2020-11-16T15:31:11-07:00 2019-12-31 990 2019-01-01 470377998 TABITHA INC TABI 4024837671 4720 Randolph Street Lincoln NE 68510 Christina Hinrichs President 4024837671 2020-11-16 167.248.17.140 2019 2021-01-29 14:40:06Z Christina Hinrichs 4720 Randolph Street Lincoln NE 68510 61629489 0 X www.tabitha.org X 1886 NE Motivated by Christian compassion, Tabitha delivers a continuum of exceptional and innovative Elder care services that promote the diginity, independence, and well-being of older adults. 15 12 1304 1500 0 0 2763912 2164210 56693160 58811143 12784 32829 552046 621307 60021902 61629489 0 0 0 0 39061777 42766289 0 0 0 21176479 21548685 60238256 64314974 -216354 -2685485 34918888 46064626 30059479 35603623 4859409 10461003 Motivated by Christian compassion, Tabitha delivers a continuum of exceptional and innovative Elder care services that promote the diginity, independence, and well-being of older adults 0 0 27817699 0 28555129 The Tabitha Nursing and Rehabilitation Center (TNRC) has 208 beds, Tabitha at Williamsburg has 50 beds, and Tabitha in Crete (TiC) has 44 beds. The facilities provide skilled nursing care with rehabilitation programs, including physical, occupational, and speech therapy. In addition, spiritual counseling, social workers, coordinated activities, and continual health planning are provided at no additional cost.TNRC also operates units that provide memory care and hospice inpatient services. 11410467 0 15618033 Tabitha's Medicare and Medicaid certified Hospice program provides care for terminally ill persons and their families enabling the patient to stay home. Services include medical director, visiting nurses, social workers, hospice aides, and spiritual and bereavement counselors. 8507980 0 9138490 Tabitha's Medicare and Medicaid certified Home Health Agency provides licensed and certified home skilled nursing, home health aides, rehabilitation therapy, and social work visits. The agency also provides screening and clinics and blood pressure checks in the community. VoiceCare supports independent living with a secure, reliable emergency response system. 5912881 0 5499491 The Meals on Wheels (MOW) program provides hot noon meals to any disabled or elderly person in need regardless of ability to pay. Meals are prepared by Tabitha staff and delivered by volunteers to residents in Lincoln and parts of Lancaster county. Tabitha in Crete - The Gardens and GracePointe Assisted Living provides maintenance free residences, around-the-clock personal care, and activities in a secure living community. Additionally, GracePointe's Memory Care unit provides security and safety for adults with memory loss. 5912881 0 5499491 53649027 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 42 1304 1 1304 1 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Brian Shanks 4024837671 4720 Randolph Street Lincoln NE 68510 Christina Hinrichs President & CEO 40 0 X X 456123 0 32055 Heath Stukenholtz Chief Development Officer 0 40 X 0 238610 16054 Darcie Brink Vice President - Finance 40 0 X X 186798 0 6279 Katie Lechner Chief Operating Officer 40 0 X 138676 0 17795 Mary Joyce Ebmeier Senior Vice President 40 0 X 137675 0 16301 Brian Shanks Secretary/Treasurer 40 0 X X X 44754 0 1599 Eric Schafer Chair 0 0 X X 0 0 0 Renee Sjulin Vice Chair 0 0 X X 0 0 0 Mark Hesser Member 0 0 X 0 0 0 Dirk Brom Member 0 0 X 0 0 0 Lee Chapin Member 0 0 X 0 0 0 Carol Friesen Member 0 0 X 0 0 0 Bishop Brian Mass Member 0 0 X 0 0 0 Michael Jenkins Member 0 0 X 0 0 0 Kimberly Rath Member 0 0 X 0 0 0 Juliann Sebastian Member 0 0 X 0 0 0 Neal Lyons Member 0 0 X 0 0 0 Lisa Smith Member 0 0 X 0 0 0 964026 238610 90083 7 0 1 0 Central NE Rehab Services PO Box 5285 Grand Island NE 68802 Medical 343832 Converage One Inc NW 5806 Minneapolis MN 554855806 Technology 177230 Crete Area Medical Center PO Box 220 Crete NE 68333 Medical 197435 Fusion Medical Staffing PO Box 82674 Lincoln NE 685012674 Medical 152210 Pope Architects 1295 Bandana Blvd N Suite 200 St Paul MN 55108 Consulting 208737 8 0 0 0 0 0 2164210 0 2164210 Nutritional Services 624210 772292 772292 0 0 Nursing Home Care 623000 28555129 28555129 0 0 Home Health Care 621610 9138490 9138490 0 0 Hospice 623000 15618033 15618033 0 0 Other 900099 4727199 4727199 0 0 0 0 0 0 58811143 32829 32829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 621307 621307 0 0 621307 61629489 59465279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34688347 29231380 5456967 0 655028 541418 113610 0 4972155 4112422 859733 0 2450759 2083512 367247 0 0 0 0 0 117212 3200 114012 0 65796 0 65796 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204801 1407 203394 0 3635371 3368212 267159 0 0 0 0 0 0 0 0 0 4397733 3147374 1250359 0 722284 680503 41781 0 0 0 0 0 86852 34424 52428 0 887070 623958 263112 0 0 0 0 0 2816966 2316448 500518 0 330510 326055 4455 0 Food & Catering 1619852 1579125 40727 0 Professional Services 2695302 2001352 693950 Medicaid Per Diem 3087756 3087756 0 0 Loss of Disposal on Property & Equipment 68373 68373 0 0 812807 442108 370699 0 64314974 53649027 10665947 0 3074297 7482817 64495 84810 0 5160481 5337531 0 0 0 0 0 0 172085 173086 262061 335727 58973581 34015229 25110163 24958352 0 0 0 0 1075306 7692303 34918888 46064626 7654848 7800214 0 0 0 0 18235000 17140000 0 0 0 0 2099782 1904769 0 0 2069849 8758640 30059479 35603623 X 4369409 9971003 490000 490000 4859409 10461003 34918888 46064626 X -2685485 0 0 0 0 8287079 X 1 X 1 X 1 0 X 2811275 2038913 1112409 1506797 1566798 9036192 53256975 54529057 53893634 56553759 58665392 276898817 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56068250 56567970 55006043 58060556 60232190 285935009 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285935009 4359 2157 4169 12784 32829 56298 0 0 0 0 0 0 4359 2157 4169 12784 32829 56298 0 0 0 0 0 0 0 0 0 0 0 0 56072609 56570127 55010212 58073340 60265019 285991307 0.99980 0.99991 0.00020 0.00009 X 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 490000 0 0 0 0 0 490000 1 0 0 0 0 0 678111 678111 0 38546698 21969265 16577433 0 4219260 1444736 2774524 0 15529512 10601228 4928284 0 0 0 0 24958352 Assets Limited as to use 945899 Investment assets limited as to use, less amount required to meet current obligations 151288 Right-of-use assets - operating leases 6595116 7692303 Obligation to Affliliate 2259160 Lease liability, net of current portion 6499480 8758640 X Schedule D, Part V, Line 4 Nursing Facility Conversion Cash Fund Grant Schedule D, Part X, Line 2 The affiliated entities are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code. All entities have received a determination letter verifying they are exempt from federal income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. The IRS has established standards to be met to maintain tax-exempt status. Tabitha accounts for uncertainties in accounting for income tax assets and liabilites using the guidance included in the Financial Accounting Standards Board (FASB) and Accounting Standards Codification (ASC), Topic 740, Income Taxes. Tabitha recognizes the effect of income tax positions only if those positions are most likely unsustainable. The organization had no uncertain tax positions accrued at December 31, 2018 and 2019. X X X X X 0 0 0 0 0 0 0 0 0 Christina Hinrichs President & CEO 456123 0 0 0 32055 0 0 0 0 0 488178 0 0 Heath Stukenholtz Chief Development Officer 0 238610 0 0 0 16054 0 0 0 0 0 254664 0 0 Darcie Brink Vice President - Finance 186798 0 0 0 6729 0 0 0 0 0 193527 0 0 0 Katie Lechner Chief Operating Officer 138676 0 0 0 17795 0 0 0 0 0 156471 0 0 0 Mary Joyce Ebmeier Senior Vice President 137675 0 0 0 16301 0 0 0 0 0 153976 0 0 0 Schedule J, Part I, Line 3 Periodic reviews will be conducted to ensure the Organization operates in a manner consistent with charitable purposes and does not engage in activities that would jeapordize its tax-exempt status. The periodic reviews shall at a minimum include the following subjects: A) Whether the compensation arrangements and benefits are reasonable, based on competent survey information, and are the result of arm's length bargaining. B) Whether partnerships, joint ventures, and arrangements with management organizations conform to the Organization's written policies, are properly recorded, reflect reasonable investment or payment for goods and services, further charitable purposes, and do not result in inurement, impermissable private benefit, or in an excess benefit transaction. Each director, principal officer, and member of a committee with a governing board delegated powers shall annually sign a statement which affirms such person: a) has received a copy of the conflict of interest policy; b) Has read and understands the policy; c) has agreed to comply with the policy; d) understands the Organization is charitable and must engage primarily in activities which accomplish one or more of its tax-exempt purposes to maintain its federal tax exemption. The Organization may use outside advisors when conducting periodic reviews as provided for in Article VII if necessary. If outside experts are used, their use shall not relieve the governing board of its responsibility for ensuring periodic reviews are conducted. A conflict of interest policy is also intended to establish procedures under which individuals who have a conflict of interest will be excused from voting on such matters. All Tabitha Board members shall serve without compensation. Reimbursement for actual costs of meals, mileage, and lodging in the conduct of Tabitha business is allowed. The President of Tabitha shall be responsible for establishing wages, salaries, benefits, and pay increases for all Tabitha employees, subject to Board approval. The Executive Committee of the Tabitha Board shall annually determine the salary, benefit, and severance package for the President/CEO. The President's compensation must meet the Fair Market Value and Comparability Tests for similar positions in not-for-profit organizations. The President shall be evaluated annually by the Board. A Hospital Authority No 1 of Lancaster Cnty NE 470721900 513885CZ4 2011-12-15 1950000 Construct/equip/furnish improvement to existing facilities 0 0 0 B Hospital Authority No 1 of Lancaster Cnty NE 470721900 513885DQ3 2014-06-30 7175000 Refund prior issues (06/30/2009) (9/15/2009) (07/15/2010) 0 0 0 C The County of Saline Nebraska 476006503 79517VAM3 2015-01-28 3155000 Refund of prior issue (01/06/2010) 0 0 0 D Hospital Authority No 1 of Lancaster Cnty NE 470721900 513885ED1 2015-01-28 3100000 Refund of prior issue (07/15/2010) 0 0 0 A 625000 0 1950021 151288 0 0 38713 0 0 1760022 0 0 2012 0 0 1 1 B 1615000 0 7175315 0 0 0 142146 0 0 0 7033170 2011 1 1 1 1 C 1000000 0 3155000 0 0 0 59357 0 0 0 3095643 2010 1 0 1 1 D 305000 0 3100000 0 0 0 46500 0 0 0 3053500 0 2011 0 1 1 1 A 0 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 0 1 D 0 0 0 0 0 0 0 0 0 1 A 0 0 1 1 0 0 0 0 1 B 0 0 1 1 0 0 0 0 1 C 0 0 1 1 0 0 0 0 1 D 0 0 1 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part IV, Line 2c-12/15/2011 1,950,000 Hospital Authority No 1 of Lancaster Cnty NE Date the Rebate Computation was Performed: 11/30/2016. The total proceeds do not agree to the issue price in Part I Column (e) due to investment earnings. Since the bond proceeds have been spent, a spending exception was met, and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary. Schedule K, Part IV, Line 2c-06/30/2014 7,175,000 Hospital Authority No 1 of Lancaster Cnty NE Date the Rebate Computation was Performed: 12/01/2014. The total proceeds do not agree to the issue price in Part I Column (e) due to investment earnings. Since the bond proceeds have been spent, a spending exception was met, and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary. Schedule K, Part IV, Line 2c-01/28/2015 3,155,000 The County of Saline Nebraska Date the Rebate Computation was Performed: 07/28/2015. The total proceeds do not agree to the issue price in Part I Column (e) due to investment earnings. Since the bond proceeds have been spent, a spending exception was met, and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary. Schedule K, Part IV, Line 2c-01/28/2015 3,100,000 Hospital Authority No 1 of Lancaster Cnty NE Date the Rebate Computation was Performed: 07/28/2015. The total proceeds do not agree to the issue price in Part I Column (e) due to investment earnings. Since the bond proceeds have been spent, a spending exception was met, and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary. A The County of Lancaster Nebraska 476006482 513841AQ9 2015-07-23 6060000 Purchase, construct, furnish new facility 0 0 0 A 755000 0 6060387 0 0 0 108250 0 0 5952137 0 0 2016 0 0 1 1 A 0 0 0 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Schedule K, Part IV, Line 2c-07/23/2015 6,060,000 The County of Lancaster Nebraska Date the Rebate Computation was Performed: 06/30/2017. The total proceeds do not agree to the issue price in Part I Column (e) due to investment earnings. Since the bond proceeds have been spent, a spending exception was met, and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary. Form 990, Part V, Line 1c Tabitha, Inc. has complied with the withholding rules for reportable payments. They are filed by January 31st for those receiving more than $600. Form 990, Part VI, Section B, Line 11b The IRS form 990 together with all required schedules for Tabitha, Inc. and Affiliates shall be provided in a paper or electronic format to all members of both Boards. The President shall arrange for the CFO or Vice President of Finance to conduct a review of the 990 for all interested Board members. A copy shall be posted to the President's office and is available upon request. The 990 shall be prepared by the General Accountant and reviewed by the CFO. Form 990, Part VI, Section B, Line 12c Periodic reviews will be conducted to ensure the Organization operates in a manner consistent with charitable purposes and does not engage in activities that would jeapordize its tax-exempt status. The periodic reviews shall at a minimum include the following subjects: A) Whether the compensation arrangements and benefits are reasonable, based on competent survey information, and are the result of arm's length bargaining. B) Whether partnerships, joint ventures, and arrangements with management organizations conform to the Organization's written policies, are properly recorded, reflect reasonable investment or payment for goods and services, further charitable purposes, and do not result in inurement, impermissable private benefit, or in an excess benefit transaction. Each director, principal officer, and member of a committee with a governing board delegated powers shall annually sign a statement which affirms such person: a) has received a copy of the conflict of interest policy; b) Has read and understands the policy; c) has agreed to comply with the policy; d) understands the Organization is charitable and must engage primarily in activities which accomplish one or more of its tax-exempt purposes to maintain its federal tax exemption. The Organization may use outside advisors when conducting periodic reviews as provided for in Article VII if necessary. If outside experts are used, their use shall not relieve the governing board of its responsibility for ensuring periodic reviews are conducted. A conflict of interest policy is also intended to establish procedures under which individuals who have a conflict of interest will be excused from voting on such matters. Form 990, Part VI, Section B, Line 15 All Tabitha Board members shall serve without compensation. Reimbursement for actual costs of meals, mileage, and lodging in the conduct of Tabitha business is allowed. The President of Tabitha shall be responsible for establishing wages, salaries, benefits, and pay increases for all Tabitha employees, subject to Board approval. The Executive Committee of the Tabitha Board shall annually determine the salary, benefit, and severance package for the President/CEO. The President's compensation must meet the Fair Market Value and Comparability Tests for similar positions in not-for-profit organizations. The President shall be evaluated annually by the Board. Form 990, Part VI, Section C, Line 19 The official minutes of the Board and Committee meetings shall be kept in perpetuity. Financial records and patient clinical records shall be retained for seven years by the department generating the documents. Any notice of a pending investigation by any local, state, or federal authority will immediately halt all document destruction throughout the Organization. The policy recognizes that it is a violation of the Sarbanes-Oxley Act to destroy records with the intent to obstruct a federal investigation. Destruction of any records, information, or documents must have prior approval in writing by Tabitha's President or CFO. Form 990, Part XI, Line 9 Proceeds on sale of affiliate Tabitha Village in the amount of $8,087,193 and gifts, grants, and bequests for the purchase of property and equipment in the amount of $199,886. Tabitha Foundation 4720 Randolph Street Lincoln NE 68510 470636199 Fundraising NE 501(c)(3) 9 N/A 0 Tabitha Village 841 South 47th Street Lincoln NE 68510 470529173 Elderly Housing NE 501(c)(3) 9 N/A 0 Tabitha ALF Real Estate Holding Company 4620 Randolph Street Lincoln NE 68510 270241402 Real Estate NE 501(c)(3) 9 N/A 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 Tabitha Foundation c 2364097 Actual Tabitha ALF Real Estate Holding Company k 846159 Actual Tabitha Village q 552357 Actual Tabitha Foundation e 17140000 FMV Tabitha Foundation q 428899 Actual Tabitha ALF Real Estate Holding Company b 65194 Actual Form 8868 filing an extension was mailed on 5/13/2020, but it doesn't appear the IRS received it. I will be mailing in our 8868 with copies of the certified mail receipts to verify it was sent in.