2023-11-09T13:36:19-06:00 2022-12-31 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2022-01-01 430834159 KABUL NURSING HOME INC % MICHELLE WRIGHT KABU 4179623713 1000 MAIN STREET CABOOL MO 65689 TOM COATS PRESIDENT 4179623713 2023-05-05 true TOM COATS 999009999 Brian D Todd P00422601 4178658701 3 2022 2023-04-26 12:10:37Z MICHELLE WRIGHT 1000 MAIN STREET CABOOL MO 65689 5320779 false X WWW.KABULNH.COM X 1966 MO KABUL NURSING HOME OFFERS 24-HR SKILLED CARE. SERVICES ARE OFFERED REGARDLESS OF RACE, COLOR, CREED, SEX, RELIGIOUS AFFILIATION OR THE ABILITY TO PAY. 7 7 139 16 0 0 664539 81842 5467907 5121437 1727 -2829 0 116399 6134173 5316849 0 0 0 0 3403295 3436684 0 0 0 2386879 2329272 5790174 5765956 343999 -449107 3459683 2989068 618333 596825 2841350 2392243 X TO PLAN, BUILD AND OPERATE A NURSING AND CONVALESCENT HOME IN THE CABOOL, MISSOURI AREA. SEE SCHEDULE O FOR THE FULL MISSION. false false 3187895 3519233 KABUL NURSING HOME - A FULL SERVICE SKILLED NURSING HOME FOR SHORT AND LONG TERM STAYS. KABUL OFFERS A RANGE OF SERVICES INCLUDING: PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, IN-HOUSE BEAUTY SHOP, SOCIAL SERVICES, PHYSICIAN VISITS, PHARMACY SERVICES AND A DIETICIAN, AS WELL AS NUMEROUS OTHER ITEMS TO HELP MAKE PATIENTS STAY MORE ENJOYABLE. APPROXIATELY 112 RESIDENTS WERE SERVED DURING THE YEAR. 991969 1228195 LANDMARK VILLA - A 24-HOUR STAFFED ASSISTED LIVING FACILITY. LANDMARK VILLA OFFERS PRIVATE ROOMS, MEDICATION ADMINISTRATION, FREE LAUNDRY AND HOUSEKEEPING SERVICES, THREE BLANACED MEALS A DAY, IN-HOUSE BEAUTY SHOP, DAILY AND EXTRACURRICULAR ACTIVITIES, ON-SITE NURSE, EMERGENCY PULL CORDS IN EACH APARTMENT, AND CHURCH SERVICES. APPROXIMATELY 54 RESIDENTS WERE SERVED DURING THE YEAR. 382887 374009 PINEVIEW HEIGHTS SENIOR APARTMENTS - SENIOR INDEPENDENT LIVING WITH INCOME BASED RENT. PINEVIEW HEIGHTS OFFERS SOCIAL SERVICES, IN-HOUSE BEAUTY SHOP, GROCERY DELIVERY, TRANSPORTATION SERVICE, NOON MEAL SERVICE, EMERGENCY PULL CORDS IN EACH APARTMENT, AND WEEKLY ACTIVITIES. APPROXIMATELY 63 RESIDENTS WERE SERVED DURING THE YEAR. 4562751 true true false true false false false false false true true false false false true false true false false false false false false false false false false false false false false false false false false false false false false false false false false true true true false false true 19 0 true 139 true false false false false false false false false false false false false X 7 7 false false false false true true true true true false false true true true true true true false false false X MICHELLE WRIGHT 4179623713 1000 MAIN STREET CABOOL MO 65689 DEBRA DOTSON ADMINISTRATOR END 12/22 40.0 0.0 X 83246 0 13520 MICHELLE WRIGHT ADMINISTRATOR BEG 12/22 40.0 0.0 X 51759 0 0 GARY MAGGARD VICE PRESIDENT 1.0 0.0 X X 0 0 0 TOM COATS PRESIDENT 1.0 0.0 X X 0 0 0 LINDA EVERETT TREASURER 1.0 0.0 X X 0 0 0 ROBERTA TAYLOR SECRETARY END 05/22 1.0 0.0 X X 0 0 0 EVELYN WHETSTINE BOARD MEMBER 1.0 0.0 X 0 0 0 JIM PERRY BD MMR END 05/22/SEC BEG 05/22 1.0 0.0 X X 0 0 0 LARRY BAKER BOARD MEMBER 1.0 0.0 X 0 0 0 JUDY FREDRICK BOARD MEMBER BEG 05/22 1.0 0.0 X 0 0 0 135005 0 13520 0 false false false QCR INC 8477 S SUNCOAST BLVD HOMOSASSA FL 34446 THERAPY 397944 FORVIS LLP 910 E ST LOUIS ST SPRINGFIELD MO 65801 AUDIT/TAX/ACCOUNTING 169428 MOUNTAIN MAN CONSTRUCTION LLC 3774 COUNTY ROAD 4300 POMONA MO 65789 CONSTRUCTION 163800 WEST PLAINS ROOFING LLC 902 W BROADWAY 500 WEST PLAINS MO 65775 ROOFING 127000 4 81117 725 81842 NET PATIENT SERVICE REVENUE 623000 4805397 4805397 RENTAL INCOME 531110 306237 306237 OTHER OPERATING REVENUE 623000 9803 9803 5121437 1101 1101 0 0 0 0 0 3930 -3930 -3930 -3930 0 0 0 0 0 0 0 0 0 GAIN ON INVOLUNTARY CONVERSION 900099 116399 116399 116399 5316849 5121437 113570 0 0 0 0 148525 148525 0 2979642 2607537 372105 0 102625 94052 8573 205892 166727 39165 0 74 74 162107 162107 0 0 0 383267 375067 8200 20077 20077 509064 439231 69833 115870 115870 0 304382 238483 65899 15705 9001 6704 0 7174 5028 2146 13646 10195 3451 0 204355 166011 38344 48433 1934 46499 NRFA & NFAC FEES 234879 234879 MEDICAL SUPPLIES & DRUGS 160982 160982 LICENSES, DUES, SUBSCRIPTIONS 69161 2504 66657 REPAIRS & MAINTENANCE 17471 11013 6458 62625 40107 22518 5765956 4562751 1203205 0 530 555 1082224 359879 0 0 359321 383430 0 0 0 0 0 0 47828 59072 23399 19086 9466957 7354119 1902373 2112838 0 0 0 0 0 0 0 0 44008 54208 3459683 2989068 325052 329913 0 0 0 0 0 0 0 0 0 0 266104 244450 0 0 27177 22462 618333 596825 X 2831350 2382243 10000 10000 2841350 2392243 3459683 2989068 -449107 X true X false true false X 66457 68231 728624 664539 81842 1609693 4803298 4998837 5045438 5467907 5121437 25436917 0 0 0 4869755 5067068 5774062 6132446 5203279 27046610 0 0 0 27046610 1194 1236 2388 1727 1101 7646 0 1194 1236 2388 1727 1101 7646 0 0 4870949 5068304 5776450 6134173 5204380 27054256 0.99972 0.99970 0.00028 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1343 1343 false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO AHCA AND MHCA. A PORTION OF THESE DUES ARE USED FOR LOBBYING PURPOSES. 15741 55 15796 15662 79 15741 15584 78 15662 15506 78 15584 15429 77 15506 1.00000 false false true 354520 354520 6009394 5261867 747527 1325108 879144 445964 1721847 1162002 559845 56088 51106 4982 2112838 0 TENANT SECURITY DEPOSITS 22462 22462 5320779 5320779 -3930 -3930 5316849 5769886 3930 3930 5765956 5765956 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS: THIS ENDOWMENT IS A CD, WITH A PRINCIPAL AMOUNT OF $10,000, AT THE REQUEST OF THE CONTRIBUTOR OF THE FUNDS. THE CD IS PERPETUAL AND THE INTEREST IS ROLLED BACK INTO THE CD. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VII, LINE 12, BUT NOT ON LINE 1: $(3,930) LOSS ON SALE OF ASSET SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 3,930 LOSS ON SALE OF ASSET FORM 990, PART I, LINE 6 VOLUNTEERS: THE ORGANIZATION'S BOARD MEMBERS ARE VOLUNTEERS TO THE ORGANIZATION. IN ADDITION, THE ORGANIZATION HAS NINE INDIVIDUALS WHO VOLUNTEER AT THE NURSING HOME FACILITY. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: TO PLAN, BUILD AND OPERATE A NURSING AND CONVALESCENT HOME IN THE CABOOL, MISSOURI AREA ON A NON-PROFIT PLAN, TO CARE FOR THE AGED, INFIRM, AFFLICTED AND CONVALESCENT, REGARDLESS OF RACE, COLOR, CREED, SEX, RELIGIOUS AFFILIATION OR ABILITY TO PAY, WITH NO PART OF NET EARNINGS OR ASSETS INURING TO THE BENEFIT OF AN OFFICER, MEMBER, DIRECTOR OR INDIVIDUAL WHATSOEVER. TO BE A PROVIDER OF PATIENT-CENTERED CARE BY OFFERING HIGH QUALITY, CARING, HOME-LIKE, LONG TERM CARE SERVICES TO ITS RESIDENTS IN AN INNOVATIVE, THERAPEUTIC AND SAFE ENVIRONMENT WHERE ACTIONS ARE DIRECTED TO THE ULTIMATE GOOD OF THE PATIENT. FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B MEMBERS/STOCKHOLDERS: THE ORGANIZATION'S MEMBERS CONSIST OF DELEGATES FROM THE VARIOUS CIVIC SERVICES, SOCIAL AND RELIGIOUS CLUBS, ORGANIZATION AND CHURCHES IN AND AROUND THE CITY OF CABOOL, MO. MEMBERS ARE SELECTED BY EACH INDIVIDUAL'S CLUB, ORGANIZATION, OR CHURCH AND THEN SUBMITTED TO THE CORPORATION. THE MEMBERS ELECT THE BOARD OF DIRECTORS. THE MEMBERS HAVE THE POWER TO ALTER, AMEND, OR REPEAL THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM USING THE COMPILED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ORGANIZATION'S MANAGEMENT. THE RETURN IS REVIEWED BY THE ADMINISTRATOR AND DISTRIBUTED TO ALL BOARD MEMBERS PRIOR TO THE RETURN'S SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST: PERSONS COVERED UNDER THIS POLICY ARE DIRECTORS, OFFICERS, AND ALL EMPLOYEES SUCH AS MANAGEMENT AND PURCHASING, WHO CAN INFLUENCE THE ACTIONS OF THE COMPANY. IT SHALL BE THE BOARD, OFFICER'S, AND MANAGEMENT'S RESPONSIBILITY TO SCRUTINIZE TRANSACTIONS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES BEFORE ANY TRANSACTION IS CONSUMMATED. ANY BOARD MEMBER WITH A CONFLICT OR POTENTIAL CONFLICT OF INTEREST WILL ABSTAIN FROM VOTING ON ANY ISSUE RELATED TO THAT CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A ADMINISTRATOR COMPENSATION: THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE COMPENSATION OF THE ADMINISTRATOR. THE REVIEW IS BASED ON PERFORMANCE AND IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION'S DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR VIEWING AT THE FACILITY UPON REQUEST. PERPETUAL TRUST TRUST MO NA TRUST 55 15796 1.00000 true true false false false false false false false false false false false false false false false false false false PERPETUAL TRUST A 55 FMV