MIZPAH ASSISTED LIVING SERVICES: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MIZPAH ASSISTED LIVING SERVICES (EIN 43-1744746)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-07-16
IRS object ID
201201989349301050
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)
Timestamp2012-07-16T14:03:45-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1JAMES C THOMPSON and CO CPAsBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line19909 Clayton Rd Ste 206AddressLine1
CitySaint LouisCity
StateMOState
ZIP Code63124ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN431744746EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MIZPAH ASSISTED LIVING SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMIZPNameControl

US Address USAddress

FieldValueIRS element (for citing)
Address Line16633 DELMAR BLVDAddressLine1
CitySaint LouisCity
StateMOState
ZIP Code63130ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGREG ELLIOTTName
TitleCFOTitle
Date Signed2012-05-14DateSigned
Authorize Third PartyfalseAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHOMAS M SIMPSONName
Phone3149912929Phone
Date Prepared2012-07-16DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts992529GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionASSISTED LIVING ELDERLY PERSONActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1056122ProgramServiceRevenuePriorYear
Program Service Revenue CY990252ProgramServiceRevenueCY
Investment Income Prior Year824InvestmentIncomePriorYear
Investment Income Current Year577InvestmentIncomeCurrentYear
Other Revenue Prior Year2950OtherRevenuePriorYear
Other Revenue Current Year1700OtherRevenueCurrentYear
Total Revenue Prior Year1059896TotalRevenuePriorYear
Total Revenue Current Year992529TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year502362SalariesEtcPriorYear
Salaries Etc Current Year503336SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year537479OtherExpensePriorYear
Other Expenses Current Year637955OtherExpensesCurrentYear
Total Expenses Prior Year1039841TotalExpensesPriorYear
Total Expenses Current Year1141291TotalExpensesCurrentYear
Revenues Less Expenses Prior Year20055RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-148762RevenuesLessExpensesCY
Total Assets BOY2046966TotalAssetsBOY
Total Assets EOY2072425TotalAssetsEOY
Total Liabilities BOY2753016TotalLiabilitiesBOY
Total Liabilities EOY2927237TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-706050NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-854812NetAssetsOrFundBalancesEOY
Mission DescriptionASSISTED LIVING ELDERLY PERSONMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense952022Expense
DescriptionPROVIDING HOUSING MEALS AND ASSISTED PERSONAL CARE TO SENIOR CITIZENSDescription
Total Program Service Expense952022TotalProgramServiceExpense
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 LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
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 RequiredfalseScheduleJRequired
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 EntityfalseRelatedEntity
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
Number Of Employees0NumberOfEmployees
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 Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
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 CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonGreg EllottNamePerson
Telephone Number3147260111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16633 DELMAR BLVDAddressLine1
CitySaint LouisCity
StateMOState
ZIP Code63130ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (3 entries)

TitleTitleIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per WeekAverageHoursPerWeekOfficerOfficer
Katy VerHagen
Director as neededX000
Maureen Dunn
PresidentX0001.00X
Nan Klassan
Director as neededX000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNURSING HOME FEESDescription
Business Code623000BusinessCode
Total Revenue Column990252TotalRevenueColumn
Related Or Exempt Function Income990252RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue990252TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column577TotalRevenueColumn
Related Or Exempt Function Income577RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1700TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column992529TotalRevenueColumn
Related Or Exempt Function Income992529RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total405177Total
Program Services322153ProgramServices
Management And General83024ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total67457Total
Program Services53635ProgramServices
Management And General13822ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total30702Total
Program Services24411ProgramServices
Management And General6291ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total66515Total
Management And General66515ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2294Total
Program Services2294ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5400Total
Program Services5400ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total12201Total
Management And General12201ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total7416Total
Management And General7416ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total292074Total
Program Services292074ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total119484Total
Program Services119484ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total67710Total
Program Services67710ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total42405Total
Program Services42405ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
SUPPLIES1563015630
TELEPHONE EXPENSE55995599
POSTAGE12271227
BAD DEBT EXPENSE

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1141291Total
Program Services952022ProgramServices
Management And General189269ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY76149BOY
EOY67514EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY105246BOY
EOY212038EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3970BOY
EOY652EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY27282BOY
EOY35684EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2265430LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec734561LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1569702BOY
EOY1530869EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY264617BOY
EOY225668EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2046966BOY
EOY2072425EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY687403BOY
EOY709383EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2065613BOY
EOY2217854EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2753016BOY
EOY2927237EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY-706050BOY
EOY-854812EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-706050BOY
EOY-854812EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2046966BOY
EOY2072425EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-148762ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years983728CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1008635CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1097638CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1056122CurrentTaxYearMinus1Year
Current Tax Year990250CurrentTaxYear
Total5136373Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years983728CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1008635CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1097638CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1056122CurrentTaxYearMinus1Year
Current Tax Year990250CurrentTaxYear
Total5136373Total
FieldValueIRS element (for citing)
Public Support Total5095136373PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3680CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1961CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years740CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year824CurrentTaxYearMinus1Year
Current Tax Year577CurrentTaxYear
Total7782Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3680CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1961CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years740CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year824CurrentTaxYearMinus1Year
Current Tax Year577CurrentTaxYear
Total7782Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years667CurrentTaxYearMinus4Years
Current Tax Year Minus1 Year2950CurrentTaxYearMinus1Year
Current Tax Year1700CurrentTaxYear
Total5317Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years988075CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1010596CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1098378CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1059896CurrentTaxYearMinus1Year
Current Tax Year992527CurrentTaxYear
Total5149472Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99750PublicSupportPercentage509
Prior Year Support Percentage0.99720PriorYearSupportPercentage
Investment Income Percentage0.00150InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00280PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis200000InvestmentCostOrOtherBasis
Book Value200000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1819970InvestmentCostOrOtherBasis
Depreciation543852Depreciation
Book Value1276118BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis245460InvestmentCostOrOtherBasis
Depreciation190709Depreciation
Book Value54751BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1530869TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
MISCELLANEOUS CURRENT ASSETS59791
TENANT SECURITY DEP92409
RESERVE FOR RESIDUAL RECEIPTS8991
DEFERRED FINANCING COSTS64477
FieldValueIRS element (for citing)
Total Book Value Other Assets225668TotalBookValueOtherAssets
Total Revenue992529TotalRevenue
Total Expenses1141291TotalExpenses
Excess Or Deficit For Year-148762ExcessOrDeficitForYear
Excess Or Deficit Per FS-148762ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt992529TotRevenueEtcAuditedFinclStmt
Revenue Subtotal992529RevenueSubtotal
Total Revenue Per Form990992529TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1141291TotExpensesEtcAuditedFinclStmt
Expenses Subtotal1141291ExpensesSubtotal
Total Expenses Per Form9901141291TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
01. Management duties delegation (Part VI, line 3)Operational control and responsibility of providing housing meals and assisted personal care to residents Managerial control over the property which involves the upkeep maintenance and improvement of the building and land This also requires the appropriate bookkeeping and reporting requirements mandated by HUD
02. Form 990 governing body review (Part VI, line 11)Form 990 is sent to the Board Chairman for review The Board Chairman then determines how to distribute Form 990
03. Conflict of interest policy compliance (Part VI, line 12c)The organization has each board member sign a conflict of interest form disclosing what if any conflicts of interest the member would have annually
04. Governing documents, etc, available to public (Part VI, line 19)The organization makes public documents available upon request Documents are available in paper or by email
05. Explanation of other changes in net assets or fund balances (Part XI, line 5)THE PROJECT RECORDED A PRIOR ADJUSTMENT TO ACCRUED MORTGAGE INTEREST PAYABLE IN THE AMOUNT OF -10446

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