FOREST RIDGE MANOR INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
FOREST RIDGE MANOR INC (EIN 20-1885811)
Tax period
2009-04-01 to 2010-03-31
Filed
2011-01-27
IRS object ID
201120279349300807
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-01-27T09:50:06-06:00Timestamp
Tax Period End Date2010-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Coulter & Justus PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line19717 Cogdill Road Suite 201AddressLine1
CityKnoxvilleCity
StateTNState
ZIP Code37932ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN201885811EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Forest Ridge Manor IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFORENameControl
Phone8659826109Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1910 Wilder Chapel LaneAddressLine1
CityMaryvilleCity
StateTNState
ZIP Code37804ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMary Deborah HubbardName
TitlePresidentTitle
Phone8659826109Phone
Date Signed2011-01-26DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNan C Bobbett CPAName
Phone8656374161Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMary Deborah HubbardNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11300 Bloomingdale PikeAddressLine1
CityKingsportCity
StateTNState
ZIP Code37660ZIPCode
FieldValueIRS element (for citing)
Gross Receipts119803GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionTo provide elderly persons and handicapped persons with housing facilities and services.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year92365ProgramServiceRevenuePriorYear
Program Service Revenue CY119061ProgramServiceRevenueCY
Investment Income Prior Year721InvestmentIncomePriorYear
Investment Income Current Year742InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year93086TotalRevenuePriorYear
Total Revenue Current Year119803TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year287352OtherExpensePriorYear
Other Expenses Current Year206242OtherExpensesCurrentYear
Total Expenses Prior Year287352TotalExpensesPriorYear
Total Expenses Current Year206242TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-194266RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-86439RevenuesLessExpensesCY
Total Assets BOY3591708TotalAssetsBOY
Total Assets EOY3502009TotalAssetsEOY
Total Liabilities BOY3488656TotalLiabilitiesBOY
Total Liabilities EOY3485397TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY103052NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY16612NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide elderly persons and handicapped persons with housing facilities and services specially designed to meet their physical, social, and psychological needs, and to promote their health, security, happiness, and usefulness in longer living.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense160666Expense
Revenue119061Revenue
DescriptionFOREST RIDGE MANOR, INC. IS A RESIDENTIAL LIVING HOUSING DEVELOPMENT FOR LOW INCOME SENIORS THAT MINISTERS TO THE SPIRITUAL & PHYSICAL NEEDS OF ITS RESIDENTS, PROVIDES A SAFE, CLEAN, AND COMFORTABLE ENVIRONMENT, & TREATS SENIORS W/RESPECT & DIGNITY.Description
Total Program Service Expense160666TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
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
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
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 Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledTNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCindy CarterNamePerson
Telephone Number4232450360TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 Netherland LaneAddressLine1
CityKingsportCity
StateTNState
ZIP Code37660ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Bernie Bowman
SECRETARY1.00XX000
Cindy Carter
TREASURER15.00XX0327960
JACKIE DINGUS
Board Member1.00X000
MARVIN EICHORN
Board Member1.00X000
RICK GOINS
Board Member1.00X000
MARY D DEBBIE HUBBARD
PRESIDENT15.00XX0743140
MARJORIE SHONNARD
Board Member1.00X000
Robert Bob Feagins
Board Member1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs107110TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SERVICE RENTSDescription
Business Code531110BusinessCode
Total Revenue Column119061TotalRevenueColumn
Related Or Exempt Function Income119061RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue119061TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column742TotalRevenueColumn
Exclusion$742ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column119803TotalRevenueColumn
Related Or Exempt Function Income119061RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$742ExclusionAmount

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total15000Total
Management And General15000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3329Total
Management And General3329ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total11858Total
Management And General11858ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2794Total
Management And General2794ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total6654Total
Management And General6654ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total64780Total
Program Services61156ProgramServices
Management And General3624ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total99510Total
Program Services99510ProgramServices

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionAdministrativeDescription
Total2317Total
Management And General2317ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total206242Total
Program Services160666ProgramServices
Management And General45576ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY75052BOY
EOY62501EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3620214LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec247709LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3458953BOY
EOY3372505EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY57703BOY
EOY67003EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3591708BOY
EOY3502009EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY60955BOY
EOY57696EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3427701BOY
EOY3427701EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3488656BOY
EOY3485397EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY103052BOY
EOY16612EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY103052BOY
EOY16612EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3591708BOY
EOY3502009EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1ASBURY INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN620630670EIN
Type Of Organization9TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$15,000Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts15000SumOfAmounts

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3599601OtherCostOrOtherBasis
Depreciation246299Depreciation
Book Value3353302BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis20613OtherCostOrOtherBasis
Depreciation1410Depreciation
Book Value19203BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3372505TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Affordable housing program grant note$134,101
HUD capital advance$3,293,600
FieldValueIRS element (for citing)
Total Of Amounts3427701TotalOfAmounts
Total Revenue119803TotalRevenue
Total Expenses206242TotalExpenses
Excess Or Deficit For Year-86439ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-86439ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt119803TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal119803RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990119803TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt206242TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal206242ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990206242TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 8bThis entity does not have any committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11The Forest Ridge Manor, Inc. Board of Directors received a copy of the Form 990 for their review prior to the date of filing. Any comments and suggestions that they had were communicated to Jack Edwards, Reimbursement & Tax Manager for Asbury Communities, Inc.
Form 990, Part VI, Section B, line 12cMembers of the Board of Directors, members of board committees, and certain associates in management positions shall be required to sign a statement annually, which affirms that such person: has received a copy of the Conflict of Interest Policy; has read and understands the policy; has agreed to comply with the policy; understands that The Asbury Group may provide management services to charitable organizations and that in order to maintain their federal tax exemptions, they must engage primarily in activities which accomplish one or more of its tax-exempt purposes; discloses any Financial Interest he/she may have, and any gifts he/she has received in the past year from companies doing business with The Asbury Group; and completes a Conflict of Interest Disclosure Statement ("CIDS") annually. The Compliance Officer shall collect and compile a CIDS report and shall file a report with the Audit Committee with respect to all CIDS. All CIDS shall be available to the Audit Committee, and the Audit Committee shall monitor conflict of interest.
Form 990, Part VI, Section C, line 19The organization's governing documents, conflict of interest policy, and financial statements are all available upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Asbury Inc
910 Wilder Chapel LaneMaryvilleTN37804620630670Provide a regional network of continuing care retirement communities.TN501(c)(3)Line 9N/A
ASBURY CENTERS INDEPENDENT LIVING SERVICES INC
910 Wilder Chapel LaneMaryvilleTN37804621768254No activityTN501(c)(3)Line 9Asbury Inc
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 Org0LoansOrGuaranteesToOtherOrg
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 Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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