FURP.ORG / PUBLIC DATA EXPLORER

EVERGREEN RETIREMENT COMMUNITY INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
EVERGREEN RETIREMENT COMMUNITY INC (EIN 39-1081800)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-17
IRS object ID
201433219349304863
Schema version
2013v3.0
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)
Return2014-11-17T11:48:31-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391081800EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN RETIREMENT COMMUNITY INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlEVERBusinessNameControlTxt
Phone9202332340PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code549023217ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN M KRUEGERPersonNm
Person TitleVP OF FINANCE/IS & TREASURERPersonTitleTxt
Phone9202332340PhoneNum
Signature2014-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNIONPreparerPersonNm
PTINP01469618PTIN
Phone6123764500PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENNETH A ARNESONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code549023217ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$15,434,092GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EVERGREENOSHKOSH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1965FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO PROVIDE A CONTINUUM OF POSSIBILITIES FOR INDIVIDUALS 55 AND OLDER.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee350TotalEmployeeCnt
Total Volunteers332TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$602,837PYContributionsGrantsAmt
CY Contributions Grants$590,240CYContributionsGrantsAmt
PY Program Service Revenue$13,662,621PYProgramServiceRevenueAmt
CY Program Service Revenue$13,992,354CYProgramServiceRevenueAmt
PY Investment Income$93,005PYInvestmentIncomeAmt
CY Investment Income$72,879CYInvestmentIncomeAmt
PY Other Revenue$1,614,653PYOtherRevenueAmt
CY Other Revenue$770,931CYOtherRevenueAmt
PY Total Revenue$15,973,116PYTotalRevenueAmt
CY Total Revenue$15,426,404CYTotalRevenueAmt
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$8,508,846PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,480,366CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,738,110PYOtherExpensesAmt
CY Other Expenses$6,588,968CYOtherExpensesAmt
PY Total Expenses$15,246,956PYTotalExpensesAmt
CY Total Expenses$15,069,334CYTotalExpensesAmt
PY Revenues Less Expenses$726,160PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$357,070CYRevenuesLessExpensesAmt
Total Assets BOY$19,620,705TotalAssetsBOYAmt
Total Assets EOY$27,089,417TotalAssetsEOYAmt
Total Liabilities BOY$10,103,359TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,970,564TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,517,346NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,118,853NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE A CONTINUUM OF POSSIBILITIES FOR INDIVIDUALS 55 YEARS AND OLDER.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$13,437,743ExpenseAmt
Grant$0GrantAmt
Revenue$13,992,354RevenueAmt
DescEVERGREEN IS A NONPROFIT CONTINUING CARE RETIREMENT COMMUNITY (CCRC) SERVING OLDER ADULTS, AGES 55 AND OLDER. IDEAL FOR THOSE LOOKING FOR A LIFESTYLE OF CHOICE, FREEDOM, SAFETY, COMMUNITY AND VALUE, EVERGREEN IS MORE THAN JUST A SENIOR LIVING COMMUNITY.EVERGREEN'S 35-ACRE CAMPUS IS NOT ONLY HOME TO ALMOST 300 RESIDENTS, BUT IT IS ALSO A DESTINATION FOR FAMILIES, COMMUNITY MEMBERS, VOLUNTEERS, NONPROFIT GROUPS AND OTHER VISITORS.LOCATED IN A PLEASANT RESIDENTIAL NEIGHBORHOOD IN OSHKOSH, WISCONSIN AMONG BEAUTIFUL, NATURAL SURROUNDINGS AND BORDERED BY OUR OWN OAK SAVANNA WOODLANDS, EVERGREEN PROVIDES LIVELY OPPORTUNITIES FOR YOU AND YOUR FRIENDS TO LIVE AS YOU CHOOSE. CHOOSE FROM THREE STYLES OF INDEPENDENT LIVING ACCOMMODATIONS, FOUR LEVELS OF ASSISTED LIVING, SHORT-TERM REHAB AND POST SURGICAL CARE, LONG-TERM SKILLED NURSING, OR EVERGREEN AT HOME SERVICES TO MEET YOUR UNIQUE NEEDS.LIFE ENRICHMENT ABOUNDS AT EVERGREEN. THERAPEUTIC SWIMMING POOLS, AN AEROBIC STUDIO, LAPIDARY SHOP, AND SUPPERS WITH THE CHEF ARE JUST A FEW OF THE MANY OPPORTUNITIES THAT ENCOURAGE ACTIVE LIFESTYLES. PARTNERSHIPS WITH THE UNIVERSITY OF WISCONSIN OSHKOSH, LEARNING IN RETIREMENT AND THE OSHKOSH GALLERY WALK ALSO PROVIDE ENTERTAINING AND FULFILLING EXPERIENCES AND ENSURE THAT NO TWO DAYS ARE THE SAME. AT EVERGREEN, POSSIBILITIES AWAIT.Desc
Total Program Service Expenses$13,437,743TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
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 LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
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 BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
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 Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art ContributionYes (1)DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document74IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee350EmployeeCnt
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 Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
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 Policy0ConflictOfInterestPolicyInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
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 Line1JOHN M KRUEGERBusinessNameLine1
FieldValueIRS element (for citing)
Phone9202372110PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code549023217ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
BARRY YARBRO
CHAIRMAN1.000.00Yes (X)Yes (X)$0$0$0
DEIRDRE DEWITT
VICE CHAIR1.000.00Yes (X)Yes (X)$0$0$0
BARBARA COOK
DIRECTOR1.001.00Yes (X)$0$0$0
PAT DAY
DIRECTOR1.000.00Yes (X)$0$0$0
WILL DEPPIESSE
DIRECTOR1.000.00Yes (X)$0$0$0
MIKE GRACEFFA
DIRECTOR1.000.00Yes (X)$0$0$0
VERNICE HAASE
DIRECTOR1.000.00Yes (X)$0$0$0
ELIZABETH HARTMAN
DIRECTOR1.000.00Yes (X)$0$0$0
RANDY HEDGE
DIRECTOR1.000.00Yes (X)$0$0$0
MARSHA HUGHES
DIRECTOR1.000.00Yes (X)$0$0$0
RANDY HUSMAN
DIRECTOR1.001.00Yes (X)$0$0$0
ALICE JENKINS
DIRECTOR1.000.00Yes (X)$0$0$0
SUE KREIBICH
DIRECTOR1.000.00Yes (X)$0$0$0
MARCIA LARSON
DIRECTOR1.000.00Yes (X)$0$0$0
FRED LILLY
DIRECTOR1.000.00Yes (X)$0$0$0
JAYNE LINDSAY
DIRECTOR1.000.00Yes (X)$0$0$0
ROY NEY
DIRECTOR1.000.00Yes (X)$0$0$0
BETTY PATERSON
DIRECTOR1.000.00Yes (X)$0$0$0
CHRIS VANSTRATEN
DIRECTOR1.000.00Yes (X)$0$0$0
KENNETH A ARNESON
PRESIDENT/CEO40.001.00Yes (X)$169,363$0$26,586
JOHN M KRUEGER
VP OF FINANCE/IS & TREASURER40.001.00Yes (X)$97,956$0$39,843
KRISTEN POUZAR
EXECUTIVE ASSISTANT/SECRETARY40.000.00Yes (X)$34,342$0$11,742
FieldValueIRS element (for citing)
Total Reportable Comp From Org$301,661TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$78,171TotalOtherCompensationAmt
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/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
REHABCARE SERVICES GROUP
680 SOUTH FOURTH STREETLOUISVILLEKY40202THERAPY$913,740
MIRON CONSTRUCTION CO INC
BOX 1372GREEN BAYWI54305CONSTRUCTION$503,449
HEALTHCARE SERVICES GROUP
3220 TILLMAN DRIVEBENSALEMPA19020HOUSEKEEPING$378,000
PACKER VALLEY BUILDERS INC
2277 CLAIRVILLE ROADOSHKOSHWI54904CONSTRUCTION$318,182
AG ARCHITECTURE
1414 UNDERWOOD AVE SUITE 301WAUWATOSAWI53213ARCHITECTURAL$229,058
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Related Organizations$588,340RelatedOrganizationsAmt
All Other Contributions$1,900AllOtherContributionsAmt
Noncash Contributions$42,448NoncashContributionsAmt
Total Contributions$590,240TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT SERVICE REV623000$13,418,003$13,418,003
MANAGEMENT FEE REV900099$574,351$574,351
FieldValueIRS element (for citing)
Total Program Service Revenue$13,992,354TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$74,517TotalRevenueColumnAmt
Exclusion$74,517ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$9,260RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$6,050RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$3,210RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,210TotalRevenueColumnAmt
Exclusion$3,210ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,638SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$1,638SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,638TotalRevenueColumnAmt
Exclusion-$1,638ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEAL REVENUES900099$301,343$301,343
EVERGREEN AT HOME900099$177,253$177,253
OTHER REVENUE900099$148,437$148,437

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$140,688TotalRevenueColumnAmt
Exclusion$140,688ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$767,721OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,426,404TotalRevenueColumnAmt
Related Or Exempt Func Income$13,992,354RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$843,810ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$379,832TotalAmt
Program Services$379,832ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,592,673TotalAmt
Program Services$5,402,168ProgramServicesAmt
Management And General$1,190,505ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$311,847TotalAmt
Program Services$255,534ProgramServicesAmt
Management And General$56,313ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$698,241TotalAmt
Program Services$558,037ProgramServicesAmt
Management And General$140,204ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$497,773TotalAmt
Program Services$421,201ProgramServicesAmt
