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OWSLEY COUNTY HEALTH CARE CENTER, INC.

Company Details

Name: OWSLEY COUNTY HEALTH CARE CENTER, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 13 Apr 1979 (46 years ago)
Organization Date: 13 Apr 1979 (46 years ago)
Last Annual Report: 03 Jun 2024 (10 months ago)
Organization Number: 0117135
Industry: Health Services
Number of Employees: Large (100+)
Principal Office: P.O. BOX 250, BOONEVILLE, KY 413140250
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2023 610984463 2024-09-17 OWSLEY COUNTY HEALTH CARE CENTER, INC. 108
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address 20 COUNTY BARN ROAD, BOONEVILLE, KY, 41314
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2020 610984463 2021-04-13 OWSLEY COUNTY HEALTH CARE CENTER, INC. 117
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address 20 COUNTY BARN RD., BOONEVILLE, KY, 41314
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2019 610984463 2020-09-30 OWSLEY COUNTY HEALTH CARE CENTER, INC. 119
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address 20 COUNTY BARN RD., BOONEVILLE, KY, 41314
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2018 610984463 2019-02-25 OWSLEY COUNTY HEALTH CARE CENTER, INC. 101
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address 20 COUNTY BARN RD., BOONEVILLE, KY, 41314
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2017 610984463 2018-10-03 OWSLEY COUNTY HEALTH CARE CENTER, INC. 112
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address KY 11, BOONEVILLE, KY, 41314
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2016 610984463 2017-07-19 OWSLEY COUNTY HEALTH CARE CENTER, INC. 100
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing WHITTNEY YOUNTS
Valid signature Filed with authorized/valid electronic signature
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2015 610984463 2016-07-28 OWSLEY COUNTY HEALTH CARE CENTER, INC. 93
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing WHITTNEY YOUNTS
Valid signature Filed with authorized/valid electronic signature
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2015 610984463 2016-07-29 OWSLEY COUNTY HEALTH CARE CENTER, INC. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing WHITTNEY YOUNTS
Valid signature Filed with authorized/valid electronic signature
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2014 610984463 2015-05-13 OWSLEY COUNTY HEALTH CARE CENTER, INC. 102
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Signature of
Role Plan administrator
Date 2015-05-04
Name of individual signing WHITTNEY YOUNTS
Valid signature Filed with authorized/valid electronic signature
OWSLEY COUNTY HEALTH CARE CENTER, INC. 403(B) RETIREMENT PLAN 2013 610984463 2014-10-01 OWSLEY COUNTY HEALTH CARE CENTER, INC. 92
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Signature of
Role Plan administrator
Date 2014-10-01
Name of individual signing WHITTNEY YOUNTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/15/20131015144436P030039633971001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing WHITTNEY YOUNTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/27/20120727152433P040001274755001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Plan administrator’s name and address
Administrator’s EIN 610984463
Plan administrator’s name OWSLEY COUNTY HEALTH CARE CENTER, INC.
Plan administrator’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314
Administrator’s telephone number 6065936302

Signature of
Role Plan administrator
Date 2012-07-27
Name of individual signing JUDY TERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/17/20111017073738P030700497616001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Plan administrator’s name and address
Administrator’s EIN 610984463
Plan administrator’s name OWSLEY COUNTY HEALTH CARE CENTER, INC.
Plan administrator’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314
Administrator’s telephone number 6065936302

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing JUDY TERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/04/20101004180656P070002176355001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 6065936302
Plan sponsor’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314

Plan administrator’s name and address
Administrator’s EIN 610984463
Plan administrator’s name OWSLEY COUNTY HEALTH CARE CENTER, INC.
Plan administrator’s address STATE HIGHWAY 11, BOONEVILLE, KY, 41314
Administrator’s telephone number 6065936302

Signature of
Role Plan administrator
Date 2010-10-04
Name of individual signing JUDY TERRY
Valid signature Filed with authorized/valid electronic signature

Director

Name Role
DALE ROBERTS Director
BERNARD WILSON Director
KENNETH GUMM Director
ARNOLD WILSON Director
WAYNE MARSHALL Director
Arnold Wilson Director
Bobby Smith Director
Jason Wilson Director
Phyllis Reffitt Director
Roger Roberts Director

Incorporator

Name Role
SANDRA D. FREEBURGER Incorporator

Treasurer

Name Role
Linda Witt Treasurer

Registered Agent

Name Role
TIMOTHY C. WILLS Registered Agent

President

Name Role
Travis Smith President

Secretary

Name Role
Linda Witt Secretary

Filings

Name File Date
Annual Report 2024-06-03
Annual Report 2023-06-06
Annual Report 2022-04-18
Annual Report 2021-03-05
Annual Report 2020-02-18
Annual Report 2019-05-03
Annual Report 2018-04-19
Annual Report 2017-05-04
Annual Report 2016-06-13
Registered Agent name/address change 2015-12-31

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
61-0984463 Corporation Unconditional Exemption 20 COUNTY BARN RD, BOONEVILLE, KY, 41314-6500 1989-11
In Care of Name % JUDY TERRY
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that normally receives no more than one-third of its support from gross investment income and unrelated business income and at the same time more than one-third of its support from contributions, fees, and gross receipts related to exempt purposes 509(a)(2)
Tax Period 2024-06
Asset 1,000,000 to 4,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Jun
Asset Amount 4179700
Income Amount 7346233
Form 990 Revenue Amount 7346233
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name OWSLEY COUNTY HEALTH CARE CENTER INC
EIN 61-0984463
Tax Period 202206
Filing Type E
Return Type 990
File View File
Organization Name OWSLEY COUNTY HEALTH CARE CENTER INC
EIN 61-0984463
Tax Period 202106
Filing Type E
Return Type 990
File View File
Organization Name OWSLEY COUNTY HEALTH CARE CENTER INC
EIN 61-0984463
Tax Period 202006
Filing Type E
Return Type 990
File View File
Organization Name OWSLEY COUNTY HEALTH CARE CENTER INC
EIN 61-0984463
Tax Period 201906
Filing Type E
Return Type 990
File View File
Organization Name OWSLEY COUNTY HEALTH CARE CENTER INC
EIN 61-0984463
Tax Period 201806
Filing Type E
Return Type 990
File View File
Organization Name OWSLEY COUNTY HEALTH CARE CENTER INC
EIN 61-0984463
Tax Period 201706
Filing Type E
Return Type 990
File View File
Organization Name OWSLEY COUNTY HEALTH CARE CENTER INC
EIN 61-0984463
Tax Period 201606
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1456477401 2020-05-04 0457 PPP 20 County Barn Rd, Booneville, KY, 41314-6500
Loan Status Date 2021-06-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 740700
Loan Approval Amount (current) 740700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27542
Servicing Lender Name Republic Bank & Trust Company
Servicing Lender Address 601 W Market St Republic Corporate Center, LOUISVILLE, KY, 40202
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Booneville, OWSLEY, KY, 41314-6500
Project Congressional District KY-05
Number of Employees 116
NAICS code 621999
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 27542
Originating Lender Name Republic Bank & Trust Company
Originating Lender Address LOUISVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 748168.72
Forgiveness Paid Date 2021-05-06

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Sources: Kentucky Secretary of State

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