2016-04-01T18:21:33-05:00 2015-06-30 420732909 RYUN GIVENS & COMPANY PLC 2900 100TH STREET SUITE 301 URBANDALE IA 50322 990 2014-07-01 421308032 ON WITH LIFE INC ONWI 5159651339 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 JULIE FIDLER DIXON EXECUTIVE DIRECTOR 5159651339 2016-03-29 1 CURTIS E BRAND CPA P00299230 5152253141 2014 2016-08-17 19:52:53Z JULIE FIDLER DIXON 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 9394008 0 X ON-WITH-LIFE.ORG X 1987 IA JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. 16 16 210 211 0 0 52600 1025823 8421021 8297513 87252 70672 0 0 8560873 9394008 0 0 0 0 6103667 6455729 0 0 0 2089806 1929190 8193473 8384919 367400 1009089 9099149 10968463 2953173 3400183 6145976 7568280 X JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. WE PROVIDE COMPREHENSIVE IN-PATIENT AND COMMUNITY-BASED REHABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES, AND THEIR FAMILIES, AND PROVIDE EDUCATION REGARDING THE PREVENTION OF BRAIN INJURIES. 0 0 5626473 8297513 FUNCTIONAL EXPENSES WERE INCURRED IN PROVIDING 8,238 DAYS OF SPECIALIZED CARE AND REHABILITATION SERVICES TO INDIVIDUALS WHO HAVE SUSTAINED AN ACQUIRED TRAUMATIC BRAIN INJURY OR OTHER NEUROLOGICAL DISABILITY. 5626473 1 1 0 1 0 0 0 0 0 0 1 1 0 1 0 1 0 1 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 0 0 0 1 51 0 1 210 1 0 0 0 0 0 0 0 0 0 0 0 X 16 16 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X JULIE FIDLER DIXON 5159651339 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 CARL HARRIS PRESIDENT 0.60 X X 0 0 0 JANET PHIPPS BURKHEAD VICE PRESIDENT 0.60 X X 0 0 0 KATE BENSON LARSON SECRETARY 0.60 X X 0 0 0 DONNA WALTER TREASURER 0.60 X X 0 0 0 GAIL BOLIVER DIRECTOR 0.60 X 0 0 0 THOMAS CARLSTROM DIRECTOR 0.60 X 0 0 0 TROY DEJOODE DIRECTOR 0.60 X 0 0 0 ARTHUR FILEAN DIRECTOR 0.60 X 0 0 0 THOMAS FRIEDMAN DIRECTOR 0.60 X 0 0 0 MARC HARDING DIRECTOR 0.60 X 0 0 0 JEFFREY LAMBERTI DIRECTOR 0.60 X 0 0 0 KAM STUPKA DIRECTOR 0.60 X 0 0 0 VILIA TARVYDAS DIRECTOR 0.60 X 0 0 0 ELI WIRTZ DIRECTOR 0.60 X 0 0 0 DAVID ZIELKE DIRECTOR 0.60 X 0 0 0 TRACY BOLLIN DIRECTOR 0.60 X 0 0 0 JULIE FIDLER DIXON EXECUTIVE DIRECTOR 40.00 X 151881 0 22357 JAMES FOREMAN CHIEF FINANCIAL OFFICER 40.00 X 78690 0 27198 DAVID DEMAREST NEUROPSYCHOLOGIST 40.00 X 121566 0 11506 352137 0 61061 2 0 1 0 STORY CONSTRUCTION 300 SOUTH BELL AVE AMES IA 50010 CONSTRUCTION 3248312 1 1025796 27 1025823 MEDICARE/MEDICAID PAYM 623000 4762923 4762923 PATIENT SERVICES 623000 3461453 3461453 DIETARY/COBRA/MISC 900099 73137 73137 8297513 70672 70672 9394008 8297513 0 70672 230571 230571 5175138 3966639 1208499 176470 110629 65841 464195 312078 152117 409355 304357 104998 17951 470 17481 31981 10622 21359 26776 6641 20135 109083 109083 26841 26841 171137 26705 144432 98912 68787 30125 59451 30646 28805 69199 69199 314526 314526 7728 7728 SUPPLIES 253309 253309 SERVICE FEES 182614 182614 FOOD AND DIETARY 108358 108358 EQUIPMENT RENTAL & MAIN 94181 94181 357143 150437 206706 8384919 5626473 2758446 0 1205 1005 774669 424931 1315760 1596944 34100 29900 7331 638 6177732 3705105 2608271 2472627 13963 19584 2462824 1650259 1881026 4772575 9099149 10968463 1033031 1376762 1910000 2023421 10142 0 2953173 3400183 X 6145976 7568280 6145976 7568280 9099149 10968463 X 1009089 -21460 434675 X 0 1 X 1 0 X 24000 45329 47550 52600 1025823 1195302 7555710 7556704 7880368 8421021 8297513 39711316 89959 64283 64111 218353 7669669 7666316 7992029 8473621 9323336 41124971 0 0 0 41124971 81691 69427 80063 75812 70672 377665 81691 69427 80063 75812 70672 377665 7751360 7735743 8072092 8549433 9394008 41502636 0.99090 0.99020 0.00910 0.00980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 15025 0 0 15025 0 PART II-B, LINE 1: (G) PAYMENTS TO PROFESSIONAL FIRM TO LOBBY ON BEHALF OF THE ORGANIZATION. THE FIRM MONITORS THE STATE LEGISLATIVE PROCESS ANNUALLY FOR ITEMS THAT MIGHT DIRECTLY OR INDIRECTLY IMPACT FIRM OPERATIONS. 154240 154240 4422866 2683830 1739036 836242 523020 313222 764384 498255 266129 2472627 VANGUARD GROUP - GNMA 425913 F VANGUARD GROUP - SHORT TERM 1216129 F VANGUARD - INFLATION PRO 8546 F VANGUARD - INFL. P ALLOW -8546 F VANGUARD- GNMA ALLOWANCE UNREALIZED -26700 F VANGUARD - SHORT TERM ALLOWANCE UNR 30463 F VANGUARD - PRIME MMKT 4454 F 1650259 DUE FROM COMMUNITY SERVICES 684065 DUE FROM GLENWOOD 224705 LOAN TO GLENWOOD 75987 CONSTRUCTION IN PROGRESS 3787818 4772575 X 9372548 -21460 -21460 9394008 0 9394008 7950244 -434675 -434675 8384919 0 8384919 PART X, LINE 2: THE ORGANIZATION HAS ADOPTED THE ACCOUNTING STANDARD REGARDING "ACCOUNTING FOR UNCERTAIN TAX POSITIONS." THIS STANDARD PROVIDES DETAILED GUIDANCE FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, AND DISCLOSURE OF UNCERTAIN TAX POSITIONS RECOGNIZED IN THE ENTITY'S FINANCIAL STATEMENTS. IT REQUIRES AN ENTITY TO RECOGNIZE THE FINANCIAL STATEMENT BENEFIT OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THE ADOPTION OF THIS STANDARD HAD NO MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOW. PART XII, LINE 2D - OTHER ADJUSTMENTS: INTERCOMPANY CORPORATE ALLOCATION -434,675. X X X 0 0 0 0 0 0 0 0 0 JULIE FIDLER DIXON EXECUTIVE DIRECTOR 146381 0 5500 0 0 0 6359 0 15998 0 174238 0 0 0 PART I, LINE 3 WAGES ARE COMPARED TO SALARIES PUBLISHED IN BUSINESS RECORD FOR SIMILAR POSITIONS. THE BOARD ALSO USES WAGE SURVEYS FROM IOWA WORKFORCE, IOWA HEALTH CARE ASSOCIATION, AND SIMILAR ASSOCIATIONS. THE EXECUTIVE COMMITTEE COMPLETES PERFORMANCE REVIEW REVIEWS AND THE FULL BOARD VOTES ON THE EXECUTIVE DIRECTOR'S SALARY. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP BETWEEN JULIE FIDLER DIXON AND BOARD MEMBERS OF ON WITH LIFE, INC. WHO ARE ALSO BOARD MEMBERS OF RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 11 AN ELECTRONIC COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. ANY QUESTIONS AND CLARIFICATIONS ARE DIRECTED TO THE FINANCE COMMITTEE CHAIR. FORM 990, PART VI, SECTION B, LINE 12C EVERY BOARD MEETING BEGINS WITH A REVIEW OF THE AGENDA ITEMS, AND DIRECTORS ARE PROMPTED TO DISCLOSE ANY CONFLICTS OF INTEREST RELATED TO THOSE ITEMS. FORM 990, PART VI, SECTION B, LINE 15A WAGES ARE COMPARED TO SALARIES PUBLISHED IN BUSINESS RECORD FOR SIMILAR POSITIONS. THE BOARD ALSO USES WAGE SURVEYS FROM IOWA WORKFORCE, IOWA HEALTH CARE ASSOCIATION, AND SIMILAR ASSOCIATIONS. THE EXECUTIVE COMMITTEE COMPLETES PERFORMANCE REVIEWS AND THE FULL BOARD VOTES ON THE EXECUTIVE DIRECTOR'S SALARY. FORM 990, PART VI, SECTION C, LINE 19 ARTICLES OF INCORPORATION ARE PUBLISHED ON THE SECRETARY OF STATE WEBSITE. THE BYLAWS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. THE CONSOLIDATED FINANCIAL STATEMENT SUMMARY INCLUDED IN THE ANNUAL REPORT IS ON THE ORGANIZATION'S WEBSITE, AND FORM 990 IS AVAILABLE ON GUIDESTAR. FORM 990, PART XI, LINE 9: INTERCOMPANY CORPORATE ALLOCATION 434,675. ON WITH LIFE EXTENDED SERVICES LTD 715 SW ANKENY RD ANKENY IA 50023 421521198 PROVIDE SKILLED CARE AND REHAB SERVICES FOR INDIVIDUALS WITH BRAIN INJURIES IA 501(C)(3) 9 0 ON WITH LIFE FOUNDATION 715 SW ANKENY RD ANKENY IA 50023 421399777 TO SUPPORT ON WITH LIFE, INC. AND ON WITH LIFE EXTENDED SERVICES, LTD. IA 501(C)(3) 11B 0 ON WITH LIFE SUPPORTIVE HOUSING CORPORATION 715 SW ANKENY RD ANKENY IA 50023 460516882 SUBSIDIZED HOUSING FOR INDIVIDUALS WHO HAVE EXPERIENCED A BRAIN INJURY IA 501(C)(3) 9 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 ON WITH LIFE FOUNDATION C 1025796 ACTUAL ON WITH LIFE EXTENDED SERVICES LTD D 434235 ACTUAL ON WITH LIFE FOUNDATION O 67694 ACTUAL ON WITH LIFE FOUNDATION Q 2400 ACTUAL ON WITH LIFE SUPPORTIVE HOUSING L 7210 ACTUAL ON WITH LIFE EXTENDED SERVICES LTD Q 541328 ACTUAL ON WITH LIFE SUPPORTIVE HOUSING Q 13163 ACTUAL