EMMANUEL HOSPICE: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- EMMANUEL HOSPICE (EIN 45-4485835)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-18
- IRS object ID
- 201742919349300204
- 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 | 2017-10-18T07:59:34-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 Trade Centre Way Ste 300 | AddressLine1Txt |
| City | Portage | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49002 | 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 | 454485835 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMMANUEL HOSPICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EMMA | BusinessNameControlTxt |
| Phone | 6167190919 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2161 LEONARD ST NW | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49504 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SARA LOWE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6167190919 | PhoneNum |
| Signature | 2017-09-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Carol LaLonde CPA | PreparerPersonNm |
| PTIN | P00181637 | PTIN |
| Phone | 2695674500 | PhoneNum |
| Preparation | 2017-09-08 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.59.56.31 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-09-13 | IPDt |
| IP Tm | 12:39:16 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 58F74DC53CB874483B207ADF23CD6921384352E9 | 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 | DR LAURENCE BURNS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2161 LEONARD ST NW | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,213,835 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.emmanuelhospice.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE END OF LIFE HOSPICE CARE AND RELATED SERVICES TO INDIVIDUALS IN THE COMMUNITY WHO HAVE A TERMINAL CONDITION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 38 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $51,811 | PYContributionsGrantsAmt |
| CY Contributions Grants | $72,205 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,722,345 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,138,099 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $78 | PYOtherRevenueAmt |
| CY Other Revenue | -$4,168 | CYOtherRevenueAmt |
| PY Total Revenue | $2,774,234 | PYTotalRevenueAmt |
| CY Total Revenue | $4,206,136 | 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 | $1,227,637 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,793,239 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $14,813 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $14,832 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $20,126 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,461,981 | PYOtherExpensesAmt |
| CY Other Expenses | $1,958,801 | CYOtherExpensesAmt |
| PY Total Expenses | $2,704,431 | PYTotalExpensesAmt |
| CY Total Expenses | $3,766,872 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $69,803 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $439,264 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $653,127 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,163,442 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $922,939 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $438,364 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$269,812 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $725,078 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF EMMANUEL HOSPICE, AN INTERFAITH PARTNERSHIP, IS TO PROVIDE EXEMPLARY SPIRITUAL AND PHYSICAL CARE CREATING A PEACEFUL EXPERIENCE FOR THE DYING AND THEIR LOVED ONES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,507,375 | ExpenseAmt |
| Revenue | $4,138,099 | RevenueAmt |
| Desc | HOSPICE AND BEREAVEMENT CARE | Desc |
| Total Program Service Expenses | $2,507,375 | 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 | 0 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | 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 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 38 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | 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 | 0 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRAIG VANDENBOS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6169541799 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4450 CASCADE ROAD | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49546 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 |
|---|---|---|---|---|---|---|---|
| LAURENCE BURNS | |||||||
| CHAIR | 5.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JANE TOOT | |||||||
| VICE CHAIR | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICK WALKER | |||||||
| TREASURER | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SISTER GABRIELA HILKE | |||||||
| DIRECTOR, CHAPLAIN | 30.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS WESHOLSKI | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DONNA HINTON | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| COREY KOPERSKI | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARY THERESA HEGARTY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES BRADY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT HERR | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JUDY BAKER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| PAT BERGSTROM | |||||||
| DIRECTOR - PART YEAR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SARA LOWE | |||||||
| EXECUTIVE DIRECTOR | 50.00 | 0.00 | Yes (X) | $96,318 | $0 | $8,989 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $96,318 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $8,989 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $28,478 | FundraisingAmt |
| All Other Contributions | $43,727 | AllOtherContributionsAmt |
| Total Contributions | $72,205 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE/MEDICAID | 623000 | $3,989,588 | $3,989,588 |
| INSURANCE CLAIM | 623000 | $148,511 | $148,511 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,138,099 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $3,200 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $28,478 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,699 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,499 | TotalRevenueColumnAmt |
| Exclusion | -$4,499 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $331 | TotalRevenueColumnAmt |
| Exclusion | $331 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $331 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,206,136 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,138,099 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$4,168 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,887 | TotalAmt |
| Management And General | $100,593 | ManagementAndGeneralAmt |
| Fundraising | $5,294 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,466,113 | TotalAmt |
| Program Services | $984,456 | ProgramServicesAmt |
| Management And General | $481,657 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,150 | TotalAmt |
| Program Services | $8,066 | ProgramServicesAmt |
| Management And General | $2,084 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,089 | TotalAmt |
| Program Services | $160,002 | ProgramServicesAmt |
| Management And General | $51,087 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,524 | TotalAmt |
| Management And General | $295,524 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,148 | TotalAmt |
| Management And General | $6,148 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,435 | TotalAmt |
| Management And General | $11,435 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,832 | TotalAmt |
| Fundraising | $14,832 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,546 | TotalAmt |
| Management And General | $1,546 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,196 | TotalAmt |
| Management And General | $39,196 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,227 | TotalAmt |
| Management And General | $22,227 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,406 | TotalAmt |
| Management And General | $14,406 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,835 | TotalAmt |
| Management And General | $53,835 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,000 | TotalAmt |
| Management And General | $9,000 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,506 | TotalAmt |
| Program Services | $85,159 | ProgramServicesAmt |
| Management And General | $6,347 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $677 | TotalAmt |
| Management And General | $677 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,761 | TotalAmt |
| Management And General | $17,761 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,854 | TotalAmt |
| Management And General | $8,854 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| NURSING HOME ROOM & BOA | $806,166 | $806,166 | |
| EQUIPMENT/SUPPLIES | $166,903 | $146,510 | $20,393 |
| PHARMACY | $154,647 | $154,647 | |
| BAD DEBT | $10,780 | $10,780 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,190 | TotalAmt |
| Program Services | $162,369 | ProgramServicesAmt |
| Management And General | $85,821 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,766,872 | TotalAmt |
| Program Services | $2,507,375 | ProgramServicesAmt |
| Management And General | $1,239,371 | ManagementAndGeneralAmt |
| Fundraising | $20,126 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $529,636 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $590,676 | BOYAmt |
| EOY | $562,793 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,456 | BOYAmt |
| EOY | $10,296 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $131,883 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $71,166 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,995 | BOYAmt |
| EOY | $60,717 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $653,127 | BOYAmt |
| EOY | $1,163,442 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $367,313 | BOYAmt |
| EOY | $438,364 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $555,626 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $922,939 | BOYAmt |
| EOY | $438,364 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$269,812 | BOYAmt |
| EOY | $725,078 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$269,812 | BOYAmt |
| EOY | $725,078 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $653,127 | BOYAmt |
| EOY | $1,163,442 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $439,264 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $555,626 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| 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 | $750 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $56,060 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $51,811 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72,205 | CurrentTaxYearAmt |
| Total | $180,826 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $55,396 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,450,182 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,722,345 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,138,099 | CurrentTaxYearAmt |
| Total | $9,366,022 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $750 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,396 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,506,242 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,774,156 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,210,304 | CurrentTaxYearAmt |
| Total | $9,546,848 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $9,969 | CurrentTaxYearAmt |
| Total | $9,969 | 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) |
|---|---|---|
| Current Tax Year | $9,969 | CurrentTaxYearAmt |
| Total | $9,969 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $9,536,879 | PublicSupportTotal509Amt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $14,212 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $78 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,531 | CurrentTaxYearAmt |
| Total | $17,844 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $750 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $69,608 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,506,265 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,774,234 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,213,835 | CurrentTaxYearAmt |
| Total | $9,564,692 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
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 | MISCELLANEOUS REVENUE - 2013 Amount: $ 14,212. 2014 Amount: $ 23. 2015 Amount: $ 78. 2016 Amount: $ 331. FUNDRAISING - 2016 Amount: $ 3,200. | ExplanationTxt |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $94,514 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $57,205 | DepreciationAmt |
| Book Value | $37,309 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $37,369 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $13,961 | DepreciationAmt |
| Book Value | $23,408 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $60,717 | TotalBookValueLandBuildingsAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNUAL CELEBRATION | Event1Nm |
| Gross Receipts Event1 | $31,678 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $28,478 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $3,200 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $855 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $3,959 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $165 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $2,720 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $31,678 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $28,478 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $3,200 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $855 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $3,959 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $165 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,720 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,699 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$4,499 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | THE STOCKHOLDERS ARE ST ANN'S - 54%, PORTER HILLS - 18%, CLARK RETIREMENT COMMUNITY - 18%, AND SUNSET MANOR - 10%. |
| Form 990, Part VI, Section A, line 7a | THE MEMBERS ARE AUTHORIZED TO APPOINT INDIVIDUALS TO AND REMOVE INDIVIDUALS FROM THE BOARD OF DIRECTORS. |
| Form 990, Part VI, Section A, line 7b | CHANGES IN PURPOSE, MERGERS, INCURRENCE OF LONG TERM DEBT, SALE OF ASSETS GREATER THAN $5,000, HIRING OF EXECUTIVE DIRECTOR REQUIRE UNANIMOUS STOCKHOLDER VOTE. |
| Form 990, Part VI, Section A, line 8b | THERE ARE NO COMMITTEES WITH AUTHORITY. |
| Form 990, Part VI, Section B, line 11b | THE FINANCE COMMITTEE PLANS TO REVIEW THE RETURN BEFORE FILING THE 990. THE ENTIRE BOARD RECEIVES A COPY OF THE FORM 990 PRIOR TO FILING. |
| Form 990, Part VI, Section B, line 12c | ON AN ANNUAL BASIS, THE CONFLICT OF INTEREST POLICY IS SIGNED BY EACH BOARD MEMBER. IF A CONFLICT DOES ARISE, THE SITUATION IS REVIEWED WITH THE MEMBER AND THE BOARD CHAIR. IF A MATTER IS UNDER CONSIDERATION BY THE BOARD IN WHICH THERE IS A POSSIBLE CONFLICT OF INTEREST, THE BOARD MEMBER SHALL NOT VOTE OR USE THEIR PERSONAL INFLUENCE ON THE MATTER. |
| Form 990, Part VI, Section B, line 15a | ON AN ANNUAL BASIS THE EXECUTIVE DIRECTOR'S SALARY IS APPROVED BY THE BOARD AFTER REVIEWING COMPARATIVE DATA. THE DELIBERATION AND APPROVAL OF THE COMPENSATION IS DOCUMENTED. |
| Form 990, Part VI, Section C, line 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN PROCESS SINCE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANN'S HOME INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2161 LEONARD ST NW | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381872660 | EIN |
| Primary Activities | NURSING HOME | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 10 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | Yes (1) | 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 |
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