2025-09-02T13:04:44-05:00 2024-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-01-01 390968652 GLENHAVEN INC GLEN 7152654555 612 E OAK ST GLENWOOD CITY WI 54013 KEVIN LARSON ADMINISTRATOR 7152654555 2025-08-22 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-08-22 2024 2025-03-06 01:10:19Z KEVIN LARSON 612 E OAK ST GLENWOOD CITY WI 54013 4071080 0 X WWW.GLENHAVENINC.COM/INDEX.HTML X 1960 WI TO PROVIDE THERAPEUTIC, PREVENTATIVE, AND RESTORATIVE CARE TO OUR RESIDENTS THAT WILL ASSIST THEM TO OBTAIN AND MAINTAIN AN OPTIMUM LEVEL OF HEALTH AND WELL-BEING. 7 7 94 25 0 0 38613 19528 3541852 3991329 107490 27911 37832 32312 3725787 4071080 0 0 0 0 1832695 1723413 0 0 0 2465320 2641564 4298015 4364977 -572228 -293897 9159728 8656917 8143052 7934138 1016676 722779 X TO PROVIDE THERAPEUTIC, PREVENTATIVE, AND RESTORATIVE CARE TO OUR RESIDENTS THAT WILL ASSIST THEM TO OBTAIN AND MAINTAIN AN OPTIMUM LEVEL OF HEALTH AND WELL-BEING. 0 1 3939736 0 3991329 SKILLED NURSING HOME, 44 BED FACILITY, 16 UNIT COMMUNITY BASED RESIDENTIAL FACILITY, AND 16-UNIT RESIDENTIAL CARE APARTMENT COMPLEX. 3939736 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 8 0 94 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X THE ORGANIZATION 7152654555 612 E OAK ST GLENWOOD CITY WI 54013 JOHN MCCUTCHIN PRESIDENT 1.00 X X 0 0 0 ROBIN DARWIN VICE PRESIDENT 1.00 X X 0 0 0 CYNTHIA TUTTLE TREASURER 1.00 X X 0 0 0 LESLEY NELSON SECRETARY 1.00 X X 0 0 0 DAVID BARTZ DIRECTOR 1.00 X 0 0 0 MELISSA LARSON DIRECTOR 1.00 X 0 0 0 PAUL RAMEY DIRECTOR 1.00 X 0 0 0 EVELYN WYLIE DIRECTOR 1.00 X 0 0 0 KEVIN LARSON ADMINSTRATOR 40.00 X 57833 0 2298 SHERRY GOODMAN ADMINISTRATOR (THRU 06/24) 40.00 X 79396 0 8090 SAMANTHA MOE DIRECTOR OF FINANCE 40.00 X 54910 0 13459 ROBIN MERTEN DIRECTOR OF NURSING 40.00 X 114968 0 3449 307107 0 27296 1 0 0 0 RTG MEDICAL 4611 EAST 22ND STREET FREMONT NE 68025 STAFFING AGENCY 519243 NORTHERN STAFFING LLC 273 110TH STREET AMERY WI 54013 STAFFING AGENCY 446811 SELECT REHABILITATION PO BOX 71985 CHICAGO IL 60694 THERAPY SERVICES 197040 MARTIN BROTHERS PO BOX 69 CEDAR FALLS IA 50613 FOOD SERVICES 166225 4 8823 10705 19528 SKILLED NURSING FACILI 623000 3290706 3290706 COMMUNITY BASED RESIDE 623000 499832 499832 ASSISTED LIVING REVENU 623000 178821 178821 DAY CARE REVENUE 624410 21970 21970 3991329 27911 27911 32312 32312 32312 4071080 3991329 0 60223 215986 215986 1285249 1184037 101212 14940 14940 96867 92322 4545 110371 88455 21916 38865 38865 30 30 20858 20858 11153 11153 93707 88047 5660 777 777 2342 2342 253923 238586 15337 359103 337413 21690 80137 80137 NURSING EXPENSES 1320067 1320067 FOOD & DIETARY SUPPLIES 150019 150019 REPAIRS AND MAINTENANCE 117322 117322 PROVIDER BED TAX ASSESS 89760 89760 103501 103501 4364977 3939736 425241 0 288 142 1131437 882905 40027 6618 326278 429898 10246 10334 11329649 4321542 7324210 7008107 327242 318913 9159728 8656917 260409 292122 3338 3868 7879305 7638148 8143052 7934138 X 1016676 722779 1016676 722779 9159728 8656917 -293897 0 X 0 1 X 1 1 1 X 551390 725666 782102 38613 19528 2117299 4724225 3593309 3148622 3541852 3991329 18999337 5275615 4318975 3930724 3580465 4010857 21116636 0 0 0 21116636 15507 7873 8870 28634 27911 88795 15507 7873 8870 28634 27911 88795 500 51055 65924 37832 32312 187623 5291622 4377903 4005518 3646931 4071080 21393054 0.98710 0.99690 0.00420 0.00310 X 0 1 X 188315 188315 9593258 3070196 6523062 1474333 1177603 296730 73743 73743 0 7008107 X PART IV, LINE 2B: THE ORGANIZATION REQUIRES SECURITY DEPOSITS FROM TENANTS OF ITS APARTMENTS. WITHDRAWALS ARE MADE TO REFUND TENANT DEPOSITS OR TO PAY THE COSTS OF REPAIRING VACANT UNITS. THE ORGANIZATION ALSO HOLDS FUNDS ON BEHALF OF RESIDENTS. THE ORGANIZATION HAS A RESPONSIBILITY FOR BOTH THE ADMINISTRATION AND DISTRIBUTION OF THE FUNDS TO THE RESIDENTS. PART X, LINE 2: THE ORGANIZATION IS REQUIRED TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION HAS DETERMINED THERE ARE NO AMOUNTS TO RECORD AS ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. X 0 0 0 0 0 0 0 0 0 FORM 990, PART III, LINE 3 GLENHAVEN NO LONGER HAS THEIR OWN DAYCARE. THE GLENWOOD CITY SCHOOL RENTS THE SPACE FOR THEIR CHILD CARE FOR $2000.00 PER MONTH FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF FORM 990 IS REVIEWED BY THE ADMINISTRATOR AND BOARD OF DIRECTORS BEFORE IT IS SIGNED AND FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY AND UNDERSTANDS THE CORPORATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15A IN MANY YEARS, LEADING AGE WISCONSIN DATA IS USED TO DETERMINE THE COMPENSATION OF THE ADMINISTRATOR. ANNUALLY A PERFORMANCE REVIEW IS CONDUCTED, AND YEAR OF EXPERIENCE IS CONSIDERED IN DETERMINING AND APPROVING ADMINISTRATOR COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTATION IS AVAILABLE UPON REQUEST. HAVENWOOD MANAGER LLC 612 E OAK STREET GLENWOOD CITY WI 54013 390968652 LOW-INCOME RESIDENTIAL CARE APARTMENT COMPLEX WI 0 0 GLENHAVEN INC HAVENWOOD LLC 612 E OAK STREET GLENWOOD CITY WI 54013 260440303 LOW-INCOME RESIDENTIAL CARE APARTMENT COMPLEX WI GLENHAVEN INC EXCLUDED -9 720825 1 1 0.00010 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0