PINE HAVEN CHRISTIAN HOME INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PINE HAVEN CHRISTIAN HOME INC (EIN 39-0816900)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2013-10-25
- IRS object ID
- 201322989349301112
- 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 | 2013-10-25T14:49:24-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391173131 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHENCK SC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 712 RIVERFRONT DRIVE STE 301 | AddressLine1 |
| City | SHEBOYGAN | City |
| State | WI | State |
| ZIP Code | 53081 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390816900 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PINE HAVEN CHRISTIAN HOME INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PINE | NameControl |
| Phone | 9204672401 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVENUE | AddressLine1 |
| City | SHEBOYGAN FALLS | City |
| State | WI | State |
| ZIP Code | 53085 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RON WALVOORT | Name |
| Title | OFFICER | Title |
| Phone | 9204672401 | Phone |
| Date Signed | 2013-10-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TERRY T STRITTMATER CPA | Name |
| PTIN | P00012661 | PTIN |
| Phone | 9204580341 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RON WALVOORT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVENUE | AddressLine1 |
| City | SHEBOYGAN FALLS | City |
| State | WI | State |
| ZIP Code | 53085 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 13046441 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PINEHAVEN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1950 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | PINE HAVEN CHRISTIAN COMMUNITIES WILL PROVIDE THE AGING POPULATION WE SERVE AN ENVIRONMENT THAT IS A CHRIST-CENTERED, SAFE HAVEN OFFERING QUALITY, COMPASSIONATE CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 18 | NbrIndependentVotingMembers |
| Total Nbr Employees | 294 | TotalNbrEmployees |
| Total Nbr Volunteers | 140 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 22829 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 14118 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12168630 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12978233 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 61035 | InvestmentIncomePriorYear |
| Investment Income Current Year | 42678 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 9588 | OtherRevenuePriorYear |
| Other Revenue Current Year | 11412 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12262082 | TotalRevenuePriorYear |
| Total Revenue Current Year | 13046441 | 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 | 6709342 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6959806 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 1000 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4142407 | OtherExpensePriorYear |
| Other Expenses Current Year | 4366322 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 10851749 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11326128 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1410333 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1720313 | RevenuesLessExpensesCY |
| Total Assets BOY | 21511235 | TotalAssetsBOY |
| Total Assets EOY | 22827994 | TotalAssetsEOY |
| Total Liabilities BOY | 12773906 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 12327748 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8737329 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10500246 | NetAssetsOrFundBalancesEOY |
| Mission Description | PINE HAVEN CHRISTIAN COMMUNITIES WILL PROVIDE THE AGING POPULATION WE SERVE AN ENVIRONMENT THAT IS A CHRIST-CENTERED, SAFE HAVEN OFFERING QUALITY, COMPASSIONATE CARE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 9902852 | Expense |
| Revenue | 12978233 | Revenue |
| Description | PROVIDING HOUSING, HEALTH CARE AND OTHER RELATED SERVICES TO RESIDENTS IN A NON-PROFIT NURSING HOME AND ASSISTED LIVING FACILITIES. | Description |
| Total Program Service Expense | 9902852 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 0 | 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 | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | 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 | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 40 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 294 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | 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 | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RON WALVOORT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9204672401 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVENUE | AddressLine1 |
| City | SHEBOYGAN FALLS | City |
| State | WI | State |
| ZIP Code | 53085 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| DAVE BRASSER | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| JANE BUTEYN | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| PAUL DAMKOT | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| DON DEMASTER | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| ROBERT DESMIDT | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| CAROL DULMES | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| DARRELL HAUSE | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| CARL HUENINK | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| NORENE HUIBREGTSE | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| MIKE FOLEY | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| CARL JOOSSE | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| LARRY LORENZ | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| DAN NEERHOFF | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| LOIS OOSTDYKE | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| JEFF RISSEEUW | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| CHRISTINE TEMPAS | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| RANDY TEUNISSEN | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| BOB VANDER PUY | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| NANCY VERSTRATE | ||||||
| BOARD MEMBER | 0.00 | X | 0 | 0 | 0 | |
| RICH DAANE | ||||||
| PRESIDENT | 0.00 | 0 | 0 | 0 | X | |
| VIRGIL NAVIS | ||||||
| VICE PRESIDENT | 0.00 | 0 | 0 | 0 | X | |
| JOHN ACKERMANN | ||||||
| SECRETARY | 0.00 | 0 | 0 | 0 | X | |
| WENDY BAACKES | ||||||
| TREASURER | 0.00 | 0 | 0 | 0 | X | |
| RON WALVOORT | ||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 102533 | 0 | 26723 | X | |
| ROGER LEYS | ||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | 120223 | 0 | 10251 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 222756 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 36974 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REHAB CARE GROUP EAST INC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 503534 | AddressLine1 |
| City | ST LOUIS | City |
| State | MO | State |
| ZIP Code | 631503534 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | THERAPY | DescriptionOfServices |
| Compensation | 406089 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 14118 | AllOtherContributions |
| Noncash Contributions | 6020 | NoncashContributions |
| Total Contributions | 14118 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| RES CENTER RES. FEES | 623000 | 7011735 | 7011735 |
| NURSING HOME RES. FEES | 623000 | 4314153 | 4314153 |
| RES CARE APARTMENT COMPLEX | 623000 | 1652345 | 1652345 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12978233 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 42678 | TotalRevenueColumn |
| Exclusion | $42,678 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 11412 | TotalRevenueColumn |
| Exclusion | $11,412 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 11412 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13046441 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12978233 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $54,090 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222756 | Total |
| Management And General | 222756 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5727670 | Total |
| Program Services | 5171438 | ProgramServices |
| Management And General | 555881 | ManagementAndGeneral |
| Fundraising | 351 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58885 | Total |
| Program Services | 51006 | ProgramServices |
| Management And General | 7879 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 498253 | Total |
| Program Services | 417861 | ProgramServices |
| Management And General | 80325 | ManagementAndGeneral |
| Fundraising | 67 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 452242 | Total |
| Program Services | 391723 | ProgramServices |
| Management And General | 60509 | ManagementAndGeneral |
| Fundraising | 10 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8109 | Total |
| Management And General | 8109 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34945 | Total |
| Management And General | 34750 | ManagementAndGeneral |
| Fundraising | 195 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80901 | Total |
| Management And General | 80901 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122817 | Total |
| Management And General | 122727 | ManagementAndGeneral |
| Fundraising | 90 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 261348 | Total |
| Program Services | 261348 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35751 | Total |
| Management And General | 35749 | ManagementAndGeneral |
| Fundraising | 2 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 372697 | Total |
| Program Services | 372697 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 796547 | Total |
| Program Services | 796533 | ProgramServices |
| Fundraising | 14 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148697 | Total |
| Program Services | 148661 | ProgramServices |
| Fundraising | 36 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| NURSING AND MEDICAL | 707539 | 707539 | ||
| DIETARY - FOOD | 500433 | 500433 | ||
| UTILITIES | 392610 | 391355 | 1224 | 31 |
| SUPPLIES | 303944 | 249928 | 53946 | 70 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 599984 | Total |
| Program Services | 442330 | ProgramServices |
| Management And General | 157520 | ManagementAndGeneral |
| Fundraising | 134 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11326128 | Total |
| Program Services | 9902852 | ProgramServices |
| Management And General | 1422276 | ManagementAndGeneral |
| Fundraising | 1000 | Fundraising |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | X | JointCosts |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2934118 | BOY |
| EOY | 5828941 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 444805 | BOY |
| EOY | 550331 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15567 | BOY |
| EOY | 18115 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200942 | BOY |
| EOY | 17252 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 23021627 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7952286 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14584494 | BOY |
| EOY | 15069341 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 299056 | BOY |
| EOY | 347455 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2435803 | BOY |
| EOY | 725391 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 596450 | BOY |
| EOY | 271168 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21511235 | BOY |
| EOY | 22827994 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1133906 | BOY |
| EOY | 1267748 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11640000 | BOY |
| EOY | 11060000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12773906 | BOY |
| EOY | 12327748 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8737329 | BOY |
| EOY | 10500246 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8737329 | BOY |
| EOY | 10500246 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21511235 | BOY |
| EOY | 22827994 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1720313 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 42604 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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 | 71418 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 163946 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6065 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 22829 | CurrentTaxYearMinus1Year |
| Current Tax Year | 14118 | CurrentTaxYear |
| Total | 278376 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9893073 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9481663 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10800365 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12168630 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12978233 | CurrentTaxYear |
| Total | 55321964 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9964491 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9645609 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10806430 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12191459 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12992351 | CurrentTaxYear |
| Total | 55600340 | 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 | 55600340 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 60130 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 61035 | CurrentTaxYearMinus1Year |
| Current Tax Year | 42678 | CurrentTaxYear |
| Total | 163843 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 60130 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 61035 | CurrentTaxYearMinus1Year |
| Current Tax Year | 42678 | CurrentTaxYear |
| Total | 163843 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 38196 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus2 Years | 10438 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9587 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11412 | CurrentTaxYear |
| Total | 69633 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10002687 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9645609 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10876998 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12262081 | CurrentTaxYearMinus1Year |
| Current Tax Year | 13046441 | CurrentTaxYear |
| Total | 55833816 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99580 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99440 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00290 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00410 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 0 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART IV, SUPPLEMENTAL INFORMATION: | Identifier |
| Explanation | EXPENSES INCURRED IN CONTACTING GOVERNMENT REPRESENTATIVES CONSISTED SOLEY OF TIME EXPENDED BY SALARIED EMPLOYEES TO COMMUNICATE EITHER VERBALLY OR IN WRITING FOR AN APPROXIMATE TIME OF FOUR HOURS. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1892727 | OtherCostOrOtherBasis |
| Book Value | 1892727 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19163241 | OtherCostOrOtherBasis |
| Depreciation | 6551103 | Depreciation |
| Book Value | 12612138 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1965659 | OtherCostOrOtherBasis |
| Depreciation | 1401183 | Depreciation |
| Book Value | 564476 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 15069341 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 13089045 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 42604 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 42604 | RevenueNotRptdF990 |
| Revenue Subtotal | 13046441 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 13046441 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11326128 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 11326128 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 11326128 | TotalExpensesPerForm990 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE BOARD OF TRUSTEES |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | PINE HAVEN CHRISTIAN HOME HAS A BOARD OF DIRECTOR'S APPROVED "CODE OF ETHICS" DOCUMENT. THE CODE OF ETHICS INCLUDES A SECTION COVERING "CONFLICT OF INTEREST". IT PROVIDES A DEFINITION AND ALL EMPLOYEES ARE REQUIRED TO SIGN A STATEMENT EACH YEAR THAT THEY DO NOT HAVE A "CONFLICT OF INTEREST" OR THEY DECLARE ANY EXISTING CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION FOR THE CEO AND OTHER KEY EMPLOYEES IS COMPARED TO INDUSTRY DATA COMPILED BY LEADING AGE WISCONSIN. THE SURVEY COMPARES COMPENSATION BASED ON THREE CRITERIA: GROSS REVENUES, GEOGRAPHIC AREA AND TOTAL BED RESPONSIBILITIES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVALIABLE TO THE PUBLIC AT THIS TIME. |
| FORM 990, PART XII, LINE 2C | THERE IS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PINE HAVEN CHRISTIAN HOME FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVE | AddressLine1 |
| City | SHEBOYGAN FALLS | City |
| State | WI | State |
| ZIP Code | 53085 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391963866 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| 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 | 0 | 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 | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| PINE HAVEN CHRISTIAN HOME FOUNDATION INC | ||
| C | 8098 | ACTUAL AMOUNT RECEIVED |
| PINE HAVEN CHRISTIAN HOME FOUNDATION INC | ||
| D | 21140 | ACTUAL AMOUNT BORROWED |
| PINE HAVEN CHRISTIAN HOME FOUNDATION INC | ||
| O | 9122 | ALLOCATION BASED ON HOURS WORKED |
| PINE HAVEN CHRISTIAN HOME FOUNDATION INC | ||
| Q | 36411 | ACTUAL EXPENSE INCURRED |