HOOSIER CARE INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HOOSIER CARE INC (EIN 62-1486858)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-10
IRS object ID
201141309349300649
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)
Timestamp2011-05-10T14:17:47-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1REZNICK GROUP PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 EAST PRATT STREET SUITE 200AddressLine1
CityBALTIMORECity
StateMDState
ZIP Code212023100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN621486858EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CLAREMONT HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCLARNameControl
Phone2154446350Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1148 WEST STATE STREETAddressLine1
CityKENNETT SQUARECity
StatePAState
ZIP Code19348ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN GILLMORName
TitleVPTitle
Date Signed2011-05-02DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4107834900Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLEWIS F WOOD JRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1148 WEST STATE STREETAddressLine1
CityKENNETT SQUARECity
StatePAState
ZIP Code19348ZIPCode
FieldValueIRS element (for citing)
Gross Receipts10253535GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number5138GroupExemptionNumber
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees176TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9864762ProgramServiceRevenuePriorYear
Program Service Revenue CY10250312ProgramServiceRevenueCY
Investment Income Prior Year6518InvestmentIncomePriorYear
Investment Income Current Year3223InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year9871280TotalRevenuePriorYear
Total Revenue Current Year10253535TotalRevenueCurrentYear
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 Year5934571SalariesEtcPriorYear
Salaries Etc Current Year5256562SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3672864OtherExpensePriorYear
Other Expenses Current Year4559898OtherExpensesCurrentYear
Total Expenses Prior Year9607435TotalExpensesPriorYear
Total Expenses Current Year9816460TotalExpensesCurrentYear
Revenues Less Expenses Prior Year263845RevenuesLessExpensesPriorYear
Revenues Less Expenses CY437075RevenuesLessExpensesCY
Total Assets BOY7818828TotalAssetsBOY
Total Assets EOY7999918TotalAssetsEOY
Total Liabilities BOY8287229TotalLiabilitiesBOY
Total Liabilities EOY8031244TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-468401NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-31326NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense9527876Expense
Revenue10250312Revenue
DescriptionOPERATED INTERMEDIATE AND SKILLED-CARE NURSING HOME FACILITIES FOR THE CARE OF ELDERLY PATIENTS. OVER 110 PATIENTS WERE PROVIDED CARE DURING THE FISCAL YEAR.Description
Total Program Service Expense9527876TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
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
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 EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees176NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
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
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
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDENNIS GREGORYNamePerson
Telephone Number6104446350TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1148 WEST STATE STREETAddressLine1
CityKENNETT SQUARECity
StatePAState
ZIP Code19348ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
BRUCE P HUTSON
PRESIDENT1.0XX0574000
STEPHEN F WOOD
VP/TREASURER1.0XX0638500
JOHN G FOOS
VP/DIRECTOR1.0XX0494000
JOHN E GILLMOR
VP/SECRETARY1.0XX0484000
LEWIS F WOOD JR
CEO6.0X04529510
CYNTHIA WOOD
ASSISTANT SECRETARY1.0X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs672001TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
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
GENESIS ELDERCARE NETWORK SERVICES
101 E STATE STREETKENNETT SQUAREPA19348MANAGEMENT FEES6460917
GENESIS REHABILITATION SERVICES
101 E STATE STREETKENNETT SQUAREPA19348REHAB THERAPIES771773
OMNICARE
2100 QUAKER POINTE DRIVEQUAKERTOWNPA18981PHARMACEUTICALS321509
New Jersey Nursing Home
Nursing services357327
sysco eastern MD
33239 Costen RoadPOCOMOKEMD21851food service175225
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SVC REVDescription
Total Revenue Column10250312TotalRevenueColumn
Related Or Exempt Function Income10250312RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue10250312TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3223TotalRevenueColumn
Exclusion$3,223ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

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
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10253535TotalRevenueColumn
Related Or Exempt Function Income10250312RelatedOrExemptFunctionIncome
Exclusion$3,223ExclusionAmount

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4458225Total
Program Services4458225ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total364413Total
Program Services364413ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total433924Total
Program Services433924ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total506202Total
Program Services506202ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total18879Total
Program Services18879ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total24212Total
Program Services0ProgramServices
Management And General24212ManagementAndGeneral
Fundraising0Fundraising

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)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total19729Total
Program Services19729ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total427544Total
Program Services427544ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total379941Total
Program Services379941ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBTS973249732400
ADMINISTRATIVE26437202643720
UTILITIES19915319915300
SUPPLIES14640214640200
CONTRACTS173091730900

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2458831Total
Program Services2458831ProgramServices
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total9816460Total
Program Services9527876ProgramServices
Management And General288584ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY250347BOY
EOY548182EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY884225BOY
EOY1018446EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY23487BOY
EOY30803EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1042189BOY
EOY1029676EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis10075782LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5356930LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4952221BOY
EOY4718852EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY666359BOY
EOY653959EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7818828BOY
EOY7999918EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY699840BOY
EOY444756EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY53754BOY
EOY42576EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY7522957BOY
EOY7416086EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10678BOY
EOY127826EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8287229BOY
EOY8031244EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-468401BOY
EOY-31326EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-468401BOY
EOY-31326EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7818828BOY
EOY7999918EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10159420CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9834498CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9431036CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9864762CurrentTaxYearMinus1Year
Current Tax Year10250312CurrentTaxYear
Total49540028Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10159420CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9834498CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9431036CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9864762CurrentTaxYearMinus1Year
Current Tax Year10250312CurrentTaxYear
Total49540028Total
FieldValueIRS element (for citing)
Public Support Total50949540028PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years40052CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years23058CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12920CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6518CurrentTaxYearMinus1Year
Current Tax Year3223CurrentTaxYear
Total85771Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years40052CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years23058CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12920CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6518CurrentTaxYearMinus1Year
Current Tax Year3223CurrentTaxYear
Total85771Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10199472CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9857556CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9443956CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9871280CurrentTaxYearMinus1Year
Current Tax Year10253535CurrentTaxYear
Total49625799Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99827PublicSupportPercentage509
Prior Year Support Percentage0.99799PriorYearSupportPercentage
Investment Income Percentage0.00173InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00201PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis750000OtherCostOrOtherBasis
Book Value750000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7613157OtherCostOrOtherBasis
Depreciation4078817Depreciation
Book Value3534340BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1501116OtherCostOrOtherBasis
Depreciation1123670Depreciation
Book Value377446BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis211509OtherCostOrOtherBasis
Depreciation154443Depreciation
Book Value57066BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4718852TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
FINANCING FEES, NET OF AMORT626580
OTHER ASSETS27379
FieldValueIRS element (for citing)
Total Book Value Other Assets653959TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCRUED WAGES$8,528
OTHER LIABILITY$119,298
FieldValueIRS element (for citing)
Total Of Amounts127826TotalOfAmounts
Total Revenue10253535TotalRevenue
Total Expenses9816460TotalExpenses
Excess Or Deficit For Year437075ExcessOrDeficitForYear
Excess Or Deficit Per FS437075ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt10253535TotRevenueEtcAuditedFinclStmt
Revenue Subtotal10253535RevenueSubtotal
Total Revenue Per Form99010253535TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt9816460TotExpensesEtcAuditedFinclStmt
Expenses Subtotal9816460ExpensesSubtotal
Total Expenses Per Form9909816460TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
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

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonLEWIS F WOOD JRNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs452951CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs452951TotalCompensationRelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION A, LINE 2RELATIONSHIP SCHEDULE --------------------- NAME OF OFFICER, DIRECTOR, ETC: STEPHEN WOOD NAME OF RELATED ENTITY: LEWIS F. WOOD, JR CYNTHIA WOOD TITLE OR ROLE: CEO/TREASURER RELATIONSHIP: BROTHER/SISTER-IN-LAW NAME OF OFFICER, DIRECTOR, ETC: LEWIS F. WOOD, JR NAME OF RELATED ENTITY: CYNTHIA WOOD STEPHEN WOOD TITLE OR ROLE: TREASURER/VP RELATIONSHIP: WIFE/BROTHER NAME OF OFFICER, DIRECTOR, ETC: CYNTHIA WOOD NAME OF RELATED ENTITY: LEWIS F. WOOD, JR STEPHEN WOOD TITLE OR ROLE: CEO/VP RELATIONSHIP: HUSBAND/BROTHER-IN-LAW
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION A, LINES 10A DRAFT OF FORM 990 IS REVIEWED & AUTHORIZED BY A MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION B, LINE 15COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON AN INDEPENDENT COMPENSATION STUDY, AND INCREASES ARE BASED ON THE CPI (ALL CONSUMERS MARKET BASKET) AND THE DISCRETION OF THE BOARD.
GOVERNANCE, MANAGEMENT & DISCLOSUREPART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ORGANIZATION'S OFFICE DURING REGULAR BUSINESS HOURS UPON REQUEST.
STATEMENT OF FUNCTIONAL EXPENSESPART IX, LINE 24(F): ALL OTHER EXPENSESTOTAL PROG SERV MGMT & GEN FUNDRAISING ---------- --------- ---------- ----------- TRASH REMOVAL 24,391 24,391 NONE NONE VEHICLE MAINTENANCE 22,717 22,717 NONE NONE MISC. OPERATING 36,673 36,673 NONE NONE PROPERTY, LIAB. INS. 151,612 151,612 NONE NONE WORKERS COMP. 202,460 202,460 NONE NONE LICENSES AND CERT. 17,191 17,191 NONE NONE MORTGAGE INS. PREM. 37,370 37,370 NONE NONE AMORTIZATION EXPENSE 23,126 23,126 NONE NONE FOOD 179,119 179,119 NONE NONE DRUGS AND PHARM. 323,061 323,061 NONE NONE MEDICAL SUPPLIES 73,197 73,197 NONE NONE nursing services 92,508 92,508 NONE NONE rehabiliation service 718,746 718,746 NONE NONE activity services 11,870 11,870 NONE NONE OTHER SERVICE EXP. 544,790 544,790 NONE NONE ---------- --------- ---------- ----------- TOTAL $2,458,831 $2,458,831 NONE NONE
COMPENSATION OF OFFICERSPART VII, SECTION A, AVERAGE HOURS PER WEEKTHE OFFICERS AND DIRECTORS DO NOT KEEP DETAILED TIME RECORDS OF HOURS SPENT FOR THIS AND RELATED ENTITIES. HOWEVER, THROUGH DISCUSSIONS WITH EACH, AN ESTIMATE HAS BEEN MADE OF THE TIME THEY SPENT ON MATTERS OF THIS ENTITY AND ITS RELATED CHARITABLE ENTITIES. THERE ARE nine RELATED CHARITABLE ENTITIES FOR WHICH THE OFFICERS AND DIRECTORS PROVIDE SERVICES. OFTEN BOARD MEETINGS AND OTHER WORK INVOLVES MATTERS FOR SEVERAL OR ALL OF THESE ENTITIES. THE COMPENSATION FROM EACH ENTITY IS BASED UPON AN ESTIMATE OF THE WORK DONE FOR EACH ENTITY.
GOVERNANCE, MANAGEMENT & DISCLOSUREPart VI Section B Line 12The Board members annually certify that they are aware of the conflict of interest policy and have no conflicts of interest.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HOOSIER CARE INC
535 WEST SECOND STREETLEXINGTONKY40508311262572NURSING HOMEKY501(c)(3)9NA
HOOSIER CARE II INC
535 WEST SECOND STREETLEXINGTONKY40508311274121NURSING HOMEKY501(c)(3)9HOOSIER CARE
HOOSIER CARE III INC
148 WEST STATE STREETKENNETT SQUAREPA19348621459304NURSING HOMEPA501(c)(3)9HOOSIER CARE
HOOSIER PROPERTIES INC
1600 DIVISION STREETNASHVILLETN37203200377349NURSING HOMETN501(c)(3)9HOOSIER CARE
VICTORIA HEALTH CORPORATION
148 WEST STATE STREETKENNETT SQUAREPA19348621518645NURSING HOMEPA501(c)(3)9HOOSIER CARE
DELAWARE HEALTH CORPORATION
3 MILL ROADWILMINGTONDE19806621548336NURSING HOMEDE501(c)(3)9HOOSIER CARE
HIGHLAND HEALTH SYSTEMS INC
148 WEST STATE STREETKENNETT SQUAREPA19348621486857NURSING HOMEPA501(c)(3)9HOOSIER CARE
BIRCHWOOD SENIOR HOUSING CORPORATION
1600 DIVISION STREETNASHVILLETN37203204800428sr housingTN501(c)(3)9HOOSIER CARE

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CARE INVESTMENTS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1535 WEST SECOND STREETAddressLine1
CityLEXINGTONCity
StateKYState
ZIP Code40508ZIPCode
FieldValueIRS element (for citing)
EIN200479449EIN
Primary ActivityINVESTMENTPrimaryActivity
Legal Domicile StateKYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOOSIER CAREBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TyperelatedPredominantIncomeType
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 OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1hoosier care investment llcBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeoTransactionType
Amount Involved117000AmountInvolved

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