ELK HAVEN NURSING HOME ASSOCIATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ELK HAVEN NURSING HOME ASSOCIATION (EIN 23-1945075)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-09-24
- IRS object ID
- 202042689349300704
- 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 | 2020-09-24T07:28:19-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 311543240 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CBIZ MHM LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 PLYMOUTH ROAD SUITE 200 | AddressLine1Txt |
| City | PLYMOUTH MEETING | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19462 | 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 | 231945075 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELK HAVEN NURSING HOME ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ELKH | BusinessNameControlTxt |
| Phone | 8148342618 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 785 JOHNSONBURG ROAD | AddressLine1Txt |
| City | ST MARYS | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15857 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUNE SORG | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 8148342618 | PhoneNum |
| Signature | 2020-09-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOSEPH G SULLIVAN | PreparerPersonNm |
| PTIN | P00360476 | PTIN |
| Phone | 6108622249 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 141.151.80.82 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-09-09 | IPDt |
| IP Tm | 12:36:00 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 56971691821012DDD9905C946DE3CC28305BB2C4 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JUNE SORG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 785 JOHNSONBURG ROAD | AddressLine1Txt |
| City | ST MARYS | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15857 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,795,981 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ELKHAVENNURSINGHOME.COM | WebsiteAddressTxt |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDING LONG TERM NURSING CARE THROUGH A SKILLED NURSING FACILITY AND PERSONAL CARE UNIT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 268 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $18,208 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,906 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,464,934 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,981,274 | CYProgramServiceRevenueAmt |
| PY Investment Income | $541,181 | PYInvestmentIncomeAmt |
| CY Investment Income | $432,027 | CYInvestmentIncomeAmt |
| PY Other Revenue | $51,574 | PYOtherRevenueAmt |
| CY Other Revenue | $69,774 | CYOtherRevenueAmt |
| PY Total Revenue | $11,075,897 | PYTotalRevenueAmt |
| CY Total Revenue | $11,495,981 | 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 | $7,247,688 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,238,454 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,840,412 | PYOtherExpensesAmt |
| CY Other Expenses | $3,644,706 | CYOtherExpensesAmt |
| PY Total Expenses | $11,088,100 | PYTotalExpensesAmt |
| CY Total Expenses | $10,883,160 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$12,203 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $612,821 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,944,697 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,660,055 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $771,198 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,025,578 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,173,499 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,634,477 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS TO BE THE LEADING PROVIDER OF SPECIALIZED HEALTH CARE PROGRAMS, PRODUCTS AND SERVICES IN THE AREA. WE ARE COMMITTED TO QUALITY, DIGNITY, RESPECT AND HOSPITALITY IN OUR CUSTOMER SERVICE AND ACTIVE PARTICIPATION IN THE COMMUNITIES WE SERVE. EMPOWERED EMPLOYEES DRIVE OUR CUSTOMER RELATIONS AND CREATE AN ATMOSPHERE WHICH ENHANCES PERSONAL GROWTH, EXPANDS RESPONSIBILITY, MAXIMIZES CREATIVITY AND INSTILLS TRUST. WE BELIEVE IN CREATING VALUE FOR OUR CUSTOMERS. MEETING THEIR INDIVIDUAL AND COLLECTIVE NEEDS IS A SHARED RESPONSIBILITY AND THE STANDARD OF CONDUCT BY WHICH EACH OF US IS MEASURED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,704,619 | ExpenseAmt |
| Revenue | $10,981,274 | RevenueAmt |
| Desc | ASSOCIATION OPERATES A 120-BED NURSING FACILITY AND A 40-UNIT PERSONAL CARE CENTER, PROVIDING HOUSING, HEALTH CARE AND OTHER RELATED SERVICES FOR THE RESIDENTS OF ELK COUNTY, PENNSYLVANIA. IN PROVIDING SERVICES, CERTAIN INDIVIDUALS ARE NOT DENIED SERVICES IN EXCESS OF THEIR MEANS. THE ESTIMATED COST OF PROVIDING CHARITY CARE IS APPROXIMATELY $748,000 FOR THE YEAR ENDED DECEMBER 31, 2019. | Desc |
| Total Program Service Expenses | $9,704,619 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 |
| 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 268 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPLETE HEALTHCARE RESOURCES-EASTERN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2153285723 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 DRYDEN ROAD SUITE 2000 | AddressLine1Txt |
| City | DRESHER | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| ROBERT SCHRIEBER | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JUNE SORG | ||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SANDRA SCHWABENBAUER | ||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CHARLETTE GERG | ||||||
| VICE PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LOU RADKOWSKI | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MARK JACOB | ||||||
| SOLICITOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| ARLENE ANDERSON | ||||||
| ADMINISTRATOR | 40.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| REHABCARE GROUP INC | |||||
| PO BOX 503534 | ST LOUIS | MO | 63150 | REHABILIATION SERVICES | $735,108 |
| COMPLETE HEALTHCARE RESOURCES-EASTERN I | |||||
| 200 DRYDEN ROAD SUITE 3100 | DRESHER | PA | 19025 | MANAGEMENT SERVICES | $529,970 |
| HALLSTROM CONSTRUCTION INC | |||||
| 101 EAST LONG AVENUE PO BOX 648 | DEBOIS | PA | 15801 | CONSTRUCTION | $282,593 |
| ST MARY'S PHARMACY | |||||
| 4 RAILROAD ST | ST MARYS | PA | 15857 | PHARMACY | $205,643 |
| BUDGET MEDICAL PARTS AND SUPPLY | |||||
| PO BOX 946 | MORRITON | AR | 72110 | MAINTENANCE REPAIRS | $190,684 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $12,906 | AllOtherContributionsAmt |
| Total Contributions | $12,906 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESIDENT SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $10,981,274 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,981,274 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,981,274 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $435,037 | TotalRevenueColumnAmt |
| Exclusion | $435,037 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $296,990 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $300,000 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$3,010 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,010 | TotalRevenueColumnAmt |
| Exclusion | -$3,010 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER REVENUE | 900099 | $35,527 | $35,527 |
| FOOD REVENUE | 900099 | $34,247 | $34,247 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $69,774 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,495,981 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,981,274 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $501,801 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,462,965 | TotalAmt |
| Program Services | $5,308,924 | ProgramServicesAmt |
| Management And General | $154,041 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,073 | TotalAmt |
| Management And General | $29,073 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,322,634 | TotalAmt |
| Program Services | $1,300,619 | ProgramServicesAmt |
| Management And General | $22,015 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423,782 | TotalAmt |
| Program Services | $412,037 | ProgramServicesAmt |
| Management And General | $11,745 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,376 | TotalAmt |
| Program Services | $78,512 | ProgramServicesAmt |
| Management And General | $419,864 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,027 | TotalAmt |
| Management And General | $23,027 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,225 | TotalAmt |
| Management And General | $42,225 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,640 | TotalAmt |
| Program Services | $962,645 | ProgramServicesAmt |
| Management And General | $90,995 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,594 | TotalAmt |
| Program Services | $36 | ProgramServicesAmt |
| Management And General | $13,558 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,821 | TotalAmt |
| Program Services | $1,708 | ProgramServicesAmt |
| Management And General | $112,113 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,678 | TotalAmt |
| Management And General | $55,678 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,786 | TotalAmt |
| Program Services | $220,786 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,728 | TotalAmt |
| Program Services | $17,575 | ProgramServicesAmt |
| Management And General | $6,153 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,160 | TotalAmt |
| Program Services | $4,160 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,100 | TotalAmt |
| Program Services | $403,373 | ProgramServicesAmt |
| Management And General | $38,727 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,552 | TotalAmt |
| Management And General | $123,552 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $715,864 | $696,942 | $18,922 |
| PHYSICIAN FEES | $202,148 | $202,148 | |
| EQUIPMENT RENTAL | $34,400 | $20,579 | $13,821 |
| MISCELLANEOUS | $33,747 | $32,445 | $1,302 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,860 | TotalAmt |
| Program Services | $42,130 | ProgramServicesAmt |
| Management And General | $1,730 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,883,160 | TotalAmt |
| Program Services | $9,704,619 | ProgramServicesAmt |
| Management And General | $1,178,541 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,457,682 | BOYAmt |
| EOY | $1,749,551 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,672,232 | BOYAmt |
| EOY | $2,524,560 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $931,347 | BOYAmt |
| EOY | $809,428 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,944 | BOYAmt |
| EOY | $123,454 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,128,754 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,719,821 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,105,433 | BOYAmt |
| EOY | $5,408,933 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,380,961 | BOYAmt |
| EOY | $17,874,765 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,098 | BOYAmt |
| EOY | $169,364 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,944,697 | BOYAmt |
| EOY | $28,660,055 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $652,384 | BOYAmt |
| EOY | $961,158 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,695 | BOYAmt |
| EOY | $7,796 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,119 | BOYAmt |
| EOY | $56,624 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $771,198 | BOYAmt |
| EOY | $1,025,578 | 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 | $26,173,499 | BOYAmt |
| EOY | $27,634,477 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,173,499 | BOYAmt |
| EOY | $27,634,477 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,944,697 | BOYAmt |
| EOY | $28,660,055 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $612,821 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $848,157 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | $12,277 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,558 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,287 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,208 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,906 | CurrentTaxYearAmt |
| Total | $60,236 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,317,160 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,953,140 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,808,697 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,464,934 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,981,274 | CurrentTaxYearAmt |
| Total | $54,525,205 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,329,437 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,962,698 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,815,984 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,483,142 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,994,180 | CurrentTaxYearAmt |
| Total | $54,585,441 | 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 | $54,585,441 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $463,728 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $483,353 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $474,819 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $632,287 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $435,037 | CurrentTaxYearAmt |
| Total | $2,489,224 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $463,728 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $483,353 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $474,819 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $632,287 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $435,037 | CurrentTaxYearAmt |
| Total | $2,489,224 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $80,641 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57,833 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $49,811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $51,574 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $69,774 | CurrentTaxYearAmt |
| Total | $309,633 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,873,806 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,503,884 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,340,614 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,167,003 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,498,991 | CurrentTaxYearAmt |
| Total | $57,384,298 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.95120 | PublicSupportCY509Pct |
| Public Support PY509 | 0.95030 | PublicSupportPY509Pct |
| Investment Income CY | 0.04340 | InvestmentIncomeCYPct |
| Investment Income PY | 0.04420 | InvestmentIncomePYPct |
| 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 | OTHER REVENUE - 2015 AMOUNT: $ 25,576. 2016 AMOUNT: $ 15,658. 2017 AMOUNT: $ 12,370. 2018 AMOUNT: $ 15,904. 2019 AMOUNT: $ 35,527. FOOD REVENUE - 2015 AMOUNT: $ 55,065. 2016 AMOUNT: $ 42,175. 2017 AMOUNT: $ 37,441. 2018 AMOUNT: $ 35,670. 2019 AMOUNT: $ 34,247. | 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,000 | OtherCostOrOtherBasisAmt |
| Book Value | $44,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,689,671 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,014,082 | DepreciationAmt |
| Book Value | $4,675,589 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $263,911 | OtherCostOrOtherBasisAmt |
| Depreciation | $222,425 | DepreciationAmt |
| Book Value | $41,486 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,879,339 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,261,452 | DepreciationAmt |
| Book Value | $617,887 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $251,833 | OtherCostOrOtherBasisAmt |
| Depreciation | $221,862 | DepreciationAmt |
| Book Value | $29,971 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,408,933 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY SETTLEMENTS | Desc |
| Amt | $56,624 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $56,624 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $12,344,138 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $848,157 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $848,157 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,495,981 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,495,981 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,883,160 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,883,160 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,883,160 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ASSOCIATION IS A NOT-FOR-PROFIT CORPORATION AND IS RECOGNIZED AS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THE COMMONWEALTH ACT OF MAY 5, 1933, KNOWN AS THE NONPROFIT ORGANIZATION LAW AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. THE ASSOCIATION ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON A "MORE LIKELY THAN NOT" THRESHOLD APPLIED TO THE RECOGNITION OF THE TAX POSITIONS BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE UNRECOGNIZED TAX BENEFIT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILITY ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR ALL UNCERTAIN TAX POSITIONS. INTEREST AND PENALTIES ASSESSED, IF ANY, ARE ACCRUED AS INCOME TAX EXPENSE. THE ASSOCIATION HAS IDENTIFIED ITS TAX STATUS AS TAX-EXEMPT ENTITY AS A TAX POSITION; HOWEVER, THE ASSOCIATION HAS DETERMINED THAT SUCH TAX POSITION DOES NOT RESULT IN AN UNCERTAINTY REQUIRING RECOGNITION. THE ASSOCIATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2016. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | ELK HAVEN ENTERED INTO A MANAGEMENT AGREEMENT WITH COMPLETE HEALTHCARE RESOURCES - EASTERN, (CHRE) INC. TO PROVIDE FINANCIAL AND ACCOUNTING SERVICES AND SUPERVISE THE DAY-TO-DAY OPERATIONS. ARLENE ANDERSON, ADMINISTRATOR OF THE FACILITY, IS AN EMPLOYEE OF CHRE. HER COMPENSATION FOR HER WORK AT ELK HAVEN DURING 2019 WAS $121,797. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS SENT TO THE BOARD MEMBERS FOR REVIEW AND SIGNATURE PRIOR TO FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE DISCLOSURES ARE REVIEWED ANNUALLY BY THE BOARD AND AS NEW CONFLICTS ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | MARKET STUDIES ARE PERFORMED IN THE REGION TO DETERMINE THE APPROPRIATE LEVEL OF COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC BASED UPON REQUEST. |
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