SJL HEALTH SYSTEMS INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SJL HEALTH SYSTEMS INC (EIN 43-1710785)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-07-01
- IRS object ID
- 201331829349300703
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-07-01T09:35:56-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371106622 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ginoli & Company LtdCPA's | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7625 N University Ste A | AddressLine1 |
| City | Peoria | City |
| State | IL | State |
| ZIP Code | 616148303 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431710785 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SJL HEALTH SYSTEMS INC | BusinessNameLine1 |
| Business Name Line2 | D/B/A PRAIRIE ROSE HEALTH CARE CENTER | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SJLH | NameControl |
| Phone | 3096918113 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 830 WEST TRAILCREEK DRIVE | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61614 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRAD BARKLEY | Name |
| Title | TREASURER | Title |
| Phone | 3096918113 | Phone |
| Date Signed | 2013-06-25 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL REMMELECPA | Name |
| PTIN | P00444163 | PTIN |
| Phone | 3096712350 | Phone |
| Date Prepared | 2013-06-25 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRAD BARKLEY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 830 W TRAILCREEK DR | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61614 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9130332 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | OPERATION OF A SKILLED NURSING CENTER | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 4 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 261 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 8366881 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9129464 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 351 | InvestmentIncomePriorYear |
| Investment Income Current Year | 868 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8367232 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9130332 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4990097 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5174038 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4912949 | OtherExpensePriorYear |
| Other Expenses Current Year | 5488941 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9903046 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10662979 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1535814 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1532647 | RevenuesLessExpensesCY |
| Total Assets BOY | 8486481 | TotalAssetsBOY |
| Total Assets EOY | 8401033 | TotalAssetsEOY |
| Total Liabilities BOY | 13164771 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14611970 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -4678290 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -6210937 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE CARE FOR THE ELDERLY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8141019 | Expense |
| Revenue | 9130332 | Revenue |
| Description | OPERATION OF A SKILLED NURSING CENTER | Description |
| Total Program Service Expense | 8141019 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 261 | NumberOfEmployees |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 4 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 0 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARK B PETERSEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3096918113 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 830 W TRAILCREEK DR | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61614 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (4 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| MICHAEL KUHL | |||||
| PRESIDENT | 1.00 | X | 0 | 0 | 0 |
| THOMAS HAMMERTON | |||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 |
| BRAD BARKLEY | |||||
| TREASURER | 1.00 | X | 0 | 0 | 0 |
| MICHAEL A AHEARN | |||||
| DIRECTOR AT LARGE | 1.00 | X | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MARTIN BROS | |||||
| 406 VIKING ROAD | CEDER FALLS | IA | 50613 | FOOD SUPPLY VENDOR | 193593 |
| REHAB CARE GROUP INC | |||||
| PO BOX 503534 | ST LOUIS | MO | 63150 | THERAPY SERVICES | 166466 |
| OMNICARE | |||||
| 100 EAST RIVER CENTER BLVD | COVINGTON | KY | 41011 | PHARMACEUTICAL SERVICES | 107539 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE | 623000 | 9114657 | 9114657 |
| RESIDENT SERVICES | 623000 | 14807 | 14807 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9129464 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 868 | TotalRevenueColumn |
| Related Or Exempt Function Income | 868 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9130332 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9130332 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4734122 | Total |
| Program Services | 4447602 | ProgramServices |
| Management And General | 286520 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 439916 | Total |
| Program Services | 439916 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32214 | Total |
| Management And General | 32214 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25265 | Total |
| Management And General | 25265 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26359 | Total |
| Management And General | 26359 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56952 | Total |
| Management And General | 56952 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26123 | Total |
| Management And General | 26123 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10467 | Total |
| Management And General | 10467 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16056 | Total |
| Management And General | 16056 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 668341 | Total |
| Program Services | 668341 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 404471 | Total |
| Program Services | 404471 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVIDER BED TAX | 809009 | 809009 | |
| PURCHASED SERVICES | 722349 | 722349 | |
| MANAGEMENT FEE | 520700 | 520700 | |
| NURSING SERVICES | 474066 | 474066 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1696569 | Total |
| Program Services | 897614 | ProgramServices |
| Management And General | 798955 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10662979 | Total |
| Program Services | 8141019 | ProgramServices |
| Management And General | 2521960 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82502 | BOY |
| EOY | 79023 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1812367 | BOY |
| EOY | 2112017 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32153 | BOY |
| EOY | 32153 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8734251 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4003813 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5052003 | BOY |
| EOY | 4730438 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1507456 | BOY |
| EOY | 1447402 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8486481 | BOY |
| EOY | 8401033 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1989309 | BOY |
| EOY | 2356807 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8123582 | BOY |
| EOY | 8064665 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 630000 | BOY |
| EOY | 630000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2421880 | BOY |
| EOY | 3560498 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13164771 | BOY |
| EOY | 14611970 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -4678290 | BOY |
| EOY | -6210937 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -4678290 | BOY |
| EOY | -6210937 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8486481 | BOY |
| EOY | 8401033 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1532647 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6381343 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8514227 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8721792 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8366881 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9129464 | CurrentTaxYear |
| Total | 41113707 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6381343 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8514227 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8721792 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8366881 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9129464 | CurrentTaxYear |
| Total | 41113707 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 41113707 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4094 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2707 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2015 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 351 | CurrentTaxYearMinus1Year |
| Current Tax Year | 868 | CurrentTaxYear |
| Total | 10035 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4094 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2707 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2015 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 351 | CurrentTaxYearMinus1Year |
| Current Tax Year | 868 | CurrentTaxYear |
| Total | 10035 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6385437 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8516934 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8723807 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8367232 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9130332 | CurrentTaxYear |
| Total | 41123742 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99980 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99960 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00020 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00040 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 487408 | InvestmentCostOrOtherBasis |
| Book Value | 487408 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 6595555 | InvestmentCostOrOtherBasis |
| Depreciation | 2673975 | Depreciation |
| Book Value | 3921580 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1651288 | InvestmentCostOrOtherBasis |
| Depreciation | 1329838 | Depreciation |
| Book Value | 321450 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4730438 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DEFERRED FINANCING COSTS | 717915 |
| ASSETS LIMITED AS TO USE | 662850 |
| PREPAID EXPENSES | 66637 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1447402 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED PAYROLL | $357,389 |
| INTEREST PAYABLE | $867,959 |
| DUE TO AFFILIATES | $351,000 |
| DUE TO TUTERA HEALTH CARE | $458,743 |
| OTHER LIABILITES | $1,525,407 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3560498 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 9130332 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 9130332 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9130332 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 10662979 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 10662979 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 10662979 | TotalExpensesPerForm990 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF GARY INDIANA SERIES A & B | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 356001040 | IssuerEIN |
| CUSIP Number | 582065598 | CUSIPNumber |
| Date Issued | 2008-10-01 | DateIssued |
| Issue Price | 5100000 | IssuePrice |
| Description Of Purpose | PURCHASE OF FACILITY | DescriptionOfPurpose |
| Defeased | 1 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 1 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 3 | Management company operates the nursing home facility. | |
| Form 990, Part VI, Section A, line 8a | No official meetings were held and no written actions were needed by the governing body. | |
| Form 990, Part VI, Section A, line 8b | There were no committees with authority to act on behalf of the governing body. | |
| Form 990, Part VI, Section B, line 11 | A draft copy of the Form 990 along with a copy of the audited financial statements are given to management to review. These are compared and any changes, if any, that are needed will be done at their request. | |
| Form 990, Part VI, Section B, line 15 | The top management official is the Administrator of the nursing home. They are compensated at the same level of various other nursing home admistrators with the same responsibilites. All key employee salaries are set at the comparable rates with other nursing homes. | |
| Form 990, Part VI, Section C, line 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. | |
| Form 990, Part IX, line 24e | OPERATIONS & MAINTENANCE: Program service expenses 0. Management and general expenses 430,964. Fundraising expenses 0. Total expenses 430,964. FOOD: Program service expenses 371,544. Management and general expenses 0. Fundraising expenses 0. Total expenses 371,544. SUPPLIES: Program service expenses 322,121. Management and general expenses 0. Fundraising expenses 0. Total expenses 322,121. MISC. ADMIN. EXPENSES: Program service expenses 0. Management and general expenses 243,924. Fundraising expenses 0. Total expenses 243,924. PROPERTY & LIABILITY INSURANCE: Program service expenses 97,277. Management and general expenses 0. Fundraising expenses 0. Total expenses 97,277. WORKMEN'S COMPENSATION: Program service expenses 74,471. Management and general expenses 0. Fundraising expenses 0. Total expenses 74,471. MISC. PAYROLL TAXES AND EMPLOYEE BENEFITS: Program service expenses 0. Management and general expenses 65,425. Fundraising expenses 0. Total expenses 65,425. BAD DEBT EXPENSE: Program service expenses 0. Management and general expenses 58,642. Fundraising expenses 0. Total expenses 58,642. MISC. EXPENSES: Program service expenses 10,011. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,011. OTHER DIETARY: Program service expenses 9,726. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,726. EQUIPMENT RENTAL: Program service expenses 9,559. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,559. TRAINING: Program service expenses 2,905. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,905. | All Other Functional Expenses |