SHEBOYGAN SENIOR COMMUNITY INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- SHEBOYGAN SENIOR COMMUNITY INC (EIN 39-6069188)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-02-21
- IRS object ID
- 202020529349300337
- Schema version
- 2018v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-02-21T14:34:20-06:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8215 GREENWAY BOULEVARD SUITE 600 | AddressLine1Txt |
| City | MIDDLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53562 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 396069188 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHEBOYGAN SENIOR COMMUNITY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SHEB | BusinessNameControlTxt |
| Phone | 9204582137 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3505 COUNTY ROAD Y | AddressLine1Txt |
| City | SHEBOYGAN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53083 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TARA HOLZEM | PersonNm |
| Person Title | OFFICER | PersonTitleTxt |
| Phone | 9204582137 | PhoneNum |
| Signature | 2020-02-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIMBERLY ANDERSON | PreparerPersonNm |
| PTIN | P00188889 | PTIN |
| Phone | 6086628600 | PhoneNum |
| Preparation | 2020-02-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-02-14 | IPDt |
| IP Tm | 10:35:02 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F630F1EEE6B1AF3350F47F5F27B062EA6FC5A2EF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TARA HOLZEM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3505 COUNTY ROAD Y | AddressLine1Txt |
| City | SHEBOYGAN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53083 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,707,924 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SHEBOYGANSENIORCOMMUNITY.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1962 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS, WHICH SHALL ENHANCE, HONOR AND PRESERVE THE DIGNITY OF THE INDIVIDUAL, AND WHERE SPIRITUAL, PHYSICAL AND SOCIAL NEEDS ARE SUPPLIED IN A SPIRIT OF CHRISTIAN LOVE AND CONCERN WITHOUT REGARD TO AGE, SEX, RACE, CREED OR COLOR. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 206 | TotalEmployeeCnt |
| Total Volunteers | 66 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $21,605 | PYContributionsGrantsAmt |
| CY Contributions Grants | $16,329 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,235,002 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,690,907 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,209 | PYInvestmentIncomeAmt |
| CY Investment Income | $688 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,257,816 | PYTotalRevenueAmt |
| CY Total Revenue | $7,707,924 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,680,469 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,940,863 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,991,705 | PYOtherExpensesAmt |
| CY Other Expenses | $2,986,527 | CYOtherExpensesAmt |
| PY Total Expenses | $7,672,174 | PYTotalExpensesAmt |
| CY Total Expenses | $7,927,390 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$414,358 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$219,466 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,724,664 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,249,842 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,546,551 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,291,195 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,178,113 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $958,647 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS, WHICH SHALL ENHANCE, HONOR AND PRESERVE THE DIGNITY OF THE INDIVIDUAL, AND WHERE SPIRITUAL, PHYSICAL AND SOCIAL NEEDS ARE SUPPLIED IN A SPIRIT OF CHRISTIAN LOVE AND CONCERN WITHOUT REGARD TO AGE, SEX, RACE, CREED OR COLOR. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,756,972 | ExpenseAmt |
| Revenue | $7,690,907 | RevenueAmt |
| Desc | OPERATION OF A FULL-TIME SKILLED NURSING HOME AND RESIDENTIAL CARE CENTER. TOTAL PATIENT DAYS: 29,394. | Desc |
| Total Program Service Expenses | $6,756,972 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 206 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TARA HOLZEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9204582137 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3505 CTY RD Y | AddressLine1Txt |
| City | SHEBOYGAN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53083 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| DAVID VANDEWATER | |||||||
| PRESIDENT | 0.50 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PERRY FRITZ | |||||||
| VICE PRESIDENT | 0.50 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MEG TRAGER | |||||||
| SECRETARY | 0.50 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LYNN COADY | |||||||
| TREASURER | 0.50 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CINDY THOMPSON | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| BRIAN GENSCH | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| KEITH ISKEN | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| JAMES PRICE | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| DONNA WENDLANDT | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| PETER MUEHLEIS | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| LAURA RECTOR | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| ERIC STUART | |||||||
| DIRECTOR | 0.50 | 0.25 | Yes (X) | $0 | $0 | $0 | |
| TARA HOLZEM | |||||||
| BUSINESS OFFICE MANAGER | 39.75 | 0.25 | Yes (X) | $70,596 | $0 | $1,473 | |
| PAUL TREFFERT | |||||||
| EXECUTIVE DIRECTOR | 39.75 | 0.25 | Yes (X) | $114,417 | $0 | $11,412 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $185,013 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $12,885 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AEGIS THERAPIES | |||||
| PO BOX 8103 | FORT SMITH | AR | 72902 | THERAPY | $439,094 |
| SYSCO EASTERN WISCONSIN | |||||
| ONE SYSCO DRIVE | JACKSON | WI | 53037 | FOOD | $246,253 |
| OMNICARE INC | |||||
| PO BOX 78000 DEPT 781668 | DETROIT | MI | 48278 | PHARMACY | $139,296 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $9,558 | RelatedOrganizationsAmt |
| All Other Contributions | $6,771 | AllOtherContributionsAmt |
| Total Contributions | $16,329 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| SKILLED NURSING FACILI | 900099 | $5,792,945 | $5,792,945 |
| RESIDENTIAL CENTER | 623000 | $1,518,294 | $1,518,294 |
| INDEPENDENT LIVING | 623990 | $226,838 | $226,838 |
| OTHER SERVICES | 900099 | $130,607 | $130,607 |
| BEAUTY SHOP | 812900 | $22,223 | $22,223 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,690,907 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $688 | TotalRevenueColumnAmt |
| Exclusion | $688 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,707,924 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,690,907 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $688 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,898 | TotalAmt |
| Management And General | $197,898 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,846,837 | TotalAmt |
| Program Services | $3,478,528 | ProgramServicesAmt |
| Management And General | $368,309 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,497 | TotalAmt |
| Program Services | $44,997 | ProgramServicesAmt |
| Management And General | $6,500 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,069 | TotalAmt |
| Program Services | $429,872 | ProgramServicesAmt |
| Management And General | $68,197 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $346,562 | TotalAmt |
| Program Services | $302,812 | ProgramServicesAmt |
| Management And General | $43,750 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,188 | TotalAmt |
| Management And General | $2,188 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,658 | TotalAmt |
| Management And General | $21,658 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $688,431 | TotalAmt |
| Program Services | $585,749 | ProgramServicesAmt |
| Management And General | $102,682 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,266 | TotalAmt |
| Management And General | $35,266 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,801 | TotalAmt |
| Management And General | $46,801 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,418 | TotalAmt |
| Program Services | $173,418 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $476,020 | TotalAmt |
| Program Services | $476,020 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $599,212 | TotalAmt |
| Program Services | $498,293 | ProgramServicesAmt |
| Management And General | $100,919 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,315 | TotalAmt |
| Program Services | $71,315 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $695,968 | $695,968 | |
| DUES AND SUBSCRIPTIONS | $95,472 | $95,472 | |
| BAD DEBT EXPENSE | $36,304 | $36,304 | |
| EMPLOYMENT COSTS | $32,781 | $32,781 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,693 | TotalAmt |
| Management And General | $11,693 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,927,390 | TotalAmt |
| Program Services | $6,756,972 | ProgramServicesAmt |
| Management And General | $1,170,418 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $364,019 | BOYAmt |
| EOY | $416,591 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,998 | BOYAmt |
| EOY | $185,071 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $536,516 | BOYAmt |
| EOY | $457,752 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,051 | BOYAmt |
| EOY | $35,474 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,888 | BOYAmt |
| EOY | $95,431 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,386,794 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,327,271 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,480,192 | BOYAmt |
| EOY | $15,059,523 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,724,664 | BOYAmt |
| EOY | $16,249,842 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,305 | BOYAmt |
| EOY | $430,510 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,769,958 | BOYAmt |
| EOY | $13,496,397 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,364,288 | BOYAmt |
| EOY | $1,364,288 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,546,551 | BOYAmt |
| EOY | $15,291,195 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,094,363 | BOYAmt |
| EOY | $871,742 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,750 | BOYAmt |
| EOY | $86,905 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,178,113 | BOYAmt |
| EOY | $958,647 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,724,664 | BOYAmt |
| EOY | $16,249,842 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$219,466 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $477,831 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $497,260 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $39,679 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,605 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,329 | CurrentTaxYearAmt |
| Total | $1,052,704 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,556,950 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,773,201 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,325,061 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,235,002 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,690,907 | CurrentTaxYearAmt |
| Total | $33,581,121 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,034,781 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,270,461 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,364,740 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,256,607 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,707,236 | CurrentTaxYearAmt |
| Total | $34,633,825 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $15,000 | CurrentTaxYearMinus2YearsAmt |
| Total | $15,000 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $257,760 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $425,314 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $773,588 | CurrentTaxYearAmt |
| Total | $1,456,662 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $272,760 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $425,314 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $773,588 | CurrentTaxYearAmt |
| Total | $1,471,662 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $33,162,163 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,034 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $658 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $339 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,209 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $688 | CurrentTaxYearAmt |
| Total | $6,928 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,034 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $658 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $339 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,209 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $688 | CurrentTaxYearAmt |
| Total | $6,928 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $44,372 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $107,039 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $79,038 | CurrentTaxYearMinus2YearsAmt |
| Total | $230,449 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,083,187 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,378,158 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,444,117 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,257,816 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,707,924 | CurrentTaxYearAmt |
| Total | $34,871,202 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.95100 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97750 | PublicSupportPY509Pct |
| Investment Income CY | 0.00020 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME - CHANGE IN PRESENT VALUE OF DEVELOPMENT INCENTIVE RECEIVABLE - 2014 AMOUNT: $ 44,372. 2015 AMOUNT: $ 107,039. 2016 AMOUNT: $ 79,038. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $572,217 | OtherCostOrOtherBasisAmt |
| Book Value | $572,217 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,182,215 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,610,759 | DepreciationAmt |
| Book Value | $13,571,456 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,046,081 | OtherCostOrOtherBasisAmt |
| Depreciation | $523,086 | DepreciationAmt |
| Book Value | $522,995 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $586,281 | OtherCostOrOtherBasisAmt |
| Depreciation | $193,426 | DepreciationAmt |
| Book Value | $392,855 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,059,523 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATE | Desc |
| Amt | $1,364,288 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,364,288 | TotalLiabilityAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A PDF COPY OF FORM 990 IS EMAILED TO THE BUSINESS MANAGER. THE BUSINESS MANAGER FORWARDS THE EMAIL TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. THE 990 IS REVIEWED BY THE BUSINESS MANAGER PRIOR TO FILING. THE BUSINESS MANAGER CHECKS FORM 990 WITH INTERNAL REPORTS. |
| FORM 990, PART VI, SECTION B, LINE 12C | A NEW CONFLICT OF INTEREST POLICY IS FILLED OUT ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15A | SHEBOYGAN SENIOR COMMUNITY, INC. USES DATA GATHERED FOR THEIR STATE ASSOCIATION (WISCONSIN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) BY MANAGEMENT RESOURCE ASSOCIATES (MRA), A THIRD PARTY INDEPENDENT, NOT FOR PROFIT, MANAGEMENT CONSULTING GROUP. THE DATA IS GATHERED FROM PARTICIPATING NOT FOR PROFIT HOMES THROUGHOUT THE STATE OF WISCONSIN. CLIFTONLARSONALLEN ALSO COMPLETED A COMPENSATION BENCHMARK REPORT FOR A CEO POSITION. SALARY RECOMMENDATIONS FOR THE EXECUTIVE DIRECTOR ARE REVIEWED AND SET BY THE EXECUTIVE COMMITTEE IN AN EXECUTIVE SESSION WITHOUT THE EXECUTIVE DIRECTOR'S PRESENCE AFTER THE FULL ANNUAL PERFORMANCE EVALUATION, UTILIZING THE DATA DESCRIBED ABOVE. NO OTHER MANAGEMENT STAFF ARE REVIEWED IN THIS MANNER, THOUGH ALL SALARY AND EXPENSE DATA IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD IN THEIR ANNUAL BUDGET PREPARATION AND APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHEBOYGAN SENIOR COMMUNITY FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3505 CTY RD Y | AddressLine1Txt |
| City | SHEBOYGAN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53083 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391450846 | EIN |
| Primary Activities | RAISE/RECEIVE FUNDS TO BE USED FOR GENERAL SUPPORT OF THIS ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12B, II | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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