WRAY COMMUNITY DISTRICT HOSPITAL: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- WRAY COMMUNITY DISTRICT HOSPITAL (EIN 46-3225995)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-10-02
- IRS object ID
- 202042769349301559
- 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 | 2020-10-02T16:02:45-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 South Tejon Suite 800 | AddressLine1Txt |
| City | Colorado Springs | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 809039848 | 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 | 463225995 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WRAY COMMUNITY LONG TERM CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % TOBY STULTS | InCareOfNm |
| Business Name Control | WRAY | BusinessNameControlTxt |
| Phone | 9703324856 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 360 CANYON RIDGE DRIVE | AddressLine1Txt |
| City | WRAY | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80758 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN HART | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9703324811 | PhoneNum |
| Signature | 2020-09-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Adam R Smith CPA | PreparerPersonNm |
| PTIN | P00958966 | PTIN |
| Phone | 7194714290 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 84022720202765000000 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-10-02 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 26C3A9CF11B26F9C2D280370FFBE8B4C03C04303 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2CA45E37415201352F759B3DAE2F163B407DB0E3 | 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 | HILLCREST CARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN HART | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1017 W 7TH ST | AddressLine1Txt |
| City | WRAY | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80758 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,538,962 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HILLCRESTCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | HILLCREST CARE CENTER PROMOTES AN ELDER-CENTERED CARE COMMUNITY WHERE RESIDENTS FEEL LOVED, SECURE AND CONTENT WHILE MAINTAINING INDEPENDENCE AND CHOICE IN DAILY LIFE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 125 | TotalEmployeeCnt |
| Total Volunteers | 35 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $841,760 | PYContributionsGrantsAmt |
| CY Contributions Grants | $660,092 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,220,530 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,870,254 | CYProgramServiceRevenueAmt |
| PY Investment Income | $72 | PYInvestmentIncomeAmt |
| CY Investment Income | -$1,045 | CYInvestmentIncomeAmt |
| PY Other Revenue | $66,129 | PYOtherRevenueAmt |
| CY Other Revenue | $8,527 | CYOtherRevenueAmt |
| PY Total Revenue | $5,128,491 | PYTotalRevenueAmt |
| CY Total Revenue | $5,537,828 | 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 | $3,204,296 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,085,132 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,014,557 | PYOtherExpensesAmt |
| CY Other Expenses | $2,320,952 | CYOtherExpensesAmt |
| PY Total Expenses | $5,218,853 | PYTotalExpensesAmt |
| CY Total Expenses | $5,406,084 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$90,362 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $131,744 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,108,096 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,881,735 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,637,042 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,278,937 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,471,054 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,602,798 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROMOTE HEALTHIER SENIOR LIVING THROUGH COMPASSIONATE, QUALITY, PERSON-DIRECTED CARE...FAMILY CARE WITH A FAMILY TOUCH. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $5,032,056 | ExpenseAmt |
| Revenue | $4,870,254 | RevenueAmt |
| Desc | WRAY COMMUNITY LONG TERM CARE, INC. D/B/A HILLCREST CARE CENTER AND THE TOWERS OPERATES A 45-BED SKILLED NURSING FACILITY AND A 24-UNIT ASSISTED LIVING FACILITY. THE PURPOSE OF HILLCREST CARE CENTER IS TO MAINTAIN AN ENVIRONMENT THAT WILL BE RESPONSIVE TO THE NEEDS OF OUR RESIDENTS AND THEIR FAMILIES, THUS ALLOWING PEOPLE TO BE IN THIS COMMUNITY AND TO LIVE WHERE FAMILIES AND FRIENDS CAN VISIT WITHOUT HAVING TO TRAVEL A LONG DISTANCE. | Desc |
| Total Program Service Expenses | $5,032,056 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 125 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | 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 | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TOBY STULTS | PersonNm |
| Phone | 9703324811 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1017 W 7TH ST | AddressLine1Txt |
| City | WRAY | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80758 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 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 |
|---|---|---|---|---|---|---|---|
| JOHN S HART | |||||||
| CEO | 1.0 | 39.0 | Yes (X) | $0 | $177,787 | $1,913 | |
| JENNIFER S KRAMER | |||||||
| CCO | 1.0 | 39.0 | Yes (X) | $0 | $136,288 | $17,458 | |
| TOBY D STULTS | |||||||
| CFO | 1.0 | 39.0 | Yes (X) | $0 | $122,235 | $14,313 | |
| GINGER M WILLIAMS | |||||||
| ADMINISTRATOR | 40.0 | 0.0 | Yes (X) | $90,839 | $0 | $35 | |
| BRYAN BECKNER | |||||||
| CHAIR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CRAIG SOEHNER | |||||||
| VICE CHAIR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| REBECCA LENZ | |||||||
| SECRETARY/TREASURER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DUSTIN DUNN DC | |||||||
| MEMBER | 1.0 | 1.0 | $0 | $0 | $0 | Yes (X) | |
| PHILIP RIGGLEMAN | |||||||
| MEMBER | 1.0 | 1.0 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $90,839 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $436,310 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $33,719 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BKD LLP | |||||
| 910 E St Louis St Ste 200 | SPRINGFIELD | MH | 65801 | Billing & Support | $104,844 |
| Prime Time Healthcare LLC | |||||
| PO Box 3544 | OMAHA | NE | 68103 | Contract Nursing | $263,831 |
| STAT Staffing LLC | |||||
| PO Box 45 | OSHKOSH | NE | 69154 | Contract Nursing | $188,746 |
| Trustaff Travel Nurses | |||||
| PO Box 63-8231 | CINCINNATI | OH | 45263 | Contract Nursing | $188,094 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $653,997 | RelatedOrganizationsAmt |
| All Other Contributions | $6,095 | AllOtherContributionsAmt |
| Total Contributions | $660,092 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Hillcrest Resident Revenue | 623000 | $3,851,390 | $3,851,390 |
| Towers Resident Revenue | 623000 | $667,727 | $667,727 |
| Provider Fee | 900099 | $343,650 | $343,650 |
| OTHER PROGRAM REVENUE | 900099 | $7,487 | $7,487 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,870,254 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $89 | TotalRevenueColumnAmt |
| Exclusion | $89 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,134 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,134 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,134 | TotalRevenueColumnAmt |
| Exclusion | -$1,134 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Meal Income | 900099 | $6,192 | $6,192 |
| Gift Shop Revenue | 900099 | $2,310 | $2,310 |
| MISCELLANEOUS INCOME | 900099 | $25 | $25 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,527 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,537,828 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,870,254 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $7,482 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,874 | TotalAmt |
| Management And General | $90,874 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,403,167 | TotalAmt |
| Program Services | $2,309,921 | ProgramServicesAmt |
| Management And General | $93,246 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,278 | TotalAmt |
| Program Services | $390,278 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,813 | TotalAmt |
| Program Services | $200,813 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,159 | TotalAmt |
| Management And General | $26,159 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $888,931 | TotalAmt |
| Program Services | $825,921 | ProgramServicesAmt |
| Management And General | $63,010 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,383 | TotalAmt |
| Management And General | $9,383 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,072 | TotalAmt |
| Management And General | $71,072 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,578 | TotalAmt |
| Program Services | $138,578 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,957 | TotalAmt |
| Program Services | $5,022 | ProgramServicesAmt |
| Management And General | $1,935 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,788 | TotalAmt |
| Program Services | $1,448 | ProgramServicesAmt |
| Management And General | $7,340 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,427 | TotalAmt |
| Program Services | $64,427 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,872 | TotalAmt |
| Program Services | $307,872 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,908 | TotalAmt |
| Program Services | $153,908 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $353,540 | $353,385 | $155 | |
| Food Supplies | $201,980 | $201,980 | ||
| Repair & Maintenance | $14,823 | $14,823 | ||
| Other - less than 5% of total | $74,534 | $63,680 | $10,854 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,406,084 | TotalAmt |
| Program Services | $5,032,056 | ProgramServicesAmt |
| Management And General | $374,028 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,183 | BOYAmt |
| EOY | $334,877 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,541 | BOYAmt |
| EOY | $52,466 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $377,580 | BOYAmt |
| EOY | $261,857 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,613,908 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,381,373 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,541,792 | BOYAmt |
| EOY | $4,232,535 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,108,096 | BOYAmt |
| EOY | $4,881,735 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $589,769 | BOYAmt |
| EOY | $304,657 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,064 | BOYAmt |
| EOY | $3,724 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,044,209 | BOYAmt |
| EOY | $1,970,556 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,637,042 | BOYAmt |
| EOY | $2,278,937 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,471,054 | BOYAmt |
| EOY | $2,602,798 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,471,054 | BOYAmt |
| EOY | $2,602,798 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,108,096 | BOYAmt |
| EOY | $4,881,735 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $131,744 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | $31,653 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,586,876 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $174,444 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $841,760 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $660,092 | CurrentTaxYearAmt |
| Total | $3,294,825 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,627,605 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,640,075 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,440,387 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,230,987 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,870,254 | CurrentTaxYearAmt |
| Total | $22,809,308 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,659,258 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,226,951 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,614,831 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,072,747 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,530,346 | CurrentTaxYearAmt |
| Total | $26,104,133 | 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 | $1,615,018 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $866,488 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,279,200 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,480,809 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,257,131 | CurrentTaxYearAmt |
| Total | $6,498,646 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,615,018 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $866,488 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,279,200 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,480,809 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,257,131 | CurrentTaxYearAmt |
| Total | $6,498,646 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $19,605,487 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $64 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $89 | CurrentTaxYearAmt |
| Total | $275 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $64 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $89 | CurrentTaxYearAmt |
| Total | $275 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $13,062 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,216 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $55,672 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,527 | CurrentTaxYearAmt |
| Total | $90,477 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,659,278 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,240,043 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,628,111 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,128,491 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,538,962 | CurrentTaxYearAmt |
| Total | $26,194,885 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.74845 | PublicSupportCY509Pct |
| Public Support PY509 | 0.76200 | PublicSupportPY509Pct |
| Investment Income CY | 0.00001 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00002 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,177 | OtherCostOrOtherBasisAmt |
| Book Value | $13,177 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,126,523 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,012,835 | DepreciationAmt |
| Book Value | $4,113,688 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $474,208 | OtherCostOrOtherBasisAmt |
| Depreciation | $368,538 | DepreciationAmt |
| Book Value | $105,670 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $4,232,535 | TotalBookValueLandBuildingsAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART IV, LINE 2B | ARRANGEMENT FOR CUSTODIAL ACCOUNT LIABILITY: HILLCREST ACTS AS CUSTODIAN FOR THE FUNDS OF THE NURSING FACILITY RESIDENTS. THESE FUNDS ARE INCLUDED IN CASH AND CASH EQUIVALENTS AND ACCOUNTS PAYABLE IN THE BALANCE SHEET. RESIDENT TRUST TOTALED $34,199.12 JAN-DEC 2019. |
| SCHEDULE D, PART X, LINE 2 | Uncertain Tax Position: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN S HART | ||||||||||||
| CEO | $0 | $177,787 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,913 | $0 | $179,700 |
| JENNIFER S KRAMER | ||||||||||||
| CCO | $0 | $136,288 | $0 | $0 | $0 | $0 | $0 | $4,717 | $0 | $12,741 | $0 | $153,746 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Compensation Paid by a Related Organization The shared board of wray district hospital and wray community long term care reviews comparative data from similar organizations before approving the compensation of the CEO and Administrator. This process and decision reached are documented in the board minutes and personnel files. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | CHANGES IN PROGRAM SERVICES: WE REDUCED THE NUMBER OF SNF BEDS FROM 58 TO 45. WE NO LONGER PROVIDE SECURED MEMORY CARE SERVICES, ALLOWING US TO SERVE THE LARGER COMMUNITY AT A GREATER CAPACITY BASED ON COMMUNITY NEEDS DATA. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS AND MEMBER RIGHTS: FOR FORM 990 PURPOSES, WRAY COMMUNITY HOSPITAL DISTRICT IS A MEMBER OF WRAY COMMUNITY LONG TERM CARE. WRAY COMMUNITY HOSPITAL DISTRICT'S BOARD OF DIRECTORS SERVE AS THE GOVERNING BODY OF WRAY COMMUNITY LONG TERM CARE. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND ADMINISTRATOR BEFORE BEING PRESENTED TO THE BOARD FOR REVIEW AND THEN FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY PROCESS: TO PROTECT THE IMPARTIAL DECISION MAKING AND REPUTATION OF BOTH THE ORGANIZATION AND THOSE INVOLVED WITH IT, TRANSACTIONS WITH RELATED PARTIES WHERE A POTENTIAL CONFLICT OF INTERESTS EXISTS OR MAY APPEAR TO EXIST ARE REVIEWED BY AN ADMINISTRATOR, THE CFO. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS AVAILABLE TO THE PUBLIC: THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION: THE SHARED BOARD OF WRAY DISTRICT HOSPITAL AND WRAY COMMUNITY LONG TERM CARE REVIEWS COMPARATIVE DATA FROM SIMILAR ORGANIZATIONS BEFORE APPROVING THE COMPENSATION OF THE CEO AND ADMINISTRATOR. THIS PROCESS AND DECISION REACHED ARE DOCUMENTED IN THE BOARD MINUTES AND PERSONNEL FILES. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:NURSING SERVICES TOTAL FEES:651535 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL CONSULTANTS TOTAL FEES:63010 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PROFESSIONAL SERVICES TOTAL FEES:48662 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICARE BILLING SERVICES TOTAL FEES:100320 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL DIRECTOR SERVICES TOTAL FEES:25404 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WRAY COMMUNITY DISTRICT HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1017 WEST 7TH STREET | AddressLine1Txt |
| City | WRAY | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80758 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463225995 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Exempt Code Section | 501(A) | ExemptCodeSectionTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |