ST JOSEPH RESIDENCE INC MRS SHAW: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ST JOSEPH RESIDENCE INC MRS SHAW (EIN 39-1087412)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-05-14
IRS object ID
201241359349302274
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)
Timestamp2012-05-14T11:03:10-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN391173131EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SCHENCK SCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 23819AddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code543053819ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391087412EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST JOSEPH RESIDENCE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTJONameControl
Phone9209825310Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1107 E BECKERT ROADAddressLine1
CityNEW LONDONCity
StateWIState
ZIP Code54961ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBOB FIETSCHName
TitleEXECUTIVE DIRECTORTitle
Phone9209825310Phone
Date Signed2012-05-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePAUL G DENISName
PTINP00240969PTIN
Phone9204367800Phone
Date Prepared2012-05-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBOB FIETSCHNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1107 E BECKERT ROADAddressLine1
CityNEW LONDONCity
StateWIState
ZIP Code54961ZIPCode
FieldValueIRS element (for citing)
Gross Receipts8278221GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.STJOSEPHRESIDENCE.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1965YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE ELDERLY HEALTHCARE AND HOUSINGActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees298TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year14982ContributionsGrantsPriorYear
Contributions Grants Current Year77207ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8966867ProgramServiceRevenuePriorYear
Program Service Revenue CY8191859ProgramServiceRevenueCY
Investment Income Prior Year7243InvestmentIncomePriorYear
Investment Income Current Year6405InvestmentIncomeCurrentYear
Other Revenue Prior Year4511OtherRevenuePriorYear
Other Revenue Current Year2750OtherRevenueCurrentYear
Total Revenue Prior Year8993603TotalRevenuePriorYear
Total Revenue Current Year8278221TotalRevenueCurrentYear
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 Year5273378SalariesEtcPriorYear
Salaries Etc Current Year5175081SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2732909OtherExpensePriorYear
Other Expenses Current Year2656124OtherExpensesCurrentYear
Total Expenses Prior Year8006287TotalExpensesPriorYear
Total Expenses Current Year7831205TotalExpensesCurrentYear
Revenues Less Expenses Prior Year987316RevenuesLessExpensesPriorYear
Revenues Less Expenses CY447016RevenuesLessExpensesCY
Total Assets BOY7095672TotalAssetsBOY
Total Assets EOY7264089TotalAssetsEOY
Total Liabilities BOY2348777TotalLiabilitiesBOY
Total Liabilities EOY2070178TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4746895NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5193911NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE ELDERLY HEALTHCARE AND HOUSING.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6359534Expense
Revenue6973386Revenue
DescriptionSKILLED NURSING FACILITY PROVIDED 33,506 DAYS OF CARE IN 2011.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense708025Expense
Revenue1218473Revenue
DescriptionCOMMUNITY BASED RESIDENTIAL FACILITY AND ASSISTED LIVING PROVIDED 19,173 DAYS OF CARE DURING 2011.Description
FieldValueIRS element (for citing)
Total Program Service Expense7067559TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees298NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SUE WOLFEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9209825354TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1107 E BECKERT ROADAddressLine1
CityNEW LONDONCity
StateWIState
ZIP Code54961ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
CHARLES HARTZHEIM
PRESIDENT1.00XX000
DAVID RUSCH
VICE PRESIDENT1.00XX000
ANTHONY VAN KAMPEN
SEC-TREASURER1.00XX000
SISTER ADELE DEMULLING
BOARD MEMBER1.00X000
BILL KREJCAREK
BOARD MEMBER1.00X000
FATHER DAVID LEWIS
BOARD MEMBER1.00X000
PAUL NOEL
BOARD MEMBER1.00X000
ANN SCHNEIDER
BOARD MEMBER1.00X000
KENNETH BILGRIEN
BOARD MEMBER1.00X000
BOB FIETSCH
EXECUTIVE DIRECTOR40.00X104540016874
SUE WOLFE
DIRECTOR OF FINANCIAL SERV40.00X6018609870
FieldValueIRS element (for citing)
Total Reportable Comp From Org164726TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation26744TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions77207AllOtherContributions
Total Contributions77207TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROG.SERV.REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column8191859TotalRevenueColumn
Related Or Exempt Function Income8191859RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue8191859TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6405TotalRevenueColumn
Related Or Exempt Function Income6405RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISC. REVENUE-RELATED-Description
Business Code623000BusinessCode
Total Revenue Column2750TotalRevenueColumn
Related Or Exempt Function Income2750RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue2750TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column8278221TotalRevenueColumn
Related Or Exempt Function Income8201014RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total191470Total
Program Services21062ProgramServices
Management And General170408ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4141321Total
Program Services4007379ProgramServices
Management And General133942ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total503450Total
Program Services503450ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total338840Total
Program Services317378ProgramServices
Management And General21462ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total11054Total
Management And General11054ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total673766Total
Program Services632303ProgramServices
Management And General41463ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total23317Total
Program Services945ProgramServices
Management And General22372ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total70996Total
Program Services42323ProgramServices
Management And General28673ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total402051Total
Program Services380902ProgramServices
Management And General21149ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total32612Total
Program Services8904ProgramServices
Management And General23708ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total11520Total
Management And General11520ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total251918Total
Program Services251918ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total12259Total
Program Services4040ProgramServices
Management And General8219ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
THERAPY SUPPLIES283872283872
DIETARY SUPPLIES250226250226
NURSING HOME BED ASSESS218280218280
NURSING PROGRAM EXPENSE211129211129

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total203124Total
Program Services151728ProgramServices
Management And General51396ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7831205Total
Program Services7067559ProgramServices
Management And General763646ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY335888BOY
EOY604480EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY960041BOY
EOY772132EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY731624BOY
EOY716775EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY41635BOY
EOY42598EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY35742BOY
EOY24469EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9106928LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6461037LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2700060BOY
EOY2645891EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2290682BOY
EOY2457744EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7095672BOY
EOY7264089EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY596490BOY
EOY415728EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY803172BOY
EOY713357EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY949115BOY
EOY941093EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2348777BOY
EOY2070178EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4746895BOY
EOY5193911EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4746895BOY
EOY5193911EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7095672BOY
EOY7264089EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses447016ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years30712CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18082CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years157391CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14982CurrentTaxYearMinus1Year
Current Tax Year77207CurrentTaxYear
Total298374Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7242168CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7629797CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8403793CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8966867CurrentTaxYearMinus1Year
Current Tax Year8191859CurrentTaxYear
Total40434484Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7272880CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7647879CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8561184CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8981849CurrentTaxYearMinus1Year
Current Tax Year8269066CurrentTaxYear
Total40732858Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50940732858PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years83145CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years89049CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3694CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7243CurrentTaxYearMinus1Year
Current Tax Year6405CurrentTaxYear
Total189536Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years83145CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years89049CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3694CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7243CurrentTaxYearMinus1Year
Current Tax Year6405CurrentTaxYear
Total189536Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years151125CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8024CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3626CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4511CurrentTaxYearMinus1Year
Current Tax Year2750CurrentTaxYear
Total170036Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7507150CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7744952CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8568504CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8993603CurrentTaxYearMinus1Year
Current Tax Year8278221CurrentTaxYear
Total41092430Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99120PublicSupportPercentage509
Prior Year Support Percentage0.98560PriorYearSupportPercentage
Investment Income Percentage0.00460InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00650PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis182042OtherCostOrOtherBasis
Book Value182042BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5050241OtherCostOrOtherBasis
Depreciation2932224Depreciation
Book Value2118017BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3874645OtherCostOrOtherBasis
Depreciation3528813Depreciation
Book Value345832BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2645891TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RESIDENT TRUST FUND6094
DUE FROM RELATED COMPANY2451650
FieldValueIRS element (for citing)
Total Book Value Other Assets2457744TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionSECURITY DEPOSITSDescription
Amount$941,093Amount
FieldValueIRS element (for citing)
Total Of Amounts941093TotalOfAmounts
Total Revenue8278221TotalRevenue
Total Expenses7831205TotalExpenses
Excess Or Deficit For Year447016ExcessOrDeficitForYear
Excess Or Deficit Per FS447016ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt8278221TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal8278221RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9908278221TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt7831205TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal7831205ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9907831205TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION CURRENTLY HAS NO FORMAL REVIEW PROCESS IN PLACE FOR THE 990.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD REQUIRES AN ANNUAL CONFLICT OF INTEREST STATEMENT. IT REQUIRES THE BOARD MEMBERS TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES THESE RECORDS PUBLIC UPON REQUEST.
PART XII LINE 2CNO CHANGE IN PROCESS FOR 2011.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE WASHINGTON CENTER INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 W WASHINGTONAddressLine1
CityNEW LONDONCity
StateWIState
ZIP Code54961ZIPCode
FieldValueIRS element (for citing)
EIN200349479EIN
Primary ActivitiesASSISTED LIVING, ADULT DAY CARE, SENIOR CENTERPrimaryActivities
Legal Domicile StateWILegalDomicileState
Exempt Code Section501 (C) 3ExemptCodeSection
Public Charity Status509(A)(2)PublicCharityStatus
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1THE WASHINGTON CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeDTransactionType
Amount Involved2451650AmountInvolved
Method Of Amt DeterminationCOSTMethodOfAmtDetermination

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