ST MARYS VILLA NURSING HOME INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS VILLA NURSING HOME INC (EIN 23-2057177)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-19
- IRS object ID
- 201722929349300002
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-10-19T07:22:09-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232057177 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Villa Nursing Home Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 5708427621 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 516 StMarys Villa Road | AddressLine1Txt |
| City | Elmhurst Twp | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18444 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Nancy Newcomb | PersonNm |
| Person Title | Chief Executive Officer | PersonTitleTxt |
| Phone | 5708427621 | PhoneNum |
| Signature | 2017-10-19 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 155.212.6.161 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-10-19 | IPDt |
| IP Tm | 08:22:03 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 7EA5F91826FDEC39AFBB39687538FEB01BFA2691 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | E1A65C102B06E5C9ADAF8DC78101520DB9B2CC9D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Nancy Newcomb | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 516 St Marys Villa Road | AddressLine1Txt |
| City | Elmhurst Twp | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18444 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,825,113 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | stmarysvilla.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 292 | TotalEmployeeCnt |
| Total Volunteers | 27 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $22,259 | PYContributionsGrantsAmt |
| CY Contributions Grants | $48,133 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,885,766 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,562,673 | CYProgramServiceRevenueAmt |
| PY Investment Income | $87,481 | PYInvestmentIncomeAmt |
| CY Investment Income | $143,945 | CYInvestmentIncomeAmt |
| PY Other Revenue | $48,388 | PYOtherRevenueAmt |
| CY Other Revenue | $47,241 | CYOtherRevenueAmt |
| PY Total Revenue | $14,043,894 | PYTotalRevenueAmt |
| CY Total Revenue | $13,801,992 | 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 | $8,401,812 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,042,585 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,636,936 | PYOtherExpensesAmt |
| CY Other Expenses | $4,665,773 | CYOtherExpensesAmt |
| PY Total Expenses | $13,038,748 | PYTotalExpensesAmt |
| CY Total Expenses | $12,708,358 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,005,146 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,093,634 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,982,953 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,043,260 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,166,333 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,626,767 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,816,620 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,416,493 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our Judeo-Christian tradition compels us to promote Gospel values in all of our endeavors. We commit to honor these core values:Compassion,We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.Integrity - We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.Collaboration - We work in partnership, dialogue and shared purpose to create healthy communities. Excellence - We deliver all services with the highest level of quality, while seeking creative innovation. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,452,742 | ExpenseAmt |
| Revenue | $10,725,514 | RevenueAmt |
| Desc | St Mary's Villa provides care to the elderly with the operation of a 112 bed skilled nursing facility. 38,552 resident days of service were provided in 2016. St Mary's admits a number of residents who lack the resources to pay the full cost of services and also residents whose care is funded under the the state Medicaid program. In 2016 both benevolent care and contractual allowances were provided to residents in the skilled nursing facility. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,866,565 | ExpenseAmt |
| Revenue | $2,862,737 | RevenueAmt |
| Desc | St Mary's Villa also provides care to the elderly with the operation of a 64 bed personal care facility. 20,612 resident days of service were provided in 2016.This operation provides a cost based alternative to skilled nursing services. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $16,364 | ExpenseAmt |
| Desc | In the spirit of the Covenant Health and the Poor Sisters of Jesus Crucified and keeping with our mission St. Mary's Villa continues to respond to the needs of the poor and underserved in our community. Under the guidance of the the mission committee St. Mary's Villa Campus donated a total of $16,364 in dollars, goods and services and 564 service hours to the community. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,335,671 | 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 | Yes (1) | 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 | 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 | Yes (1) | 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 | 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 | Yes (1) | 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 | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 292 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | 0 | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | 0 | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | 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 | PA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lisa Zamber | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5708427621 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 516 St Marys Villa Road | AddressLine1Txt |
| City | Elmhurst Twp | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18444 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|
| Blumer James | |||||||
| Vice Chair | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Burkey Ellen | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Castellano Frank P Esquire | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Cisowski Antoinette | |||||||
| Secretary | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Denaples Charles | |||||||
| Director Thru 6/16 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Gianuzzi Dominick | |||||||
| Director From 7/16 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kanton Peter | |||||||
| Treasurer | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Loftus James F IV | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Loftus Renee | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Lovecchio Catherine | |||||||
| Chairperson | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Musheno Jerome RPhEsq | |||||||
| Director From 7/16 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Sanderson John P III Esquire | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Mary Valliere CJC | |||||||
| President | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| Sister Mary Ruth Dauginikas CJC | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Wolff Beth | |||||||
| Director Thru 6/16 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Newcomb Nancy | |||||||
| CEO From 6/16 | 50.00 | Yes (X) | $115,190 | $0 | $9,843 | Yes (X) | |
| Zamber Lisa | |||||||
| CFO | 50.00 | $126,250 | $0 | $19,015 | Yes (X) | ||
| Kanarr Linda | |||||||
| Former CEO Thru 6/16 | 50.00 | $96,035 | $0 | $9,151 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $337,475 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $38,009 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GEISINGER HEALTH PLAN | |||||
| PO BOX 822434 | PHILADELPHIA | PA | 19182 | EMPLOYEE HEALTH INSURANCE | $940,591 |
| REHAB CARE GROUP | |||||
| PO BOX 50534 | ST LOUIS | MO | 63150 | THERAPY FOR RESIDENTS | $545,244 |
| LACKAWANAA NATIONAL INSURNANCE | |||||
| 9 NORTH MAIN ST | PITTSTON | PA | 18640 | WORKMEN'S COMP INSURANCE | $254,379 |
| US FOODSERVICE | |||||
| PO BOX 7780 | PHILADELPHIA | PA | 19182 | RESIDENTS FOOD | $250,130 |
| REINHART FOODSERVICE | |||||
| 100 INDUSTRIAL PARK ROAD | COAL TOWNSHIP | PA | 17866 | RESIDENTS FOOD | $185,400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $48,133 | AllOtherContributionsAmt |
| Total Contributions | $48,133 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient services | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $13,562,673 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,562,673 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,562,673 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $146,312 | TotalRevenueColumnAmt |
| Exclusion | $146,312 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,367 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$2,367 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,367 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$2,367 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $39,050 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $19,754 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,296 | TotalRevenueColumnAmt |
| Exclusion | $19,296 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Guest & Employee Meal | 623000 | $20,394 | $20,394 |
| Tv Other ancillary | 623000 | $7,551 | $7,551 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $27,945 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,801,992 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,588,251 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $165,608 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $337,475 | TotalAmt |
| Program Services | $126,250 | ProgramServicesAmt |
| Management And General | $211,225 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,452,026 | TotalAmt |
| Program Services | $5,865,344 | ProgramServicesAmt |
| Management And General | $586,682 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,236 | TotalAmt |
| Program Services | $44,089 | ProgramServicesAmt |
| Management And General | $5,147 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $729,389 | TotalAmt |
| Program Services | $642,846 | ProgramServicesAmt |
| Management And General | $86,543 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $474,459 | TotalAmt |
| Program Services | $418,164 | ProgramServicesAmt |
| Management And General | $56,295 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,416 | TotalAmt |
| Management And General | $154,416 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,712 | TotalAmt |
| Management And General | $21,712 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,766 | TotalAmt |
| Management And General | $33,766 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,532 | TotalAmt |
| Program Services | $71,532 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,860 | TotalAmt |
| Program Services | $90,860 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,424 | TotalAmt |
| Program Services | $165,424 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,685 | TotalAmt |
| Management And General | $69,685 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,006 | TotalAmt |
| Management And General | $5,006 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,796 | TotalAmt |
| Program Services | $265,796 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $814,035 | TotalAmt |
| Program Services | $814,035 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,142 | TotalAmt |
| Program Services | $366,142 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $1,060,539 | $1,052,794 | $7,745 |
| Purchase Services | $993,420 | $858,955 | $134,465 |
| Provider Taxes | $279,356 | $279,356 | |
| Utilities | $274,084 | $274,084 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,708,358 | TotalAmt |
| Program Services | $11,335,671 | ProgramServicesAmt |
| Management And General | $1,372,687 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,215,962 | BOYAmt |
| EOY | $1,295,775 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $886,102 | BOYAmt |
| EOY | $1,167,033 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $328,668 | BOYAmt |
| EOY | $337,618 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,426,415 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,833,745 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,085,091 | BOYAmt |
| EOY | $10,592,670 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,961,335 | BOYAmt |
| EOY | $10,265,695 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $505,795 | BOYAmt |
| EOY | $384,469 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,982,953 | BOYAmt |
| EOY | $24,043,260 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525,104 | BOYAmt |
| EOY | $542,956 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,408,375 | BOYAmt |
| EOY | $3,902,057 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,232,854 | BOYAmt |
| EOY | $3,181,754 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,166,333 | BOYAmt |
| EOY | $7,626,767 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,465,703 | BOYAmt |
| EOY | $16,093,396 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350,917 | BOYAmt |
| EOY | $323,097 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,816,620 | BOYAmt |
| EOY | $16,416,493 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,982,953 | BOYAmt |
| EOY | $24,043,260 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,093,634 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $506,239 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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 | 0 | 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 Minus4 Years | $11,250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,802 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,647 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,259 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $48,133 | CurrentTaxYearAmt |
| Total | $117,091 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,355,979 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $133,579,416 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $133,970,929 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,885,766 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,562,673 | CurrentTaxYearAmt |
| Total | $308,354,763 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,367,229 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $133,598,218 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $133,987,576 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,908,025 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,610,806 | CurrentTaxYearAmt |
| Total | $308,471,854 | 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 | $308,471,854 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $79,360 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $80,827 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $121,397 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $87,481 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $146,312 | CurrentTaxYearAmt |
| Total | $515,377 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $79,360 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $80,827 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $121,397 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $87,481 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $146,312 | CurrentTaxYearAmt |
| Total | $515,377 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $39,882 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $40,999 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $39,706 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $48,346 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $44,874 | CurrentTaxYearAmt |
| Total | $213,807 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,486,471 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $133,720,044 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $134,148,679 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,043,852 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,801,992 | CurrentTaxYearAmt |
| Total | $309,201,038 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99760 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99040 | PublicSupportPY509Pct |
| Investment Income CY | 0.00170 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00960 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $350,917 | BeginningYearBalanceAmt |
| Contributions | $24,750 | ContributionsAmt |
| Investment Earnings Or Losses | $7,325 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $59,895 | OtherExpendituresAmt |
| End Year Balance | $323,097 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $340,649 | BeginningYearBalanceAmt |
| Contributions | $25,828 | ContributionsAmt |
| Investment Earnings Or Losses | $1,314 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $16,874 | OtherExpendituresAmt |
| End Year Balance | $350,917 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $323,497 | BeginningYearBalanceAmt |
| Contributions | $26,846 | ContributionsAmt |
| Investment Earnings Or Losses | $1,372 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $11,066 | OtherExpendituresAmt |
| End Year Balance | $340,649 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $353,259 | BeginningYearBalanceAmt |
| Contributions | $28,425 | ContributionsAmt |
| Investment Earnings Or Losses | $947 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $59,134 | OtherExpendituresAmt |
| End Year Balance | $323,497 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $335,625 | BeginningYearBalanceAmt |
| Contributions | $25,138 | ContributionsAmt |
| Investment Earnings Or Losses | $1,189 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $8,693 | OtherExpendituresAmt |
| End Year Balance | $353,259 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $170,398 | OtherCostOrOtherBasisAmt |
| Book Value | $170,398 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,386,884 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,909,948 | DepreciationAmt |
| Book Value | $9,476,936 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,869,133 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,923,797 | DepreciationAmt |
| Book Value | $945,336 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,592,670 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| Resident Trust Funds | $17,957 |
| Due to Affiliate | $2,753,732 |
| Refundabale Fees | $35,867 |
| Retirement Obligation | $313,300 |
| Professional Liability Reserve | $29,080 |
| Due to Third Party Payors | $31,818 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,181,754 | 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 | The facility is a non-profit corporation as described in section 501(C)(3) of the Internal Revenue Code and is exempt from federal income taxes. In accordance with the financial accounting standards board guidance on accounting for uncertainty in income taxes; management evaluated the facilities tax position and concluded that the facility had taken no uncertain tax positions that require adjustment to the financial statements to comply with the provisions of this guidance. With few exceptions, the facility is no longer subject to income tax examinations by the U.S. Federal, State or local tax authorities for years before 2013. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $39,050 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $39,050 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $2,382 | NonCashPrizesEvent1Amt |
| Other Direct Expenses Event1 | $17,372 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $39,050 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $39,050 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $2,382 | NonCashPrizesTotalEventsAmt |
| Oth Direct Expnss Total Events | $17,372 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $19,754 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $19,296 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kanarr Linda | PersonNm |
| Title | Former CEO Thru 6/16 | TitleTxt |
| Base Compensation Filing Org | $96,035 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $9,151 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $105,186 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Every two to three years the compensation committee of Covenant Health Board of Director's engages an external consultant to provide competitive market data from various survey sources, which is used to develop recommendations for changes to the compensation program. The compensation committee currently engages Sullivan Cotter to conduct this analysis. The specific objectives of this analysis are to assess the compositeness of the current cash compensation levels for the senior leadership team, develop market based competitive salary ranges for all executive positions and ensure that the annual incentive opportunities, if any are competitive and reasonable. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Domnick Gianuzzi | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Director | RelationshipDescriptionTxt |
| Transaction | $0 | TransactionAmt |
| Transaction | Officer with Peoples Security Bank and Trust Company | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | FAMILY RELATIONSHIP |
| Form 990, Part VI, Section A, line 6 | COVENANT HEALTH, INC. IS THE SOLE MEMBER OF THE BOARD. COVENANT HEALTH, INC. HAS EXCLUSIVE VOTING POWER OVER CERTAIN CORPORATE MATTERS, INCLUDING THE ELECTION OF DIRECTORS,THE APPOINTMENT OF THE CEO AND AUDITORS, AND APPROVAL OF STRATEGIC PLANS AND BUDGETS. |
| Form 990, Part VI, Section A, line 7a | COVENANT HEALTH, INC. IS THE SOLE MEMBER OF THE BOARD. COVENANT HEALTH. INC. HAS EXCLUSIVE VOTING POWER OVER THE ELECTION OF TRUSTEES AND THE APPOINTMENT OF THE CEO. |
| Form 990, Part VI, Section A, line 7b | COVENANT HEALTH, INC. IS THE SOLE MEMBER OF THE BOARD. COVENANT HEALTH. INC. APPROVES LONG-RANGE STRATEGIC PLANS,ANNUAL BUDGETS AND AUDITOR SELECTION. |
| Form 990, Part VI, Section B, line 11b | A COPY OF THE FORM 990 IS SENT TO EACH BOARD MEMBER. THE FORM 990 IS THEN PRESENTED AND REVIEWED BY MANAGEMENT DURING A BOARD MEETING. |
| Form 990, Part VI, Section B, line 12c | THE BOARD IS EDUCATED ON THE COMPLIANCE ANNUALLY AND ARE ASKED TO COMPLETE A DISCLOSURE STATEMENT ANNUALLY. |
| Form 990, Part VI, Section B, line 15 | EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF COVENANT HEALTH, INC. BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS TO BE USED TO DEVELOP RECOMMENDATIONS FOR CAHNGE TO THE COMPENSATION PROGRAM. THE COMPENSATION COMMITTEE HAS ENGAGED SULLIVAN COTTER CONSULTING TO CONDUCT THIS ANALYSIS. THE SPECIFIC OBJECTIVES OF THIS ANALYSIS ARE TO ASSESS THE COMPOSITENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR LEADERSHIP TEAM,DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS, AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION HAS ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON COVENANT HEALTH, INC.'S WEBSITE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Covenant Health Inc | |||||||||
| 100 Ames Pond Suite 102 | Tewksbury | MA | 01876 | 222484505 | Catholic Health and Elder Care System | MA | 501(c)(3) | Line 10 | 0 |
| St Joseph's Hospital | |||||||||
| 172 Kinsley St | Nashua | NH | 03061 | 020222215 | Hospital | NH | 501(c)(3) | Line 10 | 0 |
| 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 | 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 |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| St Joseph's Hospital | ||
| E | $2,424,276 | Accrual |
| Covenant Health Inc | ||
| E | $329,456 | Accrual |
| Covenant Health Inc | ||
| M | $154,416 | Accrual |
Comments