2011-11-15T15:19:57-06:00 2010-12-31 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2010-01-01 231945075 ELK HAVEN NURSING HOME ASSOCIATION ELKH 8148342618 785 JOHNSONBURG ROAD ST MARYS PA 15857 CAROLE HARSHBARGER 8148342618 2011-11-15 1 JAY ADKISSON 4144319300 2011-11-14 2010 2016-03-07 17:11:31Z CAROLE HARSHBARGER 785 JOHNSONBURG ROAD ST MARYS PA 15857 12156590 0 X N/A X 1967 PA LONG TERM NURSING CARE 5 5 210 45 0 0 0 0 11100103 11667029 384807 489561 63647 0 11548557 12156590 0 0 0 0 5758032 6062700 0 0 0 4283790 4438841 10041822 10501541 1506735 1655049 21113014 22785836 3545897 3336451 17567117 19449385 LONG TERM NURSING CARE AND OTHER RELATED PATIENT SERVICES AT A 120 BED NURSING FACILITY AND A 40 UNIT ASSISTED LIVING CENTER 0 0 9499587 11667029 LONG TERM NURSING CARE AND OTHER RELATED PATIENT SERVICES AT A 120 BED NURSING FACILITY AND A 40 UNIT ASSISTED LIVING CENTER 9499587 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 46 0 1 210 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 1 1 0 X EXTENDICARE HEALTH SERVICES 4149088023 111 W MICHIGAN STREET MILWAUKEE WI 53203 X CAROLE HARSHBARGER 1.00 X X 0 0 0 JOE FUSCO 1.00 X X 0 0 0 SANDRA SCHWABENBAUER 1.00 X X 0 0 0 JOE KIM 1.00 X 0 0 0 JOE KOCH 1.00 X 0 0 0 NANCY VOTANO 40.00 X 104685 0 18823 THOMAS R DAVIDO 40.00 X 117927 0 20944 222612 0 39767 2 0 0 0 MARDEN REHABILITATION ASSOCIATES INC PO BOX 941 MARIETT OH 45750 THERAPY SERVICES 928895 OMNICARE PO BOX 715276 COLUMBUS WI 43271 DRUG SUPPLIER 262082 PARTNERS HEALTH GROUP 111 W MICHIGAN ST MILWAUKEE WI 53203 MANAGEMENT SERVICES 197691 3 MEDICARE/MEDICAID PAYM 623000 7916246 7916246 ROUTINE SERVICE 623000 3300968 3300968 ANCILLARY 623000 369861 369861 OTHER REVENUE 623000 26233 26233 MEALS ON WHEELS 623000 24417 24417 29304 29304 11667029 489561 489561 12156590 11667029 0 489561 4017701 3634372 383329 33702 30486 3216 1614887 1460810 154077 396410 358588 37822 200823 181662 19161 676 612 64 32751 29626 3125 374501 338770 35731 200607 181467 19140 9934 8986 948 1284 1161 123 102971 93147 9824 351095 317597 33498 141694 128175 13519 ACILLARY SERVICES 1589666 1437996 151670 STATE ASSESSMENTS 829328 750202 79126 FOOD PURCHASES 356564 322544 34020 REPAIRS & MAINTENACE 90498 81864 8634 PROFESSIONAL FEES & PUR 72375 65470 6905 84074 76052 8022 10501541 9499587 1001954 0 1606598 2532722 1673153 1586537 11450 125866 120131 9578893 5716091 3446216 3862802 13026404 13755255 1223327 928389 21113014 22785836 1003860 1022733 2542037 2313718 3545897 3336451 X 17567117 19449385 17567117 19449385 21113014 22785836 X 1655049 227219 X 0 1 1 X 0 X 9032646 10208502 10521155 11100103 11667029 52529435 9032646 10208502 10521155 11100103 11667029 52529435 0 0 0 52529435 465238 530433 538151 384807 489561 2408190 465238 530433 538151 384807 489561 2408190 61346 66078 66798 63647 257869 9559230 10805013 11126104 11548557 12156590 55195494 0.95170 0.95170 0.04360 0.04250 X 44000 44000 3979998 2314498 1665500 3157773 1922551 1235222 1659210 1479042 180168 737912 737912 3862802 REVENUE BONDS 2313718 2313718 12156590 10501541 1655049 298517 -71298 227219 1882268 12156590 0 12156590 0 12156590 10501541 0 10501541 0 10501541 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ASSOCIATION IS A TAX-EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 509(A)(2) OF THE CODE. THE ASSOCIATION IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ASSOCIATION DETERMINES WHETHER IT IS MORE-LIKELY-THAN-NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ASSOCIATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2010 OR 2009. FEDERAL TAX RETURNS FOR THE YEARS 2007 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 8 - OTHER ADJUSTMENTS: LOSS ON EARLY EXTINGUISHMENT OF LONG-TERM DEBT -71,298. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS SENT TO THE BOARD MEMBERS FOR REVIEW AND SIGNATURE PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 15 MARKET STUDIES ARE DONE IN THE REGION TO DETERMINE THE APPROPRIATE AMOUNTS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 298,517. LOSS ON EARLY EXTINGUISHMENT OF LONG-TERM DEBT -71,298. TOTAL TO FORM 990, PART XI, LINE 5: 227,219.