MARY HEALTH OF THE SICK CONVALESCENT & NURSING HOSPITAL IN: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MARY HEALTH OF THE SICK CONVALESCENT & NURSING HOSPITAL IN (EIN 95-2299398)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-04-16
IRS object ID
201231079349300323
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)
Timestamp2012-04-16T14:44:26-04:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KELLOGG & ANDELSON ACCOUNTANCY CORPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line121700 OXNARD STREET SUITE 900AddressLine1
CityWOODLAND HILLSCity
StateCAState
ZIP Code91367ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952299398EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MARY HEALTH OF THE SICK CONVALESCENTBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% BETTY SCHMIDTInCareOfName
Name ControlMARYNameControl
Phone8054983644Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12929 THERESA DRIVEAddressLine1
CityNEWBURY PARKCity
StateCAState
ZIP Code91320ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSISTER LOURDES LARAName
TitleEXECUTIVE DIRECTORTitle
Date Signed2012-04-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone8189715100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSISTER CRISTINA JUAREZNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12929 THERESA DRIVEAddressLine1
CityNEWBURY PARKCity
StateCAState
ZIP Code91320ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6921815GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MARYHEALTH.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE THE HIGHEST LEVEL OF LONG-TERM CARE IN SOUTHERN CALIFORNIA.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees126TotalNbrEmployees
Total Nbr Volunteers120TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year583194ContributionsGrantsPriorYear
Contributions Grants Current Year716914ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5493952ProgramServiceRevenuePriorYear
Program Service Revenue CY6053304ProgramServiceRevenueCY
Investment Income Prior Year18761InvestmentIncomePriorYear
Investment Income Current Year91867InvestmentIncomeCurrentYear
Other Revenue Prior Year165557OtherRevenuePriorYear
Other Revenue Current Year26170OtherRevenueCurrentYear
Total Revenue Prior Year6261464TotalRevenuePriorYear
Total Revenue Current Year6888255TotalRevenueCurrentYear
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 Year4214974SalariesEtcPriorYear
Salaries Etc Current Year4164616SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year187205TotalFundrsngExpCurrentYear
Other Expense Prior Year2058290OtherExpensePriorYear
Other Expenses Current Year2615867OtherExpensesCurrentYear
Total Expenses Prior Year6273264TotalExpensesPriorYear
Total Expenses Current Year6780483TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-11800RevenuesLessExpensesPriorYear
Revenues Less Expenses CY107772RevenuesLessExpensesCY
Total Assets BOY10531564TotalAssetsBOY
Total Assets EOY10627038TotalAssetsEOY
Total Liabilities BOY401346TotalLiabilitiesBOY
Total Liabilities EOY385394TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10130218NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10241644NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE THE HIGHEST LEVEL OF LONG-TERM CARE IN SOUTHERN CALIFORNIA. THE SERVANTS OF MARY, MINISTERS TO THE SICK, ARE DEDICATED TO HELPING IN THE PERSONAL LIFE TRANSITION OF THE RESIDENTS AND THEIR FAMILIES IN A SPIRIT AND EXPRESSION OF LOVE AND CONCERN.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense5904361Expense
DescriptionPROVIDED LONG-TERM NURSING CARE TO THE ELDERLY. IN 2011, THE RESIDENT CENSUS WAS 21,581 PATIENT DAYS, WHICH INCLUDE 9,566 PRIVATE PATIENT DAYS, 1,903 MEDICARE A PATIENT DAYS, AND 10,112 MEDIC-CAL PATIENT DAYS.Description
Total Program Service Expense5904361TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
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 AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
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 ActivitiestrueFundraisingActivities
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 EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109620NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees126NumberOfEmployees
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 Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
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
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
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
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBETTY SCHMIDTNamePerson
Telephone Number8054983644TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12929 THERESA DRIVEAddressLine1
CityNEWBURY PARKCity
StateCAState
ZIP Code91320ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
SISTER ADRIANA OLIVARES
VICE PRESIDENT/ SECRETARY50.0X000
SISTER LOURDES LARA
PRESIDENT50.0X000
SISTER GERMANA CONTRERAS
TREASURER50.0X000
SISTER ESTHER FONSECA
50.0X000
SHIDEH AFSHAR-TAVANA
Adminstrator40.07161600X
FieldValueIRS element (for citing)
Total Reportable Comp From Org71616TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions716914AllOtherContributions
Total Contributions716914TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT CARE AND RESIDENT REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column6053304TotalRevenueColumn
Related Or Exempt Function Income6053304RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6053304TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column91867TotalRevenueColumn
Exclusion$91,867ExclusionAmount

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
FieldValueIRS element (for citing)
Gross Income Fundraising Events59730GrossIncomeFundraisingEvents
Fundraising Direct Expenses33560FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column26170TotalRevenueColumn
Exclusion$26,170ExclusionAmount

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 Column6888255TotalRevenueColumn
Related Or Exempt Function Income6053304RelatedOrExemptFunctionIncome
Exclusion$118,037ExclusionAmount

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)
Total71616Total
Program Services35808ProgramServices
Management And General17904ManagementAndGeneral
Fundraising17904Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3440677Total
Program Services2988509ProgramServices
Management And General377183ManagementAndGeneral
Fundraising74985Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total359279Total
Program Services328213ProgramServices
Management And General16401ManagementAndGeneral
Fundraising14665Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total293044Total
Program Services253916ProgramServices
Management And General29339ManagementAndGeneral
Fundraising9789Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total28200Total
Management And General28200ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8466Total
Management And General8466ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

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)
Total67952Total
Management And General67952ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total6497Total
Management And General4922ManagementAndGeneral
Fundraising1575Fundraising

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)
Total13141Total
Management And General13141ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total186442Total
Program Services186442ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total259164Total
Program Services259164ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total61246Total
Program Services42872ProgramServices
Management And General12249ManagementAndGeneral
Fundraising6125Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
ANCILLARY SERVICES/SUPPLIES548070548070
UTILITIES206612179753206616198
QA ASSESMENT FEE294182294182
PLANT OPERATIONS & MAINTENANCE251281251281

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total684614Total
Program Services536151ProgramServices
Management And General92499ManagementAndGeneral
Fundraising55964Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6780483Total
Program Services5904361ProgramServices
Management And General688917ManagementAndGeneral
Fundraising187205Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY161655BOY
EOY308808EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY101229BOY
EOY1900EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY301242BOY
EOY200518EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY77881BOY
EOY60537EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis12107545LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5646925LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6672726BOY
EOY6460620EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3221103BOY
EOY3594655EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY-4272BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY10531564BOY
EOY10627038EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY368535BOY
EOY385394EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY32811BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY401346BOY
EOY385394EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY9696124BOY
EOY9998133EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY434094BOY
EOY243511EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10130218BOY
EOY10241644EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10531564BOY
EOY10627038EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses107772ReconcilationRevenueExpenses
Reconcilation Other Changes3654ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Church170b1 AiXChurch170b1Ai

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)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11396440OtherCostOrOtherBasis
Depreciation4944577Depreciation
Book Value6451863BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis610631OtherCostOrOtherBasis
Depreciation609773Depreciation
Book Value858BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis100474OtherCostOrOtherBasis
Depreciation92575Depreciation
Book Value7899BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6460620TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Total Revenue6888255TotalRevenue
Total Expenses6780483TotalExpenses
Excess Or Deficit For Year107772ExcessOrDeficitForYear
Excess Or Deficit Per FS107772ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt8013544TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-622NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities1125911DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F9901125289RevenueNotRptdF990
Revenue Subtotal6888255RevenueSubtotal
Total Revenue Per Form9906888255TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt7906394TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities1125911DonatedServicesUseOfFacilities
Expenses Not Rptd F9901125911ExpensesNotRptdF990
Expenses Subtotal6780483ExpensesSubtotal
Total Expenses Per Form9906780483TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPART X, LINE 2Identifier
Return ReferenceDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER ASC 740 (FIN 48)ReturnReference
ExplanationThe Organization is exempt from federal and California income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC) and corresponding California provisions, except to the extent of unrelated business taxable income (UBTI) as defined by IRC. The Organization evaluates uncertain tax positions through its review of the sources of income to identify UBTI and certain other matters, including those which may affect its tax exempt status. The effect of the uncertainty would be recorded if the outcome was considered probable and reasonably estimable. As of December 31, 2011 and 2010, the Organization had no uncertain tax positions requiring accrual. The Organization files federal and California exempt organization returns. They are no longer subject to income tax examinations by taxing authorities for years before 2008 for its federal and 2007 for its state tax filings.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1100 CLUBNameOfEvent1
Gross Receipts Event159730GrossReceiptsEvent1
Gross Revenue Event159730GrossRevenueEvent1
Other Direct Expenses Event133560OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total59730GrossReceiptsTotal
Gross Revenue Total Events59730GrossRevenueTotalEvents
Other Direct Expenses Total Events33560OtherDirectExpensesTotalEvents
Direct Expense Summary Events33560DirectExpenseSummaryEvents
Net Income Summary26170NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (20 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11REGULARITY OR CONSISTENCY MONITORTHE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE DRAFT OF THE TAX RETURN AND APPROVES IT FOR FILING. THE BALANCES ARE COMPARED TO AUDITED FINANCIAL STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION OF OFFICERS AND KEY EMPLOYEESCOMPENSATION OF OFFICERS AND KEY EMPLOYEES IS DETERMINED AND APPROVED BY THE BOARD OF DIRECTORS BASED ON THE AVAILABLE MARKET DATA.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST POLICYCOMPLIANCE WITH THE CONFLICT OF THE INTEREST POLICY IS MONITERED ON A REGULAR BASIS (EMPLOYEE HANDBOOK, HANDS-ON MEETINGS, ETC.).
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS FOR PUBLICTHE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VI, Section A, Line 8bGoverning Body and ManagementThere are no committees with authority to act on behalf of the governing body.
FORM 990, PART XI, LINE 5OTHER CHANGE IN NET ASSETS REPRESENTS THE NET CHANGE IN AN INVESTMENT IN A PASSTHROUGH ENTITY FROM PRIOR YEAR, WHICH WAS NOT REPORTED IN THE AUDITED FINANCIAL STATEMENTS FYE 12/31/2010.
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:FOOD TOTAL EXPENSES:159206 PROGRAM SERVICES:159206
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:LAUNDRY EXPENSES TOTAL EXPENSES:62875 PROGRAM SERVICES:62875
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:PHARMACEUTICALS TOTAL EXPENSES:90672 PROGRAM SERVICES:90672
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:TAXES AND LICENSES TOTAL EXPENSES:20855 MANAGEMENT AND GENERAL:20855
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:TELEPHONE TOTAL EXPENSES:11790 MANAGEMENT AND GENERAL:11790
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:MEDICAL RECORDS TOTAL EXPENSES:12347 PROGRAM SERVICES:12347
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:DUES AND SUBSCRIPTIONS TOTAL EXPENSES:5823 MANAGEMENT AND GENERAL:5823
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:HOUSEKEEPING SUPPLIES TOTAL EXPENSES:40756 PROGRAM SERVICES:40756
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:POSTAGE TOTAL EXPENSES:2008 MANAGEMENT AND GENERAL:2008
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:FUNDRAISING EXPENSES TOTAL EXPENSES:55964 FUNDRAISING:55964
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:BAD DEBT TOTAL EXPENSES:53402 PROGRAM SERVICES:53402
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:DIETARY SUPPLIES AND EXPENSES TOTAL EXPENSES:34054 PROGRAM SERVICES:34054
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:OTHER PATIENT SERVICES EXP TOTAL EXPENSES:82839 PROGRAM SERVICES:82839
OTHER EXPENSESFORM 990 PART IXDESCRIPTION:G&A EXPENSES TOTAL EXPENSES:52023 MANAGEMENT AND GENERAL:52023

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE SERVANTS OF MARY MINISTERS TO THEBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1800 NORTH 18TH STREETAddressLine1
CityKANSAS CITYCity
StateKSState
ZIP Code66102ZIPCode
FieldValueIRS element (for citing)
Primary ActivitiesCONVENTPrimaryActivities
Legal Domicile StateKSLegalDomicileState
Public Charity StatusIPublicCharityStatus
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 OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1THE SERVANTS OF MARY MINISTERS TO THE SICKBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeQTransactionType
Amount Involved186442AmountInvolved

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