FURP.ORG / PUBLIC DATA EXPLORER

PULASKI HEALTH FOUNDATION INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
PULASKI HEALTH FOUNDATION INC (EIN 23-7125454)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-14
IRS object ID
201943189349301589
Schema version
2018v3.1
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

FieldValueIRS element (for citing)
Return2019-11-14T08:39:56-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1201 N Illinois StreetAddressLine1Txt
CityIndianapolisCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237125454EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pulaski Health Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% STACEY WAYBERGInCareOfNm
Business Name ControlPULABusinessNameControlTxt
Phone5749460692PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1739 N US HIGHWAY 35AddressLine1Txt
CityWINAMACCityNm
State AbbreviationINStateAbbreviationCd
ZIP46996ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSCOTT FRITZPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5749463394PhoneNum
Signature2019-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNICOLE B FISHBACKPreparerPersonNm
PTINP01279475PTIN
Phone3173834000PhoneNum
Preparation2019-11-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43033020193185000004FederalOriginalSubmissionId
Federal Original Submission Id2019-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id853F56B20686315F3B567D2AC67D999A99BAAA42AtSubmissionCreationDeviceId
At Submission Filing Device IdE43C2FEF5D838BC286DC3B96AF984EDC8464B4B8AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Pulaski Health Care CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSHARON MCKINLEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1739 N US HIGHWAY 35AddressLine1Txt
CityWINAMACCityNm
State AbbreviationINStateAbbreviationCd
ZIP46996ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$700,299GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PULASKIHEALTHFOUNDATION.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1959FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionPULASKI HEALTH FOUNDATION IS DEDICATED TO ENHANCING THE LIVES OF OLDER ADULTS THROUGH QUALITY HEALTH CARE.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee264TotalEmployeeCnt
Total Volunteers135TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$235,766PYContributionsGrantsAmt
CY Contributions Grants$46,591CYContributionsGrantsAmt
PY Program Service Revenue$758,322PYProgramServiceRevenueAmt
CY Program Service Revenue$537,354CYProgramServiceRevenueAmt
PY Investment Income$9,275PYInvestmentIncomeAmt
CY Investment Income$3,745CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue-$172,127CYOtherRevenueAmt
PY Total Revenue$1,003,363PYTotalRevenueAmt
CY Total Revenue$415,563CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$741,653PYOtherExpensesAmt
CY Other Expenses$696,254CYOtherExpensesAmt
PY Total Expenses$741,653PYTotalExpensesAmt
CY Total Expenses$696,254CYTotalExpensesAmt
PY Revenues Less Expenses$261,710PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$280,691CYRevenuesLessExpensesAmt
Total Assets BOY$9,187,643TotalAssetsBOYAmt
Total Assets EOY$9,052,782TotalAssetsEOYAmt
Total Liabilities BOY$6,644,530TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,718,596TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,543,113NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,334,186NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO IMPROVE OUR COMMUNITY THROUGH HEALTH AND WELLNESSMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$636,112ExpenseAmt
Revenue$365,227RevenueAmt
DescPULASKI HEALTH FOUNDATION, INC., A NOT-FOR-PROFIT ORGANIZATION, WAS ESTABLISHED IN 1959 TO PROMOTE CHARITABLE AND EDUCATIONAL PURPOSES, BOTH DIRECTLY TO AND BY THE APPLICATION OF FUNDS AND ASSETS TO A HEALTH CARE ORGANIZATION IN PULASKI COUNTY. ITS FIRST PROJECT WAS TO FACILITATE DONATIONS AND BUILD PULASKI MEMORIAL HOSPITAL. PULASKI HEALTH FOUNDATION CONTINUED TO CARE FOR AND IMPROVE LIFE AND HEALTH FOR THOSE WHO CAN NO LONGER DO SO FOR THEMSELVES BY FACILITATING FUNDS, BUILDING AND MANAGING PULASKI HEALTH CARE CENTER, A 58 BED SKILLED NURSING FACILITY, WHICH PROVIDES MEDICARE SHORT STAY RESTORATIVE SERVICES AND LONG-TERM CONTINUED CARE. PULASKI HEALTH CARE CENTER'S COMPREHENSIVE CARE PROGRAMS, DESIGNED TO MEET THE DAILY LIVING NEEDS OF EACH RESIDENT, INCLUDE: 24-HOUR NURSING SERVICES, ASSISTANCE WITH MEDICATION, PERSONAL HYGIENE, AND AMBULATION. THE THERAPY PROGRAM PROVIDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. THE MEAL SERVICE PROVIDES DINING IN A RESTAURANT STYLE ATMOSPHERE AND INCLUDES THERAPEUTIC AND MECHANICALLY ALTERED DIETS. OTHER SERVICES OFFERED TO RESIDENTS ARE ACTIVITIES WITH MANY RECREATIONAL OPPORTUNITIES, SOCIAL SERVICES, LAUNDRY, AND HOUSEKEEPING. PULASKI HEALTH CARE CENTER PROVIDES A HOME LIKE ENVIRONMENT, A FRIENDLY ATMOSPHERE THAT FACILITATES SELF-WORTH AND DIGNITY IN THE PEOPLE THAT RESIDE HERE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescPULASKI HEALTH FOUNDATION'S GOAL TO PROVIDE SAFE, DECENT AND AFFORDABLE HOUSING FOR LOW AND MODERATE INCOME SENIOR CITIZENS IS ACCOMPLISHED THROUGH THE ESTABLISHMENT OF RIVERWOOD COMMONS, A 24 UNIT APARTMENT BUILDING THAT PROVIDES SECURE INDEPENDENT HOUSING FOR LOW AND MODERATE INCOME/55 AND OLDER OR DISABLED PERSONS. RIVERWOOD COMMONS WAS ESTABLISHED THROUGH THE USE OF TAX CREDITS AND REMAINS UNDER THE SPECIFIED PROGRAMS OF THE INDIANA HOUSING AND COMMUNITY DEVELOPMENT AUTHORITY AND FEDERAL HOME LOAN BANK OF INDIANAPOLIS. PULASKI HEALTH FOUNDATION, AS OWNER, PROVIDES ACTIVITY PROGRAMS TO THE RESIDENTS THAT LIVE AT RIVERWOOD COMMONS, CAPITAL FUNDS FOR IMPROVEMENTS TO THE PROPERTY, AND REPLACEMENT OF FURNISHINGS. PULASKI HEALTH FOUNDATION ALSO PROVIDES DIRECT OVERSIGHT OF THE MANAGEMENT COMPANY, HARRISON REAL ESTATE. PROPERTY MANAGEMENT PERFORMS THE DAILY MANAGEMENT OF THE PROPERTY, PROVIDES INFORMATION FOR AUDITS AND INSPECTIONS, AND ASSISTS TENANTS WITH THEIR FINANCIAL REGULATORY REQUIREMENTS ACCORDING TO THE INDIANA HOUSING AND COMMUNITY DEVELOPMENT AUTHORITY TAX CREDIT PROGRAMS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
DescPULASKI HEALTH FOUNDATION'S GOAL TO RECEIVE AND MAINTAIN A FUND (OR FUNDS) OF REAL OR PERSONAL PROPERTY, OR BOTH, (WHICH ARE SUBJECT TO THE RESTRICTIONS AND LIMITATIONS THEREIN AFTER SET FORTH TO USE AND APPLY THE WHOLE OR ANY PART OF THE INCOME FOR THE CONSTRUCTION, FURNISHING, EQUIPPING, IMPROVEMENT, REPAIR, OPERATION AND MAINTENANCE OF THE FACILITIES AND SERVICES OF HEALTH CARE ORGANIZATIONS OF PULASKI COUNTY) WAS MET BY THE PURCHASE OF PARKVIEW HAVEN, A CONTINUING CARE RETIREMENT COMMUNITY (CRCC) LOCATED IN FRANCESVILLE, INDIANA IN PULASKI COUNTY ON SEPTEMBER 1, 2013. PARKVIEW HAVEN WAS A NOT-FOR-PROFIT CHURCH BASED CCRC THAT SHARED MANY OF THE SAME GOALS AND MISSIONS OF PULASKI HEALTH FOUNDATION. THIS ACQUISITION WOULD FURTHER ADVANCE PULASKI HEALTH FOUNDATION'S MISSION TO CARE FOR AND IMPROVE LIFE AND HEALTH FOR THOSE WHO CAN NO LONGER DO SO FOR THEMSELVES, TO PROVIDE A HOME LIKE ENVIRONMENT WITH A FRIENDLY PLACE THAT ACTIVATES SELF-WORTH AND DIGNITY FOR THE SENIOR POPULATION AND TO PROVIDE SAFE, DECENT AND AFFORDABLE HOUSING FOR LOW AND MODERATE INCOME SENIOR CITIZENS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$636,112TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document27IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee264EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSTACEY WAYBERGPersonNm
Phone2195672172PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 CONSTITUTION DRIVE STE AAddressLine1Txt
CityFRANCESVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP47946ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
SCOTT FRITZ
CHAIRMAN5.00.0Yes (X)Yes (X)$0$0$0
DR ROBERT KLITZMAN
VICE CHAIRMAN3.00.0Yes (X)Yes (X)$0$0$0
LIN MORRISON
TREASURER5.00.0Yes (X)Yes (X)$0$0$0
LINDA MURPHY
SECRETARY3.00.0Yes (X)Yes (X)$0$0$0
JOHN GOBLE
MEMBER AT LARGE3.00.0Yes (X)$0$0$0
JIM PIERROU
BOARD MEMBER3.00.0Yes (X)$0$0$0
LACY MCCARTY
BOARD MEMBER1.00.0Yes (X)$0$0$0
LARRY LEMAN
BOARD MEMBER3.00.0Yes (X)$0$0$0
STACEY WAYBERG
FINANCE DIRECTOR/CFO56.00.0Yes (X)$114,069$0$5,739
SHARON MCKINLEY
EXECUTIVE DIRECTOR55.00.0Yes (X)$118,940$0$5,739
FieldValueIRS element (for citing)
Total Reportable Comp From Org$233,009TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$11,478TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GORDON FOOD SERVICE
PO BOX 88029CHICAGOIL606801029FOOD EQUIP. AND FOOD$331,028
HEALTH CARE THERAPY SERVICES INC
1411 W COUNTY LINE RD SUITE AGREENWOODIN46142PT, OT, ST THERAPY$508,370
IN TOUCH PHARMACEUTICALS
PO BOX 2028WARSAWIN465812028PHARMACY SUPPLIERS$208,016
ONESTAFF MEDICAL LLC
11718 NICHOLAS ST SUITE 101OMAHANE68154NURSE AGENCY$171,539
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
All Other Contributions$46,591AllOtherContributionsAmt
Noncash Contributions$17,280NoncashContributionsAmt
Total Contributions$46,591TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ENTRANCE FEE INCOME623000$18,218$18,218
MAINTENANCE FEE INCOME623000$56,760$56,760
MANAGEMENT FEES & RENT623000$460,193$460,193
OTHER OPERATING REVENUE900099$2,183$2,183
FieldValueIRS element (for citing)
Total Program Service Revenue$537,354TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,099TotalRevenueColumnAmt
Exclusion$9,099ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$107,255RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$279,382RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$172,127RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$172,127TotalRevenueColumnAmt
Related Or Exempt Func Income-$172,127RelatedOrExemptFuncIncomeAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$5,354OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$5,354OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$5,354TotalRevenueColumnAmt
Exclusion-$5,354ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$415,563TotalRevenueColumnAmt
Related Or Exempt Func Income$365,227RelatedOrExemptFuncIncomeAmt
Exclusion$3,745ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$9,856TotalAmt
Program Services$4,928ProgramServicesAmt
Management And General$4,928ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,214TotalAmt
Management And General$55,214ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$32,359TotalAmt
Program Services$32,359ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$163,387TotalAmt
Program Services$163,387ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$382,471TotalAmt
Program Services$382,471ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$20,961TotalAmt
Program Services$20,961ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescOTHERDesc
Total$32,006TotalAmt
Program Services$32,006ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$696,254TotalAmt
Program Services$636,112ProgramServicesAmt
Management And General$60,142ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,241,489BOYAmt
EOY$1,462,329EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,367,006BOYAmt
EOY$1,180,607EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$400,430BOYAmt
EOY$26,023EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$42,140BOYAmt
EOY$43,807EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$95,110BOYAmt
EOY$82,987EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,478,963LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,226,842LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,635,095BOYAmt
EOY$6,252,121EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$406,373BOYAmt
EOY$4,908EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,187,643BOYAmt
EOY$9,052,782EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$548,024BOYAmt
EOY$711,179EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,565,063BOYAmt
EOY$3,398,512EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$430,516BOYAmt
EOY$772,383EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,100,927BOYAmt
EOY$1,836,522EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,644,530BOYAmt
EOY$6,718,596EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,443,113BOYAmt
EOY$2,234,186EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$100,000EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,543,113BOYAmt
EOY$2,334,186EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,187,643BOYAmt
EOY$9,052,782EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$280,691ReconcilationRevenueExpnssAmt
Prior Period Adjustments$71,764PriorPeriodAdjustmentsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,110CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$119,466CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$39,746CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$235,766CurrentTaxYearMinus1YearAmt
Current Tax Year$46,591CurrentTaxYearAmt
Total$443,679TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$464,772CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$773,977CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$938,437CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$758,322CurrentTaxYearMinus1YearAmt
Current Tax Year$537,354CurrentTaxYearAmt
Total$3,472,862TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$466,882CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$893,443CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$978,183CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$994,088CurrentTaxYearMinus1YearAmt
Current Tax Year$583,945CurrentTaxYearAmt
Total$3,916,541TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$3,916,541PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,326CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,289CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,810CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,309CurrentTaxYearMinus1YearAmt
Current Tax Year$116,354CurrentTaxYearAmt
Total$169,088TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,326CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,289CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,810CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,309CurrentTaxYearMinus1YearAmt
Current Tax Year$116,354CurrentTaxYearAmt
Total$169,088TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$482,208CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$905,732CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$991,993CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,005,397CurrentTaxYearMinus1YearAmt
Current Tax Year$700,299CurrentTaxYearAmt
Total$4,085,629TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.95861PublicSupportCY509Pct
Public Support PY5090.98304PublicSupportPY509Pct
Investment Income CY0.04139InvestmentIncomeCYPct
Investment Income PY0.01696InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
Incl Escrow Custodial Acct LiabfalseInclEscrowCustodialAcctLiabInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,097BeginningYearBalanceAmt
Investment Earnings Or Losses-$1,282InvestmentEarningsOrLossesAmt
Grants Or Scholarships$615GrantsOrScholarshipsAmt
End Year Balance$14,200EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,552BeginningYearBalanceAmt
Investment Earnings Or Losses$1,825InvestmentEarningsOrLossesAmt
Grants Or Scholarships$280GrantsOrScholarshipsAmt
End Year Balance$16,097EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,223BeginningYearBalanceAmt
Investment Earnings Or Losses$936InvestmentEarningsOrLossesAmt
Grants Or Scholarships$607GrantsOrScholarshipsAmt
End Year Balance$14,552EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$15,396BeginningYearBalanceAmt
Investment Earnings Or Losses-$567InvestmentEarningsOrLossesAmt
Grants Or Scholarships$606GrantsOrScholarshipsAmt
End Year Balance$14,223EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$15,384BeginningYearBalanceAmt
Investment Earnings Or Losses$595InvestmentEarningsOrLossesAmt
Grants Or Scholarships$583GrantsOrScholarshipsAmt
End Year Balance$15,396EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$575,698OtherCostOrOtherBasisAmt
Book Value$575,698BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,549,806OtherCostOrOtherBasisAmt
Depreciation$3,517,552DepreciationAmt
Book Value$5,032,254BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$846,519OtherCostOrOtherBasisAmt
Depreciation$618,302DepreciationAmt
Book Value$228,217BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,506,940OtherCostOrOtherBasisAmt
Depreciation$1,090,988DepreciationAmt
Book Value$415,952BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,252,121TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
REFUNDABLE ENTRANCE FEES$1,679,699
DEFERRED ENTRANCE FEES$156,823
FieldValueIRS element (for citing)
Total Liability$1,836,522TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$694,945TotalRevEtcAuditedFinclStmtAmt
Other Revenue$279,382OtherRevenueAmt
Revenue Not Reported$279,382RevenueNotReportedAmt
Revenue Subtotal$415,563RevenueSubtotalAmt
Total Revenue Per Form990$415,563TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$975,636TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$279,382OtherExpensesIncludedAmt
Expenses Not Reported$279,382ExpensesNotReportedAmt
Expenses Subtotal$696,254ExpensesSubtotalAmt
Total Expenses Per Form990$696,254TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: TO SUPPORT THE ACTIVITY DEPARTMENT OF PULASKI HEALTH CARE CENTER. THE FUNDS ASSIST WITH OUTINGS, SUPPLIES AND ENTERTAINMENT FOR THE RESIDENTS THAT LIVE AT PULASKI HEALTH CARE CENTER. THE PERMANENT ENDOWMENT FUND IS USED TO CONTINUE THE MISSION OF PULASKI HEALTH FOUNDATION. THE TEMPORARILY RESTRICTED ENDOWMENT IS USED TO FURTHER THE MISSION OF PULASKI HEALTH FOUNDATION.
SCHEDULE D, PART X, LINE 2ASC 740 DISCLOSURE: 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 D, PART XI AND PART XII, LINE 2DOTHER ADJUSTMENTS: RENTAL EXPENSES: $ 279,382

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1INDIANA FINANCE AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN351602316BondIssuerEIN
Bond Issued2013-09-30BondIssuedDt
Issue Price$4,173,000IssuePriceAmt
PurposePURCHASE OF FACILITY AND REFINANCIPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$931,231RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$4,173,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$0IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$0CapitalExpendituresAmt
Other Spent Proceeds$4,173,000OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2014SubstantialCompletionYr
Refunding Tax Exempt BondsYes (true)RefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (true)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (true)EngageBondCounselContractsInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetYes (true)RebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART I, LINE A(F)REFUND (1) PRIOR ISSUE ISSUED 03/05/1997 AND (2) PRIOR ISSUE ISSUED 08/30/2013.
SCHEDULE K, PART II, LINE 11PROCEEDS USED TO REDEEM PRIOR ISSUES ON 09/30/2013.

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due$0TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonFIRST NATIONAL BANK OF MONTEREYPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionVP SPOUSE OF TREASURERRelationshipDescriptionTxt
Transaction$14,725TransactionAmt
TransactionMORTGAGE LOANTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE GAVE VOTING RIGHTS TO THE ASSISTED LIVING COMMITTEE DUE TO THE MAJORITY OF ASSISTED LIVING COMMITTEE MEMBERS ALSO BEING BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BPROCESS TO REVIEW FORM 990: THE FORM 990 IS REVIEWED IN DETAIL BY MANAGEMENT. THEN, A COPY OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST POLICY: ANNUAL DISCLOSURE IS PROVIDED BY EACH OFFICER AND MEMBER OF THE BOARD, AS WELL AS THE EXECUTIVE DIRECTOR THROUGH THE COMPLETION OF THE CONFLICT OF INTEREST QUESTIONNAIRE. THE RESPONSES ARE MAINTAINED BY THE EXECUTIVE DIRECTOR. IF THERE IS A POTENTIAL CONFLICT OF INTEREST, THE EXECUTIVE DIRECTOR AND THE BOARD PRESIDENT REVIEW THE CORRESPONDING ISSUE AND DETERMINE IF THERE IS AN ACTUAL CONFLICT OF INTEREST. IF A CONFLICT OF INTEREST IS DEEMED TO EXIST, THEN THE PERSON WITH THE CONFLICT IS EXCLUDED FROM ANY DISCUSSION AND SUBSEQUENT ACTION TAKEN. ANY PURCHASES AND/OR BIDDING PROPOSALS ARE ALSO REVIEWED FOR ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO SUBMITTING BIDS OR MAKING SUCH PURCHASES. THE BOARD PRESIDENT ATTENDS THE BOARD MEETINGS AND ENSURES THAT COMPLIANCE WITH THESE GUIDELINES ARE FOLLOWED.
FORM 990, PART VI, SECTION B, LINE 15ADETERMINATION OF COMPENSATION: THE PROCESS FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR INCLUDES A REVIEW AND APPROVAL BY THE BOARD CHAIRMAN AND VICE CHAIRMAN, WHO ARE BOTH INDEPENDENT. THE CHAIRMAN AND VICE CHAIRMAN USE MCKNIGHT'S CAREER GUIDE, LEADINGAGE AND LEADINGAGE INDIANA, THE NATIONAL AND STATE ASSOCIATION FOR NON PROFIT AGING SERVICE COMMUNITIES' NURSING HOME SALARY AND BENEFITS REPORT. THE MYERS AND STAUFFER LC LONG-TERM CARE COMPENSATION REPORT IS ALSO REFERENCED AS PART OF THE DECISION PROCESS. ONCE THE CHAIRMAN AND VICE CHAIRMAN DETERMINE THE COMPENSATION AMOUNT, THEY REPORT THEIR FINDINGS AND DECISION TO THE FULL BOARD OF DIRECTORS. COMPENSATION FOR SHARON MCKINLEY WAS LAST REVIEWED ON JULY 6, 2014.
FORM 990, PART VI, SECTION C, LINE 19AVAILABILITY OF GOVERNING DOCUMENTS, COI POLICY, AND FINANCIAL STATEMENTS: A COPY OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART V AND PART VIICOMPENSATION PAID BY THE FOUNDATION IS REIMBURSED BY PULASKI MEMORIAL HOSPITAL.