2017-11-08T16:25:18-06:00 2017-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2016-07-01 391913323 OAKS OF DUNN COUNTY INC OAKS 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 SCOTT HOFFMAN CHIEF FINANCIAL OFFICER 4028963884 2017-11-07 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2017-11-07 08:33:03 CS P 876BE3EDFAF35ED687A48C1D6A395F974978876D FCEDDD786A52D146CD6D5AF04BB3D8B974087028 2016 2021-01-29 14:40:06Z SCOTT HOFFMAN 4980 SOUTH 118TH STREET OMAHA NE 68137 1772800 0 X WWW.MOSAICINFO.ORG X 1998 WI THE OAKS OF DUNN COUNTY PROVIDES SUPPORTED LIVING TO SENIORS LIVING IN MENOMONIE, WI. THE FACILITY OFFERS SECURE, ACCESSIBLE, AND MAINTENANCE-FREE HOMES IN A HOUSING COMPLEX WITH COMMON SPACE AND BASIC SERVICES, INCLUDING TRANSPORTATION, WEEKLY HOUSEKEEPING, LAUNDRY SERVICES, PLANNED ACTIVITIES, AND A DAILY MAIN MEAL. 7 4 0 9 0 0 0 0 541118 554249 21727 128902 0 0 562845 683151 125 0 0 0 155835 165921 0 0 0 311173 308944 467133 474865 95712 208286 2804037 2772378 2361196 2154230 442841 618148 X THE OAKS OF DUNN COUNTY PROVIDES SUPPORTED LIVING TO SENIORS LIVING IN MENOMONIE, WI. THE FACILITY OFFERS SECURE, ACCESSIBLE, AND MAINTENANCE-FREE HOMES IN A HOUSING COMPLEX WITH COMMON SPACE AND BASIC SERVICES, INCLUDING TRANSPORTATION, WEEKLY HOUSEKEEPING, LAUNDRY SERVICES, PLANNED ACTIVITIES, AND A DAILY MAIN MEAL. THE OAKS OF DUNN COUNTY IS AN AFFILIATE OF MOSAIC. MOSAIC IS A FAITH-BASED ORGANIZATION SERVING PEOPLE WITH DEVELOPMENTAL DISABILITIES SO THAT ALL MAY REALIZE GOD'S GIFT OF WHOLENESS OF LIFE. WE ARE GUIDED BY THE PRINCIPLE THAT "EVERY INDIVIDUAL IS A PERSON OF WORTH." MOSAIC'S STAFF MEMBERS AND VOLUNTEERS PROVIDE INDIVIDUALIZED SERVICES, LIVING OPTIONS, WORK CHOICES, SPIRITUAL NURTURING, AND ADVOCACY TO APPROXIMATELY 3,500 INDIVIDUALS IN MORE THAN 50 COMMUNITIES ACROSS 12 STATES. INTERESTED PEOPLE CAN FIND MORE INFORMATION REGARDING THE OAKS OF DUNN COUNTY AT WWW.MOSAICINFO.ORG OR BY CALLING 715-235-7793. 0 0 443398 554249 PROVIDE RESIDENTIAL HOUSING AND SUPPORTED LIVING TO SENIORS. THE FACILITY OFFERS SECURE, ACCESSIBLE, AND MAINTENANCE-FREE HOMES IN A HOUSING COMPLEX WITH COMMON SPACE AND BASIC SERVICES, INCLUDING TRANSPORTATION, WEEKLY HOUSEKEEPING, LAUNDRY SERVICES, PLANNED ACTIVITIES, AND A DAILY MAIN MEAL. 443398 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 5 0 1 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X X SCOTT HOFFMAN 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 ROBERT SPINTI PRESIDENT 0.10 0.00 X X 0 0 0 LINDA TIMMONS VICE PRESIDENT (THRU 5/8/17) 0.10 39.90 X X 0 503675 138532 SCOTT HOFFMAN VICE PRESIDENT 0.10 39.90 X X 0 238671 36409 JACK JEATRAN SECRETARY 0.10 0.00 X X 0 0 0 KRISTIN ROSSOW TREASURER 0.10 39.90 X X 0 144118 25894 ARDEN ALEXANDER DIRECTOR (THRU 11/1/16) 0.10 0.00 X 0 0 0 DOLORES BANGERT DIRECTOR (THRU 9/5/16) 0.10 39.90 X 0 141293 15640 ROGER NATWICK DIRECTOR 0.10 0.00 X 0 0 0 KNUTE ROTTO DIRECTOR 0.10 39.90 X 0 0 0 MICHAEL SCHENDEL DIRECTOR 0.10 0.00 X 0 0 0 CINDY SCHROEDER FORMER TREASURER 0.00 30.00 X 0 129273 5914 0 1157030 222389 0 1 1 0 0 RENTAL INCOME 532000 524624 524624 NON-REFUNDABLE FEES 532000 29625 29625 554249 24990 24990 1193561 1089649 103912 103912 103912 683151 554249 0 128902 133427 133427 22586 22586 9908 9908 31389 31389 78 78 6891 6891 23868 23868 63563 63563 53 53 47878 47878 83807 83807 16328 16328 FOOD COSTS 34758 34758 DUES, FEES & REGISTRATI 221 221 LOAN FEE 110 110 474865 443398 31467 0 6039 11050 3225581 1520978 1778226 1704603 1019056 1056119 716 606 2804037 2772378 13035 14410 81 81 1164298 1031056 1183782 1108683 2361196 2154230 X 432841 608148 10000 10000 442841 618148 2804037 2772378 208286 -32979 0 X X 0 1 X 1 0 X 509264 479341 469547 541118 554249 2553519 509264 479341 469547 541118 554249 2553519 0 0 0 2553519 18205 21424 18881 23504 24990 107004 18205 21424 18881 23504 24990 107004 527469 500765 488428 564622 579239 2660523 0.95980 0.95990 0.04020 0.04010 X 10000 10000 10000 10000 10000 10000 10000 10000 10000 10000 0.00000 0.00000 1.00000 0 0 95195 95195 2999066 1392245 1606821 131320 128733 2587 1704603 TENANT SECURITY DEPOSITS 658963 AFFILIATE PAYABLE 449720 1108683 X PART V, LINE 4: THE ORGANIZATION'S INTENDED USE OF THE TEMPORARILY RESTRICTED NET ASSETS IS FOR PROGRAM PURPOSES AS RESTRICTED BY THE DONORS. PART X, LINE 2: THE FOLLOWING FOOTNOTE IS TAKEN FROM THE CONSOLIDATED FINANCIAL STATEMENTS: ALL CONSOLIDATED AFFILIATED ENTITIES, EXCEPT FOR MOSAIC HOUSING CORP V, INC., EASE-E MEDICAL, INC. AND BICO, LTD. ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN MOSAIC'S TAX EXEMPT STATUS. MOSAIC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2017 AND 2016, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OTHER THAN DESCRIBED PREVIOUSLY. 0 0 0 0 0 0 0 0 0 LINDA TIMMONS VICE PRESIDENT (THRU 5/8/17) 0 467632 0 28280 0 7763 0 106744 0 31788 0 642207 0 0 SCOTT HOFFMAN VICE PRESIDENT 0 225818 0 9580 0 3273 0 14233 0 22176 0 275080 0 0 KRISTIN ROSSOW TREASURER 0 142090 0 1525 0 503 0 4078 0 21816 0 170012 0 0 DOLORES BANGERT DIRECTOR (THRU 9/5/16) 0 75357 0 0 0 65936 0 1965 0 13675 0 156933 0 0 CINDY SCHROEDER FORMER TREASURER 0 129273 0 0 0 0 0 5914 0 0 0 135187 0 0 PART I, LINE 3 THE SALARIES OF LINDA TIMMONS, SCOTT HOFFMAN, KRISTIN ROSSOW, AND DOLORES BANGERT ARE PAID FROM A RELATED ORGANIZATION, MOSAIC. THE SALARY FOR MS. TIMMONS IS SET BY THE MOSAIC EXECUTIVE COMMITTEE AND MOSAIC BOARD OF DIRECTORS. CINDY SCHROEDER IS ALSO PAID FROM A RELATED ORGANIZATION, MOSAIC, AS AN INDEPENDENT CONTRACTOR. MS. SCHROEDER'S WAGES ARE NOT RELATED TO ANY CURRENT OR PRIOR SERVICES PROVIDED TO OAKS OF DUNN COUNTY, INC. AS THE FORMER TREASURER. MOSAIC'S BOARD AND EXECUTIVE COMMITTEE USE AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, AND A COMPENSATION SURVEY IN ESTABLISHING THE COMPENSATION OF THE PRESIDENT AND CEO OF MOSAIC AND GUIDELINES FOR OTHER KEY STAFF. SCHEDULE J, PART II, COLUMN C: MOSAIC EVALUATES THE LIABILITY RELATED TO THEIR POSTRETIREMENT BENEFITS (SALARY AND HEALTH INSURANCE CONTINUATION) THROUGH AN ACTUARIAL REVIEW. THE ADJUSTMENT IS INCLUDED IN RETIREMENT AND OTHER DEFERRED COMPENSATION. FORM 990, PART VI, SECTION A, LINE 7A THE MOSAIC BOARD OF DIRECTORS APPOINTS THE OAKS OF DUNN COUNTY'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS REVIEWED BY THE TREASURER OF THE ORGANIZATION AND THEN SHARED WITH THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD DIRECTOR COMPLETES A CONFLICT OF INTEREST FORM ANNUALLY AND SUBMITS IT TO THE CHAIRPERSON OF THE MOSAIC'S BOARD GOVERNANCE RISK AND INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE TREASURER AND MOSAIC'S CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 OAKS OF DUNN COUNTY, INC. DOES NOT PAY COMPENSATION TO A CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIAL, OFFICERS, OR ANY OTHER EMPLOYEES. THEREFORE, A PROCESS FOR DETERMINING COMPENSATION HAS NOT BEEN ESTABLISHED. FORM 990, PART VI, SECTION C, LINE 19 INDIVIDUALS MAY REQUEST MOSAIC'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS THROUGH AN E-MAIL REQUEST FORM, WHICH IS AVAILABLE ON MOSAIC'S PUBLIC WEBSITE (WWW.MOSAICINFO.ORG). FORM 990, PART XII, LINE 2C: THE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC 4980 S 118 ST OMAHA NE 68137 113669999 SERVICES FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES NE 501(C)(3) LINE 10 N/A 0 MOSAIC FOUNDATION 4980 S 118 ST OMAHA NE 68137 363837360 FUNDRAISING & INVESTMENT ASSET MANAGEMENT NE 501(C)(3) LINE 12A, I MOSAIC 1 MOSAIC HOUSING CORPORATION I 4980 S 118 ST OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION II 4980 S 118 ST OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION III 4980 S 118 ST OMAHA NE 68137 470788396 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IV 4980 S 118 ST OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VII 4980 S 118 ST OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VIII 4980 S 118 ST OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IX 4980 S 118 ST OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION X 4980 S 118 ST OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XI 4980 S 118 ST OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XII 4980 S 118 ST OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIII 4980 S 118 ST OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIV 4980 S 118 ST OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XV 4980 S 118 ST OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVI 4980 S 118 ST OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVII 4980 S 118 ST OMAHA NE 68137 261710013 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVIII 4980 S 118 ST OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIX 4980 S 118 ST OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XX 4980 S 118 ST OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXI 4980 S 118 ST OMAHA NE 68137 264555313 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXII 4980 S 118 ST OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXIII 4980 S 118 ST OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING I 4980 S 118 ST OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING II 4980 S 118 ST OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF MACOMB I 4980 S 118 ST OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF ROCKFORD I 4980 S 118 ST OMAHA NE 68137 204841856 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC VEBA 4980 S 118 ST OMAHA NE 68137 363831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 1 MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A EASE-E MEDICAL INC 731 SOUTH 8TH STREET CANON CITY CO 81212 470842353 MEDICAL EQUIPMENT/SUPPLIES SALES NE N/A C 1 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE N/A C 1 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD N/A C 1 CHARITABLE REMAINDER TRUSTS (4) INVESTMENT MANAGEMENT NE N/A T 1 CHARITABLE REMAINDER TRUST (1) INVESTMENT MANAGEMENT FL N/A T 1 0 1 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0