STRATEGY STUDIO / PUBLIC DATA EXPLORER

JEFFCO HEALTH SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
JEFFCO HEALTH SERVICES INC (EIN 25-1505478)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-04
IRS object ID
201222789349300142
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)
Timestamp2012-10-04T16:25:23-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Date2011-01-01TaxPeriodBeginDate

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
CityBROOKVILLECity
StatePAState
ZIP Code15825ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRICK GRAHAMName
TitleCFOTitle
Date Signed2012-07-24DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
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 Receipts13506065GrossReceipts
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 Employees291TotalNbrEmployees
Total Nbr Volunteers19TotalNbrVolunteers
Total Gross UBI-1999TotalGrossUBI
Net Unrelated Business Txbl Income-1999NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year83676ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11703743ProgramServiceRevenuePriorYear
Program Service Revenue CY12536187ProgramServiceRevenueCY
Investment Income Prior Year283812InvestmentIncomePriorYear
Investment Income Current Year199661InvestmentIncomeCurrentYear
Other Revenue Prior Year-2678OtherRevenuePriorYear
Other Revenue Current Year-1999OtherRevenueCurrentYear
Total Revenue Prior Year12068553TotalRevenuePriorYear
Total Revenue Current Year12733849TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY968GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7827636SalariesEtcPriorYear
Salaries Etc Current Year7468318SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3919414OtherExpensePriorYear
Other Expenses Current Year4502348OtherExpensesCurrentYear
Total Expenses Prior Year11747050TotalExpensesPriorYear
Total Expenses Current Year11971634TotalExpensesCurrentYear
Revenues Less Expenses Prior Year321503RevenuesLessExpensesPriorYear
Revenues Less Expenses CY762215RevenuesLessExpensesCY
Total Assets BOY15795333TotalAssetsBOY
Total Assets EOY16016445TotalAssetsEOY
Total Liabilities BOY4132169TotalLiabilitiesBOY
Total Liabilities EOY3778840TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11663164NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12237605NetAssetsOrFundBalancesEOY
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
Expense9822115Expense
Grants968Grants
Revenue11691677Revenue
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)
Expense739867Expense
Grants0Grants
Revenue772841Revenue
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)
Expense71012Expense
Grants0Grants
Revenue71669Revenue
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 Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense10632994TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
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
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109613NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees291NumberOfEmployees
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
DIRECTOR1.0X000
RON KING
ADMINISTRATOR40.0120141010387X
RICK GRAHAM
CFO40.082795018460X
FieldValueIRS element (for citing)
Total Reportable Comp From Org202936TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation28847TotalOtherCompensation
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
Compensation941375Compensation
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 REVENUE6230001250392812503928
OTHER9000993225932259
FieldValueIRS element (for citing)
Total Program Service Revenue12536187TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column208627TotalRevenueColumn
Exclusion$208,627ExclusionAmount

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)
Real3500Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real5499Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-1999Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-1999TotalRevenueColumn
Unrelated Business Revenue-1999UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities753751Securities
Other4000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities725236Securities
Other41481Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities28515Securities
Other-37481Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-8966TotalRevenueColumn
Exclusion-$8,966ExclusionAmount

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 Column12733849TotalRevenueColumn
Related Or Exempt Function Income12536187RelatedOrExemptFunctionIncome
Unrelated Business Revenue-1999UnrelatedBusinessRevenue
Exclusion$199,661ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total968Total
Program Services968ProgramServices

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)
Total231783Total
Management And General231783ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5552097Total
Program Services5202602ProgramServices
Management And General349495ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total60226Total
Program Services54410ProgramServices
Management And General5816ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1229047Total
Program Services1129958ProgramServices
Management And General99089ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total395165Total
Program Services357004ProgramServices
Management And General38161ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total4759Total
Management And General4759ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48000Total
Management And General48000ManagementAndGeneral

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)
Total30615Total
Management And General30615ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1230029Total
Program Services1111113ProgramServices
Management And General118916ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total74978Total
Management And General74978ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total397736Total
Program Services288910ProgramServices
Management And General108826ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total10596Total
Program Services10596ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total285497Total
Program Services253806ProgramServices
Management And General31691ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total181823Total
Program Services166942ProgramServices
Management And General14881ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total26271Total
Program Services9723ProgramServices
Management And General16548ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total122173Total
Program Services108472ProgramServices
Management And General13701ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total794106Total
Program Services705050ProgramServices
Management And General89056ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total79532Total
Program Services17293ProgramServices
Management And General62239ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL SUPPLIES & DRUGS577988577988
CAFETERIA & VENDING494299494299
BAD DEBT7725677256
PATIENT HEALTH4953949539

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total17151Total
Program Services17065ProgramServices
Management And General86ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11971634Total
Program Services10632994ProgramServices
Management And General1338640ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY232258BOY
EOY465006EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY944969BOY
EOY492785EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2269502BOY
EOY1510809EOY

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)
BOY19790BOY
EOY25312EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY112328BOY
EOY110287EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis19829304LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec13237008LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7115089BOY
EOY6592296EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4966233BOY
EOY6627858EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY135164BOY
EOY192092EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY15795333BOY
EOY16016445EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY606406BOY
EOY667637EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY4225BOY
EOY16250EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3458513BOY
EOY3030060EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY63025BOY
EOY64893EOY

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
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4132169BOY
EOY3778840EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11663164BOY
EOY12237605EOY

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)
BOY11663164BOY
EOY12237605EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15795333BOY
EOY16016445EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses762215ReconcilationRevenueExpenses
Reconcilation Other Changes-187774ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 Years10205CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years676CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year83676CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total95557Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11214342CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10762057CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11855564CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11703743CurrentTaxYearMinus1Year
Current Tax Year12536187CurrentTaxYear
Total58071893Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11224547CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10762733CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11856564CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11787419CurrentTaxYearMinus1Year
Current Tax Year12536187CurrentTaxYear
Total58167450Total
FieldValueIRS element (for citing)
Public Support Total50958167450PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years151050CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years172098CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years137993CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year195268CurrentTaxYearMinus1Year
Current Tax Year212127CurrentTaxYear
Total868536Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years151050CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years172098CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years137993CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year195268CurrentTaxYearMinus1Year
Current Tax Year212127CurrentTaxYear
Total868536Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11375597CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10934831CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11994557CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11982687CurrentTaxYearMinus1Year
Current Tax Year12748314CurrentTaxYear
Total59035986Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98529PublicSupportPercentage509
Prior Year Support Percentage0.98652PriorYearSupportPercentage
Investment Income Percentage0.01471InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01348PriorYrInvestIncomePercentage
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
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

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

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9573551OtherCostOrOtherBasis
Depreciation7162777Depreciation
Book Value2410774BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5484258OtherCostOrOtherBasis
Depreciation2299633Depreciation
Book Value3184625BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4346013OtherCostOrOtherBasis
Depreciation3530108Depreciation
Book Value815905BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis351343OtherCostOrOtherBasis
Depreciation244490Depreciation
Book Value106853BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6592296TotalOfBookValueLandBuildings
Total Revenue12733849TotalRevenue
Total Expenses11971634TotalExpenses
Excess Or Deficit For Year762215ExcessOrDeficitForYear
Net Unrealized GL On Investments-187774NetUnrealizedGLOnInvestments
Total Adjustments-187774TotalAdjustments
Excess Or Deficit Per FS574441ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12558440TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-187774NetUnrealizedGainsInvestments
Other Revenues-30615OtherRevenues
Revenue Not Rptd F990-218389RevenueNotRptdF990
Revenue Subtotal12776829RevenueSubtotal
Other Revenues Not Included-42980OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-42980RevenueNotRptdOnFinStmt
Total Revenue Per Form99012733849TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt11983999TotExpensesEtcAuditedFinclStmt
Other Expenses Included42980OtherExpensesIncluded
Expenses Not Rptd F99042980ExpensesNotRptdF990
Expenses Subtotal11941019ExpensesSubtotal
Other Expenses Not Included30615OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt30615ExpensesNotRptdOnFinStmt
Total Expenses Per Form99011971634TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 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.
RECONCILING ITEMSSCHEDULE D, PART XII, LINE 4B AND PART XIII, LINE 2D$ 5,499 RENTAL EXPENSES 37,481 LOSS ON SALE OF FIXED ASSETS -------------- $ 42,980 SCHEDULE D, PART XII, LINE 2D AND PART XIII, LINE 4B $ 30,615 INVESTMENT MANAGEMENT FEES

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

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)
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)
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
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
Exception To RebatefalseExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 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 19 TOTAL VOLUNTEERS - NINE NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND TEN 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, LINE 15 A & BIN 2011, 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.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5$( 187,774) NET UNREALIZED LOSSES