WILMOT CARE CENTER: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- WILMOT CARE CENTER (EIN 46-0460801)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-15
- IRS object ID
- 202421369349306257
- Schema version
- 2022v5.0
- 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) |
|---|---|---|
| Return | 2024-05-15T10:48:53-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 460403496 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASEY PETERSON LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 ST JOSEPH ST STE 101 | AddressLine1Txt |
| City | RAPID CITY | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460460801 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILMOT CARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WILM | BusinessNameControlTxt |
| Phone | 6059384418 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 4TH | AddressLine1Txt |
| City | WILMOT | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57279 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAN VAN BEEK | PersonNm |
| Person Title | ADMINISTRATOR | PersonTitleTxt |
| Phone | 6059384418 | PhoneNum |
| Signature | 2024-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JAN | PersonFirstNm |
| Person Last | VAN BEEK | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KAYLA GIESEY CPA | PreparerPersonNm |
| PTIN | P01874520 | PTIN |
| Phone | 6053481930 | PhoneNum |
| Preparation | 2024-05-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAN VAN BEEK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 4TH | AddressLine1Txt |
| City | WILMOT | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57279 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,526,311 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WILMOTCARECENTER.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE LONG-TERM NURSING CARE TO THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 57 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $399,222 | PYContributionsGrantsAmt |
| CY Contributions Grants | $26,818 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,303,607 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,472,348 | CYProgramServiceRevenueAmt |
| PY Investment Income | $244 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,981 | CYInvestmentIncomeAmt |
| PY Other Revenue | $21,389 | PYOtherRevenueAmt |
| CY Other Revenue | $12,526 | CYOtherRevenueAmt |
| PY Total Revenue | $2,724,462 | PYTotalRevenueAmt |
| CY Total Revenue | $2,513,673 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,210,269 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $680,336 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,216,963 | PYOtherExpensesAmt |
| CY Other Expenses | $2,193,424 | CYOtherExpensesAmt |
| PY Total Expenses | $2,427,232 | PYTotalExpensesAmt |
| CY Total Expenses | $2,873,760 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $297,230 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$360,087 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,584,146 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,282,981 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,175,386 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,234,308 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,408,760 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,048,673 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE WILMOT CARE CENTER, THROUGH THE EFFORTS OF DEDICATED EMPLOYEES, PROVIDES HIGH QUALITY, COMPASSIONATE, AND AFFORDABLE CARE FOR THE RESIDENTS ENTRUSTED TO US. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,304,146 | ExpenseAmt |
| Revenue | $2,472,348 | RevenueAmt |
| Desc | THE WILMOT CARE CENTER IS A 32-BED NURSING HOME WITH 10 ASSISTED LIVING BEDS THAT PROVIDES CARE TO THE ELDERLY RESIDENTS OF WILMOT, SD AND ITS SURROUNDING AREA. | Desc |
| Total Program Service Expenses | $2,304,146 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 57 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6059384418 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 4TH STREET | AddressLine1Txt |
| City | WILMOT | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57279 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| HEIDI PELZEL | ||||||
| PRESIDENT | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LINDA REMUND | ||||||
| VICE PRESIDENT/TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KEVIN JURGENS | ||||||
| MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |
| RACHEL BEUMER | ||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JANNETTE VAN BEEK | ||||||
| ADMINISTRATOR | 40.00 | Yes (X) | $86,166 | $0 | $2,804 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $86,166 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,804 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALCOA MEDICAL STAFFING | |||||
| 15222 PIPELINE LANE | HUNTINGTON BEACH | CA | 92649 | MEDICAL STAFFING | $241,070 |
| FUSION WORKFORCE SOLUTIONS | |||||
| PO BOX 30133 | OMAHA | NE | 681031233 | MEDICAL STAFFING | $216,359 |
| AEGIS THERAPIES | |||||
| PO BOX 8103 | FORT SMITH | AR | 72902 | THERAPY SERVICES | $162,528 |
| PRIME TIME HEALTHCARE LLC | |||||
| PO BOX 3544 | OMAHA | NE | 681030544 | MEDICAL STAFFING | $118,096 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $26,818 | AllOtherContributionsAmt |
| Total Contributions | $26,818 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENT SERVICE REVEN | 623000 | $2,452,701 | $2,452,701 |
| OTHER RESIDENT FEES | 900099 | $12,510 | $12,510 |
| MEALS | 900099 | $7,137 | $7,137 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,472,348 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,981 | TotalRevenueColumnAmt |
| Exclusion | $1,981 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,164 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $12,638 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $12,526 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,526 | TotalRevenueColumnAmt |
| Exclusion | $12,526 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,513,673 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,472,348 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,507 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,849 | TotalAmt |
| Management And General | $92,849 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $415,480 | TotalAmt |
| Program Services | $308,970 | ProgramServicesAmt |
| Management And General | $106,510 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,998 | TotalAmt |
| Program Services | $9,666 | ProgramServicesAmt |
| Management And General | $3,332 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,424 | TotalAmt |
| Program Services | $70,962 | ProgramServicesAmt |
| Management And General | $24,462 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,585 | TotalAmt |
| Program Services | $47,285 | ProgramServicesAmt |
| Management And General | $16,300 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,995 | TotalAmt |
| Management And General | $2,995 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,658 | TotalAmt |
| Management And General | $41,658 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,474,259 | TotalAmt |
| Program Services | $1,420,759 | ProgramServicesAmt |
| Management And General | $53,500 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,806 | TotalAmt |
| Program Services | $1,310 | ProgramServicesAmt |
| Management And General | $5,496 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,062 | TotalAmt |
| Program Services | $12,659 | ProgramServicesAmt |
| Management And General | $12,403 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,361 | TotalAmt |
| Program Services | $19,661 | ProgramServicesAmt |
| Management And General | $100,700 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,629 | TotalAmt |
| Program Services | $639 | ProgramServicesAmt |
| Management And General | $2,990 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,116 | TotalAmt |
| Program Services | $67,116 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,921 | TotalAmt |
| Program Services | $72,518 | ProgramServicesAmt |
| Management And General | $25,403 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,828 | TotalAmt |
| Program Services | $31,492 | ProgramServicesAmt |
| Management And General | $14,336 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DIETARY SERVICES | $116,226 | $116,226 | |
| MEDICAL SUPPLIES | $77,430 | $74,203 | $3,227 |
| REPAIRS AND MAINTENANCE | $74,910 | $37,979 | $36,931 |
| MEDICARE PENALTY | $24,922 | $24,922 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,301 | TotalAmt |
| Program Services | $12,701 | ProgramServicesAmt |
| Management And General | $1,600 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,873,760 | TotalAmt |
| Program Services | $2,304,146 | ProgramServicesAmt |
| Management And General | $569,614 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $527,655 | BOYAmt |
| EOY | $119,294 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $352,526 | BOYAmt |
| EOY | $383,284 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,783 | BOYAmt |
| EOY | $299,167 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,117 | BOYAmt |
| EOY | $13,117 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,914 | BOYAmt |
| EOY | $12,914 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,781,028 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,325,823 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,489,151 | BOYAmt |
| EOY | $2,455,205 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,584,146 | BOYAmt |
| EOY | $3,282,981 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,412 | BOYAmt |
| EOY | $188,211 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,694 | BOYAmt |
| EOY | $3,905 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,077,280 | BOYAmt |
| EOY | $2,042,192 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,175,386 | BOYAmt |
| EOY | $2,234,308 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,317,786 | BOYAmt |
| EOY | $962,132 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,974 | BOYAmt |
| EOY | $86,541 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,408,760 | BOYAmt |
| EOY | $1,048,673 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,584,146 | BOYAmt |
| EOY | $3,282,981 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$360,087 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,329 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,724 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $476,502 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $399,222 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $26,818 | CurrentTaxYearAmt |
| Total | $937,595 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,666,631 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,609,976 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,940,011 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,303,607 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,472,348 | CurrentTaxYearAmt |
| Total | $11,992,573 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,682,960 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,628,700 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,416,513 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,702,829 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,499,166 | CurrentTaxYearAmt |
| Total | $12,930,168 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $705,249 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $667,578 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $291,986 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $482,463 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $494,146 | CurrentTaxYearAmt |
| Total | $2,641,422 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $705,249 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $667,578 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $291,986 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $482,463 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $494,146 | CurrentTaxYearAmt |
| Total | $2,641,422 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $10,288,746 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $158 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,606 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,351 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $244 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,981 | CurrentTaxYearAmt |
| Total | $7,340 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $158 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,606 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,351 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $244 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,981 | CurrentTaxYearAmt |
| Total | $7,340 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,991 | CurrentTaxYearMinus4YearsAmt |
| Total | $6,991 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,690,109 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,631,306 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,418,864 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,703,073 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,501,147 | CurrentTaxYearAmt |
| Total | $12,944,499 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.79480 | PublicSupportCY509Pct |
| Public Support PY509 | 0.79130 | PublicSupportPY509Pct |
| Investment Income CY | 0.00060 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00040 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,447,066 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,087,480 | DepreciationAmt |
| Book Value | $2,359,586 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $333,962 | OtherCostOrOtherBasisAmt |
| Depreciation | $238,343 | DepreciationAmt |
| Book Value | $95,619 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,455,205 | TotalBookValueLandBuildingsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINE 2B: | FormAndLineReferenceDesc |
| Explanation | THE FACILITY ADMINISTERS A RESIDENT TRUST FUND. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THERE IS ONE CLASS OF MEMBERS. ANY PERSON WHO CONTRIBUTES $25 TO THE ORGANIZATION CAN BECOME A MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE BOARD OF DIRECTORS AT AN ANNUAL MEETING. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ADMINISTRATOR WILL REVIEW A DRAFT OF THE FORM 990 AND THE BOARD MEMBERS WILL REVIEW THE FORM 990 AT A BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS AND STAFF ALIKE. THE BOARD REVIEWS ANY CONFLICTS THAT MAY EXIST. IF A CONFLICT EXISTS, THAT INDIVIDUAL IS REQUIRED TO ABSTAIN FROM THE DECISION MAKING PROCESS FROM WHICH THE CONFLICT AROSE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD REVIEWS THE COMPENSATION PACKAGE REQUEST FROM THE ADMINISTRATOR. THROUGH DELIBERATION AND COMPROMISE, BOTH PARTIES AGREE ON THE COMPENSATION PACKAGE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACTED ADMIN: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 53,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,500. CONTRACTED NURSING: PROGRAM SERVICE EXPENSES 1,231,015. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,231,015. CONTRACTED THERAPY: PROGRAM SERVICE EXPENSES 180,774. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,774. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 7,521. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,521. OUTSIDE LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 1,449. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,449. |