CHRISTIAN COMMUNITY HOMES AND SERVICES INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CHRISTIAN COMMUNITY HOMES AND SERVICES INC (EIN 91-2052713)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-09-10
- IRS object ID
- 202442549349301229
- Schema version
- 2023v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-09-10T11:01:09-05:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 912052713 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRISTIAN COMMUNITY HOMES AND SERVICES | BusinessNameLine1Txt |
| Business Name Line2 | INC GROUP RETURN | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHRI | BusinessNameControlTxt |
| Phone | 7153869303 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WISCONSIN STREET | AddressLine1Txt |
| City | HUDSON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54016 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAMELA KLINGFUS | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7153869303 | PhoneNum |
| Signature | 2024-09-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2024-09-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAMELA KLINGFUS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WISCONSIN STREET | AddressLine1Txt |
| City | HUDSON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54016 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,432,148 | GrossReceiptsAmt |
| Group Return For Affiliates | Yes (1) | GroupReturnForAffiliatesInd |
| All Affiliates Included | Yes (1) | AllAffiliatesIncludedInd |
| Group Exemption | 3557 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CCHHUDSON.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | NONPROFIT ORGANIZATION SERVING SENIORS IN WAYS THAT REFLECT THE IMPORTANCE OF EACH UNIQUE LIFE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 354 | TotalEmployeeCnt |
| Total Volunteers | 140 | TotalVolunteersCnt |
| Total Gross UBI | $141,648 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $259,889 | PYContributionsGrantsAmt |
| CY Contributions Grants | $261,002 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,925,788 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,690,795 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,397,861 | PYInvestmentIncomeAmt |
| CY Investment Income | $449,526 | CYInvestmentIncomeAmt |
| PY Other Revenue | $9,165 | PYOtherRevenueAmt |
| CY Other Revenue | $10,720 | CYOtherRevenueAmt |
| PY Total Revenue | $15,592,703 | PYTotalRevenueAmt |
| CY Total Revenue | $16,412,043 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $11,140 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,958,279 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,425,954 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $17,311 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,774,661 | PYOtherExpensesAmt |
| CY Other Expenses | $6,390,579 | CYOtherExpensesAmt |
| PY Total Expenses | $15,734,940 | PYTotalExpensesAmt |
| CY Total Expenses | $16,827,673 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$142,237 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$415,630 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,463,981 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,290,549 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,916,724 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,060,284 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,547,257 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,230,265 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE A NONPROFIT, FAITH-BASED ORGANIZATION OFFERING SENIOR LIVING COMMUNITIES DEDICATED TO SERVING INDIVIDUALS IN WAYS THAT REFLECT THE IMPORTANCE OF EACH UNIQUE LIFE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,500,505 | ExpenseAmt |
| Grant | $11,140 | GrantAmt |
| Revenue | $15,549,147 | RevenueAmt |
| Desc | CHRISTIAN COMMUNITY HOME OF HUDSON, INC. IS A 50 BED NURSING HOME (CCH-HUDSON), A 38-UNIT COMMUNITY BASED RESIDENTIAL FACILITY (PINE RIDGE), AND A 92-UNIT APARTMENT COMPLEX WHICH INCLUDES A 20-UNIT RESIDENTIAL CARE APARTMENT COMPLEX (WINTERGREEN). CHRISTIAN COMMUNITY HOME OF OSCEOLA, INC. IS A 40-BED NURSING HOME (CCH-OSCEOLA) AND AN 18-UNIT COMMUNITY BASED RESIDENTIAL FACILITY (HEARTHSIDE). HEALTH CARE SERVICES TO MEDICAID NURSING HOME RESIDENTS ARE CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN THE COSTS OF PROVIDING CARE. FOR 2023, CCH-HUDSON'S TOTAL NURSING HOME RESIDENT DAYS WERE 10,906 INCLUDED IN THIS TOTAL WAS 5,099 DAYS FOR RESIDENTS COVERED UNDER THE MEDICAID/HOSPICE MEDICAID PROGRAM. CCH-OSCEOLA'S TOTAL NURSING HOME RESIDENT DAYS WERE 9,983 AND INCLUDED IN THIS TOTAL WAS 5,257 COVERED UNDER THE MEDICAID/HOSPICE MEDICAID PROGRAM.THE NURSING HOME OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY.PINE RIDGE OFFERS MONITORED CARE PLANS TO RESIDENTS GIVING THEM THE COMFORT OF KNOWING THAT ADDITIONAL CARE IS AVAILABLE AS THEY NEED IT. SERVICES OFFERED AT PINE RIDGE INCLUDE HOUSEKEEPING, LAUNDRY, NURSING ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, DIETARY SERVICES, MEDICATION MANAGEMENT, AND OTHER NURSING SUPERVISION AND CARE SERVICES. TOTAL RESIDENT DAYS FOR 2023 WERE 13,989. ADDITIONALLY, HEARTHSIDE HAD 6,461 RESIDENT DAYS FOR 2023.WINTERGREEN PROVIDES SENIORS AND HANDICAPPED PERSONS WITH HOUSING AND SERVICES AVAILABLE TO MEET THEIR NEEDS. AMONG THE MANY SERVICES PROVIDED ARE 24-HOUR ON-SITE STAFF, ASSISTANCE WITH MEDICATIONS AND VITAL CHECKS, QUARTERLY AND ANNUAL NURSING ASSESSMENTS, TRANSPORTATION SERVICES, AND ASSISTANCE WITH DAILY CARES. TOTAL RENTAL DAYS AT WINTERGREEN APARTMENTS FOR 2023 WERE 32,963. ADDITIONALLY, EVERGREEN HAD 9,900 RESIDENT DAYS FOR 2023.WINTERGREEN APARTMENTS, INC. IS THE REAL ESTATE HOLDING COMPANY AND THE LESSOR FOR THE PROPERTY AND EQUIPMENT IN WHICH CHRISTIAN COMMUNITY HOME OF HUDSON, INC. PROVIDES ITS OPERATIONS. CHRISTIAN COMMUNITY HOME OF HUDSON, INC. PAYS WINTERGREEN APARTMENTS, INC. MONTHLY RENT TO LEASE THE PROPERTY AND EQUIPMENT.CHRISTIAN COMMUNITY CAMPUS FOUNDATION, INC. (FOUNDATION) IS A FUND DEVELOPMENT COMPANY FOR THE NONPROFIT FACILITIES. THE FOUNDATION ORGANIZES EVENTS AND PROJECTS WHICH RAISE FUNDS THAT ALLOW FOR EQUIPMENT UPGRADES, INVESTMENT IN CAMPUS ENHANCEMENT PROJECTS, AND EXPANSION AND ENHANCEMENT OF SERVICES. IN 2023, CHRISTIAN COMMUNITY FOUNDATION, INC. RAISED ABOUT $123,000 IN FUNDS FOR THESE PURPOSES. | Desc |
| Total Program Service Expenses | $14,500,505 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 354 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | 0 | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES KACZROWSKI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7153869303 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1320 WISCONSIN STREET | AddressLine1Txt |
| City | HUDSON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54016 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DARYL SIMONSON | ||||||||
| PRESIDENT | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CLAIRE ZAJAC | ||||||||
| VICE PRESIDENT | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ERIC JOHNSON | ||||||||
| TREASURER | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DEB SCHWAB | ||||||||
| SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ELLIOT ANDERSON | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE BEBAULT | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RHONDA DUNHAM | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| FR JOHN GERRITS | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG GIBSON | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RICK HAGAR | ||||||||
| MEMBER (TERMED MAY) | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MEL HERMANSEN | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RUTH KNAPP | ||||||||
| MEMBER (TERMED MAY) | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| AARON MORK | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| TOM NIELSEN | ||||||||
| MEMBER (TERMED MAY) | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| REV DR DAWN JEFFERS RAMSTAD | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| TOM REDDING | ||||||||
| MEMBER (TERMED MAY) | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BOB STAEBELL | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| REV JACK STARR | ||||||||
| MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PAMELA KLINGFUS | ||||||||
| CEO | 38.00 | 2.00 | Yes (X) | $198,482 | $0 | $12,115 | ||
| JIM KACZROWSKI | ||||||||
| DIRECTOR OF FINANCE | 38.00 | 2.00 | Yes (X) | $130,579 | $0 | $16,048 | ||
| JENNIE ORMAN | ||||||||
| HUDSON ADMINISTRATOR | 40.00 | $103,620 | $0 | $28,545 | Yes (X) | |||
| HEIDI MCGEEHAN | ||||||||
| OSCEOLA ADMINISTRATOR | 40.00 | $108,827 | $0 | $12,993 | Yes (X) | |||
| KARI ANDERSON | ||||||||
| OSCEOLA DIRECTOR OF NURSING | 40.00 | $107,747 | $0 | $4,027 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $649,255 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $73,728 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SPECIALIZED MEDICAL STAFFING | |||||
| 1413 198TH ST | CHIPPEWA FALLS | WI | 54729 | STAFFING AGENCY | $225,000 |
| WIPFLI CPAS AND CONSULTANTS LLP | |||||
| PO BOX 3160 | MILWAUKEE | WI | 532013160 | ACCOUNTING & CONSULTING | $211,641 |
| CLIPBOARD HEALTH | |||||
| PO BOX 103125 | PASADENA | CA | 911893125 | STAFFING AGENCY | $131,497 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $15,500 | FundraisingAmt |
| All Other Contributions | $245,502 | AllOtherContributionsAmt |
| Total Contributions | $261,002 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NURSING HOME | 623000 | $9,244,544 | $9,244,544 | |
| ASSISTED LIVING | 623990 | $6,160,680 | $6,160,680 | |
| CAFETERIA & VENDING | 623000 | $141,648 | $141,648 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $143,923 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $143,923 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,690,795 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,056 | TotalRevenueColumnAmt |
| Exclusion | $16,056 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $24,605 | SecuritiesAmt |
| Other | $415,017 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $6,152 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $24,605 | SecuritiesAmt |
| Other | $408,865 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $433,470 | TotalRevenueColumnAmt |
| Exclusion | $433,470 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $24,673 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $15,500 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $13,953 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,720 | TotalRevenueColumnAmt |
| Exclusion | $10,720 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,412,043 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,549,147 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $141,648 | UnrelatedBusinessRevenueAmt |
| Exclusion | $460,246 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,140 | TotalAmt |
| Program Services | $11,140 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,224 | TotalAmt |
| Management And General | $357,224 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,631,670 | TotalAmt |
| Program Services | $7,785,737 | ProgramServicesAmt |
| Management And General | $845,933 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,920 | TotalAmt |
| Program Services | $183,257 | ProgramServicesAmt |
| Management And General | $8,663 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,168 | TotalAmt |
| Program Services | $533,580 | ProgramServicesAmt |
| Management And General | $79,588 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $631,972 | TotalAmt |
| Program Services | $548,199 | ProgramServicesAmt |
| Management And General | $83,773 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,000 | TotalAmt |
| Program Services | $96,000 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,811 | TotalAmt |
| Management And General | $11,274 | ManagementAndGeneralAmt |
| Fundraising | $537 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,205 | TotalAmt |
| Management And General | $349,205 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $746,779 | TotalAmt |
| Program Services | $746,779 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,980 | TotalAmt |
| Management And General | $94,980 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,733 | TotalAmt |
| Program Services | $93,608 | ProgramServicesAmt |
| Management And General | $190,351 | ManagementAndGeneralAmt |
| Fundraising | $16,774 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,557 | TotalAmt |
| Management And General | $132,557 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $611,875 | TotalAmt |
| Program Services | $559,017 | ProgramServicesAmt |
| Management And General | $52,858 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,294 | TotalAmt |
| Management And General | $32,294 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,417 | TotalAmt |
| Program Services | $597,882 | ProgramServicesAmt |
| Management And General | $6,535 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,157,928 | TotalAmt |
| Program Services | $1,144,889 | ProgramServicesAmt |
| Management And General | $13,039 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,009 | TotalAmt |
| Program Services | $199,929 | ProgramServicesAmt |
| Management And General | $23,080 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DIETARY SUPPLIES | $621,928 | $621,928 | |
| BAD DEBT EXPENSE | $457,992 | $457,992 | |
| MEDICAL SUPPLIES | $336,675 | $336,675 | |
| REPAIRS/MAINTENANCE | $297,683 | $296,813 | $870 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,713 | TotalAmt |
| Program Services | $287,080 | ProgramServicesAmt |
| Management And General | $27,633 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,827,673 | TotalAmt |
| Program Services | $14,500,505 | ProgramServicesAmt |
| Management And General | $2,309,857 | ManagementAndGeneralAmt |
| Fundraising | $17,311 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,001,572 | BOYAmt |
| EOY | $1,987,653 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,370,975 | BOYAmt |
| EOY | $4,990,427 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,671,389 | BOYAmt |
| EOY | $1,294,559 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,656 | BOYAmt |
| EOY | $179,551 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,627,939 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,589,605 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,439,982 | BOYAmt |
| EOY | $11,038,334 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $723,407 | BOYAmt |
| EOY | $800,025 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,463,981 | BOYAmt |
| EOY | $20,290,549 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,248,989 | BOYAmt |
| EOY | $872,619 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $221,000 | BOYAmt |
| EOY | $157,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,169,200 | BOYAmt |
| EOY | $15,760,581 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,535 | BOYAmt |
| EOY | $270,084 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,916,724 | BOYAmt |
| EOY | $17,060,284 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,547,257 | BOYAmt |
| EOY | $3,105,265 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $125,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,547,257 | BOYAmt |
| EOY | $3,230,265 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,463,981 | BOYAmt |
| EOY | $20,290,549 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$415,630 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $98,638 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $78,007 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,406,644 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $399,415 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $259,889 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $261,002 | CurrentTaxYearAmt |
| Total | $4,404,957 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,849,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,589,923 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,207,303 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,656,263 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,690,795 | CurrentTaxYearAmt |
| Total | $72,993,804 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,927,527 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,996,567 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,606,718 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,916,152 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,951,797 | CurrentTaxYearAmt |
| Total | $77,398,761 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,935 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,443 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,568 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,300 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,235 | CurrentTaxYearAmt |
| Total | $18,481 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,935 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,443 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,568 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,300 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,235 | CurrentTaxYearAmt |
| Total | $18,481 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $77,380,280 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,303 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,444 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,596 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,107 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,056 | CurrentTaxYearAmt |
| Total | $88,506 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,303 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,444 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,596 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,107 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,056 | CurrentTaxYearAmt |
| Total | $88,506 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,656 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $9,165 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,720 | CurrentTaxYearAmt |
| Total | $29,541 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,972,486 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,016,011 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,613,314 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,936,424 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,978,573 | CurrentTaxYearAmt |
| Total | $77,516,808 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99820 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99850 | PublicSupportPY509Pct |
| Investment Income CY | 0.00110 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00130 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $331,453 | OtherCostOrOtherBasisAmt |
| Book Value | $331,453 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,684,110 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,651,838 | DepreciationAmt |
| Book Value | $10,032,272 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,600,376 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,937,767 | DepreciationAmt |
| Book Value | $662,609 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,000 | OtherCostOrOtherBasisAmt |
| Book Value | $12,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,038,334 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION PLAN LIABILITY | $230,644 |
| RELATED PARTY PAYABLES | $39,440 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $270,084 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINE 2B: | FormAndLineReferenceDesc |
| Explanation | FOR A RESIDENT TO RESERVE AN APARTMENT, THEY AGREE TO TRANSFER TO WINTERGREEN A REFUNDABLE TENANT SECURITY DEPOSIT. UPON VACATING AN APARTMENT, THIS DEPOSIT IS REFUNDED TO THE RESIDENT THE FIRST OF THE MONTH AFTER THE APARTMENT HAS BEEN RE-RENTED OR AFTER SIX MONTHS AFTER VACATING IT, WHICHEVER COMES FIRST. RESIDENT TRUST FUNDS CONSIST OF AMOUNTS ON DEPOSIT WITH THE CORPORATION BY RESIDENTS FOR SAFEKEEPING. THESE FUNDS CAN BE WITHDRAWN AT ANY TIME BY THE RESIDENTS. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | RIVER CRUISE | Event1Nm |
| Gross Receipts Event1 | $40,173 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,500 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $24,673 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $13,953 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $40,173 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $15,500 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $24,673 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $13,953 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $13,953 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $10,720 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 7 | RecipientCnt |
| Cash Grant | $11,140 | CashGrantAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAMELA KLINGFUS | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $195,982 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $2,500 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $11,920 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $195 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $210,597 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 3B | THE SPECIFIC ENTITY WITHIN THE GROUP (CHRISTIAN COMMUNITY HOMES OF OSCEOLA, INC. - 80-0495631) FILES A 990-T FOR THE UNRELATED BUSINESS INCOME REPORTED ON PART VIII, COLUMN C. |
| FORM 990, PART V, LINE 3B: | THE SPECIFIC ENTITY WITHIN THE GROUP (CHRISTIAN COMMUNITY HOMES OF OSCEOLA, INC. - 80-0495631) FILES A 990-T FOR THE UNRELATED BUSINESS INCOME REPORTED ON PART VIII, COLUMN C. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS SHALL BE COMPOSED OF INDIVIDUALS AT LEAST 51% OF WHOM ARE AFFILIATED WITH THE UNITED METHODIST CHURCH OF HUDSON. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE RETURN IS MADE AVAILABLE TO THE BOARD OF DIRECTORS PRIOR TO FILING FOR THEIR REVIEW AND COMMENTS. THE DIRECTOR OF FINANCE AND CHIEF EXECUTIVE OFFICER OF CHRISTIAN COMMUNITY HOMES AND SERVICES, INC. REVIEWS AND APPROVES THE FORM 990 PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE EXECUTIVE DIRECTOR AND DIRECTOR OF MISSION ADVANCEMENT MONITOR THE CONFLICT OF INTEREST POLICY FOR COMPLIANCE ON AN ON-GOING BASIS TO ENSURE THAT MEMBERS OF THE BOARD OF DIRECTORS HAVE IDENTIFIED AND DISCLOSED ALL POTENTIAL CONFLICTS THAT COULD INFLUENCE THEIR DECISION MAKING IN THEIR ROLES AS BOARD MEMBERS. EXAMPLES INCLUDED IN THE POLICY INCLUDE BOARD MEMBERS WHO HAVE BUSINESS DEALINGS WITH THE ORGANIZATION OR WHO HAVE RELATIVES WHO ARE RESIDENTS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | CHRISTIAN COMMUNITY HOMES AND SERVICES, INC.'S EXECUTIVE COMMITTEE APPROVES THE COMPENSATION AGREEMENT WITH THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS, AFTER OBTAINING AND CONSIDERING COMPARABILITY DATA. THE BASIS FOR THE COMPENSATION DETERMINATION IS ADEQUATELY DOCUMENTED IN THE MINUTES OF THE MEETING FOR WHICH THE DETERMINATION WAS MADE. ON AN ANNUAL BASIS, THE BOARD APPROVES THE SALARY INCREASE BUDGET FOR ALL EMPLOYEES. AS ANNUAL PERFORMANCE REVIEWS ARE DUE (BASED ON ANNIVERSARY DATES), THE EXECUTIVE DIRECTOR WILL REVIEW THE LEADING AGE WAGE SURVEYS AND BRING FORTH THE RECOMMENDATION TO THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | CHRISTIAN COMMUNITY HOMES AND SERVICES MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS AT THE OFFICES OF CHRISTIAN COMMUNITY HOMES AND SERVICES. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CCH OSCEOLA LAND LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 65TH AVENUE | AddressLine1Txt |
| City | OSCEOLA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54620 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 814907444 | EIN |
| Primary Activities | TO HOLD PARCEL OF LAND FOR FUTURE DEVELOPMENT | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $26,600 | EndOfYearAssetsAmt |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRISTIAN COMMUNITY HOMES AND SERVICES INC | |||||||||||
| 1320 WISCONSIN ST | HUDSON | WI | 54016 | 391801003 | TO SERVE AS THE PARENT COMPANY FOR SEVERAL SENIOR CARE FACILITIES | WI | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| EVERGREEN SENIOR LIVING INC | |||||||||||
| 1320 WISCONSIN ST | HUDSON | WI | 54016 | 873555983 | SENIOR LIVING | WI | 501(C)(3) | LINE 10 | Yes (1) | CHRISTIAN COMMUNITY HOMES AND SERVICES INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVERGREEN SENIOR LIVING INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionTypeTxt |
| Involved | $760,585 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |