COMMUNITY LTC INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY LTC INC (EIN 35-1877441)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-15
IRS object ID
202143199349313394
Schema version
2020v4.1
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)
Return2021-11-15T11:39:22-08:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GORDON & GORDON PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19850 N 950 EAddressLine1Txt
CityBROWNSBURGCityNm
State AbbreviationINStateAbbreviationCd
ZIP46112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351877441EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Community LTC IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone7652032681PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11030 South Scatterfield RdAddressLine1Txt
CityAndersonCityNm
State AbbreviationINStateAbbreviationCd
ZIP46012ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDiana SmithPersonNm
Person TitleChief Financial OfficerPersonTitleTxt
Phone7652032681PhoneNum
Signature2021-11-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDianaPersonFirstNm
Person LastSmithPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDON GATLINPreparerPersonNm
PTINP00019229PTIN
Phone3178867422PhoneNum
Preparation2021-11-15PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Elizabeth HarpeBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11030 South Scatterfield RdAddressLine1Txt
CityAndersonCityNm
State AbbreviationINStateAbbreviationCd
ZIP46012ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$14,281,089GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTo provide room, board, and nursing care services as well as assisted living services to elderly citizens of Madison and surrounding counties.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee381TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$11,386,119PYProgramServiceRevenueAmt
CY Program Service Revenue$14,270,007CYProgramServiceRevenueAmt
PY Investment Income$4,620PYInvestmentIncomeAmt
CY Investment Income$1,846CYInvestmentIncomeAmt
PY Other Revenue$41,246PYOtherRevenueAmt
CY Other Revenue$9,236CYOtherRevenueAmt
PY Total Revenue$11,431,985PYTotalRevenueAmt
CY Total Revenue$14,281,089CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,124,365PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,531,121CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$629,949PYOtherExpensesAmt
CY Other Expenses$637,854CYOtherExpensesAmt
PY Total Expenses$10,754,314PYTotalExpensesAmt
CY Total Expenses$13,168,975CYTotalExpensesAmt
PY Revenues Less Expenses$677,671PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,112,114CYRevenuesLessExpensesAmt
Total Assets BOY$14,614,739TotalAssetsBOYAmt
Total Assets EOY$17,374,536TotalAssetsEOYAmt
Total Liabilities BOY$106,755TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,756,226TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,507,984NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,618,310NetAssetsOrFundBalancesEOYAmt
MissionTo provide room, board, and nursing care services as well as assisted living services to elderly citizens of Madison and surrounding counties.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$12,209,809ExpenseAmt
Grant$0GrantAmt
Revenue$14,270,007RevenueAmt
DescCommunity Long Term Care, Inc. ("CLTC") operates 3 nursing facilities with a total of 254 licensed beds of which 193 are licensed as skilled nursing beds and 1 assisted living facility. The facility provides long term nursing care or assisted living to area residents who need such services. CLTC participates in the Medicare, Medicaid, Tri-Care, and other government sponsored health care programs as well as private managed care and other health insurance programs. The staff at CLTC make every effort to provide quality services to the residents. Goals are to 1) meet or exceed expectations, 2) display a positive and energetic attitude, 3) honor the dignity, value and involvement of others, 4) provide high quality services at a reasonable cost, and 5) continously improve services. The CLTC governing body is comprised of independent members of the community.Desc
Total Program Service Expenses$12,209,809TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee381EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressYes (true)OfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Diana SmithBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7652032681PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11030 South Scatterfield RdAddressLine1Txt
CityAndersonCityNm
State AbbreviationINStateAbbreviationCd
ZIP46012ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
Jay Ricker
Chairman0.50Yes (X)$0$0$0
John Longnaker
Member-Board of Directors0.50Yes (X)$0$0$0
Amie Neiling
Member-Board of Directors0.50Yes (X)$0$0$0
Elizabeth Harpe
Director of Senior Services40.00$174,670$0$4,561Yes (X)
Diana Smith
CFO40.00$168,094$0$6,723Yes (X)
John Harris
Secretary/Treasurer0.50Yes (X)$0$0$0
Mary Jo Lee
Member-Board of Directors0.50Yes (X)$0$0$0
Dr Kelly Chambers
Member-Board of Directors0.50Yes (X)$0$0$0
Elizabeth Tharp
Member-Board of Directors0.50Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$342,764TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$11,284TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonBW Construction LLCPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 Russell AveAddressLine1Txt
CityIndianapolisCityNm
State AbbreviationINStateAbbreviationCd
ZIP46225ZIPCd
FieldValueIRS element (for citing)
ServicesConstruction WorkServicesDesc
Compensation$972,398CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescProgram Service RevenueDesc
Business623000BusinessCd
Total Revenue Column$14,270,007TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$14,270,007TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,846TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,846ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMisc. IncomeDesc
Business623000BusinessCd
