AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC (EIN 38-2236926)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-04
- IRS object ID
- 202013099349301411
- Schema version
- 2019v5.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-04T10:54:32-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2601 CAMBRIDGE CT STE 500 | AddressLine1Txt |
| City | AUBURN HILLS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48326 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382236926 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUSABLE VALLEY CONTINUING CARE | BusinessNameLine1Txt |
| Business Name Line2 | RETIREMENT COMMUNITY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AUSA | BusinessNameControlTxt |
| Phone | 9896523470 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 PIER NORTH BLVD NO STE A | AddressLine1Txt |
| City | FLINT | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48504 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY KALBFLEISCH | PersonNm |
| Person Title | SVP AND CFO | PersonTitleTxt |
| Phone | 9896523470 | PhoneNum |
| Signature | 2020-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TINA PETERS | PreparerPersonNm |
| PTIN | P00904574 | PTIN |
| Phone | 2483757100 | PhoneNum |
| Preparation | 2020-10-28 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 68.34.66.206 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-10-28 | IPDt |
| IP Tm | 15:14:34 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3BA07AC1E7B37A4123F7B0FAF00AF3DF039E44A3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLSPRING LUTHERAN SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID M GEHM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 PIER NORTH BLVD NO STE A | AddressLine1Txt |
| City | FLINT | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,241,769 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WELLSPRINGLUTHERAN.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 96 | TotalEmployeeCnt |
| Total Volunteers | 38 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $328 | PYContributionsGrantsAmt |
| CY Contributions Grants | $45,460 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,703,852 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,177,176 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$666 | PYInvestmentIncomeAmt |
| CY Investment Income | -$7,667 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,759 | PYOtherRevenueAmt |
| CY Other Revenue | $19,133 | CYOtherRevenueAmt |
| PY Total Revenue | $3,714,273 | PYTotalRevenueAmt |
| CY Total Revenue | $4,234,102 | 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 | $2,310,289 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,491,702 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,640,218 | PYOtherExpensesAmt |
| CY Other Expenses | $1,508,772 | CYOtherExpensesAmt |
| PY Total Expenses | $3,950,507 | PYTotalExpensesAmt |
| CY Total Expenses | $4,000,474 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$236,234 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $233,628 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,463,554 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,049,544 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,850,846 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,254,858 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,387,292 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$3,205,314 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,298,104 | ExpenseAmt |
| Revenue | $4,196,309 | RevenueAmt |
| Desc | SKILLED NURSING CARE AND INDEPENDENT LIVING OPTIONS PROVIDED 13,035 DAYS OF CARE AND 1,153 DAYS OF REHABILITATION, ROOM AND BOARD, NURSING CARE AND RELIGIOUS SERVICES FOR RESIDENTS. | Desc |
| Total Program Service Expenses | $3,298,104 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 12 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 96 | 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 |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAURA MCKAY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9892627381 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 PIER NORTH BLVD STE A | AddressLine1Txt |
| City | FLINT | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48504 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| DAVID M GEHM | |||||||
| PRESIDENT & CEO | 0.00 | 40.00 | Yes (X) | $0 | $265,141 | $14,956 | |
| AMY STORMS | |||||||
| SR. VP FINANCE/CFO - THRU 7/15/19 | 0.08 | 39.92 | Yes (X) | $0 | $171,737 | $7,702 | |
| TIMOTHY KALBFLEISCH | |||||||
| SR. VP FINANCE AND CFO | 0.08 | 39.92 | Yes (X) | $0 | $158,086 | $5,989 | |
| ALBERT D KAUL | |||||||
| VP HUMAN RESOURCES, CPO | 0.00 | 40.00 | Yes (X) | $0 | $142,822 | $11,690 | |
| SEAN DE FOUR | |||||||
| SR. VP AND COO | 0.25 | 39.75 | Yes (X) | $0 | $148,484 | $5,907 | |
| ERIC R MUSUM | |||||||
| VP, CAA AND CTO | 0.00 | 40.00 | Yes (X) | $0 | $139,522 | $11,214 | |
| RITCH CUSHWAY | |||||||
| CHAIRMAN | 0.20 | 0.80 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| PETE BENDER | |||||||
| TREASURER/SECRETARY | 0.20 | 0.80 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DARRELL ZOLTON | |||||||
| DIRECTOR | 0.20 | 0.80 | $0 | $0 | $0 | Yes (X) | |
| PAUL NYQUIST | |||||||
| DIRECTOR | 0.20 | 0.80 | $0 | $0 | $0 | Yes (X) | |
| CARL SCHOENOW | |||||||
| DIRECTOR | 0.20 | 0.80 | $0 | $0 | $0 | Yes (X) | |
| AMY BENKO | |||||||
| DIRECTOR | 0.20 | 0.80 | $0 | $0 | $0 | Yes (X) | |
| KEITH STONE | |||||||
| DIRECTOR - PART YEAR | 0.20 | 0.80 | $0 | $0 | $0 | Yes (X) | |
| KAREN STORCK | |||||||
| DIRECTOR | 0.20 | 0.80 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,025,792 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $57,458 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SELECT REHABILITATION | |||||
| 2600 COMPASS RD | GLENVIEW | IL | 60026 | THERAPY SERVICES | $201,811 |
| GORDON FOOD SERVICE INC | |||||
| 1300 GEZON PARKWAY SW | WYOMING | MI | 49509 | FOOD SERVICE | $135,303 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $45,460 | RelatedOrganizationsAmt |
| Total Contributions | $45,460 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ROOM/CARE/SKILLED NURS | 623990 | $4,173,089 | $4,173,089 |
| OTHER RESIDENT REIMB | 623990 | $4,087 | $4,087 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,177,176 | TotalProgramServiceRevenueAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,667 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$7,667 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,667 | TotalRevenueColumnAmt |
| Exclusion | -$7,667 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | $12,473 | $12,473 |
| REBATE INCOME | 900099 | $6,480 | $6,480 |
| MEALS - GUEST | 900099 | $180 | $180 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $19,133 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,234,102 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,196,309 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$7,667 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,109,623 | TotalAmt |
| Program Services | $1,931,906 | ProgramServicesAmt |
| Management And General | $177,717 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,658 | TotalAmt |
| Program Services | $20,165 | ProgramServicesAmt |
| Management And General | $4,493 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,188 | TotalAmt |
| Program Services | $156,278 | ProgramServicesAmt |
| Management And General | $43,910 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,233 | TotalAmt |
| Program Services | $143,857 | ProgramServicesAmt |
| Management And General | $13,376 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,039 | TotalAmt |
| Management And General | $239,039 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,515 | TotalAmt |
| Management And General | $8,515 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205 | TotalAmt |
| Management And General | $205 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,993 | TotalAmt |
| Program Services | $311,441 | ProgramServicesAmt |
| Management And General | $11,552 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,952 | TotalAmt |
| Program Services | $17,952 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,368 | TotalAmt |
| Program Services | $3,048 | ProgramServicesAmt |
| Management And General | $35,320 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,945 | TotalAmt |
| Program Services | $3,014 | ProgramServicesAmt |
| Management And General | $14,931 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,562 | TotalAmt |
| Program Services | $166,577 | ProgramServicesAmt |
| Management And General | $21,985 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,060 | TotalAmt |
| Program Services | $3,023 | ProgramServicesAmt |
| Management And General | $2,037 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,837 | TotalAmt |
| Program Services | $13,035 | ProgramServicesAmt |
| Management And General | $1,802 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,245 | TotalAmt |
| Program Services | $49,245 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,808 | TotalAmt |
| Program Services | $83,846 | ProgramServicesAmt |
| Management And General | $20,962 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,048 | TotalAmt |
| Management And General | $42,048 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS/MEDICAL SUPPLIES | $193,152 | $193,151 | $1 |
| FOOD | $110,668 | $110,668 | |
| MISCELLANEOUS EXPENSE | $90,296 | $49,113 | $41,183 |
| BAD DEBT EXPENSE | $41,785 | $41,785 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,294 | TotalAmt |
| Management And General | $23,294 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000,474 | TotalAmt |
| Program Services | $3,298,104 | ProgramServicesAmt |
| Management And General | $702,370 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $628,737 | BOYAmt |
| EOY | $166,064 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,554 | BOYAmt |
| EOY | $290,641 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,669 | BOYAmt |
| EOY | $4,005 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,624 | BOYAmt |
| EOY | $36,503 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,529,325 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,027,283 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,416,840 | BOYAmt |
| EOY | $1,502,042 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,130 | BOYAmt |
| EOY | $50,289 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,463,554 | BOYAmt |
| EOY | $2,049,544 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $266,652 | BOYAmt |
| EOY | $137,518 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,062,543 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $321,576 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,584,194 | BOYAmt |
| EOY | $3,733,221 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,850,846 | BOYAmt |
| EOY | $5,254,858 | 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 | -$3,418,998 | BOYAmt |
| EOY | -$3,235,458 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,706 | BOYAmt |
| EOY | $30,144 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,387,292 | BOYAmt |
| EOY | -$3,205,314 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,463,554 | BOYAmt |
| EOY | $2,049,544 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $233,628 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$51,650 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,069 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,030 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $328 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $45,460 | CurrentTaxYearAmt |
| Total | $64,887 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,736,077 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,492,977 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,475,490 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,703,852 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,177,176 | CurrentTaxYearAmt |
| Total | $20,585,572 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,383 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $600 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $313 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $365 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $180 | CurrentTaxYearAmt |
| Total | $10,841 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,745,460 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,496,646 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,491,833 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,704,545 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,222,816 | CurrentTaxYearAmt |
| Total | $20,661,300 | 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) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,311 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,723 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,191 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,145 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $59,078 | CurrentTaxYearAmt |
| Total | $129,448 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,311 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,723 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,191 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,145 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $59,078 | CurrentTaxYearAmt |
| Total | $129,448 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $20,531,852 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $2 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $1 | CurrentTaxYearMinus2YearsAmt |
| Total | $2 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,872 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $33,345 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,999 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,394 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,953 | CurrentTaxYearAmt |
| Total | $131,563 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,791,333 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,529,991 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,514,833 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,714,939 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,241,769 | CurrentTaxYearAmt |
| Total | $20,792,865 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98740 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98540 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME | ExplanationTxt |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $205 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $205 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | MEMBERSHIP FEE ALLOCATED TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $7,128 | BeginningBalanceAmt |
| Additions During Year | $102,849 | AdditionsDuringYearAmt |
| Distributions During Year | $101,069 | DistributionsDuringYearAmt |
| Ending Balance | $8,908 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $180,000 | OtherCostOrOtherBasisAmt |
| Book Value | $180,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,623,561 | OtherCostOrOtherBasisAmt |
| Depreciation | $502,853 | DepreciationAmt |
| Book Value | $1,120,708 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $725,764 | OtherCostOrOtherBasisAmt |
| Depreciation | $524,430 | DepreciationAmt |
| Book Value | $201,334 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,502,042 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $3,624,750 |
