STRATEGY STUDIO / PUBLIC DATA EXPLORER

COUNTRY CARE CENTER CORPORATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
COUNTRY CARE CENTER CORPORATION (EIN 42-1295331)
Tax period
2016-07-01 to 2017-06-30
Filed
2017-09-13
IRS object ID
201742569349300214
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

FieldValueIRS element (for citing)
Return2017-09-13T07:08:48-07:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Muxfeldt Associates CPA PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12309 B Chatburn AveAddressLine1Txt
CityHarlanCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51537ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421295331EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COUNTRY CARE CENTER CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOUNBusinessNameControlTxt
Phone7127443453PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 351AddressLine1Txt
CityHARLANCityNm
State AbbreviationIAStateAbbreviationCd
ZIP515370351ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAT DAVITTPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7127443453PhoneNum
Signature2017-09-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMUXFELDT ASSOCIATES CPA PCPreparerPersonNm
Phone7127553366PhoneNum
Preparation2017-09-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.120.121.34IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-09-13IPDt
IP Tm07:08:42IPTm
IP TimezonePDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id3A4DC7474C7B6B4330AB52E3BBEC3D569DC4D846AtSubmissionCreationDeviceId
At Submission Filing Device Id8D41A463FE3DA58A3E6BB580CD4C58E64C856421AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPAT DAVITTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1LOCALAddressLine1Txt
CityHARLANCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51537ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,004,182GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionRESIDENTIAL CARE FACILITYActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee36TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$6,000PYContributionsGrantsAmt
CY Contributions Grants$4,600CYContributionsGrantsAmt
PY Program Service Revenue$969,798PYProgramServiceRevenueAmt
CY Program Service Revenue$995,853CYProgramServiceRevenueAmt
PY Investment Income$80PYInvestmentIncomeAmt
CY Investment Income$102CYInvestmentIncomeAmt
PY Other Revenue$4,737PYOtherRevenueAmt
CY Other Revenue$3,627CYOtherRevenueAmt
PY Total Revenue$980,615PYTotalRevenueAmt
CY Total Revenue$1,004,182CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$988,861PYOtherExpensesAmt
CY Other Expenses$961,307CYOtherExpensesAmt
PY Total Expenses$988,861PYTotalExpensesAmt
CY Total Expenses$961,307CYTotalExpensesAmt
PY Revenues Less Expenses-$8,246PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$42,875CYRevenuesLessExpensesAmt
Total Assets BOY$568,133TotalAssetsBOYAmt
Total Assets EOY$593,214TotalAssetsEOYAmt
Total Liabilities BOY$58,183TotalLiabilitiesBOYAmt
Total Liabilities EOY$45,345TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$509,950NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$547,869NetAssetsOrFundBalancesEOYAmt
MissionRESIDENTIAL CARE FACILITYMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$961,307ExpenseAmt
DescRESIDENTIAL CAREDesc
Total Program Service Expenses$961,307TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredfalseScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee36EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COUNTRY CARE CENTER CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7127443453PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 351AddressLine1Txt
CityHARLANCityNm
State AbbreviationIAStateAbbreviationCd
ZIP515370351ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
PAT DAVITT
PRESIDENT AND TREASURER1.00Yes (X)
ROGER DAVIDSON
VICE PRESIDENT1.00Yes (X)
JOYCE RODENBORN
DIRECTOR1.00Yes (X)
LEONA KONZ
DIRECTOR1.00Yes (X)
MARY JOHNSON
SECRETARY1.00Yes (X)
KRIS OLSON-HARMON
DIRECTOR1.00Yes (X)
CALLA POLDBERG
DIRECTOR1.00Yes (X)
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$4,600AllOtherContributionsAmt
Total Contributions$4,600TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRESIDENTIAL CAREDesc
Business999999BusinessCd
Total Revenue Column$995,853TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$995,853TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$102TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,920RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,920RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,920TotalRevenueColumnAmt
Related Or Exempt Func Income$1,920RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISC INCOME999999$1,707$1,707
GAIN ON SALE OF ASSETS999999
FieldValueIRS element (for citing)
Other Revenue Total$1,707OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,004,182TotalRevenueColumnAmt
Related Or Exempt Func Income$999,582RelatedOrExemptFuncIncomeAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$31,620TotalAmt
Program Services$31,620ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
ADMINISTRATIVE EXPENSES$324,988$324,988$0$0
RESIDENT ACTIVITIES$103,999$103,999$0$0
DIETARY EXPENSES$126,959$126,959$0$0
PROPERTY MAINTENANCE$118,739$118,739$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$255,002TotalAmt
Program Services$255,002ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$961,307TotalAmt
Program Services$961,307ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$184,819BOYAmt
EOY$210,593EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$65,913BOYAmt
EOY$68,767EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,498BOYAmt
EOY$3,321EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,068BOYAmt
EOY$3,042EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$733,623LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$426,132LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$308,835BOYAmt
EOY$307,491EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$568,133BOYAmt
EOY$593,214EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$58,183BOYAmt
EOY$45,345EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$58,183BOYAmt
EOY$45,345EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$509,950BOYAmt
EOY$547,869EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$509,950BOYAmt
EOY$547,869EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$568,133BOYAmt
EOY$593,214EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$42,875ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$4,956PriorPeriodAdjustmentsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$41,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,843CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,000CurrentTaxYearMinus1YearAmt
Current Tax Year$4,600CurrentTaxYearAmt
Total$64,443TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$41,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,843CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,000CurrentTaxYearMinus1YearAmt
Current Tax Year$4,600CurrentTaxYearAmt
Total$64,443TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$64,443PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$64,443TotalSupportAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind
Public Support Total509$0PublicSupportTotal509Amt
Public Support CY5090PublicSupportCY509Pct
Investment Income CY0InvestmentIncomeCYPct

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$733,623OtherCostOrOtherBasisAmt
Depreciation$426,132DepreciationAmt
Book Value$307,491BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$307,491TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$1,004,182TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$1,004,182RevenueSubtotalAmt
Total Revenue Per Form990$1,004,182TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$961,307TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$961,307ExpensesSubtotalAmt
Total Expenses Per Form990$961,307TotalExpensesPerForm990Amt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 11bBOARD OF DIRECTORS
Form 990EZ, Part II, Line 24Accounts Receivable - Net
Form 990EZ, Part II, Line 24Other Receivables
Form 990EZ, Part II, Line 24Inventories
Form 990EZ, Part II, Line 24Prepaids
Form 990EZ, Part II, Line 24Investments
Form 990EZ, Part II, Line 26Accounts Payable & Accrued Expenses
Form 990, Part IX, Line 24eRESIDENT CARE 208320. 208320. 0. 0.
Form 990, Part IX, Line 24eUTILITIES 46682. 46682. 0. 0.