2024-05-14T11:09:42-05:00 2023-06-30 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2022-07-01 272865454 GOOSE LAKE MEDICAL SERVICES INC GOOS 5419472114 700 SOUTH J STREET LAKEVIEW OR 97630 LANDON DYBDAL CEO 5419472114 2024-05-14 1 LANDON DYBDAL 999009999 0 SOLOMON MARDAKHAEV P01806552 6105653930 2024-05-13 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z LANDON DYBDAL 700 SOUTH J STREET LAKEVIEW OR 97630 5395184 0 X N/A X 2010 OR TO PROMOTE THE WELL BEING IN RURAL COMMUNITIES THROUGH EDUCATION AND DELIVERY OF MEDICAL SERVICES. PROVIDE THE BEST CARE IN THE REGION THROUGH LONG TERM CARE AND ASSISTED LIVING SERVICES TO THE COMMUNITY. PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO THE COMMUNITY. 3 3 0 3 0 0 3077193 2142471 3297101 3264145 32 12 36125 -11444 6410451 5395184 0 0 0 0 2982676 2722413 0 0 0 3153508 2399324 6136184 5121737 274267 273447 1876715 2150162 0 0 1876715 2150162 TO PROMOTE THE WELL BEING IN RURAL COMMUNITIES THROUGH EDUCATION AND DELIVERY OF MEDICAL SERVICES. PROVIDE THE BEST CARE IN THE REGION THROUGH LONG TERM CARE AND ASSISTED LIVING SERVICES TO THE COMMUNITY. PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO THE COMMUNITY. 0 0 4650122 0 3264145 TO PROMOTE THE WELL BEING IN RURAL COMMUNITIES THROUGH EDUCATION AND DELIVERY OF MEDICAL SERVICES. PROVIDE THE BEST CARE IN THE REGION THROUGH LONG TERM CARE AND ASSISTED LIVING SERVICES TO THE COMMUNITY. PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO THE COMMUNITY. 4650122 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 CA OR X NATASHA START 5419472114 700 SOUTH J STREET LAKEVIEW OR 97630 JUDITH M GRAHAM CHAIR 0.50 X X 0 0 0 SUZANNE STEWARD TREASURER 0.50 X X 0 0 0 KEN KESTNER SECRETARY (THRU JUNE 2023) 0.50 X X 0 0 0 EMERY CHANG MD BOARD MEMBER (THRU DEC 2022) 0.50 X 0 0 0 JERALD STEWARD BOARD MEMBER 0.50 X 0 0 0 CHARLES B TVEIT CEO 1.00 40.00 X 0 273117 29698 EDWARD KEOUGH CFO (THRU MAY 2023) 1.00 40.00 X 0 137283 19253 0 410400 48951 0 0 1 0 0 1642471 500000 2142471 PATIENT SERVICE REVENU 621110 3264145 3264145 3264145 12 12 -11444 -11444 -11444 5395184 3264145 0 -11432 X 2048214 1843393 204821 674199 606779 67420 1750 1575 175 993713 894342 99371 64291 57862 6429 72524 65272 7252 613877 552489 61388 1091 982 109 MEDICAL SUPPLIES 405575 405575 LICENSES AND OTHER 211010 189909 21101 REPAIRS AND MAINTENANCE 11393 10254 1139 DUES AND SUBSCRIPTIONS 3002 2702 300 21098 18988 2110 5121737 4650122 471615 0 261283 208768 1171927 1466064 443505 475330 1876715 2150162 0 0 X 1876715 2150162 1876715 2150162 1876715 2150162 273447 0 X 0 1 X 1 0 X 2400424 1267130 2243485 3077193 2142471 11130703 2482765 3205490 3328251 3297101 3264145 15577752 59419 36125 -11444 84100 4883189 4472620 5631155 6410419 5395172 26792555 0 0 0 26792555 21 32 12 65 21 32 12 65 4883189 4472620 5631176 6410451 5395184 26792620 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: GLMS IS A TAX-EXEMPT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE (IRC). IT IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. MANAGEMENT BELIEVES GLMS HAS TAKEN NO UNCERTAIN TAX POSITIONS AND ITS TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2023, 2022, AND 2021 ARE SUBJECT TO EXAMINATION. 0 0 0 0 0 0 0 0 0 CHARLES B TVEIT CEO 0 273117 0 0 0 0 0 15928 0 13770 0 302815 0 0 EDWARD KEOUGH CFO (THRU MAY 2023) 0 137283 0 0 0 0 0 5365 0 13888 0 156536 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY A CERTIFIED PUBLIC ACCOUNTANT AND REVIEWED BY MANAGEMENT. A COPY IS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS MONITORED AT LEAST ANNUALLY VIA INFORMATION REQUESTED OF BOARD MEMBERS AND OFFICERS BY THE CEO/ADMINISTRATOR. IF ANY CONFLICT ARISES THE MEMBER MUST RECUSE THEMSELVES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE GENERALLY MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 894,342. MANAGEMENT AND GENERAL EXPENSES 99,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 993,713. LAKEVIEW GARDENS LLC 700 SOUTH J STREET LAKEVIEW OR 97630 383938314 LONG TERM CARE FACILITY OR 293081 1538432 GOOSE LAKE MEDICAL SERVICES INC LAKE HEALTH DISTRICT 700 SOUTH J STREET LAKEVIEW OR 97630 930577593 GOVERNMENTAL HOSPITAL OR 501(C)(3) N/A 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0