FURP.ORG / PUBLIC DATA EXPLORER

THE OZARKS METHODIST MANOR: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
THE OZARKS METHODIST MANOR (EIN 44-0579862)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-06-29
IRS object ID
201111809349300201
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)
Timestamp2011-06-29T07:34:12-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTON GUNDERSON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1333 S KIRKWOOD ROAD SUITE 300AddressLine1
CityST LOUISCity
StateMOState
ZIP Code63122ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN440579862EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE OZARKS METHODIST MANORBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOZARNameControl
Phone4172582573Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1205 S COLLEGE AVEAddressLine1
CityMARIONVILLECity
StateMOState
ZIP Code65705ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGLORIA JONESName
TitleCHAIRPERSONTitle
Phone4172582573Phone
Date Signed2011-05-31DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIEANNE BEASLEYName
Phone3149666622Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGLORIA JONESNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1205 S COLLEGE AVEAddressLine1
CityMARIONVILLECity
StateMOState
ZIP Code65705ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6249399GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.GBGM-UMC.ORG/METHODISTMANORWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1925YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionRETIREMENT VILLAGE OPERATIONS: 82 BED RESIDENTIAL CARE FACILITY, 78 BED SKILLED NURSING FACILITY, 58 COTTAGES, AND SUPPORTING SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees199TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year86547ContributionsGrantsPriorYear
Contributions Grants Current Year87562ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6381267ProgramServiceRevenuePriorYear
Program Service Revenue CY5996682ProgramServiceRevenueCY
Investment Income Prior Year-37391InvestmentIncomePriorYear
Investment Income Current Year50589InvestmentIncomeCurrentYear
Other Revenue Prior Year168357OtherRevenuePriorYear
Other Revenue Current Year104346OtherRevenueCurrentYear
Total Revenue Prior Year6598780TotalRevenuePriorYear
Total Revenue Current Year6239179TotalRevenueCurrentYear
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 Year3474797SalariesEtcPriorYear
Salaries Etc Current Year3529062SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3154465OtherExpensePriorYear
Other Expenses Current Year3445727OtherExpensesCurrentYear
Total Expenses Prior Year6629262TotalExpensesPriorYear
Total Expenses Current Year6974789TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-30482RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-735610RevenuesLessExpensesCY
Total Assets BOY7055594TotalAssetsBOY
Total Assets EOY6705913TotalAssetsEOY
Total Liabilities BOY3508382TotalLiabilitiesBOY
Total Liabilities EOY3624140TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3547212NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3081773NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE CONTINUING CARE TO THE ELDERLY, MEETING THEIR NEEDS AS THEY CHANGE DURING THE AGING PROCESS, PROVIDING RETIREMENT HOMES AND SUPPORT, ASSISTED LIVING AND SKILLED NURSING.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6066062Expense
Revenue6100243Revenue
DescriptionRETIREMENT VILLAGE OPERATIONS - 76 BED RESIDENTIAL CARE FACILITY, 78 BED SKILLED NURSING FACILITY, 58 COTTAGES, AND SUPPORTING SERVICESDescription
Total Program Service Expense6066062TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109625NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees199NumberOfEmployees
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
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
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 Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ROBERTA FRENCHBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4172582573TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1205 S COLLEGEAddressLine1
CityMARIONVILLECity
StateMOState
ZIP Code65705ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
JACK EBERT
DIRECTOR1.00X000
DR RON MCINTIRE
DIRECTOR1.00X000
TERRELL BARKETT
DIRECTOR1.00X000
RICHARD DELMONT
TREASURER1.00X000X
MORRIS DOCK
VICE-CHAIRPERSON1.00X000X
REV GLORIA JONES
CHAIRPERSON1.00X000X
RALPH PROSSER
DIRECTOR1.00X000
MARTHA BARTELSMEYER
SECRETARY1.00X000X
GARY TWITTY
DIRECTOR1.00X000
REV LEE MILLER
DIRECTOR1.00X000
JOE W MCCARTY
DIRECTOR1.00X000
REV MICHAEL BLACKSHER
DIRECTOR1.00X000
NANCY HANSFORD
DIRECTOR1.00X000
TJ MCKENZIE
DIRECTOR1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHABCARE
7733 FORSYTH BLVD SUITE 1700ST LOUISMO63105AGENCY STAFFING424737
LIFE CARE SERVICES LLC
400 LOCUST ST SUITE 820DES MOINESIA50309MANAGEMENT FEES406343
NURSEFINDERS
236 E PRIMROSE STSPRINGFIELDMO65807STAFFING242984
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
All Other Contributions87562AllOtherContributions
Total Contributions87562TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REVENU62300059816505981650
OTHER REVENUES6230001503215032
FieldValueIRS element (for citing)
Total Program Service Revenue5996682TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column55646TotalRevenueColumn
Exclusion$55,646ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5163Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9435Securities
Other785Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-4272Securities
Other-785Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-5057TotalRevenueColumn
Related Or Exempt Function Income-785RelatedOrExemptFunctionIncome
Exclusion-$4,272ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column104346TotalRevenueColumn
Related Or Exempt Function Income104346RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue104346TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6239179TotalRevenueColumn
Related Or Exempt Function Income6100243RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$51,374ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2804454Total
Program Services2594607ProgramServices
Management And General209847ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total11901Total
Program Services10252ProgramServices
Management And General1649ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total492788Total
Program Services371832ProgramServices
Management And General120956ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total219919Total
Program Services204670ProgramServices
Management And General15249ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total184416Total
Management And General184416ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total5472Total
Management And General5472ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total22050Total
Management And General22050ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total14033Total
Management And General14033ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total22681Total
Program Services22681ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total19759Total
Program Services402ProgramServices
Management And General19357ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total393909Total
Program Services326767ProgramServices
Management And General67142ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5398Total
Management And General5398ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total266464Total
Program Services266464ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total27454Total
Program Services16598ProgramServices
Management And General10856ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total395358Total
Program Services395358ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total177878Total
Management And General177878ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
THERAPIES415212415212
FOOD & FOOD SUPPLIES380402380402
CONTRACT LABOR30650629459911907
PROVISION FOR UNCOLLECT287919287919
LICENSES & FEES2784922771521340

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total242324Total
Program Services201147ProgramServices
Management And General41177ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6974789Total
Program Services6066062ProgramServices
Management And General908727ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY203590BOY
EOY384438EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1132349BOY
EOY920012EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY104143BOY
EOY91284EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11225931LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8457065LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2964305BOY
EOY2768866EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2366844BOY
EOY2270947EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY107881BOY
EOY95520EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY131597BOY
EOY131597EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY44885BOY
EOY43249EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7055594BOY
EOY6705913EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1407238BOY
EOY1731275EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2079979BOY
EOY1872360EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY21165BOY
EOY20505EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3508382BOY
EOY3624140EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2496751BOY
EOY2044557EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY53604BOY
EOY40359EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY996857BOY
EOY996857EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3547212BOY
EOY3081773EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7055594BOY
EOY6705913EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-735610ReconcilationRevenueExpenses
Reconcilation Other Changes270171ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
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 Years109022CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years100934CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years55833CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year86547CurrentTaxYearMinus1Year
Current Tax Year87562CurrentTaxYear
Total439898Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5458046CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5808253CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5892458CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6549624CurrentTaxYearMinus1Year
Current Tax Year6109706CurrentTaxYear
Total29818087Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5567068CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5909187CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5948291CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6636171CurrentTaxYearMinus1Year
Current Tax Year6197268CurrentTaxYear
Total30257985Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6896CurrentTaxYearMinus4Years
Total6896Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6896CurrentTaxYearMinus4Years
Total6896Total
FieldValueIRS element (for citing)
Public Support Total50930251089PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years71100CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years85370CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years81975CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year55217CurrentTaxYearMinus1Year
Current Tax Year55646CurrentTaxYear
Total349308Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years71100CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years85370CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years81975CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year55217CurrentTaxYearMinus1Year
Current Tax Year55646CurrentTaxYear
Total349308Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5638168CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5994557CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6030266CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6691388CurrentTaxYearMinus1Year
Current Tax Year6252914CurrentTaxYear
Total30607293Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98840PublicSupportPercentage509
Prior Year Support Percentage0.98400PriorYearSupportPercentage
Investment Income Percentage0.01140InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01580PriorYrInvestIncomePercentage
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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2392554BeginningOfYearBalance
Investment Earnings Or Losses300960InvestmentEarningsOrLosses
Other Expenditures375000OtherExpenditures
Administrative Expenses14033AdministrativeExpenses
End Of Year Balance2304481EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2038185BeginningOfYearBalance
Investment Earnings Or Losses458149InvestmentEarningsOrLosses
Other Expenditures91500OtherExpenditures
Administrative Expenses12280AdministrativeExpenses
End Of Year Balance2392554EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2963991BeginningOfYearBalance
Contributions4000Contributions
Investment Earnings Or Losses-836237InvestmentEarningsOrLosses
Other Expenditures-79000OtherExpenditures
Administrative Expenses-14569AdministrativeExpenses
End Of Year Balance2038185EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.54000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.43000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis196487OtherCostOrOtherBasis
Book Value196487BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8349233OtherCostOrOtherBasis
Depreciation6358435Depreciation
Book Value1990798BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis807213OtherCostOrOtherBasis
Depreciation578526Depreciation
Book Value228687BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis855389OtherCostOrOtherBasis
Depreciation613379Depreciation
Book Value242010BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1017609OtherCostOrOtherBasis
Depreciation906725Depreciation
Book Value110884BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2768866TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionRESIDENTS' PERSONAL FUNDSDescription
Amount$20,505Amount
FieldValueIRS element (for citing)
Total Of Amounts20505TotalOfAmounts
Total Revenue6239179TotalRevenue
Total Expenses6974789TotalExpenses
Excess Or Deficit For Year-735610ExcessOrDeficitForYear
Net Unrealized GL On Investments256474NetUnrealizedGLOnInvestments
Other$13,697OtherAmount
Total Adjustments270171TotalAdjustments
Excess Or Deficit Per FS-465439ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt6508562TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments256474NetUnrealizedGainsInvestments
Other Revenues26942OtherRevenues
Revenue Not Rptd F990283416RevenueNotRptdF990
Revenue Subtotal6225146RevenueSubtotal
Investment Expenses Not Included14033InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt14033RevenueNotRptdOnFinStmt
Total Revenue Per Form9906239179TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt6960756TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal6960756ExpensesSubtotal
Investment Expenses Not Included214033InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt14033ExpensesNotRptdOnFinStmt
Total Expenses Per Form9906974789TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:EARNINGS FROM THE ORGANIZATION'S ENDOWMENT FUNDS PRIMARILY USED TO PROVIDE SCHOLARSHIPS TO THE EMPLOYEES FOR NURSING EDUCATION, AND OTHER PROGRAM NEEDS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE MANOR HAS ADOPTED ASC 740-10, INCOME TAXES, AS IT RELATES TO UNCERTAIN TAX POSITIONS, DURING THE YEAR ENDED DECEMBER 31, 2009 AND HAS EVALUATED ITS TAX POSITIONS TAKEN FOR ALL OPEN TAX YEARS. CURRENTLY, THE 2007 AND SUBSEQUENT TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR THE ORGANIZATION. HOWEVER, THE MANOR IS NOT CURRENTLY UNDER AUDIT NOR HAVE THEY BEEN CONTACTED BY THE IRS. BASED ON THE EVALUATION OF THE MANOR'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER AN EXAMINATION. NO PROVISION FOR THE EFFECT OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED AS OF DECEMBER 31, 2010 AND 2009.
PART XI, LINE 8 - OTHER ADJUSTMENTS:TEMPORARILY RESTRICTED NET ASSETS-GAIN (LOSS) ON ANNUITY AGREEMENTS 13,697.
PART XII, LINE 2D - OTHER ADJUSTMENTS:ASSETS RELEASED FROM RESTRICTION 26,942.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3MANAGEMENT DUTIES ARE PERFORMED BY LIFE CARE SERVICES.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION HAS NO SEPARATE COMMITTEES, N/A.
FORM 990, PART VI, SECTION B, LINE 11DRAFT FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL.
THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH GENERAL BOARD OVERSIGHT AND ANNUAL REVIEW. ALSO, INDIVIDUAL DIRECTORS ARE REQUIRED TO SIGN NON-CONFLICT OF INTEREST STATEMENTS.FORM 990, PART VI, SECTION B, LINE 12C
DOCUMENTS AVAILABLE PER REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 256,474. TEMPORARILY RESTRICTED NET ASSETS-GAIN (LOSS) ON ANNUITY AGREEMENTS 13,697. TOTAL TO FORM 990, PART XI, LINE 5: 270,171.FORM 990, PART XI, LINE 5:
THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT.