2015-02-13T10:12:40-06:00 2014-06-30 420732909 RYUN GIVENS & COMPANY PLC 2900 100TH STREET SUITE 301 URBANDALE IA 50322 990 2013-07-01 421308032 ON WITH LIFE INC ONWI 5159651339 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 JULIE FIDLER DIXON EXECUTIVE DIRECTOR 5159651339 2015-02-11 1 CURTIS E BRAND CPA P00299230 5152253141 2013 2016-02-25 16:41:14Z JULIE FIDLER DIXON 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 8560873 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 16 197 100 0 0 47550 52600 7951585 8421021 80202 87252 0 0 8079337 8560873 0 0 0 0 5695116 6103667 0 0 0 1911962 2089806 7607078 8193473 472259 367400 8543742 9099149 3190677 2953173 5353065 6145976 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 5516312 8421021 FUNCTIONAL EXPENSES WERE INCURRED IN PROVIDING 7,651 DAYS OF SPECIALIZED CARE AND REHABILITATION SERVICES TO INDIVIDUALS WHO HAVE SUSTAINED A TRAUMATIC BRAIN INJURY OR OTHER NEUROLOGICAL DISABILITY. 5516312 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 49 0 1 197 1 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 MIKKI STIER 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 JULIE FIDLER DIXON EXECUTIVE DIRECTOR 40.00 X 133377 0 10520 JAMES FOREMAN CHIEF FINANCIAL OFFICER 40.00 X 0 0 0 DAVID DEMAREST NEUROPSYCHOLOGIST 40.00 X 116343 0 7820 249720 0 18340 2 0 0 0 0 52600 52600 PATIENT SERVICES 623000 4371650 4371650 MEDICARE/MEDICAID PAYM 623000 3976405 3976405 DIETARY/COBRA/MISC 900099 72966 72966 8421021 75812 75812 11440 0 11440 11440 11440 8560873 8421021 0 87252 355346 355346 4755788 3753817 1001971 159662 113996 45666 445313 294532 150781 387558 287105 100453 19963 19963 28936 11626 17310 37085 345 36740 129735 129735 5604 5604 176573 27392 149181 89738 63227 26511 50978 24051 26927 142853 142853 294566 294566 7608 7608 SUPPLIES 288188 288188 SERVICE FEES 242558 242558 EQUIPMENT RENTAL & MAIN 114776 114776 FOOD AND DIETARY 108035 108035 352610 186664 165946 8193473 5516312 2677161 0 1206 1205 889898 774669 1237282 1315760 35800 34100 638 7331 6011752 3403481 2739784 2608271 12401 13963 2233841 2462824 1392892 1881026 8543742 9099149 502958 1033031 2110000 1910000 577719 10142 3190677 2953173 X 5353065 6145976 5353065 6145976 8543742 9099149 X 367400 45361 380150 X 0 1 X 1 0 X 13131 24000 45329 47550 52600 182610 7064004 7555710 7556704 7880368 8421021 38477807 96676 89959 64283 64111 315029 7173811 7669669 7666316 7992029 8473621 38975446 0 0 0 38975446 76933 81691 69427 80063 75812 383926 76933 81691 69427 80063 75812 383926 7250744 7751360 7735743 8072092 8549433 39359372 0.99020 0.98920 0.00980 0.01080 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 4000 0 1 953 4953 0 PART II-B, LINE 1: (G) PAYMENTS TO PROFESSIONAL FIRM TO LOBBY ON BEHALF OF THE ORGANIZATION; (I) PORTION OF DUES TO INDUSTRY ASSOCIATION ALLOCATED TO LOBBYING ACTIVITIES 154240 154240 4422866 2507508 1915358 751120 441362 309758 683526 454611 228915 2608271 VANGUARD GROUP - GNMA 812809 F VANGUARD GROUP - SHORT TERM 1314706 F VANGUARD - INFLATION PRO 141108 F VANGUARD - INFL. P ALLOW -4426 F VANGUARD- GNMA ALLOWANCE UNREALIZED -24554 F VANGUARD - SHORT TERM ALLOWANCE UNR 44565 F VANGUARD - HY ADMIRAL 175671 F VANGUARD - HY ADMIRAL ALLOW 2945 F 2462824 DUE FROM COMMUNITY SERVICES 545274 DUE FROM GLENWOOD 38213 LOAN TO GLENWOOD 519226 DUE FROM CORPORATE 15000 DEBT SERVICE RESERVE FUND 171639 SERIES A BOND FUND 222343 SERIES B BOND-OLD PROJECT FUND 13136 BOND ISSUANCE COSTS 114326 BOND ISSUANCE COSTS-AMORTIZED -75634 PROJECT FUND 23907 CONSTRUCTION IN PROGRESS 293596 1881026 DUE TO CORPORATE 10142 10142 X 8594794 45361 45361 8549433 11440 11440 8560873 7801883 -391590 -391590 8193473 0 8193473 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. THE ORGANIZATION'S FEDERAL RETURNS OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) FOR 2010, 2011 AND 2012 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF ASSET 11,440. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON SALE OF ASSET -11,440. INTERCOMPANY CORPORATE ALLOCATION -380,150. A CITY OF ANKENY IOWA - SERIES 2004A 426004235 035362AZ5 2004-07-29 2840000 REFUNDING SERIES 1994 BONDS 0 0 0 B CITY OF ANKENY IOWA - SERIES 2004B 426004235 035362AY8 2004-07-29 600000 EXPANDING AND MAKING IMPROVEMENTS ON HEALTH CARE FACILITY 0 0 0 A 1330000 2840000 169732 2616312 53956 2004 0 1 1 1 B 600000 13132 600000 2004 0 0 1 1 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 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 REVIEW 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 380,150. 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 52600 ACTUAL ON WITH LIFE EXTENDED SERVICES LTD D 279058 ACTUAL ON WITH LIFE FOUNDATION N 75504 ACTUAL ON WITH LIFE FOUNDATION & EXTENDED SERVICES LTD P 489341 ACTUAL ON WITH LIFE SUPPORTIVE HOUSING CORPORATION L ACTUAL