FURP.ORG / PUBLIC DATA EXPLORER

MISSION HEALTH SERVICES: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MISSION HEALTH SERVICES (EIN 74-2561471)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-10-18
IRS object ID
201102919349300425
Schema version
2010v3.2
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)
Timestamp2011-10-18T14:04:30-07:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Ross & Workman LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11223 W Chavez DrAddressLine1
CitySo JordanCity
StateUTState
ZIP Code84095ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742561471EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MISSION HEALTH SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMISSNameControl
Phone8017452348Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110331 E HWY 39AddressLine1
CityHUNTSVILLECity
StateUTState
ZIP Code84317ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY KELSOName
TitlePresidentTitle
Date Signed2011-10-18DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSTEVEN L ROSSName
Phone8012549781Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY KELSONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110331 EAST HWY 39AddressLine1
CityHUNTSVILLECity
StateUTState
ZIP Code84317ZIPCode
FieldValueIRS element (for citing)
Gross Receipts16592677GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.MISSIONHEALTHSERVICES.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1990YearFormation
State Legal DomicileUTStateLegalDomicile
Activity Or Mission DescriptionMission Health Services is dedicated to providing for the needs of the elderly in the state of Utah through the operation of four skilled nursing care facilities, and one intermediate nursing care facility.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees595TotalNbrEmployees
Total Nbr Volunteers35TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year52085ContributionsGrantsPriorYear
Contributions Grants Current Year27960ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16551567ProgramServiceRevenuePriorYear
Program Service Revenue CY16307160ProgramServiceRevenueCY
Investment Income Prior Year2507InvestmentIncomePriorYear
Investment Income Current Year8230InvestmentIncomeCurrentYear
Other Revenue Prior Year606932OtherRevenuePriorYear
Other Revenue Current Year249327OtherRevenueCurrentYear
Total Revenue Prior Year17213091TotalRevenuePriorYear
Total Revenue Current Year16592677TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9531077SalariesEtcPriorYear
Salaries Etc Current Year9481482SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year20936TotalFundrsngExpCurrentYear
Other Expense Prior Year7591334OtherExpensePriorYear
Other Expenses Current Year6664562OtherExpensesCurrentYear
Total Expenses Prior Year17122411TotalExpensesPriorYear
Total Expenses Current Year16146044TotalExpensesCurrentYear
Revenues Less Expenses Prior Year90680RevenuesLessExpensesPriorYear
Revenues Less Expenses CY446633RevenuesLessExpensesCY
Total Assets BOY11058172TotalAssetsBOY
Total Assets EOY11441850TotalAssetsEOY
Total Liabilities BOY13900234TotalLiabilitiesBOY
Total Liabilities EOY13850335TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-2842062NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-2408485NetAssetsOrFundBalancesEOY
Mission DescriptionMission Health Services (MHS) is committed to providing for the special needs of the elderly throughout Utah. MHS facilities include four skilled nursing care facilities, and one intermediate nursing care facility. Currently, mhs employs over 500 Utahans who work and care for the frail, elderly, and those with special needs. MHS has a strong commitment to build and strengthen a sense of community through support for each other and among residents, staff and volunteers.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense15502248Expense
Revenue16307160Revenue
DescriptionMISSION HEALTH SERVICES (MHS) OPERATES FACILITIES (four SKILLED FACILITIES AND one INTERMEDIATE NURSING CARE FACILITy) IN THE STATE OF UTAH FOR long term care, rehabilitation services, and the care for those individuals with disabilities. BESIDES THE DONATED SERVICES LISTED IN THE RETURN, MHS ALSO DONATED COMMUNITY EDUCATION AND RELATED SERVICES AT AN APPROXIMATE VALUE OF $168,216. SIMILARLY, MHS PROVIDED UNPAID CARE TO INDIGENTS, waived UNREIMBURSED MEDICAid COSTS AND OTHER GIFTS TO THE COMMUNITY VALUED AT APPROXIMATELY $1,203,233, WHICH IS NEITHER REPORTED ON PAGE 1 NOR DISCLOSED ELSEWHERE IN THE RETURN.Description
Total Program Service Expense15502248TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
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
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 EntitytrueDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109632NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees595NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonGary KelsoNamePerson
Telephone Number8017452348TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110331 E HWY 39AddressLine1
CityHUNTSVILLECity
StateUTState
ZIP Code84317ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekKey EmployeeKeyEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficer
WARREN WALKER
ADMINISTRATOR40.00X10425109120
LISA ARBOGAST
BOARD MEMBER1.00200000X
GARY KELSO
President40.0031410009120X
DIRK ANJEWIERDEN
Board Member1.00250000X
DAVID GESSEL
BOARD MEMBER1.00250000X
BRENT WEIL
Board Member1.00250000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org427851TotalReportableCompFromOrg
Total Other Compensation18240TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
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
MOUNTAINLAND REHAB
PO BOX 711185SALT LAKE CITYUT84171THERAPY SERVICES424552
HEALTHCARE SERVICES GROUP
3220 TILLMAN DR STE 300BENSALEMPA19020HOUSEKEEPING/LAUNDRY129923
CL CHRISTIANSEN BROTHERS
1201 EAST 1220 NORTHOREMUT84097BLDG REMODELING130874
CARE FIRST PHARMACY
5492 S ADAMS AVENUEWASHINGTON TERRACEUT84405PHARMACY257903
AHMS
121 SE SHURFINE DR STE 9ANKENYIA50021ACCTG & ADMIN SRVCS268848
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions27960AllOtherContributions
Noncash Contributions20286NoncashContributions
Total Contributions27960TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
UNCOMPENSATED CARE EXPNSE623000-1259054-1259054
PRIVATE CARE REVENUES62300019891751989175
MEDICARE/MEDICAID PAYMENT6230001557703915577039
FieldValueIRS element (for citing)
Total Program Service Revenue16307160TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8230TotalRevenueColumn
Exclusion$8,230ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
QUALITY INCENTIVE REVENUE623000240179240179
OTHER REVENUES62300024632463
CFIRST, LLC INCOME62300066856685
FieldValueIRS element (for citing)
Total Other Revenue249327TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16592677TotalRevenueColumn
Related Or Exempt Function Income16556487RelatedOrExemptFunctionIncome
Exclusion$8,230ExclusionAmount

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)
Total427851Total
Program Services104251ProgramServices
Management And General323600ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7162260Total
Program Services7146860ProgramServices
Fundraising15400Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1275049Total
Program Services1275049ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total616322Total
Program Services605689ProgramServices
Management And General10633ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total26243Total
Program Services6702ProgramServices
Management And General19541ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total293810Total
Program Services293810ProgramServices

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)
Total12742Total
Program Services12742ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total52939Total
Program Services52939ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total191406Total
Program Services141114ProgramServices
Management And General50292ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total70632Total
Program Services57844ProgramServices
Management And General12788ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total848548Total
Program Services848548ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total152695Total
Program Services22596ProgramServices
Management And General130099ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total36957Total
Management And General36957ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total690681Total
Program Services690681ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total649173Total
Program Services627461ProgramServices
Management And General21712ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total131404Total
Program Services121599ProgramServices
Management And General9805ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PHYS., SPEECH, OCC. THERAPY10377161037716
NURSING EXPENSES580417580417
HOUSEKEEPING & LAUNDRY203150203150
DIETARY EXPENSES529173529173
BED TAXES817472817472

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total339404Total
Program Services326435ProgramServices
Management And General7433ManagementAndGeneral
Fundraising5536Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16146044Total
Program Services15502248ProgramServices
Management And General622860ManagementAndGeneral
Fundraising20936Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2678910BOY
EOY3149120EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1147663BOY
EOY1061988EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY191522BOY
EOY121069EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14396164LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8550084LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5632785BOY
EOY5846080EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1407292BOY
EOY1263593EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY11058172BOY
EOY11441850EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1024332BOY
EOY1142420EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY12875902BOY
EOY12707915EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13900234BOY
EOY13850335EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2842062BOY
EOY-2408485EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-2842062BOY
EOY-2408485EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11058172BOY
EOY11441850EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses446633ReconcilationRevenueExpenses
Reconcilation Other Changes-13056ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13500942CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15367347CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16507987CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year16603652CurrentTaxYearMinus1Year
Current Tax Year16335120CurrentTaxYear
Total78315048Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Total0Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13500942CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15367347CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16507987CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year16603652CurrentTaxYearMinus1Year
Current Tax Year16335120CurrentTaxYear
Total78315048Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50978315048PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37093CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years50100CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14706CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2507CurrentTaxYearMinus1Year
Current Tax Year8230CurrentTaxYear
Total112636Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37093CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years50100CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14706CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2507CurrentTaxYearMinus1Year
Current Tax Year8230CurrentTaxYear
Total112636Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years82403CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years95627CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years359557CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year606932CurrentTaxYearMinus1Year
Current Tax Year249327CurrentTaxYear
Total1393846Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13620438CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15513074CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16882250CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year17213091CurrentTaxYearMinus1Year
Current Tax Year16592677CurrentTaxYear
Total79821530Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98110PublicSupportPercentage509
Prior Year Support Percentage0.98260PriorYearSupportPercentage
Investment Income Percentage0.00140InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00170PriorYrInvestIncomePercentage
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 Basis1558541OtherCostOrOtherBasis
Book Value1558541BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9803718OtherCostOrOtherBasis
Book Value9803718BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3033905OtherCostOrOtherBasis
Book Value3033905BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Depreciation8550084Depreciation
Book Value-8550084BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5846080TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RESTRICTED CASH778298
ORGANIZATIONAL COSTS485295
FieldValueIRS element (for citing)
Total Book Value Other Assets1263593TotalBookValueOtherAssets
Total Revenue16592677TotalRevenue
Total Expenses16146044TotalExpenses
Excess Or Deficit For Year446633ExcessOrDeficitForYear
Other-$13,056OtherAmount
Total Adjustments-13056TotalAdjustments
Excess Or Deficit Per FS433577ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt16579621TotRevenueEtcAuditedFinclStmt
