PALOLO CHINESE HOME: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- PALOLO CHINESE HOME (EIN 99-0073521)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-13
- IRS object ID
- 202523179349310767
- Schema version
- 2024v5.2
- 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 | 2025-11-13T17:22:27-06:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 421539623 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KMH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1003 BISHOP STREET SUITE 2400 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990073521 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PALOLO CHINESE HOME | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PALO | BusinessNameControlTxt |
| Phone | 8087372555 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2459 10TH AVENUE | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96816 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DARLENE NAKAYAMA | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8087372555 | PhoneNum |
| Signature | 2025-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIELLE A HARANO | PreparerPersonNm |
| PTIN | P01258470 | PTIN |
| Phone | 8085262255 | PhoneNum |
| Preparation | 2025-10-23 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DARLENE NAKAYAMA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2459 10TH AVENUE | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96816 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,610,999 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PALOLOHOME.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1920 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | TO EDUCATE, SUPPORT AND CARE FOR SENIORS AND THEIR FAMILIES BY PROVIDING A CONTINUUM OF QUALITY CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 219 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,890,519 | PYContributionsGrantsAmt |
| CY Contributions Grants | $550,570 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,880,324 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,299,260 | CYProgramServiceRevenueAmt |
| PY Investment Income | $110,895 | PYInvestmentIncomeAmt |
| CY Investment Income | $284,250 | CYInvestmentIncomeAmt |
| PY Other Revenue | $222,001 | PYOtherRevenueAmt |
| CY Other Revenue | $165,278 | CYOtherRevenueAmt |
| PY Total Revenue | $21,103,739 | PYTotalRevenueAmt |
| CY Total Revenue | $21,299,358 | 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 | $10,736,468 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,264,837 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $103,277 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,919,760 | PYOtherExpensesAmt |
| CY Other Expenses | $10,779,691 | CYOtherExpensesAmt |
| PY Total Expenses | $20,656,228 | PYTotalExpensesAmt |
| CY Total Expenses | $22,044,528 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $447,511 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$745,170 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $31,600,065 | TotalAssetsBOYAmt |
| Total Assets EOY | $31,067,299 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,656,473 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,663,133 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,943,592 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,404,166 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO EDUCATE, SUPPORT, AND CARE FOR SENIORS AND THEIR FAMILIES BY PROVIDING A CONTINUUM OF QUALITY CARE IN A CULTURALLY SENSITIVE FAMILY SETTING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,576,956 | ExpenseAmt |
| Revenue | $17,241,443 | RevenueAmt |
| Desc | ICF/SNF - PALOLO CHINESE HOME IS LICENSED AS AN ICF/SNF UNIT AND PROVIDES 113 NURSING HOME BEDS TO ELDERLY RESIDENTS, REGARDLESS OF RACE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $601,628 | ExpenseAmt |
| Revenue | $1,526,606 | RevenueAmt |
| Desc | ADULT RESIDENTIAL HOME - PALOLO CHINESE HOME IS LICENSED AS AN ADULT RESIDENTIAL CARE HOME TYPE II FACILITY (EARCH II) THAT HOUSES 18 ELDERLY RESIDENTS, REGARDLESS OF RACE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,308,199 | ExpenseAmt |
| Revenue | $479,445 | RevenueAmt |
| Desc | ADULT DAY CARE - PALOLO CHINESE HOME IS LICENSED AS AN ADULT DAY CARE CENTER FOR 40 ELDERLY PARTICIPANTS, REGARDLESS OF RACE. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,113,312 | ExpenseAmt |
| Revenue | $1,051,766 | RevenueAmt |
| Desc | OTHER PROGRAM SERVICES INCLUDE COMMUNITY OUTREACH PROGRAMS SUCH AS MEALS HOME DELIVERY, HOME CLEANING, COMPANIONSHIP, PERSONAL CARE AND CATERING. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,113,312 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $1,051,766 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $19,600,095 | 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 | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 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 With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| 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 | 0 | 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 | 34 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 219 | 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 | Yes (1) | QuidProQuoContriDisclInd |
| 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 |
| States Where Copy Of Return Is Fld | HI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUSTIN LEE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8085425260 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2459 10TH AVENUE | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96816 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| PATRICIA BLANCHETTE MD MPH | |||||||
| SECRETARY & MEDICAL DIRECT | 4.00 | Yes (X) | Yes (X) | $36,000 | $0 | $0 | |
| ELVIRA LO | |||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ISOO OSHIMACPA | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SANDRA SOUZA | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ERIC WATANABE | |||||||
| ASSISTANT TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| FRANCES GOO | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GLADYS LEE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY SCHMIDT ESQ | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GORDON AU | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LAWRENCE TSEU DDS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ANDREW FONG MD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| REGINALD YEE ESQ | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KIN MING CHING OD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RODNEY UCHIDA | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DARLENE NAKAYAMA | |||||||
| CEO | 40.00 | Yes (X) | $244,251 | $0 | $27,382 | ||
| AGNES DELOS REYES | |||||||
| REGISTERED NURSE | 40.00 | $128,908 | $0 | $13,851 | Yes (X) | ||
| JAMIE SUZUKI | |||||||
| REGISTERED NURSE | 40.00 | $146,713 | $0 | $11,246 | Yes (X) | ||
| JUAN GONZALEZ | |||||||
| DIRECTOR OF NURSING | 40.00 | $132,854 | $0 | $14,047 | Yes (X) | ||
| RACHAEL YOUNG | |||||||
| DIRECTOR OF HR | 40.00 | $119,118 | $0 | $12,823 | Yes (X) | ||
| EVA HIDALGO | |||||||
| HOMECARE AIDE | 103.00 | $122,220 | $0 | $7,104 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $930,064 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $86,453 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | 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 |
|---|---|---|---|---|---|
| KAHU MALAMA NURSES INC | |||||
| 1357 KAPIOLANI BOULEVARD SUITE 915 | HONOLULU | HI | 96814 | STAFFING | $1,537,610 |
| GENESIS ELDERCARE REHABILITATIONLLC | |||||
| PO BOX 821322 | PHILADELPHIA | PA | 191821322 | THERAPY | $523,933 |
| PRIME TIME HEALTHCARE LLC | |||||
| 15380 WEIR STREET | OMAHA | NE | 68137 | STAFFING | $315,680 |
| TRAVEL CARE HAWAII LLC | |||||
| 1050 QUEEN STREET | HONOLULU | HI | 96814 | STAFFING | $289,660 |
| PROLINK STAFFING | |||||
| 4600 MONTGOMERY ROAD SUITE 300 | CINCINNATI | OH | 45212 | STAFFING | $268,192 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $10,241 | FederatedCampaignsAmt |
| All Other Contributions | $540,329 | AllOtherContributionsAmt |
| Total Contributions | $550,570 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ICF/SNF UNIT AND NURSING HOME | 623000 | $17,241,443 | $17,241,443 |
| ADULT RESIDENTIAL CARE HOME | 623000 | $1,526,606 | $1,526,606 |
| OTHER - COMM. OUTREACH, ETC. | 624200 | $1,051,766 | $1,051,766 |
| ADULT DAY CARE CENTER | 621400 | $479,445 | $479,445 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,299,260 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $221,282 | TotalRevenueColumnAmt |
| Exclusion | $221,282 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $89,724 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,954 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $66,770 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,770 | TotalRevenueColumnAmt |
| Exclusion | $66,770 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $295,558 | SecuritiesAmt |
| Other | $35,007 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $261,390 | SecuritiesAmt |
| Other | $6,207 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $34,168 | SecuritiesAmt |
| Other | $28,800 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,968 | TotalRevenueColumnAmt |
| Exclusion | $62,968 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $78,360 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $21,090 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,270 | TotalRevenueColumnAmt |
| Exclusion | $57,270 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CHANGE IN VALUE OF PERM TRUST | 900099 | $20,852 | $20,852 |
| MISCELLANEOUS REVENUE | 900099 | $20,386 | $20,386 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $41,238 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,299,358 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,299,260 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $449,528 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280,251 | TotalAmt |
| Program Services | $36,000 | ProgramServicesAmt |
| Management And General | $195,401 | ManagementAndGeneralAmt |
| Fundraising | $48,850 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,878,184 | TotalAmt |
| Program Services | $8,120,834 | ProgramServicesAmt |
| Management And General | $756,018 | ManagementAndGeneralAmt |
| Fundraising | $1,332 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,634 | TotalAmt |
| Program Services | $166,380 | ProgramServicesAmt |
| Management And General | $31,809 | ManagementAndGeneralAmt |
| Fundraising | $445 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,223,279 | TotalAmt |
| Program Services | $1,064,552 | ProgramServicesAmt |
| Management And General | $158,727 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $684,489 | TotalAmt |
| Program Services | $612,317 | ProgramServicesAmt |
| Management And General | $72,172 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,090 | TotalAmt |
| Management And General | $39,090 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,304 | TotalAmt |
| Management And General | $103,304 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,957 | TotalAmt |
| Management And General | $19,522 | ManagementAndGeneralAmt |
| Fundraising | $5,435 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,520,961 | TotalAmt |
| Program Services | $4,116,248 | ProgramServicesAmt |
| Management And General | $377,416 | ManagementAndGeneralAmt |
| Fundraising | $27,297 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,289 | TotalAmt |
| Management And General | $114,289 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,663 | TotalAmt |
| Program Services | $15,483 | ProgramServicesAmt |
| Management And General | $96,864 | ManagementAndGeneralAmt |
| Fundraising | $3,316 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,023 | TotalAmt |
| Program Services | $159,142 | ProgramServicesAmt |
| Management And General | $187,881 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550,796 | TotalAmt |
| Program Services | $528,559 | ProgramServicesAmt |
| Management And General | $20,355 | ManagementAndGeneralAmt |
| Fundraising | $1,882 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,180 | TotalAmt |
| Program Services | $18,613 | ProgramServicesAmt |
| Management And General | $11,567 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,697 | TotalAmt |
| Program Services | $1,610 | ProgramServicesAmt |
| Management And General | $5,087 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,339 | TotalAmt |
| Program Services | $166,339 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $852,948 | TotalAmt |
| Program Services | $753,248 | ProgramServicesAmt |
| Management And General | $94,812 | ManagementAndGeneralAmt |
| Fundraising | $4,888 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,416 | TotalAmt |
| Program Services | $198,593 | ProgramServicesAmt |
| Management And General | $16,114 | ManagementAndGeneralAmt |
| Fundraising | $3,709 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| NURSING & DIETARY SUPPL | $1,704,194 | $1,704,194 | $0 | $0 |
| TAXES & LICENSES | $1,228,824 | $1,227,928 | $896 | $0 |
| REPAIRS & MAINTENANCE | $315,348 | $311,940 | $1,746 | $1,662 |
| MISCELLANEOUS EXPENSE | $247,504 | $204,957 | $38,086 | $4,461 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,158 | TotalAmt |
| Program Services | $193,158 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,044,528 | TotalAmt |
| Program Services | $19,600,095 | ProgramServicesAmt |
| Management And General | $2,341,156 | ManagementAndGeneralAmt |
| Fundraising | $103,277 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $498,529 | BOYAmt |
| EOY | $583,851 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,305,897 | BOYAmt |
| EOY | $3,026,848 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,000 | BOYAmt |
| EOY | $214,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,046,387 | BOYAmt |
| EOY | $2,750,825 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,455 | BOYAmt |
| EOY | $96,233 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,836 | BOYAmt |
| EOY | $168,680 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $37,060,839 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,667,538 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,981,524 | BOYAmt |
| EOY | $21,393,301 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,222,301 | BOYAmt |
| EOY | $2,498,573 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,136 | BOYAmt |
| EOY | $330,988 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,000 | BOYAmt |
| EOY | $4,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,600,065 | BOYAmt |
| EOY | $31,067,299 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,206,622 | BOYAmt |
| EOY | $2,558,595 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | -$3,290 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500 | BOYAmt |
| EOY | $500 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,449,351 | BOYAmt |
| EOY | $5,107,328 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,656,473 | BOYAmt |
| EOY | $7,663,133 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,098,012 | BOYAmt |
| EOY | $22,243,244 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $845,580 | BOYAmt |
| EOY | $1,160,922 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,943,592 | BOYAmt |
| EOY | $23,404,166 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,600,065 | BOYAmt |
| EOY | $31,067,299 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$745,170 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $205,749 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$5 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $788,531 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,171,734 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $342,562 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,890,519 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $550,570 | CurrentTaxYearAmt |
| Total | $7,743,916 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $788,531 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,171,734 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $342,562 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,890,519 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $550,570 | CurrentTaxYearAmt |
| Total | $7,743,916 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $120,077 | SubstantialContributorsTotAmt |
| Public Support Total170 | $7,623,839 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $145,480 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $152,173 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $145,890 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $204,135 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $311,006 | CurrentTaxYearAmt |
| Total | $958,684 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,791 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,674 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $34,816 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $169,973 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $98,746 | CurrentTaxYearAmt |
| Total | $325,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,027,600 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $90,355,555 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.84450 | PublicSupportCY170Pct |
| Public Support PY170 | 0.86040 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION FOR OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME SPECIAL FUNDRAISING EVENT PROCEEDS | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $792,143 | BeginningYearBalanceAmt |
| Contributions | $298,300 | ContributionsAmt |
| Investment Earnings Or Losses | $51,413 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $34,371 | OtherExpendituresAmt |
| End Year Balance | $1,107,485 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $761,101 | BeginningYearBalanceAmt |
| Contributions | $25,301 | ContributionsAmt |
| Investment Earnings Or Losses | $93,991 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $88,250 | OtherExpendituresAmt |
| End Year Balance | $792,143 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $521,322 | BeginningYearBalanceAmt |
| Contributions | $222,652 | ContributionsAmt |
| Investment Earnings Or Losses | $96,790 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $79,663 | OtherExpendituresAmt |
| End Year Balance | $761,101 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $439,074 | BeginningYearBalanceAmt |
| Contributions | $120,100 | ContributionsAmt |
| Investment Earnings Or Losses | $54,648 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $92,500 | OtherExpendituresAmt |
| End Year Balance | $521,322 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $393,294 | BeginningYearBalanceAmt |
| Contributions | $19,550 | ContributionsAmt |
| Investment Earnings Or Losses | $34,130 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,900 | OtherExpendituresAmt |
| End Year Balance | $439,074 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | 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 | $395,050 | OtherCostOrOtherBasisAmt |
| Book Value | $395,050 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,931,521 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,743,994 | DepreciationAmt |
| Book Value | $18,187,527 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,911,553 | OtherCostOrOtherBasisAmt |
| Book Value | $1,911,553 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,487,587 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,923,544 | DepreciationAmt |
| Book Value | $564,043 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $335,128 | OtherCostOrOtherBasisAmt |
| Book Value | $335,128 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,393,301 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,331,036 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $205,749 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $44,044 | OtherRevenueAmt |
| Revenue Not Reported | $249,793 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,081,243 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $24,957 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $193,158 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $218,115 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,299,358 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,870,462 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $44,049 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $44,049 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,826,413 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $24,957 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $193,158 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $218,115 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $22,044,528 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR TWO COMPANIES LEASING SPACE. THE TENANT'S SECURITY DEPOSIT IS REFUNDED UPON TERMINATION OF THE LEASE, LESS ANY REPAIRS AND MAINTENANCE. |
| PART V, LINE 4: | EARNINGS FROM THE ENDOWMENT FUNDS ARE USED TO SUPPLEMENT THE OPERATIONS OF THE HOME'S PROGRAMS IN ACCORDANCE WITH THE HOME'S MISSION STATEMENT. |
| PART X, LINE 2: | THE HOME IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND COMPARABLE STATE LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL INCOME TAX IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE HOME'S TAX POSITIONS AND CONCLUDED THAT THE HOME HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE HOME'S 2021 THROUGH 2023 FEDERAL TAX RETURNS REMAIN OPEN TO EXAMINATION BY THE TAXING AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 21,090. RENTAL EXPENSES 22,954. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 193,158. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 21,090. RENTAL EXPENSES 22,954. ROUNDING ADJUSTMENT 5. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 193,158. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $78,360 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $78,360 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $4,415 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $7,632 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $8,247 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $797 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $78,360 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $78,360 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $4,415 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $7,632 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,247 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $797 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $21,091 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $57,269 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DARLENE NAKAYAMA | ||||||||||||||
| CEO | $244,251 | $0 | $0 | $0 | $0 | $0 | $18,970 | $0 | $8,412 | $0 | $271,633 | $0 | $0 | $0 |
| JAMIE SUZUKI | ||||||||||||||
| REGISTERED NURSE | $146,713 | $0 | $0 | $0 | $0 | $0 | $11,246 | $0 | $0 | $0 | $157,959 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1B | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDES GROSS-UP PAYMENTS FOR THE ANNIVERSARY AWARDS AND EMPLOYEE OF THE YEAR AWARDS GIVEN TO EMPLOYEES, WHICH MAY INCLUDE EMPLOYEES LISTED IN FORM 990, PART VII, SECTION A. THESE GROSS-UP PAYMENTS ARE INCLUDED IN TAXABLE COMPENSATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | PATRICIA BLANCHETTE, MD IS A DIRECTOR AND IS ALSO THE MEDICAL DIRECTOR FOR PALOLO CHINESE HOME. SHE IS COMPENSATED FOR HER WORK AS MEDICAL DIRECTOR BUT HER POSITION ON THE BOARD IS VOLUNTARY. SHE RECUSES HERSELF DURING BOARD MEETINGS ON ISSUES THAT MAY CAUSE A POTENTIAL CONFLICT OF INTEREST (ONLY WHEN IT RELATES TO HER DUTIES AS MEDICAL DIRECTOR). |
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE IS COMPRISED OF THE CHIEF EXECUTIVE OFFICER, THE OFFICERS OF THE BOARD, THE IMMEDIATE PAST PRESIDENT, AND ONE OTHER DIRECTOR ELECTED BY THE BOARD OF DIRECTORS. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE ARE SUBJECT TO RATIFICATION BY THE BOARD OF DIRECTORS. A MAJORITY OF THE MEMBERS OF THE EXECUTIVE COMMITTEE CONSTITUES A QUORUM TO TRANSACT BUSINESS, AND THE MAJORITY APPROVAL OF SUCH QUORUM ON ANY MATTER IS DEEMED VALID AND BINDING. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DIRECTOR OF FINANCE AND BUSINESS OPERATIONS REVIEWED THE FORM 990. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED THE FORM 990 AND UPON APPROVAL MADE A RECOMMENDATION TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL. THE BOARD OF DIRECTORS REVIEWED AND APPROVED THE FORM 990 BEFORE IT WAS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | PALOLO CHINESE HOME HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT WAS CREATED BY AND FOR DIRECTORS AND OFFICERS OF THE ORGANIZATION. IF IT IS UNCLEAR WHETHER A CONFLICT EXISTS, THE DETERMINATION IS MADE BY THE OFFICERS AND BOARD OF DIRECTORS. IF A CONFLICT EXISTS, THE DIRECTOR OR OFFICER ABSTAINS FROM VOTING ON THE MATTER. THE BOARD OF DIRECTORS HAS THE AUTHORITY TO REMOVE A BOARD MEMBER WHO KNOWINGLY AND INTENTIONALLY DOES NOT DISCLOSE A CONFLICT OF INTEREST. ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE REQUIRED TO BE COMPLETED AND SIGNED BY ALL DIRECTORS AND OFFICERS. |
| FORM 990, PART VI, SECTION B, LINE 15 | PALOLO CHINESE HOME REVIEWS ANNUAL COMPENSATION ADJUSTMENTS AT THE EXECUTIVE BOARD MEETING BY DISCUSSING APPROPRIATE COMPENSATION AMOUNTS IN LIGHT OF MARKET COMPARABLES. RECOMMENDATIONS ARE MADE TO THE BOARD OF DIRECTORS, WHO HAVE FINAL APPROVAL, AS WELL AS APPROVAL OVER ANY ADDITIONAL OR EXTRAORDINARY COMPENSATION. THIS PROCESS WAS LAST COMPLETED IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | PALOLO CHINESE HOME'S ORGANIZING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. PALOLO CHINESE HOME PUBLISHES AN ANNUAL REPORT CONTAINING FINANCIAL INFORMATION. THE ANNUAL REPORT IS AVAILABLE ON PALOLO CHINESE HOME'S WEBSITE. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES AND CONTRACT LABOR: PROGRAM SERVICE EXPENSES 4,116,248. MANAGEMENT AND GENERAL EXPENSES 377,416. FUNDRAISING EXPENSES 27,297. TOTAL EXPENSES 4,520,961. |
| FORM 990, PART XI, LINE 9: | ROUNDING ADJUSTMENT -5. |
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 | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| PCH MANAGEMENT LLC | |||||||||
| 2459 10TH AVENUE | HONOLULU | HI | 96816 | 461019166 | MANAGEMENT & CONSULTING | HI | $0 | $0 | PALOLO CHINESE HOME |
| PCH LANDHOLDING LLC | |||||||||
| 2459 10TH AVENUE | HONOLULU | HI | 96816 | 462398671 | REAL ESTATE HOLDING | HI | $0 | $0 | PALOLO CHINESE HOME |
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