CHRISTIAN HEALTH CARE CENTER FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CHRISTIAN HEALTH CARE CENTER FOUNDATION INC (EIN 22-3718702)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-07
IRS object ID
201333119349302303
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)
Timestamp2013-11-07T16:07:48-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN223718702EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Christian Health Care Center FoundationBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% Kevin A StaggInCareOfName
Name ControlCHRINameControl
Phone2018485200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1301 Sicomac AvenueAddressLine1
Address Line2SuiteAddressLine2
CityWyckoffCity
StateNJState
ZIP Code07481ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN A STAGGName
TitleEVP/CFOTitle
Date Signed2013-11-04DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDouglas StruykNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1301 Sicomac AvenueAddressLine1
CityWyckoffCity
StateNJState
ZIP Code07481ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1005163GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteCHCCNJ.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileNJStateLegalDomicile
Activity Or Mission DescriptionADVANCEMENT OF CHARITABLE HEALTH CARE ISSUES AND CARE AS WELL AS OTHER CHARITABLE, RELIGIOUS, EDUCATIONAL, AND SCIENTIFIC PURPOSES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year775210ContributionsGrantsPriorYear
Contributions Grants Current Year860023ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year-53InvestmentIncomePriorYear
Investment Income Current Year15InvestmentIncomeCurrentYear
Other Revenue Prior Year65190OtherRevenuePriorYear
Other Revenue Current Year91920OtherRevenueCurrentYear
Total Revenue Prior Year840347TotalRevenuePriorYear
Total Revenue Current Year951958TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year543590GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY117573GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year294744SalariesEtcPriorYear
Salaries Etc Current Year296270SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year301961TotalFundrsngExpCurrentYear
Other Expense Prior Year37701OtherExpensePriorYear
Other Expenses Current Year44906OtherExpensesCurrentYear
Total Expenses Prior Year876035TotalExpensesPriorYear
Total Expenses Current Year458749TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-35688RevenuesLessExpensesPriorYear
Revenues Less Expenses CY493209RevenuesLessExpensesCY
Total Assets BOY525117TotalAssetsBOY
Total Assets EOY1018326TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY525117NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1018326NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF THE FOUNDATION IS TO SUPPORT THE MINISTRY OF THE CENTER THROUGH FINANCIAL GIFTS, VOLUNTEER EFFORTS, AND PRAYER THROUGH MEANS THAT ARE CONSISTENT WITH THE CHRISTIAN PRINCIPALS ON WHICH THE CENTER WAS FOUNDED. THE FULFILLMENT OF THIS MISSION WILL STRENGTHEN THE CENTER'S MISSION TO PROVIDE CARE TO THOSE IN NEED OF LONG-TERM CARE, MENTAL HEALTH CARE AND RESIDENTIAL LIVING IN A COMPASSIONATE AND LOVING ENVIRONMENT.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense117573Expense
Grants117573Grants
Revenue0Revenue
DescriptionThe Foundation provides the Center with a source of funds that can be used to carry out the strategic vision and to help meet the needs of the ever-changing environment. The board is composed of business and community leaders who help develop programs and events to bring CHCC to potential benefactors. Through their advocacy and leadership, the foundation will help financially support and expand the ministry of the Center and broaden the knowledge of CHCC throughout the community.Description
Total Program Service Expense117573TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
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 ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
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 OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNJStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKevin A StaggNamePerson
Telephone Number2018485200TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1301 Sicomac AvenueAddressLine1
CityWyckoffCity
StateNJState
ZIP Code07481ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

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 CompensationOtherCompensationKey EmployeeKeyEmployee
Garry Dykhouse
Chair1.00.0XX000
David Becker
Trustee1.00.0X000
Douglas Dittrick
Trustee1.00.0X000
Thomas Dykhouse
SECRETARY1.00.0XX000
Janet Faber
Trustee1.00.0X000
William Haggerty
Trustee1.00.0X000
Gordon Stanley
VICE CHAIR1.00.0XX000
Douglas Struyk
Trustee1.040.0X037146629143
Rena Tolsma
Trustee1.00.0X000
Richard Van Hassel Sr
Trustee1.00.0X000
Ellsworth Whiteman
Trustee1.00.0X000
David Krental
Foundation Executive Director40.00.0137071011324X
FieldValueIRS element (for citing)
Total Reportable Comp From Org137071TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs371466TotalReportableCompFrmRltdOrgs
Total Other Compensation40467TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events37500FundraisingEvents
All Other Contributions822523AllOtherContributions
Noncash Contributions100945NoncashContributions
Total Contributions860023TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column15TotalRevenueColumn
Exclusion$15ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events145125GrossIncomeFundraisingEvents
Fundraising Direct Expenses53205FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column91920TotalRevenueColumn
Exclusion$91,920ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Unrelated Business Revenue0UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column951958TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$91,935ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total117573Total
Program Services117573ProgramServices

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)
Total148395Total
Fundraising148395Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total99175Total
Management And General24794ManagementAndGeneral
Fundraising74381Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7934Total
Management And General1983ManagementAndGeneral
Fundraising5951Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total21827Total
Management And General5457ManagementAndGeneral
Fundraising16370Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total18939Total
Management And General4735ManagementAndGeneral
Fundraising14204Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total11561Total
Management And General578ManagementAndGeneral
Fundraising10983Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total25299Total
Management And General1265ManagementAndGeneral
Fundraising24034Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5390Total
Management And General270ManagementAndGeneral
Fundraising5120Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total1311Total
Management And General66ManagementAndGeneral
Fundraising1245Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1345Total
Management And General67ManagementAndGeneral
Fundraising1278Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total458749Total
Program Services117573ProgramServices
Management And General39215ManagementAndGeneral
Fundraising301961Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY525117BOY
EOY1018326EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

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)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY525117BOY
EOY1018326EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY525117BOY
EOY1018326EOY

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)
BOY525117BOY
EOY1018326EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY525117BOY
EOY1018326EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses493209ReconcilationRevenueExpenses
Reconciliation Unrealized Invest0ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHRISTIAN HEALTH CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
EIN221546163EIN
Type Of Organization03TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Amount$117,573Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts117573SumOfAmounts

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 G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf OutingNameOfEvent1
Gross Receipts Event1112715GrossReceiptsEvent1
Charitable Contributions Event122500CharitableContributionsEvent1
Gross Revenue Event190215GrossRevenueEvent1
Rent Facility Costs Event123137RentFacilityCostsEvent1
Entertainment Event1506EntertainmentEvent1
Other Direct Expenses Event14612OtherDirectExpensesEvent1
Name Of Event2Jazz NightNameOfEvent2
Gross Receipts Event269910GrossReceiptsEvent2
Charitable Contributions Event215000CharitableContributionsEvent2
Gross Revenue Event254910GrossRevenueEvent2
Rent Facility Costs Event211946RentFacilityCostsEvent2
Entertainment Event25822EntertainmentEvent2
Other Direct Expenses Event27182OtherDirectExpensesEvent2
Total Number Of Other Events2TotalNumberOfOtherEvents
Gross Receipts Total182625GrossReceiptsTotal
Charitable Contributions Total37500CharitableContributionsTotal
Gross Revenue Total Events145125GrossRevenueTotalEvents
Rent Facility Costs Total Events35083RentFacilityCostsTotalEvents
Entertainment Total Events6328EntertainmentTotalEvents
Other Direct Expenses Total Events11794OtherDirectExpensesTotalEvents
Direct Expense Summary Events53205DirectExpenseSummaryEvents
Net Income Summary91920NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Christian Health Care CenterBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1301 Sicomac AvenueAddressLine1
CityWyckoffCity
StateNJState
ZIP Code07481ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient221546163EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant117573AmountOfCashGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationALL EXPENDITURES MADE UNDER A GRANT ARE APPROVED BY THE EXECUTIVE VICE president OF FINANCE WHO IS FAMILIAR WITH THE COST INVOLVED. GRANT IS MADE TO A RELATED TAX EXEMPT ORGANIZATION AND FUNDS ARE USED TO FURTHER EXEMPT PURPOSE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
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

FieldValueIRS element (for citing)
Name PersonDouglas StruykNamePerson
TitleTrusteeTitle
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs354466CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs17000OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs6250DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs22893NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs400609TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods

Cars And Other Vehicles CarsAndOtherVehicles

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99091400NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F9909545NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
family or business relationshipsForm 990, Part VI, Question 2GARRY DYKHOUSE and THOMAS DYKHOUSE have a family relationship. Description of Classes of Members or Stockholders Form 990, Part VI, Question 6 Christian Health Care Center is the sole member of Christian Health Care Center Foundation.
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11A draft copy of the Organization's Form 990 (including required SCHEDULES), IS SENT TO THE BOARD OF TRUSTEES BEFORE FILING WITH THE IRS FOR THEIR REVIEW AND OVERSIGHT. ANY COMMENT AND CHANGES RECOMMENDED BY THE BOARD ARE REVIEWED BY THE FINANCE DEPARTMENT AND, IF THE CHANGES ARE DEEMED PROPER, INCORPORATED INTO THE FINAL 990 THAT IS FILED WITH THE IRS. A FINAL COPY OF THE 990 THAT IS FILED WITH THE IRS IS MADE AVALIABLE TO THE BOARD VIA EMAIL OR HARD COPY DEPENDING ON THE BOARD MEMBER'S PREFERENCE.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cAll Officers, Directors, Trustees and Key Employees are required to read and sign the organization's written conflict of interest policy annually. During the course of the year, annual in-services are given on the subject as well as annual education. Within their disclosure they are required to state their interests and those of their family members that could give rise to conflicts of interest. If a conflict of interest does arise, the matter is reviewed by the Corporate Compliance Committee and reported do the Board if necessary for further action. The Board Chair, the Board Committee, or the Board shall ask the interested person to leave the meeting, although they may make a statement or answer any question on the matter at hand before leaving the room. The interested person will not vote on the matter that gave rise to the potential conflict and the Board or Board Committee must approve the transaction or arrangement by a Majority Vote of the Board Members present at that has Quorum, not including the vote of the interested person.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, Question 15aThe Compensation determination for the Executive Director and Top Management Officials is based on area annual salary market rates and annual performance evaluations. The process is reviewed annually by the personnel committee and uses data of comparable compensation for similar qualified persons in functionally comparable positions at similar situated organizations.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19Written request for the Organization's Governing documents, conflict of interest policy, and financial statements are considered on a case by case basis.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CHRISTIAN HEALTH CARE CENTER
301 SICOMAC AVENUEWYCKOFFNJ07481221546163HEALTH CARENJ501(c)(3)3NAfalse
HOLLAND MUTUAL CHARITABLE HEALTH CORP
301 SICOMAC AVENUEWYCKOFFNJ07481223408320SUPPORT OPSNJ501(c)(3)11-ANAfalse
CHCC CCRC INC
301 SICOMAC AVENUEWYCKOFFNJ07481204072602INACTIVENJ501(c)(3)11-ACHCCtrue
ADVENT CHRISTIAN HEALTH ASSOCIATES PC
301 SICOMAC AVENUEWYCKOFFNJ07481223629467INACTIVENJ501(c)(3)9CHCCtrue
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
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 OrgfalseReimbursementPaidToOtherOrg
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 Line1CHRISTIAN HEALTH CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeBTransactionType
Amount Involved117573AmountInvolved
Method Of Amt DeterminationCASHMethodOfAmtDetermination

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