ISLAND NURSING HOME INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ISLAND NURSING HOME INC (EIN 51-0172239)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-04-29
- IRS object ID
- 201911199349300981
- Schema version
- 2017v2.3
- 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 | 2019-04-29T14:22:49-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510172239 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Island Nursing Home Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ISLA | BusinessNameControlTxt |
| Phone | 2073482351 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 587 North Deer Isle Road | AddressLine1Txt |
| City | Deer Isle | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04627 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeffrey Dalrymple | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 2073482351 | PhoneNum |
| Signature | 2019-04-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joseph R Byrne CPA | PreparerPersonNm |
| PTIN | P01289281 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2019-04-16 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.49.157.66 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-04-16 | IPDt |
| IP Tm | 15:04:45 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | FD764483AA263AFE8AB46477EA327BFBBE809DCF | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | E262D3C9A45A77A46A0A2832CF74466488750570 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Matthew Trombley | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 587 North Deer Isle Road | AddressLine1Txt |
| City | Deer Isle | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04627 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,223,453 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.islandnursinghome.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | Island Nursing Home is committed to providing the highest level of innovative and quality healthcare to an aging population while maintaining community relationships and honoring our core values of care, compassion, and service. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 138 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $145,494 | PYContributionsGrantsAmt |
| CY Contributions Grants | $78,409 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,830,728 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,468,468 | CYProgramServiceRevenueAmt |
| PY Investment Income | $52,233 | PYInvestmentIncomeAmt |
| CY Investment Income | $48,518 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,028,455 | PYTotalRevenueAmt |
| CY Total Revenue | $4,595,395 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,821,187 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,094,757 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,913,134 | PYOtherExpensesAmt |
| CY Other Expenses | $1,758,676 | CYOtherExpensesAmt |
| PY Total Expenses | $4,734,821 | PYTotalExpensesAmt |
| CY Total Expenses | $4,854,433 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $293,634 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$259,038 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,344,956 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,172,295 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $793,839 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $726,110 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,551,117 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,446,185 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Island Nursing Home is committed to providing the highest level of innovative and quality healthcare to an aging population while maintaining community relationships and honoring our core values of care, compassion, and service. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,165,917 | ExpenseAmt |
| Grant | $1,000 | GrantAmt |
| Revenue | $4,468,468 | RevenueAmt |
| Desc | Nursing Home Care - Seventy-bed long term care facility offering skilled nursing, residential and ancillary services to medically needy residents. | Desc |
| Total Program Service Expenses | $4,165,917 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 138 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Matthew Trombley | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2073482351 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 587 North Deer Isle Rd | AddressLine1Txt |
| City | Deer Isle | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04627 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Anne Sigmund | ||||||
| President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Bobbi Billings | ||||||
| Vice President | 6.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Jeff Dalrymple | ||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Deborah Ludlow | ||||||
| Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Linda Campbell | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Karen Chapman | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Deborah Cummins | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Deborah DeWitt | ||||||
| Director, Past Vice President | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Evelyn Duncan | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Samuel Harrington | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Donald Holmes | ||||||
| Past Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Robert Lasky | ||||||
| Director, Past Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Kathleen Osborn | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Joseph Perkins | ||||||
| Past Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Sara Stone | ||||||
| Past Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Dianne Thompson | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Judith Williams | ||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Hailey Wetherbee | ||||||
| Past Administrator | 40.00 | Yes (X) | $116,965 | $0 | $15,399 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $116,965 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $15,399 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BK Burgess Inc | |||||
| 561 N Deer Isle Rd | Deer Isle | ME | 04627 | Construction | $450,277 |
| Arete Rehabilitation | |||||
| 110 Haverhill Road Ste 101 | Amesbury | MA | 01913 | Therapy Services | $256,249 |
| Ted Berry Company Inc | |||||
| 521 Federal Rd | Livermore | ME | 04253 | Plumbing | $177,413 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $78,409 | AllOtherContributionsAmt |
| Noncash Contributions | $5,440 | NoncashContributionsAmt |
| Total Contributions | $78,409 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medicare/Medicaid Rev. | 623000 | $5,907,020 | $5,907,020 |
| Pvt. Pay Nursing Care | 623000 | $878,643 | $878,643 |
| Miscellaneous Revenue | 623000 | $821 | $821 |
| Contractual Adjustment | 623000 | -$2,318,016 | -$2,318,016 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,468,468 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,790 | TotalRevenueColumnAmt |
| Exclusion | $41,790 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $634,261 | SecuritiesAmt |
| Other | $525 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $617,346 | SecuritiesAmt |
| Other | $10,712 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,915 | SecuritiesAmt |
| Other | -$10,187 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,728 | TotalRevenueColumnAmt |
| Exclusion | $6,728 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,595,395 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,468,468 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $48,518 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,765 | TotalAmt |
| Management And General | $104,765 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,215,631 | TotalAmt |
| Program Services | $2,001,795 | ProgramServicesAmt |
| Management And General | $213,836 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $575,827 | TotalAmt |
| Program Services | $483,426 | ProgramServicesAmt |
| Management And General | $92,401 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,534 | TotalAmt |
| Program Services | $162,341 | ProgramServicesAmt |
| Management And General | $36,193 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,105 | TotalAmt |
| Management And General | $2,105 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,140 | TotalAmt |
| Management And General | $70,140 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $313,399 | TotalAmt |
| Program Services | $279,544 | ProgramServicesAmt |
| Management And General | $33,855 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,935 | TotalAmt |
| Program Services | $35,935 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,073 | TotalAmt |
| Program Services | $28,679 | ProgramServicesAmt |
| Management And General | $20,394 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,155 | TotalAmt |
| Management And General | $2,155 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,662 | TotalAmt |
| Program Services | $100,662 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,983 | TotalAmt |
| Program Services | $6,983 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,386 | TotalAmt |
| Program Services | $10,636 | ProgramServicesAmt |
| Management And General | $750 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,148 | TotalAmt |
| Program Services | $226,148 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,227 | TotalAmt |
| Program Services | $92,227 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $264,502 | $264,502 | |
| Provider Tax Expense | $261,111 | $261,111 | |
| Miscellanous | $183,038 | $71,116 | $111,922 |
| Food | $139,812 | $139,812 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,854,433 | TotalAmt |
| Program Services | $4,165,917 | ProgramServicesAmt |
| Management And General | $688,516 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600 | BOYAmt |
| EOY | $600 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $815,132 | BOYAmt |
| EOY | $545,034 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $383,741 | BOYAmt |
| EOY | $104,943 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,566 | BOYAmt |
| EOY | $607,470 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,890 | BOYAmt |
| EOY | $47,253 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,106 | BOYAmt |
| EOY | $25,488 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,165,732 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,289,204 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,203,230 | BOYAmt |
| EOY | $1,876,528 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,270,691 | BOYAmt |
| EOY | $1,871,442 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $93,537 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,344,956 | BOYAmt |
| EOY | $5,172,295 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $463,905 | BOYAmt |
| EOY | $556,066 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,857 | BOYAmt |
| EOY | $18,857 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $300,244 | BOYAmt |
| EOY | $151,187 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,833 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $793,839 | BOYAmt |
| EOY | $726,110 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,335,881 | BOYAmt |
| EOY | $2,847,990 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,171,229 | BOYAmt |
| EOY | $537,779 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,044,007 | BOYAmt |
| EOY | $1,060,416 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,551,117 | BOYAmt |
| EOY | $4,446,185 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,344,956 | BOYAmt |
| EOY | $5,172,295 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$259,038 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $154,106 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $91,945 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,588,948 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $702,311 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $145,494 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $78,409 | CurrentTaxYearAmt |
| Total | $2,607,107 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,116,422 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,309,001 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,451,327 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,830,728 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,468,468 | CurrentTaxYearAmt |
| Total | $22,175,946 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,208,367 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,897,949 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,153,638 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,976,222 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,546,877 | CurrentTaxYearAmt |
| Total | $24,783,053 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,525 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $232,750 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $59,400 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,360 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,530 | CurrentTaxYearAmt |
| Total | $324,565 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $902,094 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $944,297 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $975,487 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $949,060 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,127,549 | CurrentTaxYearAmt |
| Total | $4,898,487 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $918,619 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,177,047 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,034,887 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $956,420 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,136,079 | CurrentTaxYearAmt |
| Total | $5,223,052 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $19,560,001 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $36,376 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $42,656 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,434 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $50,214 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $41,790 | CurrentTaxYearAmt |
| Total | $222,470 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $36,376 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $42,656 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,434 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $50,214 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $41,790 | CurrentTaxYearAmt |
| Total | $222,470 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,244,743 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,940,605 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,205,072 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,026,436 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,588,667 | CurrentTaxYearAmt |
| Total | $25,005,523 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.78220 | PublicSupportCY509Pct |
| Public Support PY509 | 0.78890 | PublicSupportPY509Pct |
| Investment Income CY | 0.00890 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00880 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,384 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,384 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Organization pays dues to various organizations, a portion of which are attributable to lobbying expenses. | ExplanationTxt |
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 |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,142,878 | BeginningYearBalanceAmt |
| Contributions | $16,409 | ContributionsAmt |
| Investment Earnings Or Losses | $108,127 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $73,248 | OtherExpendituresAmt |
| End Year Balance | $1,194,166 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,089,373 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $124,017 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $70,512 | OtherExpendituresAmt |
| End Year Balance | $1,142,878 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,062,719 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $27,154 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $500 | AdministrativeExpensesAmt |
| End Year Balance | $1,089,373 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $47,598 | BeginningYearBalanceAmt |
| Contributions | $1,000,000 | ContributionsAmt |
| Investment Earnings Or Losses | $15,706 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $585 | AdministrativeExpensesAmt |
| End Year Balance | $1,062,719 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $47,369 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $479 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $250 | AdministrativeExpensesAmt |
| End Year Balance | $47,598 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.88800 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.11200 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,290 | OtherCostOrOtherBasisAmt |
| Book Value | $55,290 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,445,025 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,186,689 | DepreciationAmt |
| Book Value | $1,258,336 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,259,725 | OtherCostOrOtherBasisAmt |
| Depreciation | $741,165 | DepreciationAmt |
| Book Value | $518,560 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $405,692 | OtherCostOrOtherBasisAmt |
| Depreciation | $361,350 | DepreciationAmt |
| Book Value | $44,342 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,876,528 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $4,729,501 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $154,106 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $154,106 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,575,395 | RevenueSubtotalAmt |
| Other Revenues Not Included | $20,000 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $20,000 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,595,395 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,834,433 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,834,433 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $20,000 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $20,000 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,854,433 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | The Organization holds private funds for residents and provides these funds to the resident, as needed, for various personal expenses. |
| Part V, Line 4: | Intended use of earnings on endowment funds include funding for scholarships and operating activities of the nursing home. |
| Part XI, Line 4b - Other Adjustments: | Provision for Uncollectible Pledges 20,000. |
| Part XII, Line 4b - Other Adjustments: | Provision for Uncollectible Pledges 20,000. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | Form 990 was provided to the governing body by email prior to being filed. It was reviewed by the Finance Committee and the President of the Board of Directors. |
| Form 990, Part VI, Section B, line 12c | Each director, principal officer and member of a committee with governing board-delegated powers shall annually sign a statement, which affirms such person: (a) has received a copy of the conflict of interest policy, (b) has read and understands the policy, (c) has agreed to comply with the policy and (d) understands the Island Nursing Home is charitable and in order to maintain its federal exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest transaction shall be approved or ratified. |
| Form 990, Part VI, Section B, line 15a | The administrator is reviewed annually by the board. The process for determining the administrator's compensation includes a compensation survey or study and approval by the board. This occurs on a periodic basis. |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment | Section 1.263(a)-3(n) Election: Island Nursing Home, Inc. 587 North Deer Isle Road Deer Isle, ME 04627 EIN: 51-0172239 Section 1.263(a)-3(n) Election: Island Nursing Home, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |