PULASKI HEALTH FOUNDATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PULASKI HEALTH FOUNDATION INC (EIN 23-7125454)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202223199349304717
- 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 | 2022-11-15T08:27:03-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N Illinois Street | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | 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 | 237125454 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pulaski Health Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % STACEY WAYBERG | InCareOfNm |
| Business Name Control | PULA | BusinessNameControlTxt |
| Phone | 5745955002 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 624 EAST 13TH STREET Suite A | AddressLine1Txt |
| City | WINAMAC | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46996 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT FRITZ | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5749463394 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SCOTT | PersonFirstNm |
| Person Last | FRITZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NICOLE B FISHBACK | PreparerPersonNm |
| PTIN | P01279475 | PTIN |
| Phone | 3173834000 | PhoneNum |
| Preparation | 2022-11-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| 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 | SHARON MCKINLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 CONSTITUTION DR | AddressLine1Txt |
| City | FRANCESVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,252,806 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PULASKIHEALTHFOUNDATION.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | PULASKI HEALTH FOUNDATION IS DEDICATED TO ENHANCING THE LIVES OF OLDER ADULTS THROUGH QUALITY HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 387 | TotalEmployeeCnt |
| Total Volunteers | 120 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,167,627 | PYContributionsGrantsAmt |
| CY Contributions Grants | $76,650 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,465,882 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,035,264 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$126,747 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,359 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$56,926 | PYOtherRevenueAmt |
| CY Other Revenue | -$75,107 | CYOtherRevenueAmt |
| PY Total Revenue | $10,449,836 | PYTotalRevenueAmt |
| CY Total Revenue | $8,038,166 | 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 | $5,460,767 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,127,088 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,816,500 | PYOtherExpensesAmt |
| CY Other Expenses | $3,906,593 | CYOtherExpensesAmt |
| PY Total Expenses | $9,277,267 | PYTotalExpensesAmt |
| CY Total Expenses | $9,033,681 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,172,569 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$995,515 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,310,067 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,480,545 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,517,665 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,683,658 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,792,402 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,796,887 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE OUR COMMUNITY THROUGH HEALTH AND WELLNESS | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,748,617 | ExpenseAmt |
| Revenue | $7,960,157 | RevenueAmt |
| Desc | PULASKI HEALTH FOUNDATION, INC., A NOT-FOR-PROFIT ORGANIZATION, WAS ESTABLISHED IN 1959 TO PROMOTE CHARITABLE AND EDUCATIONAL PURPOSES, BOTH DIRECTLY TO AND BY THE APPLICATION OF FUNDS AND ASSETS TO A HEALTH CARE ORGANIZATION IN PULASKI COUNTY. ITS FIRST PROJECT WAS TO FACILITATE DONATIONS AND BUILD PULASKI MEMORIAL HOSPITAL. PULASKI HEALTH FOUNDATION CONTINUED TO CARE FOR AND IMPROVE LIFE AND HEALTH FOR THOSE WHO CAN NO LONGER DO SO FOR THEMSELVES BY FACILITATING FUNDS, BUILDING AND MANAGING PULASKI HEALTH CARE CENTER, A 58 BED SKILLED NURSING FACILITY, WHICH PROVIDES MEDICARE SHORT STAY RESTORATIVE SERVICES AND LONG-TERM CONTINUED CARE. PULASKI HEALTH CARE CENTER'S COMPREHENSIVE CARE PROGRAMS, DESIGNED TO MEET THE DAILY LIVING NEEDS OF EACH RESIDENT, INCLUDE: 24-HOUR NURSING SERVICES, ASSISTANCE WITH MEDICATION, PERSONAL HYGIENE, AND AMBULATION. THE THERAPY PROGRAM PROVIDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. THE MEAL SERVICE PROVIDES DINING IN A RESTAURANT STYLE ATMOSPHERE AND INCLUDES THERAPEUTIC AND MECHANICALLY ALTERED DIETS. OTHER SERVICES OFFERED TO RESIDENTS ARE ACTIVITIES WITH MANY RECREATIONAL OPPORTUNITIES, SOCIAL SERVICES, LAUNDRY, AND HOUSEKEEPING. PULASKI HEALTH CARE CENTER PROVIDES A HOME LIKE ENVIRONMENT, A FRIENDLY ATMOSPHERE THAT FACILITATES SELF-WORTH AND DIGNITY IN THE PEOPLE THAT RESIDE HERE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | PULASKI HEALTH FOUNDATION'S GOAL TO PROVIDE SAFE, DECENT AND AFFORDABLE HOUSING FOR LOW AND MODERATE INCOME SENIOR CITIZENS IS ACCOMPLISHED THROUGH THE ESTABLISHMENT OF RIVERWOOD COMMONS, A 24 UNIT APARTMENT BUILDING THAT PROVIDES SECURE INDEPENDENT HOUSING FOR LOW AND MODERATE INCOME/55 AND OLDER OR DISABLED PERSONS. RIVERWOOD COMMONS WAS ESTABLISHED THROUGH THE USE OF TAX CREDITS AND REMAINS UNDER THE SPECIFIED PROGRAMS OF THE INDIANA HOUSING AND COMMUNITY DEVELOPMENT AUTHORITY AND FEDERAL HOME LOAN BANK OF INDIANAPOLIS. PULASKI HEALTH FOUNDATION, AS OWNER, PROVIDES ACTIVITY PROGRAMS TO THE RESIDENTS THAT LIVE AT RIVERWOOD COMMONS, CAPITAL FUNDS FOR IMPROVEMENTS TO THE PROPERTY, AND REPLACEMENT OF FURNISHINGS. PULASKI HEALTH FOUNDATION ALSO PROVIDES DIRECT OVERSIGHT OF THE MANAGEMENT COMPANY, HARRISON REAL ESTATE. PROPERTY MANAGEMENT PERFORMS THE DAILY MANAGEMENT OF THE PROPERTY, PROVIDES INFORMATION FOR AUDITS AND INSPECTIONS, AND ASSISTS TENANTS WITH THEIR FINANCIAL REGULATORY REQUIREMENTS ACCORDING TO THE INDIANA HOUSING AND COMMUNITY DEVELOPMENT AUTHORITY TAX CREDIT PROGRAMS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | PULASKI HEALTH FOUNDATION'S GOAL TO RECEIVE AND MAINTAIN A FUND (OR FUNDS) OF REAL OR PERSONAL PROPERTY, OR BOTH, (WHICH ARE SUBJECT TO THE RESTRICTIONS AND LIMITATIONS THEREIN AFTER SET FORTH TO USE AND APPLY THE WHOLE OR ANY PART OF THE INCOME FOR THE CONSTRUCTION, FURNISHING, EQUIPPING, IMPROVEMENT, REPAIR, OPERATION AND MAINTENANCE OF THE FACILITIES AND SERVICES OF HEALTH CARE ORGANIZATIONS OF PULASKI COUNTY) WAS MET BY THE PURCHASE OF PARKVIEW HAVEN, A CONTINUING CARE RETIREMENT COMMUNITY (CRCC) LOCATED IN FRANCESVILLE, INDIANA IN PULASKI COUNTY ON SEPTEMBER 1, 2013. PARKVIEW HAVEN WAS A NOT-FOR-PROFIT CHURCH BASED CCRC THAT SHARED MANY OF THE SAME GOALS AND MISSIONS OF PULASKI HEALTH FOUNDATION. THIS ACQUISITION WOULD FURTHER ADVANCE PULASKI HEALTH FOUNDATION'S MISSION TO CARE FOR AND IMPROVE LIFE AND HEALTH FOR THOSE WHO CAN NO LONGER DO SO FOR THEMSELVES, TO PROVIDE A HOME LIKE ENVIRONMENT WITH A FRIENDLY PLACE THAT ACTIVATES SELF-WORTH AND DIGNITY FOR THE SENIOR POPULATION AND TO PROVIDE SAFE, DECENT AND AFFORDABLE HOUSING FOR LOW AND MODERATE INCOME SENIOR CITIZENS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,748,617 | 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 | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 50 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 387 | 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 |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | 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 | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STACEY WAYBERG | PersonNm |
| Phone | 2195672172 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 CONSTITUTION DRIVE STE A | AddressLine1Txt |
| City | FRANCESVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| SHARON MCKINLEY | |||||||
| EXECUTIVE DIRECTOR | 56.0 | 0.0 | Yes (X) | $119,097 | $0 | $7,203 | |
| STACEY WAYBERG | |||||||
| FINANCE DIRECTOR/CFO | 56.0 | 0.0 | Yes (X) | $117,579 | $0 | $7,203 | |
| SCOTT FRITZ | |||||||
| CHAIRMAN | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DR ROBERT KLITZMAN | |||||||
| VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LIN MORRIZON | |||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| LINDA MURPHY | |||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JIM PIERROU | |||||||
| BOARD MEMEBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |
| JOHN GOBLE- END JAN 2021 | |||||||
| MEMBER AT LARGE | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |
| LACY MCCARTY | |||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |
| PATRICIA BAWCUM | |||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $236,676 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $14,406 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GORDON FOOD SERVICE | |||||
| PO BOX 8820 | CHICAGO | IL | 606801029 | FOOD EQUIP. AND FOOD | $296,839 |
| HEALTH CARE THERAPY SERVICES | |||||
| 1411 E COUNTY RD SUITE A | GREENWOOD | IN | 46142 | PT, OT, ST THERAPY | $478,601 |
| INTOUCH PHARMACEUTICALS | |||||
| PO BOX 2028 | WARSAW | IN | 465812028 | PHARMACY SUPPLIER | $236,685 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $76,650 | AllOtherContributionsAmt |
| Noncash Contributions | $9,900 | NoncashContributionsAmt |
| Total Contributions | $76,650 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ENTRANCE FEE INCOME | 623000 | $43,120 | $43,120 |
| MAINTENANCE FEE INCOME | 623000 | $65,010 | $65,010 |
| OTHER OPERATING REVENUE | 900099 | $90,791 | $90,791 |
| RESIDENT SERVICE REVENUE | 623000 | $7,836,343 | $7,836,343 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,035,264 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,475 | TotalRevenueColumnAmt |
| Exclusion | $2,475 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $138,417 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $213,524 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$75,107 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$75,107 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$75,107 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,116 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,116 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,116 | TotalRevenueColumnAmt |
| Exclusion | -$1,116 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,038,166 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,960,157 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,359 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,122 | TotalAmt |
| Management And General | $276,122 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,850,966 | TotalAmt |
| Program Services | $4,636,333 | ProgramServicesAmt |
| Management And General | $214,633 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,341 | TotalAmt |
| Management And General | $368,341 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,102 | TotalAmt |
| Program Services | $4,551 | ProgramServicesAmt |
| Management And General | $4,551 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,836 | TotalAmt |
| Management And General | $96,836 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $944,054 | TotalAmt |
| Program Services | $853,691 | ProgramServicesAmt |
| Management And General | $90,363 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,108 | TotalAmt |
| Management And General | $21,108 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $634,068 | TotalAmt |
| Program Services | $573,376 | ProgramServicesAmt |
| Management And General | $60,692 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,982 | TotalAmt |
| Program Services | $32,538 | ProgramServicesAmt |
| Management And General | $3,444 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,858 | TotalAmt |
| Program Services | $244,932 | ProgramServicesAmt |
| Management And General | $25,926 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,863 | TotalAmt |
| Program Services | $151,795 | ProgramServicesAmt |
| Management And General | $16,068 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,269 | TotalAmt |
| Program Services | $325,785 | ProgramServicesAmt |
| Management And General | $34,484 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,859 | TotalAmt |
| Program Services | $243,124 | ProgramServicesAmt |
| Management And General | $25,735 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| QUALITY ASSESSMENT FEE | $283,520 | $256,382 | $27,138 |
| DIETARY | $240,722 | $240,722 | |
| OTHER | $205,011 | $185,388 | $19,623 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,033,681 | TotalAmt |
| Program Services | $7,748,617 | ProgramServicesAmt |
| Management And General | $1,285,064 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,729,018 | BOYAmt |
| EOY | $1,961,387 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $679,303 | BOYAmt |
| EOY | $883,695 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,161 | BOYAmt |
| EOY | $59,085 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,989 | BOYAmt |
| EOY | $148,831 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,088,480 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,667,229 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,730,856 | BOYAmt |
| EOY | $5,421,251 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,740 | BOYAmt |
| EOY | $6,296 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,310,067 | BOYAmt |
| EOY | $8,480,545 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $893,357 | BOYAmt |
| EOY | $938,990 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,072,224 | BOYAmt |
| EOY | $2,897,118 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $745,582 | BOYAmt |
| EOY | $718,338 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,806,502 | BOYAmt |
| EOY | $2,129,212 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,517,665 | BOYAmt |
| EOY | $6,683,658 | 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 | $2,792,402 | BOYAmt |
| EOY | $1,796,887 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,792,402 | BOYAmt |
| EOY | $1,796,887 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,310,067 | BOYAmt |
| EOY | $8,480,545 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$995,515 | 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 | $235,766 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $46,591 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $39,131 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,167,627 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $76,650 | CurrentTaxYearAmt |
| Total | $1,565,765 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $758,322 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $537,354 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,226,511 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,465,882 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,035,444 | CurrentTaxYearAmt |
| Total | $28,023,513 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $994,088 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $583,945 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,265,642 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,633,509 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,112,094 | CurrentTaxYearAmt |
| Total | $29,589,278 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $20,875 | CurrentTaxYearAmt |
| Total | $20,875 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $20,875 | CurrentTaxYearAmt |
| Total | $20,875 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $29,568,403 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,309 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $116,354 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $134,010 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $145,627 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $140,892 | CurrentTaxYearAmt |
| Total | $548,192 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,309 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $116,354 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $134,010 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $145,627 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $140,892 | CurrentTaxYearAmt |
| Total | $548,192 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,005,397 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $700,299 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,399,652 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,779,136 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,252,986 | CurrentTaxYearAmt |
| Total | $30,137,470 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98112 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98159 | PublicSupportPY509Pct |
| Investment Income CY | 0.01819 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01841 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,740 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $899 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $230 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $112 | AdministrativeExpensesAmt |
| End Year Balance | $6,297 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,575 | BeginningYearBalanceAmt |
| Contributions | $2 | ContributionsAmt |
| Investment Earnings Or Losses | $500 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $239 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $98 | AdministrativeExpensesAmt |
| End Year Balance | $5,740 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,908 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $980 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $212 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $101 | AdministrativeExpensesAmt |
| End Year Balance | $5,575 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,553 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$331 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $209 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $105 | AdministrativeExpensesAmt |
| End Year Balance | $4,908 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,139 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $778 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $267 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $97 | AdministrativeExpensesAmt |
| End Year Balance | $5,553 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $445,698 | OtherCostOrOtherBasisAmt |
| Book Value | $445,698 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,713,140 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,314,680 | DepreciationAmt |
| Book Value | $4,398,460 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,212,387 | OtherCostOrOtherBasisAmt |
| Depreciation | $947,820 | DepreciationAmt |
| Book Value | $264,567 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,717,255 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,404,729 | DepreciationAmt |
| Book Value | $312,526 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,421,251 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| REFUNDABLE ENTRANCE FEES | $1,784,640 |
| DEFERRED ENTRANCE FEES | $344,572 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,129,212 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $8,251,690 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $213,524 | OtherRevenueAmt |
| Revenue Not Reported | $213,524 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,038,166 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $8,038,166 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,247,205 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $213,524 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $213,524 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,033,681 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $9,033,681 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 3a(i) | Unrelated organization donation: The Pulaski County Community Foundation, Inc. holds the endowment fund. |
| SCHEDULE D, PART V, LINE 4 | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: TO SUPPORT THE ACTIVITY DEPARTMENT OF PULASKI HEALTH CARE CENTER. THE FUNDS ASSIST WITH OUTINGS, SUPPLIES AND ENTERTAINMENT FOR THE RESIDENTS THAT LIVE AT PULASKI HEALTH CARE CENTER. THE PERMANENT ENDOWMENT FUND IS USED TO CONTINUE THE MISSION OF PULASKI HEALTH FOUNDATION. THE TEMPORARILY RESTRICTED ENDOWMENT IS USED TO FURTHER THE MISSION OF PULASKI HEALTH FOUNDATION. |
| SCHEDULE D, PART X, LINE 2 | ASC 740 DISCLOSURE: 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 AND PART XII, LINE 2D | OTHER ADJUSTMENTS: RENTAL EXPENSES: $ 213,524 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 351602316 | BondIssuerEIN |
| Bond Issued | 2013-09-30 | BondIssuedDt |
| Issue Price | $4,173,000 | IssuePriceAmt |
| Purpose | PURCHASE OF FACILITY AND REFINANCI | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,275,882 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $4,173,000 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $0 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $4,173,000 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2014 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (true) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (true) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (true) | EngageBondCounselContractsInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0 | PrivateBusUseByOthersPct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART II, LINE 11 | FormAndLineReferenceDesc |
| Explanation | PROCEEDS USED TO REDEEM PRIOR ISSUES ON 09/30/2013. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE GAVE VOTING RIGHTS TO THE ASSISTED LIVING COMMITTEE DUE TO THE MAJORITY OF ASSISTED LIVING COMMITTEE MEMBERS ALSO BEING BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW FORM 990: THE FORM 990 IS REVIEWED IN DETAIL BY MANAGEMENT. THEN, A COPY OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: ANNUAL DISCLOSURE IS PROVIDED BY EACH OFFICER AND MEMBER OF THE BOARD, AS WELL AS THE EXECUTIVE DIRECTOR THROUGH THE COMPLETION OF THE CONFLICT OF INTEREST QUESTIONNAIRE. THE RESPONSES ARE MAINTAINED BY THE EXECUTIVE DIRECTOR. IF THERE IS A POTENTIAL CONFLICT OF INTEREST, THE EXECUTIVE DIRECTOR AND THE BOARD PRESIDENT REVIEW THE CORRESPONDING ISSUE AND DETERMINE IF THERE IS AN ACTUAL CONFLICT OF INTEREST. IF A CONFLICT OF INTEREST IS DEEMED TO EXIST, THEN THE PERSON WITH THE CONFLICT IS EXCLUDED FROM ANY DISCUSSION AND SUBSEQUENT ACTION TAKEN. ANY PURCHASES AND/OR BIDDING PROPOSALS ARE ALSO REVIEWED FOR ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO SUBMITTING BIDS OR MAKING SUCH PURCHASES. THE BOARD PRESIDENT ATTENDS THE BOARD MEETINGS AND ENSURES THAT COMPLIANCE WITH THESE GUIDELINES ARE FOLLOWED. |
| FORM 990, PART VI, SECTION B, LINE 15A | DETERMINATION OF COMPENSATION: THE PROCESS FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR INCLUDES A REVIEW AND APPROVAL BY THE BOARD CHAIRMAN AND VICE CHAIRMAN, WHO ARE BOTH INDEPENDENT. THE CHAIRMAN AND VICE CHAIRMAN USE MCKNIGHT'S CAREER GUIDE, LEADINGAGE AND LEADINGAGE INDIANA, THE NATIONAL AND STATE ASSOCIATION FOR NON PROFIT AGING SERVICE COMMUNITIES' NURSING HOME SALARY AND BENEFITS REPORT. THE MYERS AND STAUFFER LC LONG-TERM CARE COMPENSATION REPORT IS ALSO REFERENCED AS PART OF THE DECISION PROCESS. ONCE THE CHAIRMAN AND VICE CHAIRMAN DETERMINE THE COMPENSATION AMOUNT, THEY REPORT THEIR FINDINGS AND DECISION TO THE FULL BOARD OF DIRECTORS. COMPENSATION FOR SHARON MCKINLEY WAS LAST REVIEWED ON JULY 6, 2014. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF GOVERNING DOCUMENTS, COI POLICY, AND FINANCIAL STATEMENTS: A COPY OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART V AND PART VII | COMPENSATION PAID BY THE FOUNDATION IS REIMBURSED BY PULASKI MEMORIAL HOSPITAL. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:944054 |