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BETHANY HEALTH CARE CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BETHANY HEALTH CARE CENTER INC (EIN 04-2104039)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-06-15
IRS object ID
201211679349300956
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

FieldValueIRS element (for citing)
Timestamp2012-06-15T14:28:09-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 CROWN COLONY DRIVE SUITE 310AddressLine1
CityQUINCYCity
StateMAState
ZIP Code02169ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042104039EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BETHANY HEALTH CARE CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBETHNameControl
Phone5082708673Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line197 BETHANY ROADAddressLine1
CityFRAMINGHAMCity
StateMAState
ZIP Code01702ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSR JACQUELYN MCCARTHYName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone5082708673Phone
Date Signed2012-06-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBARBARA J MORRISONName
PTINP00173340PTIN
Phone6179848100Phone
Date Prepared2012-06-06DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSR JACQUELYN MCCARTHYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line197 BETHANY ROADAddressLine1
CityFRAMINGHAMCity
StateMAState
ZIP Code01702ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11433758GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.BETHANYHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionOPERATION OF A SKILLED NURSING FACILITY, RESIDENT CARE FACILITY, AND CLINIC SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees251TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year600108ContributionsGrantsPriorYear
Contributions Grants Current Year651077ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10557028ProgramServiceRevenuePriorYear
Program Service Revenue CY10639344ProgramServiceRevenueCY
Investment Income Prior Year4932InvestmentIncomePriorYear
Investment Income Current Year20998InvestmentIncomeCurrentYear
Other Revenue Prior Year21589OtherRevenuePriorYear
Other Revenue Current Year10599OtherRevenueCurrentYear
Total Revenue Prior Year11183657TotalRevenuePriorYear
Total Revenue Current Year11322018TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8099483SalariesEtcPriorYear
Salaries Etc Current Year8101231SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year135185TotalFundrsngExpCurrentYear
Other Expense Prior Year4044117OtherExpensePriorYear
Other Expenses Current Year4231259OtherExpensesCurrentYear
Total Expenses Prior Year12143600TotalExpensesPriorYear
Total Expenses Current Year12332490TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-959943RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1010472RevenuesLessExpensesCY
Total Assets BOY7982227TotalAssetsBOY
Total Assets EOY7668872TotalAssetsEOY
Total Liabilities BOY6983901TotalLiabilitiesBOY
Total Liabilities EOY6445293TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY998326NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1223579NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE QUALITY HEALTHCARE IN A MANNER THAT HELPS RESIDENTS TO BE CONNECTED WITH GOD, WITH OTHER PEOPLE AND WITH THE WORLD IN WHICH THEY LIVE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11325272Expense
Revenue10639344Revenue
DescriptionSKILLED NURSING FACILITY, RESIDENT CARE FACILITY, AND CLINIC SERVICESDescription
Total Program Service Expense11325272TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109613NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees251NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1FINANCE OFFICEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5088726750TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line197 BETHANY ROADAddressLine1
CityFRAMINGHAMCity
StateMAState
ZIP Code01702ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
SR MARYLOU CASSIDY
TRUSTEE1.00X000
MARY KILCOMMONS
TRUSTEE1.00X000
SR ROSEMARY BRENNAN
TRUSTEE1.00X000
SR BRENDA FORRY
TRUSTEE1.00X000
SR MARILYN MCGOLDRICK
TRUSTEE1.00X000
SR ELLEN POWERS
TRUSTEE1.00X000
SR HELEN SULLIVAN
TRUSTEE1.00X000
CHRISTINE ALESSANDRO
TRUSTEE1.00X000
THOMAS E GUNNOUD
TRUSTEE1.00X000
LORI FERRANTE
TRUSTEE1.00X000
MICHAEL CONKLIN
TRUSTEE1.00X000
WILLIAM MCGINLEY
TRUSTEE1.00X000
SR LEE HOGAN
VICE CHAIR1.00000X
SR MARY MURPHY
CHAIRMAN1.00000X
SR JACQUELYN MCCARTHY
CEO/ADMINISTRATOR40.0012290800X
FieldValueIRS element (for citing)
Total Reportable Comp From Org122908TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXO
PO BOX 81049WOBURNMA01913DIETARY, HOUSEKEEPING, & LAUNDRY703178
QUALITY REHABILITATION SERVICES
42 LANDAU ROADPLAINVILLEMA01746REHABILITATION SERVICES235002
LARSONALLEN LLP
300 CROWN COLONY DRIVE SUITE 310QUINCYMA02169ACCOUNTING SERVICES113500
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Fundraising Events183198FundraisingEvents
All Other Contributions467879AllOtherContributions
Total Contributions651077TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REDescription
Business Code623000BusinessCode
Total Revenue Column10639344TotalRevenueColumn
Related Or Exempt Function Income10639344RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue10639344TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column16269TotalRevenueColumn
Exclusion$16,269ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4729Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4729Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4729TotalRevenueColumn
Exclusion$4,729ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events122339GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events183198CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses111740FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column10599TotalRevenueColumn
Exclusion$10,599ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column11322018TotalRevenueColumn
Related Or Exempt Function Income10639344RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$31,597ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6488262Total
Program Services5768730ProgramServices
Management And General591324ManagementAndGeneral
Fundraising128208Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total245386Total
Program Services223022ProgramServices
Management And General22364ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total918048Total
Program Services834379ProgramServices
Management And General83669ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total449535Total
Program Services408566ProgramServices
Management And General40969ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total365Total
Management And General365ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total107752Total
Management And General107752ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total356998Total
Program Services356998ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total12671Total
Program Services12671ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total64247Total
Program Services61378ProgramServices
Fundraising2869Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total17463Total
Program Services17463ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total411380Total
Program Services411380ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total9343Total
Program Services9068ProgramServices
Fundraising275Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total10497Total
Program Services8416ProgramServices
Fundraising2081Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total218991Total
Program Services218991ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total696679Total
Program Services696679ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total29995Total
Program Services29995ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PATIENT CARE EXPENSES12392701239270
USER FEES595839595839
REPAIR & MAINTENNANCE299043299043
HOUSEKEEPING5358653586

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total107140Total
Program Services79798ProgramServices
Management And General25590ManagementAndGeneral
Fundraising1752Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12332490Total
Program Services11325272ProgramServices
Management And General872033ManagementAndGeneral
Fundraising135185Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY274815BOY
EOY273091EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1121397BOY
EOY306257EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY10000EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY593566BOY
EOY705631EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY68832BOY
EOY64710EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14047667LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8389425LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5738107BOY
EOY5658242EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY110155BOY
EOY612417EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY75355BOY
EOY38524EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7982227BOY
EOY7668872EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1846956BOY
EOY1833834EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY196292BOY
EOY206275EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4925495BOY
EOY4398278EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15158BOY
EOY6906EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6983901BOY
EOY6445293EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY973326BOY
EOY1223579EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY25000BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY998326BOY
EOY1223579EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7982227BOY
EOY7668872EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1010472ReconcilationRevenueExpenses
Reconcilation Other Changes1235725ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1719064CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years776850CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2058316CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year600108CurrentTaxYearMinus1Year
Current Tax Year340222CurrentTaxYear
Total5494560Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9706153CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10810532CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10376513CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10557028CurrentTaxYearMinus1Year
Current Tax Year10604941CurrentTaxYear
Total52055167Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11425217CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11587382CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12434829CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11157136CurrentTaxYearMinus1Year
Current Tax Year10945163CurrentTaxYear
Total57549727Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1447542CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years247889CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years590000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year492004CurrentTaxYearMinus1Year
Current Tax Year446436CurrentTaxYear
Total3223871Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1447542CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years247889CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years590000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year492004CurrentTaxYearMinus1Year
Current Tax Year446436CurrentTaxYear
Total3223871Total
FieldValueIRS element (for citing)
Public Support Total50954325856PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13849CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11107CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4174CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4932CurrentTaxYearMinus1Year
Current Tax Year16269CurrentTaxYear
Total50331Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13849CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11107CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4174CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4932CurrentTaxYearMinus1Year
Current Tax Year16269CurrentTaxYear
Total50331Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6295CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years49451CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years35796CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21589CurrentTaxYearMinus1Year
Current Tax Year60169CurrentTaxYear
Total173300Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11445361CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11647940CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12474799CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11183657CurrentTaxYearMinus1Year
Current Tax Year11021601CurrentTaxYear
Total57773358Total
FieldValueIRS element (for citing)
Public Support Percentage5090.94030PublicSupportPercentage509
Prior Year Support Percentage0.99540PriorYearSupportPercentage
Investment Income Percentage0.00090InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00130PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$722OtherActivitiesAmount
Total Lobbying Expenditures IIB722TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationPART OF MEMBERSHIP DUES PAID TO STATE HEALTHCARE ORGANIZATIONSExplanation

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10735498OtherCostOrOtherBasis
Depreciation6074507Depreciation
Book Value4660991BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3312169OtherCostOrOtherBasis
Depreciation2314918Depreciation
Book Value997251BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5658242TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INV HELD BY CONG-DONAT-B603136C
INV HELD BY CONG-DONATIO9281C
FieldValueIRS element (for citing)
Total Of Book Value Securities612417TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOTHER LIABILITIESDescription
Amount$6,906Amount
FieldValueIRS element (for citing)
Total Of Amounts6906TotalOfAmounts
Total Revenue11322018TotalRevenue
Total Expenses12332490TotalExpenses
Excess Or Deficit For Year-1010472ExcessOrDeficitForYear
Net Unrealized GL On Investments-24276NetUnrealizedGLOnInvestments
Other$1,260,001OtherAmount
Total Adjustments1235725TotalAdjustments
Excess Or Deficit Per FS225253ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12750085TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-24276NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities80603DonatedSrvcAndUseOfFacilities
Other Revenues1371740OtherRevenues
Revenue Not Rptd F9901428067RevenueNotRptdF990
Revenue Subtotal11322018RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99011322018TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt12524832TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities80603DonatedServicesUseOfFacilities
Other Expenses Included111740OtherExpensesIncluded
Expenses Not Rptd F990192343ExpensesNotRptdF990
Expenses Subtotal12332489ExpensesSubtotal
Other Expenses Not Included1OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1ExpensesNotRptdOnFinStmt
Total Expenses Per Form99012332490TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:EQUITY TRANSFER 1,260,000. ROUNDING 1. TOTAL TO SCHEDULE D, PART XI, LINE 8: 1,260,001.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EVENT EXPENSE NETTED AGAINST REVENUES 111,740. EQUITY TRANSFER INCLUDED IN REVENUE 1,260,000.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EVENT EXPENSE NETTED AGAINST REVENUES 111,740.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:ROUNDING 1.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event178420GrossReceiptsEvent1
Charitable Contributions Event115735CharitableContributionsEvent1
Gross Revenue Event162685GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event19579NonCashPrizesEvent1
Rent Facility Costs Event18550RentFacilityCostsEvent1
Food And Beverage Event111444FoodAndBeverageEvent1
Entertainment Event10EntertainmentEvent1
Other Direct Expenses Event116566OtherDirectExpensesEvent1
Name Of Event250TH ANNIVERSARYNameOfEvent2
Gross Receipts Event2177547GrossReceiptsEvent2
Charitable Contributions Event2117893CharitableContributionsEvent2
Gross Revenue Event259654GrossRevenueEvent2
Cash Prizes Event20CashPrizesEvent2
Non Cash Prizes Event218745NonCashPrizesEvent2
Rent Facility Costs Event26549RentFacilityCostsEvent2
Food And Beverage Event216881FoodAndBeverageEvent2
Entertainment Event20EntertainmentEvent2
Other Direct Expenses Event22110OtherDirectExpensesEvent2
Total Number Of Other Events3TotalNumberOfOtherEvents
Gross Receipts Other Events49570GrossReceiptsOtherEvents
Charitable Contrib Other Events49570CharitableContribOtherEvents
Non Cash Prizes Other Events21316NonCashPrizesOtherEvents
Gross Receipts Total305537GrossReceiptsTotal
Charitable Contributions Total183198CharitableContributionsTotal
Gross Revenue Total Events122339GrossRevenueTotalEvents
Non Cash Prizes Total Events49640NonCashPrizesTotalEvents
Rent Facility Costs Total Events15099RentFacilityCostsTotalEvents
Food And Beverage Total Events28325FoodAndBeverageTotalEvents
Other Direct Expenses Total Events18676OtherDirectExpensesTotalEvents
Direct Expense Summary Events111740DirectExpenseSummaryEvents
Net Income Summary10599NetIncomeSummary

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionCHAPEL RENOVATIONSDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990294604NoncashContribsRptdF990
Method Of Determining RevenuesCOST OF RENOVATIONSMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 7ATHE TRUSTEES ELECT MEMBERS OF THE GOVERNING BOARD.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE GOVERNING BOARD ARE SUBJECT TO APPROVAL BY THE TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 15MERIT RAISE REVIEW IS PERFORMED BY THE BOARD OF DIRECTORS FOR THE CEO. FOR OFFICERS AND KEY EMPLOYEES A MERIT BASED RAISE REVIEW IS PERFORMED BY THE CEO/ADMINISTRATOR.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -24,276. EQUITY TRANSFER 1,260,000. ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: 1,235,725.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE RELATED ORGANIZATION IS RELIGIOUS BASED AND HAVE NO FILING REQUIREMENTBusinessNameLine1
FieldValueIRS element (for citing)
EIN999999999EIN
Legal Domicile StateMALegalDomicileState
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1THE RELATED ORGANIZATION IS RELIGIOUS BASED AND HAVE NO FILING REQUIREMENTBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType