2020-11-13T09:12:45-06:00 2019-12-31 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2019-01-01 236276101 MENNO-HAVEN INC MENN 7172621000 2011 SCOTLAND AVENUE CHAMBERSBURG PA 17201 DAVID GENTRY CFO 7172621000 2020-10-28 1 KERRI N BOGDA CPA P00760402 7177404863 174.55.78.125 2020-10-28 08:04:59 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF78FC311707138AE8A35EE5AF434BBB9CACA7EB 2019 2021-01-29 14:40:06Z HUGH DAVIS 2011 SCOTLAND AVENUE CHAMBERSBURG PA 17201 55447074 0 X WWW.MENNOHAVEN.ORG X 1964 PA OUR MISSION IS TO BE AN INNOVATIVE ORGANIZATION THAT NURTURES THE HUMAN SPIRIT, IS PASSIONATE ABOUT SERVICE, AND DEMONSTRATES GOD'S LOVE, ONE PERSON AT A TIME. 12 12 907 248 397895 0 2734691 4390939 47106803 47084441 2581883 1263469 1203380 1150808 53626757 53889657 0 0 0 0 26416275 27406629 0 0 733471 23176641 27005860 49592916 54412489 4033841 -522832 188806535 230843715 149593945 186441485 39212590 44402230 X OUR MISSION IS TO BE AN INNOVATIVE ORGANIZATION THAT NURTURES THE HUMAN SPIRIT, IS PASSIONATE ABOUT SERVICE, AND DEMONSTRATES GOD'S LOVE, ONE PERSON AT A TIME. 0 0 23027208 0 23562986 MENNO HAVEN INC. OPERATES TWO CONTINUING CARE RETIREMENT COMMUNITIES IN CHAMBERSBURG, PA. EACH CAMPUS OPERATES A LICENSED SKILLED NURSING FACILITY. DURING 2019, MENNO HAVEN OPENED A 44-BED REHABILITATION CENTER. IT IS A MEDICARE LICENSED SKILLED NURSING FACILITY THAT PROVIDES STATE-OF-THE-ART REHABILITATION SERVICES IN A WELL CERTIFIED BUILDING. THE CENTER OFFERS ROOM AND BOARD, NURSING CARE, MEDICAL AND REHABILITATION SERVICES, SOCIAL SERVICES AND ACTIVITY PROGRAMS. MENNO HAVEN ALSO REDUCED THE OCCUPANCY OF THE BROOKVIEW HEALTH CARE CENTER FROM THE DUALLY LICENSED 152 BEDS DOWN TO 75 BEDS IN ACCORDANCE WITH THE 2020 PLANNED TRANSFER TO THE NEW 56 BED SKILLED NURSING FACILITY THAT'S REPLACING THE ORIGINAL BROOKVIEW HEALTH CARE CENTER. CHAMBERS POINTE PLUS HAS ALSO TRANSITIONED TO THE NEIGHBORHOOD MODEL OF CARE BEING PROVIDED IN THE NEIGHBORHOOD. 10096893 0 10331819 MENNO HAVEN INC. OPERATES TWO CONTINUING CARE RETIREMENT COMMUNITIES IN CHAMBERSBURG, PA. EACH CAMPUS OPERATES LICENSED PERSONAL CARE AND RESIDENTIAL LIVING FACILITIES. THE BROOKVIEW CAMPUS OPERATES THE VILLAGE SQUARE PERSONAL CARE WHICH IS LICENSED FOR 84 UNITS AND PROVIDES ROOM AND BOARD, LIMITED NURSING CARE, MEDICAL AND REHABILITATION SERVICES ALONG WITH SOCIAL, WELLNESS, AND ACTIVITY PROGRAMS. THE CHAMBERS POINTE CAMPUS OPERATES MANOR PERSONAL CARE WHICH IS LICENSED FOR 94 UNITS AND PROVIDES ROOM AND BOARD, LIMITED NURSING CARE, MEDICAL AND REHABILITATION SERVICES ALONG WITH SOCIAL, WELLNESS, AND ACTIVITY PROGRAMS. DURING 2019, MENNO HAVEN ADDED TWO 12-BED MEMORY CARE HOMES THAT OPERATE AT THE PERSONAL CARE LEVEL OF CARE IN THE HOUSEHOLD MODEL. THE HOMES OFFER ALL ELEMENTS OF HOUSEHOLD CARE BEING PROVIDED BY ALL TEAM MEMBERS TO THE CHAMBERS POINTE CAMPUS. 11290093 0 11552782 MENNO HAVEN INC. OPERATES TWO CONTINUING CARE RETIREMENT COMMUNITIES IN CHAMBERSBURG, PA. EACH CAMPUS OPERATES A VARIETY OF INDEPENDENT LIVING UNITS FOR INDIVIDUALS AND COUPLES WHO WISH TO MAINTAIN MORE INDEPENDENCE, BUT DESIRE THE ACCESS TO THE FOLLOWING CONTINUING CARE SERVICES: EMERGENCY NURSE CALL, WELLNESS CHECKS, WELLNESS PROGRAMS, CULINARY SERVICES, GROUNDS, MAINTENANCE, AND TRANSPORTATION SERVICES AS WELL AS ACCESS TO THE OTHER LEVELS OF SERVICES PROVIDED AT MENNO HAVEN. THE BROOKVIEW CAMPUS HAS 81 INDEPENDENT LIVING ("IL") VILLA HOMES, 192 IL COTTAGES, AND 74 IL APARTMENTS. THE CHAMBERS POINTE CAMPUS HAS 112 IL COTTAGES AND 47 IL APARTMENTS. 1599635 0 1636854 MENNO HAVEN, INC. OPERATES HOME AND COMMUNITY BASED SERVICES, WHEREBY THE ORGANIZATION PROVIDES HOME CARE SERVICES TO INDEPENDENT LIVING RESIDENTS AND THOSE SENIORS WHO ARE LOCAL TO THE COMMUNITY WHERE THEY CAN ACCESS THE SERVICES. 1599635 0 1636854 46013829 1 1 0 1 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 1 0 0 0 0 0 0 0 0 1 103 0 907 1 1 1 0 0 0 0 1 1 0 0 0 1 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA MD X LYNETTE M MCCULLOCH DIRECTOR OF ACCOUNTING SERVICES 7172612343 2011 SCOTLAND AVENUE CHAMBERSBURG PA 17201 HUGH DAVIS CEO 40.00 X 359953 0 47613 DAVID GENTRY CFO 40.00 X 200798 0 13395 JONATHAN BAKER CAO 40.00 X 185339 0 9371 ROGER BEINS COO 40.00 X 166091 0 22171 CHARLES NELSON EXECUTIVE DIRECTOR 40.00 X 173778 0 7940 LARRY LUGARO DIRECTOR FACILITY DEVELOPMENT 40.00 X 157940 0 7447 ROSALYN BURKE NHA 40.00 X 124985 0 22290 TRACEY ECHELBERGER EXEC. DIR., INDEPENDENT LIVING 40.00 X 115522 0 5403 CHRISTINA COOVER RN 40.00 X 104821 0 12426 DEANNA BEINS NHA 40.00 X 100644 0 11990 TIMOTHY JOHNSON CCO - RETIRED 2019 40.00 X 92877 0 8686 WAYNE YEAGER CHAIR 1.80 X X 0 0 0 ARNOLD BARBOUR VICE-CHAIR 1.30 X X 0 0 0 LIN ACE HOSKINSON SECRETARY 1.10 X X 0 0 0 RONALD G GIPE TREASURER 1.00 X X 0 0 0 DARRELL BAER ASST. SECRETARY/TREASURER 0.80 X X 0 0 0 DALE HORST BOARD MEMBER 0.60 X 0 0 0 MARTHA WALKER BOARD MEMBER 0.80 X 0 0 0 PAMELA GAUDIOSE BOARD MEMBER 0.70 X 0 0 0 THOMAS GILBERT BOARD MEMBER 1.00 X 0 0 0 MATTHEW NOLT BOARD MEMBER 0.80 X 0 0 0 CHARLENE GINGRICH BOARD MEMBER 0.60 X 0 0 0 LYNN MACBRIDE BOARD MEMBER 0.50 X 0 0 0 1782748 0 168732 11 0 1 0 WARFEL CONSTRUCTION COMPANY 1110 ENTERPRISE RD EAST PETERSBURG PA 17520 CONSTRUCTION 17844904 ECI SERVICES 124 WEST CHURCH ST DILLSBURG PA 17019 CONSTRUCTION 10108046 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 60694 THERAPY 2958104 PREMIER CONSTRUCTION 39 S YORK ROAD SUITE A DILLSBURG PA 17019 CONSTRUCTION 1239789 WAYNESBORO CONSTRUCTION CO PO BOX 229 WAYNESBORO PA 17268 CONSTRUCTION 1076643 35 4390939 297650 4390939 NURSING & PERSONAL CARE 623000 47084441 47084441 47084441 888155 888155 168355 168355 173160 235337 -62177 -62177 -62177 1520535 8504 987335 334745 533200 -326241 206959 206959 MEALS 900099 885966 370218 515748 HAIR CARE 900099 206906 206906 GUEST ROOMS 900099 27677 27677 92436 92436 1212985 53889657 47084441 397895 2016382 1288011 1288011 21219630 18316029 2649413 254188 400552 290545 103741 6266 2849436 2312569 515103 21764 1649000 1332020 305228 11752 57081 57081 82497 82497 1145 1145 1131192 732053 394422 4717 738021 1574 327728 408719 3343626 3079783 237778 26065 873186 68905 804281 3875542 3867944 7598 169591 145771 23820 161118 111055 50063 3508919 3508919 6823305 6823305 383731 171877 211854 MEDICAL EXPENSES 4306356 4306356 MEDICAID NF ASSESSMENT 426667 426667 ADMINISTRATIVE EXPENSES 191331 191331 HAIR CARE 179494 179494 753058 338963 414095 54412489 46013829 7665189 733471 2150 2450 7418575 6744904 725364 1817081 3151633 3273840 252322 259497 998036 1197082 214448950 79605898 98344586 134843052 75927514 79454602 1986355 3251207 188806535 230843715 7544131 10938709 29483045 37825470 100485791 126812794 1341419 276746 201500 201500 10538059 10386266 149593945 186441485 X 30170650 32889924 9041940 11512306 39212590 44402230 188806535 230843715 X -522832 5421782 290690 X 0 1 X 1 0 X 660847 754959 1595802 2734691 4390939 10137238 44125400 44017804 45862179 47106803 47084441 228196627 44786247 44772763 47457981 49841494 51475380 238333865 4320 52000 28500 24862 15474 125156 0 4320 52000 28500 24862 15474 125156 238208709 984956 1022093 992247 1202119 1229670 5431085 984956 1022093 992247 1202119 1229670 5431085 687756 768475 815090 2271321 45771203 45794856 49137984 51812088 53520140 246036271 0.96820 0.97070 0.02210 0.02270 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: HAIR CARE - 2017 AMOUNT: $ 227,581. 2018 AMOUNT: $ 221,030. 2019 AMOUNT: $ 206,906. MEALS - 2017 AMOUNT: $ 406,252. 2018 AMOUNT: $ 444,166. 2019 AMOUNT: $ 515,748. MISCELLANEOUS - 2017 AMOUNT: $ 33,923. 2018 AMOUNT: $ 29,441. 2019 AMOUNT: $ 31,874. ENTRANCE FEES - 2017 AMOUNT: $ 15,000. INSTALLMENT REVENUE - 2017 AMOUNT: $ 5,000. INSURANCE CLAIMS - 2018 AMOUNT: $ 73,838. 2019 AMOUNT: $ 19,672. PET CARE - 2019 AMOUNT: $ 25,721. TRANSPORTATION ASSISTANCE - 2019 AMOUNT: $ 12,865. SPECIAL EVENT INCOME - 2019 AMOUNT: $ 2,304. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1145 1145 0 PART II-B, LINE 1: MENNO-HAVEN INC PAYS DUES TO LEADINGAGE AND LEADINGAGE PA WHICH ADVOCATE FOR NURSING HOMES AND OTHER CARE FACILITIES FOR THE AGED. SMALL PORTIONS OF THE DUES TO LEADINGAGE AND LEADINGAGE PA ARE USED FOR LOBBYING EXPENSES. 0 1 X 5462182 2421467 229732 1133552 6979829 6906365 155965 -320875 1279273 5462182 6760278 127061 767664 748638 6906365 7202117 175282 297863 914984 6760278 8183932 164311 -83643 1061483 7203117 0.00000 0.44000 0.56000 1 0 3687320 3687320 132301333 55093408 77207925 47069768 24512490 22557278 31390529 31390529 134843052 GIFT ANNUITIES 148650 RESIDENT AND EMPLOYEE FUNDS 629665 REFUNDABLE ENTRANCE FEES 9607951 10386266 60163707 5421782 290690 5712472 54451235 -561578 -561578 53889657 54974067 561578 561578 54412489 0 54412489 PART IV, LINE 2B: THE ORGANIZATION IS THE REP PAYEE FOR TWO RESIDENTS WHO RECEIVE THEIR SOCIAL SECURITY FUNDS INTO THE ACCOUNT. THE ORGANIZATION ALSO HOLDS SMALL GUEST FUNDS, WHERE FAMILIES CAN PUT SMALL ALLOWANCES IN TO BE HELD FOR FUTURE USE ONCE THE RESIDENT NEEDS MORE RESTRICTIVE LEVELS OF CARE. THE RESIDENTS THEN WITHDRAW THE FUNDS AS NEEDED. THERE ARE ALSO ESCROW ACCOUNT LIABILITIES THAT ARE DEPOSITS WHICH ARE RECEIVED ON INDEPENDENT LIVING CONTRACTS FOR RESIDENTS WHO HAVE NOT YET MOVED IN. PART V, LINE 4: ENDOWMENT FUNDS ARE MAINTAINED FOR THE BENEFIT OF OUR RESIDENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTERESTS IN ANNUITIES 60,957. CHANGE IN VALUE OF PERPETUAL TRUSTS 229,733. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF FIXED ASSETS -326,241. RENTAL EXPENSES -235,337. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF FIXED ASSETS 326,241. RENTAL EXPENSES 235,337. X X X 0 0 0 0 0 0 0 0 0 HUGH DAVIS CEO 297233 0 50000 0 12720 0 31300 0 16313 0 407566 0 0 0 DAVID GENTRY CFO 195078 0 5000 0 720 0 0 0 13395 0 214193 0 0 0 JONATHAN BAKER CAO 179619 0 5000 0 720 0 8215 0 1156 0 194710 0 0 0 ROGER BEINS COO 160371 0 5000 0 720 0 7323 0 14848 0 188262 0 0 0 CHARLES NELSON EXECUTIVE DIRECTOR 169989 0 3069 0 720 0 7709 0 231 0 181718 0 0 0 LARRY LUGARO DIRECTOR FACILITY DEVELOPMENT 154511 0 2709 0 720 0 0 0 7447 0 165387 0 0 0 A FRANKLIN COUNTY INDUSTRIAL DEVELOPMENT 232261213 353273B27 2018-09-01 102460808 REFUND PRIOR YEAR BONDS, CONSTRUCTION, FURNISHING & EQUIPMENT 0 0 0 B FRANKLIN COUNTY INDUSTRIAL DEVELOPMENT 232261213 353273CF0 2019-09-04 27462488 CONSTRUCTION, FURNISHING & EQUIPMENT 0 0 0 A 610000 102460808 6246963 2683695 1644160 45352194 43427500 3106296 2020 1 0 1 1 B 27462488 1981567 292895 536742 10581657 14069627 2020 0 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 0 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 0 B 0 X 2 56650 APPRAISAL X 2 241000 NYSE 4 0 1 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTORS IS REPORTED FOR ALL GIFTS. FORM 990, PART VI, SECTION B, LINE 11B INTERNAL FINANCE PERSONNEL PERFORM AN INITIAL REVIEW OF THE FORM 990. ONCE THE DRAFT IS SHARED WITH THE CEO, THE FORM IS PROVIDED TO THE FINANCE COMMITTEE FOR REVIEW. DURING A FINANCE COMMITTEE MEETING, MANAGEMENT RESPONDS TO ANY QUESTIONS FROM THE COMMITTEE. THE 990 DRAFT IS THEN MADE AVAILABLE TO THE FULL BOARD AS AN AGENDA ITEM DURING A FULL BOARD MEETING. NOTE THE BOARD REVIEWS THE FORM 990 RATHER THAN "APPROVES" IT AS THE FILING OF THE FORM 990 IS CONSIDERED A MANAGEMENT RESPONSIBILITY. THE FORM 990 IS THEN FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND CORPORATE OFFICERS ARE AMONG THOSE WHO SIGN AN ANNUAL CONFLICT OF INTEREST FORM. THE FORMS ARE REVIEWED BY THE SECRETARY OF THE BOARD AND ANY DISCLOSED CONFLICTS ARE DISCUSSED WITH THE EXECUTIVE COMMITTEE OR APPROPRIATE OFFICERS OF THE GOVERNING BODY. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE CONFLICT OF INTEREST POLICY AS SOURCES OF POTENTIAL CONFLICTS. IF A CONFLICT IS DISCLOSED, THE INTERESTED PARTY MAY NOT PARTICIPATE IN CONSIDERATION OR DISCUSSION OF THE PROPOSED TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO, EXECUTIVE DIRECTOR, AND TOP MANAGEMENT OFFICIALS IS DETERMINED BY A COMPENSATION SURVEY OR STUDY USING PRIMARILY THE LEADING AGE AGENCY WAGE SURVEY OF SIMILAR SIZE FACILITIES. LEADING AGE IS AN ASSOCIATION OF NONPROFIT SENIOR SERVICES IN THE STATE OF PENNSYLVANIA. THE EXECUTIVE COMMITTEE OF THE BOARD ALSO HAS THE LIBERTY TO UTILIZE OTHER SURVEYS OF SIMILAR OPERATIONS IF THEY CHOOSE TO DO SO. COMPENSATION RANGES FOR OTHER OFFICERS AND KEY EMPLOYEES ARE DETERMINED BY A COMPENSATION SURVEY USING THE LEADING AGE PARENT AGENCY WAGE SURVEY. DISCRETION AS TO WHERE THESE EMPLOYEES FALL IN THE APPROPRIATE RANGE IS DETERMINED BY THE EMPLOYEE'S EXPERIENCE AND KNOWLEDGE AND IS DETERMINED BY EACH EMPLOYEE'S SENIOR MANAGER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT ITS ADMINISTRATIVE OFFICES LOCATED AT 2011 SCOTLAND AVE, CHAMBERSBURG, PA 17201. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTERESTS IN ANNUITIES 60,957. CHANGE IN VALUE OF PERPETUAL TRUSTS 229,733.