2012-11-15T14:47:18-06:00 2011-12-31 381357951 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2011-01-01 237125454 PULASKI HEALTH FOUNDATION INC PULA 5749463394 624 EAST 13TH STREET WINAMAC IN 46996 SCOTT FRITZ 5749463394 2012-11-15 1 CAROL LALONDE CPA P00181637 2695674500 2011 2016-02-24 21:20:13Z PULASKI HEALTH CARE CENTER SHARON MCKINLEY 624 EAST 13TH STREET WINAMAC IN 46996 4399629 0 X WWW.PULASKIHEALTHCARECENTER.COM X 1959 IN AS A NOT-FOR-PROFIT, SKILLED NURSING FACILITY, PULASKI HEALTH CARE CENTER IS DEDICATED TO ENHANCING THE LIVES OF OLDER ADULTS THROUGH QUALITY HEALTH CARE. 7 7 115 37 0 0 3499 3974 4075139 4359475 9292 11346 34200 22117 4122130 4396912 0 0 0 0 2423535 2659412 0 0 0 1396768 1564749 3820303 4224161 301827 172751 3315271 3381655 1405032 1298695 1910239 2082960 X TO IMPROVE OUR COMMUNITY THROUGH HEALTH AND WELLNESS. 0 0 3686048 4359475 DIGNITY, QUALITY OF LIFE, AND PROFESSIONAL COMPETENCE - THIS IS THE FOUNDATION OF CARE YOU CAN EXPECT AT PULASKI HEALTH CARE CENTER (PHCC). WHEN A FAMILY MEMBER OR LOVED ONE IS NO LONGER ABLE TO CARE FOR HIMSELF OR HERSELF, WE OFFER COMFORTABLE, SECURE, LIFE CARE IN A SUPPORTIVE ENVIRONMENT. AS A NOT-FOR-PROFIT, SKILLED NURSING FACILITY, PHCC IS DEDICATED TO ENHANCING THE LIVES OF OLDER ADULTS THROUGH QUALITY HEALTH CARE. THE CENTER WAS DEVELOPED AND BUILT BY THE PULASKI HEALTH FOUNDATION, A NOT-FOR-PROFIT ORGANIZATION, WHOSE PRIMARY GOAL WAS TO DESIGN A FACILITY IN PULASKI COUNTY THAT PROVIDED SUPERIOR LONG-TERM CARE FOR OLDER ADULTS. PHCC OFFERS THE SERVICES OUR RESIDENTS NEED, INCLUDING SHORT-TERM RESTORATIVE SERVICES, MEDICARE SHORT STAY SERVICES, AND LONG-TERM CONTINUED CARE. THE COMPREHENSIVE CARE PROGRAM IS DESIGNED TO MEET THE DAILY LIVING NEEDS OF EACH RESIDENT. ALL OF OUR PROGRAMS INCLUDE 24-HOUR NURSING SERVICES, THERAPIES (PHYSICAL, OCCUPATIONAL, AND SPEECH), MEAL SERVICE, INCLUDING SPECIAL DIETS, ASSISTANCE WITH MEDICATION, PERSONAL HYGIENE, AND AMBULATION, SOCIAL SERVICES, ACTIVITIES AND RECREATION, LAUNDRY AND HOUSEKEEPING SERVICES. THE ORGANIZATION'S OCCUPANCY PERCENTAGE FOR THE YEAR ENDED DECEMBER 31, 2011 WAS 91%, WITH 58 LICENSED BEDS AVAILABLE. THE ORGANIZATION'S AVERAGE DAILY RESIDENT CENSUS WAS 53. THE ORGANIZATION'S PROGRAM SERVICE REVENUES APPROXIMATED $226 PER RESIDENT PER DAY. 3686048 1 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 15 0 1 115 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X SHARON K MCKINLEY 5749463394 624 EAST 13TH STREET WINAMAC IN 46996 SCOTT FRITZ 2.00 X X 0 0 0 LAURA BAILEY 2.50 X X 0 0 0 LINDA MURPHY 0.50 X X 0 0 0 LIN MORRISON 1.00 X X 0 0 0 JOHN GOBLE 0.50 X 0 0 0 JIM PIERROU 0.50 X 0 0 0 RITA MURRAY 1.00 X 0 0 0 ROBERT LIZENBY 1.00 X 0 0 0 SHARON MCKINLEY 50.00 X 64576 0 6593 64576 0 6593 0 0 0 0 HEALTH CARE THERAPY SERVICES 1411 W COUNTY LINE RD GREENWOOD IN 46142 THERAPY SERVICES 280103 GORDON FOOD SERVICE DEPT CH 10490 PALATINE IL 60055 FOOD PURCHASES 172045 2 3974 3974 RESIDENT SERVICE REVEN 623000 4359475 4359475 4359475 13933 13933 130 2717 -2587 -2587 -2587 VENDING/CATERING INCOM 900099 13841 13841 OTHER INCOME 900099 5717 5717 BEAUTY/BARBER SHOP INC 900099 2559 2559 22117 4396912 4359475 0 33463 71169 71169 2165964 2033264 132700 257034 233611 23423 165245 150186 15059 11798 11798 1361 1361 47225 47225 339967 317498 22469 9721 9721 47114 47114 27418 27418 103959 96682 7277 6990 6990 24863 24863 165149 147489 17660 39351 39351 NURSING SUPPLIES AND OT 241698 241698 PROVIDER TAXES 181400 181400 FOOD 171132 163100 8032 BAD DEBT EXPENSE 73590 73590 72013 47530 24483 4224161 3686048 538113 0 500 500 633487 410548 397436 413150 375700 472518 15160 17509 35018 79336 3693794 2101668 1613430 1592126 105311 290687 139229 105281 3315271 3381655 211430 264318 8878 1184724 1034377 1405032 1298695 X 1809777 1982498 100462 100462 1910239 2082960 3315271 3381655 X 172751 -30 X X 1 0 1 X 0 X 1918 3254 9501 3499 3974 22146 3423161 3707509 3674150 4075139 4359475 19239434 15828 41217 29540 17738 104323 3440907 3751980 3713191 4096376 4363449 19365903 0 140640 140640 140640 140640 19225263 36983 27374 25748 16090 13933 120128 36983 27374 25748 16090 13933 120128 3882 208 38 4128 6240 4854 14789 22117 48000 3488012 3779562 3743831 4127255 4399499 19538159 0.98400 0.98270 0.00610 0.00740 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE 0 0 0 0 0 0 0 0 1 199 199 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION PAYS ANNUAL DUES TO THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (AAHSA) AND THE INDIANA ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (IAHSA). THE FOLLOWING PERCENTAGES OF THE ORGANIZATION'S DUES ARE EARMARKED FOR LOBBYING PURPOSES: AAHSA = 5.3%, IAHSA = 5.9% 0 1 4304 -30 4274 3562 250 549 57 4304 2500 500 584 22 3562 2500 2500 1.00000 1 0 28875 28875 2437029 1374554 1062475 69755 61069 8686 1134416 666045 468371 23719 23719 1592126 TRADING SECURITIES 290687 C 290687 4396912 4224161 172751 -30 -30 172721 4399499 0 4399499 -2587 -2587 4396912 4226748 2587 2587 4224161 0 4224161 PART IV, LINE 2B: THE ORGANIZATION HAS A RESIDENT TRUST ACCOUNT SET UP FOR RESIDENTS' PERSONAL FUNDS. RESIDENTS AND/OR THEIR AUTHORIZED REPRESENTATIVE ARE REQUIRED TO SIGN AN AUTHORIZATION FORM GIVING THE ORGANIZATION THE RIGHT TO MANAGE THE RESIDENTS' PERSONAL FUNDS WHILE HE OR SHE RESIDES AT THE FACILITY. RESIDENTS AND/OR THEIR AUTHORIZED REPRESENTATIVE RECEIVE QUARTERLY REPORTS THAT PROVIDE AN ACCOUNTING OF THE ACTIVITY DURING THAT PERIOD. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUND IS TO SUPPORT THE ORGANIZATION'S ACTIVITIES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY IF UNCERTAIN TAX POSITIONS ARE TAKEN THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION'S FEDERAL TAX RETURNS FOR THE YEARS ENDED PRIOR TO DECEMBER 31, 2008 ARE NO LONGER SUBJECT TO EXAMINATION. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST -30. PART XII, LINE 4B: LOSS ON SALE OF FIXED ASSETS -2,587 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED IN DETAIL BY MANAGEMENT. THEN A COPY OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS PROVIDED TO EACH BOARD MEMBER AND REVIEWED WITH THE ORGANIZATION'S TAX ADVISORS AT A SCHEDULED BOARD MEETING PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL DISCLOSURE IS PROVIDED TO EACH OFFICER AND BOARD MEMBER (THE ORGANIZATION DOES NOT HAVE ANY KEY EMPLOYEES OR HIGHEST COMPENSATED EMPLOYEES). EACH BOARD MEMBER AND OFFICER COMPLETES AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. ONCE THE QUESTIONNAIRES ARE COMPLETED, THE ADMINISTRATOR REVIEWS THE RESPONSES AND DETERMINES WHETHER OR NOT THERE ARE ANY POTENTIAL CONFLICTS OF INTEREST. IF THERE IS A POTENTIAL CONFLICT OF INTEREST, THE ADMINISTRATOR AND THE BOARD PRESIDENT REVIEW THE CORRESPONDING ISSUE AND DETERMINE IF THERE IS AN ACTUAL CONFLICT OF INTEREST. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THAT PERSON IS EXCLUDED FROM ANY DISCUSSIONS CONCERNING THE CONFLICTING ISSUE. ANY PURCHASES AND/OR BIDDING PROPOSALS ARE ALSO REVIEWED FOR ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO SUBMITTING BIDS OR MAKING PURCHASES. THE BOARD PRESIDENT ATTENDS THE BOARD MEETINGS AND ENSURES THAT COMPLIANCE WITH THESE GUIDELINES ARE FOLLOWED. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S ADMINISTRATOR INCLUDED A REVIEW AND APPROVAL BY THE BOARD PRESIDENT AND VICE PRESIDENT, WHO ARE BOTH INDEPENDENT. THE PRESIDENT AND VICE PRESIDENT USED MCKNIGHT'S CAREER GUIDE, WHICH INCLUDED AN AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (AAHSA) NURSING HOME SALARY AND BENEFITS REPORT, AS WELL AS THE MYERS AND STAUFFER LC LONG TERM CARE COMPENSATION REPORT. THE INDIANA ASSOCIATION FOR THE HOMES AND SERVICES OF THE AGING'S SALARY AND WAGE SURVEY IS ALSO REFERENCED FOR THE DECISION PROCESSES. ONCE THE PRESIDENT AND VICE PRESIDENT DETERMINED THE COMPENSATION AMOUNT, THEY REPORTED THEIR FINDINGS AND DECISION TO THE FULL BOARD OF DIRECTORS AT A BOARD MEETING. THIS WAS DOCUMENTED IN THE BOARD MEETING MINUTES, AND WAS LAST DONE IN APRIL OF 2011 FOR THE ADMINISTRATOR'S SALARY. FORM 990, PART VI, SECTION C, LINE 19 A COPY OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGE IN BENEFICIAL INTEREST -30. TOTAL TO FORM 990, PART XI, LINE 5: -30. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. PULASKI HOUSING ASSOCIATES INC 624 EAST 13TH STREET WINAMAC IN 46996 352120172 APARTMENT RENTAL IN PULASKI HEALTH FOUNDATION INC C -5 70640 0.75000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 RIVERWOOD COMMONS A 9028 BOOK VALUE