2022-11-15T08:04:04-06:00 2021-12-31 381357951 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2021-01-01 381387113 RESTHAVEN REST 6167963504 948 WASHINGTON AVE HOLLAND MI 494235205 DEEDRE VRIESMAN PRESIDENT/CEO 6167963504 2022-11-14 1 DEEDRE VRIESMAN 999009999 DAVID LOWENTHAL P00378651 2695674500 2022-11-14 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z RESTHAVEN CARE COMMUNITY DEEDRE VRIESMAN 948 WASHINGTON AVE HOLLAND MI 494235205 29172178 0 X WWW.RESTHAVEN.ORG X 1945 MI RESTHAVEN'S MISSION IS TO GLORIFY GOD BY PROVIDING A CONTINUUM OF QUALITY CARE AND SERVICES THAT DEMONSTRATES THE LOVE AND COMPASSION OF JESUS CHRIST. 9 9 715 35 -65428 0 2631962 5014220 23110990 23818213 102326 168471 101279 86516 25946557 29087420 0 0 0 0 14401169 15091321 0 0 28541 9322439 9269721 23723608 24361042 2222949 4726378 32501578 35879779 13251891 11782224 19249687 24097555 X RESTHAVEN'S MISSION IS TO GLORIFY GOD BY PROVIDING A CONTINUUM OF QUALITY CARE AND SERVICES THAT DEMONSTRATES THE LOVE AND COMPASSION OF JESUS CHRIST. 0 0 16225207 0 17251642 RESTHAVEN CARE CENTER - PROVIDES MEDICAL REHABILITATION, LONG-TERM CARE SERVICES, AND MEMORY SUPPORT FOR SENIORS IN HOLLAND, MI. SERVING AN AVERAGE OF 140 RESIDENTS PER DAY. THE CARE AND SERVICES ARE PROVIDED IN A COMFORTABLE, HOME-LIKE SURROUNDING, INCLUDING TWO SMALL HOUSE MODELS OF 10 RESIDENTS EACH. THE INDIVIDUAL'S PHYSICAL, SPIRITUAL, AND SOCIAL NEEDS ARE SUPPORTED. RESTHAVEN CARE CENTER PROVIDES SERVICES TO THOSE WHO HAVE EXHAUSTED THEIR FINANCIAL RESOURCES. MEDICAID ELIGIBLE RESIDENTS ACCOUNT FOR APPROXIMATELY 73% OF THE CENSUS. THE ORGANIZATION PROVIDES UNCOMPENSATED COST OF PRIVATE ROOMS TO MANY OF THOSE ON MEDICAID AND A HIGHER STAFFING RATIO OF CAREGIVERS THAN MANDATED BY MEDICAID TO PROMOTE PERSON-CENTERED CARE FOR RESIDENTS. 4284672 0 4586855 RESTHAVEN MAPLE WOODS - AN AFFORDABLE ASSISTED LIVING FACILITY THAT PROVIDES SENIORS WITH 3 MEALS PER DAY, SOCIAL OPPORTUNITIES AND A SUPERVISED ENVIRONMENT TO PROMOTE THEIR HIGHEST LEVEL OF INDEPENDENCE, WHILE PROVIDING SUPPORTS NEEDED TO HELP THEM REMAIN IN THE COMMUNITY. MAPLE WOODS PROVIDES UNCOMPENSATED SERVICES TO THOSE ON MEDICAID AND THOSE RECEIVING SUPPLEMENTAL SOCIAL SECURITY INCOME, APPROXIMATELY 22% OF RESIDENTS AT THIS TIME. DUE TO ITS AFFORDABILITY, RESTHAVEN IS ABLE TO SERVE MANY RESIDENTS WITH INCOMES OF 50% AMI OR LESS AT MAPLE WOODS. THERE IS ALSO A SEPARATE 24-BED SMALL HOUSE MODEL ASSISTED LIVING ON THE MAPLE WOODS CAMPUS. 1384005 0 1977403 THE WARM FRIEND- AN INDEPENDENT LIVING FACILITY WITH 60 APARTMENTS FOR SENIORS, SERVING APPROXIMATELY 66 RESIDENTS. THE WARM FRIEND PROVIDES LIFE ENRICHMENT, DINING OPTIONS AND 24 HR ONSITE STAFF TO HELP SENIORS REMAIN INDEPENDENT IN THE COMMUNITY. 242521 2313 OTHER SERVICES 242521 2313 22136405 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 49 0 1 715 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X SETH WEENER 6167963504 948 WASHINGTON AVE HOLLAND MI 494235205 NATE BAUMANN BOARD CHAIR 1.00 X X 0 0 0 RICK ZWEERING BOARD VICE CHAIR 1.00 X X 0 0 0 BOB CARLSON BOARD TREASURER 1.00 X X 0 0 0 KEVIN VANDERKLOK BOARD SECRETARY 1.00 X X 0 0 0 JACK GISINGER TRUSTEE (PART YEAR) 1.00 X 0 0 0 MARIANNE BOUWENS TRUSTEE (PART YEAR) 1.00 X 0 0 0 CRAIG JANUSZ TRUSTEE (PART YEAR) 1.00 X 0 0 0 KAITLIN DEMAAGD TRUSTEE 1.00 X 0 0 0 SAM MARTIN TRUSTEE (PART YEAR) 1.00 X 0 0 0 HAANS MULDER TRUSTEE 1.00 X 0 0 0 ANNIE STERKEN TRUSTEE 1.00 X 0 0 0 BARB KLEINHEKSEL TRUSTEE 1.00 X 0 0 0 DAVID LUTZ TRUSTEE 1.00 X 0 0 0 DEEDRE VRIESMAN PRESIDENT/CEO 40.00 X 205905 0 12636 SETH WEENER CHIEF FINANCIAL OFFICER 40.00 X 153403 0 31655 TIFFANY ZIEMBA ADMINISTRATOR 40.00 X 112416 0 12969 471724 0 57260 3 0 1 0 THW DESIGN 2100 RIVEREDGE PARKWAY STE 900 ATLANTA GA 30328 ARCHITECT 1134849 FUNCTIONAL PATHWAYS OF TN LLC 10133 SHERRILL BLVD STE 200 KNOXVILLE TN 37932 THERAPY PROVIDER 635095 DHE PLUMBING AND MECHANICAL 4475 8TH AVE GRANDVILLE MI 49418 PLUMBING HVAC CONTRACTOR 468064 NXGEN MDX LLC 801 BROADWAY AVE NW SUITE 203 GRAND RAPIDS MI 49504 COVID-19 TESTING LAB 406600 CREATIVE DINING SERVICES INC ONE ROYAL PARK DRIVE SUITE 3 ZEELAND MI 49464 CONTRACT DINING SERVICE PROVIDER 395957 9 4232340 781880 5014220 ROOM AND BOARD 624310 17664594 17664594 ANCILLARY SERVICES 900099 5781978 5781978 OTHER OPERATING INCOME 900099 371641 371641 23818213 168471 168471 171274 84758 86516 86516 -65428 151944 29087420 23818213 -65428 320415 383551 383551 12140668 11531614 599102 9952 152884 151703 800 381 1506656 1407559 95566 3531 907562 840445 65009 2108 10922 1037 9885 56141 9597 46544 2076635 1835740 238874 2021 445905 440712 5193 199198 119958 78630 610 296221 208307 84144 3770 995611 984680 10931 12927 5194 7733 94075 77163 16848 64 1606231 1520679 85397 155 199724 181004 18487 233 DUES & LICENSES 1173100 1170237 2538 325 RESIDENT SUPPLIES 1083222 1083222 FOOD 812750 801207 11345 198 BAD DEBTS 207059 207059 24361042 22136405 2196096 28541 1490 1490 10927910 9520678 925444 434147 1898677 2330199 1992 0 251904 31831 99001 134493 40370050 22404292 17285660 17965758 633793 4712757 315707 588426 160000 160000 32501578 35879779 2466547 3867851 660000 660000 6027500 5657750 1607744 1596623 2490100 13251891 11782224 X 19066348 23648120 183339 449435 19249687 24097555 32501578 35879779 X 4726378 -101678 223168 X X 0 1 X 1 1 1 X 682829 654834 417173 2631962 5014220 9401018 19764483 21361914 22234886 23110990 23818213 110290486 20447312 22016748 22652059 25742952 28832433 119691504 10000 50000 16115 19500 10000 105615 0 10000 50000 16115 19500 10000 105615 119585889 218079 275840 323842 277727 336955 1432443 218079 275840 323842 277727 336955 1432443 20665391 22292588 22975901 26020679 29169388 121123947 0.98730 0.98820 0.01180 0.01100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 39728 450 6739 0 326 46591 35572 350 4157 7 344 39728 29730 450 5724 3 329 35572 31696 200 -1839 7 320 29730 27526 200 4202 7 225 31696 0.00000 1.00000 0.00000 1 0 2351076 2351076 30505247 18703147 11802100 1562827 868376 694451 4387314 2832769 1554545 1563586 1563586 17965758 29277128 -101678 291386 189708 29087420 0 29087420 24429260 68218 68218 24361042 0 24361042 PART V, LINE 4: THE ORGANIZATION CREATED A CHARITABLE ENDOWMENT FUND TO AID AND ASSIST IT IN CARRYING OUT ITS WORK WHICH INCLUDES PROVIDING HOUSING FACILITIES, HEALTHCARE SERVICES AND LIFE ENRICHMENT ACTIVITIES FOR SENIORS IN OUR COMMUNITY. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON EARNINGS OF JOINT VENTURE 223,168. RENTAL EXPENSES FROM PART IX TO PART VIII, LINE 6B 68,218. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES FROM PART IX TO PART VIII, LINE 6B 68,218. X X X X 0 0 0 0 0 0 0 1 0 DEEDRE VRIESMAN PRESIDENT/CEO 180226 0 25530 0 149 0 6049 0 6587 0 218541 0 0 0 SETH WEENER CHIEF FINANCIAL OFFICER 139489 0 13770 0 144 0 4885 0 26770 0 185058 0 0 0 PART I, LINE 7 THE PRESIDENT/CEO, CFO, AND TWO DIRECTORS OF THE ORGANIZATION RECEIVED A PERFORMANCE BONUS BASED ON MEETING GOALS AND EXPECTATIONS. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES DETERMINES AND VOTES ON THE DISCRETIONARY BONUS. A MICHIGAN STRATEGIC FUND SERIES 2013 521417332 2013-07-09 5100000 REFINANCE LOAN AND CONSTRUCTION OF 16 BED SNF 0 0 0 B MICHIGAN STRATEGIC FUND SERIES 2017 521417332 2017-06-22 3000000 CONSTRUCTION OF 24 BED ASSISTED LIVING 0 0 0 A 1955500 5100000 5100000 2013 1 0 1 1 B 486750 3000000 3000000 2017 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 1 B 1 FORM 990, PART I, ITEM C DBA: RESTHAVEN CARE CENTER DBA: THE WARM FRIEND DBA: VERN AND LOIS BOERSMA COTTAGE DBA: GOOD SHEPHERD HOME, MEMORY SUPPORT DBA: RESTHAVEN REHABILITATION DBA: RESTHAVEN MAPLE WOODS DBA: MAPLE WOODS COTTAGES DBA: CARE COTTAGES OF RESTHAVEN DBA: COTTAGE GROVE AT VAN RAALTE WOODS DBA: COTTAGE GROVE HOLLAND DBA: GOOD SHEPHERD DEMENTIA PROGRAM DBA: MAPLE WOODS, A RESTHAVEN COMMUNITY DBA: RESTHAVEN CARE CENTER AT FOUNTAINVIEW DBA: RESTHAVEN COTTAGE GROVE DBA: RESTHAVEN GOOD SHEPHERD HOME DBA: RESTHAVEN GREEN HOUSE DBA: RESTHAVEN GREEN HOUSE HOME DBA: RESTHAVEN HOME HEALTH CARE DBA: RESTHAVEN PATRONS, INC. DBA: RESTHAVEN REHAB COTTAGE DBA: RESTHAVEN REHABILITATION COTTAGE DBA: THE COTTAGES AT MAPLE WOODS DBA: THE COTTAGES OF RESTHAVEN DBA: THE REHAB COTTAGE DBA: THE RESTHAVEN GREEN HOUSE DBA: JAY & HAZEL JANSSEN COTTAGE FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING FIRM PROVIDES THE ORGANIZATION WITH A DRAFT COPY OF THE 990 FORM. THE ENTIRE GOVERNING BOARD REVIEWS THE FORM AND MAKES ANY CORRECTIONS OR SUGGESTIONS AS NEEDED. THE ACCOUNTING FIRM THEN REVISES THE FORM AND FILES IT ELECTRONICALLY. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY APPLIES TO ALL DIRECTORS, TRUSTEES, OFFICERS, ADVISORY MEMBERS AND EXECUTIVE STAFF. ALL ACTUAL AND POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO THE PRESIDENT/CEO AND CHAIRPERSON OF THE BOARD. BOARD MEMBERS ARE REQUIRED TO SIGN A NEW CONFLICT OF INTEREST POLICY ANNUALLY. IF A CONFLICT ARISES, THE BOARD MEMBER MUST LEAVE THE ROOM DURING DISCUSSION AND ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 TOP OFFICIALS ARE RATED ON A SCALE AND EVALUATED ON SEVERAL PERFORMANCE FACTORS. IT IS THE ORGANIZATION'S POLICY TO MAINTAIN FAIR AND COMPETITIVE SALARY RANGES CONSISTENT WITH THE ECONOMIC REQUIREMENTS OF THE ORGANIZATION AND COMMENSURATE WITH THOSE OF THE COMMUNITY IN WHICH IT OPERATES. LASTLY, THE BOARD OF DIRECTORS DELIBERATES AND DETERMINES WHAT IS AN APPROPRIATE COMPENSATION PACKAGE FOR TOP OFFICIALS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2021. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: GAIN ON EARNINGS OF JOINT VENTURE 223,168. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.