Liabilities / Assets
72nd percentile
Higher debt load relative to assets than 72% of similar nonprofits.
EIN 76-0262402 • 501(c)3 • West Des Moines, IA
Profile
To provide for the health and convalescent care needs of the elderly in local communities through pleasant, secure and homelike health care facilities staffed by professionally trained and caring personnel. To support charitable and benevolent causes, which improve the quality of life of the elderly in the communitiies in which our facilities are located.
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
Liabilities / Assets
72nd percentile
Higher debt load relative to assets than 72% of similar nonprofits.
Liabilities / Revenue
40th percentile
Higher debt load relative to revenue than 40% of similar nonprofits.
Net Margin
45th percentile
Higher net margin than 45% of similar nonprofits.
Top Officer Pay
Score unavailable
No filing with officer rows is available for this organization yet.
Asset Growth
27th percentile
Faster asset growth than 27% of similar nonprofits.
Revenue Growth
39th percentile
Faster revenue growth than 39% of similar nonprofits.
Assets
Up$173,770,747
Up $395,585 (+0.2%) from 2023
Liabilities
Down$98,931,093
Down $7,455,698 (-7.0%) from 2023
Net Assets
Up$74,839,654
Up $7,851,283 (+12%) from 2023
Revenue
Up$271,912,461
Up $10,837,210 (+4.2%) from 2023
Expenses
Up$265,428,959
Up $3,620,617 (+1.4%) from 2023
Net Income
Up$6,483,502
Up $7,216,593 (+984%) from 2023
Most recent year
2024 • Form 990Facts available. Structured filing facts are available, but richer extracted sections are limited.
To provide for the health and convalescent care needs of the elderly in local communities through pleasant, secure and homelike health care facilities staffed by professionally trained and caring personnel. To support charitable and benevolent causes, which improve the quality of life of the elderly in the communitiies in which our facilities are located.
Charitable non-profit: 43 skilled nursing care locations, 2 assisted living locations, 7 independent living locations and 7 hospice locations.
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Land, Buildings, and Equipment, Net | $80,422,926 | $78,159,580 | ▼ $2,263,346 |
| Savings and Temporary Cash Investments | $34,555,753 | $38,051,709 | ▲ $3,495,956 |
| Accounts Receivable | $29,621,132 | $26,876,067 | ▼ $2,745,065 |
| Investments in Publicly Traded Securities | $18,446,227 | $14,525,544 | ▼ $3,920,683 |
| Investments Program Related | $2,646,798 | $3,264,136 | ▲ $617,338 |
| Prepaid Expenses and Deferred Charges | $3,817,584 | $1,788,102 | ▼ $2,029,482 |
| Inventories for Sale or Use | $655,921 | $637,514 | ▼ $18,407 |
| Cash and Non-Interest-Bearing Accounts | $17,690 | $17,055 | ▼ $635 |
| Total Assets | $173,375,162 | $173,770,747 | ▲ $395,585 |
| Other Assets Total | $3,191,131 | $10,451,040 | ▲ $7,259,909 |
| Liabilities | |||
| Tax Exempt Bond Liabilities | $45,546,276 | $42,664,637 | ▼ $2,881,639 |
| Accounts Payable and Accrued Expenses | $39,850,639 | $35,813,297 | ▼ $4,037,342 |
| Mortgage Notes Payable Secured by Investment Property | $19,896,000 | $19,696,000 | ▼ $200,000 |
| Other Liabilities | $1,093,876 | $757,159 | ▼ $336,717 |
| Total Liabilities | $106,386,791 | $98,931,093 | ▼ $7,455,698 |
| Net Assets / Fund Balance | |||
| Net Assets Without Donor Restrictions | $66,988,371 | $74,839,654 | ▲ $7,851,283 |
| Total Net Assets Fund Balance | $66,988,371 | $74,839,654 | ▲ $7,851,283 |
| Total Liabilities and Net Assets / Fund Balance | $173,375,162 | $173,770,747 | ▲ $395,585 |
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Buildings | $55,090,051 | $126,040,396 | $181,130,447 |
| Equipment | $10,169,569 | $46,818,874 | $56,988,443 |
| Other Land Buildings | $783,094 | $11,657,080 | $12,440,174 |
| Land | $8,553,111 | - | $8,553,111 |
| Leasehold Improvements | $3,563,755 | $4,563,889 | $8,127,644 |
| Other Assets Org | $757,159 | - | - |
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| Michael Beal | President/CEO/vice Chair | FT | $691,050 | $65,776 | $756,826 |
| David Dixon | SVP/CFO/treasurer | FT | $399,257 | $40,747 | $440,004 |
| Emily Drake | VP General Counsel | FT | $259,989 | $65,339 | $325,328 |
| Jessica Mcdyer | VP Skilled Nursing Operati | FT | $262,473 | $61,416 | $323,889 |
| Johanna Volm | VP Clinical Services | FT | $272,318 | $49,778 | $322,096 |
| Darline Etienne | Charge Nurse Rn | FT | $311,770 | $9,280 | $321,050 |
| Joeilynn Leonhardt | VP Human Resources | FT | $249,427 | $62,894 | $312,321 |
| Jeramy Kuhn | Chief Compliance Officer | FT | $256,928 | $48,500 | $305,428 |
| Jennifer Harwood | VP Hospice | FT | $173,282 | $107,787 | $281,069 |
| Cami Black | VP Hospice | FT | $28,723 | $271 | $28,994 |
| Elizabeth Rust | Director | - | $28,000 | - | $28,000 |
| Keith Krein | Director | - | $28,000 | - | $28,000 |
| Denise Sturm | Chair | - | $28,000 | - | $28,000 |
| Linda Upmeyer | Director | - | $28,000 | - | $28,000 |
| Mary Jane Carothers | Secretary | - | $28,000 | - | $28,000 |
| Kevin Childs | Director | - | $28,000 | - | $28,000 |
| Lane Bowen | Director | - | $28,000 | - | $28,000 |
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Blue Stone Therapy INC | Phys/occ/sp Therapy | 2830 100TH ST SUITE 100, Urbandale, IA 50322 | $5,176,248 |
| Reliant Pro Rehab LLC | Phys/occ/sp Therapy | 5800 GRANITE PKWY SUITE 1000, Plano, TX 75024 | $4,642,145 |
| Curana Health Of Iowa Pllc | Medical Director Services | PO BOX 121998, Dallas, TX 75312 | $1,270,507 |
| Grape Tree Medical Staffing LLC | Nurse Staffing | PO BOX 5340, Sioux Falls, SD 57117 | $1,012,019 |
| Shiftkey LLC | Nurse Staffing | 5221 N O CONNOR BLVD STE 1400, Irving, TX 75039 | $954,330 |
| Line Item | Amount |
|---|---|
| Salaries, Compensation, and Employee Benefits | $171,141,398 |
| Other Expenses | $94,223,922 |
| Grants and Similar Amounts Paid | $63,639 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Salaries and Wages | $138,749,841 | $11,428,402 | - | $150,178,243 |
| Fees for Services Other | $17,399,754 | $532,001 | - | $17,931,755 |
| Payroll Taxes | $10,459,171 | $705,265 | - | $11,164,436 |
| Occupancy | $9,877,555 | $300,089 | - | $10,177,644 |
| Depreciation Depletion | $7,981,863 | $215,806 | - | $8,197,669 |
| Other Employee Benefits | $6,852,918 | $673,365 | - | $7,526,283 |
| Travel | $4,845,870 | $350,617 | - | $5,196,487 |
| Information Technology | - | $4,511,855 | - | $4,511,855 |
| Insurance | $4,467,428 | $27,940 | - | $4,495,368 |
| All Other Expenses | $3,486,416 | $151,384 | - | $3,637,800 |
| Interest | $2,741,413 | $75,505 | - | $2,816,918 |
| Other Expenses | $2,128,855 | - | - | $2,128,855 |
| Current Officers, Directors, Trustees, and Key Employees | - | $2,026,782 | - | $2,026,782 |
| Office Expenses | $1,273,264 | $160,847 | - | $1,434,111 |
| Advertising | $653,211 | $115,506 | - | $768,717 |
| Fees for Services Legal | - | $285,598 | - | $285,598 |
| Pension Plan Contributions | $206,192 | $39,462 | - | $245,654 |
| Fees for Services Accounting | - | $207,926 | - | $207,926 |
| Grants to Domestic Individuals | $47,358 | - | - | $47,358 |
| Grants to Domestic Orgs | $16,281 | - | - | $16,281 |
| Total Functional Expenses | $243,620,609 | $21,808,350 | $0 | $265,428,959 |
| Recipient | Location | Category | Purpose | Amount |
|---|---|---|---|---|
| Iowa Health Care Association Foundation | West Des Moines, IA | 501c3 | General Support | $10,000 |
| Region | Activity | Services | Offices | Employees | Spending |
|---|---|---|---|---|---|
| Central America & the Caribbean | Investments | N/a | 1 | 0 | $195,299 |
| Central America & the Caribbean | Professional & General Liability Insurance | N/a | 1 | 0 | $67,140 |
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
| Liability | Amount |
|---|---|
| Short Term Right to Use Liability | $617,774 |
| Long Term Right to Use Liability | $139,385 |
| Bond | Issuer | Issued | Issue Price | Purpose |
|---|---|---|---|---|
| B | Iowa Finance Authority | 2014-12-11 | $41,736,000 | SEE PART VI |
| A | Iowa Finance Authority | 2018-12-19 | $10,592,000 | Refund prior bonds (6/1/15) |
| Bond | Total Proceeds | Spent | Retired | Issuance Costs |
|---|---|---|---|---|
| B | $41,736,496 | $21,406,007 | $12,004,473 | $414,991 |
| A | $10,592,000 | $10,383,611 | $5,659,429 | $208,389 |
“The draft of the annual form 990 is reviewed, prior to filing, by the full board of directors in a regularly scheduled board meeting. Subsequent to filing, a filed copy of the 990 is made available to the board members. Additionally, the filed 990 is published on care's public website.”
“The board of directors and officers are required to read the corporate policy and complete an annual signed certificate regarding the corporate conflict of interest policy. This process is administered by the vp/chief compliance officer. Additionally, the board and officers receive required annual compliance training, including business practices and conflict of interest, again under the supervision of the compliance officer. The compliance officer also attends each board meeting and serves, along with all board members, to recognize and identify potential conflict of interest events. Identified conflict of interest situations and deliberations, if any, are documented in formal board of director minutes.”
“Care initiatives' president/ceo, svp/cfo, vp skilled nursing operations and vp hospice have been identified as disqualified persons. Compensation for these positions is determined by independent directors of the compensation committee without the affected parties being present and is subsequently provided to the full board for their action or approval. Formal performance evaluations and documentations of each step in the deliberation process are contained in retained compensation committee reports. The determination of the compensation committee is supported by a 2024 report by qualified independent compensation consultants using appropriate comparability data. The deliberations of the compensation committee and board are contemporaneously recorded in formal meeting minutes that are retained by the organization. Other executive compensation is determined by the president/ceo in consultation with the members of the compensation committee and board of directors. The reports of compensation consultants utilized in the evaluation of compensation levels for the president/ceo, svp/cfo, vp skilled nursing operations and vp hospice are reviewed, along with performance evaluations, inflation data and competitive factors, all to establish compensation levels. Compensation changes are documented and retained by the corporation's human resource department. Other management compensation is determined according to long standing personnel policies administered by the corporation's human resources department. The compensation review process described above occurs on an annual basis.”
“Care provides its form 990 on the organization's public website. The organization does not make its governing documents, financial statement, or conflict of interest policy available to the public.”
“Care initiatives had 6,093 recorded volunteer hours in 2024. The average volunteer works one hour per week resulting in a calculated number of volunteers of 117. Volunteers mainly provide entertainment for, and converse with, residents.”
“Adjustment due to ownership change of three limited liability companies -92,670. Book/tax difference american health holdings llc 89,793. Book/tax difference lc pharmco llc k-1 35,496. Book/tax difference iowa indemnity company 44,075.”
“Care initiatives is classified as a tax-exempt organization; the wholly owned subsidiaries are pass through entities; generally, none of these entities are subject to federal and state income taxes on related income. Care is subject to federal and state income taxes to the extent it has unrelated business income. In accordance with the accounting guidance for uncertainty in income taxes, management has evaluated care's material tax positions and determined that there are no income taxes that need to be reflected in its consolidated financial statements.”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
| Path | # | Value |
|---|---|---|
| IRS990/AccountantCompileOrReviewInd | 0 | 0 |
| IRS990/AccountsPayableAccrExpnssGrp/BOYAmt | 0 | 39850639 |
| IRS990/AccountsPayableAccrExpnssGrp/EOYAmt | 0 | 35813297 |
| IRS990/AccountsReceivableGrp/BOYAmt | 0 | 29621132 |
| IRS990/AccountsReceivableGrp/EOYAmt | 0 | 26876067 |
| IRS990/ActivitiesConductedPrtshpInd | 0 | 0 |
| IRS990/ActivityOrMissionDesc | 0 | CHARITABLE NON-PROFIT: 43 SKILLED NURSING CARE LOCATIONS, 2 ASSISTED LIVING LOCATIONS, 7 INDEPENDENT LIVING LOCATIONS AND 7 HOSPICE LOCATIONS. |
| IRS990/AdvertisingGrp/ManagementAndGeneralAmt | 0 | 115506 |
| IRS990/AdvertisingGrp/ProgramServicesAmt | 0 | 653211 |
| IRS990/AdvertisingGrp/TotalAmt | 0 | 768717 |
| IRS990/AllOtherContributionsAmt | 0 | 64490 |
| IRS990/AllOtherExpensesGrp/ManagementAndGeneralAmt | 0 | 151384 |
| IRS990/AllOtherExpensesGrp/ProgramServicesAmt | 0 | 3486416 |
| IRS990/AllOtherExpensesGrp/TotalAmt | 0 | 3637800 |
| IRS990/AnnualDisclosureCoveredPrsnInd | 0 | 1 |
| IRS990/AuditCommitteeInd | 0 | 1 |
| IRS990/BackupWthldComplianceInd | 0 | 1 |
| IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt | 0 | DAVID DIXON |
| IRS990/BooksInCareOfDetail/PhoneNum | 0 | 5152244442 |
| IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | 1611 WEST LAKES PKWY |
| IRS990/BooksInCareOfDetail/USAddress/CityNm | 0 | WEST DES MOINES |
| IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | IA |
| IRS990/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 502668212 |
| IRS990/BusinessRlnWith35CtrlEntInd | 0 | 0 |
| IRS990/BusinessRlnWithFamMemInd | 0 | 0 |
| IRS990/BusinessRlnWithOrgMemInd | 0 | 0 |
| IRS990/CashNonInterestBearingGrp/BOYAmt | 0 | 17690 |
| IRS990/CashNonInterestBearingGrp/EOYAmt | 0 | 17055 |
| IRS990/ChangeToOrgDocumentsInd | 0 | 0 |
| IRS990/CntrctRcvdGreaterThan100KCnt | 0 | 22 |
| IRS990/CollectionsOfArtInd | 0 | 0 |
| IRS990/CompCurrentOfcrDirectorsGrp/ManagementAndGeneralAmt | 0 | 2026782 |
| IRS990/CompCurrentOfcrDirectorsGrp/TotalAmt | 0 | 2026782 |
| IRS990/CompensationFromOtherSrcsInd | 0 | 0 |
| IRS990/CompensationProcessCEOInd | 0 | 1 |
| IRS990/CompensationProcessOtherInd | 0 | 1 |
| IRS990/ConflictOfInterestPolicyInd | 0 | 1 |
| IRS990/ConservationEasementsInd | 0 | 0 |
| IRS990/ConsolidatedAuditFinclStmtInd | 0 | 1 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 0 | 5176248 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 1 | 4642145 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 2 | 1270507 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 3 | 1012019 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 4 | 954330 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 0 | 2830 100TH ST SUITE 100 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 1 | 5800 GRANITE PKWY SUITE 1000 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 2 | PO BOX 121998 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 3 | PO BOX 5340 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 4 | 5221 N O CONNOR BLVD STE 1400 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 0 | URBANDALE |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 1 | PLANO |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 2 | DALLAS |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 3 | SIOUX FALLS |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 4 | IRVING |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 0 | IA |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 1 | TX |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 2 | TX |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 3 | SD |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 4 | TX |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 0 | 50322 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 1 | 75024 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 2 | 75312 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 3 | 57117 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 4 | 75039 |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 0 | BLUE STONE THERAPY INC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 1 | RELIANT PRO REHAB LLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 2 | CURANA HEALTH OF IOWA PLLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 3 | GRAPE TREE MEDICAL STAFFING LLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 4 | SHIFTKEY LLC |
| IRS990/ContractorCompensationGrp/ServicesDesc | 0 | PHYS/OCC/SP THERAPY |
| IRS990/ContractorCompensationGrp/ServicesDesc | 1 | PHYS/OCC/SP THERAPY |
| IRS990/ContractorCompensationGrp/ServicesDesc | 2 | MEDICAL DIRECTOR SERVICES |
| IRS990/ContractorCompensationGrp/ServicesDesc | 3 | NURSE STAFFING |
| IRS990/ContractorCompensationGrp/ServicesDesc | 4 | NURSE STAFFING |
| IRS990/CreditCounselingInd | 0 | 1 |
| IRS990/CYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/CYContributionsGrantsAmt | 0 | 619729 |
| IRS990/CYGrantsAndSimilarPaidAmt | 0 | 63639 |
| IRS990/CYInvestmentIncomeAmt | 0 | 1347990 |
| IRS990/CYOtherExpensesAmt | 0 | 94223922 |
| IRS990/CYOtherRevenueAmt | 0 | 811075 |
| IRS990/CYProgramServiceRevenueAmt | 0 | 269133667 |
| IRS990/CYRevenuesLessExpensesAmt | 0 | 6483502 |
| IRS990/CYSalariesCompEmpBnftPaidAmt | 0 | 171141398 |
| IRS990/CYTotalExpensesAmt | 0 | 265428959 |
| IRS990/CYTotalFundraisingExpenseAmt | 0 | 0 |
| IRS990/CYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/CYTotalRevenueAmt | 0 | 271912461 |
| IRS990/DecisionsSubjectToApprovaInd | 0 | 0 |
| IRS990/DeductibleArtContributionInd | 0 | 0 |
| IRS990/DeductibleNonCashContriInd | 0 | 0 |
| IRS990/DelegationOfMgmtDutiesInd | 0 | 0 |
| IRS990/DepreciationDepletionGrp/ManagementAndGeneralAmt | 0 | 215806 |
| IRS990/DepreciationDepletionGrp/ProgramServicesAmt | 0 | 7981863 |
| IRS990/DepreciationDepletionGrp/TotalAmt | 0 | 8197669 |
| IRS990/Desc | 0 | DURING 2024, CARE INITIATIVES PROVIDED SERVICES TO A DAILY AVERAGE OF 2,269 INDIVIDUALS IN 43 SKILLED NURSING CARE LOCATIONS, TWO ASSISTED LIVING LOCATIONS AND SEVEN INDEPENDENT LIVING LOCATIONS. CARE INITIATIVES PROVIDES QUALITY HEALTH CARE, AT THE LOWEST POSSIBLE COST TO OUR RESIDENTS AND PATIENTS. SERVICES PROVIDED INCLUDE LODGING, NUTRITIOUS MEALS, ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, ENGAGING ACTIVITIES TO MAINTAIN THE HIGHEST PHYSICAL AND MENTAL QUALITY OF LIFE ATTAINABLE. ADDITIONAL SERVICES INCLUDE OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY, OUTPATIENT THERAPY SERVICES, SKILLED NURSING CARE, SENIOR LIVING APARTMENTS AND ASSISTED LIVING LOCATIONS. IN ADDITION, CARE INITIATIVES HAS INITIATED A PROGRAM OF REHAB TO HOME CARE TO PROVIDE INDIVIDUALS THE OPPORTUNITY TO SAFELY RETURN TO THEIR HOMES. IN ADDITION, CARE INITIATIVES PROVIDES LIMITED OUTPATIENT THERAPY SERVICES IN THE COMMUNITIES IT SERVES.DURING 2024, CARE INITIATIVES ALSO PROVIDED HOSPICE SERVICES TO A DAILY AVERAGE OF 376 PATIENTS THROUGH SEVEN HOSPICE LOCATIONS. CARE INITIATIVES HOSPICE PROVIDES COORDINATED CARE WITH COMPASSION, RESPECT AND DIGNITY TO PATIENTS AND THEIR FAMILIES EXPERIENCING SERIOUS ILLNESS AND GRIEF FOR A LOVED ONE. SOME OF THE SERVICES PROVIDED INCLUDE NURSING CARE, PHYSICIAN CARE, PHYSICAL AND SPEECH THERAPY, MASSAGE THERAPY, MUSIC THERAPY, SPIRITUAL SUPPORT, RESPITE CARE AND BEREAVEMENT SUPPORT.CARE INITIATIVES IS THE LARGEST NONPROFIT SKILLED NURSING PROVIDER FOR MEDICAID RESIDENTS IN IOWA. IN 2024, A DAILY AVERAGE OF 1,364 RESIDENTS PARTICIPATED IN THE MEDICAID PROGRAM. CARE INITIATIVES' COST FOR THESE RESIDENTS EXCEEDED REVENUE BY $25,233,000. NO RESIDENT IS DENIED A MEDICATION, NURSING SUPPLY OR THERAPY, REGARDLESS OF THEIR ABILITY TO PAY.CARE INITIATIVES HAS A HISTORY OF MODERNIZATION AND REPLACEMENT OF NURSING FACILITIES. SINCE INCEPTION, CARE INITIATIVES HAS INVESTED MORE THAN $147 MILLION TO MODERNIZE ITS COMMUNITIES. SINCE INCEPTION, CARE INITIATIVES HAS INVESTED MORE THAN $111 MILLION IN FOURTEEN NEW REPLACEMENT FACILITIES THROUGHOUT IOWA.CARE INITIATIVES PROMOTES ECONOMIC DEVELOPMENT IN THE COMMUNITIES WE SERVE BY ADDRESSING HOUSING, EMPLOYMENT, EDUCATIONAL OR ENVIRONMENTAL NEEDS AND CONCERNS. IN 2024, CARE INITIATIVES CONTRIBUTED TO OUR LOCAL COMMUNITIES BY PAYING PROPERTY TAX OF $2.52 MILLION. IN MANY COMMUNITIES WE SERVE, CARE INITIATIVES IS AMONG THE LARGEST EMPLOYERS.CARE INITIATIVES SUPPORTS OUR COMMUNITY VOLUNTEERS WHO PROVIDED 6,093 HOURS TO HELP OUR RESIDENTS AND PATIENTS. USING THE INDEPENDENT SECTOR'S ESTIMATED DOLLAR VALUE OF VOLUNTEER TIME, THE ESTIMATED VALUE OF VOLUNTEER TIME TOTALED APPROXIMATELY $182,556.CARE INITIATIVES' CONTINUUM OF CARE EXTENDED INTO THE COMMUNITIES IT SERVES BY PROVIDING REDUCED OR NO-FEE SERVICES SUCH AS MEALS-ON-WHEELS, MEALS FOR COUNTY JAILS, EDUCATIONAL SERVICES AND PUBLIC AWARENESS PROGRAMS.IN 2024, $16,281 IN CHARITABLE CONTRIBUTIONS WERE MADE TO SUPPORT CHARITABLE ORGANIZATIONS THAT FURTHER CARE INITIATIVES' NONPROFIT MISSION. |
| IRS990/DescribedInSection501c3Ind | 0 | 1 |
| IRS990/DisregardedEntityInd | 0 | 1 |
| IRS990/DocumentRetentionPolicyInd | 0 | 1 |
| IRS990/DonorAdvisedFundInd | 0 | 0 |
| IRS990/DonorRstrOrQuasiEndowmentsInd | 0 | 0 |
| IRS990/ElectionOfBoardMembersInd | 0 | 0 |
| IRS990/EmployeeCnt | 0 | 5686 |
| IRS990/EmploymentTaxReturnsFiledInd | 0 | 1 |
| IRS990/EngagedInExcessBenefitTransInd | 0 | 0 |
| IRS990/EscrowAccountInd | 0 | 0 |
| IRS990/ExpenseAmt | 0 | 243620609 |
| IRS990/FamilyOrBusinessRlnInd | 0 | 0 |
| IRS990/FederalGrantAuditRequiredInd | 0 | 0 |
| IRS990/FeesForServicesAccountingGrp/ManagementAndGeneralAmt | 0 | 207926 |
| IRS990/FeesForServicesAccountingGrp/TotalAmt | 0 | 207926 |
| IRS990/FeesForServicesLegalGrp/ManagementAndGeneralAmt | 0 | 285598 |
| IRS990/FeesForServicesLegalGrp/TotalAmt | 0 | 285598 |
| IRS990/FeesForServicesOtherGrp/ManagementAndGeneralAmt | 0 | 532001 |
| IRS990/FeesForServicesOtherGrp/ProgramServicesAmt | 0 | 17399754 |
| IRS990/FeesForServicesOtherGrp/TotalAmt | 0 | 17931755 |
| IRS990/ForeignActivitiesInd | 0 | 1 |
| IRS990/ForeignCountryCd | 0 | TK |
| IRS990/ForeignFinancialAccountInd | 0 | 1 |
| IRS990/ForeignOfficeInd | 0 | 1 |
| IRS990/Form8282PropertyDisposedOfInd | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 0 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 1 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 2 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 3 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 4 | 1.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 5 | 3.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 6 | 3.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 7 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 8 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 9 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 10 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 11 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 12 | 90.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 13 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 14 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 15 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 16 | 40.00 |
| 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/IndividualTrusteeOrDirectorInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 6 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 7 | 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/OfficerInd | 6 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 27676 |
| 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 | 2647 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 9 | 26583 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 10 | 6167 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 11 | 271 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 12 | 9280 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 13 | 11678 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 14 | 27239 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 15 | 10400 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 16 | 24794 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | MICHAEL BEAL |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | DENISE STURM |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | MARY JANE CAROTHERS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | LANE BOWEN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | KEVIN CHILDS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 5 | KEITH KREIN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 6 | ELIZABETH RUST |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 7 | LINDA UPMEYER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 8 | DAVID DIXON |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 9 | JESSICA MCDYER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 10 | JENNIFER HARWOOD |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 11 | CAMI BLACK |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 12 | DARLINE ETIENNE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 13 | JOHANNA VOLM |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 14 | EMILY DRAKE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 15 | JERAMY KUHN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 16 | JOEILYNN LEONHARDT |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 729150 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 28000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 28000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 28000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 28000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 5 | 28000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 6 | 28000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 7 | 28000 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 8 | 437357 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 9 | 297306 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 10 | 274902 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 11 | 28723 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 12 | 311770 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 13 | 310418 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 14 | 298089 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 15 | 295028 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 16 | 287527 |
| 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/ReportableCompFromRltdOrgAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 16 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | PRESIDENT/CEO/VICE CHAIR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | CHAIR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | SECRETARY |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 6 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 7 | DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 8 | SVP/CFO/TREASURER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 9 | VP SKILLED NURSING OPERATI |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 10 | VP HOSPICE |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 11 | VP HOSPICE |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 12 | CHARGE NURSE RN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 13 | VP CLINICAL SERVICES |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 14 | VP GENERAL COUNSEL |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 15 | CHIEF COMPLIANCE OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 16 | VP HUMAN RESOURCES |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | 1 |
| IRS990/Form990TFiledInd | 0 | 1 |
| IRS990/FormationYr | 0 | 1989 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | 0 |
| IRS990/FSAuditedBasisGrp/ConsolidatedBasisFinclStmtInd | 0 | X |
| IRS990/FSAuditedInd | 0 | 1 |
| IRS990/FundraisingActivitiesInd | 0 | 0 |
| IRS990/GainOrLossGrp/OtherAmt | 0 | 78920 |
| IRS990/GamingActivitiesInd | 0 | 0 |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 8 |
| IRS990/GovernmentGrantsAmt | 0 | 555239 |
| IRS990/GrantAmt | 0 | 63639 |
| IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt | 0 | 47358 |
| IRS990/GrantsToDomesticIndividualsGrp/TotalAmt | 0 | 47358 |
| IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt | 0 | 16281 |
| IRS990/GrantsToDomesticOrgsGrp/TotalAmt | 0 | 16281 |
| IRS990/GrantsToIndividualsInd | 0 | 1 |
| IRS990/GrantsToOrganizationsInd | 0 | 1 |
| IRS990/GrantToRelatedPersonInd | 0 | 0 |
| IRS990/GrossAmountSalesAssetsGrp/OtherAmt | 0 | 119620 |
| IRS990/GrossReceiptsAmt | 0 | 271953161 |
| IRS990/GroupReturnForAffiliatesInd | 0 | 0 |
| IRS990/IncludeFIN48FootnoteInd | 0 | 1 |
| IRS990/IndependentAuditFinclStmtInd | 0 | 0 |
| IRS990/IndependentVotingMemberCnt | 0 | 7 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 224 |
| IRS990/IndoorTanningServicesInd | 0 | 0 |
| IRS990/InfoInScheduleOPartIIIInd | 0 | X |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartXIIInd | 0 | X |
| IRS990/InfoInScheduleOPartXIInd | 0 | X |
| IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt | 0 | 4511855 |
| IRS990/InformationTechnologyGrp/TotalAmt | 0 | 4511855 |
| IRS990/InsuranceGrp/ManagementAndGeneralAmt | 0 | 27940 |
| IRS990/InsuranceGrp/ProgramServicesAmt | 0 | 4467428 |
| IRS990/InsuranceGrp/TotalAmt | 0 | 4495368 |
| IRS990/InterestGrp/ManagementAndGeneralAmt | 0 | 75505 |
| IRS990/InterestGrp/ProgramServicesAmt | 0 | 2741413 |
| IRS990/InterestGrp/TotalAmt | 0 | 2816918 |
| IRS990/InventoriesForSaleOrUseGrp/BOYAmt | 0 | 655921 |
| IRS990/InventoriesForSaleOrUseGrp/EOYAmt | 0 | 637514 |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 1269070 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 1269070 |
| IRS990/InvestmentInJointVentureInd | 0 | 1 |
| IRS990/InvestmentsProgramRelatedGrp/BOYAmt | 0 | 2646798 |
| IRS990/InvestmentsProgramRelatedGrp/EOYAmt | 0 | 3264136 |
| IRS990/InvestmentsPubTradedSecGrp/BOYAmt | 0 | 18446227 |
| IRS990/InvestmentsPubTradedSecGrp/EOYAmt | 0 | 14525544 |
| IRS990/InvestTaxExemptBondsInd | 0 | 0 |
| IRS990/IRPDocumentCnt | 0 | 634 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LandBldgEquipAccumDeprecAmt | 0 | 189080239 |
| IRS990/LandBldgEquipBasisNetGrp/BOYAmt | 0 | 80422926 |
| IRS990/LandBldgEquipBasisNetGrp/EOYAmt | 0 | 78159580 |
| IRS990/LandBldgEquipCostOrOtherBssAmt | 0 | 267239819 |
| IRS990/LegalDomicileStateCd | 0 | TX |
| IRS990/LessCostOthBasisSalesExpnssGrp/OtherAmt | 0 | 40700 |
| IRS990/LoanOutstandingInd | 0 | 0 |
| IRS990/LobbyingActivitiesInd | 0 | 1 |
| IRS990/LocalChaptersInd | 0 | 1 |
| IRS990/MaterialDiversionOrMisuseInd | 0 | 0 |
| IRS990/MembersOrStockholdersInd | 0 | 0 |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
| IRS990/MinutesOfCommitteesInd | 0 | 1 |
| IRS990/MinutesOfGoverningBodyInd | 0 | 1 |
| IRS990/MissionDesc | 0 | IMPROVING QUALITY OF LIFE FOR IOWANS AND THEIR FAMILIES DURING LIFE'S HEALTH TRANSITIONS THROUGH COMPASSIONATE INDIVIDUALIZED CARE. |
| IRS990/MoreThan5000KToIndividualsInd | 0 | 0 |
| IRS990/MoreThan5000KToOrgInd | 0 | 0 |
| IRS990/MortgNotesPyblScrdInvstPropGrp/BOYAmt | 0 | 19896000 |
| IRS990/MortgNotesPyblScrdInvstPropGrp/EOYAmt | 0 | 19696000 |
| IRS990/NetAssetsOrFundBalancesBOYAmt | 0 | 66988371 |
| IRS990/NetAssetsOrFundBalancesEOYAmt | 0 | 74839654 |
| IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt | 0 | 78920 |
| IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt | 0 | 78920 |
| IRS990/NetUnrelatedBusTxblIncmAmt | 0 | 40628 |
| IRS990/NetUnrlzdGainsLossesInvstAmt | 0 | 900000 |
| IRS990/NoDonorRestrictionNetAssetsGrp/BOYAmt | 0 | 66988371 |
| IRS990/NoDonorRestrictionNetAssetsGrp/EOYAmt | 0 | 74839654 |
| IRS990/NondeductibleContributionsInd | 0 | 0 |
| IRS990/OccupancyGrp/ManagementAndGeneralAmt | 0 | 300089 |
| IRS990/OccupancyGrp/ProgramServicesAmt | 0 | 9877555 |
| IRS990/OccupancyGrp/TotalAmt | 0 | 10177644 |
| IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt | 0 | 160847 |
| IRS990/OfficeExpensesGrp/ProgramServicesAmt | 0 | 1273264 |
| IRS990/OfficeExpensesGrp/TotalAmt | 0 | 1434111 |
| IRS990/OfficerMailingAddressInd | 0 | 0 |
| IRS990/OnBehalfOfIssuerInd | 0 | 0 |
| IRS990/OperateHospitalInd | 0 | 0 |
| IRS990/Organization501c3Ind | 0 | X |
| IRS990/OrganizationFollowsFASB117Ind | 0 | X |
| IRS990/OtherAssetsTotalGrp/BOYAmt | 0 | 3191131 |
| IRS990/OtherAssetsTotalGrp/EOYAmt | 0 | 10451040 |
| IRS990/OtherChangesInNetAssetsAmt | 0 | 76694 |
| IRS990/OtherEmployeeBenefitsGrp/ManagementAndGeneralAmt | 0 | 673365 |
| IRS990/OtherEmployeeBenefitsGrp/ProgramServicesAmt | 0 | 6852918 |
| IRS990/OtherEmployeeBenefitsGrp/TotalAmt | 0 | 7526283 |
| IRS990/OtherExpensesGrp/Desc | 0 | MEDICAL EXPENSE |
| IRS990/OtherExpensesGrp/Desc | 1 | BAD DEBT EXPENSE |
| IRS990/OtherExpensesGrp/Desc | 2 | DIETARY SUPPLIES |
| IRS990/OtherExpensesGrp/Desc | 3 | MAINTENANCE |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 0 | 13376240 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 1 | 11527848 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 2 | 7529131 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 3 | 2128855 |
| IRS990/OtherExpensesGrp/TotalAmt | 0 | 13376240 |
| IRS990/OtherExpensesGrp/TotalAmt | 1 | 11527848 |
| IRS990/OtherExpensesGrp/TotalAmt | 2 | 7529131 |
| IRS990/OtherExpensesGrp/TotalAmt | 3 | 2128855 |
| IRS990/OtherLiabilitiesGrp/BOYAmt | 0 | 1093876 |
| IRS990/OtherLiabilitiesGrp/EOYAmt | 0 | 757159 |
| IRS990/OtherRevenueMiscGrp/BusinessCd | 0 | 623000 |
| IRS990/OtherRevenueMiscGrp/BusinessCd | 1 | 900099 |
| IRS990/OtherRevenueMiscGrp/Desc | 0 | LTC PHARMCO LLC |
| IRS990/OtherRevenueMiscGrp/Desc | 1 | SUBPART F INCOME |
| IRS990/OtherRevenueMiscGrp/ExclusionAmt | 0 | 160459 |
| IRS990/OtherRevenueMiscGrp/RelatedOrExemptFuncIncomeAmt | 0 | 602239 |
| IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt | 0 | 650616 |
| IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt | 1 | 160459 |
| IRS990/OtherRevenueMiscGrp/UnrelatedBusinessRevenueAmt | 0 | 48377 |
| IRS990/OtherRevenueTotalAmt | 0 | 811075 |
| IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt | 0 | 11428402 |
| IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt | 0 | 138749841 |
| IRS990/OtherSalariesAndWagesGrp/TotalAmt | 0 | 150178243 |
| IRS990/OwnWebsiteInd | 0 | X |
| IRS990/PartialLiquidationInd | 0 | 0 |
| IRS990/PayPremiumsPrsnlBnftCntrctInd | 0 | 0 |
| IRS990/PayrollTaxesGrp/ManagementAndGeneralAmt | 0 | 705265 |
| IRS990/PayrollTaxesGrp/ProgramServicesAmt | 0 | 10459171 |
| IRS990/PayrollTaxesGrp/TotalAmt | 0 | 11164436 |
| IRS990/PensionPlanContributionsGrp/ManagementAndGeneralAmt | 0 | 39462 |
| IRS990/PensionPlanContributionsGrp/ProgramServicesAmt | 0 | 206192 |
| IRS990/PensionPlanContributionsGrp/TotalAmt | 0 | 245654 |
| IRS990/PoliciesReferenceChaptersInd | 0 | 1 |
| IRS990/PoliticalCampaignActyInd | 0 | 0 |
| IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt | 0 | 3817584 |
| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 1788102 |
| IRS990/PrincipalOfficerNm | 0 | MICHAEL BEAL |
| IRS990/PriorPeriodAdjustmentsAmt | 0 | 391087 |
| IRS990/ProfessionalFundraisingInd | 0 | 0 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 0 | 623000 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 1 | 623000 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 2 | 623990 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 3 | 623990 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 4 | 721210 |
| IRS990/ProgramServiceRevenueGrp/Desc | 0 | NURSING HOME SERVICES |
| IRS990/ProgramServiceRevenueGrp/Desc | 1 | HOSPICE SERVICES |
| IRS990/ProgramServiceRevenueGrp/Desc | 2 | ASSISTED LIVING SERVIC |
| IRS990/ProgramServiceRevenueGrp/Desc | 3 | SENIOR LIVING APARTMEN |
| IRS990/ProgramServiceRevenueGrp/Desc | 4 | GUEST MEALS |
| IRS990/ProgramServiceRevenueGrp/ExclusionAmt | 0 | 35706 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 246130160 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 1 | 22501733 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 2 | 308484 |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 3 | 149564 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 0 | 246130160 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 1 | 22501733 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 2 | 308484 |
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