2014-10-15T15:30:32-05:00 2013-12-31 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PKWY/PO BOX 690 EAU CLAIRE WI 547020690 990 2013-01-01 912052713 CHRISTIAN COMMUNITY HOMES AND SERVICES GROUP RETURN CHRI 7153869303 1320 WISCONSIN STREET HUDSON WI 54016 DAN GOODIER EXECUTIVE DIRECTOR 7153869303 2014-10-13 1 HOLLY POKRANDT CPA P00449155 7158323407 2014-09-29 2013 2015-11-30 17:44:51Z DAN GOODIER 1320 WISCONSIN STREET HUDSON WI 54016 13918414 1 1 3557 X WWW.CCHHUDSON.ORG X 1994 WI THE MISSION OF CHRISTIAN COMMUNITY HOMES AND SERVICES, A CHURCH-SPONSORED ORGANIZATION, IS TO SERVE THE RESIDENTS OF THE CAMPUS, AND EXTENDED COMMUNITY, IN A LOVING AND CARING ENVIRONMENT. WE ARE DEDICATED TO HELPING TO MEET THEIR PHYSICAL, SOCIAL, EMOTIONAL, AND SPIRITUAL NEEDS, AND TO ENCOURAGE A SENSE OF DIGNITY AND INDIVIDUALITY. 15 15 360 217 0 0 116400 69167 12744609 13828285 4754 7629 9473 6387 12875236 13911468 0 0 0 0 7310405 7583327 0 0 0 6252470 6706662 13562875 14289989 -687639 -378521 22448565 21805595 19717879 19441710 2730686 2363885 X THE MISSION OF CHRISTIAN COMMUNITY HOMES AND SERVICES, A CHURCH-SPONSORED ORGANIZATION, IS TO SERVE THE RESIDENTS OF THE CAMPUS, AND EXTENDED COMMUNITY, IN A LOVING AND CARING ENVIRONMENT. WE ARE DEDICATED TO HELPING TO MEET THEIR PHYSICAL, SOCIAL, EMOTIONAL, AND SPIRITUAL NEEDS, AND TO ENCOURAGE A SENSE OF DIGNITY AND INDIVIDUALITY. 0 0 11172004 12088982 CHRISTIAN COMMUNITY HOME OF HUDSON, INC. IS AN 81-BED NURSING HOME PROVIDING SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED (CCH-HUDSON) AND A 37-UNIT COMMUNITY-BASED RESIDENTIAL FACILITY (CBRF), WHICH INCLUDED 17 UNITS OF MEMORY CARE (PINE RIDGE). CHRISTIAN COMMUNITY HOMES OF OSCEOLA, INC. IS A 40-BED NURSING HOME PROVIDING SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED (CCH-OSCEOLA) AND A 20-BED MEMORY CARE CENTER LICENSED AS A CBRF (HEARTHSIDE). HEALTH CARE SERVICES TO MEDICAID NURSING HOME RESIDENTS, ARE CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY, SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN THE COSTS OF PROVIDING CARE. FOR 2013, CHRISTIAN CCH-HUDSON'S TOTAL NURSING HOME RESIDENT DAYS WERE 23,591. INCLUDED IN THIS TOTAL WAS 10,219 DAYS FOR RESIDENTS COVERED UNDER THE MEDICAID PROGRAM. CCH-OSCEOLA'S TOTAL NURSING HOME RESIDENT DAYS WERE 13,593, AND INCLUDED IN THIS TOTAL WAS 7,488 COVERED UNDER THE MEDICAID PROGRAM. THE NURSING HOME OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY AMONG MANY OF THE CARE PROGRAMS PROVIDED.PINE RIDGE OFFERS MONITORED CARE PLANS TO RESIDENTS GIVING THEM THE COMFORT OF KNOWING THAT ADDITIONAL CARE IS AVAILABLE AS THEY NEED IT. SERVICES OFFERED AT PINE RIDGE INCLUDE HOUSEKEEPING, LAUNDRY, NURSING ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, DIETARY SERVICES, MEDICATION MANAGEMENT, AND OTHER NURSING SUPERVISION AND CARE SERVICES. TOTAL RESIDENT DAYS FOR 2013 AT PINE RIDGE WERE 13,089. ADDITIONALLY, HEARTHSIDE HAD 6,203 RESIDENT DAYS FOR 2013. 1373273 1708162 WINTERGREEN APARTMENTS, INC. (WINTERGREEN) IS A 92-UNIT APARTMENT COMPLEX, WHICH INCLUDES A 40-UNIT RESIDENTIAL CARE APARTMENT COMPLEX (RCAC) THAT PROVIDES ELDERLY AND HANDICAPPED PERSONS WITH HOUSING FACILITIES AND SERVICES AVAILABLE TO MEET THEIR NEEDS. AMONG THE MANY SERVICES PROVIDED ARE 24-HOUR ON-SITE STAFF, ASSISTANCE WITH MEDICATIONS, MONTHLY OR WEEKLY VITAL CHECKS, QUARTERLY AND ANNUAL NURSING ASSESSMENTS, TRANSPORTATION SERVICES, AND ASSISTANCE WITH DAILY CARES. TOTAL RESIDENT DAYS AT WINTERGREEN FOR 2013 WERE 32,797. 6874 CHRISTIAN COMMUNITY CAMPUS FOUNDATION, INC. (FOUNDATION) IS A FUND DEVELOPMENT COMPANY FOR THE NON-PROFIT FACILITIES. THE FOUNDATION ORGANIZES EVENTS AND PROJECTS WHICH RAISE FUNDS THAT ALLOW FOR EQUIPMENT UPGRADES, INVESTMENT IN FACILITY ENHANCEMENT PROJECTS, AND EXPANSION AND ENHANCEMENT OF SERVICES. IN 2013, CHRISTIAN COMMUNITY CAMPUS FOUNDATION, INC. GAVE APPROXIMATELY $37,000 IN SUPPORT TO CCH-HUDSON, CCH-OSCEOLA AND WINTERGREEN FOR THESE PURPOSES. 12552151 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 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 1 0 0 0 1 78 0 360 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 0 1 1 1 0 WI MN X DAN GOODIER 7153869303 1320 WISCONSIN STREET HUDSON WI 54016 CARL MEINCKE MEMBER 1.00 X 0 0 0 ARVID LEDIN MEMBER 1.00 X 0 0 0 MIKE BEBAULT MEMBER 1.00 X 0 0 0 BOB BENISH MEMBER 1.00 X 0 0 0 ROBERT SCHEFFEN MEMBER 1.00 X 0 0 0 JOHN DEGRAFF MEMBER 1.00 X 0 0 0 JANE HANSON MEMBER 1.00 X 0 0 0 SUE BURMOOD MEMBER 1.00 X 0 0 0 PASTOR BRUCE STUNKARD MEMBER 1.00 X 0 0 0 KATHLEEN ANDERSON MEMBER 1.00 X 0 0 0 DEBRA ENGLAND MEMBER 1.00 X 0 0 0 CHRIS MUELLER PRESIDENT 1.00 X X 0 0 0 DOUG PETERSON VICE PRESIDENT 1.00 X X 0 0 0 MIKE SCHICK TREASURER 1.00 X X 0 0 0 JEANNE SCHMIDT SECRETARY 1.00 X X 0 0 0 DAN GOODIER EXECUTIVE DIRECTOR 40.00 X 214192 0 22053 BETH ANN RICHTER FINANCE DIRECTOR 40.00 X 111712 0 3694 325904 0 25747 2 0 1 0 REHABCARE GROUP INC 19860 COUNTY ROAD 14 KELLOGG MN 55945 THERAPY SERVICES 1009281 HIGH TECH CLEANING SERVICES 1178 42ND STREET HUDSON WI 54016 CLEANING SERVICES 243728 OMNICARE PHARMACIES OF WISCONSIN 3235 AIRPORT ROAD LACROSSE WI 54603 PHARMACEUTICALS 167940 3 7666 61501 69167 RESIDENT SERVICE REVENUE 623000 9630341 9630341 RENTAL REVENUE 623000 4055557 4055557 SENIOR NUTRITION PROGRAMS 623000 59045 59045 CAFETERIA & VENDING 623000 31141 31141 52201 52201 13828285 7635 7635 407 407 6000 0 6000 6000 6000 413 -413 -413 -413 6920 7666 6533 387 387 13911468 13797144 0 45157 351651 351651 6168217 5492638 675579 100765 89729 11036 488387 434896 53491 474307 401162 73145 25231 25231 41150 41150 1423532 1399901 23631 65062 65062 435273 214139 221134 59314 59314 1493642 1493642 31238 31238 1173198 1173198 92513 92513 DIETARY SUPPLIES 751055 751055 MEDICAL SUPPLIES 473102 473102 ASSESSMENT 255845 255845 BAD DEBT EXPENSE 194486 194486 192021 178358 13663 14289989 12552151 1737838 0 672840 679753 106230 228383 265888 134926 1084128 1161266 120961 91236 30299672 13725404 17351156 16574268 2160770 2260640 686592 675123 22448565 21805595 803582 922821 18802593 17569951 638655 111704 310283 19717879 19441710 X 2464798 2215159 265888 148726 2730686 2363885 22448565 21805595 -378521 11720 0 X X 0 1 X 1 0 X SCHEDULE A, PART I, LINE 3: LINE 3 OF PART I OF SCHEDULE A HAS BEEN CHECKED, BECAUSE THIS LINE DESCRIBES THE REASON FOR PUBLIC CHARITY STATUS FOR TWO OF THE FOUR ORGANIZATIONS INCLUDED IN THIS GROUP RETURN. HOWEVER, PER THE IRS INSTRUCTIONS FOR GROUP RETURNS, LINES 11E-11H OF PART I OF SCHEDULE A SHOULD ALSO HAVE BEEN COMPLETED BECAUSE THE ONE ORGANIZATION INCLUDED IN THE GROUP RETURN, CHRISTIAN COMMUNITY CAMPUS FOUNDATION, INC., IS A SUPPORTING ORGANIZATION. THIS ORGANIZATION'S PURPOSE IS TO PROVIDE MANAGEMENT, OVERSIGHT, FUNDRAISING, INVESTMENT, AND FUNDING SERVICES TO CHRISTIAN COMMUNITY HOMES AND SERVICES, INC., WHICH INCLUDES CHRISTIAN COMMUNITY HOME OF HUDSON, INC., WINTERGREEN APARTMENTS, INC., AND CHRISTIAN COMMUNITY HOME OF OSCEOLA, INC. CHRISTIAN COMMUNITY CAMPUS FOUNDATION, INC. IS A TYPE II SUPPORTING ORGANIZATION THAT IS NOT CONTROLLED DIRECTLY OR INDIRECTLY BY ONE OR MORE DISQUALIFIED PERSONS OTHER THAN FOUNDATION MANAGERS AND OTHER THAN ONE OR MORE PUBLICLY SUPPORTED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(1) OR SECTION 509(A)(2). CHRISTIAN COMMUNITY CAMPUS FOUNDATION, INC. PROVIDED $16,454 OF SUPPORT TO CHRISTIAN COMMUNITY HOME OF HUDSON, INC. - EIN 39-1363520, $20,933 OF SUPPORT TO CHRISTIAN COMMUNITY HOME OF OSCEOLA, INC. - EIN 80-0495631, AND $250 OF SUPPORT TO WINTERGREEN APARTMENTS, INC. - EIN 93-0838759. THESE ORGANIZATIONS WERE LISTED IN THE ARTICLES OF INCORPORATION OF CHRISTIAN COMMUNITY CAMPUS FOUNDATION, INC., WERE ORGANIZED IN THE U.S., AND WERE NOTIFIED OF THE SUPPORT RECEIVED. WINTERGREEN APARTMENTS, INC., IS CLASSIFIED AS A PUBLIC CHARITY UNDER CODE SECTION 509(A)(2). RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 896 896 0 PART II-B, LINE 1: CHRISTIAN COMMUNITY HOMES AND SERVICES PAYS ANNUAL ASSOCIATION DUES TO LEADING AGE WISCONSIN. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL INDUSTRY ENVIRONMENT. 252070 252070 26578575 11624946 14953629 3469027 2100458 1368569 16574268 TENANT DEPOSIT FUNDS 148242 F CAPITAL IMPROVEMENT FUND 283717 F BOND RESERVE FUND 1250402 F BOND PRINCIPAL AND INTEREST FUND 342527 F BOND REPAIR AND REPLACEMENT FUND 50467 F DEFERRED COMPENSATION PLAN ASSETS 185285 F 2260640 DEFERRED COMPENSATION PLAN LIABILITY 185285 AMOUNT PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAM 124998 310283 X PART X, LINE 2: THE CORPORATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATION IS ALSO EXEMPT FROM STATE INCOME TAXES PURSUANT TO SIMILAR STATE OF WISCONSIN TAX LAWS. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2013 AND 2012. FEDERAL TAX RETURNS FOR THE TAX YEARS ENDED DECEMBER 31, 2010, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. X X X 0 0 0 0 0 0 0 0 0 DAN GOODIER EXECUTIVE DIRECTOR 214192 0 0 0 0 0 6316 0 15737 0 236245 0 0 0 A CITY OF HUDSON WISCONSIN 396005468 44418ABD2 2003-04-01 4380452 CCH RENOVATION 0 0 0 B HOUSING AUTHORITY OF THE CITY OF HUDSON WISCONSIN 391129819 44419HCX1 2003-04-01 2292776 PINE RIDGE RENOVATION 0 0 0 C HOUSING AUTHORITY OF THE CITY OF HUDSON WISCONSIN 391129819 44419HCY9 2006-04-06 5515000 WINTERGREEN RENOVATION 0 0 0 D HOUSING AUTHORITY OF THE VILLAGE OF OSCEOLA 391660040 2011-04-29 7400000 CONSTRUCTION OF CCH-OSCEOLA FACILITY 0 0 0 A 690452 4380452 302263 81400 2275362 1721427 2004 1 0 1 1 B 402776 2292776 158000 42550 31222 2061004 2003 1 0 1 1 C 610000 5515000 188560 110300 5216140 2006 1 0 1 1 D 153351 7238302 148000 7090302 2011 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 C 0 0 1 0 0 0 0 0 0 D 0 0 1 0 1 0 0 0 0 A 0 B 0 C 0 D 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF HUDSON, WISCONSIN DATE THE REBATE COMPUTATION WAS PERFORMED: 06/12/2014 ISSUER NAME: HOUSING AUTHORITY OF THE CITY OF HUDSON, WISCONSIN DATE THE REBATE COMPUTATION WAS PERFORMED: 06/12/2014 PART II, LINE 11 THE AMOUNTS LISTED IN COLUMNS A, B, AND C WERE USED TO REFINANCE EXISTING DEBT. PART IV, LINE 2, COLUMN C A REBATE HAS NOT BEEN CALCULATED BECAUSE THE PROCEEDS IN RESERVE ACCOUNTS ARE NOT EARNING INTEREST. FORM 990, PART VI, SECTION A, LINE 7A CHRISTIAN COMMUNITY HOMES AND SERVICES, INC.'S ARTICLES OF INCORPORATION STATE THAT 60% OF THE BOARD OF DIRECTORS ARE MEMBERS OF AND ELECTED BY THE UNITED METHODIST CHURCH. FORM 990, PART VI, SECTION B, LINE 11 THE TREASURER OF THE BOARD OF DIRECTORS OF CHRISTIAN COMMUNITY HOMES AND SERVICES, INC. REVIEWS AND APPROVS THE FORM 990 PRIOR TO SUBMISSION. A COPY OF THE RETURN IS ALSO PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE EXECUTIVE DIRECTOR AND DIRECTOR OF FINANCE MONITOR THE CONFLICT OF INTEREST POLICY FOR COMPLIANCE ON AN ON-GOING BASIS TO ENSURE THAT MEMBERS OF THE BOARD OF DIRECTORS HAVE IDENTIFIED AND DISCLOSED ALL POTENTIAL CONFLICTS THAT COULD INFLUENCE THEIR DECISION MAKING IN THEIR ROLES AS BOARD MEMBERS. EXAMPLES INCLUDED IN THE POLICY INCLUDE BOARD MEMBERS WHO HAVE BUSINESS DEALINGS WITH THE ORGANIZATION OR WHO HAVE RELATIVES WHO ARE RESIDENT CUSTOMERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 CHRISTIAN COMMUNITY HOMES AND SERVICES, INC.'S EXECUTIVE COMMITTEE APPROVES THE COMPENSATION AGREEMENT WITH THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS, AFTER OBTAINING AND CONSIDERING COMPARABILITY DATA. THE BASIS FOR THE COMPENSATION DETERMINATION IS ADEQUATELY DOCUMENTED IN THE MINUTES OF THE MEETING FOR WHICH THE DETERMINATION WAS MADE. FORM 990, PART VI, SECTION C, LINE 19 CHRISTIAN COMMUNITY HOMES AND SERVICES MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS AT THE OFFICES OF CHRISTIAN COMMUNITY HOMES AND SERVICES. FORM 990, PART XI, LINE 2C: COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDI THE CHRISTIAN COMMUNITY HOMES AND SERVICES, INC. BOARD OF DIRECTORS ASSUMES FINAL RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT THAT PERFORMS THE AUDIT. NO CHANGES HAVE BEEN MADE IN THE PAST YEAR REGARDING THIS OVERSIGHT FUNCTION OF THE GOVERNING BODY. CHRISTIAN COMMUNITY HOMES AND SERVICES INC 1320 WISCONSIN ST HUDSON WI 54016 391801003 TO SERVE AS THE PARENT COMPANY FOR SEVERAL SENIOR CARE FACILITIES WI 501(C)(3) LINE 11C, III-FI N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0