FURP.ORG / PUBLIC DATA EXPLORER

EVERGREEN RETIREMENT COMMUNITY INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
EVERGREEN RETIREMENT COMMUNITY INC (EIN 39-1081800)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-15
IRS object ID
202123199349331242
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)
Return2021-11-15T21:32:46-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18215 GREENWAY BOULEVARD SUITE 600AddressLine1Txt
CityMIDDLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53562ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391081800EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN RETIREMENT COMMUNITY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEVERBusinessNameControlTxt
Phone9202332340PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549023217ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBILLIE JO HIGGINSPersonNm
Person TitleTREASURERPersonTitleTxt
Phone9202372184PhoneNum
Signature2021-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBILLIEPersonFirstNm
Person LastJO HIGGINSPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIMBERLY ANDERSONPreparerPersonNm
PTINP00188889PTIN
Phone6086628600PhoneNum
Preparation2021-11-15PreparationDt

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

FieldValueIRS element (for citing)
Principal OfficerKENNETH A ARNESONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549023217ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$22,510,959GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EVERGREENOSHKOSH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1965FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionGUIDED BY CHRISTIAN IDEALS, WE STRIVE TO PROVIDE EXCEPTIONAL LIVING ENVIRONMENTS, SERVICES AND EXPERIENCES FOR PEOPLE 55 AND OLDER.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee479TotalEmployeeCnt
Total Volunteers63TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$659,528PYContributionsGrantsAmt
CY Contributions Grants$3,882,268CYContributionsGrantsAmt
PY Program Service Revenue$19,137,849PYProgramServiceRevenueAmt
CY Program Service Revenue$18,131,543CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$567,983PYOtherRevenueAmt
CY Other Revenue$497,148CYOtherRevenueAmt
PY Total Revenue$20,365,360PYTotalRevenueAmt
CY Total Revenue$22,510,959CYTotalRevenueAmt
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$10,046,794PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,591,897CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,324,311PYOtherExpensesAmt
CY Other Expenses$8,908,148CYOtherExpensesAmt
PY Total Expenses$19,371,105PYTotalExpensesAmt
CY Total Expenses$19,500,045CYTotalExpensesAmt
PY Revenues Less Expenses$994,255PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,010,914CYRevenuesLessExpensesAmt
Total Assets BOY$42,525,878TotalAssetsBOYAmt
Total Assets EOY$43,849,079TotalAssetsEOYAmt
Total Liabilities BOY$27,962,143TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,254,954TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,563,735NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$17,594,125NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionGUIDED BY CHRISTIAN IDEALS, WE STRIVE TO PROVIDE EXCEPTIONAL LIVING ENVIRONMENTS, SERVICES AND EXPERIENCES FOR PEOPLE 55 AND OLDER.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$16,081,067ExpenseAmt
Revenue$18,628,691RevenueAmt
DescEVERGREEN IS A NONPROFIT CONTINUING CARE RETIREMENT COMMUNITY (CCRC) SERVING OLDER ADULTS, AGES 55 AND OLDER. IDEAL FOR THOSE LOOKING FOR A LIFESTYLE OF CHOICE, FREEDOM, SAFETY, COMMUNITY AND VALUE, EVERGREEN IS MORE THAN JUST A SENIOR LIVING COMMUNITY.EVERGREEN'S 35-ACRE CAMPUS IS NOT ONLY HOME TO ALMOST 300 RESIDENTS, BUT IT IS ALSO A DESTINATION FOR FAMILIES, COMMUNITY MEMBERS, VOLUNTEERS, NONPROFIT GROUPS AND OTHER VISITORS.LOCATED IN A PLEASANT RESIDENTIAL NEIGHBORHOOD IN OSHKOSH, WISCONSIN AMONG BEAUTIFUL, NATURAL SURROUNDINGS AND BORDERED BY OUR OWN OAK SAVANNA WOODLANDS, EVERGREEN PROVIDES LIVELY OPPORTUNITIES FOR YOU AND YOUR FRIENDS TO LIVE AS YOU CHOOSE. CHOOSE FROM THREE STYLES OF INDEPENDENT LIVING ACCOMMODATIONS, FOUR LEVELS OF ASSISTED LIVING, SHORT-TERM REHAB AND POST SURGICAL CARE, LONG-TERM SKILLED NURSING, OR EVERGREEN AT HOME SERVICES TO MEET YOUR UNIQUE NEEDS.LIFE ENRICHMENT ABOUNDS AT EVERGREEN. THERAPEUTIC SWIMMING POOLS, AN AEROBIC STUDIO, LAPIDARY SHOP, AND SUPPERS WITH THE CHEF ARE JUST A FEW OF THE MANY OPPORTUNITIES THAT ENCOURAGE ACTIVE LIFESTYLES. PARTNERSHIPS WITH THE UNIVERSITY OF WISCONSIN OSHKOSH, LEARNING IN RETIREMENT AND THE OSHKOSH GALLERY WALK ALSO PROVIDE ENTERTAINING AND FULFILLING EXPERIENCES AND ENSURE THAT NO TWO DAYS ARE THE SAME. AT EVERGREEN, POSSIBILITIES AWAIT.Desc
Total Program Service Expenses$16,081,067TotalProgramServiceExpensesAmt
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 CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
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 Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
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 Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document79IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee479EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
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 Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
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 Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BILLIE JO HIGGINSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9202372184PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549023217ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JIM CHITWOOD
DIRECTOR1.00Yes (X)$0$0$0
GINI DAVIS
DIRECTOR1.00Yes (X)$0$0$0
ANN TULIP
DIRECTOR1.00Yes (X)$0$0$0
STEVE DUNN
DIRECTOR1.00Yes (X)$0$0$0
VERNICE HAASE
CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
ELIZABETH HARTMAN
DIRECTOR1.00Yes (X)$0$0$0
JOHN HINTZE
DIRECTOR1.00Yes (X)$0$0$0
TONY RENNING
DIRECTOR1.00Yes (X)$0$0$0
FRED LILLY
DIRECTOR1.00Yes (X)$0$0$0
SANDY MUINDE
DIRECTOR1.00Yes (X)$0$0$0
DR JOHN NEWMAN
DIRECTOR1.00Yes (X)$0$0$0
RICK PICARD
DIRECTOR1.00Yes (X)$0$0$0
TOM RAMSEY
DIRECTOR1.00Yes (X)$0$0$0
BARBARA RAU
VICE CHAIR1.00Yes (X)$0$0$0Yes (X)
LUELLA REMMEL
DIRECTOR1.00Yes (X)$0$0$0
JOHN SCHATZ
DIRECTOR1.00Yes (X)$0$0$0
CATHY WEDIGAND
DIRECTOR1.00Yes (X)$0$0$0
MIKE GREY
DIRECTOR1.00Yes (X)$0$0$0
LISA RUIZ
EXECUTIVE ASSISTANT/SECRET40.00$44,821$0$9,000Yes (X)
KEN ARNESON
PRESIDENT/CEO40.00$236,580$0$15,673Yes (X)1.00
JOHN KRUEGER
VP FINANCE & IS/TREASURER UNTIL JUNE40.00$93,942$0$5,310Yes (X)1.00
BILLIE JO HIGGINS
CFO/TREASURER STARTING JUNE40.00$105,402$0$175Yes (X)1.00
PEGGY BELLIN
VP HEALTH & SUPPORT SERVICES40.00$105,058$0$17,4031.00Yes (X)
ERIN SANDERS
VP HUMAN RESOURCES40.00$108,533$0$22,5241.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$694,336TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$70,085TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
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
NEW HORIZON FOODS
PO BOX 860246MINNEAPOLISMN554860246DINING SERVICES$858,677
REHABCARE GROUP INC
BOX 277365ATLANTAGA303847365THERAPY SERVICES$671,531
HEALTHCARE SERVICES GROUP
PO BOX 829677PHILADELPHIAPA191829677HOUSEKEEPING SERVICES$571,737
PARASOL ALLIANCE
557 FOREST VIEW RDLINDENHURSTIL60046IT SERVICES$204,305
MORTON DRUG COMPANY
201 EAST BELL STNEENAHWI54956PHARMACUETICALS$176,903
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$810,860RelatedOrganizationsAmt
Government Grants$3,071,408GovernmentGrantsAmt
Total Contributions$3,882,268TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT SERVICE FEES623000$17,375,566$17,375,566
MANAGEMENT FEE INCOME900099$755,977$755,977
FieldValueIRS element (for citing)
Total Program Service Revenue$18,131,543TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER SERVICE REVENUEDesc
Business900099BusinessCd
Total Revenue Column$497,148TotalRevenueColumnAmt
Related Or Exempt Func Income$497,148RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$497,148OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,510,959TotalRevenueColumnAmt
Related Or Exempt Func Income$18,628,691RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$510,902TotalAmt
Program Services$423,479ProgramServicesAmt
Management And General$87,423ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,108,905TotalAmt
Program Services$6,721,345ProgramServicesAmt
Management And General$1,387,560ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$327,873TotalAmt
Program Services$272,582ProgramServicesAmt
Management And General$55,291ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,021,434TotalAmt
Program Services$849,184ProgramServicesAmt
Management And General$172,250ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$622,783TotalAmt
Program Services$517,760ProgramServicesAmt
Management And General$105,023ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$12,890TotalAmt
Management And General$12,890ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$28,666TotalAmt
Management And General$28,666ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,528,085TotalAmt
Program Services$1,933,065ProgramServicesAmt
Management And General$595,020ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$107,015TotalAmt
Program Services$84,497ProgramServicesAmt
Management And General$22,518ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$211,981TotalAmt
Program Services$167,376ProgramServicesAmt
Management And General$44,605ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$16,839TotalAmt
Program Services$13,296ProgramServicesAmt
Management And General$3,543ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$752,400TotalAmt
Program Services$594,080ProgramServicesAmt
Management And General$158,320ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$12,640TotalAmt
Program Services$9,980ProgramServicesAmt
Management And General$2,660ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$59,369TotalAmt
Program Services$46,877ProgramServicesAmt
Management And General$12,492ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$637,369TotalAmt
Program Services$637,369ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,238,542TotalAmt
Program Services$1,963,322ProgramServicesAmt
Management And General$275,220ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$163,735TotalAmt
Program Services$129,282ProgramServicesAmt
Management And General$34,453ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
FOOD SUPPLIES$985,683$778,276$207,407
RESIDENT SUPPLIES$460,466$363,575$96,891
GENERAL SUPPLIES$294,885$232,835$62,050
BAD DEBTS$137,642$137,642

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$259,941TotalAmt
Program Services$205,245ProgramServicesAmt
Management And General$54,696ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$19,500,045TotalAmt
Program Services$16,081,067ProgramServicesAmt
Management And General$3,418,978ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,031,344BOYAmt
EOY$8,113,046EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$836,880BOYAmt
EOY$657,043EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,159,101BOYAmt
EOY$2,205,812EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$14,196BOYAmt
EOY$36,670EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$88,417BOYAmt
EOY$394,957EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$302,579BOYAmt
EOY$226,891EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$63,029,242LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$32,155,761LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$32,592,886BOYAmt
EOY$30,873,481EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$274,998BOYAmt
EOY$274,998EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$225,477BOYAmt
EOY$1,066,181EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$42,525,878BOYAmt
EOY$43,849,079EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,220,731BOYAmt
EOY$1,808,259EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$5,712,067BOYAmt
EOY$5,435,762EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,972,682BOYAmt
EOY$18,976,442EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$9,295BOYAmt
EOY$6,599EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,368BOYAmt
EOY$27,892EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,962,143BOYAmt
EOY$26,254,954EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,563,735BOYAmt
EOY$17,594,125EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,563,735BOYAmt
EOY$17,594,125EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$42,525,878BOYAmt
EOY$43,849,079EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,010,914ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$19,476NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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 Required0FederalGrantAuditRequiredInd

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$499,592CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,058,362CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$583,871CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$659,528CurrentTaxYearMinus1YearAmt
Current Tax Year$3,882,268CurrentTaxYearAmt
Total$7,683,621TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,728,646CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,633,243CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,517,998CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,137,849CurrentTaxYearMinus1YearAmt
Current Tax Year$18,131,543CurrentTaxYearAmt
Total$88,149,279TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,228,238CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,691,605CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$19,101,869CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,797,377CurrentTaxYearMinus1YearAmt
Current Tax Year$22,013,811CurrentTaxYearAmt
Total$95,832,900TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$95,832,900PublicSupportTotal509Amt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$484,101CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$494,089CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$554,976CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$567,983CurrentTaxYearMinus1YearAmt
Current Tax Year$497,148CurrentTaxYearAmt
Total$2,598,297TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,712,339CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,185,694CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$19,656,845CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$20,365,360CurrentTaxYearMinus1YearAmt
Current Tax Year$22,510,959CurrentTaxYearAmt
Total$98,431,197TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97360PublicSupportCY509Pct
Public Support PY5090.97090PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
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

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,677,264BeginningYearBalanceAmt
Contributions$22,450ContributionsAmt
Investment Earnings Or Losses$1,006,818InvestmentEarningsOrLossesAmt
Other Expenditures$59,932OtherExpendituresAmt
Administrative Expenses$39,751AdministrativeExpensesAmt
End Year Balance$9,606,849EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,448,232BeginningYearBalanceAmt
Contributions$448ContributionsAmt
Investment Earnings Or Losses$1,327,688InvestmentEarningsOrLossesAmt
Other Expenditures$60,892OtherExpendituresAmt
Administrative Expenses$37,163AdministrativeExpensesAmt
End Year Balance$8,677,264EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,918,740BeginningYearBalanceAmt
Contributions$62,563ContributionsAmt
Investment Earnings Or Losses-$433,229InvestmentEarningsOrLossesAmt
Other Expenditures$60,561OtherExpendituresAmt
Administrative Expenses$39,281AdministrativeExpensesAmt
End Year Balance$7,448,232EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,425,527BeginningYearBalanceAmt
Contributions$677,925ContributionsAmt
Investment Earnings Or Losses$898,650InvestmentEarningsOrLossesAmt
Other Expenditures$48,964OtherExpendituresAmt
Administrative Expenses$34,398AdministrativeExpensesAmt
End Year Balance$7,918,740EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,129,413BeginningYearBalanceAmt
Contributions$7,810ContributionsAmt
Investment Earnings Or Losses$363,749InvestmentEarningsOrLossesAmt
Other Expenditures$49,744OtherExpendituresAmt
Administrative Expenses$25,701AdministrativeExpensesAmt
End Year Balance$6,425,527EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.45887BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.51867PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.02246TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$414,939OtherCostOrOtherBasisAmt
Book Value$414,939BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,782,586OtherCostOrOtherBasisAmt
Depreciation$18,594,771DepreciationAmt
Book Value$26,187,815BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,341,831OtherCostOrOtherBasisAmt
Depreciation$1,385,644DepreciationAmt
Book Value$956,187BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,385,321OtherCostOrOtherBasisAmt
Depreciation$12,175,346DepreciationAmt
Book Value$3,209,975BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$104,565OtherCostOrOtherBasisAmt
Book Value$104,565BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,873,481TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLIABILITY ON INTEREST SWAP AGREEMENTDesc
Amt$27,892Amt
FieldValueIRS element (for citing)
Total Liability$27,892TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:FOR 2020, THERE WAS A RESIDENT FUNDS ACCOUNT IN THE AMOUNT OF $6,599
PART V, LINE 4:THE ENDOWMENT FUNDS ARE HELD BY THE RELATED FOUNDATION FOR THE BENEVOLENT NEEDS FOR RESIDENTS OF EVERGREEN RETIREMENT COMMUNITY WHO HAVE EXHAUSTED THEIR PERSONAL RESOURCES, WOODLANDS PRESERVATION, LIFECARE LEARNING, PASTORAL CARE, CREATIVE ARTS, AND GROUNDS BEAUTIFICATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonKEN ARNESONPersonNm
TitlePRESIDENT/CEOTitleTxt
Base Compensation Filing Org$229,215BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$7,365BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$15,366DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$307NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$252,253TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING THE PERFORMANCE REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES.
PART I, LINE 6PRESIDENT/CEO (KEN ARNESON), VP OF FINANCE/IS & TREASURER (JOHN KRUEGER-RETIRED 6/2020), EXECUTIVE ASSISTANT/SECRETARY (LISA RUIZ) OF EVERGREEN RETIREMENT COMMUNITY, AS MEMBERS OF THE MANAGEMENT TEAM, RECEIVE AN ANNUAL BONUS, PART OF WHICH RELATES TO THE NET INCOME OF THE ORGANIZATION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ELDERLY HOUSING AUTHORITY OF THE CITY OF OSHKOSH
A3912517772003-11-25$6,600,000CONSTRUCTION OF SKILLED NURSING FACILITY AND FITNESS & AQUATIC CENTER000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY
B3913378552016-12-01$14,150,000CONSTRUCTION OF 62 APARTMENTS AND A WORSHIP AND PERFORMING ARTS CENTER000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY
C3913378552013-12-20$7,000,000CAMPUS REMODEL (REPOSITIONING)000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndUnspentUnspentAmt
A$4,926,000$6,600,000$6,600,0002004Yes (1)0Yes (1)Yes (1)
B$3,416,246$14,150,000$12,149,5572016000Yes (1)$2,000,443
C$248,171$7,000,000$7,000,0002014000Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B0000000
C000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
ASSOCIATED BANK NA
A00Yes (1)00Yes (1)9.58333330000000000
(no name)
B000Yes (1)0000Yes (1)
(no name)
C000Yes (1)Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
WILLIAM KRUEGER
BROTHER TO JOHN KRUEGER, BOARD TREASURER$67,280EMPLOYEE0
KEALI WINCHELL
DAUGHTER TO VIRGINIA DAVIS, BOARD MEMBER$64,602EMPLOYEE0
ELIZABETH BELLIN
DAUGHTER TO PEGGY BELLIN, VP HEALTH & SUPPORT SERVICES$28,152EMPLOYEE0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR AND VICE CHAIR OF THE BOARD AND THE CHAIRS OF THE THREE OTHER STANDING BOARD COMMITTEES. THE CHAIR SHALL SERVE AS THE CHAIR OF THE EXECUTIVE COMMITTEE. A QUORUM SHALL CONSIST OF THREE MEMBERS. THE COMMITTEE SHALL MEET AT THE CALL OF THE CHAIR OR ANY TWO EXECUTIVE COMMITTEE MEMBERS. THE COMMITTEE SHALL HAVE FULL AUTHORITY TO ACT ON BEHALF OF THE BOARD BETWEEN MEETINGS OF THE BOARD, EXCEPT THE ELECTION OF OFFICERS OR THE AUTHORITY TO DECLARE OR FILL ANY VACANCY ON THE BOARD. ALL ACTIONS OF THE COMMITTEE SHALL BE REPORTED AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD. THE COMMITTEE SHALL PERFORM SUCH OTHER FUNCTIONS AS MAY BE DELEGATED TO IT BY THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION'S TREASURER WILL REVIEW THE 990 IN DETAIL. AN ELECTRONIC VERSION OF THE FORM 990 WILL BE POSTED ON THE BOARD WEB PAGE WITH MEMBERS GIVEN THE OPPORTUNITY TO REVIEW IT PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL EMPLOYEES AND IT HAS A CODE OF CONDUCT POLICY THAT APPLIES TO ALL BOARD MEMBERS. BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST AND TO CONDUCT BUSINESS WITH EVERGREEN IN A MANNER THAT SUPPORTS THE INTERESTS OF EVERGREEN AND AVOIDS UNFAIR PERSONAL ADVANTAGE. NON-COMPLIANCE WITH THE CODE OF CONDUCT MAY RESULT IN REMOVAL FROM THE BOARD FOLLOWING AN OPPORTUNITY FOR EXPLANATION TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING THE PERFORMANCE REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES. VICE PRESIDENTS ARE REVIEWED BY THE PRESIDENT/CEO. THE SECRETARY OF THE BOARD IS THE EXECUTIVE ASSISTANT TO THE PRESIDENT/CEO AND IS REVIEWED BY THE PRESIDENT/CEO. PERIODIC WAGE & SALARY SURVEYS ARE CONDUCTED TO ASSURE COMPENSATION IS COMPARABLE TO INDUSTRY/AREA MARKET. FORMS ARE USED TO DOCUMENT ACCOMPLISHMENTS.
FORM 990, PART VI, SECTION C, LINE 19EVERGREEN RETIREMENT COMMUNITY, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. REQUESTED DOCUMENTS ARE PROVIDED WITHIN A REASONABLE TIME FRAME.
FORM 990, PART IX, LINE 11GCONTRACTS AND OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,933,065. MANAGEMENT AND GENERAL EXPENSES 595,020. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,528,085.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd
FieldValueIRS element (for citing)
EIN391388991EIN
Primary ActivitiesFUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN VILLAGE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54901ZIPCd
FieldValueIRS element (for citing)
EIN391505337EIN
Primary ActivitiesCO-OPERATIVEPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
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 Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd