
Prepaid Expenses EOYFMV$45,272PrepaidExpensesEOYFMVAmt
Other Investments BOY$11,513,459OtherInvestmentsBOYAmt
Other Investments EOY$12,766,095OtherInvestmentsEOYAmt
Other Investments EOYFMV$12,766,095OtherInvestmentsEOYFMVAmt
Land Bldg Equip Cost Or Other Bss$6,216,303LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,927,708LandBldgEquipAccumDeprecAmt
Land BOY$1,275,244LandBOYAmt
Land EOY$1,288,595LandEOYAmt
Land EOYFMV$1,288,595LandEOYFMVAmt
Other Assets BOY$187,672OtherAssetsBOYAmt
Other Assets EOY$174,849OtherAssetsEOYAmt
Other Assets EOYFMV$174,849OtherAssetsEOYFMVAmt
Total Assets BOY$13,540,752TotalAssetsBOYAmt
Total Assets EOY$14,881,326TotalAssetsEOYAmt
Total Assets EOYFMV$14,881,326TotalAssetsEOYFMVAmt
Accounts Payable BOY$121,188AccountsPayableBOYAmt
Accounts Payable EOY$216,050AccountsPayableEOYAmt
Deferred Revenue BOY$1,172DeferredRevenueBOYAmt
Deferred Revenue EOY$20,340DeferredRevenueEOYAmt
Other Liabilities BOY$2,592OtherLiabilitiesBOYAmt
Other Liabilities EOY$2,092OtherLiabilitiesEOYAmt
Total Liabilities BOY$124,952TotalLiabilitiesBOYAmt
Total Liabilities EOY$238,482TotalLiabilitiesEOYAmt
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind
No Donor Rstr Net Assests BOY$12,186,251NoDonorRstrNetAssestsBOYAmt
No Donor Rstr Net Assests EOY$13,337,717NoDonorRstrNetAssestsEOYAmt
Donor Rstr Net Assets BOY$1,229,549DonorRstrNetAssetsBOYAmt
Donor Rstr Net Assets EOY$1,305,127DonorRstrNetAssetsEOYAmt
Tot Net Ast Or Fund Balances BOY$13,415,800TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$14,642,844TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$13,540,752TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$14,881,326TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$13,415,800TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$666,547ExcessRevenueOverExpensesAmt
Other Increases$560,497OtherIncreasesAmt
Subtotal$14,642,844SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$14,642,844TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (7 entries)

PropertyPropertyDescSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmtHow AcquiredHowAcquiredCd
SYB ACCOUNT #0729 - DETAIL MAINTAINED2020-12-31$29,440$24,225$5,215$5,215
SYB ACCOUNT #0729 - DETAIL MAINTAINED2021-12-31$94,665$55,477$39,188$39,188
SYB ACCOUNT #0523 - DETAIL MAINTAINED2021-12-31$85,975$48,634$37,341$37,341
SYB ACCOUNT #0523 - DETAIL MAINTAINED2021-12-31$1,570,847$1,296,056$274,791$274,791
SYB ACCOUNT #0569 - DETAIL MAINTAINED2021-12-31$21,000$11,515$9,485$9,485
SYB ACCOUNT #0569 - DETAIL MAINTAINED2021-12-31$184,799$126,868$57,931$57,931
CAPITAL GAINS DIVIDENDS$194,988$194,988$194,988P
FieldValueIRS element (for citing)
Capital Gain Net Income$618,939CapitalGainNetIncomeAmt
Net Short Term Capital Gain Loss$52,041NetShortTermCapitalGainLossAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Exempt Operating FoundationsYes (X)ExemptOperatingFoundationsInd
Ruling Letter1986-04-16RulingLetterDt
Not ApplicableN/ANotApplicableCd
Tax Based On Investment Income$0TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$0EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$0TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Tax Due$0TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateKYOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating FoundationYes (1)PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressWWW.THEALTENHEIM.ORGWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1THE FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5025847417PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1936 BARRET AVENUEAddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40204ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
JAMES BROWN
936 BARRET AVENUELOUISVILLEKY40204TREASURER5.00$0$0$0
JIM BURD
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
MICHAEL BUSICK
936 BARRET AVENUELOUISVILLEKY40204PRESIDENT5.00$0$0$0
RACHEL CARRIGAN
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
BOB WYNKOOP
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
EILEEN VAN HOOSE
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
JON BINGHAM
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
JOE WHITT
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
MARY JO COKER
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
KIM STASIAK
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
BETH CLARK
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0
BOB WHITE
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR1.00$0$0$0

Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee BenefitsEmployeeBenefitsAmtExpense AccountExpenseAccountAmt
DANA GRAVITT
936 BARRET AVENUELOUISVILLEKY40204ADMINISTRATOR40.00$115,000$3,500$0
MARK KITCHEN
936 BARRET AVENUELOUISVILLEKY40204MAINTENANCE SUPERVIS40.00$67,978$55$0
LUIS DAISSON
936 BARRET AVENUELOUISVILLEKY40204NURSING ASSISTANT40.00$55,400$1,014$0
KENNEISHA PARHAM
936 BARRET AVENUELOUISVILLEKY40204LPN40.00$53,620$2,412$0
STACEY THOMPSON
936 BARRET AVENUELOUISVILLEKY40204DIRECTOR OF NURSING40.00$53,354$0$0
FieldValueIRS element (for citing)
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt

Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdService TypeServiceTypeTxtCompensationCompensationAmt
HEALTHCARE SERVICES GROUP
3220 TILLMAN DRIVE SUITE 300BENSALEMPA19020DIETARY SERVICES$400,469
CAREER STAFF UNLIMITED
PO BOX 301076DALLASTX75303CONTRACT NURSING$164,510
FieldValueIRS element (for citing)
Contractor Paid Over50k0ContractorPaidOver50kCnt

Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp

FieldValueIRS element (for citing)
Description1THE LOUISVILLE PROTESTANT ALTENHEIM (THE "ALTENHEIM") WAS FOUNDED IN 1906 AS A LONG-TERM CARE FACILITY IN LOUISVILLE, KENTUCKY. IT IS A CONTINUING CARE RETIREMENT COMMUNITY WITH FOUR LEVELS OF CARE: INDEPENDENT LIVING; PERSONAL CARE; INTERMEDIATE CARE; AND NURSING HOME BEDS.Description1Txt
Expenses1$2,616,243Expenses1Amt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$12,153,507AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$0AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$174,849FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$12,328,356TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$12,328,356AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$184,925CashDeemedCharitableAmt
Net Vl Noncharitable Assets$12,143,431NetVlNoncharitableAssetsAmt
Minimum Investment Return$607,172MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Sect4942j3j5 Fndtn And Frgn OrgYes (X)Sect4942j3j5FndtnAndFrgnOrgInd

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$0ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Charitable Assets Acquis Paid$113,407CharitableAssetsAcquisPaidAmt
Qualifying Distributions$113,407QualifyingDistributionsAmt

Private Operating Foundations PrivateOperatingFoundationsGrp

FieldValueIRS element (for citing)
Private Operating Fndtn Ruling1986-04-16PrivateOperatingFndtnRulingDt
Section4942j5Yes (X)Section4942j5Ind

Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp

FieldValueIRS element (for citing)
Current Year$0CurrentYearAmt
Total$0TotalAmt

Qualifying Distributions QualifyingDistributionsGrp

FieldValueIRS element (for citing)
Current Year$113,407CurrentYearAmt
Year1$34,622Year1Amt
Year2$187,938Year2Amt
Year3$90,298Year3Amt
Total$426,265TotalAmt

Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp

FieldValueIRS element (for citing)
Current Year$0CurrentYearAmt
Year1$0Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$0TotalAmt

Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp

FieldValueIRS element (for citing)
Current Year$113,407CurrentYearAmt
Year1$34,622Year1Amt
Year2$187,938Year2Amt
Year3$90,298Year3Amt
Total$426,265TotalAmt

Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp

FieldValueIRS element (for citing)
Current Year$404,781CurrentYearAmt
Year1$339,886Year1Amt
Year2$303,247Year2Amt
Year3$95,591Year3Amt
Total$1,143,505TotalAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd
Total Grant Or Contri Pd Dur Yr$0TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Program Service Revenue Dtl ProgramServiceRevenueDtl (2 entries)

DescDescExclusionExclusionCdExclusionExclusionAmt
NURSING HOME FEES08$2,847,027
RESIDENTIAL INCOME08$80,224

Dividends And Interest From Sec Dtl DividendsAndInterestFromSecDtl

FieldValueIRS element (for citing)
Related Or Exempt Function Incm$182,799RelatedOrExemptFunctionIncmAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Related Or Exempt Function Incm$618,939RelatedOrExemptFunctionIncmAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$2,927,251ExclusionAmt
Related Or Exempt Function Incm$801,738RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$3,728,989TotalIncomeProducingActyAmt

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp (2 entries)

Line NumberLineNumberTxtRelationship StatementRelationshipStatementTxt
1ADIRECT CHARGES TO INDIVIDUALS FOR CARE AT NURSING HOME
1ADIRECT CHARGES TO INDIVIDUALS FOR CARE AT NURSING HOME

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (3 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
SYB TRUSTFMV$8,993,197$8,993,197
SYB STITZEL TRUSTFMV$2,475,002$2,475,002
SYB CPMF TRUSTFMV$1,297,896$1,297,896

Land Etc Schedule2 LandEtcSchedule2

Land Etc LandEtcGrp (3 entries)

Category Or ItemCategoryOrItemTxtCost Or Other BasisCostOrOtherBasisAmtAccumulated DepreciationAccumulatedDepreciationAmtBook ValueBookValueAmtEOYFMVEOYFMVAmt
LAND$350,000$0$350,000$350,000
BUILDNGS AND IMPROVEMENTS$4,748,954$3,945,503$803,451$803,451
MACHINERY AND EQUIPMENT$1,117,349$982,205$135,144$135,144

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescCASH SURRENDER OF LIFE INSURANCEDesc
BOY Book Value$187,672BOYBookValueAmt
EOY Book Value$174,849EOYBookValueAmt
EOYFMV$174,849EOYFMVAmt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (14 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
DIETARY SUPPLIES$402,238$0$402,238$0
HOUSEKEEPING EXPENSE$23,102$0$23,102$0
PROPERTY INSURANCE$61,379$0$61,379$0
OTHER INSURANCE$74,474$0$74,474$0
HEALTH PROVIDER FEES$13,700$0$13,700$0
ADVERTISING$27,182$0$27,182$0
OFFICE EXPENSES$45,884$0$45,884$0
ACTIVITIES$3,864$0$3,864$0
NURSING SUPPLIES$51,614$0$51,614$0
CONSULTANTS/CONTRACT LABOR$573,925$0$573,925$0
NURSING HOME$112,269$0$112,269$0
CONTINUING EDUCATION$4,460$0$4,460$0
BUSINESS LICENSES$2,815$0$2,815$0
INTERNMENT EXPENSES$897$0$897$0

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtAdjusted Net IncomeAdjustedNetIncomeAmt
NURSING HOME FEES$2,847,027$2,847,027
RESIDENTIAL INCOME$80,224$80,224

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail

FieldValueIRS element (for citing)
DescUNREALIZED GAINDesc
Amt$560,497Amt

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail

FieldValueIRS element (for citing)
DescSECURITY DEPOSITSDesc
BOY Book Value$2,592BOYBookValueAmt
EOY Book Value$2,092EOYBookValueAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
OTHER PROFESSIONAL FEES$14,758$0$14,758$0
INVESTMENT FEES$62,308$62,308$0$0

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryPAYROLL TAXESCategoryTxt
Amt$82,329Amt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$82,329AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt