2019-11-12T15:33:05-06:00 2019-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2018-07-01 391913323 OAKS OF DUNN COUNTY INC OAKS 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 SCOTT HOFFMAN CHIEF FINANCIAL OFFICER 4028963884 2019-11-04 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2019-11-04 13:29:23 CS P 4492BEC4F3BAD6652306010BEE5B0619D04D8C2F 5D066E2939FE45487034BD10C4A0DC94BE27FEF9 2018 2020-03-31 21:24:44Z SCOTT HOFFMAN 4980 SOUTH 118TH STREET OMAHA NE 68137 781191 0 X WWW.MOSAICINFO.ORG X 1998 WI THE OAKS OF DUNN COUNTY PROVIDES SUPPORTED LIVING TO SENIORS LIVING IN MENOMONIE, WI. THE FACILITY OFFERS SECURE, ACCESSIBLE, AND MAINTENANCE-FREE HOMES IN A HOUSING COMPLEX WITH COMMON SPACE AND BASIC SERVICES, INCLUDING TRANSPORTATION, WEEKLY HOUSEKEEPING, LAUNDRY SERVICES, PLANNED ACTIVITIES, AND A DAILY MAIN MEAL. 6 3 0 5 0 0 0 0 498390 370851 46715 38527 0 0 545105 409378 0 0 0 0 163756 172703 0 0 0 298642 287879 462398 460582 82707 -51204 2609849 2500265 1914088 1829263 695761 671002 X THE OAKS OF DUNN COUNTY PROVIDES SUPPORTED LIVING TO SENIORS LIVING IN MENOMONIE, WI. THE FACILITY OFFERS SECURE, ACCESSIBLE, AND MAINTENANCE-FREE HOMES IN A HOUSING COMPLEX WITH COMMON SPACE AND BASIC SERVICES, INCLUDING TRANSPORTATION, WEEKLY HOUSEKEEPING, LAUNDRY SERVICES, PLANNED ACTIVITIES, AND A DAILY MAIN MEAL. THE OAKS OF DUNN COUNTY IS AN AFFILIATE OF MOSAIC. MOSAIC IS A FAITH-BASED ORGANIZATION SERVING PEOPLE WITH DEVELOPMENTAL DISABILITIES SO THAT ALL MAY REALIZE GOD'S GIFT OF WHOLENESS OF LIFE. WE ARE GUIDED BY THE PRINCIPLE THAT "EVERY INDIVIDUAL IS A PERSON OF WORTH." MOSAIC'S STAFF MEMBERS AND VOLUNTEERS PROVIDE INDIVIDUALIZED SERVICES, LIVING OPTIONS, WORK CHOICES, SPIRITUAL NURTURING, AND ADVOCACY TO APPROXIMATELY 3,500 INDIVIDUALS IN MORE THAN 50 COMMUNITIES ACROSS 12 STATES. INTERESTED PEOPLE CAN FIND MORE INFORMATION REGARDING THE OAKS OF DUNN COUNTY AT WWW.MOSAICINFO.ORG OR BY CALLING 715-235-7793. 0 0 439507 370851 PROVIDE RESIDENTIAL HOUSING AND SUPPORTED LIVING TO SENIORS. THE FACILITY OFFERS SECURE, ACCESSIBLE, AND MAINTENANCE-FREE HOMES IN A HOUSING COMPLEX WITH COMMON SPACE AND BASIC SERVICES, INCLUDING TRANSPORTATION, WEEKLY HOUSEKEEPING, LAUNDRY SERVICES, PLANNED ACTIVITIES, AND A DAILY MAIN MEAL. 439507 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X X SCOTT HOFFMAN 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 ROBERT SPINTI PRESIDENT 0.10 0.00 X X 0 0 0 SCOTT HOFFMAN VICE PRESIDENT 0.10 39.90 X X 0 277440 39063 JACK JEATRAN SECRETARY 0.10 0.00 X X 0 0 0 KRISTIN ROSSOW TREASURER 0.10 39.90 X X 0 157780 26371 ROGER NATWICK DIRECTOR THRU 03/19 0.10 0.00 X 0 0 0 MICHAEL SCHENDEL DIRECTOR 0.10 0.00 X 0 0 0 MARLIN WILKERSON DIRECTOR 0.10 39.90 X 0 197313 38935 0 632533 104369 0 0 1 0 0 RENTAL INCOME 532000 346075 346075 NON-REFUNDABLE FEES 532000 18350 18350 6426 6426 370851 36124 36124 374216 371813 2403 2403 2403 409378 370851 0 38527 140531 140531 21768 21768 10404 10404 20993 20993 82 82 