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HOOSIER CARE INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
HOOSIER CARE INC (EIN 62-1486858)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-10
IRS object ID
202101309349302915
Schema version
2019v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-10T16:31:20-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19600 Brownsboro Road Suite 400AddressLine1Txt
CityLouisvilleCityNm
State AbbreviationKYStateAbbreviationCd
ZIP402411122ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN621486858EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CLAREMONT HEALTH SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCLARBusinessNameControlTxt
Phone6156479004PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 58908AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37205ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDouglass B SmithPersonNm
Person TitlePresidentPersonTitleTxt
Signature2021-05-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRachel SpurlockPreparerPersonNm
PTINP00520729PTIN
Phone5023263996PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Douglass B SmithBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 58908AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37205ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$0GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption5138GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateNJLegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee107TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$0PYTotalRevenueAmt
CY Total Revenue$0CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
CY Other Expenses$0CYOtherExpensesAmt
CY Total Expenses$0CYTotalExpensesAmt
PY Revenues Less Expenses$0PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$0CYRevenuesLessExpensesAmt
Total Assets BOY$838,641TotalAssetsBOYAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities BOY$191,045TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$647,596NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$0ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescTHE ORGANIZATION OPERATES A SKILLED-CARE NURSING HOME FACILITY FOR THE CARE OF ELDERLY PATIENTS. THE ORGANIZATION HAS 118 BEDS IN ITS NURSING HOME FACILITY. The assets of Claremont Health System, Inc. were sold as of 3/13/2019.Desc
Total Program Service Expenses$0TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee107EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DOUGLASS B SMITHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6156479004PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 58908AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37205ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Douglass Smith
Director/President of Emerald Shelter Group1.538.5Yes (X)Yes (X)$0$388,946$12,012
Stephen F Wood Sr
EXECUTIVE CHAIRMAN OF EMERALD SHELTER GROUP0.519.5Yes (X)Yes (X)$0$500,000$0
Jim Ridenour
DIRECTOR0.16.9Yes (X)$0$82,683$0
Jo Ann Corbitt
Director0.16.9Yes (X)$0$80,273$0
John E Gillmor
Director0.16.9Yes (X)$0$75,000$0
John G Foos
DIRECTOR0.16.9Yes (X)$0$72,500$0
Laura Hawken
Director0.16.9Yes (X)$0$47,950$0
Stephen F Wood Jr
DIRECTOR0.16.9Yes (X)$0$70,000$0
Andrea Barach
VP AND CORPORATE SECRETARY1.538.5Yes (X)$0$242,242$6,039
John Noffsinger
COO1.538.5Yes (X)$0$230,640$6,039
Kylie Waters
CFO (termed 5/1/2020)1.538.5Yes (X)$0$187,157$6,667
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,977,391TotReportableCompRltdOrgAmt
Total Other Compensation$30,757TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtAddress Line2ContractorAddress/USAddress/AddressLine2TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HEALTHCARE SERVICES GROUP INC
3220 Tillman DriveSuite 300BensalemPA19020Housekeeping, Laundry, Food, Environmental$274,483
Medical Rehabilitation Center
1050 Chinoe RoadSuite 350LexingtonKY40502Management$178,976
Exceptional Rehab
1050 Chinoe RoadSuite 350LexingtonKY40502Rehabilitation$115,230
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,500BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$837,141BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$838,641BOYAmt
EOY$0EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$191,045BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$191,045BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$647,596BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$647,596BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$838,641BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$0ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$647,596OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,159,887CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,111,529CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,849,578CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$32,120,994TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,159,887CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,111,529CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,849,578CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$32,120,994TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$32,120,994PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,991CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,323CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,672CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$7,986TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,991CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,323CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,672CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$7,986TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$881CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$293CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,770CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$3,944TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,162,759CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,115,145CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,855,020CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$32,132,924TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9996PublicSupportCY509Pct
Public Support PY5090.9997PublicSupportPY509Pct
Investment Income CY0.0002InvestmentIncomeCYPct
Investment Income PY0.0002InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - MISCELLANEOUS REVENUE, COLUMN A - 881.0, COLUMN B - 293.0, COLUMN C - 2770.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 3944.0;ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Douglass Smith
Director/President of Emerald Shelter Group$0$388,946$0$0$0$0$0$0$0$12,012$0$400,958$0$0
Stephen F Wood Sr
EXECUTIVE CHAIRMAN OF EMERALD SHELTER GROUP$0$500,000$0$0$0$0$0$0$0$0$0$500,000$0$0
Andrea Barach
VP AND CORPORATE SECRETARY$0$242,242$0$0$0$0$0$0$0$6,039$0$248,281$0$0
John Noffsinger
COO$0$230,640$0$0$0$0$0$0$0$6,039$0$236,679$0$0
Kylie Waters
CFO (termed 5/1/2020)$0$187,157$0$0$0$0$0$0$0$6,667$0$193,824$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 3 Significant changes in program servicesThe assets of Claremont Health System, Inc. were sold as of 3/13/2019.
Form 990, Part VI, Line 15a COMPENSATION - TOP MANAGEMENT OFFICIALCOMPENSATION FOR THE TOP MANAGEMENT OFFICAL IS PAID BY A RELATED ORGANIZATION, THEREFORE LINE 15A IS NOT APPLICABLE AND HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS FOR APPROVAL BY THE BOARD OF DIRECTORS. COMPENSATION IS BASED ON AN INDEPENDENT COMPENSATION STUDY AND INCREASES IN COMPENSATION ARE AT THE DISCRETION OF THE BOARD. DURING THE FILING YEAR A COMPENSATION STUDY WAS PERFORMED BY A THIRD PARTY AND INCLUDED A REVIEW OF THE ECONOMIC RESEARCH INSTITUTE'S EXECUTIVE ASSESSOR DATABASE, THE MERCER EXECUTIVE BENCHMARK DATABASE AND SURVEY DATA FROM A GROUP OF PEER COMPANIES WITHIN THE ASSISTED AND LONG-TERM CARE INDUSTRY.
Form 990, Part VI, Line 15b COMPENSATION - OTHER OFFICERS OR KEY EMPLOYEESCOMPENSATION FOR ALL OTHER OFFICERS OR KEY EMPLOYEES IS PAID BY A RELATED ORGANIZATION, THEREFORE LINE 15B IS NOT APPLICABLE AND HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS FOR APPROVAL BY THE BOARD OF DIRECTORS. COMPENSATION IS BASED ON AN INDEPENDENT COMPENSATION STUDY AND INCREASES IN COMPENSATION ARE AT THE DISCRETION OF THE BOARD. DURING THE FILING YEAR A COMPENSATION STUDY WAS PERFORMED BY A THIRD PARTY AND INCLUDED A REVIEW OF THE ECONOMIC RESEARCH INSTITUTE'S EXECUTIVE ASSESSOR DATABASE, THE MERCER EXECUTIVE BENCHMARK DATABASE AND SURVEY DATA FROM A GROUP OF PEER COMPANIES WITHIN THE ASSISTED AND LONG-TERM CARE INDUSTRY.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsSTEPHEN F. WOOD, SR. & STEPHEN F. WOOD, JR. - Family relationship
Form 990, Part VI, Line 3 Delegation of management dutiesUntil March 13, 2019, THE ORGANIZATION had A MANAGEMENT AGREEMENT WITH MEDICAL REHABILITATION CENTERS, LLC, D/B/A EXCEPTIONAL LIVING CENTERS. MANAGEMENT SERVICES INCLUDEd SUPERVISION OF FACILITY OPERATIONS, ADMINISTRATIVE SERVICES, MANAGEMENT INFORMATION SYSTEM SERVICES, ACCOUNTING, AND COST REPORT PREPARATION. THERE ARE NO CURRENT OFFICERS, DIRECTORS, OR HIGHEST COMPENSATED EMPLOYEES WHO WERE COMPENSATED BY THE MANAGEMENT COMPANY. The management contracted ended when the real estate, personal property, and intangible property was sold on March 13, 2019.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing bodyTHERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY, THEREFORE THIS QUESTION HAS BEEN MARKED "NO" IN ACCORDANCE TO THE IRS INSTRUCTIONS.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyA complete copy of the form 990 is reviewed by the organization's legal counsel and an authorized member of the board of directors prior to filing with the IRS. Additionally, a complete copy of the form 990 is provided to all members of the governing body prior to filing.
Form 990, Part VI, Line 12c Conflict of interest policyAnnual certifications are received from all officers and directors to determine whether any potential conflicts of interest exist. The board of directors discuss the annual certifications at the board meetings to determine whether an actual conflict of interest exists. If a conflict is determined to exist, that person would be recused from taking part in any decisions concerning the conflicting issue.
Form 990, Part VI, Line 19 Required documents available to the publicTHE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ORGANIZATION'S OFFICE DURING REGULAR BUSINESS HOURS UPON REQUEST.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesDistributions to Affiliate - -94800; Loss from discontinued operations - -552796;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
BIRCHWOOD SENIOR HOUSING CORPORATION
PO BOX 58908NASHVILLETN37205204800428SENIOR HOUSINGDE501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
CLEVELAND SENIOR HOUSING CORPORATION
PO BOX 58908NASHVILLETN37205264739076SENIOR HOUSINGTN501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
DELAWARE HEALTH CORPORATION
PO BOX 58908NASHVILLETN37205621548336NURSING HOMEDE501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
EMERALD UPPER MIDWEST HEALTHCARE HOLDING CORPORATION
PO BOX 58908NASHVILLETN37205364825354HOLDING COMPANYWI501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
EMERALD SPRING HILL INC
PO BOX 58908NASHVILLETN37205474584314NURSING HOMETN501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
HEALTH AND HOUSING SUPPORT SERVICES INC
PO BOX 58908NASHVILLETN37205452449379SUPPORTING ORGANIZATIONNV501(c)(3)Type IIHEALTH AND HOUSING SUPPORT SERVICES INCfalse
HOOSIER CARE II INC
PO BOX 58908NASHVILLETN37205311274121NURSING HOMEIN501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
HOOSIER CARE III INC
PO BOX 58908NASHVILLETN37205621459304NURSING HOMEDE501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
HOOSIER CARE PROPERTIES INC
PO BOX 58908NASHVILLETN37205200377349HOLDING COMPANYIN501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
HOOSIER CARE INC
PO BOX 58908NASHVILLETN37205311262572NURSING HOMEIN501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
HOOSIER HOUSING GROUP INC
PO BOX 58908NASHVILLETN37205463491686HOLDING COMPANYNV501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse
LAURELWOOD SENIOR HOUSING CORPORATION
PO BOX 58908NASHVILLETN37205320362338SENIOR HOUSINGTN501(c)(3)10HEALTH AND HOUSING SUPPORT SERVICES INCfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
GATE MANOR HOUSING GP LLC
PO BOX 58908NASHVILLETN37205352531184AFFORDABLE HOUSING PROJECTSTNNAC Corporationfalse
KNOXVILLE HOUSING PORTFOLIO GP LLC
PO BOX 58908NASHVILLETN37205474536542AFFORDABLE HOUSING PROJECTSTNNAC Corporationfalse
JACKSON HOUSING PORTFOLIO GP LLC
PO BOX 58908NASHVILLETN37205364843724AFFORDABLE HOUSING PROJECTSTNNAC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd