2024-10-29T12:24:41-05:00 2023-12-31 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2023-01-01 391081800 EVERGREEN RETIREMENT COMMUNITY INC EVER 9202332340 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 BILLIE JO HIGGINS TREASURER 9202332340 2024-10-22 1 0 SOLOMON MARDAKHAEV P01806552 6105653930 2024-10-22 2023 2024-10-15 13:58:12Z KENNETH A ARNESON 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 24015472 0 X WWW.EVERGREENOSHKOSH.COM X 1965 WI GUIDED BY CHRISTIAN IDEALS THAT NURTURE ALL PEOPLE, WE STRIVE TO PROVIDE EXCEPTIONAL LIVING ENVIRONMENTS, SERVICES AND EXPERIENCES FOR PEOPLE 55 AND OLDER. 19 19 490 120 0 0 742255 1184170 18181372 22494234 0 0 637489 337068 19561116 24015472 0 0 0 0 10964151 11202252 0 0 0 9326541 11434547 20290692 22636799 -729576 1378673 48530279 48166998 31976818 30234864 16553461 17932134 X GUIDED BY CHRISTIAN IDEALS THAT NURTURE ALL PEOPLE, WE STRIVE TO PROVIDE EXCEPTIONAL LIVING ENVIRONMENTS, SERVICES AND EXPERIENCES FOR PEOPLE 55 AND OLDER. 0 0 19335548 0 22831302 EVERGREEN IS A NONPROFIT CONTINUING CARE RETIREMENT COMMUNITY (CCRC) SERVING OLDER ADULTS, AGES 55 AND OLDER. IDEAL FOR THOSE LOOKING FOR A LIFESTYLE OF CHOICE, FREEDOM, SAFETY, COMMUNITY AND VALUE, EVERGREEN IS MORE THAN JUST A SENIOR LIVING COMMUNITY. EVERGREEN'S 35-ACRE CAMPUS IS NOT ONLY HOME TO ALMOST 300 RESIDENTS, BUT IT IS ALSO A DESTINATION FOR FAMILIES, COMMUNITY MEMBERS, VOLUNTEERS, NONPROFIT GROUPS AND OTHER VISITORS. LOCATED IN A PLEASANT RESIDENTIAL NEIGHBORHOOD IN OSHKOSH, WISCONSIN AMONG BEAUTIFUL, NATURAL SURROUNDINGS AND BORDERED BY OUR OWN OAK SAVANNA WOODLANDS, EVERGREEN PROVIDES LIVELY OPPORTUNITIES FOR YOU AND YOUR FRIENDS TO LIVE AS YOU CHOOSE. CHOOSE FROM THREE STYLES OF INDEPENDENT LIVING ACCOMMODATIONS, FOUR LEVELS OF ASSISTED LIVING, SHORT-TERM REHAB AND POST SURGICAL CARE, LONG-TERM SKILLED NURSING, OR EVERGREEN AT HOME SERVICES TO MEET YOUR UNIQUE NEEDS. LIFE ENRICHMENT ABOUNDS AT EVERGREEN. THERAPEUTIC SWIMMING POOLS, AN AEROBIC STUDIO, LAPIDARY SHOP, AND SUPPERS WITH THE CHEF ARE JUST A FEW OF THE MANY OPPORTUNITIES THAT ENCOURAGE ACTIVE LIFESTYLES. PARTNERSHIPS WITH THE UNIVERSITY OF WISCONSIN OSHKOSH, LEARNING IN RETIREMENT AND THE OSHKOSH GALLERY WALK ALSO PROVIDE ENTERTAINING AND FULFILLING EXPERIENCES AND ENSURE THAT NO TWO DAYS ARE THE SAME. AT EVERGREEN, POSSIBILITIES AWAIT. 19335548 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 99 0 490 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 WI X BILLIE JO HIGGINS 9202332340 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 BARBARA RAU CHAIRMAN 1.00 X X 0 0 0 TOM RAMSEY VICE CHAIR 1.00 X X 0 0 0 JAVAD AHMAD DIRECTOR 1.00 X 0 0 0 JIM CHITWOOD DIRECTOR 1.00 X 0 0 0 SARAH DEARMOND DIRECTOR 1.00 X 0 0 0 DEDE DEWITT DIRECTOR 1.00 X 0 0 0 VERNA FUNCKE DIRECTOR 1.00 X 0 0 0 MIKE GREY DIRECTOR 1.00 X 0 0 0 DAVID KRUCK DIRECTOR 1.00 X 0 0 0 SHERRY LYNCH DIRECTOR 1.00 X 0 0 0 ANDREW MATHES DIRECTOR 1.00 X 0 0 0 CHAD MILLER DIRECTOR 1.00 X 0 0 0 LUELLA REMMEL DIRECTOR 1.00 X 0 0 0 TONY RENNING DIRECTOR 1.00 X 0 0 0 EMILY RICHESON DIRECTOR 1.00 X 0 0 0 ALAN ROMMELFANGER DIRECTOR 1.00 X 0 0 0 JOHN STUBBS DIRECTOR 1.00 X 0 0 0 GAIL SULLIVAN DIRECTOR 1.00 X 0 0 0 ANN WILKES DIRECTOR 1.00 X 0 0 0 KEN ARNESON PRESIDENT /CEO 40.00 2.00 X 284401 0 22186 BILLIE JO HIGGINS CFO/TREASURER 40.00 2.00 X 159608 0 10458 LISA RUIZ EXECUTIVE ASSISTANT/SECRETARY 40.00 X 53781 0 15008 ERIN SANDERS VP HUMAN RESOURCES 40.00 X 120254 0 24264 PEGGY BELLIN VP HEALTH & SUPPORT SERVICES 40.00 X 117378 0 20162 735422 0 92078 4 0 1 0 NEW HORIZON FOODS 2670 106TH STREET URBANDALE IA 50322 DINING SERVICES 1002622 HEALTHCARE SERVICES GROUP PO BOX 829677 PHILADELPHIA PA 19182 HOUSKEEPING SERVICES 623864 UNITI MED LLC PO BOX 204695 DALLAS TX 75320 AGENCY STAFF 564225 UNITED METHODIST HOMES & SERVICES 1415 W FOSTER AVE CHICAGO IL 60640 AGENCY STAFF 418038 PRIME TIME HEALTHCARE LLC PO BOX 3544 OMAHA NE 68103 AGENCY STAFF 340684 11 1184170 1184170 HEALTH CENTER REVENUE 623000 8128237 8128237 CBRF REVENUE 623000 5505094 5505094 INDEPENDENT LIVING REVENUE 623000 5386565 5386565 ANCILLARY SERVICE REVENUE 623000 2308727 2308727 RCAC REVENUE 623000 1068892 1068892 96719 96719 22494234 NON-OPERATING INCOME 900099 337068 337068 337068 24015472 22831302 0 0 X 545439 456482 88957 8696927 7220189 1476738 288314 241291 47023 997281 834630 162651 674291 564318 109973 14604 14604 49003 49003 3588494 3033399 555095 47356 39836 7520 382721 321949 60772 1305157 1097914 207243 18152 15270 2882 832309 832309 2343675 2172502 171173 209136 175928 33208 FOOD & DIETARY SUPPLIES 1242248 1044994 197254 BAD DEBT EXPENSE 663904 663904 RESIDENT SUPPLIES 414152 348390 65762 PHARMACEUTICALS 114949 96696 18253 208687 175547 33140 22636799 19335548 3301251 0 5528475 3541731 2541547 5495979 1840087 1479850 43113 43113 227879 48805 184983 222414 73502486 37449591 37289804 36052895 642035 524998 232356 757213 48530279 48166998 2057200 1869308 4811542 308823 25051942 23839688 5292 4517 50842 4212528 31976818 30234864 X 16553461 17932134 16553461 17932134 48530279 48166998 1378673 0 X 0 1 X 1 0 X 659528 3882268 949183 742255 1184170 7417404 19137849 18131543 17806436 18181372 22494234 95751434 19797377 22013811 18755619 18923627 23678404 103168838 0 0 0 103168838 567983 497148 669218 637489 337068 2708906 20365360 22510959 19424837 19561116 24015472 105877744 0.97440 0.97120 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 8123849 5105 952998 109308 8972644 9359493 1285 -1175308 61621 8123849 9606849 636799 1267606 2104418 47343 9359493 8677264 22450 1006818 59932 39751 9606849 7448232 448 1327688 62892 37163 8677264 0.45260 0.00000 0.54740 0 1 1 994628 994628 52490945 22762103 29728842 3676531 1673864 2002667 16219271 13013624 3205647 121111 121111 36052895 CONTRACT LIABILITY - ACCOMMODATION FEES 4212528 4212528 24015472 0 24015472 0 24015472 22636799 0 22636799 0 22636799 PART IV, LINE 2B: RESIDENT FUNDS ACCOUNT PART V, LINE 4: THE FOUNDATION'S ENDOWMENT FUNDS BENEVOLENT NEEDS ARE FOR RESIDENTS OF EVERGREEN RETIREMENT COMMUNITY WHO HAVE EXHAUSTED THEIR PERSONAL RESOURCES, WOODLANDS PRESERVATION, LIFECARE LEARNING, PASTORAL CARE, CREATIVE ARTS, GROUNDS BEAUTIFICATION AND UNRESTRICTED USES. 1 X X 0 0 0 0 0 1 0 0 0 KEN ARNESON PRESIDENT /CEO 273151 0 11250 0 0 0 17053 0 5133 0 306587 0 0 0 BILLIE JO HIGGINS CFO/TREASURER 156027 0 3581 0 0 0 9573 0 885 0 170066 0 0 0 PART I, LINE 3 THE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING THE PERFORMANCE REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES. PART I, LINE 6 PRESIDENT/CEO (KEN ARNESON), CFO/TREASURER (BILLIE JO HIGGINS), VP HEALTH & SUPPORT SERVICES (PEGGY BELLIN), VP HUMAN RESOURCES (ERIN SANDERS), AND EXECUTIVE ASSISTANT/SECRETARY (LISA RUIZ) OF EVERGREEN RETIREMENT COMMUNITY, AS MEMBERS OF THE MANAGEMENT TEAM, RECEIVE AN ANNUAL BONUS, PART OF WHICH RELATES TO THE NET INCOME OF THE ORGANIZATION. A ELDERLY HOUSING AUTHORITY OF THE CITY OF OSHKOSH 391251777 2003-11-25 6600000 CONSTRUCTION OF SKILLED NURSING FACILITY AND FITNESS & AQUATIC CENTER 0 0 0 B WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 2016-12-23 14150000 CONSTRUCTION OF 62 APARTMENTS AND A WORSHIP AND PERFORMING ARTS CENTER 0 0 0 C WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 2013-12-20 7000000 CAMPUS REMODEL (REPOSITIONING) 0 0 0 D WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 2021-07-01 8300000 CONSTRUCTION OF 40 RANCH-STYLE HOMES 0 0 0 A 6342000 6600000 6600000 2004 1 0 1 1 B 5049174 14150000 97440 12149557 2000443 2017 0 0 1 1 C 476849 7000000 138167 6861833 2014 0 0 1 1 D 90435 8300000 50000 8235000 65000 2021 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 0 B 0 C 0 D 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ELDERLY HOUSING AUTHORITY OF THE CITY OF OSHKOSH DATE THE REBATE COMPUTATION WAS PERFORMED: 11/25/2023 ISSUER NAME: WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/14/2021 ISSUER NAME: WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/01/2023 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S TREASURER WILL REVIEW THE FORM 990 IN DETAIL. AN ELECTRONIC VERSION OF THE FORM 990 WILL BE POSTED ON THE BOARD WEB PAGE WITH MEMBERS GIVEN THE OPPORTUNITY TO REVIEW IT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL EMPLOYEES AND IT HAS A CODE OF CONDUCT POLICY THAT APPLIES TO ALL BOARD MEMBERS. BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST AND TO CONDUCT BUSINESS WITH EVERGREEN IN A MANNER THAT SUPPORTS THE INTERESTS OF EVERGREEN AND AVOIDS UNFAIR PERSONAL ADVANTAGE. NONCOMPLIANCE WITH THE CODE OF CONDUCT MAY RESULT IN REMOVAL FROM THE BOARD FOLLOWING AN OPPORTUNITY FOR EXPLANATION TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING THE PERFORMANCE REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES. VICE PRESIDENTS ARE REVIEWED BY THE PRESIDENT/CEO. THE SECRETARY OF THE BOARD IS THE EXECUTIVE ASSISTANT TO THE PRESIDENT/CEO AND IS REVIEWED BY THE PRESIDENT/CEO. PERIODIC WAGE & SALARY SURVEYS ARE CONDUCTED TO ASSURE COMPENSATION IS COMPARABLE TO INDUSTRY/AREA MARKET. FORMS ARE USED TO DOCUMENT ACCOMPLISHMENTS. FORM 990, PART VI, SECTION C, LINE 19 EVERGREEN RETIREMENT COMMUNITY, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. REQUESTED DOCUMENTS ARE PROVIDED WITHIN A REASONABLE TIME FRAME. FORM 990, PART IX, LINE 11G CONTRACT AND OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,183,692. MANAGEMENT AND GENERAL EXPENSES 400,280. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,583,972. CONSULTING FEES: PROGRAM SERVICE EXPENSES 31,377. MANAGEMENT AND GENERAL EXPENSES 5,717. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,094. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 10,151. MANAGEMENT AND GENERAL EXPENSES 1,849. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,000. PURCHASED ANCILLARY SERVICES: PROGRAM SERVICE EXPENSES 36,691. MANAGEMENT AND GENERAL EXPENSES 6,685. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,376. MANAGEMENT SERVICES/FEES: PROGRAM SERVICE EXPENSES 771,488. MANAGEMENT AND GENERAL EXPENSES 140,564. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 912,052. ERC VENTURES LLC 1130 N WESTFIELD ST OSHKOSH WI 54902 811662625 SENIOR LIVING WI 0 0 EVERGREEN RETIREMENT COMMUNITY LINDEN OAKS LLC 1130 N WESTFIELD ST OSHKOSH WI 54902 871008466 SENIOR LIVING WI 0 0 EVERGREEN RETIREMENT COMMUNITY EVERGREEN FOUNDATION INC 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 391388991 FUNDRAISING WI 501(C)(3) LINE 7 0 EVERGREEN COMMUNITIES INC 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 874810560 SENIOR LIVING WI 501(C)(3) LINE 12D, III-O 0 EVERGREEN VILLAGE INC 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 391505337 CO-OPERATIVE WI N/A C 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0