BETHEL HOME INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
BETHEL HOME INC (EIN 39-1209707)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202003219349303075
Schema version
2019v5.1
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)
Return2020-11-16T08:41:31-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

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 Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391209707EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BETHEL HOME INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBETHBusinessNameControlTxt
Phone9202354653PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHERESA M BERTRAMPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone9202325238PhoneNum
Signature2020-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIMBERLY ANDERSONPreparerPersonNm
PTINP00188889PTIN
Phone6086628600PhoneNum
Preparation2020-11-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address69.128.51.26IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-13IPDt
IP Tm09:19:52IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdA1689719603EECE49B4BD9359BAB3CB0B273ED06AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHERESA M BERTRAMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,971,517GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption9386GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MIRAVIDALIVING.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1966FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO PROVIDE NURSING CARE FOR AGING PERSONS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee224TotalEmployeeCnt
Total Volunteers87TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$362,054PYContributionsGrantsAmt
CY Contributions Grants$267,415CYContributionsGrantsAmt
PY Program Service Revenue$8,488,466PYProgramServiceRevenueAmt
CY Program Service Revenue$8,625,713CYProgramServiceRevenueAmt
PY Investment Income$8,654PYInvestmentIncomeAmt
CY Investment Income$4,619CYInvestmentIncomeAmt
PY Other Revenue$95,896PYOtherRevenueAmt
CY Other Revenue$73,770CYOtherRevenueAmt
PY Total Revenue$8,955,070PYTotalRevenueAmt
CY Total Revenue$8,971,517CYTotalRevenueAmt
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$5,893,480PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,921,662CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$215CYTotalFundraisingExpenseAmt
PY Other Expenses$3,590,010PYOtherExpensesAmt
CY Other Expenses$3,576,635CYOtherExpensesAmt
PY Total Expenses$9,483,490PYTotalExpensesAmt
CY Total Expenses$9,498,297CYTotalExpensesAmt
PY Revenues Less Expenses-$528,420PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$526,780CYRevenuesLessExpensesAmt
Total Assets BOY$6,536,984TotalAssetsBOYAmt
Total Assets EOY$6,119,612TotalAssetsEOYAmt
Total Liabilities BOY$2,953,520TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,062,928TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,583,464NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,056,684NetAssetsOrFundBalancesEOYAmt
MissionBETHEL HOME IS PART OF A FAMILY OF HEALTHCARE AND RESIDENTIAL SERVICE ORGANIZATIONS COMMITTED TO PROVIDING QUALITY CARE AND LIFE ENRICHING OPPORTUNITIES TO THE AGING AND THOSE IN NEED IN A CARING, CHRISTIAN ENVIRONMENT.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,867,517ExpenseAmt
Revenue$8,625,713RevenueAmt
DescBETHEL HOME, INC., OPERATES A 124-BED NURSING HOME PROVIDING SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED OF OSHKOSH AND THE SURROUNDING AREA. THE HOME ALSO OPERATES A 12-BED DEMENTIA-SPECIFIC COMMUNITY-BASED RESIDENTIAL FACILITY.Desc
Total Program Service Expenses$8,867,517TotalProgramServiceExpensesAmt
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 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 FootnoteYes (1)IncludeFIN48FootnoteInd
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 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 Mem0BusinessRlnWithFamMemInd
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 Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee224EmployeeCnt
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
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KIM MAKIBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9202325238PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
KAREN JACOBSON
CHAIR0.201.40Yes (X)Yes (X)$0$0$0
MARY MURKEN
VICE CHAIR0.201.40Yes (X)Yes (X)$0$0$0
LOIS JAENKE
SECRETARY0.202.90Yes (X)Yes (X)$0$0$0
MARK BEECHER
BOARD MEMBER0.202.90Yes (X)$0$0$0
KATHY BERMINGHAM
BOARD MEMBER0.201.40Yes (X)$0$0$0
JAMIE BONELL
BOARD MEMBER0.201.40Yes (X)$0$0$0
REV HAN LAVAKE
BOARD MEMBER0.201.40Yes (X)$0$0$0
GLENN NELSON
BOARD MEMBER0.201.40Yes (X)$0$0$0
PEG OLSON
BOARD MEMBER0.201.40Yes (X)$0$0$0
STEW RIECKMAN
BOARD MEMBER0.201.40Yes (X)$0$0$0
THERESA BERTRAM
PRESIDENT & CEO4.5033.50Yes (X)$0$361,348$0
DAVID MERKLEY
ADMINISTRATOR40.000.00$0$124,004$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$485,352TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
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
GREENFIELD REHABILITATION AGENCY
7517 W COLDSPRING RDGREENFIELDWI53220THERAPY SERVICES$514,499
REINHART FOOD SERVICE LLC
2655 EAST RICHMOND STSHAWANOWI54166FOOD SUPPLIER$346,508
WI DEPARTMENT OF HEALTH SERVICES
PO BOX 093594MILWAUKEEWI53293HEALTH SERVICES$261,120
NURSES PRN
1101 E SOUTH RIVER STAPPLETONWI54915STAFFING SERVICES$146,534
ELIM PREFERRED SERVICES
3500 HOLLY LANE STE 30PLYMOUTHWI55447MEDICAL SUPPLIES$100,860
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Related Organizations$267,415RelatedOrganizationsAmt
Total Contributions$267,415TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRESIDENT REVENUEDesc
Business623000BusinessCd
Total Revenue Column$8,625,713TotalRevenueColumnAmt
Related Or Exempt Func Income$8,625,713RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$8,625,713TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,619TotalRevenueColumnAmt
Exclusion$4,619ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$15,002RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$15,002RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,002TotalRevenueColumnAmt
Exclusion$15,002ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEAL REVENUE900099$42,959$42,959
VACCINE REVENUE900099$8,351$8,351
OBRA SCREENING900099$5,160$5,160

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,298TotalRevenueColumnAmt
Exclusion$2,298ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$58,768OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,971,517TotalRevenueColumnAmt
Related Or Exempt Func Income$8,625,713RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$78,389ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,053,830TotalAmt
Program Services$4,744,049ProgramServicesAmt
Management And General$309,781ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$124,565TotalAmt
Program Services$116,930ProgramServicesAmt
Management And General$7,635ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$393,291TotalAmt
Program Services$369,184ProgramServicesAmt
Management And General$24,107ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$349,976TotalAmt
Program Services$328,524ProgramServicesAmt
Management And General$21,452ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$585,576TotalAmt
Program Services$585,576ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,183TotalAmt
Management And General$2,183ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$75,292TotalAmt
Program Services$2,500ProgramServicesAmt
Management And General$72,792ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$624,270TotalAmt
Program Services$614,229ProgramServicesAmt
Management And General$10,041ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$20,045TotalAmt
Management And General$20,045ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$800,705TotalAmt
Program Services$733,806ProgramServicesAmt
Management And General$66,684ManagementAndGeneralAmt
Fundraising$215FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$75,621TotalAmt
Management And General$75,621ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$401,926TotalAmt
Program Services$398,011ProgramServicesAmt
Management And General$3,915ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,380TotalAmt
Program Services$2,160ProgramServicesAmt
Management And General$6,220ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$443,224TotalAmt
Program Services$443,224ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$155,878TotalAmt
Program Services$155,878ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BED ASSESSMENT$261,120$261,120
MISCELLANEOUS$57,162$57,162
EQUIPMENT AND REPAIRS$31,059$31,059
EMPLOYEE EDUCATION$10,430$10,340$90

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$23,764TotalAmt
Program Services$13,765ProgramServicesAmt
Management And General$9,999ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,498,297TotalAmt
Program Services$8,867,517ProgramServicesAmt
Management And General$630,565ManagementAndGeneralAmt
Fundraising$215FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,012BOYAmt
EOY$2,012EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,252,589BOYAmt
EOY$682,062EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$655,644BOYAmt
EOY$724,331EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$25,242BOYAmt
EOY$25,430EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$31,706BOYAmt
EOY$35,413EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$16,806,589LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,957,445LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,974,510BOYAmt
EOY$2,849,144EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$348,553EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,595,281BOYAmt
EOY$1,452,667EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,536,984BOYAmt
EOY$6,119,612EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,209,608BOYAmt
EOY$925,867EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$72,935BOYAmt
EOY$65,463EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,670,977BOYAmt
EOY$2,071,598EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,953,520BOYAmt
EOY$3,062,928EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,583,464BOYAmt
EOY$3,056,684EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,583,464BOYAmt
EOY$3,056,684EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,536,984BOYAmt
EOY$6,119,612EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$526,780ReconcilationRevenueExpnssAmt
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$137,638CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$77,692CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$808,777CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$362,054CurrentTaxYearMinus1YearAmt
Current Tax Year$267,415CurrentTaxYearAmt
Total$1,653,576TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,576,232CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,345,251CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,181,346CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,488,466CurrentTaxYearMinus1YearAmt
Current Tax Year$8,625,713CurrentTaxYearAmt
Total$46,217,008TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,713,870CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,422,943CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,990,123CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,850,520CurrentTaxYearMinus1YearAmt
Current Tax Year$8,893,128CurrentTaxYearAmt
Total$47,870,584TotalAmt

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$47,870,584PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,152CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$20,707CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,453CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,154CurrentTaxYearMinus1YearAmt
Current Tax Year$19,621CurrentTaxYearAmt
Total$109,087TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,152CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$20,707CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,453CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,154CurrentTaxYearMinus1YearAmt
Current Tax Year$19,621CurrentTaxYearAmt
Total$109,087TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$76,615CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$93,445CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$66,144CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,396CurrentTaxYearMinus1YearAmt
Current Tax Year$58,768CurrentTaxYearAmt
Total$374,368TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,810,637CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,537,095CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,079,720CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,955,070CurrentTaxYearMinus1YearAmt
Current Tax Year$8,971,517CurrentTaxYearAmt
Total$48,354,039TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99000PublicSupportCY509Pct
Public Support PY5090.98940PublicSupportPY509Pct
Investment Income CY0.00230InvestmentIncomeCYPct
Investment Income PY0.00210InvestmentIncomePYPct
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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,261OtherCostOrOtherBasisAmt
Book Value$26,261BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,561,729OtherCostOrOtherBasisAmt
Depreciation$7,489,172DepreciationAmt
Book Value$1,072,557BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$556,309OtherCostOrOtherBasisAmt
Depreciation$456,038DepreciationAmt
Book Value$100,271BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,471,666OtherCostOrOtherBasisAmt
Depreciation$6,012,235DepreciationAmt
Book Value$1,459,431BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$190,624OtherCostOrOtherBasisAmt
Book Value$190,624BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,849,144TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$1,346,249
RESIDENTS' CUSTODIAL ACCOUNTS$106,418
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,452,667TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ASSET RETIREMENT OBLIGATIONS$123,669
DUE/TO FROM AFFILIATES$1,947,929
FieldValueIRS element (for citing)
Total Liability$2,071,598TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:RESIDENTS' CUSTODIAL ACCOUNTS CONSIST OF AMOUNTS ON DEPOSIT WITH BETHEL HOME BY RESIDENTS FOR SAFEKEEPING. THESE FUNDS CAN BE WITHDRAWN AT ANY TIME BY RESIDENTS.
PART X, LINE 2:THE ORGANIZATION FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THE INCOME TAX STANDARD HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATOIN FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonTHERESA BERTRAMPersonNm
TitlePRESIDENT & CEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$321,348CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$40,000BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$361,348TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE COMPENSATION OF THE PRESIDENT & CEO IS DETERMINED BY THE ORGANIZATION'S SOLE MEMBER, MIRAVIDA LIVING, INC. THE FOLLOWING METHODS WERE USED BY MIRAVIDA LIVING, INC. TO ESTABLISH THE PRESIDENT & CEO'S COMPENSATION: 1. COMPENSATION SURVEY OR STUDY 2. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEEExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS PLUS TWO OTHER MEMBERS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE AGENDA FOR THE BOARD AND VOTING MEMBERSHIP MEETINGS. THIS COMMITTEE SHALL KEEP ITSELF INFORMED OF THE ENTIRE OPERATION OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS, AND SHALL EXECUTE SUCH ACTIONS AS MAY BE ASSIGNED TO IT BY THE BOARD. THE COMMITTEE SHALL ALSO CONCERN ITSELF WITH MATTERS NOT ASSIGNED TO OTHER COMMITTEES.
FORM 990, PART VI, SECTION A, LINE 6MIRAVIDA LIVING, INC., IS THE SOLE MEMBER OF BETHEL HOME, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE DIRECTORS OF BETHEL HOME, INC. ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC.
