Liabilities / Assets
74th percentile
Higher debt load relative to assets than 74% of similar nonprofits.
Health Services Management Inc
EIN 62-1808817 • 501(c)3 • Murfreesboro, TN
Profile
To provide care for indigent and elderly individuals in nursing homes and assisted living facilities.
Siviq Scores
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
0.60x
Liabilities / Revenue
68th percentile
Higher debt load relative to revenue than 68% of similar nonprofits.
Net Margin
59th percentile
Higher net margin than 59% of similar nonprofits.
Top Officer Pay
64th percentile
Higher top officer pay than 64% of similar nonprofits.
Top officer pay equals 0.5% of source-year revenue.
Asset Growth
30th percentile
Faster asset growth than 30% of similar nonprofits.
Revenue Growth
63rd percentile
Faster revenue growth than 63% of similar nonprofits.
Balance Sheet
Assets
Up$159,018,685
Up $2,480,187 (+1.6%) from 2023
Liabilities
Down$94,768,344
Down $10,618,135 (-10%) from 2023
Net Assets
Up$64,250,341
Up $13,098,322 (+26%) from 2023
Revenue
Up$121,311,118
Up $14,174,208 (+13%) from 2023
Expenses
Down$111,569,768
Down $3,655,452 (-3.2%) from 2023
Net Income
Up$9,741,350
Up $17,829,660 (+220%) from 2023
Trend Graphs
Filings
Most recent year
2024 • Form 990Detailed filing. Detailed filing data is available for this year.
- Assets
- $159,018,685
- Liabilities
- $94,768,344
- Net assets
- $64,250,341
- Revenue
- $121,311,118
- Expenses
- $111,569,768
- Net income
- $9,741,350
Latest Filing Detail
Jump To
Filing Snapshot
- Filing Period
- Jan 1, 2024 to Dec 31, 2024
- Signed
- Nov 12, 2025
- Return Version
- 2024v5.1
- Gross Receipts
- $121,963,810
Mission and Program Overview
Mission
To provide care for indigent and elderly individuals in nursing homes and assisted living facilities.
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Land, Buildings, and Equipment, Net | $61,932,949 | $47,483,659 | ▼ $14,449,290 |
| Savings and Temporary Cash Investments | $7,829,998 | $15,956,073 | ▲ $8,126,075 |
| Other Notes and Loans Receivable, Net | $1,638,435 | $13,102,751 | ▲ $11,464,316 |
| Accounts Receivable | $9,823,534 | $10,806,625 | ▲ $983,091 |
| Cash and Non-Interest-Bearing Accounts | $6,151,572 | $6,400,745 | ▲ $249,173 |
| Prepaid Expenses and Deferred Charges | $1,608,546 | $1,383,552 | ▼ $224,994 |
| Investments Other Securities | $563,239 | $715,354 | ▲ $152,115 |
| Inventories for Sale or Use | $426,752 | $336,320 | ▼ $90,432 |
| Receivable From Disqualified Prsn | $0 | $0 | → $0 |
| Receivables From Officers Etc | $0 | $0 | → $0 |
| Investments Program Related | $0 | - | - |
| Loans From Officers Directors | $0 | $0 | → $0 |
| Total Assets | $156,538,498 | $159,018,685 | ▲ $2,480,187 |
| Other Assets Total | $66,563,473 | $62,833,606 | ▼ $3,729,867 |
| Liabilities | |||
| Other Liabilities | $62,378,149 | $54,397,125 | ▼ $7,981,024 |
| Mortgage Notes Payable Secured by Investment Property | $35,551,009 | $34,014,554 | ▼ $1,536,455 |
| Accounts Payable and Accrued Expenses | $7,032,048 | $6,078,129 | ▼ $953,919 |
| Escrow Account Liability | $425,273 | $278,536 | ▼ $146,737 |
| Total Liabilities | $105,386,479 | $94,768,344 | ▼ $10,618,135 |
| Net Assets / Fund Balance | |||
| Net Assets Without Donor Restrictions | $51,152,019 | $64,250,341 | ▲ $13,098,322 |
| Total Net Assets Fund Balance | $51,152,019 | $64,250,341 | ▲ $13,098,322 |
| Total Liabilities and Net Assets / Fund Balance | $156,538,498 | $159,018,685 | ▲ $2,480,187 |
Asset Categories
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Buildings | $35,612,156 | $28,121,638 | $63,733,794 |
