2025-11-04T09:26:57-06:00 2025-06-30 393647910 WIPFLI ADVISORY LLC 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2024-07-01 390816900 PINE HAVEN CHRISTIAN HOME INC PINE 9204672401 531 GIDDINGS AVENUE SHEBOYGAN FALLS WI 53085 LINDA EVRAETS CHIEF FINANCIAL OFFICER 9204672401 2025-10-31 1 1 SOLOMON MARDAKHAEV P01806552 6105653930 2025-10-21 2024 2025-03-06 01:10:19Z PINE HAVEN CHRISTIAN COMMUNITIES RONALD WALVOORT 531 GIDDINGS AVENUE SHEBOYGAN FALLS WI 53085 19643488 0 X WWW.PINEHAVEN.ORG X 1950 WI PINE HAVEN CHRISTIAN HOME, INC. (PINE HAVEN CHRISTIAN COMMUNITIES) WILL PROVIDE THE AGING POPULATION WE SERVE AN ENVIRONMENT THAT IS A CHRIST-CENTERED, SAFE HAVEN OFFERING QUALITY, COMPASSIONATE CARE. 14 14 420 125 0 0 101682 165163 17227527 18635497 154055 456931 110342 22032 17593606 19279623 0 0 0 0 11032166 11443920 0 0 15965 7770546 7509270 18802712 18953190 -1209106 326433 38166756 38139041 24467714 23557372 13699042 14581669 PINE HAVEN CHRISTIAN COMMUNITIES WILL PROVIDE THE AGING POPULATION WE SERVE AN ENVIRONMENT THAT IS A CHRIST-CENTERED, SAFE HAVEN OFFERING QUALITY, COMPASSIONATE CARE. 0 0 16576824 0 18635497 PINE HAVEN CHRISTIAN HOME, INC. PROVIDES HOUSING, HEALTH CARE AND OTHER RELATED SERVICES TO RESIDENTS IN ASSISTED LIVING FACILITIES AND SENIOR HOUSING FACILITIES. PINE HAVEN CHRISTIAN HOME, INC. OPERATES AN ASSISTED LIVING COMMUNITY BASED RESIDENTIAL FACILITY (CBRF) INCLUDING MEMORY CARE AND AN ASSISTED LIVING RESIDENTIAL CARE APARTMENT COMPLEX (RCAC) AT ITS HAVEN DRIVE LOCATION; A CBRF INCLUDING MEMORY CARE AT ITS GIDDINGS AVENUE LOCATION; AND A CBRF AND SENIOR HOUSING UNITS AT ITS OOSTBURG LOCATION. 16576824 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 34 0 420 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X LINDA EVRAETS 9204672401 531 GIDDINGS AVENUE SHEBOYGAN FALLS WI 53085 DARRELL HAUSE PRESIDENT (THRU SEP 2024) 1.00 X X 0 0 0 KEVIN VELDHORST PRESIDENT 1.00 X X 0 0 0 DENNIS BEACH VICE PRESIDENT (THRU SEP 2024) 1.00 X X 0 0 0 ROBERT CALJOUW VICE PRESIDENT 1.00 X X 0 0 0 FLOYD LEO TREASURER 1.00 X X 0 0 0 SANDY BAATZ SECRETARY 1.00 X X 0 0 0 JOHN ACKERMANN DIRECTOR 1.00 X 0 0 0 JANE BUTEYN DIRECTOR 1.00 X 0 0 0 JERI GESCH DIRECTOR 1.00 X 0 0 0 JON GROSSHUESCH DIRECTOR 1.00 X 0 0 0 MARY HUENINK DIRECTOR (THRU SEP 2024) 1.00 X 0 0 0 MARK KAPPERS DIRECTOR 1.00 X 0 0 0 CINDY LENZ DIRECTOR 1.00 X 0 0 0 RON LORIER DIRECTOR (THRU NOV 2024) 1.00 X 0 0 0 ROSEMARY MENTINK DIRECTOR 1.00 X 0 0 0 PAUL PLANTON DIRECTOR 1.00 X 0 0 0 JEWEL RAUWERDINK DIRECTOR (THRU SEP 2024) 1.00 X 0 0 0 VICKI SOERENS DIRECTOR 1.00 X 0 0 0 KENNETH VELIER DIRECTOR 1.00 X 0 0 0 RONALD WALVOORT CHIEF EXECUTIVE OFFICER 40.00 X 190687 0 21966 LINDA EVRAETS CHIEF FINANCIAL OFFICER 40.00 X 133439 0 12691 NATALIE NONNEMACHER DIRECTOR OF RESIDENT SERVICES 40.00 X 116835 0 30829 KARI MORALES LPN 40.00 X 117670 0 11063 JOYCE MUELBERGER LPN 40.00 X 112920 0 10405 671551 0 86954 5 0 1 0 STAT NURSING SOLUTIONS LLC 1117 SOUTH 16TH STREET SHEBOYGAN WI 53081 STAFFING SERVICES 1073341 ELITE NURSES PO BOX 100173 FORTH WORTH TX 76185 STAFFING SERVICES 310430 DEDICATED NURSING ASSOCIATES INC 6536 WILLIAM PENN HWY RT 22 DELMONT PA 15626 STAFFING SERVICES 233056 SHIFTKEY LLC PO BOX 735913 DALLAS TX 753735913 STAFFING SERVICES 211631 PRIME TIME HEALTHCARE LLC PO BOX 3544 OMAHA NE 68103 STAFFING SERVICES 101709 5 165163 165163 CBRF REVENUE 623000 16203145 16203145 RESIDENTIAL CARE REVENUE 623000 2193562 2193562 INDEPENDENT LIVING REVENUE 623000 238790 238790 18635497 309916 309916 510880 335571 28294 175309 -28294 147015 147015 22032 22032 22032 19279623 18635497 0 478963 X 361033 361033 9168624 7365668 1791905 11051 135361 135361 1060148 1021544 36651 1953 718754 674909 43845 685 685 26856 26856 31433 31433 1906278 1906278 59228 59228 104244 80581 23663 176821 176821 841021 831670 9351 11830 11830 729327 719146 10181 1776400 1751602 24798 244187 244187 FOOD EXPENSES 938530 938530 MAINTENANCE & REPAIRS 405070 405070 MEDICAL SUPPLIES 130606 130606 DIETARY SUPPLIES 65516 65516 61238 58277 2961 18953190 16576824 2360401 15965 60017 113096 1103852 1862984 768146 749683 197500 161085 50487216 24259047 27782970 26228169 8254271 9024024 38166756 38139041 1329992 1326472 13079 71046 23078867 22111704 45776 48150 24467714 23557372 X 13671215 14526314 27827 55355 13699042 14581669 38166756 38139041 326433 556194 0 X 0 1 X 1 0 X 2880254 1179175 199954 101682 165163 4526228 16225478 17090546 16714541 17227527 18635497 85893589 19105732 18269721 16914495 17329209 18800660 90419817 10000 10000 0 10000 10000 90409817 171039 333790 264811 300155 309916 1379711 171039 333790 264811 300155 309916 1379711 10539 3579 17796 18452 22032 72398 19287310 18607090 17197102 17647816 19132608 91871926 0.98410 0.98590 0.01500 0.01330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1345944 1345944 43843156 20376916 23466240 4869206 3882131 987075 428910 428910 26228169 SECURITY DEPOSITS 32215 RESIDENT TRUST FUNDS 15935 48150 19804384 556194 556194 19248190 31433 31433 19279623 18921757 0 18921757 31433 31433 18953190 X X 0 0 0 0 0 0 0 0 0 RONALD WALVOORT CHIEF EXECUTIVE OFFICER 190687 0 0 0 0 0 5976 0 15990 0 212653 0 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2014-05-01 10000000 ADJUSTABLE RATE REFUNDING REVENUE BONDS, SERIES 2014A 0 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2014-05-01 19100000 NEW PROJECT, SERIES 2014B 0 0 0 A 4276809 10000000 10000000 2006 1 0 1 1 B 3108968 19100000 18100000 1000000 2015 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 0 1 0 0 0 1 A 0 B 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/13/2021 FORM 990, PART VI, SECTION A, LINE 6 PINE HAVEN CHRISTIAN HOME, INC. HAS ONE CLASS OF MEMBERS. A PERSON WILL BE ADMITTED TO MEMBERSHIP OF PINE HAVEN CHRISTIAN HOME, INC. UPON THE CONDITIONS THAT (I) THE INDIVIDUAL BE A MEMBER OF GOOD STANDING IN ANY CONGREGATION, AND (II) SUCH INDIVIDUAL CONSENTS TO BEING A MEMBER OF PINE HAVEN CHRISTIAN HOME, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C 1. THE PERSONS COVERED BY THE CONFLICT OF INTEREST POLICY ARE DIRECTORS AND OFFICERS. 2. DETERMINATIONS OF WHETHER A CONFLICT EXISTS ARE MADE BY THE BOARD OF DIRECTORS. 3. ACTUAL CONFLICTS ARE REVIEWED AT THE BOARD OF DIRECTORS LEVEL. 4. IF A CONFLICT EXISTS, THE BOARD'S OPTIONS INCLUDE BUT ARE NOT LIMITED TO I) PROHIBITING THE AFFECTED DIRECTOR OR OFFICER FROM PARTICIPATING IN ANY PINE HAVEN DISCUSSION OR DECISIONS INVOLVING THE CONFLICT OF INTEREST; II) MODIFYING OR REDEFINING THE DUTIES AND RESPONSIBILITIES OF THE AFFECTED DIRECTOR OR OFFICER; III) REQUIRING THE RESIGNATION OF THE AFFECTED DIRECTOR OR OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AND OTHER OFFICERS IS COMPARED TO INDUSTRY DATA COMPILED BY LEADING AGE WISCONSIN. THE SURVEY COMPARES COMPENSATION BASED ON THREE CRITERIA: GROSS REVENUES, GEOGRAPHIC AREA AND TOTAL BED RESPONSIBILITIES. THE CHIEF EXECUTIVE OFFICER HAS AN ANNUAL REVIEW COMPLETED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART IX, LINE 11G CNA PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,022,294. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,022,294. LPN PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 748,920. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 748,920. RN PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 38,205. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,205. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 96,859. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,859.