2018-11-15T17:30:48-07:00 2017-12-31 990 2017-01-01 470377998 TABITHA INC TABI 4024837671 4720 Randolph Street Lincoln NE 68510 Christina Hinrichs President 4024837671 2018-11-15 208.87.237.201 2017 2019-02-21 02:37:17Z Christina Hinrichs 4720 Randolph Street Lincoln NE 68510 56097066 0 X www.tabitha.org X 1886 NE Motivated by Christian compassion, Tabitha delivers a continuum of exceptional and innovative Elder care services that promote the diginity, independence, and well-being of older adults. 12 12 1291 1250 0 0 1687147 1815845 54749281 53893637 2157 4169 1003419 383415 57442004 56097066 0 0 0 0 43429116 39173851 0 0 0 18189338 21158145 61618454 60331996 -4176450 -4234930 37857286 34835202 30021240 30496804 7836046 4338398 Motivated by Christian compassion, Tabitha delivers a continuum of exceptional and innovative Elder care services that promote the diginity, independence, and well-being of older adults 0 0 27359382 0 25176249 The Tabitha Nursing and Rehabilitation Center (TNRC) has 187 skilled nursing beds and Tabitha in Crete (TiC) nursing center has 38 skilled nursing beds.Both facilities provide long term care. TNRC and TiC provide skilled nursing care with rehabilitation programs including physical, occupational, and speech therapy. TNRC operates units that provide alzheimers and dementia services and hospice inpatient service. Staff in these units have been specifically trained to provide optimal care in these areas. In addition, spiritual counseling, social workers, coordinated activities, and continual health care planning are provided at no additional cost to the patient. Tabitha at Williamsburg has 17 skilled nursing beds and focuses on bringing peace and dignity to the end-of-life journey through hospice care. The innovative community boasts the support of a highly involved, interdisciplinary team of caregivers, clergy, and volunteers. Throughout Tabitha at Williamsburg, patients find peace and dignity in a restriction free environment where they can experience life's final season in the freedom to direct their own lifestyle, including meal times, social activities, relaxation, and more. Tabitha at Williamsburg-Cove House/Harbor House, which has 34 skilled nursing beds, was created to de-institutionalize the "nursing home culture". Tabitha set out a place where clients could enjoy all the comforts of home, including the ability to direct their own care and lifestyle and remain as independent as possible. 8899997 0 12447713 Tabitha's Medicare and Medicaid certified Hospice program provides care for terminally ill persons and their families which enables the patient to stay home in a comfortable environment while giving their family members an opportunity to renew and enhance their relationship to the patient and each other. The inter-disciplinary team approach allows comprehensive and intensive information-sharing, problem solving, and service delivery. Services include medical director, visiting nurses, social workers, home health aides, spiritual counselors, consulting pharmacists, nutritionists, and bereavement counselors. 8342853 0 9465138 Tabitha Medicare and Medicaid certified Home Health Agency provides licensed and certified home skilled nursing, home health aides, rehabilitation therapy (physical, speech, and occupational), and social work visits to those whose injury or illness can be safely managed in the home. Family members are trained to supplement care if desired. The agency also provides health screening clinics and blood pressure checks in the communities it serves. The Home Health Agency provides services to communities in all or parts of 28 counties, including the surrounding Lancaster County. Home Care Specialties of Tabitha supplements Medicare/Medicaid Home Health Care and Medicare certified Hospice programs by providing non-medicare covered services such as bath and personal care aides to assist with bathing, grooming, and other daily living activities. Homemakers assist with light cleaning, laundry, grocery shopping, and food preparation. 24 hours caregivers are available day or night with reduced sleep-over rates. Tuck-in service assists with bed-time care. VoiceCare supports independent living with a secure, reliable emergency response system. Clients simply wear a personal activator button that, when pressed, will contact designated responders such as family, neighbors, or emergency response personnel. 6100430 0 6804537 The Meals on Wheels program which provides hot noon meals prepared by Tabitha staff and delivered by volunteers to residents in Lincoln and parts of Lancaster County who are recovering from an illness, regaining strength after a hospital stay, physically unable to prepare their own meals, or who need assistance to remain living independently. It provides meals to any disabled or elderly person in need regardless of ability to pay. Tabitha Adult Day Service is intended to be a home away from home for loved ones who need care and support during the day while you work. On those occasions when you need respite, Tabitha Adult Day Services is there for you. Adults are offered the opportunity to interact with others and enjoy activities which foster happier, healthier, and more meaningful lives. We provide a nurturing environment that honors each person's integrity, dignity, and self worth. At Tabitha in Crete - The Gardens, we create a warm, home-like setting for those who want to live life with choices. Whether you desire an active social schedule or a more relaxed way of life, our respect for other's individuality and dignity is at the center of all we do. We are located in a quiet residential area in close proximity to the local hospital, doctor's offices, and shopping centers. Our rural setting as a small-town feel, yet is close enough to Lincoln to take advantage of all the exciting opportunities that a larger city has to offer. GracePointe Assisted Living provides maintenance free residences, around-the-clock personal care, enriching activities focused on life and wellness, and leading-age technology in a welcome, secure living community. GracePointe offers several floor plan options in spacious one and two bedroom suites, along with community style dining rooms, fireplace lounge, library and media den, community living rooms, pub-style gathering lace, private dining room, beauty salon and barbershop, outdoor patios and walking paths, secure underground parking, paid utilities, innovative Healthsense technology, WiFi coverage, and 24-hour on-site emergency response personnel. GracePointe caregivers compassionately meet your physical and emotional needs so you feel secure at at home. We work in small teams, service specific GracePointe "neighborhoods" where residents and staff can develop caring, family-like relationships. When family caregivers need some time off, Elders can enjoy loving, compassionate care at GracePointe for two weeks or longer in our fully furnished respite care suites. Our commitment to memory care starts with two key ingredients - grace and love. GracePointe Memory Care Suites are an ideal solution for adults with memory loss who are not in need of skilled nursing care, yet require assistance for the activities of daily living. We strive to let each resident live as independently as possible while providing care and compassionate support. Every detail, from the nostalgic design of the building, to secure monitoring and creative recall activities has been developed to provide a comfortable, safe, and enriching lifestyle. Tabitha's EngAGE program is the ideal solution for any family experiencing the aging journey of a loved one. With EngAGE, Tabitha offers truly customized, consultation, and personal services to set up critical choices in advance, rather than waiting for a crisis. The premier, membership-based program offers peace of mind to spouses, children, and caregivers knowing that a plan is in place for whatever lies ahead. When it comes to aging, too many adults and their loves ones find themselves facing difficult decisions alone, uninformed, and unaware of options. For discerning Elders and their families, EngAGE offers personalized answers for your aging journey. Through EngAGE by Tabitha, a family adds depth and breadth to their loved one's aging journey, proactively identifying options and directing choices in advance. 6100430 0 6804537 50702662 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 43 1291 1 1291 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Darcie Brink 4024868538 4720 Randolph Street Lincoln NE 68510 Mark Hesser Chair 0 0 X X 0 0 0 Dirk Brom Member 0 0 X 0 0 0 Lee Chapin Member 0 0 X 0 0 0 Carol Friesen Member 0 0 X 0 0 0 Christopher Kelly Member 0 0 X 0 0 0 Sandra Latshaw Member 0 0 X 0 0 0 Bishop Brian Mass Member 0 0 X 0 0 0 Boyd Ober Member 0 0 X 0 0 0 Michael Jenkins Member 0 0 X 0 0 0 Kimberly Rath Member 0 0 X 0 0 0 Eric Schafer Vice Chair 0 0 X X 0 0 0 Renee Sjulin Member 0 0 X 0 0 0 Christina Hinrichs President & CEO 0 0 X X 339803 0 25278 Darcie Brink Chief Financial Officer 0 0 X X 137595 0 1849 Amy Ostermeyer Chief Operating Officer 0 0 X 185000 0 19852 Heath Stukenholtz Chief Development Officer 0 0 X 0 177072 13582 Gina Cotton Director of Foundation 0 0 X 0 124163 12087 Mary Joyce Ebmeier Senior Vice President 0 0 X 120530 0 16423 Darrell Sievert Vice President of Information Services 0 0 X 113317 0 21164 896245 301235 110235 7 0 1 1 RTG Medical 1005 E 23rd St Ste 200 Fremont NE 68504 Medical 271294 Kidwell Companies 3333 Folkways Circle Lincoln NE 68504 Electrical 241898 Prime Time Healthcare LLC PO Box 3544 Omaha NE 681030544 Medical 239865 Crete Area Medical Center PO Box 220 Crete NE 68333 Medical 192959 Davis Contract Furnishings 1221 N St Ste 600 Lincoln NE 68508 Construction 148340 9 0 0 0 0 0 1815845 0 1815845 Nutritional Services 900000 872446 872446 0 0 Nursing Home Care 623000 25176249 25176249 0 0 Home Health Care 621610 9465138 9465138 0 0 Hospice 623000 12447713 12447713 0 0 Other 900099 5932091 5932091 0 0 0 0 0 0 53893637 4169 4169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383415 383415 0 0 383415 56097066 54281221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31795186 26681816 5113370 0 618836 506608 112228 0 4455701 3697051 758650 0 2304128 1923552 380576 0 0 0 0 0 0 0 0 0 143581 6401 137180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161831 3029 158802 0 3250150 3015208 234942 0 0 0 0 0 0 0 0 0 3783521 2711493 1072028 0 725182 616558 108624 0 0 0 0 0 78370 46391 31979 0 863836 754838 108998 0 0 0 0 0 2780090 2308873 471217 0 328607 321315 7292 0 Food and Catering 1489853 1449611 40242 0 Professional Services 3501627 2854826 646801 0 Hospice Medicaid per Diem 2203866 2203866 0 0 Impairment Loss 1180735 1180735 0 0 666896 420491 246405 0 60331996 50702662 9629334 0 656443 738626 40830 57326 0 0 5855233 5967932 0 0 0 0 0 0 189310 188980 264077 349967 55639017 29149474 29898211 26489543 0 0 0 0 0 0 0 0 953182 1042828 37857286 34835202 5562224 6670716 0 0 0 0 20170000 19260000 0 0 0 0 2504746 2674605 0 0 1784270 1891483 30021240 30496804 X 7346046 3848398 490000 490000 0 0 7836046 4338398 37857286 34835202 X -4234930 0 0 0 0 737282 X 1 X 1 X 1 0 X 285835 1244527 2811275 2038913 1112409 7492959 47484929 53799450 53256975 54529057 53893634 262964045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47770764 55043977 56068250 56567970 55006043 270457004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270457004 8413 749 4359 2157 4169 19847 0 0 0 0 0 0 8413 749 4359 2157 4169 19847 0 0 0 0 0 0 0 0 0 0 0 0 47779177 55044726 56072609 56570127 55010212 270476851 0.99993 0.9998 0.00007 0.0002 X 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 1 0 0 0 0 675611 0 675611 38257573 0 18823352 19434221 3705746 0 1187909 2517837 13000087 0 9138213 3861874 0 0 0 0 26489543 0 Payable to Affiliates 1891483 1891483 X Schedule D, Part V, Line 4 Nursing Facility Conversion Cash Fund Grant Schedule D, Part X, Line 1 The affiliated entities are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code. All entities have received a determination letter verifying they are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. The Internal Revenue Service has established standards to be met to maintain tax-exempt status. Tabitha accounts for uncertainties in accounting for income tax assets and liabilities using guidance included in the Financial Accounting Standards Board (FASB) and Accounting Standards Codification (ASC), Topic 740, Income Taxes. Tabitha recognizes the effect of income tax positions only if those positions are more likely unsustainable. At December 31, 2017 and 2016, the Organization has no uncertain tax positions accrued. Schedule D, Part X, Line 2 The official minutes of the Board and Committee meetings shall be keep in perpetuity. Financial records and information and patient clinical records shall be retained for seven years by the department generating the documents. Any notice of a pending investigation by any local, state, or federal authority will immediately halt all document destruction throughout the organization. This policy recognizes that it is a violation of the Sarbanes-Oxley Act to destroy records with the intent to obstruct a federal investigation. Destruction of any records, information, or documents must have prior approval in writing by Tabitha's President or Senior Vice President/CFO. X X X X X 0 0 0 0 0 0 0 0 0 Christina Hinrichs President & CEO 312097 0 0 0 25278 0 0 0 0 0 337375 0 0 Amy Ostermeyer Chief Operating Officer 185000 0 0 0 19852 0 0 0 0 0 204852 0 0 0 Heath Stukenholtz Chief Development Officer 0 177072 0 0 0 13582 0 0 0 0 0 190654 0 0 A Hospital Authority No 1 of Lancaster Cnty NE 470721900 513885CZ4 2011-12-15 1950000 Construct/equip/furnish improvement to existing facilities 0 0 0 B Hospital Authority No 1 of Lancaster Cnty NE 470721900 513885DQ3 2014-06-30 7175000 Refund prior issues (06/30/2009) (9/15/2009) (07/15/2010) 0 0 0 C The County of Saline Nebraska 476006503 79517VAM3 2015-01-28 3155000 Refund of prior issue (01/06/2010) 0 0 0 D Hospital Authority No 1 of Lancaster Cnty NE 470721900 513885ED1 2015-01-28 3100000 Refund of prior issue (07/15/2010) 0 0 0 A 460000 0 1950288 151554 0 0 38713 0 0 1760022 0 0 2012 0 0 1 1 B 945000 0 7175315 0 0 0 142146 0 0 0 7033170 0 2011 1 1 1 1 C 525000 0 3155000 0 0 0 59366 0 0 0 3095643 0 2010 1 0 1 1 D 0 0 3100000 0 0 0 46500 0 0 0 3053500 0 2011 0 1 1 1 A 0 0 0 0 0 0 0 1 0 1 B 0 0 0 0 0 0 0 1 0 1 C 0 0 0 0 0 0 0 1 0 1 D 0 0 0 0 0 0 0 1 0 1 A 0 0 1 1 0 0 0 0 1 B 0 0 1 1 0 0 0 0 1 C 0 0 1 1 0 0 0 0 1 D 0 0 1 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part IV, Line 2c-12/15/2011 1,950,000 Hospital Authority No 1 of Lancaster Cnty NE (A) Issuer Name: Hospital Authority No 1 of Lancaster County, NE Date the Rebate Computation was performed: 11/30/2016 Note regarding the rebate computations: Since the bond proceeds have been spent, a spending exception was met and the debt service fund was operated on a bona fide basis, no further rebate calculations necessary. Schedule K, Part IV, Line 2c-06/30/2014 7,175,000 Hospital Authority No 1 of Lancaster Cnty NE (B) Issuer Name: Hospital Authority No 1 of Lancaster County, NE Date the Rebate Computation was performed: 12/1/2014 Note regarding the rebate computations: Since the bond proceeds have been spent, a spending exception was met and the debt service fund was operated on a bona fide basis, no further rebate calculations necessary. Schedule K, Part IV, Line 2c-01/28/2015 3,155,000 The County of Saline Nebraska (C) Issuer Name: The County of Saline, NE Date the Rebate Computation was performed: 07/28/2015 Note regarding the rebate computations: Since the bond proceeds have been spent, a spending exception was met and the debt service fund was operated on a bona fide basis, no further rebate calculations necessary. Schedule K, Part IV, Line 2c-01/28/2015 3,100,000 Hospital Authority No 1 of Lancaster Cnty NE (D) Issuer Name: Hospital Authority No 1 of Lancaster County, NE Date the Rebate Computation was performed: 07/28/2015 Note regarding the rebate computations: Since the bond proceeds have been spent, a spending exception was met and the debt service fund was operated on a bona fide basis, no further rebate calculations necessary. A The County of Lancaster Nebraska 476006482 513841AQ9 2015-07-23 6060000 Purchase, construct, furnish new facility 0 0 0 A 250000 0 6060387 0 0 0 108250 0 0 5952137 0 0 2016 0 0 1 1 A 0 0 0 0 0 0 0 1 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Schedule K, Part IV, Line 2c-07/23/2015 6,060,000 The County of Lancaster Nebraska (E) Issuer Name: The County of Lancaster, Nebraska Date the Rebate Computation was performed: 06/30/2017 Note regarding the rebate computations: Since the bond proceeds have been spent, a spending exception was met and the debt service fund was operated on a bona fide basis, no further rebate calculations necessary. Form 990, Part VI, Section B, Line 11b The IRS form 990 together with all required schedules for Tabitha Inc., and Affiliates shall be provided in paper or electronic format to all members of both Boards. The President shall arrange for the Senior Vice President/CFO to conduct a review of the 990 for interested Board Members. A copy shall be posted to the President's Office and be provided to the public upon request. The 990 shall be prepared by the General Accountant and reviewed by the Senior Vice President/CFO. The form 990 shall be signed by the Chief Executive Officer or Senior Vice President/CFO. Form 990, Part VI, Section B, Line 12c To ensure the Organization operates in a manner consistent with charitable purposes and does not engage in activities that could jeopordize its tax-exempt status, periodic reviews shall be conducted. The periodic reviews shall, at a minimum, include the following subjects: A) Whether the compensation arrangements and benefits are reasonable, based on competent survey information, and the results of arm's length bargaining. B) Whether partnerships, joint ventures, and arrangements with management organizations conform to the Organization's written policies, are properly recorded, reflect reasonable investment or payment for goods and services, further charitable purposes and do not result in inurement, impermissible private benefit or in an excess benefit transaction. Each director, principal officer, and member of a committee with a governing board delegated powers shall annually sign a statement which affirms such person: a) has received a copy of the conflicts of interest policy; b) Has read and understands the policy; c) has agreed to comply with the policy and d) understands the Organization is charitable and in order to maintain its federal tax exemption, must engage primarily in activities which accomplish one or more of its tax-exempt purposes. When conducting periodic reviews as provided for in Article VII, the Organization may use outside advisors if necessary. If outside experts are used, their use shall not relieve the governing board of its responsibility for ensuring periodic reviews are conducted. A conflict of interest policy is also intended to establish procedures under which individuals who have a conflict of interest will be excused from voting on such matters. Form 990, Part VI, Section B, Line 15 All Tabitha Board Members shall serve without compensation. Reimbursement for actual costs of meals, mileage, and lodging in the conduct of Tabitha business is allowed. The President of Tabitha shall be responsible for establishing wages, salaries, benefits, and pay increases for all Tabitha employees, subject to Board approval. The Executive Committee of the Tabitha Board shall annually determine the salary, benefit, and severance package for the President/Chief Executive Officer. The President's compensation must meet the Fair Market Value Test and the Comparability Test for similar positions in not-for-profit organizations. The President shall be evaluated annually. Form 990, Part VI, Section C, Line 19 The official minutes of the Board and Committee meetings shall be keep in perpetuity. Financial records and information and patient clinical records shall be retained for seven years by the department generating the documents. Any notice of a pending investigation by any local, state, or federal authority will immediately halt all document destruction throughout the organization. This policy recognizes that it is a violation of the Sarbanes-Oxley Act to destroy records with the intent to obstruct a federal investigation. Destruction of any records, information, or documents must have prior approval in writing by Tabitha's President or Senior Vice President/CFO. Form 990, Part XI, Line 9 Transfer from affiliate $429,652 and gifts, grants, and bequests for purchase of property and equipment $307,630. Tabitha Foundation 4720 Randolph Street Lincoln NE 68510 470636199 Fundraising NE 501(c)(3) 9 N/A 0 Tabitha Village 841 South 47th Street Lincoln NE 68510 470529173 Elderly Housing NE 501(c)(3) 9 N/A 0 Tabitha ALF Real Estate Holding Company 4620 Randolph Street Lincoln NE 68510 270241402 Real Estate NE 501(c)(3) 9 N/A 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 Tabitha Foundation c 2160918 Actual Tabitha ALF Real Estate Holding Company k 930000 FMV Tabitha Village q 336484 Actual Tabitha Foundation e 19260000 FMV Tabitha ALF Real Estate Holding Company b 70348 Actual Tabitha Foundation q 697879 Actual