2021-11-01T14:35:22-05:00 2020-12-31 232108173 RKL LLP 1330 BROADCASTING ROAD PO BOX 7008 WYOMISSING PA 196106008 990 2020-01-01 231312627 THE SHOOK HOME SHOO 7172646815 55 SOUTH SECOND STREET CHAMBERSBURG PA 17201 JEFFREY TRUHAN CEO/ADMINISTRATOR 7172646815 2021-10-29 1 JEFFREY TRUHAN 999009999 STEPHANIE E KANE CPA P01275157 6103761595 2021-10-22 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JEFFREY TRUHAN 55 SOUTH SECOND STREET CHAMBERSBURG PA 17201 10449760 0 X WWW.SHOOKHOME.ORG X 1918 PA PROVIDING QUALITY CARE AND SERVICES TO INDIVIDUALS IN A HOME-LIKE ENVIRONMENT. 15 14 210 31 0 0 25118 706123 8325963 8331418 579223 490593 304864 323978 9235168 9852112 0 0 0 0 5851326 6740099 0 0 0 3609404 3723531 9460730 10463630 -225562 -611518 23973357 25359747 5185315 5745640 18788042 19614107 WE ARE COMMITTED TO PROVIDING QUALITY HEALTH CARE AND REHABILITATION SERVICES TO EMPOWER INDIVIDUALS TO ACHIEVE THEIR HIGHEST LEVEL OF INDEPENDENCE, DIGNITY, AND SELF-WORTH IN A HOME-LIKE ENVIRONMENT. 0 0 9238507 8682846 THE ORGANIZATION IS A LICENSED CONTINUING CARE RETIREMENT COMMUNITY (CCRC) OFFERING SKILLED NURSING (65 BEDS), PERSONAL CARE (45 BEDS), RESIDENTIAL LIVING, AND OUTPATIENT PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. AS SUCH, THE FACILITY PROVIDES ROOM & BOARD, NURSING CARE, MEDICAL & THERAPY SERVICES, ETC., TO ITS RESIDENTS AND OUTPATIENT CLIENTS AS APPLICABLE. THE ORGANIZATION PROVIDED 18,507 RESIDENT DAYS FOR SKILLED NURSING CARE, 11,884 RESIDENT DAYS FOR PERSONAL CARE AND 1,094 RESIDENT DAYS FOR INDEPENDENT LIVING. 9238507 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 210 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X THE SHOOK HOME 7172646815 55 SOUTH SECOND STREET CHAMBERSBURG PA 17201 JOHN BRET ELBIN PRESIDENT 1.00 X X 0 0 0 MARK LONG VICE PRESIDENT 1.00 X X 0 0 0 ROXI SEILHAMER SECRETARY 1.00 X X 0 0 0 MICHAEL KUGLER TREASURER 1.00 X X 0 0 0 DEBRA BRECHBILL DIRECTOR 1.00 X 0 0 0 JANYCE COLLIER START 32020 DIRECTOR 1.00 X 0 0 0 SUMMER FRANZONI DIRECTOR 1.00 X 0 0 0 TROY GARMAN DIRECTOR 1.00 X 0 0 0 THEODORE GUARRIELLO DIRECTOR 1.00 X 0 0 0 KATHLEEN JACOBSON DIRECTOR 1.00 X 0 0 0 LANCE KEGERREIS DIRECTOR 1.00 X 0 0 0 LUKE MARTIN DIRECTOR 1.00 X 0 0 0 LORETTA MCCLURE DIRECTOR 1.00 X 0 0 0 MARY BETH SHANK TIL 022020 DIRECTOR 1.00 X 0 0 0 CELESTE SNAVELY DIRECTOR 1.00 X 0 0 0 GEORGE ED WENGER DIRECTOR 1.00 X 0 0 0 JEFFREY TRUHAN CEO/ADMINISTRATOR 40.00 X 131174 0 13792 BARBARA LAW CFO 40.00 X 100509 0 3916 MARJORIE LONARDO RN SUPERVISOR 40.00 X 114712 0 10100 DONNA FLYTHE RN SUPERVISOR 40.00 X 103342 0 13193 KRISTIN MARKS RN SUPERVISOR 40.00 X 103684 0 21700 MARY RUTHRAUFF RN SUPERVISOR 40.00 X 102116 0 21700 655537 0 84401 6 0 0 0 TRINITY REHABILITATION SERVICES LLC 510 WASHINGTON AVENUE GLEN DALE WV 26038 PATIENT THERAPY 1143357 LYCOMING SUPPLY INC 801 BEEBER STREET WILLIAMSPORT PA 17701 BUILDING DEMOLITION 217176 CARE OPTIONS RX 219 N BALTIMORE STREET MT HOLLY SPRINGS PA 17065 PHARMACY SERVICES 129341 QUEST DIAGNOSTICS PO BOX 828669 PHILADELPHIA PA 191828669 COVID TESTING 102700 4 671054 35069 706123 PRIVATE PAY REVENUE 623000 2565905 2565905 MEDICAL ASSISTANCE 623000 1912574 1912574 MEDICARE 623000 1837524 1837524 PERSONAL CARE 623000 1710869 1710869 COMMERCIAL INSURANCE 623000 304546 304546 8331418 420476 420476 632 0 632 632 632 80710 587055 5273 592375 75437 -5320 70117 70117 PRESCRIPTION DRUGS 623000 101926 101926 MEDICAL SUPPLIES 623000 91813 91813 FFCRA TAX CREDITS 623000 42667 42667 86940 86940 323346 9852112 8682846 0 463143 X 250066 223854 26212 4883072 4370357 512715 65121 58439 6682 1145837 1028274 117563 396003 355373 40630 7771 7771 21800 21800 30730 30730 1285909 1238284 47625 7968 700 7268 273459 234409 39050 75594 38737 36857 436203 407430 28773 3315 3261 54 5707 5677 30 393790 329917 63873 14584 14584 ANCILLARY EXPENSES 553737 553737 0 FOOD AND DIETARY 272521 272521 0 ADMINISTRATIVE EXPENSE 193476 0 193476 REPAIRS AND MAINTENANCE 146967 117537 29430 10463630 9238507 1225123 0 2598 2778 934730 364835 736848 712706 49797 136889 15167693 6579720 8689101 8587973 10723141 12561342 2837142 2993224 23973357 25359747 765061 405111 65065 52272 4342905 4146345 12284 14547 0 1127365 5185315 5745640 X 15823567 15300391 2964475 4313716 18788042 19614107 23973357 25359747 X -611518 1281501 156082 X X 0 1 X 1 0 X 149492 134478 138427 25118 35069 482584 7975819 7484106 8332807 8325963 8374085 40492780 8125311 7618584 8471234 8351081 8409154 40975364 84 3419 3420 3399 10322 0 84 3419 3420 3399 10322 40965042 254571 407340 344487 460775 421108 1888281 254571 407340 344487 460775 421108 1888281 279059 279059 8379882 8025924 8815721 8811856 9109321 43142704 0.94950 0.95950 0.04380 0.04040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 8821425 9145 1102123 127034 9807545 7550915 13445 1434402 175451 8823311 8325820 6019 -673504 107420 7550915 7368360 10960 1010891 64391 8325820 7108944 9910 346823 97317 7368360 0.56030 0.43970 0.00000 1 0 1831482 1831482 11765058 5598230 6166828 1325242 877796 447446 245911 103694 142217 8587973 THIRD PARTY TRUST ACCOUNTS 2993224 2993224 X 11258965 1281501 156082 1437583 9821382 30730 30730 9852112 10432900 0 10432900 30730 30730 10463630 PART IV, LINE 2B: THE ORGANIZATION IS CUSTODIAN FOR RESIDENT TRUST FUNDS FOR SOME OF THE FACILITY'S RESIDENTS. PART V, LINE 4: ENDOWMENT FUNDS ARE USED BY THE ORGANIZATION FOR BENEVOLENT CARE AND GENERAL TAX-EXEMPT PURPOSES. PART X, LINE 2: THE HOME FOLLOWS THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ACCORDING TO THE PRINCIPLES OF FASB ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, WHICH PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTABLE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOME, INCLUDING WHETHER THE ENTITY IS EXEMPT FROM INCOME TAXES. MANAGEMENT EVALUATED THE TAX POSITIONS TAKEN AND CONCLUDED THAT THE HOME HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAVE BEEN INCLUDED IN THE FINANCIAL STATEMENTS. WITH FEW EXCEPTIONS, THE HOME IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL AUTHORITIES FOR YEARS ENDING PRIOR TO 2017. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE - THIRD PARTY TRUST 156,082. A BOROUGH OF CHAMBERSBURG 251742939 2015-12-21 4900000 CONSTRUCTION 0 0 0 A 753655 4900000 787 90779 1200000 3608434 2017 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 MIKE KUGLER TREASURER BOARD MEMBER OF KEYSTONE HEALTH CENTER 10000 INFECTIOUS DISEASE CONSULTING 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS, THE CEO AND THE CFO FOR COMPLETENESS AND ACCURACY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REMINDED PERIODICALLY TO UPDATE THE FACILITY WITH ANY CONFLICTS OF INTEREST. THE FACILITY MONITORS VENDORS PAID FOR GOODS AND SERVICES FOR RELATED PARTY TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICAL: PERFORMANCE EVALUATIONS ARE COMPLETED BY EACH MEMBER OF THE BOARD OF DIRECTORS ANNUALLY. COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED UPON THESE EVALUATIONS. COMPENSATION PROCESS FOR OFFICERS: PERFORMANCE EVALUATIONS ARE COMPLETED BY THE CEO ANNUALLY. RECOMMENDED COMPENSATION, BASED ON THESE EVALUATIONS AND BOARD APPROVED PARAMETERS, IS PRESENTED TO THE BOARD PRESIDENT AND HR COMMITTEE CHAIR FOR FINAL APPROVAL. ANNUAL WAGE SURVEY PROVIDED BY LEADINGAGE OF PA IS USED AS A TOOL IN DETERMINING APPROPRIATE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G NURSING PROFESSIONAL: PROGRAM SERVICE EXPENSES 68,373. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,373. CONTRACTED THERAPY: PROGRAM SERVICE EXPENSES 1,057,661. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,057,661. CONSULTANTS: PROGRAM SERVICE EXPENSES 70,250. MANAGEMENT AND GENERAL EXPENSES 47,625. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 117,875. MEDICAL DIRECTOR: PROGRAM SERVICE EXPENSES 42,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,000. FORM 990, PART XI, LINE 9: CHANGE IN VALUE-THIRD PARTY TRUST 156,082. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, REVIEW, OR COMPILATION OF ITS FINANCIAL STATMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.