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 Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
CUMBERLAND VALLEY MANOR
 
Employer identification number

61-0913814
Return Reference Explanation
FORM 990, PAGE 6, PART VI, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PAGE 6, PART VI, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC
FORM 990, PART IX, LINE 24E PLANT OPERATING & MAINTEN 294,035 0 0 PHARMACY 243,726 0 0 HOUSEKEEPING 145,667 0 0 ACTIVITIES 94,353 0 0 LAUNDRY & LINEN 75,257 0 0 RESPIRATORY THERAPY 34,068 0 0 SOCIAL SERVICES 31,499 0 0 LABORATORY 12,683 0 0 AMBULANCE 9,540 0 0 TOTAL 940,828 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) 2016


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