BETHANY HOME INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- BETHANY HOME INC (EIN 39-0868849)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-03
- IRS object ID
- 202002169349300420
- Schema version
- 2018v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-03T11:37:56-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390868849 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETHANY HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BETH | BusinessNameControlTxt |
| Phone | 7152585521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1226 BERLIN STREET | AddressLine1Txt |
| City | WAUPACA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54981 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHELLY SONTAG | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7152585521 | PhoneNum |
| Signature | 2020-07-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2020-07-02 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.54.158.12 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-02 | IPDt |
| IP Tm | 05:52:13 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9747BB8E0DC0E78824B7C9EDF76D609BB7F00C05 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-11-19 02:30:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHELLY SONTAG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1226 BERLIN STREET | AddressLine1Txt |
| City | WAUPACA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54981 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,488,421 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BETHANYOFWAUPACA.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1961 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE A CHRISTIAN HOME FOR AGED AND INFIRM MEN AND WOMEN WHO NEED THE SERVICES OF THE HOME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 358 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $52,238 | PYContributionsGrantsAmt |
| CY Contributions Grants | $66,760 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,197,576 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,375,376 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$12,833 | PYInvestmentIncomeAmt |
| CY Investment Income | -$2,259 | CYInvestmentIncomeAmt |
| PY Other Revenue | $43,409 | PYOtherRevenueAmt |
| CY Other Revenue | $43,403 | CYOtherRevenueAmt |
| PY Total Revenue | $10,280,390 | PYTotalRevenueAmt |
| CY Total Revenue | $11,483,280 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,028,979 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,193,722 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,783,845 | PYOtherExpensesAmt |
| CY Other Expenses | $5,757,929 | CYOtherExpensesAmt |
| PY Total Expenses | $12,812,824 | PYTotalExpensesAmt |
| CY Total Expenses | $12,951,651 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,532,434 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,468,371 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,036,045 | TotalAssetsBOYAmt |
| Total Assets EOY | $26,530,764 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,212,672 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,170,364 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $823,373 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$639,600 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BETHANY HOME IS ORGANIZED TO PROVIDE A CHRISTIAN HOME FOR AGED AND INFIRM MEN AND WOMEN WHO NEED THE SERVICES OF THE HOME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,160,496 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $8,073,130 | RevenueAmt |
| Desc | NURSING HOME:BETHANY HOME, INC. OPERATES A 85 BED NURSING HOME TO PROVIDE LONG-TERM CARE SERVICES TO RESIDENTS OF WAUPACA COUNTY AND THE IMMEDIATE SURROUNDING AREA. BETHANY HOME, INC. MEMBERSHIP CONSISTS OF 32 CHURCH CONGREGATIONS FROM WAUPACA, THE SURROUNDING RURAL AREAS, AND SEVERAL NEIGHBORING COMMUNITIES. DURING OUR FISCAL YEAR ENDED SEPTEMBER 30, 2019, WE PROVIDED 28,509 INPATIENT DAYS OF SERVICE. OF THESE DAYS, 18,986 DAYS, ABOUT 67% OF OUR CARE, WERE PROVIDED TO MEN AND WOMEN WHO NO LONGER HAD ADEQUATE FUNDS TO PAY FOR THEIR CARE. THEIR CARE WAS PAID FOR BY THE WISCONSIN MEDICAL ASSISTANCE PROGRAM AT RATES THAT WERE BELOW OUR COST OF PROVIDING THAT CARE. WE ALSO PROVIDED 3,884 DAYS OF CARE TO RESIDENTS WHO WERE FUNDED BY THE FEDERAL MEDICARE PART A PROGRAM. THESE DAYS EQUALED 13.6% OF THE CARE WE PROVIDED. THE REMAINING 5,639 DAYS OF CARE, REPRESENTING 20% OF OUR BUSINESS, WERE PROVIDED TO RESIDENTS WHO PAID FROM THEIR PERSONAL PRIVATE FUNDS.THE SERVICES THAT BETHANY HOME PROVIDES TO ITS RESIDENTS INCLUDE: *24 HOUR PER DAY NURSING CARE DELIVERED BY OUR STAFF OF REGISTERED NURSES *LICENSED PRACTICAL NURSES *CERTIFIED NURSING ASSISTANTS *7 DAY PER WEEK REHABILITATION SERVICES PROVIDED BY REGISTERED PHYSICAL THERAPISTS *PHYSICAL THERAPY ASSISTANTS AND AIDES *REGISTERED OCCUPATIONAL THERAPISTS *CERTIFIED OCCUPATIONAL THERAPY ASSISTANTS *REGISTERED SPEECH THERAPISTS *DELICIOUS AND NUTRITIOUS MEALS *SOCIAL SERVICES *RECREATIONAL ACTIVITIES *HOUSEKEEPING AND LAUNDRY SERVICES, INCLUDING THE IRONING OF PERSONAL CLOTHING *BUILDING AND GROUNDS MAINTENANCE *TRANSPORTATION TO MEDICAL APPOINTMENTS *BEAUTY AND BARBER SHOP SERVICES *ADMINISTRATIVE SERVICESBETHANY COMMUNITY CARE MINISTRYBETHANY HOME PROVIDES NURSES FOR SERVICES IN THE COMMUNITY SUCH AS CLINICS AND SCREENINGS, EDUCATION TO OLDER AND DISABLED ADULTS AND CAREGIVERS, INFORMATION AND REFERRAL, SEMINARS, AND VOLUNTEER PROGRAM DEVELOPMENT TO SERVE OLDER ADULTS IN THEIR HOMES. THE PURPOSE OF THE PROGRAM IS TO HELP THOSE IN THE COMMUNITY REMAIN IN THEIR HOME FOR AS LONG AS THEY AND THEIR FAMILIES ARE ABLE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,614,852 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,569,829 | RevenueAmt |
| Desc | BETHANY PINES - COMMUNITY-BASED RESIDENTIAL FACILITY:BETHANY HOME, INC. ALSO OPERATES BETHANY PINES, A 49 BED BUILDING THAT PROVIDES SUPPORTIVE LIVING SERVICES AND ASSISTED LIVING TO RESIDENTS OF WAUPACA COUNTY AND THE IMMEDIATE SURROUNDING AREA. AS OF SEPTEMBER 30, 2019, BETHANY PINES HAD 40 ROOMS RENTED AS A REGISTERED COMMUNITY BASED RESIDENTIAL FACILITY. BETHANY PINES CBRF ACCEPTS RESIDENTS WHO PAY PRIVATELY AND THOSE WHO ARE ON A FAMILY CARE PLAN. AS OF SEPTEMBER 30, 2019, 73% OF THE RESIDENTS WERE IN THE COMMUNITY BASED RESIDENTIAL FACILITY UNDER THE FAMILY CARE PROGRAM.THE SERVICES PROVIDED BY BETHANY PINES MAKE IT POSSIBLE FOR ITS RESIDENTS TO REMAIN IN A HOMELIKE ATMOSPHERE FOR A LONGER PERIOD OF TIME AND DELAYS, AND IN MANY CASES ELIMINATES ENTIRELY, THEIR ENTRANCE INTO A NURSING HOME. THE SERVICES THAT BETHANY PINES PROVIDES TO OUR RESIDENTS INCLUDE:*TASTY AND NUTRITIOUS MEALS*HELP WITH LAUNDRY AND HOUSEKEEPING NEEDS*ASSISTANCE AS NEEDED WITH ACTIVITIES OF DAILY LIFE, INCLUDING BATHING, DRESSING, TOILETING, AMBULATING, AND TRANSFERRING*MEDICATION MONITORING AND DELIVERY*RECREATIONAL ACTIVITIES*SPIRITUAL COUNSELING*ACTIVITIES OF DAILY LIVING*MEDICATION PASS*CLINICAL ASSESSMENTS*MONITORING*TRANSFERRING IF/WHEN NECESSARY*SOCIAL WORK AND RN SERVICESTHE RESIDENTS OF BETHANY PINES ALSO RECEIVE PRIORITY ADMISSION TO BETHANY HOME IF THEIR HEALTH CONDITIONS CHANGE AND THEY REQUIRE SKILLED CARE NURSING SERVICES. THIS FEATURE OF OUR CONTINUUM OF CARE GIVES THE BETHANY PINES RESIDENTS A REAL SENSE OF SECURITY, BECAUSE THEY KNOW THAT WE WILL CONTINUE TO CARE FOR THEM, EVEN WHEN THEIR NEEDS BECOME GREATER. OUR BETHANY PINES APARTMENT BUILDING IS CONNECTED TO BETHANY HOME BY AN ENCLOSED, HEATED, AIR-CONDITIONED WALKWAY. THIS FEATURE MAKES IT VERY EASY AND CONVENIENT FOR RESIDENTS OF BETHANY PINES TO FREQUENTLY VISIT THEIR SPOUSES AND/OR FRIENDS WHOM LIVE IN BETHANY HOME. THIS EASY ACCESS TO THEIR LOVED ONE IN THE NURSING HOME HAS HELPED MANY OF OUR BETHANY PINES RESIDENTS TO BETTER DEAL WITH THE GUILT THAT IS SO OFTEN ASSOCIATED WITH HAVING TO PLACE A SPOUSE OR OTHER LOVED ONE IN A NURSING HOME. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,165,495 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,732,417 | RevenueAmt |
| Desc | BETHANY PINES APARTMENTS:BETHANY HOME, INC. ALSO OPERATES BETHANY PINES, A 40-UNIT APARTMENT BUILDING THAT PROVIDES SUPPORTIVE LIVING SERVICES AND ASSISTED LIVING SERVICES TO RESIDENTS OF WAUPACA COUNTY AND THE IMMEDIATE SURROUNDING AREA. AS OF SEPTEMBER 30, 2019, BETHANY PINES HAD 38 APARTMENTS RENTED AS A REGISTERED RESIDENTIAL CARE APARTMENT COMPLEX. THE SERVICES PROVIDED BY BETHANY PINES MAKE IT POSSIBLE FOR ITS RESIDENTS TO REMAIN IN A HOMELIKE ATMOSPHERE FOR A LONGER PERIOD OF TIME AND DELAYS, AND IN MANY CASES ELIMINATES ENTIRELY, THEIR ENTRANCE INTO A NURSING HOME. THE SERVICES THAT BETHANY PINES PROVIDES TO OUR RESIDENTS INCLUDE:*TASTY AND NUTRITIOUS MEALS*HELP WITH LAUNDRY AND HOUSEKEEPING NEEDS*ASSISTANCE AS NEEDED WITH ACTIVITIES OF DAILY LIFE, INCLUDING BATHING, DRESSING, TOILETING, AMBULATING, AND TRANSFERRING*MEDICATION MONITORING AND DELIVERY*RECREATIONAL ACTIVITIES*SPIRITUAL COUNSELING*ACTIVITIES OF DAILY LIVING*MEDICATION PASS*CLINICAL ASSESSMENTS*MONITORING*TRANSFERRING IF/WHEN NECESSARY*SOCIAL WORK AND RN SERVICESTHE RESIDENTS OF BETHANY PINES ALSO RECEIVE PRIORITY ADMISSION TO BETHANY HOME IF THEIR HEALTH CONDITIONS CHANGE AND THEY REQUIRE SKILLED CARE NURSING SERVICES. THIS FEATURE OF OUR CONTINUUM OF CARE GIVES THE BETHANY PINES RESIDENTS A REAL SENSE OF SECURITY, BECAUSE THEY KNOW THAT WE WILL CONTINUE TO CARE FOR THEM, EVEN WHEN THEIR NEEDS BECOME GREATER. OUR BETHANY PINES APARTMENT BUILDING IS CONNECTED TO BETHANY HOME BY AN ENCLOSED, HEATED, AIR-CONDITIONED WALKWAY. THIS FEATURE MAKES IT VERY EASY AND CONVENIENT FOR RESIDENTS OF BETHANY PINES TO FREQUENTLY VISIT THEIR SPOUSES AND/OR FRIENDS WHOM LIVE IN BETHANY HOME. THIS EASY ACCESS TO THEIR LOVED ONE IN THE NURSING HOME HAS HELPED MANY OF OUR BETHANY PINES RESIDENTS TO BETTER DEAL WITH THE GUILT THAT IS SO OFTEN ASSOCIATED WITH HAVING TO PLACE A SPOUSE OR OTHER LOVED ONE IN A NURSING HOME. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,940,843 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 358 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHELLY SONTAG | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7152585521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1226 BERLIN STREET | AddressLine1Txt |
| City | WAUPACA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54981 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| VICKI GROTH | |||||||
| DIRECTOR | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | |
| WAYNE LUCK | |||||||
| DIRECTOR | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | |
| ROBERT NYGAARD | |||||||
| DIRECTOR | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | |
| JEFF OESTREICH | |||||||
| DIRECTOR | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | |
| WILSON ROANE | |||||||
| DIRECTOR | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | |
| DALE WILSON | |||||||
| DIRECTOR | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | |
| GLEN BULLICK | |||||||
| PRESIDENT | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| PAUL ONAN | |||||||
| VICE PRESIDENT | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BIL SUTLIEF | |||||||
| SECRETARY/ TREASURER | 0.40 | 0.10 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| PAULINE DARLING | |||||||
| ADMINISTRATOR/CEO (TERMED 3/2019) | 35.00 | 5.00 | $150,623 | $0 | $12,518 | Yes (X) | |
| SHELLY SONTAG | |||||||
| ADMINISTRATOR/CEO | 35.00 | 5.00 | $0 | $0 | $0 | Yes (X) | |
| KERRY LEE BLANKE | |||||||
| FINANCE DIRECTOR | 35.00 | 5.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $150,623 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $12,518 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GENESIS ELDERCARE REHABILITATION SERVICE | |||||
| PO BOX 821322 | PHILADELPHIA | PA | 19182 | THERAPY CONTRACTOR | $773,759 |
| WIPFLI LLP | |||||
| 11 SCOTT STREET | WAUSAU | WI | 54403 | ACCOUNTING SERVICES | $135,444 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $45,498 | GovernmentGrantsAmt |
| All Other Contributions | $21,262 | AllOtherContributionsAmt |
| Noncash Contributions | $45,498 | NoncashContributionsAmt |
| Total Contributions | $66,760 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENT SERVICE REVENUE | 623000 | $7,694,650 | $7,694,650 |
| BETHANY PINES RENTAL | 532000 | $3,302,246 | $3,302,246 |
| BETHANY SHADOW WOODS SERVICE AGRE | 900099 | $106,704 | $106,704 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $271,776 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $271,776 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,375,376 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,882 | TotalRevenueColumnAmt |
| Exclusion | $2,882 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,141 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$5,141 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,141 | TotalRevenueColumnAmt |
| Exclusion | -$5,141 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 900099 | $25,135 | $25,135 |
| BEAUTY SHOP | 900099 | $18,268 | $18,268 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $43,403 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,483,280 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,375,376 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $41,144 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,258 | TotalAmt |
| Program Services | $121,403 | ProgramServicesAmt |
| Management And General | $41,855 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,495,117 | TotalAmt |
| Program Services | $4,976,067 | ProgramServicesAmt |
| Management And General | $519,050 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,718 | TotalAmt |
| Program Services | $85,148 | ProgramServicesAmt |
| Management And General | $10,570 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $987,228 | TotalAmt |
| Program Services | $878,582 | ProgramServicesAmt |
| Management And General | $108,646 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $452,401 | TotalAmt |
| Program Services | $402,637 | ProgramServicesAmt |
| Management And General | $49,764 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,088 | TotalAmt |
| Management And General | $4,088 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,744 | TotalAmt |
| Management And General | $135,744 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,594 | TotalAmt |
| Program Services | $147,594 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,418 | TotalAmt |
| Program Services | $46,155 | ProgramServicesAmt |
| Management And General | $1,263 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $342,888 | TotalAmt |
| Program Services | $342,888 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,441 | TotalAmt |
| Management And General | $36,441 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,611 | TotalAmt |
| Program Services | $362,611 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,888 | TotalAmt |
| Program Services | $34,834 | ProgramServicesAmt |
| Management And General | $6,054 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,727 | TotalAmt |
| Program Services | $4,623 | ProgramServicesAmt |
| Management And General | $7,104 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,004 | TotalAmt |
| Program Services | $636,004 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,344,300 | TotalAmt |
| Program Services | $1,277,085 | ProgramServicesAmt |
| Management And General | $67,215 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,386 | TotalAmt |
| Program Services | $91,386 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| SUPPLIES | $970,501 | $970,501 |
| THERAPIES | $785,095 | $785,095 |
| T19 ASSESSMENT | $186,660 | $186,660 |
| BAD DEBTS | $106,786 | $106,786 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,798 | TotalAmt |
| Program Services | $484,784 | ProgramServicesAmt |
| Management And General | $23,014 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,951,651 | TotalAmt |
| Program Services | $11,940,843 | ProgramServicesAmt |
| Management And General | $1,010,808 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,293 | BOYAmt |
| EOY | $601,732 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,014 | BOYAmt |
| EOY | $816,027 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,498,081 | BOYAmt |
| EOY | $975,075 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,848 | BOYAmt |
| EOY | $42,761 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,195 | BOYAmt |
| EOY | $63,321 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,509,740 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,709,526 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,984,396 | BOYAmt |
| EOY | $23,800,214 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216,937 | BOYAmt |
| EOY | $222,335 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,281 | BOYAmt |
| EOY | $9,299 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,036,045 | BOYAmt |
| EOY | $26,530,764 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,197,101 | BOYAmt |
| EOY | $1,404,406 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,421 | BOYAmt |
| EOY | $66,142 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,959,150 | BOYAmt |
| EOY | $24,966,170 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $733,646 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,212,672 | BOYAmt |
| EOY | $27,170,364 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $648,220 | BOYAmt |
| EOY | -$869,860 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,776 | BOYAmt |
| EOY | $108,883 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,377 | BOYAmt |
| EOY | $121,377 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $823,373 | BOYAmt |
| EOY | -$639,600 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,036,045 | BOYAmt |
