SUSANNA WESLEY HEALTH CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SUSANNA WESLEY HEALTH CENTER INC (EIN 59-1837338)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-03-29
- IRS object ID
- 202130889349300673
- Schema version
- 2019v5.2
- 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 | 2021-03-29T10:42:01-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 593070669 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MSL PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 E BROWARD BLVD SUITE 1550 | AddressLine1Txt |
| City | FORT LAUDERDALE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33394 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591837338 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSANNA WESLEY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SUSA | BusinessNameControlTxt |
| Phone | 3055563500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5345 WEST 18TH AVENUE | AddressLine1Txt |
| City | HIALEAH | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33012 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MADELYN SIMON LOZANO | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3055563500 | PhoneNum |
| Signature | 2021-03-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | COURTNEY HOGBEN | PreparerPersonNm |
| PTIN | P01619105 | PTIN |
| Phone | 9548478910 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MADELYN SIMON LOZANO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5345 WEST 18TH AVENUE | AddressLine1Txt |
| City | HIALEAH | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33012 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,776,881 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.EPWORTHVILLAGERC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE ELDERLY AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES DESIGNED TO MEET THEIR NEEDS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $500,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,274,052 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,953 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,829 | CYInvestmentIncomeAmt |
| PY Other Revenue | $63,662 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $65,615 | PYTotalRevenueAmt |
| CY Total Revenue | $1,776,881 | 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 | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $40,000 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,093 | PYOtherExpensesAmt |
| CY Other Expenses | $1,162,949 | CYOtherExpensesAmt |
| PY Total Expenses | $3,093 | PYTotalExpensesAmt |
| CY Total Expenses | $1,202,949 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $62,522 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $573,932 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,580,955 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,770,265 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,735,229 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,350,607 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$5,154,274 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$4,580,342 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES ELDERLY PERSONS AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES ESPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS THROUGH THE LEASE OF A SKILLED NURSING FACILITY TO ITS SUPPORTED 501(C)(3) TAX-EXEMPT AFFILIATE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,004,773 | ExpenseAmt |
| Revenue | $1,274,052 | RevenueAmt |
| Desc | THE ORGANIZATION LEASES A FACILITY USED AS A SKILLED CARE NURSING HOME FOR THE HOUSING AND CARE OF THE ELDERLY AND SUPPORTS THE LESSEE IN OPERATING THE FACILITY IN A CHARITABLE MANNER. | Desc |
| Total Program Service Expenses | $1,004,773 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | 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 | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHANTAL FALBY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3055563500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5345 WEST 18TH AVENUE | AddressLine1Txt |
| City | HIALEAH | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33012 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| MADELYN SIMON LOZANO | |||||||
| EXECUTIVE DIRECTOR | 10.00 | 25.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BELINDA BACON | |||||||
| CHAIR | 5.00 | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| REV RUBEN VELASCO | |||||||
| VICE-CHAIR | 5.00 | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GEORGE PEDLAR | |||||||
| SECRETARY/TREASURER | 5.00 | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GEORGE FERNANDEZ | |||||||
| DIRECTOR (END 12/31/2019) | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| JAKE ROUDENBUSH | |||||||
| DIRECTOR (END 12/31/2019) | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| JONAH PRUITT | |||||||
| DIRECTOR (END 12/31/2019) | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| OPAL WINEBRENNER | |||||||
| DIRECTOR | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| REV CYNTHIA WEEMS | |||||||
| DIRECTOR | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| REV DANILO QUEVEDO | |||||||
| DIRECTOR | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| REV RENE RAMIREZ | |||||||
| DIRECTOR (END 12/31/2019) | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| JUDITH PIERRE-OKERSON | |||||||
| DIRECTOR (BEG. 01/01/2020) | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| JESSICA RODRIGUEZ | |||||||
| DIRECTOR (BEG. 01/01/2020) | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| KENNETH VICTOR | |||||||
| DIRECTOR (BEG. 01/01/2020) | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |
| 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
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TURNER CONSTRUCTION COMPANY | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7235 CORPORATE CENTER DRIVE SUITE | AddressLine1Txt |
| City | MIAMI | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33126 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | RENOVATION SERVICES | ServicesDesc |
| Compensation | $758,132 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $500,000 | RelatedOrganizationsAmt |
| Total Contributions | $500,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RENTAL INCOME FROM AFFILIATE | Desc |
| Business | 531110 | BusinessCd |
| Total Revenue Column | $1,274,052 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,274,052 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,274,052 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,829 | TotalRevenueColumnAmt |
| Exclusion | $2,829 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,776,881 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,274,052 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,829 | ExclusionAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,000 | TotalAmt |
| Management And General | $40,000 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,200 | TotalAmt |
| Management And General | $40,200 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,240 | TotalAmt |
| Management And General | $2,240 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,168 | TotalAmt |
| Program Services | $420,168 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,731 | TotalAmt |
| Program Services | $367,647 | ProgramServicesAmt |
| Management And General | $16,084 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,610 | TotalAmt |
| Program Services | $216,958 | ProgramServicesAmt |
| Management And General | $99,652 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,202,949 | TotalAmt |
| Program Services | $1,004,773 | ProgramServicesAmt |
| Management And General | $198,176 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,417 | BOYAmt |
| EOY | $100,092 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,805 | BOYAmt |
| EOY | $196,515 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,138,728 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,822,698 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,508,705 | BOYAmt |
| EOY | $5,316,030 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,859,028 | BOYAmt |
| EOY | $1,157,628 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,580,955 | BOYAmt |
| EOY | $6,770,265 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,853 | BOYAmt |
| EOY | $46,190 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,663,910 | BOYAmt |
| EOY | $11,190,386 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,466 | BOYAmt |
| EOY | $114,031 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,735,229 | BOYAmt |
| EOY | $11,350,607 | 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 | -$5,154,274 | BOYAmt |
| EOY | -$4,580,342 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,154,274 | BOYAmt |
| EOY | -$4,580,342 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,580,955 | BOYAmt |
| EOY | $6,770,265 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $573,932 | ReconcilationRevenueExpnssAmt |
| 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALDERSGATE HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161676092 | EIN |
| Organization Type | 10 | OrganizationTypeCd |
| Governing Document Listed | 0 | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | Yes (1) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (1) | ActivitiesEngagedOrgInvlmntInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART I, LINE 12, COLUMN (VI) | THE FILING ORGANIZATION SUPPORTS IT SUPPORTED ORGANIZATION THROUGH THE PROVISION AND LEASE TO ITS SUPPORTED ORGANIZATION OF LAND, BUILDINGS, AND PERSONAL PROPERTY THAT CONSTITUTES THE SKILLED NURSING FACILITY OPERATED BY ITS SUPPORTED ORGANIZATION. THE FILING ORGANIZATION AND ITS SUPPORTED ORGANIZATION ARE RELATED TAX-EXEMPT ORGANIZATIONS. |
| SCHEDULE A, PART IV, SECTION A, LINE 1 | THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION STATE THAT SUSANNA WESLEY HEALTH CENTER, INC. IS ORGANIZED TO PROVIDE ELDERLY PERSONS AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES ESPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS. IN ACCORDANCE WITH ITS CHARITABLE PURPOSE, THE FILING ORGANIZATION LEASES REAL AND PERSONAL PROPERTY THAT CONSTITUTES A SKILLED NURSING FACILITY TO ALDERSGATE HEALTHCARE, INC., A RELATED 501(C)(3) ORGANIZATION, THAT OPERATES THE FACILITY. |
