HIGHLAND HEALTH SYSTEM INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HIGHLAND HEALTH SYSTEM INC (EIN 62-1486857)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-10
IRS object ID
201241319349301834
Schema version
2010v3.7
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)
Timestamp2012-05-10T12:58:03-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1REZNICK GROUP PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 EAST PRATT STREET SUITE 200AddressLine1
CityBALTIMORECity
StateMDState
ZIP Code212023100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN621486857EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HIGHLAND HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHIGHNameControl
Phone6152522305Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 DIVISION STREET Suite 700AddressLine1
CityNASHVILLECity
StateTNState
ZIP Code37203ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN GILLMOREName
TitleOFFICERTitle
Date Signed2012-05-09DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NamePHILIP H CORNBLATT CPAName
Phone4107834900Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonLEWIS F WOOD JRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11600 Division St Suite 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9033208GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number5138GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION WAS FORMED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLYActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees143TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8690594ProgramServiceRevenuePriorYear
Program Service Revenue CY8485272ProgramServiceRevenueCY
Investment Income Prior Year101423InvestmentIncomePriorYear
Investment Income Current Year336737InvestmentIncomeCurrentYear
Other Revenue Prior Year143181OtherRevenuePriorYear
Other Revenue Current Year211199OtherRevenueCurrentYear
Total Revenue Prior Year8935198TotalRevenuePriorYear
Total Revenue Current Year9033208TotalRevenueCurrentYear
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 Year4511459SalariesEtcPriorYear
Salaries Etc Current Year4517047SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4530083OtherExpensePriorYear
Other Expenses Current Year4473225OtherExpensesCurrentYear
Total Expenses Prior Year9041542TotalExpensesPriorYear
Total Expenses Current Year8990272TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-106344RevenuesLessExpensesPriorYear
Revenues Less Expenses CY42936RevenuesLessExpensesCY
Total Assets BOY7563572TotalAssetsBOY
Total Assets EOY7620141TotalAssetsEOY
Total Liabilities BOY7792305TotalLiabilitiesBOY
Total Liabilities EOY7955714TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-228733NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-335573NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION WAS FORMED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense8807370Expense
Revenue8905556Revenue
DescriptionOPERATED A 97 BED INTERMEDIATE AND SKILLED-CARE NURSING FACILITY FOR THE CARE OF ELDERLY PATIENTS.Description
Total Program Service Expense8807370TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
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 With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees143NumberOfEmployees
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 RelationshiptrueFamilyOrBusinessRelationship
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
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN GILLMORNamePerson
Telephone Number6152522305TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11600 DIVISION ST SUITE 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
BRUCE P HUTSON
PRESIDENT1.0XX0662500
STEPHEN F WOOD
VP/TREASURER0.3XX02528000
JOHN G FOOS
VP/DIRECTOR0.35XX0622500
JOHN GILLMOR
VP/SECRETARY0.25XX0852500
LEWIS F WOOD JR
CEO6.0X05369250
CYNTHIA WOOD
ASSISTANT SECRETARY0.5X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1003475TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
GENESIS ELDERCARE NETWORK SERVICES
101 EAST STATE STREETKENNETT SQUAREPA19348MANAGEMENT4697043
GENESIS REHABILITATION SERVICES
PO Box 7247-6524PHILADELPHIAPA19170REHAB SERVICES640164
MEDLINE INDUSTRIES INC
Po Box 382075PITTSBURGHPA15251NURSING SUPPLIES126198
OMNICARE
PO Box 715276COLUMBUSOH43271PHARMACEUTICALS413805
US FOOD SERVICE WEST VIRGINIA
PO Box 644540PITTSBURGHPA15264FOOD & DIETARY151110
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICEDescription
Total Revenue Column8485272TotalRevenueColumn
Related Or Exempt Function Income8485272RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue8485272TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column127651TotalRevenueColumn
Exclusion$127,651ExclusionAmount

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 Column209086TotalRevenueColumn
Exclusion$209,086ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISC. REVENUE1659816598
HOOSIER CARE INVESTMENTS, LLC - OTHER INCOME194601194601
FieldValueIRS element (for citing)
Total Other Revenue211199TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9033208TotalRevenueColumn
Related Or Exempt Function Income8696471RelatedOrExemptFunctionIncome
Exclusion$336,737ExclusionAmount

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4517047Total
Program Services4517047ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total399274Total
Program Services399274ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total69764Total
Program Services69764ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total20300Total
Program Services0ProgramServices
Management And General20300ManagementAndGeneral

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)
Total105796Total
Program Services105796ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total576295Total
Program Services576295ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total313010Total
Program Services313010ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total150999Total
Program Services150999ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
CONTRACT SERVICES73967773967700
SUPPLIES AND OTHER EXPENSES77834677834600
AMORTIZATION164201642000
BAD DEBT955839558300
HOOSIER CARE INVESTMENTS, LLC16260201626020

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1045159Total
Program Services1045159ProgramServices
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total8990272Total
Program Services8807370ProgramServices
Management And General182902ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1118772BOY
EOY780005EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1427704BOY
EOY1864191EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY826039BOY
EOY872829EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY39749BOY
EOY36496EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY82734BOY
EOY49985EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8610603LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5454527LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3417134BOY
EOY3156076EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY651440BOY
EOY860559EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7563572BOY
EOY7620141EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1582611BOY
EOY2006717EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY26751BOY
EOY29898EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5410779BOY
EOY5146935EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY772164BOY
EOY772164EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7792305BOY
EOY7955714EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-228733BOY
EOY-335573EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-228733BOY
EOY-335573EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7563572BOY
EOY7620141EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses42936ReconcilationRevenueExpenses
Reconcilation Other Changes-149776ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8862911CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8987050CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8422135CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8690594CurrentTaxYearMinus1Year
Current Tax Year8485272CurrentTaxYear
Total43447962Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8862911CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8987050CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8422135CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8690594CurrentTaxYearMinus1Year
Current Tax Year8485272CurrentTaxYear
Total43447962Total
FieldValueIRS element (for citing)
Public Support Total50943447962PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years29239CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years57181CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years82601CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year101423CurrentTaxYearMinus1Year
Current Tax Year127651CurrentTaxYear
Total398095Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years29239CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years57181CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years82601CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year101423CurrentTaxYearMinus1Year
Current Tax Year127651CurrentTaxYear
Total398095Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years199054CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years214491CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years111328CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year143181CurrentTaxYearMinus1Year
Current Tax Year211199CurrentTaxYear
Total879253Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9091204CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9258722CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8616064CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8935198CurrentTaxYearMinus1Year
Current Tax Year8824122CurrentTaxYear
Total44725310Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97144PublicSupportPercentage509
Prior Year Support Percentage0.97405PriorYearSupportPercentage
Investment Income Percentage0.00890InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00665PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis81548OtherCostOrOtherBasis
Book Value81548BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6906102OtherCostOrOtherBasis
Depreciation4132571Depreciation
Book Value2773531BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1434406OtherCostOrOtherBasis
Depreciation1171016Depreciation
Book Value263390BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis188547OtherCostOrOtherBasis
Depreciation150940Depreciation
Book Value37607BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3156076TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM THIRD PARTY PAYOR424
FINANCING FEES, NET OF AMORT112895
INVESTMENTS, LLC726257
DUE FROM AFFILIATE20583
OTHER ASSETS400
FieldValueIRS element (for citing)
Total Book Value Other Assets860559TotalBookValueOtherAssets
Total Revenue9033208TotalRevenue
Total Expenses8990272TotalExpenses
Excess Or Deficit For Year42936ExcessOrDeficitForYear
Other-$107,014OtherAmount
Total Adjustments-107014TotalAdjustments
Excess Or Deficit Per FS-64078ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt8763592TotRevenueEtcAuditedFinclStmt
Revenue Subtotal8763592RevenueSubtotal
Other Revenues Not Included269616OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt269616RevenueNotRptdOnFinStmt
Total Revenue Per Form9909033208TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt8827670TotExpensesEtcAuditedFinclStmt
Expenses Subtotal8827670ExpensesSubtotal
Other Expenses Not Included162602OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt162602ExpensesNotRptdOnFinStmt
Total Expenses Per Form9908990272TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL FINANCIAL STATEMENTSIdentifier
Return ReferencePART XI, LINE 8/PART XII, LINE 4B/PART XIII, LINE 4BReturnReference
ExplanationFROM HOOSIER CARE INVESTMENTS, LLCExplanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
STEPHEN F WOOD
0252800000000000252800
LEWIS F WOOD JR
0536925000000000536925

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI SECTION A LINE 2RELATIONSHIP SCHEDULE --------------------- NAME OF OFFICER, DIRECTOR, ETC: STEPHEN WOOD NAME OF RELATED ENTITY: LEWIS F. WOOD, JR CYNTHIA WOOD TITLE OR ROLE: CEO/TREASURER RELATIONSHIP: BROTHER/SISTER-IN-LAW NAME OF OFFICER, DIRECTOR, ETC: LEWIS F. WOOD, JR NAME OF RELATED ENTITY: CYNTHIA WOOD STEPHEN WOOD TITLE OR ROLE: TREASURER/VP RELATIONSHIP: WIFE/BROTHER NAME OF OFFICER, DIRECTOR, ETC: CYNTHIA WOOD NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD TITLE OR ROLE: CEO/VP RELATIONSHIP: HUSBAND/BROTHER-IN-LAW
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION A, LINE 10A DRAFT OF FORM 990 IS REVIEWED AND AUTHORIZED BY A MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI SECTION B LINE 15COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON AN INDEPENDENT COMPENSATION STUDY, AND INCREASES ARE BASED ON THE CPI (ALL CONSUMERS MARKET BASKET) AND THE DISCRETION OF THE BOARD.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI SECTION C LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ORGANIZATION'S OFFICE DURING REGULAR BUSINESS HOURS UPON REQUEST.
COMPENSATION OF OFFICERSPART VII, SECTION A, AVERAGE HOURS PER WEEKTHE OFFICERS AND DIRECTORS DO NOT KEEP DETAILED TIME RECORDS OF HOURS SPENT FOR THIS AND RELATED ENTITIES. HOWEVER, THROUGH DISCUSSIONS WITH EACH, AN ESTIMATE HAS BEEN MADE OF THE TIME THEY SPENT ON MATTERS OF THIS ENTITY AND ITS RELATED CHARITABLE ENTITIES. THERE ARE ten RELATED CHARITABLE ENTITIES FOR WHICH THE OFFICERS AND DIRECTORS PROVIDE SERVICES. OFTEN BOARD MEETINGS AND OTHER WORK INVOLVES MATTERS FOR SEVERAL OR ALL OF THESE ENTITIES.
GOVERNANCE, MANAGEMENT & DISCLOSUREPart VI Section B Line 12The Board members annually certify that they are aware of the conflict of interest policy and have no conflicts of interest.
STATEMENT OF FUNCTIONAL EXPENSES990, PART IX, 24FTOTAL PROG SERV MGMT & GEN FUNDRAISING ---------- --------- ---------- ----------- ADMINISTRATIVE 207,260 207,260 NONE NONE MAINTENANCE 34,818 34,818 NONE NONE MEDICAID ASSESSMENT 609,068 609,068 NONE NONE REAL ESTATE TAXES 84,078 84,078 NONE NONE UTILITIES 109,935 109,935 NONE NONE ---------- --------- ---------- ----------- TOTAL 1,045,159 1,045,159 NONE NONE
reconciliation of net assetsPart XI line 5Hoosier Care Investments LLC - book/tax difference - (149,776)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BRUCE P. HUTSON TITLE:PRESIDENT HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:STEPHEN F. WOOD TITLE:VP/TREASURER HOURS:19
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN G. FOOS TITLE:VP/DIRECTOR HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN GILLMOR TITLE:VP/SECRETARY HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:LEWIS F. WOOD, JR. TITLE:CEO HOURS:38
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CYNTHIA WOOD TITLE:ASSISTANT SECRETARY HOURS:8

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HOOSIER CARE INC
1600 DIVISION STREET STE 700NASHVILLETN37203311262572NURSING HOMEIN501(C)(3)9NA
HOOSIER CARE II INC
1600 DIVISION STREET STE 700NASHVILLETN37203311274121NURSING HOMEIN501(C)(3)9HOOSIER CARE
HOOSIER CARE III INC
1600 DIVISION STREET STE 700NASHVILLETN37203621459304NURSING HOMEDE501(C)(3)9HOOSIER CARE
HOOSIER care PROPERTIES INC
1600 DIVISION STREET STE 700NASHVILLETN37203200377349NURSING HOMEIN501(C)(3)9HOOSIER CARE
CLAREMONT HEALTH SYSTEMS INC
1600 DIVISION STREET STE 700NASHVILLETN37203621486858NURSING HOMENJ501(C)(3)9HOOSIER CARE
VICTORIA HEALTH CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203621518645NURSING HOMENJ501(C)(3)9HOOSIER CARE
DELAWARE HEALTH CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203621548336NURSING HOMEDE501(C)(3)9HOOSIER CARE
BIRCHWOOD SENIOR HOUSING CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203204800428sr housingDE501(C)(3)9HOOSIER CARE
CLEVELAND SENIOR HOUSING CORPORATION
1600 DIVISION STREET STE 700NASHVILLETN37203264739076SR HOUSINGTN501(C)(3)9HOOSIER CARE

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CARE INVESTMENTS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11600 DIVISION STREET STE 700AddressLine1
CityNashvilleCity
StateTNState
ZIP Code37203ZIPCode
FieldValueIRS element (for citing)
EIN200479449EIN
Primary ActivityINVESTMENTPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CAREBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TyperelatedPredominantIncomeType
Share Of Total Income368233ShareOfTotalIncome
Share Of EOY Assets726583ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V$126,822CodeVAmount
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership0.20000PercentageOwnership
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 OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Hoosier care investments llcBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeoTransactionType
Amount Involved67511AmountInvolved

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