MIDWEST COVENANT HOME INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MIDWEST COVENANT HOME INC (EIN 47-0397679)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2022-11-10
- IRS object ID
- 202223149349303877
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-10T12:17:17-06:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470625816 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUTZ AND COMPANY PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3320 JAMES ROAD SUITE 100 | AddressLine1Txt |
| City | GRAND ISLAND | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68803 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470397679 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST COVENANT HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MIDW | BusinessNameControlTxt |
| Phone | 4027642711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 E 9TH ST | AddressLine1Txt |
| City | STROMSBURG | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68666 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAN CRAMER | PersonNm |
| Person Title | BOARD PRESIDENT | PersonTitleTxt |
| Phone | 4027545993 | PhoneNum |
| Signature | 2022-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAN | PersonFirstNm |
| Person Last | CRAMER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | STEVEN K PLACKE | PreparerPersonNm |
| PTIN | P00078534 | PTIN |
| Phone | 3083827850 | PhoneNum |
| Preparation | 2022-11-07 | PreparationDt |
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 | DAN CRAMER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 SEMINARY STREET | AddressLine1Txt |
| City | STROMSBURG | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68666 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,143,808 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MIDWESTCOVENANTHOME.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | NURSING HOME CARE AND ASSISTED LIVING FOR THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 114 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,152,585 | PYContributionsGrantsAmt |
| CY Contributions Grants | $349,667 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,813,648 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,275,432 | CYProgramServiceRevenueAmt |
| PY Investment Income | $199,645 | PYInvestmentIncomeAmt |
| CY Investment Income | $35,259 | CYInvestmentIncomeAmt |
| PY Other Revenue | $144,988 | PYOtherRevenueAmt |
| CY Other Revenue | $151,503 | CYOtherRevenueAmt |
| PY Total Revenue | $5,310,866 | PYTotalRevenueAmt |
| CY Total Revenue | $5,811,861 | 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 | $2,925,660 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,128,059 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $17,070 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,191,831 | PYOtherExpensesAmt |
| CY Other Expenses | $2,908,956 | CYOtherExpensesAmt |
| PY Total Expenses | $5,117,491 | PYTotalExpensesAmt |
| CY Total Expenses | $6,037,015 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $193,375 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$225,154 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,248,285 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,762,105 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,789,404 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,834,872 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,458,881 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,927,233 | NetAssetsOrFundBalancesEOYAmt |
| Mission | NURSING HOME CARE AND ASSISTED LIVING FOR THE ELDERLY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,607,693 | ExpenseAmt |
| Revenue | $5,435,885 | RevenueAmt |
| Desc | NURSING HOME CARE AND ASSISTED LIVING FOR THE ELDERLY. | Desc |
| Total Program Service Expenses | $5,607,693 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | 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 | 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 | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 114 | 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 |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| 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 | SHEILA BJERRUM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4027642711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 E 9TH STREET | AddressLine1Txt |
| City | STROMSBURG | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68666 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Institutional TrusteeInstitutionalTrusteeInd |
|---|---|---|---|---|---|---|---|
| DAN CRAMER | |||||||
| PRESIDENT | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LYLE PERSON | |||||||
| DIRECTOR-AT-LARGE | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT SMALL | |||||||
| VICE-PRESIDENT | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PHIL BURKE | |||||||
| DIRECTOR-AT-LARGE | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MERLIN FELT | |||||||
| DIRECTOR-AT-LARGE | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| NELDA RILEY | |||||||
| TREASURER | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JILL CRAIG | |||||||
| SECRETARY/CONFERENCE LIASO | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIMOTHY MCIVOR | |||||||
| DIRECTOR-AT-LARGE | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GRACE GERRARD | |||||||
| DIRECTOR-AT-LARGE | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHERI GIANNOU | |||||||
| DIRECTOR-AT-LARGE | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN ROSENBAUM | |||||||
| DIRECTOR-AT-LARGE | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN JOHNSON | |||||||
| CONFERENCE SUPERINTENDENT | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MAXIM HEALTHCARE STAFFING SERVICES | |||||
| 9239 WEST CENTER ROAD SUITE 100 | OMAHA | NE | 68124 | AGENCY STAFFING | $297,722 |
| CARIANT HEALTH PARTNERS | |||||
| 11623 ARBOR STREET SUITE 100 | OMAHA | NE | 68144 | AGENCY STAFFING | $213,708 |
| 24HOURNURSE LLC | |||||
| 318 DAINGERFIELD STREET | PITTSBURGH | TX | 75686 | AGENCY STAFFING | $128,013 |
| FUNCTION FOREVER OT SERVICES | |||||
| 1005 FARNUM STREET | ST PAUL | NE | 68873 | THERAPY SERVICES | $127,663 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $116,916 | GovernmentGrantsAmt |
| All Other Contributions | $232,751 | AllOtherContributionsAmt |
| Total Contributions | $349,667 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PRIVATE PAY RESIDENTS | 623000 | $1,820,047 | $1,820,047 |
| MEDICAID/DHHS | 623000 | $1,457,519 | $1,457,519 |
| ASSISTED LIVING | 623000 | $1,029,900 | $1,029,900 |
| MEDICARE | 623000 | $913,926 | $913,926 |
| POLK COUNTY SENIOR SER | 623000 | $54,040 | $54,040 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,275,432 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,191 | TotalRevenueColumnAmt |
| Exclusion | $13,191 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $160,899 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,603 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $144,296 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $144,296 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $144,296 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $326,012 | SecuritiesAmt |
| Other | $11,400 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $313,144 | SecuritiesAmt |
| Other | $2,200 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,868 | SecuritiesAmt |
| Other | $9,200 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,068 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,200 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $12,868 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EMPLOYEE & GUEST MEALS | 623000 | $5,975 | $5,975 | |
| MISCELLANEOUS | 623000 | $982 | $982 | |
| CROP INCOME | 623000 | $250 | $250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,207 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,811,861 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,435,885 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $26,309 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,597,981 | TotalAmt |
| Program Services | $2,376,776 | ProgramServicesAmt |
| Management And General | $221,205 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,720 | TotalAmt |
| Program Services | $327,952 | ProgramServicesAmt |
| Management And General | $22,768 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,358 | TotalAmt |
| Program Services | $164,922 | ProgramServicesAmt |
| Management And General | $14,436 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,538 | TotalAmt |
| Management And General | $19,538 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,001 | TotalAmt |
| Program Services | $13,735 | ProgramServicesAmt |
| Management And General | $2,266 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,268 | TotalAmt |
| Management And General | $6,268 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,027 | TotalAmt |
| Program Services | $83,815 | ProgramServicesAmt |
| Management And General | $13,212 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,187 | TotalAmt |
| Program Services | $171,187 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,139 | TotalAmt |
| Program Services | $9,872 | ProgramServicesAmt |
| Management And General | $1,267 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,370 | TotalAmt |
| Program Services | $145,370 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,122 | TotalAmt |
| Program Services | $404,122 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,829 | TotalAmt |
| Program Services | $78,245 | ProgramServicesAmt |
| Management And General | $43,584 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| NURSING AGENCY LABOR | $930,304 | $930,304 |
| SUPPLIES | $340,644 | $340,644 |
| CONSULTANTS | $256,831 | $256,831 |
| FOOD | $220,051 | $220,051 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,645 | TotalAmt |
| Program Services | $83,867 | ProgramServicesAmt |
| Management And General | $67,708 | ManagementAndGeneralAmt |
| Fundraising | $17,070 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,037,015 | TotalAmt |
| Program Services | $5,607,693 | ProgramServicesAmt |
| Management And General | $412,252 | ManagementAndGeneralAmt |
| Fundraising | $17,070 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $776,657 | BOYAmt |
| EOY | $760,775 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $501,460 | BOYAmt |
| EOY | $254,980 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,637 | BOYAmt |
| EOY | $475,519 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,912 | BOYAmt |
| EOY | $34,686 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,620,924 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,384,869 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,595,529 | BOYAmt |
| EOY | $5,236,055 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90 | BOYAmt |
| EOY | $90 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,248,285 | BOYAmt |
| EOY | $6,762,105 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,939 | BOYAmt |
| EOY | $463,875 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,434,770 | BOYAmt |
| EOY | $3,320,847 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,695 | BOYAmt |
| EOY | $50,150 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,789,404 | BOYAmt |
| EOY | $3,834,872 | 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 | $3,458,881 | BOYAmt |
| EOY | $2,927,233 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,458,881 | BOYAmt |
| EOY | $2,927,233 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,248,285 | BOYAmt |
| EOY | $6,762,105 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$225,154 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$37,494 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$269,000 | OtherChangesInNetAssetsAmt |
| 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 | $9,467 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,168 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,208 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $897,985 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $349,667 | CurrentTaxYearAmt |
| Total | $1,297,495 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,204,904 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,290,254 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,148,270 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,792,648 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,242,496 | CurrentTaxYearAmt |
| Total | $21,678,572 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $500 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $500 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $750 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $250 | CurrentTaxYearAmt |
| Total | $2,500 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,214,871 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,304,922 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,174,978 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,691,383 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,592,413 | CurrentTaxYearAmt |
| Total | $22,978,567 | 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 | $22,978,567 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $143,719 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $14,497 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,191 | CurrentTaxYearAmt |
| Total | $171,407 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $143,719 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $14,497 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,191 | CurrentTaxYearAmt |
| Total | $171,407 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,358,590 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,304,922 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,174,978 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,705,880 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,605,604 | CurrentTaxYearAmt |
| Total | $23,149,974 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99260 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98580 | PublicSupportPY509Pct |
| Investment Income CY | 0.00740 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01420 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $63,809 | OtherCostOrOtherBasisAmt |
| Book Value | $63,809 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,251,401 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,467,690 | DepreciationAmt |
| Book Value | $4,783,711 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,305,714 | OtherCostOrOtherBasisAmt |
| Depreciation | $917,179 | DepreciationAmt |
| Book Value | $388,535 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,236,055 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESIDENT CARE ADVANCES | Desc |
| Amt | $50,150 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $50,150 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $5,774,367 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$37,494 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$37,494 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,811,861 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,811,861 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,037,015 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,037,015 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,037,015 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S PROCESS TO REVIEW FORM 990: BOARD RECEIVES A COPY OF FORM 990 TO REVIEW BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS DISCLOSURE EXPLANATION GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION DOES NOT HAVE A CONFLICT OF INTEREST POLICY. |
| FORM 990, PART XI, LINE 9: | UNCOLLECTIBLE CAPITAL CAMPAIGN PLEDGES -269,000. |
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