2011-10-17T09:29:52-05:00 2011-06-30 SCHENCK SC 712 RIVERFRONT DRIVE STE 301 SHEBOYGAN WI 53081 990 2010-07-01 396069188 SHEBOYGAN SENIOR COMMUNITY INC SHEB 9204582137 930 N 6TH STREET SHEBOYGAN WI 53081 BARB TESS 9204582137 2011-10-07 1 TERRY T STRITTMATER CPA 9204580341 2010 2016-03-07 17:11:31Z BARB TESS 930 N 6TH STREET SHEBOYGAN WI 53081 10210253 0 X WWW.RETIRESHEBOYGAN.COM X 1962 WI 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. 16 16 259 14 0 0 10334 10155 8440573 9058728 4460 2330 -359554 -266724 8095813 8804489 0 0 0 0 5085170 4969922 0 0 0 3176466 4867260 8261636 9837182 -165823 -1032693 11667662 9257769 7273212 5896012 4394450 3361757 X 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. 0 0 8891606 9058728 OPERATION OF A FULL-TIME SKILLED NURSING HOME AND RESIDENTIAL CARE CENTER. TOTAL PATIENT DAYS: 46,139. 8891606 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 1 10 0 1 259 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X X BARB TESS 9204582137 930 N 6TH STREET SHEBOYGAN WI 53081 JOHN HUMBERT X 0 0 0 STEVE STAUBER X 0 0 0 REV KARL NELSON X 0 0 0 TRYG JACOBSON X 0 0 0 MARCY KERPE X 0 0 0 ATTY ELDON BOHROFEN X 0 0 0 NANCY MCADAMS X 0 0 0 LISA O'NEILL X 0 0 0 BARBARA DODGE X 0 0 0 REV STEVE HANUSA X 0 0 0 DENNIS OHL X 0 0 0 JIM HOUWERS X 0 0 0 DORIS THEUNE X 0 0 0 STEVE HAMER X 0 0 0 REV ROGER CLAPP X 0 0 0 GARY MAPLES X 0 0 0 MICHAEL BASCH 40.00 X 119770 0 8676 BARBARA TESS 40.00 X 61529 0 4757 181299 0 13433 1 0 0 0 PEOPLE FIRST REHABILITATION BOX 277365 ATLANTA GA 303847365 PHYSICAL AND OCCUPATIONAL THERAPIES 836803 SYSCO EASTERN WISCONSIN ONE SYSCO DRIVE JACKSON WI 53037 PROVIDE VARIOUS SUPPLIES AND FOOD 372128 HUMANA PO BOX 567 CAROL STREAM IL 60132 HEALTH AND DENTAL INSURANCE 311565 BSG MAINTENANCE PO BOX 165 NEWBURG WI 53060 HOUSEKEEPING 236312 BURKHART HEISDORF INSURANCE 1807 ERIE AVENUE SHEBOYGAN WI 53082 COMPANY INSURANCE 126296 9 10155 10155 MEDICARE/MEDICAID PROG 900099 6304687 6304687 RESIDENTIAL CENTER 623000 2408104 2408104 INDEPENDENT LIVING 623990 270371 270371 BEAUTY SHOP 812900 36705 36705 MISCELLANEOUS 900099 27491 27491 11370 11370 9058728 2521 2521 191 -191 -191 -191 1104931 1405573 -300642 -300642 FORFEITURE REVENUE 900099 31257 31257 GUEST MEALS 721000 2661 2661 33918 8804489 8758086 0 36248 181299 155736 25563 4043998 3597465 446533 42796 38495 4301 379140 344668 34472 322689 290258 32431 36751 36751 69785 69785 51887 8377 43510 48334 48334 342421 340561 1860 2119 2119 50970 50970 326208 267943 58265 89445 89445 PURCHASED SERVICES AND 2357067 2294340 62727 IMPAIRMENT OF INVENTORY 1119144 1119144 INVENTORY HOLDING COSTS 291263 291263 DUES AND SUBSCRIPTIONS 33570 33570 BAD DEBT EXPENSE 24161 24161 24135 2941 21194 9837182 8891606 945576 0 X 277007 293922 541974 801660 2982751 3051860 36134 40457 151159 89276 10336763 7598031 2928563 2738732 4750074 2241862 11667662 9257769 1926396 1861044 365453 387845 4968227 3647123 13136 0 7273212 5896012 X 4394450 3361757 4394450 3361757 11667662 9257769 -1032693 0 X X 0 1 1 X 0 X 74840 31043 70357 10334 10155 196729 7231910 14428203 9825942 8894962 10163659 50544676 7306750 14459246 9896299 8905296 10173814 50741405 0 0 0 50741405 24105 959 3865 1681 2521 33131 24105 959 3865 1681 2521 33131 4664 4585 99376 4564 33918 147107 7335519 14464790 9999540 8911541 10210253 50921643 0.99650 0.99660 0.00070 0.00090 X 254703 254703 6904711 4929357 1975354 1924474 1715902 208572 1252875 952772 300103 2738732 BOND FEES NET OF ACCUMULATED DEPREC 17333 LANDMARK SQUARE PROJECT 2224529 2241862 8804489 9837182 -1032693 0 -1032693 9073873 300641 300641 8773232 31257 31257 8804489 10106566 300641 300641 9805925 31257 31257 9837182 PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS FROM SALES OF INVENTORY INCLUDED ON 990 PAGE 9, LINE 10C 300,641. PART XII, LINE 4B - OTHER ADJUSTMENTS: FORFEITURES 31,257. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SALE OF INVENTORY INLOSS FROM SALES OF INVENTOCLUDED ON 990 PAGE 9, LINE 10C 300,641. PART XIII, LINE 4B - OTHER ADJUSTMENTS: FORFEITURES 31,257. MICHAEL ROTH PARTNER AT WURTZ, ROTH, BASLER, AND BROCK 1209 SHEBOYGAN SENIOR COMMUNITY, INC. USED WURTZ, ROTH, BASLER, AND BROCK FOR LAW SERVICES 0 FORM 990, PART VI, SECTION A, LINE 4 THE NUMBER OF DIRECTORS CONSITITUING THE BOARD OF DIRECTORS WAS CHANGED FROM AT LEAST 15 BUT NO MORE THAN 25 TO AT LEAST 11 BUT NO MORE THAN 15. AT LEAST 3 OF THE DIRECTORS SHALL BE MEMBERS OF THE UNITED METHODIST CHURCH INSTEAD OF AT LEAST 6. IT IS NO LONGER NESSESSARY FOR THE VICE PRESIDENT TO INCLUDE THE CHAIRS OF THE STRATEGIC PLANNING, SERVICES AND FINANCE COMMITTEES. THE EXECUTIVE COMMITTEE MEMBERS WAS CHANGED FROM CONSISTING OF THE PRESIDENT, 3 VICE PRESIDENTS, SECRETARY/TREASURER AND THE IMMEDIATE PAST PRESIDENT OF THE BOARD TO CONSISTING OF THE PRESIDENT, VICE PRESIDENT AND THE SECRETARY/TREASURER. THE AMOUNT OF EXPENDITURES AND TRANSFERS OF PROPERTY THE COMMITTEE CAN CONDUCT BUSINESS AND AFFAIRS OF THE CORPORATION AND CARRY ON CORPORATE OPERATIONS CHANGED FROM UP TO $10,000 TO UP TO $30,000. THE SERVICE COMMITTEE WENT FROM BEING COMPOSED OF AT LEAST 5 MEMBERS TO AT LEAST 3 MEMBERS. THE CHAIRPERSON NO LONGER HAS TO BE THE VICE PRESIDENT OF SERVICES. THE STRATEGIC PLANNING COMMITTEE CHANGED FROM BEING COMPOSED OF AT LEAST 5 MEMBERS TO AT LEAST 3 MEMBERS. 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. SHEBOYGAN SENIOR COMMUNITY FOUNDATION 930 N 6TH STREET SHEBOYGAN WI 53081 391450846 RAISE/RECEIVE FUNDS TO BE USED FOR GENERAL SUPPORT OF THIS ORGANIZATION WI 501(C)(3) 11 BOARD OF DIRECTORS 0 LSQ CONDO OWNER'S ASSOCIATION 930 NORTH 6TH STREET SHEBOYGAN WI 53081 261895173 CONDOMINIUM MANAGEMENT ASSOCIATION AND MANAGING CONDOMINIUMS WI BOARD OF DIRECTORS C -38718 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 LSQ CONDO OWNER'S ASSOCIATION O 38718 ACTUAL LOSS INCURRED SHEBOYGAN SENIOR COMMUNITY FOUNDATION E 1243192 ACTUAL BALANCE OUTSTANDING