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JEFFCO HEALTH SERVICES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
JEFFCO HEALTH SERVICES INC (EIN 25-1505478)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201303179349302915
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

FieldValueIRS element (for citing)
Timestamp2013-11-13T11:33:24-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN251505478EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1JEFFCO HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% RICK GRAHAM CFOInCareOfName
Name ControlJEFFNameControl
Phone8148498026Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1417 ROUTE 28AddressLine1
Address Line2SuiteAddressLine2
CityBROOKVILLECity
StatePAState
ZIP Code15825ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRICK GRAHAMName
TitleCFOTitle
Phone8148498026Phone
Date Signed2013-08-26DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRON KINGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1417 ROUTE 28AddressLine1
CityBROOKVILLECity
StatePAState
ZIP Code15825ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13764723GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.JEFFERSONMANOR.NETWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionJEFFERSON MANOR HEALTH CENTER IS A NONPROFIT FACILITY, FULLY CERTIFIED TO PARTICIPATE IN THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS AND ALSO ACCEPTS MANY MAJOR INSURANCE PLANS. SEE SCHEDULE O FOR DETAILS.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees277TotalNbrEmployees
Total Nbr Volunteers60TotalNbrVolunteers
Total Gross UBI-1059TotalGrossUBI
Net Unrelated Business Txbl Income-1059NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12536187ProgramServiceRevenuePriorYear
Program Service Revenue CY12136730ProgramServiceRevenueCY
Investment Income Prior Year199661InvestmentIncomePriorYear
Investment Income Current Year531075InvestmentIncomeCurrentYear
Other Revenue Prior Year-1999OtherRevenuePriorYear
Other Revenue Current Year-1059OtherRevenueCurrentYear
Total Revenue Prior Year12733849TotalRevenuePriorYear
Total Revenue Current Year12666746TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year968GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1140GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7468318SalariesEtcPriorYear
Salaries Etc Current Year7479495SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4502348OtherExpensePriorYear
Other Expenses Current Year4711896OtherExpensesCurrentYear
Total Expenses Prior Year11971634TotalExpensesPriorYear
Total Expenses Current Year12192531TotalExpensesCurrentYear
Revenues Less Expenses Prior Year762215RevenuesLessExpensesPriorYear
Revenues Less Expenses CY474215RevenuesLessExpensesCY
Total Assets BOY16016445TotalAssetsBOY
Total Assets EOY17029462TotalAssetsEOY
Total Liabilities BOY3778840TotalLiabilitiesBOY
Total Liabilities EOY3921584TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12237605NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY13107878NetAssetsOrFundBalancesEOY
Mission DescriptionJEFFERSON MANOR HEALTH CENTER IS COMMITTED TO BEING THE MOST CARING AND PROGRESSIVE PROVIDER OF EXTENDED CARE IN THE (WESTERN PENNSYLVANIA) AREA.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense10004978Expense
Grants1140Grants
Revenue11265759Revenue
DescriptionJEFFERSON MANOR HEALTH CENTER IS AN INDEPENDENT NOT-FOR-PROFIT ONE HUNDRED SIXTY (160) BED SKILLED NURSING AND REHABILITATION FACILITY. AS SUCH WE PROVIDE CARE FOR MEDICARE AND MEDICAL ASSISTANCE RESIDENTS ALONG WITH MANY FORMS OF INSURANCE AND PRIVATE PAY INDIVIDUALS. WE HAVE TWO DEMENTIA UNITS, A DEDICATED REHAB WING (SPECIALTY CARE UNIT) AND OFFER RESPITE, HOSPICE AND MOST FORMS OF LONG TERM CARE.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense775075Expense
Revenue816769Revenue
DescriptionJEFFERSON COURT IS A FORTY EIGHT (48) BED ASSISTED LIVING FACILITY LOCATED ADJACENT TO JEFFERSON MANOR. IT IS A TWO STORY BUILDING PROVIDING CARE ON THE FIRST FLOOR FOR THOSE WHO NEED SOME FORM OF ASSISTANCE WITH DAILY LIVING BUT ARE INDEPENDENT ENOUGH TO CARE FOR THEMSELVES. THE SECOND FLOOR HAS TWENTY FOUR BEDS AND IS DESIGNED FOR THOSE WITH EARLY MEMORY LOSS. IT IS A SECURE UNIT AND WE PROVIDE MEALS, LAUNDRY, HOUSEKEEPING, ETC FOR THOSE INDIVIDUALS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense62789Expense
Revenue54202Revenue
DescriptionJEFFERSON SUITES IS A NINE (9) UNIT INDEPENDENT LIVING SUITE. THESE INDIVIDUALS ARE RESPONSIBLE FOR THERE OWN CARE BUT HOUSEKEEPING AND MAINTENANCE SERVICES ARE PROVIDED. JEFFERSON SUITES HAS ITS OWN ENTRANCE ALTHOUGH INDIVIDUALS LIVING ON SUITES ARE WELCOME TO PARTICIPATE IN ACTIVITIES AND OTHER EVENTS WITH JEFFERSON MANOR. COMBINED, WE PROVIDE A COMPLETE CONTINUUM OF CARE AND AS SUCH, WE ARE LICENSED TO BE A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) EFFECTIVE FEBRUARY, 2009.Description
FieldValueIRS element (for citing)
Total Program Service Expense10842842TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
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 RequiredfalseScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
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 MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109611NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees277NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
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 CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
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 PersonRICK GRAHAM CFONamePerson
Telephone Number8148498026TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1417 ROUTE 28AddressLine1
CityBROOKVILLECity
StatePAState
ZIP Code15825ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
JACK SISK
DIRECTOR1.0X000
JIM CURTIS
VICE CHAIRMAN1.0X000X
JUDY GROMLEY
CHAIRWOMAN1.0X000X
REV WILLIAM SAXMAN
TREASURER1.0X000X
JULIE PEER
SECRETARY1.0X000X
GUY LESTER
DIRECTOR1.0X000
DIANE KIEHL
DIRECTOR1.0X000
DR AMANDA CHAMBERLIN
DIRECTOR1.0X000
JOHN MEESTER
DIRECTOR1.0X
RON KING
ADMINISTRATOR40.0131474011640X
RICK GRAHAM
CFO40.097827018675X
FieldValueIRS element (for citing)
Total Reportable Comp From Org229301TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation30315TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonFUNCTIONAL PATHWAYSNamePerson
FieldValueIRS element (for citing)
Address Of ContractorAddressOfContractor
Description Of ServicesTHERAPY MANAGEMENTDescriptionOfServices
Compensation978303Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE6230001210702812107028
OTHER9000992970229702
FieldValueIRS element (for citing)
Total Program Service Revenue12136730TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column205734TotalRevenueColumn
Exclusion$205,734ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2093Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real3152Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-1059Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-1059TotalRevenueColumn
Unrelated Business Revenue-1059UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1420166Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1094825Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities325341Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column325341TotalRevenueColumn
Exclusion$325,341ExclusionAmount

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 Column12666746TotalRevenueColumn
Related Or Exempt Function Income12136730RelatedOrExemptFunctionIncome
Unrelated Business Revenue-1059UnrelatedBusinessRevenue
Exclusion$531,075ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1140Total
Program Services1140ProgramServices

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)
Total259616Total
Management And General259616ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5649648Total
Program Services5298629ProgramServices
Management And General351019ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total56044Total
Program Services50512ProgramServices
Management And General5532ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1121953Total
Program Services1031614ProgramServices
Management And General90339ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total392234Total
Program Services353518ProgramServices
Management And General38716ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total4830Total
Management And General4830ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total49400Total
Management And General49400ManagementAndGeneral

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)
Total32619Total
Management And General32619ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1153559Total
Program Services1095193ProgramServices
Management And General58366ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total77577Total
Program Services215ProgramServices
Management And General77362ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total582653Total
Program Services451627ProgramServices
Management And General131026ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total11327Total
Program Services11327ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total359749Total
Program Services321349ProgramServices
Management And General38400ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total52911Total
Program Services38655ProgramServices
Management And General14256ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13244Total
Program Services6438ProgramServices
Management And General6806ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total105566Total
Program Services94246ProgramServices
Management And General11320ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total779133Total
Program Services695581ProgramServices
Management And General83552ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total75487Total
Program Services17293ProgramServices
Management And General58194ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
BAD DEBT164277164277
DIETARY SUPPLIES504463504463
MEDICAL SUPPLIES & DRUGS641937641937
PATIENT HEALTH4889548895

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total54269Total
Program Services15933ProgramServices
Management And General38336ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12192531Total
Program Services10842842ProgramServices
Management And General1349689ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY465006BOY
EOY396179EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY492785BOY
EOY857879EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1510809BOY
EOY1893952EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY25312BOY
EOY20063EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY110287BOY
EOY93131EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis20021485LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14011035LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6592296BOY
EOY6010450EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6627858BOY
EOY6950394EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY327619EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY192092BOY
EOY479795EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY16016445BOY
EOY17029462EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY667637BOY
EOY920858EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY16250BOY
EOY13650EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3030060BOY
EOY2583627EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY64893BOY
EOY60094EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY343355EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3778840BOY
EOY3921584EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12237605BOY
EOY13107878EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12237605BOY
EOY13107878EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16016445BOY
EOY17029462EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses474215ReconcilationRevenueExpenses
Reconciliation Unrealized Invest396058ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
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 Years676CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years83676CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total85352Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10762057CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11855564CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11703743CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12536187CurrentTaxYearMinus1Year
Current Tax Year12136730CurrentTaxYear
Total58994281Total

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)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10762733CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11856564CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11787419CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12536187CurrentTaxYearMinus1Year
Current Tax Year12136730CurrentTaxYear
Total59079633Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50959079633PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years172098CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years137993CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years195268CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year212127CurrentTaxYearMinus1Year
Current Tax Year207827CurrentTaxYear
Total925313Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years172098CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years137993CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years195268CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year212127CurrentTaxYearMinus1Year
Current Tax Year207827CurrentTaxYear
Total925313Total

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 Years10934831CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11994557CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11982687CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12748314CurrentTaxYearMinus1Year
Current Tax Year12344557CurrentTaxYear
Total60004946Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98458PublicSupportPercentage509
Prior Year Support Percentage0.98529PriorYearSupportPercentage
Investment Income Percentage0.01542InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01471PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis74139OtherCostOrOtherBasis
Book Value74139BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9573551OtherCostOrOtherBasis
Depreciation7494165Depreciation
Book Value2079386BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5521009OtherCostOrOtherBasis
Depreciation2563202Depreciation
Book Value2957807BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4501443OtherCostOrOtherBasis
Depreciation3690405Depreciation
Book Value811038BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis351343OtherCostOrOtherBasis
Depreciation263263Depreciation
Book Value88080BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6010450TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED AMT DUE TO 3RD PTY PYRS$126,438
ESTIMATED INSURANCE COSTS$216,917
FieldValueIRS element (for citing)
Total Of Amounts343355TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt13033337TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments396058NetUnrealizedGainsInvestments
Other Revenues-32619OtherRevenues
Revenue Not Rptd F990363439RevenueNotRptdF990
Revenue Subtotal12669898RevenueSubtotal
Other Revenues Not Included-3152OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-3152RevenueNotRptdOnFinStmt
Total Revenue Per Form99012666746TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt12163064TotExpensesEtcAuditedFinclStmt
Other Expenses Included3152OtherExpensesIncluded
Expenses Not Rptd F9903152ExpensesNotRptdF990
Expenses Subtotal12159912ExpensesSubtotal
Other Expenses Not Included32619OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt32619ExpensesNotRptdOnFinStmt
Total Expenses Per Form99012192531TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CUSTODIAL ACCOUNT RESPONSIBILITYSCHEDULE D, PART IV, LINE 2BJEFFCO HEALTH SERVICES IS THE TRUSTEE OF FUNDS RECEIVED ON BEHALF OF VARIOUS RESIDENTS. JEFFCO HAS FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THE BANK ACCOUNTS AND THE DISTRIBUTION OF THE FUNDS TO RESIDENTS. UNDER THIS SERVICE, RESIDENTS CAN DEPOSIT FUNDS WITH JEFFCO FOR HOLDING AND THEN OBTAIN THE FUNDS WHEN NEEDED TO PAY THEIR BILLS.
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12SCHEDULE D, PART XI, LINE 2D$ (32,619) INVESTMENT MANAGEMENT FEES
AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1SCHEDULE D, PART XI, LINE 4B$ (3,152) RENTAL EXPENSES
AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25SCHEDULE D, PART XII, LINE 2D$ 3,152 RENTAL EXPENSES
AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1SCHEDULE D, PART XII, LINE 4B$ 32,619 INVESTMENT MANAGEMENT FEES

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1JEFFERSON COUNTY MUNICIPAL AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN251518584IssuerEIN
Date Issued2010-04-01DateIssued
Issue Price3735372IssuePrice
Description Of PurposeLOAN MODIFICATION - 2003 NOTEDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds3735372TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow3732016RefundingEscrow
Issuance Costs From Proceeds3356IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2010YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
Rebate Not Due YetfalseRebateNotDueYet
Exception To RebatefalseExceptionToRebate
No Rebate DuefalseNoRebateDue
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

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

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION MISSIONFORM 990, PART I, LINE 1VISION: JEFFERSON MANOR HEALTH CENTER WILL PROVIDE STATE OF THE ART ACCOMMODATIONS FOR ITS CUSTOMERS. THROUGH OUR CONTINUOUS INNOVATIVE, COLLABORATIVE EFFORTS, WITH PRIMARY FOCUS UPON RESIDENT CARE AND EDUCATION OF OUR STAKEHOLDERS, WE WILL BECOME THE RECOGNIZED LEADER IN LONG TERM CARE. THE ORGANIZATION IS DEDICATED TO PROVIDING OUR RESIDENTS WITH PROGRESSIVE QUALITY HEALTH CARE SERVICES. THE ORGANIZATION IS COMMITTED TO THE MEDICAL, PHYSICAL, SPIRITUAL, PSYCHOLOGICAL AND EMOTIONAL WELL BEING OF EVERY RESIDENT, AND IT IS A GOAL TO CREATE AND MAINTAIN A SAFE, HOMELIKE ENVIRONMENT WHERE EACH RESIDENT IS TREATED WITH DIGNITY AND RESPECT. HIGHLY TRAINED PROFESSIONAL STAFF WORKS TOGETHER WITH THE RESIDENT AND FAMILY TO ASSIST THE RESIDENT TO ATTAIN OR MAINTAIN THEIR HIGHEST LEVEL OF INDEPENDENCE.
VOLUNTEERSFORM 990, PART I, LINE 6THE ORGANIZATION HAS 60 TOTAL VOLUNTEERS - NINE NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND FIFTY-ONE AUXILIARY MEMBERS WHO HELP OUT WITH VARIOUS ACTIVITIES.
990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, THE ADMINISTRATOR AND CFO PERFORM A THOROUGH REVIEW OF THE RETURN. A DRAFT IS THEN PROVIDED TO THE EXECUTIVE COMMITTEE FOR REVIEW. ANY QUESTIONS RAISED BY THE COMMITTEE ARE REVIEWED AND FOLLOW-UP INFORMATION IS PROVIDED. THE BOARD IS PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING WITH THE IRS.
CONFLICTS OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CTHE SOLICITOR DRAFTS AN INTERNAL CONTROL POLICY THAT MUST BE SIGNED BY EACH BOARD MEMBER ANNUALLY IN WHICH ALL CONFLICTS MUST BE LISTED. EACH BOARD MEMBER THAT HAS A CONFLICT ABSTAINS FROM VOTING ON MATTERS THAT PERTAIN TO THAT CONFLICT. IN ADDITION, CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSE CONFLICTS OF INTEREST.
COMPENSATIONFORM 990, PART VI, SECTION B, LINES 15 A & BIN 2012, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PERFORMED A COMPENSATION REVIEW FOR THE ADMINISTRATOR USING COMPARABILITY DATA. THE COMMITTEE'S REVIEW OF COMPENSATION WAS DOCUMENTED IN THE EXECUTIVE COMMITTEE BOARD MINUTES. A COMPENSATION REVIEW FOR OTHER OFFICERS OF THE ORGANIZATION WAS COMPLETED BY THE ADMINISTRATOR AND EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE GROUP USED STATISTICAL COMPARISONS OF OFFICERS WITH SIMILAR DUTIES AND RESPONSIBILITIES FROM LIKE ORGANIZATIONS. THIS REVIEW WAS DOCUMENTED IN THE EXECUTIVE COMMITTEE BOARD MINUTES.
DOCUMENT DISCLOSUREFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.