REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME (EIN 36-2382853)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202223199349321992
Schema version
2021v4.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-15T15:39:59-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110 S RIVERSIDE PLAZA 9TH FLOORAddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP60606ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362382853EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1REST HAVEN ILLIANA CHRISTIANBusinessNameLine1Txt
Business Name Line2CONVALESCENT HOMEBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlRESTBusinessNameControlTxt
Phone7083428100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRIVEAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBARRY VANDERGENUGTENPersonNm
Person TitleCFOPersonTitleTxt
Phone7083428100PhoneNum
Signature2022-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBARRYPersonFirstNm
Person LastVANDERGENUGTENPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID LOWENTHALPreparerPersonNm
PTINP00378651PTIN
Phone3122071040PhoneNum
Preparation2022-11-14PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE LIFE SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRICHARD SCHUTTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRIVEAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$150,110,779GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PROVIDENCELIFESERVICES.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionREST HAVEN'S PURPOSE IS TO PROVIDE SERVICES FOR THE AGED INCLUDING SKILLED NURSING AND REHAB SERVICES, HOME HEALTH CARE, TOWN HOME LIVING, INDEPENDENT AND ASSISTED LIVING.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee1128TotalEmployeeCnt
Total Volunteers155TotalVolunteersCnt
Total Gross UBI$554,309TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$90,301NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,887,369PYContributionsGrantsAmt
CY Contributions Grants$6,552,517CYContributionsGrantsAmt
PY Program Service Revenue$56,204,654PYProgramServiceRevenueAmt
CY Program Service Revenue$56,161,018CYProgramServiceRevenueAmt
PY Investment Income$2,826,442PYInvestmentIncomeAmt
CY Investment Income$1,344,984CYInvestmentIncomeAmt
PY Other Revenue-$16,391PYOtherRevenueAmt
CY Other Revenue-$35,731CYOtherRevenueAmt
PY Total Revenue$64,902,074PYTotalRevenueAmt
CY Total Revenue$64,022,788CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$37,326,090PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$36,729,113CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$418,929CYTotalFundraisingExpenseAmt
PY Other Expenses$29,729,140PYOtherExpensesAmt
CY Other Expenses$28,964,660CYOtherExpensesAmt
PY Total Expenses$67,055,230PYTotalExpensesAmt
CY Total Expenses$65,693,773CYTotalExpensesAmt
PY Revenues Less Expenses-$2,153,156PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,670,985CYRevenuesLessExpensesAmt
Total Assets BOY$89,097,338TotalAssetsBOYAmt
Total Assets EOY$77,792,257TotalAssetsEOYAmt
Total Liabilities BOY$68,809,785TotalLiabilitiesBOYAmt
Total Liabilities EOY$58,712,983TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,287,553NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,079,274NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionREST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME D/B/A PROVIDENCE LIFE SERVICES (REST HAVEN) IS A NOT-FOR-PROFIT ILLINOIS CORPORATION WHOSE PURPOSE IS TO PROVIDE NURSING AND RESIDENTIAL LIVING ARRANGEMENTS FOR THE AGED INCLUDING SKILLED NURSING AND REHABILITATION SERVICES, HOME HEALTH CARE, TOWNHOME LIVING, INDEPENDENT LIVING, AND ASSISTED LIVING.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$57,341,354ExpenseAmt
Revenue$54,924,189RevenueAmt
DescTO PROVIDE PROPER CARE FOR THE SICK AND ELDERLY. 805 BEDS/UNITS WITH OCCUPANCY OVER 77% ON THE FULL CONTINUUM OF CARE.Desc
Total Program Service Expenses$57,341,354TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document79IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1128EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BARRY VANDERGENUGTENBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7083428100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRIVEAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
RICH SCHUTT
DIRECTOR & CEO40.005.00Yes (X)Yes (X)$608,196$0$25,187
PAUL KATS
CHAIR1.002.00Yes (X)Yes (X)$0$0$0
DAVE LARSEN
CHAIR (JAN-APR 2021)1.002.00Yes (X)Yes (X)$0$0$0
ROGER BOEREMA
VICE CHAIR1.002.00Yes (X)Yes (X)$0$0$0
BILL ZANDSTRA
SECRETARY/TREASURER1.002.00Yes (X)Yes (X)$0$0$0
KEVIN BOTMA
ASST. SECRETARY/TREASURER1.002.00Yes (X)Yes (X)$0$0$0
HOWARD RYNBERK JR
ASST. SECRETARY/TREASURER1.002.00Yes (X)Yes (X)$0$0$0
PAUL BUIKEMA
DIRECTOR1.002.00Yes (X)$0$0$0
EDWARD DAMSTRA III
DIRECTOR1.002.00Yes (X)$0$0$0
JAKE GROENEWOLD
DIRECTOR1.002.00Yes (X)$0$0$0
SHERYL HAMMER
