VISTA GRANDE VILLA: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- VISTA GRANDE VILLA (EIN 38-1941267)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-06-26
- IRS object ID
- 202341779349301369
- 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 | 2023-06-26T18:18:38-04:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381961213 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LALLY GROUP PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1066 | AddressLine1Txt |
| City | JACKSON | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 492041066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381941267 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VISTA GRANDE VILLA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | VIST | BusinessNameControlTxt |
| Phone | 5177870222 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2251 SPRINGPORT ROAD | AddressLine1Txt |
| City | JACKSON | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GREG PUTRA | PersonNm |
| Person Title | DIRECTOR | PersonTitleTxt |
| Phone | 5177870222 | PhoneNum |
| Signature | 2023-06-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | GREG | PersonFirstNm |
| Person Last | PUTRA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JON A NOWINSKI CPA | PreparerPersonNm |
| PTIN | P00004583 | PTIN |
| Phone | 5177870064 | PhoneNum |
| Preparation | 2023-06-23 | PreparationDt |
| 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 | GREG PUTRA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3391 HARBEN ST | AddressLine1Txt |
| City | JACKSON | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,520,815 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.VISTAGRANDEVILLA.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | RETIREMENT AND CONVALESCENT HOME | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 273 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $414,918 | PYContributionsGrantsAmt |
| CY Contributions Grants | $360,481 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,035,276 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,532,185 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,876 | PYInvestmentIncomeAmt |
| CY Investment Income | $88,127 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,424,026 | PYOtherRevenueAmt |
| CY Other Revenue | $540,022 | CYOtherRevenueAmt |
| PY Total Revenue | $15,877,096 | PYTotalRevenueAmt |
| CY Total Revenue | $15,520,815 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,094,079 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,001,346 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $77,770 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,147,626 | PYOtherExpensesAmt |
| CY Other Expenses | $10,291,828 | CYOtherExpensesAmt |
| PY Total Expenses | $16,241,705 | PYTotalExpensesAmt |
| CY Total Expenses | $17,293,174 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$364,609 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,772,359 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,128,782 | TotalAssetsBOYAmt |
| Total Assets EOY | $24,220,880 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $31,056,731 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $38,921,188 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$12,927,949 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$14,700,308 | NetAssetsOrFundBalancesEOYAmt |
| Mission | RETIREMENT AND CONVALESCENT HOME | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $13,899,505 | ExpenseAmt |
| Revenue | $14,532,185 | RevenueAmt |
| Desc | PROVISION OF RETIREMENT APARTMENT SERVICES, ASSISTED LIVING, AND SKILLED NURSING CARE TO RESIDENTS. | Desc |
| Total Program Service Expenses | $13,899,505 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 273 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | 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 | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VISTA GRANDE VILLA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5177870222 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2251 SPRINGPORT RD | AddressLine1Txt |
| City | JACKSON | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|
| GREG PUTRA | |||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 |
| MICHAEL BURGESS | |||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 |
| ALEX DINKELS | |||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 |
| WENDY KIM | |||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MORRISON COMMUNITY LIVING | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD SERVICES | $1,261,055 |
| HEALTHCARE SERVICES GROUP | |||||
| PO BOX 829677 | PHILADELPHIA | PA | 19182 | NUTRITION SVCS | $1,243,472 |
| KAUHALE HEALTH LLC | |||||
| 72 DORCHESTER SQUARE | WESTERVILLE | OH | 43081 | SENIOR SVCS | $552,554 |
| LAKEWOOD CONSTRUCTION COMPANY | |||||
| 11253 JAMES STREET | HOLLAND | MI | 49424 | CONSTRUCTION | $521,478 |
| MTELEHEALTH LLC | |||||
| 255 NE 6TH AVENUE SUITE A | DELRAY BEACH | FL | 33483 | PT MONITORING | $339,912 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $360,481 | AllOtherContributionsAmt |
| Total Contributions | $360,481 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| APARTMENT SERVICE FEES | $6,988,872 | $6,988,872 |
| SKILLED NURSING | $4,354,873 | $4,354,873 |
| ASSISTED LIVING | $1,885,531 | $1,885,531 |
| ENTRANCE FEES | $1,302,909 | $1,302,909 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,532,185 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,127 | TotalRevenueColumnAmt |
| Exclusion | $88,127 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| OTHER NON-OPERATING INCOME | $355,241 | $355,241 |
| UNREALIZED GAIN/LOSS ON INVES | $237,597 | $237,597 |
| OTHER MISCELLANEOUS REVENUE | $66,298 | $66,298 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$119,114 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$119,114 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $540,022 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,520,815 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,072,207 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $88,127 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,807,539 | TotalAmt |
| Program Services | $4,545,638 | ProgramServicesAmt |
| Management And General | $1,189,689 | ManagementAndGeneralAmt |
| Fundraising | $72,212 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,925 | TotalAmt |
| Management And General | $5,925 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $739,715 | TotalAmt |
| Program Services | $585,526 | ProgramServicesAmt |
| Management And General | $154,189 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,167 | TotalAmt |
| Program Services | $350,780 | ProgramServicesAmt |
| Management And General | $91,829 | ManagementAndGeneralAmt |
| Fundraising | $5,558 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $590,802 | TotalAmt |
| Management And General | $590,802 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,785 | TotalAmt |
| Management And General | $2,785 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,855 | TotalAmt |
| Management And General | $49,855 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,494 | TotalAmt |
| Management And General | $107,494 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,444 | TotalAmt |
| Program Services | $7,700 | ProgramServicesAmt |
| Management And General | $241,744 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,109,225 | TotalAmt |
| Program Services | $843,580 | ProgramServicesAmt |
| Management And General | $265,645 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,194 | TotalAmt |
| Management And General | $4,194 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,675,937 | TotalAmt |
| Program Services | $2,675,937 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,439,726 | TotalAmt |
| Program Services | $1,439,726 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,168 | TotalAmt |
| Management And General | $232,168 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| FOOD SERVICES - PROGRAM S | $1,795,111 | $1,795,111 | |
| MEDICAL EXPENSE | $599,531 | $599,531 | |
| REPAIRS - PROGRAM SERVICE | $456,138 | $456,138 | |
| BAD DEBTS - ADMINISTRATIV | $314,436 | $314,436 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $664,982 | TotalAmt |
| Program Services | $599,838 | ProgramServicesAmt |
| Management And General | $65,144 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,293,174 | TotalAmt |
| Program Services | $13,899,505 | ProgramServicesAmt |
| Management And General | $3,315,899 | ManagementAndGeneralAmt |
| Fundraising | $77,770 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,755,164 | BOYAmt |
| EOY | $3,581,911 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,351,655 | BOYAmt |
| EOY | $1,906,848 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,362 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,499 | BOYAmt |
| EOY | $56,271 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $42,151,396 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,084,048 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,487,809 | BOYAmt |
| EOY | $13,067,348 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,085,293 | BOYAmt |
| EOY | $5,608,502 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,128,782 | BOYAmt |
| EOY | $24,220,880 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,506,939 | BOYAmt |
| EOY | $2,091,809 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,400 | BOYAmt |
| EOY | $65,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,207,332 | BOYAmt |
| EOY | $31,087,293 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,142,139 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,127,921 | BOYAmt |
| EOY | $5,677,086 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,056,731 | BOYAmt |
| EOY | $38,921,188 | 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 | -$13,422,008 | BOYAmt |
| EOY | -$15,007,457 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $494,059 | BOYAmt |
| EOY | $307,149 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$12,927,949 | BOYAmt |
| EOY | -$14,700,308 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,128,782 | BOYAmt |
| EOY | $24,220,880 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,772,359 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | $128,805 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $52,387 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $179,506 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $414,918 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $360,481 | CurrentTaxYearAmt |
| Total | $1,136,097 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,691,561 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,860,653 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,641,293 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,459,302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,072,207 | CurrentTaxYearAmt |
| Total | $76,725,016 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,820,366 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,913,040 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,820,799 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,874,220 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,432,688 | CurrentTaxYearAmt |
| Total | $77,861,113 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $77,861,113 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $96,075 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $84,604 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,299 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,876 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $88,127 | CurrentTaxYearAmt |
| Total | $302,981 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $96,075 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $84,604 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,299 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,876 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $88,127 | CurrentTaxYearAmt |
| Total | $302,981 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,916,441 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,997,644 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,852,098 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,877,096 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,520,815 | CurrentTaxYearAmt |
| Total | $78,164,094 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99610 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99660 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $234,101 | OtherCostOrOtherBasisAmt |
| Book Value | $234,101 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,223,938 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,653,004 | DepreciationAmt |
| Book Value | $10,570,934 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,612,975 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,567,917 | DepreciationAmt |
| Book Value | $1,045,058 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,080,382 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,863,127 | DepreciationAmt |
| Book Value | $1,217,255 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,067,348 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BOND ESCROW FUNDS | Desc |
| Book Value | $5,608,502 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,608,502 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED ENDOWMENT INCOME | Desc |
| Amt | $5,677,086 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,677,086 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $15,520,815 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $15,520,815 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $15,520,815 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,293,174 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $17,293,174 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $17,293,174 | TotalExpensesPerForm990Amt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| PUBLIC FINANCE AUTHORITY 2022A | ||||||||
| A | 911821036 | 74442PXJ9 | 2022-03-01 | $23,830,000 | REFUND PRIOR BONDS, ORIGINALLY ISSUED IN 2015. | false | false | false |
| PUBLIC FINANCE AUTHORITY 2022B | ||||||||
| B | 911821036 | 74442PXK6 | 2022-03-01 | $6,745,000 | REFUND PRIOR BONDS, ORIGINALLY ISSUED IN 2015. | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Capitalized InterestCapitalizedInterestAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $15,640,737 | $23,830,000 | $2,000,000 | $953,116 | $5,236,147 | Yes (true) | false | Yes (true) | Yes (true) | |
| B | $3,559,263 | $6,745,000 | $1,013,974 | $1,195,843 | Yes (true) | false | Yes (true) | Yes (true) | $975,920 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false |
| B | false | false | false | false | false | false | false |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false | false | false |
| B | false | false | false | false | false | false | false | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | false |
| B | false |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PURPOSE OF ISSUE DESCRIPTION | PUBLIC FINANCE AUTHORITY 2022A REFUND PRIOR BONDS, ORIGINALLY ISSUED IN 2015. |
| PURPOSE OF ISSUE DESCRIPTION | PUBLIC FINANCE AUTHORITY 2022B REFUND PRIOR BONDS, ORIGINALLY ISSUED IN 2015. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 3 | MANAGEMENT HAS BEEN DELEGATED TO KAUHALE HEALTH MANAGEMENT LLC. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE FORM 990 IS REVIEWED BY MANAGEMENT AND THE BOARD OF DIRECTORS. THE BOARD HAS APPROVED THE 990 PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUAL DISCLOSURES SIGNED BY EACH DIRECTOR. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE ORGANIZATION'S BOARD OF DIRECTORS IS REQUIRED UNDER THE WRITTEN MANAGEMENT COMPANY AGREEMENT TO, "ACTIVELY PARTICIPATE IN THE REVIEW AND APPROVAL OF THE EXECUTIVE DIRECTOR'S SELECTION, PERFORMANCE METRICS, PERFORMANCE GOALS, BOARD REPORTING PROTOCOLS, AND LONG-TERM MANAGEMENT PLAN FOR THE FACILITY." |
| FORM 990, PAGE 6, PART VI, LINE 15B | OUTSIDE OF THE EXECUTIVE DIRECTOR, THE BOARD OF DIRECTORS REVIEWS AND SETS THE COMPENSATION OF ALL KEY EMPLOYEES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE INCLUDED IN THE DISCLOSURE DOCUMENTS AND ARE AVAILABLE BY REQUEST AT THE FRONT OFFICE. |