EVERGREEN RETIREMENT COMMUNITY INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- EVERGREEN RETIREMENT COMMUNITY INC (EIN 39-1081800)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-11
- IRS object ID
- 201313169349301096
- Schema version
- 2012v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-11T09:20:05-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391081800 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVERGREEN RETIREMENT COMMUNITY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | EVER | NameControl |
| Phone | 9202332340 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 NORTH WESTFIELD STREET | AddressLine1 |
| City | OSHKOSH | City |
| State | WI | State |
| ZIP Code | 549023217 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN M KRUEGER | Name |
| Title | VP OF FINANCE/IT & TREASURER | Title |
| Phone | 9202332340 | Phone |
| Date Signed | 2013-11-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CORY RUTLEDGE | Name |
| PTIN | P01329381 | PTIN |
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEN ARNESON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 NORTH WESTFIELD STREET | AddressLine1 |
| City | OSHKOSH | City |
| State | WI | State |
| ZIP Code | 549023217 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 15983928 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.EVERGREENOSHKOSH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1965 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE A CONTINUUM OF POSSIBILITIES FOR INDIVIDUALS 55 AND OLDER. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 18 | NbrIndependentVotingMembers |
| Total Nbr Employees | 376 | TotalNbrEmployees |
| Total Nbr Volunteers | 110 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 604296 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 602837 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14234028 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13662621 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 38851 | InvestmentIncomePriorYear |
| Investment Income Current Year | 93005 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1211006 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1614653 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16088181 | TotalRevenuePriorYear |
| Total Revenue Current Year | 15973116 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8731706 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8508846 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6727270 | OtherExpensePriorYear |
| Other Expenses Current Year | 6738110 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15458976 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15246956 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 629205 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 726160 | RevenuesLessExpensesCY |
| Total Assets BOY | 19336408 | TotalAssetsBOY |
| Total Assets EOY | 19620705 | TotalAssetsEOY |
| Total Liabilities BOY | 10625314 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10103359 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8711094 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9517346 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE A CONTINUUM OF POSSIBILITIES FOR INDIVIDUALS 55 YEARS AND OLDER. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 13690849 | Expense |
| Grants | 0 | Grants |
| Revenue | 13662621 | Revenue |
| Description | EVERGREEN 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. | Description |
| Total Program Service Expense | 13690849 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 67 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 376 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 18 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 0 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 0 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN M KRUEGER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9202372110 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 NORTH WESTFIELD STREET | AddressLine1 |
| City | OSHKOSH | City |
| State | WI | State |
| ZIP Code | 549023217 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|---|
| BARRY YARBRO | |||||||
| CHAIRMAN/DIRECTOR | 1.00 | 0.00 | X | X | 0 | 0 | 0 |
| DEIRDRE DEWITT | |||||||
| VICE CHAIR/DIRECTOR | 1.00 | 0.00 | X | X | 0 | 0 | 0 |
| BARBARA COOK | |||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | |
| PAT DAY | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| WILL DEPPIESSE | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| VERNICE HAASE | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| RANDY HEDGE | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| MARSHA HUGHES | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| RANDY HUSMAN | |||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | |
| ALICE JENKINS | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| SUE KREIBICH | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| MARCIA LARSON | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| FRED LILLY | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| JAYNE LINDSAY | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| DANIEL MCINTOSH | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| ROY NEY | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| BETTY PATERSON | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| CHRIS VANSTRATEN | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| SUSAN VETTE | |||||||
| DIRECTOR | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| KEN ARNESON | |||||||
| PRESIDENT/CEO | 40.00 | 1.00 | X | 169619 | 0 | 10363 | |
| JOHN M KRUEGER | |||||||
| VP OF FINANCE/IS & TREASURER | 40.00 | 1.00 | X | 123364 | 0 | 10135 | |
| ERIN STANDLEY | |||||||
| EXECUTIVE ASSISTANT/SECRETARY (FORMER) | 40.00 | 0.00 | X | 50834 | 0 | 1809 | |
| KRISTEN POUZAR | |||||||
| EXECUTIVE ASSISTANT/SECRETARY | 40.00 | 0.00 | X | 39147 | 0 | 1716 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 382964 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 24023 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| REHABCARE GROUP | |||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | THERAPY SERVICES | 830675 |
| PACKER VALLEY BUILDERS INC | |||||
| 2277 CLAIRVILLE ROAD | OSHKOSH | WI | 54904 | BUILDING CONTRACTORS | 561140 |
| KINDRED REHAB SERVICES INC | |||||
| BOX 277365 | ATLANTA | GA | 30384 | THERAPY SERVICES | 277607 |
| D & M FLOORING | |||||
| 309 ALLEGIANCE COURT | APPLETON | WI | 54913 | FLOORING & INSTALLATION | 194865 |
| HEALTHCARE SERVICES | |||||
| 3220 TILLMAN DRIVE | BENSALEM | PA | 19020 | HOUSEKEEPING SERVICES | 166821 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Related Organizations | 602837 | RelatedOrganizations |
| Total Contributions | 602837 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RESIDENT SERVICE REV | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 13662621 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13662621 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13662621 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 88624 | TotalRevenueColumn |
| Exclusion | $88,624 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 18196 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 6043 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 12153 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12153 | TotalRevenueColumn |
| Exclusion | $12,153 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9150 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4769 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4381 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4381 | TotalRevenueColumn |
| Exclusion | $4,381 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MANAGEMENT FEE REV | 900099 | 544020 | $544,020 |
| INSURANCE PROCEEDS | 900099 | 245775 | $245,775 |
| EVERGREEN AT HOME | 900099 | 222899 | $222,899 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 589806 | TotalRevenueColumn |
| Exclusion | $589,806 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1602500 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15973116 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13662621 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,707,658 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 406987 | Total |
| Program Services | 406987 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6487701 | Total |
| Program Services | 5385791 | ProgramServices |
| Management And General | 1101910 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 307433 | Total |
| Program Services | 251877 | ProgramServices |
| Management And General | 55556 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 810578 | Total |
| Program Services | 672164 | ProgramServices |
| Management And General | 138414 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 496147 | Total |
| Program Services | 425807 | ProgramServices |
| Management And General | 70340 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2975 | Total |
| Management And General | 2975 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20219 | Total |
| Management And General | 20219 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22185 | Total |
| Management And General | 22185 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2274175 | Total |
| Program Services | 2161612 | ProgramServices |
| Management And General | 112563 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58316 | Total |
| Program Services | 58316 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74173 | Total |
| Program Services | 53895 | ProgramServices |
| Management And General | 20278 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84551 | Total |
| Program Services | 84551 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 523032 | Total |
| Program Services | 523032 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43536 | Total |
| Program Services | 31869 | ProgramServices |
| Management And General | 11667 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 306321 | Total |
| Program Services | 306321 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1412591 | Total |
| Program Services | 1412591 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110699 | Total |
| Program Services | 110699 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| FOOD | 847641 | 847641 |
| SUPPLIES | 540431 | 540431 |
| BED TAX EXPENSE | 220320 | 220320 |
| PHARMACY | 123946 | 123946 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72999 | Total |
| Program Services | 72999 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15246956 | Total |
| Program Services | 13690849 | ProgramServices |
| Management And General | 1556107 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 606757 | BOY |
| EOY | 1532368 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100007 | BOY |
| EOY | 120276 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1809281 | BOY |
| EOY | 1512169 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1714142 | BOY |
| EOY | 1702174 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85958 | BOY |
| EOY | 84712 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 156679 | BOY |
| EOY | 67885 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 33968792 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 19476962 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14742893 | BOY |
| EOY | 14491830 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120691 | BOY |
| EOY | 109291 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19336408 | BOY |
| EOY | 19620705 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1319208 | BOY |
| EOY | 1543102 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1802715 | BOY |
| EOY | 1733882 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8476 | BOY |
| EOY | 8074 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6829703 | BOY |
| EOY | 6216647 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 665212 | BOY |
| EOY | 601654 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10625314 | BOY |
| EOY | 10103359 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8711094 | BOY |
| EOY | 9517346 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8711094 | BOY |
| EOY | 9517346 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19336408 | BOY |
| EOY | 19620705 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 726160 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 63558 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 16534 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 502069 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 677283 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 529297 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 604296 | CurrentTaxYearMinus1Year |
| Current Tax Year | 602837 | CurrentTaxYear |
| Total | 2915782 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12791914 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14732057 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 14138044 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14234028 | CurrentTaxYearMinus1Year |
| Current Tax Year | 13662621 | CurrentTaxYear |
| Total | 69558664 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 13293983 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 15409340 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 14667341 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14838324 | CurrentTaxYearMinus1Year |
| Current Tax Year | 14265458 | CurrentTaxYear |
| Total | 72474446 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 72474446 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 69665 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 88323 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 79971 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 109993 | CurrentTaxYearMinus1Year |
| Current Tax Year | 106820 | CurrentTaxYear |
| Total | 454772 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 69665 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 88323 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 79971 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 109993 | CurrentTaxYearMinus1Year |
| Current Tax Year | 106820 | CurrentTaxYear |
| Total | 454772 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 584540 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 559136 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 681702 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1207794 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1602500 | CurrentTaxYear |
| Total | 4635672 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 13948188 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 16056799 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 15429014 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 16156111 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15974778 | CurrentTaxYear |
| Total | 77564890 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.93440 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.95170 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00590 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00570 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE MANAGEMENT FEE REVENUE EVERGREEN AT HOME INSURANCE PROCEEDS | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
| Explanation In Part XIII | X | ExplanationInPartXIII |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5228355 | BeginningOfYearBalance |
| Contributions | 3850 | Contributions |
| Investment Earnings Or Losses | 474768 | InvestmentEarningsOrLosses |
| Other Expenditures | 96676 | OtherExpenditures |
| Administrative Expenses | 21185 | AdministrativeExpenses |
| End Of Year Balance | 5589112 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4428650 | BeginningOfYearBalance |
| Contributions | 2320 | Contributions |
| Investment Earnings Or Losses | 914470 | InvestmentEarningsOrLosses |
| Other Expenditures | 97937 | OtherExpenditures |
| Administrative Expenses | 19148 | AdministrativeExpenses |
| End Of Year Balance | 5228355 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4234561 | BeginningOfYearBalance |
| Contributions | 5215 | Contributions |
| Investment Earnings Or Losses | 242243 | InvestmentEarningsOrLosses |
| Other Expenditures | 37007 | OtherExpenditures |
| Administrative Expenses | 16362 | AdministrativeExpenses |
| End Of Year Balance | 4428650 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4214347 | BeginningOfYearBalance |
| Contributions | 5245 | Contributions |
| Investment Earnings Or Losses | 75676 | InvestmentEarningsOrLosses |
| Other Expenditures | 46670 | OtherExpenditures |
| Administrative Expenses | 14037 | AdministrativeExpenses |
| End Of Year Balance | 4234561 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3195963 | BeginningOfYearBalance |
| Contributions | 1018775 | Contributions |
| Investment Earnings Or Losses | 58012 | InvestmentEarningsOrLosses |
| Other Expenditures | 50445 | OtherExpenditures |
| Administrative Expenses | 7958 | AdministrativeExpenses |
| End Of Year Balance | 4214347 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.10140 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.89860 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 374864 | OtherCostOrOtherBasis |
| Book Value | 374864 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21076200 | OtherCostOrOtherBasis |
| Depreciation | 10252097 | Depreciation |
| Book Value | 10824103 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11207875 | OtherCostOrOtherBasis |
| Depreciation | 8379207 | Depreciation |
| Book Value | 2828668 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1309853 | OtherCostOrOtherBasis |
| Depreciation | 845658 | Depreciation |
| Book Value | 464195 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 14491830 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | LIABILITY ON INTEREST SWAP AGREEMENT | Description |
| Amount | $601,654 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 601654 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 2B: | FOR 2012, THERE WAS A RESIDENT FUNDS SAVINGS ACCOUNT IN THE AMOUNT OF $6,015. THERE WAS ALSO A RESIDENT CHECKING FUND WITH A BALANCE OF $2,059. | |
| 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. | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: |
| 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 2008 THROUGH 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL OR STATE AUTHORITIES. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KEN ARNESON | NamePerson |
| Title | PRESIDENT/CEO | Title |
| Base Compensation Filing Org | 151642 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 3274 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 14703 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 10080 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 283 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 179982 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 3 | ReturnReference |
| Explanation | THE 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. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELDERLY HOUSING AUTHORITY OF THE CITY OF OSHKOSH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 391251777 | IssuerEIN |
| Date Issued | 2003-11-25 | DateIssued |
| Issue Price | 6600000 | IssuePrice |
| Description Of Purpose | CONSTRUCTION OF SKILLED NURSING FACILITY AND FITNESS & AQUATIC CENTER | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 2064000 | AmountRetired |
| Total Proceeds | 6600000 | TotalProceeds |
| Capital Expenditures | 6600000 | CapitalExpenditures |
| Year Of Subst Completion | 2004 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASSOCIATED BANK NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 9.583333300000 | TermOfHedge |
| Superintegrated Hedge | 0 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE 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 11 | THE 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 15A | THE 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. THE VICE PRESIDENT, TOP MANAGEMENT OFFICIALS AND OTHER OFFICERS 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 19 | EVERGREEN 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 11G | THERAPY SERVICES: PROGRAM SERVICE EXPENSES 1,103,576. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,103,576. BUILDING MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 294,741. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 294,741. HOUSEKEEPING: PROGRAM SERVICE EXPENSES 167,137. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 167,137. LAUNDRY: PROGRAM SERVICE EXPENSES 136,768. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 136,768. SPECIAL PROJECT: PROGRAM SERVICE EXPENSES 243,547. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 243,547. OTHER FEES: PROGRAM SERVICE EXPENSES 215,843. MANAGEMENT AND GENERAL EXPENSES 112,563. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 328,406. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | NET RENTAL INCOME AND GAIN ON SALE 16,534. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVERGREEN FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 NORTH WESTFIELD STREET | AddressLine1 |
| City | OSHKOSH | City |
| State | WI | State |
| ZIP Code | 54902 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391388991 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 7 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVERGREEN RETIREMENT COMMUNITY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVERGREEN VILLAGE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1130 NORTH WESTFIELD STREET | AddressLine1 |
| City | OSHKOSH | City |
| State | WI | State |
| ZIP Code | 54901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391505337 | EIN |
| Primary Activity | CO-OPERATIVE | PrimaryActivity |
| Legal Domicile State | WI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVERGREEN RETIREMENT COMMUNITY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 841846 | ShareOfTotalIncome |
| Share Of EOY Assets | 2742314 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| EVERGREEN FOUNDATION INC | ||
| C | 602837 | CASH RECEIVED |
| EVERGREEN FOUNDATION INC | ||
| L | 122969 | CASH TRANSFERED |
| EVERGREEN VILLIAGE INC | ||
| L | 421051 | CASH TRANSFERED |
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