FURP.ORG / PUBLIC DATA EXPLORER

REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME (EIN 36-2382853)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-10-18
IRS object ID
202122919349302102
Schema version
2020v4.1
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)
Return2021-10-18T17:12:57-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

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 Begin2020-01-01TaxPeriodBeginDt

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
Signature2021-10-12SignatureDt
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
Preparation2021-10-12PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
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$136,308,939GrossReceiptsAmt
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 Employee1149TotalEmployeeCnt
Total Volunteers155TotalVolunteersCnt
Total Gross UBI$557,605TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$107,367NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,651,685PYContributionsGrantsAmt
CY Contributions Grants$5,887,369CYContributionsGrantsAmt
PY Program Service Revenue$63,117,604PYProgramServiceRevenueAmt
CY Program Service Revenue$56,204,654CYProgramServiceRevenueAmt
PY Investment Income$1,095,432PYInvestmentIncomeAmt
CY Investment Income$2,826,442CYInvestmentIncomeAmt
PY Other Revenue$14,265,341PYOtherRevenueAmt
CY Other Revenue-$16,391CYOtherRevenueAmt
PY Total Revenue$80,130,062PYTotalRevenueAmt
CY Total Revenue$64,902,074CYTotalRevenueAmt
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$37,398,602PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$37,326,090CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$445,948CYTotalFundraisingExpenseAmt
PY Other Expenses$30,895,808PYOtherExpensesAmt
CY Other Expenses$29,729,140CYOtherExpensesAmt
PY Total Expenses$68,294,410PYTotalExpensesAmt
CY Total Expenses$67,055,230CYTotalExpensesAmt
PY Revenues Less Expenses$11,835,652PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,153,156CYRevenuesLessExpensesAmt
Total Assets BOY$92,895,917TotalAssetsBOYAmt
Total Assets EOY$89,097,338TotalAssetsEOYAmt
Total Liabilities BOY$67,292,282TotalLiabilitiesBOYAmt
Total Liabilities EOY$68,809,785TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,603,635NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$20,287,553NetAssetsOrFundBalancesEOYAmt
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$58,691,181ExpenseAmt
Revenue$55,626,399RevenueAmt
DescTO PROVIDE PROPER CARE FOR THE SICK AND ELDERLY. 926 BEDS/UNITS WITH OCCUPANCY OVER 80% ON THE FULL CONTINUUM OF CARE.Desc
Total Program Service Expenses$58,691,181TotalProgramServiceExpensesAmt
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 Document91IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1149EmployeeCnt
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 Rln0FamilyOrBusinessRlnInd
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 (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
RICHARD SCHUTT
DIRECTOR & CEO40.005.00Yes (X)Yes (X)$540,361$0$25,509
WILLAM DEYOUNG
COO40.005.00Yes (X)$375,916$0$72,502
BARRY VANDERGENUGTEN
CFO40.005.00Yes (X)$295,040$0$30,753
SUSAN ENRIGHT
VP HOME & COMMUNITY BASED SERVICES40.000.00$204,037$0$14,708Yes (X)
RAY HEMPHILL
EVP PROJECT DEVELOPMENT40.005.00$178,568$0$26,568Yes (X)
JOHANNA ZANDSTRA
VP OF OPERATIONS40.005.00$165,635$0$26,200Yes (X)
SCOTT STUDEBAKER
VP MINISTRY ADVANCEMENT & DEVELOPMENT40.005.00$165,124$0$19,576Yes (X)
MEGAN TENGERSTROM
VP OF OPERATIONS40.005.00$171,943$0$10,979Yes (X)
DAVE LARSEN
CHAIR1.002.00Yes (X)Yes (X)$0$0$0
ROBERT WORKMAN
CHAIR (JAN-MAY 2020)1.002.00Yes (X)Yes (X)$0$0$0
PAUL KATS
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
TIM SMITS
DIRECTOR1.002.00Yes (X)$0$0$0
ROGER BOEREMA
DIRECTOR1.002.00Yes (X)$0$0$0
JACOB 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
BASTIAN KNOPPERS
DIRECTOR1.002.00Yes (X)$0$0$0
EMILY MCMASTER
DIRECTOR1.002.00Yes (X)$0$0$0
TIM OZINGA
DIRECTOR1.002.00Yes (X)$0$0$0
HOWARD RYNBERK JR
DIRECTOR1.002.00Yes (X)$0$0$0
GARY SMIT
DIRECTOR1.002.00Yes (X)$0$0$0
RICK VANDYKEN
DIRECTOR1.002.00Yes (X)$0$0$0
ROBERT VAN STAALDUINEN
DIRECTOR1.002.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,096,624TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$226,795TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K38IndivRcvdGreaterThan100KCnt
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 PARKWAY SUITE 600WARRENVILLEIL60555THERAPY$1,711,694
PROVINET SOLUTIONS
18645 WEST CREEK DRIVETINLEY PARKIL60477IT SERVICES$1,338,819
GORDON FOOD SERVICE INC
PO BOX 88029CHICAGOIL60680DINING SERVICES$1,284,767
CREATIVE DINING SERVICES
ONE ROYAL PARK DRIVE STE 3ZEELANDMI49464DINING SERVICES$913,700
SYMBRIA RX SERVICES
28100 TORCH PARKWAYWARRENVILLEIL60555THERAPY$833,460
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K47CntrctRcvdGreaterThan100KCnt
Fundraising$562,033FundraisingAmt
Government Grants$4,165,642GovernmentGrantsAmt
All Other Contributions$1,159,694AllOtherContributionsAmt
Total Contributions$5,887,369TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
ROUTINE REVENUE621610$53,286,517$53,286,517
ANCILLARY REVENUE621610$2,918,137$2,360,532$557,605
FieldValueIRS element (for citing)
Total Program Service Revenue$56,204,654TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$483,540TotalRevenueColumnAmt
Exclusion$483,540ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$73,656,736SecuritiesAmt
Other$17,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$71,293,184SecuritiesAmt
Other$37,650OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,363,552SecuritiesAmt
Other-$20,650OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,342,902TotalRevenueColumnAmt
Related Or Exempt Func Income-$20,650RelatedOrExemptFuncIncomeAmt
Exclusion$2,363,552ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$59,640FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$562,033ContriRptFundraisingEventAmt
Fundraising Direct Expenses$76,031FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$16,391TotalRevenueColumnAmt
Exclusion-$16,391ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$64,902,074TotalRevenueColumnAmt
Related Or Exempt Func Income$55,626,399RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$557,605UnrelatedBusinessRevenueAmt
Exclusion$2,830,701ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,340,081TotalAmt
Management And General$1,340,081ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,646,220TotalAmt
Program Services$26,331,559ProgramServicesAmt
Management And General$3,944,016ManagementAndGeneralAmt
Fundraising$370,645FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$500,736TotalAmt
Program Services$394,068ProgramServicesAmt
Management And General$91,808ManagementAndGeneralAmt
Fundraising$14,860FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,620,708TotalAmt
Program Services$2,061,404ProgramServicesAmt
Management And General$524,622ManagementAndGeneralAmt
Fundraising$34,682FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,218,345TotalAmt
Program Services$1,917,698ProgramServicesAmt
Management And General$274,886ManagementAndGeneralAmt
Fundraising$25,761FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$475,693TotalAmt
Management And General$475,693ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$17,500TotalAmt
Management And General$17,500ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,519,612TotalAmt
Program Services$2,319,678ProgramServicesAmt
Management And General$199,934ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,468,616TotalAmt
Program Services$1,468,616ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,713,668TotalAmt
Program Services$1,407,545ProgramServicesAmt
Management And General$306,123ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,231,999TotalAmt
Program Services$2,096,261ProgramServicesAmt
Management And General$135,738ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,832,016TotalAmt
Program Services$2,738,783ProgramServicesAmt
Management And General$93,233ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,592,986TotalAmt
Program Services$1,501,285ProgramServicesAmt
Management And General$91,701ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
NURSING EXPENSE$5,862,146$5,862,146
FOOD & DIETARY EXPENSE$2,341,659$2,341,659
REPAIRS & MAINTENANCE$1,112,120$1,112,120
PHARMACY EXPENSE$1,059,683$1,059,683

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,501,442TotalAmt
Program Services$6,078,676ProgramServicesAmt
Management And General$422,766ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$67,055,230TotalAmt
Program Services$58,691,181ProgramServicesAmt
Management And General$7,918,101ManagementAndGeneralAmt
Fundraising$445,948FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$597,747BOYAmt
EOY$1,244,947EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$314,306BOYAmt
EOY$313,325EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,083,700BOYAmt
EOY$10,598,397EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,291,738BOYAmt
EOY$1,151,791EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$79,008,295LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$35,742,212LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$44,335,386BOYAmt
EOY$43,266,083EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$18,584,499BOYAmt
EOY$19,718,386EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$18,688,541BOYAmt
EOY$12,804,409EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$92,895,917BOYAmt
EOY$89,097,338EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,256,084BOYAmt
EOY$10,046,188EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$447,654BOYAmt
EOY$487,814EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$49,457,062BOYAmt
EOY$48,260,074EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,131,482BOYAmt
EOY$10,015,709EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$67,292,282BOYAmt
EOY$68,809,785EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,475,079BOYAmt
EOY$20,182,750EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$128,556BOYAmt
EOY$104,803EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,603,635BOYAmt
EOY$20,287,553EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$92,895,917BOYAmt
EOY$89,097,338EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$2,153,156ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$846,444NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2,316,482OtherChangesInNetAssetsAmt
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$1,341,054CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,337,547CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,724,032CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,651,685CurrentTaxYearMinus1YearAmt
Current Tax Year$5,887,369CurrentTaxYearAmt
Total$13,941,687TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$71,192,640CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$76,087,087CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$80,188,343CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$77,473,126CurrentTaxYearMinus1YearAmt
Current Tax Year$56,204,654CurrentTaxYearAmt
Total$361,145,850TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$72,533,694CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$77,424,634CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$83,912,375CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,124,811CurrentTaxYearMinus1YearAmt
Current Tax Year$62,092,023CurrentTaxYearAmt
Total$375,087,537TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$60,952CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$81,468CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$96,282CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$142,964CurrentTaxYearMinus1YearAmt
Current Tax Year$155,395CurrentTaxYearAmt
Total$537,061TotalAmt

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$60,952CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$81,468CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$96,282CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$142,964CurrentTaxYearMinus1YearAmt
Current Tax Year$155,395CurrentTaxYearAmt
Total$537,061TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$374,550,476PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$491,933CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$480,665CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$338,317CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$543,487CurrentTaxYearMinus1YearAmt
Current Tax Year$483,540CurrentTaxYearAmt
Total$2,337,942TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17,576CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,136CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,018CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$35,313CurrentTaxYearMinus1YearAmt
Current Tax Year$22,547CurrentTaxYearAmt
Total$95,590TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$509,509CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$484,801CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$354,335CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$578,800CurrentTaxYearMinus1YearAmt
Current Tax Year$506,087CurrentTaxYearAmt
Total$2,433,532TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$73,043,203CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$77,909,435CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$84,266,710CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,703,611CurrentTaxYearMinus1YearAmt
Current Tax Year$62,598,110CurrentTaxYearAmt
Total$377,521,069TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99210PublicSupportCY509Pct
Public Support PY5090.98190PublicSupportPY509Pct
Investment Income CY0.00640InvestmentIncomeCYPct
Investment Income PY0.01710InvestmentIncomePYPct
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$4,439,746OtherCostOrOtherBasisAmt
Book Value$4,439,746BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$66,524,839OtherCostOrOtherBasisAmt
Depreciation$32,643,707DepreciationAmt
Book Value$33,881,132BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,979,513OtherCostOrOtherBasisAmt
Depreciation$3,055,747DepreciationAmt
Book Value$1,923,766BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,064,197OtherCostOrOtherBasisAmt
Depreciation$42,758DepreciationAmt
Book Value$3,021,439BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$43,266,083TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDescBook ValueBookValueAmt
GROUND LEASE RECEIVABLES$1,107,074
ASSETS LIMITED TO USE$653,387
DUE FROM AFFILIATES$7,256,384
OTHER ASSETS$434,652
LEGAL LIABILITY INS RECOVERIES$2,596,407
DEFERRED COMP GRANTOR TRUST$422,568
INVESTMENTS IN PMDC & PDG$333,937
FieldValueIRS element (for citing)
Total Book Value Other Assets$12,804,409TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
ESTIMATED SELF-INS LIABILITIES$4,456,774
ASSET RETIREMENT OBLIGATION$179,082
RESIDENT NOTES AND DEPOSITS$1,687,407
ACCRUED INTEREST PAYABLE$128,550
CHARITABLE ANNUITY CONTRACTS$135,250
FMV INTEREST RATE SWAP VALUE$3,428,646
FieldValueIRS element (for citing)
Total Liability$10,015,709TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BANQUETEvent1Nm
Gross Receipts Event1$474,682GrossReceiptsEvent1Amt
Charitable Contri Event1$474,682CharitableContriEvent1Amt
Other Direct Expenses Event1$14,005OtherDirectExpensesEvent1Amt
Event2GOLF OUTINGEvent2Nm
Gross Receipts Event2$127,791GrossReceiptsEvent2Amt
Charitable Contri Event2$68,151CharitableContriEvent2Amt
Gross Revenue Event2$59,640GrossRevenueEvent2Amt
Other Direct Expenses Event2$62,026OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$19,200GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$19,200CharitableContriOtherEventsAmt
Gross Receipts Total$621,673GrossReceiptsTotalAmt
Charitable Contributions Tot$562,033CharitableContributionsTotAmt
Gross Revenue Total Events$59,640GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$76,031OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$76,031DirectExpenseSummaryEventsAmt
Net Income Summary-$16,391NetIncomeSummaryAmt

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 $621,673 FOR 2020. THE COMBINED COSTS OF THE EVENTS TOTALED $76,031. THE NET INCOME TO THE ORGANIZATION FOR HOSTING ALL OF THE EVENTS WAS $545,642.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
RICHARD SCHUTT
DIRECTOR & CEO$470,921$0$49,521$0$19,919$0$11,200$0$14,309$0$565,870$0$0$0
WILLAM DEYOUNG
COO$327,986$0$31,704$0$16,226$0$51,360$0$21,142$0$448,418$0$0$0
BARRY VANDERGENUGTEN
CFO$254,011$0$24,554$0$16,475$0$10,245$0$20,508$0$325,793$0$0$0
SUSAN ENRIGHT
VP HOME & COMMUNITY BASED SERVICES$200,000$0$2,000$0$2,037$0$8,080$0$6,628$0$218,745$0$0$0
RAY HEMPHILL
EVP PROJECT DEVELOPMENT$159,717$0$9,573$0$9,278$0$6,389$0$20,179$0$205,136$0$0$0
JOHANNA ZANDSTRA
VP OF OPERATIONS$154,840$0$6,608$0$4,187$0$6,458$0$19,742$0$191,835$0$0$0
SCOTT STUDEBAKER
VP MINISTRY ADVANCEMENT & DEVELOPMEN$157,490$0$0$0$7,634$0$6,307$0$13,269$0$184,700$0$0$0
MEGAN TENGERSTROM
VP OF OPERATIONS$157,707$0$12,501$0$1,735$0$3,404$0$7,575$0$182,922$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 2020, 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 (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
LINDA SCHUTT
SPOUSE OF CEO$105,171EMPLOYMENT COMPENSATION; MASTERS PREPARED R.N. THAT LEADS THE ORGANZATION'S EDUCATION.0
ALLISON OLESHKO
DAUGHTER OF CEO$31,525EMPLOYMENT COMPENSATION0

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 (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 ORANIZATION'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 -2,963. UNREALIZED LOSS ON INTEREST RATE SWAP -2,313,519.
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 12/31/20, BUT PLAN TO BE COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-21-20.

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$3,016,520REST HAVEN
PARK PLACE REALTY GROUP LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$17,661$143,326REST HAVEN
PROVIDENCE OPERATIONS LLC
18601 N CREEK DRIVETINLEY PARKIL60477OPERATIONSIL$20,600,043$5,068,937REST HAVEN
PROVIDENCE TENANT LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$0$0REST HAVEN
PROVIDENCE DOWNERS GROVE LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$1,110,335$6,760,614PROVIDENCE TENANT LLC
PROVIDENCE GRAND RAPIDS LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$414,101$2,215,950PROVIDENCE TENANT LLC
ROYAL PARK PLACE II LLC
18601 N CREEK DRIVETINLEY PARKIL60477REAL ESTATEIL$2,996,919$4,905,858REST 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-$364,389$5,035,3831.00000Yes (1)
PROVIDENCE HOUSING CORPORATION
18601 N CREEK DRIVETINLEY PARKIL60477461379112HOUSINGILC$57,161$686,3181.00000Yes (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$1,468,616FMV
PROVIDENCE MGMT & DEVELOPMENT
Q$554,851FMV
TIMOTHY PLACE
Q$360,000FMV
PARK PLACE OF ST JOHN
Q$1,042,948FMV