WISCONSIN MASONIC HOME INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
WISCONSIN MASONIC HOME INC (EIN 39-0813463)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-12
IRS object ID
201131329349301798
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-12T11:11:08-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390813463EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Wisconsin Masonic Home IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWISCNameControl
Phone2629652111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1410 N Main StreetAddressLine1
CityDousmanCity
StateWIState
ZIP Code531189348ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDave OinesName
TitleCFOTitle
Phone2629652111Phone
Date Signed2011-05-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMark StaurtmanNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1410 N Main StreetAddressLine1
CityDousmanCity
StateWIState
ZIP Code531189348ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4906945GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.threepillars.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionMEET THE SOCIAL, PHYSICAL, AND SPIRITUAL NEEDS OF OLDER ADULTS THROUGH QUALITY HOUSING.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees126TotalNbrEmployees
Total Nbr Volunteers45TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year266210ContributionsGrantsPriorYear
Contributions Grants Current Year311203ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3867096ProgramServiceRevenuePriorYear
Program Service Revenue CY3986055ProgramServiceRevenueCY
Investment Income Prior Year1128455InvestmentIncomePriorYear
Investment Income Current Year605208InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year5261761TotalRevenuePriorYear
Total Revenue Current Year4902466TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year19580GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY20630GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2409123SalariesEtcPriorYear
Salaries Etc Current Year2391110SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year93613TotalFundrsngExpCurrentYear
Other Expense Prior Year2697164OtherExpensePriorYear
Other Expenses Current Year2767351OtherExpensesCurrentYear
Total Expenses Prior Year5125867TotalExpensesPriorYear
Total Expenses Current Year5179091TotalExpensesCurrentYear
Revenues Less Expenses Prior Year135894RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-276625RevenuesLessExpensesCY
Total Assets BOY54093246TotalAssetsBOY
Total Assets EOY58678791TotalAssetsEOY
Total Liabilities BOY14899232TotalLiabilitiesBOY
Total Liabilities EOY14886692TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39194014NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY43792099NetAssetsOrFundBalancesEOY
Mission DescriptionWisconsin Masonic Home, Inc., sponsored by the Masonic fraternity, provides for the social, physical, and spiritual needs of older adults through high quality housing and services.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2686111Expense
Grants20630Grants
Revenue3000344Revenue
DescriptionCOMPASS POINT - An assisted living option is available for persons aged 55 and older in a residential care apartment complex. This program provides assisted living services, including meals, wellness services, social assistance, housekeeping, and assistance with activities of daily living and medical needs. A meals on wheels program is also available to the non resident community. On average, 74 residents are served on a daily basis, and 7% of the residents are able to continue living with a spouse.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense850741Expense
Grants0Grants
Revenue706584Revenue
DescriptionRIVERSIDE LODGE - An assisted living option is available for persons aged 55 and older in a community based residential facility. This program provides services similar to the assisted living identified above, in a more secure environment. Several of the 16 residents are likely to have memory care needs.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense473537Expense
Grants0Grants
Revenue279127Revenue
DescriptionMASONWOODS - An independent living option is availabe for persons 55 and older. Social interaction and security are important to the 53 resideNts living in the facility on an average daily basis, and 62% of the units are occupied by couples.Description
FieldValueIRS element (for citing)
Total Program Service Expense4010389TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109635NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees126NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Dave OinesBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2629652111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1410 N Main StAddressLine1
CityDousmanCity
StateWIState
ZIP Code531189348ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
JEFF BRYDEN
DIRECTOR1.00X000
ROBERT GORSUCH
DIRECTOR1.00X000
GARY KRAUSE
DIRECTOR1.00X000
JOE HARKER
DIRECTOR1.00X000
ALLAN ILDING
DIRECTOR1.00X000
A WILLIAM HUELSMAN
DIRECTOR1.00X000
ROBERT MOORE
DIRECTOR1.00X000
KRIS ENGBRING
DIRECTOR1.00X000
GARY STANG
DIRECTOR1.00X000
DENNIS SIEWERT
DIRECTOR1.00X000
MONTE STEIBER
DIRECTOR1.00X000
FRANK STRUBLE
DIRECTOR1.00X000
DAVEY WHITE
DIRECTOR1.00X000
MARK STRAUTMAN
CEO40.00654698857726856X
DAVID OINES
CFO40.00390754775819679X
FieldValueIRS element (for citing)
Total Reportable Comp From Org104544TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs136335TotalReportableCompFrmRltdOrgs
Total Other Compensation46535TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MORRISON MANAGEMENT SPECIALISTSBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 102289AddressLine1
CityATLANTACity
StateGAState
ZIP Code30368ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesDINING SERVICESDescriptionOfServices
Compensation386223Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions311203AllOtherContributions
Total Contributions311203TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SCV REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column3986055TotalRevenueColumn
Related Or Exempt Function Income3986055RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3986055TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column609687TotalRevenueColumn
Exclusion$609,687ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4479Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-4479Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-4479TotalRevenueColumn
Exclusion-$4,479ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4902466TotalRevenueColumn
Related Or Exempt Function Income3986055RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$605,208ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total20630Total
Program Services20630ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total114083Total
Management And General114083ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1798778Total
Program Services1486019ProgramServices
Management And General312759ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total45276Total
Program Services35173ProgramServices
Management And General10103ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total240360Total
Program Services186725ProgramServices
Management And General53635ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total192613Total
Program Services149633ProgramServices
Management And General42980ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total28488Total
Management And General28488ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total11677Total
Management And General11677ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total60989Total
Management And General60989ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total55042Total
Management And General55042ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total36639Total
Management And General36639ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total355648Total
Program Services289694ProgramServices
Management And General65954ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total6125Total
Management And General6125ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6287Total
Management And General6287ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total484024Total
Program Services483731ProgramServices
Management And General293ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total875183Total
Program Services735874ProgramServices
Management And General139309ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total74267Total
Program Services20098ProgramServices
Management And General54169ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
DINING SERVICES377070377070
PURCHASED SERVICES191426575404027393613
SUPPLIES14041010412636284
OTHER MISCELLANEOUS3224332243
UNCOLLECTIBLE ACCOUNTS3183331833

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5179091Total
Program Services4010389ProgramServices
Management And General1075089ManagementAndGeneral
Fundraising93613Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1175748BOY
EOY1096954EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY380798BOY
EOY303242EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY106248BOY
EOY63035EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY37544BOY
EOY60878EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis20913515LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5184891LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY16121672BOY
EOY15728624EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY18689825BOY
EOY20975216EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY10697987BOY
EOY13153526EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6883424BOY
EOY7297316EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY54093246BOY
EOY58678791EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY693217BOY
EOY851403EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12728015BOY
EOY12367289EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1478000BOY
EOY1668000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14899232BOY
EOY14886692EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY23380923BOY
EOY25733558EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5112159BOY
EOY7285600EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10700932BOY
EOY10772941EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39194014BOY
EOY43792099EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY54093246BOY
EOY58678791EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1166038CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1018945CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years543412CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year266210CurrentTaxYearMinus1Year
Current Tax Year311203CurrentTaxYear
Total3305808Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1166038CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1018945CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years543412CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year266210CurrentTaxYearMinus1Year
Current Tax Year311203CurrentTaxYear
Total3305808Total
FieldValueIRS element (for citing)
Public Support Total1703305808PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years930128CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1409458CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1349254CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year997842CurrentTaxYearMinus1Year
Current Tax Year609687CurrentTaxYear
Total5296369Total
FieldValueIRS element (for citing)
Total Support8602177TotalSupport
Gross Receipts From Admissions Etc17047747GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.38430PublicSupportPertcentage170
Public Support Pertcent Prior Year0.33930PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance10136529BeginningOfYearBalance
Contributions32742Contributions
End Of Year Balance10169271EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance9802031BeginningOfYearBalance
Contributions334498Contributions
End Of Year Balance10136529EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis504824OtherCostOrOtherBasis
Book Value504824BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17263458OtherCostOrOtherBasis
Depreciation3554847Depreciation
Book Value13708611BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1880115OtherCostOrOtherBasis
Depreciation917004Depreciation
Book Value963111BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1085272OtherCostOrOtherBasis
Depreciation599122Depreciation
Book Value486150BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis179846OtherCostOrOtherBasis
Depreciation113918Depreciation
Book Value65928BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings15728624TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
POOLED INVESTMENTS19859450F
FUNDS HELD BY TRUSTEES UNDER BOND INDENTURE AGREEMENTS1115766F
FieldValueIRS element (for citing)
Total Of Book Value Securities20975216TotalOfBookValueSecurities

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionINVESTMENT IN NET ASSETS OF WISCONSIN MASONIC FOUNDATIONDescription
Book Value13153526BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related13153526TotalOfBookValueProgramRelated

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCE CHARGE242804
Related Party Receivable7054512
FieldValueIRS element (for citing)
Total Book Value Other Assets7297316TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionREFUNDABLE RESIDENCY FEESDescription
Amount$1,668,000Amount
FieldValueIRS element (for citing)
Total Of Amounts1668000TotalOfAmounts
Total Revenue4902466TotalRevenue
Total Expenses5179091TotalExpenses
Excess Or Deficit For Year-276625ExcessOrDeficitForYear
Net Unrealized GL On Investments1565227NetUnrealizedGLOnInvestments
Other$3,309,483OtherAmount
Total Adjustments4874710TotalAdjustments
Excess Or Deficit Per FS4598085ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt5961790TotRevenueEtcAuditedFinclStmt
Other Revenues1059324OtherRevenues
Revenue Not Rptd F9901059324RevenueNotRptdF990
Revenue Subtotal4902466RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9904902466TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5158461TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal5158461ExpensesSubtotal
Other Expenses Not Included20630OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt20630ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905179091TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part V, Line 4:Description of Intended Use of Endowment Funds:The organization's endowment funds include the following: Wisconsin Masonic Foundation - Home Endowment Fund: These funds are held by the related organization, Wisconsin Masonic Foundation. The interest in the net assets of the foundation is reflected on the balance sheet of Wisconsin Masonic Home. These funds available for use by Wisconsin Masonic Home are used for general operating purposes, and support the charitable mission of Wisconsin Masonic Home. The Ohde Fund: This fund is included in the net assets of Wisconsin Masonic Home. The funds under the Ohde endowment are to be used for present and future residents of the Wisconsin Masonic Home, the Bark River Apartments and the Riverside Lodge, who cannot afford to pay for their own care. The Cummings Fund: This fund is included in the net assets of Wisconsin Masonic Home. The funds under the Cummings endowment are to be used to provide services which will improve resident quality of life. Examples of these services include (1) medical assessment and care, (2) spiritual activity, and (3) activities, leadership and community events. Activities, leadership and community events would include staff and programs that would provide attention to education, entertainment, transportation, personal development, and other activities relating to resident preferences. The Butler Perpetual Trust: The Butler Perpetual Trust has been established from an estate, and is currently reflected on the balance sheet of Wisconsin Masonic Home as part of restricted net assets. Wisconsin Masonic Home exerts no influence or control over the investments. This endowment will be used to support the charitable mission of Wisconsin Masonic Home.
Part XI, Line 8 - Other Adjustments:CHANGE IN INTEREST IN NET ASSETS OF WISCONSIN MASONIC FOUNDATION: 3268353. Restricted Contributions: 9000. Change in Value of Contributions Receivable: -7137. Change in Value of Perpetual Trust: 39267.
Part XII, Line 2d - Other Adjustments:net assets released from restriction: 1059324.
Part XIII, Line 4b - Other Adjustments:TRANSFER TO AFFILIATE: 20630.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1village on the squareBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1410 n main streetAddressLine1
CitydousmanCity
StateWIState
ZIP Code53118ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient391662636EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant20630AmountOfCashGrant
Purpose Of GrantIncome on restricted fund paid to village on the square, inc. in support of certain categories of expenses.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: on an annual basis, the audit and finance committee of the organization reviews the financial statements and general ledger of the donee, a related organization, to confirm that the grants are used for the specific purposes as intended.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required0SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MARK STRAUTMANBusinessNameLine1
FieldValueIRS element (for citing)
Base Compensation Filing Org62199BaseCompensationFilingOrg
Comp Based On Related Orgs84152CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org3270OtherCompensationFilingOrg
Other Compensation Related Orgs4425OtherCompensationRelatedOrgs
Deferred Comp Filing Org6316DeferredCompFilingOrg
Deferred Comp Related Orgs8546DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org5097NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs6897NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org76882TotalCompensationFilingOrg
Total Compensation Related Orgs104020TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 1aReturnReference
ExplanationHealth club fees for the CEO are included in his compensation. These fees are included as a reviewed item in the compensation process.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
WISCONSIN HEALTH AND EDUCATION FACILITIES AUTHORITY REV BDS SERIES 2003
39133785597710VPR92003-10-143869942WHEFA 2003 SERIES (THREE PILLARS SENIOR LIVING COMM.) REFINANCE 1996 BONDS00
WISCONSIN HEALTH AND EDUCATION FACILITIES AUTHORITY REV BDS SERIES 2004A
39133785597670FAA92004-12-295125000WHEFA 2004A (THREE PILLARS SENIOR LIVING COMM.) CONSTRUCTION COMPASS POINT00
WISCONSIN HEALTH AND EDUCATION FACILITIES AUTHORITY REV BDS SERIES 2004b 2
39133785597670FAM32004-12-296500000WHEFA 2004B (THREE PILLARS SENIOR LIVING COMM.) CONSTRUCTION COMPASS POINT00

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundAmount DefeasedAmountDefeasedIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
386116630049634848507582020031011
5077307351806101546200600114623955
6500000118309200600116381691

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000001
000001
000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000001
000001
010001

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 4In May of 2010, the following changes were made to the bylaws of Wisconsin Masonic Home: -Increased the number of Directors from 15 to 16. -Added the Grand Master of Masons of Wisconsin as an ex-officio director. -Changed authority for filling a vacancy from Directors in office to an election of the Members from persons recommended by the Grand Master of Masons of Wisconsin. -Identified the Grand Master of Masons of Wisconsin or his designee, who must be a Board member, as the Chairman of the Board of Directors. -Eliminated the Vice Chair as a Board Officer and adds a President and Vice President as Board Officers. -Added requirement of consent from the Members for certain duties of the President of the Corporation, including, but not limited to, signing contracts and incurring debt. -Eliminated ability of the Board to alter or amend the bylaws and replaces the authority with the Members.
Form 990, Part VI, Section A, line 6THE MEMBERS OF THE ORGANIZATION ARE THE MEMBERS OF THE WISCONSIN MASONIC BENEVOLENT ACTIVITIES BOARD OF DIRECTORS.
Form 990, Part VI, Section A, line 7aTHE MEMBERS OF THE CORPORATION ELECT 12 MEMBERS OF THE BOARD OF DIRECTORS. THE GRAND MASTER OF MASONS OF WISCONSIN APPOINTS THE REMAINING THREE MEMBERS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Section A, line 7bTHE MEMBERS HAVE CERTAIN RESERVE POWERS OVER THE DECISIONS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Section B, line 11A COPY OF THE FORM 990 OF WISCONSIN MASONIC HOME, INC. WAS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. MANAGEMENT REVIEWS THE 990, THEN THE BOARD REVIEWS.
Form 990, Part VI, Section B, line 12cALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES SIGN A WRITTEN CONFLICT OF INTEREST FORM AT THE ANNUAL MEETING. IF A CONFLICT EXISTS WITH A MEETING'S AGENDA, THAT DIRECTOR OR OFFICER WILL ABSTAIN FROM DISCUSSION AND VOTING.
Form 990, Part VI, Section B, line 15aAN EXECUTIVE COMMITTEE OF THE BOARD DETERMINED THE SALARY OF THE CEO, USING A COMPENSATION SURVEY. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THE CFO'S SALARY WAS DETERMINED INTERNALLY, BASED ON MARKET COMPARISONS TO CONFIRM THAT TOTAL COMPENSATION TO BE PAID WAS REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS.
Form 990, Part VI, Section C, line 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF WISCONSIN MASONIC HOME, INC. ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VII, Line 1Mark Strautman devotes approximately 40 hours per week as follows: Wisconsin Masonic Home - 16 Hours, Masonic Center for Health and Rehab, Inc - 12 hours, Village on the Square - 12 hours. Dave Oines devotes approximately 40 hours per week as follows: Wisconsin Masonic Home - 18 Hours, Masonic Center for Health and Rehab, Inc - 16 hours, Village on the Square - 6 hours.Shared hours

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
MASONIC CENTER FOR HEALTH AND REHAB INC
410 N MAIN STREETDOUSMANWI53118391506910REHABILITATION SERVICESWI501(c)(3)Line 9N/A
VILLAGE ON THE SQUARE INC
410 N MAIN STREETDOUSMANWI53118391662636SENIOR ASSISTED LIVINGWI501(c)(3)Line 9N/A
GRAND LODGE FREE & ACCEPTED MASONS OF WISCONSIN
36275 SUNSET DRIVEDOUSMANWI53118390129695FRATERNAL ORGANIZATIONWI501(c)(8) & (c)(10)N/A
Wisconsin Masonic Foundation
36275 SUNSET DRIVEDOUSMANWI53118396044637SCHOLARSHIP PROVIDERWI
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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