PENDLETON MANOR INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PENDLETON MANOR INC (EIN 55-0547603)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-07-25
- IRS object ID
- 201732069349300523
- 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 | 2017-07-25T10:50:39-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 540504608 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROWN EDWARDS & COMPANY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 124 NEWMAN AVENUE | AddressLine1Txt |
| City | HARRISONBURG | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22801 | 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 | 550547603 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENDLETON MANOR INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEND | BusinessNameControlTxt |
| Phone | 3043582320 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 700 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26807 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GREG BOWERS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3043582320 | PhoneNum |
| Signature | 2017-07-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JAMES R FRIES | PreparerPersonNm |
| PTIN | P01320612 | PTIN |
| Phone | 5404346736 | PhoneNum |
| Preparation | 2017-07-20 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 206.248.228.130 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-07-20 | IPDt |
| IP Tm | 15:56:13 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EF1C1A0CA49DBA0E0B0319B7F92942CEFA511A8D | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 6C2E7FE575F144BDACDAF9C1D644CFEFE9CD29DA | 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) |
|---|---|---|
| Principal Officer | GREG BOWERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 700 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26807 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,681,981 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GOOD-SAM.COM/LOCATIONS/PENDLETON-MANOR | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS TO SHARE GOD'S WORD IN LOVE AND DEED BY PROVIDING SHELTER AND SUPPORTIVE SERVICES TO OLDER PERSONS AND OTHERS IN NEED BELIEVING THAT IN CHRIST'S LOVE, EVERYONE IS SOMEONE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 175 | TotalEmployeeCnt |
| Total Volunteers | 214 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $57,620 | PYContributionsGrantsAmt |
| CY Contributions Grants | $53,193 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,863,671 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,627,974 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,869 | PYInvestmentIncomeAmt |
| CY Investment Income | $175 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $8,923,160 | PYTotalRevenueAmt |
| CY Total Revenue | $8,681,342 | 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 | $4,540,089 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,845,155 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,344 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,545,328 | PYOtherExpensesAmt |
| CY Other Expenses | $3,383,610 | CYOtherExpensesAmt |
| PY Total Expenses | $8,085,417 | PYTotalExpensesAmt |
| CY Total Expenses | $8,228,765 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $837,743 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $452,577 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,180,182 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,489,925 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $479,017 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $780,747 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,701,165 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,709,178 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR MISSION IS TO BUILD A STRONGER COMMUNITY BY IMPROVING AND ENRICHING THE LIVES OF THOSE WHO HAVE EXCEPTIONAL PHYSICAL, DEVELOPMENTAL OR FINANCIAL CHALLENGES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,795,976 | ExpenseAmt |
| Revenue | $8,627,974 | RevenueAmt |
| Desc | PROVIDE INTERMEDIATE AND SKILLED CARE NURSING SERVICES FOR ELDERLY PATIENTS; 91 BEDS AVAILABLE, 31,564 PATIENT DAYS PROVIDED. PROVIDING HOME HEALTH AND OUTPATIENT THERAPY SERVICES FOR THE COMMUNITY. | Desc |
| Total Program Service Expenses | $6,795,976 | 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 | 0 | TempOrPermanentEndowmentsInd |
| 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 | 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 | 0 | 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 | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 175 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | 0 | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARILYNN WAGGY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3043582320 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 700 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26807 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| GREG BOWERS | ||||||
| PRESIDENT | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| WENDY SUESS | ||||||
| VICE PRESIDENT | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARSHALL HARPER | ||||||
| TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JUDY RADER | ||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KENNETH HARPER | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| LYNN VANDEVANDER | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| BYRON BLAND | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| DYER ANDERSON | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| DAVID O'BOYLE | ||||||
| ADMINISTRATOR | 40.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | 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 |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AEGIS THERAPIES INC | |||||
| PO BOX 8103 | FT SMITH | AR | 72902 | THERAPY PROVIDER | $815,348 |
| EVANGELICAL LUTHERAN GOOD SAMARITAN SOCI | |||||
| 4800 W 57 ST | SIOUX FALLS | SD | 57108 | MANAGEMENT SERVICES | $413,319 |
| OMNICARE EVERGREEN PHARMACY | |||||
| 6990B SNOWDRIFT RD | ALLENTOWN | PA | 18106 | PHARMACY PROVIDER | $108,666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $53,193 | AllOtherContributionsAmt |
| Total Contributions | $53,193 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 623000 | $7,420,516 | $7,420,516 |
| ANCILLARY SERVICES | 623000 | $663,908 | $663,908 |
| SPECIAL CARE SERVICES | 623000 | $483,161 | $483,161 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60,389 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,389 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,627,974 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $814 | TotalRevenueColumnAmt |
| Exclusion | $814 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $639 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$639 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$639 | TotalRevenueColumnAmt |
| Exclusion | -$639 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,681,342 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,627,974 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $175 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,923,334 | TotalAmt |
| Program Services | $3,615,842 | ProgramServicesAmt |
| Management And General | $307,492 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,000 | TotalAmt |
| Program Services | $115,860 | ProgramServicesAmt |
| Management And General | $10,140 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,755 | TotalAmt |
| Program Services | $444,397 | ProgramServicesAmt |
| Management And General | $63,358 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,066 | TotalAmt |
| Program Services | $265,402 | ProgramServicesAmt |
| Management And General | $22,664 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $502,177 | TotalAmt |
| Management And General | $502,177 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,822 | TotalAmt |
| Management And General | $10,822 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,693 | TotalAmt |
| Management And General | $56,693 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,058,651 | TotalAmt |
| Program Services | $933,678 | ProgramServicesAmt |
| Management And General | $124,973 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,925 | TotalAmt |
| Management And General | $14,600 | ManagementAndGeneralAmt |
| Fundraising | $1,325 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,829 | TotalAmt |
| Management And General | $38,829 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $452,819 | TotalAmt |
| Program Services | $452,819 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,917 | TotalAmt |
| Program Services | $2,602 | ProgramServicesAmt |
| Management And General | $14,315 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,636 | TotalAmt |
| Program Services | $92,636 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,481 | TotalAmt |
| Management And General | $123,481 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $692,821 | $679,220 | $13,601 |
| EQUIPMENT RENTAL & MAIN | $112,616 | $88,541 | $24,075 |
| SERVICE CENTER SERVICES | $57,608 | $57,608 | |
| STAFF DEVELOPMENT | $40,716 | $17,203 | $23,513 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,899 | TotalAmt |
| Program Services | $87,776 | ProgramServicesAmt |
| Management And General | $23,104 | ManagementAndGeneralAmt |
| Fundraising | $19 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,228,765 | TotalAmt |
| Program Services | $6,795,976 | ProgramServicesAmt |
| Management And General | $1,431,445 | ManagementAndGeneralAmt |
| Fundraising | $1,344 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100 | BOYAmt |
| EOY | $100 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $674,076 | BOYAmt |
| EOY | $630,184 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $998,306 | BOYAmt |
| EOY | $1,329,204 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,577 | BOYAmt |
| EOY | $34,955 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,863 | BOYAmt |
| EOY | $36,134 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,493,677 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,046,878 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $457,109 | BOYAmt |
| EOY | $446,799 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,151 | BOYAmt |
| EOY | $12,549 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,180,182 | BOYAmt |
| EOY | $2,489,925 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $472,220 | BOYAmt |
| EOY | $774,155 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,797 | BOYAmt |
| EOY | $6,592 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $479,017 | BOYAmt |
| EOY | $780,747 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,555,441 | BOYAmt |
| EOY | $1,696,562 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,724 | BOYAmt |
| EOY | $12,616 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,701,165 | BOYAmt |
| EOY | $1,709,178 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,180,182 | BOYAmt |
| EOY | $2,489,925 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $452,577 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$444,564 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| 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 | $45,186 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $69,220 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $73,166 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $57,620 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,194 | CurrentTaxYearAmt |
| Total | $298,386 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,516,959 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,509,169 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,656,028 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,810,266 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,567,585 | CurrentTaxYearAmt |
| Total | $43,060,007 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $52,462 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $43,015 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,902 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $53,405 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $60,389 | CurrentTaxYearAmt |
| Total | $261,173 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,614,607 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,621,404 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,781,096 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,921,291 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,681,168 | CurrentTaxYearAmt |
| Total | $43,619,566 | 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 | $43,619,566 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,517 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $718 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,328 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $814 | CurrentTaxYearAmt |
| Total | $6,071 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,517 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $718 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,328 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $814 | CurrentTaxYearAmt |
| Total | $6,071 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,615,301 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,622,921 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,781,814 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,923,619 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,681,982 | CurrentTaxYearAmt |
| Total | $43,625,637 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99990 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99990 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00010 | 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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,364,393 | OtherCostOrOtherBasisAmt |
| Depreciation | $922,366 | DepreciationAmt |
| Book Value | $442,027 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $129,284 | OtherCostOrOtherBasisAmt |
| Depreciation | $124,512 | DepreciationAmt |
| Book Value | $4,772 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $446,799 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RESIDENT TRUST FUNDS | Desc |
| Amt | $6,592 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,592 | TotalLiabilityAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY HAS BEEN HIRED BY PENDLETON MANOR TO PROVIDE MANAGEMENT SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE ADMINISTRATOR AND THE BOARD OF DIRECTORS, AND THE FINANCIAL DATA ARE VERIFIED BY THE ACCOUNTING DEPARTMENT AND MANAGEMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT-OF-INTEREST POLICY IS REVIEWED PERIODICALLY BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE WAGE FOR THE ADMINISTRATOR IS SET BY THE MANAGING AGENCY - EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. |
| FORM 990, PART VI, SECTION C, LINE 19 | ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 933,678. MANAGEMENT AND GENERAL EXPENSES 124,973. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,058,651. |
| FORM 990, PART XI, LINE 9: | TRANSFER TO PENDLETON VILLAGE, INC. 55,436. TRANSFER FROM THE PENDLETON, INC. -500,000. ROUNDING |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PENDLETON APARTMENTS INC | |||||||||||
| PO BOX 700 | FRANKLIN | WV | 26807 | 311130225 | TO PROVIDE HOUSING TO ELDERLY PERSONS | WV | 501(C)(3) | LINE 10 | PENDLETON VILLAGE INC | 0 | |
| PENDLETON VILLAGE INC | |||||||||||
| PO BOX 700 | FRANKLIN | WV | 26807 | 261339734 | ACT AS MANAGEMENT COMPANY FOR THE OTHER ENTITIES | WV | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| THE PENDLETON INC | |||||||||||
| PO BOX 700 | FRANKLIN | WV | 26807 | 261339779 | REAL ESTATE AND EQUIPMENT HOLDING COMPANY FOR RELATED ORGANIZATIONS. | WV | 501(C)(2) | PENDLETON VILLAGE INC | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PENDLETON INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $213,397 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |