SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC: Form 990, tax year 2020
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- Organization
- SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC (EIN 80-0687948)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-10
- IRS object ID
- 202133149349305128
- Schema version
- 2020v4.1
- 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 | 2021-11-10T14:19:23-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | 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 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800687948 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH COVE MANOR AT QUINCY POINT | BusinessNameLine1Txt |
| Business Name Line2 | REHABILITATION CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 6174230590 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 288 WASHINGTON STREET | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM GRAVES | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 6174230590 | PhoneNum |
| Signature | 2021-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | WILLIAM | PersonFirstNm |
| Person Last | GRAVES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2021-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILLIAM GRAVES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 288 WASHINGTON STREET | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,497,174 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SOUTHCOVEMANOR.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 242 | TotalEmployeeCnt |
| Total Volunteers | 19 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $38,024 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,658,316 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,279,074 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,802,856 | CYProgramServiceRevenueAmt |
| PY Investment Income | $386,612 | PYInvestmentIncomeAmt |
| CY Investment Income | $31,592 | CYInvestmentIncomeAmt |
| PY Other Revenue | $18,419 | PYOtherRevenueAmt |
| CY Other Revenue | $4,410 | CYOtherRevenueAmt |
| PY Total Revenue | $15,722,129 | PYTotalRevenueAmt |
| CY Total Revenue | $17,497,174 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,370,669 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,772,618 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $169 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,908,674 | PYOtherExpensesAmt |
| CY Other Expenses | $5,383,854 | CYOtherExpensesAmt |
| PY Total Expenses | $15,279,343 | PYTotalExpensesAmt |
| CY Total Expenses | $16,156,472 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $442,786 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,340,702 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,742,399 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,957,860 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,809,222 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,640,659 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,933,177 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,317,201 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED REHABILITATION AND NURSING CARE THAT REFLECTS ASIAN CULTURAL VALUES. THE ORGANIZATION'S CORE VALUES INCLUDE: 1.RESPECTING THE PEOPLE WE SERVE, THEIR TRADITIONS, AND THEIR PREFERENCES, 2.PROVIDING EXCELLENT, LEADING EDGE CARE AND SERVICES, 3.INVESTING IN OUR EMPLOYEES, AND 4.SERVING OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,218,074 | ExpenseAmt |
| Revenue | $13,807,266 | RevenueAmt |
| Desc | NURSING & REHABILITATION SERVICES - THE ORGANIZATION'S MISSION IS TO PROVIDE INDIVIDUALIZED NURSING AND REHABILITATION CARE THAT REFLECTS ASIAN CULTURAL VALUES THROUGH THE OPERATION OF A 141-BED LONG-TERM CARE FACILITY IN QUINCY, MASSACHUSETTS. | Desc |
| Total Program Service Expenses | $14,218,074 | 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 | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 242 | 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 | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT HANSON DIRECTOR OF FINANCE | PersonNm |
| Phone | 6174230590 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 288 WASHINGTON STREET | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|---|
| RICHARD LUI | ||||||||
| CHAIRMAN OF THE BOARD | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MAY CHIN | ||||||||
| VICE PRESIDENT | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JASON QU | ||||||||
| TREASURER | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| HEMMIE CHANG | ||||||||
| CLERK | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ALICE ROSE | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID TING | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| EDWARD CHENG | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| HELEN CHIN SCHLICHTE | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| HON HOI YEE | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LISA MUI | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LEONARD LAI | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARIANNE BOWLER | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| STANLEY ELKERTON | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN LUO | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS CHIN | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| HEATHER O'SULLIVAN | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY LAW | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ERIC SCHLICHTE | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM HSU | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT HANSON | ||||||||
| DIRECTOR OF FINANCE | 40.00 | 2.00 | Yes (X) | $146,475 | $0 | $14,537 | ||
| WILLIAM GRAVES | ||||||||
| PRESIDENT/CEO | 40.00 | 2.00 | Yes (X) | $268,832 | $0 | $10,737 | ||
| LI CHEN | ||||||||
| ADMINISTRATOR | 40.00 | 2.00 | $169,114 | $0 | $18,883 | Yes (X) | ||
| MARY LOUISE BUTLER | ||||||||
| DIRECTOR OF NURSING | 40.00 | 2.00 | $140,167 | $0 | $12,341 | Yes (X) | ||
| SHINJIA CHOI | ||||||||
| RN | 40.00 | 2.00 | $149,605 | $0 | $16,689 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $874,193 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $73,187 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PARAGON REHABILITATION | |||||
| 303 N HURSTBOURNE PKWY | LOUISVILLE | KY | 40222 | THERAPY SERVICES | $368,334 |
| PRO EMS SOLUTIONS INC | |||||
| 31 SMITH PLACE | CAMBRIDGE | MA | 02138 | COVID TESTING | $288,900 |
| US FOODS | |||||
| PO BOX 3155 | BOSTON | MA | 02241 | FOOD SERVICES | $286,065 |
| GERIATRIC MEDICAL | |||||
| PO BOX 2503 | WOBURN | MA | 01888 | MEDICAL PRODUCT SUPPLIER | $184,840 |
| SIMPLEX JANITORIAL SUPPLIES | |||||
| 6 COMMERCIAL STREET | SHARON | MA | 02067 | JANITORIAL SUPPLIES | $129,339 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,645,769 | GovernmentGrantsAmt |
| All Other Contributions | $12,547 | AllOtherContributionsAmt |
| Total Contributions | $3,658,316 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $13,802,856 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,802,856 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,802,856 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,592 | TotalRevenueColumnAmt |
| Exclusion | $31,592 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $4,410 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,410 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,410 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,497,174 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,807,266 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $31,592 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $440,581 | TotalAmt |
| Management And General | $440,581 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,760,310 | TotalAmt |
| Program Services | $7,893,902 | ProgramServicesAmt |
| Management And General | $866,408 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,602 | TotalAmt |
| Program Services | $129,552 | ProgramServicesAmt |
| Management And General | $21,050 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,406 | TotalAmt |
| Program Services | $610,251 | ProgramServicesAmt |
| Management And General | $99,155 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $711,719 | TotalAmt |
| Program Services | $612,241 | ProgramServicesAmt |
| Management And General | $99,478 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,881 | TotalAmt |
| Management And General | $21,881 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,005 | TotalAmt |
| Management And General | $47,005 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $571,830 | TotalAmt |
| Program Services | $560,061 | ProgramServicesAmt |
| Management And General | $11,769 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,017 | TotalAmt |
| Management And General | $14,017 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,901 | TotalAmt |
| Program Services | $69,901 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,257 | TotalAmt |
| Program Services | $476,907 | ProgramServicesAmt |
| Management And General | $22,350 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48 | TotalAmt |
| Management And General | $48 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,281 | TotalAmt |
| Program Services | $20,031 | ProgramServicesAmt |
| Management And General | $250 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $581,663 | TotalAmt |
| Program Services | $555,624 | ProgramServicesAmt |
| Management And General | $26,039 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $901,621 | TotalAmt |
| Program Services | $861,258 | ProgramServicesAmt |
| Management And General | $40,363 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,779 | TotalAmt |
| Program Services | $88,333 | ProgramServicesAmt |
| Management And General | $54,446 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| USER FEE | $988,232 | $988,232 | |
| MEDICAL SUPPLIES AND EX | $750,930 | $750,930 | |
| DIETARY | $468,513 | $468,513 | |
| PROVISION FOR BAD DEBTS | $108,000 | $108,000 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,896 | TotalAmt |
| Program Services | $132,338 | ProgramServicesAmt |
| Management And General | $65,389 | ManagementAndGeneralAmt |
| Fundraising | $169 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,156,472 | TotalAmt |
| Program Services | $14,218,074 | ProgramServicesAmt |
| Management And General | $1,938,229 | ManagementAndGeneralAmt |
| Fundraising | $169 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,678,226 | BOYAmt |
| EOY | $1,247,923 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $763,480 | BOYAmt |
| EOY | $2,811,651 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,627,723 | BOYAmt |
| EOY | $2,050,365 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,843 | BOYAmt |
| EOY | $162,421 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,784,877 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,219,622 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,416,175 | BOYAmt |
| EOY | $27,565,255 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,952 | BOYAmt |
| EOY | $120,245 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,742,399 | BOYAmt |
| EOY | $33,957,860 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,153,337 | BOYAmt |
| EOY | $1,151,931 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,918 | BOYAmt |
| EOY | $443,902 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,016,239 | BOYAmt |
| EOY | $16,526,454 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,543,728 | BOYAmt |
| EOY | $4,518,372 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,809,222 | BOYAmt |
| EOY | $22,640,659 | 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 | $9,933,177 | BOYAmt |
| EOY | $11,317,201 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,933,177 | BOYAmt |
| EOY | $11,317,201 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,742,399 | BOYAmt |
| EOY | $33,957,860 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,340,702 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $43,322 | 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 | $32,365 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $120,819 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $124,202 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $38,024 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,658,316 | CurrentTaxYearAmt |
| Total | $3,973,726 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,513,017 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,602,746 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,036,223 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,279,074 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,802,856 | CurrentTaxYearAmt |
| Total | $73,233,916 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,545,382 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,723,565 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,160,425 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,317,098 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,461,172 | CurrentTaxYearAmt |
| Total | $77,207,642 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $77,207,642 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $465,113 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $465,159 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $463,020 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $386,612 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $31,592 | CurrentTaxYearAmt |
| Total | $1,811,496 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $465,113 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $465,159 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $463,020 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $386,612 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $31,592 | CurrentTaxYearAmt |
| Total | $1,811,496 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $10,844 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,094 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,419 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,410 | CurrentTaxYearAmt |
| Total | $44,767 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,010,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,199,568 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,634,539 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,722,129 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,497,174 | CurrentTaxYearAmt |
| Total | $79,063,905 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97650 | PublicSupportCY509Pct |
| Public Support PY509 | 0.96910 | PublicSupportPY509Pct |
| Investment Income CY | 0.02290 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02920 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $41,862 | BeginningBalanceAmt |
| Additions During Year | $298,922 | AdditionsDuringYearAmt |
| Distributions During Year | $293,299 | DistributionsDuringYearAmt |
| Ending Balance | $47,485 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $130,942 | BeginningYearBalanceAmt |
| Contributions | $11,750 | ContributionsAmt |
| Investment Earnings Or Losses | $6,508 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $22,575 | OtherExpendituresAmt |
| End Year Balance | $126,625 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $179,306 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $7,261 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $41,103 | OtherExpendituresAmt |
| End Year Balance | $130,942 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $146,584 | BeginningYearBalanceAmt |
| Contributions | $67,500 | ContributionsAmt |
| Investment Earnings Or Losses | $4,475 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $39,253 | OtherExpendituresAmt |
| End Year Balance | $179,306 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $166,440 | BeginningYearBalanceAmt |
| Contributions | $17,500 | ContributionsAmt |
| Investment Earnings Or Losses | $3,648 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $41,004 | OtherExpendituresAmt |
| End Year Balance | $146,584 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $40,518 | BeginningYearBalanceAmt |
| Contributions | $266,113 | ContributionsAmt |
| Investment Earnings Or Losses | $1,683 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $141,874 | OtherExpendituresAmt |
| End Year Balance | $166,440 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.23692 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.76308 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,437,032 | OtherCostOrOtherBasisAmt |
| Book Value | $2,437,032 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,742,107 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,776,106 | DepreciationAmt |
| Book Value | $23,966,001 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $522,381 | OtherCostOrOtherBasisAmt |
| Depreciation | $68,124 | DepreciationAmt |
| Book Value | $454,257 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,054,160 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,375,392 | DepreciationAmt |
| Book Value | $678,768 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,197 | OtherCostOrOtherBasisAmt |
| Book Value | $29,197 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $27,565,255 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $4,450,837 |
| OTHER LIABILITIES | $67,535 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,518,372 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | THE ORGANIZATION HAS FIDUCIARY CONTROL OF THE PERSONAL NEEDS ACCOUNT HELD FOR THE BENEFIT OF THE RESIDENTS. |
| PART V, LINE 4: | THE ORGANIZATION'S ENDOWMENT IS HELD BY A RELATED ORGANIZATION, SOUTH COVE NURSING FACILITIES FOUNDATION, INC. IN ACCORDANCE WITH THE DONOR REQUIREMENTS, THE ENDOWMENT FUNDS ARE HELD IN PERPETUITY. ENDOWMENT RETURNS MAY BE USED FOR THE APPRECIATION EVENTS FOR THE EMPLOYEES OF THE NURSING HOME OPERATOR. |
| PART X, LINE 2: | THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FOLLOWS THE GUIDANCE OF ACCOUNTING STANDARDS CODIFICATION (ASC) 740, ACCOUNTING FOR INCOME TAXES, RELATED TO THE UNCERTAINTIES IN INCOME TAXES, WHICH PRESCRIBES A THRESHOLD OF MORE LIKELY THAN NOT FOR RECOGNITION AND DERECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MANAGEMENT HAS EVALUATED THE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN, IF ANY, ON ITS EXEMPT ORGANIZATION FILINGS, AND THE LIKELIHOOD THAT UPON EXAMINATION THOSE POSITIONS WOULD BE SUSTAINED. BASED ON THE RESULTS OF THIS EVALUATION, MANAGEMENT DETERMINED THERE ARE NO POSITIONS THAT NECESSITATE DISCLOSURES AND/OR ADJUSTMENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM GRAVES | ||||||||||||||
| PRESIDENT/CEO | $213,832 | $0 | $55,000 | $0 | $0 | $0 | $0 | $0 | $10,737 | $0 | $279,569 | $0 | $0 | $0 |
| LI CHEN | ||||||||||||||
| ADMINISTRATOR | $148,014 | $0 | $21,100 | $0 | $0 | $0 | $8,179 | $0 | $10,704 | $0 | $187,997 | $0 | $0 | $0 |
| SHINJIA CHOI | ||||||||||||||
| RN | $149,605 | $0 | $0 | $0 | $0 | $0 | $3,959 | $0 | $12,730 | $0 | $166,294 | $0 | $0 | $0 |
| SCOTT HANSON | ||||||||||||||
| DIRECTOR OF FINANCE | $130,975 | $0 | $15,500 | $0 | $0 | $0 | $3,841 | $0 | $10,696 | $0 | $161,012 | $0 | $0 | $0 |
| MARY LOUISE BUTLER | ||||||||||||||
| DIRECTOR OF NURSING | $121,872 | $0 | $18,295 | $0 | $0 | $0 | $0 | $0 | $12,341 | $0 | $152,508 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MASSACHUSETTS DEVELOPMENT FINANCE AGENCY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 043431814 | BondIssuerEIN |
| Bond Issued | 2012-10-30 | BondIssuedDt |
| Issue Price | $19,000,000 | IssuePriceAmt |
| Purpose | LAND ACQUISITION AND FACILITY CONSTRUCTION AND FURNISHING | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,392,184 | RetiredAmt |
| Total Proceeds | $19,000,000 | TotalProceedsAmt |
| Capitalized Interest | $252,483 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $100,640 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $18,646,877 | CapitalExpendituresAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CONSISTS OF ALL VOTING DIRECTORS WHO ARE ALSO OFFICERS OR COMMITTEE CHAIRS. THE EXECUTIVE COMMITTEE HAS FULL AUTHORITY BETWEEN BOARD SESSIONS, IF NEEDED. |
| FORM 990, PART VI, SECTION A, LINE 2 | A FAMILY RELATIONSHIP EXISTS BETWEEN MAY CHIN, VICE PRESIDENT; THOMAS CHIN, DIRECTOR; AND HELEN CHIN SCHLICHTE, DIRECTOR. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S AUDIT COMMITTEE REVIEWS AND APPROVES THE DRAFT FORM 990. THE COMPLETE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS PART OF THE ORGANIZATION'S BY-LAWS AND IS DISCUSSED BY THE BOARD OF DIRECTORS AND TOP MANAGEMENT PERSONNEL AT THE FIRST BOARD MEETING EACH YEAR REGARDING ANY/ALL SIGNIFICANT TRANSACTIONS. THE CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, AND EMPLOYEES. ANY CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD PRIOR TO APPROVAL OR RATIFICATION OF THE CONTRACT OR TRANSACTION BY MAJORITY VOTE OF THE DISINTERESTED PERSONS. THE CEO, ADMINISTRATOR AND FINANCE DIRECTOR ARE TASKED WITH OVERSEEING THE DISBURSEMENTS AND CONTRACT MANAGEMENT FUNCTIONS AND MONITORING FOR ANY CONFLICTING RELATIONSHIP WITH THE ORGANIZATION. ALL BOARD MEMBERS ARE AWARE OF THE NEED TO NOTIFY THE BOARD AND MANAGEMENT TEAM OF ANY CONFLICTS. THE BOARD IS NOTIFIED WHEN A CONFLICT OF INTEREST MIGHT OCCUR. SHOULD AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST PRESENT ITSELF, THE MANAGEMENT TEAM IS FULLY PREPARED TO ASK THE BOARD TO CONSIDER APPROPRIATE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CEO AND TOP MANAGEMENT INCLUDES A COMPARABILITY STUDY, APPROVAL BY THE COMPENSATION COMMITTEE, AND DOCUMENTATION OF THE DELIBERATION OF THE DECISION DONE IN EXECUTIVE SESSION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER 43,322. |
| FORM 990, PART XII, LINE 2C | PROCESS IS UNCHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH COVE INVESTMENT FUND LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 288 WASHINGTON STREET | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461020387 | EIN |
| Primary Activities | NMTC FINANCING VEHICLE | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH COVE NURSING FACILITIES FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 288 WASHINGTON STREET | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 046406242 | EIN |
| Primary Activities | NURSING AND CARE FACILITIES | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH COVE MANOR NURSING AND REHABILITATION CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SOUTH COVE REALTY COMPANY LIMITED PARTNERSHIP | ||||||||||
| 288 WASHINGTON STREET | QUINCY | MA | 02169 | 042820700 | REAL ESTATE - OPERATIONS CEASED 2014 | MA | SOUTH COVE NURSING FACILITIES FOUNDATION | RELATED | 0 | 0 |
| SOUTH COVE INVESTMENT FUND LLC - DISREGARDED ENTITY OF SCM N&R | ||||||||||
| 288 WASHINGTON STREET | QUINCY | MA | 02169 | 451020387 | NMTC FINANCING | MA | SOUTH COVE MANOR NURSING AND REHABILITATION CENTER | RELATED | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH COVE MANOR INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 288 WASHINGTON STREET | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02169 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042820772 | EIN |
| Primary Activities | NURSING HOME | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH COVE NURSING FACILITIES FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| 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 | Yes (1) | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SOUTH COVE NURSING FACILITIES FOUNDATION INC | ||
| C | $43,322 | INTERCOMPANY TRANSFER |
| SOUTH COVE MANOR NURSING FACILITIES FOUNDATION INC | ||
| E | $4,450,837 | INTERCOMPANY LOAN |