DIRECTOR1.002.00Yes (X)$0$0$0
KEN HOVING
DIRECTOR1.002.00Yes (X)$0$0$0
KAREN HUIZENGA
DIRECTOR1.002.00Yes (X)$0$0$0
PATTI JABAAY
DIRECTOR1.002.00Yes (X)$0$0$0
BASTIAN KNOPPERS
DIRECTOR (JAN-APR 2021)1.002.00Yes (X)$0$0$0
EMILY MCMASTER
DIRECTOR1.002.00Yes (X)$0$0$0
TIM OZINGA
DIRECTOR1.002.00Yes (X)$0$0$0
GARY SMIT
DIRECTOR1.002.00Yes (X)$0$0$0
WILLIAM DEYOUNG
COO40.005.00Yes (X)$421,351$0$75,309
BARRY VANDERGENUGTEN
CFO40.005.00Yes (X)$338,815$0$31,595
SUSAN ENRIGHT
VP HOME & COMMUNITY BASED SERVICES40.000.00$209,274$0$14,695Yes (X)
JOHANNA ZANDSTRA
VP OF OPERATIONS40.005.00$174,754$0$26,114Yes (X)
MEGAN TENGERSTROM
VP OF OPERATIONS40.005.00$182,370$0$14,532Yes (X)
JEFFREY COURTNEY
VP OF PROPERTY DEVELOPMENT40.005.00$169,529$0$20,068Yes (X)
SCOTT STUDEBAKER
VP MINISTRY ADVANCEMENT & DEVELOPMENT40.005.00$169,045$0$19,668Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,273,334TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$227,168TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K36IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SYMBRIA REHAB
28100 TORCH PARKWAYWARRENVILLEIL60555THERAPY$3,460,703
PROVINET SOLUTIONS
18645 WEST CREEK DRIVETINLEY PARKIL60477IT SERVICES$1,940,577
GORDON FOOD SERVICE
PO BOX 88029CHICAGOIL60680DINING SERVICES$1,713,962
SYMBRIA RX SERVICES
28100 TORCH PARKWAYWARRENVILLEIL60555PHARMACY$1,110,412
MEDLINE INDUSTRIES
DPT CH 14400PALATINEIL60055MEDICAL SUPPLIES$1,033,697
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K43CntrctRcvdGreaterThan100KCnt
Fundraising$395,368FundraisingAmt
Government Grants$5,049,134GovernmentGrantsAmt
All Other Contributions$1,108,015AllOtherContributionsAmt
Total Contributions$6,552,517TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
ROUTINE REVENUE621610$52,321,246$52,321,246
ANCILLARY REVENUE621610$3,839,772$3,285,463$554,309
FieldValueIRS element (for citing)
Total Program Service Revenue$56,161,018TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$364,052TotalRevenueColumnAmt
Exclusion$364,052ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$85,008,996SecuritiesAmt
Other$1,950,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$83,345,544SecuritiesAmt
Other$2,632,520OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,663,452SecuritiesAmt
Other-$682,520OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$980,932TotalRevenueColumnAmt
Related Or Exempt Func Income-$682,520RelatedOrExemptFuncIncomeAmt
Exclusion$1,663,452ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$74,196FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$395,368ContriRptFundraisingEventAmt
Fundraising Direct Expenses$109,927FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$35,731TotalRevenueColumnAmt
Exclusion-$35,731ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$64,022,788TotalRevenueColumnAmt
Related Or Exempt Func Income$54,924,189RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$554,309UnrelatedBusinessRevenueAmt
Exclusion$1,991,773ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,500,453TotalAmt
Management And General$1,500,453ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$29,200,060TotalAmt
Program Services$24,753,629ProgramServicesAmt
Management And General$4,102,793ManagementAndGeneralAmt
Fundraising$343,638FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$513,253TotalAmt
Program Services$400,687ProgramServicesAmt
Management And General$99,303ManagementAndGeneralAmt
Fundraising$13,263FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,205,899TotalAmt
Program Services$2,537,118ProgramServicesAmt
Management And General$632,269ManagementAndGeneralAmt
Fundraising$36,512FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,309,448TotalAmt
Program Services$2,010,493ProgramServicesAmt
Management And General$273,439ManagementAndGeneralAmt
Fundraising$25,516FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,711TotalAmt
Management And General$6,711ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$18,000TotalAmt
Management And General$18,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,901,327TotalAmt
Program Services$2,729,174ProgramServicesAmt
Management And General$172,153ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,341,725TotalAmt
Program Services$1,341,725ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,945,190TotalAmt
Program Services$1,636,020ProgramServicesAmt
Management And General$309,170ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,140,680TotalAmt
Program Services$2,003,486ProgramServicesAmt
Management And General$137,194ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,806,145TotalAmt
Program Services$2,710,191ProgramServicesAmt
Management And General$95,954ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,438,704TotalAmt
Program Services$2,337,338ProgramServicesAmt
Management And General$101,366ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
NURSING EXPENSE$4,232,334$4,232,334
FOOD & DIETARY EXPENSE$2,364,607$2,364,607
REPAIRS & MAINTENANCE$1,261,995$1,261,995
PHARMACY EXPENSE$1,234,618$1,234,618

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,272,624TotalAmt
Program Services$5,787,939ProgramServicesAmt
Management And General$484,685ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$65,693,773TotalAmt
Program Services$57,341,354ProgramServicesAmt
Management And General$7,933,490ManagementAndGeneralAmt
Fundraising$418,929FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,244,947BOYAmt
EOY$175,795EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$313,325BOYAmt
EOY$313,333EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,598,397BOYAmt
EOY$10,197,184EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,151,791BOYAmt
EOY$646,895EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$74,592,511LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$36,591,080LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$43,266,083BOYAmt
EOY$38,001,431EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$19,718,386BOYAmt
EOY$9,170,379EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$652,869BOYAmt
EOY$652,869EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$12,151,540BOYAmt
EOY$18,634,371EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$89,097,338BOYAmt
EOY$77,792,257EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,046,188BOYAmt
EOY$6,947,199EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$487,814BOYAmt
EOY$530,985EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$48,260,074BOYAmt
EOY$43,349,113EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,015,709BOYAmt
EOY$7,885,686EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$68,809,785BOYAmt
EOY$58,712,983EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,182,750BOYAmt
EOY$18,976,703EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$104,803BOYAmt
EOY$102,571EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,287,553BOYAmt
EOY$19,079,274EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$89,097,338BOYAmt
EOY$77,792,257EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,670,985ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$496,665NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$959,371OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit Performed0FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,337,547CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,724,032CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,651,685CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,887,369CurrentTaxYearMinus1YearAmt
Current Tax Year$6,552,517CurrentTaxYearAmt
Total$19,153,150TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$76,087,087CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$80,188,343CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,473,126CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$56,204,654CurrentTaxYearMinus1YearAmt
Current Tax Year$56,161,018CurrentTaxYearAmt
Total$346,114,228TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$77,424,634CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$83,912,375CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$79,124,811CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$62,092,023CurrentTaxYearMinus1YearAmt
Current Tax Year$62,713,535CurrentTaxYearAmt
Total$365,267,378TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$81,468CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$96,282CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$142,964CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$155,395CurrentTaxYearMinus1YearAmt
Current Tax Year$202,321CurrentTaxYearAmt
Total$678,430TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$81,468CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$96,282CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$142,964CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$155,395CurrentTaxYearMinus1YearAmt
Current Tax Year$202,321CurrentTaxYearAmt
Total$678,430TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$364,588,948PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$480,665CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$338,317CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$543,487CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$483,540CurrentTaxYearMinus1YearAmt
Current Tax Year$364,052CurrentTaxYearAmt
Total$2,210,061TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,136CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,018CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$35,313CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$22,547CurrentTaxYearMinus1YearAmt
Current Tax Year$18,963CurrentTaxYearAmt
Total$96,977TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$484,801CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$354,335CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$578,800CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$506,087CurrentTaxYearMinus1YearAmt
Current Tax Year$383,015CurrentTaxYearAmt
Total$2,307,038TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$77,909,435CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$84,266,710CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$79,703,611CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$62,598,110CurrentTaxYearMinus1YearAmt
Current Tax Year$63,096,550CurrentTaxYearAmt
Total$367,574,416TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99190PublicSupportCY509Pct
Public Support PY5090.99210PublicSupportPY509Pct
Investment Income CY0.00630InvestmentIncomeCYPct
Investment Income PY0.00640InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,710,101OtherCostOrOtherBasisAmt
Book Value$4,710,101BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$63,675,016OtherCostOrOtherBasisAmt
Depreciation$33,098,173DepreciationAmt
Book Value$30,576,843BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,950,699OtherCostOrOtherBasisAmt
Depreciation$3,441,410DepreciationAmt
Book Value$1,509,289BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,256,695OtherCostOrOtherBasisAmt
Depreciation$51,497DepreciationAmt
Book Value$1,205,198BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$38,001,431TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
GROUND LEASE RECEIVABLES$1,044,249
ASSETS LIMITED TO USE$527,821
DUE FROM AFFILIATES$13,483,785
OTHER ASSETS$133,678
LEGAL LIABILITY INS RECOVERIES$2,853,421
DEFERRED COMP GRANTOR TRUST$591,417
FieldValueIRS element (for citing)
Total Book Value Other Assets$18,634,371TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
ESTIMATED SELF-INS LIABILITIES$4,556,468
ASSET RETIREMENT OBLIGATION$184,192
RESIDENT NOTES AND DEPOSITS$1,333,957
ACCRUED INTEREST PAYABLE$110,531
CHARITABLE ANNUITY CONTRACTS$120,250
FMV INTEREST RATE SWAP VALUE$1,580,288
FieldValueIRS element (for citing)
Total Liability$7,885,686TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BANQUETEvent1Nm
Gross Receipts Event1$288,608GrossReceiptsEvent1Amt
Charitable Contri Event1$288,608CharitableContriEvent1Amt
Other Direct Expenses Event1$6,417OtherDirectExpensesEvent1Amt
Event2GOLF OUTINGEvent2Nm
Gross Receipts Event2$148,417GrossReceiptsEvent2Amt
Charitable Contri Event2$85,777CharitableContriEvent2Amt
Gross Revenue Event2$62,640GrossRevenueEvent2Amt
Other Direct Expenses Event2$83,332OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$32,539GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$20,983CharitableContriOtherEventsAmt
Gross Revenue Other Events$11,556GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$20,178OthDirectExpnssOtherEventsAmt
Gross Receipts Total$469,564GrossReceiptsTotalAmt
Charitable Contributions Tot$395,368CharitableContributionsTotAmt
Gross Revenue Total Events$74,196GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$109,927OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$109,927DirectExpenseSummaryEventsAmt
Net Income Summary-$35,731NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE G, PART II:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION HOSTS EVENTS FOR PUBLIC RELATIONS AND FUNDRAISING PURPOSES. THESE EVENTS ARE OFTEN UNDERWRITTEN BY LEADERSHIP SPONSORS OF WHICH THEIR SPONSORSHIPS ARE ALLOCATED AMONGST THE VARIOUS EVENTS. THE COMBINED GROSS RECEIPTS OF THE EVENTS TOTALED $469,564 FOR 2021. THE COMBINED COSTS OF THE EVENTS TOTALED $109,927. THE NET INCOME TO THE ORGANIZATION FOR HOSTING ALL OF THE EVENTS WAS $359,637.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RICH SCHUTT
DIRECTOR & CEO$532,645$0$56,166$0$19,385$0$11,200$0$13,987$0$633,383$0$0$0
WILLIAM DEYOUNG
COO$370,084$0$36,220$0$15,047$0$54,371$0$20,938$0$496,660$0$0$0
BARRY VANDERGENUGTEN
CFO$290,974$0$28,600$0$19,241$0$11,200$0$20,395$0$370,410$0$0$0
SUSAN ENRIGHT
VP HOME & COMMUNITY BASED SERVICES$206,165$0$0$0$3,109$0$8,247$0$6,448$0$223,969$0$0$0
JOHANNA ZANDSTRA
VP OF OPERATIONS$159,613$0$11,071$0$4,070$0$6,584$0$19,530$0$200,868$0$0$0
MEGAN TENGERSTROM
VP OF OPERATIONS$164,115$0$16,563$0$1,692$0$5,914$0$8,618$0$196,902$0$0$0
JEFFREY COURTNEY
VP OF PROPERTY DEVELOPMENT$164,093$0$0$0$5,436$0$505$0$19,563$0$189,597$0$0$0
SCOTT STUDEBAKER
VP MINISTRY ADVANCEMENT & DEVELOPMEN$160,913$0$0$0$8,132$0$6,437$0$13,231$0$188,713$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATHE ORGANIZATION PROVIDES AN ALLOWANCE FOR UP TO 10 BOARD MEMBERS TO ATTEND THE ANNUAL ASSOCIATION CONVENTION TO PROVIDE MORE IN DEPTH KNOWLEDGE OF THE SENIOR CARE INDUSTRY. THE COST OF TRAVEL FOR SPOUSES IS PERMITTED AS LONG AS THE TOTAL DOES NOT EXCEED THE ESTABLISHED ALLOWANCE AMOUNT. THE BENEFIT OF SPOUSAL TRAVEL IS INCLUDED IN TAXABLE COMPENSATION. DOCUMENTATION OF ATTENDANCE AT THE ANNUAL CONVENTION IS REQUIRED.
PART I, LINE 4BREST HAVEN HAS ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN IN AN EFFORT TO RETAIN SELECTED OFFICERS ON A LONG TERM BASIS. WILLIAM DEYOUNG PARTICIPATES IN THE PLAN. IN 2021, THERE WERE NO DISTRIBUTIONS FROM OR AMOUNTS VESTED IN THE ACCOUNT. THE PLAN WAS ORIGINALLY SET UP IN 2005 BY THE BOARD OF DIRECTORS TO ESTABLISH A RETENTION INITIATIVE FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES AND ESTABLISHES AN INCENTIVE FOR THEM TO CONTINUE THEIR EMPLOYMENT WITH THE ORGANIZATION UNTIL NORMAL RETIREMENT AGE. AMONG VARIOUS CRITERIA, IN ORDER TO QUALIFY FOR THE BENEFIT, THE EXECUTIVE WILL NEED TO BE CONTINUOUSLY EMPLOYED THRU AND UNTIL A FUTURE DATE. THE ORGANIZATION'S PAYMENTS INTO THE PLAN ARE RECORDED ON THE 990 AS DEFERRED COMPENSATION. HOWEVER, THESE MONIES ARE ONLY ELIGIBLE TO BE RECEIVED BASED UPON THE ACHIEVEMENT OR SATISFACTION OF SOME FUTURE EVENTS. THE PLAN CONTRIBUTIONS ARE NOT UNDER THE CONTROL OF THE EXECUTIVE, THEY REMAIN THE ASSET OF THE ORGANIZATION, AND THE ENTIRE PLAN IS SUBJECT TO A FULL RISK OF FORFEITURE BY THE INDIVIDUAL.
PART I, LINE 7THE EXECUTIVE COMPENSATION PROGRAM HAS TWO MAJOR ELEMENTS, SALARY, OR BASE PAY, AND VARIABLE PAY. THE SALARY REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABILITIES AND EXPERIENCE. THE VARIABLE PAY REFLECTS THE ORGANIZATION'S COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS THE ORGANIZATION'S GOALS. THE VARIABLE PAY IS AWARDED SEMI-ANNUALLY BASED UPON A SPECIFIC REVIEW OF GOALS AND OBJECTIVES (INCLUDING THOSE WHICH RELATE TO MISSION, OPERATIONAL EFFICIENCY, FINANCIAL EFFECTIVENESS, AND STRATEGIC GOALS). THE COMPENSATION COMMITTEE REVIEWS, ASSESSES AND DETERMINES ANY AWARD UNDER THE VARIABLE PAY COMPONENT. EXECUTIVE EMPLOYEES ARE REVIEWED BY THE COMPENSATION COMMITTEE AND OUTSIDE CONSULTANTS TO ENSURE THEY ARE COMPETITIVE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE ROUTINELY RECEIVES AN EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATION'S EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY AND SCALE OF OPERATIONS. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonLINDA SCHUTTPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSPOUSE OF CEORelationshipDescriptionTxt
Transaction$82,939TransactionAmt
TransactionEMPLOYMENT COMPENSATION; MASTERS PREPARED R.N. THAT LEADS THE ORGANZATION'S EDUCATION.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCH L, PART IV:FormAndLineReferenceDesc
ExplanationTHE TRANSACTIONS REPORTED ABOVE INVOLVING INTERESTED PERSONS ARE REVIEWED ANNUALLY BY THE BOARD'S COMPENSATION COMMITTEE AND HAVE BEEN DEEMED APPROPRIATE BASED ON THE POSITION EMPLOYED.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2JOHANNA ZANDSTRA (VP OF OPERATIONS) AND BILL ZANDSTRA (SECRETARY/TREASURER) HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT OF THE 990 WAS PREPARED AND SENT FOR INITIAL REVIEW BY THE CONTROLLER, CFO AND CEO. UPON REVIEW AND APPROVAL, THE 990 WAS MADE AVAILABLE TO THE ENTIRE BOARD PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT UPON BEGINNING THEIR POSITION. THEREAFTER, THE CONFLICT OF INTEREST STATEMENTS ARE UPDATED ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS ARE REVIEWED AND ADDRESSED BY THE BOARD AS NECESSARY.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMPENSATION PROGRAM'S PRIMARY OBJECTIVE IS TO PROVIDE COMPETITVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIP TALENT IN ORDER TO ACHIEVE THE ORGANIZATION'S MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECUTIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:TRANSFER OF EQUITY TO RELATED ENTITIES -888,985. UNREALIZED LOSS ON INTEREST RATE SWAP 1,848,356.
FORM 990, PART XII, LINE 2:THE ORGANIZATION IS REQUIRED TO UNDERGO MULTIPLE SINGLE AUDITS AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. WHILE SOME AUDITS HAVE BEEN COMPLETED, NOT ALL HAVE BEEN COMPLETED FOR THE CALENDAR YEAR-END 12/31/21, BUT PLAN TO BE COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN THE RELEVANT GUIDANCE.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
PROVIDENCE DEVELOPMENT GROUP
18601 N CREEK DRIVETINLEY PARKIL60477DEVELOPMENTIL$0$1,860,402REST HAVEN
PARK PLACE REALTY GROUP LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$28,526$164,024REST HAVEN
PROVIDENCE OPERATIONS LLC
18601 N CREEK DRIVETINLEY PARKIL60477OPERATIONSIL$17,912,750$494,487REST HAVEN
PROVIDENCE TENANT LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$0$0REST HAVEN
PROVIDENCE DOWNERS GROVE LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$1,090,178$3,629,755PROVIDENCE TENANT LLC
PROVIDENCE GRAND RAPIDS LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$382,054$0PROVIDENCE TENANT LLC
ROYAL PARK PLACE II LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$2,793,295$4,882,527REST HAVEN

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CHRISTIAN HEALTHCARE FOUNDATION
18601 N CREEK DRIVETINLEY PARKIL60477200722359RESEARCHIL501(C)(3)LINE 10REST HAVENYes (1)
CHRISTIAN LIVING CAMPUS
18601 N CREEK DRIVETINLEY PARKIL60477200226221SENIOR LIVINGIL501(C)(3)LINE 10REST HAVENYes (1)
TIMOTHY PLACE
18601 N CREEK DRIVETINLEY PARKIL60477201835089SENIOR LIVINGIL501(C)(3)LINE 10REST HAVENYes (1)
PARK PLACE OF ST JOHN
18601 N CREEK DRIVETINLEY PARKIL60477201834903SENIOR LIVINGIL501(C)(3)LINE 10REST HAVENYes (1)
HUDSONVILLE PARK PLACE
18601 N CREEK DRIVETINLEY PARKIL60477201834667SENIOR LIVINGIL501(C)(3)LINE 10REST HAVENYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
PROVIDENCE MGMT & DEVELOPMENT
18601 N CREEK DRIVETINLEY PARKIL60477363774205IT SERVICESILN/AC-$477,774$4,545,2181.00000Yes (1)
PROVIDENCE HOUSING CORPORATION
18601 N CREEK DRIVETINLEY PARKIL60477461379112HOUSINGILC$75,469$772,1271.00000Yes (1)REST HAVEN
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PROVIDENCE MGMT & DEVELOPMENT
P$1,341,725FMV
PROVIDENCE MGMT & DEVELOPMENT
Q$553,242FMV
TIMOTHY PLACE
Q$712,938FMV
PARK PLACE OF ST JOHN
Q$1,439,904FMV

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