FOSS HOME & VILLIAGE: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FOSS HOME & VILLIAGE (EIN 91-0573114)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-09
- IRS object ID
- 202213139349301686
- Schema version
- 2021v4.2
- 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 | 2022-11-09T09:12:30-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910573114 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOSS HOME & VILLAGE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FOSS | BusinessNameControlTxt |
| Phone | 2063641300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13023 GREENWOOD AVENUE NORTH | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 981337397 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | R KEVIN MCFEELY | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 2063641300 | PhoneNum |
| Signature | 2022-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | R | PersonFirstNm |
| Person Last | KEVIN MCFEELY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2022-11-07 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | R KEVIN MCFEELY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13023 GREENWOOD AVENUE NORTH | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 981337397 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,760,418 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FOSSCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1929 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | NURSING HOME AND ASSISTED LIVING FACILITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 295 | TotalEmployeeCnt |
| Total Volunteers | 19 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,660,130 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,766,978 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,588,783 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,477,342 | CYProgramServiceRevenueAmt |
| PY Investment Income | $125,465 | PYInvestmentIncomeAmt |
| CY Investment Income | $98,615 | CYInvestmentIncomeAmt |
| PY Other Revenue | $283,022 | PYOtherRevenueAmt |
| CY Other Revenue | $207,579 | CYOtherRevenueAmt |
| PY Total Revenue | $18,657,400 | PYTotalRevenueAmt |
| CY Total Revenue | $20,550,514 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,241,591 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,483,125 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $82,854 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,077,958 | PYOtherExpensesAmt |
| CY Other Expenses | $5,560,566 | CYOtherExpensesAmt |
| PY Total Expenses | $20,319,549 | PYTotalExpensesAmt |
| CY Total Expenses | $19,043,691 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,662,149 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,506,823 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,533,947 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,479,734 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,829,981 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,069,922 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,703,966 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,409,812 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | NURSING HOME AND ASSISTED LIVING FACILITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,443,019 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $14,477,342 | RevenueAmt |
| Desc | SINCE 1929 FOSS HOME AND VILLAGE HAS PROVIDED CARE FOR THE COMMUNITY IN A NURSING HOME AND ASSISTED LIVING SETTING. FOSS SERVES A POPULATION WITH A SUBSTANTIAL NUMBER OF MEDICAID AND MEDICARE SUPPORTED RESIDENTS AND PATIENTS, WITH 70% OF ITS SERVICE REVENUE FROM MEDICAID/MEDICARE. IN ADDITION TO PROVIDING CARE, FOSS STRIVES TO BE ACTIVE IN THE COMMUNITY BY PARTNERING WITH THE UNIVERSITY OF WASHINGTON, SHORELINE COMMUNITY COLLEGE AND OTHER COLLEGES AND UNIVERSITIES. FOSS PROVIDES A LEARNING ENVIRONMENT FOR INTERNSHIPS BASED IN THE FIELDS OF DENTISTRY, PHARMACY, RESTORATIVE THERAPY, NURSING, AND NURSING ASSISTANT TRAINING. FOSS ALSO HAS AN ACTIVE VOLUNTEER PROGRAM THAT ENCOURAGES HIGH SCHOOL AND COLLEGE STUDENTS. FOSS SERVED 262 NURSING HOME CLIENTS AND 49 ASSISTED LIVING CLIENTS, (CONTINUED IN SCHEDULE O)WITH THE AVERAGE LENGTH OF STAY FOR SHORT-STAY RESIDENTS, DEFINED BY THOSE WHO STAYED 100 DAYS OR LESS, OF APPROXIMATELY 22 DAYS. RATES ARE SET BASED ON THE MARKET IN THE SEATTLE AREA, WHICH ARE NECESSARY TO MAKE THE ORGANIZATION VIABLE. | Desc |
| Total Program Service Expenses | $14,443,019 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 34 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 295 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | R KEVIN MCFEELY | PersonNm |
| Phone | 2063641300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13023 GREENWOOD AVENUE NORTH | AddressLine1Txt |
| City | SEATTLE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 981337397 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| GILBERT DIGA | |||||||
| HR DIRECTOR | 40.00 | Yes (X) | $321,193 | $0 | $12,113 | ||
| JOHN RICK HENRY JR | |||||||
| PRESIDENT & CEO | 40.00 | $210,018 | $0 | $23,855 | Yes (X) | ||
| TIMOTHY TEACHMAN | |||||||
| ES DIRECTOR (THROUGH MAY 2021) | 40.00 | Yes (X) | $207,418 | $0 | $5,454 | ||
| BANAFSHEH BAHARLOO RN | |||||||
| NURSE | 40.00 | Yes (X) | $175,605 | $0 | $18,122 | ||
| RACHAEL GERDIS | |||||||
| ADMINISTRATOR | 40.00 | $137,017 | $0 | $42,779 | Yes (X) | ||
| AIDAN TRO | |||||||
| DENTIST | 40.00 | Yes (X) | $141,208 | $0 | $12,212 | ||
| SOLOMON G-KIDANE LPN | |||||||
| NURSE | 40.00 | Yes (X) | $137,257 | $0 | $13,795 | ||
| TODD HEGERMAN | |||||||
| DIRECTOR OF FINANCIAL SERVICES | 40.00 | $89,136 | $0 | $11,804 | Yes (X) | ||
| JULIE YARI | |||||||
| CHAIR | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JEFF WEST RN | |||||||
| VICE CHAIR | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| KRIS CHICK | |||||||
| TREASURER | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| LARRAINE KING | |||||||
| SECRETARY | 0.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| MARTA ACEDO | |||||||
| TRUSTEE (THROUGH JANUARY 2021) | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| LYNNE DASHER | |||||||
| TRUSTEE (THROUGH JULY 2021) | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| JOHN GIENAPP | |||||||
| TRUSTEE (THROUGH JANUARY 2021) | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| BEV ROACH | |||||||
| TRUSTEE | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| JUDY WILDES | |||||||
| TRUSTEE | 0.50 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,418,852 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $140,134 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CONSONUS REHAB | |||||
| 4560 SE INTERNATIONAL WAY | MILWAUKIE | OR | 97222 | THERAPY SERVICES | $363,768 |
| QUALITY IMPROVEMENT CONSULTING | |||||
| 16907 76TH AVENUE W | EDMONDS | WA | 98026 | NURSE CONSULTANT | $163,124 |
| EASTGATE STAFFING AGENCY LLC | |||||
| 4957 LAKEMONT BOULEVARD SE | BELLEVUE | WA | 98006 | NURSES/NURSING ASSISTANTS | $137,704 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,496,128 | GovernmentGrantsAmt |
| All Other Contributions | $270,850 | AllOtherContributionsAmt |
| Total Contributions | $5,766,978 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESIDENT FEES | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $14,477,342 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,477,342 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,477,342 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,615 | TotalRevenueColumnAmt |
| Exclusion | $98,615 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $272,007 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $208,942 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,065 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,065 | TotalRevenueColumnAmt |
| Exclusion | $63,065 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $13,866 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $962 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,904 | TotalRevenueColumnAmt |
| Exclusion | $12,904 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $131,610 | TotalRevenueColumnAmt |
| Exclusion | $131,610 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $131,610 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,550,514 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,477,342 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $306,194 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $514,612 | TotalAmt |
| Management And General | $514,612 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,293,531 | TotalAmt |
| Program Services | $8,179,234 | ProgramServicesAmt |
| Management And General | $2,057,461 | ManagementAndGeneralAmt |
| Fundraising | $56,836 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,952 | TotalAmt |
| Program Services | $236,718 | ProgramServicesAmt |
| Management And General | $50,589 | ManagementAndGeneralAmt |
| Fundraising | $1,645 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,416,701 | TotalAmt |
| Program Services | $1,123,291 | ProgramServicesAmt |
| Management And General | $285,604 | ManagementAndGeneralAmt |
| Fundraising | $7,806 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $969,329 | TotalAmt |
| Program Services | $738,917 | ProgramServicesAmt |
| Management And General | $225,277 | ManagementAndGeneralAmt |
| Fundraising | $5,135 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,838 | TotalAmt |
| Management And General | $92,838 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,949 | TotalAmt |
| Management And General | $53,949 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,417,055 | TotalAmt |
| Program Services | $1,110,453 | ProgramServicesAmt |
| Management And General | $303,883 | ManagementAndGeneralAmt |
| Fundraising | $2,719 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,807 | TotalAmt |
| Management And General | $55,393 | ManagementAndGeneralAmt |
| Fundraising | $414 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,021 | TotalAmt |
| Program Services | $27,186 | ProgramServicesAmt |
| Management And General | $17,284 | ManagementAndGeneralAmt |
| Fundraising | $6,551 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $936,749 | TotalAmt |
| Program Services | $583,430 | ProgramServicesAmt |
| Management And General | $353,319 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,122 | TotalAmt |
| Management And General | $5,122 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,629 | TotalAmt |
| Management And General | $121,629 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,256 | TotalAmt |
| Program Services | $512,293 | ProgramServicesAmt |
| Management And General | $26,963 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $1,089,712 | $1,089,480 | $232 | |
| FOOD | $551,197 | $551,197 | ||
| MISCELLANEOUS EXPENSES | $255,010 | $461 | $252,801 | $1,748 |
| BAD DEBT EXPENSE | $222,489 | $222,489 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,732 | TotalAmt |
| Program Services | $67,870 | ProgramServicesAmt |
| Management And General | $100,862 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,043,691 | TotalAmt |
| Program Services | $14,443,019 | ProgramServicesAmt |
| Management And General | $4,517,818 | ManagementAndGeneralAmt |
| Fundraising | $82,854 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,576,068 | BOYAmt |
| EOY | $2,639,674 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,108,484 | BOYAmt |
| EOY | $1,512,058 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,040 | BOYAmt |
| EOY | $122,885 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,915 | BOYAmt |
| EOY | $265,825 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,971,210 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,179,785 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,236,872 | BOYAmt |
| EOY | $8,791,425 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,253,631 | BOYAmt |
| EOY | $2,140,355 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,937 | BOYAmt |
| EOY | $7,512 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,533,947 | BOYAmt |
| EOY | $15,479,734 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,275,771 | BOYAmt |
| EOY | $1,392,087 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,430,738 | BOYAmt |
| EOY | $125,678 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,937 | BOYAmt |
| EOY | $7,512 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,223,408 | BOYAmt |
| EOY | $3,013,777 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $885,127 | BOYAmt |
| EOY | $530,868 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,829,981 | BOYAmt |
| EOY | $5,069,922 | 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 | $8,146,808 | BOYAmt |
| EOY | $9,836,579 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $557,158 | BOYAmt |
| EOY | $573,233 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,703,966 | BOYAmt |
| EOY | $10,409,812 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,533,947 | BOYAmt |
| EOY | $15,479,734 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,506,823 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $199,023 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 | $399,150 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $332,935 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $351,078 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,660,130 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,766,978 | CurrentTaxYearAmt |
| Total | $8,510,271 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,009,743 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,877,132 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,638,829 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,588,783 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,477,342 | CurrentTaxYearAmt |
| Total | $90,591,829 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $52,968 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $58,764 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $59,524 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,589 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,866 | CurrentTaxYearAmt |
| Total | $204,711 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,461,861 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,268,831 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,049,431 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,268,502 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,258,186 | CurrentTaxYearAmt |
| Total | $99,306,811 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $1,923 | CurrentTaxYearAmt |
| Total | $1,923 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $1,923 | CurrentTaxYearAmt |
| Total | $1,923 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $99,304,888 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $200,940 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $288,001 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $280,969 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $363,425 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $370,622 | CurrentTaxYearAmt |
| Total | $1,503,957 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $200,940 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $288,001 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $280,969 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $363,425 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $370,622 | CurrentTaxYearAmt |
| Total | $1,503,957 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,972 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $140,331 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $230,959 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $210,695 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $131,610 | CurrentTaxYearAmt |
| Total | $759,567 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,708,773 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,697,163 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,561,359 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,842,622 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,760,418 | CurrentTaxYearAmt |
| Total | $101,570,335 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97770 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97990 | PublicSupportPY509Pct |
| Investment Income CY | 0.01480 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01340 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME | ExplanationTxt |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,525,501 | OtherCostOrOtherBasisAmt |
| Book Value | $3,525,501 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,928,679 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,758,966 | DepreciationAmt |
| Book Value | $4,169,713 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,323,297 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,133,749 | DepreciationAmt |
| Book Value | $189,548 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,193,733 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,287,070 | DepreciationAmt |
| Book Value | $906,663 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,791,425 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFFERRED COMPENSATION | Desc |
| Amt | $530,868 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $530,868 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $20,664,858 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $199,023 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $30,657 | OtherRevenueAmt |
| Revenue Not Reported | $229,680 | RevenueNotReportedAmt |
| Revenue Subtotal | $20,435,178 | RevenueSubtotalAmt |
| Other Revenues Not Included | $115,336 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $115,336 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $20,550,514 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $18,975,087 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $18,975,087 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $68,604 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $68,604 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $19,043,691 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION HOLDS TRUST ACCOUNTS FOR RESIDENTS WHO REQUEST THAT WE DO SO AND FOR ANY RESIDENTS OF WHICH THE ORGANIZATION IS REPRESENTATIVE PAYEE FOR SOCIAL SECURITY PURPOSES. THE MONEY IS HELD IN AN INTEREST-BEARING CHECKING ACCOUNT. RESIDENTS CAN OBTAIN THEIR MONEY UPON REQUEST. THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR ASSISTED LIVING RESIDENTS AND OTHER RENTAL TENANTS. SECURITY DEPOSITS ARE HELD IN NON-INTEREST BEARING ACCOUNTS. SECURITY DEPOSITS ARE RETURNED TO TENANTS WHEN THE LEASE IS TERMINATED, LESS ANY AMOUNTS FOR DAMAGES. |
| PART X, LINE 2: | FOSS IS A NONPROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND FILES AN ANNUAL FEDERAL INFORMATION RETURN FORM 990. FOSS IS EXEMPT FROM INCOME TAXES EXCEPT FOR INCOME, IF ANY, DERIVED FROM UNRELATED BUSINESS ACTIVITIES. THERE WAS NO NET UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020. THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (TOPIC 740) ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. FOSS ADOPTED THIS GUIDANCE FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020. MANAGEMENT EVALUATED FOSS' TAX POSITIONS AND CONCLUDED THAT FOSS HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. FOSS IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2017. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NET ASSET RELEASED FROM RESTRICTION FOR OPERATIONS 30,657. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTIONS RESTRICTED FOR CAPITAL USE 46,732. EXPENSES NETTED AGAINST REVENUES IN THE FINANCIAL STATEMENTS 29,613. BAD DEBT EXPENSE 38,991. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES NETTED AGAINST REVENUES IN THE FINANCIAL STATEMENTS 29,613. BAD DEBT EXPENSE 38,991. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GILBERT DIGA | ||||||||||||||
| HR DIRECTOR | $95,137 | $0 | $226,056 | $0 | $0 | $0 | $3,788 | $0 | $8,325 | $0 | $333,306 | $0 | $0 | $0 |
| JOHN RICK HENRY JR | ||||||||||||||
| PRESIDENT & CEO | $210,018 | $0 | $0 | $0 | $0 | $0 | $12,482 | $0 | $11,373 | $0 | $233,873 | $0 | $0 | $0 |
| TIMOTHY TEACHMAN | ||||||||||||||
| ES DIRECTOR (THROUGH MAY 2021) | $50,586 | $0 | $156,832 | $0 | $0 | $0 | $2,031 | $0 | $3,423 | $0 | $212,872 | $0 | $0 | $0 |
| BANAFSHEH BAHARLOO RN | ||||||||||||||
| NURSE | $164,955 | $0 | $10,650 | $0 | $0 | $0 | $7,152 | $0 | $10,970 | $0 | $193,727 | $0 | $0 | $0 |
| RACHAEL GERDIS | ||||||||||||||
| ADMINISTRATOR | $137,017 | $0 | $0 | $0 | $0 | $0 | $5,509 | $0 | $37,270 | $0 | $179,796 | $0 | $0 | $0 |
| AIDAN TRO | ||||||||||||||
| DENTIST | $141,208 | $0 | $0 | $0 | $0 | $0 | $5,654 | $0 | $6,558 | $0 | $153,420 | $0 | $0 | $0 |
| SOLOMON G-KIDANE LPN | ||||||||||||||
| NURSE | $131,932 | $0 | $5,325 | $0 | $0 | $0 | $5,517 | $0 | $8,278 | $0 | $151,052 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | GILBERT DIGA PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2021, $0 WAS CONTRIBUTED TO THE PLAN, $6,075 WAS ACCRUED WITHIN THE PLAN, AND $226,056 WAS PAID OUT OF THE PLAN. TIMOTHY TEACHMAN PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2021, $0 WAS CONTRIBUTED TO THE PLAN, $2,136 ACCRUED WITHIN THE PLAN, AND $156,832 WAS PAID OUT OF THE PLAN. JOHN (RICK) HENRY, JR. PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2021, $0 WAS CONTRIBUTED TO THE PLAN, $4,081 ACCRUED WITHIN THE PLAN, AND $0 WAS PAID OUT OF THE PLAN. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE BOARD. THE DUTIES OF THE EXECUTIVE COMMITTEE ARE TO (A) PERFORM SPECIFIC TASKS ASSIGNED TO IT BY THE BOARD; (B) TAKE ACTION ON BEHALF OF THE BOARD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD WHEN IT IS NOT FEASIBLE FOR THE BOARD TO ACT OR WHEN THE MATTER(S) ARE OF AN ADMINISTRATIVE NATURE; AND (C) COORDINATE THE PLANNING OF THE BOARD'S ACTIVITIES AND PRIORITIES, SUCH AS COMMITTEE STRUCTURE AND ASSIGNMENTS AND SPECIAL TASK FORCES. THE EXECUTIVE COMMITTEE IS PROHIBITED FROM (A) AMENDING, ALTERING OR REPEALING THE BYLAWS OR ARTICLES OF INCORPORATION; (B) ELECTING, APPOINTING OR REMOVING ANY MEMBER OF ANY COMMITTEE, BOARD MEMBER OR OFFICER; (C) ADOPTING A PLAN OF MERGER OR CONSOLIDATION; (D) AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S PROPERTY OR ASSETS OR REVOKING THE PROCEEDINGS THEREOF; (E) ADOPTING A PLAN FOR THE DISTRIBUTION OF THE ORGANIZATION'S ASSETS; AND (F) AMENDING, ALTERING OR REPEALING ANY RESOLUTION OF THE BOARD THAT BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY ANY COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE FOLLOWING SIGNIFICANT CHANGES WERE MADE TO THE ORGANIZATION'S BYLAWS WHEN THEY WERE AMENDED IN JANUARY 2021: (A) CHANGE THE MINIMUM NUMBER OF BOARD MEMBERS FROM 9 TO 5; (B) CHANGE THE MAXIMUM NUMBER OF BOARD MEMBERS FROM 18 TO 15; (C) CHANGE THE MINIMUM VOTES TO REMOVE A BOARD MEMBER FROM MORE THAN 2/3 OF THE BOARD TO MORE THAN 1/2 OF THE BOARD; (D) UPDATE THE EXECUTIVE COMMITTEE'S COMPOSITION AND POWERS; (E) REMOVE THE FINANCE COMMITTEE, GOVERNANCE COMMITTEE, AND STRATEGIC PLANNING COMMITTEE AS MANDATORY; AND (F) UPDATE THE RESPONSIBILITIES OF THE BOARD'S OFFICERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, A DRAFT OF THE FORM 990 WAS REVIEWED BY THE CEO AND CFO, THEN SUBMITTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED AT THE BOARD MEETING, AND MEMBERS ARE REQUIRED TO COMPLETE AND SIGN THE FORM FOR PROPER DISCLOSURE. MEMBERS ARE DIRECTED TO NOTIFY THE BOARD DURING THE YEAR IF A CONFLICT OF INTEREST DEVELOPS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS REVIEWS SALARY DATA FROM A SALARY SURVEY COMPILED BY LEADINGAGE WASHINGTON AND FROM REVIEWING THE FORMS 990 OF COMPARABLE ORGANIZATIONS. THE CEO REVIEWS SALARY DATA IN A SIMILAR MANNER FOR THE OTHER OFFICERS. THE REVIEW PROCESS WAS LAST CONDUCTED IN 2019 FOR THE CEO AND IN 2018 FOR THE CFO. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | DURING 2021, THE FINANCE COMMITTEE WAS DISSOLVED AND THE RESPONSIBILITY FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT WAS MOVED TO THE BOARD OF DIRECTORS. |