STRATEGY STUDIO / PUBLIC DATA EXPLORER

TIMOTHY PLACE NFP: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
TIMOTHY PLACE NFP (EIN 20-1835089)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202013219349306691
Schema version
2019v5.0
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

FieldValueIRS element (for citing)
Return2020-11-16T10:49:17-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LARRY J OTTE CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110755 HAWTHORNE DRAddressLine1Txt
CitySAINT JOHNCityNm
State AbbreviationINStateAbbreviationCd
ZIP46373ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201835089EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TIMOTHY PLACE NFPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTIMOBusinessNameControlTxt
Phone7083428100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRIVEAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonVANDERGENUGTEN BARRYPersonNm
Person TitleCFOPersonTitleTxt
Phone7083428100PhoneNum
Signature2020-11-16SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLARRY J OTTEPreparerPersonNm
PTINP01427347PTIN
Phone7083593329PhoneNum
Preparation2020-11-16PreparationDt
Self EmployedYes (X)SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.58.216.254IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-16IPDt
IP Tm10:49:17IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id05F5D912F79D4F939E4B956C0FD9A55DB61B7E32AtSubmissionCreationDeviceId
At Submission Filing Device Id05F5D912F79D4F939E4B956C0FD9A55DB61B7E32AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PARK PLACE CHRISTIAN COMM ELMHURSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerVANDERGENUGTEN BARRYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 N CREEK DRAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$20,811,497GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressPROVIDENCELIFESERVICES.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTO PROVIDE HOUSING AND THE FULL CONTINUUM OF CARE FOR SENIORS.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee374TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$102,165PYContributionsGrantsAmt
CY Contributions Grants$140,049CYContributionsGrantsAmt
PY Program Service Revenue$19,800,526PYProgramServiceRevenueAmt
CY Program Service Revenue$20,384,088CYProgramServiceRevenueAmt
PY Investment Income$268,370PYInvestmentIncomeAmt
CY Investment Income$287,360CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$20,171,061PYTotalRevenueAmt
CY Total Revenue$20,811,497CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,698,109PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,207,452CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$18,508,721PYOtherExpensesAmt
CY Other Expenses$18,729,873CYOtherExpensesAmt
PY Total Expenses$26,206,830PYTotalExpensesAmt
CY Total Expenses$26,937,325CYTotalExpensesAmt
PY Revenues Less Expenses-$6,035,769PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$6,125,828CYRevenuesLessExpensesAmt
Total Assets BOY$140,488,578TotalAssetsBOYAmt
Total Assets EOY$134,977,939TotalAssetsEOYAmt
Total Liabilities BOY$240,684,032TotalLiabilitiesBOYAmt
Total Liabilities EOY$234,072,751TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$100,195,454NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$99,094,812NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HOUSING AND THE FULL CONTINUUM OF CARE FOR SENIORS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$26,087,108ExpenseAmt
DescTO PROVIDE HOUSING AND CARE FOR THE ELDERLY AND SICK.Desc
Total Program Service Expenses$26,087,108TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document39IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee374EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE LIFE SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7083428100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 NORTH CREEK DRAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
SCHUTT RICHARD
CEO5.0045.00Yes (X)$0$1,995,413$26,022
DEYOUNG WILLIAM
COO5.0045.00Yes (X)$0$372,252$70,380
VANDERGENUGTEN BARRY
CFO5.0045.00Yes (X)$0$285,879$30,526
ENGELSMAN DONALD
ADMINISTRATO40.00$168,841$0$19,308Yes (X)
SMITH SHELLY
HEALTHCARE D40.00$153,215$0$25,958Yes (X)
MARY BETH FRITZ
MARKETING DI40.00$123,241$0$8,308Yes (X)
OPELARIO-ARROYO ARLENE
DIRECTOR OF40.00$118,386$0$2,980Yes (X)
CARRASQUILLA GEORGE
DIRECTOR RES40.00$100,811$0$14,092Yes (X)
DIEPSTRA AL
VICE CHAIR1.00Yes (X)$0$0$0Yes (X)
KOLDENHOVEN ARNIE
DIRECTOR1.00$0$0$0Yes (X)
TAMELING CAL
ASST SECT/TR1.00Yes (X)$0$0$0Yes (X)
VAN DYK DON
SECT/TREASUR1.00Yes (X)$0$0$0Yes (X)
HOVING KEN
DIRECTOR1.00$0$0$0Yes (X)
VAN HATTEM RICH
CHAIR1.00Yes (X)$0$0$0Yes (X)
BREEMS TIM
DIRECTOR1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$664,494TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,653,544TotReportableCompRltdOrgAmt
Total Other Compensation$197,574TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (true)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtAddress Line2ContractorAddress/USAddress/AddressLine2TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SYMBRIA REHAB
28100 TORCH PARKWAYSUITE 600WARRENVILLEIL60555THERAPY$809,967
GORDON FOOD SERVICE
PO BOX 88029CHICAGOIL60680DIETARY$679,647
PROVINET SOLUTIONS
18645 WEST CREEK DRTINLEY PARKIL60477IT SERVICES$490,217
AEP ENERGY
DEPT CH 19346PALATINEIL60055UTILITY$449,479
SYMBRIA RX SERVICES
28100 TORCH PARKWAYSUITE 600WARRENVILLEIL60555PHARMACY$382,660
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
All Other Contributions$140,049AllOtherContributionsAmt
Total Contributions$140,049TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ROUTINE REVENUE623000$20,016,048$20,016,048
ANCILLARY REVENUE623000$368,040$368,040
FieldValueIRS element (for citing)
Total Program Service Revenue$20,384,088TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$287,360TotalRevenueColumnAmt
Exclusion$287,360ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,811,497TotalRevenueColumnAmt
Related Or Exempt Func Income$20,384,088RelatedOrExemptFuncIncomeAmt
Exclusion$287,360ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,825,855TotalAmt
Program Services$6,825,855ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$94,595TotalAmt
Program Services$94,595ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$789,107TotalAmt
Program Services$789,107ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$497,895TotalAmt
Program Services$497,895ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$360,000TotalAmt
Management And General$360,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$17,518TotalAmt
Program Services$17,518ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$97,750TotalAmt
Program Services$97,750ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$37,436TotalAmt
Program Services$37,436ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$230,905TotalAmt
Program Services$230,905ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$91,525TotalAmt
Program Services$91,525ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$490,217TotalAmt
Management And General$490,217ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$874,446TotalAmt
Program Services$874,446ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,955,682TotalAmt
Program Services$7,955,682ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,771,675TotalAmt
Program Services$3,771,675ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$534,450TotalAmt
Program Services$534,450ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DIETARY SERVICES$837,368$837,368
THERAPY$758,177$758,177
MAINTENANCE & REPAIR$579,584$579,584
PHARMACY$381,511$381,511

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,711,629TotalAmt
Program Services$1,711,629ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,937,325TotalAmt
Program Services$26,087,108ProgramServicesAmt
Management And General$850,217ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,986,888BOYAmt
EOY$3,114,851EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,783,803BOYAmt
EOY$1,562,778EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$18,632BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$499,523BOYAmt
EOY$163,589EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$138,523,373LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$25,948,424LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$115,358,044BOYAmt
EOY$112,574,949EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$2,684,707BOYAmt
EOY$2,470,389EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,156,981BOYAmt
EOY$15,091,383EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$140,488,578BOYAmt
EOY$134,977,939EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,805,832BOYAmt
EOY$3,985,237EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$81,061,134BOYAmt
EOY$81,339,548EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$141,106,642BOYAmt
EOY$141,106,642EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,710,424BOYAmt
EOY$7,641,324EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$240,684,032BOYAmt
EOY$234,072,751EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$100,195,454BOYAmt
EOY-$99,094,812EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$100,195,454BOYAmt
EOY-$99,094,812EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$140,488,578BOYAmt
EOY$134,977,939EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$6,125,828ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$24,112NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$40,551PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$7,242,909OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,950CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,100CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$78,123CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$102,165CurrentTaxYearMinus1YearAmt
Current Tax Year$140,049CurrentTaxYearAmt
Total$325,387TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,192,394CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,843,184CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$19,376,787CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,800,526CurrentTaxYearMinus1YearAmt
Current Tax Year$20,384,088CurrentTaxYearAmt
Total$91,596,979TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,195,344CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,845,284CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$19,454,910CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,902,691CurrentTaxYearMinus1YearAmt
Current Tax Year$20,524,137CurrentTaxYearAmt
Total$91,922,366TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$91,922,366PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$114,526CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$30,095CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$62,349CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$268,370CurrentTaxYearMinus1YearAmt
Current Tax Year$287,360CurrentTaxYearAmt
Total$762,700TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$114,526CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$30,095CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$62,349CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$268,370CurrentTaxYearMinus1YearAmt
Current Tax Year$287,360CurrentTaxYearAmt
Total$762,700TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,309,870CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,875,379CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$19,517,259CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$20,171,061CurrentTaxYearMinus1YearAmt
Current Tax Year$20,811,497CurrentTaxYearAmt
Total$92,685,066TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99180PublicSupportCY509Pct
Public Support PY5090.99270PublicSupportPY509Pct
Investment Income CY0.01000InvestmentIncomeCYPct
Investment Income PY0.01000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,600,000OtherCostOrOtherBasisAmt
Book Value$14,600,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$121,125,255OtherCostOrOtherBasisAmt
Depreciation$24,001,030DepreciationAmt
Book Value$97,124,225BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,725,955OtherCostOrOtherBasisAmt
Depreciation$1,899,529DepreciationAmt
Book Value$826,426BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$112,550,651TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescASSETS LIMITED TO USEDesc
Book Value$15,091,383BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$15,091,383TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
OBLIGATION TO PROVIDE FUTURE SERVICE$9,042,554
RESIDENT DEPOSITS$271,145
ORIGINAL ISSUE DISCOUNT-$1,672,375
FieldValueIRS element (for citing)
Total Liability$7,641,324TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$20,811,497TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$20,811,497RevenueSubtotalAmt
Total Revenue Per Form990$20,811,497TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$26,937,325TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$26,937,325ExpensesSubtotalAmt
Total Expenses Per Form990$26,937,325TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmount
SCHUTT RICHARD
CEO$500,649$25,186$1,469,578$11,200$14,822$2,021,435$1,372,554
DEYOUNG WILLIAM
COO$348,691$14,755$8,806$48,557$21,823$442,632
VANDERGENUGTEN BARRY
CFO$261,580$11,427$12,872$10,463$20,063$316,405
ENGELSMAN DONALD
ADMINISTRATOR$158,587$10,254$6,343$12,965$188,149
SMITH SHELLY
HEALTHCARE DIRECTOR$148,579$886$5,943$20,015$179,173$3,750

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART IIIFormAndLineReferenceDesc
ExplanationPART 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. RICHARD SCHUTT AND WILLIAM DEYOUNG PARTICIPATE IN THE PLAN. IN 2019, RICHARD SCHUTT RECIEVED A DISTRIBUTION FROM THE ACCOUNT OF 1,450,030; HAVING ACHIEVED NORMAL RETIREMENT AGE AND OVER 40 YEARS OF EMPLOYMENT WITH REST HAVEN. IN 2005, THE PLAN WAS SET UP BY THE BOARD OF DIRECTORS TO ESTABLISH A RETENTION INCENTIVE PLAN 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 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 RECEIVED 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 EXECUTIVE COMPENSATION PROGRAM HAS TWO MAJOR ELEMENTS; SALARY, OR BASE PAY, AND VARIABLE PAY. THE SALARY REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABALITIES AND EXPERIENCE. THE VARIABLE PAY REFLECTS THE ORGANIZATION'S COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS THE 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 INSURE THEY ARE COMPETITIVE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE ROUTNINELY RECIEVES AN EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATION'S EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY, AND SCOPE OF OPERATIONS. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ILLINOIS FINANCE AUTHORITY
A86109196745203H7D82016-04-01$10,710,000DEBT REFINANCINGfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
B86109196745203H7E62016-04-01$15,801,500DEBT REFINANCINGfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
C86109196745203H7F32016-04-01$34,310,250DEBT REFINANCINGfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
D86109196745203H7G12016-04-01$42,869,750DEBT REFINANCINGfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$10,710,000$146,646$10,710,000Yes (true)falsefalseYes (true)
B$15,801,500$216,268$15,801,500Yes (true)falsefalseYes (true)
C$34,310,250$469,747$34,310,250Yes (true)falsefalseYes (true)
D$42,869,750$586,983$42,869,750Yes (true)falsefalseYes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
Afalsefalsefalsefalsefalsefalsefalse
Bfalsefalsefalsefalsefalsefalsefalse
Cfalsefalsefalsefalsefalsefalsefalse
Dfalsefalsefalsefalsefalsefalsefalse

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
AfalsefalsefalsefalsefalsefalsefalsefalseYes (true)
BfalsefalsefalsefalsefalsefalsefalsefalseYes (true)
CfalsefalsefalsefalsefalsefalsefalsefalseYes (true)
DfalsefalsefalsefalsefalsefalsefalsefalseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)
CYes (true)
DYes (true)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PURPOSE OF ISSUE DESCRIPTIONILLINOIS FINANCE AUTHORITY DEBT REFINANCING
PURPOSE OF ISSUE DESCRIPTIONILLINOIS FINANCE AUTHORITY DEBT REFINANCING
PURPOSE OF ISSUE DESCRIPTIONILLINOIS FINANCE AUTHORITY DEBT REFINANCING
PURPOSE OF ISSUE DESCRIPTIONILLINOIS FINANCE AUTHORITY DEBT REFINANCING

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ILLINOIS FINANCE AUTHORITY
A86109196745203H7H92016-04-01$20,514,750DEBT REFINANCINGfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
B86109196745203H7J52016-04-01$21,918,750DEBT REFINANCINGfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$5,018,358$20,514,750$280,888$20,514,750Yes (true)falsefalseYes (true)
B$21,918,750$300,094$21,918,750Yes (true)falsefalseYes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
Afalsefalsefalsefalsefalsefalsefalse
Bfalsefalsefalsefalsefalsefalsefalse

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
AfalsefalsefalsefalsefalsefalsefalsefalseYes (true)
BfalsefalsefalsefalsefalsefalsefalsefalseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PURPOSE OF ISSUE DESCRIPTIONILLINOIS FINANCE AUTHORITY DEBT REFINANCING
PURPOSE OF ISSUE DESCRIPTIONILLINOIS FINANCE AUTHORITY DEBT REFINANCING

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
LINDA SCHUTT
SPOUSE OF CEO$104,843EMPLOYMENT COMPfalse
BONNIE HEIRENDT
SISTER OF CEO$14,130EMPLOYMENT COMPfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationSCH 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. (A) NAME OF PERSON: BONNIE HEIRENDT (D) DESCRIPTION OF TRANSACTION: EMPLOYMENT COMPENSATION SCH L, PART IV: THE TRANSACTIONS REPORTED ABOVE INVOLVING INTERESTED PERSONS ARE REVIEWED ANNUALLY BY THE BOARD'S COMPENSATION COMMITTEE AND HAVE BEEN DEEMED APPROPRIATE BASED ON THE POSTION EMPLOYED.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 3RESPONSIBILITES PAID THROUGH MANAGEMENT FEES TO REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME DBA PROVIDENCE LIFE SERVICES.
FORM 990, PAGE 6, PART VI, LINE 6THE 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 7ATHE 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 REVIEW 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 ESATE OR SUBSTANTIALLY ALL OF THE OTHER ASSETS OF THE CORPORATION; (6) TO DISSOLVE THE CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 7BTHE MEMBER SHALL HAVE AND EXERCISE THE 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 REVIEW 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 ESATE OR SUBSTANTIALLY ALL OF THE OTHER ASSETS OF THE CORPORATION; (6) TO DISSOLVE THE CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 11BA 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 12CTHE OFFICERS AND DIRECTORS/TRUSTEES 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 15ATHE PARENT COMPANY'S 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 ORGANIZATION'S 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 KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES.
FORM 990, PAGE 6, PART VI, LINE 15BTHE EXCECUTIVE COMPENSATION OF THE PARENT (REST HAVEN) COMPANYS EXECUTIVES IS SET BY THE PARENT COMPANYS BOARD OF DIRECTORS THROUGH BOARD OVERSIGHT. THE 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 EXECTUIVE 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 KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES.
FORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9DEBT RELEIF - AFFILIATE 5,000,000 CHANGE IN FSO OBLIGATION 2,242,909 TOTAL 7,242,909

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Business Name Line2DisregardedEntityName/BusinessNameLine2TxtAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
REST HAVEN ILLIANA CHRISTIAN
REST HAVEN ILLIANA CHRISTIAN18601 N CREEK DRIVETINLEY PARKIL60477362382853HEALTHCAREIL501C37N/Afalse
CHRISTIAN HEALTHCARE FOUNDATION
CHRISTIAN HEALTHCARE FOUNDATION18601 N CREEK DRIVETINLEY PARKIL60477200722359RESEARCHIL501C37N/Afalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE MANAGEMENT & DEVELOPMENTBusinessNameLine1Txt
Business Name Line2PROVIDENCE MANAGEMENT & DEVELOPMENTBusinessNameLine2Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line118601 N CREEK DRAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd
FieldValueIRS element (for citing)
EIN363774205EIN
Primary ActivitiesIT SERVICEPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
REST HAVEN ILLIANA CHRISTIAN
P$360,000FMV
PROVIDENCE MANAGEMENT
P$490,217FMV