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CANTERBURY HEALTH CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CANTERBURY HEALTH CARE INC (EIN 38-2971898)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-01-21
IRS object ID
201400229349300420
Schema version
2012v2.0
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)
Timestamp2014-01-21T14:32:38-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN382971898EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CANTERBURY HEALTH CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCANTNameControl
Phone2486749292Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15601 HatcheryAddressLine1
CityWaterfordCity
StateMIState
ZIP Code48329ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRochelle RothwellName
TitleExecutive DirectorTitle
Phone2486749292Phone
Date Signed2014-01-21DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRochelle RothwellNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15601 HatcheryAddressLine1
CityWaterfordCity
StateMIState
ZIP Code48329ZIPCode
FieldValueIRS element (for citing)
Gross Receipts19048548GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitecanterburyonthelake.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1991YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTo provide housing, nursing care and related services for senior adults.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees324TotalNbrEmployees
Total Nbr Volunteers200TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year108070ContributionsGrantsPriorYear
Contributions Grants Current Year91750ContributionsGrantsCurrentYear
Program Service Revenue Prior Year18968002ProgramServiceRevenuePriorYear
Program Service Revenue CY18169394ProgramServiceRevenueCY
Investment Income Prior Year-1275058InvestmentIncomePriorYear
Investment Income Current Year745907InvestmentIncomeCurrentYear
Other Revenue Prior Year-3201OtherRevenuePriorYear
Other Revenue Current Year22172OtherRevenueCurrentYear
Total Revenue Prior Year17797813TotalRevenuePriorYear
Total Revenue Current Year19029223TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8060924SalariesEtcPriorYear
Salaries Etc Current Year7807396SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year153370TotalFundrsngExpCurrentYear
Other Expense Prior Year10543759OtherExpensePriorYear
Other Expenses Current Year10596045OtherExpensesCurrentYear
Total Expenses Prior Year18604683TotalExpensesPriorYear
Total Expenses Current Year18403441TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-806870RevenuesLessExpensesPriorYear
Revenues Less Expenses CY625782RevenuesLessExpensesCY
Total Assets BOY23124291TotalAssetsBOY
Total Assets EOY22786694TotalAssetsEOY
Total Liabilities BOY24376875TotalLiabilitiesBOY
Total Liabilities EOY23181154TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1252584NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-394460NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide housing, nursing care and related services for senior adults.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense16974340Expense
Grants0Grants
Revenue0Revenue
DescriptionTo provide housing, nursing care and related services for senior adults.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense16974340TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109648NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees324NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRay EmsleyNamePerson
Telephone Number2486745315TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15601 HatcheryAddressLine1
CityWaterfordCity
StateMIState
ZIP Code48329ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Cheryl Drutchas
Board Member10X000
Jim Gessner
Board Member10X000
Kristine Miller
Board Member10X000
Char Maybee
Board Member10X000
Robert Wollard
Board Member10X000
Nancy Boari
Board Member10X000
Diane Pick
Board Member10X000
Michelle McDonald Carey
Board Member10X000
Shannon Striebich
Board Member10X000
Cindy Maxwell-Phillips
Secretary10000X
Phillip Hough
Treasurer10000X
William Ahlstrom
Board Chair10000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Life Care Services
400 Locust StDes MoinesIA503092334Managment534767
SunDance Rehabilitation
6549 Paysphere CircleChicagoIL60674Rehabilitation Services1303598
Morrison Senior Dining
PO Box 102289AtlantaGA303682289Food Service2357000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events47361FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions44389AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions91750TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Independent Living Revenue623311261011126101110$0
Health Center Revenue62331113618539136185390$0
Assisted Living Revenue623311194074419407440$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue18169394TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column745907TotalRevenueColumn
Related Or Exempt Function Income745907RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Gross Income Fundraising Events18265GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events47361CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses19325FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-1060TotalRevenueColumn
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$1,060ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMiscellaneousDescription
Business Code900099BusinessCode
Total Revenue Column23232TotalRevenueColumn
Related Or Exempt Function Income23232RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue23232TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column19029223TotalRevenueColumn
Related Or Exempt Function Income18938533RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$1,060ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6648897Total
Program Services6399666ProgramServices
Management And General192818ManagementAndGeneral
Fundraising56413Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total31254Total
Program Services30348ProgramServices
Management And General906ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total586716Total
Program Services546659ProgramServices
Management And General17015ManagementAndGeneral
Fundraising23042Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total540529Total
Program Services524854ProgramServices
Management And General11668ManagementAndGeneral
Fundraising4007Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total637876Total
Management And General637876ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total19973Total
Management And General19973ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total56750Total
Management And General56750ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total166520Total
Program Services114899ProgramServices
Management And General51621ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total201969Total
Management And General132165ManagementAndGeneral
Fundraising69804Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total97896Total
Management And General97792ManagementAndGeneral
Fundraising104Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total116958Total
Program Services78362ProgramServices
Management And General38596ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6486055Total
Program Services6486055ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total33684Total
Program Services22568ProgramServices
Management And General11116ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total20422Total
Program Services13683ProgramServices
Management And General6739ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1124714Total
Program Services1124714ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1246768Total
Program Services1246768ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total169170Total
Program Services169170ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Dues & Licenses6956968873696
Bad Debts14313414313400
Board Expenses4587458700

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18403441Total
Program Services16974340ProgramServices
Management And General1275731ManagementAndGeneral
Fundraising153370Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4811007BOY
EOY5423539EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2829233BOY
EOY2837929EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY50405BOY
EOY45585EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1315047BOY
EOY1235761EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY285457BOY
EOY298073EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis32207017LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21005113LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY12162429BOY
EOY11201904EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1428794BOY
EOY1505610EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY241919BOY
EOY238293EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY23124291BOY
EOY22786694EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3674870BOY
EOY2933567EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY20130000BOY
EOY19700000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY572005BOY
EOY547587EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY24376875BOY
EOY23181154EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-1252584BOY
EOY-626802EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY232342EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1252584BOY
EOY-394460EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23124291BOY
EOY22786694EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses625782ReconcilationRevenueExpenses
Reconciliation Unrealized Invest0ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes232342ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years51067CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years236617CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years118113CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year118440CurrentTaxYearMinus1Year
Current Tax Year91750CurrentTaxYear
Total615987Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17289337CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17893757CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19271584CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year18972895CurrentTaxYearMinus1Year
Current Tax Year18191566CurrentTaxYear
Total91619139Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17340404CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18130374CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19389697CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19091335CurrentTaxYearMinus1Year
Current Tax Year18283316CurrentTaxYear
Total92235126Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year0CurrentTaxYear
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year0CurrentTaxYear
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total
FieldValueIRS element (for citing)
Public Support Total50992235126PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years67619CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years47070CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years36279CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year118135CurrentTaxYearMinus1Year
Current Tax Year10757CurrentTaxYear
Total279860Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year0CurrentTaxYear
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years67619CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years47070CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years36279CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year118135CurrentTaxYearMinus1Year
Current Tax Year10757CurrentTaxYear
Total279860Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year0CurrentTaxYear
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17408023CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18177444CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19425976CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19209470CurrentTaxYearMinus1Year
Current Tax Year18294073CurrentTaxYear
Total92514986Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99697PublicSupportPercentage509
Prior Year Support Percentage0.99607PriorYearSupportPercentage
Investment Income Percentage0.00303InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00393PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1420575InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value1420575BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis25865749InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation17075958Depreciation
Book Value8789791BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis4920693InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation3929155Depreciation
Book Value991538BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings11201904TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

FieldValueIRS element (for citing)
Book Value0BookValue

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value0BookValue

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Debt Service Reserve723788C
Refundable Deposits665504C
Miscellaneous Investments116318F
FieldValueIRS element (for citing)
Total Of Book Value Securities1505610TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Resident Deposits$543,352
Refunds In Process$4,235
FieldValueIRS element (for citing)
Total Of Amounts547587TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt18353966TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal18353966RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included675257OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt675257RevenueNotRptdOnFinStmt
Total Revenue Per Form99019029223TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16031959TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal16031959ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included2371482OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2371482ExpensesNotRptdOnFinStmt
Total Expenses Per Form99018403441TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P10_S00_L02Schedule D, Part X, Line 2Private paying residents are required to pay a deposit before moving into the facility.
SchD_P11_S00_L04bSchedule D, Part XI, Line 4bTotal operating revenue per the audited financial statements does not include the unrealized gain in the fair value of interest rate swap, as well as unrealized losses on investments and realized loss on disposal of assets.
SchD_P12_S00_L04bSchedule D, Part XII, Line 4bAudited financial statements show interest and depreciation as non operating expenses.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GalaNameOfEvent1
Gross Receipts Event121147GrossReceiptsEvent1
Charitable Contributions Event112581CharitableContributionsEvent1
Gross Revenue Event18566GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event10NonCashPrizesEvent1
Rent Facility Costs Event10RentFacilityCostsEvent1
Food And Beverage Event1455FoodAndBeverageEvent1
Entertainment Event13221EntertainmentEvent1
Other Direct Expenses Event115649OtherDirectExpensesEvent1
Name Of Event2Golf OutingNameOfEvent2
Gross Receipts Event220509GrossReceiptsEvent2
Charitable Contributions Event210810CharitableContributionsEvent2
Gross Revenue Event29699GrossRevenueEvent2
Cash Prizes Event20CashPrizesEvent2
Non Cash Prizes Event20NonCashPrizesEvent2
Rent Facility Costs Event26678RentFacilityCostsEvent2
Food And Beverage Event20FoodAndBeverageEvent2
Entertainment Event20EntertainmentEvent2
Other Direct Expenses Event23765OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events5705GrossReceiptsOtherEvents
Charitable Contrib Other Events5705CharitableContribOtherEvents
Gross Revenue Other Events0GrossRevenueOtherEvents
Cash Prizes Other Events0CashPrizesOtherEvents
Non Cash Prizes Other Events0NonCashPrizesOtherEvents
Rent Facility Costs Other Events0RentFacilityCostsOtherEvents
Food And Beverage Other Events0FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Other Direct Expenses Other Events1249OtherDirectExpensesOtherEvents
Gross Receipts Total47361GrossReceiptsTotal
Charitable Contributions Total29096CharitableContributionsTotal
Gross Revenue Total Events18265GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events0NonCashPrizesTotalEvents
Rent Facility Costs Total Events6678RentFacilityCostsTotalEvents
Food And Beverage Total Events455FoodAndBeverageTotalEvents
Entertainment Total Events3221EntertainmentTotalEvents
Other Direct Expenses Total Events20663OtherDirectExpensesTotalEvents
Direct Expense Summary Events31017DirectExpenseSummaryEvents
Net Income Summary-12752NetIncomeSummary

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Economic Development Corporation Of The Charter Township Of WaterfordBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN386007299IssuerEIN
Date Issued2009-09-10DateIssued
Issue Price21295000IssuePrice
Description Of PurposeRefund Series 2005 Bonds and pay costs of issuanceDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds22000000TotalProceeds
Amount In Reserve Fund723827AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds360490IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion1994YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0PercentageOfPrvtBusinessReUBI
Total Private Business Use0TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test1BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L03Form 990, Part VI, Section A, Line 3The organization has contracted with Life Care Services, Inc. to manage the business.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bA completed Form 990 is given to the Finance Committee of the Board of Directors for detailed review before filing. After their review, their findings are presented to the full Board, where a motion to accept the Form 990 as prepared is made and moved. From that point the return is filed with the IRS.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cA Director's Duties Statement and Acknowledgment is presented to each Board Member every January that reviews the conflict of interest policy, requires disclosures and duties expected of a Board Member, and is required to be signed.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15The Executive Director and Administrator positions are filled by employees of the management services company that is under contract to manage the business. The contract is reviewed and approved by the Board of Directors.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19All the required documents are available for inspection on site upon request.
F990_P11_S00_L09Form 990, Part XI, Line 9Temporarily Restricted Net Asset category was created during the fiscal year.