SAMARITAN HEALTH & LIVING CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SAMARITAN HEALTH & LIVING CENTER INC (EIN 35-1288674)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-09-29
- IRS object ID
- 201702729349301100
- Schema version
- 2016v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-09-29T13:07:15-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 99 | AddressLine1Txt |
| City | ELKHART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 465150099 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351288674 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMARITAN HEALTH & LIVING CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMA | BusinessNameControlTxt |
| Phone | 5742623597 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 WEST HIGH STREET | AddressLine1Txt |
| City | ELKHART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46516 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RANDAL J RHOADE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5742623597 | PhoneNum |
| Signature | 2017-09-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ERIKA ENGLER | PreparerPersonNm |
| PTIN | P01379489 | PTIN |
| Phone | 5745220410 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.171.130.186 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-09-18 | IPDt |
| IP Tm | 12:29:37 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0E7F707857290DE5701119E3E094DACDBBE1B63C | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 0F3AA4A7BAC2059577889FBE5C1A7D3E2BF71AF4 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | RANDAL J RHOADE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 WEST HIGH STREET | AddressLine1Txt |
| City | ELKHART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46516 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,058,572 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | WE PROVIDE PSYCHOTHERAPY, PASTORAL COUNSELING, CONSULTATION, AND EDUCATION WITH A "WHOLE PERSON-MIND, BODY AND SPIRIT" EMPHASIS, WITH THE GOAL OF OFFERING HEALING, HOPE AND GROWTH. OUR MISSION IS TO SHARE THE LOVE OF GOD BY HELPING PEOPLE UNDER STRESS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 12 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $418,086 | PYContributionsGrantsAmt |
| CY Contributions Grants | $708,787 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $286,379 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $331,526 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,530 | PYInvestmentIncomeAmt |
| CY Investment Income | $18,259 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$43,407 | PYOtherRevenueAmt |
| CY Other Revenue | -$41,718 | CYOtherRevenueAmt |
| PY Total Revenue | $669,588 | PYTotalRevenueAmt |
| CY Total Revenue | $1,016,854 | 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 | $324,678 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $347,866 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $19,143 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $93,166 | PYOtherExpensesAmt |
| CY Other Expenses | $119,159 | CYOtherExpensesAmt |
| PY Total Expenses | $417,844 | PYTotalExpensesAmt |
| CY Total Expenses | $467,025 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $251,744 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $549,829 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $594,951 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,144,780 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $594,951 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,144,780 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE PROVIDE PSYCHOTHERAPY, PASTORAL COUNSELING, CONSULTATION, AND EDUCATION WITH A "WHOLE PERSON-MIND,BODY, AND SPIRIT" EMPHASIS, WITH THE GOAL OF OFFERING HEALNG, HOPE AND GROWTH. OUR MISSION IS TO SHARE THE LOVE OF GOD BY HELPING PEOPLE UNDER STRESS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $401,228 | ExpenseAmt |
| Revenue | $331,526 | RevenueAmt |
| Desc | PSYCHOTHERAPY, PASTORAL COUNSELING AND CONSULTATION | Desc |
| Total Program Service Expenses | $401,228 | 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 | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 12 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 12 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDAL J RHOADE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5742623597 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 WEST HIGH STREET | AddressLine1Txt |
| City | ELKHART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46516 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| BRIAN HOUSAND | ||||||
| BOARD MEMBER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| FRANK LUCCHESE | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JULIE APP BREITLING DOD 1316 | ||||||
| SECRETARY | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARY JO SARTORIUS | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GINNY RUSSELL | ||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LINDA BURNS | ||||||
| BOARD MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| CHUCK WILLOUR | ||||||
| BOARD MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| KATIE MCCORMICK | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MEGHAN WENGER | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KAREN SMITH | ||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |
| TIM KOCH | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MICHELLE THOMAS | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JENNIFER COLLINS | ||||||
| SECRETARY | 3.00 | Yes (X) | $0 | $0 | $0 | |
| ANN CHRIS NILSEN | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JESSICA BOND | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LAURA EZZELL | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DEB HALL | ||||||
| BOARD MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL TERLEP | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOAN VIDIC | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ALANA WOODWORTH | ||||||
| BOARD MEMBER | 0.10 | Yes (X) | $0 | $0 | $0 | |
| RANDAL RHOADE | ||||||
| CEO | 20.00 | Yes (X) | $44,200 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $44,200 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $275,935 | FundraisingAmt |
| All Other Contributions | $432,852 | AllOtherContributionsAmt |
| Total Contributions | $708,787 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROFESSIONAL FEES | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $331,526 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $331,526 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $331,526 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,259 | TotalRevenueColumnAmt |
| Exclusion | $18,259 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $275,935 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $41,718 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$41,718 | TotalRevenueColumnAmt |
| Exclusion | -$41,718 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,016,854 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $331,526 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$23,459 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,200 | TotalAmt |
| Program Services | $10,300 | ProgramServicesAmt |
| Management And General | $24,720 | ManagementAndGeneralAmt |
| Fundraising | $6,180 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,638 | TotalAmt |
| Program Services | $268,810 | ProgramServicesAmt |
| Management And General | $4,485 | ManagementAndGeneralAmt |
| Fundraising | $8,343 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,028 | TotalAmt |
| Program Services | $21,633 | ProgramServicesAmt |
| Management And General | $2,269 | ManagementAndGeneralAmt |
| Fundraising | $1,126 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,500 | TotalAmt |
| Program Services | $29,500 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,211 | TotalAmt |
| Program Services | $11,432 | ProgramServicesAmt |
| Management And General | $2,309 | ManagementAndGeneralAmt |
| Fundraising | $1,470 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,371 | TotalAmt |
| Program Services | $6,328 | ProgramServicesAmt |
| Management And General | $269 | ManagementAndGeneralAmt |
| Fundraising | $774 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,376 | TotalAmt |
| Program Services | $8,300 | ProgramServicesAmt |
| Management And General | $2,076 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,361 | TotalAmt |
| Program Services | $3,288 | ProgramServicesAmt |
| Management And General | $1,073 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,010 | TotalAmt |
| Program Services | $505 | ProgramServicesAmt |
| Management And General | $455 | ManagementAndGeneralAmt |
| Fundraising | $50 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,315 | TotalAmt |
| Program Services | $8,801 | ProgramServicesAmt |
| Management And General | $3,264 | ManagementAndGeneralAmt |
| Fundraising | $250 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| TRAINING EVENT EXPENSE | $18,662 | $18,662 | ||
| DUES & SUBSCRIPTIONS | $9,561 | $5,658 | $3,372 | $531 |
| EDUCATION & DEVELOPMENT | $4,995 | $4,995 | ||
| PAYROLL PROCESSING | $163 | $163 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,634 | TotalAmt |
| Program Services | $2,853 | ProgramServicesAmt |
| Management And General | $2,362 | ManagementAndGeneralAmt |
| Fundraising | $419 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $467,025 | TotalAmt |
| Program Services | $401,228 | ProgramServicesAmt |
| Management And General | $46,654 | ManagementAndGeneralAmt |
| Fundraising | $19,143 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,570 | BOYAmt |
| EOY | $368,335 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $463,765 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,282 | BOYAmt |
| EOY | $463,765 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $227,104 | BOYAmt |
| EOY | $250,507 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,995 | BOYAmt |
| EOY | $62,173 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,951 | BOYAmt |
| EOY | $1,144,780 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,456 | BOYAmt |
| EOY | $929,400 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,500 | BOYAmt |
| EOY | $153,207 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,995 | BOYAmt |
| EOY | $62,173 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,951 | BOYAmt |
| EOY | $1,144,780 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,951 | BOYAmt |
| EOY | $1,144,780 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $549,829 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| 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 | $177,965 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $211,772 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $227,136 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $418,086 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $708,787 | CurrentTaxYearAmt |
| Total | $1,743,746 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $244,002 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $192,771 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $193,040 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $286,379 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $331,526 | CurrentTaxYearAmt |
| Total | $1,247,718 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $421,967 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $404,543 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $420,176 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $704,465 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,040,313 | CurrentTaxYearAmt |
| Total | $2,991,464 | 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 | $2,991,464 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,876 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,125 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,599 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,530 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,259 | CurrentTaxYearAmt |
| Total | $41,389 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,876 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,125 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,599 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,530 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,259 | CurrentTaxYearAmt |
| Total | $41,389 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $424,843 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $409,668 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $426,775 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $712,995 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,058,572 | CurrentTaxYearAmt |
| Total | $3,032,853 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98640 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99000 | PublicSupportPY509Pct |
| Investment Income CY | 0.01360 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01000 | 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 | 0 | AgentTrusteeEtcInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $36,995 | BeginningYearBalanceAmt |
| Contributions | $22,800 | ContributionsAmt |
| Investment Earnings Or Losses | $2,628 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $251 | AdministrativeExpensesAmt |
| End Year Balance | $62,173 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $24,263 | BeginningYearBalanceAmt |
| Contributions | $13,250 | ContributionsAmt |
| Investment Earnings Or Losses | -$451 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $67 | AdministrativeExpensesAmt |
| End Year Balance | $36,995 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,887 | BeginningYearBalanceAmt |
| Contributions | $7,760 | ContributionsAmt |
| Investment Earnings Or Losses | $712 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $96 | AdministrativeExpensesAmt |
| End Year Balance | $24,263 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,463 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,125 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $580 | OtherExpendituresAmt |
| Administrative Expenses | $121 | AdministrativeExpensesAmt |
| End Year Balance | $15,887 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,707 | BeginningYearBalanceAmt |
| Contributions | $1,478 | ContributionsAmt |
| Investment Earnings Or Losses | $1,500 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $222 | AdministrativeExpensesAmt |
| End Year Balance | $14,463 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $463,765 | OtherCostOrOtherBasisAmt |
| Book Value | $463,765 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $463,765 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FUNDS HELD AT ELKHART COUNTY COMMUNITY FOUNDATION | Desc |
| Book Value | $62,173 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $62,173 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ELKHART COMMUNITY FOUNDATION INC. (THE FOUNDATION) HOLDS A FUND NAMED THE SAMARITAN CENTER KINTNER-ROSS FUND (THE FUND). THE PURPOSE OF THE FUND IS TO FURTHER THE CHARITABLE PURPOSES OF THE ORGANIZATION. |
| PART X, LINE 2: | THE PROVISIONS OF FASB ASC TOPIC 740-10 ACCOUNTING FOR INCOME TAXES HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS AND, ACCORDINGLY, NO INTEREST OR PENALTIES WERE INCURRED AS OF DECEMBER 31, 2016. MANAGEMENT BELIEVES IT HAS NO MATERIAL UNCERTAIN TAX POSITIONS OR ANY RELATED PENALTIES AND INTEREST TO DISCLOSE FOR THE YEAR ENDED DECEMBER 31, 2016. THE ORGANIZATION FILES FORM 990 ANNUALLY WITH THE FEDERAL GOVERNMENT AND IS STILL OPEN TO EXAMINATION BY TAXING AUTHORITIES FOR FISCAL YEAR 2013 AND LATER. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | DANCING COMPETITION | Event1Nm |
| Gross Receipts Event1 | $263,610 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $263,610 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $40,498 | OtherDirectExpensesEvent1Amt |
| Event2 | SILENT SAMAITAN LUNCHEON | Event2Nm |
| Gross Receipts Event2 | $12,325 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $12,325 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $1,220 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $275,935 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $275,935 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $41,718 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $41,718 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$41,718 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS EMAILED TO THE EXECUTIVE DIRECTOR FOR DISTRIBUTION TO THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES THEIR CONFLICT OF INTEREST POLICY VIA ANNUAL DISCLOSURE QUESTIONNAIRES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS, DETERMINES COMPENSATION FOR THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES. THE COMPENSATION IS THEN REVIEWED ANNUALLY. MINUTES ARE TAKEN FOR ALL EXECUTIVE COMMITTEE MEETINGS AND COMPARATIVE DATA, INCLUDING THE SAMARITAN INSTITUTE REPORT ON COMPENSATION, ARE USED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D). |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELKHART COUNTY SAMARITAN CENTER FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 WEST HIGH STREET | AddressLine1Txt |
| City | ELKHART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46516 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311164839 | EIN |
| Primary Activities | ENDOWMENT FUND - SUPPORT OF THE SAMARITAN HEALTH AND LIVING CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 509(A)(3), TYPE I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMARITAN HEALTH AND LIVING CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | 0 | 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |