HOOSIER CARE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HOOSIER CARE INC (EIN 62-1486858)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-10
IRS object ID
201341309349302969
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)
Timestamp2013-05-10T15:11:27-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHNREZNICK LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 EAST PRATT STREET SUITE 200AddressLine1
CityBALTIMORECity
StateMDState
ZIP Code212023100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN621486858EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CLAREMONT HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN GILLMORInCareOfName
Name ControlCLARNameControl
Phone6152522305Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 Division St Suite 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN GILMORName
TitleOFFICERTitle
Date Signed2013-05-10DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePHILIP H CORNBLATT CPAName
Phone4107834900Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJohn GillmorNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11600 Division St Suite 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9316153GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number5138GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileNJStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees140TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9975631ProgramServiceRevenuePriorYear
Program Service Revenue CY9312489ProgramServiceRevenueCY
Investment Income Prior Year2022InvestmentIncomePriorYear
Investment Income Current Year3664InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year9977653TotalRevenuePriorYear
Total Revenue Current Year9316153TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5306327SalariesEtcPriorYear
Salaries Etc Current Year5101245SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4517038OtherExpensePriorYear
Other Expenses Current Year4017029OtherExpensesCurrentYear
Total Expenses Prior Year9823365TotalExpensesPriorYear
Total Expenses Current Year9118274TotalExpensesCurrentYear
Revenues Less Expenses Prior Year154288RevenuesLessExpensesPriorYear
Revenues Less Expenses CY197879RevenuesLessExpensesCY
Total Assets BOY7926393TotalAssetsBOY
Total Assets EOY7977648TotalAssetsEOY
Total Liabilities BOY7803431TotalLiabilitiesBOY
Total Liabilities EOY7656807TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY122962NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY320841NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense8874522Expense
Revenue9312489Revenue
DescriptionOPERATED INTERMEDIATE AND SKILLED-CARE NURSING HOME FACILITIES FOR THE CARE OF ELDERLY PATIENTS. The organization has 118 beds in its nursing home facility.Description
Total Program Service Expense8874522TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
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 ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees140NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
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 OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN GILLMORNamePerson
Telephone Number6152522305TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11600 DIVISION ST SUITE 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
BRUCE P HUTSON
PRESIDENT0.4XX0555000
STEPHEN F WOOD Sr
CEO/VP/TREASURER1.0XX244000
JOHN G FOOS
VP/asst. TREASURER0.1XX55500
JOHN E GILLMOR
VP/SECRETARY0.2XX70878
DOUGLASS SMITH
DIRECTOR0.1X
JO ANN CORBITT
DIRECTOR0.1X
STEPHEN F WOOD JR
DIRECTOR0.1X
CYNTHIA WOOD
ASSISTANT SECRETARY0.48X21000
LEWIS F WOOD JR
former CEO548713X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs995591TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
GENESIS ELDERCARE NETWORK SERVICES
101 E STATE STREETKENNETT SQUAREPA19348MANAGEMENT FEES6066722
GENESIS REHABILITATION SERVICES
101 E STATE STREETKENNETT SQUAREPA19348REHAB THERAPIES634671
OMNICARE
2100 QUAKER POINTE DRIVEQUAKERTOWNPA18981PHARMACEUTICALS173717
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SVC REVDescription
Business Code623000BusinessCode
Total Revenue Column9312489TotalRevenueColumn
Related Or Exempt Function Income9312489RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue9312489TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3664TotalRevenueColumn
Exclusion$3,664ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9316153TotalRevenueColumn
Related Or Exempt Function Income9312489RelatedOrExemptFunctionIncome
Exclusion$3,664ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4342728Total
Program Services4342728ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total340022Total
Program Services340022ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total418495Total
Program Services418495ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total533447Total
Program Services533447ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total13869Total
Program Services13869ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total26850Total
Management And General26850ManagementAndGeneral

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)
Total6609Total
Program Services6609ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total414623Total
Program Services414623ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total394546Total
Program Services394546ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total174007Total
Program Services174007ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBTS353233532300
ADMINISTRATIVE21690202169020
UTILITIES17261817261800
SUPPLIES14127914127900

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1886956Total
Program Services1886956ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total9118274Total
Program Services8874522ProgramServices
Management And General243752ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY998968BOY
EOY1448820EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY820485BOY
EOY878485EOY

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)
BOY34531BOY
EOY25467EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY901687BOY
EOY868186EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis10322705LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6144492LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4567891BOY
EOY4178213EOY

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)
BOY602831BOY
EOY578477EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7926393BOY
EOY7977648EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY344175BOY
EOY379590EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY84057BOY
EOY55052EOY

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)
BOY7302938BOY
EOY7183147EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY72261BOY
EOY39018EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7803431BOY
EOY7656807EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY122962BOY
EOY320841EOY

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)
BOY122962BOY
EOY320841EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7926393BOY
EOY7977648EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses197879ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9431036CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9864762CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10250312CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9975621CurrentTaxYearMinus1Year
Current Tax Year9312489CurrentTaxYear
Total48834220Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9431036CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9864762CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10250312CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9975621CurrentTaxYearMinus1Year
Current Tax Year9312489CurrentTaxYear
Total48834220Total
FieldValueIRS element (for citing)
Public Support Total50948834220PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12920CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6518CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3223CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2022CurrentTaxYearMinus1Year
Current Tax Year3664CurrentTaxYear
Total28347Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12920CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6518CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3223CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2022CurrentTaxYearMinus1Year
Current Tax Year3664CurrentTaxYear
Total28347Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9443956CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9871280CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10253535CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9977643CurrentTaxYearMinus1Year
Current Tax Year9316153CurrentTaxYear
Total48862567Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99942PublicSupportPercentage509
Prior Year Support Percentage0.99903PriorYearSupportPercentage
Investment Income Percentage0.00058InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00097PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis750000OtherCostOrOtherBasis
Book Value750000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7629311OtherCostOrOtherBasis
Depreciation4684952Depreciation
Book Value2944359BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1710849OtherCostOrOtherBasis
Depreciation1278132Depreciation
Book Value432717BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis232545OtherCostOrOtherBasis
Depreciation181408Depreciation
Book Value51137BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4178213TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionFINANCING FEES, NET OF AMORTDescription
Book Value578477BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets578477TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOTHER LIABILITYDescription
Amount$39,018Amount
FieldValueIRS element (for citing)
Total Of Amounts39018TotalOfAmounts
Total Revenue9316153TotalRevenue
Total Expenses9118274TotalExpenses
Excess Or Deficit For Year197879ExcessOrDeficitForYear
Excess Or Deficit Per FS197879ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt9316153TotRevenueEtcAuditedFinclStmt
Revenue Subtotal9316153RevenueSubtotal
Total Revenue Per Form9909316153TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt9118274TotExpensesEtcAuditedFinclStmt
Expenses Subtotal9118274ExpensesSubtotal
Total Expenses Per Form9909118274TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48Identifier
Return ReferencePART X LINE 2ReturnReference
ExplanationThe Company has applied for and received a determination letter from the Internal Revenue Service (IRS) to be treated as a tax-exempt entity pursuant to Section 501(c)(3) of the Internal Revenue Code and did not have any unrelated business income for the year ended June 30, 2012. Due to its tax-exempt status, the Company is not subject to income taxes. The Company is required to file and does file tax returns with the IRS and other taxing authorities. Accordingly, these financial statements do not reflect a provision for income taxes and the Company has no other tax positions which must be considered for disclosure. Open tax years for the Company are 2009, 2010 and 2011.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
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 (2 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
STEPHEN F WOOD Sr
244000244000
LEWIS F WOOD JR
548713548713

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (30 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION A, LINE 2RELATIONSHIP SCHEDULE --------------------- NAME OF OFFICER, DIRECTOR, ETC: Stephen Wood NAME OF RELATED ENTITY: LEWIS F. WOOD, JR CYNTHIA WOOD Stephen Wood, JR TITLE OR ROLE: CEO/TREASURER RELATIONSHIP: BROTHER/SISTER-IN-LAW/son NAME OF OFFICER, DIRECTOR, ETC: LEWIS F. WOOD, JR NAME OF RELATED ENTITY: CYNTHIA WOOD STEPHEN WOOD stephen wood, jr TITLE OR ROLE: Former officer RELATIONSHIP: WIFE/BROTHER/nephew NAME OF OFFICER, DIRECTOR, ETC: CYNTHIA WOOD NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD Stephen wood, jr TITLE OR ROLE: Asst Secretary RELATIONSHIP: HUSBAND/BROTHER-IN-LAW/nephew NAME OF OFFICER, DIRECTOR, ETC: Stephen Wood Jr NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD Cynthia Wood TITLE OR ROLE: director RELATIONSHIP: uncle/father/uncle
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION A, LINES 11A DRAFT OF FORM 990 IS REVIEWED & AUTHORIZED BY A MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION B, LINE 15COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON AN INDEPENDENT COMPENSATION STUDY, AND INCREASES ARE BASED ON THE CPI (ALL CONSUMERS MARKET BASKET) AND THE DISCRETION OF THE BOARD.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ORGANIZATION'S OFFICE DURING REGULAR BUSINESS HOURS UPON REQUEST.
COMPENSATION OF OFFICERSPART VII, SECTION A, AVERAGE HOURS PER WEEKTHE OFFICERS AND DIRECTORS DO NOT KEEP DETAILED TIME RECORDS OF HOURS SPENT FOR THIS AND RELATED ENTITIES. HOWEVER, THROUGH DISCUSSIONS WITH EACH, AN ESTIMATE HAS BEEN MADE OF THE TIME THEY SPENT ON MATTERS OF THIS ENTITY AND ITS RELATED CHARITABLE ENTITIES. THERE ARE twelve RELATED CHARITABLE ENTITIES FOR WHICH THE OFFICERS AND DIRECTORS PROVIDE SERVICES. OFTEN BOARD MEETINGS AND OTHER WORK INVOLVES MATTERS FOR SEVERAL OR ALL OF THESE ENTITIES.
GOVERNANCE, MANAGEMENT & DISCLOSUREPart VI Section B Line 12The Board members annually certify that they are aware of the conflict of interest policy and have no conflicts of interest.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BRUCE P. HUTSON TITLE:PRESIDENT HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:STEPHEN F. WOOD, Sr. TITLE:CEO/VP/TREASURER HOURS:29
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN G. FOOS TITLE:VP/asst. TREASURER HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN E. GILLMOR TITLE:VP/SECRETARY HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DOUGLASS SMITH TITLE:DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JO ANN CORBITT TITLE:DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:STEPHEN F. WOOD, JR TITLE:DIRECTOR HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CYNTHIA WOOD TITLE:ASSISTANT SECRETARY HOURS:4
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:CONTRACTS TOTAL EXPENSES:10924 PROGRAM SERVICES:10924 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:TRASH REMOVAL TOTAL EXPENSES:23625 PROGRAM SERVICES:23625 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:VEHICLE MAINTENACE TOTAL EXPENSES:17367 PROGRAM SERVICES:17367 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:MISCELLANEOUS OPERATING TOTAL EXPENSES:19663 PROGRAM SERVICES:19663 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:WORKERS COMP TOTAL EXPENSES:144594 PROGRAM SERVICES:144594 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:LICENSES & CERTIFICATION TOTAL EXPENSES:10079 PROGRAM SERVICES:10079 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:MORTGAGE INSURANCE PREMIUM TOTAL EXPENSES:36240 PROGRAM SERVICES:36240 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:AMORTIZATION EXPENSE TOTAL EXPENSES:24354 PROGRAM SERVICES:24354 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:FOOD TOTAL EXPENSES:189833 PROGRAM SERVICES:189833 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:DRUGS AND PHARM. TOTAL EXPENSES:185857 PROGRAM SERVICES:185857 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:MEDICAL SUPPLIES TOTAL EXPENSES:32647 PROGRAM SERVICES:32647 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:OTHER SERVICE EXPENSES TOTAL EXPENSES:511681 PROGRAM SERVICES:511681 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:NURSING SERVICES TOTAL EXPENSES:35432 PROGRAM SERVICES:35432 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:REHABILITATION SERVICES TOTAL EXPENSES:621162 PROGRAM SERVICES:621162 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:ACTIVITIES SERVICES TOTAL EXPENSES:23210 PROGRAM SERVICES:23210 MANAGEMENT AND GENERAL:FUNDRAISING:
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:MISC FINANCIAL EXPENSES TOTAL EXPENSES:288 PROGRAM SERVICES:288 MANAGEMENT AND GENERAL:FUNDRAISING:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HOOSIER CARE INC
1600 Division St Suite 700NashvilleTN37203311262572NURSING HOMEIN501(C)(3)9NAfalse
HOOSIER CARE II INC
1600 Division St Suite 700NashvilleTN37203311274121NURSING HOMEIN501(C)(3)9HOOSIER CAREfalse
HOOSIER CARE III INC
1600 Division St Suite 700NashvilleTN37203621459304NURSING HOMEDE501(C)(3)9HOOSIER CAREfalse
HOOSIER care PROPERTIES INC
1600 Division St Suite 700NASHVILLETN37203200377349NURSING HOMEIN501(C)(3)9HOOSIER CAREfalse
VICTORIA HEALTH CORPORATION
1600 Division St Suite 700NashvilleTN37203621518645NURSING HOMENJ501(C)(3)9HOOSIER CAREfalse
DELAWARE HEALTH CORPORATION
1600 Division St Suite 700NashvilleTN37203621548336NURSING HOMEDE501(C)(3)9HOOSIER CAREfalse
HIGHLAND HEALTH SYSTEMS INC
1600 Division St Suite 700NashvilleTN37203621486857NURSING HOMEPA501(C)(3)9HOOSIER CAREfalse
BIRCHWOOD SENIOR HOUSING CORPORATION
1600 Division St Suite 700NASHVILLETN37203204800428sr housingDE501(C)(3)9HOOSIER CAREfalse
Cleveland Senior Housing Corporation
1600 Division St Suite 700NashvilleTN37203264739076sr housingTN501(C)(3)9HOOSIER CAREfalse
LAURELWOOD SENIOR HOUSING CORPORATION
1600 DIVISION STREET STE 700NashvilleTN37203320362338SR HOUSINGTN501(C)(3)9HOOSIER CAREfalse
HEALTH & HOUSING SUPPORT SERVICES INC
1600 DIVISION STREET STE 700NASHVILLETN37203452449379sr hsg & svcsNV501(C)(3)11HOOSIER CAREfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CARE INVESTMENTS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11600 Division St Suite 700AddressLine1
CitynashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
EIN200479449EIN
Primary ActivityINVESTMENTPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CAREBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
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 OrgtrueReimbursementPaidToOtherOrg
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 Line1hoosier care investment llcBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeoTransactionType
Amount Involved121200AmountInvolved
Method Of Amt DeterminationcostMethodOfAmtDetermination

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.