PARK PLACE CHRISTIAN COMMUNITY OF: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PARK PLACE CHRISTIAN COMMUNITY OF (EIN 20-1834903)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202223199349309257
- Schema version
- 2021v4.0
- 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) |
|---|---|---|
| Return | 2022-11-15T11:51:40-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LARRY J OTTE CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10755 HAWTHORNE DR | AddressLine1Txt |
| City | SAINT JOHN | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46373 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201834903 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARK PLACE CHRISTIAN COMMUNITY | BusinessNameLine1Txt |
| Business Name Line2 | OF ST JOHN INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PARK | BusinessNameControlTxt |
| Phone | 7083428100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 N CREEK DR | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VANDERGENUGTEN BARRY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7083428100 | PhoneNum |
| Signature | 2022-11-10 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BARRY | PersonFirstNm |
| Person Last | VANDERGENUGTEN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LARRY J OTTE | PreparerPersonNm |
| PTIN | P01427347 | PTIN |
| Phone | 7083593329 | PhoneNum |
| Preparation | 2022-11-11 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | VANDERGENUGTEN BARRY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 N CREEK DR | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,217,204 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | PROVIDENCELIFESERVICES.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO MAINTAIN RESIDENTIAL AND RELATED FACILITIES AND PROVIDE FOR THE PROPER CARE AND NURTURE OF THE ELDERLY AND INFIRM PEOPLE WHO SEEK COMPASSIONATE SERVICES IN THE LATER YEARS OF THEIR LIFE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 196 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,250,913 | PYContributionsGrantsAmt |
| CY Contributions Grants | $83,152 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,499,115 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,134,052 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $12,750,028 | PYTotalRevenueAmt |
| CY Total Revenue | $12,217,204 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,060,999 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,539,328 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,481,566 | PYOtherExpensesAmt |
| CY Other Expenses | $9,797,372 | CYOtherExpensesAmt |
| PY Total Expenses | $13,542,565 | PYTotalExpensesAmt |
| CY Total Expenses | $14,336,700 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$792,537 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,119,496 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $45,921,533 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,991,406 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $44,309,367 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $43,615,845 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,612,166 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $375,561 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO MAINTAIN RESIDENTIAL AND RELATED FACILITIES AND PROVIDE FOR THE PROPER CARE AND NURTURE OF THE ELDERLY AND INFIRM PEOPLE WHO SEEK COMPASSIONATE SERVICES IN THE LATER YEARS OF THEIR LIFE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $12,512,049 | ExpenseAmt |
| Desc | TO PROVIDE THE GENERAL PUBLIC LONG-TERM HEALTHCARE FACILITIES AND SERVICES FOR THE SICK, INJURED &/OR AGED. | Desc |
| Total Program Service Expenses | $12,512,049 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 196 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VANDERGENUGTEN BARRY | PersonNm |
| Phone | 7083428100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 N CREEK DR | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| SCHUTT RICHARD | |||||||
| CEO | 2.00 | 43.00 | Yes (X) | $0 | $608,196 | $25,187 | |
| DEYOUNG WILLIAM | |||||||
| COO | 2.00 | 43.00 | Yes (X) | $0 | $421,351 | $75,309 | |
| VANDERGENUGTEN BARRY | |||||||
| CFO | 2.00 | 43.00 | Yes (X) | $0 | $338,815 | $31,595 | |
| ZANDSTRA BILL | |||||||
| SECT/TREASUR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| GROENEWOLD JAKE | |||||||
| DIRECTOR | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| RYNBERK HOWARD JR | |||||||
| ASST SEC / T | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| HOVING KEN | |||||||
| DIRECTOR | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| BOTMA KEVIN | |||||||
| ASST SECT/TR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| KATS PAUL | |||||||
| CHAIR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BOEREMA ROGER | |||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $1,368,362 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $132,091 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| PROVIDENCE LIFE SERVICES | ||||||
| 18601 NORTH CREEK DR | TINLEY PARK | IL | 60477 | MGMT, EDUC, MKT | $1,439,905 | |
| SYMBRIA REHAB | ||||||
| 28100 TORCH PARKWAY | WARRENVILLE | IL | 60555 | THERAPY | $918,434 | SUITE 600 |
| SYMBRIA RX SERVICES | ||||||
| 28100 TORCH PARKWAY | WARRENVILLE | IL | 60555 | PHARMACY | $485,663 | SUITE 600 |
| GORDON FOOD SERVICE | ||||||
| PO BOZ 88029 | CHICAGO | IL | 60680 | DIETARY | $436,180 | |
| PROVINET SOLUTIONS | ||||||
| 18645 W CREEK DR | TINLEY PARK | IL | 60477 | IT SERVICES | $384,746 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $77,152 | GovernmentGrantsAmt |
| All Other Contributions | $6,000 | AllOtherContributionsAmt |
| Total Contributions | $83,152 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ROUTINE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $12,134,052 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,134,052 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,134,052 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,217,204 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,134,052 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,808,986 | TotalAmt |
| Program Services | $3,808,986 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,543 | TotalAmt |
| Program Services | $43,543 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,200 | TotalAmt |
| Program Services | $407,200 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,599 | TotalAmt |
| Program Services | $279,599 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,439,905 | TotalAmt |
| Management And General | $1,439,905 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,123 | TotalAmt |
| Program Services | $64,123 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,197 | TotalAmt |
| Program Services | $67,197 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,128 | TotalAmt |
| Program Services | $49,128 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $277,129 | TotalAmt |
| Program Services | $277,129 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,746 | TotalAmt |
| Management And General | $384,746 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $452,428 | TotalAmt |
| Program Services | $452,428 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,359,441 | TotalAmt |
| Program Services | $1,359,441 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,590,632 | TotalAmt |
| Program Services | $1,590,632 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,209 | TotalAmt |
| Program Services | $322,209 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| THERAPY | $918,434 | $918,434 |
| PHARMACY | $485,663 | $485,663 |
| NURSING SUPPLIES | $467,221 | $467,221 |
| M&R | $442,378 | $442,378 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,476,738 | TotalAmt |
| Program Services | $1,476,738 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,336,700 | TotalAmt |
| Program Services | $12,512,049 | ProgramServicesAmt |
| Management And General | $1,824,651 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,736 | BOYAmt |
| EOY | $105,560 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,045,143 | BOYAmt |
| EOY | $595,437 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,377 | BOYAmt |
| EOY | $71,575 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,020,402 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,957,204 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,505,169 | BOYAmt |
| EOY | $43,063,198 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,108 | BOYAmt |
| EOY | $155,636 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,921,533 | BOYAmt |
| EOY | $43,991,406 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,800,899 | BOYAmt |
| EOY | $1,264,106 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,133,391 | BOYAmt |
| EOY | $33,503,127 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,375,077 | BOYAmt |
| EOY | $8,848,612 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,309,367 | BOYAmt |
| EOY | $43,615,845 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,612,166 | BOYAmt |
| EOY | $375,561 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,612,166 | BOYAmt |
| EOY | $375,561 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,921,533 | BOYAmt |
| EOY | $43,991,406 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,119,496 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $882,891 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,250,913 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $83,152 | CurrentTaxYearAmt |
| Total | $1,334,065 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,576,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,572,372 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,041,990 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,499,115 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,134,052 | CurrentTaxYearAmt |
| Total | $46,824,255 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,576,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,572,372 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,041,990 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,750,028 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,217,204 | CurrentTaxYearAmt |
| Total | $48,158,320 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $48,158,320 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,576,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,572,372 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,041,990 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,750,028 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,217,204 | CurrentTaxYearAmt |
| Total | $48,158,320 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,574,154 | OtherCostOrOtherBasisAmt |
| Book Value | $1,574,154 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,763,118 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,122,542 | DepreciationAmt |
| Book Value | $40,640,576 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,683,130 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,834,662 | DepreciationAmt |
| Book Value | $848,468 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $43,063,198 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $8,392,454 |
| INTEREST RATE SWAP VALUE | $456,158 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,848,612 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|
| SCHUTT RICHARD | ||||||
| CEO | $532,645 | $56,166 | $19,385 | $11,200 | $13,987 | $633,383 |
| DEYOUNG WILLIAM | ||||||
| COO | $370,084 | $36,220 | $15,047 | $54,371 | $20,938 | $496,660 |
| VANDERGENUGTEN BARRY | ||||||
| CFO | $290,974 | $28,600 | $19,241 | $11,200 | $20,395 | $370,410 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART III | FormAndLineReferenceDesc |
| Explanation | PART I, LINE 1A: THE ORGANIZATION PROVIDES AN ALLOWANCE FOR UP TO 10 BOARD MEMBERS TO ATTEND THE ANNUAL ASSOCIATION CONVENTION TO PROVIDE MORE IN DEPTH KNOWLEDGE OF THE SENIOR CARE INDUSTRY. THE COST OF TRAVEL FOR SPOUSES IS PERMITTED AS LONG AS THE TOTAL DOES NOT EXCEED THE ESTABLISHED ALLOWANCE AMOUNT. THE BENEFIT OF SPOUSAL TRAVEL IS INCLUDED IN TAXABLE COMPENSATION. DOCUMENTATION OF ATTENDANCE AT THE ANNUAL CONVENTION IS REQUIRED. PART I, LINE 4B: REST HAVEN HAS ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN IN AN EFFORT TO RETAIN SELECTED OFFICERS ON A LONG TERM BASIS. WILLIAM DEYOUNG PARTICIPATES IN THE PLAN. IN 2021, THERE WERE NO DISTRIBUTIONS FROM OR AMOUNTS VESTED IN THE PLAN. IN 2005, THE PLAN WAS SET UP BY THE BOARD OF DIRECTORS TO ESTABLISH A RETENTION INITIATIVE FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES AND ESTABLISHES AN INCENTIVE FOR THEM TO CONTINUE THEIR EMPLOYMENT WITH THE ORGANIZATION UNTIL NORMAL RETIREMENT AGE. AMONG VARIOUS CRITERIA, IN ORDER TO QUALIFY FOR THE BENEFIT, THE EXECUTIVE WILL NEED TO BE CONTINOUSLY EMPLOYED THRU AND UNTIL THE A FUTURE DATE. THE ORGANIZATION'S PAYMENTS INTO THE PLAN ARE RECORDED ON THE 990 AS DEFERRED COMPENSATION. HOWEVER, THESE MONIES ARE ONLY ELIGIBLE TO BE RECIEVED BASED UPON ACHIEVEMENT OR SATISFACTION OF SOME FUTURE EVENTS. THE PLAN CONTRIBUTIONS ARE NOT UNDER THE CONTROL OF THE EXECUTIVES, THEY REMAIN THE ASSET OF THE ORGANIZATION, AND THE ENTIRE PLAN IS SUBJECT TO A FULL RISK FORFEITURE BY THE INDIVIDUAL. PART I, LINE 7: THE PARENT COMPANYS EXECUTIVE COMPENSATION PROGRAM HAS TWO MAJOR ELEMENTS: SALARY, OR BASE PAY, AND VARIABLE PAY. THE SALARY REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABILITIES AND EXPERIENCE. THE VARIABLE PAY REFLECTS THE ORGANIZATIONS COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS ORGANIZATION'S GOALS. THE VARIABLE PAY IS AWARDED SEMI-ANNUALLY BASED UPON A SPECIFIC REVIEW OF GOALS AND OBJECTIVES (INCLUDING THOSE WHICH RELATE TO MISSION, OPERATIONAL EFFICIENCY, FINANCIAL EFFECTIVENESS, AND STRATEGIC GOALS). THE COMPENSATION COMMITTEE REVIEWS, ASSESSES AND DETERMINES ANY AWARD UNDER THE VARIABLE PAY COMPONENT. EXECUTIVE EMPLOYEES ARE REVIEWED BY THE COMPENSATION COMMITTEE AND OUTSIDE CONSULTANTS TO ENSURE THEY ARE COMPETITIVE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSTIONS IN SIMILARLY SIZED AND TYPE ORGANIZAITONS. THE COMMITTEE ROUTINELY RECEIEVES AN EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATIONS EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY AND SCALE OF OPERATIONS. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LINDA SCHUTT | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SPOUSE OF CEO | RelationshipDescriptionTxt |
| Transaction | $82,939 | TransactionAmt |
| Transaction | EMPLOYMENT COMP | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: LINDA SCHUTT (D) DESCRIPTION OF TRANSACTION: EMPLOYMENT COMPENSATION; MASTERS PREPARED R.N. THAT LEADS THE ORGANIZATION'S EDUCATION. SCH L, PART IV: THE TRANSACTIONS REPORTED ABOVE INVOLVING INTERESTED PERSONS ARE REVIEWED ANNUALLY BY THE PARENT COMPANY'S COMPENSATION COMMITTEE AND HAVE BEEN DEEMED APPROPRIATE BASED ON THE POSITIONS EMPLOYED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 3 | RESPONSIBILITIES PAID THROUGH MANAGEMENT FEES TO REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME DBA PROVIDENCE LIFE SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME. THE AFFAIRS, BUSINESS AND ALL LEGAL MATTERS OF THE CORPORATION SHALL BE MANAGED BY ITS BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE MEMBER SHALL HAVE AND EXERCISE THE FOLLOWING RESERVE POWERS: (1) TO APPOINT OR REMOVE DIRECTORS; (2) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (3) TO REVEIW ALL ANNUAL BUDGETS AND AUDITED FINANCIAL STATEMENTS, AND TO APPROVE ANY DEFICIT BUDGET; (4) TO APPROVE THE CONSTRUCTION OF ANY NEW OR THE ALTERATION OF ANY EXISTING FACILITY INVLOVING AN EXPENDITURE OF 500,000 OR MORE; (5) TO SELL, MORTGAGE, PLEDGE OR ALIENATE ALL OR ANY PART OF THE REAL ESTATE OR SUBSTANTIALLY ALL OF THE OTHER ASSETS OF THE CORPORATION; (6) TO DISSOLVE THE CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE MEMBER SHALL HAVE AND EXERCISE THE FOLLOWING RESERVE POWERS: (1) TO APPOINT OR REMOVE DIRECTORS; (2) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (3) TO REVEIW ALL ANNUAL BUDGETS AND AUDITED FINANCIAL STATEMENTS, AND TO APPROVE ANY DEFICIT BUDGET; (4) TO APPROVE THE CONSTRUCTION OF ANY NEW OR THE ALTERATION OF ANY EXISTING FACILITY INVOLVING AN EXPENDITURE OF 500,000 OR MORE; (5) TO SELL, MORTGAGE, PLEDGE OR ALIENATE ALL OR ANY PART OF THE REAL ESTATE OR SUBSTANTIALLY ALL OF THE OTHER ASSETS OF THE CORPORATION; (6) TO DISSOLVE THE CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A DRAFT OF THE 990 WAS PREPARED AND SENT FOR INITIAL REVIEW BY THE CONTROLLER, CFO AND CEO. UPON REVIEW AND APPROVAL, THE 990 WAS MADE AVAILABLE TO THE ENTIRE BOARD PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE OFFICERS, DIRECTOR/TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT UPON BEGINNING THEIR POSITION. THEREAFTER, THE CONFLICT OF INTEREST STATEMENTS ARE UPDATED ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS ARE REVIEWED AND ADDRESSED BY THE BOARD AS NECESSARY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE PARENT COMPANY'S EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIP TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECUTIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR THE REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE EXECUTIVE COMPENSATION OF THE PARENT (REST HAVEN) COMPANYS EXECUTIVES IS SET BY THE PARENT COMPANYS BOARD OF DIRECTORS THROUGH BOARD OVERSIGHT. THE EXECUTIVE COMPENSATION PROGRAM'S PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIP TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECUTIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR THE REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 24E | DIETARY 436,180 0 0 CONTRACT NURSING 334,689 0 0 BAD DEBT 202,761 0 0 PROVIDER BED TAX 111,709 0 0 SENIOR TV 84,928 0 0 COVID SUPPLIES 76,327 0 0 LAUNDRY 68,321 0 0 SOCIAL SERVICES 62,723 0 0 ACTIVITIES 49,586 0 0 HOUSEKEEPING 35,589 0 0 VEHICLE EXP 13,925 0 0 TOTAL 1,476,738 0 0 |
| FORM 990, PART XI, LINE 9 | CHANGE IN FMV OF INTEREST RATE SWAP 882,891 |
| FORM 990, PAGE 12, PART XII, LINE 3B | THE ORGANIZATION IS REQUIRED TO UNDERGO SINGLE AUDITS AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE AUDITS ARE PLANNED TO BE COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN THE RELEVANT GUIDANCE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REST HAVEN ILLIANA CHRISTIAN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 N CREEK DRIVE | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362382853 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE MANAGMENT & DEVELOPMENT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 N CREEK DRIVE | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363774205 | EIN |
| Primary Activities | IT SERVICE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| Share Of Total Income | -$477,774 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $4,545,218 | ShareOfEOYAssetsAmt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROVIDENCE MANAGEMENT DEVELOPEMENT | ||
| P | $384,706 | FMV |
| REST HAVEN ILLIANA CHRISTIAN | ||
| P | $1,439,904 | FMV |