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BETHANY HEALTH CARE CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BETHANY HEALTH CARE CENTER INC (EIN 04-2104039)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-08-11
IRS object ID
201102239349301740
Schema version
2010v3.4
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)
Timestamp2011-08-11T14:04:59-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LARSONALLEN 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 Date2010-01-01TaxPeriodBeginDate

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 Signed2011-08-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBARBARA J MORRISONName
Phone6179848100Phone
Date Prepared2011-08-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
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 Receipts11240867GrossReceipts
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 Employees242TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2023525ContributionsGrantsPriorYear
Contributions Grants Current Year600108ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10376513ProgramServiceRevenuePriorYear
Program Service Revenue CY10557028ProgramServiceRevenueCY
Investment Income Prior Year11739InvestmentIncomePriorYear
Investment Income Current Year4932InvestmentIncomeCurrentYear
Other Revenue Prior Year35796OtherRevenuePriorYear
Other Revenue Current Year21589OtherRevenueCurrentYear
Total Revenue Prior Year12447573TotalRevenuePriorYear
Total Revenue Current Year11183657TotalRevenueCurrentYear
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 Year8143786SalariesEtcPriorYear
Salaries Etc Current Year8099483SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year141402TotalFundrsngExpCurrentYear
Other Expense Prior Year3794065OtherExpensePriorYear
Other Expenses Current Year4044117OtherExpensesCurrentYear
Total Expenses Prior Year11937851TotalExpensesPriorYear
Total Expenses Current Year12143600TotalExpensesCurrentYear
Revenues Less Expenses Prior Year509722RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-959943RevenuesLessExpensesCY
Total Assets BOY8459114TotalAssetsBOY
Total Assets EOY7982227TotalAssetsEOY
Total Liabilities BOY7351703TotalLiabilitiesBOY
Total Liabilities EOY6983901TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1107411NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY998326NetAssetsOrFundBalancesEOY
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
Expense11161894Expense
Revenue10557028Revenue
DescriptionSKILLED NURSING FACILITY, RESIDENT CARE FACILITY, AND CLINIC SERVICESDescription
Total Program Service Expense11161894TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
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 Contributions0DeductibleNonCashContributions
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 With109616NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees242NumberOfEmployees
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
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 (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
SR MAUREEN DOHERTY
TREASURER/TRUSTEE1.00XX000
SR MARYLOU CASSIDY
TRUSTEE1.00X000
SR LEE HOGAN
CLERK/SECRETARY1.00XX000
SR MARY MURPHY
PRESIDENT1.00X000
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
BRUCE GLASS
TRUSTEE1.00X000
MARYANN OUTWATER
TRUSTEE1.00X000
LORI FERRANTE
TRUSTEE1.00X000
MICHAEL CONKLIN
TRUSTEE1.00X000
FRANK SABA
TRUSTEE1.00X000
SR JACQUELYN MCCARTHY
CEO/ADMINISTRATOR40.00X13256800X
SUSAN GONZALES
DON40.0011805100X
CHRISTY CAMPEA
CONTROLLER40.009144000X
BARBARA SHOCKLEY
DIRECTOR OF ADVANCEMENT40.0010355300X
MAE MONTEZA
NURSING SUPERVISOR40.0010030600X
FieldValueIRS element (for citing)
Total Reportable Comp From Org454478TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXO
PO BOX 81049WOBURNMA01913DIETARY, HOUSEKEEPING, & LAUNDRY632876
QUALITY REHABILITATION SERVICES
116 COURTLAND STHOLLISTONMA01746REHABILITATION SERVICES212749
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Fundraising Events22200FundraisingEvents
All Other Contributions577908AllOtherContributions
Total Contributions600108TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REDescription
Business Code623000BusinessCode
Total Revenue Column10557028TotalRevenueColumn
Related Or Exempt Function Income10557028RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue10557028TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4025TotalRevenueColumn
Exclusion$4,025ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities907Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities907Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column907TotalRevenueColumn
Exclusion$907ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events78799GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events22200CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses57210FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column21589TotalRevenueColumn
Exclusion$21,589ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column11183657TotalRevenueColumn
Related Or Exempt Function Income10557028RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$26,521ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6596650Total
Program Services5881409ProgramServices
Management And General591144ManagementAndGeneral
Fundraising124097Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total167230Total
Program Services152171ProgramServices
Management And General15059ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total878552Total
Program Services796477ProgramServices
Management And General82075ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total457051Total
Program Services415894ProgramServices
Management And General41157ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1615Total
Management And General1615ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total54100Total
Management And General54100ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total353460Total
Program Services353460ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total8431Total
Program Services8431ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total58049Total
Program Services54690ProgramServices
Fundraising3359Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total17528Total
Program Services17528ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total385204Total
Program Services385204ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total8746Total
Program Services8492ProgramServices
Fundraising254Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6030Total
Program Services2433ProgramServices
Fundraising3597Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total251598Total
Program Services251598ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total662986Total
Program Services662986ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total29311Total
Program Services29311ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PATIENT CARE EXPENSES11378841137884
USER FEES634639634639
REPAIR & MAINTENANCE268672268672
OTHER MANAGEMENT EXPENS5515455154
HOUSEKEEPING5224752247

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total58463Total
Program Services48368ProgramServices
Fundraising10095Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12143600Total
Program Services11161894ProgramServices
Management And General840304ManagementAndGeneral
Fundraising141402Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY578642BOY
EOY274815EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY897471BOY
EOY1121397EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY605619BOY
EOY593566EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY88010BOY
EOY68832EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis13430854LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7692747LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6139586BOY
EOY5738107EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY90615BOY
EOY110155EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY59171BOY
EOY75355EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8459114BOY
EOY7982227EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1759378BOY
EOY1846956EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY170022BOY
EOY196292EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY5410346BOY
EOY4925495EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11957BOY
EOY15158EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7351703BOY
EOY6983901EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1107411BOY
EOY973326EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY25000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1107411BOY
EOY998326EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8459114BOY
EOY7982227EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-959943ReconcilationRevenueExpenses
Reconcilation Other Changes850858ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
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 Years549386CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1719064CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years776850CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2058316CurrentTaxYearMinus1Year
Current Tax Year1445108CurrentTaxYear
Total6548724Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9357852CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9706153CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10810532CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10376513CurrentTaxYearMinus1Year
Current Tax Year10557028CurrentTaxYear
Total50808078Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9907238CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11425217CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11587382CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12434829CurrentTaxYearMinus1Year
Current Tax Year12002136CurrentTaxYear
Total57356802Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50957356802PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years42071CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13849CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11107CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4174CurrentTaxYearMinus1Year
Current Tax Year4025CurrentTaxYear
Total75226Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years42071CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13849CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11107CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4174CurrentTaxYearMinus1Year
Current Tax Year4025CurrentTaxYear
Total75226Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years51710CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6295CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years49451CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year35796CurrentTaxYearMinus1Year
Current Tax Year44696CurrentTaxYear
Total187948Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10001019CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11445361CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11647940CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12474799CurrentTaxYearMinus1Year
Current Tax Year12050857CurrentTaxYear
Total57619976Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99540PublicSupportPercentage509
Prior Year Support Percentage0.94840PriorYearSupportPercentage
Investment Income Percentage0.00130InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00210PriorYrInvestIncomePercentage
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$187OtherActivitiesAmount
Total Lobbying Expenditures IIB187TotalLobbyingExpendituresIIB
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 Basis10463396OtherCostOrOtherBasis
Depreciation5513811Depreciation
Book Value4949585BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2967458OtherCostOrOtherBasis
Depreciation2178936Depreciation
Book Value788522BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5738107TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOTHER LIABILITIESDescription
Amount$15,158Amount
FieldValueIRS element (for citing)
Total Of Amounts15158TotalOfAmounts
Total Revenue11183657TotalRevenue
Total Expenses12143600TotalExpenses
Excess Or Deficit For Year-959943ExcessOrDeficitForYear
Net Unrealized GL On Investments5858NetUnrealizedGLOnInvestments
Other$845,000OtherAmount
Total Adjustments850858TotalAdjustments
Excess Or Deficit Per FS-109085ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt11327328TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments5858NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities80603DonatedSrvcAndUseOfFacilities
Other Revenues57210OtherRevenues
Revenue Not Rptd F990143671RevenueNotRptdF990
Revenue Subtotal11183657RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99011183657TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt12281413TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities80603DonatedServicesUseOfFacilities
Other Expenses Included57210OtherExpensesIncluded
Expenses Not Rptd F990137813ExpensesNotRptdF990
Expenses Subtotal12143600ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99012143600TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:EQUITY TRANSFER 845,000.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EVENT EXPENSE INCLUDED IN REVENUES 57,210.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:FUNDRASING EVENTS EXPENSES INCLUDED IN REVENUES 57,210.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event1100999GrossReceiptsEvent1
Charitable Contributions Event122200CharitableContributionsEvent1
Gross Revenue Event178799GrossRevenueEvent1
Cash Prizes Event1300CashPrizesEvent1
Non Cash Prizes Event119977NonCashPrizesEvent1
Rent Facility Costs Event111450RentFacilityCostsEvent1
Food And Beverage Event115002FoodAndBeverageEvent1
Other Direct Expenses Event110481OtherDirectExpensesEvent1
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Total100999GrossReceiptsTotal
Charitable Contributions Total22200CharitableContributionsTotal
Gross Revenue Total Events78799GrossRevenueTotalEvents
Cash Prizes Total Events300CashPrizesTotalEvents
Non Cash Prizes Total Events19977NonCashPrizesTotalEvents
Rent Facility Costs Total Events11450RentFacilityCostsTotalEvents
Food And Beverage Total Events15002FoodAndBeverageTotalEvents
Other Direct Expenses Total Events10481OtherDirectExpensesTotalEvents
Direct Expense Summary Events57210DirectExpenseSummaryEvents
Net Income Summary21589NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
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.
MERIT 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 B, LINE 15
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 5,858. EQUITY TRANSFER 845,000. TOTAL TO FORM 990, PART XI, LINE 5: 850,858.FORM 990, PART XI, LINE 5:
THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT SUPERVISES THE AUDIT AND ENGAGES THE AUDITOR.FORM 990 PART XI LINE 2C

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 Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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