FORM 990, PART VI, SECTION A, LINE 7BMAJOR STANDARD OPERATING PROCEDURES, MAJOR POLICIES, AND PROGRAMS OF BETHEL HOME, INC. ARE SUBMITTED TO THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC., FOR APPROVAL AND IMPLEMENTATION. AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS REQUIRE THE APPROVAL OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC.
FORM 990, PART VI, SECTION B, LINE 11BBEFORE IT WAS FILED, THE FORM 990 WAS REVIEWED BY THE CEO, THEN DISTRIBUTED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST FORM TO EACH MEMBER OF THE BOARD OF DIRECTORS AND VARIOUS COMMITTEE MEMBERS NOT ON THE BOARD THAT REQUIRES EACH TO IDENTIFY POTENTIAL CONFLICTS OR OTHER RELATED PARTY INTERESTS. THE REPORTS ARE REVIEWED BY THE SECRETARY AND CEO AND ANY CONFLICTS ARE BROUGHT TO THE BOARD'S ATTENTION. A MEMBER OF THE BOARD WHO HAS A CONFLICT OF INTEREST MAY NOT VOTE ON ANY SUCH ISSUE BEFORE THE BOARD. ANY QUESTION OF WHETHER THERE IS A CONFLICT IS RESOLVED BY THE BOARD OF DIRECTORS. IF THE BOARD OF DIRECTORS DETERMINES THAT A DIRECTOR HAS COMMITTED A SUBSTANTIAL VIOLATION OF THE CONFLICT OF INTEREST POLICY, THE INDIVIDUAL IS REMOVED FROM THE OFFICE OF DIRECTOR. IN ADDITION, ALL MANAGEMENT AND SUPERVISORY EMPLOYEES ARE INFORMED OF THE ORGANIZATION'S POLICY REGARDING RELATED PARTY TRANSACTIONS AND CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15CEO COMPENSATION IS DETERMINED BY A COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE CONSIDERS COMPARABLE DATA AND ECONOMIC CONDITIONS. THE DELIBERATIONS ARE RECORDED. COMPENSATION AND BENEFITS FOR OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED ANNUALLY BY THE CEO. COMPARABLE INDUSTRY STANDARDS ARE CONSIDERED INCLUDING COMPENSATION AND BENEFIT INFORMATION PROVIDED BY LEADINGAGE WISCONSIN. DELIBERATIONS INCLUDE A REVIEW OF OBJECTIVES AND ACTUAL DELIVERABLES. PROCESS IS DOCUMENTED/MAINTAINED ELECTRONICALLY. THESE PROCESSES LAST OCCURRED IN 2019.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND IS ALSO AVAILABLE AT WWW.CANDID.ORG. THE ORGANIZATION'S FORM 1023 IS ALSO AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MIRAVIDA LIVING INC
225 NORTH EAGLE STREETOSHKOSHWI59402391032234MANAGEMENT SERVICESWI501(C)(3)LINE 10N/A0
CARMEL RESIDENCE INC
220 NORTH WESTFIELD STREETOSHKOSHWI59402391448325SENIOR HOUSINGWI501(C)(3)LINE 100MIRAVIDA LIVING INC
GABRIEL'S VILLA INC
215 NORTH WESTFIELD STREETOSHKOSHWI59402391857036SENIOR HOUSINGWI501(C)(3)LINE 100MIRAVIDA LIVING INC
SIMEANNA APARTMENTS INC
155 NORTH EAGLE STREETOSHKOSHWI59402237148097SENIOR HOUSINGWI501(C)(3)LINE 100MIRAVIDA LIVING INC
SIMEANNA SOUTH INC
225 NORTH EAGLE STREETOSHKOSHWI59402391238670SENIOR HOUSINGWI501(C)(3)LINE 100MIRAVIDA LIVING INC
SIMEANNA III INC
225 NORTH EAGLE STREETOSHKOSHWI59402391270056SENIOR HOUSINGWI501(C)(3)LINE 100MIRAVIDA LIVING INC
MIRAVIDA LIVING FOUNDATION INC
225 NORTH EAGLE STREETOSHKOSHWI59402010938793FUNDRAISINGWI501(C)(3)LINE 12A, I0MIRAVIDA LIVING INC
EDEN REHABILITATION SUITES AND GREENHOUSE HOMES INC
3151 EDEN COURTOSHKOSHWI54904900506872SKILLED NURSING FACILITYWI501(C)(3)LINE 100MIRAVIDA LIVING INC
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
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 Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.