STRATEGY STUDIO / PUBLIC DATA EXPLORER

COUNTRY CARE CENTER CORPORATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
COUNTRY CARE CENTER CORPORATION (EIN 42-1295331)
Tax period
2015-07-01 to 2016-06-30
Filed
2016-09-28
IRS object ID
201642729349300644
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-09-28T12:10:20-07:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

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 Begin2015-07-01TaxPeriodBeginDt

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
Signature2016-09-28SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMUXFELDT ASSOCIATES CPA PCPreparerPersonNm
Phone7127553366PhoneNum
Preparation2016-09-28PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

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$980,615GrossReceiptsAmt
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 Employee25TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$3,000PYContributionsGrantsAmt
CY Contributions Grants$6,000CYContributionsGrantsAmt
PY Program Service Revenue$1,028,429PYProgramServiceRevenueAmt
CY Program Service Revenue$969,798CYProgramServiceRevenueAmt
PY Investment Income$70PYInvestmentIncomeAmt
CY Investment Income$80CYInvestmentIncomeAmt
PY Other Revenue$21,928PYOtherRevenueAmt
CY Other Revenue$4,737CYOtherRevenueAmt
PY Total Revenue$1,053,427PYTotalRevenueAmt
CY Total Revenue$980,615CYTotalRevenueAmt
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$987,198PYOtherExpensesAmt
CY Other Expenses$988,861CYOtherExpensesAmt
PY Total Expenses$987,198PYTotalExpensesAmt
CY Total Expenses$988,861CYTotalExpensesAmt
PY Revenues Less Expenses$66,229PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$8,246CYRevenuesLessExpensesAmt
Total Assets BOY$627,795TotalAssetsBOYAmt
Total Assets EOY$568,133TotalAssetsEOYAmt
Total Liabilities BOY$91,626TotalLiabilitiesBOYAmt
Total Liabilities EOY$58,183TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$536,169NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$509,950NetAssetsOrFundBalancesEOYAmt
MissionRESIDENTIAL CARE FACILITYMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$988,861ExpenseAmt
DescRESIDENTIAL CAREDesc
Total Program Service Expenses$988,861TotalProgramServiceExpensesAmt
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 Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee25EmployeeCnt
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)
DAVE SWINTON
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$6,000AllOtherContributionsAmt
Total Contributions$6,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRESIDENTIAL CAREDesc
Business999999BusinessCd
Total Revenue Column$969,798TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$969,798TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$80TotalRevenueColumnAmt

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$2,817$2,817
GAIN ON SALE OF ASSETS999999
FieldValueIRS element (for citing)
Other Revenue Total$2,817OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$980,615TotalRevenueColumnAmt
Related Or Exempt Func Income$974,615RelatedOrExemptFuncIncomeAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$32,662TotalAmt
Program Services$32,662ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
ADMINISTRATIVE EXPENSES$348,076$348,076$0$0
RESIDENT ACTIVITIES$96,622$96,622$0$0
DIETARY EXPENSES$129,268$129,268$0$0
PROPERTY MAINTENANCE$128,106$128,106$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$254,127TotalAmt
Program Services$254,127ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$988,861TotalAmt
Program Services$988,861ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$249,052BOYAmt
EOY$184,819EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$80,056BOYAmt
EOY$65,913EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,742BOYAmt
EOY$3,498EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$7,101BOYAmt
EOY$5,068EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$703,348LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$394,513LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$286,844BOYAmt
EOY$308,835EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$627,795BOYAmt
EOY$568,133EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$91,626BOYAmt
EOY$58,183EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$91,626BOYAmt
EOY$58,183EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$536,169BOYAmt
EOY$509,950EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$536,169BOYAmt
EOY$509,950EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$627,795BOYAmt
EOY$568,133EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$8,246ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$17,973PriorPeriodAdjustmentsAmt
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 Minus3 Years$41,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,843CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,000CurrentTaxYearMinus1YearAmt
Current Tax Year$6,000CurrentTaxYearAmt
Total$59,843TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$41,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,843CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,000CurrentTaxYearMinus1YearAmt
Current Tax Year$6,000CurrentTaxYearAmt
Total$59,843TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$59,843PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$59,843TotalSupportAmt
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$703,348OtherCostOrOtherBasisAmt
Depreciation$394,513DepreciationAmt
Book Value$308,835BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$308,835TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$980,615TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$980,615RevenueSubtotalAmt
Total Revenue Per Form990$980,615TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$988,861TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$988,861ExpensesSubtotalAmt
Total Expenses Per Form990$988,861TotalExpensesPerForm990Amt

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 206558. 206558. 0. 0.
Form 990, Part IX, Line 24eUTILITIES 47569. 47569. 0. 0.