2018-01-30T10:35:28-06:00 2017-06-30 420732909 RYUN GIVENS & COMPANY PLC 2900 100TH STREET SUITE 301 URBANDALE IA 50322 990 2016-07-01 421308032 ON WITH LIFE INC ONWI 5159651339 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 JEAN SHELTON EXECUTIVE DIRECTOR 5159651339 2018-01-25 1 CURTIS E BRAND CPA P00299230 5152253141 209.23.131.178 2018-01-25 17:00:37 CS P A7D5E25DAEC07BF928152232DF11EC837B19E891 8DA4BDE78A712CCFBAEC3C8592ADBFA7ABFBA1B3 2016 2021-01-29 14:40:06Z JEAN SHELTON 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 12200166 0 X ON-WITH-LIFE.ORG X 1987 IA JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. 15 15 204 191 0 0 680406 336217 9028117 11855425 31572 8524 0 0 9740095 12200166 0 1783 0 0 6868672 5733878 0 0 0 2306763 5192632 9175435 10928293 564660 1271873 11257388 12559820 4480937 4539428 6776451 8020392 X JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. WE PROVIDE COMPREHENSIVE IN-PATIENT AND COMMUNITY-BASED REHABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES, AND THEIR FAMILIES, AND PROVIDE EDUCATION REGARDING THE PREVENTION OF BRAIN INJURIES. 0 0 9077193 1783 11855425 FUNCTIONAL EXPENSES WERE INCURRED IN PROVIDING 8,600 DAYS OF SPECIALIZED CARE AND REHABILITATION SERVICES TO INDIVIDUALS WHO HAVE SUSTAINED A TRAUMATIC BRAIN INJURY OR OTHER NEUROLOGICAL DISABILITY. 9077193 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 49 0 1 204 1 0 0 0 0 0 0 0 0 0 0 X 15 15 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X JULIE FIDLER DIXON 5159651339 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 CARL HARRIS BOARD MEMBER 0.60 X 0 0 0 JANET PHIPPS BURKHEAD BOARD CHAIR 0.60 X X 0 0 0 KATE BENSON LARSON SECRETARY 0.60 X X 0 0 0 TRACY BOLLIN TREASURER 0.60 X X 0 0 0 GAIL BOLIVER DIRECTOR 0.60 X 0 0 0 TROY DEJOODE DIRECTOR 0.60 X 0 0 0 ARTHUR FILEAN DIRECTOR 0.60 X 0 0 0 THOMAS FRIEDMAN VICE-CHAIR 0.60 X X 0 0 0 MARC HARDING DIRECTOR 0.60 X 0 0 0 MEREDITH LAMBERTI DIRECTOR 0.60 X 0 0 0 KAM STUPKA DIRECTOR 0.60 X 0 0 0 VILIA TARVYDAS DIRECTOR 0.60 X 0 0 0 ELI WIRTZ DIRECTOR 0.60 X 0 0 0 DAVID ZIELKE DIRECTOR 0.60 X 0 0 0 DONNA WALTER DIRECTOR 0.60 X 0 0 0 JULIE FIDLER DIXON EXECUTIVE DIRECTOR 40.00 X 206576 0 22539 JAMES FOREMAN CHIEF FINANCIAL OFFICER 40.00 X 0 0 0 DAVID DEMAREST NEUROPSYCHOLOGIST 40.00 X 144988 0 12264 PATRICK STILWELL ADMINISTRATOR 40.00 X 103211 0 4399 MATTHEW STEEN HR DIRECTOR 40.00 X 108952 0 23396 563727 0 62598 4 0 1 0 COUNTRY LANDSCAPE 56985 LINCOLN HIGHWAY AMES IA 50010 GROUNDS PROJECT 240958 1 336217 336217 PATIENT SERVICES 623000 8239282 8239282 MANAGEMENT REVENUE 623000 1488888 1488888 OTHER ANCILLARY 623000 1233491 1233491 BI HCBA WAIVER 623000 722655 722655 171109 171109 11855425 8524 8524 12200166 11855425 0 8524 1783 1783 206576 206576 4516743 4336056 180687 645637 588996 56641 364922 328970 35952 1010714 88730 921984 129907 37906 92001 35877 25721 10156 203995 181345 22650 96493 58406 38087 55455 44721 10734 121261 121261 565529 565529 44237 41693 2544 CONTRACTED SERVICES 1884033 1884033 SUPPLIES 626963 357152 269811 MISCELLANEOUS 330384 330384 SMALL EQUIP & REPAIRS 87784 84507 3277 10928293 9077193 1851100 0 1005 2352296 576612 2046422 1585620 36600 43500 1276 11032 12062607 4690872 7137728 7371735 27881 1429864 1195637 11257388 12559820 1377703 897404 3075138 2890477 28096 751547 4480937 4539428 X 6776451 8020392 6776451 8020392 11257388 12559820 X 1271873 -2042 -25890 X 0 1 X 1 0 X 47550 52600 1025823 680406 336217 2142596 7880368 8421021 8297513 9028117 11855425 45482444 64111 64111 7992029 8473621 9323336 9708523 12191642 47689151 0 0 0 47689151 80063 75812 70672 50014 8524 285085 80063 75812 70672 50014 8524 285085 8072092 8549433 9394008 9758537 12200166 47974236 0.99410 0.99200 0.00590 0.00800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 223011 223011 10112327 3656608 6455719 1727269 1034264 693005 7371735 INTERCOMPANY NOTES REC. 1195637 1195637 INTERCOMPANY LIABILITIES 751547 751547 X 10807933 -2042 98697 96655 10711278 1488888 1488888 12200166 9538102 98697 98697 9439405 1488888 1488888 10928293 PART X, LINE 2: THE ORGANIZATION HAS ADOPTED THE ACCOUNTING STANDARD REGARDING "ACCOUNTING FOR UNCERTAIN TAX POSITIONS." THIS STANDARD PROVIDES DETAILED GUIDANCE FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, AND DISCLOSURE OF UNCERTAIN TAX POSITIONS RECOGNIZED IN THE ENTITY'S FINANCIAL STATEMENTS. IT REQUIRES AN ENTITY TO RECOGNIZE THE FINANCIAL STATEMENT BENEFIT OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THE ADOPTION OF THIS STANDARD HAD NO MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOW. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBTS 159,897. LEASE COSTS -61,200. PART XI, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT REVENUE 1,488,888. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBTS 159,897. LEASE COSTS -61,200. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTERCOMPANY CORPORATE ALLOCATION 1,488,888. X X X 0 0 0 0 0 0 0 0 0 JULIE FIDLER DIXON EXECUTIVE DIRECTOR 181176 0 25400 0 0 0 8263 0 14276 0 229115 0 0 0 DAVID DEMAREST NEUROPSYCHOLOGIST 144588 0 400 0 0 0 5800 0 6464 0 157252 0 0 0 PART I, LINE 3 WAGES ARE COMPARED TO SALARIES PUBLISHED IN BUSINESS RECORD FOR SIMILAR POSITIONS. THE BOARD ALSO USES WAGE SURVEYS FROM IOWA WORKFORCE, IOWA HEALTH CARE ASSOCIATION, AND SIMILAR ASSOCIATIONS. THE EXECUTIVE COMMITTEE COMPLETES PERFORMANCE REVIEW REVIEWS AND THE FULL BOARD VOTES ON THE EXECUTIVE DIRECTOR'S SALARY. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP BETWEEN JULIE FIDLER DIXON AND BOARD MEMBERS OF ON WITH LIFE, INC. WHO ARE ALSO BOARD MEMBERS OF RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 11B AN ELECTRONIC COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. ANY QUESTIONS AND CLARIFICATIONS ARE DIRECTED TO THE FINANCE COMMITTEE CHAIR. FORM 990, PART VI, SECTION B, LINE 12C EVERY BOARD MEETING BEGINS WITH A REVIEW OF THE AGENDA ITEMS, AND DIRECTORS ARE PROMPTED TO DISCLOSE ANY CONFLICTS OF INTEREST RELATED TO THOSE ITEMS. FORM 990, PART VI, SECTION B, LINE 15A WAGES ARE COMPARED TO SALARIES PUBLISHED IN BUSINESS RECORD FOR SIMILAR POSITIONS. THE BOARD ALSO USES WAGE SURVEYS FROM IOWA WORKFORCE, IOWA HEALTH CARE ASSOCIATION, AND SIMILAR ASSOCIATIONS. THE EXECUTIVE COMMITTEE COMPLETES PERFORMANCE REVIEW REVIEWS AND THE FULL BOARD VOTES ON THE EXECUTIVE DIRECTOR'S SALARY. FORM 990, PART VI, SECTION C, LINE 19 ARTICLES OF INCORPORATION ARE PUBLISHED ON THE SECRETARY OF STATE WEBSITE. THE BYLAWS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. THE CONSOLIDATED FINANCIAL STATEMENT SUMMARY INCLUDED IN THE ANNUAL REPORT IS ON THE ORGANIZATION'S WEBSITE, AND FORM 990 IS AVAILABLE ON GUIDESTAR. FORM 990, PART XI, LINE 9: TRANSFER OF ASSETS TO OWL FOUNDATION -25,890. ON WITH LIFE EXTENDED SERVICES LTD 715 SW ANKENY RD ANKENY IA 50023 421521198 PROVIDE SKILLED CARE AND REHAB SERVICES FOR INDIVIDUALS WITH BRAIN INJURIES IA 501(C)(3) 9 0 ON WITH LIFE FOUNDATION 715 SW ANKENY RD ANKENY IA 50023 421399777 TO SUPPORT ON WITH LIFE, INC. AND ON WITH LIFE EXTENDED SERVICES, LTD. IA 501(C)(3) 11B 0 ON WITH LIFE SUPPORTIVE HOUSING CORPORATION 715 SW ANKENY RD ANKENY IA 50023 460516882 SUBSIDIZED HOUSING FOR INDIVIDUALS WHO HAVE EXPERIENCED A BRAIN INJURY IA 501(C)(3) 9 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 ON WITH LIFE FOUNDATION C 336217 ACTUAL ON WITH LIFE EXTENDED SERVICES LTD D 91313 ACTUAL ON WITH LIFE FOUNDATION O 115685 ACTUAL ON WITH LIFE SUPPORTIVE HOUSING Q 10457 ACTUAL ON WITH LIFE FOUNDATION D 87142 ACTUAL ON WITH LIFE EXTENDED SERVICES LTD O 26613 ACTUAL ON WITH LIFE FOUNDATION I 25890 ACTUAL ON WITH LIFE SUPPORTIVE HOUSING O 7985 ACTUAL