COUNTRY CARE CENTER CORPORATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: COUNTRY CARE CENTER CORPORATION (EIN 42-1295331)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-02-13
IRS object ID: 201330449349300463
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
Form 990
Schedule A
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-02-13T06:53:39-08:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MUXFELDT ASSOCIATES CPA PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2309 B CHATBURN AVE	AddressLine1
City	HARLAN	City
State	IA	State
ZIP Code	51537	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	421295331	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COUNTRY CARE CENTER CORPORATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	COUN	NameControl
Phone	7127443453	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 351	AddressLine1
City	HARLAN	City
State	IA	State
ZIP Code	515370351	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	PAT DAVITT	Name
Title	PRESIDENT	Title
Phone	7127443453	Phone
Date Signed	2012-11-13	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	MUXFELDT ASSOCIATES CPA PC	Name
Phone	7127553366	Phone

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	PAT DAVITT	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	LOCAL	AddressLine1
City	HARLAN	City
State	IA	State
ZIP Code	51537	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	907794	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1987	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	RESIDENTIAL CARE FACILITY	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	25	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	882014	ProgramServiceRevenuePriorYear
Program Service Revenue CY	892600	ProgramServiceRevenueCY
Investment Income Prior Year	1040	InvestmentIncomePriorYear
Investment Income Current Year	836	InvestmentIncomeCurrentYear
Other Revenue Prior Year	11488	OtherRevenuePriorYear
Other Revenue Current Year	14358	OtherRevenueCurrentYear
Total Revenue Prior Year	894542	TotalRevenuePriorYear
Total Revenue Current Year	907794	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	884787	OtherExpensePriorYear
Other Expenses Current Year	891687	OtherExpensesCurrentYear
Total Expenses Prior Year	884787	TotalExpensesPriorYear
Total Expenses Current Year	891687	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	9755	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	16107	RevenuesLessExpensesCY
Total Assets BOY	554532	TotalAssetsBOY
Total Assets EOY	567417	TotalAssetsEOY
Total Liabilities BOY	110793	TotalLiabilitiesBOY
Total Liabilities EOY	107569	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	443739	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	459848	NetAssetsOrFundBalancesEOY
Mission Description	RESIDENTIAL CARE FACILITY	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	891687	Expense
Revenue	907794	Revenue
Description	RESIDENTIAL CARE	Description
Total Program Service Expense	891687	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	false	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	25	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	COUNTRY CARE CENTER CORPORATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7127443453	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 351	AddressLine1
City	HARLAN	City
State	IA	State
ZIP Code	515370351	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Institutional TrusteeInstitutionalTrustee
PAT DAVITT
PRESIDENT AND TREASURER	1.00	X	0	0	0
ROGER DAVIDSON
VICE PRESIDENT	1.00	X	0	0	0
JOYCE RODENBORN
DIRECTOR	1.00	X	0	0	0	X
DAVE SWINTON
DIRECTOR	1.00	X	0	0	0
MARY JOHNSON
SECRETARY	1.00	X	0	0	0
KRIS OLSON-HARMON
DIRECTOR	1.00	X	0	0	0
CALLA POLDBERG
DIRECTOR	1.00	X	0	0	0

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	RESIDENTIAL CARE	Description
Business Code	999999	BusinessCode
Total Revenue Column	892600	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Program Service Revenue	892600	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	836	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISC INCOME	999999	10218	10218
GAIN ON SALE OF ASSETS	999999	4140	4140

Field	Value	IRS element (for citing)
Total Other Revenue	14358	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	907794	TotalRevenueColumn
Related Or Exempt Function Income	907794	RelatedOrExemptFunctionIncome

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	24621	Total
Program Services	24621	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
ADMINISTRATIVE EXPENSES	321576	321576
DIETARY EXPENSES	101912	101912
PROPERTY MAINTENANCE	121052	121052

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	322526	Total
Program Services	322526	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	891687	Total
Program Services	891687	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	172835	BOY
EOY	193941	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	75000	BOY
EOY	75000	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	40254	BOY
EOY	28770	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	347	BOY
EOY	185	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3949	BOY
EOY	4201	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	30068	BOY
EOY	36684	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	528929	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	300293	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	232079	BOY
EOY	228636	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	554532	BOY
EOY	567417	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	110793	BOY
EOY	107569	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	110793	BOY
EOY	107569	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	443739	BOY
EOY	459848	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	443739	BOY
EOY	459848	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	554532	BOY
EOY	567417	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	16107	ReconcilationRevenueExpenses
Reconcilation Other Changes	2	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	true	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	false	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	509	CurrentTaxYearMinus4Years
Total	509	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	509	CurrentTaxYearMinus4Years
Total	509	Total

Field	Value	IRS element (for citing)
Public Support Total170	509	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4990	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3015	CurrentTaxYearMinus3Years
Total	8005	Total

Field	Value	IRS element (for citing)
Total Support	8514	TotalSupport
Public Support Pertcentage170	0.05980	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.07090	PublicSupportPertcentPriorYear
Private Foundation170	X	PrivateFoundation170
Public Support Total509	0	PublicSupportTotal509
Public Support Percentage509	0	PublicSupportPercentage509
Investment Income Percentage	0	InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	528929	OtherCostOrOtherBasis
Depreciation	300293	Depreciation
Book Value	228636	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	228636	TotalOfBookValueLandBuildings
Total Revenue	907794	TotalRevenue
Total Expenses	891687	TotalExpenses
Excess Or Deficit For Year	16107	ExcessOrDeficitForYear
Excess Or Deficit Per FS	16107	ExcessOrDeficitPerFS

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifier	ExplanationExplanation
Pt VI, Line 11a	BOARD OF DIRECTORS
Form 990EZ, Part II, Line 24	ACCOUNTS RECEIVABLE - NET OTHER RECEIVABLES INVENTORIES PREPAIDS INVESTMENTS
Form 990EZ, Part II, Line 26	ACCOUNTS PAYABLE & ACCRUED EXPENSES
Form 990, Part IX, Line 24f	RESIDENT CARE 187659. 187659. 0. 0. UTILITIES 63839. 63839. 0. 0. RESIDENT ACTIVITIES 71028. 71028. 0. 0.