HARBOR HOUSE: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- HARBOR HOUSE (EIN 36-4003095)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-13
- IRS object ID
- 201141339349300914
- Schema version
- 2009v1.4
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-13T09:43:06-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CENTRAL PARK PLAZA SUITE 1501 | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 681021626 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364003095 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARBOR HOUSE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HARB | NameControl |
| Phone | 4023434323 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 W DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SCOTT M WOOTEN | Name |
| Title | SENIOR VP/CFO | Title |
| Phone | 4023434323 | Phone |
| Date Signed | 2011-05-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Angela Lea | Name |
| Phone | 4023481450 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SCOTT M WOOTEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68142 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1929581 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | To provide care in a homelike environment to the terminally ill. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 23 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 23 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 454 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 388244 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 316819 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1772013 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1580464 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 27115 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4958 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1661 | OtherRevenuePriorYear |
| Other Revenue Current Year | 27340 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2189033 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1929581 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 82764 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 52372 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2332933 | OtherExpensePriorYear |
| Other Expenses Current Year | 2337914 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2415697 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2390286 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -226664 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -460705 | RevenuesLessExpensesCY |
| Total Assets BOY | 3799191 | TotalAssetsBOY |
| Total Assets EOY | 3328616 | TotalAssetsEOY |
| Total Liabilities BOY | 39056 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 34693 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3760135 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3293923 | NetAssetsOrFundBalancesEOY |
| Mission Description | To embrace residents living with terminal illnesses and their families and friends with compassionate care and comfort, and to provide end-of-life education in the community. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2251663 | Expense |
| Grants | 52372 | Grants |
| Revenue | 1580464 | Revenue |
| Description | HARBOR HOUSE, DOING BUSINESS AS HOSPICE HOUSE-THE JOSIE HARPER RESIDENCE, OPERATES A LICENSED 26-BED RESIDENTIAL FACILITY WHICH PROVIDES 24-HOUR PROFESSIONAL CARE AND SUPERVISION TO SERVE THE SPIRITUAL, EMOTIONAL, AND PHYSICAL NEEDS OF TERMINALLY ILL RESIDENTS AND THEIR FAMILIES IN A HOME-LIKE SETTING. HARBOR HOUSE PROVIDED SERVICES TO 481 RESIDENTS IN FISCAL 2010. IN ADDITION TO RESIDENTIAL LIVING SPACE, THE BUILDING ALSO INCLUDES CLASSROOMS, STORAGE, SHOWER FACILITIES FOR FAMILIES AND GUESTS, AND A RESOURCE LIBRARY. | Description |
| Total Program Service Expense | 2251663 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 23 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 23 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCOTT M WOOTEN SENIOR VPCFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4023434323 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 W DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68154 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| DEBRA ROMBERGER MD | ||||||
| dIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BARBARA FITZGERALD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| RICHARD A HACHTEN II | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CAROLYN HARPER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JOANIE KUSH | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ROBERT LANGDON MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| STEPHEN J LEMON MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SUNNY LUNDGREN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SUZY SHRIER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DAVID SILVERBERG MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JAMES SUMMERFELT | ||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | X |
| WILLIAM SUTTON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| THERESA FRANCO RN MSN | ||||||
| cHAIR | 1.00 | X | 0 | 0 | 0 | X |
| SALLY KAMPFE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JAYNE MCCORMICK MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ROSEANNE GOLLAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CARL GREINER MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SUSAN KAMBHU MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ROSEMARY LEBEDA | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| NEIL FORTKAMP | ||||||
| SECRETARY/TREASURER | 1.00 | X | 0 | 0 | 0 | X |
| STEVE GOESER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BERNARD SU | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DIANE RANDOLPH | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CINDY ALLOWAY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MARY LEE FITZSIMMONS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| GARY GEORGE | ||||||
| OFFICER | 40.00 | 78916 | 0 | 10574 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 78916 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 10574 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ALEGENT HEALTH | |||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68154 | MANAGEMENT SERVICES | 1829600 |
| ALL MIDLANDS HEALTH SERVICES | |||||
| 8610 West Dodge Road | OMAHA | NE | 68114 | STAFFING AGENCY | 135963 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| All Other Contributions | 316819 | AllOtherContributions |
| Total Contributions | 316819 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET DAILY RESIDENT SVC | Description |
| Business Code | 621500 | BusinessCode |
| Total Revenue Column | 1580464 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1580464 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1580464 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4958 | TotalRevenueColumn |
| Exclusion | $4,958 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER OPERATING REVENU | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 27340 | TotalRevenueColumn |
| Exclusion | $27,340 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 27340 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1929581 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1580464 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $32,298 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52372 | Total |
| Program Services | 52372 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1829600 | Total |
| Program Services | 1717737 | ProgramServices |
| Management And General | 111863 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15000 | Total |
| Management And General | 15000 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11760 | Total |
| Management And General | 11760 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2292 | Total |
| Program Services | 2292 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 217071 | Total |
| Program Services | 217071 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37588 | Total |
| Program Services | 37588 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 516 | Total |
| Program Services | 516 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 490 | Total |
| Program Services | 490 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147343 | Total |
| Program Services | 147343 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29169 | Total |
| Program Services | 29169 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| PURCHASED SERVICES | 43623 | 43623 |
| MISCELLANEOUS | 2704 | 2704 |
| MEMBERSHIP & DUES | 650 | 650 |
| TAXES/LICENSES | 108 | 108 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2390286 | Total |
| Program Services | 2251663 | ProgramServices |
| Management And General | 138623 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 251 | BOY |
| EOY | 250 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 237815 | BOY |
| EOY | 241842 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1400 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500228 | BOY |
| EOY | 513645 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32037 | BOY |
| EOY | 27639 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3373517 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1541597 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1960155 | BOY |
| EOY | 1831920 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1067305 | BOY |
| EOY | 660960 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 52360 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3799191 | BOY |
| EOY | 3328616 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39056 | BOY |
| EOY | 34693 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39056 | BOY |
| EOY | 34693 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3733628 | BOY |
| EOY | 3272923 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11507 | BOY |
| EOY | 6000 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15000 | BOY |
| EOY | 15000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3760135 | BOY |
| EOY | 3293923 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3799191 | BOY |
| EOY | 3328616 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 263149 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 715180 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 291786 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 388244 | CurrentTaxYearMinus1Year |
| Current Tax Year | 316819 | CurrentTaxYear |
| Total | 1975178 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1324452 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1464598 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1717485 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1773674 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1607804 | CurrentTaxYear |
| Total | 7888013 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1587601 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2179778 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2009271 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2161918 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1924623 | CurrentTaxYear |
| Total | 9863191 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 30000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 413237 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 31250 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10000 | CurrentTaxYearMinus1Year |
| Total | 484487 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 30000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 413237 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 31250 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10000 | CurrentTaxYearMinus1Year |
| Total | 484487 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 9378704 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 24796 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 56095 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 66010 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 27115 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4958 | CurrentTaxYear |
| Total | 178974 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 24796 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 56095 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 66010 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 27115 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4958 | CurrentTaxYear |
| Total | 178974 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1612397 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2235873 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2075281 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2189033 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1929581 | CurrentTaxYear |
| Total | 10042165 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.93390 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.92970 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.01780 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01830 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 26507 | BeginningOfYearBalance |
| Other Expenditures | 5507 | OtherExpenditures |
| End Of Year Balance | 21000 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 58080 | BeginningOfYearBalance |
| Contributions | 14420 | Contributions |
| Administrative Expenses | 45993 | AdministrativeExpenses |
| End Of Year Balance | 26507 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.71430 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.28570 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 320000 | OtherCostOrOtherBasis |
| Book Value | 320000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2301108 | OtherCostOrOtherBasis |
| Depreciation | 1014715 | Depreciation |
| Book Value | 1286393 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14449 | OtherCostOrOtherBasis |
| Depreciation | 13206 | Depreciation |
| Book Value | 1243 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 737960 | OtherCostOrOtherBasis |
| Depreciation | 513676 | Depreciation |
| Book Value | 224284 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1831920 | TotalOfBookValueLandBuildings |
| Total Revenue | 1929581 | TotalRevenue |
| Total Expenses | 2390286 | TotalExpenses |
| Excess Or Deficit For Year | -460705 | ExcessOrDeficitForYear |
| Other | -$3,874 | OtherAmount |
| Total Adjustments | -3874 | TotalAdjustments |
| Excess Or Deficit Per FS | -464579 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1847564 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 1847564 | RevenueSubtotal |
| Other Revenues Not Included | 82017 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 82017 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1929581 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 2312143 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -78143 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -78143 | ExpensesNotRptdF990 |
| Expenses Subtotal | 2390286 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 2390286 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF HARBOR HOUSE. |
| PART X, LINE 2 - HARBOR HOUSE ADOPTED FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, INCLUDED IN FASB ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL, HARBOR HOUSE RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. DURING 2010 AND 2009, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 8 - RESTRICTED CONTRIBUTIONS RECLASS - ($3,874). PART XII, LINE 4B AND PART XIII, LINE 2D - CHARITY CARE RELCASS ($52,372) & MALPRACTICE INSURANCE ($25,771). PART XII, LINE 4B - RESTRICTED CONTRIBUTIONS RECLASS - $3,874. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | CHARITY CARE | TypeOfGrant |
| Number Of Recipients | 48 | NumberOfRecipients |
| Amount Of Non Cash Assistance | 52372 | AmountOfNonCashAssistance |
| Method Of Valuation | BOOK | MethodOfValuation |
| Description Of Non Cash Assistance | REDUCE OR WRITE OFF OF PATIENT SERVICES. | DescriptionOfNonCashAssistance |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. Schedule I, Part I, Line 1: Harbor House recognizes the right to quality healthcare regardless of age, sex, race, religion, national origin, or ability to pay. HARBOR HOUSE PROVIDES CHARITY CARE to patients with demonstrated inability to pay for medically necessary services. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | GARY GEORGE IS an OFFICER BECAUSE HE IS THE EXECUTIVE DIRECTOR OF HARBOR HOUSE. HE IS PAID BY ALEGENT HEALTH THROUGH THE COORDINATION OF SERVICES AGREEMENT. HOWEVER, COMPENSATION IS NOT REPORTED ON SCHEDULE J BECAUSE IT IS BELOW THE REPORTING THRESHOLD. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | NEIL FORTKAMP and SUSAN KAMBHU - FAMILY RELATIONSHIP. STEPHEN LEMON AND STEVE GOESER - BUSINESS RELATIONSHIP. |
| Form 990, Part VI, Section A, line 3 | Harbor House entered into a Coordination of Services agreement with Alegent Health for Alegent Health to perform and manage financial services for a monthly fee. Services include but are not limited to financial reporting, budgeting, billing and collections, fixed asset management and tax return preparation. In addition to financial services, Alegent Health provides information systems support, security, risk management and corporate compliance, purchasing, maintenance and various other support services. |
| Form 990, Part VI, Section A, line 6 | The CORPORATE MEMBERS OF HARBOR HOUSE ARE ALEGENT HEALTH, THE VISITING NURSE ASSOCIATION OF THE MIDLANDS, NEBRASKA METHODIST HOSPITAL AND THE NEBRASKA MEDICAL CENTER. |
| Form 990, Part VI, Section A, line 7a | EACH CORPORATE MEMBER WILL BE EQUALLY REPRESENTED ON THE BOARD OF DIRECTORS. THE NUMBER OF VOTING DIRECTORS SHALL BE NO LESS THAN FOUR (4), THE EXACT NUMBER TO BE DETERMINED FROM TIME TO TIME BY DECISION OF THE CORPORATE MEMBERS. CURRENTLY, EACH MEMBER APPOINTS SIX (6) DIRECTORS, FOR A TOTAL OF TWENTY-FOUR (24) DIRECTORS. |
| Form 990, Part VI, Section A, line 7b | SUBJECT TO THE NEBRASKA NONPROFIT CORPORATION ACT AND OTHER APPLICABLE LAW, THE CORPORATE MEMBERS, BY UNANIMOUS AGREEMENT, SHALL HAVE THE POWER TO: A. FIX THE NUMBER OF DIRECTORS OF THE CORPORATION B. APPROVE, AMEND, OR REPEAL THE BYLAWS OR ARTICLES OF INCORPORATION OF THE CORPORATION C. APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. D. APPROVE THE FORMATION OF OTHER ENTITIES BY THE CORPORATION. E. APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF SUBSTANTIALLY ALL OF THE PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATIONS BUSINESS. F. APPROVE DEBT INCURRED BY THE CORPORATION IN EXCESS OF $25,000. G. APPROVE THE LONG-RANGE FINANCIAL AND STRATEGIC PLAN FOR THE CORPORATION. H. APPROVE ASSESSMENT UPON, OR REQUIRE CAPITAL CONTRIBUTIONS BY, THE CORPORATE MEMBERS. I. APPROVE ANY DISTRIBUTIONS OF CAPITAL OR NET EARNINGS OF THE CORPORATION. UPON EXERCISE OF ANY POWER DESCRIBED ABOVE, EACH CORPORATE MEMBER SHALL PROMPTLY DELIVER TO THE CORPORATION A DULY EXECUTED CERTIFICATE OR OTHER DOCUMENT EVIDENCING THE APPROVAL OF THAT EXERCISE OF POWER BY SUCH CORPORATE MEMBER. |
| Form 990, Part VI, Section B, line 11 | Harbor House and Alegent Health have a Coordination of Service agreement in which Alegent provides the accounting and finance functions for Harbor House for a monthly fee. The tax department of Alegent Health prepares the Form 990 for Harbor House. Following the preparation of Form 990 by Alegent Health internal tax staff, the return is reviewed by the Alegent Health Tax Director, Chief Financial Officer, External Tax Advisor, AND Harbor HOUSE'S FINANCE COMMITTEE. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED A WEB LINK THAT DIRECTS THEM TO THE FINAL TAX RETURN AND ALL REQUIRED SCHEDULES. QUESTIONS ARE REFERRED TO THE ALEGENT HEALTH TAX DIRECTOR AND THE BOARD IS NOTIFIED OF THE DATE THE TAX RETURN WILL BE FILED. |
| Form 990, Part VI, Section B, line 12c | Written Conflict of Interest Policy - HARBOR HOUSE has adopted the conflict of interest policy and conflict investigation process of Alegent Health. Annual completion of the disclosure statement is required by the Board of DIRECTORS. Stated disclosures are investigated by the Alegent Health Compliance Officer and reported to the Conflicts of Interest Committee. The Conflicts of Interest Committee reviews the investigation and makes recommendations to the Governance Committee. The Governance Committee makes the final determination of whether or not there is a disqualifying event and communicates it to the HARBOR HOUSE Board OF DIRECTORS. At any time a Board Member may declare a conflict of interest and recuse his/herself from the discussion. The individual is also required to disclose any known or possible conflicts of interest that arise during the calendar year. |
| Form 990, Part VI, Section C, line 19 | HARBOR HOUSE HAS ADOPTED THE CONFLICT OF INTEREST POLICY OF ALEGENT HEALTH, WHICH IS AVAILABLE TO THE PUBLIC AT WWW.ALEGENT.COM. HARBOR HOUSE DOES NOT MAKE THE GOVERNING DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. However, the Articles of Incorporation are available at www.sos.state.ne.us. |
| FORM 990, PART I, LINE 5 AND PART V, LINE 2A: | HARBOR HOUSE DOES NOT HAVE ANY EMPLOYEES. INDIVIDUALS PROVIDING SERVICES TO PATIENTS OF HARBOR HOUSE ARE LEASED FROM ALEGENT HEALTH. |
| FORM 990, PART V, LINE 1A: | AS PART OF THE COORDINATION OF SERVICES AGREEMENT WITH ALEGENT HEALTH, ALEGENT HEALTH PERFORMS THE ACCOUNTS PAYABLE FUNCTION FOR HARBOR HOUSE. HARBOR HOUSE REIMBURSES ALEGENT HEALTH FOR VENDOR PAYMENTS, THEREFORE NO FORM 1099S ARE ISSUED BY HARBOR HOUSE. ALEGENT HEALTH ISSUES THE FORM 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. HOWEVER, PER THE INSTRUCTIONS THOSE 1099S ISSUED BY ALEGENT HEALTH ON BEHALF OF HARBOR HOUSE ARE REPORTED. |
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