| SCHEDULE A, PART IV, SECTION D, LINE 3 | THE FILING ORGANIZATION SUPPORTS ALDERSGATE HEALTHCARE, INC. (THE SUPPORTED ORGANIZATION). THE PRIMARY ACTIVITY OF THE FILING ORGANIZATION IS TO OWN REAL AND PERSONAL PROPERTY THAT CONSTITUTES A SKILLED NURSING FACILITY AND LEASE SUCH PROPERTY TO THE SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. THE SUPPORTED ORGANIZATION HAS A SIGNIFICANT VOICE IN DIRECTING THE USE OF THE FILING ORGANIZATION'S ASSETS THROUGH THE OVERLAP OF THE EXECUTIVE DIRECTOR AND CERTAIN BOARD MEMBERS THAT PARTICIPATE IN THE GOVERNANCE OF BOTH ORGANIZATIONS. AS PRESCRIBED IN THE LEASE AGREEMENT PERTAINING TO THE SKILLED NURSING FACILITY, THE FILING ORGANIZATION IS RESPONSIVE TO THE NEEDS OF ITS SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. |
| SCHEDULE A, PART IV, SECTION E, LINE 2A | THE FILING ORGANIZATION SUPPORTS ALDERSGATE HEALTHCARE, INC. (THE SUPPORTED ORGANIZATION). THE SOLE ACTIVITY OF THE FILING ORGANIZATION IS THE LEASE OF REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY TO THE SUPPORTED ORGANIZATION THAT OPERATES THE FACILITY. THE ACTIVITY OF HOLDING TITLE TO AND LEASING THE SKILLED NURSING FACILITY TO THE SUPPORTED ORGANIZATION IS A DIRECT FURTHERANCE ACTIVITY AS THE FILING ORGANIZATION'S ASSETS ARE USED IN CARRYING OUT THE EXEMPT PURPOSE OF PROVIDING HOUSING AND SERVICES TO ELDERLY PERSONS AND HANDICAPPED PERSONS. PLEASE SEE OUR RESPONSE FOR SCHEDULE A, PART IV, SECTION D, QUESTION 3 REGARDING HOW THE FILING ORGANIZATION IS RESPONSIVE TO THE NEEDS AND DEMANDS OF THE SUPPORTED ORGANIZATION. |
| SCHEDULE A, PART IV, SECTION E, LINE 2B | THE ACTIVITY OF OWNING TITLE TO AND LEASING REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY TO ITS SUPPORTED ORGANIZATION IS AN ACTIVITY THAT, BUT FOR THE INVOLVEMENT OF THE FILING ORGANIZATION, THE SUPPORTED ORGANIZATION WOULD BE REQUIRED TO ENGAGE IN. WERE IT NOT FOR THE FILING ORGANIZATION, THE SUPPORTED ORGANIZATION WOULD EITHER BE REQUIRED TO PURCHASE THE REAL AND PERSONAL PROPERTY CONSTITUTING A SKILLED NURSING FACILITY OR LEASE SUITABLE PROPERTY IN ORDER TO CONDUCT ITS BUSINESS OF OPERATING A SKILLED NURSING FACILITY AND PROVIDING THESE NECESSARY SERVICES TO THE COMMUNITY. |
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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $261,000 | OtherCostOrOtherBasisAmt |
| Book Value | $261,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,996,501 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,112,584 | DepreciationAmt |
| Book Value | $4,883,917 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,773,986 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,710,114 | DepreciationAmt |
| Book Value | $63,872 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $107,241 | OtherCostOrOtherBasisAmt |
| Book Value | $107,241 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,316,030 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAPITAL RESERVE | Desc |
| Book Value | $1,157,628 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,157,628 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $114,031 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $114,031 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,776,881 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,776,881 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,776,881 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,202,949 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,202,949 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,202,949 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES, AS IT IS ORGANIZED UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MSL PUBLIC RELATIONS LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | ENTITY MORE THAN 35% OWNED BY MADELYN SIMON LOZANO, EXECUTIVE DIRECTOR | RelationshipDescriptionTxt |
| Transaction | $40,000 | TransactionAmt |
| Transaction | INDEPENDENT CONTRACTOR COMPENSATION | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR. A COPY OF THE FORM 990 IS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS BEFORE ITS FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE ANNUAL DISCLOSURE PROCESS AND PROHIBITS OFFICERS AND DIRECTORS FROM VOTING ON MATTERS WHERE ACTUAL CONFLICTS OF INTEREST EXIST. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS COMPENSATED AS AN INDEPENDENT CONTRACTOR AS APPROVED BY THE BOARD OF DIRECTORS. SEE SCHEDULE L, PART IV FOR FURTHER INFORMATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE FINANCIAL COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGNT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| EPWORTH VILLAGE INC | ||||||||||
| 5300 WEST 16TH AVENUE | HIALEAH | FL | 33012 | 590589990 | FUND RAISING FOR RELATED TAX-EXEMPT ORGANIZATIONS | FL | 501(C)(3) | LINE 12B, II | N/A | 0 |
| EPWORTH VILLAGE WEST INC | ||||||||||
| 5300 WEST 16TH AVENUE | HIALEAH | FL | 33012 | 591920293 | LEASE OF RETIREMENT LIVING FACILITY TO RELATED ORGANIZATION | FL | 501(C)(3) | LINE 12C, III-FI | N/A | 0 |
| ALDERSGATE HEALTHCARE INC | ||||||||||
| 5300 WEST 16TH AVENUE | HIALEAH | FL | 33012 | 161676092 | OPERATES SKILLED NURSING FACILITY | FL | 501(C)(3) | LINE 10 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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