2021-08-19T15:45:31-05:00 2020-12-31 480958002 MILLER HAVILAND KETTER PC PA 1901 W 47TH PLACE SUITE 204 WESTWOOD KS 66205 990 2020-01-01 431084953 BEAUTIFUL SAVIOR HOME BEAU 8163310781 1003 S CEDAR STREET BELTON MO 64012 BRENDA BUFORD ADMINISTRATOR 8163310781 2021-08-09 1 BRENDA BUFORD 999009999 JAMES P KETTER P00165162 9134322727 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z BRENDA BUFORD 1003 S CEDAR STREET BELTON MO 64012 9399924 0 X WWW.BEAUTIFULSAVIORLUTHERANHOME.ORG X 1978 MO TO PROVIDE QUALITY CARE FOR SENIOR CITIZENS AND OTHERS IN NEED OF SUPERVISION AND TO IMPROVE EACH RESIDENT'S QUALITY OF LIFE. 9 9 232 8 0 0 0 1436835 8603170 7963089 0 0 0 0 8603170 9399924 0 0 0 0 4059428 4370410 0 0 0 5082550 4009651 9141978 8380061 -538808 1019863 5307808 6043285 3286914 3002528 2020894 3040757 TO PROVIDE QUALITY CARE FOR SENIOR CITIZENS AND OTHERS IN NEED OF SUPERVISION AND TO IMPROVE EACH RESIDENT'S QUALITY OF LIFE. 0 0 6541852 7963089 OPERATION OF 126-BED LONG-TERM CARE AND 50-BED RESIDENTIAL CARE NURSING HOME FOR PRIVATE PAY INDIVIDUALS AND FOR MEDICAID RECIPIENTS AT RATES DETERMINED BY THE STATE OF MISSOURI. 6541852 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 19 0 1 232 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X BRENDA BUFORD 8163310781 1003 S CEDAR STREET BELTON MO 64012 PASTOR STEPHEN STREUFERT VICE PRESIDENT 1.00 X X 0 0 0 PEGGY POE TREASURER 1.00 X X 0 0 0 DALE HEIL DIRECTOR 1.00 X 0 0 0 PEGGY NOAH DIRECTOR 1.00 X 0 0 0 BRENDA BUFORD ADMINISTRATOR 40.00 X X 124268 0 0 PASTOR DAVID M ROLF PRESIDENT 1.00 X X 0 0 0 CAROL BEHM DIRECTOR / ASST. SECRETARY 1.00 X X 0 0 0 JENNIFER DELUCA DIRECTOR / SECRETARY 1.00 X X 0 0 0 PAULINE MCDANIEL DIRECTOR 1.00 X 0 0 0 124268 0 0 1 0 0 0 AEGIS THERAPIES PO BOX 8103 FORT SMITH AR 72902 THERAPY 630446 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE STE 300 BENSALEM PA 19020 LAUNDRY & HOUSEKEEPING 329743 CLIFTON LARSON ALLEN 600 WASHINGTON AVE STE 1800 ST LOUIS MO 63101 ACCOUNTING SERVICE 197403 3 1436835 1436835 PATIENT REVENUES 623000 7963089 7963089 7963089 9399924 7963089 0 0 X 124268 124268 3754675 2993658 761017 21462 18243 3219 173851 147773 26078 296154 251731 44423 1242468 789302 453166 17391 17391 672 672 333767 283702 50065 6094 6094 85652 72804 12848 200253 170215 30038 436624 371130 65494 SUPPLIES 897070 725299 171771 MISSOURI BED TAX 438398 438398 BAD DEBT EXPENSE 260002 260002 EQUIPMENT & RENTAL 62984 19595 43389 28276 28276 8380061 6541852 1838209 0 358925 2111025 2742956 2009994 101148 15847 7295825 5389406 2104779 1906419 5307808 6043285 1096596 798194 1750245 1938727 440073 265607 3286914 3002528 X 2020894 3040757 2020894 3040757 5307808 6043285 1019863 0 X X 1 X 0 1 0 X 1436835 1436835 8867560 8434339 8206747 8603170 7963089 42074905 8867560 8434339 8206747 8603170 9399924 43511740 0 0 0 43511740 8867560 8434339 8206747 8603170 9399924 43511740 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 40173 40173 5416708 4251358 1165350 1838944 1138048 700896 1906419 DEPOSITS 67219 PATIENT CREDIT BALANCES 198388 265607 X PART X, LINE 2: THE HOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW AND THEREFORE HAS MADE NO PROVISION FOR INCOME TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS; IT IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. INCOME TAX RETURNS FILED BY THE HOME ON FORM 990 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) FOR THREE YEARS AFTER THE DATE FILED, WITH THE RESULT THAT YEARS 2020, 2019, 2018, AND 2017 REMAIN OPEN AS OF SEPTEMBER 30, 2021, ALTHOUGH NO RETURNS HAVE BEEN SELECTED FOR EXAMINATION BY THE IRS. MANAGEMENT HAS EVALUATED TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE HOME'S TAX RETURNS WITH ASSISTANCE FROM THE HOME'S TAX PREPARER TO DETERMINE WHETHER ITS TAX POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED BY APPLICABLE TAXING AUTHORITIES; LIKELY TAX POSITIONS ARE REPORTED IN THESE FINANCIAL STATEMENTS, AND MANAGEMENT IS NOT AWARE OF ANY UNLIKELY TAX POSITIONS, WITH THE RESULT THAT NO UNLIKELY TAX POSITIONS ARE REPORTED. FORM 990, PART VI, SECTION B, LINE 11B AN OUTSIDE INDEPENDENT CPA FIRM PREPARES AND REVIEWS THE FORM 990. PRIOR TO FILING, THE FORM 990 IS ALSO REVIEWED BY THE ADMINISTRATOR AND IS PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ANY CONFLICTS ARE EVALUATED BY THE BOARD. WHEN THERE IS A CONFLICT OF INTEREST: THE DIRECTOR OR OFFICER THAT HAS A CONFLICT WILL EXCUSE THEMSELVES FROM THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS REVIEWS THE EXECUTIVE DIRECTORS COMPENSATION USING COMPARABLE DATA AND DOCUMENTS THEIR DECISION PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE BEAUTIFUL SAVIOR HOME MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 789,302. MANAGEMENT AND GENERAL EXPENSES 39,410. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 828,712. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 361,606. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 361,606. DATA PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 52,150. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,150. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. FORM 990 ELECTION SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION BEAUTIFUL SAVIOR HOME 1003 S. CEDAR STREET BELTON, MO 64012 EMPLOYER IDENTIFICATION NUMBER: 43-1084953 FOR THE YEAR ENDING DECEMBER 31, 2020 BEAUTIFUL SAVIOR HOME IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER REG. SEC. 1.263(A)-1(F).