PELICAN RAPIDS LIVING AT HOME BLOCK NURSE PROGRAM: Form 990EZ, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- PELICAN RAPIDS LIVING AT HOME BLOCK NURSE PROGRAM (EIN 20-0067395)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-05-16
- IRS object ID
- 202431379349201563
- Schema version
- 2023v5.0
- 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 | 2024-05-16T09:27:24-07:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200067395 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PELICAN RAPIDS LIVING AT HOME BLOCK NURSE PROGRAM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PELI | BusinessNameControlTxt |
| Phone | 2188631515 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 East Mill Box 225 | AddressLine1Txt |
| City | Pelican Rapids | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56572 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Maggie Driscoll | PersonNm |
| Person Title | Program Director | PersonTitleTxt |
| Phone | 2188631515 | PhoneNum |
| Signature | 2024-05-16 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Maggie | PersonFirstNm |
| Person Last | Driscoll | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 1 | TrustedCustomerCd |
| OOB Security Verification | 11 | OOBSecurityVerificationCd |
| Last Submission Rqr OOB | 0 | LastSubmissionRqrOOBCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Profile Password Change | Yes (X) | ProfilePasswordChangeInd |
| Profile Email Address Change | Yes (X) | ProfileEmailAddressChangeInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Type Of Organization Other | non profit | TypeOfOrganizationOtherDesc |
| Gross Receipts | $52,932 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $52,932 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $0 | ProgramServiceRevenueAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Investment Income | $0 | InvestmentIncomeAmt |
| Sale Of Assets Gross | $0 | SaleOfAssetsGrossAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Gain Or Loss From Sale Of Assets | $0 | GainOrLossFromSaleOfAssetsAmt |
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | $0 | SpecialEventsNetIncomeLossAmt |
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Gross Profit Loss Sls Of Invntry | $0 | GrossProfitLossSlsOfInvntryAmt |
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
| Total Revenue | $52,932 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $0 | GrantsAndSimilarAmountsPaidAmt |
| Benefits Paid To Or For Members | $0 | BenefitsPaidToOrForMembersAmt |
| Salaries Other Comp Empl Bnft | $42,582 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $0 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $2,420 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $878 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $9,455 | OtherExpensesTotalAmt |
| Total Expenses | $55,335 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$2,403 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $128,464 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $126,061 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,464 | BOYAmt |
| EOY | $126,061 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,464 | BOYAmt |
| EOY | $126,061 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,464 | BOYAmt |
| EOY | $126,061 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Pelican Rapids OAKS is successful in providing services to elders 65 and older in the areas of health and wellness, exercise programs, social events, chore service, social events, providing resources and transportation, We served over 200 unduplicated elders during 2023. No foreign grants were received. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | Pelican Rapids OAKS was successful in providing services to elders 65 and older in the areas of: health and wellness, exercise programs, social events, chore service, social events, providing resources and transportation. We served over 200 unduplicated elders during 2022. No foreign grants were received. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $39,748 | GrantsAndAllocationsAmt |
| Program Service Expenses | $55,335 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $55,335 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (10 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Maggie Driscoll | ||||
| Program Director | 20 | $25,673 | $0 | $0 |
| Lori Kekaha | ||||
| Board Member | 2 | $0 | $0 | $0 |
| Julie Ann Holt | ||||
| Board Chairperson | 2 | $0 | $0 | $0 |
| Bonnie DelGreco | ||||
| Board member | 1 | $0 | $0 | $0 |
| Renee Evenson | ||||
| Boardmember | 1 | $0 | $0 | $0 |
| Bonnie McGregor | ||||
| Boardmember | 1 | $0 | $0 | $0 |
| Collee Moerke | ||||
| Boardmember | 1 | $0 | $0 | $0 |
| Rudy Butenas | ||||
| Boardmember | 1 | $0 | $0 | $0 |
| Tyler Ahloff | ||||
| Board Member | 1 | $0 | $0 | $0 |
| Barbara Leger | ||||
| Volunteer Coordinator | 15 | $13,964 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Form1120 Pol Filed | 0 | Form1120PolFiledInd |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pelican Rapids OAKS | BusinessNameLine1Txt |
| Business Name Line2 | Pelican Rapids Living At Home Block Nurse Program | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 East Mill Box 225 | AddressLine1Txt |
| City | Pelican Rapids | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56572 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2188631515 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
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 | $61,784 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $73,589 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,802 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $62,776 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,932 | CurrentTaxYearAmt |
| Total | $298,883 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $61,784 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $73,589 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,802 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $62,776 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,932 | CurrentTaxYearAmt |
| Total | $298,883 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $6 | CurrentTaxYearMinus2YearsAmt |
| Total | $6 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $6 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $298,877 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $61,784 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $73,589 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,802 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $62,776 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,932 | CurrentTaxYearAmt |
| Total | $298,883 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 16 | 1Workers comp 251, LIving At Home Block Nurse program 1583, Travel 2010 and misc costs 5611. |
| Form 990-EZ, Part I, Line 20 | Other costs include memberships for the Chamber and Sam's club, workers comp, health and wellness education, social events, supplies, insurance and Living At Home membership |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Pelican Rapids OAKS was unable to complete the required on line form on May 15th due to technical computer sign on issues and internet issues in the city of Pelican Rapids. A signed paper form however was sent to the IRS timely on May 15th. | ExplanationTxt |