Coulterville Care Inc: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: Coulterville Care Inc (EIN 36-4137587)
Tax period: 2013-01-01 to 2013-12-31
Filed: 2014-04-28
IRS object ID: 201421279349300917
Schema version: 2013v3.0
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
Form 990
Schedule A
Schedule D
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2014-04-28T19:21:42-07:00	ReturnTs
Tax Period End	2013-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	452838168	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Templin Healthcare Accounting Services LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 9	AddressLine1
City	Dunlap	City
State	IL	State
ZIP Code	61525	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	364137587	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Coulterville Care Inc	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	COUL	BusinessNameControlTxt
Phone	6184432395	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1101 North Market Street	AddressLine1
City	Sparta	City
State	IL	State
ZIP Code	62286	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Harold Joines	PersonNm
Person Title	Board President	PersonTitleTxt
Phone	6187582256	PhoneNum
Signature	2014-04-30	SignatureDt
Discuss With Paid Preparer	0	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Larry Templin	PreparerPersonNm
PTIN	P01696703	PTIN
Phone	6303612868	PhoneNum
Preparation	2014-04-30	PreparationDt

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Andrea McFadden	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	13138 State Route 13	AddressLine1
City	Coulterville	City
State	IL	State
ZIP Code	62237	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$5,133,986	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1995	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	Long Term Health Care Facility	ActivityOrMissionDesc
Voting Members Governing Body	4	VotingMembersGoverningBodyCnt
Voting Members Independent	3	VotingMembersIndependentCnt
Total Employee	138	TotalEmployeeCnt
Total Volunteers	20	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$4,889,948	PYProgramServiceRevenueAmt
CY Program Service Revenue	$5,125,906	CYProgramServiceRevenueAmt
PY Investment Income	$13,493	PYInvestmentIncomeAmt
CY Investment Income	$1,515	CYInvestmentIncomeAmt
PY Other Revenue	$3,646	PYOtherRevenueAmt
CY Other Revenue	$6,565	CYOtherRevenueAmt
PY Total Revenue	$4,907,087	PYTotalRevenueAmt
CY Total Revenue	$5,133,986	CYTotalRevenueAmt
PY Grants And Similar Paid	$3,025	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$413	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$2,170,777	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$2,362,624	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$3,056,946	PYOtherExpensesAmt
CY Other Expenses	$2,694,838	CYOtherExpensesAmt
PY Total Expenses	$5,230,748	PYTotalExpensesAmt
CY Total Expenses	$5,057,875	CYTotalExpensesAmt
PY Revenues Less Expenses	-$323,661	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$76,111	CYRevenuesLessExpensesAmt
Total Assets BOY	$4,297,408	TotalAssetsBOYAmt
Total Assets EOY	$5,292,426	TotalAssetsEOYAmt
Total Liabilities BOY	$3,895,726	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$4,814,633	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$401,682	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$477,793	NetAssetsOrFundBalancesEOYAmt
Mission	The mission of Coulterville Care Center is to create a caring and supportive environment for the people we serve and their families so that they are respected for their uniqueness and are encouraged to treat themselves and each other with kindness and respect.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$4,591,404	ExpenseAmt
Grant	$413	GrantAmt
Revenue	$5,133,986	RevenueAmt
Desc	Coulterville Care Inc was organized for religious charitable educational and scientific purposes. Specifically, the organization was organized to operate a 75 bed long term care health care fracility located in Coulterville Illinois. The facility consists of 75 skilled care beds.	Desc
Total Other Prog Srvc Expense	$0	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$0	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$0	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$4,591,404	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	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	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	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	0	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	Yes (1)	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	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	9	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	138	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
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	4	GoverningBodyVotingMembersCnt
Independent Voting Member	3	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	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Howell Business Solutions	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	6184432395	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1101 North Market Street	AddressLine1
City	Sparta	City
State	IL	State
ZIP Code	62286	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (5 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	Key EmployeeKeyEmployeeInd
Harold Joines
President	0.5	0	Yes (X)	Yes (X)	$0	$0	$0
Kenneth Curry
Secretary / Treasurer	0.5	0	Yes (X)	Yes (X)	$0	$0	$0
William Jarrett
Board Member	0.5	0	Yes (X)		$0	$0	$0
William Mueller
Board Member	0.5	0	Yes (X)		$0	$0	$0
Andrea McFadden
Executive Director	40	0		Yes (X)	$83,403	$0	$4,509	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$83,403	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$4,509	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

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt	Address Line2ContractorAddress/USAddress/AddressLine2
Select Rehabilitation
PO Box 809056	Chicago	IL	60680	Therapy	$567,435
Omnicare Inc
900 Omnicare Center	Cincinnati	OH	45202	Pharmacy	$191,918	201 East Fourth Street

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	2	CntrctRcvdGreaterThan100KCnt
Total Contributions	$0	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	Nursing Care Revenues	Desc
Business	623000	BusinessCd
Total Revenue Column	$5,125,906	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,125,906	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$5,125,906	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,515	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,515	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	Other Income	Desc
Business	900099	BusinessCd
Total Revenue Column	$6,565	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$6,565	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$6,565	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,133,986	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,125,906	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$8,080	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$413	TotalAmt
Program Services	$413	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$83,403	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$83,403	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,861,512	TotalAmt
Program Services	$1,734,337	ProgramServicesAmt
Management And General	$127,175	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$275,038	TotalAmt
Program Services	$245,259	ProgramServicesAmt
Management And General	$29,779	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$142,671	TotalAmt
Program Services	$127,224	ProgramServicesAmt
Management And General	$15,447	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$85,000	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$85,000	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$10,304	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$10,304	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$15,000	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$15,000	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$77,618	TotalAmt
Program Services	$77,618	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$12,786	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$12,786	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$60,131	TotalAmt
Program Services	$60,131	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$48,673	TotalAmt
Program Services	$48,673	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$224,587	TotalAmt
Program Services	$224,587	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$3,999	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$3,999	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$8,819	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$8,819	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$396,261	TotalAmt
Program Services	$396,261	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$251,454	TotalAmt
Program Services	$251,454	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$74,759	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$74,759	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Therapy Expense	$654,251	$654,251	$0	$0
Food	$205,784	$205,784	$0	$0
Bad Debts	$6,117	$6,117	$0	$0
Provider Assessment	$155,445	$155,445	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$403,850	TotalAmt
Program Services	$403,850	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,057,875	TotalAmt
Program Services	$4,591,404	ProgramServicesAmt
Management And General	$466,471	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,150	BOYAmt
EOY	$1,000	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$89,343	BOYAmt
EOY	$668,105	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$916,072	BOYAmt
EOY	$1,386,612	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$106,675	BOYAmt
EOY	$187,927	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$3,335,319	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$586,537	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,884,168	BOYAmt
EOY	$2,748,782	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$300,000	BOYAmt
EOY	$300,000	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,297,408	BOYAmt
EOY	$5,292,426	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$661,482	BOYAmt
EOY	$670,147	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$2,680	BOYAmt
EOY	$2,676	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$200,000	BOYAmt
EOY	$1,130,051	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,031,564	BOYAmt
EOY	$3,011,759	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,895,726	BOYAmt
EOY	$4,814,633	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$401,682	BOYAmt
EOY	$477,793	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$401,682	BOYAmt
EOY	$477,793	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,297,408	BOYAmt
EOY	$5,292,426	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$76,111	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$0	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
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

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,331,206	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,134,109	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,700,309	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,889,948	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,125,906	CurrentTaxYearAmt
Total	$23,181,478	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,331,206	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,134,109	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,700,309	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,889,948	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,125,906	CurrentTaxYearAmt
Total	$23,181,478	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$23,181,478	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,819	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,340	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$441	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$13,493	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,515	CurrentTaxYearAmt
Total	$23,608	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,819	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,340	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$441	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$13,493	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,515	CurrentTaxYearAmt
Total	$23,608	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$10,720	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$211,728	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,334	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$3,646	CurrentTaxYearMinus1YearAmt
Current Tax Year	$6,565	CurrentTaxYearAmt
Total	$234,993	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,345,745	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,350,177	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,703,084	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,907,087	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,133,986	CurrentTaxYearAmt
Total	$23,440,079	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.98897	PublicSupportCY509Pct
Public Support PY509	0.98802	PublicSupportPY509Pct
Investment Income CY	0.00101	InvestmentIncomeCYPct
Investment Income PY	0.00162	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part IV Form990ScheduleAPartIVGrp

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule A, Part III, Line 12	FormAndLineReferenceDesc
Explanation	Miscellaneous Income	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Book Value	$0	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$4,643	OtherCostOrOtherBasisAmt
Depreciation	$2,321	DepreciationAmt
Book Value	$2,322	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$87,416	OtherCostOrOtherBasisAmt
Depreciation	$24,275	DepreciationAmt
Book Value	$63,141	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$190,592	OtherCostOrOtherBasisAmt
Depreciation	$59,302	DepreciationAmt
Book Value	$131,290	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$3,052,668	OtherCostOrOtherBasisAmt
Depreciation	$500,639	DepreciationAmt
Book Value	$2,552,029	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,748,782	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

Field	Value	IRS element (for citing)
Desc	Lease Deposit	Desc
Book Value	$300,000	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$300,000	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Deferred Gain/Loss, net of amortization	$21,030
Capital Lease Obligation	$2,953,736
Due to IDPH	$31,056
Resident Funds	$5,937

Field	Value	IRS element (for citing)
Total Liability	$3,011,759	TotalLiabilityAmt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Linda Mueller
Spouse of William Mueller	$77,226	Director of Nursing Wages	0
Vanda Welty
Mother of Andrea McFadden	$27,301	CNA Wages	0
Donald McFadden
Husband of Andrea McFadden	$31,240	Employee Wages	0
Misty Hewitt
Family Member of Executive Director	$3,733	RN Wages	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11b	The draft Form 990 is reviewed by the financial consultant for accuracy and made available to the entire Board. The final Form 990 is mailed to the President of the Board for review and signature.
Form 990, Part VI, Section B, Line 12c	Every year, disclosure forms are sent to the Board Members and Coulterville Care Center's one key employee to ensure that they are in compliance with the written conflict of interest policy.
Form 990, Part VI, Section B, Line 15	Every year, the Organization's Board reviews data provided by a LTC association which provides comparative salary information. It also receives current competitive salary information from the local county nursing home. Based on this data, the Board annually revises and approves the salary of the Executive Director. No other officers or key employees are compensated.
Form 990, Part VI, Section C, Line 19	The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.