2025-08-22T07:03:54-05:00 2024-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2024-01-01 350913539 MAPLE MANOR CHRISTIAN HOME INC MAPL 8122464866 643 W UTICA ST SELLERSBURG IN 471721163 STEPHEN WILSON DIRECTOR OF FINANCE 8122464866 2025-08-22 1 1 TYLER K GREENE CPA P00057872 3176334705 2025-08-22 2024 2025-03-06 01:10:19Z STEVE CUNNINGHAM 643 W UTICA ST SELLERSBURG IN 471721163 4676847 0 X MAPLEMANORCHRISTIANHOME.ORG X 1972 IN NURSING HOME TO PROVIDE MEDICAL CARE INCLUDING ROOM AND BOARD (FORMED IN 1972). ALSO PROVIDING PHYSICAL PROPERTY FOR CHILDREN'S HOME (FORMED 1945). 12 10 122 10 0 0 22045 17809 3880107 4634674 31071 13364 12000 11000 3945223 4676847 580 494 0 0 3161454 3826100 0 0 0 180120 158806 3342154 3985400 603069 691447 4245156 4027377 33564 893 4211592 4026484 NURSING HOME TO PROVIDE MEDICAL CARE IN ADDITION TO ROOM AND BOARD; PROVIDE PHYSICAL PROPERTY FOR OPERATIONS OF CHILDREN HOME TO CARE FOR DISPLACED AND AT-RISK CHILDREN. 0 0 3770485 494 4645674 MAPLE MANOR IS A CMS TOP RATED FACILITY WITH 57 LICENSED BEDS FOR INDIANA STATE MEDICAID PROVIDING INDIGENT CARE. 3770485 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 122 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X STEPHEN WILSON 8122464866 643 W UTICA ST SELLERSBURG IN 471721163 STEVE CUNNINGHAM ADMINISTRATOR/CEO 40.00 0.00 X X 106160 0 51365 CULLEN ISTRE ADMINISTATOR IN TRAINING 40.00 0.00 X 67253 0 0 RICK SIMPSON DIRECTOR 4.00 0.00 X 0 0 0 JONATHAN RAKICH DIRECTOR 4.00 0.00 X 0 0 0 KENNY LEACH DIRECTOR 4.00 0.00 X 0 0 0 ROB JONES DIRECTOR 4.00 0.00 X 0 0 0 HOUSTON COCKRELL DIRECTOR 4.00 0.00 X 0 0 0 KENNETH PETTIT SECRETARY 4.00 0.00 X X 0 0 0 NICK RAY VICE PRESIDENT 4.00 0.00 X X 0 0 0 NATHAN GRIMES PRESIDENT 4.00 0.00 X X 0 0 0 LARRY MILES DIRECTOR 4.00 0.00 X 0 0 0 WILL NETHERY DIRECTOR 4.00 0.00 X 0 0 0 STEPHEN WILSON DIRECTOR OF FINANCE 40.00 0.00 X 74269 0 22143 JACQUELYN PIKE DIRECTOR OF NURSING 40.00 0.00 X 142788 0 3938 390470 0 77446 2 0 1 0 ACCURATE HEALTHCARE PROFESSIONALS 2221 BUECHEL AVE SUITE 1 LOUISVILLE KY 40218 HEALTHCARE EMPLOYMENT SERVICES 616368 SHIFTKEY LLC PO BOX 735913 DALLAS TX 75373 STAFFING AGENCY 582114 HTS HEALTHCARE THERAPY 1500 AMERICAN WAY STE 110 GREENWOOD IN 46143 THERAPY SERVICES 196054 3 17809 17809 OTHER MGMT SVC REVENUE 623000 3823523 3823523 LEASE REVENUE 623000 444000 444000 MANAGEMENT SERVICE REV 623000 367151 367151 4634674 13364 13364 11000 0 11000 11000 11000 4676847 4645674 0 13364 494 494 253938 126969 126969 3068660 3068660 45900 43605 2295 214506 208071 6435 243096 221217 21879 3800 3800 4500 4500 1926 1926 21129 21129 107073 53536 53537 10189 10189 DUES & LICENSES 3000 3000 7189 7189 3985400 3770485 214915 0 123976 80790 758124 574216 1175424 1095757 584958 570000 5605 6417 4983507 3283310 1597069 1700197 4245156 4027377 33564 893 33564 893 X 0 0 0 0 4211592 4026484 4211592 4026484 4245156 4027377 691447 14263 -890818 0 X X 0 0 0 X 22443 24622 21560 22045 17809 108479 22443 24622 21560 22045 17809 108479 108479 17350 21952 16794 43071 24364 123531 4437 4437 236447 10859673 0.45880 0.46750 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 4,437. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100664 100664 2306393 1694196 612197 1482873 672570 810303 1051348 916544 134804 42229 42229 1700197 X 0 0 X 0 0 0 0 0 0 0 0 0 STEVE CUNNINGHAM ADMINISTRATOR/CEO 106160 0 0 0 0 0 2884 0 48481 0 157525 0 0 0 PART I, LINE 1A THE ADMINISTRATOR/CEO WAS PROVIDED RENT-FREE HOUSING ON CAMPUS DURING 2024. THE HOUSING PROVIDED WAS NOT INCLUDED IN TAXABLE INCOME. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS AVAILABLE TO ALL BOARD MEMBERS FOR REVIEW. THE ADMINISTRATOR AND THE DIRECTOR OF FINANCE REVIEW THE 990 WITH THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEETING, THE DIRECTORS ARE ASKED IF THEY HAVE A CONFLICT OF INTEREST TO DISCLOSE AND IS RECORDED IN THE MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICERS' COMPENSATION IS SET AND DETERMINED BY THE BOARD OF DIRECTORS EACH YEAR AT THE BOARD MEETING IN EITHER OCTOBER OR JANUARY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST TO MAPLE MANOR 643 WEST UTICA STREET, SELLERSBURG, INDIANA ATTN: CULLEN ISTRE. FORM 990, PART XII: THE FINANCIALS ARE COMPILED AND REVIEWED BY FORVIS, AN ACCOUNTING FIRM, TO FILE SKILLED NURSING FACILITY FEDERAL MEDICARE COST REPORT AND INDIANA ANNUAL MEDICAID REPORTS. THESE REPORTS ARE THEN REVIEWED BY MYERS AND STAUFFER FOR RATE REIMBURSEMENTS AND ARE SUBJECT TO REVIEW AND AUDIT.