2020-10-29T08:39:12-05:00 2019-12-31 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2019-01-01 362606227 FAIRHAVEN CHRISTIAN RETIREMENT CENTER FAIR 8158771441 3470 N ALPINE ROAD ROCKFORD IL 61114 KEITH PENNINGTON DIRECTOR OF FINANCE 8158771441 2020-10-26 1 CHLOE CHIUMINATTO P01924323 4144319300 2020-10-23 184.59.22.73 2020-10-26 13:00:34 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CC322FB1B7FC8ED290785ACCB7D2994D8745AEAD 2019 2021-01-29 14:40:06Z KEITH PENNINGTON 3470 N ALPINE ROAD ROCKFORD IL 61114 14083327 0 X WWW.FAIRHAVEN.CC X 1965 IL PROVIDE A COMFORTABLE LIFESTYLE AND EXCEPTIONAL CARE WHICH ENHANCES QUALITY OF LIFE IN A MANNER THAT GLORIFIES GOD. 13 13 344 250 0 0 271589 288143 13171915 13413900 111147 113239 283343 268045 13837994 14083327 0 0 0 0 7840438 8095527 0 0 4103 5618443 5660905 13458881 13756432 379113 326895 27564377 29117405 14722632 15868790 12841745 13248615 X FAIRHAVEN CHRISTIAN RETIREMENT CENTER'S MISSION IS TO PROVIDE A COMFORTABLE LIFESTYLE AND EXCEPTIONAL CARE WHICH ENHANCES QUALITY OF LIFE IN A MATTER THAT GLORIFIES GOD. THE CENTER IS DESIGNED AND EQUIPPED SPECIFICALLY FOR THE COMFORT, CONVENIENCE, AND SAFETY OF THE ELDERLY PEOPLE. 0 0 5262635 0 5682144 NURSING CARE:THE CENTER OPERATES A 96 BED NURSING CARE FACILITY. 4817282 0 5201289 INDEPENDENT LIVING AND RESIDENTIAL CARE:THE CENTER OPERATES 112 UNITS OF INDEPENDENT LIVING DUPLEXES AND A 92 UNIT INDEPENDENT LIVING RESIDENTIAL APARTMENT FACILITY. 2343644 0 2530467 SUPPORTIVE CARE:THE CENTER OPERATES A 50 BED SUPPORTIVE CARE FACILITY. 12423561 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 344 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X KEITH PENNINGTON 8158771441 3470 N ALPINE ROAD ROCKFORD IL 61114 DR NEIL BROGREN DIRECTOR 0.25 X 0 0 0 BRENDA BUZZARD DIRECTOR 0.25 X 0 0 0 TOM EWING DIRECTOR 0.50 X 0 0 0 GREG JOHNSON DIRECTOR 0.25 X 0 0 0 PALMER KLAAS DIRECTOR 0.75 X 0 0 0 DAVID NORBERG DIRECTOR 0.75 X 0 0 0 RICHARD THOMPSON DIRECTOR 0.25 X 0 0 0 RITA VERSENDAAL DIRECTOR 0.50 X 0 0 0 RANDY VOORHIES DIRECTOR 0.25 X 0 0 0 DAVID WILES PRESIDENT 1.00 X X 0 0 0 CHUCK SCHLUETER VICE PRESIDENT 0.75 X X 0 0 0 DAN NYBERG SECRETARY 0.25 X X 0 0 0 STEVE SJOGREN TREASURER 0.50 X X 0 0 0 JEFF REIERSON EXECUTIVE DIRECTOR 40.00 X 145961 0 6552 CAROL REIERSON DIRECTOR OF FINANCE (THRU NOVEMBER) 40.00 X 79255 0 96 KEITH PENNINGTON DIRECTOR OF FINANCE (BEG. AUGUST) 40.00 X 31013 0 1395 256229 0 8043 1 0 1 0 JOHN EVANS CONSTRUCTION CO 5343 ARBUTUS ROAD ROCKFORD IL 61107 CONSTRUCTION SERVICES 214014 SECURITAS SECURITY SERVICES 3600 E STATE STREET ROCKFORD IL 61108 SECURITY SERVICES 164441 2 288143 288143 NURSING CARE REVENUE 623000 5682144 5682144 INDEPENDENT LIVING REVENUE 623000 5201289 5201289 SUPPORTIVE CARE REVENUE 623000 2530467 2530467 13413900 107039 107039 6200 0 6200 6200 6200 268045 268045 268045 14083327 13413900 0 381284 264272 264272 6612122 6137944 474178 74150 74150 651788 556917 94871 493195 429457 63738 5848 5848 44200 44200 562670 562670 21555 21555 182015 182015 984887 984887 6974 6974 9485 9485 270560 270560 1716187 1716187 242464 242464 FOOD 770865 770865 SUPPLIES 247668 247668 OCCUPIED BED TAX 233198 233198 REPAIRS & MAINTENANCE 215805 215805 146524 25472 116949 4103 13756432 12423561 1328768 4103 1400 1400 1496530 2182648 998293 657769 63785 64155 76284 141534 55413189 32965362 22213949 22447827 1136100 2447114 288418 9546 1289618 1165412 27564377 29117405 1170815 1286435 3614713 3734082 5770196 5466158 12990 14256 1134787 1417336 3019131 3950523 14722632 15868790 X 11535898 12068240 1305847 1180375 12841745 13248615 27564377 29117405 X 326895 205447 -125472 X 0 1 X 1 0 X 181462 134718 86171 271589 288143 962083 13079883 12826305 12724994 13171915 13413900 65216997 13261345 12961023 12811165 13443504 13702043 66179080 5390 2230 2095 7455 7555 24725 0 5390 2230 2095 7455 7555 24725 66154355 52247 55746 90739 111147 107039 416918 52247 55746 90739 111147 107039 416918 297012 289623 283343 268045 1138023 13313592 13313781 13191527 13837994 14077127 67734021 0.97670 0.98120 0.00620 0.00540 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1306596 104100 257069 11165 1656600 1339187 80678 -102540 10729 1306596 1091127 72500 184798 9238 1339187 1045431 28797 25185 8286 1091127 908377 147612 -2964 7594 1045431 0.98240 0.01760 0.00000 0 0 837757 837757 43441848 24891993 18549855 11117071 8073369 3043702 16513 16513 22447827 ADVANCED DEPOSITS 288259 REFUNDABLE FOUNDERS' FEES 3515081 SETTLEMENTS PAYABLE 147183 3950523 14282574 205447 205447 14077127 6200 6200 14083327 13750232 -6200 -6200 13756432 0 13756432 PART IV, LINE 2B: THE ACCOUNT THAT THE ORGANIZATION IS A CUSTODIAN FOR IS RESIDENT TRUST FUNDS, WHICH ARE FOR RESIDENTS TO USE AS THEY WISH FOR PERSONAL EXPENSES. PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT CONSISTS OF ONE FUND ESTABLISHED TO BENEFIT THE ORGANIZATION FOR A VARIETY OF PURPOSES. THE CENTER HAS ADOPTED AN INVESTMENT POLICY FOR ITS ENDOWMENT ASSETS THAT REQUIRES THE INVESTMENT PORTFOLIO TO BE MAINTAINED FOR LONG-TERM INVESTMENT PURPOSES. PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON DISPOSAL OF PROPERTY AND EQUIPMENT 6,200. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON DISPOSAL OF PROPERTY AND EQUIPMENT -6,200. X X 0 0 0 0 0 0 0 0 0 JEFF REIERSON EXECUTIVE DIRECTOR 145703 0 0 0 258 0 0 0 6552 0 152513 0 0 0 A CITY OF ROCKFORD WINNEBAGO COUNTY ILLINOIS 366006082 2009-06-17 8000000 REPAY LINE OF CREDIT, BUILDING IMPROVEMENTS 0 0 0 A 2452962 8000000 880666 140108 4130749 2848477 2010 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 2 OFFICERS JEFF REIERSON AND CAROL REIERSON HAVE A FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE ORGANIZATION SHALL BE THOSE PERSONS WHO FROM TIME TO TIME ARE ELECTED DIRECTORS OF THE GREAT LAKES DISTRICT CONFERENCE OF THE EVANGELICAL FREE CHURCH OF AMERICA OR ITS SUCCESSOR DISTRICT IN WHICH FAIRHAVEN CHRISTIAN RETIREMENT CENTER IS LOCATED. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION SHALL ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BY-LAWS MAY BE ALTERED, AMENDED OR REPEALED AND NEW BY-LAWS MAY BE ADOPTED BY RESOLUTION, ADOPTED BY A TWO-THIRDS VOTE OF THE BOARD OF DIRECTORS AND APPROVED BY MAJORITY OF THE MEMBERS THIS CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE COMPANY'S BOARD MEMBERS ARE REQUIRED TO COMPLETE THE CONFLICT OF INTEREST STATEMENT. THE POLICY IS REVIEWED BY THE BOARD ANNUALLY AND GIVEN TO EACH NEW BOARD MEMBER FOR SIGNATURE DURING ORIENTATION. RESTRICTION - ONE MEMBER IS EXCUSED WHEN VOTING ON ISSUES RELATED TO THE ENDOWMENT AND BTS INVESTMENTS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE EXECUTIVE DIRECTOR OF THE ORGANIZATION IS REVIEWED AND INCREASED DIRECTLY BY A COMMITTEE ON THE BOARD. THEY DO A PEER, SELF, AND BOARD EVALUATION TO DETERMINE PERFORMANCE AND PROVIDE A BASE FOR ADJUSTMENTS IN COMPENSATION. THE COMMITTEE ALSO LOOKS AT THE LEADING AGE (NATIONAL LONG-TERM CARE ORGANIZATION) COMPENSATION TO VERIFY THAT HE IS PAID COMPARABLY TO OTHER EXECUTIVE DIRECTORS WHO ARE EMPLOYED AT FACILITIES SIMILAR IN SIZE AND GEOGRAPHICAL LOCATION. MANAGERS' COMPENSATION IS EVALUATED BY THE EXECUTIVE DIRECTOR OR HIS MANAGEMENT TEAM. THEY USE PEER, SELF, AND MANAGER EVALUATIONS TO DETERMINE PERFORMANCE AND PROVIDE A BASE FOR ADJUSTMENTS IN COMPENSATION. THEIR COMPENSATION IS ALSO BASED ON COMPARISONS BETWEEN LEADING AGE AND AN INTERNAL HUMAN RESOURCES WAGE RANGE ANALYSIS CALCULATED EACH YEAR BY JOB CLASS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. INDIVIDUALS ARE ALLOWED TO REVIEW THE FINANCIAL STATEMENTS AND FORM 990 IN THE ORGANIZATION'S OFFICE. FORM 990, PART XI, LINE 9: INCREASE IN BENEFICIAL INTEREST IN ANNUITY CONTRACT 3,000. NET ASSETS RELEASED FROM RESTRICTIONS -128,472.