SHADY LANE HOME INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SHADY LANE HOME INC (EIN 39-0829541)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-02-14
IRS object ID
201710459349300711
Schema version
2015v3.0
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)
Return2017-02-14T07:37:11-06:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Wipfli LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 12237AddressLine1Txt
CityGreen BayCityNm
State AbbreviationWIStateAbbreviationCd
ZIP543072237ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390829541EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHADY LANE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSHADBusinessNameControlTxt
Phone9206828254PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11235 SOUTH 24TH STREETAddressLine1Txt
CityMANITOWOCCityNm
State AbbreviationWIStateAbbreviationCd
ZIP542205516ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKasandra PaiderPersonNm
Person TitlecfoPersonTitleTxt
Phone9206828254PhoneNum
Signature2017-02-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTerri Rexrode CPA MSTPreparerPersonNm
PTINP00096513PTIN
Phone9206620016PhoneNum
Preparation2017-02-13PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKASANDRA PAIDERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11235 SOUTH 24TH STREETAddressLine1Txt
CityMANITOWOCCityNm
State AbbreviationWIStateAbbreviationCd
ZIP542205516ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,914,176GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.shadylaneinc.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1950FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionNURSING CARE FOR the AGED AND DISABLED.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee283TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$8,463PYContributionsGrantsAmt
CY Contributions Grants$2,796CYContributionsGrantsAmt
PY Program Service Revenue$9,465,340PYProgramServiceRevenueAmt
CY Program Service Revenue$8,815,821CYProgramServiceRevenueAmt
PY Investment Income$43,164PYInvestmentIncomeAmt
CY Investment Income$55,059CYInvestmentIncomeAmt
PY Other Revenue$12,945PYOtherRevenueAmt
CY Other Revenue$8,894CYOtherRevenueAmt
PY Total Revenue$9,529,912PYTotalRevenueAmt
CY Total Revenue$8,882,570CYTotalRevenueAmt
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$6,675,107PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,403,046CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,097,150PYOtherExpensesAmt
CY Other Expenses$3,513,691CYOtherExpensesAmt
PY Total Expenses$10,772,257PYTotalExpensesAmt
CY Total Expenses$9,916,737CYTotalExpensesAmt
PY Revenues Less Expenses-$1,242,345PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,034,167CYRevenuesLessExpensesAmt
Total Assets BOY$13,669,745TotalAssetsBOYAmt
Total Assets EOY$13,233,040TotalAssetsEOYAmt
Total Liabilities BOY$886,672TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,295,856TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,783,073NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,937,184NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionShady Lane strives to provide older adults in Manitowoc County the highest quality residential care at a reasonable cost. Residents of Shady Lane can expect to enjoy a home-like setting with a supportive atmosphere that respects individuality, promotes physical and emotional well being, and encourages independence.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,927,418ExpenseAmt
Revenue$5,922,393RevenueAmt
DescSkilled Nursing services are offered to the senior population. These are the higher acuity population needing the most intense skilled nursing services. residents treated can include the private pay residents, and the residents on government funding (Medicare and Medicaid). Number of residents treated in plan year were 201.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,834,976ExpenseAmt
Revenue$2,832,573RevenueAmt
DescAssisted living services are offered to the lighter care assisted living population. These residents can maintain an amount of independence while still receiving the necessary nursing service to maintain a quality of life. Residents in the assisted living can include the private pay residents and residents receiving government funding. Number of residents treated in plan year were 85.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$8,762,394TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
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 With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee283EmployeeCnt
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
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
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
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KASANDRA PAIDERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9206828254PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11235 S 24TH STREETAddressLine1Txt
CityManitowocCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54220ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Jim Noffke
Board Chair0.50Yes (X)Yes (X)$0$0$0
Tom Mueller
Board Vice Chair0.50Yes (X)Yes (X)$0$0$0
Katherine Reynolds
Board Secretary0.50Yes (X)Yes (X)$0$0$0
Dr Joseph DiRaimondo
Board Member0.50Yes (X)$0$0$0
Marilyn Kaufmann
Board Member0.50Yes (X)$0$0$0
Mike Schaus
Board Member0.50Yes (X)$0$0$0
Scott McMeans
Board Member0.50Yes (X)$0$0$0
Judy Carey
Board Member0.50Yes (X)$0$0$0
Dennis Tienor
Board Member0.50Yes (X)$0$0$0
DON KARMAN
BOARD MEMBER0.50Yes (X)$0$0$0
SANDY HARDRATH
BOARD MEMber0.50Yes (X)$0$0$0
STANLEY JOHNSON
BOARD MEMber0.50Yes (X)$0$0$0
JEREMY SEHLOFF
BOARD MEMBER0.50Yes (X)$0$0$0
DAVID LESS
BOARD MEMBER0.50Yes (X)$0$0$0
TODD MEERDINK
CEO40.00Yes (X)$148,450$0$27,599
KASANDRA PAIDER
CFO40.00Yes (X)$62,298$0$10,182
FieldValueIRS element (for citing)
Total Reportable Comp From Org$210,748TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$37,781TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
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
Ace Building Service
3510 S 26TH STREETMANITOWOCWI54220CONSTRUCTION CONTRACTOR$936,778
SCHAUS ROOFING AND MECHANICAL CONTRACTOR
2901 CALUMET AVEMANITOWOCWI54220MECHANICAL CONTRACTOR$522,215
HOLY FAMILY REHAB SERVICE
2100 WESTERN AVEMANITOWOCWI54220THERAPY SERVICES$413,845
FAITH TECHNOLOGIES
4738 s taylor drivesheboyganWI53081electrician$222,999
OMNICARE
PO BOX 78000DETROITMI48278PHARMACY SERVICES$149,538
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$2,796AllOtherContributionsAmt
Total Contributions$2,796TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Skilled Nursing Facili623000$5,922,393$5,922,393
Assisted Living Facili623000$2,832,573$2,832,573
Other623000$26,136$26,136
Beauty & Barber Shop623000$23,186$23,186
Cafeteria Revenues623000$11,533$11,533
FieldValueIRS element (for citing)
Total Program Service Revenue$8,815,821TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$55,059TotalRevenueColumnAmt
Exclusion$55,059ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$40,500RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$31,606RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$8,894RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,894TotalRevenueColumnAmt
Exclusion$8,894ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,882,570TotalRevenueColumnAmt
Related Or Exempt Func Income$8,754,966RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$124,808ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$248,529TotalAmt
Management And General$248,529ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,028,396TotalAmt
Program Services$4,695,632ProgramServicesAmt
Management And General$332,764ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$67,426TotalAmt
Program Services$66,242ProgramServicesAmt
Management And General$1,184ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$673,565TotalAmt
Program Services$621,367ProgramServicesAmt
Management And General$52,198ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$385,130TotalAmt
Program Services$344,513ProgramServicesAmt
Management And General$40,617ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$13,775TotalAmt
Management And General$13,775ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$27,500TotalAmt
Management And General$27,500ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$547,433TotalAmt
Program Services$521,829ProgramServicesAmt
Management And General$25,604ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$149,236TotalAmt
Management And General$149,236ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,225,212TotalAmt
Program Services$1,087,860ProgramServicesAmt
Management And General$137,352ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$277,124TotalAmt
Program Services$257,714ProgramServicesAmt
Management And General$19,410ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,765TotalAmt
Program Services$4,391ProgramServicesAmt
Management And General$374ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$753,537TotalAmt
Program Services$700,619ProgramServicesAmt
Management And General$52,918ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$202,668TotalAmt
Program Services$184,688ProgramServicesAmt
Management And General$17,980ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
BED ASSESSMENT$197,200$197,200
REPAIRS AND MAINTENANCE$50,531$50,531

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$64,710TotalAmt
Program Services$29,808ProgramServicesAmt
Management And General$34,902ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,916,737TotalAmt
Program Services$8,762,394ProgramServicesAmt
Management And General$1,154,343ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$207,660BOYAmt
EOY$89,335EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$66,973BOYAmt
EOY$69,769EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$647,138BOYAmt
EOY$673,448EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$31,270BOYAmt
EOY$28,645EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$83,581BOYAmt
EOY$268,915EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,678,708LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$9,372,689LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,099,768BOYAmt
EOY$8,306,019EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,592,970BOYAmt
EOY$2,784,566EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$940,385BOYAmt
EOY$1,012,343EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,669,745BOYAmt
EOY$13,233,040EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$868,932BOYAmt
EOY$1,284,151EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$17,740BOYAmt
EOY$11,705EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$886,672BOYAmt
EOY$1,295,856EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,758,073BOYAmt
EOY$11,912,184EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,000BOYAmt
EOY$25,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,783,073BOYAmt
EOY$11,937,184EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,669,745BOYAmt
EOY$13,233,040EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,034,167ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$110,285NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$77,993OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
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$746CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,702CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,838CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,463CurrentTaxYearMinus1YearAmt
Current Tax Year$2,796CurrentTaxYearAmt
Total$31,545TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,550,512CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,229,343CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,010,778CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,228,911CurrentTaxYearMinus1YearAmt
Current Tax Year$8,754,966CurrentTaxYearAmt
Total$48,774,510TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$243,988CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$299,415CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$217,255CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$236,429CurrentTaxYearMinus1YearAmt
Current Tax Year$60,855CurrentTaxYearAmt
Total$1,057,942TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,795,246CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,539,460CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,236,871CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,473,803CurrentTaxYearMinus1YearAmt
Current Tax Year$8,818,617CurrentTaxYearAmt
Total$49,863,997TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$16,434CurrentTaxYearMinus1YearAmt
Current Tax Year$80,418CurrentTaxYearAmt
Total$96,852TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$16,434CurrentTaxYearMinus1YearAmt
Current Tax Year$80,418CurrentTaxYearAmt
Total$96,852TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$49,767,145PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$143,056CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$128,891CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$137,540CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$83,664CurrentTaxYearMinus1YearAmt
Current Tax Year$95,559CurrentTaxYearAmt
Total$588,710TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$143,056CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$128,891CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$137,540CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$83,664CurrentTaxYearMinus1YearAmt
Current Tax Year$95,559CurrentTaxYearAmt
Total$588,710TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,938,302CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,668,351CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,374,411CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,557,467CurrentTaxYearMinus1YearAmt
Current Tax Year$8,914,176CurrentTaxYearAmt
Total$50,452,707TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98640PublicSupportCY509Pct
Public Support PY5090.98730PublicSupportPY509Pct
Investment Income CY0.01170InvestmentIncomeCYPct
Investment Income PY0.01240InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$25,000BeginningYearBalanceAmt
Investment Earnings Or Losses$25InvestmentEarningsOrLossesAmt
Other Expenditures$25OtherExpendituresAmt
End Year Balance$25,000EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$25,000BeginningYearBalanceAmt
Investment Earnings Or Losses$18InvestmentEarningsOrLossesAmt
Other Expenditures$18OtherExpendituresAmt
End Year Balance$25,000EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$25,000BeginningYearBalanceAmt
Investment Earnings Or Losses$15InvestmentEarningsOrLossesAmt
Other Expenditures$15OtherExpendituresAmt
End Year Balance$25,000EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$25,000BeginningYearBalanceAmt
Investment Earnings Or Losses$50InvestmentEarningsOrLossesAmt
Other Expenditures$50OtherExpendituresAmt
End Year Balance$25,000EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$25,000BeginningYearBalanceAmt
Investment Earnings Or Losses$73InvestmentEarningsOrLossesAmt
Other Expenditures$73OtherExpendituresAmt
End Year Balance$25,000EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$216,216OtherCostOrOtherBasisAmt
Book Value$216,216BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,430,003OtherCostOrOtherBasisAmt
Depreciation$7,981,402DepreciationAmt
Book Value$4,448,601BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,143,903OtherCostOrOtherBasisAmt
Depreciation$1,391,287DepreciationAmt
Book Value$1,752,616BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,888,586OtherCostOrOtherBasisAmt
Book Value$1,888,586BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,306,019TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
Investment in Lakeshore Community Foundation$1,000,638
resident funds held in trust$11,705
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,012,343TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$9,102,454TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$110,285NetUnrealizedGainsInvstAmt
Other Revenue$77,993OtherRevenueAmt
Revenue Not Reported$188,278RevenueNotReportedAmt
Revenue Subtotal$8,914,176RevenueSubtotalAmt
Other Revenues Not Included-$31,606OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$31,606RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$8,882,570TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$9,948,343TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$31,606OtherExpensesIncludedAmt
Expenses Not Reported$31,606ExpensesNotReportedAmt
Expenses Subtotal$9,916,737ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$9,916,737TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:Residents' funds held in trust consist of amounts on deposit with the Organization by residents for safekeeping. These funds can be withdrawn at any time by the residents.
Part V, Line 4:Permanently restricted net assets at September 30, 2016 represent a donor-restricted endowment fund. The income from the endowment fund is expendable to support incidental expenses of residents.
Part XI, Line 2d - Other Adjustments:change in beneficial interest in lakeshore community foundation 77,993.
Part XI, Line 4b - Other Adjustments:RENTAL EXPENSES -31,606.
Part XII, Line 2d - Other Adjustments:RENTAL EXPENSES 31,606.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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)
PersonTODD MEERDINKPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$148,450BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$4,708DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$22,891NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$176,049TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
STANLEY JOHNSON - OWNER OF ACE BUILDING SERVICE
BOARD MEMBER$936,778BUILDING CONSTRUCTION0
MIKE SCHAUS - BROTHER OF THE OWNER OF SCHAUS ROOFING AND MECHANICAL
BOARD MEMBER$522,215CAPITAL PURCHASES0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11The Form 990 is provided to the organizations' Board of Directors executive committee before it was filed. The final form 990 is made available to all board members. The executive committee designates the detail review of the Form 990 to management, but has final approval of the return.
Form 990, Part VI, Section B, line 12cThe board of directors authorizes the Officers of the Organization to periodically, but not less than annually, survey the board members regarding any potential conflicts, to maintain such information and report back to the Board regarding any potential conflicts of interest. Board members have the duty to fully disclose to the Board, prior to deliberations, the nature and extent of any interest in any transaction being considered. After the disclosure is made and the interested party answers all appropriate questions, he shall depart from the portion of the meeting in which the transaction is being considered and shall not participate in further discussion of or vote on the transaction.
Form 990, Part VI, Section B, line 15The process for determining compensation for the officers and other key employees of the organization include: 1) review and approval by the Executive Committee of the Board of Directors (those without conflict); 2) use of data as to comparable compensation; and 3) contemporaneous documentation and record keeping.
Form 990, Part VI, Section C, line 19The organization believes its governing documents, conflict of interest policy, and financial statements are the property of the organization and does not make them available to the public.
Form 990, Part XI, line 9:Change in beneficial interest in LakeShore Community Foundation 77,993.
Form 990, Part XII, Line 2c:Form 990, Part XII, Line 2c: The Finance Committee is responsible for the oversight of the audit and selection of the audit firm. This process has not changed from the prior year.

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