2024-10-28T15:30:06-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2023-01-01 390979908 FAIRHAVEN CORPORATION FAIR 2624732140 435 STARIN ROAD WHITEWATER WI 53190 PAUL KUENNING PRESIDENT/CEO 2624732140 2024-10-28 1 0 KIMBERLY ANDERSON P00188889 6086628600 2024-10-28 2023 2024-10-15 13:58:12Z PAUL KUENNING 435 STARIN ROAD WHITEWATER WI 53190 10377349 0 X WWW.FAIRHAVEN.ORG X 1962 WI TO PROVIDE HOUSING AND SERVICES, INCLUDING SKILLED NURSING AND REHAB TO SENIOR ADULTS. 17 16 173 150 0 0 28071 2172685 8518816 6964102 115712 401521 8392 833456 8670991 10371764 0 0 0 0 5001654 4407215 0 0 87133 4955115 4552135 9956769 8959350 -1285778 1412414 31058260 33802785 18200454 19435139 12857806 14367646 X TO PROVIDE HOUSING AND SERVICES WHICH PROMOTE DIGNITY AND WELL-BEING WITH SPIRITUAL, INTELLECTUAL, CULTURAL AND RECREATIONAL VITALITY. 0 1 7799239 0 7336343 SERVING RESIDENTS SINCE 1962, FAIRHAVEN CORPORATION (FAIRHAVEN OR THE CORPORATION) IS A NONPROFIT LIFE PLAN COMMUNITY RELATED TO THE WISCONSIN CONFERENCE OF THE UNITED CHURCH OF CHRIST, LOCATED IN WHITEWATER, WISCONSIN. FAIRHAVEN'S MAIN CAMPUS INCLUDES INDEPENDENT APARTMENTS, ASSISTED LIVING, SUPPORTIVE LIVING, MEMORY CARE, AND THE HEALTH AND REHABILITATION CENTER OFFERING SKILLED NURSING CARE. THE CORPORATION OFFERS LIFE LEASE ENTRANCE FEE AND MONTHLY FEE AGREEMENTS. THE CORPORATION HOLDS A COMMUNITY BASED RESIDENTIAL FACILITY (CBRF) LICENSE FOR 150 BEDS AVAILABLE IN 105 APARTMENTS AND 23 ASSISTED LIVING UNITS. IT ALSO HOLDS LICENSES FOR AN 82-BED SKILLED NURSING FACILITY AND A 24-BED CBRF MEMORY CARE RESIDENCE CALLED HEARTHSTONE. PRAIRIE VILLAGE IS AN INDEPENDENT PATIO HOME COMMUNITY FOR THOSE 55 AND OLDER LOCATED ONE MILE FROM THE MAIN CAMPUS. FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, 65 DUPLEX UNITS WERE IN USE. 7799239 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 27 0 1 173 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 16 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X DAVID GACKSTATTER 2624732140 435 STARIN ROAD WHITEWATER WI 53190 JAMES CALDWELL CHAIRMAN OF BOARD 1.00 1.00 X X 0 0 0 DR FRED WILEMAN VICE PRESIDENT 1.00 1.00 X X 0 0 0 GARY KINCAID SECRETARY/TREASURER 1.00 X X 0 0 0 ANN HERDENDORF DIRECTOR 1.00 X 0 0 0 DR RICHARD HANEY DIRECTOR 1.00 X 0 0 0 MARLEEN LIPPERT DIRECTOR 1.00 X 0 0 0 SHARON MCCULLOUGH DIRECTOR 1.00 X 0 0 0 MARK OLM EXECUTIVE COMMITTEE 1.00 X X 0 0 0 REV MAX RIGERT EXECUTIVE COMMITTEE 1.00 1.00 X X 0 0 0 MICHAEL WALLACE DIRECTOR 1.00 X 0 0 0 REV MARGARET SHEPHERD DIRECTOR 1.00 X 0 0 0 DR RICHARD TELFER DIRECTOR 1.00 X 0 0 0 REV JERALD WENDT DIRECTOR 1.00 X 0 0 0 PAUL KUENNING EXECUTIVE DIRECTOR 40.00 1.00 X X 137711 0 0 DR GERALD THEUNE DIRECTOR 1.00 X 0 0 0 DR ROBERTA WEDL DIRECTOR 1.00 X 0 0 0 REV FRANZ RIGERT EX-OFFICIO 1.00 X 0 0 0 DR KENNETH KIDD DIRECTOR 1.00 X 0 0 0 137711 0 0 1 0 0 0 PRIME TIME HEALTHCARE LLC PO BOX 3544 OMAHA NE 68103 HEALTHCARE WORKER AGENCY 263869 CLIFTONLARSONALLEN PO BOX 775967 CHICAGO IL 60677 AUDITING/FINANCIAL PLANNING & ADVISING 210589 BK PROPERTY MANAGEMENT LLC N6734 WISCONSIN PKWY DELAVAN WI 53115 PROPERTY MANAGEMENT 189380 EUA 333 EAST CHICAGO ST MILWAUKEE WI 53202 ARCHITECTURAL/CONSTRUCTION ADMINISTRATIO 141420 4 2172685 2172685 HEARTHSTONE REVENUE 623000 2092477 2092477 APARTMENT REVENUE 623000 1851622 1851622 ASSISTED LIVING REVENUE 623000 1383389 1383389 SKILLED NURSING REVENUE 623000 545885 545885 PRAIRIE VILLAGE REVENUE 623000 486048 486048 604681 604681 6964102 353 353 16800 5585 11215 11215 11215 401168 0 401168 401168 401168 FORGIVENESS OF RELATED PARTY PAYA 990009 450000 450000 OTHER OPERATING INCOME 990009 372241 372241 822241 10371764 7336343 0 862736 137711 107414 20657 9640 3865310 3252074 594435 18801 153911 119481 23660 10770 250283 195208 37551 17524 8012 8012 207592 207592 490857 466083 24774 130588 130588 536130 215537 319450 1143 806120 806120 84799 84799 19567 19567 133006 51300 77225 4481 1481388 1481388 146474 146474 FOOD 350814 350814 BAD DEBT EXPENSE 77118 77118 HOUSEKEEPING AND LAUNDR 57516 57516 ACTIVITIES 22154 22154 8959350 7799239 1072978 87133 653234 1339775 717838 895600 688942 251082 55876 45418 55082585 27632467 27467547 27450118 1468424 1987683 6399 1833109 31058260 33802785 984209 1356128 14896011 15079147 1122888 704769 132000 100000 1065346 2195095 18200454 19435139 X 12857806 14367646 12857806 14367646 31058260 33802785 X 1412414 121897 -25400 929 X 0 1 X 1 0 X 18537 358866 1742095 28071 2172685 4320254 11620125 11605565 8148305 7946955 6964102 46285052 11638662 11964431 9890400 7975026 9136787 50605306 0 11891 17801 425148 333536 142223 930599 11891 17801 425148 333536 142223 930599 49674707 26999 23605 20092 14288 17153 102137 26999 23605 20092 14288 17153 102137 513540 633759 475274 571861 822241 3016675 12179201 12621795 10385766 8561175 9976181 53724118 0.92460 0.93210 0.00190 0.00190 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: ENTRY FEES - 2019 AMOUNT: $ 513,540. 2020 AMOUNT: $ 633,759. 2021 AMOUNT: $ 475,274. 2022 AMOUNT: $ 571,861. OTHER OPERATING INCOME - 2023 AMOUNT: $ 372,241. DEBT FORGIVENESS - 2023 AMOUNT: $ 450,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1454631 318799 187173 -5622 1966225 1717007 -177286 91153 -6063 1454631 1384624 114437 211398 -6548 1717007 1170167 105801 109596 940 1384624 1839405 158649 172113 1000000 1170167 1.00000 0.00000 0.00000 0 0 985126 3480407 4465533 37948982 19975294 17973688 9791145 7657173 2133972 2876925 2876925 27450118 ROU ASSET - FINANCING LEASE 4977 ASSETS LIMITED TO USE 1828132 1833109 REQUIRED DONOR ANNUITY RESERVE 48885 ASSET RETIREMENT OBLIGATION 144464 DUE TO FAIRHAVEN FOUNDATION 1920000 ST FINANCING LEASE LIABILITY 1394 LT FINANCING LEASE LIABILITY 3786 OTHER CURRENT LIABILITIES 76566 2195095 X PART X, LINE 2: THE CORPORATION AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM WISCONSIN FRANCHISE AND INCOME TAX. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. FORM 990, PART III, LINE 3 ON 3/30/2023 THE ORGANIZATION CEASED OPERATIONS OF THEIR SKILLED NURSING UNIT. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS COMPRISED OF THE BOARD CHAIR, THE PRESIDENT/CEO AND FOUR OTHER DIRECTORS FROM THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE FULL AUTHORITY OF THE BOARD OF DIRECTORS BETWEEN MEETINGS OF THE FULL BOARD. FORM 990, PART VI, SECTION A, LINE 2 REV. MAX RIGERT, EXECUTIVE COMMITTEE, AND REV. FRANZ RIGERT, EX-OFFICO, ARE FATHER AND SON. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE ORGANIZATION'S MANAGEMENT AND WAS PRESENTED TO THE FULL BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER OR DIRECTOR OF FAIRHAVEN CORPORATION CURRENTLY IN OFFICE IS EXPECTED TO COMPLETE, SIGN AND RETURN TO THE CORPORATION A DISCLOSURE STATEMENT ANNUALLY REPORTING DIRECT AND INDIRECT PERSONAL OR FINANCIAL INTERESTS WITH CONFLICTING BUSINESSES AND ORGANIZATIONS. DETERMINATIONS ARE MADE BY THE REMAINING BOARD MEMBERS OR COMMITTEE MEMBERS. INDIVIDUALS WITH A CONFLICT ABSTAIN BOTH FROM DISCUSSION AND VOTING ON THE ISSUE BEFORE THE BOARD OF DIRECTORS. ALL PROCEEDINGS RELATED TO CONFLICTS OF INTEREST ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S FINANCE AND PERSONNEL COMMITTEE APPROVES THE ANNUAL BUDGET WHICH INCLUDES GENERAL INCREASES FOR ALL EMPLOYEES. THE GENERAL INCREASES FOR ALL EMPLOYEES ARE DETERMINED UTILIZING INFORMATION FROM THE LEADING AGE WISCONSIN ANNUAL WAGE SURVEY AND PERFORMANCE AT THE ORGANIZATIONAL AND INDIVIDUAL LEVELS. THIS PROCESS WAS LAST UNDERTAKEN IN 2019 FOR THE EXECUTIVE DIRECTOR, PAUL KUENNING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN DONOR ANNUITIES 929. REVERSAL OF ALLOWANCE FAIRHAVEN FOUNDATION 435 STARIN ROAD WHITEWATER WI 53190 391797563 TO SUPPORT FAIRHAVEN CORPORATION WI 501(C)(3) LINE 12A, I FAIRHAVEN CORPORATION 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0