SHALOM PARK: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SHALOM PARK (EIN 74-2376546)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-08-29
- IRS object ID
- 201732419349300818
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-29T11:45:23-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 461497033 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EKS&H LLLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8181 E TUFTS AVENUE SUITE 600 | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 802372579 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742376546 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHALOM PARK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SHAL | BusinessNameControlTxt |
| Phone | 3036805000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14800 E BELLEVIEW DRIVE | AddressLine1Txt |
| City | AURORA | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 800152258 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL STENERSEN | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 3036805000 | PhoneNum |
| Signature | 2017-08-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DORI J EGGETT | PreparerPersonNm |
| PTIN | P00645252 | PTIN |
| Phone | 3037409400 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.42.238.132 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-08-29 | IPDt |
| IP Tm | 11:43:35 | IPTm |
| IP Timezone | MD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EC37ECE0FF53FE1DFF8E980E88E00C11881B4804 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 4D7219D1452441062C513A13E39A5E42DAB0668F | 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 | DANIEL STENERSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14800 E BELLEVIEW DRIVE | AddressLine1Txt |
| City | AURORA | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,177,899 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SHALOMPARK.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | DELIVERY AND INNOVATION OF COMMUNITY AND RESIDENTIAL HEALTH AND SOCIAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 348 | TotalEmployeeCnt |
| Total Volunteers | 170 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,521,319 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,158,601 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,541 | PYOtherRevenueAmt |
| CY Other Revenue | $19,298 | CYOtherRevenueAmt |
| PY Total Revenue | $14,525,860 | PYTotalRevenueAmt |
| CY Total Revenue | $14,177,899 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,434 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $7,360 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,532,919 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,597,222 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,354,523 | PYOtherExpensesAmt |
| CY Other Expenses | $7,429,223 | CYOtherExpensesAmt |
| PY Total Expenses | $15,892,876 | PYTotalExpensesAmt |
| CY Total Expenses | $16,033,805 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,367,016 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,855,906 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,392,243 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,197,449 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,977,268 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,638,380 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,585,025 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$4,440,931 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SHALOM PARK OPERATES A NURSING CARE FACILITY AND CENTER FOR CARE OF THE AGED. IT PROVIDES HEALTH CARE AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A MULTI-LEVEL SKILLED NURSING FACILITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,197,698 | ExpenseAmt |
| Grant | $7,360 | GrantAmt |
| Revenue | $14,158,601 | RevenueAmt |
| Desc | SHALOM PARK OPERATES A NURSING HOME FACILITY AND CENTER FOR THECARE OF THE AGED. DURING THE TAX YEAR, THE ORGANIZATION PROVIDEDCARE FOR OVER 300 PATIENT AND ASSISTED LIVING RESIDENTS. | Desc |
| Total Program Service Expenses | $14,197,698 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 64 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 348 | 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIEL STENERSEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3036805000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14800 E BELLEVIEW DRIVE | AddressLine1Txt |
| City | AURORA | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 800152258 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DANIEL STENERSEN | ||||||||
| PRESIDENT/CEO | 37.00 | 3.00 | Yes (X) | Yes (X) | $281,483 | $17,967 | $38,479 | |
| GARY YOURTZ | ||||||||
| VICE CHAIR | 5.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAY MOSKOWITZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRUCE BENDELL | ||||||||
| TREASURER | 5.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOE BORUS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBIN CHOTIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KEN FEILER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SUSY GRAZI | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDY MILLER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL STREAR | ||||||||
| CHAIR | 20.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LISA COOK | ||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NEIL OBERFELD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MELINDA QUIAT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANDY HEINS | ||||||||
| CHAIR-ELECT | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| VERN ENGBAR | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELISA ROBYN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RUTH MINNEMA | ||||||||
| DIRECTOR OF NURSING | 40.00 | $119,465 | $0 | $6,816 | Yes (X) | |||
| BETH IRTZ | ||||||||
| ADMINISTRATOR | 40.00 | $118,521 | $0 | $2,259 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $519,469 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $17,967 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $47,554 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | 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 |
|---|---|---|---|---|---|
| MORRISON MANGEMENT SPECIALIST | |||||
| PO BOX 1202289 | ATLANTA | GA | 30368 | DIETARY/HOUSEKEEPING SERVICE | $1,169,860 |
| PREMERE REHAB LLC | |||||
| 25117 SW PARKWAY SUITE D | WILSONVILLE | OR | 97070 | THERAPY SERVICES | $431,893 |
| AAM INC | |||||
| PO BOX 1328 | EVERGREEN | CO | 80437 | ROOFING SERVICES | $387,403 |
| EKS&H LLLP | |||||
| 8181 E TUFTS AVE SUITE 600 | DENVER | CO | 80237 | IT CONSULTING, AUDIT, AND TAX | $259,670 |
| MEDLINE INDUSTRIES INC | |||||
| PO BOX 121080 | DALLAS | TX | 75312 | MEDICAL SERVICES | $240,156 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REV | 623000 | $12,146,150 | $12,146,150 |
| RESIDENT RENTAL | 623000 | $1,508,029 | $1,508,029 |
| OTHER NURSING HOME REV | 623000 | $504,422 | $504,422 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,158,601 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $19,298 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,298 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $19,298 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,177,899 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,177,899 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,360 | TotalAmt |
| Program Services | $7,360 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,653 | TotalAmt |
| Management And General | $317,653 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,616,103 | TotalAmt |
| Program Services | $6,828,321 | ProgramServicesAmt |
| Management And General | $787,782 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,958 | TotalAmt |
| Program Services | $38,079 | ProgramServicesAmt |
| Management And General | $12,879 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $612,508 | TotalAmt |
| Program Services | $541,076 | ProgramServicesAmt |
| Management And General | $71,432 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,229 | TotalAmt |
| Program Services | $5,494 | ProgramServicesAmt |
| Management And General | $735 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,505 | TotalAmt |
| Program Services | $42,783 | ProgramServicesAmt |
| Management And General | $5,722 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,965,747 | TotalAmt |
| Program Services | $1,733,846 | ProgramServicesAmt |
| Management And General | $231,901 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,801 | TotalAmt |
| Program Services | $183,300 | ProgramServicesAmt |
| Management And General | $25,501 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $505,843 | TotalAmt |
| Program Services | $446,168 | ProgramServicesAmt |
| Management And General | $59,675 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,242 | TotalAmt |
| Program Services | $27,771 | ProgramServicesAmt |
| Management And General | $2,471 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,741 | TotalAmt |
| Program Services | $371,106 | ProgramServicesAmt |
| Management And General | $49,635 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,429,537 | TotalAmt |
| Program Services | $1,260,894 | ProgramServicesAmt |
| Management And General | $168,643 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $801,469 | TotalAmt |
| Program Services | $706,919 | ProgramServicesAmt |
| Management And General | $94,550 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| FOOD | $876,512 | $876,230 | $282 |
| PROGRAM SUPPLIES | $819,304 | $819,304 | |
| BAD DEBT EXPENSE | $142,208 | $142,208 | |
| REPAIRS AND MAINTENANCE | $112,650 | $112,650 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,435 | TotalAmt |
| Program Services | $54,189 | ProgramServicesAmt |
| Management And General | $7,246 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,033,805 | TotalAmt |
| Program Services | $14,197,698 | ProgramServicesAmt |
| Management And General | $1,836,107 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,610 | BOYAmt |
| EOY | $188,214 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $842,824 | BOYAmt |
| EOY | $984,322 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $348,532 | BOYAmt |
| EOY | $294,176 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,867,015 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,295,219 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,963,712 | BOYAmt |
| EOY | $12,571,796 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,565 | BOYAmt |
| EOY | $158,941 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,392,243 | BOYAmt |
| EOY | $14,197,449 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $806,140 | BOYAmt |
| EOY | $1,282,858 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $134,145 | BOYAmt |
| EOY | $118,220 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,416,387 | BOYAmt |
| EOY | $12,176,165 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,620,596 | BOYAmt |
| EOY | $5,061,137 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,977,268 | BOYAmt |
| EOY | $18,638,380 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,585,025 | BOYAmt |
| EOY | -$4,440,931 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,585,025 | BOYAmt |
| EOY | -$4,440,931 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,392,243 | BOYAmt |
| EOY | $14,197,449 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,855,906 | ReconcilationRevenueExpnssAmt |
| 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 | 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 Minus4 Years | $203,925 | CurrentTaxYearMinus4YearsAmt |
| Total | $203,925 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,136,313 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,091,624 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,002,605 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,521,319 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,158,601 | CurrentTaxYearAmt |
| Total | $71,910,462 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,340,238 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,091,624 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,002,605 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,521,319 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,158,601 | CurrentTaxYearAmt |
| Total | $72,114,387 | 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 | $72,114,387 | PublicSupportTotal509Amt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $2,338 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,504 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,541 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,298 | CurrentTaxYearAmt |
| Total | $29,681 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,340,238 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,093,962 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,006,109 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,525,860 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,177,899 | CurrentTaxYearAmt |
| Total | $72,144,068 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99960 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99990 | PublicSupportPY509Pct |
| 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 | MISC REVENUE - 2013 AMOUNT: $ 2,338. 2014 AMOUNT: $ 3,504. 2015 AMOUNT: $ 4,541. 2016 AMOUNT: $ 19,298. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,767,682 | BeginningYearBalanceAmt |
| Contributions | $125 | ContributionsAmt |
| Investment Earnings Or Losses | $156,417 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $45,312 | OtherExpendituresAmt |
| End Year Balance | $2,878,912 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,880,924 | BeginningYearBalanceAmt |
| Contributions | $400 | ContributionsAmt |
| Investment Earnings Or Losses | -$64,937 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $48,705 | OtherExpendituresAmt |
| End Year Balance | $2,767,682 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,860,581 | BeginningYearBalanceAmt |
| Contributions | $525 | ContributionsAmt |
| Investment Earnings Or Losses | $70,854 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $51,036 | OtherExpendituresAmt |
| End Year Balance | $2,880,924 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,570,336 | BeginningYearBalanceAmt |
| Contributions | $625 | ContributionsAmt |
| Investment Earnings Or Losses | $338,607 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $48,987 | OtherExpendituresAmt |
| End Year Balance | $2,860,581 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,321,345 | BeginningYearBalanceAmt |
| Contributions | $208,559 | ContributionsAmt |
| Investment Earnings Or Losses | $236,427 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $195,995 | OtherExpendituresAmt |
| End Year Balance | $2,570,336 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.82350 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.17650 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,561,563 | OtherCostOrOtherBasisAmt |
| Book Value | $2,561,563 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,480,914 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,844,460 | DepreciationAmt |
| Book Value | $8,636,454 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,796,695 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,763,197 | DepreciationAmt |
| Book Value | $1,033,498 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,027,843 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,687,562 | DepreciationAmt |
| Book Value | $340,281 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,571,796 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATE | Desc |
| Amt | $5,061,137 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,061,137 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $14,177,899 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,177,899 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,177,899 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,033,805 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,033,805 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $16,033,805 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE BETH ISRAEL FOUNDATION, A RELATED ORGANIZATION, HOLDS ASSETS IN ENDOWMENT FUNDS. THE ENDOWMENTS CONSIST OF VARIOUS INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. |
| PART X, LINE 2: | THE ORGANIZATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE COMBINED FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. IF TAXING AUTHORITIES WERE TO DISALLOW ANY TAX POSITIONS TAKEN BY THE ORGANIZATION, THE ADDITIONAL INCOME TAXES,IF ANY, WOULD BE IMPOSED ON SHALOM PARK AND THE FOUNDATION, WHICH IS THE SOLE MEMBER OF WELLNESS CENTER. ACCORDINGLY, THERE WOULD BE NO EFFECT ON THE ORGANIZATION'S COMBINED FINANCIAL STATEMENTS. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS GENERAL EXPENSE. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF DECEMBER 31, 2016. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 | DANIEL STENERSEN | PersonNm |
| Title | PRESIDENT/CEO | TitleTxt |
| Base Compensation Filing Org | $281,483 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $17,967 | 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 | $16,889 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $1,078 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $19,281 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $1,231 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $317,653 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $20,276 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CURRENT OFFICERS, THE PAST CHAIR(S) AND SUCH OTHER MEMBERS AS MAY BE APPOINTED BY THE CHAIR. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF AND IN PLACE OF THE BOARD OF TRUSTEES BETWEEN REGULAR MEETINGS OF THE BOARD OF TRUSTEES WHEN REASONABLY NECESSARY TO FULFILL THE PURPOSES AND DUTIES OF THE BOARD OF TRUSTEES, AS DETERMINED BY THE CHAIR, AND SHALL BE RESPONSIBLE FOR MAKING RECOMMENDATIONS TO THE BOARD OF TRUSTEES AND FOR SUCH OTHER POWERS AS THE BOARD FROM TIME TO TIME MAY PRESCRIBE. ACTIONS OF THE EXECUTIVE COMMITTEE MAY BE OVERRULED OR AMENDED BY LATER ACTION OF THE BOARD, BUT ANY ACTION PROPERLY TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE BINDING UPON THE CORPORATION UNTIL SUCH LATER ACTION OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CERTAIN BOARD MEMBERS REVIEW THE TAX RETURN WITH THE ORGANIZATION'S AUDITOR AND TAX RETURN PREPARER. THE RETURN IS AVAILABLE TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO IT BEING FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY THROUGH AN ANNUAL AFFIRMATION WITH THE BOARD. THE ORGANIZATION MONITORS COMPLIANCE WITH THE POLICY DURING THE YEAR BY INQUIRING AT ITS BOARD MEETINGS WHETHER ANY CONFLICTS OF INTEREST HAVE ARISEN SINCE THE ANNUAL AFFIRMATION WAS SIGNED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CHAIR OF THE BOARD OF DIRECTORS APPOINTS A MEMBER OF THE EXECUTIVE COMMITTEE TO ACT AS THE COMPENSATION REPRESENTATIVE FOR THE BOARD. THE COMPENSATION REPRESENTATIVE CONSIDERS SEVERAL FACTORS, SUCH AS (1)THE COMPLEXITY AND DIVERSITY OF RESPONSIBILITIES OF THE CEO'S POSITION (INCLUDING LICENSURE, REGULATION, CERTIFICATION, AND OPERATION OF THE SKILLED NURSING FACILITY); (2)INITIATIVES UNDERTAKEN, IN PROCESS, OR PLANNED; (3)STATUS AND PROGRESS OF THE ORGANIZATION; (4)THE SOCIAL SECURITY ADMINISTRATION COST OF LIVING ADJUSTMENT; (5)THE ASSOCIATION OF JEWISH AGING SERVICE COMPENSATION SURVEY; (6)MANAGEMENT OF MULTIPLE LINES OF BUSINESS; AND (7)THE CONTINUOUS EMPLOYMENT AGREEMENT BETWEEN THE ORGANIZATION AND THE CEO. BASED UPON THESE FACTORS, A MUTUALLY AGREEABLE COMPENSATION AMOUNT IS DETERMINED BY THE COMPENSATION REPRESENTATIVE AND THE CEO. THE COMPENSATION REPRESENTATIVE CONFERS WITH CERTAIN MEMBERS OF THE BOARD FOR APPROVAL OF THE COMPENSATION AGREEMENT. THE ORGANIZATION MAINTAINS THE APPROPRIATE DOCUMENTATION OF THE PROCESS THROUGH WHICH THE COMPENSATION AMOUNT WAS SET. THIS COMPENSATION-SETTING PROCESS IS DONE ON AN ANNUAL BASIS. THE ORGANIZATION DOES NOT HAVE ANY OTHER OFFICERS OR KEY EMPLOYEES; HOWEVER, IT DOES HAVE A PROCESS TO DETERMINE REASONABLE COMPENSATION FOR ITS EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 1,733,846. MANAGEMENT AND GENERAL EXPENSES 231,901. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,965,747. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| SHALOM PARK PROFESSIONAL SERVICES LLC | |||||||
| 14800 E BELLEVIEW DRIVE | AURORA | CO | 80015 | 264399163 | HEALTH CARE | CO | BETH ISRAEL FOUNDATION FOR THE AGED |
| SHALOM CARES WELLNESS CENTER LLC | |||||||
| 14800 E BELLEVIEW DRIVE | AURORA | CO | 80015 | 452808418 | HEALTH CARE | CO | BETH ISRAEL FOUNDATION FOR THE AGED |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETH ISRAEL FOUNDATION FOR THE AGED | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14800 E BELLEVIEW DRIVE | AddressLine1Txt |
| City | AURORA | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742195249 | EIN |
| Primary Activities | CHARITABLE | PrimaryActivitiesTxt |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Exempt Code Section | 501(C) (3) | ExemptCodeSectionTxt |
| Public Charity Status | 9-509(A)(2) | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHALOM PARK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BETH EZRA AT SHALOM PARK | ||||||||||
| 14800 E BELLEVIEW DRIVE | AURORA | CO | 80015 | 320179215 | CHARITABLE | CO | SHALOM PARK | C | 1.00000 | Yes (1) |
| (no name) | ||||||||||
| Yes (1) | ||||||||||
| 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DUE TO FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionTypeTxt |
| Involved | -$5,061,137 | InvolvedAmt |