BETHEL HOME INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- BETHEL HOME INC (EIN 39-1209707)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-14
- IRS object ID
- 201943189349306904
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-14T12:43:51-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8215 GREENWAY BOULEVARD SUITE 600 | AddressLine1Txt |
| City | MIDDLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53562 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391209707 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETHEL HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BETH | BusinessNameControlTxt |
| Phone | 9202354653 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH EAGLE STREET | AddressLine1Txt |
| City | OSHKOSH | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54902 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THERESA M BERTRAM | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 9202325238 | PhoneNum |
| Signature | 2019-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIMBERLY ANDERSON | PreparerPersonNm |
| PTIN | P00188889 | PTIN |
| Phone | 6086628600 | PhoneNum |
| Preparation | 2019-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-07 | IPDt |
| IP Tm | 08:07:07 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D96076016A1D85786C0DD27C05D232F375DC2AFE | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 08598E5CD8BEAEC8C407760E8BF8A64CD65A21BD | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | THERESA M BERTRAM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH EAGLE STREET | AddressLine1Txt |
| City | OSHKOSH | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54902 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,955,070 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 9386 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MIRAVIDALIVING.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1966 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE NURSING CARE FOR AGING PERSONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 267 | TotalEmployeeCnt |
| Total Volunteers | 87 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $808,777 | PYContributionsGrantsAmt |
| CY Contributions Grants | $362,054 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,181,346 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,488,466 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,735 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,654 | CYInvestmentIncomeAmt |
| PY Other Revenue | $85,862 | PYOtherRevenueAmt |
| CY Other Revenue | $95,896 | CYOtherRevenueAmt |
| PY Total Revenue | $10,079,720 | PYTotalRevenueAmt |
| CY Total Revenue | $8,955,070 | 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 | $6,163,847 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,893,480 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,699,051 | PYOtherExpensesAmt |
| CY Other Expenses | $3,590,010 | CYOtherExpensesAmt |
| PY Total Expenses | $9,862,898 | PYTotalExpensesAmt |
| CY Total Expenses | $9,483,490 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $216,822 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$528,420 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,804,469 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,536,984 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,642,585 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,953,520 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,161,884 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,583,464 | NetAssetsOrFundBalancesEOYAmt |
| Mission | BETHEL HOME IS PART OF A FAMILY OF HEALTHCARE AND RESIDENTIAL SERVICE ORGANIZATIONS COMMITTED TO PROVIDING QUALITY CARE AND LIFE ENRICHING OPPORTUNITIES TO THE AGING AND THOSE IN NEED IN A CARING, CHRISTIAN ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,813,069 | ExpenseAmt |
| Revenue | $8,488,466 | RevenueAmt |
| Desc | BETHEL HOME, INC., OPERATES A 128-BED NURSING HOME PROVIDING SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED OF OSHKOSH AND THE SURROUNDING AREA. THE HOME ALSO OPERATES A 12-BED DEMENTIA-SPECIFIC COMMUNITY-BASED RESIDENTIAL FACILITY. | Desc |
| Total Program Service Expenses | $8,813,069 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 267 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KIM MAKI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9202325238 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 NORTH EAGLE STREET | AddressLine1Txt |
| City | OSHKOSH | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54902 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| KAREN JACOBSON | |||||||
| CHAIR AS OF JUNE 30, 2018 | 0.20 | 1.40 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARY MURKEN | |||||||
| VICE CHAIR AS OF JUNE 30, 2018 | 0.20 | 1.40 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LOIS JAENKE | |||||||
| SECRETARY AS OF JUNE 30, 2018 | 0.20 | 2.90 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARK BEECHER | |||||||
| BOARD MEMBER | 0.20 | 2.90 | Yes (X) | $0 | $0 | $0 | |
| KATHY BERMINGHAM | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| JAMIE BONELL | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| REV HAN LAVAKE | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| GLENN NELSON | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| PEG OLSON | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| STEW RIECKMAN | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| KATHLEEN BELLAIRE | |||||||
