SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
Kingman County Retirement Home Assoc
 
Employer identification number

48-1022366
Return Reference Explanation
Pt VI, Line 11b The IRS form 990 is reviewed by the board of directors at a regularly scheduled meeting of the board.
Pt VI, Line 15a The compensation level of the administrator is set by the board of directors. All other employees are hired by the administrator.
Pt VI, Line 19 The governing documents and IRS Form 990 is made available upon specific written request.
Form 990EZ, Part II, Line 24 Accounts Receivable - Net
Form 990EZ, Part II, Line 24 Pledges Receivable - Net
Form 990EZ, Part II, Line 24 Prepaids
Form 990EZ, Part II, Line 26 Accounts Payable & Accrued Expenses
Form 990EZ, Part II, Line 26 Bonds, Mortgages & Other Notes
Form 990, Part IX, Line 24e Lawn care/snow removal 5449. 0. 5449. 0.
Form 990, Part IX, Line 24e Dues/subscriptions 10739. 0. 10739. 0.
Form 990, Part IX, Line 24e Consumable supplies 161734. 129580. 32154. 0.
Form 990, Part IX, Line 24e Lease and rental 771. 0. 771. 0.
Form 990, Part IX, Line 24e Utilities 131286. 118157. 13129. 0.
Form 990, Part IX, Line 24e Property taxes 104. 0. 104. 0.
Form 990, Part IX, Line 24e Minor equipment 33568. 5357. 28211. 0.
Form 990, Part IX, Line 24e Telephone 9141. 8227. 914. 0.
Form 990, Part IX, Line 24e Apartment expense 515846. 464262. 51584. 0.
Form 990, Part IX, Line 24e Medicare expenses 343174. 343174. 0. 0.
Form 990, Part IX, Line 24e Provider bed tax 44172. 0. 44172. 0.
Form 990, Part IX, Line 24e Other 1433. 303. 1130. 0.
Form 990, Part IX, Line 24e Background checks 423. 0. 423. 0.
Form 990, Part IX, Line 24e Software updates 7345. 7345. 0. 0.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


Additional Data


Software ID: 17005306
Software Version: