2024-10-28T12:45:02-05:00 2024-06-30 470625816 LUTZ AND COMPANY PC 3320 JAMES ROAD SUITE 100 GRAND ISLAND NE 68803 990PF 2023-07-01 470690851 COFFMAN-LEVI CHARITABLE TRUST INC DBA GOLD CREST RETIREMENT CENTER COFF 4029887115 200 LEVI LANE ADAMS NE 683018830 CHRIS GRAMANN CHAIRMAN 4029887115 2024-10-22 1 0 STEVEN K PLACKE P00078534 3083827850 2024-10-22 2023 2024-10-15 13:58:12Z X 18287063 X 56350 98366 98366 98366 -8587 0 0 5776683 0 5776683 5922812 98366 5875049 3583 0 3583 0 3112372 0 3112372 0 274983 0 274983 0 17755 0 17755 0 221415 0 221415 0 253716 0 253716 115773 0 115773 0 27626 0 27626 0 2414 0 2414 0 1845575 0 1845575 0 5875212 0 5875212 0 0 0 5875212 0 5875212 0 47600 98366 0 1559002 994185 994185 452540 530999 452540 452540 2570011 3034171 3034171 11491454 6764568 4364693 4726886 13796324 3700 9843 9843 9028405 9217625 18287063 382820 499248 29580 54772 412400 554020 X 8616005 8663605 8616005 8663605 9028405 9217625 8616005 47600 0 8663605 0 8663605 X 1988-08-25 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 1 WWW.GOLDCREST.NET JENNIFER GRAFF 4029887115 200 LEVI LANE ADAMS NE 68301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MAX GRAMANN PO BOX 106 ADAMS NE 68301 BOARD MEMBER 2.00 950 0 0 WES SIEFKES PO BOX 33 ADAMS NE 68301 BOARD MEMBER 2.00 450 0 0 CHRIS GRAMANN PO BOX 106 ADAMS NE 68310 CHAIRMAN 2.00 700 0 0 RONALD SUTTER 415 N 21ST BEATRICE NE 68310 BOARD MEMBER 2.00 525 0 0 JULIE KEALY 7500 N HAMPTON ROAD LINCOLN NE 68506 SECRETARY 2.00 783 0 0 JOE GRAMANN PO BOX 106 ADAMS NE 68301 BOARD MEMBER 2.00 175 0 0 JENNIFER GRAFF 200 LEVI LANE ADAMS NE 68301 EXECUTIVE DIRECTOR 40.00 138468 0 0 KILI KRAUTER 200 LEVI LANE ADAMS NE 68301 DIRECTOR OF NURSING 40.00 100360 0 0 0 NONE 0 OPERATE AND MAINTAIN A FACILITY FOR THE LONG-TERM CARE, COMFORT, AND MAINTENANCE OF THE ELDERLY. 4754976 0 0 8042 45000 53042 0 0 53042 796 52246 2612 X 0 0 758554 758554 1988-08-25 X 0 0 758554 1730979 84175 132411 2706119 0 0 0 0 0 758554 1730979 84175 132411 2706119 1741 1555 1543 1502 6341 X 0 0 PRIVATE CARE REVENUE 2130856 ASSISTED LIVING CARE REVENUE 871785 DAYCARE REVENUE 442186 MEDICARE/MEDICAID PMTS 2222277 14 98366 -8587 BEAUTY SHOP NET INCOME 1362 MEAL INCOME 26736 FARM INCOME 3823 DUPLEX INCOME (NET) 74319 MISCELLANEOUS INCOME 3339 0 98366 5768096 5866462 1A 1A - 1E INCOME FROM OPERATION OF LONG-TERM CARE FACILITY. 11A 11A - 11E INCOME FROM LONG-TERM CARE FACILITY SUPPORT SERVICES. 0 0 0 0 0 0 0 0 0 0 X X 1 NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES-ARPA 301 CENTENNIAL MALL SOUTH LINCOLN NE 68509 52343 X INDIRECT ACCOUNTING FEES 17755 0 17755 0 NOT APPLICABLE CERTIFICATES OF DEPOSIT FMV 233566 233566 CERTIFICATES OF DEPOSIT FMV 2800605 2800605 ACCRUED INTEREST RECEIVABLE 3700 9843 9843 ADVERTISING 39132 0 39132 0 DUES AND LICENSES 10462 0 10462 0 FOOD 247522 0 247522 0 LIABILITY INSURANCE 57800 0 57800 0 PROPERTY INSURANCE 93666 0 93666 0 MISCELLANEOUS 9339 0 9339 0 OFFICE SUPPLIES 13629 0 13629 0 MEDICARE SERVICES & SUPPLIES 248329 0 248329 0 CONTRACTED SERVICES 781597 0 781597 0 REPAIRS AND MAINTENANCE 75343 0 75343 0 RESIDENT BENEFITS 29264 0 29264 0 SUPPLIES 174991 0 174991 0 TELEPHONE 12777 0 12777 0 CLINIC FEES AND SUPPLIES 6100 0 6100 0 COMPUTER SUPPORT 33313 0 33313 0 LEASE EXPENSE 12311 0 12311 0 PRIVATE CARE REVENUE 2130856 2130856 ASSISTED LIVING CARE REVENUE 871785 871785 DAYCARE REVENUE 442186 442186 MEDICARE/MEDICAID PMTS 2222277 2222277 BEAUTY SHOP NET INCOME 1362 1362 MEAL INCOME 26736 26736 FARM INCOME 3823 3823 DUPLEX INCOME (NET) 74319 74319 MISCELLANEOUS INCOME 3339 3339 RESIDENT CASH 1180 1578 DAMAGE DEPOSITS-DUPLEXES/TOWNHOUSES 28400 28210 RESIDENT CARE ADVANCES 0 24984 PAYROLL TAXES 221415 0 221415 0