FURP.ORG / PUBLIC DATA EXPLORER

FLORENCE HOME FOR THE AGED: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FLORENCE HOME FOR THE AGED (EIN 47-0384319)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201323189349303257
Schema version
2012v2.1
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)
Timestamp2013-11-14T11:28:16-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN476097913EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SEIM JOHNSON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line118081 BURT STREET SUITE 200AddressLine1
CityOMAHACity
StateNEState
ZIP Code680224722ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470384319EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FLORENCE HOME FOR THE AGEDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFLORNameControl
Phone4028276000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17915 NORTH 30TH STREETAddressLine1
CityOMAHACity
StateNEState
ZIP Code68112ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEBRA L THACKERName
TitleCFOTitle
Phone4028276000Phone
Date Signed2013-11-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIE M GERKENName
PTINP00400882PTIN
Phone4023302660Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDEBRA L THACKERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line17915 NORTH 30TH STREETAddressLine1
CityOMAHACity
StateNEState
ZIP Code68112ZIPCode
FieldValueIRS element (for citing)
Gross Receipts10226481GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.OMAHASENIORCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionPROVIDE CARE FOR THE ELDERLYActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees257TotalNbrEmployees
Total Nbr Volunteers15TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year338561ContributionsGrantsPriorYear
Contributions Grants Current Year479359ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10034375ProgramServiceRevenuePriorYear
Program Service Revenue CY9654918ProgramServiceRevenueCY
Investment Income Prior Year17011InvestmentIncomePriorYear
Investment Income Current Year51888InvestmentIncomeCurrentYear
Other Revenue Prior Year40755OtherRevenuePriorYear
Other Revenue Current Year37864OtherRevenueCurrentYear
Total Revenue Prior Year10430702TotalRevenuePriorYear
Total Revenue Current Year10224029TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year21316GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY4386GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4983196SalariesEtcPriorYear
Salaries Etc Current Year4817995SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5467665OtherExpensePriorYear
Other Expenses Current Year5252632OtherExpensesCurrentYear
Total Expenses Prior Year10472177TotalExpensesPriorYear
Total Expenses Current Year10075013TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-41475RevenuesLessExpensesPriorYear
Revenues Less Expenses CY149016RevenuesLessExpensesCY
Total Assets BOY3523421TotalAssetsBOY
Total Assets EOY3862067TotalAssetsEOY
Total Liabilities BOY2006322TotalLiabilitiesBOY
Total Liabilities EOY2407052TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1517099NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1455015NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE A CONTINUUM OF QUALITY SERVICES AND PROGRAMS FOR SENIORS AND OTHER PERSONS NEEDING SPECIALIZED CARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6062887Expense
Grants4386Grants
Revenue6607382Revenue
DescriptionSKILLED NURSING CAREDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense813228Expense
Revenue886492Revenue
DescriptionASSISTED LIVING CAREDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1971944Expense
Revenue2148860Revenue
DescriptionALZHEIMER'S ASSISTED LIVING CAREDescription

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense10631Expense
Revenue12184Revenue
DescriptionOTHER SERVICESDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp10631TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev12184TotalOfOtherProgramServiceRev
Total Program Service Expense8858690TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109620NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees257NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEBRA L THACKER CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4028276000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17915 NORTH 30TH STREETAddressLine1
CityOMAHACity
StateNEState
ZIP Code68112ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
ROBERT A BLOECHLE
CHAIRMAN1.003.00XX000
BETTY G FOSTER PHD
SECRETARY / TREASURER1.003.00XX000
LOIS JORDAN
PRESIDENT / CEO2.0040.00XX01540838092
DEBRA L THACKER
CFO2.0040.00XX014340321801
JULIE SCHULTZ SELF
DIRECTOR1.000.00X000
PHIL CHRISTENSEN
DIRECTOR1.002.00X000
LYN M HOLLEY
DIRECTOR1.000.00X000
JOHN JEANETTA
DIRECTOR1.000.00X000
NANCY A MCCARTHY
DIRECTOR1.000.00X000
JULIE MONACO
DIRECTOR1.000.00X000
MARC BUTTERFIELD
DIRECTOR1.000.00X000
GLENN TREMBLEY
DIRECTOR1.000.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs297486TotalReportableCompFrmRltdOrgs
Total Other Compensation29893TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEALTHCARE SERVICES GROUP
SUITE 300 3220 TILLMAN DRIVEBENSALEMPA19020DIETARY732245
HALLMARK REHABILITATION
27442 PORTOLA PARKWAY SUITE 200FOOTHILL RANCHCA92610REHAB SERVICES529359
UNLIMITED OPPORTUNITY INC DBA JANA-KING
14821 W 95TH STREETLENEXAKS66215HSKP/LAUNDRY324352
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Related Organizations449299RelatedOrganizations
All Other Contributions30060AllOtherContributions
Total Contributions479359TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYMENTS62300078408607840860
PRIVATE PAY/INSURANCE REVENUE62300018018741801874
MISCELLANEOUS INCOME62300095089508
VENDOR REBATES62300026762676
FieldValueIRS element (for citing)
Total Program Service Revenue9654918TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column50640TotalRevenueColumn
Exclusion$50,640ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real36517Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real36517Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column36517TotalRevenueColumn
Exclusion$36,517ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other3700Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2452Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other1248Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1248TotalRevenueColumn
Exclusion$1,248ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCAFETERIA & VENDING REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column1347TotalRevenueColumn
Exclusion$1,347ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1347TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10224029TotalRevenueColumn
Related Or Exempt Function Income9654918RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$89,752ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total4386Total
Program Services4386ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4095065Total
Program Services3866159ProgramServices
Management And General228906ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total378782Total
Program Services350013ProgramServices
Management And General28769ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total344148Total
Program Services325291ProgramServices
Management And General18857ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total777168Total
Management And General777168ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total16869Total
Management And General16869ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total28603Total
Management And General28603ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2090047Total
Program Services2004779ProgramServices
Management And General85268ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total11247Total
Program Services4526ProgramServices
Management And General6721ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total568463Total
Program Services555340ProgramServices
Management And General13123ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total607977Total
Program Services607977ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total19012Total
Program Services19012ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total24105Total
Program Services24105ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total19536Total
Program Services19536ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total343792Total
Program Services343792ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL SUPPLIES379932379932
DIETARY-FOOD193492193492
BAD DEBT & CHARITY CARE9840098400
MISCELLANEOUS5076750767

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total23222Total
Program Services11183ProgramServices
Management And General12039ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10075013Total
Program Services8858690ProgramServices
Management And General1216323ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY18204BOY
EOY17975EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY155212BOY
EOY224680EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY855057BOY
EOY1059086EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY21839BOY
EOY14804EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY40167BOY
EOY39771EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis7839250LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6469783LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1346360BOY
EOY1369467EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1086582BOY
EOY1136284EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3523421BOY
EOY3862067EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY605949BOY
EOY1059528EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY1385000BOY
EOY1320000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15373BOY
EOY27524EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2006322BOY
EOY2407052EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-506899BOY
EOY-611513EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1040000BOY
EOY1040000EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY983998BOY
EOY1026528EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1517099BOY
EOY1455015EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3523421BOY
EOY3862067EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses149016ReconcilationRevenueExpenses
Reconciliation Unrealized Invest42530ReconciliationUnrealizedInvest
Reconcilation Other Changes-253630ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5621CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6198CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2983CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3643CurrentTaxYearMinus1Year
Current Tax Year30060CurrentTaxYear
Total48505Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10872522CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10515986CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10561250CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10034375CurrentTaxYearMinus1Year
Current Tax Year9654918CurrentTaxYear
Total51639051Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5687CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6289CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1893CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3345CurrentTaxYearMinus1Year
Current Tax Year1347CurrentTaxYear
Total18561Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10883830CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10528473CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10566126CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10041363CurrentTaxYearMinus1Year
Current Tax Year9686325CurrentTaxYear
Total51706117Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50951706117PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years97165CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years80902CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years79309CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year57708CurrentTaxYearMinus1Year
Current Tax Year87157CurrentTaxYear
Total402241Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years97165CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years80902CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years79309CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year57708CurrentTaxYearMinus1Year
Current Tax Year87157CurrentTaxYear
Total402241Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10980995CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10609375CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10645435CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10099071CurrentTaxYearMinus1Year
Current Tax Year9773482CurrentTaxYear
Total52108358Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99230PublicSupportPercentage509
Prior Year Support Percentage0.99230PriorYearSupportPercentage
Investment Income Percentage0.00770InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00770PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis154347OtherCostOrOtherBasis
Book Value154347BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5532683OtherCostOrOtherBasis
Depreciation4596879Depreciation
Book Value935804BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2023326OtherCostOrOtherBasis
Depreciation1795419Depreciation
Book Value227907BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis128894OtherCostOrOtherBasis
Depreciation77485Depreciation
Book Value51409BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1369467TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING COSTS, NET72684
BENEFICIAL INTEREST IN PERPETUAL TRUST1026528
THIRD PARTY PAYOR SETTLEMENTS RECEIVABLE37072
FieldValueIRS element (for citing)
Total Book Value Other Assets1136284TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCRUED INTEREST PAYABLE$3,205
DUE TO AFFILIATES$24,319
FieldValueIRS element (for citing)
Total Of Amounts27524TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationMIDWEST GERIATRICS, INC., ROYALE OAKS HOUSE OF HOPE, GERIMED, INC., FLORENCE HOME AND SENIOR HEALTH FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THESE NOT-FOR-PROFIT CORPORATIONS HAVE EACH RECEIVED A DETERMINATION LETTER THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. UNIMED, INC. IS A TAXABLE CORPORATION. UNIMED, INC. HAS A NET OPERATING LOSS CARRYFORWARD AS OF DECEMBER 31, 2012 AND 2011, AVAILABLE FOR FEDERAL AND STATE INCOME TAX PURPOSES. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2012, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS ENDED PRIOR TO DECEMBER 31, 2009.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LOIS JORDAN
PRESIDENT / CEO015408300000008092016217500
DEBRA L THACKER
CFO0143403000000021801016520400

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 3ReturnReference
ExplanationFLORENCE HOME FOR THE AGED DOES NOT HAVE ANY OFFICERS IT DIRECTLY COMPENSATES. MIDWEST GERIATRICS, INC., AN AFFILIATE OF FLORENCE HOME FOR THE AGED, COMPENSATES THE OFFICERS OF FLORENCE HOME FOR THE AGED. THEREFORE, THE POLICY ON THE PROCESS FOR DETERMINING COMPENSATION OF MIDWEST GERIATRICS, INC. APPLIES TO THE COMPENSATION OF THE FOLLOWING PERSONS SERVING AS OFFICERS OF FLORENCE HOME FOR THE AGED. CHIEF EXECUTIVE OFFICER: LOIS JORDAN CHIEF FINANCIAL OFFICER: DEBRA THACKER THE PROCESS IS UTILIZED BY THE EXECUTIVE COMMITTEE OF THE MIDWEST GERIATRICS, INC. FOR FURTHER EXPLANATION OF THE PROCESS SEE SCHEDULE O.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11ONCE THE CONTROLLER HAS PREPARED THE FORM 990 AND RELATED SCHEDULES, THE CFO WILL REVIEW IT, MAKE ANY CHANGES AND ACCEPT THE DRAFT FORM 990. THE FINANCE COMMITTEE WILL THEN BE CONTACTED VIA E-MAIL THAT THE DRAFT FORM 990 IS READY FOR REVIEW AND ASK IF THEY WANT IT SENT OUT TO THEM OR IF THEY WILL BE COMING TO THE FACILITY TO REVIEW. ONCE 2/3 OF THE COMMITTEE HAVE REVIEWED AND ACCEPTED THE FORM 990, IT WILL BE FILED.
FORM 990, PART VI, SECTION B, LINE 12CON AN ANNUAL BASIS, THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE ASKED TO REVIEW AND DISCLOSE ANY CONFLICTS OF INTERESTS THAT THEY MAY HAVE WITH FLORENCE HOME FOR THE AGED OPERATIONS. THEY ARE THEN ASKED TO SIGN A DOCUMENT INDICATING CONFLICTS, IF ANY. THE BOARD CHAIR IS THEN INFORMED OF ANY CURRENT CONFLICTS FOR CONSIDERATION IN FUTURE VOTING MATTERS OF THE BOARD.
FLORENCE HOME FOR THE AGED DOES NOT HAVE ANY OFFICERS THAT IT DIRECTLY COMPENSATES. MIDWEST GERIATRICS, INC., AN AFFILIATE OF FLORENCE HOME, COMPENSATES THE OFFICERS OF FLORENCE HOME AND THEREFORE, THE POLICY ON THE PROCESS FOR DETERMINING COMPENSATION OF MIDWEST GERIATRICS, INC. APPLIES TO THE COMPENSATION OF THE FOLLOWING PERSONS SERVING AS OFFICERS OF FLORENCE HOME. THE PROCESS IS UTILIZED BY THE EXECUTIVE COMMITTEE OF THE MIDWEST GERIATRICS, INC. BOARD ON AN ANNUAL BASIS. CHIEF EXECUTIVE OFFICER: LOIS JORDAN CHIEF FINANCIAL OFFICER: DEBRA THACKER THE PROCESS INCLUDES ALL OF THESE ELEMENTS: (1) REVIEW AND APPROVAL BY THE EXECUTIVE COMMITTEE OF MIDWEST GERIATRICS, INC.; (2) USE OF DATA AS TO COMPARABLE COMPENSATION; AND (3) CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING. 1. REVIEW AND APPROVAL. THE COMPENSATION OF THE PERSON IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF MIDWEST GERIATRICS, INC., PROVIDED THAT PERSONS WITH CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED IN THIS REVIEW AND APPROVAL. 2. USE OF DATA AS TO COMPARABLE COMPENSATION. THE COMPENSATION OF THE PERSON IS REVIEWED AND APPROVED USING DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. 3. CONTEMPORANEOUS DOCUMENTATION AND RECORDING. THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST A COPY OF THE REQUESTED DOCUMENT IS PROVIDED WITHIN 72 HOURS.
FORM 990, PART IX, LINE 11GHSKP/LNDRY/DIETARY: PROGRAM SERVICE EXPENSES 1,056,597. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,056,597. REHAB SERVICES: PROGRAM SERVICE EXPENSES 529,359. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 529,359. OTHER: PROGRAM SERVICE EXPENSES 418,823. MANAGEMENT AND GENERAL EXPENSES 85,268. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 504,091.OTHER FEES
FORM 990, PART XI, LINE 9:IMPAIRMENT LOSS -253,630.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PAGE 12, PART XII,LINE 2C:THE BOARD OF DIRECTORS OF MIDWEST GERIATRICS, INC ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
SENIOR HEALTH FOUNDATION
7915 N 30TH STREETOMAHANE68112470709560PROVIDE ASSISTANCE TO THE ELDERLY.NE501(C)(3)7N/A0
GERIMED
7915 N 30TH STREETOMAHANE68112470727973PHARMACEUTICAL SALES.NE501(C)(3)9N/A0
MIDWEST GERIATRICS INC
7915 N 30TH STREETOMAHANE68112470727974SUPPORT FLORENCE HOME AND RELATED ORANGIZATIONS THROUGH MANAGEMENT SERVICES.NE501(C)(3)11B TYPE IIN/A0
ROYALE OAKS HOUSE OF HOPE
4801 N 52ND STREETOMAHANE68104260808357SUPPORT FLORENCE HOME BY SERVICING A FHA-INSURED NON-RECOURSE LOAN.NE501(C)(3)11A TYPE IN/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1UNIMEDBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17915 N 30TH STREETAddressLine1
CityOMAHACity
StateNEState
ZIP Code68112ZIPCode
FieldValueIRS element (for citing)
EIN470759285EIN
Primary ActivityPHARMACEUTICAL SALESPrimaryActivity
Legal Domicile StateNELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg