EMMANUEL HOSPICE: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- EMMANUEL HOSPICE (EIN 45-4485835)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-10-01
- IRS object ID
- 201832749349301203
- 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 | 2018-10-01T15:05:28-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 TRADE CENTRE WAY STE 300 | AddressLine1Txt |
| City | PORTAGE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49002 | 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 | 454485835 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMMANUEL HOSPICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EMMA | BusinessNameControlTxt |
| Phone | 6167190919 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2161 LEONARD ST NW | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49504 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SARA LOWE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6167190919 | PhoneNum |
| Signature | 2018-09-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CAROL LALONDE CPA | PreparerPersonNm |
| PTIN | P00181637 | PTIN |
| Phone | 2695674500 | PhoneNum |
| Preparation | 2018-09-25 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR LAURENCE BURNS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2161 LEONARD ST NW | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,880,828 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.EMMANUELHOSPICE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE END OF LIFE HOSPICE CARE AND RELATED SERVICES TO INDIVIDUALS IN THE COMMUNITY WHO HAVE A TERMINAL CONDITION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 41 | TotalEmployeeCnt |
| Total Volunteers | 29 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $72,205 | PYContributionsGrantsAmt |
| CY Contributions Grants | $106,187 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,138,099 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,770,913 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$4,168 | PYOtherRevenueAmt |
| CY Other Revenue | -$7,989 | CYOtherRevenueAmt |
| PY Total Revenue | $4,206,136 | PYTotalRevenueAmt |
| CY Total Revenue | $4,869,111 | 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 | $1,793,239 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,223,658 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $14,832 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $810 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $72,850 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,958,801 | PYOtherExpensesAmt |
| CY Other Expenses | $2,157,629 | CYOtherExpensesAmt |
| PY Total Expenses | $3,766,872 | PYTotalExpensesAmt |
| CY Total Expenses | $4,382,097 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $439,264 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $487,014 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,163,442 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,830,439 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $438,364 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $729,474 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $725,078 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,100,965 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF EMMANUEL HOSPICE, AN INTERFAITH PARTNERSHIP, IS TO PROVIDE EXEMPLARY SPIRITUAL AND PHYSICAL CARE CREATING A PEACEFUL EXPERIENCE FOR THE DYING AND THEIR LOVED ONES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,886,501 | ExpenseAmt |
| Revenue | $4,770,913 | RevenueAmt |
| Desc | HOSPICE AND BEREAVEMENT CARE | Desc |
| Total Program Service Expenses | $2,886,501 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 41 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | 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 | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRAIG VANDENBOS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6169541799 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4450 CASCADE ROAD | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49546 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 |
|---|---|---|---|---|---|---|---|
| LAURENCE BURNS | |||||||
| CHAIR | 5.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JANE TOOT | |||||||
| VICE CHAIR | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICK WALKER | |||||||
| TREASURER | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SISTER GABRIELA HILKE | |||||||
| DIRECTOR, CHAPLAIN | 30.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS WESHOLSKI | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DONNA HINTON | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| COREY KOPERSKI | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARY THERESA HEGARTY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES BRADY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT HERR | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JUDY BAKER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KATHLEEN HOLT | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SARA LOWE | |||||||
| EXECUTIVE DIRECTOR | 50.00 | 0.00 | Yes (X) | $113,006 | $0 | $13,361 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $113,006 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $13,361 | 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 |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $25,015 | FundraisingAmt |
| All Other Contributions | $81,172 | AllOtherContributionsAmt |
| Total Contributions | $106,187 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE/MEDICAID | 623000 | $4,630,847 | $4,630,847 |
| INSURANCE CLAIM | 623000 | $140,066 | $140,066 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,770,913 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $3,150 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $25,015 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $11,717 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,567 | TotalRevenueColumnAmt |
| Exclusion | -$8,567 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $578 | TotalRevenueColumnAmt |
| Exclusion | $578 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $578 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,869,111 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,770,913 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$7,989 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,061 | TotalAmt |
| Management And General | $120,708 | ManagementAndGeneralAmt |
| Fundraising | $6,353 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,769,371 | TotalAmt |
| Program Services | $1,106,106 | ProgramServicesAmt |
| Management And General | $620,299 | ManagementAndGeneralAmt |
| Fundraising | $42,966 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,935 | TotalAmt |
| Program Services | $8,975 | ProgramServicesAmt |
| Management And General | $5,535 | ManagementAndGeneralAmt |
| Fundraising | $425 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,291 | TotalAmt |
| Program Services | $208,989 | ProgramServicesAmt |
| Management And General | $92,114 | ManagementAndGeneralAmt |
| Fundraising | $11,188 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,278 | TotalAmt |
| Management And General | $225,278 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,998 | TotalAmt |
| Management And General | $12,998 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,450 | TotalAmt |
| Management And General | $17,450 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $810 | TotalAmt |
| Fundraising | $810 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,944 | TotalAmt |
| Management And General | $1,944 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,577 | TotalAmt |
| Program Services | $1,706 | ProgramServicesAmt |
| Management And General | $32,341 | ManagementAndGeneralAmt |
| Fundraising | $530 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,119 | TotalAmt |
| Management And General | $75,119 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,296 | TotalAmt |
| Management And General | $16,296 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,774 | TotalAmt |
| Management And General | $65,774 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,000 | TotalAmt |
| Management And General | $12,000 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,549 | TotalAmt |
| Program Services | $92,637 | ProgramServicesAmt |
| Management And General | $5,564 | ManagementAndGeneralAmt |
| Fundraising | $348 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83 | TotalAmt |
| Management And General | $83 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,210 | TotalAmt |
| Management And General | $25,210 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,109 | TotalAmt |
| Management And General | $7,109 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| NURSING HOME ROOM & BOA | $849,515 | $849,515 | ||
| EQUIPMENT/SUPPLIES | $232,380 | $217,827 | $12,877 | $1,676 |
| PHARMACY | $186,678 | $186,678 | ||
| SEQUESTRATION | $55,861 | $55,861 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,808 | TotalAmt |
| Program Services | $158,207 | ProgramServicesAmt |
| Management And General | $74,047 | ManagementAndGeneralAmt |
| Fundraising | $8,554 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,382,097 | TotalAmt |
| Program Services | $2,886,501 | ProgramServicesAmt |
| Management And General | $1,422,746 | ManagementAndGeneralAmt |
| Fundraising | $72,850 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $529,636 | BOYAmt |
| EOY | $612,279 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $562,793 | BOYAmt |
| EOY | $1,129,341 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,296 | BOYAmt |
| EOY | $12,309 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $172,885 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $96,375 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,717 | BOYAmt |
| EOY | $76,510 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,163,442 | BOYAmt |
| EOY | $1,830,439 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $438,364 | BOYAmt |
| EOY | $658,806 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $70,668 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $438,364 | BOYAmt |
| EOY | $729,474 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $725,078 | BOYAmt |
| EOY | $1,100,965 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $725,078 | BOYAmt |
| EOY | $1,100,965 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,163,442 | BOYAmt |
| EOY | $1,830,439 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $487,014 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$111,127 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| 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 | $56,060 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,205 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $106,187 | CurrentTaxYearAmt |
| Total | $286,263 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,396 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,450,182 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,722,345 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,138,099 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,770,913 | CurrentTaxYearAmt |
| Total | $14,136,935 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,396 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,506,242 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,774,156 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,210,304 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,877,100 | CurrentTaxYearAmt |
| Total | $14,423,198 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $9,969 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,421 | CurrentTaxYearAmt |
| Total | $25,390 | 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) |
|---|---|---|
| Current Tax Year Minus1 Year | $9,969 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,421 | CurrentTaxYearAmt |
| Total | $25,390 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $14,397,808 | PublicSupportTotal509Amt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,212 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $78 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,531 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,728 | CurrentTaxYearAmt |
| Total | $21,572 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $69,608 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,506,265 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,774,234 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,213,835 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,880,828 | CurrentTaxYearAmt |
| Total | $14,444,770 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99670 | PublicSupportCY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| 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 | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS REVENUE - 2013 AMOUNT: $ 14,212. 2014 AMOUNT: $ 23. 2015 AMOUNT: $ 78. 2016 AMOUNT: $ 331. 2017 AMOUNT: $ 578. FUNDRAISING - 2016 AMOUNT: $ 3,200. 2017 AMOUNT: $ 3,150. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $133,611 | OtherCostOrOtherBasisAmt |
| Depreciation | $74,750 | DepreciationAmt |
| Book Value | $58,861 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,274 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,625 | DepreciationAmt |
| Book Value | $17,649 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $76,510 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATE | Desc |
| Amt | $70,668 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $70,668 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNUAL CELEBRATION | Event1Nm |
| Gross Receipts Event1 | $28,165 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $25,015 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $3,150 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $1,000 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $8,530 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $400 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,787 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $28,165 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $25,015 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $3,150 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,000 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,530 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $400 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,787 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $11,717 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$8,567 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE STOCKHOLDERS ARE ST ANN'S - 54%, PORTER HILLS - 18%, CLARK RETIREMENT COMMUNITY - 18%, AND SUNSET MANOR - 10%. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ARE AUTHORIZED TO APPOINT INDIVIDUALS TO AND REMOVE INDIVIDUALS FROM THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | CHANGES IN PURPOSE, MERGERS, INCURRENCE OF LONG TERM DEBT, SALE OF ASSETS GREATER THAN $5,000, HIRING OF EXECUTIVE DIRECTOR REQUIRE UNANIMOUS STOCKHOLDER VOTE. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES WITH AUTHORITY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE COMMITTEE PLANS TO REVIEW THE RETURN BEFORE FILING THE 990. THE ENTIRE BOARD RECEIVES A COPY OF THE FORM 990 PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS, THE CONFLICT OF INTEREST POLICY IS SIGNED BY EACH BOARD MEMBER. IF A CONFLICT DOES ARISE, THE SITUATION IS REVIEWED WITH THE MEMBER AND THE BOARD CHAIR. IF A MATTER IS UNDER CONSIDERATION BY THE BOARD IN WHICH THERE IS A POSSIBLE CONFLICT OF INTEREST, THE BOARD MEMBER SHALL NOT VOTE OR USE THEIR PERSONAL INFLUENCE ON THE MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15A | ON AN ANNUAL BASIS THE EXECUTIVE DIRECTOR'S SALARY IS APPROVED BY THE BOARD AFTER REVIEWING COMPARATIVE DATA. THE DELIBERATION AND APPROVAL OF THE COMPENSATION IS DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | TRANSFER TO AFFILIATES -111,127. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN PROCESS SINCE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANN'S HOME INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2161 LEONARD ST NW | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381872660 | EIN |
| Primary Activities | NURSING HOME | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 10 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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