PELICAN RAPIDS LIVING AT HOME BLOCK NURSE PROGRAM: Form 990EZ, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PELICAN RAPIDS LIVING AT HOME BLOCK NURSE PROGRAM (EIN 20-0067395)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-05-15
- IRS object ID
- 202301369349201400
- 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 | 2023-05-15T10:12:46-07:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | 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 | 2023-05-13 | SignatureDt |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $62,777 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $62,776 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $0 | ProgramServiceRevenueAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Investment Income | $1 | 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 | $62,777 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $0 | GrantsAndSimilarAmountsPaidAmt |
| Benefits Paid To Or For Members | $0 | BenefitsPaidToOrForMembersAmt |
| Salaries Other Comp Empl Bnft | $39,259 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $0 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $1,169 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $629 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $9,639 | OtherExpensesTotalAmt |
| Total Expenses | $50,696 | TotalExpensesAmt |
| Excess Or Deficit For Year | $12,081 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $116,383 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $128,464 | NetAssetsOrFundBalancesEOYAmt |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,383 | BOYAmt |
| EOY | $128,464 | 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 | $116,383 | BOYAmt |
| EOY | $128,464 | 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 | $116,383 | BOYAmt |
| EOY | $128,464 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Pelican Rapids OAKS supports elders 65 and older in the community so they can remain safe and independent in their homes. | 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 | $50,053 | GrantsAndAllocationsAmt |
| Program Service Expenses | $50,696 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $50,696 | 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 | $24,664 | $0 | $0 |
| Lori Kekaha | ||||
| Outreach and Volunteer Coordinator | 18 | $10,173 | $0 | $0 |
| Julie Ann Holt | ||||
| Board Chairperson | 2 | $0 | $0 | $0 |
| Bonnie DelGreco | ||||
| Board member | 1 | $0 | $0 | $0 |
| Renee Evenson | ||||
| Boardmember | 2 | $0 | $0 | $0 |
| Bonnie McGregor | ||||
| Boardmember | 1 | $0 | $0 | $0 |
| Collee Moerke | ||||
| Boardmember | 2 | $0 | $0 | $0 |
| Rudy Butenas | ||||
| Boardmember | 1 | $0 | $0 | $0 |
| Tyler Ahloff | ||||
| Board Member | 2 | $0 | $0 | $0 |
| Barbara Leger | ||||
| Volunteer Coordinator | 15 | $1,632 | $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 |
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 | $54,642 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $61,784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $73,589 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $47,802 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $62,776 | CurrentTaxYearAmt |
| Total | $300,593 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54,642 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $61,784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $73,589 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $47,802 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $62,776 | CurrentTaxYearAmt |
| Total | $300,593 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $6 | CurrentTaxYearMinus1YearAmt |
| 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 | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $6 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $300,587 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54,642 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $61,784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $73,589 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $47,802 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $62,776 | CurrentTaxYearAmt |
| Total | $300,593 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99998 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99998 | PublicSupportPY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
| Investment Income PY | 0 | 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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Header, Line A | Pelican Rapids Living At Home Block Nurse Program, Chamber membership, Sam's membership, Workers Comp, Health care activities, supplies, insurance, travel, volunteer appreciation, social events, Health and Wellness activities conferences. |
| Form 990-EZ, Part I, Line 10 | no grants paid out |
| Form 990-EZ, Part I, Line 16 | Description;Amount^Travel;2037|Living At Home Network;720|Insurance;978|Subscriptions;50|Workers Comp;251|Misc and supplies;5603^Total;9639^ |