| CHAIR UNITL JUNE 30, 2018 | 0.20 | 1.40 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JIM STAPEL | |||||||
| SECRETARY UNTIL JUNE 30, 2018 | 0.20 | 1.40 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR SUZANNE MARNOCHA | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| WAYNE MUELLER | |||||||
| BOARD MEMBER | 0.20 | 1.40 | Yes (X) | $0 | $0 | $0 | |
| THERESA BERTRAM | |||||||
| PRESIDENT & CEO | 4.50 | 35.50 | Yes (X) | $0 | $376,828 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $376,828 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GREENFIELD REHABILITATION AGENCY | |||||
| 7517 W COLDSPRING RD | GREENFIELD | WI | 53220 | THERAPY SERVICES | $501,690 |
| REINHART FOOD SERVICE LLC | |||||
| 2655 EAST RICHMOND ST | SHAWANO | WI | 54166 | FOOD SUPPLIER | $334,847 |
| CANDEO CREATIVE | |||||
| 146 ALGOMA BLVD SUITE G | OSHKOSH | WI | 54903 | CONSULTING/MARKETING | $296,425 |
| STAT TEMPORARY SERVICES INC | |||||
| 5800 N BAYSHORE DR SUITE A-220 | GLENDALE | WI | 53217 | STAFFING AGENCY | $244,435 |
| WI DEPARTMENT OF HEALTH SERVICES | |||||
| PO BOX 093594 | MILWAUKEE | WI | 53293 | HEALTH SERVICES | $152,320 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $362,054 | RelatedOrganizationsAmt |
| Total Contributions | $362,054 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESIDENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $8,488,466 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,488,466 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,488,466 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,654 | TotalRevenueColumnAmt |
| Exclusion | $8,654 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,500 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,500 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,500 | TotalRevenueColumnAmt |
| Exclusion | $16,500 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEAL REVENUE | 900099 | $60,681 | $60,681 |
| VACCINE REVENUE | 900099 | $8,572 | $8,572 |
| OBRA SCREENING | 900099 | $4,260 | $4,260 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,883 | TotalRevenueColumnAmt |
| Exclusion | $5,883 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $79,396 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,955,070 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,488,466 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $104,550 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,077,528 | TotalAmt |
| Program Services | $4,797,169 | ProgramServicesAmt |
| Management And General | $280,359 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,793 | TotalAmt |
| Program Services | $95,228 | ProgramServicesAmt |
| Management And General | $5,565 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $356,733 | TotalAmt |
| Program Services | $337,036 | ProgramServicesAmt |
| Management And General | $19,697 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $358,426 | TotalAmt |
| Program Services | $338,635 | ProgramServicesAmt |
| Management And General | $19,791 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $640,920 | TotalAmt |
| Program Services | $640,920 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,881 | TotalAmt |
| Management And General | $33,881 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,512 | TotalAmt |
| Program Services | $2,250 | ProgramServicesAmt |
| Management And General | $64,262 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $643,874 | TotalAmt |
| Program Services | $622,682 | ProgramServicesAmt |
| Management And General | $21,192 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,406 | TotalAmt |
| Management And General | $71,406 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $804,054 | TotalAmt |
| Program Services | $735,130 | ProgramServicesAmt |
| Management And General | $68,924 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,433 | TotalAmt |
| Management And General | $65,433 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,760 | TotalAmt |
| Program Services | $386,752 | ProgramServicesAmt |
| Management And General | $3,008 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,092 | TotalAmt |
| Program Services | $6,624 | ProgramServicesAmt |
| Management And General | $468 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,033 | TotalAmt |
| Program Services | $347,033 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,530 | TotalAmt |
| Program Services | $132,530 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BED ASSESSMENT | $261,120 | $261,120 | |
| MISCELLANEOUS | $42,887 | $42,872 | $15 |
| EQUIPMENT AND REPAIRS | $36,462 | $36,462 | |
| EMPLOYEE EDUCATION | $18,166 | $17,751 | $415 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,880 | TotalAmt |
| Program Services | $12,875 | ProgramServicesAmt |
| Management And General | $16,005 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,483,490 | TotalAmt |
| Program Services | $8,813,069 | ProgramServicesAmt |
| Management And General | $670,421 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,012 | BOYAmt |
| EOY | $2,012 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,283,955 | BOYAmt |
| EOY | $1,252,589 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $721,412 | BOYAmt |
| EOY | $655,644 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,426 | BOYAmt |
| EOY | $25,242 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,583 | BOYAmt |
| EOY | $31,706 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,488,732 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,514,222 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,857,986 | BOYAmt |
| EOY | $2,974,510 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $227,362 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,654,733 | BOYAmt |
| EOY | $1,595,281 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,804,469 | BOYAmt |
| EOY | $6,536,984 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $955,243 | BOYAmt |
| EOY | $1,209,608 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,451 | BOYAmt |
| EOY | $72,935 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,605,891 | BOYAmt |
| EOY | $1,670,977 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,642,585 | BOYAmt |
| EOY | $2,953,520 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,161,884 | BOYAmt |
| EOY | $3,583,464 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,161,884 | BOYAmt |
| EOY | $3,583,464 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,804,469 | BOYAmt |
| EOY | $6,536,984 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$528,420 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$50,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $386,924 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $137,638 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $77,692 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $808,777 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $362,054 | CurrentTaxYearAmt |
| Total | $1,773,085 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,022,581 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,576,232 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,345,251 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,181,346 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,488,466 | CurrentTaxYearAmt |
| Total | $47,613,876 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,409,505 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,713,870 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,422,943 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,990,123 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,850,520 | CurrentTaxYearAmt |
| Total | $49,386,961 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $49,386,961 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,779 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,152 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,707 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,453 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $25,154 | CurrentTaxYearAmt |
| Total | $104,245 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,779 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,152 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,707 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,453 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $25,154 | CurrentTaxYearAmt |
| Total | $104,245 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $110,462 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $76,615 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $93,445 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $66,144 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $79,396 | CurrentTaxYearAmt |
| Total | $426,062 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,534,746 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,810,637 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,537,095 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,079,720 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,955,070 | CurrentTaxYearAmt |
| Total | $49,917,268 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98940 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98810 | PublicSupportPY509Pct |
| Investment Income CY | 0.00210 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00180 | 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) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,261 | OtherCostOrOtherBasisAmt |
| Book Value | $26,261 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,561,729 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,342,684 | DepreciationAmt |
| Book Value | $1,219,045 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $526,776 | OtherCostOrOtherBasisAmt |
| Depreciation | $431,706 | DepreciationAmt |
| Book Value | $95,070 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,291,787 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,739,832 | DepreciationAmt |
| Book Value | $1,551,955 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,179 | OtherCostOrOtherBasisAmt |
| Book Value | $82,179 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,974,510 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $1,490,910 |
| RESIDENTS' CUSTODIAL ACCOUNTS | $104,371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,595,281 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATIONS | $117,780 |
| DUE/TO FROM AFFILIATES | $1,553,197 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,670,977 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | RESIDENTS' CUSTODIAL ACCOUNTS CONSIST OF AMOUNTS ON DEPOSIT WITH BETHEL HOME BY RESIDENTS FOR SAFEKEEPING. THESE FUNDS CAN BE WITHDRAWN AT ANY TIME BY RESIDENTS. |
| PART X, LINE 2: | THE ORGANIZATION FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THE INCOME TAX STANDARD HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATOIN FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THERESA BERTRAM | PersonNm |
| Title | PRESIDENT & CEO | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $314,828 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $62,000 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $376,828 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE COMPENSATION OF THE PRESIDENT & CEO IS DETERMINED BY THE ORGANIZATION'S SOLE MEMBER, MIRAVIDA LIVING, INC. THE FOLLOWING METHODS WERE USED BY MIRAVIDA LIVING, INC. TO ESTABLISH THE PRESIDENT & CEO'S COMPENSATION: 1. COMPENSATION SURVEY OR STUDY 2. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS PLUS TWO OTHER MEMBERS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE AGENDA FOR THE BOARD AND VOTING MEMBERSHIP MEETINGS. THIS COMMITTEE SHALL KEEP ITSELF INFORMED OF THE ENTIRE OPERATION OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS, AND SHALL EXECUTE SUCH ACTIONS AS MAY BE ASSIGNED TO IT BY THE BOARD. THE COMMITTEE SHALL ALSO CONCERN ITSELF WITH MATTERS NOT ASSIGNED TO OTHER COMMITTEES. |
| FORM 990, PART VI, SECTION A, LINE 6 | MIRAVIDA LIVING, INC., IS THE SOLE MEMBER OF BETHEL HOME, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DIRECTORS OF BETHEL HOME, INC. ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | MAJOR STANDARD OPERATING PROCEDURES, MAJOR POLICIES, AND PROGRAMS OF BETHEL HOME, INC. ARE SUBMITTED TO THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC., FOR APPROVAL AND IMPLEMENTATION. AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS REQUIRE THE APPROVAL OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC. |
| FORM 990, PART VI, SECTION B, LINE 11B | BEFORE IT WAS FILED, THE FORM 990 WAS REVIEWED BY THE CEO, THEN DISTRIBUTED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST FORM TO EACH MEMBER OF THE BOARD OF DIRECTORS AND VARIOUS COMMITTEE MEMBERS NOT ON THE BOARD THAT REQUIRES EACH TO IDENTIFY POTENTIAL CONFLICTS OR OTHER RELATED PARTY INTERESTS. THE REPORTS ARE REVIEWED BY THE SECRETARY AND CEO AND ANY CONFLICTS ARE BROUGHT TO THE BOARD'S ATTENTION. A MEMBER OF THE BOARD WHO HAS A CONFLICT OF INTEREST MAY NOT VOTE ON ANY SUCH ISSUE BEFORE THE BOARD. ANY QUESTION OF WHETHER THERE IS A CONFLICT IS RESOLVED BY THE BOARD OF DIRECTORS. IF THE BOARD OF DIRECTORS DETERMINES THAT A DIRECTOR HAS COMMITTED A SUBSTANTIAL VIOLATION OF THE CONFLICT OF INTEREST POLICY, THE INDIVIDUAL IS REMOVED FROM THE OFFICE OF DIRECTOR. IN ADDITION, ALL MANAGEMENT AND SUPERVISORY EMPLOYEES ARE INFORMED OF THE ORGANIZATION'S POLICY REGARDING RELATED PARTY TRANSACTIONS AND CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO COMPENSATION IS DETERMINED BY A COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE CONSIDERS COMPARABLE DATA AND ECONOMIC CONDITIONS. THE DELIBERATIONS ARE RECORDED. COMPENSATION AND BENEFITS FOR OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED ANNUALLY BY THE CEO. COMPARABLE INDUSTRY STANDARDS ARE CONSIDERED INCLUDING COMPENSATION AND BENEFIT INFORMATION PROVIDED BY LEADINGAGE WISCONSIN. DELIBERATIONS INCLUDE A REVIEW OF OBJECTIVES AND ACTUAL DELIVERABLES. PROCESS IS DOCUMENTED/MAINTAINED ELECTRONICALLY. THESE PROCESSES LAST OCCURRED IN 2018. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND IS ALSO AVAILABLE AT WWW.GUIDESTAR.ORG. THE ORGANIZATION'S FORM 1023 IS ALSO AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | INTERCOMPANY NET ASSET TRANSFER -50,000. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MIRAVIDA LIVING INC | |||||||||||
| 225 NORTH EAGLE STREET | OSHKOSH | WI | 59402 | 391032234 | MANAGEMENT SERVICES | WI | 501(C)(3) | LINE 10 | N/A | 0 | |
| CARMEL RESIDENCE INC | |||||||||||
| 220 NORTH WESTFIELD STREET | OSHKOSH | WI | 59402 | 391448325 | SENIOR HOUSING | WI | 501(C)(3) | LINE 10 | 0 | MIRAVIDA LIVING INC | |
| GABRIEL'S VILLA INC | |||||||||||
| 215 NORTH WESTFIELD STREET | OSHKOSH | WI | 59402 | 391857036 | SENIOR HOUSING | WI | 501(C)(3) | LINE 10 | 0 | MIRAVIDA LIVING INC | |
| SIMEANNA APARTMENTS INC | |||||||||||
| 155 NORTH EAGLE STREET | OSHKOSH | WI | 59402 | 237148097 | SENIOR HOUSING | WI | 501(C)(3) | LINE 10 | 0 | MIRAVIDA LIVING INC | |
| SIMEANNA SOUTH INC | |||||||||||
| 225 NORTH EAGLE STREET | OSHKOSH | WI | 59402 | 391238670 | SENIOR HOUSING | WI | 501(C)(3) | LINE 10 | 0 | MIRAVIDA LIVING INC | |
| SIMEANNA III INC | |||||||||||
| 225 NORTH EAGLE STREET | OSHKOSH | WI | 59402 | 391270056 | SENIOR HOUSING | WI | 501(C)(3) | LINE 10 | 0 | MIRAVIDA LIVING INC | |
| MIRAVIDA LIVING FOUNDATION INC | |||||||||||
| 225 NORTH EAGLE STREET | OSHKOSH | WI | 59402 | 010938793 | FUNDRAISING | WI | 501(C)(3) | LINE 12A, I | 0 | MIRAVIDA LIVING INC | |
| EDEN REHABILITATION SUITES AND GREENHOUSE HOMES INC | |||||||||||
| 3151 EDEN COURT | OSHKOSH | WI | 54904 | 900506872 | SKILLED NURSING FACILITY | WI | 501(C)(3) | LINE 10 | 0 | MIRAVIDA LIVING INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments