| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING | 14,400 | 5,000 | 12,859 | 1,541 |
| Description of Property | Date Acquired | Cost or Other Basis | Prior Years' Depreciation | Computation Method | Rate / Life (# of years) |
Current Year's Depreciation Expense | Net Investment Income | Adjusted Net Income | Cost of Goods Sold Not Included |
|---|---|---|---|---|---|---|---|---|---|
| LAND IMPROVEMENTS | 2001-01-01 | 63,198 | 35,499 | SL | 20.000000000000 | 3,613 | 0 | 3,613 | |
| BUILDING | 2001-01-01 | 431,775 | 173,363 | SL | 10.000000000000 | 24,887 | 0 | 24,887 | |
| NURSING UNIT | 2001-01-01 | 1,168,522 | 411,177 | SL | 10.000000000000 | 39,176 | 0 | 39,176 | |
| FURNITURE AND EQUIPMENT | 2001-01-01 | 213,259 | 91,238 | SL | 10.000000000000 | 14,424 | 0 | 14,424 | |
| GENERATOR | 2001-01-01 | 61,359 | 17,193 | SL | 10.000000000000 | 3,139 | 0 | 3,139 | |
| MOTOR VEHICLES | 2001-01-01 | 36,677 | 5,502 | SL | 10.000000000000 | 3,668 | 0 | 3,668 | |
| LAND | 2001-01-01 | 6,822 | L | 0 | 0 | 0 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| EQUITY SECURITIES | 588,359 | 588,359 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| MUTUAL FUNDS | FMV | 2,211,774 | 2,211,774 |
| OTHER SECURITIES | FMV | 130,851 | 130,851 |
| LIFE INSURANCE ANNUITY CONTRACT | FMV | 45,065 | 45,065 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| LAND IMPROVEMENTS | 63,198 | 39,112 | 24,086 | 0 |
| BUILDING | 431,775 | 198,250 | 233,525 | 0 |
| NURSING UNIT | 1,168,522 | 450,353 | 718,169 | 0 |
| FURNITURE AND EQUIPMENT | 213,259 | 105,662 | 107,597 | 0 |
| GENERATOR | 61,359 | 20,332 | 41,027 | 0 |
| MOTOR VEHICLES | 36,677 | 9,170 | 27,507 | 0 |
| LAND | 6,822 | 0 | 6,822 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL | 1,033 | 0 | 922 | 111 |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| CONSTRUCTION IN PROGRESS | 46,202 | 46,202 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TELEPHONE | 4,760 | 0 | 4,250 | 510 |
| CONSULTANTS/SPECIALISTS | 20,678 | 0 | 18,465 | 2,213 |
| MISCELLANEOUS | 2,049 | 0 | 1,830 | 219 |
| FOOD | 104,319 | 0 | 93,153 | 11,166 |
| UTILITIES | 62,015 | 0 | 55,377 | 6,638 |
| NURSING/MEDICAL SUPPLIES | 49,929 | 0 | 44,585 | 5,344 |
| INSURANCE | 78,628 | 0 | 70,212 | 8,416 |
| MOTOR VEHICLE | 747 | 0 | 667 | 80 |
| ADVERTISING | 4,187 | 0 | 3,739 | 448 |
| LICENSES & FEES | 1,665 | 0 | 1,487 | 178 |
| OFFICE SUPPLIES & EXPENSE | 66,807 | 0 | 59,656 | 7,151 |
| FUNDRAISING | 1,390 | 0 | 1,241 | 149 |
| REPAIRS & MAINTENANCE | 54,508 | 0 | 48,673 | 5,835 |
| RESIDENT SERVICES | 44,479 | 0 | 39,718 | 4,761 |
| SEMINARS | 121 | 0 | 108 | 13 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| FEES FROM RESIDENTS | 544,379 | 544,379 | |
| LIFE CARE ADMISSIONS | 544,819 | 544,819 | |
| FUTURE SERV OBLIG CHN | 198,365 | 198,365 | |
| ADMISSION ADMIN FEE | 50,000 | 50,000 |
| Description | Amount |
|---|---|
| CHANGE IN NET UNREALIZED LOSSES ON INVESTMENTS | 213,515 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| ESTIMATED OBLIGATION TO PROVIDE FUTURE SERVICES | 1,939,828 | 1,741,463 |
| PORTFOLIO CREDIT LINE PAYABLE | 204,991 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PAYROLL TAXES | 75,883 | 0 | 67,760 | 8,123 |