FURP.ORG / PUBLIC DATA EXPLORER

ISLAND NURSING HOME INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ISLAND NURSING HOME INC (EIN 51-0172239)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-02-04
IRS object ID
201340359349300739
Schema version
2011v1.2
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)
Timestamp2013-02-04T12:49:56-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN010391345EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Berry Dunn McNeil & Parker LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line136 Pleasant StreetAddressLine1
CityBangorCity
StateMEState
ZIP Code04401ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN510172239EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Island Nursing HomeBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlISLANameControl
Phone2073482351Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1587 North Deer Isle RoadAddressLine1
CityDeer IsleCity
StateMEState
ZIP Code04627ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMarc PlourdeName
TitleAdministratorTitle
Phone2073482351Phone
Date Signed2013-01-31DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBarbara J McGuan CPAName
PTINP00219457PTIN
Phone2079421600Phone
Date Prepared2013-01-31DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMarc PlourdeNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1587 North Deer Isle RoadAddressLine1
CityDeer IsleCity
StateMEState
ZIP Code04627ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4136132GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Siten/aWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileMEStateLegalDomicile
Activity Or Mission DescriptionTo provide nursing care and adult day careActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees134TotalNbrEmployees
Total Nbr Volunteers32TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year94326ContributionsGrantsPriorYear
Contributions Grants Current Year133237ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3995804ProgramServiceRevenuePriorYear
Program Service Revenue CY3972672ProgramServiceRevenueCY
Investment Income Prior Year23343InvestmentIncomePriorYear
Investment Income Current Year25845InvestmentIncomeCurrentYear
Other Revenue Prior Year50OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year4113523TotalRevenuePriorYear
Total Revenue Current Year4131754TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2310GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2750GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2576922SalariesEtcPriorYear
Salaries Etc Current Year2628091SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1308224OtherExpensePriorYear
Other Expenses Current Year1330929OtherExpensesCurrentYear
Total Expenses Prior Year3887456TotalExpensesPriorYear
Total Expenses Current Year3961770TotalExpensesCurrentYear
Revenues Less Expenses Prior Year226067RevenuesLessExpensesPriorYear
Revenues Less Expenses CY169984RevenuesLessExpensesCY
Total Assets BOY3561185TotalAssetsBOY
Total Assets EOY3800178TotalAssetsEOY
Total Liabilities BOY1842234TotalLiabilitiesBOY
Total Liabilities EOY1896372TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1718951NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1903806NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission of Island Nursing Home, Deer Isle, Maine, a non-profit facility, is to incorporate the values of dignity, compassion, professionalism and community in providing life-care services or resources to individuals and families in need; to instill purpose and hope; and to support all stages of living and dying.The Island Nursing Home is committed to a primary obligation to serve residents of the communities of Deer Isle, Stonington, Isle au Haut, Brooksville, Brooklin, Sedgwick and Blue Hill.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3519605Expense
Grants2750Grants
Revenue3972672Revenue
DescriptionNursing Home Care - Seventy-bed long term care facility offering skilled nursing, residential and ancillary services to medically needy residents.Description
Total Program Service Expense3519605TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
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 Required0ScheduleJRequired
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109611NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees134NumberOfEmployees
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 Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
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 CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Marc PlourdeBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2073482351TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1587 North Deer Isle RdAddressLine1
CityDeer IsleCity
StateMEState
ZIP Code04627ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Pamela N Siewers
President1.00XX000
Claudette O Kydd
Director1.00X000
Don Holmes
Director1.00X000
Robert Lasky
Vice President/Treasurer1.00XX000
Kathleen Billings-Pezaris
Director1.00X000
John P Eysenbach
Director1.00X000
Deborah DeWitt
Director1.00X000
Kathleen Hayward
Director1.00X000
Joe Perkins
Director1.00X000
Marilyn Verhey
Director1.00X000
Joan Freeman
Director1.00X000
Marc Plourde
Administrator40.00X11223002587
FieldValueIRS element (for citing)
Total Reportable Comp From Org112230TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation2587TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SynertxBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17540 North 19th Av Suite 200AddressLine1
CityPhoenixCity
StateAZState
ZIP Code85021ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPhys & Occup TherapyDescriptionOfServices
Compensation127983Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Fundraising Events8053FundraisingEvents
All Other Contributions125184AllOtherContributions
Total Contributions133237TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medicare/medicaid Rev62300057506095750609
Pvt. Pay Nursing Care623000721766721766
Miscellaneous Revenue62300011021102
Contractual Adjustment623000-2500805-2500805
FieldValueIRS element (for citing)
Total Program Service Revenue3972672TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column28326TotalRevenueColumn
Exclusion$28,326ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other1000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other3481Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-2481Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-2481TotalRevenueColumn
Exclusion-$2,481ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events897GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events8053CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses897FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4131754TotalRevenueColumn
Related Or Exempt Function Income3972672RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$25,845ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total2750Total
Program Services2750ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total114817Total
Management And General114817ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1924631Total
Program Services1785112ProgramServices
Management And General139519ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total370854Total
Program Services305657ProgramServices
Management And General65197ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total217789Total
Program Services204612ProgramServices
Management And General13177ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3291Total
Management And General3291ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total35463Total
Management And General35463ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11135Total
Program Services11135ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total28230Total
Program Services28230ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total227593Total
Program Services221932ProgramServices
Management And General5661ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total120443Total
Program Services120443ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total10566Total
Program Services10566ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total50889Total
Program Services50889ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total174259Total
Program Services174259ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total81921Total
Program Services81921ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Provider tax expense223729223729
Food133088133088
Therapy services120325120325
Data processing costs2503025030

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total84967Total
Program Services44957ProgramServices
Management And General40010ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3961770Total
Program Services3519605ProgramServices
Management And General442165ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2663BOY
EOY3439EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY352226BOY
EOY440535EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY376644BOY
EOY414273EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY54312BOY
EOY59600EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY68662BOY
EOY57676EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4477834LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3055478LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1446807BOY
EOY1422356EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1258182BOY
EOY1400862EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1689BOY
EOY1437EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3561185BOY
EOY3800178EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY787689BOY
EOY915815EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1013848BOY
EOY915350EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY40697BOY
EOY65207EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1842234BOY
EOY1896372EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1669080BOY
EOY1841673EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5864BOY
EOY18126EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY44007BOY
EOY44007EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1718951BOY
EOY1903806EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3561185BOY
EOY3800178EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses169984ReconcilationRevenueExpenses
Reconcilation Other Changes14871ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 Years192198CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years25861CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years26212CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year94326CurrentTaxYearMinus1Year
Current Tax Year133237CurrentTaxYear
Total471834Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3962082CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3823024CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3812146CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3995804CurrentTaxYearMinus1Year
Current Tax Year3972672CurrentTaxYear
Total19565728Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year1564CurrentTaxYearMinus1Year
Current Tax Year897CurrentTaxYear
Total2461Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4154280CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3848885CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3838358CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4091694CurrentTaxYearMinus1Year
Current Tax Year4106806CurrentTaxYear
Total20040023Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3233CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1675CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5350CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6860CurrentTaxYearMinus1Year
Current Tax Year8500CurrentTaxYear
Total25618Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3233CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1675CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5350CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6860CurrentTaxYearMinus1Year
Current Tax Year8500CurrentTaxYear
Total25618Total
FieldValueIRS element (for citing)
Public Support Total50920014405PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years29285CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21838CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years20134CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23854CurrentTaxYearMinus1Year
Current Tax Year28326CurrentTaxYear
Total123437Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years29285CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21838CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years20134CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23854CurrentTaxYearMinus1Year
Current Tax Year28326CurrentTaxYear
Total123437Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4183565CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3870723CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3858492CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4115548CurrentTaxYearMinus1Year
Current Tax Year4135132CurrentTaxYear
Total20163460Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99260PublicSupportPercentage509
Prior Year Support Percentage0.99250PriorYearSupportPercentage
Investment Income Percentage0.00610InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00650PriorYrInvestIncomePercentage
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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$1,093OtherActivitiesAmount
Total Lobbying Expenditures IIB1093TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
Explanation29.80% of dues paid to Maine Health Care Association were attributable to lobbying.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1295208BeginningOfYearBalance
Contributions146678Contributions
Investment Earnings Or Losses42680InvestmentEarningsOrLosses
Other Expenditures16161OtherExpenditures
End Of Year Balance1468405EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance721890BeginningOfYearBalance
Contributions475923Contributions
Investment Earnings Or Losses130404InvestmentEarningsOrLosses
Other Expenditures33009OtherExpenditures
End Of Year Balance1295208EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance435937BeginningOfYearBalance
Contributions254946Contributions
Investment Earnings Or Losses37015InvestmentEarningsOrLosses
Other Expenditures6008OtherExpenditures
End Of Year Balance721890EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance548983BeginningOfYearBalance
Contributions25861Contributions
Investment Earnings Or Losses-58999InvestmentEarningsOrLosses
Other Expenditures79908OtherExpenditures
End Of Year Balance435937EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.95770BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.03000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01230TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis55290OtherCostOrOtherBasis
Book Value55290BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2755291OtherCostOrOtherBasis
Depreciation1872193Depreciation
Book Value883098BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1187750OtherCostOrOtherBasis
Depreciation877457Depreciation
Book Value310293BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis479503OtherCostOrOtherBasis
Depreciation305828Depreciation
Book Value173675BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1422356TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionEstimated third party payor settlementDescription
Amount$65,207Amount
FieldValueIRS element (for citing)
Total Of Amounts65207TotalOfAmounts
Total Revenue4131754TotalRevenue
Total Expenses3961770TotalExpenses
Excess Or Deficit For Year169984ExcessOrDeficitForYear
Net Unrealized GL On Investments14871NetUnrealizedGLOnInvestments
Total Adjustments14871TotalAdjustments
Excess Or Deficit Per FS184855ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt4146625TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments14871NetUnrealizedGainsInvestments
Revenue Not Rptd F99014871RevenueNotRptdF990
Revenue Subtotal4131754RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9904131754TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3961770TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal3961770ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9903961770TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Intended Use of Endowment Funds:Identifier
Return ReferencePart V, Line 4:ReturnReference
ExplanationThe intended uses of the endowment funds include funding for scholarships and other activities of the nursing home.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section B, line 11Form 990 was provided to the governing body by email. It was reviewed by the Chair of the Finance Committee and the President of the Board of Directors.
Form 990, Part VI, Section B, line 12cEach director, principal officer and member of a committee with governing board-delegated powers shall annually sign a statement, which affirms such person: (a) has received a copy of the conflict of interest policy, (b) has read and understands the policy, (c) has agreed to comply with the policy and (d) understands the Island Nursing Home is charitable and in order to maintain its federal exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest transaction shall be approved or ratified.
Form 990, Part VI, Section B, line 15aThe process for determining the administrator's compensation includes a compensation committee, compensation survey or study and approval by the board or compensation committee.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request.
Form 990, Part XI, line 5:Net unrealized gains on investments: 14,871.Changes in Net Assets or Fund Balances:
Form 990, Part XII, Line 2cThe audit process has not changed from the prior year.Oversight of Audit