WISCONSIN ILLINOIS SENIOR HOUSING INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- WISCONSIN ILLINOIS SENIOR HOUSING INC (EIN 36-4016275)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-07
- IRS object ID
- 201233129349300548
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-07T10:44:24-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810385940 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDERSON ZURMUEHLEN & CO PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 748 | AddressLine1 |
| City | BUTTE | City |
| State | MT | State |
| ZIP Code | 59703 | 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 | 364016275 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN ILLINOIS SENIOR HOUSING INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WISC | NameControl |
| Phone | 2627288167 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13185 W GREEN MOUNTAIN DRIVE | AddressLine1 |
| City | LAKEWOOD | City |
| State | CO | State |
| ZIP Code | 80228 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANDY KERWIN | Name |
| Title | SECRETARY | Title |
| Phone | 2627288167 | Phone |
| Date Signed | 2012-11-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES E WOY | Name |
| PTIN | P00102054 | PTIN |
| Phone | 4067820451 | Phone |
| Date Prepared | 2012-11-04 | 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 | ANDY KERWIN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13185 W GREEN MOUNTAIN DRIVE | AddressLine1 |
| City | LAKEWOOD | City |
| State | CO | State |
| ZIP Code | 80228 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 32436875 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WISCONSINILLINOISSENOIRHOUSING.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | SKILLED NURSING AND ASSISTED LIVING FACILITIES INCLUDING DEVELOPMENTALLY DISABLED FACILITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 981 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 39569 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 21937 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 30421464 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 31588458 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 228140 | InvestmentIncomePriorYear |
| Investment Income Current Year | 56396 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -566 | OtherRevenuePriorYear |
| Other Revenue Current Year | -42362 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 30688607 | TotalRevenuePriorYear |
| Total Revenue Current Year | 31624429 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 15808230 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16307580 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14091510 | OtherExpensePriorYear |
| Other Expenses Current Year | 15054122 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 29899740 | TotalExpensesPriorYear |
| Total Expenses Current Year | 31361702 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 788867 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 262727 | RevenuesLessExpensesCY |
| Total Assets BOY | 44420361 | TotalAssetsBOY |
| Total Assets EOY | 43884718 | TotalAssetsEOY |
| Total Liabilities BOY | 38977543 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 38192800 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5442818 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5691918 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PRIMARY PURPOSE IS TO PROVIDE SKILLED NURSING AND ASSISTED LIVING FACILITIES FOR AGED INDIVIDUALS INCLUDING ONE HOME DEDICATED TO INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 26382837 | Expense |
| Revenue | 31588458 | Revenue |
| Description | WISCONSIN ILLINOIS SENIOR HOUSING, INC. OWNS AND OPERATES SKILLED NURSING AND ASSISTED LIVING FACILITIES INCLUDING DEVELOPMENTALLY DISABLED FACILITIES. THE ORGANIZATION CONSISTS OF: FAIR OAKS HEALTH CENTER--46 BED FACILITY, GENEVA LAKE MANOR--60 BED FACILITY, WILD ROSE MANOR--78 BED FACILITY, SHELTERED VILLAGE OF RIPON--50 BED DEVELOPMENTALLY DISABLED FACILITY, HOLTON MANOR--60 BED FACILITY, AND MONTELLO CARE CENTER--46 BED SKILLED NURSING AND 7 BED COMMUNITY BASED RESIDENTIAL FACILITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | WELLINGTON HOMES OF WISCONSIN WAS ORGANIZED TO OPERATE SIX RESIDENTIAL ASSISTED LIVING FACILITIES OF THE BENEFIT OF THE ELDERLY. THE FACILITES HAVE A COMBINED TOTAL OF 160 BEDS. ALL HOMES ARE LOCATED IN THE FOLLOWING WISCONSIN LOCATIONS: FORT ATKINSON, HARTFORD, SEEVENS POINT, WAUSAU, AND WISCONSIN RAPIDS. WELLINGTON HOMES OF WISCONSIN, LLC IS A LIMITED LIABILITY CORPORATION OPERATING AS A DISREGARDED ENTITY. THE FEDERAL ID NUMBER IS 26-0564338. THE SOLE MEMBER OF THE LLC IS WISCONSIN ILLINOIS SENIOR HOUSING, INC. THE ASSISTED LIVING FACILITY OPERATIONS BEGAN IN SEPTEMBER 2007. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 26382837 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 38 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 981 | NumberOfEmployees |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUTH BABINEAUX | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3039800611 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13185 W GREEN MOUNTAIN DRIVE | AddressLine1 |
| City | LAKEWOOD | City |
| State | CO | State |
| ZIP Code | 80228 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| CHARLES W NASON | ||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |
| KEN DEVITO | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| MIRIAM GEHLER | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| ANDREW KERWIN | ||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | |
| JILL KRUEGER | ||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | |
| NICHOLAS LYNN | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| MARY TELLIS-NAYAK | ||||||
| EXECUTIVE DIRECTOR | 8.00 | 0 | 39375 | 0 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 39375 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CARRIAGE HEALTHCARE INC | |||||
| 13185 W GREEN MTN DRIVE | LAKEWOOD | CO | 80228 | MANAGEMENT COMPANY | 1107858 |
| GENESIS REHAB SERVICES | |||||
| PO BOX 7247-6524 | PHILADELPHIA | PA | 191706524 | THERAPY SERVICES | 1024125 |
| SYSCO EASTER WI | |||||
| ONE SYSCO DRIVE | JACKSON | WI | 53037 | FOOD SERVICES | 278317 |
| REINHART | |||||
| 2655 EAST RICHMOND STREET | SHWNO | WI | 51466 | FOOD SERVICES | 266632 |
| OMNICARE PHARMACIES OF WI | |||||
| PO BOX 715268 | COLUMBUS | OH | 432715268 | PHARMACY SERVICES | 257717 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 21937 | AllOtherContributions |
| Total Contributions | 21937 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| RESIDENT CARE REVENUE | 623000 | 18972404 | 18972404 |
| ANCILLIARY REVENUE | 623000 | 7076749 | 7076749 |
| ASSISTED LIVING REVENU | 623000 | 5433151 | 5433151 |
| MISC PATIENT BENEFIT R | 623000 | 106154 | 106154 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 31588458 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 139265 | TotalRevenueColumn |
| Exclusion | $139,265 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 5914 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 6326 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -412 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -412 | TotalRevenueColumn |
| Related Or Exempt Function Income | -412 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 722014 | Securities |
| Other | 1237 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 779975 | Securities |
| Other | 26145 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -57961 | Securities |
| Other | -24908 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -82869 | TotalRevenueColumn |
| Exclusion | -$82,869 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISC. REVENUE | 623000 | 49167 | $49,167 |
| MISC. REVENUE: HEALTH | 623000 | 1694 | $1,694 |
| PRIOR YEAR ADJUSTMENTS | 623000 | -29027 | -$29,027 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -63784 | TotalRevenueColumn |
| Exclusion | -$63,784 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -41950 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31624429 | TotalRevenueColumn |
| Related Or Exempt Function Income | 31588046 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $14,446 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13961003 | Total |
| Program Services | 13806671 | ProgramServices |
| Management And General | 154332 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 972307 | Total |
| Program Services | 874749 | ProgramServices |
| Management And General | 97558 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1374270 | Total |
| Program Services | 1266319 | ProgramServices |
| Management And General | 107951 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1107858 | Total |
| Program Services | 1107858 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83063 | Total |
| Management And General | 83063 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200373 | Total |
| Management And General | 200373 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28734 | Total |
| Management And General | 28734 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85227 | Total |
| Program Services | 12645 | ProgramServices |
| Management And General | 72582 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121932 | Total |
| Program Services | 21980 | ProgramServices |
| Management And General | 99952 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1156855 | Total |
| Program Services | 1067931 | ProgramServices |
| Management And General | 88924 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109309 | Total |
| Program Services | 16696 | ProgramServices |
| Management And General | 92613 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2164852 | Total |
| Management And General | 2164852 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1258877 | Total |
| Program Services | 1258877 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245532 | Total |
| Program Services | 245432 | ProgramServices |
| Management And General | 100 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES AND | 3542989 | 3542989 | |
| SUPPLIES | 2690801 | 2690801 | |
| BUSINESS TAXES | 922278 | 922278 | |
| BAD DEBT EXPENSE | 536514 | 536514 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 798928 | Total |
| Program Services | 469889 | ProgramServices |
| Management And General | 329039 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31361702 | Total |
| Program Services | 26382837 | ProgramServices |
| Management And General | 4978865 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4850 | BOY |
| EOY | 4850 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2524154 | BOY |
| EOY | 3045050 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4748839 | BOY |
| EOY | 4928500 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52086 | BOY |
| EOY | 56054 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 137086 | BOY |
| EOY | 44273 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 34056022 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 9271522 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24979045 | BOY |
| EOY | 24784500 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2084515 | BOY |
| EOY | 1680692 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7878594 | BOY |
| EOY | 7488606 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2011192 | BOY |
| EOY | 1852193 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44420361 | BOY |
| EOY | 43884718 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4300194 | BOY |
| EOY | 4233500 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 230445 | BOY |
| EOY | 164700 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34395002 | BOY |
| EOY | 33705100 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51902 | BOY |
| EOY | 89500 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38977543 | BOY |
| EOY | 38192800 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5442818 | BOY |
| EOY | 5691918 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5442818 | BOY |
| EOY | 5691918 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44420361 | BOY |
| EOY | 43884718 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 262727 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -13627 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
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 | 9563 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7633 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 19999 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 39569 | CurrentTaxYearMinus1Year |
| Current Tax Year | 21937 | CurrentTaxYear |
| Total | 98701 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20196628 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 24701607 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 28822103 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30421464 | CurrentTaxYearMinus1Year |
| Current Tax Year | 31588458 | CurrentTaxYear |
| Total | 135730260 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20206191 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 24709240 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 28842102 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30461033 | CurrentTaxYearMinus1Year |
| Current Tax Year | 31610395 | CurrentTaxYear |
| Total | 135828961 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 135828961 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 199562 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 200161 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 83860 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 190842 | CurrentTaxYearMinus1Year |
| Current Tax Year | 139265 | CurrentTaxYear |
| Total | 813690 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 199562 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 200161 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 83860 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 190842 | CurrentTaxYearMinus1Year |
| Current Tax Year | 139265 | CurrentTaxYear |
| Total | 813690 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20405753 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 24909401 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 28925962 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30651875 | CurrentTaxYearMinus1Year |
| Current Tax Year | 31749660 | CurrentTaxYear |
| Total | 136642651 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99400 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99270 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00600 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00730 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3185843 | OtherCostOrOtherBasis |
| Book Value | 3185843 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 30870179 | OtherCostOrOtherBasis |
| Depreciation | 9271522 | Depreciation |
| Book Value | 21598657 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 24784500 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RESTRICTED BOND RESERVES | Description |
| Book Value | 7488606 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 7488606 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| RESIDENT TRUST ACCOUNTS | $53,200 |
| OTHER LIABILITIES | $36,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 89500 | TotalOfAmounts |
| Total Revenue | 31624429 | TotalRevenue |
| Total Expenses | 31361702 | TotalExpenses |
| Excess Or Deficit For Year | 262727 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -9993 | NetUnrealizedGLOnInvestments |
| Prior Period Adjustments | -426 | PriorPeriodAdjustments |
| Other | -$3,208 | OtherAmount |
| Total Adjustments | -13627 | TotalAdjustments |
| Excess Or Deficit Per FS | 249100 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 31633800 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 13160 | OtherRevenues |
| Revenue Not Rptd F990 | 13160 | RevenueNotRptdF990 |
| Revenue Subtotal | 31620640 | RevenueSubtotal |
| Other Revenues Not Included | 3789 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 3789 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 31624429 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 31384700 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 23511 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 23511 | ExpensesNotRptdF990 |
| Expenses Subtotal | 31361189 | ExpensesSubtotal |
| Other Expenses Not Included | 513 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 513 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 31361702 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | FOOTNOTE 1 TO THE FINANCIAL STATEMENTS STATES MANAGEMENT HAS REVIEWED ITS OPERATIONS FOR UNCERTAIN TAX POSITIONS AND HAS DETERMINED NO UNCERTAIN TAX POSITIONS EXIST. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | ROUNDING -300. DEPRECIATION -2,908. TOTAL TO SCHEDULE D, PART XI, LINE 8: -3,208. | |
| PART X: RESIDENT TRUST ACCOUNTS BALANCE $53,064 CARRIAGE HEALTHCARE,INC. MANAGEMENT AGENT PAYABLE $369,100 DUE TO THIRD PARTY PAYORS $0 PART XII LINE 2D ROUNDED FINANCIAL STATEMENT ADJUSTMENT RENTAL EXPENSES -PG 9 LINE 6B NET ADJUSTMENT - LINE 2D PART XIII LINE 2D ROUNDEND FINANCIAL STATEMENT ADJUSTMENT RENTAL EXPENSES - PG 9 LINE 6B NET ADJUSTMENT 6,942 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710VJ84 | 2006-07-19 | 330000 | DEBT PREVIOUSLY FINANCED FOR ACQUISITION OF FIVE NURSING HOME FACILITIES | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710VH92 | 2006-07-19 | 345000 | DEBT PREVIOUSLY FINANCED FOR ACQUISITION OF FIVE NURSING HOME FACILITIES | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710VJ66 | 2003-07-19 | 2020000 | DEBT PREVIOUSLY FINANCED FOR ACQUISITION OF FIVE NURSING HOME FACILITIES | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710VJ74 | 2006-07-19 | 2655000 | DEBT PREVIOUSLY FINANCED FOR ACQUISITION OF FIVE NURSING HOME FACILITIES | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount RetiredAmountRetired |
|---|---|---|---|---|---|
| 2006 | 0 | 0 | 0 | 0 | |
| 2006 | 0 | 0 | 0 | 0 | 345000 |
| 2006 | 0 | 0 | 0 | 0 | |
| 2006 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710VJ82 | 2006-07-19 | 7170000 | DEBT PREVIOUSLY FINANCED FOR ACQUISITION OF FIVE NURSING HOME FACILITIES | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710V4B1 | 2007-09-07 | 585000 | ACQUISITION OF SIX ASSISTED LIVING FACILITIES LOCATED IN WISCONSIN | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710V460 | 2007-09-17 | 1130000 | ACQUISITION OF SIX ASSISTED LIVING FACILITIES LOCATED IN WISCONSIN | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710V4H8 | 2007-09-17 | 3605000 | ACQUISITION OF SIX ASSISTED LIVING FACILITIES LOCATED IN WISCONSIN | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount RetiredAmountRetired |
|---|---|---|---|---|---|
| 2006 | 0 | 0 | 0 | 0 | |
| 2007 | 0 | 0 | 0 | 0 | 180000 |
| 2007 | 0 | 0 | 0 | 0 | |
| 2007 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 9771044J4 | 2007-09-17 | 7935000 | ACQUISITION OF SIX ASSISTED LIVING FACILITIES LOCATED IN WISCONSIN | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 977108VD1 | 2010-08-01 | 980000 | REFINANCE AND IMPROVEMENTS OF LIVIING FACILITIES | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710BVE9 | 2010-08-01 | 1275000 | REFINANCE AND IMPROVEMENTS OF LIVIING FACILITIES | 0 | 0 | 0 |
| WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 977108BG4 | 2010-08-01 | 6910000 | REFINANCE AND IMPROVEMENTS OF LIVIING FACILITIES | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount RetiredAmountRetired |
|---|---|---|---|---|---|
| 2007 | 0 | 0 | 0 | 0 | |
| 2010 | 0 | 0 | 0 | 0 | 180000 |
| 2010 | 0 | 0 | 0 | 0 | |
| 2010 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION HAS ENGAGED CARRIAGE HEALTHCARE INC. (CHC) TO PROVIDE MANAGEMENT SERVICES THROUGH JUNE 30, 2012. CHC IS AN INDEPENDENT "FOR PROFIT" ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD HAS DESIGNATED THE CHAIRMAN AND SECRETARY TO REVIEW AND SIGN THE 990 ON BEHALF OF THE BOARD. ALL BOARD MEMBERS RECEIVE A COPY OF FORM 990. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE POLICY IS MONITORED THROUGH THE CORPORATE COMPLIANCE PROGRAM. REPORTS ARE PROVIDED TO THE BOARD ON AN ANNUAL BASIS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION AND MANAGEMENT COMPANY AGREEMENTS ARE REVIEW BY INDEPENDENT BOARD MEMBERS ON AN ANNUAL BASIS. COMPARABLE DATA IS OBTAINED IN ORDER TO ESTABLISH REASONABLE AMOUNTS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE DOCUMENTS UPON WRITTEN REQUEST TO THE COMPANY. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -9,993. PRIOR PERIOD ADJUSTMENTS: -426. ROUNDING -300. DEPRECIATION -2,908. TOTAL TO FORM 990, PART XI, LINE 5: -13,627. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990 - LINE 2C SCHEDULE XI | THE ENTIRE BOARD REVIEWS AND HAS RESPONSIBILITY FOR THE FINANCIAL STATEMENTS. THIS POLICY IS UNCHANGED FROM PRIOR YEARS. | BOARD RESPONSIBILITY |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLINGTON HOMES OF WISCONSIN LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13185 WEST GREEN MOUNTAIN DRIVE | AddressLine1 |
| City | LAKEWOOD | City |
| State | CO | State |
| ZIP Code | 80228 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260564338 | EIN |
| Primary Activities | ASSISTED LIVING FACILITY | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLINGTON HOMES OF WISCONSIN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionType |
| Amount Involved | 211600 | AmountInvolved |
| Method Of Amt Determination | FIAR VALUE | MethodOfAmtDetermination |
Comments