PENDLETON MANOR INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PENDLETON MANOR INC (EIN 55-0547603)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-09
- IRS object ID
- 201302219349300610
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-09T08:12:17-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540504608 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROWN EDWARDS & COMPANY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 124 NEWMAN AVENUE | AddressLine1 |
| City | HARRISONBURG | City |
| State | VA | State |
| ZIP Code | 22801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550547603 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENDLETON MANOR INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PEND | NameControl |
| Phone | 3043582320 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 700 | AddressLine1 |
| City | FRANKLIN | City |
| State | WV | State |
| ZIP Code | 26807 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREG BOWERS | Name |
| Title | PRESIDENT | Title |
| Phone | 3043582320 | Phone |
| Date Signed | 2013-08-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES R FRIES | Name |
| PTIN | P01320612 | PTIN |
| Phone | 5404346736 | Phone |
| Date Prepared | 2013-08-02 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GREG BOWERS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 700 | AddressLine1 |
| City | FRANKLIN | City |
| State | WV | State |
| ZIP Code | 26807 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 8615301 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1974 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY IS TO SHARE GOD'S WORD IN LOVE AND DEED BY PROVIDING SHELTER AND SUPPORTIVE SERVICES TO OLDER PERSONS AND OTHERS IN NEED BELIEVING THAT IN CHRIST'S LOVE, EVERYONE IS SOMEONE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 192 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 38828 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 45186 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 8145461 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 8569421 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 289 | InvestmentIncomePriorYear |
| Investment Income Current Year | -11092 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8184578 | TotalRevenuePriorYear |
| Total Revenue Current Year | 8603515 | 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 | 4249096 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4189631 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3185152 | OtherExpensePriorYear |
| Other Expenses Current Year | 3671176 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7434248 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7860807 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 750330 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 742708 | RevenuesLessExpensesCY |
| Total Assets BOY | 2792511 | TotalAssetsBOY |
| Total Assets EOY | 2602007 | TotalAssetsEOY |
| Total Liabilities BOY | 469566 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 536629 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2322945 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2065378 | NetAssetsOrFundBalancesEOY |
| Mission Description | OUR MISSION IS TO BUILD A STRONGER COMMUNITY BY IMPROVING AND ENRICHING THE LIVES OF THOSE WHO HAVE EXCEPTIONAL PHYSICAL, DEVELOPMENTAL OR FINANCIAL CHALLENGES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6600909 | Expense |
| Revenue | 8517653 | Revenue |
| Description | PROVIDE INTERMEDIATE CARE NURSING SERVICES FOR ELDERLY PATIENTS; 91 BEDS AVAILABLE, 30,882 PATIENT DAYS PROVIDED. PROVIDING HOME HEALTH AND OUTPATIENT THERAPY SERVICES FOR THE COMMUNITY. | Description |
| Total Program Service Expense | 6600909 | 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 | 0 | 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 | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 13 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 192 | 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 |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | 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 | 0 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARILYNN WAGGY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3043582320 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 700 | AddressLine1 |
| City | FRANKLIN | City |
| State | WV | State |
| ZIP Code | 26807 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| GREG BOWERS | ||||||
| PRESIDENT | 0.50 | X | X | 0 | 0 | 0 |
| WENDY SUESS | ||||||
| VICE PRESIDENT | 0.50 | X | X | 0 | 0 | 0 |
| MARSHALL HARPER | ||||||
| TREASURER | 0.50 | X | X | 0 | 0 | 0 |
| JUDY RADER | ||||||
| SECRETARY | 0.50 | X | X | 0 | 0 | 0 |
| KENNETH HARPER | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| MERL WARNER | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| BYRON BLAND | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| DYER ANDERSON | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| LYNN VANDEVANDER | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| DAVID O'BOYLE | ||||||
| ADMINISTRATOR | 40.00 | 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 | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| AEGIS THERAPIES INC | |||||
| PO BOX 8103 | FT SMITH | AR | 72902 | THERAPY PROVIDER | 726798 |
| EVANGELICAL LUTHERAN GOOD SAMARITAN SOCI | |||||
| 4800 W 57 ST | SIOUX FALLS | SD | 57108 | MANAGEMENT SERVICES | 432515 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| All Other Contributions | 45186 | AllOtherContributions |
| Noncash Contributions | 455 | NoncashContributions |
| Total Contributions | 45186 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENU | 623000 | 5597071 | 5597071 |
| ANCILLARY SERVICES | 623000 | 2533842 | 2533842 |
| SPECIAL CARE SERVICES | 623000 | 386046 | 386046 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 52462 | TotalRevenueColumn |
| Exclusion | $52,462 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 8569421 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 694 | TotalRevenueColumn |
| Related Or Exempt Function Income | 694 | RelatedOrExemptFunctionIncome |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 11786 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -11786 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -11786 | TotalRevenueColumn |
| Exclusion | -$11,786 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8603515 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8517653 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $40,676 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3509095 | Total |
| Program Services | 3228215 | ProgramServices |
| Management And General | 280880 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126569 | Total |
| Program Services | 116438 | ProgramServices |
| Management And General | 10131 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293219 | Total |
| Program Services | 274740 | ProgramServices |
| Management And General | 18479 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 260748 | Total |
| Program Services | 240064 | ProgramServices |
| Management And General | 20684 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 511314 | Total |
| Management And General | 511314 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 781 | Total |
| Management And General | 781 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19255 | Total |
| Management And General | 19255 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 864984 | Total |
| Program Services | 821864 | ProgramServices |
| Management And General | 43120 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19060 | Total |
| Program Services | 3327 | ProgramServices |
| Management And General | 15733 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34277 | Total |
| Management And General | 34277 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419145 | Total |
| Program Services | 419145 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27525 | Total |
| Program Services | 16204 | ProgramServices |
| Management And General | 11321 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109722 | Total |
| Management And General | 109722 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 270987 | Total |
| Program Services | 166252 | ProgramServices |
| Management And General | 104735 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 782546 | 768822 | 13724 |
| TAXES AND LICENSES | 418668 | 417644 | 1024 |
| EQUIPMENT RENTAL & MAIN | 69515 | 67963 | 1552 |
| STAFF DEVELOPMENT | 26266 | 11281 | 14985 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97131 | Total |
| Program Services | 48950 | ProgramServices |
| Management And General | 48181 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7860807 | Total |
| Program Services | 6600909 | ProgramServices |
| Management And General | 1259898 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100 | BOY |
| EOY | 100 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1170420 | BOY |
| EOY | 836450 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 929345 | BOY |
| EOY | 1097327 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38787 | BOY |
| EOY | 34445 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47370 | BOY |
| EOY | 39822 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1552276 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 961528 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 602121 | BOY |
| EOY | 590748 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4368 | BOY |
| EOY | 3115 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2792511 | BOY |
| EOY | 2602007 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 461769 | BOY |
| EOY | 527490 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7797 | BOY |
| EOY | 9139 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 469566 | BOY |
| EOY | 536629 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2312089 | BOY |
| EOY | 2059434 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10856 | BOY |
| EOY | 5944 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2322945 | BOY |
| EOY | 2065378 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2792511 | BOY |
| EOY | 2602007 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 742708 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1000275 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| 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 | 39546 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6288 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7748 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 38828 | CurrentTaxYearMinus1Year |
| Current Tax Year | 45186 | CurrentTaxYear |
| Total | 137596 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6434899 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6793615 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7509606 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8101915 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8516959 | CurrentTaxYear |
| Total | 37356994 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 46546 | CurrentTaxYearMinus1Year |
| Current Tax Year | 52462 | CurrentTaxYear |
| Total | 99008 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6474445 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6799903 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7517354 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8187289 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8614607 | CurrentTaxYear |
| Total | 37593598 | 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 | 37593598 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 223406 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2104 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 75 | CurrentTaxYearMinus2Years |
| Current Tax Year | 694 | CurrentTaxYear |
| Total | 226279 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 223406 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2104 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 75 | CurrentTaxYearMinus2Years |
| Current Tax Year | 694 | CurrentTaxYear |
| Total | 226279 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 6697851 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6802007 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7517429 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8187289 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8615301 | CurrentTaxYear |
| Total | 37819877 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99400 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.98660 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00600 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01340 | 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
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1429724 | OtherCostOrOtherBasis |
| Depreciation | 838976 | Depreciation |
| Book Value | 590748 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 122552 | OtherCostOrOtherBasis |
| Depreciation | 122552 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 590748 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RESIDENT TRUST FUNDS | Description |
| Amount | $9,139 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 9139 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | N/A | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVID O'BOYLE | NamePerson |
| Title | ADMINISTRATOR | Title |
| Base Compensation Filing Org | 0 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 88024 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 0 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 88024 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | COMPENSATION FOR DAVID O'BOYLE WAS PAID BY THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY HAS BEEN HIRED BY PENDLETON MANOR TO PROVIDE MANAGEMENT SERVICES. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE ADMINISTRATOR AND THE BOARD OF DIRECTORS, AND THE FINANCIAL DATA ARE VERIFIED BY THE ACCOUNTING DEPARTMENT AND MANAGEMENT, AS WELL AS BEING AUDITED BY AN INDEPENDENT ACCOUNTING FIRM. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT-OF-INTEREST POLICY IS REVIEWED PERIODICALLY BY THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE WAGE FOR THE ADMINISTRATOR IS SET BY THE MANAGING AGENCY - EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. | |
| FORM 990, PART VI, SECTION C, LINE 19 | ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. | |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 821,864. MANAGEMENT AND GENERAL EXPENSES 43,120. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 864,984. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | TRANSFER TO PENDLETON VILLAGE, INC. -1,000,275. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PENDLETON APARTMENTS INC | |||||||||||
| PO BOX 700 | FRANKLIN | WV | 26807 | 311130225 | TO PROVIDE HOUSING TO ELDERLY PERSONS | WV | 501(C)(3) | LINE 9 | PENDLETON VILLAGE INC | 1 | |
| PENDLETON VILLAGE INC | |||||||||||
| PO BOX 700 | FRANKLIN | WV | 26807 | 261339734 | ACT AS MANAGEMENT COMPANY FOR THE OTHER ENTITIES | WV | 501(C)(3) | LINE 11B, II | 0 | N/A | |
| THE PENDLETON INC | |||||||||||
| PO BOX 700 | FRANKLIN | WV | 26807 | 261339779 | REAL ESTATE AND EQUIPMENT HOLDING COMPANY FOR RELATED ORGANIZATIONS. | WV | 501(C)(2) | PENDLETON VILLAGE INC | 1 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PENDLETON INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionType |
| Amount Involved | 197200 | AmountInvolved |
| Method Of Amt Determination | CASH | MethodOfAmtDetermination |