2024-05-09T12:08:18-05:00 2023-06-30 470625816 LUTZ AND COMPANY PC 3320 JAMES ROAD SUITE 100 GRAND ISLAND NE 68803 990 2022-07-01 470378987 CROWELL MEMORIAL HOME CROW 4024262177 245 SOUTH 22ND STREET BLAIR NE 68008 DAVID DREW PRESIDENT 4024262177 2024-04-29 1 DAVID DREW 999009999 0 STEVEN K PLACKE P00078534 3083827850 2024-04-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DAVID DREW 1612 LINCOLN ST BLAIR NE 68008 6174245 0 X WWW.CROWELLMEMORIALHOME.COM X 1975 NE NURSING HOME AND ASSISTED LIVING CARE FOR THE ELDERLY AND DISABLED, INCLUDING PRIVATE PAY, MEDICAID, AND MEDICARE ELIGIBLE RESIDENTS. 10 10 162 0 0 0 1185299 207415 5255083 5952659 -9900 1966 2710 12205 6433192 6174245 0 0 0 0 3874900 4446851 0 0 0 2384534 2090713 6259434 6537564 173758 -363319 3701687 3145266 611058 407337 3090629 2737929 NURSING HOME AND ASSISTED LIVING CARE FOR THE ELDERLY AND DISABLED, INCLUDING PRIVATE PAY, MEDICAID, AND MEDICARE ELIGIBLE RESIDENTS. 0 0 5983368 5964864 NURSING HOME AND ASSISTED LIVING CARE FOR THE ELDERLY AND DISABLED. RESIDENTS INCLUDE PRIVATE PAY, MEDICAID, AND MEDICARE ELIGIBLE RESIDENTS. 5983368 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 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 1 0 0 0 1 18 0 1 162 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X X JACLYN SVENDGARD 4024262177 245 S 22ND ST BLAIR NE 68008 X DOUG ANDERSON VICE PRESIDENT 1.00 X X 0 0 0 GLENN COATES BOARD MEMBER 1.00 X 0 0 0 SUZIE KIRWAN BOARD MEMBER 1.00 X 0 0 0 KIM CULP BOARD MEMBER 1.00 X 0 0 0 JACLYN SVENDGARD ADMINISTRATOR 1.00 X 0 0 0 DAVID DREW PRESIDENT 1.00 X X 0 0 0 STACY BENNER SECRETARY 1.00 X X 0 0 0 GINA GILES BOARD MEMBER 1.00 X 0 0 0 JOAN BRYANT BOARD MEMBER 1.00 X 0 0 0 CHAD LEGGOTT TREASURER 1.00 X X 0 0 0 JAY WOLFF BOARD MEMBER 1.00 X 0 0 0 0 0 0 0 0 0 0 0 207415 207415 MEDICAID 623000 3784921 3784921 PRIVATE PAY RESIDENTS 623000 811494 811494 MEDICARE 623000 722867 722867 ASSISTED LIVING MEDICA 623000 433035 433035 ASSISTED LIVING PRIVAT 623000 200342 200342 5952659 1966 1966 MISCELLANEOUS INCOME 623000 12205 12205 12205 6174245 5964864 0 1966 X 3757200 3486241 270959 406418 377102 29316 283233 262802 20431 18880 18880 920439 798948 121491 20585 60 20525 21867 21867 253670 253670 14773 7527 7246 287553 287553 75691 75691 FOOD 233181 233181 SUPPLIES 175707 175707 CMS PENALTY 30000 30000 BEAUTY SHOP EXPENSES 17477 17477 20890 7409 13481 6537564 5983368 554196 0 148977 263848 96558 53032 644407 635063 10467 10137 10308 59668 9535547 7419169 2370713 2116378 420257 7140 3701687 3145266 600709 407337 10349 0 611058 407337 X 3083489 2730789 7140 7140 3090629 2737929 3701687 3145266 X -363319 270 10349 X 0 1 X 1 0 X 15829 265882 221545 98078 33564 634898 5646594 5843042 5205019 5254139 5952659 27901453 47866 47866 5710289 6108924 5426564 5352217 5986223 28584217 0 0 0 28584217 2227 652 190 271 1966 5306 2227 652 190 271 1966 5306 5712516 6109576 5426754 5352488 5988189 28589523 0.99980 0.00020 X 6888 6888 8167963 6201738 1966225 1241803 1155223 86580 118893 62208 56685 2116378 X 6174515 270 270 6174245 0 6174245 6537564 0 6537564 0 6537564 PART X, LINE 2: THE HOME IS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE HOME'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE HOME'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOME AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE HOME HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOME IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOME'S MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2020. THE HOME'S POLICY IS TO INCLUDE PENALTIES AND INTEREST ASSOCIATED WITH INCOME TAXES AS INCOME TAX EXPENSE AND INTEREST EXPENSE, RESPECTIVELY. THE HOME DID NOT INCUR ANY PENALTIES OR INTEREST ON INCOME TAXES FOR THE PERIODS BEING REPORTED. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PRESENTED AT A BOARD MEETING AND REVIEWED ALONG WITH THE ORGANIZATION'S FINANCIAL STATEMENTS. FOLLOWING THE REVIEW, THE FORM IS SIGNED FOR FILING. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH INDIVIDUAL REQUEST. FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 57,943. MANAGEMENT AND GENERAL EXPENSES 121,491. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 179,434. NURSING CONSULTANTS: PROGRAM SERVICE EXPENSES 66,162. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,162. CONTRACTED SERVICES - PLANT: PROGRAM SERVICE EXPENSES 37,915. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,915. CONTRACTED SERVICES - NURSING: PROGRAM SERVICE EXPENSES 268,454. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 268,454. POOL NURSING: PROGRAM SERVICE EXPENSES 368,474. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 368,474. FORM 990, PART XI, LINE 9: INTER-COMPANY PAYABLE (FOUNDATION) 10,349. CROWELL MEMORIAL HOME FOUNDATION 245 S 22ND STREET BLAIR NE 68008 470810702 SUPPORT NE 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 CROWELL MEMORIAL HOME FOUNDATION E