2019-11-14T14:56:11-06:00 2018-12-31 232108173 RKL LLP 91 CUMBERLAND PARKWAY MECHANICSBURG PA 17055 990 2018-01-01 231312627 THE SHOOK HOME SHOO 7172646815 55 SOUTH SECOND STREET CHAMBERSBURG PA 17201 JEFFREY TRHAN CEO/ADMINISTRATOR 7172646815 2019-11-14 1 NATHAN J BABINSACK CPA P01204934 7177909333 2019-11-14 50.200.65.190 2019-11-14 13:10:59 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 858D3D31AFAEB25414B49DA530E7F158620AFD44 2018 2020-03-31 21:24:44Z JEFFREY TRUHAN 55 SOUTH SECOND STREET CHAMBERSBURG PA 17201 13730129 0 X WWW.SHOOKHOME.ORG X 1918 PA SEE SCHEDULE O 15 15 221 48 0 0 134478 138427 7463111 8288073 545415 627654 20800 42533 8163804 9096687 0 0 0 0 5349881 5760156 0 0 923 2898175 3326212 8248056 9086368 -84252 10319 24102138 22279742 5455210 5187329 18646928 17092413 SEE SCHEDULE O 0 0 7881975 8613773 THE ORGANIZATION IS A LICENSED CONTINUING CARE RETIREMENT COMMUNITY (CCRC) OFFERING SKILLED NURSING (65 BEDS), PERSONAL CARE (45 BEDS), RESIDENTIAL LIVING, AND OUTPATIENT PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. AS SUCH, THE FACILITY PROVIDES ROOM & BOARD, NURSING CARE, MEDICAL & THERAPY SERVICES, ETC., TO ITS RESIDENTS AND OUTPATIENT CLIENTS AS APPLICABLE. THE ORGANIZATION PROVIDED 21,222 RESIDENT DAYS FOR SKILLED NURSING CARE, 12,237 RESIDENT DAYS FOR PERSONAL CARE AND 1,443 RESIDENT DAYS FOR INDEPENDENT LIVING. 7881975 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 5 0 1 221 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X THE SHOOK HOME 7172646815 55 SOUTH SECOND STREET CHAMBERSBURG PA 17201 GEORGE ED WENGER PRESIDENT 1.00 X X 0 0 0 JOHN BRET ELBIN VICE PRESIDENT 1.00 X X 0 0 0 ROXI SEILHAMER SECRETARY 1.00 X X 0 0 0 MICHAEL KUGLER TREASURER 1.00 X X 0 0 0 DEBRA BRECHBILL DIRECTOR 1.00 X 0 0 0 LUKE MARTIN DIRECTOR 1.00 X 0 0 0 CELESTE SNAVELY DIRECTOR 1.00 X 0 0 0 JANYCE COLLIER DIRECTOR 1.00 X 0 0 0 TROY GARMAN DIRECTOR 1.00 X 0 0 0 KATHLEEN JACOBSON DIRECTOR 1.00 X 0 0 0 SUMMER FRANZONI DIRECTOR 1.00 X 0 0 0 LANCE KEGERREIS DIRECTOR 1.00 X 0 0 0 LORETTA MCCLURE DIRECTOR 1.00 X 0 0 0 THEODORE GUARRIELLO DIRECTOR 1.00 X 0 0 0 MARK LONG DIRECTOR 1.00 X 0 0 0 MARY BETH SHANK DIRECTOR 1.00 X 0 0 0 JEFFREY TRUHAN CEO/ADMINISTATOR 40.00 X 115589 0 11202 BARBARA LAW CFO 40.00 X 89537 0 3820 MARJORIE LONARDO RN SUPERVISOR 40.00 X 105866 0 1128 MARY RUTHRAUFF RN SUPERVISOR 40.00 X 100477 0 3644 411469 0 19794 3 0 0 0 GENESIS REHABILITATION SERVICES PO BOX 821322 PHILADELPHIA PA 191821322 PATIENT THERAPY 720691 F&M TRUST CO PO BOX 6010 CHAMBERSBURG PA 17201 ESCROW SERVICES 509825 SYSCO FOOD SERVICES OF CENTRAL PA PO BOX 3641 HARRISBURG PA 171053641 FOOD SERVICES 301914 PHARMERICA PO BOX 409251 ATLANTA GA 303849251 PHARMACY SERVICES 124687 MANHEIM MEDICAL SUPPLY INC PO BOX 9065 LANCASTER PA 176049065 MEDICAL SUPPLIES 106810 6 138427 138427 PROGRAM SERVICE FEES 623000 8288073 8288073 8288073 344487 344487 2201 -2201 -2201 -2201 4914178 230 4615709 15532 298469 -15302 283167 283167 MISCELLANEOUS INCOME MA SNF 23530 23530 PURCHASE DISCOUNTS 8301 8301 EMPLOYEE MEAL REVENUE 4041 4041 8862 8862 44734 9096687 8613773 0 344487 222164 197918 24246 4379192 3902723 476469 48237 42757 5480 772042 684338 87704 338521 300065 38456 10214 10214 19863 19863 900683 864092 36591 112143 1845 110298 300705 197738 102967 95383 33970 61413 431583 403381 28202 11059 9665 1394 10705 6167 4538 382178 320190 61988 14014 14014 RESIDENT FOOD 292895 292895 OTHER PURCHASED SERVICE 132829 125621 7208 RESIDENT MEDICATIONS 122268 122268 MEDICAL SUPPLIES 117289 117289 372401 259053 112425 923 9086368 7881975 1203470 923 2597 2597 473688 217417 875701 858913 98936 96807 14101116 6027304 8009366 8073812 14161793 12831714 480057 198482 24102138 22279742 522723 479462 117468 79849 4805597 4614809 9422 13209 5455210 5187329 X 14727926 13570201 949 0 3918053 3522212 18646928 17092413 24102138 22279742 X 10319 -1255437 -309397 X X 0 1 X 1 0 X 143491 134727 149492 134478 138427 700615 7610177 8355605 7975819 7484106 8332807 39758514 7753668 8490332 8125311 7618584 8471234 40459129 84 3419 3503 0 84 3419 3503 40455626 262341 260161 254571 407340 344487 1528900 262341 260161 254571 407340 344487 1528900 8016009 8750493 8379882 8025924 8815721 41988029 0.96350 0.96430 0.03640 0.03570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 8325820 6019 -673504 107420 7550915 7368360 10960 1010891 64391 8325820 7108944 9910 346823 97317 7368360 7476038 6980 -257499 116575 7108944 7101392 16632 469970 111956 7476038 0.53370 0.46630 1 0 1399979 1399979 11298463 5085562 6212901 1209509 851281 358228 193165 90461 102704 8073812 X 7515312 -1255437 -309397 -1564834 9080146 28171 -11630 16541 9096687 9069827 0 9069827 28171 -11630 16541 9086368 PART IV, LINE 2B: THE ORGANIZATION IS CUSTODIAN FOR RESIDENT TRUST FUNDS FOR SOME OF THE FACILITY'S RESIDENTS. PART V, LINE 4: ENDOWMENT FUNDS ARE USED BY THE ORGANIZATION FOR BENEVOLENT CARE AND GENERAL TAX-EXEMPT PURPOSES. PART X, LINE 2: THE HOME FOLLOWS THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ACCORDING TO THE PRINCIPLES OF FASB ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, WHICH PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTABLE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOME, INCLUDING WHETHER THE ENTITY IS EXEMPT FROM INCOME TAXES. MANAGEMENT EVALUATED THE TAX POSITIONS TAKEN AND CONCLUDED THAT THE HOME HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAVE BEEN INCLUDED IN THE FINANCIAL STATEMENTS. WITH FEW EXCEPTIONS, THE HOME IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL AUTHORITIES FOR YEARS ENDING PRIOR TO 2015. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE - THIRD PARTY TRUST -309,397. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -15,000. BANK FEES - CHECKING 3,371. ROUNDING -1. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -15,000. BANK FEES - CHECKING 3,371. ROUNDING -1. A BOROUGH OF CHAMBERSBURG 251742939 2015-12-21 4900000 CONSTRUCTION 0 0 0 A 285191 4900000 787 90779 1200000 3608434 2017 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 MIKE KUGLER BOARD MEMBER OF KEYSTONE HEALTH CENTER 30000 MEDICAL DIRECTOR & INFECTIOUS DISEASE CONSULTING 0 JEFFREY TRUHAN BOARD MEMBER OF KEYSTONE HEALTH CENTER 10050 MEDICAL DIRECTOR & INFECTIOUS DISEASE CONSULTING 0 FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: THE SHOOK HOME AND THE QUARTERS AT THE SHOOK IS A NOT-FOR-PROFIT ORGANIZATION COMMITTED TO PROVIDING QUALITY CARE AND SERVICES TO EMPOWER RESIDENTS TO ACHIEVE THEIR HIGHEST LEVEL OF INDEPENDENCE. DIGNITY, AND SEF-WORTH IN A HOME-LIKE ENVIRONMENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS, THE CEO AND THE CFO FOR COMPLETENESS AND ACCURACY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REMINDED PERIODICALLY TO UPDATE THE FACILITY WITH ANY CONFLICTS OF INTEREST. THE FACILITY MONITORS VENDORS PAID FOR GOODS AND SERVICES FOR RELATED PARTY TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICAL: PERFORMANCE EVALUATIONS ARE COMPLETED BY EACH MEMBER OF THE BOARD OF DIRECTORS ANNUALLY. COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED UPON THESE EVALUATIONS. ALSO, THE ANNUAL WAGE SURVEY PROVIDED BY LEADINGAGE OF PA IS USED AS A TOOL IN DETERMINING APPROPRIATE COMPENSATION. COMPENSATION PROCESS FOR OFFICERS: PERFORMANCE EVALUATIONS ARE COMPLETED BY THE CEO ANNUALLY. THE CEO THEN MAKES A RECOMMENDATION FOR COMPENSATION BASED ON THESE EVALUATIONS, WITHIN BOARD APPROVED PARAMETERS, TO THE PRESIDENT OF THE BOARD OF DIRECTORS AND THE CHAIR OF THE HUMAN RESOURCES COMMITTEE FOR FINAL APPROVAL. ALSO, THE ANNUAL WAGE SURVEY PROVIDED BY LEADINGAGE OF PA IS USED AS A TOOL IN DETERMINING APPROPRIATE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE-THIRD PARTY TRUST -309,397. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.