SHEBOYGAN SENIOR COMMUNITY INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SHEBOYGAN SENIOR COMMUNITY INC (EIN 39-6069188)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2012-11-12
- IRS object ID
- 201243179349302069
- Schema version
- 2011v1.2
- 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 | 2012-11-12T14:46:25-06:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | 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 | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 396069188 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHEBOYGAN SENIOR COMMUNITY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SHEB | NameControl |
| Phone | 9204582137 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 930 N 6TH STREET | AddressLine1 |
| City | SHEBOYGAN | City |
| State | WI | State |
| ZIP Code | 53081 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL JONAS | Name |
| Title | OFFICER | Title |
| Phone | 9204582137 | Phone |
| Date Signed | 2012-10-04 | 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 | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL JONAS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 930 N 6TH STREET | AddressLine1 |
| City | SHEBOYGAN | City |
| State | WI | State |
| ZIP Code | 53081 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 10926993 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RETIRESHEBOYGAN.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1962 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS, WHICH SHALL ENHANCE, HONOR AND PRESERVE THE DIGNITY OF THE INDIVIDUAL, AND WHERE SPIRITUAL, PHYSICAL AND SOCIAL NEEDS ARE SUPPLIED IN A SPIRIT OF CHRISTIAN LOVE AND CONCERN WITHOUT REGARD TO AGE, SEX, RACE, CREED OR COLOR. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 258 | TotalNbrEmployees |
| Total Nbr Volunteers | 27 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 10155 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7811 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9058728 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 8983855 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2330 | InvestmentIncomePriorYear |
| Investment Income Current Year | 6010 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -266724 | OtherRevenuePriorYear |
| Other Revenue Current Year | 155361 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8804489 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9153037 | 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 | 4969922 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4997535 | 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 | 4867260 | OtherExpensePriorYear |
| Other Expenses Current Year | 3416468 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9837182 | TotalExpensesPriorYear |
| Total Expenses Current Year | 8414003 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1032693 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 739034 | RevenuesLessExpensesCY |
| Total Assets BOY | 9257769 | TotalAssetsBOY |
| Total Assets EOY | 7856780 | TotalAssetsEOY |
| Total Liabilities BOY | 5896012 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3755989 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3361757 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4100791 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS, WHICH SHALL ENHANCE, HONOR AND PRESERVE THE DIGNITY OF THE INDIVIDUAL, AND WHERE SPIRITUAL, PHYSICAL AND SOCIAL NEEDS ARE SUPPLIED IN A SPIRIT OF CHRISTIAN LOVE AND CONCERN WITHOUT REGARD TO AGE, SEX, RACE, CREED OR COLOR. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7404375 | Expense |
| Revenue | 8983855 | Revenue |
| Description | OPERATION OF A FULL-TIME SKILLED NURSING HOME AND RESIDENTIAL CARE CENTER. TOTAL PATIENT DAYS: 43,204. | Description |
| Total Program Service Expense | 7404375 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | 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 | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | 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 |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 8 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 258 | 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 |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | 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 | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | 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 |
| 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 | MICHAEL JONAS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9204582137 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 930 N 6TH STREET | AddressLine1 |
| City | SHEBOYGAN | City |
| State | WI | State |
| ZIP Code | 53081 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| JOHN HUMBERT | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| ATTY MICHAEL ROTH | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| REV RIC OLSON | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| JAMES F PRICE | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| MARCY KERPE | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| ATTY ELDON BOHROFEN | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| NANCY MCADAMS | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| LISA O'NEILL | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| DENNIS OHL | ||||||
| DIRECTOR | 0.00 | X | 0 | 0 | 0 | |
| JIM HOUWERS | ||||||
| PRESIDENT | 0.00 | 0 | 0 | 0 | X | |
| DORIS THUENE | ||||||
| SECRETARY/TREASURER | 0.00 | 0 | 0 | 0 | X | |
| STEVE HAMER | ||||||
| VICE PRESIDENT | 0.00 | 0 | 0 | 0 | X | |
| REV ROGER CLAPP | ||||||
| VICE PRESIDENT | 0.00 | 0 | 0 | 0 | X | |
| GARY MAPLES | ||||||
| VICE PRESIDENT | 0.00 | 0 | 0 | 0 | X | |
| MICHAEL BASCH | ||||||
| EXECUTIVE DIRECTOR | 40.00 | 120178 | 0 | 2600 | X | |
| BARB TESS | ||||||
| CFO | 40.00 | 59059 | 0 | 1989 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 179237 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 4589 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | 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 |
|---|---|---|---|---|---|
| PEOPLE FIRST REHABILITATION | |||||
| BOX 277365 | ATLANTA | GA | 303847365 | PHYSICAL AND OCCUPATIONAL THERAPIES | 507541 |
| SYSCO EASTERN WISCONSIN | |||||
| ONE SYSCO DRIVE | JACKSON | WI | 53037 | PROVIDE VARIOUS SUPPLIES AND FOOD | 374441 |
| REHABCARE GROUP INC | |||||
| DIVISION OF KINDRED HEALTHCARE | ST LOUIS | MO | 63150 | PHYSICAL AND OCCUPATIONAL THERAPIES | 286613 |
| BSG MAINTENANCE | |||||
| PO BOX 165 | NEWBURG | WI | 53060 | HOUSEKEEPING | 236652 |
| BURKHART HEISDORF INSURANCE | |||||
| 1807 ERIE AVENUE | SHEBOYGAN | WI | 53082 | COMPANY INSURANCE | 115498 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| All Other Contributions | 7811 | AllOtherContributions |
| Total Contributions | 7811 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE/MEDICAID PROG | 900099 | 6474308 | 6474308 |
| RESIDENTIAL CENTER | 623000 | 2087295 | 2087295 |
| INDEPENDENT LIVING | 623990 | 311106 | 311106 |
| MISCELLANEOUS | 900099 | 63725 | 63725 |
| BEAUTY SHOP | 812900 | 36861 | 36861 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10560 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10560 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 8983855 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6010 | TotalRevenueColumn |
| Exclusion | $6,010 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 1896543 | GrossSalesOfInventory |
| Cost Of Goods Sold | 1773956 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 122587 | TotalRevenueColumn |
| Related Or Exempt Function Income | 122587 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| FORFEITURE REVENUE | 900099 | 29679 | $29,679 |
| GUEST MEALS | 721000 | 3095 | $3,095 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 32774 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9153037 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9106442 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $38,784 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 179237 | Total |
| Program Services | 154257 | ProgramServices |
| Management And General | 24980 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4105037 | Total |
| Program Services | 3615233 | ProgramServices |
| Management And General | 489804 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49587 | Total |
| Program Services | 43439 | ProgramServices |
| Management And General | 6148 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 313363 | Total |
| Program Services | 274512 | ProgramServices |
| Management And General | 38851 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350311 | Total |
| Program Services | 306879 | ProgramServices |
| Management And General | 43432 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2986 | Total |
| Management And General | 2986 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63432 | Total |
| Management And General | 63432 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44479 | Total |
| Program Services | 2229 | ProgramServices |
| Management And General | 42250 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51644 | Total |
| Management And General | 51644 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 312558 | Total |
| Program Services | 311317 | ProgramServices |
| Management And General | 1241 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2298 | Total |
| Management And General | 2298 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44715 | Total |
| Program Services | 44715 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 305300 | Total |
| Program Services | 255175 | ProgramServices |
| Management And General | 50125 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85556 | Total |
| Program Services | 85556 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES AND | 2316453 | 2262076 | 54377 |
| BAD DEBT EXPENSE | 70364 | 70364 | |
| INVENTORY HOLDING COSTS | 42782 | 42782 | |
| DUES AND SUBSCRIPTIONS | 34469 | 34469 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39432 | Total |
| Program Services | 6205 | ProgramServices |
| Management And General | 33227 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8414003 | Total |
| Program Services | 7404375 | ProgramServices |
| Management And General | 1009628 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | X | JointCosts |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 293922 | BOY |
| EOY | 296714 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 801660 | BOY |
| EOY | 1814874 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3051860 | BOY |
| EOY | 2534213 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40457 | BOY |
| EOY | 40991 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89276 | BOY |
| EOY | 87432 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10454694 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7898830 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2738732 | BOY |
| EOY | 2555864 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2241862 | BOY |
| EOY | 526692 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9257769 | BOY |
| EOY | 7856780 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1861044 | BOY |
| EOY | 1835598 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 387845 | BOY |
| EOY | 383052 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3647123 | BOY |
| EOY | 1534319 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 3020 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5896012 | BOY |
| EOY | 3755989 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3361757 | BOY |
| EOY | 4100791 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3361757 | BOY |
| EOY | 4100791 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9257769 | BOY |
| EOY | 7856780 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 739034 | ReconcilationRevenueExpenses |
| 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 |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 | 31043 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 70357 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10334 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10155 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7811 | CurrentTaxYear |
| Total | 129700 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 14428203 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9825942 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8894962 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10163659 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10880398 | CurrentTaxYear |
| Total | 54193164 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 14459246 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9896299 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8905296 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10173814 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10888209 | CurrentTaxYear |
| Total | 54322864 | 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 | 54322864 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 959 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3865 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1681 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2521 | CurrentTaxYearMinus1Year |
| Current Tax Year | 6010 | CurrentTaxYear |
| Total | 15036 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 959 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3865 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1681 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2521 | CurrentTaxYearMinus1Year |
| Current Tax Year | 6010 | CurrentTaxYear |
| Total | 15036 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4585 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 99376 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4564 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 33918 | CurrentTaxYearMinus1Year |
| Current Tax Year | 32774 | CurrentTaxYear |
| Total | 175217 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 14464790 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9999540 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8911541 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10210253 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10926993 | CurrentTaxYear |
| Total | 54513117 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99650 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99650 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00030 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00070 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 254703 | OtherCostOrOtherBasis |
| Book Value | 254703 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6934978 | OtherCostOrOtherBasis |
| Depreciation | 5116456 | Depreciation |
| Book Value | 1818522 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1984977 | OtherCostOrOtherBasis |
| Depreciation | 1784636 | Depreciation |
| Book Value | 200341 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1280036 | OtherCostOrOtherBasis |
| Depreciation | 997738 | Depreciation |
| Book Value | 282298 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2555864 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BOND FEES NET OF ACCUMULATED DEPREC | 15333 |
| LANDMARK SQUARE PROJECT | 508339 |
| CUSTOMER ESCROW DEPOSIT | 3020 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 526692 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CUSTOMER ESCROW DEPOSIT UNEARNED | Description |
| Amount | $3,020 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3020 | TotalOfAmounts |
| Total Revenue | 9153037 | TotalRevenue |
| Total Expenses | 8414003 | TotalExpenses |
| Excess Or Deficit For Year | 739034 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 739034 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 9081318 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 80547 | OtherRevenues |
| Revenue Not Rptd F990 | 80547 | RevenueNotRptdF990 |
| Revenue Subtotal | 9000771 | RevenueSubtotal |
| Other Revenues Not Included | 152266 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 152266 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9153037 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8342284 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 80547 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 80547 | ExpensesNotRptdF990 |
| Expenses Subtotal | 8261737 | ExpensesSubtotal |
| Other Expenses Not Included | 152266 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 152266 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 8414003 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | GAIN FROM SALES OF INVENTORY REPORTED ON THE FINANCIAL STATEMENTS 80,547. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | FORFEITURES 29,679. GAIN FROM SALES OF INVENTORY INCLUDED ON 990 PAGE 9, LINE 10C 122,587. |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | GAIN FROM SALES OF INVENTORY REPORTED ON THE FINANCIAL STATEMENTS 80,547. |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | FORFEITURES 29,679. GAIN FROM SALES OF INVENTORY INCLUDED ON 990 PAGE 9, LINE 10C 122,587. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MICHAEL ROTH | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | PARTNER AT WURTZ, ROTH, BASLER, AND BROCK | Relationship |
| Amount Of Transaction | 2047 | AmountOfTransaction |
| Description Of Transaction | SHEBOYGAN SENIOR COMMUNITY, INC. USED WURTZ, ROTH, BASLER, AND BROCK FOR LAW SERVICES | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A PDF COPY OF FORM 990 IS EMAILED TO THE CHIEF FINANCIAL OFFICER. THE CFO FORWARDS THE EMAIL TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. THE 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING. THE CFO CHECKS FORM 990 WITH INTERNAL REPORTS. |
| FORM 990, PART VI, SECTION B, LINE 12C | A NEW CONFLICT OF INTEREST POLICY IS FILLED OUT ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15A | SHEBOYGAN SENIOR COMMUNITY, INC. USES DATA GATHERED FOR THEIR STATE ASSOCIATION (WISCONSIN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) BY MANAGEMENT RESOURCE ASSOCIATES (MRA), A THIRD PARTY INDEPENDENT, NOT FOR PROFIT, MANAGEMENT CONSULTING GROUP. THE DATA IS GATHERED FROM PARTICIPATING NOT FOR PROFIT HOMES THROUGHOUT THE STATE OF WISCONSIN. SALARY RECOMMENDATIONS FOR THE CEO ARE REVIEWED AND SET BY THE EXECUTIVE COMMITTEE IN AN EXECUTIVE SESSION WITHOUT THE CEO'S PRESENCE AFTER THE FULL ANNUAL PERFORMANCE EVALUATION, UTILIZING THE DATA DESCRIBED ABOVE. NO OTHER MANAGEMENT STAFF ARE REVIEWED IN THIS MANOR, THOUGH ALL SALARY AND EXPENSE DATA IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD IN THEIR ANNUAL BUDGET PREPARATION AND APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FROM 990, PART XI, LINE 2C: | THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHEBOYGAN SENIOR COMMUNITY FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 930 N 6TH STREET | AddressLine1 |
| City | SHEBOYGAN | City |
| State | WI | State |
| ZIP Code | 53081 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391450846 | EIN |
| Primary Activities | RAISE/RECEIVE FUNDS TO BE USED FOR GENERAL SUPPORT OF THIS ORGANIZATION | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOARD OF DIRECTORS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| 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 | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHEBOYGAN SENIOR COMMUNITY FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | E | TransactionType |
| Amount Involved | 1256847 | AmountInvolved |
| Method Of Amt Determination | ACTUAL BALANCE OUTSTANDING | MethodOfAmtDetermination |
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