2020-11-13T14:26:33-06:00 2019-12-31 480958002 MILLER HAVILAND KETTER PC PA 1901 W 47TH PLACE SUITE 204 WESTWOOD KS 66205 990 2019-01-01 431084953 BEAUTIFUL SAVIOR HOME BEAU 8163310781 1003 S CEDAR STREET BELTON MO 64012 BRENDA BUFORD ADMINISTRATOR 8163310781 2020-11-05 1 JAMES P KETTER P00165162 9134322727 136.41.2.51 2020-11-05 16:07:29 CS P 4776A6E09FE625D9554E656BBFC5180B2E0220DD 4776A6E09FE625D9554E656BBFC5180B2E0220DD 2019 2021-01-29 14:40:06Z BRENDA BUFORD 1003 S CEDAR STREET BELTON MO 64012 8603170 0 X WWW.BEAUTIFULSAVIORLUTHERANHOME.ORG X 1978 MO TO PROVIDE QUALITY CARE FOR SENIOR CITIZENS AND OTHERS IN NEED OF SUPERVISION AND TO IMPROVE EACH RESIDENT'S QUALITY OF LIFE. 9 9 205 12 0 0 0 0 8206747 8603170 0 0 0 0 8206747 8603170 0 0 0 0 4269898 4059428 0 0 0 4845544 5082550 9115442 9141978 -908695 -538808 4988215 5307808 2428513 3286914 2559702 2020894 TO PROVIDE QUALITY CARE FOR SENIOR CITIZENS AND OTHERS IN NEED OF SUPERVISION AND TO IMPROVE EACH RESIDENT'S QUALITY OF LIFE. 0 0 7708788 8603170 OPERATION OF 126-BED LONG-TERM CARE AND 50-BED RESIDENTIAL CARE NURSING HOME FOR PRIVATE PAY INDIVIDUALS AND FOR MEDICAID RECIPIENTS AT RATES DETERMINED BY THE STATE OF MISSOURI. 7708788 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 12 0 1 205 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X BRENDA BUFORD 8163310781 1003 S CEDAR STREET BELTON MO 64012 TOM FITZGERALD DIRECTOR 1.00 X 0 0 0 PEGGY POE DIRECTOR 1.00 X 0 0 0 DALE HEIL DIRECTOR/PRESIDENT 1.00 X X 0 0 0 PEGGY NOAH DIRECTOR 1.00 X 0 0 0 BRENDA BUFORD ADMINISTRATOR 40.00 X X 131683 0 0 PASTOR DAVID M ROLF DIRECTOR / VICE PRESIDENT 1.00 X X 0 0 0 CAROL BEHM DIRECTOR / ASST. SECRETARY 1.00 X X 0 0 0 JENNIFER DELUCA DIRECTOR / SECRETARY 1.00 X X 0 0 0 PAULINE MCDANIEL DIRECTOR 1.00 X 0 0 0 131683 0 0 1 0 0 0 AEGIS THERAPIES PO BOX 8103 FORT SMITH AR 72902 THERAPY 442191 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE STE 300 BENSALEM PA 19020 LAUNDRY & HOUSEKEEPING 273611 2 PATIENT REVENUES 623000 8603170 8603170 8603170 8603170 8603170 0 0 X 131683 131683 3420168 2922313 497855 14060 11951 2109 224334 190684 33650 269183 228806 40377 2376 2376 1018255 785864 232391 40719 40719 12478 12478 299771 254805 44966 12073 12073 60898 51763 9135 201992 171693 30299 410187 348659 61528 BAD DEBT EXPENSE 1626570 1626570 SUPPLIES 835021 647763 187258 MISSOURI BED TAX 427171 427171 REPAIRS & MAINTENANCE 64990 64990 70049 40746 29303 9141978 7708788 1433190 0 712380 358925 1896576 2742956 13441 195330 101148 7294065 5189286 2170488 2104779 4988215 5307808 863684 1096596 1334070 1750245 230759 440073 2428513 3286914 X 2559702 2020894 2559702 2020894 4988215 5307808 -538808 0 X X 1 X 0 1 0 X 8585982 8867560 8434339 8206747 8603170 42697798 8585982 8867560 8434339 8206747 8603170 42697798 0 0 0 42697798 8585982 8867560 8434339 8206747 8603170 42697798 1.00000 1.00000 0.00000 X 40173 40173 5416708 4102313 1314395 1837184 1086973 750211 2104779 DEPOSITS 143716 PATIENT CREDIT BALANCES 296357 440073 X PART X, LINE 2: THE HOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW AND THEREFORE HAS MADE NO PROVISION FOR INCOME TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS; IT IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. INCOME TAX RETURNS FILED BY THE HOME ON FORM 990 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) FOR THREE YEARS AFTER THE DATE FILED, WITH THE RESULT THAT YEARS 2019, 2018, 2017, AND 2016 REMAIN OPEN AS OF OCTOBER 2, 2020, ALTHOUGH NO RETURNS HAVE BEEN SELECTED FOR EXAMINATION BY THE IRS. MANAGEMENT HAS EVALUATED TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE HOME'S TAX RETURNS WITH ASSISTANCE FROM THE HOME'S TAX PREPARER TO DETERMINE WHETHER ITS TAX POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED BY APPLICABLE TAXING AUTHORITIES; LIKELY TAX POSITIONS ARE REPORTED IN THESE FINANCIAL STATEMENTS, AND MANAGEMENT IS NOT AWARE OF ANY UNLIKELY TAX POSITIONS, WITH THE RESULT THAT NO UNLIKELY TAX POSITIONS ARE REPORTED. FORM 990, PART VI, SECTION B, LINE 11B AN OUTSIDE INDEPENDENT CPA FIRM PREPARES AND REVIEWS THE FORM 990. PRIOR TO FILING, THE FORM 990 IS ALSO REVIEWED BY THE ADMINISTRATOR AND IS PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ANY CONFLICTS ARE EVALUATED BY THE BOARD. WHEN THERE IS A CONFLICT OF INTEREST: THE DIRECTOR OR OFFICER THAT HAS A CONFLICT WILL EXCUSE THEMSELVES FROM THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS REVIEWS THE EXECUTIVE DIRECTORS COMPENSATION USING COMPARABLE DATA AND DOCUMENTS THEIR DECISION PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE BEAUTIFUL SAVIOR HOME MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 785,864. MANAGEMENT AND GENERAL EXPENSES 10,543. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 796,407. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 157,502. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 157,502. DATA PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 64,346. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64,346. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. FORM 990 ELECTION SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION BEAUTIFUL SAVIOR HOME 1003 S. CEDAR STREET BELTON, MO 64012 EMPLOYER IDENTIFICATION NUMBER: 43-1084953 FOR THE YEAR ENDING DECEMBER 31, 2019 BEAUTIFUL SAVIOR HOME IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER REG. SEC. 1.263(A)-1(F).