| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING & TAX SERVICES | 8,400 | 8,400 |
| Person Name | Explanation |
|---|---|
| SHAWNA STARNES BARBER | |
| CHAD OLDHAM | |
| WARREN SHULL | |
| BRENT CASSADY | |
| JIM AGAN | |
| DR JW MASON | |
| TIM MCCALL | |
| JULIE L MCMAHAN | |
| BARBARA SUTTERFIELD |
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| EQUIPMENT, FURNITURE, AUTO & IMPROV-VARIOUS | 128,144 | 110,321 | 6,952 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| EQUIPMENT, FURNITURE, AUTO & IMPROV. | 128,144 | 117,273 | 10,871 | 28,000 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| ADVERTISING | 211 | 211 | ||
| CONTRACT CONSULTANTS | 15,600 | 15,600 | ||
| DUES & SUBSCRIPTIONS | 401 | 401 | ||
| FOOD COST | 20,429 | 20,429 | ||
| HOUSEKEEPING | 1,462 | 1,462 | ||
| PROPERTY & LIABILITY INSURANC | 11,642 | 11,642 | ||
| MEDICAID FEES | 89 | 89 | ||
| MEDICAID PROVIDER FEES | 70,916 | 71,024 | ||
| POSTAGE | 679 | 679 | ||
| PROFESSIONAL MEDICAL SERVICES | 5,138 | 5,138 | ||
| PURCHASED DAY SERVICES | 116,890 | 116,549 | ||
| REPAIRS & MAINTENANCE | 9,855 | 9,855 | ||
| SUPPLIES | 16,546 | 16,546 | ||
| TELEPHONE/CABLE/INTERNET | 7,314 | 7,314 | ||
| TRANSPORTATION | 5,318 | 5,318 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| MEDICAID PAYMENTS | 743,680 | 743,680 | |
| PATIENT LIABILITY | 61,875 | 61,875 | |
| MISCELLANEOUS INCOME | 8,352 | 8,352 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| STATE GOVERNMENT FEES/BACKGROUND | 820 | 820 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PERSONAL PROPERTY TAX | 336 | 336 | ||
| LICENSES & PERMITS | 245 | 245 | ||
| FORM 990PF FEDERAL TAX | 1 | 1 |