OTTERBEIN PORTAGE VALLEY INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- OTTERBEIN PORTAGE VALLEY INC (EIN 34-1193296)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202223199349310937
- 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 | 2022-11-15T12:25:15-06:00 | 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 | 600 WASHINGTON AVENUE SUITE 1800 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63101 | 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 | 341193296 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OTTERBEIN PORTAGE VALLEY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OTTE | BusinessNameControlTxt |
| Phone | 4198337000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20311 PEMBERVILLE ROAD | AddressLine1Txt |
| City | PEMBERVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43450 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | J CHRISTOPHER GREEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5139335400 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | J | PersonFirstNm |
| Person Last | CHRISTOPHER GREEN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMBER ROGNAN-HAMILTON | PreparerPersonNm |
| PTIN | P01251012 | PTIN |
| Phone | 3149254300 | PhoneNum |
| Preparation | 2022-11-11 | 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 | J CHRISTOPHER GREEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3855 LOWER MARKET STREET SUITE 300 | AddressLine1Txt |
| City | LEBANON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,437,536 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | OTTERBEIN.ORG/FIND-A-LOCATION/PEMBERVILLE | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING AND SERVICES FOR OLDER ADULTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 234 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $55,583 | PYContributionsGrantsAmt |
| CY Contributions Grants | $479,485 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,424,243 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,753,267 | CYProgramServiceRevenueAmt |
| PY Investment Income | $782,406 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,369,265 | CYInvestmentIncomeAmt |
| PY Other Revenue | $215,804 | PYOtherRevenueAmt |
| CY Other Revenue | $253,177 | CYOtherRevenueAmt |
| PY Total Revenue | $11,478,036 | PYTotalRevenueAmt |
| CY Total Revenue | $12,855,194 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,451 | 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 | $4,466,733 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,644,995 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,287,109 | PYOtherExpensesAmt |
| CY Other Expenses | $7,468,630 | CYOtherExpensesAmt |
| PY Total Expenses | $10,758,293 | PYTotalExpensesAmt |
| CY Total Expenses | $12,113,625 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $719,743 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $741,569 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $37,395,768 | TotalAssetsBOYAmt |
| Total Assets EOY | $41,129,489 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,050,174 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,913,567 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,345,594 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,215,922 | NetAssetsOrFundBalancesEOYAmt |
| Mission | IN KEEPING WITH OUR UNITED METHODIST TRADITION WE SEEK TO ENHANCE THE QUALITY OF LIFE AND HOLISTIC GROWTH OF OLDER PERSONS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,415,231 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,675,897 | RevenueAmt |
| Desc | OTTERBEIN PORTAGE VALLEY, INC. PROVIDES A CONTINUUM OF CARE INCLUDINGINDEPENDENT LIVING, ASSISTED LIVING, NURSING CARE, AND DEMENTIA CARE.REHABILITATION, SOCIAL SERVICES AND CHAPLAINCY SERVICES ARE AVAILABLETO ALL RESIDENTS.LOCAL GROUPS SUCH AS THE VETERANS, CHURCH CIRCLES, COMMUNITY CIVICGROUPS AND A HOST OF OTHERS USE OTTERBEIN AS A MEETING PLACE. INADDITION OTTERBEIN PROVIDES SPECIAL PROGRAMS AND EVENTS FOR THECOMMUNITY ON AN ONGOING BASIS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | GENEROUS DONORS HAVE ESTABLISHED A BENEVOLENT CARE FUND WHICH OFFERS ASSISTANCE TO RESIDENTS WHO CANNOT PAY THE FULL COST OF CARE. OTTERBEIN'S RICH HERITAGE HAS EARNED US A SOLID REPUTATION AS A TRUSTED AND VALUABLE RESOURCE. BY PROVIDING INFORMATION AND SERVICES ON AGING ISSUES WE CONTINUE TO SERVE RESIDENTS, THEIR FAMILIES, AND THE SURROUNDING COMMUNITIES. OTTERBEIN RESIDENTS AND STAFF VOLUNTEER THEIR TIME AND TALENTS AT OTTERBEIN PORTAGE VALLEY RETIREMENT LIVING COMMUNITY BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | -$922,630 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES NURSING CARE TO RESIDENTS UNDER THE MEDICAID PROGRAM FOR WHICH THE COSTS TO PROVIDE SUCH CARE EXCEEDS REIMBURSEMENT. THE ORGANIZATION FUNDS THIS DIFFERENCE THROUGH ITS OPERATIONS. THE SHORTFALL IS NETTED WITH PROGRAM SERVICE REVENUE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,415,231 | 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 234 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | 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 | J CHRISTOPHER GREEN | PersonNm |
| Phone | 5139335400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3855 LOWER MARKET STREET SUITE 300 | AddressLine1Txt |
| City | LEBANON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45036 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARILYN BOWLUS | ||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JILL WILSON | ||||||||
| PRESIDENT/CEO | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $534,169 | $17,243 | |
| JAMES C GREEN | ||||||||
| CFO/TREASURER | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $352,645 | $17,534 | |
| MEL MILLER | ||||||||
| BOARD CHAIR OF OTTERBEIN HOMES | 1.00 | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| VICTOR SCHUERMAN | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SUE DONALDSON | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TOM KYLLO | ||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JASON MILLER | ||||||||
| VP OF OPERATIONS | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $393,110 | $16,001 | |
| BECKI SPANGLER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARCIA COUSINO | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DYLAN CLEMENT | ||||||||
| DIRECTOR (TERM ENDED) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| NORRIS HINDS | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SANDY SNYDER | ||||||||
| DIRECTOR (TERM ENDED) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DENICE DAY | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | 0.00 | Yes (X) | $146,372 | $0 | $1,300 | ||
| GARY HORNING | ||||||||
| VICE PRESIDENT - MARKETING | 2.00 | 38.00 | $0 | $280,326 | $14,935 | Yes (X) | ||
| PAMELA RICHMOND | ||||||||
| VP OF STRATEGIC PLANNING | 2.00 | 38.00 | $0 | $299,362 | $14,598 | Yes (X) | ||
| LOIS MILLS | ||||||||
| VP OF HUMAN RESOURCES | 2.00 | 38.00 | $0 | $246,110 | $11,191 | Yes (X) | ||
| SHONIA RUSSELLE | ||||||||
| AVP MARKETING | 2.00 | 38.00 | $0 | $209,307 | $16,268 | Yes (X) | ||
| EMILY WEIKERT | ||||||||
| VP OF CLINICAL SERVICES | 2.00 | 38.00 | $0 | $212,846 | $13,392 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $146,372 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,527,875 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $122,462 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $307,164 | GovernmentGrantsAmt |
| All Other Contributions | $172,321 | AllOtherContributionsAmt |
| Noncash Contributions | $4,214 | NoncashContributionsAmt |
| Total Contributions | $479,485 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENTIAL REVENUE & FEES | 623000 | $10,744,337 | $10,744,337 |
| DEPARTMENTAL REVENUE | 623000 | $8,930 | $8,930 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,753,267 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $398,776 | TotalRevenueColumnAmt |
| Exclusion | $398,776 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9 | TotalRevenueColumnAmt |
| Exclusion | $9 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,551,502 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,581,022 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $970,480 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $970,480 | TotalRevenueColumnAmt |
| Exclusion | $970,480 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Of Goods Sold | $1,320 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,320 | TotalRevenueColumnAmt |
| Exclusion | -$1,320 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| DIETARY | 623000 | $179,651 | $179,651 |
| ADMIN | 623000 | $39,398 | $39,398 |
| BEAUTY AND BARBER | 623000 | $11,907 | $11,907 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,541 | TotalRevenueColumnAmt |
| Exclusion | $23,541 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $254,497 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,855,194 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,753,267 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,622,442 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,372 | TotalAmt |
| Management And General | $146,372 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,247,466 | TotalAmt |
| Program Services | $3,150,549 | ProgramServicesAmt |
| Management And General | $96,917 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $521,146 | TotalAmt |
| Program Services | $483,787 | ProgramServicesAmt |
| Management And General | $37,359 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $481,572 | TotalAmt |
| Program Services | $447,050 | ProgramServicesAmt |
| Management And General | $34,522 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,439 | TotalAmt |
| Program Services | $230,630 | ProgramServicesAmt |
| Management And General | $17,809 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,969 | TotalAmt |
| Management And General | $3,969 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,314 | TotalAmt |
| Management And General | $9,314 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,169 | TotalAmt |
| Management And General | $44,169 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,071,438 | TotalAmt |
| Program Services | $2,056,846 | ProgramServicesAmt |
| Management And General | $14,592 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,806 | TotalAmt |
| Management And General | $218,806 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $991,312 | TotalAmt |
| Program Services | $873,417 | ProgramServicesAmt |
| Management And General | $117,895 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,277 | TotalAmt |
| Management And General | $95,277 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $993,618 | TotalAmt |
| Program Services | $943,122 | ProgramServicesAmt |
| Management And General | $50,496 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,164 | TotalAmt |
| Program Services | $10,364 | ProgramServicesAmt |
| Management And General | $800 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,636 | TotalAmt |
| Program Services | $80,335 | ProgramServicesAmt |
| Management And General | $4,301 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,026,966 | TotalAmt |
| Program Services | $974,775 | ProgramServicesAmt |
| Management And General | $52,191 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,260 | TotalAmt |
| Program Services | $177,743 | ProgramServicesAmt |
| Management And General | $9,517 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REFUNDABLE LIFE USE FEE | $720,200 | $720,200 | |
| CORPORATE SERVICE FEES | $695,278 | $695,278 | |
| BED DEBT | $138,938 | $138,938 | |
| UNUSUAL (COVID) | $94,503 | $94,503 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,782 | TotalAmt |
| Program Services | $32,972 | ProgramServicesAmt |
| Management And General | $48,810 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,113,625 | TotalAmt |
| Program Services | $10,415,231 | ProgramServicesAmt |
| Management And General | $1,698,394 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,208 | BOYAmt |
| EOY | $24,423 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,637,948 | BOYAmt |
| EOY | $604,689 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,013 | BOYAmt |
| EOY | $25,311 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,281 | BOYAmt |
| EOY | $55,359 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,223,705 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,765,965 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,996,046 | BOYAmt |
| EOY | $21,457,740 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,658,272 | BOYAmt |
| EOY | $18,961,967 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,395,768 | BOYAmt |
| EOY | $41,129,489 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,127,917 | BOYAmt |
| EOY | $2,176,427 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $509,941 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,593,556 | BOYAmt |
| EOY | $13,259,180 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,208 | BOYAmt |
| EOY | $24,423 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,811,552 | BOYAmt |
| EOY | $8,453,537 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,050,174 | BOYAmt |
| EOY | $23,913,567 | 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 | $14,743,260 | BOYAmt |
| EOY | $16,198,614 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $602,334 | BOYAmt |
| EOY | $1,017,308 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,345,594 | BOYAmt |
| EOY | $17,215,922 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,395,768 | BOYAmt |
| EOY | $41,129,489 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $741,569 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $78,091 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,050,668 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $159,697 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $111,879 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $376,863 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $55,583 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $479,485 | CurrentTaxYearAmt |
| Total | $1,183,507 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,284,373 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,153,234 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,176,627 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,424,243 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,753,267 | CurrentTaxYearAmt |
| Total | $51,791,744 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1,556 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,038 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $215,099 | CurrentTaxYearAmt |
| Total | $217,693 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,444,070 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,265,113 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,555,046 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,480,864 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,447,851 | CurrentTaxYearAmt |
| Total | $53,192,944 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,843 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,555 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,931 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $54,824 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,142 | CurrentTaxYearAmt |
| Total | $214,295 | 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 Minus4 Years | $10,843 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,555 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,931 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $54,824 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,142 | CurrentTaxYearAmt |
| Total | $214,295 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $52,978,649 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $345,684 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $338,594 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $438,139 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $397,548 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $398,785 | CurrentTaxYearAmt |
| Total | $1,918,750 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $345,684 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $338,594 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $438,139 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $397,548 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $398,785 | CurrentTaxYearAmt |
| Total | $1,918,750 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $231,909 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $212,681 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $570,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $214,968 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39,398 | CurrentTaxYearAmt |
| Total | $1,269,096 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,021,663 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,816,388 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,563,325 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,093,380 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,886,034 | CurrentTaxYearAmt |
| Total | $56,380,790 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.93970 | PublicSupportCY509Pct |
| Public Support PY509 | 0.94320 | PublicSupportPY509Pct |
| Investment Income CY | 0.03400 | InvestmentIncomeCYPct |
| Investment Income PY | 0.03210 | 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 | BEAUTY AND BARBER - 2017 AMOUNT: $ 41,910. 2018 AMOUNT: $ 29,310. 2019 AMOUNT: $ 24,427. 2020 AMOUNT: $ 7,503. HOUSEKEEPING - 2017 AMOUNT: $ 11,699. 2018 AMOUNT: $ 9,829. 2019 AMOUNT: $ 7,277. 2020 AMOUNT: $ -19. MISC - 2017 AMOUNT: $ 32,020. 2018 AMOUNT: $ 31,707. 2019 AMOUNT: $ 385,369. 2020 AMOUNT: $ 47,476. 2021 AMOUNT: $ 39,398. DIETARY - 2017 AMOUNT: $ 142,465. 2018 AMOUNT: $ 135,383. 2019 AMOUNT: $ 146,165. 2020 AMOUNT: $ 148,148. PLANT GROUNDS MAINT - 2017 AMOUNT: $ 3,815. 2018 AMOUNT: $ 6,452. 2019 AMOUNT: $ 6,902. 2020 AMOUNT: $ 11,860. | 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 | $151,422 | OtherCostOrOtherBasisAmt |
| Book Value | $151,422 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,478,082 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,528,408 | DepreciationAmt |
| Book Value | $6,949,674 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,269,753 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,875,970 | DepreciationAmt |
| Book Value | $393,783 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,424,990 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,361,587 | DepreciationAmt |
| Book Value | $1,063,403 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,899,458 | OtherCostOrOtherBasisAmt |
| Book Value | $12,899,458 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,457,740 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| REFUNDABLE ADVANCE DEPOSITS | $8,284,400 |
| SPLIT INTEREST AGREEMENT | $107,060 |
| INTERCOMPANY PAYABLE | $62,077 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,453,537 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | RESIDENT FUNDS ARE DEPOSITS HELD UNDER A FIDUCIARY RESPONSIBILITY AND ARE REQUIRED BY STATE REGULATION. |
| PART X, LINE 2: | 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 CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JILL WILSON | ||||||||||||||
| PRESIDENT/CEO | $0 | $407,870 | $0 | $125,839 | $0 | $460 | $0 | $7,943 | $0 | $9,300 | $0 | $551,412 | $0 | $0 |
| JASON MILLER | ||||||||||||||
| VP OF OPERATIONS | $0 | $317,658 | $0 | $74,089 | $0 | $1,363 | $0 | $7,705 | $0 | $8,296 | $0 | $409,111 | $0 | $0 |
| JAMES C GREEN | ||||||||||||||
| CFO/TREASURER | $0 | $271,430 | $0 | $78,111 | $0 | $3,104 | $0 | $8,292 | $0 | $9,242 | $0 | $370,179 | $0 | $0 |
| PAMELA RICHMOND | ||||||||||||||
| VP OF STRATEGIC PLANNING | $0 | $229,836 | $0 | $66,393 | $0 | $3,133 | $0 | $6,302 | $0 | $8,296 | $0 | $313,960 | $0 | $0 |
| GARY HORNING | ||||||||||||||
| VICE PRESIDENT - MARKETING | $0 | $213,760 | $0 | $62,542 | $0 | $4,024 | $0 | $6,639 | $0 | $8,296 | $0 | $295,261 | $0 | $0 |
| LOIS MILLS | ||||||||||||||
| VP OF HUMAN RESOURCES | $0 | $185,081 | $0 | $55,365 | $0 | $5,664 | $0 | $5,877 | $0 | $5,314 | $0 | $257,301 | $0 | $0 |
| EMILY WEIKERT | ||||||||||||||
| VP OF CLINICAL SERVICES | $0 | $162,887 | $0 | $48,001 | $0 | $1,958 | $0 | $5,096 | $0 | $8,296 | $0 | $226,238 | $0 | $0 |
| SHONIA RUSSELLE | ||||||||||||||
| AVP MARKETING | $0 | $161,359 | $0 | $46,043 | $0 | $1,905 | $0 | $4,972 | $0 | $11,296 | $0 | $225,575 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE PARENT ORGANIZATION, OTTERBEIN HOMES INC., USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FROM 990, PAGE 5, PART V, LINE 1A | THE PARENT COMPANY, OTTERBEIN HOMES, (FEIN 31-0549058) PROCESSES ACCOUNTS PAYABLE PAYMENTS FOR ALL RELATED ENTITIES. AS A RESULT, THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF 1099S REPORTED BY ENTITY. AS A RESULT, ALL 1099S ARE ISSUED AND REPORTED OUT OF THE PARENT COMPANY. |
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE IS AUTHORIZED TO ACT FOR THE BOARD OF DIRECTORS BETWEEN REGULAR AND/OR CALLED SESSIONS OF THE BOARD. THE EXECUTIVE COMMITTEE HAS AUTHORITY TO MAKE ALL DECISIONS WITHOUT HAVING TO WAIT AND BRING THE ACTION TO THE FULL BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS OTTERBEIN LSC, LLC. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBER OF THE CORPORATION UPON NOMINATION BY THE CORPORATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING CORPORATE POWERS AND ACTIONS MAY ONLY BE TAKEN WITH THE APPROVAL OF THE MEMBER AFTER GIVING CONSIDERATION TO THE CONCERNS OF THE BOARD OF DIRECTORS: 1. THE DETERMINATION AND ADOPTION OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS. 2. THE EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF $25,000 3. DETERMINING CORPORATION ADMINISTRATIVE AND OPERATING STAFF COMPENSATION AND BENEFITS. 4. DETERMINING ALL BUILDING PROGRAMS AND THE MAKING OF CERTIFICATE OF NEED APPLICATIONS 5. DETERMINING TO ADD OR TERMINATE ANY SERVICES 6. THE EXECUTION OF ANY CONTRACT OR AGREEMENT FOR FINANCIAL COMMITMENTS IN EXCESS OF THAT APPROVED IN THE ANNUAL BUDGET 7. THE APPOINTMENT OF AUDITORS AND LEGAL COUNSEL 8. EMPLOYING, EVALUATING, DISCIPLINING OR DISCHARGING THE PRESIDENT AND/OR TREASURER OF THE CORPORATION 9. THE ADOPTION OF LONG-RANGE PLANS AND MANAGEMENT OBJECTIVES, INCLUDING THE EXECUTION OF ANY AGREEMENT WITH CONSORTIUMS, ALLIANCES OR OTHER ORGANIZATIONS. 10. TAKING MEMBERSHIP IN OR JOINING ANY ORGANIZATION 11. THE SALE, LEASE, MORTGAGING, ENCUMBERING. LEASE OR OTHER DISPOSITION OF ANY REAL PROPERTY OR ANY PERSONAL PROPERTY OF A VALUE IN EXCESS OF $10,000 12. THE MANAGEMENT AND ADMINISTRATION OF ALL LEGAL MATTERS INVOLVING THE CORPORATION 13. THE MANAGEMENT AND ADMINISTRATION OF ALL INSURANCE FOR THE CORPORATION 14. THE ESTABLISHMENT OF UNIFORM EMPLOYMENT PRACTICES AND POLICIES 15. THE DEVELOPMENT AND IMPLEMENTATION OF MARKETING, PUBLIC RELATIONS AND FUNDRAISING EFFORTS ON BEHALF OF THE CORPORATION WITHOUT PRIOR NOTIFICATION TO AND APPROVAL FROM AN OFFICER OF THE MEMBER UNLESS APPROVED IN THE ANNUAL BUDGET 16. THE ASSUMPTION OR ISSUANCE OF ANY LONG-TERM OR SHORT-TERM DEBT IN EXCESS OF AN AMOUNT DETERMINED FROM TIME TO TIME BY THE MEMBER 17. THE APPROVAL OF ANY VOLUNTARY MERGER OR CONSOLIDATION OF THE CORPORATION OF THE SALE, ASSIGNMENT, MORTGAGING, ENCUMBERING, PLEDGING, LEASING OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR THE TRANSFER OF CONTROL OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM IS PROVIDED AND REVIEWED BY THE CHIEF FINANACIAL OFFICER BEFORE THE FORM IS FILED. A COMPLETE COPY OF THE 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | IN ACCORDANCE WITH THE BY-LAWS, ANY POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER, CORPORATE EXECUTIVE, EXECUTIVE DIRECTOR, OR ADMINISTRATIVE STAFF MEMBER, OR COMMITTEE MEMBERS, WHO ARE NOT MEMBERS OF THE BOARD OF TRUSTEES OF OTTERBEIN HOMES SHALL BE DISCLOSED TO THE BOARD AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST BECOMES RELEVANT TO A MATTER OF BOARD ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE INDEPENDENT EXECUTIVE COMMITTEE OF THE OTTERBEIN HOMES BOARD OF TRUSTEES HAS THE RESPONSIBILITY FOR DETERMINING THE ANNUAL COMPENSATION FOR THE OFFICERS BY THE USE OF INDUSTRY SPECIFIC DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE SALARIES OF THE KEY EMPLOYEES ARE DETERMINED BY THE OFFICERS USING INDUSTRY COMPARATIVE DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE DELIBERATIONS AND DECISIONS REGARDING COMPENSATION ARE DOCUMENTED. THIS PROCESS WAS LAST PERFORMED IN 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ANNUAL REPORT IS PROVIDED TO THE PUBLIC WHICH INCLUDES THE AUDITED FINANCIAL STATEMENT SUMMARY. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | NURSE AGENCY FEES/CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,056,846. MANAGEMENT AND GENERAL EXPENSES 14,592. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,071,438. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -10,789. CHANGE IN MINIMUM PENSION LIABILITY 1,047,111. TRANSFER NET ASSET 14,346. |
| FORM 990, PAGE 12, PART XII, LINE 2C | THERE HAS BEEN NO CHANGE TO THE SELECTION OR OVERSIGHT PROCESS. |
| FORM 990, PART X, PAGE 11, LINE 20 - TAX EXEMPT BOND LIABILITIES | THE PARENT COMPANY, OTTERBEIN HOMES, HAS ALLOCATED A PORTION OF THE TAX EXEMPT BONDS THAT WERE ISSUED TO THE PARENT COMPANY. THE DETAILS OF THE TAX EXEMPT BONDS ISSUED TO OTTERBEIN HOMES ARE CONTAINED ON THE SCHEDULE K THAT IS FILED WITH THE FORM 990 FOR THE PARENT COMPANY (FEIN 31-0549058). THERE IS NO SCHEDULE K FOR THIS TAX RETURN. THIS TREATMENT IS CONSISTENT WITH PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OTTERBEIN PORTAGE VALLEY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3855 LOWER MARKET STREET SUITE 300 | AddressLine1Txt |
| City | LEBANON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270512972 | EIN |
| Primary Activities | REAL ESTATE HOLDING COMPANY | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| End Of Year Assets | $151,422 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OTTERBEIN PORTAGE VALLEY | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OTTERBEIN HOMES | |||||||||||
| 3855 LOWER MARKET STREET SUITE 300 | LEBANON | OH | 45036 | 310549058 | PARENT - RETIREMENT LIVING COMMUNITIES | OH | 501(C)(3) | LINE 10 | N/A | 0 | |
| OTTERBEIN CRIDERSVILLE | |||||||||||
| 100 RED OAK DRIVE | CRIDERSVILLE | OH | 45806 | 341940884 | RETIREMENT LIVING COMMUNITY | OH | 501(C)(3) | LINE 10 | 0 | OTTERBEIN HOMES | |
| OTTERBEIN NORTH SHORE | |||||||||||
| 9400 NORTH SHORE BLVD | LAKESIDE | OH | 43440 | 341743836 | RETIREMENT LIVING COMMUNITY | OH | 501(C)(3) | LINE 10 | 0 | OTTERBEIN HOMES | |
| OTTERBEIN ST MARYS | |||||||||||
| 11230 STATE ROUTE 364 | ST MARYS | OH | 45885 | 341940880 | RETIREMENT LIVING COMMUNITY | OH | 501(C)(3) | LINE 10 | 0 | OTTERBEIN HOMES | |
| OTTERBEIN LEBANON | |||||||||||
| 585 STATE ROUTE 741 | LEBANON | OH | 45036 | 311743874 | RETIREMENT LIVING COMMUNITY | OH | 501(C)(3) | LINE 10 | 0 | OTTERBEIN HOMES | |
| THE FRANKLIN UNITED METHODIST HOME INC | |||||||||||
| 1070 WEST JEFFERSON STREET | FRANKLIN | IN | 46131 | 350988712 | RETIREMENT LIVING COMMUNITY | IN | 501(C)(3) | LINE 10 | 0 | OTTERBEIN HOMES | |
| SUNSET RETIREMENT COMMUNITIES INC | |||||||||||
| 4040 INDIAN ROAD | TOLEDO | OH | 43606 | 344428230 | RETIREMENT LIVING COMMUNITY | OH | 501(C)(3) | LINE 10 | 0 | OTTERBEIN HOMES | |
| KENDAL AT GRANVILLE | |||||||||||
| 2158 COLUMBUS ROAD | GRANVILLE | OH | 43023 | 311657346 | RETIREMENT LIVING COMMUNITY | OH | 501(C)(3) | LINE 10 | 0 | OTTERBEIN HOMES | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |