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Fairmount Long Term Care: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
Fairmount Long Term Care (EIN 23-2746587)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-04-21
IRS object ID
201411119349300511
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)
Timestamp2014-04-21T09:01:12-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN232746587EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Fairmount Long Term CareBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFAIRNameControl
Phone2156850800Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12100 W Girard AvenueAddressLine1
CityPhiladelphiaCity
StatePAState
ZIP Code19130ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJames T ScannapiecoName
TitleAssoc Admin, FinanceTitle
Date Signed2014-04-21DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonHerbert LongNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12100 W Girard AvenueAddressLine1
CityPhiladelphiaCity
StatePAState
ZIP Code19130ZIPCode
FieldValueIRS element (for citing)
Gross Receipts35981099GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.fltcpnh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionFairmount Long Term Care (FLTC), operates the Philadelphia Nursing Home on behalf of the City of Philadelphia. FLTC provides nursing home services primarily to indigent residents of Philadelphia. Licensed as a 451-bed long-term care facility, 99.5% of the residents of the nursing home are covered by the Medical Assistance program (Medicaid) or Medicare. In fiscal year 2013 the nursing home provided services to 561 individuals providing 144,244 days of nursing home care. Services that FLTC provides its residents include, daily routine nursing care, physical therapy, speech therapy, occupational therapy, recreational therapy, routine physician services, specialty physician services, and mental health services. Most of the residents at FLTC have very complex psychosocial histories. Many are here with medical problems directly related to substance abuse and/or violence, and many have very little social supports in their lives. The goal is to provide comprehensive care and services to ensurActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees553TotalNbrEmployees
Total Nbr Volunteers3TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3734004ContributionsGrantsPriorYear
Contributions Grants Current Year3508783ContributionsGrantsCurrentYear
Program Service Revenue Prior Year33985568ProgramServiceRevenuePriorYear
Program Service Revenue CY32463407ProgramServiceRevenueCY
Investment Income Prior Year9615InvestmentIncomePriorYear
Investment Income Current Year8909InvestmentIncomeCurrentYear
Other Revenue Prior Year5210OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year37734397TotalRevenuePriorYear
Total Revenue Current Year35981099TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year26582421SalariesEtcPriorYear
Salaries Etc Current Year25738444SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year10744649OtherExpensePriorYear
Other Expenses Current Year10584701OtherExpensesCurrentYear
Total Expenses Prior Year37327070TotalExpensesPriorYear
Total Expenses Current Year36323145TotalExpensesCurrentYear
Revenues Less Expenses Prior Year407327RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-342046RevenuesLessExpensesCY
Total Assets BOY12859526TotalAssetsBOY
Total Assets EOY12438777TotalAssetsEOY
Total Liabilities BOY9665935TotalLiabilitiesBOY
Total Liabilities EOY9587232TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3193591NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2851545NetAssetsOrFundBalancesEOY
Mission DescriptionFairmount Long Term Care (FLTC), operates the Philadelphia Nursing Home on behalf of the City of Philadelphia. FLTC provides nursing home services primarily to indigent residents of Philadelphia. Licensed as a 451-bed long-term care facility, 99.5% of the residents of the nursing home are covered by the Medical Assistance program (Medicaid) or Medicare. In fiscal year 2013 the nursing home provided services to 561 individuals providing 144,244 days of nursing home care. Services that FLTC provides its residents include, daily routine nursing care, physical therapy, speech therapy, occupational therapy, recreational therapy, routine physician services, specialty physician services, and mental health services. Most of the residents at FLTC have very complex psychosocial histories. Many are here with medical problems directly related to substance abuse and/or violence, and many have very little social supports in their lives. The goal is to provide comprehensive care and services to ensurMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense32964944Expense
Revenue32454865Revenue
DescriptionFLTC provided long-term care services to approximately 561 residents during the past year. The total days of care provided were 144,244 days. Government programs subsidized the cost of care for almost all of these days. Only a small portion of the cost for care is paid for by private individuals. Medicaid days total 138,645 - 96.1%Medicare days total 3,936 - 2.7%Gov't subs managed care prog. total 940 - 0.7%Private pay days total 433 - 0.3% Benevolent Care days total 290 - 0.2% --------------Total 144,244Description
Total Program Service Expense32964944TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees553NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJames T ScannapiecoNamePerson
Telephone Number2156850800TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12100 W Girard AvenueAddressLine1
CityPhiladelphiaCity
StatePAState
ZIP Code19130ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Gene Newton MD
Vice Chairman2.000.00XX000
Theodor Burden MD
Trustee2.000.00X000
Arthur Anderson
Treasurer2.000.00XX000
Kathleen Barron
Secretary2.000.00XX000
Herbert Long
Chairman2.000.00XX000
James T Scannapieco
CFO40.000.00X127390014231
Mary K Hess
Executive Direc40.000.00X148924026438
Maria Julia Florescio
Registered Nurse72.000.00169979015236X
Pansey Clarke
Registered Nurse53.000.00151042015198X
Juliana Joseph-Diggs
Registered Nurse67.000.00162907031153X
Annette Carter
Registered Nurse70.000.00166083022386X
Linda Rakoski
Registered Nurse61.000.00145378025679X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1071703TotalReportableCompFromOrg
Total Other Compensation150321TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
US Security Associates Inc
200 Munsel Court 5th FloorRoswellGA30076Security Services440369
Temple University Hospital
3401 N Broad StreetPhiladelphiaPA19140Respiratory Therapy368016
Temple Physicians Inc
2450 W Hunting Park AvenuePhiladelphiaPA19129Physician Services576513
Premier Therapy Services
701 Sharon RoadBeaverPA15009Rehabilitation Serv1058287
Clean Tex Services Inc
1420 20 E Linden AveLinden NJNJ07036Laundry & Linen Serv398240
FieldValueIRS element (for citing)
Number Of Contractors GT100 K13NumberOfContractorsGT100K
Government Grants3508783GovernmentGrants
Total Contributions3508783TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMedicare / Medicaid PaymeDescription
Business Code623000BusinessCode
Total Revenue Column32463407TotalRevenueColumn
Related Or Exempt Function Income32463407RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue32463407TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8909TotalRevenueColumn
Exclusion$8,909ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column35981099TotalRevenueColumn
Related Or Exempt Function Income32463407RelatedOrExemptFunctionIncome
Exclusion$8,909ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total316983Total
Program Services31698ProgramServices
Management And General285285ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19464364Total
Program Services17759547ProgramServices
Management And General1704817ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total499664Total
Program Services496851ProgramServices
Management And General2813ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3758188Total
Program Services3584314ProgramServices
Management And General173874ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1699245Total
Program Services1614512ProgramServices
Management And General84733ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total113900Total
Management And General113900ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total95085Total
Management And General95085ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4723123Total
Program Services4557563ProgramServices
Management And General165560ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total10428Total
Management And General10428ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total92722Total
Program Services53714ProgramServices
Management And General39008ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total356955Total
Program Services5635ProgramServices
Management And General351320ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total808344Total
Program Services791708ProgramServices
Management And General16636ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total31850Total
Program Services648ProgramServices
Management And General31202ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total9526Total
Program Services4102ProgramServices
Management And General5424ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total207605Total
Management And General207605ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Postage and Shipping4757385146722
Equipment, Rental and Maint.74916772603723130
Resident Care Supplies33384233337764659

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total36323145Total
Program Services32964944ProgramServices
Management And General3358201ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY674555BOY
EOY941893EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5110280BOY
EOY4958084EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5777530BOY
EOY5718669EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY160062BOY
EOY159984EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1137099BOY
EOY660147EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY12859526BOY
EOY12438777EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9167930BOY
EOY9065770EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY498005BOY
EOY521462EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9665935BOY
EOY9587232EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3193591BOY
EOY2851545EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3193591BOY
EOY2851545EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12859526BOY
EOY12438777EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-342046ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3500000CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3500000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3500000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3734004CurrentTaxYearMinus1Year
Current Tax Year3508783CurrentTaxYear
Total17742787Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years34239037CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years33741404CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years33545939CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year33985568CurrentTaxYearMinus1Year
Current Tax Year32463407CurrentTaxYear
Total167975355Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3559536CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3666322CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3823770CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3758760CurrentTaxYearMinus1Year
Current Tax Year3861200CurrentTaxYear
Total18669588Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years41298573CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years40907726CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40869709CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year41478332CurrentTaxYearMinus1Year
Current Tax Year39833390CurrentTaxYear
Total204387730Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509204387730PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years38890CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1927CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years37515CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14825CurrentTaxYearMinus1Year
Current Tax Year8909CurrentTaxYear
Total102066Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years38890CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1927CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years37515CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14825CurrentTaxYearMinus1Year
Current Tax Year8909CurrentTaxYear
Total102066Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years41337463CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years40909653CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40907224CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year41493157CurrentTaxYearMinus1Year
Current Tax Year39842299CurrentTaxYear
Total204489796Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99950PublicSupportPercentage509
Prior Year Support Percentage0.99910PriorYearSupportPercentage
Investment Income Percentage0.00050InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00090PriorYrInvestIncomePercentage
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

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Rounding$3
Due to Resident Trust Fund$521,459
FieldValueIRS element (for citing)
Total Of Amounts521462TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Pansey Clarke
Registered Nurse15104259819217166240
Mary K Hess
Executive Direc148924599520443175362
Maria Julia Florescio
Registered Nurse16997967998437185215
Linda Rakoski
Registered Nurse145378581519864171057
Juliana Joseph-Diggs
Registered Nurse162907651624637194060
Annette Carter
Registered Nurse166083664315743188469

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Anne B DeLuca
Sis. of M Hess155311Employmentfalse
Stacy Long
Dau. of H Long44451Employmentfalse
Newton and Burden Assoc
35%+ owned/Trustee70000Independent contractorfalse
Urban Health
35%+ owned/Trustee365500Independent contractorfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTo the extent required by applicable law, the organization makes its governing documents available to the public upon request.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsOfficers,directors, and key employees are required to submit signed conflict of interest disclosure statements annually. Directors, officers, and key employees have an obligation to disclose potential conflicts as matters arise. The Board of Directors evaluates any disclosures and determines whether a conflict of interest exists and how it should be handled. Board Members do not participate in discussions or votes on matters as to which a conflict of interest has been determined to exist.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessThe 990 was prepared by Staff, with drafts submitted to FLTC Treasurer and outside legal counsel for review and comment. A final draft was submitted to the Board for review and approval prior to submission to the IRS.
Form 990, Part VI, Line 2Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtFairmount Long Term Care utilizes the services of Urban Health, Inc. for quality assurance and medical director services for Philadelphia Nursing Home. Principals for Urban Health, Gene Newton, MD and Theodore Burden, MD are also members of Fairmount Long Term Care's Board of Directors.The Board maintains a conflict of interest policy. All transactions are entered into with Board Members are conducted at arms length and are approved by members of the Board of Directors who do not have a conflict.