BETA

MAPLE CITY HEALTH CARE CENTER INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
MAPLE CITY HEALTH CARE CENTER INC (EIN 35-1749398)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-06-23
IRS object ID
201511749349301001
Schema version
2014v5.0
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

FieldValueIRS element (for citing)
Return2015-06-23T14:00:32-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351794199PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WEIDNER AND COMPANY PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11650 SOUTH BEND AVEAddressLine1Txt
CitySOUTH BENDCityNm
State AbbreviationINStateAbbreviationCd
ZIP46617ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351749398EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAPLE CITY HEALTH CARE CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMAPLBusinessNameControlTxt
Phone5745343300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1213 MIDDLEBURY STREETAddressLine1Txt
CityGOSHENCityNm
State AbbreviationINStateAbbreviationCd
ZIP465282956ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKAREN MILLER RUSHPersonNm
Person TitleOFFICERPersonTitleTxt
Phone5745343300PhoneNum
Signature2015-06-23SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN A FREDLAKE CPAPreparerPersonNm
PTINP00071521PTIN
Phone5742348822PhoneNum
Preparation2015-05-14PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKAREN MILLER RUSHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1213 MIDDLEBURY STREETAddressLine1Txt
CityGOSHENCityNm
State AbbreviationINStateAbbreviationCd
ZIP465282956ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,978,169GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MCHCC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1988FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionHEALTH CARE SERVICES; PROVIDES NEIGHBORHOOD PATIENTS WITH MEDICAL, COUNSELING, EDUCATIONAL, AND SOCIAL SERVICES THROUGH THE HEALTH CARE CENTER, IMPROVING THEIR PRACTICAL LIVES.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee50TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,513,013PYContributionsGrantsAmt
CY Contributions Grants$1,591,914CYContributionsGrantsAmt
PY Program Service Revenue$1,296,819PYProgramServiceRevenueAmt
CY Program Service Revenue$1,379,176CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income-$3,896CYInvestmentIncomeAmt
PY Other Revenue$4,703PYOtherRevenueAmt
CY Other Revenue$175CYOtherRevenueAmt
PY Total Revenue$4,814,535PYTotalRevenueAmt
CY Total Revenue$2,967,369CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,732,931PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,114,412CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$29,891CYTotalFundraisingExpenseAmt
PY Other Expenses$941,257PYOtherExpensesAmt
CY Other Expenses$971,484CYOtherExpensesAmt
PY Total Expenses$2,674,188PYTotalExpensesAmt
CY Total Expenses$3,085,896CYTotalExpensesAmt
PY Revenues Less Expenses$2,140,347PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$118,527CYRevenuesLessExpensesAmt
Total Assets BOY$3,533,305TotalAssetsBOYAmt
Total Assets EOY$3,462,430TotalAssetsEOYAmt
Total Liabilities BOY$168,541TotalLiabilitiesBOYAmt
Total Liabilities EOY$216,193TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,364,764NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,246,237NetAssetsOrFundBalancesEOYAmt
MissionHEALTH CARE SERVICES; PROVIDES NEIGHBORHOOD PATIENTS WITH MEDICAL, COUNSELING, EDUCATIONAL, AND SOCIAL SERVICES THROUGH THE HEALTH CARE CENTER, IMPROVING THEIR PRACTICAL LIVES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,764,395ExpenseAmt
Revenue$1,379,351RevenueAmt
DescVISITS BY PATIENTS WITH MEDICAL, COUNSELING, EDUCATIONAL, AND SOCIAL SERVICES THROUGH THE HEALTH CARE CENTER, IMPROVING THEIR PRACTICAL LIVES.Desc
Total Program Service Expenses$2,764,395TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee50EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KAREN MILLER RUSHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5745343300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1213 MIDDLEBURY STREETAddressLine1Txt
CityGOSHENCityNm
State AbbreviationINStateAbbreviationCd
ZIP465282956ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MAX MERTZ
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
JOHN DRIVER
BOARD MEMBER1.00Yes (X)$0$0$0
KEVIN FARMWALD
BOARD MEMBER1.00Yes (X)$0$0$0
JENNIFER HIRE
BOARD MEMBER1.00Yes (X)$0$0$0
DENISE METTERT
BOARD MEMBER1.00Yes (X)$0$0$0
MIGUEL MILLAN
BOARD MEMBER1.00Yes (X)$0$0$0
ADRIANA ORTIZ
BOARD MEMBER1.00Yes (X)$0$0$0
JAMES NELSON GINGERICH
EXECUTIVE DIRECTOR60.00Yes (X)Yes (X)$134,323$0$3,200
RACHEL MILLER-JACOBS
BOARD MEMBER1.00Yes (X)$0$0$0
SARAH METZLER
BOARD MEMBER1.00Yes (X)$0$0$0
ROSE GILLIN
DIRECTOR OF CLINICAL CARE40.00Yes (X)$114,351$0$8,100
FieldValueIRS element (for citing)
Total Reportable Comp From Org$248,674TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$11,300TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CLUBHOUSE OF ELKHART CO
114 S FIFTH STGOSHENIN46528MENTAL HEALTH SERVICES$200,000
ABG DENTAL
622 W LINCOLNGOSHENIN46526DENTAL SERVICES$170,998
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$1,395,647GovernmentGrantsAmt
All Other Contributions$196,267AllOtherContributionsAmt
Noncash Contributions$96,794NoncashContributionsAmt
Total Contributions$1,591,914TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM SERVICESDesc
Business621400BusinessCd
Total Revenue Column$1,379,176TotalRevenueColumnAmt
Related Or Exempt Func Income$1,379,176RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,379,176TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,904TotalRevenueColumnAmt
Exclusion$6,904ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$10,800OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$10,800OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$10,800TotalRevenueColumnAmt
Related Or Exempt Func Income-$10,800RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$175TotalRevenueColumnAmt
Related Or Exempt Func Income$175RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$175OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,967,369TotalRevenueColumnAmt
Related Or Exempt Func Income$1,368,551RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$6,904ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$307,164TotalAmt
Program Services$279,519ProgramServicesAmt
Management And General$24,573ManagementAndGeneralAmt
Fundraising$3,072FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,231,475TotalAmt
Program Services$1,120,642ProgramServicesAmt
Management And General$98,518ManagementAndGeneralAmt
Fundraising$12,315FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$99,785TotalAmt
Program Services$90,804ProgramServicesAmt
Management And General$7,983ManagementAndGeneralAmt
Fundraising$998FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$356,116TotalAmt
Program Services$324,066ProgramServicesAmt
Management And General$28,489ManagementAndGeneralAmt
Fundraising$3,561FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$119,872TotalAmt
Program Services$109,083ProgramServicesAmt
Management And General$9,590ManagementAndGeneralAmt
Fundraising$1,199FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$32,171TotalAmt
Program Services$27,345ProgramServicesAmt
Management And General$4,504ManagementAndGeneralAmt
Fundraising$322FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$28,225TotalAmt
Program Services$23,991ProgramServicesAmt
Management And General$3,952ManagementAndGeneralAmt
Fundraising$282FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$27,341TotalAmt
Program Services$23,240ProgramServicesAmt
Management And General$3,828ManagementAndGeneralAmt
Fundraising$273FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$31,238TotalAmt
Program Services$26,553ProgramServicesAmt
Management And General$4,373ManagementAndGeneralAmt
Fundraising$312FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$37,564TotalAmt
Program Services$31,929ProgramServicesAmt
Management And General$5,259ManagementAndGeneralAmt
Fundraising$376FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$511,488$434,765$71,608$5,115
VACCINATIONS$96,795$96,795
COMPUTER$70,115$59,598$9,816$701
PROFESSIONAL SERVICES$64,129$54,510$8,978$641

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$72,418TotalAmt
Program Services$61,555ProgramServicesAmt
Management And General$10,139ManagementAndGeneralAmt
Fundraising$724FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,085,896TotalAmt
Program Services$2,764,395ProgramServicesAmt
Management And General$291,610ManagementAndGeneralAmt
Fundraising$29,891FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$498,708BOYAmt
EOY$351,717EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$199,401BOYAmt
EOY$199,700EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$257,228BOYAmt
EOY$223,990EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$231,432BOYAmt
EOY$227,630EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$23,523BOYAmt
EOY$29,118EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,001,093LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$339,746LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$595,910BOYAmt
EOY$661,347EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,727,103BOYAmt
EOY$1,768,928EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,533,305BOYAmt
EOY$3,462,430EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$168,541BOYAmt
EOY$216,193EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$168,541BOYAmt
EOY$216,193EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,373,260BOYAmt
EOY$1,262,609EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,991,504BOYAmt
EOY$1,983,628EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,364,764BOYAmt
EOY$3,246,237EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,533,305BOYAmt
EOY$3,462,430EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$118,527ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$183,004OtherCostOrOtherBasisAmt
Book Value$183,004BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$174,786OtherCostOrOtherBasisAmt
Depreciation$46,056DepreciationAmt
Book Value$128,730BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$576,282OtherCostOrOtherBasisAmt
Depreciation$254,918DepreciationAmt
Book Value$321,364BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$67,021OtherCostOrOtherBasisAmt
Depreciation$38,772DepreciationAmt
Book Value$28,249BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$661,347TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescCONTRIBUTED RENT RECEIVABLEDesc
Book Value$1,768,928BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,768,928TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$3,006,529TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$39,160DonatedServicesAndUseFcltsAmt
Revenue Not Reported$39,160RevenueNotReportedAmt
Revenue Subtotal$2,967,369RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,967,369TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,125,056TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$39,160DonatedServicesUseFcltsAmt
Expenses Not Reported$39,160ExpensesNotReportedAmt
Expenses Subtotal$3,085,896ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,085,896TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION'S POLICY IS TO RECORD AN UNRECOGNIZED TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES. INTEREST AND PENALTIES RELATED TO GROSS UNRECOGNIZED TAX BENEFITS WOULD BE INCLUDED WITHIN THE PROVISION FOR INCOME TAXES. TO THE EXTENT ACCRUED INTEREST AND PENALTIES DO NOT ULTIMATELY BECOME PAYABLE, AMOUNTS ACCRUED WOULD BE REDUCED IN THE PERIOD THAT SUCH DETERMINATION IS MADE AND REFLECTED AS A REDUCTION OF THE OVERALL INCOME TAX PROVISION. THE ORGANIZATION FILES A FEDERAL AND AN INDIANA STATE INCOME TAX RETURN. THE TAX YEARS THAT REMAIN SUBJECT TO EXAMINATION BY THE FEDERAL AND INDIANA TAX JURISDICTIONS DATE BACK TO THE YEAR ENDED DECEMBER 31, 2011.ExplanationTxt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$96,794NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS MEMBERS OR STOCKHOLDERS
FORM 990, PART VI, SECTION A, LINE 7AMEMBERS ON THE BOARD OF DIRECTORS APPOINT NEW MEMBERS OF THE BOARD AFTER A CONSULTATION PROCESS.
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF THE FORM 990 IS EMAILED TO BOARD MEMBERS BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12CBOARD OF DIRECTORS REVIEWS CONFLICTS OF INTEREST ANNUALLY AT THE TIME OF ANNUAL BOARD ELECTIONS. STAFF IS MADE AWARE OF THE POLICY AND IN RELEVANT SITUATIONS, THE POLICY IS REVIEWED.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION HAS A POINT SYSTEM TO DETERMINE SALARY LEVELS FOR ALL STAFF INCLUDING ALL MANAGEMENT PERSONNEL. THE POINT SYSTEM IS BASED ON: * EDUCATION, EXPERIENCE, LANGUAGE ABILITY, RESPONSIBILITY LEVEL, AND WHETHER OR NOT THEY HAVE CALL RESPONSIBILITIES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.