Management And General$76,572ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$3,659TotalAmt
Management And General$3,659ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,723TotalAmt
Management And General$23,723ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$21,218TotalAmt
Management And General$21,218ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,072,596TotalAmt
Program Services$1,988,512ProgramServicesAmt
Management And General$84,084ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$47,368TotalAmt
Program Services$47,368ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$79,662TotalAmt
Program Services$56,042ProgramServicesAmt
Management And General$23,620ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$120,400TotalAmt
Program Services$120,400ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$550,164TotalAmt
Program Services$550,164ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$29,958TotalAmt
Program Services$18,265ProgramServicesAmt
Management And General$11,693ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$257,375TotalAmt
Program Services$257,375ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,435,730TotalAmt
Program Services$1,435,730ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$111,616TotalAmt
Program Services$111,616ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
FOOD$813,465$813,465
SUPPLIES$529,270$529,270
BED TAX EXPENSE$191,080$191,080
PHARMACY$152,140$152,140

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$149,544TotalAmt
Program Services$149,544ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,069,334TotalAmt
Program Services$13,437,743ProgramServicesAmt
Management And General$1,631,591ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,532,368BOYAmt
EOY$770,470EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$120,276BOYAmt
EOY$134,380EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,512,169BOYAmt
EOY$2,531,157EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,702,174BOYAmt
EOY$1,130,246EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$84,712BOYAmt
EOY$122,094EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$67,885BOYAmt
EOY$124,037EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$36,509,297LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$20,890,288LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,491,830BOYAmt
EOY$15,619,009EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$59,708BOYAmt
EOY$187,592EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$49,583BOYAmt
EOY$6,470,432EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$19,620,705BOYAmt
EOY$27,089,417EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,543,102BOYAmt
EOY$1,989,754EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,733,882BOYAmt
EOY$1,969,403EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,016,647BOYAmt
EOY$11,545,389EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$8,074BOYAmt
EOY$8,802EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,200,000BOYAmt
EOY$1,100,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$601,654BOYAmt
EOY$357,216EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,103,359BOYAmt
EOY$16,970,564EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,517,346BOYAmt
EOY$10,118,853EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,517,346BOYAmt
EOY$10,118,853EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,620,705BOYAmt
EOY$27,089,417EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$357,070ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$244,437NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
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$677,283CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$529,297CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$604,296CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$602,837CurrentTaxYearMinus1YearAmt
Current Tax Year$590,240CurrentTaxYearAmt
Total$3,003,953TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,732,057CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,138,044CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,234,028CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,662,621CurrentTaxYearMinus1YearAmt
Current Tax Year$13,992,354CurrentTaxYearAmt
Total$70,759,104TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,409,340CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,667,341CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,838,324CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,265,458CurrentTaxYearMinus1YearAmt
Current Tax Year$14,582,594CurrentTaxYearAmt
Total$73,763,057TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$73,763,057PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$88,323CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$79,971CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$109,993CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$106,820CurrentTaxYearMinus1YearAmt
Current Tax Year$83,777CurrentTaxYearAmt
Total$468,884TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$88,323CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$79,971CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$109,993CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$106,820CurrentTaxYearMinus1YearAmt
Current Tax Year$83,777CurrentTaxYearAmt
Total$468,884TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$559,136CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$681,702CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,207,794CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,602,500CurrentTaxYearMinus1YearAmt
Current Tax Year$767,701CurrentTaxYearAmt
Total$4,818,833TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,056,799CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,429,014CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,156,111CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,974,778CurrentTaxYearMinus1YearAmt
Current Tax Year$15,434,072CurrentTaxYearAmt
Total$79,050,774TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.93310PublicSupportCY509Pct
Public Support PY5090.93440PublicSupportPY509Pct
Investment Income CY0.00590InvestmentIncomeCYPct
Investment Income PY0.00590InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part IV Form990ScheduleAPartIVGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER REVENUE MEAL REVENUE EVERGREEN AT HOME BED TAXExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

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$5,589,110BeginningYearBalanceAmt
Contributions$154,659ContributionsAmt
Investment Earnings Or Losses$544,488InvestmentEarningsOrLossesAmt
Other Expenditures$55,706OtherExpendituresAmt
Administrative Expenses$23,550AdministrativeExpensesAmt
End Year Balance$6,209,001EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,228,355BeginningYearBalanceAmt
Contributions$3,850ContributionsAmt
Investment Earnings Or Losses$474,768InvestmentEarningsOrLossesAmt
Other Expenditures$96,676OtherExpendituresAmt
Administrative Expenses$21,185AdministrativeExpensesAmt
End Year Balance$5,589,112EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,428,650BeginningYearBalanceAmt
Contributions$2,320ContributionsAmt
Investment Earnings Or Losses$914,470InvestmentEarningsOrLossesAmt
Other Expenditures$97,937OtherExpendituresAmt
Administrative Expenses$19,148AdministrativeExpensesAmt
End Year Balance$5,228,355EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,234,561BeginningYearBalanceAmt
Contributions$5,215ContributionsAmt
Investment Earnings Or Losses$242,243InvestmentEarningsOrLossesAmt
Other Expenditures$37,007OtherExpendituresAmt
Administrative Expenses$16,362AdministrativeExpensesAmt
End Year Balance$4,428,650EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,214,347BeginningYearBalanceAmt
Contributions$5,245ContributionsAmt
Investment Earnings Or Losses$75,676InvestmentEarningsOrLossesAmt
Other Expenditures$46,670OtherExpendituresAmt
Administrative Expenses$14,037AdministrativeExpensesAmt
End Year Balance$4,234,561EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.09130BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.90870PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$378,264OtherCostOrOtherBasisAmt
Book Value$378,264BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,122,473OtherCostOrOtherBasisAmt
Depreciation$10,985,362DepreciationAmt
Book Value$11,137,111BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,287,020OtherCostOrOtherBasisAmt
Depreciation$897,740DepreciationAmt
Book Value$1,389,280BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,721,540OtherCostOrOtherBasisAmt
Depreciation$9,007,186DepreciationAmt
Book Value$2,714,354BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,619,009TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
RESIDENT FUNDS HELD IN TRUST$8,802
DUE FROM EVERGREEN FOUNDATION, INC.$53,547
BOND FUND$6,380,909
BOND INTEREST$27,174
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,470,432TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLIABILITY ON INTEREST SWAP AGREEMENTDesc
Amt$357,216Amt
FieldValueIRS element (for citing)
Total Liability$357,216TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:FOR 2013, THERE WAS A RESIDENT FUNDS SAVINGS ACCOUNT IN THE AMOUNT OF $5,838 AND A RESIDENT CHECKING FUND WITH A BALANCE OF $2,965.
PART V, LINE 4:THE ENDOWMENT FUNDS ARE HELD BY THE RELATED FOUNDATION FOR THE BENEVOLENT NEEDS FOR RESIDENTS OF EVERGREEN RETIREMENT COMMUNITY WHO HAVE EXHAUSTED THEIR PERSONAL RESOURCES, WOODLANDS PRESERVATION, LIFECARE LEARNING, PASTORAL CARE, CREATIVE ARTS, AND GROUNDS BEAUTIFICATION.
PART X, LINE 2:THE RETIREMENT COMMUNITY IS A NON-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ANNUAL TAX FILINGS OF THE RETIREMENT COMMUNITY IS SUBJECT TO REVIEW BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE RETIREMENT COMMUNITY IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE RETIREMENT COMMUNITY IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR OTHER EXCISE TAXES. THE TAX FILINGS FOR RETIREMENT COMMUNITY AND FOUNDATION FOR THE YEARS 2009 THROUGH 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL OR STATE AUTHORITIES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
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 OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonKENNETH A ARNESONPersonNm
TitlePRESIDENT/CEOTitleTxt
Base Compensation Filing Org$159,844BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$9,456BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$63OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$26,586NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$195,949TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATHE ORGANIZATION REIMBURSES THE PRESIDENT/CEO FOR HIS ROTARY CLUB DUES. THIS BENEFIT IS NOT INCLUDED IN HIS TAXABLE COMPENSATION.
PART I, LINE 1BTHE ORGANIZATION REQUIRES SUBSTANTIATION FROM THE PRESIDENT/CEO BEFORE THE EXPENSE IS PAID. THE AMOUNT IS DEEMED TO BE REASONABLE BECAUSE IT IS SUCH A SMALL DOLLAR AMOUNT - $206 FOR 2013, INCLUDING MEAL CHARGES.
PART I, LINE 3THE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING THE PERFORMANCE REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES.
PART I, LINE 6PRESIDENT/CEO (KEN ARNESON), VP OF FINANCE/IS & TREASURER (JOHN KRUEGER), AND EXECUTIVE ASSISTANT/SECRETARY (KRISTEN POUZAR) OF EVERGREEN RETIREMENT COMMUNITY, AS A MEMBERS OF THE MANAGEMENT TEAM, RECEIVE AN ANNUAL BONUS, PART OF WHICH RELATES TO THE NET INCOME OF THE ORGANIZATION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ELDERLY HOUSING AUTHORITY OF THE CITY OF OSHKOSH
A3912517772003-11-25$6,600,000CONSTRUCTION OF SKILLED NURSING FACILITY AND FITNESS & AQUATIC CENTER000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY
B3913378552013-12-20$7,000,000CAMPUS REMODEL (REPOSITIONING)000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtUnspentUnspentAmt
A$2,364,000$6,600,000$6,600,0002004Yes (1)0Yes (1)Yes (1)
B$7,000,000$502,122000Yes (1)$138,167$6,359,711

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
ASSOCIATED BANK NA
A00Yes (1)0Yes (1)Yes (1)9.58333330000000000
(no name)
B0Yes (1)00Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Schedule M IRS990ScheduleM

Works Of Art WorksOfArtGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$408NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt

Books And Publications BooksAndPublicationsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$40,804NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$1,196NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2IN THE PROCESS OF STARTING A HOME HEALTH AGENCY.
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR AND VICE CHAIR OF THE BOARD AND THE CHAIRS OF THE THREE OTHER STANDING BOARD COMMITTEES. THE COMMITTEE HAS FULL AUTHORITY TO ACT ON BEHALF OF THE BOARD BETWEEN MEETINGS OF THE BOARD, WITH THE EXCEPTION OF THE ELECTION OF OFFICERS OR THE AUTHORITY TO DECLARE OR FILL ANY VACANCY ON THE BOARD. ALL ACTIONS OF THE COMMITTEE ARE REPORTED AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD. THE COMMITTEE PERFORMS SUCH OTHER FUNCTIONS AS MAY BE DELEGATED TO IT BY THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S TREASURER WILL REVIEW THE 990 IN DETAIL. AN ELECTRONIC VERSION OF THE FORM 990 WILL BE POSTED ON THE BOARD WEB PAGE WITH MEMBERS GIVEN THE OPPORTUNITY TO REVIEW IT PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL EMPLOYEES AND IT HAS A CODE OF CONDUCT POLICY THAT APPLIES TO ALL BOARD MEMBERS. HOWEVER, THE CODE OF CONDUCT POLICY IS NOT SUFFICIENT TO ANSWER YES TO FORM 990, PART VI, LINE 12C. BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST AND TO CONDUCT BUSINESS WITH EVERGREEN IN A MANNER THAT SUPPORTS THE INTERESTS OF EVERGREEN AND AVOIDS UNFAIR PERSONAL ADVANTAGE. NON-COMPLIANCE WITH THE CODE OF CONDUCT MAY RESULT IN REMOVAL FROM THE BOARD FOLLOWING AN OPPORTUNITY FOR EXPLANATION TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 15ATHE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING A REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES. THIS PROCESS WAS LAST CONDUCTED IN 2013. THE VICE PRESIDENTS ARE REVIEWED BY THE PRESIDENT/CEO. THE SECRETARY OF THE BOARD IS THE EXECUTIVE ASSISTANT TO THE PRESIDENT/CEO AND IS REVIEWED BY THE PRESIDENT/CEO. PERIODIC WAGE & SALARY SURVEYS ARE CONDUCTED TO ASSURE COMPENSATION IS COMPARABLE TO INDUSTRY/MARKET AREA. FORMS ARE USED TO DOCUMENT ACCOMPLISHMENTS.
FORM 990, PART VI, SECTION C, LINE 19EVERGREEN RETIREMENT COMMUNITY, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. REQUESTED DOCUMENTS ARE PROVIDED WITHIN A REASONABLE TIME FRAME.
FORM 990, PART IX, LINE 11GTHERAPY SERVICES: PROGRAM SERVICE EXPENSES 1,013,789. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,013,789. BUILDING MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 238,903. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 238,903. HOUSEKEEPING: PROGRAM SERVICE EXPENSES 378,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 378,000. LAUNDRY: PROGRAM SERVICE EXPENSES 145,133. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 145,133. OTHER FEES: PROGRAM SERVICE EXPENSES 212,687. MANAGEMENT AND GENERAL EXPENSES 84,084. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 296,771.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN FOUNDATION INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54902ZIPCode
FieldValueIRS element (for citing)
EIN391388991EIN
Primary ActivitiesFUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN VILLAGE INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54901ZIPCode
FieldValueIRS element (for citing)
EIN391505337EIN
Primary ActivitiesCO-OPERATIVEPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd