CORRECTIONVILLE HEALTH CARE: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CORRECTIONVILLE HEALTH CARE (EIN 42-1508318)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2022-10-17
- IRS object ID
- 202202909349200905
- Schema version
- 2021v4.0
- 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 | 2022-10-17T09:27:05-04:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 421284539 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOULIHAN & ASSOCIATES PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4240 HICKORY LANE SUITE 100 | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 511064642 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421508318 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORRECTIONVILLE HEALTH CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CORR | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 272 | AddressLine1Txt |
| City | CORRECTIONVILLE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51016 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIM MEBIUS | PersonNm |
| Person Title | DIRECTOR | PersonTitleTxt |
| Signature | 2022-10-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KIM | PersonFirstNm |
| Person Last | MEBIUS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRENT JENSEN | PreparerPersonNm |
| PTIN | P00338159 | PTIN |
| Phone | 7122553450 | PhoneNum |
| Preparation | 2022-10-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $39,330 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $6,320 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $33,010 | InvestmentIncomeAmt |
| Total Revenue | $39,330 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $5,000 | GrantsAndSimilarAmountsPaidAmt |
| Fees And Other Pymt To Ind Cntrct | $418 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $20,976 | OccupancyRentUtltsAndMaintAmt |
| Other Expenses Total | $9,461 | OtherExpensesTotalAmt |
| Total Expenses | $35,855 | TotalExpensesAmt |
| Excess Or Deficit For Year | $3,475 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $246,453 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $249,928 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,168 | BOYAmt |
| EOY | $53,760 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,044 | BOYAmt |
| EOY | $187,855 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,241 | BOYAmt |
| EOY | $8,313 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $246,453 | BOYAmt |
| EOY | $249,928 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $246,453 | BOYAmt |
| EOY | $249,928 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | HEALTH MAINTENANCE FACILITY | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (2 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program Service ExpensesProgramServiceExpensesAmt |
|---|---|---|
| TO BUILD AND MAINTAIN A FACILITY TO BE USED FOR HEALTH MAINTENANCE OF THE RESIDENTS OF CORRECTIONVILLE AND SURROUNDING COMMUNITIES. | $5,000 | $22,883 |
| TO BUILD AND MAINTAIN A FACILITY TO BE USED FOR HEALTH MAINTENANCE OF THE RESIDENTS OF CORRECTIONVILLE AND SURROUNDING COMMUNITIES. | $12,972 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $35,855 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (11 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| KIM MEBIUS | ||
| DIRECTOR | 000.00 | $0 |
| SONYA KOSTAN | ||
| DIRECTOR | 000.00 | $0 |
| BARB ROWSE | ||
| DIRECTOR | 000.00 | $0 |
| BILL FORBES | ||
| DIRECTOR | 000.00 | $0 |
| BOB BEAZLEY | ||
| DIRECTOR | 000.00 | $0 |
| APRIL PUTZIER | ||
| DIRECTOR | 000.00 | $0 |
| ROB STOWE | ||
| DIRECTOR | 000.00 | $0 |
| CARLA MATHERS | ||
| DIRECTOR | 000.00 | $0 |
| ROB STOWE | ||
| DIRECTOR | 000.00 | $0 |
| JO DEMAAREST | ||
| DIRECTOR | 000.00 | $0 |
| DENISE WHITE | ||
| DIRECTOR | 000.00 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOULIHAN & ASSOC PC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1293 | AddressLine1Txt |
| City | SIOUX CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7122553450 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | 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 | $41,549 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $41,935 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,260 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,320 | CurrentTaxYearAmt |
| Total | $131,422 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $805 | CurrentTaxYearMinus2YearsAmt |
| Total | $805 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $41,549 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $42,740 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,260 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,320 | CurrentTaxYearAmt |
| Total | $132,227 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $132,227 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $38 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $58 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $33,033 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $33,010 | CurrentTaxYearAmt |
| Total | $66,169 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $38 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $58 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $33,033 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $33,010 | CurrentTaxYearAmt |
| Total | $66,169 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $41,587 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,416 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $42,770 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $38,293 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39,330 | CurrentTaxYearAmt |
| Total | $198,396 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.66650 | PublicSupportCY509Pct |
| Public Support PY509 | 0.83630 | PublicSupportPY509Pct |
| Investment Income CY | 0.33000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.16000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 16 | EXPENSES PROMOTION 1,750 OFFICE EXPENSE 561 SALES TAX 314 MEETINGS 36 INSURANCE 4,590 RENT 25 NON-INVESTMENT DEPRECIATION 2,185 TOTAL 9,461 |
| FORM 990-EZ, PART II, LINE 24 | EQUIPMENT 39,258 42,515 LESS ACCUMULATED DEPRECIATION 32,017 34,202 TOTAL 7,241 8,313 |
| FORM 990-EZ, PART III | SCHOLARSHIPS: MADIISYN VERMEYS 1,000, GARRETT TRAPP 2,000 , TYLER TOWNE 2,000 |
| FORM 990-EZ, PART III, LINE 31 | TO BUILD AND MAINTAIN A FACILITY TO BE USED FOR HEALTH MAINTENANCE OF THE RESIDENTS OF CORRECTIONVILLE AND SURROUNDING COMMUNITIES. |