| ACCRUED OTHER LIABILITIES | $59,637 |
| RESIDENT SECURITY DEPOSITS | $15,396 |
| INTEREST RATE SWAP MARK TO MARKET | $33,438 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,733,221 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINE 1B: | FormAndLineReferenceDesc |
| Explanation | AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY, INC. IS REQUIRED TO MAINTAIN RESIDENT TRUST FUNDS AT ITS NURSING HOME. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID M GEHM | ||||||||||||||
| PRESIDENT & CEO | $0 | $265,141 | $0 | $0 | $0 | $0 | $0 | $7,750 | $0 | $7,206 | $0 | $280,097 | $0 | $0 |
| AMY STORMS | ||||||||||||||
| SR. VP FINANCE/CFO - THRU 7/15/19 | $0 | $171,737 | $0 | $0 | $0 | $0 | $0 | $3,593 | $0 | $4,109 | $0 | $179,439 | $0 | $0 |
| TIMOTHY KALBFLEISCH | ||||||||||||||
| SR. VP FINANCE AND CFO | $0 | $158,086 | $0 | $0 | $0 | $0 | $0 | $4,714 | $0 | $1,275 | $0 | $164,075 | $0 | $0 |
| ALBERT D KAUL | ||||||||||||||
| VP HUMAN RESOURCES, CPO | $0 | $142,822 | $0 | $0 | $0 | $0 | $0 | $4,750 | $0 | $6,940 | $0 | $154,512 | $0 | $0 |
| SEAN DE FOUR | ||||||||||||||
| SR. VP AND COO | $0 | $148,484 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,907 | $0 | $154,391 | $0 | $0 |
| ERIC R MUSUM | ||||||||||||||
| VP, CAA AND CTO | $0 | $139,522 | $0 | $0 | $0 | $0 | $0 | $4,408 | $0 | $6,806 | $0 | $150,736 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE PROCESS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO IS UNDERTAKEN BY LUTHERAN HOMES OF MICHIGAN, INC., A RELATED ORGANIZATION. THE PROCESS INCLUDES USE OF A COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4A | AMY STORMS RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $52,856. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS LUTHERAN HOMES OF MICHIGAN, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S SOLE MEMBER, LUTHERAN HOMES OF MICHIGAN, INC., HAS THE AUTHORITY TO APPOINT/ELECT INDIVIDUALS TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES OF THE FORM 990 WERE SENT TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS' INPUTS AND COMMENTS WERE SOLICITED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST FORMS ARE COLLECTED IN THE BEGINNING OF EACH NEW BOARD YEAR. THE FORMS ARE REVIEWED BY THE CEO. IF A CONFLICT EXISTS, THE CEO REVIEWS WITH THE BOARD CHAIR AND DETERMINES THE APPROPRIATE ACTION, WHICH IS TYPICALLY TO REMOVE THE INDIVIDUAL FROM THE POSITION OF CONFLICT FOR THE SPECIFIC TRANSACTION/PROCESS. |
| 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 AT THE CORPORATE OFFICE OF WELLSPRING LUTHERAN SERVICES BY CONTACTING THE CHIEF FINANCIAL OFFICER. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF INTEREST RATE SWAP -50,088. CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATION -1,562. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LUTHERAN HOMES OF MICHIGAN INC | |||||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 381358410 | NURSING CARE | MI | 501(C)(3) | LINE 10 | N/A | 0 | |
| LUTHERAN HOMES OF MICHIGAN FOUNDATION | |||||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 261630687 | DONATE FUNDS | MI | 501(C)(3) | LINE 12A | Yes (1) | LUTHERAN HOMES OF MICHIGAN INC | |
| LUTHERAN HOME CARE PERSONAL ASSISTANCE | |||||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 272138954 | HOME CARE | MI | 501(C)(3) | LINE 10 | Yes (1) | LUTHERAN HOMES OF MICHIGAN INC | |
| LUTHERAN HOME CARE AGENCY INC | |||||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 383081979 | SENIOR SERVICES | MI | 501(C)(3) | LINE 10 | Yes (1) | LUTHERAN HOMES OF MICHIGAN INC | |
| PROJECT COMPASSION HEALTH | |||||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 382395647 | SKILLED NURSING FACILITY | MI | 501(C)(3) | LINE 10 | Yes (1) | LUTHERAN HOMES OF MICHIGAN INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| ALPENA VILLAGE | |||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 320090735 | RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY | MI | N/A |
| GIBRALTER LDHALP | |||||||
| 26200 LAHSER RD STE 300 | SOUTHFIELD | MI | 48034 | 301829767 | PROVIDE AFFORDABLE HOUSING TO THE ELDERLY | MI | N/A |
| MONROE ELDERLY LDHALP | |||||||
| 5309 TRANSPORTATION BLVD | CLEVELAND | OH | 44125 | 383609893 | PROVIDE AFFORDABLE HOUSING TO THE ELDERLY | MI | N/A |
| ALPENA PINES LDHALP | |||||||
| 9710 JUNCTION ROAD | FRANKENMUTH | MI | 48434 | 260236982 | PROVIDE AFFORDABLE HOUSING TO THE ELDERLY | MI | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| LHM HOUSING SERVICES INC | |||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 383609879 | HOUSING SERVICES | MI | N/A | C | 0 |
| GIBRALTER MANOR DEVELOPMENT INC | |||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 202240778 | HOUSING SERVICES | MI | N/A | C | 0 |
| ALPENA PINES DEVELOPMENT INC | |||||||||
| 4100 PIER NORTH BLVD STE A | FLINT | MI | 48504 | 260237019 | HOUSING SERVICES | MI | N/A | C | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUTHERAN HOMES OF MICHIGAN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionTypeTxt |
| Involved | $239,039 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL AMOUNT | MethodOfAmountDeterminationTxt |