TIESZEN MEMORIAL HOME INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: TIESZEN MEMORIAL HOME INC (EIN 46-0213759)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-08-23
IRS object ID: 201212369349300716
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
Form 990
Schedule A
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-08-23T13:21:44-05:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WOHLENBERG RITZMAN & CO LLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1018	AddressLine1
City	YANKTON	City
State	SD	State
ZIP Code	57078	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	460213759	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	TIESZEN MEMORIAL HOME	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	TIES	NameControl
Phone	6056483611	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	312 EAST STATE ST	AddressLine1
City	MARION	City
State	SD	State
ZIP Code	57043	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	PAUL ENGBRECHT	Name
Title	CEO	Title
Phone	6056483611	Phone
Date Signed	2012-09-01	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KATHLEEN DOYLE	Name
Phone	6056654401	Phone
Date Prepared	2012-08-20	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	PAUL ENGBRECHT	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	312 EAST STATE ST	AddressLine1
City	MARION	City
State	SD	State
ZIP Code	57043	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	3929474	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.TIESZENHOME.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
State Legal Domicile	SD	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE THE HIGHEST QUALITY OF CARE AND QUALITY OF LIFE FOR THE LONG AND SHORT TERM CARE RESIDENTS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	187	TotalNbrEmployees
Total Nbr Volunteers	50	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	3487	ContributionsGrantsPriorYear
Contributions Grants Current Year	4692	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	4064084	ProgramServiceRevenuePriorYear
Program Service Revenue CY	3908995	ProgramServiceRevenueCY
Investment Income Prior Year	4029	InvestmentIncomePriorYear
Investment Income Current Year	15787	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	4071600	TotalRevenuePriorYear
Total Revenue Current Year	3929474	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	2292697	SalariesEtcPriorYear
Salaries Etc Current Year	2260918	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1690276	OtherExpensePriorYear
Other Expenses Current Year	1709928	OtherExpensesCurrentYear
Total Expenses Prior Year	3982973	TotalExpensesPriorYear
Total Expenses Current Year	3970846	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	88627	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-41372	RevenuesLessExpensesCY
Total Assets BOY	4833168	TotalAssetsBOY
Total Assets EOY	4681930	TotalAssetsEOY
Total Liabilities BOY	1922265	TotalLiabilitiesBOY
Total Liabilities EOY	1812399	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	2910903	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2869531	NetAssetsOrFundBalancesEOY
Mission Description	TO PROVIDE THE HIGHEST QUALITY OF CARE AND QUALITY OF LIFE FOR THE LONG AND SHORT TERM CARE RESIDENTS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	3621637	Expense
Revenue	3908995	Revenue
Description	TIESZEN MEMORIAL HOME IS COMPRISED OF A 64-BED SKILLED NURSING HOME AND A 16-BED ASSISTED LIVING FACILITY AND A 4 UNIT APARTMENT COMPLEX IN MARION, SD. AND A 14-BED ASSISTED LIVING FACILITY IN PARKER, SD. THE HOME PROVIDES LONG TERM NURSING HOME CARE AND HOME HEALTH CARE SERVICES.	Description
Total Program Service Expense	3621637	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	4	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	187	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	LAURA WILSON	NamePerson
Telephone Number	6056483611	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	BOX 209	AddressLine1
City	MARION	City
State	SD	State
ZIP Code	57043	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
ROBERT LOOF
VICE PRESIDE	1.00	X	X	4915	0	0
RICHARD LUKE
MEMBER	1.00	X		536	0	0
LAWRENCE ARBEITER
PRESIDENT	1.00	X	X	487	0	0
RAVILA BERENS
SEC/TREAS	1.00	X	X	487	0	0
PAUL JOHNSON
MEMBER	1.00	X		439	0	0
JAMES A JONES
MEMBER	1.00	X		341	0	0
JEFF COLE
MEMBER	1.00	X		0	0	0
PAUL ENGBRECHT
CEO	40.00		X	82210	0	4955

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	89415	TotalReportableCompFromOrg
Total Other Compensation	4955	TotalOtherCompensation
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
All Other Contributions	4692	AllOtherContributions
Total Contributions	4692	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
RESIDENT SERVICE REVENUES	623000	3655301	3655301
TWIN HOME APTS	623000	134836		$134,836
WASHINGTON ST APTS	623000	59821		$59,821
OTHER OPERATING REVENUE	623000	59037	59037

Field	Value	IRS element (for citing)
Total Program Service Revenue	3908995	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	15787	TotalRevenueColumn
Exclusion	$15,787	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	3929474	TotalRevenueColumn
Related Or Exempt Function Income	3714338	RelatedOrExemptFunctionIncome
Exclusion	$210,444	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	89415	Total
Management And General	89415	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1815378	Total
Program Services	1694173	ProgramServices
Management And General	121205	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	52243	Total
Program Services	44639	ProgramServices
Management And General	7604	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	161683	Total
Program Services	157062	ProgramServices
Management And General	4621	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	142199	Total
Program Services	126871	ProgramServices
Management And General	15328	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	16704	Total
Program Services	16704	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	2802	Total
Program Services	2802	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	21819	Total
Program Services	2295	ProgramServices
Management And General	19524	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	259401	Total
Program Services	259401	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	46739	Total
Program Services	12585	ProgramServices
Management And General	34154	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	40420	Total
Management And General	40420	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	150404	Total
Program Services	150404	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	8650	Total
Program Services	3839	ProgramServices
Management And General	4811	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	76305	Total
Program Services	76305	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	400971	Total
Program Services	400971	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	52176	Total
Program Services	52176	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
PROGRAM SUPPLIES	233915	233915
FOOD EXPENSE	150660	150660
PHARMACY	81655	81655
BAD DEBT EXPENSE	57958	57958

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	109349	Total
Program Services	97222	ProgramServices
Management And General	12127	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	3970846	Total
Program Services	3621637	ProgramServices
Management And General	349209	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	100	BOY
EOY	100	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	416259	BOY
EOY	605335	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	498013	BOY
EOY	371069	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	4093	BOY
EOY	1121	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	21313	BOY
EOY	17954	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	8602619	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	4916268	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	3893390	BOY
EOY	3686351	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	4833168	BOY
EOY	4681930	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	176641	BOY
EOY	196046	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1724003	BOY
EOY	1594814	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	21621	BOY
EOY	21539	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	1922265	BOY
EOY	1812399	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2885463	BOY
EOY	2844091	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	25440	BOY
EOY	25440	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2910903	BOY
EOY	2869531	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	4833168	BOY
EOY	4681930	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-41372	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	12074	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2790	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	16200	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	3487	CurrentTaxYearMinus1Year
Current Tax Year	4692	CurrentTaxYear
Total	39243	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3399302	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3680394	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3866272	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4068113	CurrentTaxYearMinus1Year
Current Tax Year	3714338	CurrentTaxYear
Total	18728419	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3411376	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3683184	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3882472	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4071600	CurrentTaxYearMinus1Year
Current Tax Year	3719030	CurrentTaxYear
Total	18767662	Total

Field	Value	IRS element (for citing)
Public Support Total509	18767662	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	12074	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	11912	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1361	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4029	CurrentTaxYearMinus1Year
Current Tax Year	210444	CurrentTaxYear
Total	239820	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	12074	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	11912	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1361	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4029	CurrentTaxYearMinus1Year
Current Tax Year	210444	CurrentTaxYear
Total	239820	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3423450	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3695096	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3883833	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4075629	CurrentTaxYearMinus1Year
Current Tax Year	3929474	CurrentTaxYear
Total	19007482	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.98740	PublicSupportPercentage509
Prior Year Support Percentage	0.99710	PriorYearSupportPercentage
Investment Income Percentage	0.01000	InvestmentIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Disclosed Orgs Legal Control	false	DisclosedOrgsLegalControl
Disclosed For Charitable Purposes	false	DisclosedForCharitablePurposes
Written Policy Monitoring	false	WrittenPolicyMonitoring
Sect170h Requirements Satisfied	false	Sect170hRequirementsSatisfied
Solicited Assets For Sale	false	SolicitedAssetsForSale
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	false	IncludedOnFS
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	96521	OtherCostOrOtherBasis
Book Value	96521	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6430102	OtherCostOrOtherBasis
Depreciation	3354500	Depreciation
Book Value	3075602	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1880648	OtherCostOrOtherBasis
Depreciation	1469113	Depreciation
Book Value	411535	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	195348	OtherCostOrOtherBasis
Depreciation	92655	Depreciation
Book Value	102693	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	3686351	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	SECURITY DEPOSITS	Description
Amount	$21,539	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	21539	TotalOfAmounts
Total Revenue	3929474	TotalRevenue
Total Expenses	3970846	TotalExpenses
Excess Or Deficit For Year	-41372	ExcessOrDeficitForYear
Other	$34,715	OtherAmount
Total Adjustments	34715	TotalAdjustments
Excess Or Deficit Per FS	-6657	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	3867941	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	3867941	RevenueSubtotal
Other Revenues Not Included	61533	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	61533	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	3929474	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	3874598	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	3874598	ExpensesSubtotal
Other Expenses Not Included	96248	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	96248	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	3970846	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
RECONCILIATION OF CHANGES - OTHER	SCHEDULE D, PAGE 4, PART XI, LINE 8	WASHINGTON STREET APARTMENTS -61,533 WASHINGTON STREET APARTMENTS 96,248 PRIOR TO 2012 THIS ENTITY WAS NOT INCLUDED IN THE AUDIT 0
REVENUE AMOUNTS INCLUDED ON RETURN - OTHER	SCHEDULE D, PAGE 4, PART XII, LINE 4B	WASHINGTON STREET APARTMENTS 61,533
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER	SCHEDULE D, PAGE 4, PART XIII, LINE 4B	WASHINGTON STREET APARTMENTS 96,248 PRIOR TO 2012 THIS ENTITY WAS NOT INCLUDED IN THE AUDIT 0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS	FORM 990, PAGE 1, PART I, LINE 6	ASSIST WITH ACTIVITIES
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	REVIEWED BY CEO AND BOARD BEFORE FILING
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	ANNUAL REVIEW BY BOARD
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	CEO PREPARES AN ANNUAL BUDGET FOR THE OPERATION OF THE FACILITY FOR APPROVAL BY THE BOARD OF DIRECTORS
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	CEO PREPARES AN ANNUAL BUDGET FOR THE OPERATION OF THE FACILITY FOR APPROVAL BY THE BOARD OF DIRECTORS
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	ON REQUEST

TIESZEN MEMORIAL HOME INC: Form 990, tax year 2011

Return header ReturnHeader

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Preparer Firm US Address PreparerFirmUSAddress

Filer Filer

Name Name

US Address USAddress

Officer Officer

Preparer Preparer

Form 990 IRS990

Address Principal Officer US AddressPrincipalOfficerUS

The Books Are In Care Of TheBooksAreInCareOf

Address US AddressUS

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

Program Service Revenue ProgramServiceRevenue (4 entries)

Investment Income InvestmentIncome

Total Revenue TotalRevenue

Comp Current Officers Directors CompCurrentOfficersDirectors

Other Salaries And Wages OtherSalariesAndWages

Pension Plan Contributions PensionPlanContributions

Other Employee Benefits OtherEmployeeBenefits

Payroll Taxes PayrollTaxes

Fees For Services Management FeesForServicesManagement

Fees For Services Legal FeesForServicesLegal

Fees For Services Accounting FeesForServicesAccounting

Fees For Services Other FeesForServicesOther

Advertising Advertising

Office Expenses OfficeExpenses

Occupancy Occupancy

Travel Travel

Interest Interest

Depreciation Depletion DepreciationDepletion

Insurance Insurance

Other Expenses OtherExpenses (4 entries)

All Other Expenses AllOtherExpenses

Total Functional Expenses TotalFunctionalExpenses

Cash Non Interest Bearing CashNonInterestBearing

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Accounts Receivable AccountsReceivable

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Total Assets TotalAssets

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Other Liabilities OtherLiabilities

Total Liabilities TotalLiabilities

Unrestricted Net Assets UnrestrictedNetAssets

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Schedule A IRS990ScheduleA

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Total509 Total509

Gross Investment Income509 GrossInvestmentIncome509

Investment Income And UBTI InvestmentIncomeAndUBTI

Total Support Total TotalSupportTotal

Schedule D IRS990ScheduleD

Land Land

Buildings Buildings

Equipment Equipment

Other Land Buildings OtherLandBuildings

Other Liabilities OtherLiabilities

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

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