HILLCREST FAMILY SERVICES: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HILLCREST FAMILY SERVICES (EIN 42-0680411)
Tax period
2011-11-01 to 2012-10-31
Filed
2013-05-10
IRS object ID
201341309349302714
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-10T14:31:17-05:00Timestamp
Tax Period End Date2012-10-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13999 PENNSYLVANIA AVE SUITE 100AddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52002ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-11-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN420680411EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HILLCREST FAMILY SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHILLNameControl
Phone5635837357Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12005 ASBURY ROADAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52001ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY GANSEMERName
TitlePRESIDENT/CEOTitle
Phone5635837357Phone
Date Signed2013-04-25DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCARMEN KRANTZName
PTINP00031958PTIN
Phone5635561790Phone
Date Prepared2013-04-24DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY GANSEMERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12005 ASBURY ROADAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52001ZIPCode
FieldValueIRS element (for citing)
Gross Receipts19330739GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HILLCREST-FS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1924YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionENHANCES THE LIVES OF CHILDREN, FAMILIES AND ADULTS IN NEEDActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees548TotalNbrEmployees
Total Nbr Volunteers125TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2840849ContributionsGrantsPriorYear
Contributions Grants Current Year2580575ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15731286ProgramServiceRevenuePriorYear
Program Service Revenue CY15849428ProgramServiceRevenueCY
Investment Income Prior Year136882InvestmentIncomePriorYear
Investment Income Current Year44993InvestmentIncomeCurrentYear
Other Revenue Prior Year-108435OtherRevenuePriorYear
Other Revenue Current Year-117087OtherRevenueCurrentYear
Total Revenue Prior Year18600582TotalRevenuePriorYear
Total Revenue Current Year18357909TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY250GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year13225637SalariesEtcPriorYear
Salaries Etc Current Year13825350SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year567600TotalFundrsngExpCurrentYear
Other Expense Prior Year4294094OtherExpensePriorYear
Other Expenses Current Year4024155OtherExpensesCurrentYear
Total Expenses Prior Year17519731TotalExpensesPriorYear
Total Expenses Current Year17849755TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1080851RevenuesLessExpensesPriorYear
Revenues Less Expenses CY508154RevenuesLessExpensesCY
Total Assets BOY11803794TotalAssetsBOY
Total Assets EOY16167300TotalAssetsEOY
Total Liabilities BOY2483366TotalLiabilitiesBOY
Total Liabilities EOY6844554TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9320428NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9322746NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTOMORROW IS ABOUT CHANGING OUR LIVES SO THAT WE CAN CHANGE THE LIVES OF CHILDREN AND FAMILIES IN NEED. WE HAVE MADE THE FIVE PROMISES MODEL OUR OWN, AND ADDED A SIXTH PROMISE: CARING ADULTS, SAFE PLACES, HEALTHY STARTS, EFFECTIVE EDUCATION, OPPORTUNITIES TO SERVE, AND OPPORTUNITIES FOR A SPIRITUAL CONNECTION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense15204989Expense
Revenue15849428Revenue
DescriptionADOLESCENT PREGNANCY PREVENTION PROGRAM (Y CLUB)54 YOUTH, AGE 12 TO 18, PARTICIPATED IN THIS AFTER SCHOOL PREGNANCY PREVENTION PROGRAM. ALONG WITH NIGHTLY ACTIVITIES, THE YOUTH ALSO SPENT TIME AT A LOCAL NURSING HOME ONCE A MONTH THROUGHOUT THE YEAR.ANNA B. LAWTHER ACADEMYADOLESCENT RESIDENTIAL EDUCATION132 YOUTH PARTICIPATED IN HILLCREST'S RESIDENTIAL EDUCATION PROGRAM. KIDS WERE ACTIVELY INVOLVED IN COMMUNITY SERVICE. KIDS CONTINUED THE FARMERS MARKET/GARDENING PROJECT. K-12 SPECIAL EDUCATION PROGRAM202 STUDENTS, GRADES 1 THROUGH 12, ARE ATTENDING SCHOOL AT THE DUBUQUE IN 2012, 40 STUDENTS IN MAQUOKETA, 10 IN THOMSON AND 8 IN MONTICELLO. ADOPTION SERVICES36 PREGNANT WOMEN WERE SEEN IN 2012 FOR ADOPTION COUNSELING. 5 BABIES WERE PLACED INTO ADOPTIVE HOMES. ADOPTION STAFF WORKED WITH 12 FAMILIES SEEKING TO ADOPT A BABY IN THE FUTURE.ADULT RESIDENTIAL TREATMENTTHREE HOMES, TWO IN DUBUQUE AND ONE IN IOWA CITY, FUNCTION TO ASSIST PSYCHIATRICALLY DISABLED ADULTS. 15 INDIVIDUALS LIVED FOR VARIOUS AMOUNTS OF TIME AT THE IOWA CITY HOUSE AND 8 IN THE DUBUQUE HOUSES.ANTI-TOBACCO PROGRAM6,429 PARTICIPANTS WERE SERVICED IN TOBACCO DIVERSION, A PROGRAM FOR YOUTH CITED WITH UNDERAGE TOBACCO USE.BIG BROTHERS BIG SISTERS OF EASTERN IOWA184 SCHOOL AND COMMUNITY BASED MATCHES BETWEEN ADULT "BIGS" AND CHILDREN "LITTLES" OCCURRED. BBBS FOCUSES ON PROVIDING SERVICE ACTIVITIES FOR BIGS AND LITTLES TO PARTICIPATE IN TOGETHER.EMERGENCY SHELTER CARE88 YOUTH IN CRISIS FAMILY SITUATIONS, IN DANGER OF BODILY HARM, AT RISK OF PHYSICAL AND SEXUAL ABUSE OR NEGLECT OR RUNAWAYS RECEIVED SUPPORT AT THE EMERGENCY SHELTER.FAMILY CENTERED SERVICES525 CLIENTS WERE SEEN IN THE FOLLOWING PROGRAMS: SUPERVISED APARTMENT LIVING, COMMUNITY BASED REMEDIAL SERVICES, DRUG TESTING, TRUANCY, FAMILY EMPOWERMENT, FAMILY SUPPORT, EARLY INTERVENTION (SCHOOL & JUVENILE COURT).HEALTH AND FAMILY PLANNING CLINIC2,110 WOMEN AND MEN WERE SEEN IN THE CLINIC. 20-30 REFERRALS WERE MADE TO CRISIS COUNSELING SERVICES.HILLCREST HIGHLAND PLACE80 ADULTS WERE SERVED AT THIS RESIDENTIAL REHABILITATION FACILITY FOR PSYCHIATRICALLY DISABLED ADULTS. 14 MOVED TO ANOTHER LEVEL OF CARE; ONE WAS RE-ADMITTED TO THE FACILITY.HILLCREST MENTAL HEALTH CENTERSDUBUQUE CENTER AND ASBURY LOCATION SEEN A TOTAL OF 3,620 CLIENTS RECEIVING PSYCHIATRY AND MENTAL HEALTH COUNSELING IN DUBUQUE IN 2012. 849 INDIVIDUALS RECEIVED SERVICES AT OUR JACKSON COUNTY MENTAL HEALTH PROGRAM IN MAQUOKETA, AND 616 AT OUR WASHINGTON COUNTY OFFICE.HILLCREST-MERCY MATERNAL HEALTH PROGRAMTHE MATERNAL HEALTH PROGRAM SERVED 942 WOMEN IN DUBUQUE, DELAWARE, JONES, CLINTON, CEDAR, AND JACKSON COUNTIES IN 2012.HILLCREST SUPPORTED LIVINGTHE SUPPORTED LIVING PROGRAM WORKED WITH 180 INDIVIDUALS IN 2012. HOMELESS OUTREACH465 INDIVIDUALS WITH MENTAL HEALTH ISSUES RECEIVED SERVICES THROUGH THE HOMELESS OUTREACH PROGRAM. INTENSIVE PSYCHIATRIC REHABILITATIONTHIS PROGRAM IS INDIVIDUALIZED AS TO WHAT "SUCCESS" MEANS. 90 INDIVIDUALS SET AND WORKED TOWARD LIVING, LEARNING OR WORKING GOALS FOR THEIR LIVES.SUPERVISED APARTMENT LIVING18 YOUTH (16 TO 20 YEARS OLD) PARTICIPATED IN THE SUPERVISED APARTMENT LIVING PROGRAM IN 2012, LEARNING JOB SKILLS, BUDGETING, DAILY LIVING SKILLS AND RECEIVING CHECK-UP FROM STAFF.TRANSITIONAL HOUSING FOR HOMELESS FAMILIESFIVE FAMILIES ARE LIVING IN THE APARTMENTS; THE FIVE PARTICIPATING FAMILIES CONSIST OF SEVEN ADULTS AND EIGHT CHILDREN.WELLNESS CENTER454 INDIVIDUALS RECEIVED PEER-DRIVEN, SUPPORT-BASED SERVICES IN RECOVERY FROM MENTAL ILLNESS, ADDICTIONS, PHYSICAL INJURY/ILLNESS AND OTHER LIFE CHALLENGES. 556 INDIVIDUALS WERE SERVED BY OUR CRISIS SERVICES. WIC PROGRAMTHE WIC LOCATIONS, CLINTON AND DUBUQUE, SERVED 6,360 INDIVIDUALS IN 2012. IN 2012: SERVICES WERE PROVIDED TO INDIVIDUALS IN 54 IOWA COUNTIES, 26 STATES (INCLUDING THE DISTRICT OF COLUMBIA) FOR A TOTAL OF 24,128 PEOPLE SERVED.Description
Total Program Service Expense15204989TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
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 Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109662NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees548NumberOfEmployees
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 Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
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 FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MICHAEL LUEDTKEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5635837357TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12005 ASBURY ROADAddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52001ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MEL MILLER
CHAIRMAN0.30XX000
DEAN BERESFORD
VICE CHAIRMAN0.30XX000
CRENNA BRUMWELL SAHM
2ND VICE CHAIRMAN0.30XX000
BARB KEHL
TREASURER0.30XX000
JIM KENNEDY
SECRETARY0.30XX000
JOHN ADAMS
SECRETARY - PARTIAL YEAR0.30XX000
KEITH COOK
MEMBER0.30X000
BECKY PETERS
MEMBER0.30X000
MICHAEL DONOHUE
MEMBER0.30X000
LEN HADLEY
MEMBER0.30X000
ERNESTINE MOSS
MEMBER0.30X000
JOYCE PATTON
MEMBER0.30X000
DONNELLE FUERSTE
MEMBER0.30X000
GABE FINNIN
MEMBER0.30X000
ROB MCDONALD
MEMBER0.30X000
SAM YAMOAH
MEMBER0.30X000
WESLEY HUISINGA
MEMBER0.30X000
RANDY DECKER
MEMBER0.30X000
MARK LARUE
MEMBER0.30X000
GARY L GANSEMER
PRESIDENT/CEO40.00X153551017318
MICHAEL LUEDTKE
VICE PRESIDENT OF FINANCE40.00X66849020253
FieldValueIRS element (for citing)
Total Reportable Comp From Org220400TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation37571TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MEDICAL ASSOCIATES
1500 ASSOCIATES DRIVEDUBUQUEIA52002PSYCHIATRIC SERVICES353244
NORTHEAST IOWA BEHAVIORAL
905 MONTGOMERY STREETDECORAHIA52101PSYCHIATRIC SERVICES236450
DR MARCUS PRESSLER
1105 MAPLEWOOD DRIVECORALVILLEIA52241PSYCHIATRIC SERVICES112125
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Federated Campaigns126611FederatedCampaigns
Fundraising Events215188FundraisingEvents
Government Grants1321252GovernmentGrants
All Other Contributions917524AllOtherContributions
Total Contributions2580575TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENTIAL TREATMENT62399061763286176328
MENTAL HEALTH CENTERS62410046589154658915
SCHOOLS61160038135773813577
FAMILY SERVICES62410011713041171304
OTHER SUPPORTING REVEN9000992930429304
FieldValueIRS element (for citing)
Total Program Service Revenue15849428TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column47117TotalRevenueColumn
Exclusion$47,117ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities852359Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities854483Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-2124Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-2124TotalRevenueColumn
Exclusion-$2,124ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events1260GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events215188CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses118347FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-117087TotalRevenueColumn
Exclusion-$117,087ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18357909TotalRevenueColumn
Related Or Exempt Function Income15849428RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$72,094ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total250Total
Program Services250ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total276919Total
Management And General276919ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10737707Total
Program Services9461402ProgramServices
Management And General1012418ManagementAndGeneral
Fundraising263887Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total487284Total
Program Services413573ProgramServices
Management And General59331ManagementAndGeneral
Fundraising14380Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1522900Total
Program Services1342316ProgramServices
Management And General154820ManagementAndGeneral
Fundraising25764Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total800540Total
Program Services688261ProgramServices
Management And General94418ManagementAndGeneral
Fundraising17861Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total16719Total
Program Services9592ProgramServices
Management And General1860ManagementAndGeneral
Fundraising5267Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total23115Total
Management And General23115ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total969870Total
Program Services812898ProgramServices
Management And General72218ManagementAndGeneral
Fundraising84754Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total85365Total
Program Services24705ProgramServices
Management And General1579ManagementAndGeneral
Fundraising59081Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1030179Total
Program Services821813ProgramServices
Management And General170426ManagementAndGeneral
Fundraising37940Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total203690Total
Program Services143642ProgramServices
Management And General52410ManagementAndGeneral
Fundraising7638Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total737891Total
Program Services717142ProgramServices
Management And General6179ManagementAndGeneral
Fundraising14570Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total166617Total
Program Services133333ProgramServices
Management And General24960ManagementAndGeneral
Fundraising8324Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total74733Total
Program Services52564ProgramServices
Management And General16090ManagementAndGeneral
Fundraising6079Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total34071Total
Program Services21859ProgramServices
Management And General12172ManagementAndGeneral
Fundraising40Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total438918Total
Program Services294989ProgramServices
Management And General137699ManagementAndGeneral
Fundraising6230Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total125727Total
Program Services101044ProgramServices
Management And General21905ManagementAndGeneral
Fundraising2778Fundraising

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES148484148484
BAD DEBT EXPENSE89448944
RECOVERY OF BAD DEBT-61581-61581

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total21413Total
Program Services8178ProgramServices
Management And General228ManagementAndGeneral
Fundraising13007Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17849755Total
Program Services15204989ProgramServices
Management And General2077166ManagementAndGeneral
Fundraising567600Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY623985BOY
EOY883762EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY932132BOY
EOY864434EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2589283BOY
EOY2090293EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY221BOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY97242BOY
EOY299006EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14938658LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5707941LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4286153BOY
EOY9230717EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1886494BOY
EOY1148156EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY11490BOY
EOY11258EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1376794BOY
EOY1639674EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11803794BOY
EOY16167300EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1350634BOY
EOY1557588EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY419952BOY
EOY259002EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY61548BOY
EOY77119EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY514318BOY
EOY4635026EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY136914BOY
EOY315819EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2483366BOY
EOY6844554EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7810091BOY
EOY8464631EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1066304BOY
EOY627115EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY444033BOY
EOY231000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9320428BOY
EOY9322746EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11803794BOY
EOY16167300EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses508154ReconcilationRevenueExpenses
Reconcilation Other Changes-505836ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2403742CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2433860CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2550558CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2840849CurrentTaxYearMinus1Year
Current Tax Year2580575CurrentTaxYear
Total12809584Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2403742CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2433860CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2550558CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2840849CurrentTaxYearMinus1Year
Current Tax Year2580575CurrentTaxYear
Total12809584Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total1318395AmountsSubstContributorsTotal
Public Support Total17011491189PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years156861CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years108031CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years53484CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year58945CurrentTaxYearMinus1Year
Current Tax Year47117CurrentTaxYear
Total424438Total
FieldValueIRS element (for citing)
Total Support13234022TotalSupport
Gross Receipts From Admissions Etc77344587GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.86830PublicSupportPertcentage170
Public Support Pertcent Prior Year0.89360PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1531320BeginningOfYearBalance
Contributions156707Contributions
Investment Earnings Or Losses109546InvestmentEarningsOrLosses
Other Expenditures1061573OtherExpenditures
End Of Year Balance736000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1548630BeginningOfYearBalance
Contributions128894Contributions
Investment Earnings Or Losses-136836InvestmentEarningsOrLosses
Other Expenditures9368OtherExpenditures
End Of Year Balance1531320EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1312251BeginningOfYearBalance
Contributions46500Contributions
Investment Earnings Or Losses141961InvestmentEarningsOrLosses
Other Expenditures12082OtherExpenditures
End Of Year Balance1193630EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2552079BeginningOfYearBalance
Contributions59248Contributions
Investment Earnings Or Losses85316InvestmentEarningsOrLosses
Other Expenditures1510639OtherExpenditures
End Of Year Balance1017251EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1050InvestmentCostOrOtherBasis
Other Cost Or Other Basis43818OtherCostOrOtherBasis
Book Value44868BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9059227OtherCostOrOtherBasis
Depreciation3732001Depreciation
Book Value5327226BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis172845OtherCostOrOtherBasis
Depreciation58243Depreciation
Book Value114602BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2581444OtherCostOrOtherBasis
Depreciation1837787Depreciation
Book Value743657BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3080274OtherCostOrOtherBasis
Depreciation79910Depreciation
Book Value3000364BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9230717TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS1609283
DEFERRED FINANCING COSTS30391
FieldValueIRS element (for citing)
Total Book Value Other Assets1639674TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED HEALTH CLAIMS PAYABLE$150,000
CONSTRUCTION ACCOUNTS PAYABLE$165,819
FieldValueIRS element (for citing)
Total Of Amounts315819TotalOfAmounts
Total Revenue18357909TotalRevenue
Total Expenses17849755TotalExpenses
Excess Or Deficit For Year508154ExcessOrDeficitForYear
Net Unrealized GL On Investments72046NetUnrealizedGLOnInvestments
Prior Period Adjustments-577882PriorPeriodAdjustments
Total Adjustments-505836TotalAdjustments
Excess Or Deficit Per FS2318ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt18476256TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal18476256RevenueSubtotal
Other Revenues Not Included-118347OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-118347RevenueNotRptdOnFinStmt
Total Revenue Per Form99018357909TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt17968102TotExpensesEtcAuditedFinclStmt
Other Expenses Included118347OtherExpensesIncluded
Expenses Not Rptd F990118347ExpensesNotRptdF990
Expenses Subtotal17849755ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99017849755TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 2B:CUSTODIAL FUNDS
PART V, LINE 4:THE ENDOWMENTS ARE USED FOR SEVERAL DIFFERENT PURPOSES SOME OF WHICH ARE RESTRICTED FOR EDUCATION, FAMILY LIFE CAMPUS BUILDING PROJECT AND FUTURE OPERATING EXPENSES OF THE FAMILY LIFE CAMPUS BUILDING PROJECT. THE COMMUNITY FOUNDATION ALSO HOLDS FUNDS CONTRIBUTED BY INDIVIDUAL DONORS FOR THE BENEFIT OF HILLCREST FAMILY SERVICES, INC. IT SHOULD BE NOTED, HOWEVER, THAT THE COMMUNITY FOUNDATION HAS VARIANCE POWER, WHICH ALLOWS THEM TO MODIFY THE STIPULATIONS OF THE DONORS UNDER CERTAIN CIRCUMSTANCES AS THEY MONITOR THE CHANGING NEEDS OF THE COMMUNITY. THESE FUNDS WILL NOT BE RECORDED AS AN ASSET ON THE FINANCIAL STATEMENTS OF THE ORGANIZATION. THEY TOTAL $505,000 AND $355,000 AT OCTOBER 31, 2012 AND 2011, RESPECTIVELY, AND ARE HELD BY THE COMMUNITY FOUNDATION AS PERMANENTLY ENDOWED FOR THE SUPPORT OF HILLCREST FAMILY SERVICES, INC.DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:
PART X:THE ORGANIZATION IS ORGANIZED AS AN IOWA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), QUALIFY FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(VI) AND (VIII), AND HAS BEEN DETERMINED NOT TO BE A PRIVATE FOUNDATIONS UNDER SECTIONS 509(A)(1) AND (3), RESPECTIVELY. THE ORGANIZATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE ORGANIZATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE ORGANIZATION HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE PURPOSE FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:
FUNDRAISING EXPENSES INCLUDED IN REVENUE FOR FORM 990 -118,347. RENTAL EXPENSES INCLUDED IN REVENUE FOR FORM 990PART XII, LINE 4B - OTHER ADJUSTMENTS:
FUNDRAISING EXPENSES INCLUDED IN REVENUE FOR FORM 990 118,347. RENTAL EXPENSES INLCUDED IN REVENUE FOR FORM 990PART XIII, LINE 2D - OTHER ADJUSTMENTS:

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1LIGHTSNameOfEvent1
Gross Receipts Event1184745GrossReceiptsEvent1
Charitable Contributions Event1184745CharitableContributionsEvent1
Other Direct Expenses Event1109980OtherDirectExpensesEvent1
Name Of Event2BOWL FOR KIDS SAKENameOfEvent2
Gross Receipts Event224893GrossReceiptsEvent2
Charitable Contributions Event223633CharitableContributionsEvent2
Gross Revenue Event21260GrossRevenueEvent2
Other Direct Expenses Event21260OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events6810GrossReceiptsOtherEvents
Charitable Contrib Other Events6810CharitableContribOtherEvents
Other Direct Expenses Other Events6885OtherDirectExpensesOtherEvents
Gross Receipts Total216448GrossReceiptsTotal
Charitable Contributions Total215188CharitableContributionsTotal
Gross Revenue Total Events1260GrossRevenueTotalEvents
Other Direct Expenses Total Events118125OtherDirectExpensesTotalEvents
Direct Expense Summary Events118125DirectExpenseSummaryEvents
Net Income Summary-116865NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonGARY L GANSEMERNamePerson
Base Compensation Filing Org150462BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org3089OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org6982DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org11313NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org171846TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 1THERE IS AN EXECUTIVE COMMITTEE COMPOSED OF THE ELECTED OFFICERS. THE EXECUTIVE COMMITTEE MAY, AT ANY TIME, APPOINT, SUBJECT TO BOARD APPROVAL, NON-BOARD MEMBERS ON STANDING COMMITTEES WHERE APPROPRIATE. A SIMPLE MAJORITY OF THE MEMBERS OF THE EXECUTIVE COMMITTEE CONSTITUTE A QUORUM. THE EXECUTIVE COMMITTEE IS EMPOWERED TO TAKE SUCH ACTION AS SPECIFICALLY AUTHORIZED BY THE BOARD OF TRUSTEES AND PERFORM URGENT BUSINESS THAT CANNOT BE DELAYED UNTIL THE NEXT REGULAR BOARD MEETING. ADDITIONALLY, THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR REVIEWING AND APPROVING THE DUTIES OF THE PRESIDENT/CEO, CONDUCTING THE ANNUAL EVALUATION OF THE PRESIDENT/CEO AND RECOMMENDING ANY MODIFICATIONS TO THE EMPLOYMENT CONTRACT.
FORM 990, PART VI, SECTION A, LINE 2MICHAEL DONOHUE AND DEAN BERESFORD HAVE A BUSINESS RELATIONSHIP. MEL MILLER AND ROB MCDONALD HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6THE BOARD OF TRUSTEES CONSISTS OF NO LESS THAN 12 MEMBERS, CONSISTING OF THREE (3) CLASSES ELECTED FOR A PERIOD OF THREE (3) YEARS. HOWEVER, NO PERSON IS ALLOWED TO SERVE MORE THAN SIX CONSECUTIVE YEARS AS A TRUSTEE.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD DIRECTS THE EXECUTIVE COMMITTEE TO SUBMIT THE NAMES OF CANDIDATES TO SERVE AS REPLACEMENT MEMBERS OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11THE VICE PRESIDENT OF FINANCE AND THE FINANCE COMMITTEE REVIEW THE FORM 990. AFTER REVIEW, THE FORM 990 IS REVIEWED BY THE ENTIRE BOARD BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CHILLCREST FAMILY SERVICES HAS A CONFLICT OF INTEREST POLICY IN PLACE. OFFICERS AND BOARD MEMBERS ARE REQUIRED TO SIGN THE POLICY ANNUALLY. ANY POTENTIAL CONFLICT OF INTEREST IS REQUIRED TO BE DISCLOSED TO THE OTHER MEMBERS OF THE GOVERNING BODY AND MADE A MATTER OF RECORD WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. IF A POTENTIAL CONFLICT ARISES THE CHAIRMAN OF THE BOARD FOLLOWS UP. THE BOARD MEMBER WITH A CONFLICT IS NOT ALLOWED TO VOTE ON THE MATTER.
FORM 990, PART VI, SECTION B, LINE 15ATHE GOVERNING BOARD DETERMINES THE COMPENSATION FOR THE PRESIDENT/CEO AND IS BASED ON AN ANNUAL EVALUATION USING WAGE SCALES AND COMPARABILITY DATA. THERE IS CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE PROCESS WAS LAST COMPLETED IN FISCAL YEAR 2012. THE PRESIDENT/CEO DETERMINES THE COMPENSATION FOR THE VICE PRESIDENT OF FINANCE. THE PROCESS IS COMPLETED AND DOCUMENTED WITH AN ANNUAL EVALUATION USING WAGE SCALES AND COMPARABILITY DATA. THE ORGANIZATION DOES NOT HAVE KEY EMPLOYEES. THE PROCESS WAS LAST COMPLETED IN FISCAL YEAR 2012.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990, PART VII, SECTION A:THE FOLLOWING INDIVIDUALS DEVOTED TIME PROVIDING SERVICES TO BIRCH HOUSE CORPORATION, A RELATED ORGANIZATION. THESE INDIVIDUALS WERE NOT COMPENSATED FOR THEIR SERVICES AS BOARD MEMBERS. WESLEY HUISINGA LESS THAN 1 HOUR PER WEEK JOYCE PATTON LESS THAN 1 HOUR PER WEEK GARY GANSEMER LESS THAN 1 HOUR PER WEEK MICHAEL LUEDTKE LESS THAN 1 HOUR PER WEEK
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 72,046. PRIOR PERIOD ADJUSTMENTS: -577,882. TOTAL TO FORM 990, PART XI, LINE 5: -505,836.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1BIRCH HOUSE CORPORATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1745 PEPPER DRIVEAddressLine1
CityIOWA CITYCity
StateIAState
ZIP Code52240ZIPCode
FieldValueIRS element (for citing)
EIN421443023EIN
Primary ActivitiesHOUSING FACILITY FOR HANDICAPPED ADULTSPrimaryActivities
Legal Domicile StateIALegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 9PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HILLCREST FAMILY SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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