2019-11-14T13:57:23-06:00 2018-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2018-01-01 236276101 MENNO-HAVEN INC MENN 7172621000 2011 SCOTLAND AVENUE CHAMBERSBURG PA 17201 DAVID GENTRY CFO 7172621000 2019-11-14 1 KERRI N BOGDA CPA P00760402 7177404863 50.211.1.210 2019-11-14 11:01:46 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F58787FA80410BAE38B710EAF9FCC5760AD3BCDF 2018 2020-04-17 16:48:07Z HUGH DAVIS 2011 SCOTLAND AVENUE CHAMBERSBURG PA 17201 60010913 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 12 855 269 391488 0 1595802 2734691 45862179 47106803 3224675 2581883 1136912 1203380 51819568 53626757 0 0 0 0 25053020 26416275 0 0 453408 23482735 23176641 48535755 49592916 3283813 4033841 131120162 188806535 92780221 149593945 38339941 39212590 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 22408391 0 24944192 MENNO HAVEN INC. OPERATES TWO CONTINUING CARE RETIREMENT COMMUNITIES IN CHAMBERSBURG, PA. EACH CAMPUS OPERATES A LICENSED SKILLED NURSING FACILITY. THE BROOKVIEW HEALTH CARE CENTER PROVIDES ROOM AND BOARD, NURSING CARE, MEDICAL AND REHABILITATION SERVICES, SOCIAL SERVICES, AND ACTIVITY PROGRAMS FOR 152 DUALLY LICENSED BEDS (52 IN PRIVATE ROOMS AND 100 SEMI-PRIVATE ROOMS). THE CHAMBERS POINTE HEALTH CARE CENTER PROVIDES ROOM AND BOARD, NURSING CARE, MEDICAL AND REHABILITATION SERVICES, SOCIAL SERVICES, AND ACTIVITY PROGRAMS FOR 60 DUALLY LICENSED BEDS (12 IN PRIVATE ROOMS AND 48 IN SEMI-PRIVATE ROOMS). 9053166 0 10077650 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 THAT PROVIDE ROOM AND BOARD, LIMITED NURSING CARE, MEDICAL AND REHABILITATION SERVICES, AS WELL AS SOCIAL, WELLNESS, AND ACTIVITY PROGRAMS. THE CHAMBERS POINTE CAMPUS OPERATES THE MANOR PERSONAL CARE WHICH IS LICENSED FOR 94 UNITS THAT PROVIDE ROOM AND BOARD, LIMITED NURSING CARE, MEDICAL AND REHABILITATION SERVICES, AS WELL AS SOCIAL, WELLNESS, AND ACTIVITY PROGRAMS. 9632855 0 10722938 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 IL VILLA HOMES, 120 IL COTTAGES, AND 74 IL APARTMENTS. THE CHAMBERS POINTE CAMPUS HAS 112 IL COTTAGES, AND 47 IL APARTMENTS. 1223561 0 1362023 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. 1223561 0 1362023 42317973 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 98 0 855 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 CONTROLLER 7172612343 2011 SCOTLAND AVENUE CHAMBERSBURG PA 17201 WAYNE YEAGER CHAIR 2.00 X X 0 0 0 DALE CLUGSTON VICE-CHAIR 1.10 X X 0 0 0 LIN ACE HOSKINSON SECRETARY 1.40 X X 0 0 0 CAROLYN GEORGE ASST. SECREATARY/TREASURER 0.80 X X 0 0 0 RONALD G GIPE TREASURER 1.50 X X 0 0 0 DARRELL BAER BOARD MEMBER 0.80 X 0 0 0 DALE HORST BOARD MEMBER 0.70 X 0 0 0 ARNOLD BARBOUR BOARD MEMBER 1.20 X 0 0 0 MARTHA WALKER BOARD MEMBER 1.20 X 0 0 0 PAMELA GAUDIOSE BOARD MEMBER 0.90 X 0 0 0 THOMAS GILBERT BOARD MEMBER 1.00 X 0 0 0 MATTHEW NOLT BOARD MEMBER 0.80 X 0 0 0 HUGH DAVIS CEO 40.00 X 333538 0 43020 TIMOTHY JOHNSON CCO 40.00 X 190474 0 22646 CHARLES NELSON EXECUTIVE DIRECTOR 40.00 X 158347 0 7689 JONATHAN BAKER CAO 40.00 X 160512 0 8760 DAVID GENTRY CFO 40.00 X 176309 0 12415 ROGER BEINS COO 40.00 X 138168 0 13825 TRACEY ECHELBERGER EXEC. DIR., INDEPENDENT LIVING 40.00 X 108255 0 5082 LARRY LUGARO DIRECTOR FACILITY DEVELOPMENT 40.00 X 146187 0 7539 ROSALYN BURKE NHA 40.00 X 112483 0 10720 1524273 0 131696 9 0 1 0 WARFEL CONSTRUCTION COMPANY 1110 ENTERPRISE RD EAST PETERSBURG PA 17520 CONSTRUCTION 14706592 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 60694 THERAPY 2669850 ECI SERVICES 124 WEST CHURCH ST DILLSBURG PA 17019 CONSTRUCTION 1328841 RDG PLANNING & DESIGN 900 FARMNAM ON THE MALL 100 OMAHA NE 68102 ARCHITECTURAL/ENG. 1149937 WAYNESBORO CONSTRUCTION CO PO BOX 229 WAYNESBORO PA 17268 CONSTRUCTION 566500 26 2734691 252185 2734691 NURSING & PERSONAL CARE 623000 47106803 47106803 47106803 1067586 1067586 134533 91116 43417 43417 43417 7801892 5445 6085234 207806 1716658 -202361 1514297 1514297 MEALS 900099 806244 362078 444166 HAIR CARE 900099 221030 221030 INSURANCE CLAIMS 900099 73838 73838 58851 29410 29441 1159963 53626757 47106803 391488 3393775 1265704 1265704 19981565 17600037 2149525 232003 374250 297231 71760 5259 3255093 2760987 473940 20166 1539663 1275049 254672 9942 17314 17314 80763 80763 1371 1371 1060045 739497 307542 13006 484572 353 484219 3050956 2778213 240503 32240 726549 83300 643249 3668055 3668055 152527 133734 18793 158685 107207 51478 2239771 2239771 5125501 5125501 366150 155698 210452 MEDICAL EXPENSES 4421012 4421012 MEDICAID NF ASSESSMENT 459273 459273 HAIR CARE 190465 190465 DIETARY 161175 72632 88543 812457 209958 461707 140792 49592916 42317973 6821535 453408 2152 2150 3899522 7418575 348597 725364 4591370 3151633 251196 252322 1068873 998036 171438996 73094410 75459225 98344586 43297127 75927514 2202100 1986355 131120162 188806535 4139048 7544131 28705759 29483045 39619488 100485791 117502 1341419 211500 201500 19986924 10538059 92780221 149593945 X 28920369 30170650 7347488 7178717 2072084 1863223 38339941 39212590 131120162 188806535 X 4033841 -4302486 1141294 X 0 1 X 1 0 X 669662 660847 754959 1595802 2734691 6415961 42336245 44125400 44017804 45862179 47106803 223448431 43005907 44786247 44772763 47457981 49841494 229864392 5485 4320 52000 28500 24862 115167 0 5485 4320 52000 28500 24862 115167 229749225 1170613 984956 1022093 992247 1202119 5372028 1170613 984956 1022093 992247 1202119 5372028 687756 768475 1456231 44176520 45771203 45794856 49137984 51812088 236692651 0.97070 0.97060 0.02270 0.02600 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: HAIR CARE - 2017 AMOUNT: $ 227,581. 2018 AMOUNT: $ 221,030. MEALS - 2017 AMOUNT: $ 406,252. 2018 AMOUNT: $ 444,166. MISCELLANEOUS - 2017 AMOUNT: $ 33,923. 2018 AMOUNT: $ 29,441. ENTRANCE FEES - 2017 AMOUNT: $ 15,000. INSTALLMENT REVENUE - 2017 AMOUNT: $ 5,000. INSURANCE CLAIMS - 2018 AMOUNT: $ 73,838. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1371 1371 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 6906365 155965 -320875 1279273 5462182 6760278 127061 767664 748638 6906365 7202117 175282 297863 914984 6760278 8183932 164311 -83643 1061483 7203117 8379452 406731 429002 1031253 8183932 0.00000 0.34110 0.65890 1 0 3572774 3572774 101638772 51359775 50278997 36541125 21734635 14806490 29686325 29686325 98344586 GIFT ANNUITIES 186569 RESIDENT AND EMPLOYEE FUNDS 536689 REFUNDABLE ENTRANCE FEES 9814801 10538059 51302992 -4302486 1685244 -2617242 53920234 -293477 -293477 53626757 50430343 837427 837427 49592916 0 49592916 PART IV, LINE 1B: 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 INTEREST -6,884. CHANGE IN VALUE OF PERPETUAL TRUSTS -208,861. CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 1,900,989. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF FIXED ASSETS -202,361. RENTAL EXPENSES -91,116. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF FIXED ASSETS 202,361. RENTAL EXPENSES 91,116. LOSS ON BOND REFINANCING 543,950. X X X 0 0 0 0 0 0 0 0 0 HUGH DAVIS CEO 270798 0 50000 0 12740 0 28687 0 14333 0 376558 0 0 0 TIMOTHY JOHNSON CCO 184234 0 5500 0 740 0 9248 0 13398 0 213120 0 0 0 CHARLES NELSON EXECUTIVE DIRECTOR 154107 0 3500 0 740 0 7502 0 187 0 166036 0 0 0 JONATHAN BAKER CAO 154772 0 5000 0 740 0 7650 0 1110 0 169272 0 0 0 DAVID GENTRY CFO 172114 0 3500 0 695 0 0 0 12415 0 188724 0 0 0 ROGER BEINS COO 133928 0 3500 0 740 0 6286 0 7539 0 151993 0 0 0 LARRY LUGARO DIRECTOR FACILITY DEVELOPMENT 139989 0 5250 0 948 0 0 0 7539 0 153726 0 0 0 A FRANKLIN COUNTY INDUSTRIAL DEVELOPMENT 232261213 353273B27 2018-09-01 102460808 REFUND PRIOR YEAR BONDS, CONSTRUCTION, FURNISHING & EQUIPMENT 0 0 0 A 110000 102460808 6156250 1644160 10944725 84715673 2020 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 X 1 8500 APPRAISAL X 2 19993 APPRAISAL X 7 218692 NYSE X PIANO 1 5000 APPRAISAL 0 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 PERSONNAL 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 INTEREST -6,884. CHANGE IN VALUE OF PERPETUAL TRUSTS -208,861. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 1,900,989. LOSS ON BOND REFINANCING -543,950.