Other Revenues7230OtherRevenues
Revenue Not Rptd F9907230RevenueNotRptdF990
Revenue Subtotal16572391RevenueSubtotal
Other Revenues Not Included20286OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt20286RevenueNotRptdOnFinStmt
Total Revenue Per Form99016592677TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16146044TotExpensesEtcAuditedFinclStmt
Expenses Subtotal16146044ExpensesSubtotal
Total Expenses Per Form99016146044TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 4bPart XII, Line 4b: Other revenue amounts included on 990 but not included in F/SDONATIONS RECEIVED NOT ON BOOKS $20286
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990EXCESS PSHP INCOME RECORDED ON BOOKS $7230
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesEXCESS PSHP INCOME RECORDED ON BOOKS $7230 DONATIONS RECEIVED NOT ON BOOKS $ -20286

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
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
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonGARY KELSONamePerson
Base Compensation Filing Org231608BaseCompensationFilingOrg
Bonus Filing Org60000BonusFilingOrg
Other Compensation Filing Org22492OtherCompensationFilingOrg
Nontaxable Benefits Filing Org9120NontaxableBenefitsFilingOrg
Total Compensation Filing Org323220TotalCompensationFilingOrg

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 1aIdentifier
Return ReferencePart I, Line 1a: Relevant information in regards to selections on 1a.ReturnReference
ExplanationA MEMBERSHIP IS MAINTAINED TO THE WOLF CREEK COUNTRY CLUB FOR GARY KELSO. THE SOLE PURPOSE OF THE MEMBERSHIP IS FOR THE PROVISION OF MEALS FOR BUSINESS MEETINGS. THE MEMBERSHIP IS USED 100% FOR BUSINESS OF MISSION HEALTH SERVICES. MR. KELSO DOES NOT USE THE MEMBERSHIP PERSONALLY. HE IS ALSO REQUIRED TO PROVIDE TO MISSION HEALTH SERVICES A MONTHLY STATEMENT FROM THE COUNTRY CLUB WITH DOCUMENTATION FOR THE BUSINESS MEAL EXPENSES INCURRED.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonSHERRY WALKERNamePerson
FieldValueIRS element (for citing)
RelationshipWIFE/ADMINISTRATORRelationship
Amount Of Transaction39792AmountOfTransaction
Description Of TransactionCOMPENSATION FOR SRVCSDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTHE GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesSALARY COMPENSATION SURVEYS ARE REVIEWED BY THE EXECUTIVE COMMITTEE EACH YEAR PRIOR TO APPROVAL. COMPENSATION FOR ADMINISTRATORS IS DETERMINED BY MARKET CONDITIONS. THE PRESIDENT HAS A SALARY CONTRACT, WHICH IS REVIEWED ANNUALLY TO MAKE SURE COMPENSATION IS IN LINE WITH INDUSTRY STANDARDS BASED ON SALARY INFORMATION AVAILABLE IN NATIONAL COMPENSATION REPORTS FOR TAX-EXEMPT ORGANIZATIONS.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsTHE BOARD MEMBERS, OFFICERS AND EMPLOYEES ARE COVERED UNDER THE POLICY ON CONFLICTS OF INTEREST AND DISCLOSURE OF CERTAIN INTERESTS. THEY ARE REQUIRED EACH YEAR TO COMPLETE A DISCLOSURE FORM IDENTIFYING ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES IN WHICH THEY MAY BE INVOLVED THAT MIGHT CONTRIBUTE TO A CONFLICT OF INTEREST ARISING. THE ORGANIZATION REGULARLY MONITORS AND ASSURES COMPLIANCE. ANY PERSONS WITH A CONFLICT ARE PROHIBITED FROM MAKING ANY DECISIONS RELATED TO THE CONFLICT.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessTHE FORM 990 IS DISTRIBUTED TO EACH BOARD MEMBER PRIOR TO RELEASE. THE BOARD MEMBERS REVIEW THE FORM. THE FORM IS EITHER DISCUSSED AT THE NEXT BOARD MEETING, IF BEFORE THE FILING DATE, OR THE BOARD MEMBERS SEND THEIR QUESTIONS AND COMMENTS TO THE PRESIDENT. AFTER THE FORM 990 IS FINALIZED, THE BOARD MEMBERS RECEIVE A COPY OF THE FINALIZED RETURN.
Form 990, Part VI, Line 2Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtBRENT WEIL, A BOARD MEMBER OF MISSION HEALTH SERVICES, IS THE SON-IN-LAW OF GARY KELSO, THE PRINCIPAL OFFICER.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
MISSION WEST JORDAN CARE CENTER LLC
10331 E HWY 39HUNTSVILLEUT84317263762114OWNERSHIP OF BUILDING/LAND OF CARE CENTERUT2773969181MISSION HEALTH SERVICES
MISSION HILLSIDE REHABILITATION CTR LLC
10331 E HWY 39HUNTSVILLEUT84317263762255OWNERSHIP OF BUILDING/LAND OF CARE CENTERUT22941376253MISSION HEALTH SERVICES
MISSION ALPINE VALLEY CARE CENTER LLC
10331 E HWY 39HUNTSVILLEUT84317263762165OWNERSHIP OF BUILDING/LAND OF CARE CENTERUT1684513378MISSION HEALTH SERVICES
MISSION HEALTH LEASING LLC
10331 E HWY 39HUNTSVILLEUT84317270634589SUBLEASE OF CARE CENTERS TO MISSION HEALTH SERVICESUT496MISSION HEALTH SERVICES
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg