AMERICAN FAMILY SERVICES INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- AMERICAN FAMILY SERVICES INC (EIN 72-1150472)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-14
- IRS object ID
- 201833189349300943
- 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 | 2018-11-14T05:17:02-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 311543240 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CBIZ MHM LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 PLYMOUTH ROAD SUITE 200 | AddressLine1Txt |
| City | PLYMOUTH MEETING | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19462 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721150472 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERICAN FAMILY SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AMER | BusinessNameControlTxt |
| Phone | 2257530864 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40018 | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70835 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICHARD T DASPIT SR | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 2257530864 | PhoneNum |
| Signature | 2018-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOSEPH G SULLIVAN | PreparerPersonNm |
| PTIN | P00360476 | PTIN |
| Phone | 6108622249 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.90.32.117 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-08 | IPDt |
| IP Tm | 07:02:28 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B72324DD821F9B363145A28EC3BC93E4A28A8F36 | 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 | RICHARD T DASPIT SR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17617 S HARRELLS FERRY ROAD | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70816 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,251,642 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AFSHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPREHENSIVE NURSING CARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 138 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,378,943 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,223,176 | CYProgramServiceRevenueAmt |
| PY Investment Income | $25 | PYInvestmentIncomeAmt |
| CY Investment Income | $78 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,931 | PYOtherRevenueAmt |
| CY Other Revenue | $28,388 | CYOtherRevenueAmt |
| PY Total Revenue | $3,385,899 | PYTotalRevenueAmt |
| CY Total Revenue | $3,251,642 | 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 | $2,430,552 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,440,491 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,621,374 | PYOtherExpensesAmt |
| CY Other Expenses | $1,446,501 | CYOtherExpensesAmt |
| PY Total Expenses | $4,051,926 | PYTotalExpensesAmt |
| CY Total Expenses | $3,886,992 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$666,027 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$635,350 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,483,670 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,666,357 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,774,365 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,295,278 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$5,290,695 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$6,628,921 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SERVE THE HEALTH AND REHABILITATION NEEDS OF THE COMMUNITY AND TO IMPROVE THE QUALITY OF LIFE FOR EACH PATIENT, RESIDENT, FAMILY MEMBER, VISITOR AND CO-WORKER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,355,727 | ExpenseAmt |
| Revenue | $3,223,176 | RevenueAmt |
| Desc | AMERICAN FAMILY SERVICES WAS FORMED TO OWN AND OPERATE A 60 BEDNURSING FACILITY AND A 42 BED ASSISTED LIVING FACILITY IN NELSONIA, VIRGINIA, A RURAL COMMUNITY. | Desc |
| Total Program Service Expenses | $3,355,727 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 2 | 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 |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | LA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICHARD T DASPIT SR | PersonNm |
| Phone | 2257530864 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17617 S HARRELLS FERRY ROAD | AddressLine1Txt |
| City | BATON ROUGE | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70816 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RICHARD T DASPIT SR | ||||||||
| PRESIDENT | 5.00 | 40.00 | Yes (X) | Yes (X) | $0 | $220,562 | $5,355 | |
| G STUART MURPHY III | ||||||||
| TREASURER | 5.00 | 30.00 | Yes (X) | Yes (X) | $0 | $6,000 | $0 | |
| LOUIS HERRERO | ||||||||
| VICE PRESIDENT | 5.00 | 40.00 | Yes (X) | Yes (X) | $0 | $6,000 | $0 | |
| LONNIE PEELER | ||||||||
| COO | 5.00 | 40.00 | Yes (X) | $0 | $173,254 | $5,355 | ||
| CYNTHIA PITTMAN | ||||||||
| CFO | 5.00 | 40.00 | Yes (X) | $0 | $52,039 | $1,786 | ||
| BRANDON HOLLEMAN | ||||||||
| VICE PRESIDENT OF FINANCE | 5.00 | 40.00 | Yes (X) | $0 | $54,223 | $3,569 | ||
| MICHAEL PEELER-SMITH | ||||||||
| CCO | 5.00 | 40.00 | $0 | $134,673 | $4,910 | Yes (X) | ||
| CYNTHIA GAYLE | ||||||||
| CHIEF HR/RISK MGMT OFFICER | 5.00 | 40.00 | $0 | $103,833 | $5,355 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $750,584 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $26,330 | 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
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | US FOOD INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3682 COLLECTION CENTER DR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60693 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | FOOD SERVICE | ServicesDesc |
| Compensation | $193,878 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESIDENT SERVICE REVEN | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $3,223,176 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,223,176 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,223,176 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78 | TotalRevenueColumnAmt |
| Exclusion | $78 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS | 623000 | $23,475 | $23,475 |
| VENDING MACHINE | 623000 | $3,014 | $3,014 |
| MEALS SOLD | 623000 | $1,716 | $1,716 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $183 | TotalRevenueColumnAmt |
| Exclusion | $183 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $28,388 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,251,642 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,223,176 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $28,466 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,999,783 | TotalAmt |
| Program Services | $1,795,634 | ProgramServicesAmt |
| Management And General | $204,149 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,195 | TotalAmt |
| Program Services | $227,807 | ProgramServicesAmt |
| Management And General | $27,388 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,513 | TotalAmt |
| Program Services | $168,669 | ProgramServicesAmt |
| Management And General | $16,844 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,842 | TotalAmt |
| Program Services | $103,842 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,964 | TotalAmt |
| Management And General | $1,964 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,361 | TotalAmt |
| Program Services | $144,883 | ProgramServicesAmt |
| Management And General | $110,478 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,390 | TotalAmt |
| Management And General | $1,390 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,733 | TotalAmt |
| Management And General | $71,733 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $393,426 | TotalAmt |
| Program Services | $336,020 | ProgramServicesAmt |
| Management And General | $57,406 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,436 | TotalAmt |
| Program Services | $2,320 | ProgramServicesAmt |
| Management And General | $4,116 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,326 | TotalAmt |
| Program Services | $2,775 | ProgramServicesAmt |
| Management And General | $7,551 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,812 | TotalAmt |
| Program Services | $9,234 | ProgramServicesAmt |
| Management And General | $1,578 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,480 | TotalAmt |
| Program Services | $133,648 | ProgramServicesAmt |
| Management And General | $22,832 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,323 | TotalAmt |
| Program Services | $51,323 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DIETARY SUPPLIES | $189,841 | $189,841 |
| MEDICAL SUPPLIES | $75,370 | $75,370 |
| OTHER SUPPLIES | $50,462 | $50,462 |
| PHARMA SUPPLIES | $40,188 | $40,188 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,547 | TotalAmt |
| Program Services | $23,711 | ProgramServicesAmt |
| Management And General | $3,836 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,886,992 | TotalAmt |
| Program Services | $3,355,727 | ProgramServicesAmt |
| Management And General | $531,265 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,010 | BOYAmt |
| EOY | $193,543 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $196,782 | BOYAmt |
| EOY | $26,934 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,234 | BOYAmt |
| EOY | $188,328 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,297 | BOYAmt |
| EOY | $15,997 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,164,807 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,114,807 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,328,103 | BOYAmt |
| EOY | $1,050,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $530,715 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,529 | BOYAmt |
| EOY | $191,555 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,483,670 | BOYAmt |
| EOY | $1,666,357 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $527,496 | BOYAmt |
| EOY | $837,849 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,063,213 | BOYAmt |
| EOY | $3,082,570 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $875,000 | BOYAmt |
| EOY | $875,000 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $375,804 | BOYAmt |
| EOY | $233,533 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,932,852 | BOYAmt |
| EOY | $3,266,326 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,774,365 | BOYAmt |
| EOY | $8,295,278 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,290,695 | BOYAmt |
| EOY | -$6,628,921 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,290,695 | BOYAmt |
| EOY | -$6,628,921 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,483,670 | BOYAmt |
| EOY | $1,666,357 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$635,350 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$530,715 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$172,161 | 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 Minus3 Years | $3,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $851 | CurrentTaxYearMinus2YearsAmt |
| Total | $3,851 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,864,197 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,656,312 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,414,137 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,378,943 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,223,176 | CurrentTaxYearAmt |
| Total | $17,536,765 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,864,197 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,659,312 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,414,988 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,378,943 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,223,176 | CurrentTaxYearAmt |
| Total | $17,540,616 | 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 | $17,540,616 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,532 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $66 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $78 | CurrentTaxYearAmt |
| Total | $3,710 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,532 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $66 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $78 | CurrentTaxYearAmt |
| Total | $3,710 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,143 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,635 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,931 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,388 | CurrentTaxYearAmt |
| Total | $73,823 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,875,455 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,677,521 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,427,632 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,385,899 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,251,642 | CurrentTaxYearAmt |
| Total | $17,618,149 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99560 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99690 | PublicSupportPY509Pct |
| Investment Income CY | 0.00020 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00030 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, LINE # 12 | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME: 2013 : 7726 2014 : 18143 2015 : 12635 2016: 6931 2017: 28388 | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $157,613 | OtherCostOrOtherBasisAmt |
| Book Value | $157,613 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,266,756 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,463,776 | DepreciationAmt |
| Book Value | $802,980 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $78,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $74,517 | DepreciationAmt |
| Book Value | $3,983 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $661,938 | OtherCostOrOtherBasisAmt |
| Depreciation | $576,514 | DepreciationAmt |
| Book Value | $85,424 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,050,000 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEPOSITS | $1,500 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $190,055 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $191,555 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED PARTY | Desc |
| Amt | $3,266,326 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,266,326 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AFS IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. AFS ACCOUNTS FOR THE EFFECTS OF ANY UNCERTAIN TAX POSITIONS BASED ON A "MORE LIKELY THAN NOT" THRESHOLD TO THE RECOGNITION OF THE TAX POSITIONS BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE UNRECOGNIZED TAX BENEFIT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILITY ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR ALL UNCERTAIN TAX POSITIONS. INTEREST AND PENALTIES ASSESSED, IF ANY, ARE ACCRUED AS INCOME TAX EXPENSE. AFS HAS IDENTIFIED ITS TAX STATUS AS A TAX-EXEMPT ENTITY AS A TAX POSITION; HOWEVER, AFS HAS DETERMINED THAT SUCH TAX POSITION DOES NOT RESULT IN AN UNCERTAINTY REQUIRING RECOGNITION. AFS BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2014. | ExplanationTxt |
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 (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD T DASPIT SR | ||||||||||||||
| PRESIDENT | $0 | $220,562 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,355 | $0 | $225,917 | $0 | $0 |
| LONNIE PEELER | ||||||||||||||
| COO | $0 | $173,254 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,355 | $0 | $178,609 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE J, PART II | FormAndLineReferenceDesc |
| Explanation | WAGES WERE PAID BY FOUNDATION HEALTH SERVICES, INC. TO THE FOLLOWING: - RICHARD T. DASPIT, SR.: $220,562 - LONNIE PEELER : $173,254 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDUSTRIAL DEVELOPMENT AUTHORITY OF ACCOMACK VA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issued | 2007-03-01 | BondIssuedDt |
| Issue Price | $3,585,000 | IssuePriceAmt |
| Purpose | REFINANCE OF ORIGINAL BOND DEBT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $360,000 | RetiredAmt |
| Total Proceeds | $4,565,000 | TotalProceedsAmt |
| In Reserve Fund | $26,943 | InReserveFundAmt |
| Issuance Costs From Proceeds | $580,722 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $4,565,000 | CapitalExpendituresAmt |
| Substantial Completion | 2007 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART I, BOND ISSUES | FormAndLineReferenceDesc |
| Explanation | DIFFERENCE BETWEEN ISSUE PRICE AND TOTAL PROCEEDS OF ISSUE RELATE TO 2006 SERIES B TAXABLE BONDS OF $185,000, 2006 SERIES C TAXABLE BONDS OF $495,000 AND 2006 SERIES D SUBORDINATED BONDS OF $300,000. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | LONNIE PEELER, CHIEF OPERATING OFFICER, AND MICHAEL PEELER-SMITH, CHIEF COMPLIANCE OFFICER, ARE MARRIED. |
| FORM 990, PART VI, SECTION A, LINE 3 | AMERICAN FAMILY SERVICES HAS AN AGREEMENT WITH FOUNDATION HEALTH SERVICES, INC., SOLE MEMBER OF AMERICAN FAMILY SERVICES, TO PROVIDE MANAGEMENT SERVICES INCLUDING FINANCIAL AND ACCOUNTING SUPPORT SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS COMPLETED ANNUALLY AND COPIES ARE PROVIDED TO THE ENTIRE GOVERNING BOARD AS WELL AS THE PRESIDENT OF THE ORGANIZATION. AT THAT TIME THE PRESIDENT REVIEWS THE FORM 990 WITH THE BOARD MEMBERS. ANY NECESSARY CHANGES ARE THEN UPDATED ON THE FORM. ONCE ALL NECESSARY CHANGES ARE MADE AND THE PRESIDENT IS IN AGREEMENT WITH THE BOARD MEMBERS ON THE FINISHED FORM 990, IT IS SIGNED BY THE PRESIDENT, DATED AND SUBMITTED BY THE FILING DEADLINE. A COPY OF THE APPROVED FORM 990 IS PROVIDED TO ALL OF THE OFFICERS, DIRECTORS AND TRUSTEES BEFORE THE RETURN IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION PROMULGATES ITS CONFLICT OF INTEREST POLICY TO ASSURE CONTINUED COMMITMENT TO THE INTEGRITY OF ITS EXEMPT PURPOSE. TO PROVIDE ENFORCEMENT OF THE POLICY, A WRITTEN DISCLOSURE OF THE POLICY IS DISTRIBUTED TO THE EMPLOYEES AND BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE INDIVIDUAL IS APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF THE ORGANIZATION, MADE UP OF INDEPENDENT BOARD MEMBERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE, UPON IN-PERSON VERBAL OR WRITTEN REQUEST, DOCUMENTS RELATING TO THE GOVERNANCE, CONFLICTS OF INTEREST AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | IMPAIRMENT ADJUSTMENTS : BED RIGHTS -172,161. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FOUNDATION HEALTH SERVICES INC | |||||||||||
| PO BOX 40213 | BATON ROUGE | LA | 70835 | 581745788 | HEALTHCARE | LA | 501(C)(3) | LINE 11 | N/A | 0 | |
| BLUEBONNET HEALTHCARE INC | |||||||||||
| PO BOX 40018 | BATON ROUGE | LA | 70835 | 781187099 | HEALTHCARE | LA | 501(C)(3) | LINE 11 | 0 | FHS | |
| HUNTINGDON NURSING CENTER INC | |||||||||||
| PO BOX 40018 | BATON ROUGE | LA | 70835 | 541759925 | HEALTHCARE | VA | 501(C)(3) | LINE 11 | 0 | FHS | |
| CARROLLWOOD HEALTH FOUNDATION INC | |||||||||||
| PO BOX 40018 | BATON ROUGE | LA | 70825 | 721241847 | FINCLSERVICESHEALTHCARE | FL | 501(C)(3) | LINE 12B, II | 0 | FHS | |
| MAGNOLIA HEALTHCARE INC | |||||||||||
| PO BOX 40018 | BATON ROUGE | LA | 70835 | 721304946 | HEALTHCARE | MS | 501(C)(3) | LINE 11 | 0 | FHS | |
| ROCK GLEN HEALTHCARE INC | |||||||||||
| PO BOX 40018 | BATON ROUGE | LA | 70835 | 721277793 | HEALTHCARE | MD | 501(C)(3) | LINE 11 | 0 | FHS | |
| COLONIAL HEALTHCARE INC | |||||||||||
| PO BOX 40018 | BATON ROUGE | LA | 70835 | 721432537 | INACTIVE | MA | 501(C)(3) | LINE 11 | 0 | FHS | |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments