2017-02-06T12:30:09-06:00 2016-06-30 510227758 MASTER SIDLOW & ASSOCIATES PA 2002 WEST 14TH STREET WILMINGTON DE 19806 990 2015-07-01 510070786 MILTON & HATTIE KUTZ HOME INC MILT 3027647000 704 RIVER ROAD WILMINGTON DE 19809 KAREN FRIEDMAN EXECUTIVE DIRECTOR 3027647000 2017-02-03 1 JUDITH M SCARBOROUGH P00161946 3026523480 2015 2021-01-29 14:40:06Z KAREN FRIEDMAN 704 RIVER ROAD WILMINGTON DE 19809 15944201 0 X WWW.KUTZHOME.ORG X 1953 DE SKILLED NURSING CARE FOR THE ELDERLY 31 31 224 28 0 0 214276 191702 11220306 11989784 190835 462837 0 0 11625417 12644323 0 0 0 0 6030570 6170256 0 0 0 7064764 7214170 13095334 13384426 -1469917 -740103 22475026 20975629 14224969 14247636 8250057 6727993 THE HOME'S MISSION IS TO PROVIDE SHELTER, MEDICAL CARE, NURSING AND OTHER SERVICES FOR AGING MEN AND WOMEN. 0 0 8812583 0 9795638 LONG-TERM CARE NURSING FACILITY PROVIDING SKILLED NURSING CARE AND THERAPY TO THE ELDERLY WITHOUT REGARD TO ABILITY TO PAY. TOTAL OF 32,038 PATIENT DAYS. 3194956 0 2194146 ASSISTED LIVING FACILITY PROVIDING ASSISTED LIVING, RESPITE CARE, AND A SECURE MEMORY CARE NEIGHBORHOOD TO SENIORS WHO DO NOT NEED SKILLED NURSING CARE BUT WOULD BENEFIT FROM SOME PERSONAL ASSISTANCE. TOTAL OF 10,612 PATIENT DAYS 12007539 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 0 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 1 1 0 0 1 22 0 1 224 1 0 0 0 0 0 0 0 0 0 0 X 31 31 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 DE X X DAVID BACHER 3027647000 704 RIVER ROAD WILMINGTON DE 19809 ROBERT GOODMAN PRESIDENT 1.00 X X 0 0 0 FELISHA ALDERSON TREASURER 1.00 X X 0 0 0 GARY ALDERSON DIRECTOR 1.00 X 0 0 0 JODI COHEN DIRECTOR 1.00 X 0 0 0 STUART FELZER DIRECTOR 1.00 X 0 0 0 DONNA HARLEV DIRECTOR 1.00 X 0 0 0 NEIL LATTIN DIRECTOR 1.00 X 0 0 0 SELINDA MELNIK DIRECTOR 1.00 X 0 0 0 EILEEN SARTER DIRECTOR 1.00 X 0 0 0 GREGORY SCHIFF DIRECTOR 1.00 X 0 0 0 BARRY SCHNOLL DIRECTOR 1.00 X 0 0 0 WENDY SHLOSSMAN DIRECTOR 1.00 X 0 0 0 ANITA SOBEL DIRECTOR 1.00 X 0 0 0 JEFFREY STAPE DIRECTOR 1.00 X 0 0 0 GAIL TOLPIN DIRECTOR 1.00 X 0 0 0 GINGER WEISS DIRECTOR 1.00 X 0 0 0 LESLIE GOLDENBERG DIRECTOR 1.00 X 0 0 0 IRIS VINOKUR DIRECTOR 1.00 X 0 0 0 KAREN FRIEDMAN EXECUTIVE DIRECTOR 40.00 X 172659 0 16342 DAVE BACHER CONTROLLER 40.00 X 114608 0 14616 287267 0 30958 2 0 1 0 FLIK LIFESTYLES 17 S MARKET SQ 4TH FLOOR HARRISBURG PA 17101 OPERATIONAL CONSULTANT 2214065 SELECT REHABILITATION INC PO BOX 809056 CHICAGO IL 60680 THERAPY 621438 XPRESS NURSES LLC PO BOX 881774 SAN FRANCISCO CA 94188 TEMPORARY STAFFING - NURSES AND CNA'S 104551 3 35652 156050 191702 MEDICAID/MEDICARE 623000 7718616 7718616 RESIDENT SERVICE REV 623000 4271168 4271168 11989784 62243 62243 3700472 3299878 400594 400594 400594 12644323 11989784 0 462837 X 326438 326438 4741261 4142842 598419 56724 51377 5347 658253 562107 96146 387580 341627 45953 112483 109880 2603 1417847 1388063 29784 263811 245353 18458 8662 8662 282409 268792 13617 10568 8721 1847 11301 7458 3843 540289 523000 17289 774507 741188 33319 234497 222332 12165 CLINICAL SERVICES 735688 735688 NURSING HOME QUALITY AS 716227 716227 SUPPLIES 614102 588176 25926 FOOD 484520 484520 1007259 861526 145733 13384426 12007539 1376887 0 61304 3745 1219549 1605378 300998 158365 1184199 844486 130113 0 193414 129304 22422126 6862169 16262090 15559957 2853857 2418064 269502 256330 22475026 20975629 696532 639536 305244 375509 10283 14615 12910411 12578972 302499 639004 14224969 14247636 X 7271260 6035731 857810 571275 120987 120987 8250057 6727993 22475026 20975629 X -740103 -445456 -336505 X 0 1 X 1 0 X 1053905 474575 628546 214276 191702 2563004 8684819 9032955 9727369 11220306 11989784 50655233 9738724 9507530 10355915 11434582 12181486 53218237 157100 91606 38370 6730 17065 310871 26778 97273 11281 1594 136926 183878 188879 49651 8324 17065 447797 52770440 97128 86375 142882 165717 62243 554345 97128 86375 142882 165717 62243 554345 10016 320 1960 12296 9845868 9594225 10500757 11600299 12243729 53784878 0.98110 0.97570 0.01030 0.01140 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 120987 120987 120987 120987 120987 120987 120987 120987 120987 120987 1.00000 0 0 20627469 5783718 14843751 1791757 1078451 713306 2900 2900 15559957 DERIVATIVE CONTRACT - INTEREST RATE SWAP 639004 639004 X 12198867 -445456 -445456 12644323 0 12644323 13720931 336505 336505 13384426 0 13384426 PART IV, LINE 2B: SOME RESIDENTS HAVE SMALL CASH BALANCES ON DEPOSIT WITH THE HOME FOR USE ON ITEMS SUCH AS HAIRCUTS, MEAL TICKETS, ETC. PART V, LINE 4: THE HOME'S PERMANENTLY RESTRICTED NET ASSETS CONSIST OF THREE INDIVIDUAL DONOR-RESTRICTED ENDOWMENT FUNDS ESTABLISHED TO SUPPORT THE HOME. PART X, LINE 2: THE HOME QUALIFIES AS A TAX EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ITS ACTIVITIES DO NOT RESULT IN ANY INCOME TAX LIABILITY. THE HOME FOLLOWS PROFESSIONAL STANDARDS WHICH CLARIFY THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE HOMES FINANCIAL STATEMENTS AND PRESCRIBE A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THE STANDARDS ALSO PROVIDE GUIDANCE ON DERECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THE HOME FILES INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. THE HOMES FEDERAL INCOME TAX RETURNS FOR FISCAL YEARS 2013 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOME DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2016 AND DOES NOT EXPECT THIS TO CHANGE SIGNIFICANTLY OVER THE NEXT TWELVE MONTHS. THE HOME WILL RECOGNIZE INTEREST AND PENALTIES ACCRUED ON ANY UNRECOGNIZED TAX BENEFITS, IF ANY, AS A COMPONENT OF INCOME TAX EXPENSE. AS OF JUNE 30, 2016, THE HOME DID NOT HAVE ANY ACCRUED INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX PROVISIONS. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SWAP AGREEMENT 336,505. X 0 0 0 0 0 0 0 0 0 KAREN FRIEDMAN EXECUTIVE DIRECTOR 172659 0 0 0 0 0 0 0 16342 0 189001 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FOLLOWING REVIEW BY THE CFO AND EXECUTIVE DIRECTOR, THE TREASURER OR OTHER KNOWLEDGEABLE BOARD MEMBER REVIEWS THE RETURN IN DETAIL. THE FORM 990 IS MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTUAL SALARIES AND RELATED: PROGRAM SERVICE EXPENSES 1,388,063. MANAGEMENT AND GENERAL EXPENSES 29,784. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,417,847. FORM 990, PART XI, LINE 9: LOSS ON SWAP AGREEMENT -336,505. AUXILIARY OF THE MILTON & HATTIE KUTZ HOME INC 510136951 SUPPORT OF THE KUTZ HOME DE 501C 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AUXILIARY OF THE MILTON & HATTIE KUTZ HOME INC C 8000 FMV