Fountain View Assisted Living in Sioux City, Iowa (IA)

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Fountain View Assisted Living
Employer Identification Number (EIN)421527142
Name of OrganizationFountain View Assisted Living
In Care of NameJohn Gerwulf
Address5501 Gordon Dr, Sioux City, IA 51106-2008
SubsectionCharitable Organization
Ruling Date11/2002
DeductibilityContributions are deductible
FoundationOrganization that normally receives no more than one third of its support from gross investment income and unrelated business income and at the same time more than one third of its support from contributions, fees, and gross receipts related to exempt purposes
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period12/2013
Assets$1,000,000 to $4,999,999
Income$1,000,000 to $4,999,999
Filing Requirement990 (all other) or 990EZ return
Asset Amount$1,025,276
Amount of Income$1,863,590
Form 990 Revenue Amount$1,863,590
National Taxonomy of Exempt Entities (NTEE)Human Services - Multipurpose and Other: Senior Continuing Care Communities


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Amount of income in 2013: $1,863,590 (it was $1,112,402 in 2012)
This organization: 

 $1,863,590
Other organizations performing similar types of work: 

 $551,043

Assets in 2013: $1,025,276 (it was $1,195,258 in 2012)
Fountain View Assisted Living: 

 $1,025,276
Other organizations performing similar types of work: 

 $1,169,520

Expenses in 2013: $2,033,572
Fountain View Assisted Living: 

 $2,033,572
Other organizations performing similar types of work: 

 $625,210

Income to expenses ratio in 2013: 0.9
Fountain View Assisted Living: 

 0.9
Other organizations performing similar types of work: 

 1.1

Number of employees in 2013: 102
This organization: 

 102
Other organizations performing similar types of work: 

 9

Grants share in income in 2013: 0.0%
Fountain View Assisted Living: 

 0.0%
Other organizations performing similar types of work: 

 0.3%

Financial snapshot ($)

Assets at the end of 2013

Functional expenses for 2013

Checklist
20122013
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?YesYes
Is the organization required to complete Schedule B, Schedule of Contributors?NoNo
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?NoNo
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?NoNo
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?NoNo
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?NoNo
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?NoNo
Did the organization maintain collections of works of art, historical treasures, or other similar assets?NoNo
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?NoNo
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?NoNo
Did the organization report an amount for land, buildings, and equipment?NoNo
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?NoNo
Did the organization report an amount for investments-program related that is 5% or more of its total assets?NoNo
Did the organization report an amount for other assets that is 5% or more of its total assets?YesYes
Did the organization report an amount for other liabilities?NoNo
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?NoYes
Did the organization obtain separate, independent audited financial statements for the tax year?NoNo
Was the organization included in consolidated, independent audited financial statements for the tax year?YesYes
Is the organization a school described in section 170(b)(1)(A)(ii)?NoNo
Did the organization maintain an office, employees, or agents outside of the United States?NoNo
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?NoNo
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?NoNo
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?NoNo
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?NoNo
Did the organization report more than $15,000 total of fundraising event gross income and contributions?NoNo
Did the organization report more than $15,000 of gross income from gaming activities?NoNo
Did the organization operate one or more hospital facilities?NoNo
Did the organization attach a copy of its audited financial statements?NoNo
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?NoNo
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?NoNo
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?NoNo
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?NoNo
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?NoNo
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?NoNo
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?NoNo
Did the organization engage in an excess benefit transaction with a disqualified person during the year?NoNo
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?NoNo
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?NoNo
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?NoNo
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?NoNo
A family member of a current or former officer, director, trustee, or key employee?NoNo
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?NoNo
Did the organization receive more than $25,000 in non-cash contributions?NoNo
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?NoNo
Did the organization liquidate, terminate, or dissolve and cease operations?NoNo
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?NoNo
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?NoNo
Was the organization related to any tax-exempt or taxable entity?YesYes
Did the organization have a controlled entity within the meaning of section 512(b)(13)?NoNo
Did the organization make any transfers to an exempt non-charitable related organization?NoNo
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?NoNo
Statements Regarding Other IRS Filings and Tax Compliance
201120122013
The number reported in Box 3 of Form 109600
The number of Forms W-2G00
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?NoNo
The number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return106102
Did the organization file all required federal employment tax returns?YesYes
Did the organization have unrelated business gross income of $1,000 or more during the year?NoNoNo
Has it filed a Form 990-T for this year?NoNo
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?NoNo
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?NoNo
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?NoNo
Did the organization file Form 8886-T?NoNo
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?NoNo
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?NoNo
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?NoNo
Did the organization notify the donor of the value of the goods or services provided?NoNo
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?NoNo
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?NoNo
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?NoNo
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?NoNo
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?NoNo
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?NoNo
Did the sponsoring organization make any taxable distributions under section 4966?NoNo
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?NoNo
Initiation fees and capital contributions$0$0$0
Gross receipts for public use of club facilities $0$0$0
Gross income from members or shareholders$0$0$0
Gross income from other sources$0$0$0
Is the organization filing Form 990 in lieu of Form 1041?NoNo
The amount of tax-exempt interest received or accrued during the year$0$0
Is the organization licensed to issue qualified health plans in more than one state?NoNo
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans$0$0
The amount of reserves on hand$0$0
Did the organization receive any payments for indoor tanning services during the tax year?NoNo
Has it filed a Form 720 to report these payments?NoNo
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
20122013
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization$0$0
Total reportable compensation from related organizations$187,345$304,809
Total estimated amount of other compensation from the organization and related organizations$7,845$25,729
Total number of individuals who received more than $100,000 of reportable compensation from the organization00
Total number of independent contractors who received more than $100,000 of compensation from the organization00
Statement of Revenue
201120122013
Total revenue$1,043,241$1,112,402$1,863,590
Contributions, Gifts, Grants and Other Similar Amounts$0$0$0
Program Service Revenue$1,043,241$1,112,402$1,863,590
623000$1,112,402$1,863,590
All other program service revenue$0$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)$0$0$0
Income from investment of tax-exempt bond proceeds$0$0$0
Royalties$0$0$0
Net rental income$0$0$0
Net gain/loss from sales of assets other than inventory$0$0$0
Net income/loss from fundraising events$0$0$0
Net income/loss from gaming activities$0$0$0
Net income/loss from sales of inventory$0$0$0
Miscellaneous Revenue$0$0$0
Statement of Functional Expenses
201120122013
Total functional expenses$789,649$1,004,681$2,033,572
Grants and other assistance to domestic organizations and domestic governments$0$0
Grants and other assistance to domestic individuals$0$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals$0$0
Benefits paid to or for members$0$0
Compensation of current officers, directors, trustees, and key employees$0$0$0
Compensation not included above, to disqualified persons$0$0
Other salaries and wages$437,158$519,340$760,339
Pension plan accruals and contributions$0$0
Other employee benefits$48,679$71,826
Payroll taxes$30,956$36,682$55,927
Fees for services (non-employees)
Management$0$0
Legal$0$0
Accounting$13,874$0
Lobbying$0$0
Professional fundraising services$0$0$0
Investment management fees$0$0
Other$0$0
Advertising and promotion$29,147$39,289
Office expenses$12,052$0
Information technology$0$0
Royalties$0$0
Occupancy$73,498$64,688
Travel$560$0
Payments of travel or entertainment expenses for any federal, state, or local public officials$0$0
Conferences, conventions, and meetings$0$0
Interest$0$337,843
Payments to affiliates$0$0
Depreciation, depletion, and amortization$8,135$358,160
Insurance$35,629$20,458
Other expenses$72,523$110,117
Other expenses$62,821$83,547
Other expenses$49,395$80,013
Other expenses$27,067$51,365
Balance Sheet
201120122013
Total assets$1,087,537$1,195,258$1,025,276
Cash - non-interest-bearing$75,562$121,307
Savings and temporary cash investments$0$0
Pledges and grants receivable, net$0$0
Accounts receivable, net$11,012$32,742
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees$0$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations$0$0
Notes and loans receivable, net$0$0
Inventories for sale or use$0$0
Prepaid expenses and deferred charges$0$0
Land, buildings, and equipment: cost or other basis$0$0
Investments - publicly traded securities$0$0
Investments - other securities$0$0
Investments - program-related$0$0
Intangible assets$0$0
Other assets$1,108,684$871,227
Total liabilities$0$0$0
Total net assets or fund balances$1,087,537$1,195,258$1,025,276
Unrestricted net assets$1,195,258$1,025,276
Temporarily restricted net assets$0$0
Permanently restricted net assets$0$0
Capital stock or trust principal, or current funds$0$0
Paid-in or capital surplus, or land, building, or equipment fund$0$0
Retained earnings, endowment, accumulated income, or other funds$0$0$0
Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:An organization that normally receives: (1) more than 33 1/3 % of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3 % of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975
Number of organizations supported0
Sum of amounts of support$0
Support Schedule for Organizations Described in Section 509(a)(2) (for 2009 - 2013)
2009 - 2013 Total
Public support$6,018,699
Subtotal$6,030,972
Gifts, grants, contributions, and membership fees received$0
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose$6,030,972
Gross receipts from activities that are not an unrelated trade or business under section 513$0
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf$0
The value of services or facilities furnished by a governmental unit to the organization without charge$0
Less$12,273
Amounts received from disqualified persons$12,273
Amounts received from other than disqualified persons that exceed the greater of $5,000 or 1% of the total support$0
Total support$6,030,972
Public support$6,030,972
Subtotal$0
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources$0
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975$0
Net income from unrelated business activities, whether or not the business is regularly carried on$0
Other income$0
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9Timothy Place Nfp Park Place Christian Comm Elmhurst18601 North Creek Drive, Tinley Park, IL 60477IL2007-01$10,181,537
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Number of organizations performing similar types of work
Alaska2
Alabama13
Arkansas6
Arizona13
California66
Colorado16
Connecticut8
District of Columbia3
Florida43
Georgia39
Hawaii5
Iowa10
Idaho1
Illinois27
Indiana9
Kansas8
Kentucky8
Louisiana6
Massachusetts21
Maryland37
Maine4
Michigan34
Minnesota24
Missouri20
Mississippi6
Montana4
North Carolina22
North Dakota2
Nebraska3
New Hampshire5
New Jersey13
New Mexico2
Nevada7
New York47
Ohio33
Oklahoma8
Oregon11
Pennsylvania27
Rhode Island2
South Carolina12
South Dakota4
Tennessee18
Texas56
Utah2
Virginia18
Vermont1
Washington10
Wisconsin16
West Virginia3
Wyoming2
International5
Total762

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