GOOD SAMARITAN HOME OF QUINCY: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN HOME OF QUINCY (EIN 37-0724112)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-02-12
- IRS object ID
- 201300439349301220
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-02-12T13:15:46-06:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208896204 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dennis G Koch CPA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1007 | AddressLine1 |
| City | Quincy | City |
| State | IL | State |
| ZIP Code | 623061007 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370724112 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Samaritan Home of Quincy | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GOOD | NameControl |
| Phone | 2172238717 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2130 Harrison Street | AddressLine1 |
| City | Quincy | City |
| State | IL | State |
| ZIP Code | 62301 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael Duffy | Name |
| Title | Administrator | Title |
| Phone | 2172228471 | Phone |
| Date Signed | 2013-02-02 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dennis G Koch | Name |
| PTIN | P01210686 | PTIN |
| Phone | 2172248484 | Phone |
| Date Prepared | 2013-02-02 | DatePrepared |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Michael Duffy | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3831 Newcastle Dr | AddressLine1 |
| City | Quincy | City |
| State | IL | State |
| ZIP Code | 62301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 19442102 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.gshq.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1953 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | To maintain a home for the care of the aged, without regard to poverty or riches of residents. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 20 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 20 | NbrIndependentVotingMembers |
| Total Nbr Employees | 458 | TotalNbrEmployees |
| Total Nbr Volunteers | 300 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 434410 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 985260 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14334868 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 14689533 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 23383 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3519081 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 205025 | OtherRevenuePriorYear |
| Other Revenue Current Year | 248228 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14997686 | TotalRevenuePriorYear |
| Total Revenue Current Year | 19442102 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10001666 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10724222 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 6366 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 77378 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5883355 | OtherExpensePriorYear |
| Other Expenses Current Year | 6951875 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15891387 | TotalExpensesPriorYear |
| Total Expenses Current Year | 17676097 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -893701 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1766005 | RevenuesLessExpensesCY |
| Total Assets BOY | 55872538 | TotalAssetsBOY |
| Total Assets EOY | 59920276 | TotalAssetsEOY |
| Total Liabilities BOY | 14125594 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16407327 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 41746944 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 43512949 | NetAssetsOrFundBalancesEOY |
| Mission Description | To establish, support and maintain a home and related facilities for the care of the aged, without regard to poverty or riches of residents. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 15997290 | Expense |
| Revenue | 18456842 | Revenue |
| Description | Nursing, therapy, home care and apartments for the elderly. | Description |
| Total Program Service Expense | 15997290 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 458 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 20 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 20 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Good Samaritan Home of Quincy | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2172238717 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2130 Harrison Street | AddressLine1 |
| City | Quincy | City |
| State | IL | State |
| ZIP Code | 62301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Robert Johnson | ||||||
| President | 10.00 | X | X | 0 | 0 | 0 |
| Gena Awerkamp | ||||||
| 1st Vice President | 5.00 | X | X | 0 | 0 | 0 |
| William Winn | ||||||
| 2nd Vice President | 5.00 | X | X | 0 | 0 | 0 |
| Laura Ehrhart | ||||||
| 3rd Vice President | 5.00 | X | X | 0 | 0 | 0 |
| Carla Derrick | ||||||
| Secretary/Treasurer | 5.00 | X | X | 0 | 0 | 0 |
| Daron Duke | ||||||
| Im Past President | 5.00 | X | X | 0 | 0 | 0 |
| Mike Bickhaus | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Robert Venvertloh | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Paula Reinhardt | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Billie Menke | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Ray Scheiter | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Paul Kemner | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Charles Scholz | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Jerry Jackson | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Larry Shepard | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Richard Walz | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Michael Oberdahlhoff | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Janet Schneeberger | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| John Heidbreder | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Robert Young | ||||||
| Director | 5.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Maas Construction | |||||
| 3615 At Anthony Rd | Quincy | IL | 62305 | Construction Services | 3541287 |
| Kohl Wholesale | |||||
| 130 Jersey St Quincy IL 62301 | Quincy | IL | 62301 | Cafeteria Food | 838031 |
| First Choice Physical Therapy | |||||
| 5 W State 8th Plaza | Quincy | IL | 62305 | Physical Therapy | 408111 |
| CPI Qualified Plan Consultants | |||||
| PO Box 167 Great Bend KS 67530 | Quincy | IL | 62305 | Thrid Party Administration | 391203 |
| Wachovia Securities | |||||
| 510 Maine St 9th Fl | Quincy | IL | 62301 | Investment Services | 227289 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| All Other Contributions | 985260 | AllOtherContributions |
| Total Contributions | 985260 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Room Care | 623000 | 7454685 | 7454685 |
| Medicaid | 623000 | 3124130 | 3124130 |
| Medicare | 623000 | 2440981 | 2440981 |
| Cottage Rentals | 623000 | 1669737 | 1669737 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 14689533 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3519081 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3519081 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Barber/Beauty/Gift Sho | 623000 | 103374 | 103374 |
| Guest Meals/Rooms | 623000 | 84247 | 84247 |
| Miscellaneous | 623000 | 60607 | 60607 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 248228 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19442102 | TotalRevenueColumn |
| Related Or Exempt Function Income | 18456842 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8419065 | Total |
| Program Services | 7653985 | ProgramServices |
| Management And General | 703603 | ManagementAndGeneral |
| Fundraising | 61477 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255833 | Total |
| Program Services | 232584 | ProgramServices |
| Management And General | 20806 | ManagementAndGeneral |
| Fundraising | 2443 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1449939 | Total |
| Program Services | 1318176 | ProgramServices |
| Management And General | 123467 | ManagementAndGeneral |
| Fundraising | 8296 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 599385 | Total |
| Program Services | 549292 | ProgramServices |
| Management And General | 45390 | ManagementAndGeneral |
| Fundraising | 4703 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33260 | Total |
| Management And General | 33260 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26579 | Total |
| Management And General | 26579 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 227289 | Total |
| Management And General | 227289 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28885 | Total |
| Management And General | 28885 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 532450 | Total |
| Program Services | 532450 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 550047 | Total |
| Program Services | 550047 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1371749 | Total |
| Program Services | 1371749 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 442524 | Total |
| Program Services | 442524 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Food | 876784 | 876784 | ||
| Supplies | 845656 | 765421 | 79776 | 459 |
| Licensing | 692031 | 692031 | ||
| Therapy | 485816 | 485816 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 838805 | Total |
| Program Services | 526431 | ProgramServices |
| Management And General | 312374 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17676097 | Total |
| Program Services | 15997290 | ProgramServices |
| Management And General | 1601429 | ManagementAndGeneral |
| Fundraising | 77378 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 646049 | BOY |
| EOY | 908335 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2723537 | BOY |
| EOY | 2271476 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 377905 | BOY |
| EOY | 268756 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2204142 | BOY |
| EOY | 2630874 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 394330 | BOY |
| EOY | 389428 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 42667890 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 15430340 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23996533 | BOY |
| EOY | 27237550 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25530042 | BOY |
| EOY | 26213857 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55872538 | BOY |
| EOY | 59920276 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1592740 | BOY |
| EOY | 2459037 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11659798 | BOY |
| EOY | 11471834 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 873056 | BOY |
| EOY | 2476456 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14125594 | BOY |
| EOY | 16407327 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41199086 | BOY |
| EOY | 42959597 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 447858 | BOY |
| EOY | 453352 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100000 | BOY |
| EOY | 100000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41746944 | BOY |
| EOY | 43512949 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55872538 | BOY |
| EOY | 59920276 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1766005 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 116752 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 844034 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1119527 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 434410 | CurrentTaxYearMinus1Year |
| Current Tax Year | 985260 | CurrentTaxYear |
| Total | 3499983 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12553080 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12965698 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13164178 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14334868 | CurrentTaxYearMinus1Year |
| Current Tax Year | 14689534 | CurrentTaxYear |
| Total | 67707358 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12669832 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13809732 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 14283705 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14769278 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15674794 | CurrentTaxYear |
| Total | 71207341 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 71207341 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -4050982 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1394822 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2615852 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23383 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3519080 | CurrentTaxYear |
| Total | 3502155 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -4050982 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1394822 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2615852 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23383 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3519080 | CurrentTaxYear |
| Total | 3502155 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 111673 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 188892 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 206184 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 205025 | CurrentTaxYearMinus1Year |
| Current Tax Year | 248228 | CurrentTaxYear |
| Total | 960002 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 8730523 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 15393446 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 17105741 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14997686 | CurrentTaxYearMinus1Year |
| Current Tax Year | 19442102 | CurrentTaxYear |
| Total | 75669498 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.94100 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.91810 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.04630 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.07050 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 27990135 | BeginningOfYearBalance |
| Contributions | 892976 | Contributions |
| Investment Earnings Or Losses | 3507128 | InvestmentEarningsOrLosses |
| Other Expenditures | 3566544 | OtherExpenditures |
| Administrative Expenses | 227289 | AdministrativeExpenses |
| End Of Year Balance | 28596406 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 32285791 | BeginningOfYearBalance |
| Contributions | 352352 | Contributions |
| Investment Earnings Or Losses | 7208 | InvestmentEarningsOrLosses |
| Other Expenditures | 4397420 | OtherExpenditures |
| Administrative Expenses | 257796 | AdministrativeExpenses |
| End Of Year Balance | 27990135 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 26692748 | BeginningOfYearBalance |
| Contributions | 3286598 | Contributions |
| Investment Earnings Or Losses | 2535488 | InvestmentEarningsOrLosses |
| Administrative Expenses | 229043 | AdministrativeExpenses |
| End Of Year Balance | 32285791 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 27366419 | BeginningOfYearBalance |
| Contributions | 806953 | Contributions |
| Investment Earnings Or Losses | 1222110 | InvestmentEarningsOrLosses |
| Other Expenditures | 2465598 | OtherExpenditures |
| Administrative Expenses | 237136 | AdministrativeExpenses |
| End Of Year Balance | 26692748 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1051037 | InvestmentCostOrOtherBasis |
| Book Value | 1051037 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 32705873 | InvestmentCostOrOtherBasis |
| Depreciation | 10466290 | Depreciation |
| Book Value | 22239583 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 8910980 | InvestmentCostOrOtherBasis |
| Depreciation | 4964050 | Depreciation |
| Book Value | 3946930 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 27237550 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Refundable Deposits | Description |
| Amount | $2,476,456 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2476456 | TotalOfAmounts |
| Total Revenue | 19442102 | TotalRevenue |
| Total Expenses | 17676097 | TotalExpenses |
| Excess Or Deficit For Year | 1766005 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 1766005 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 19442102 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 19442102 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 19442102 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 17676097 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 17676097 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 17676097 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | The Home's endowment fund is used to 1) provide income to offset operating costs in order to provide affordable skilled nursing care to residents and 2) provide a source of income to pay for capital improvements to the Home's physical plant. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | The evaluation of a tax position in accordance with this Interpretation 48 is a two-step process. The first step is recognition: The organization determines whether it is more likely than not that a tax position will be sustained upon examination, including resolution of any related appeals or litigation processes, based on the technical merits of the position. In evaluating whether a tax position has met the more-likely-than-not recognition threshold, the enterprise should presume that the position will be examined by the appropriate taxing authority that has full knowledge of all relevant information. The second step is measurement: A tax position that meets the more-likely-than-not recognition threshold is measured to determine the amount of benefit to recognize in the financial statements. The tax position is measured at the largest amount of benefit that is greater than 50 percent likely of being realized upon ultimate settlement. Implementation of ASC Section 740 began with Good Samaritan's year ended September 30, 2009. The implementation of ASC Section 740 has not had any material effect on the financial statements of the Good Samaritan Home of Quincy. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Quincy Adams County Illinois | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 376000378 | IssuerEIN |
| Date Issued | 2009-12-01 | DateIssued |
| Issue Price | 100 | IssuePrice |
| Description Of Purpose | To finance a portion of the Home's construction project | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 188896 | AmountRetired |
| Year Of Subst Completion | 2011 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 0 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 0 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 1 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | One board member is a partner in the law firm that represents the Organization, a second board member is a principal in a painting firm that was hired by the general contractor overseeing the construction and renovation project undertaken by the Organization. |
| Form 990, Part VI, Section B, line 11 | Federal Form 990 and the audited financial statements are presented to the Board of Directors for their review. The auditor is available to members of the finance committee for questions before the 990 is filed. |
| Form 990, Part VI, Section B, line 12c | Officers and directors are required to disclose any potential conflicts of interest to the CEO and to abstain from voting on any such item. |
| Form 990, Part VI, Section B, line 15 | The Executive Committee of the Organization annually reviews the performance of the Administrator and Assistant Administrator. Compensation is determined by reviewing the performance assessment and comparable salaries of like individuals in area and regional nursing homes of similar size. The salary package is approved by the Executive Committee and documented in the records of the Organization. |
| Form 990, Part VI, Section C, line 18 | Federal Form 990 is available online at www.guidestar.org |
| Form 990, Part VI, Section C, line 19 | Information regarding the tax-exempt status of the Organization is available upon request. Federal Form 990 is available upon request or online at www.guidestar.org |
| Form 990, Part XI, Line 2C | The Finance Commitee of the Board of Directors is responsible for oversight of the audit |