TIESZEN MEMORIAL HOME INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- TIESZEN MEMORIAL HOME INC (EIN 46-0213759)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-07-30
- IRS object ID
- 201842119349300244
- 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 | 2018-07-30T11:56:34-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 460393458 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WOHLENBERG RITZMAN & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1018 | AddressLine1Txt |
| City | YANKTON | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57078 | 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 | 460213759 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIESZEN MEMORIAL HOME | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TIES | BusinessNameControlTxt |
| Phone | 6056483611 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 312 EAST STATE ST | AddressLine1Txt |
| City | MARION | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57043 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL ENGBRECHT | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6056483611 | PhoneNum |
| Signature | 2018-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATHLEEN DOYLE | PreparerPersonNm |
| PTIN | P01322431 | PTIN |
| Phone | 6056654401 | PhoneNum |
| Preparation | 2018-07-25 | 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 | PAUL ENGBRECHT | PrincipalOfficerNm |
| Gross Receipts | $5,252,632 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TIESZENHOME.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE THE HIGHEST QUALITY OF CARE AND QUALITY OF LIFE FOR THE LONG AND SHORT TERM CARE RESIDENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 142 | TotalEmployeeCnt |
| Total Volunteers | 70 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $473 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,385 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,051,894 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,958,868 | CYProgramServiceRevenueAmt |
| PY Investment Income | $42,202 | PYInvestmentIncomeAmt |
| CY Investment Income | -$86,836 | CYInvestmentIncomeAmt |
| CY Other Revenue | $15,863 | CYOtherRevenueAmt |
| PY Total Revenue | $5,094,569 | PYTotalRevenueAmt |
| CY Total Revenue | $4,893,280 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,872,254 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,765,927 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,142,780 | PYOtherExpensesAmt |
| CY Other Expenses | $2,140,926 | CYOtherExpensesAmt |
| PY Total Expenses | $5,015,034 | PYTotalExpensesAmt |
| CY Total Expenses | $4,906,853 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $79,535 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$13,573 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,809,754 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,787,859 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $985,712 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,007,348 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,824,042 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,780,511 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE THE HIGHEST QUALITY OF CARE AND QUALITY OF LIFE FOR THE LONG AND SHORT TERM CARE RESIDENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,444,603 | ExpenseAmt |
| Revenue | $4,958,868 | RevenueAmt |
| Desc | TIESZEN MEMORIAL HOME IS COMPRISED OF A 64-BED SKILLED NURSING HOME, A 16-BED ASSISTED LIVING FACILITY, A 4 UNIT APARTMENT COMPLEX, A 12 UNIT AND TWO 6 UNIT APARTMENT COMPLEXES IN MARION, SD. THE HOME PROVIDES LONG TERM NURSING HOME CARE AND HOME HEALTH CARE SERVICES. | Desc |
| Total Program Service Expenses | $4,444,603 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 142 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LAURA WILSON | PersonNm |
| Phone | 6056483611 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BOX 209 | AddressLine1Txt |
| City | MARION | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57043 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| RAVILA BERENS | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $845 | $0 | $0 |
| RICHARD LUKE | ||||||
| SEC/TREASURE | 1.00 | Yes (X) | Yes (X) | $845 | $0 | $0 |
| ROBERT LOOF | ||||||
| MEMBER | 1.00 | Yes (X) | $845 | $0 | $0 | |
| LAWRENCE ARBEITER | ||||||
| MEMBER | 1.00 | Yes (X) | $780 | $0 | $0 | |
| PAUL JOHNSON | ||||||
| VICE PRESIDE | 1.00 | Yes (X) | Yes (X) | $585 | $0 | $0 |
| JAMES A JONES | ||||||
| MEMBER | 1.00 | Yes (X) | $455 | $0 | $0 | |
| JEFF COLE | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LAURA M WILSON | ||||||
| ADMINISTRATO | 40.00 | Yes (X) | $88,160 | $0 | $6,409 | |
| PAUL ENGBRECHT | ||||||
| CEO | 24.00 | Yes (X) | $57,128 | $0 | $3,293 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $149,643 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $9,702 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LPL CONSTRUCTION | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 204 E 32D STREET | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57043 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | CONSTRUCTION | ServicesDesc |
| Compensation | $288,000 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $5,385 | AllOtherContributionsAmt |
| Total Contributions | $5,385 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENT SERVICE REVENUES | 623000 | $4,644,345 | $4,644,345 |
| OTHER OPERATING REVENUE | 623000 | $314,523 | $314,523 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,958,868 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,021 | TotalRevenueColumnAmt |
| Exclusion | $3,021 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $269,495 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $359,352 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$89,857 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$89,857 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$89,857 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INSURANCE PROCEEDS | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $15,863 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,863 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $15,863 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,893,280 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,884,874 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $3,021 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,288 | TotalAmt |
| Management And General | $145,288 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,105,610 | TotalAmt |
| Program Services | $2,022,201 | ProgramServicesAmt |
| Management And General | $83,409 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,670 | TotalAmt |
| Program Services | $66,868 | ProgramServicesAmt |
| Management And General | $9,802 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,923 | TotalAmt |
| Program Services | $257,068 | ProgramServicesAmt |
| Management And General | $14,855 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,436 | TotalAmt |
| Program Services | $150,787 | ProgramServicesAmt |
| Management And General | $15,649 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,170 | TotalAmt |
| Program Services | $2,556 | ProgramServicesAmt |
| Management And General | $17,614 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $674,159 | TotalAmt |
| Program Services | $646,847 | ProgramServicesAmt |
| Management And General | $27,312 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,587 | TotalAmt |
| Program Services | $12,247 | ProgramServicesAmt |
| Management And General | $56,340 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,963 | TotalAmt |
| Program Services | $126 | ProgramServicesAmt |
| Management And General | $44,837 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,714 | TotalAmt |
| Program Services | $349,714 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,580 | TotalAmt |
| Program Services | $6,555 | ProgramServicesAmt |
| Management And General | $4,025 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,737 | TotalAmt |
| Program Services | $12,737 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $419,001 | TotalAmt |
| Program Services | $419,001 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,168 | TotalAmt |
| Program Services | $59,049 | ProgramServicesAmt |
| Management And General | $43,119 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| FOOD SERVICE | $210,015 | $210,015 |
| PROGRAM SUPPLIES | $206,316 | $206,316 |
| BAD DEBT | $22,516 | $22,516 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,906,853 | TotalAmt |
| Program Services | $4,444,603 | ProgramServicesAmt |
| Management And General | $462,250 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $640,933 | BOYAmt |
| EOY | $939,058 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,029 | BOYAmt |
| EOY | $376,778 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,191 | BOYAmt |
| EOY | $26,551 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,391,759 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,973,237 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,523,017 | BOYAmt |
| EOY | $3,418,522 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,584 | BOYAmt |
| EOY | $26,950 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,809,754 | BOYAmt |
| EOY | $4,787,859 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $263,669 | BOYAmt |
| EOY | $294,555 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $697,294 | BOYAmt |
| EOY | $687,186 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,749 | BOYAmt |
| EOY | $25,607 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $985,712 | BOYAmt |
| EOY | $1,007,348 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,653,361 | BOYAmt |
| EOY | $3,610,485 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,681 | BOYAmt |
| EOY | $170,026 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,824,042 | BOYAmt |
| EOY | $3,780,511 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,809,754 | BOYAmt |
| EOY | $4,787,859 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$13,573 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$29,958 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,494 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,720 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,400 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $473 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,385 | CurrentTaxYearAmt |
| Total | $24,472 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,386,141 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,547,051 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,834,341 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,051,894 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,974,731 | CurrentTaxYearAmt |
| Total | $23,794,158 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,389,635 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,548,771 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,847,741 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,052,367 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,980,116 | CurrentTaxYearAmt |
| Total | $23,818,630 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $23,818,630 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,038 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,106 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,441 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,011 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,021 | CurrentTaxYearAmt |
| Total | $12,617 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,038 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,106 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,441 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,011 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,021 | CurrentTaxYearAmt |
| Total | $12,617 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,391,673 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,549,877 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,849,182 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,057,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,983,137 | CurrentTaxYearAmt |
| Total | $23,831,247 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99950 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $96,521 | OtherCostOrOtherBasisAmt |
| Book Value | $96,521 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,514,837 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,782,618 | DepreciationAmt |
| Book Value | $2,732,219 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,559,542 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,023,792 | DepreciationAmt |
| Book Value | $535,750 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $220,859 | OtherCostOrOtherBasisAmt |
| Depreciation | $166,827 | DepreciationAmt |
| Book Value | $54,032 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,418,522 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SECURITY DEPOSITS | Desc |
| Amt | $25,607 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $25,607 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,893,280 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $4,893,280 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $4,893,280 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,936,811 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $29,958 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $29,958 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,906,853 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $4,906,853 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XII, LINE 2D | FormAndLineReferenceDesc |
| Explanation | BOOK / TAX DEPRECIATION DIFFERENCE 29,958 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | ASSIST WITH ACTIVITIES DRIVERS FOR MEALS ON WHEELS VISIT RESIDENTS |
| FORM 990, PAGE 6, PART VI, LINE 11B | REVIEWED BY CEO AND BOARD BEFORE FILING |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUAL REVIEW BY BOARD |
| FORM 990, PAGE 6, PART VI, LINE 15A | CEO PREPARES AN ANNUAL BUDGET FOR THE OPERATION OF THE FACILITY FOR APPROVAL BY THE BOARD OF DIRECTORS |
| FORM 990, PAGE 6, PART VI, LINE 15B | CEO PREPARES AN ANNUAL BUDGET FOR THE OPERATION OF THE FACILITY FOR APPROVAL BY THE BOARD OF DIRECTORS |
| FORM 990, PAGE 6, PART VI, LINE 18 | GUIDESTAR.COM |
| FORM 990, PAGE 6, PART VI, LINE 19 | ON REQUEST |
| FORM 990, PART IX, LINE 11G | CONSULTANTS 19,593 0 0 CONTRACTED RN'S 121,243 0 0 THERAPY 297,813 0 0 MEDICARE BILLER 0 22,957 0 NURSING SUPERVISION 7,828 0 0 BOARD OF DIRECTORS 0 4,355 0 TEMPORARY STAFF 3,507 0 0 CONTRACTED CNAS 182,093 0 0 MEDICAL DIRECTOR 6,000 0 0 VA PHARMACY 4,086 0 0 CHAPLAIN 4,684 0 0 TOTAL 646,847 27,312 0 |
| FORM 990, PART XI, LINE 9 | BOOK / TAX DEPRECIATION DIFFERENCE -29,958 |
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