| Leasehold Improvements | $5,482,991 | $10,267,010 | $15,750,001 |
| Equipment | $1,295,268 | $6,905,067 | $8,200,335 |
| Other Land Buildings | $1,308,795 | $4,057,744 | $5,366,539 |
| Land | $3,784,449 | - | $3,784,449 |
| Other Assets Org | $5,716,447 | - | - |
Compensation and Service Providers
Employees
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| Jim Shatz | CEO | FT | $589,168 | $60,250 | $649,418 |
| Scott Fisher | CFO | FT | $589,168 | $60,250 | $649,418 |
| Josh White | COO | FT | $408,883 | $32,250 | $441,133 |
| Brian Jackson | Chief Quality & Risk Officer | FT | $344,893 | $32,250 | $377,143 |
| Anita Mamone | Chief Legal & Governance Officer | FT | $285,164 | - | $285,164 |
| Kevin Baxter | VP of Operations | FT | $257,367 | $18,000 | $275,367 |
| Samantha Allen | Chief Nursing Officer | FT | $273,915 | - | $273,915 |
| Clint Wells | VP, Revenue Cycle Management | FT | $253,282 | - | $253,282 |
| Jerald Erlandson | Director of Client Services | FT | $236,487 | - | $236,487 |
| Shelby Jackson | Administrator | FT | $201,637 | - | $201,637 |
| Mark Richardson | Corporate Director of Compliance & a | FT | $197,308 | - | $197,308 |
| Randy Shuck | Chairman, Director | - | $100,500 | - | $100,500 |
| Robert Conroy | Director | - | $100,500 | - | $100,500 |
| Timothy Priddy | Director | - | $97,000 | - | $97,000 |
Highest Paid Contractors
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Crestmark Pharmacy | Pharmacy | 1860 HIGHLAND OAKS BLVD, Lutz, FL 33559 | $13,979,373 |
| Reliant Rehabiliatation | Therapy | 5800 GRANITE PARKWAY STE 1000, Plano, TX 75024 | $5,435,866 |
| US Foods | Food & Dietary Supplies | POB 281841, Atlanta, GA 30384 | $2,364,104 |
| Medline | Medical Supplies | DPT CH 14400, Palatine, IL 60055 | $2,109,959 |
| Quality Care Rehab | Therapy | 8477 S SUNCOAST BLVD, Homosassa, FL 34446 | $799,950 |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $12,393
- Program Service Revenue
- $102,017,043
- Investment Income
- $13,650,873
- Other Revenue
- $5,630,809
- All Other Contributions
- $11,918
- Change in Net Assets
- $9,741,350
Audited Revenue Reconciliation
- Revenue per Audited Statements
- $0
- Revenue Not Reported on Financial Statements
- $0
- Revenue Not Reported on Form 990
- $0
- Other Revenue Adjustments
- $0
- Total Revenue per Form 990
- $0
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Other Expenses | $57,766,491 |
| Salaries, Compensation, and Employee Benefits | $53,803,277 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Salaries and Wages | $43,719,204 | $142,802 | - | $43,862,006 |
| Fees for Services Other | $13,300,934 | $556,741 | $0 | $13,857,675 |
| Occupancy | $13,253,339 | $280,947 | - | $13,534,286 |
| Insurance | $4,153,961 | $149,587 | - | $4,303,548 |
| Current Officers, Directors, Trustees, and Key Employees | $892,334 | $3,318,438 | - | $4,210,772 |
| Depreciation Depletion | $3,512,289 | $241,104 | - | $3,753,393 |
| Payroll Taxes | $3,301,552 | $155,274 | - | $3,456,826 |
| Other Expenses | $2,759,664 | $0 | - | $2,759,664 |
| All Other Expenses | $2,073,396 | $306,756 | $0 | $2,380,152 |
| Other Employee Benefits | $2,149,586 | $36,507 | - | $2,186,093 |
| Information Technology | $199,772 | $923,143 | - | $1,122,915 |
| Office Expenses | $571,732 | $449,597 | - | $1,021,329 |
| Interest | $847,528 | $50,918 | - | $898,446 |
| Advertising | $263,371 | $489,243 | - | $752,614 |
| Fees for Services Legal | - | $722,481 | - | $722,481 |
| Conferences and Meetings | $201,099 | $162,074 | - | $363,173 |
| Fees for Services Accounting | - | $229,447 | - | $229,447 |
| Travel | $75,518 | $75,033 | - | $150,551 |
| Pension Plan Contributions | $87,580 | - | - | $87,580 |
| Total Functional Expenses | $102,030,473 | $9,539,295 | $0 | $111,569,768 |
Audited Expense Reconciliation
| Line Item | Amount |
|---|---|
| Expenses Not Reported on Financial Statements | $0 |
| Expenses Not Reported on Form 990 | $0 |
| Expenses per Audited Statements | $0 |
| Other Expense Adjustments | $0 |
| Total Expenses per Form 990 | $0 |
Fundraising, Events, and Gaming
- Fundraising activities
- No
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
Political and Lobbying Activity
- Political campaign activity
- No
- Lobbying activity
- No
- Subject to proxy tax
- No
Insider Transactions and Loans
Loans and Receivables
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Loans from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Receivables from Disqualified Persons | $0 | $0 | → $0 |
| Receivables from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
Debt and Bond Financing
Other Reported Liabilities
| Liability | Amount |
|---|---|
| Lease Liability | $49,772,383 |
| Due to Related Parties | $4,621,380 |
| Other Liabilities | $3,362 |
| Federal Income Taxes | $0 |
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- Yes
- Annual disclosure for covered persons
- Yes
- Audit committee
- Yes
- Backup withholding compliance
- Yes
- Business relationship with 35% controlled entity
- No
- Business relationship with family members
- No
- Business relationship with organization members
- No
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- Yes
- Other officer compensation reviewed
- Yes
- Conflict-of-interest policy
- Yes
- Audited financial statements prepared
- Yes
- Key decisions subject to board approval
- No
- Management duties delegated
- No
Governance Explanations
Form 990, Part VI, Line 11B Review of form 990 by governing body
“The organization's general counsel reviewed the form 990 and provided comments and questions to the return preparer. A copy of the form 990 was emailed to the board prior to filing with the irs.”
Form 990, Part VI, Line 12C Conflict of interest policy
“Questionnaires are completed annually by all officers, directors, and key employees.”
Form 990, Part VI, Line 15A Process to establish compensation of top management official
“The organization used the services of an independent firm to review the compensation of the officers of the organization and related entities to determine if their compensation was comparable to other executives and entities in the same line of business. In addition, independent board members review the compensation of the inside board members, and the full board then approves compensation payable to both the inside and independent board members. Management determines the compensation of the other officers and key employees.”
Form 990, Part VI, Line 15B Process to establish compensation of other employees
“The organization used the services of an independent firm to review the compensation of the officers of the organization and related entities to determine if their compensation was comparable to other executives and entities in the same line of business. In addition, independent board members review the compensation of the inside board members, and the full board then approves compensation payable to both the inside and independent board members. Management determines the compensation of the other officers and key employees.”
Form 990, Part VI, Line 19 Required documents available to the public
“The organization's governing documents, conflict of interest policy or financial data, are available upon request.”
Filing and Contact Details
Filer
- Filer Name
- Health Services Management Inc
- EIN
- 62-1808817
- Phone
- 6158961191
- Address
- 206 Fortress Boulevard, Murfreesboro, TN 37128
Signing Officer
- Name
- James Shatz
- Title
- Principal Officer
- Phone
- 6158961191
- Signed
- 2025-11-12
- Discuss with paid preparer
- Yes
Organization Details
- Formed
- 2000
- Legal Domicile
- Tn
- Voting Board Members
- 5
- Independent Board Members
- 3
- Employees
- 3,572
- Volunteers
- 0
Preparer
- Firm
- Forvis Mazars LLP
- Address
- 255 South Orange Avenue Suite 600, Orlando, FL 32801
- Preparer
- Harry Harp
- Phone
- 4077405400
Supplemental Narrative
Additional Explanations
Form 990, Part IX, Line 11G Other Fees
“PURCHASED SERVICES - Total Expense: 10966720, Program Service Expense: 10952463, Management and General Expenses: 14257, Fundraising Expenses: ; PROFESSIONAL FEES - Total Expense: 2189323, Program Service Expense: 1731754, Management and General Expenses: 457569, Fundraising Expenses: ; PAYROLL PROCESSING FEE - Total Expense: 406293, Program Service Expense: 321378, Management and General Expenses: 84915, Fundraising Expenses: ; CASE MANAGEMENT - Total Expense: 295339, Program Service Expense: 295339, Management and General Expenses: 0, Fundraising Expenses: ;”
Form 990, Part XI, Line 8 Reconciliation of Net Assets
“Prior period adjustments were made after tax return was filed.”
Form 990, Part XII, Line 2C FINANCIAL STATEMENTS AND REPORTING
“The process is the same as in the prior year.”
Financial Statement Notes
Schedule D, Part IV, Line 2B Explanation of escrow agreement
“The organization uses a third party administrator to manage the funds held in trust for residents.”
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote
“Management performs an evaluation of all income tax positions taken or expected to be taken in the course of preparing the organization's income tax returns to determine whether the income tax positions meet a "more likely than not" standard of being sustained under examination by the applicable taxing authorities. Management has performed its evaluation of all income tax positions taken on all open income tax returns and has determined that there were no positions taken that do not meet the "more likely than not" standard. Accordingly, there are no provisions for income taxes, penalties or interest receivable or payable relating to uncertain income tax positions in the accompanying financial statements.”
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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
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| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 8 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 9 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 10 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 11 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 12 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 13 | 40.0 |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | JIM SHATZ |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | SCOTT FISHER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | RANDY SHUCK |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | ROBERT CONROY |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | TIMOTHY PRIDDY |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 5 | ANITA MAMONE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 6 | BRIAN JACKSON |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 7 | JOSH WHITE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 8 | SAMANTHA ALLEN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 9 | CLINT WELLS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 10 | JERALD ERLANDSON |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 11 | KEVIN BAXTER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 12 | MARK RICHARDSON |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 13 | SHELBY JACKSON |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 649418 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 649418 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 100500 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 100500 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 97000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 5 | 285164 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 6 | 377143 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 7 | 441133 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 8 | 273915 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 9 | 253282 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 10 | 236487 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 11 | 275367 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 12 | 197308 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 13 | 201637 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | CEO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | CFO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | CHAIRMAN, DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | CHIEF LEGAL & GOVERNANCE OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 6 | CHIEF QUALITY & RISK OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 7 | COO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 8 | CHIEF NURSING OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 9 | VP, REVENUE CYCLE MANAGEMENT |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 10 | DIRECTOR OF CLIENT SERVICES |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 11 | VP OF OPERATIONS |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 12 | CORPORATE DIRECTOR OF COMPLIANCE & A |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 13 | ADMINISTRATOR |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | true |
| IRS990/FormationYr | 0 | 2000 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | false |
| IRS990/FSAuditedBasisGrp/ConsolAndSepBasisFinclStmtInd | 0 | X |
| IRS990/FSAuditedInd | 0 | true |
| IRS990/FundraisingActivitiesInd | 0 | false |
| IRS990/GainOrLossGrp/OtherAmt | 0 | 11203415 |
| IRS990/GainOrLossGrp/SecuritiesAmt | 0 | 2236377 |
| IRS990/GamingActivitiesInd | 0 | false |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 5 |
| IRS990/GovernmentGrantsAmt | 0 | 475 |
| IRS990/GrantsToIndividualsInd | 0 | false |
| IRS990/GrantsToOrganizationsInd | 0 | false |
| IRS990/GrantToRelatedPersonInd | 0 | false |
| IRS990/GrossAmountSalesAssetsGrp/OtherAmt | 0 | 11667224 |
| IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt | 0 | 2425260 |
| IRS990/GrossReceiptsAmt | 0 | 121963810 |
| IRS990/GrossRentsGrp/RealAmt | 0 | 5616487 |
| IRS990/GroupReturnForAffiliatesInd | 0 | false |
| IRS990/IncludeFIN48FootnoteInd | 0 | true |
| IRS990/IndependentAuditFinclStmtInd | 0 | false |
| IRS990/IndependentVotingMemberCnt | 0 | 3 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 58 |
| IRS990/IndoorTanningServicesInd | 0 | false |
| IRS990/InfoInScheduleOPartIXInd | 0 | X |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt | 0 | 923143 |
| IRS990/InformationTechnologyGrp/ProgramServicesAmt | 0 | 199772 |
| IRS990/InformationTechnologyGrp/TotalAmt | 0 | 1122915 |
| IRS990/InsuranceGrp/ManagementAndGeneralAmt | 0 | 149587 |
| IRS990/InsuranceGrp/ProgramServicesAmt | 0 | 4153961 |
| IRS990/InsuranceGrp/TotalAmt | 0 | 4303548 |
| IRS990/InterestGrp/ManagementAndGeneralAmt | 0 | 50918 |
| IRS990/InterestGrp/ProgramServicesAmt | 0 | 847528 |
| IRS990/InterestGrp/TotalAmt | 0 | 898446 |
| IRS990/InventoriesForSaleOrUseGrp/BOYAmt | 0 | 426752 |
| IRS990/InventoriesForSaleOrUseGrp/EOYAmt | 0 | 336320 |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 211081 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 211081 |
| IRS990/InvestmentInJointVentureInd | 0 | true |
| IRS990/InvestmentsOtherSecuritiesGrp/BOYAmt | 0 | 563239 |
| IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt | 0 | 715354 |
| IRS990/InvestmentsProgramRelatedGrp/BOYAmt | 0 | 0 |
| IRS990/IRPDocumentCnt | 0 | 155 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LandBldgEquipAccumDeprecAmt | 0 | 49351459 |
| IRS990/LandBldgEquipBasisNetGrp/BOYAmt | 0 | 61932949 |
| IRS990/LandBldgEquipBasisNetGrp/EOYAmt | 0 | 47483659 |
| IRS990/LandBldgEquipCostOrOtherBssAmt | 0 | 96835118 |
| IRS990/LegalDomicileStateCd | 0 | TN |
| IRS990/LessCostOthBasisSalesExpnssGrp/OtherAmt | 0 | 463809 |
| IRS990/LessCostOthBasisSalesExpnssGrp/SecuritiesAmt | 0 | 188883 |
| IRS990/LoanOutstandingInd | 0 | false |
| IRS990/LoansFromOfficersDirectorsGrp/BOYAmt | 0 | 0 |
| IRS990/LoansFromOfficersDirectorsGrp/EOYAmt | 0 | 0 |
| IRS990/LobbyingActivitiesInd | 0 | false |
| IRS990/LocalChaptersInd | 0 | false |
| IRS990/MaterialDiversionOrMisuseInd | 0 | false |
| IRS990/MembersOrStockholdersInd | 0 | false |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
| IRS990/MinutesOfCommitteesInd | 0 | true |
| IRS990/MinutesOfGoverningBodyInd | 0 | true |
| IRS990/MiscellaneousRevenueGrp/ExclusionAmt | 0 | 0 |
| IRS990/MiscellaneousRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 0 |
| IRS990/MiscellaneousRevenueGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/MiscellaneousRevenueGrp/UnrelatedBusinessRevenueAmt | 0 | 0 |
| IRS990/MissionDesc | 0 | TO PROVIDE CARE FOR INDIGENT AND ELDERLY INDIVIDUALS IN NURSING HOMES AND ASSISTED LIVING FACILITIES. |
| IRS990/MoreThan5000KToIndividualsInd | 0 | false |
| IRS990/MoreThan5000KToOrgInd | 0 | false |
| IRS990/MortgNotesPyblScrdInvstPropGrp/BOYAmt | 0 | 35551009 |
| IRS990/MortgNotesPyblScrdInvstPropGrp/EOYAmt | 0 | 34014554 |
| IRS990/NetAssetsOrFundBalancesBOYAmt | 0 | 51152019 |
| IRS990/NetAssetsOrFundBalancesEOYAmt | 0 | 64250341 |
| IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt | 0 | 13439792 |
| IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt | 0 | 13439792 |
| IRS990/NetIncmFromFundraisingEvtGrp/TotalRevenueColumnAmt | 0 | 0 |
| IRS990/NetRentalIncomeOrLossGrp/RelatedOrExemptFuncIncomeAmt | 0 | 5616487 |
| IRS990/NetRentalIncomeOrLossGrp/TotalRevenueColumnAmt | 0 | 5616487 |
| IRS990/NoDonorRestrictionNetAssetsGrp/BOYAmt | 0 | 51152019 |
| IRS990/NoDonorRestrictionNetAssetsGrp/EOYAmt | 0 | 64250341 |
| IRS990/NondeductibleContributionsInd | 0 | false |
| IRS990/OccupancyGrp/ManagementAndGeneralAmt | 0 | 280947 |
| IRS990/OccupancyGrp/ProgramServicesAmt | 0 | 13253339 |
| IRS990/OccupancyGrp/TotalAmt | 0 | 13534286 |
| IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt | 0 | 449597 |
| IRS990/OfficeExpensesGrp/ProgramServicesAmt | 0 | 571732 |
| IRS990/OfficeExpensesGrp/TotalAmt | 0 | 1021329 |
| IRS990/OfficerMailingAddressInd | 0 | false |
| IRS990/OnBehalfOfIssuerInd | 0 | false |
| IRS990/OperateHospitalInd | 0 | false |
| IRS990/Organization501c3Ind | 0 | X |
| IRS990/OrganizationFollowsFASB117Ind | 0 | X |
| IRS990/OtherAssetsTotalGrp/BOYAmt | 0 | 66563473 |
| IRS990/OtherAssetsTotalGrp/EOYAmt | 0 | 62833606 |
| IRS990/OtherChangesInNetAssetsAmt | 0 | 0 |
| IRS990/OtherEmployeeBenefitsGrp/ManagementAndGeneralAmt | 0 | 36507 |
| IRS990/OtherEmployeeBenefitsGrp/ProgramServicesAmt | 0 | 2149586 |
| IRS990/OtherEmployeeBenefitsGrp/TotalAmt | 0 | 2186093 |
| IRS990/OtherExpensesGrp/Desc | 0 | TAXES |
| IRS990/OtherExpensesGrp/Desc | 1 | SUPPLIES AND EQUIPMENT |
| IRS990/OtherExpensesGrp/Desc | 2 | FOOD |
| IRS990/OtherExpensesGrp/Desc | 3 | PHARMACEUTICAL DRUGS |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 0 | 1151497 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 1 | 97706 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 2 | 0 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 3 | 0 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 0 | 4358058 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 1 | 3323483 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 2 | 2986073 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 3 | 2759664 |
| IRS990/OtherExpensesGrp/TotalAmt | 0 | 5509555 |
| IRS990/OtherExpensesGrp/TotalAmt | 1 | 3421189 |
| IRS990/OtherExpensesGrp/TotalAmt | 2 | 2986073 |
| IRS990/OtherExpensesGrp/TotalAmt | 3 | 2759664 |
| IRS990/OtherLiabilitiesGrp/BOYAmt | 0 | 62378149 |
| IRS990/OtherLiabilitiesGrp/EOYAmt | 0 | 54397125 |
| IRS990/OtherRevenueMiscGrp/BusinessCd | 0 | 900099 |
| IRS990/OtherRevenueMiscGrp/Desc | 0 | OTHER REVENUE |
| IRS990/OtherRevenueMiscGrp/RelatedOrExemptFuncIncomeAmt | 0 | 14322 |
| IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt | 0 | 14322 |
| IRS990/OtherRevenueTotalAmt | 0 | 14322 |
| IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt | 0 | 142802 |
| IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt | 0 | 43719204 |
| IRS990/OtherSalariesAndWagesGrp/TotalAmt | 0 | 43862006 |
| IRS990/OthNotesLoansReceivableNetGrp/BOYAmt | 0 | 1638435 |
| IRS990/OthNotesLoansReceivableNetGrp/EOYAmt | 0 | 13102751 |
| IRS990/PartialLiquidationInd | 0 | false |
| IRS990/PayPremiumsPrsnlBnftCntrctInd | 0 | false |
| IRS990/PayrollTaxesGrp/ManagementAndGeneralAmt | 0 | 155274 |
| IRS990/PayrollTaxesGrp/ProgramServicesAmt | 0 | 3301552 |
| IRS990/PayrollTaxesGrp/TotalAmt | 0 | 3456826 |
| IRS990/PensionPlanContributionsGrp/ProgramServicesAmt | 0 | 87580 |
| IRS990/PensionPlanContributionsGrp/TotalAmt | 0 | 87580 |
| IRS990/PoliciesReferenceChaptersInd | 0 | false |
| IRS990/PoliticalCampaignActyInd | 0 | false |
| IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt | 0 | 1608546 |
| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 1383552 |
| IRS990/PrincipalOfcrBusinessName/BusinessNameLine1Txt | 0 | JAMES SHATZ |
| IRS990/PriorPeriodAdjustmentsAmt | 0 | 3356972 |
| IRS990/ProfessionalFundraisingInd | 0 | false |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 0 | 623000 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 1 | 623000 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 2 | 812900 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 3 | 722514 |
| IRS990/ProgramServiceRevenueGrp/Desc | 0 | PATIENT SERVICE REVENUE |
| IRS990/ProgramServiceRevenueGrp/Desc | 1 | MANAGEMENT FEE REVENUE |
| IRS990/ProgramServiceRevenueGrp/Desc | 2 | CABLE & PHONE REVENUE |
| IRS990/ProgramServiceRevenueGrp/Desc | 3 | CAFETERIA & VENDING REVENUE |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 96527857 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 1 | 5435144 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 2 | 13553 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 3 | 40489 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 0 | 96527857 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 1 | 5435144 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 2 | 13553 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 3 | 40489 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | false |
| IRS990/PYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/PYContributionsGrantsAmt | 0 | 357322 |
| IRS990/PYExcessBenefitTransInd | 0 | false |
| IRS990/PYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/PYInvestmentIncomeAmt | 0 | 1164448 |
| IRS990/PYOtherExpensesAmt | 0 | 56919741 |
| IRS990/PYOtherRevenueAmt | 0 | 1341061 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 104274079 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | -8088310 |
| IRS990/PYSalariesCompEmpBnftPaidAmt | 0 | 58305479 |
| IRS990/PYTotalExpensesAmt | 0 | 115225220 |
| IRS990/PYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/PYTotalRevenueAmt | 0 | 107136910 |
| IRS990/QuidProQuoContributionsInd | 0 | false |
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