ELMWOOD NURSING HOME INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: ELMWOOD NURSING HOME INC (EIN 39-1190907)
Tax period: 2009-07-01 to 2010-06-30
Filed: 2011-01-18
IRS object ID: 201110209349300106
Schema version: 2009v1.7
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule D
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-01-18T12:15:16-06:00	Timestamp
Tax Period End Date	2010-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BAUMAN ASSOCIATES LTD	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1225	AddressLine1
City	EAU CLAIRE	City
State	WI	State
ZIP Code	547021225	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	391190907	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ELMWOOD NURSING HOME INC	BusinessNameLine1
Business Name Line2	HERITAGE OF ELMWOOD NURSING HOME	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	ELMW	NameControl
Phone	7156392911	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	232 E Springer Ave	AddressLine1
City	ELMWOOD	City
State	WI	State
ZIP Code	54740	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RODNEY GILLES	Name
Title	ADMINISTRATOR	Title
Phone	7156392911	Phone
Date Signed	2011-01-17	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	MICHAEL R MAI CPA	Name
Phone	7158342001	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RODNEY GILLES	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	232 E Springer Ave	AddressLine1
City	ELMWOOD	City
State	WI	State
ZIP Code	54740	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	2549340	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Other	X	TypeOfOrganizationOther
Type Of Org Other Description	WISCONSIN NON STOCK, NOT FOR PROFIT	TypeOfOrgOtherDescription
Year Formation	1972	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE NURSING HOME CARE FOR THE COMMUNITY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	100	TotalNbrEmployees
Total Nbr Volunteers	33	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	8531	ContributionsGrantsPriorYear
Contributions Grants Current Year	5374	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	2748913	ProgramServiceRevenuePriorYear
Program Service Revenue CY	2492537	ProgramServiceRevenueCY
Investment Income Prior Year	15123	InvestmentIncomePriorYear
Investment Income Current Year	18624	InvestmentIncomeCurrentYear
Other Revenue Prior Year	32804	OtherRevenuePriorYear
Other Revenue Current Year	32805	OtherRevenueCurrentYear
Total Revenue Prior Year	2805371	TotalRevenuePriorYear
Total Revenue Current Year	2549340	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	1906930	SalariesEtcPriorYear
Salaries Etc Current Year	1745499	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	796403	OtherExpensePriorYear
Other Expenses Current Year	777132	OtherExpensesCurrentYear
Total Expenses Prior Year	2703333	TotalExpensesPriorYear
Total Expenses Current Year	2522631	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	102038	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	26709	RevenuesLessExpensesCY
Total Assets BOY	1985433	TotalAssetsBOY
Total Assets EOY	1963860	TotalAssetsEOY
Total Liabilities BOY	455324	TotalLiabilitiesBOY
Total Liabilities EOY	407042	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1530109	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	1556818	NetAssetsOrFundBalancesEOY
Mission Description	Providing nursing home care to the people in the community.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	2267922	Expense
Revenue	2492537	Revenue
Description	NURSING HOME CARE - PROVIDES NURSING HOME CARE TO ITS RESIDENTS.	Description
Total Program Service Expense	2267922	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Balance Sheet Amounts Reported	1	BalanceSheetAmountsReported
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	100	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	0	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	0	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	ADMINISTRATOR - NURSING HOME	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7156392911	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	232 E Springer AVE	AddressLine1
City	ELMWOOD	City
State	WI	State
ZIP Code	54740	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
Deb FEILER
PRESIDENT	0.50	X	X	0	0	0
Delores Radtke
BOARD MEMBER	0.50	X		0	0	0
DAN SCHULER
SEC - TREAS.	0.50	X	X	0	0	0
PHIL DZUBAY
Vice President	0.50	X	X	0	0	0
Pamela Marson
BoarD MEMBER	0.50	X		0	0	0
JULIE COGNETTA
BOARD MEMBER	0.50	X		0	0	0
TOM WEBER
BOARD MEMBER	0.50	X		0	0	0
Trisha Knops
BOARD MEMBER	0.50	X		0	0	0
Rodney J Gilles
Administrator	40.00		X	67517	0	2034

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	67517	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	2034	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
All Other Contributions	5374	AllOtherContributions
Total Contributions	5374	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NURSING CARE AND HOUSI	623000	2285817	2285817
OTHER INCOME	623000	206720	206720

Field	Value	IRS element (for citing)
Total Program Service Revenue	2492537	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	18624	TotalRevenueColumn
Exclusion	$18,624	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	32805	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	32805	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	32805	TotalRevenueColumn
Exclusion	$32,805	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2549340	TotalRevenueColumn
Related Or Exempt Function Income	2492537	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$51,429	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	67517	Total
Management And General	67517	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1472323	Total
Program Services	1472323	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	87000	Total
Program Services	84966	ProgramServices
Management And General	2034	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	118659	Total
Program Services	118659	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	7285	Total
Program Services	7285	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	90865	Total
Program Services	90865	ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
DIETARY	123641	123641
PLANT OPERATIONS	117752	117752
INSURANCE	100104		100104
ADMINISTRATIVE	89928	4874	85054
PROVIDER ASSESSMENT	85650	85650

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	161907	Total
Program Services	161907	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	2522631	Total
Program Services	2267922	ProgramServices
Management And General	254709	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	5107	BOY
EOY	4873	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	981571	BOY
EOY	1065400	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	261163	BOY
EOY	233055	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	7917	BOY
EOY	7917	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	48146	BOY
EOY	42127	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	2246145	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	1676921	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	640709	BOY
EOY	569224	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	40820	BOY
EOY	41264	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	1985433	BOY
EOY	1963860	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	283964	BOY
EOY	262051	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	171360	BOY
EOY	144991	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	455324	BOY
EOY	407042	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	1530109	BOY
EOY	1556818	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1530109	BOY
EOY	1556818	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1985433	BOY
EOY	1963860	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	1	AccountantCompileOrReview
FS Audited	0	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	7601	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6306	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	7621	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	8531	CurrentTaxYearMinus1Year
Current Tax Year	5374	CurrentTaxYear
Total	35433	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2913998	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2839106	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2777439	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2781717	CurrentTaxYearMinus1Year
Current Tax Year	2525342	CurrentTaxYear
Total	13837602	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2921599	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2845412	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2785060	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2790248	CurrentTaxYearMinus1Year
Current Tax Year	2530716	CurrentTaxYear
Total	13873035	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Total	0	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	13873035	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	52674	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	66660	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	28163	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	15123	CurrentTaxYearMinus1Year
Current Tax Year	18624	CurrentTaxYear
Total	181244	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	52674	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	66660	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	28163	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	15123	CurrentTaxYearMinus1Year
Current Tax Year	18624	CurrentTaxYear
Total	181244	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2974273	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2912072	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2813223	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2805371	CurrentTaxYearMinus1Year
Current Tax Year	2549340	CurrentTaxYear
Total	14054279	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.98710	PublicSupportPercentage509
Prior Year Support Percentage	0.98570	PriorYearSupportPercentage
Investment Income Percentage	0.01290	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.01430	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	7000	OtherCostOrOtherBasis
Book Value	7000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1540314	OtherCostOrOtherBasis
Depreciation	1130288	Depreciation
Book Value	410026	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	698831	OtherCostOrOtherBasis
Depreciation	546633	Depreciation
Book Value	152198	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	569224	TotalOfBookValueLandBuildings

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	DAN SCHULER	NamePerson

Field	Value	IRS element (for citing)
Relationship	CURRENT OFFICER SECRETARY - TREASURER	Relationship
Amount Of Transaction	54353	AmountOfTransaction
Description Of Transaction	PURCHASED WORKERS COMPENSATION INSURANCE FROM UNITED HEARTLAND THROUGH INSURANCE AGENT DAN SHULER.	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	ExplanationExplanation
Form 990, Part VI, Section A, line 6	THE VILLAGE OF ELMWOOD IS THE ONLY MEMBER OF THE ORGANIZATON. THE VILLAGE APPOINTS 7 BOARD MEMBERS FOR THE ELMWOOD NURSING HOME, INC.
Form 990, Part VI, Section A, line 7a	THE ORGANIZATION'S MEMBERS ELECT THE GOVERNING BOARD.
Form 990, Part VI, Section A, line 8b	THE ORGANIZATION DOES NOT APPOINT ANY COMMITTEES TO ACT ON BEHALF OF THE GOVERNING BODY.
Form 990, Part VI, Section B, line 11	THE BOARD OF DIRECTORS AND RODNEY GILLES WILL REVIEW THE 990 PRIOR TO FILING.
Form 990, Part VI, Section B, line 12c	The board of directors reviews the policy annually and they disclose any conflicts at that time.
Form 990, Part VI, Section B, line 15	THE BOARD OF DIRECTORS ANNUALLY REVIEWS COMPENSATION AMOUNTS FOR THE EMPLOYEES OF THE ORGANIZATION.
Form 990, Part VI, Section C, line 19	ELMWOOD NURSING HOME, INC. MAKES ITS 990 AVAILABLE UPON REQUEST.
Form 990, Part XI, Line 2c:	The board of directors assumes responsibility for oversight of the compilation of its financial statements and selection of an independent accountant. No changes have been made since prior year.