Total Revenue Column$9,236TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$9,236ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$9,236OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,281,089TotalRevenueColumnAmt
Related Or Exempt Func Income$14,270,007RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$11,082ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$342,764TotalAmt
Program Services$0ProgramServicesAmt
Management And General$342,764ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,606,635TotalAmt
Program Services$9,260,694ProgramServicesAmt
Management And General$345,941ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,858,373TotalAmt
Program Services$1,728,287ProgramServicesAmt
Management And General$130,086ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$723,349TotalAmt
Program Services$672,715ProgramServicesAmt
Management And General$50,634ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$629,806TotalAmt
Program Services$547,274ProgramServicesAmt
Management And General$82,532ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,048TotalAmt
Program Services$839ProgramServicesAmt
Management And General$7,209ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$13,168,975TotalAmt
Program Services$12,209,809ProgramServicesAmt
Management And General$959,166ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,391,496BOYAmt
EOY$4,409,703EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,055,505BOYAmt
EOY$6,993,809EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$21,839BOYAmt
EOY$23,219EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,370,869LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,423,064LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,145,899BOYAmt
EOY$5,947,805EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$14,614,739BOYAmt
EOY$17,374,536EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$94,698BOYAmt
EOY$46,785EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$1,695,653EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,057BOYAmt
EOY$13,788EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$106,755BOYAmt
EOY$1,756,226EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,507,984BOYAmt
EOY$15,618,310EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,507,984BOYAmt
EOY$15,618,310EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,614,739BOYAmt
EOY$17,374,536EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,112,114ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$1,788PriorPeriodAdjustmentsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind
Other Support Sum$0OtherSupportSumAmt
Public Support CY1700PublicSupportCY170Pct

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,217CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$8,217TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,226,721CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,352,143CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,603,404CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,386,119CurrentTaxYearMinus1YearAmt
Current Tax Year$14,270,007CurrentTaxYearAmt
Total$59,838,394TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,226,721CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,360,360CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,603,404CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,386,119CurrentTaxYearMinus1YearAmt
Current Tax Year$14,270,007CurrentTaxYearAmt
Total$59,846,611TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$59,846,611PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$119CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,118CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,754CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,620CurrentTaxYearMinus1YearAmt
Current Tax Year$1,846CurrentTaxYearAmt
Total$12,457TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$119CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,118CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,754CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,620CurrentTaxYearMinus1YearAmt
Current Tax Year$1,846CurrentTaxYearAmt
Total$12,457TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,210CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$36,967CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,666CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$41,246CurrentTaxYearMinus1YearAmt
Current Tax Year$9,236CurrentTaxYearAmt
Total$104,325TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Total$59,963,393TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99810PublicSupportCY509Pct
Public Support PY5090.99810PublicSupportPY509Pct
Investment Income CY0.00020InvestmentIncomeCYPct
Investment Income PY0.00020InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePt III Ln 12FormAndLineReferenceDesc
ExplanationOther Income Part III, Line 12 Description: Other Income 2016: 8210. 2017: 36967. 2018: 8666. 2019: 41246. 2020: 9236.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$207,200OtherCostOrOtherBasisAmt
Book Value$207,200BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,310,644OtherCostOrOtherBasisAmt
Depreciation$4,550,769DepreciationAmt
Book Value$3,759,875BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,663,509OtherCostOrOtherBasisAmt
Depreciation$872,295DepreciationAmt
Book Value$791,214BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,189,516OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$1,189,516BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,947,805TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Resident Funds$9,840
Due to Other$3,948
FieldValueIRS element (for citing)
Total Liability$13,788TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Elizabeth Harpe
$174,670$0$0$0$0$0$0$0$4,561$0$179,231$0$0$0
Diana Smith
$168,094$0$0$0$0$0$0$0$6,723$0$174,817$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (53 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 11bThe Form 990 is prepared by an outside Accountant.
Pt VI, Line 11bA complete copy of Form 990 was provided to the CFO prior
Pt VI, Line 11bto filing. The CFO will forward the Form 990 to each member
Pt VI, Line 11bof the Board of Directors who will discuss it with each
Pt VI, Line 11bmember and answer any questions.
Pt VI, Line 12cThe conflict of interest policy is discussed with new
Pt VI, Line 12cboard members at the start of their term.
Pt VI, Line 12cThe board of directors and key employees are required to
Pt VI, Line 12csign the conflict of interest policy and disclose any
Pt VI, Line 12cconflicts at the beginning of every Board Meeting and
Pt VI, Line 12con an annual basis. Board members are prohibited from
Pt VI, Line 12cvoting or exerting personal influence related to any issue
Pt VI, Line 12cthat presents a conflict of interest.
Pt VI, Line 15aTop management compensation of Community LTC, Inc. is
Pt VI, Line 15adetermined by the Board of Directors. The Board of
Pt VI, Line 15aDirectors evaluates the performance of the CEO and CFO and
Pt VI, Line 15adetermines compensation based on average compensation
Pt VI, Line 15aincreases in the industry in general and compensation at
Pt VI, Line 15asimilar facilities.
Pt VI, Line 15aCommunity LTC, Inc. participates in a state and national
Pt VI, Line 15aindustry trade association which conducts an annual wage
Pt VI, Line 15asurvey - this survey is utilized for evaluation of
Pt VI, Line 15asalaries and wages.
Pt VI, Line 15bOther officers and key employees compensation is proposed
Pt VI, Line 15bby the CEO for Board of Directors' approval as part of
Pt VI, Line 15bthe annual budget process. The CEO and CFO together review
Pt VI, Line 15bthe performance of department heads and other regular
Pt VI, Line 15bemployees determining compensation adjustments based on
Pt VI, Line 15bindustry adjustments and compensation levels at other
Pt VI, Line 15bfacilities. Community, LTC, Inc. participates in a state
Pt VI, Line 15band national industry trade association which conducts an
Pt VI, Line 15bannual wage survey - this survey is utilized for
Pt VI, Line 15bevaluation of salaries and wages.
Pt VI, Line 19A) The articles of incorporation and certificate of
Pt VI, Line 19existence are on file with the Indiana Secretary of State
Pt VI, Line 19and are available to the public upon request to the
Pt VI, Line 19Indiana Secretary of State.
Pt VI, Line 19B) Community LTC, Inc. conflict of interest policy is
Pt VI, Line 19available to the public upon request.
Pt VI, Line 19Community LTC, Inc. does file the Form 990 tax return,
Pt VI, Line 19Medicaid and Medicare Cost Reports with the appropriate
Pt VI, Line 19agencies on an annual basis. The Form 990 tax return is
Pt VI, Line 19available upon request and/or available on a delayed
Pt VI, Line 19basis on GuideStar.com. The Medicaid and Medicare
Pt VI, Line 19Cost Reports are available via Freedom of Information
Pt VI, Line 19Request filed with the applicable agencies.
Form 990, Part VI, Line 9Jay Ricker 6320 West Foster Branch Dr. Pendleton IN 46064
Form 990, Part VI, Line 9John Longnaker 940 Meridian Street Anderson IN 46016
Form 990, Part VI, Line 9Amie Neiling 1329 Dahlgren Lane Cicero IN 46034
Form 990, Part VI, Line 9John Harris 217 Somerville Rd. Anderson IN XXX-XX-XXXX
Form 990, Part VI, Line 9Mary Jo Lee P.O. Box 1302 Anderson IN 46015
Form 990, Part VI, Line 9Dr. Kelly Chambers 9739 W. 400 N. Noblesville IN 46060
Form 990, Part VI, Line 9Elizabeth Tharp 1515 N. Madison Ave. Anderson IN 46011

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