| EOY | $26,530,764 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,468,371 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $5,398 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 Minus4 Years | $30,517 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,621 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,680 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $52,238 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,760 | CurrentTaxYearAmt |
| Total | $191,816 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,261,766 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,635,630 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,628,513 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,197,576 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,375,376 | CurrentTaxYearAmt |
| Total | $49,098,861 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $48,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $62,747 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $74,948 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $43,409 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $41,144 | CurrentTaxYearAmt |
| Total | $270,768 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,340,803 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,714,998 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,729,141 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,293,223 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,483,280 | CurrentTaxYearAmt |
| Total | $49,561,445 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46,696 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $93,945 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $61,447 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,513 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $791 | CurrentTaxYearAmt |
| Total | $226,392 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46,696 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $93,945 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $61,447 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,513 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $791 | CurrentTaxYearAmt |
| Total | $226,392 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $49,335,053 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $142 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $232 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,882 | CurrentTaxYearAmt |
| Total | $3,271 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $142 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $232 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,882 | CurrentTaxYearAmt |
| Total | $3,271 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,340,945 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,715,004 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,729,150 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,293,455 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,486,162 | CurrentTaxYearAmt |
| Total | $49,564,716 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99540 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99320 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $121,377 | BeginningYearBalanceAmt |
| End Year Balance | $121,377 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $121,377 | BeginningYearBalanceAmt |
| End Year Balance | $121,377 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $127,237 | BeginningYearBalanceAmt |
| Other Expenditures | $5,860 | OtherExpendituresAmt |
| End Year Balance | $121,377 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $127,237 | BeginningYearBalanceAmt |
| End Year Balance | $127,237 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $127,212 | BeginningYearBalanceAmt |
| Contributions | $25 | ContributionsAmt |
| End Year Balance | $127,237 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,648 | OtherCostOrOtherBasisAmt |
| Book Value | $40,648 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,226,038 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,868,175 | DepreciationAmt |
| Book Value | $22,357,863 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,225,876 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,841,351 | DepreciationAmt |
| Book Value | $1,384,525 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,178 | OtherCostOrOtherBasisAmt |
| Book Value | $17,178 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $23,800,214 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RELATED PARTY PAYABLE | Desc |
| Amt | $733,646 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $733,646 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION HOLDS SECURITY DEPOSITS UNDER LEASE AGREEMENTS WHICH ARE REFUNDABLE BACK TO THE TENANTS AT LEASE TERMINATION. |
| PART V, LINE 4: | BETHANY HOME, INC. HOLDS A PERMANENTLY RESTRICTED ENDOWMENT. THE INVESTMENT INCOME ON THE PERMANENT ENDOWMENT FUNDS ARE AVAILALBE FOR CHARITABLE PURPOSES OF BETHANY HOME, INC. |
| PART X, LINE 2: | BETHANY HOME, INC. IS A TAX-EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE CORPORATION IS ALSO EXEMPT FROM STATE INCOME TAX ON RELATED INCOME. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAULINE DARLING | PersonNm |
| Title | ADMINISTRATOR/CEO (TERMED 3/2019) | TitleTxt |
| Base Compensation Filing Org | $150,623 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $5,381 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $7,137 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $163,141 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| DAN ALLEN | |||
| SPOUSE OF PAULINE DARLING, ADMINISTRATOR | $83,050 | COMPENSATION | 0 |
| KATHLEEN DARLING | |||
| SISTER OF PAULINE DARLING, ADMINISTRATOR | $27,107 | COMPENSATION | 0 |
| JOSH EGGEMAN | |||
| CHILD OF PAULINE DARLING, ADMINISTRATOR | $16,238 | CONSULTING FEE | 0 |
Schedule M IRS990ScheduleM
Cars And Other Vehicles CarsAndOtherVehiclesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $45,498 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | BETHANY HOME, INC. MEMBERSHIP CONSISTS OF 32 CHURCH CONGREGATIONS FROM WAUPACA, THE SURROUNDING RURAL AREAS, AND SEVERAL NEIGHBORING COMMUNITIES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE COMMITTEE REVIEWS THE FORM 990 BEFORE BRINGING IT TO THE BOARD OF DIRECTORS FOR APPROVAL TO FILE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST STATEMENT IS DIRECTED NOT ONLY TO DIRECTORS AND OFFICERS, BUT TO ALL EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF BETHANY HOME, INC. THIS WOULD INCLUDE ALL WHO MAKE PURCHASING DECISIONS, ALL PERSONS WHO MIGHT BE DESCRIBED AS "MANAGEMENT PERSONNEL, AND ANYONE WHO HAS PROPRIETARY INFORMATION CONCERNING BETHANY HOME, INC. IT IS ASSUMED THAT THE DIRECTORS, OFFICERS, AND MANAGEMENT EMPLOYEES WILL RECOGNIZE CONFLICTS OF INTEREST WITH ANY PERSONS OR FIRMS MENTIONED IN THE POLICY. IT IS THE POLICY OF THE BOARD THAT THE EXISTENCE OF ANY INTERESTS DESCRIBED IN THE POLICY SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT SHALL BE THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND IMMEDIATELY MAKE SUCH DISCLOSURES. DISCLOSURE IN THE ORGANIZATION SHOULD BE MADE TO THE ADMINISTRATOR/CEO (IF SHE/HE IS THE ONE WITH THE CONFLICT, THEN THE BOARD CHAIR), WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE BOARD. DISCLOSURE INVOLVING DIRECTORS SHOULD BE MADE TO THE BOARD CHAIR (IF SHE/HE IS THE ONE WITH THE CONFLICT, THEN THE BOARD VICE-CHAIR) WHO SHALL BRING THESE MATTERS TO THE BOARD. THE BOARD SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO BETHANY HOME, INC. THE DECISION OF THE BOARD ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION, AND THEIR CONCERN MUST BE WITH THE WELFARE OF BETHANY HOME, INC. AND THE ADVANCEMENT OF ITS PURPOSE. |
| FORM 990, PART VI, SECTION B, LINE 15A | BETHANY HOME UTILIZES AN INDEPENDENT THIRD PARTY AND LEADINGAGE WI TO PERFORM A SALARY SURVEY ANNUALLY. THE PERSONNEL COMMITTEE RECOMMENDS A FINAL SALARY TO THE BOARD OF DIRECTORS FOR APPROVAL. THE BOARD IS INDEPENDENT AND USES THE COMPARABILITY STUDIES PROVIDED BY LEADINGAGE WI. THE APPROVAL DECISION IS DOCUMENTED IN THE RELATED BOARD OF DIRECTORS MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | BETHANY HOME, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE PROCESS IS CONSISTENT WITH PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETHANY SHADOW WOODS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1226 BERLIN STREET | AddressLine1Txt |
| City | WAUPACA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54981 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391948898 | EIN |
| Primary Activities | TO PROVIDE INDEPENDENT RETIREMENT LIVING FACILITIES/SERVICES. | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 10 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETHANY HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| BETHANY SHADOW WOODS INC | ||
| L | $102,000 | COST |
| BETHANY SHADOW WOODS INC | ||
| E | $733,646 | COST |