2025-07-15T11:22:13-05:00 2024-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-01-01 912052713 CHRISTIAN COMMUNITY HOMES AND SERVICES INC GROUP RETURN CHRI 7153869303 1320 WISCONSIN STREET HUDSON WI 54016 PAMELA KLINGFUS CHIEF EXECUTIVE OFFICER 7153869303 2025-07-14 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-06-27 2024 2025-03-06 01:10:19Z PAMELA KLINGFUS 1320 WISCONSIN STREET HUDSON WI 54016 18622412 1 1 3557 X WWW.CCHHUDSON.ORG X 1994 WI NONPROFIT ORGANIZATION SERVING SENIORS IN WAYS THAT REFLECT THE IMPORTANCE OF EACH UNIQUE LIFE. 14 14 379 145 122062 0 261002 247214 15690795 18314004 449526 40964 10720 6743 16412043 18608925 11140 133750 0 0 10425954 11401291 0 0 24899 6390579 6974091 16827673 18509132 -415630 99793 20290549 20430083 17060284 16952949 3230265 3477134 X 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. 0 0 15052445 133750 18191942 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 2024, CCH-HUDSON'S TOTAL NURSING HOME RESIDENT DAYS WERE 11,885 INCLUDED IN THIS TOTAL WAS 4,743 DAYS FOR RESIDENTS COVERED UNDER THE MEDICAID/HOSPICE MEDICAID PROGRAM. CCH-OSCEOLA'S TOTAL NURSING HOME RESIDENT DAYS WERE 11,469 AND INCLUDED IN THIS TOTAL WAS 6,732 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 2024 WERE 13,908. ADDITIONALLY, HEARTHSIDE HAD 6,467 RESIDENT DAYS FOR 2024.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 2024 WERE 32,766. ADDITIONALLY, EVERGREEN HAD 11,067 RESIDENT DAYS FOR 2024.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 2024, CHRISTIAN COMMUNITY FOUNDATION, INC. RAISED ABOUT $264,000 IN FUNDS FOR THESE PURPOSES. 15052445 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 X 36 0 379 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI MN X JAMES KACZROWSKI 7153869303 1320 WISCONSIN STREET HUDSON WI 54016 DARYL SIMONSON PRESIDENT 1.00 2.00 X X 0 0 0 CLAIRE ZAJAC VICE PRESIDENT 1.00 2.00 X X 0 0 0 ERIC JOHNSON TREASURER 1.00 2.00 X X 0 0 0 DEB SCHWAB SECRETARY 1.00 2.00 X X 0 0 0 ELLIOT ANDERSON MEMBER 1.00 2.00 X 0 0 0 MIKE BEBAULT MEMBER 1.00 2.00 X 0 0 0 RHONDA DUNHAM MEMBER 1.00 2.00 X 0 0 0 FR JOHN GERRITS MEMBER 1.00 2.00 X 0 0 0 CRAIG GIBSON MEMBER 1.00 2.00 X 0 0 0 MEL HERMANSEN MEMBER 1.00 2.00 X 0 0 0 AARON MORK MEMBER 1.00 2.00 X 0 0 0 REV DR DAWN JEFFERS RAMSTAD MEMBER (THRU 05/24) 1.00 2.00 X 0 0 0 BOB STAEBELL MEMBER 1.00 2.00 X 0 0 0 REV JACK STARR MEMBER 1.00 2.00 X 0 0 0 REV DAN FAHS MEMBER 1.00 2.00 X 0 0 0 PAMELA KLINGFUS CEO 38.00 2.00 X 203409 0 12244 JAMES KACZROWSKI DIRECTOR OF FINANCE 38.00 2.00 X 145110 0 15335 JENNIE ORMAN HUDSON ADMINISTRATOR 40.00 X 112974 0 24792 HEIDI MCGEEHAN OSCEOLA ADMINISTRATOR 40.00 X 115980 0 14214 JENNIFER COOK HUDSON DIRECTOR OF NURSING 40.00 X 100373 0 26120 SARAH SODERBERG DIRECTOR OF REHAB SERVICES 40.00 X 109873 0 11069 THOMAS YOUNGBERG RN 44.50 X 114411 0 3322 902130 0 107096 13 0 1 0 CLIPBOARD HEALTH PO BOX 103125 PASADENA CA 911893125 STAFFING AGENCY 695509 ABCD CLEANING SERVICES PO BOX 251116 WOODBURY MN 55125 CLEANING SERVICE 480250 WIPFLI CPAS AND CONSULTANTS LLP PO BOX 3160 MILWAUKEE WI 532013160 ACCOUNTING 259118 SPECIALIZED MEDICAL STAFFING 1413 198TH ST CHIPPEWA FALLS WI 54729 STAFFING AGENCY 159179 SENIOR CARE SOLUTIONS INC PO BOX 2283 STILLWATER MN 55082 STAFFING AGENCY 151261 5 36738 210476 247214 NURSING HOME 623000 11473099 11473099 ASSISTED LIVING 623990 6594345 6594345 CAFETERIA & VENDING 623000 122062 122062 124498 124498 18314004 19361 19361 21603 0 21603 21603 21603 20230 36738 13487 6743 6743 18608925 18191942 122062 47707 125000 125000 8750 8750 376098 376098 9386953 8467299 919654 205340 196031 9309 754007 656015 97992 678893 584775 94118 25000 25000 9891 9891 359013 359013 1513206 1466725 46481 104721 90600 14121 239504 95992 140016 3496 231475 4922 226553 576887 576887 40724 40724 2593 2593 591089 588002 3087 1155492 1140257 15235 279549 279549 DIETARY SUPPLIES 670904 670904 MEDICAL SUPPLIES 375791 375791 BAD DEBT EXPENSE 291815 291815 REPAIRS/MAINTENANCE 260127 255585 4542 246310 96989 142039 7282 18509132 15052445 3431788 24899 1987653 0 4990427 7291024 1294559 1338924 179551 270452 36423974 25745097 11038334 10678877 800025 850806 20290549 20430083 872619 1076306 70590 157000 205249 15760581 15400316 270084 200488 17060284 16952949 X 3105265 3377134 125000 100000 3230265 3477134 20290549 20430083 99793 147076 0 X 0 1 X 1 1 1 X 3406644 399415 259889 261002 247214 4574164 14589923 14207303 13656263 15690795 18314003 76458287 17996567 14606718 13916152 15951797 18561217 81032451 4443 5568 2300 3235 2255 17801 0 4443 5568 2300 3235 2255 17801 81014650 19444 6596 11107 16056 19361 72564 19444 6596 11107 16056 19361 72564 9165 10720 6743 26628 18016011 14613314 13936424 15978573 18587321 81131643 0.99860 0.99820 0.00090 0.00110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 331453 331453 31236837 21644301 9592536 4778798 4100796 678002 76886 76886 10678877 DEFERRED COMPENSATION PLAN LIABILITY 178717 RELATED PARTY PAYABLES 21771 200488 PART IV, LINE 2B: 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. RIVER CRUISE 56968 36738 20230 12941 546 56968 36738 20230 12941 546 13487 6743 1 EVERGREEN SENIOR LIVING INC 1320 WISCONSIN STREET HUDSON WI 54016 873555983 125000 0 ORGANIZATIONAL SUPPORT 1 0 SCHOLARSHIPS 7 8750 PART I, LINE 2: THE ORGANIZATION'S ONLY GRANT TO ORGANIZATIONS WAS TO A RELATED PARTY. FUNDS WILL BE USED IN ACCORDANCE WITH THE ORGANIZATION'S EXEMPT PURPOSE. X X X X 0 0 0 0 0 0 0 0 0 PAMELA KLINGFUS CEO 200909 0 2500 0 0 0 12215 0 29 0 215653 0 0 0 JAMES KACZROWSKI DIRECTOR OF FINANCE 145110 0 0 0 0 0 8346 0 6989 0 160445 0 0 0 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. CCH OSCEOLA LAND LLC 2650 65TH AVENUE OSCEOLA WI 54620 814907444 TO HOLD PARCEL OF LAND FOR FUTURE DEVELOPMENT WI 0 26600 N/A 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 CHRISTIAN COMMUNITY HOMES AND SERVICES INC 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 EVERGREEN SENIOR LIVING INC D 829035 COST