HIGHLAND HEALTH SYSTEM INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HIGHLAND HEALTH SYSTEM INC (EIN 62-1486857)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-10
IRS object ID
201321309349303157
Schema version
2011v1.5
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)
Timestamp2013-05-10T16:16:03-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHNREZNICK LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 EAST PRATT STREET SUITE 200AddressLine1
CityBALTIMORECity
StateMDState
ZIP Code212023100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN621486857EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HIGHLAND HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN GILLMORInCareOfName
Name ControlHIGHNameControl
Phone6152522305Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 DIVISION STREET Suite 700AddressLine1
CityNASHVILLECity
StateTNState
ZIP Code37203ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN GILMORName
TitleOFFICERTitle
Date Signed2013-05-10DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePHILIP H CORNBLATT CPAName
Phone4107834900Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN GILLMORNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11600 Division St Suite 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
Gross Receipts8269772GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number5138GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION WAS FORMED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLYActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees107TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8485272ProgramServiceRevenuePriorYear
Program Service Revenue CY7887620ProgramServiceRevenueCY
Investment Income Prior Year336737InvestmentIncomePriorYear
Investment Income Current Year153449InvestmentIncomeCurrentYear
Other Revenue Prior Year211199OtherRevenuePriorYear
Other Revenue Current Year228703OtherRevenueCurrentYear
Total Revenue Prior Year9033208TotalRevenuePriorYear
Total Revenue Current Year8269772TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4517047SalariesEtcPriorYear
Salaries Etc Current Year4368420SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4473225OtherExpensePriorYear
Other Expenses Current Year4668891OtherExpensesCurrentYear
Total Expenses Prior Year8990272TotalExpensesPriorYear
Total Expenses Current Year9037311TotalExpensesCurrentYear
Revenues Less Expenses Prior Year42936RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-767539RevenuesLessExpensesCY
Total Assets BOY7620141TotalAssetsBOY
Total Assets EOY7182856TotalAssetsEOY
Total Liabilities BOY7955714TotalLiabilitiesBOY
Total Liabilities EOY8286010TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-335573NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1103154NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION WAS FORMED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense8798105Expense
Revenue7887620Revenue
DescriptionOPERATED A 97 BED INTERMEDIATE AND SKILLED-CARE NURSING FACILITY FOR THE CARE OF ELDERLY PATIENTS.Description
Total Program Service Expense8798105TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees107NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN GILLMORNamePerson
Telephone Number6152522305TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11600 DIVISION ST SUITE 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
BRUCE P HUTSON
PRESIDENT0.6XX0555000
STEPHEN F WOOD SR
CEO/VP/TREASURER5.0XX244000
JOHN G FOOS
VP/TREASURER0.1XX55500
JOHN GILLMOR
VP/SECRETARY0.4XX70878
DOUGLASS SMITH
DIRECTOR0.1X
JO ANN CORBITT
DIRECTOR0.1X
STEPHEN F WOOD JR
DIRECTOR0.1X
CYNTHIA WOOD
ASSISTANT SECRETARY0.48X21000
LEWIS F WOOD JR
former CEO548713X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs995591TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
GENESIS ELDERCARE NETWORK SERVICES
101 EAST STATE STREETKENNETT SQUAREPA19348MANAGEMENT4231610
GENESIS REHABILITATION SERVICES
PO Box 7247-6524PHILADELPHIAPA19170REHAB SERVICES630473
MEDLINE INDUSTRIES INC
Po Box 382075PITTSBURGHPA15251NURSING SUPPLIES122743
OMNICARE
PO Box 715276COLUMBUSOH43271PHARMACEUTICALS249007
US FOOD SERVICE WEST VIRGINIA
PO Box 644540PITTSBURGHPA15264FOOD & DIETARY154420
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICEDescription
Business Code623000BusinessCode
Total Revenue Column7887620TotalRevenueColumn
Related Or Exempt Function Income7887620RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7887620TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column153449TotalRevenueColumn
Exclusion$153,449ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISC. REVENUE9000993553735537
HOOSIER CARE INVESTMENTS, LLC - OTHER INCOME900099193166193166
FieldValueIRS element (for citing)
Total Other Revenue228703TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column8269772TotalRevenueColumn
Related Or Exempt Function Income8116323RelatedOrExemptFunctionIncome
Exclusion$153,449ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4368420Total
Program Services4368420ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total413524Total
Program Services413524ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total77324Total
Program Services77324ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total17850Total
Program Services0ProgramServices
Management And General17850ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total85856Total
Program Services85856ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total557296Total
Program Services557296ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total308355Total
Program Services308355ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total172273Total
Program Services172273ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
CONTRACT SERVICES79580579580500
SUPPLIES AND OTHER EXPENSES77487277487200
BAD DEBT13151213151200
HOOSIER CARE INVESTMENTS, LLC22135602213560

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1112868Total
Program Services1112868ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total9037311Total
Program Services8798105ProgramServices
Management And General239206ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY780005BOY
EOY180801EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1864191BOY
EOY1997243EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY872829BOY
EOY1049098EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY36496BOY
EOY34992EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY49985BOY
EOY44234EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8672571LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5752619LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3156076BOY
EOY2919952EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY860559BOY
EOY956536EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7620141BOY
EOY7182856EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2006717BOY
EOY2579620EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY29898BOY
EOY51266EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5146935BOY
EOY4858091EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY772164BOY
EOY772164EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY24869EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7955714BOY
EOY8286010EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-335573BOY
EOY-1103154EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-335573BOY
EOY-1103154EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7620141BOY
EOY7182856EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-767539ReconcilationRevenueExpenses
Reconcilation Other Changes-42ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8987050CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8422135CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8690594CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8485272CurrentTaxYearMinus1Year
Current Tax Year7887620CurrentTaxYear
Total42472671Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8987050CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8422135CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8690594CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8485272CurrentTaxYearMinus1Year
Current Tax Year7887620CurrentTaxYear
Total42472671Total
FieldValueIRS element (for citing)
Public Support Total50942472671PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years57181CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years82601CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years101423CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year127651CurrentTaxYearMinus1Year
Current Tax Year153449CurrentTaxYear
Total522305Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years57181CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years82601CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years101423CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year127651CurrentTaxYearMinus1Year
Current Tax Year153449CurrentTaxYear
Total522305Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years214491CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years111328CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years143181CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year211199CurrentTaxYearMinus1Year
Current Tax Year228703CurrentTaxYear
Total908902Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9258722CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8616064CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8935198CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8824122CurrentTaxYearMinus1Year
Current Tax Year8269772CurrentTaxYear
Total43903878Total
FieldValueIRS element (for citing)
Public Support Percentage5090.96740PublicSupportPercentage509
Prior Year Support Percentage0.97144PriorYearSupportPercentage
Investment Income Percentage0.01190InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00890PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis81548OtherCostOrOtherBasis
Book Value81548BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6912326OtherCostOrOtherBasis
Depreciation4370022Depreciation
Book Value2542304BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1487956OtherCostOrOtherBasis
Depreciation1220201Depreciation
Book Value267755BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis190741OtherCostOrOtherBasis
Depreciation162396Depreciation
Book Value28345BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2919952TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM THIRD PARTY PAYOR424
FINANCING FEES, NET OF AMORT102632
INVESTMENTS, LLC851256
DUE FROM AFFILIATE1462
OTHER ASSETS762
FieldValueIRS element (for citing)
Total Book Value Other Assets956536TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO THIRD PARTYDescription
Amount$24,869Amount
FieldValueIRS element (for citing)
Total Of Amounts24869TotalOfAmounts
Total Revenue8269772TotalRevenue
Total Expenses9037311TotalExpenses
Excess Or Deficit For Year-767539ExcessOrDeficitForYear
Other$23,212OtherAmount
Total Adjustments23212TotalAdjustments
Excess Or Deficit Per FS-744327ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt8071628TotRevenueEtcAuditedFinclStmt
Revenue Subtotal8071628RevenueSubtotal
Other Revenues Not Included198144OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt198144RevenueNotRptdOnFinStmt
Total Revenue Per Form9908269772TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt8815955TotExpensesEtcAuditedFinclStmt
Expenses Subtotal8815955ExpensesSubtotal
Other Expenses Not Included221356OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt221356ExpensesNotRptdOnFinStmt
Total Expenses Per Form9909037311TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL FINANCIAL STATEMENTSPART XI, LINE 8/PART XII, LINE 4B/PART XIII, LINE 4BFROM HOOSIER CARE INVESTMENTS, LLC
FIN 48PART X LINE 2The Company has applied for and received a determination letter from the Internal Revenue Service (IRS) to be treated as a tax-exempt entity pursuant to Section 501(c)(3) of the Internal Revenue Code and did not have any unrelated business income for the year ended June 30, 2012. Due to its tax-exempt status, the Company is not subject to income taxes. The Company is required to file and does file tax returns with the IRS and other taxing authorities. Accordingly, these financial statements do not reflect a provision for income taxes and the Company has no other tax positions which must be considered for disclosure. Open tax years for the Company are 2009, 2010 and 2011.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
STEPHEN F WOOD SR
244000244000
LEWIS F WOOD JR
548713548713

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (20 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI SECTION A LINE 2RELATIONSHIP SCHEDULE --------------------- NAME OF OFFICER, DIRECTOR, ETC: Stephen Wood NAME OF RELATED ENTITY: LEWIS F. WOOD, JR CYNTHIA WOOD Stephen Wood, JR TITLE OR ROLE: CEO/TREASURER RELATIONSHIP: BROTHER/SISTER-IN-LAW/son NAME OF OFFICER, DIRECTOR, ETC: LEWIS F. WOOD, JR NAME OF RELATED ENTITY: CYNTHIA WOOD STEPHEN WOOD stephen wood, jr TITLE OR ROLE: Former officer RELATIONSHIP: WIFE/BROTHER/nephew NAME OF OFFICER, DIRECTOR, ETC: CYNTHIA WOOD NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD Stephen wood, jr TITLE OR ROLE: Asst Secretary RELATIONSHIP: HUSBAND/BROTHER-IN-LAW/nephew NAME OF OFFICER, DIRECTOR, ETC: Stephen Wood Jr NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD Cynthia Wood TITLE OR ROLE: director RELATIONSHIP: uncle/father/uncle
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION A, LINE 10A DRAFT OF FORM 990 IS REVIEWED AND AUTHORIZED BY A MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI SECTION B LINE 15COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON AN INDEPENDENT COMPENSATION STUDY, AND INCREASES ARE BASED ON THE CPI (ALL CONSUMERS MARKET BASKET) AND THE DISCRETION OF THE BOARD.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI SECTION C LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ORGANIZATION'S OFFICE DURING REGULAR BUSINESS HOURS UPON REQUEST.
COMPENSATION OF OFFICERSPART VII, SECTION A, AVERAGE HOURS PER WEEKTHE OFFICERS AND DIRECTORS DO NOT KEEP DETAILED TIME RECORDS OF HOURS SPENT FOR THIS AND RELATED ENTITIES. HOWEVER, THROUGH DISCUSSIONS WITH EACH, AN ESTIMATE HAS BEEN MADE OF THE TIME THEY SPENT ON MATTERS OF THIS ENTITY AND ITS RELATED CHARITABLE ENTITIES. THERE ARE twelve RELATED CHARITABLE ENTITIES FOR WHICH THE OFFICERS AND DIRECTORS PROVIDE SERVICES. OFTEN BOARD MEETINGS AND OTHER WORK INVOLVES MATTERS FOR SEVERAL OR ALL OF THESE ENTITIES.
GOVERNANCE, MANAGEMENT & DISCLOSUREPart VI Section B Line 12The Board members annually certify that they are aware of the conflict of interest policy and have no conflicts of interest.
RECONCILIATION OF NET ASSETSPart XI line 5Hoosier Care Investments LLC - book/tax difference - (42)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BRUCE P. HUTSON TITLE:PRESIDENT HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:STEPHEN F. WOOD, SR TITLE:CEO/VP/TREASURER HOURS:25
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN G. FOOS TITLE:VP/TREASURER HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN GILLMOR TITLE:VP/SECRETARY HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DOUGLASS SMITH TITLE:DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JO ANN CORBITT TITLE:DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:STEPHEN F. WOOD, JR TITLE:DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CYNTHIA WOOD TITLE:ASSISTANT SECRETARY HOURS:4
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:ADMINISTRATIVE TOTAL EXPENSES:195425 PROGRAM SERVICES:195425 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:MAINTENANCE TOTAL EXPENSES:46132 PROGRAM SERVICES:46132 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:MEDICAID ASSESSMENT TOTAL EXPENSES:644443 PROGRAM SERVICES:644443 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:REAL ESTATE TAXES TOTAL EXPENSES:97063 PROGRAM SERVICES:97063 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:UTILITIES TOTAL EXPENSES:129805 PROGRAM SERVICES:129805 MANAGEMENT AND GENERAL:FUNDRAISING:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HOOSIER CARE INC
1600 DIVISION STREET STE 700NASHVILLETN37203311262572NURSING HOMEIN501(C)(3)9NAfalse
HOOSIER CARE II INC
1600 DIVISION STREET STE 700NASHVILLETN37203311274121NURSING HOMEIN501(C)(3)9HOOSIER CAREfalse
HOOSIER CARE III INC
1600 DIVISION STREET STE 700NASHVILLETN37203621459304NURSING HOMEDE501(C)(3)9HOOSIER CAREfalse
HOOSIER CARE PROPERTIES INC
1600 DIVISION STREET STE 700NASHVILLETN37203200377349NURSING HOMEIN501(C)(3)9HOOSIER CAREfalse
CLAREMONT HEALTH SYSTEMS INC
1600 DIVISION STREET STE 700NASHVILLETN37203621486858NURSING HOMENJ501(C)(3)9HOOSIER CAREfalse
VICTORIA HEALTH CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203621518645NURSING HOMENJ501(C)(3)9HOOSIER CAREfalse
DELAWARE HEALTH CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203621548336NURSING HOMEDE501(C)(3)9HOOSIER CAREfalse
BIRCHWOOD SENIOR HOUSING CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203204800428sr housingDE501(C)(3)9HOOSIER CAREfalse
CLEVELAND SENIOR HOUSING CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203264739076SR HOUSINGTN501(C)(3)9HOOSIER CAREfalse
LAURELWOOD SENIOR HOUSING CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203320362338SR HOUSINGTN501(C)(3)9HOOSIER CAREfalse
HEALTH & HOUSING SUPPORT SERVICES INC
1600 DIVISION STREET STE 700NASHVILLETN37203452449379sr hsg & svcsNV501(C)(3)11HOOSIER CAREfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CARE INVESTMENTS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11600 DIVISION STREET STE 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
EIN200479449EIN
Primary ActivityINVESTMENTPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CAREBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income124999ShareOfTotalIncome
Share Of EOY Assets851256ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership0.20000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Hoosier care investments llcBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeoTransactionType
Amount Involved68400AmountInvolved
Method Of Amt DeterminationcashMethodOfAmtDetermination

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