FURP.ORG / PUBLIC DATA EXPLORER

INDIANA MASONIC HOME INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
INDIANA MASONIC HOME INC (EIN 35-2187477)
Tax period
2010-04-01 to 2011-03-31
Filed
2012-03-14
IRS object ID
201210749349301351
Schema version
2010v3.4
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)
Timestamp2012-03-14T21:53:56-05:00Timestamp
Tax Period End Date2011-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KSM BUSINESS SERVICES INCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 40857AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code462400857ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN352187477EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INDIANA MASONIC HOME INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlINDINameControl
Phone3177366141Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1690 STATE STREETAddressLine1
CityFRANKLINCity
StateINState
ZIP Code46131ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRIAN LANEName
TitleEXECUTIVE DIRECTORTitle
Phone3173461404Phone
Date Signed2012-03-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSCOTT A SCHUSTERName
Phone3175802000Phone
Date Prepared2012-03-08DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRIAN LANENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1690 STATE STREETAddressLine1
CityFRANKLINCity
StateINState
ZIP Code46131ZIPCode
FieldValueIRS element (for citing)
Gross Receipts39195861GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.INDIANAMASONS.ORG/IMHWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2003YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionTO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees340TotalNbrEmployees
Total Nbr Volunteers120TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5716039ContributionsGrantsPriorYear
Contributions Grants Current Year7247941ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15695657ProgramServiceRevenuePriorYear
Program Service Revenue CY16623131ProgramServiceRevenueCY
Investment Income Prior Year-187561InvestmentIncomePriorYear
Investment Income Current Year813427InvestmentIncomeCurrentYear
Other Revenue Prior Year14716OtherRevenuePriorYear
Other Revenue Current Year54783OtherRevenueCurrentYear
Total Revenue Prior Year21238851TotalRevenuePriorYear
Total Revenue Current Year24739282TotalRevenueCurrentYear
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 Year10749877SalariesEtcPriorYear
Salaries Etc Current Year10852945SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9605331OtherExpensePriorYear
Other Expenses Current Year10165940OtherExpensesCurrentYear
Total Expenses Prior Year20355208TotalExpensesPriorYear
Total Expenses Current Year21018885TotalExpensesCurrentYear
Revenues Less Expenses Prior Year883643RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3720397RevenuesLessExpensesCY
Total Assets BOY114433046TotalAssetsBOY
Total Assets EOY121224171TotalAssetsEOY
Total Liabilities BOY14208695TotalLiabilitiesBOY
Total Liabilities EOY13420587TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY100224351NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY107803584NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE CARE FOR THE ELDERLY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense16960428Expense
Revenue16129045Revenue
DescriptionPROVIDE CARE FOR THE AGEDDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense706684Expense
Revenue494086Revenue
DescriptionHOME HEALTHCAREDescription
FieldValueIRS element (for citing)
Total Program Service Expense17667112TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109656NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees340NumberOfEmployees
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 Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LYNN AUFFARTBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3177366141TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1690 STATE STREETAddressLine1
CityFRANKLINCity
StateINState
ZIP Code46131ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KEN WILLIS
BOARD MEMBER1.00XX000
GREGORY WALBRIDGE
BOARD MEMBER1.00X000
CLIFFORD HENDERSON
BOARD MEMBER1.00X000
GEORGE E GALYEAN
BOARD MEMBER1.00X000
MARK A GENUNG
BOARD MEMBER1.00X000
LORETTA RIEHL
BOARD MEMBER1.00X000
E DREW CARRELL
BOARD MEMBER1.00X000
MICHAEL D BRUMBACK
BOARD MEMBER1.00X000
LINVILLE D CONER
BOARD MEMBER1.00X000
PHILIP C THRASHER
BOARD MEMBER1.00X000
JEFFREY P ZARING
BOARD MEMBER1.00X000
ROBERT R STEVENS
BOARD MEMBER1.00X000
JAMES CHESNEY
PRESIDENT1.00X000
RODNEY A MANN
BOARD MEMBER1.00X000
GEORGE INGLES
BOARD MEMBER1.00X000
DANIEL HALL
BOARD MEMBER1.00X000
STEVE BURNSTEIN
BOARD MEMBER1.00X000
RICHARD ELMAN
BOARD MEMBER1.00XX0772730
CHARLES F MARLOWE
BOARD MEMBER1.00X000
BRIAN LANE
EXECUTIVE DIRECTOR40.00X13887406843
GREG LIMEBERRY
ADMINISTRATOR40.00X10296001764
MICHAEL MALANDRAKIS
CFO40.00X9620209338
JOHN ROSE
CEO40.00X11025004850
FieldValueIRS element (for citing)
Total Reportable Comp From Org448286TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs77273TotalReportableCompFrmRltdOrgs
Total Other Compensation22795TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MEYER NAJEM CONSTRUCTION
13099 PARKSIDE DRIVEFISHERSIN46038CONSTRUCTION4674789
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30348FOOD SERVICE2837877
ANTHEM BCBS IN GROUP
PO BOX 105674ATLANTAGA30348INSURANCE1622880
THERACARE INC
9957 ALLISONVILLE RDFISHERSIN46038THERAPY740104
MCGOWAN INSURANCE GROUP
10 W MARKET ST SUITE 1850INDIANAPOLISIN46204INSURANCE522405
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Membership Dues934443MembershipDues
Fundraising Events18042FundraisingEvents
All Other Contributions6295456AllOtherContributions
Total Contributions7247941TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENCE SERVICES6230001612904516129045
HOME HEALTH CARE621610494086494086
FieldValueIRS element (for citing)
Total Program Service Revenue16623131TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column345075TotalRevenueColumn
Exclusion$345,075ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real32891Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real32891Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column32891TotalRevenueColumn
Exclusion$32,891ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities14915178Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities14446826Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities468352Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column468352TotalRevenueColumn
Exclusion$468,352ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events8773GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events18042CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses9753FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-980TotalRevenueColumn
Exclusion-$980ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code623990BusinessCode
Total Revenue Column22872TotalRevenueColumn
Exclusion$22,872ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue22872TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column24739282TotalRevenueColumn
Related Or Exempt Function Income16623131RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$868,210ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total241003Total
Management And General241003ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7843718Total
Program Services7252709ProgramServices
Management And General591009ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total530290Total
Program Services73476ProgramServices
Management And General456814ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1633553Total
Program Services1465441ProgramServices
Management And General168112ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total604381Total
Program Services542183ProgramServices
Management And General62198ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total254005Total
Management And General254005ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9685Total
Management And General9685ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total109557Total
Management And General109557ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total154623Total
Management And General154623ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total164639Total
Program Services23723ProgramServices
Management And General140916ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total147931Total
Management And General147931ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total394879Total
Program Services83960ProgramServices
Management And General310919ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total61870Total
Program Services26017ProgramServices
Management And General35853ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total387154Total
Management And General387154ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
OUTSIDE SERVICES49840144879211104803
RESIDENT SUPPLIES AND A1076529105165924870
REPAIRS AND MAINTENANCE96442592523739188
UTILITIES96054491717943365
MEDICAL FEES, DRUGS, SU33057131122419347

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total165514Total
Program Services115093ProgramServices
Management And General50421ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total21018885Total
Program Services17667112ProgramServices
Management And General3351773ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2208462BOY
EOY1993442EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2082625BOY
EOY1632267EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY132500BOY
EOY912097EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1794345BOY
EOY1542032EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY31274BOY
EOY31274EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY118763BOY
EOY309020EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9154825BOY
EOY10657126EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY6227361BOY
EOY2172220EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY92682891BOY
EOY101974693EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY114433046BOY
EOY121224171EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2163542BOY
EOY2857330EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY6908435BOY
EOY6284705EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5136718BOY
EOY4278552EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14208695BOY
EOY13420587EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7308253BOY
EOY5828410EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY92916098BOY
EOY101975174EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY100224351BOY
EOY107803584EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY114433046BOY
EOY121224171EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3720397ReconcilationRevenueExpenses
Reconcilation Other Changes3858836ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5129855CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6483552CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6101925CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5716039CurrentTaxYearMinus1Year
Current Tax Year7247941CurrentTaxYear
Total30679312Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years14007800CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14439731CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14485362CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15695657CurrentTaxYearMinus1Year
Current Tax Year16623131CurrentTaxYear
Total75251681Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19137655CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20923283CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years20587287CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21411696CurrentTaxYearMinus1Year
Current Tax Year23871072CurrentTaxYear
Total105930993Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2998363CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4185929CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4312960CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3737428CurrentTaxYearMinus1Year
Current Tax Year5648388CurrentTaxYear
Total20883068Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2998363CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4185929CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4312960CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3737428CurrentTaxYearMinus1Year
Current Tax Year5648388CurrentTaxYear
Total20883068Total
FieldValueIRS element (for citing)
Public Support Total50985047925PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years295107CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years210254CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years543822CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year396968CurrentTaxYearMinus1Year
Current Tax Year377966CurrentTaxYear
Total1824117Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years295107CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years210254CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years543822CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year396968CurrentTaxYearMinus1Year
Current Tax Year377966CurrentTaxYear
Total1824117Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12696CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years35190CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13142CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20007CurrentTaxYearMinus1Year
Current Tax Year-980CurrentTaxYear
Total80055Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year22872CurrentTaxYear
Total22872Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19445458CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21168727CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21144251CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21828671CurrentTaxYearMinus1Year
Current Tax Year24270930CurrentTaxYear
Total107858037Total
FieldValueIRS element (for citing)
Public Support Percentage5090.78850PublicSupportPercentage509
Prior Year Support Percentage0.93700PriorYearSupportPercentage
Investment Income Percentage0.01690InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01840PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOMEGeneralExplanation

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)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionINTEREST IN NET ASSETS OF FOUNDATIONDescription
Book Value101974693BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets101974693TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ADVANCE FEES$353,250
RESIDENT DEPOSIT$90,300
ACCRUED PENSION LIABILITY$3,835,002
FieldValueIRS element (for citing)
Total Of Amounts4278552TotalOfAmounts
Total Revenue24739282TotalRevenue
Total Expenses21018885TotalExpenses
Excess Or Deficit For Year3720397ExcessOrDeficitForYear
Net Unrealized GL On Investments820786NetUnrealizedGLOnInvestments
Other$3,038,050OtherAmount
Total Adjustments3858836TotalAdjustments
Excess Or Deficit Per FS7579233ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt25729637TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments820786NetUnrealizedGainsInvestments
Other Revenues578712OtherRevenues
Revenue Not Rptd F9901399498RevenueNotRptdF990
Revenue Subtotal24330139RevenueSubtotal
Investment Expenses Not Included154623InvestmentExpensesNotIncluded
Other Revenues Not Included254520OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt409143RevenueNotRptdOnFinStmt
Total Revenue Per Form99024739282TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt20874015TotExpensesEtcAuditedFinclStmt
Other Expenses Included9753OtherExpensesIncluded
Expenses Not Rptd F9909753ExpensesNotRptdF990
Expenses Subtotal20864262ExpensesSubtotal
Investment Expenses Not Included2154623InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt154623ExpensesNotRptdOnFinStmt
Total Expenses Per Form99021018885TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOME IS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SIMILAR PROVISIONS OF INDIANA TAX LAWS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. IN ADDITION, THE HOME HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED MARCH 31, 2011 AND 2010. THE HOME FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION RETURNS. IT IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2008.
PART XI, LINE 8 - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTIONS -5,648,388. CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION 15,021,903. MINIMUM PENSION LIABILITY ADJUSTMENT 89,225. TRANSFER OF ASSETS TO INDIANA MASONIC HOME, INC. -6,424,690.
PART XII, LINE 2D - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTION 568,959. EXPENSES FROM SPECIAL EVENT 9,753.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN TEMPORARILY RESTRICTED NET ASSETS-CONTRIBUTIONS 254,520.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES FROM SPECIAL EVENT 9,753.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF OUTINGNameOfEvent1
Gross Receipts Event126815GrossReceiptsEvent1
Charitable Contributions Event118042CharitableContributionsEvent1
Gross Revenue Event18773GrossRevenueEvent1
Other Direct Expenses Event19753OtherDirectExpensesEvent1
Gross Receipts Total26815GrossReceiptsTotal
Charitable Contributions Total18042CharitableContributionsTotal
Gross Revenue Total Events8773GrossRevenueTotalEvents
Other Direct Expenses Total Events9753OtherDirectExpensesTotalEvents
Direct Expense Summary Events9753DirectExpenseSummaryEvents
Net Income Summary-980NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3EXECUTIVE DIRECTOR BRIAN LANE IS AN EMPLOYEE OF LIFE CARE SERVICES, AN OUTSITE MANAGEMENT COMPANY WHICH MANAGES, OPERATES AND MAINTAINS THE INDIANA MASONIC HOME
FORM 990, PART VI, SECTION B, LINE 11MANAGEMENT WILL REVIEW THE FORM 990.
REVIEW NOTATIONS ON CONFLICT OF INTEREST POLICY AND DISCUSS AND RESOLVE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS.FORM 990, PART VI, SECTION B, LINE 12C
THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF THE OUTSIDE MANAGEMENT COMPANY. HIS SALARY IS DETERMINED BY THE MANAGEMENT COMPANY.FORM 990, PART VI, SECTION B, LINE 15
UPON REQUEST. ANNUAL STATE DISCLOSURE STATEMENT THAT IS AVAILABLE TO ALL POTENTIAL NEW RESIDENTS.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 820,786. NET ASSETS RELEASED FROM RESTRICTIONS -5,648,388. CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION 15,021,903. MINIMUM PENSION LIABILITY ADJUSTMENT 89,225. TRANSFER OF ASSETS TO INDIANA MASONIC HOME, INC. -6,424,690. TOTAL TO FORM 990, PART XI, LINE 5: 3,858,836.FORM 990, PART XI, LINE 5:
THE PROCESS HAD NOT CHANGED.FORM 990, PART XII, LINE 2C
RECORD RETENTION AND DESTRUCTION POLICY MEDICAL RECORDS OF THE ORGANIZATION ARE GOVERNED BY A RETENTION AND STORAGE POLICY, AS WELL AS A CLOSED CHART POLICY.FORM 990, PART VI, SECTION B, LINE 14

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrg
INDIANA MASONIC HOME FOUNDATION INC
525 N ILLINOIS STINDIANAPOLISIN46204351091997PROVIDE SUPPORT TO THE INDIANA MASONIC HOMEIN501(C)(3)509(A)(3)0
IMH REALTY INC
690 STATE STREETFRANKLININ46131364513246PROVIDE PROPERTY TO ENSURE THE RESIDENTIAL AND MEDIAL CARE FOR THE ELDERLYIN501(C)(2)0
GRAND LODGE
525 N ILLINOIS STINDIANAPOLISIN46204350300010FRATERNAL ORGANIZATIONIN501(C)(10)0
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 Org1GiftGrantOrCapContrFrOtherOrg
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 Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
IMH REALTY
J6424690FAIR MARKET VALUE
INDIANA MASONIC HOME FOUNDATION
C5648388CASH

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationTHIS RETURN IS BEING FILED BETWEEN MARCH 1, 2012 AND MARCH 30, 2012 AS DIRECTED BY THE IRS IN NOTICE 2012-4 BECAUSE ELECTRONIC FILING WAS NOT AVAILABLE JANUARY 1, 2012 THROUGH FEBRUARY 29, 2012. WE REQUEST THAT PENALTIES BE WAIVED BECAUSE IT WOULD BE INEQUITABLE TO IMPOSE A PENALTY ON US DUE TO THE UNUSUAL CIRCUMSTANCES REQUIRING US TO DELAY THE FILING OF THIS RETURN.Explanation