2021-11-09T13:42:51-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2020-01-01 390979908 FAIRHAVEN CORPORATION FAIR 2624732140 435 STARIN ROAD WHITEWATER WI 53190 PAUL KUENNING EXECUTIVE DIRECTOR 2624732140 2021-11-09 1 PAUL KUENNING 999009999 KIMBERLY ANDERSON P00188889 6086628600 2021-11-09 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PAUL KUENNING 435 STARIN ROAD WHITEWATER WI 53190 12877350 0 X WWW.FAIRHAVEN.ORG X 1962 WI TO PROVIDE HOUSING AND SERVICES, INCLUDING SKILLED NURSING AND REHAB TO SENIOR ADULTS. 17 16 338 33 0 0 18537 358866 11620125 11605565 483707 158113 521868 644428 12644237 12766972 1574 2600 0 0 7405526 7016677 0 0 74377 4680399 5289942 12087499 12309219 556738 457753 30470624 33350451 16624625 18890702 13845999 14459749 X TO PROVIDE HOUSING AND SERVICES WHICH PROMOTE DIGNITY AND WELL-BEING WITH SPIRITUAL, INTELLECTUAL, CULTURAL AND RECREATIONAL VITALITY. 0 0 11388790 11601496 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. DURING 2015, THE CORPORATION DECREASED ITS COMMUNITY BASED RESIDENTIAL FACILITY (CBRF) LICENSE FROM 180 TO 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, 2020 AND 2019, 65 AND 64 DUPLEX UNITS WERE IN USE, RESPECTIVELY. 2600 2600 4069 NURSING SCHOLARSHIPS: PROVIDE FINANCIAL SUPPORT THROUGH SCHOLARSHIPS TO EMPLOYEES OBTAINING A HIGHER LEVEL OF CERTIFICATION IN THE NURSING FIELD. 11391390 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 46 0 338 1 0 0 0 0 0 0 0 0 0 1 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 PAUL KUENNING 2624732140 435 STARIN ROAD WHITEWATER WI 53190 JAMES CALDWELL PRESIDENT 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 143780 0 21872 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 KAREN BOYLE DIRECTOR OF NURSING 40.00 X 107925 0 22082 251705 0 43954 2 0 1 0 SCOTT EHLERT CONSTRUCTION 291 COBURN LANE WHITEWATER WI 53190 CONSTRUCTION 1699637 GREENFIELD REHABILITATION AGENCY 19395 W CAPITOL DR SUITE 200 BROOKFIELD WI 53045 THERAPY SERVICES 300266 OTIS ELEVATOR PO BOX 73579 CHICAGO IL 60673 ELEVATOR MAINTENANCE AND REPAIR 195701 RR WALTON & CONSTRUCTION 1005 W MAIN ST STE C WHITEWATER WI 53190 CONSTRUCTION 192727 HOME LUMBER COMPANY PO BOX 370 WHITEWATER WI 53190 CONSTRUCTION 168719 9 293896 64970 35838 358866 PRIVATE PAY 623000 8638029 8638029 MEDICAID/MEDICARE 623000 2963467 2963467 NURSING SCHOLARSHIP INCOME 623000 4069 4069 11605565 7075 7075 16530 5861 10669 10669 10669 255555 104517 151038 151038 151038 ENTRY FEES 623000 633759 633759 633759 12766972 11605565 0 802541 2600 2600 156033 139790 15704 539 5290005 4749734 522301 17970 171793 153768 17439 586 1007745 902007 102300 3438 391101 350064 39702 1335 4449 4292 157 41511 41511 882538 878227 4311 91090 89397 1693 114692 24125 89797 770 899860 898256 1604 8335 8302 33 28263 27366 897 62774 62280 494 1271021 1271021 147194 142781 4413 SUPPLIES 1227573 1207759 19814 BAD DEBT EXPENSE 266060 256641 9419 NURSING BED ASSESSMENT 167280 161358 5922 DUES AND SUBSCRIPTIONS 19077 18402 675 58225 43220 14698 307 12309219 11391390 843452 74377 2537139 3261805 607265 683605 799130 680225 188399 48619 50516197 23245895 25115568 27270302 1223123 1405895 30470624 33350451 1185711 2430050 11444555 12258548 2336552 1951683 132000 132000 1525807 2118421 16624625 18890702 X 13845999 14459749 13845999 14459749 30470624 33350451 X 457753 132448 23549 X 0 1 X 1 0 X 91053 87002 68290 18537 358866 623748 12148748 11920561 12213176 11620125 11605565 59508175 12239801 12007563 12281466 11638662 11964431 60131923 75000 75000 11891 17801 29692 75000 11891 17801 104692 60027231 19861 18883 23209 26999 23605 112557 19861 18883 23209 26999 23605 112557 774071 738205 765453 513540 633759 3425028 13033733 12764651 13070128 12179201 12621795 63669508 0.94280 0.94400 0.00180 0.00170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1170167 105801 109596 940 1384624 1839405 158649 172113 1000000 1170167 2391010 143921 4474 700000 1839405 2017185 228249 145576 2391010 1789162 152399 75624 2017185 1.00000 0 0 985126 3479627 4464753 31016600 16711035 14305565 8628788 6534860 2093928 6406056 6406056 27270302 REQUIRED DONOR ANNUITY RESERVE 61845 ASSET RETIREMENT OBLIGATION 49288 DUE TO FAIRHAVEN FOUNDATION 1611926 UNSPENT GOVERNMENT GRANTS 395362 2118421 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. X X X 0 0 0 0 0 0 0 0 0 PAUL KUENNING EXECUTIVE DIRECTOR 143780 0 0 0 0 0 0 0 21872 0 165652 0 0 0 X 1 35838 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 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 23,549. 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