SHADY REST CARE PAVILION INC: Form 990, tax year 2018
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- Organization
- SHADY REST CARE PAVILION INC (EIN 65-0850574)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-17
- IRS object ID
- 202022309349301602
- Schema version
- 2018v3.2
- 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 | 2020-08-17T13:30:10-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 592213319 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUPLEE SHEA CRAMER & ROCKLEIN PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 SOUTH OSPREY AVENUE | AddressLine1Txt |
| City | SARASOTA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 342367834 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 650850574 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHADY REST CARE PAVILION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SHAD | BusinessNameControlTxt |
| Phone | 2394182550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 CENTER POINTE DRIVE NO 112 | AddressLine1Txt |
| City | FORT MYERS | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 339169460 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WESTON EDWARDS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 2394182550 | PhoneNum |
| Signature | 2020-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS R CRAMER | PreparerPersonNm |
| PTIN | P00456445 | PTIN |
| Phone | 9413663600 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 74.93.34.33 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-17 | IPDt |
| IP Tm | 11:55:40 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 1B160AD7D319BEA4F97D97A592E597C025ADCF65 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 1B160AD7D319BEA4F97D97A592E597C025ADCF65 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAGE REHABILITATION AND HEALTHCARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WESTON EDWARDS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 CENTER POINTE DRIVE NO 112 | AddressLine1Txt |
| City | FORT MYERS | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 339169460 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,949,640 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A SKILLED NURSING FACILITY | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 451 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,800,656 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,928,048 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,303 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,081 | CYInvestmentIncomeAmt |
| PY Other Revenue | $50,465 | PYOtherRevenueAmt |
| CY Other Revenue | $19,511 | CYOtherRevenueAmt |
| PY Total Revenue | $15,854,424 | PYTotalRevenueAmt |
| CY Total Revenue | $3,949,640 | 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 | $10,096,833 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,652,009 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,272,702 | PYOtherExpensesAmt |
| CY Other Expenses | $2,194,827 | CYOtherExpensesAmt |
| PY Total Expenses | $16,369,535 | PYTotalExpensesAmt |
| CY Total Expenses | $5,846,836 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$515,111 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,897,196 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,452,442 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,692,710 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,415,727 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $222,966 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,036,715 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,469,744 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE SKILLED NURSING CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,846,836 | ExpenseAmt |
| Revenue | $3,947,559 | RevenueAmt |
| Desc | PROVIDE SKILLED NURSING CARE | Desc |
| Total Program Service Expenses | $5,846,836 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 47 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 451 | 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 |
| 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 | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | 0 | ConflictOfInterestPolicyInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FONDA POTTS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2394182550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4100 CENTER POINTE DRIVE SUITE 112 | AddressLine1Txt |
| City | FORT MYERS | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 339169460 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| ROBERT L MURRAY | ||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROBERT C MCCURDY | ||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SHEILA CARLSON | ||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SANDRA WHARTON | ||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ARIE J VANDUIJN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JO STECHER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES TAMBLYN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| WESTON EDWARDS | ||||||
| PRESIDENT/CEO | 20.00 | Yes (X) | $154,578 | $0 | $10,634 | |
| FONDA POTTS | ||||||
| CFO | 40.00 | Yes (X) | $144,872 | $0 | $9,857 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $299,450 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $20,491 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | 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 |
|---|---|---|---|---|---|
| ENCORE REHABILITATION SERVICES | |||||
| 33533 W 12TH MILE ROAD | FARMINGTON HILLS | MI | 48331 | REHABILITATION SERVICES | $1,172,578 |
| OMNICARE INC | |||||
| PO BOX 78000 | DETROIT | MI | 482781668 | PATIENT PHARMACEUTICALS | $306,143 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESIDENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $3,928,048 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,928,048 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,928,048 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,081 | TotalRevenueColumnAmt |
| Exclusion | $2,081 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $19,511 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,511 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $19,511 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,949,640 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,947,559 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,081 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,450 | TotalAmt |
| Program Services | $299,450 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,593,400 | TotalAmt |
| Program Services | $2,593,400 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,412 | TotalAmt |
| Program Services | $58,412 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,058 | TotalAmt |
| Program Services | $501,058 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,689 | TotalAmt |
| Program Services | $199,689 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,740 | TotalAmt |
| Program Services | $1,740 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,252 | TotalAmt |
| Program Services | $30,252 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,446 | TotalAmt |
| Program Services | $161,446 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $480 | TotalAmt |
| Program Services | $480 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,000 | TotalAmt |
| Program Services | $170,000 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,622 | TotalAmt |
| Program Services | $5,622 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,907 | TotalAmt |
| Program Services | $3,907 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,450 | TotalAmt |
| Program Services | $4,450 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,788 | TotalAmt |
| Program Services | $156,788 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBTS | $510,312 | $510,312 |
| PURCHASED SERVICES | $454,617 | $454,617 |
| OTHER SERVICES | $342,113 | $342,113 |
| OTHER SUPPLIES | $284,551 | $284,551 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,549 | TotalAmt |
| Program Services | $68,549 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,846,836 | TotalAmt |
| Program Services | $5,846,836 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,256,444 | BOYAmt |
| EOY | $468,148 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,074,109 | BOYAmt |
| EOY | $701,786 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,021 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,597 | BOYAmt |
| EOY | $235,871 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,996,271 | BOYAmt |
| EOY | $286,905 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,452,442 | BOYAmt |
| EOY | $1,692,710 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,261,201 | BOYAmt |
| EOY | $31,319 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,404,526 | BOYAmt |
| EOY | $191,647 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,415,727 | BOYAmt |
| EOY | $222,966 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,036,715 | BOYAmt |
| EOY | $1,469,744 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,036,715 | BOYAmt |
| EOY | $1,469,744 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,452,442 | BOYAmt |
| EOY | $1,692,710 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,897,196 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$1,669,775 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,661,816 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,540,449 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,465,779 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,800,656 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,928,048 | CurrentTaxYearAmt |
| Total | $69,396,748 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,661,816 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,540,449 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,465,779 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,800,656 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,928,048 | CurrentTaxYearAmt |
| Total | $69,396,748 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $69,396,748 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,479 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,231 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,938 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,303 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,081 | CurrentTaxYearAmt |
| Total | $23,032 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,479 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,231 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,938 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,303 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,081 | CurrentTaxYearAmt |
| Total | $23,032 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $59,127 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,506 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,835 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $50,465 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,606 | CurrentTaxYearAmt |
| Total | $195,539 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,726,422 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,558,186 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,526,552 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,854,424 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,949,735 | CurrentTaxYearAmt |
| Total | $69,615,319 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99690 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99690 | PublicSupportPY509Pct |
| Investment Income CY | 0.00030 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00030 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ACCOUNTS RECEIVABLE - OTHER | $87,896 |
| DUE FROM SHADY REST FOUNDATION, INC. | $196,131 |
| DUE FROM PAGE HEALTHCARE, INC. | $2,878 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $286,905 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED EXPENSES | $1,718 |
| DUE TO ALL ABOUT HOME CARE, INC. | $189,929 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $191,647 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WESTON EDWARDS | ||||||||||||||
| PRESIDENT/CEO | $137,089 | $0 | $0 | $0 | $17,489 | $0 | $6,854 | $0 | $3,780 | $0 | $165,212 | $0 | $0 | $0 |
| FONDA POTTS | ||||||||||||||
| CFO | $122,270 | $0 | $0 | $0 | $22,602 | $0 | $6,114 | $0 | $3,743 | $0 | $154,729 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990 AND RETURNS THE DRAFT TO MANAGEMENT OF THE ORGANIZATION. MANAGEMENT CHECKS THE RETURN AND HAS ANY SUGGESTED CHANGES MADE BEFORE DISTRIBUTING IT TO THE BOD MEMBERS. THE RETURN IS SENT TO ALL BOD MEMBERS WITH THEIR MONTHLY BOARD PACKETS SO THAT THE RETURN CAN BE REVIEWED BEFORE THE MONTHLY BOD MEETING. AT THE MEETING, AN OVERVIEW OF THE RETURN IS PROVIDED AND ANY QUESTIONS ARE ANSWERED. AFTER THE BOARD MEETING, THE 990 IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS TO DETERMINE COMPENSATION FOR THE CEO (TOP MANAGEMENT OFFICIAL) IS DIRECTED BY THE EXECUTIVE COMMITTEE OF THE BOD. THE EVALUATION IS DONE AFTER THE FINANCIAL AUDIT IS COMPLETED EACH FISCAL YEAR AND REPRESENTS MEASURABLE JOB PERFORMANCE STANDARDS. A REFERENCE BOOK, NURSING HOME SALARY AND BENEFITS REPORT, IS ORDERED EACH YEAR AND IS USED AS A BENCHMARK FOR ALL LEVELS OF MANAGEMENT AND STAFF FOR HIRING AND MARKET FACTOR INCREASES. IN ADDITION, MARKET FACTOR SURVEYS ARE CONDUCTED ANNUALLY BY THE HUMAN RESOURCES DEPARTMENT AND DATA IS OBTAINED FROM SIMILAR ORGANIZATIONS IN OUR GEOGRAPHIC AREA. OTHER OFFICERS OR KEY EMPLOYEES ARE EVALUATED ANNUALLY IN WRITING ACCORDING TO THEIR JOB DESCRIPTIONS BY THEIR SUPERVISORS. IF MERIT INCREASES ARE BEING GIVEN TO MANAGERS, THE MERIT INCREASES ARE GIVEN ACCORDING TO A SCALE OF POINTS EARNED AND USING THE SAME PERCENTAGE INCREASES AS ALL STAFF AND MANAGEMENT RECEIVE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION HAS CERTAIN GOVERNANCE INFORMATION AVAILABLE THROUGH THE CORPORATE FILING WITH THE STATE AND THE REPORTING CONTAINED IN THE 990. IN ADDITION, THE ANNUAL FINANCIAL AUDIT IS AVAILABLE AND DISTRIBUTED TO INTERESTED PARTIES (INSURANCE COMPANIES, BANKS, ETC.) IN ANY ADMINISTRATIVE MEETING OF THE ORGANIZATION, A FINANCIAL UPDATE IS PROVIDED. EACH MONTH IN FAMILY COUNCIL, A FINANCIAL REPORT IS GIVEN TO THE FAMILIES THAT ATTEND. THE PRESIDENT/CEO IS INTERVIEWED ROUTINELY BY THE NEWS MEDIA IN REGARD TO REIMBURSEMENT ISSUES, AND SHARES FINANCIAL INFORMATION REGARDING THE FINANCIAL IMPACT ON THE ORGANIZATION. AS FAR AS THE ANNUAL AHCA SURVEY INFORMATION, IT IS BOTH AVAILABLE IN THE FACILITY LOBBY FOR INTERESTED PARTIES AND POSTED ON THE MEDICARE.GOV WEBSITE. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| SHADY REST FOUNDATION INC | ||||||||||
| 4100 CENTER POINTE DRIVE SUITE 112 | FORT MYERS | FL | 339169460 | 300274280 | PROVIDE A FACILITY AND SUPPORT TO SHADY REST CARE PAVILION, INC. | FL | 501(C)(3) | 7 | N/A | 0 |
| ALL ABOUT HOME CARE INC | ||||||||||
| 4100 CENTER POINTE DRIVE SUITE 112 | FORT MYERS | FL | 339169460 | 208542270 | PROVIDE HOME HEALTH SERVICES | FL | 501(C)(3) | 3 | N/A | 0 |
| PAGE HEALTHCARE INC | ||||||||||
| 4100 CENTER POINTE DRIVE SUITE 112 | FORT MYERS | FL | 339169460 | 208542312 | PROVIDE MANAGEMENT SERVICES TO RELATED ORGANIZATIONS | FL | 501(C)(3) | 11 | 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | 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 | Yes (1) | 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 | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| SHADY REST FOUNDATION INC | |
| K | $170,000 |
| SHADY REST FOUNDATION INC | |
| P | $4,717,022 |
| ALL ABOUT HOME CARE INC | |
| Q | $147,506 |
| SHADY REST FOUNDATION INC | |
| D | $196,131 |
| ALL ABOUT HOME CARE INC | |
| E | $189,929 |
| PAGE HEALTHCARE INC | |
| D | $2,878 |
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