6187 6187 33908 33908 58392 58392 293 293 35677 35677 83112 83112 18740 18740 FOOD COSTS 29867 29867 DUES, FEES & REGISTRATI 628 628 460582 439507 21075 0 9782 8196 1964 0 3173608 1628883 1627836 1544725 969772 946959 495 385 2609849 2500265 11166 15757 81 0 892084 746689 1010757 1066817 1914088 1829263 X 685761 661002 10000 10000 695761 671002 2609849 2500265 -51204 26445 0 X X 0 1 X 1 0 X 469547 541118 554249 498390 370851 2434155 469547 541118 554249 498390 370851 2434155 0 0 0 2434155 18881 23504 24990 24503 36124 128002 18881 23504 24990 24503 36124 128002 488428 564622 579239 522893 406975 2562157 0.95000 0.95730 0.05000 0.04270 X 10000 10000 10000 10000 10000 10000 10000 10000 10000 10000 0.00000 0.00000 1.00000 0 0 95195 95195 3005590 1556060 1449530 72823 72823 0 1544725 TENANT SECURITY DEPOSITS 441916 AFFILIATE PAYABLE 624901 1066817 X PART V, LINE 4: THE ORGANIZATION'S INTENDED USE OF THE TEMPORARILY RESTRICTED NET ASSETS IS FOR PROGRAM PURPOSES AS RESTRICTED BY THE DONORS. PART X, LINE 2: THE FOLLOWING FOOTNOTE IS TAKEN FROM THE CONSOLIDATED FINANCIAL STATEMENTS: ALL CONSOLIDATED AFFILIATED ENTITIES, EXCEPT FOR MOSAIC HOUSING CORP V, INC., EASE-E MEDICAL, INC. AND BICO, LTD. ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN MOSAIC'S TAX EXEMPT STATUS. MOSAIC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2019 AND 2018, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OTHER THAN DESCRIBED PREVIOUSLY. 0 0 0 0 0 0 0 0 0 SCOTT HOFFMAN VICE PRESIDENT 0 254991 0 21601 0 848 0 16759 0 22304 0 316503 0 0 KRISTIN ROSSOW TREASURER 0 155227 0 2000 0 553 0 4477 0 21894 0 184151 0 0 MARLIN WILKERSON DIRECTOR 0 195193 0 1500 0 620 0 7707 0 31228 0 236248 0 0 PART I, LINE 3 THE SALARIES OF SCOTT HOFFMAN, KRISTIN ROSSOW AND MARLIN WILKERSON ARE PAID FROM A RELATED ORGANIZATION, MOSAIC. MOSAIC'S BOARD AND EXECUTIVE COMMITTEE USE AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, AND A COMPENSATION SURVEY IN ESTABLISHING THE COMPENSATION OF THE PRESIDENT AND CEO OF MOSAIC AND GUIDELINES FOR OTHER KEY STAFF. SCHEDULE J, PART II, COLUMN C: MOSAIC EVALUATES THE LIABILITY RELATED TO THEIR POSTRETIREMENT BENEFITS (SALARY AND HEALTH INSURANCE CONTINUATION) THROUGH AN ACTUARIAL REVIEW. THE ADJUSTMENT IS INCLUDED IN RETIREMENT AND OTHER DEFERRED COMPENSATION. FORM 990, PART VI, SECTION A, LINE 7A THE MOSAIC BOARD OF DIRECTORS APPOINTS THE OAKS OF DUNN COUNTY'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS REVIEWED BY THE TREASURER OF THE ORGANIZATION AND THEN SHARED WITH THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD DIRECTOR COMPLETES A CONFLICT OF INTEREST FORM ANNUALLY AND SUBMITS IT TO THE CHAIRPERSON OF THE MOSAIC'S BOARD GOVERNANCE RISK AND INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE TREASURER AND MOSAIC'S CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 OAKS OF DUNN COUNTY, INC. DOES NOT PAY COMPENSATION TO A CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIAL, OFFICERS, OR ANY OTHER EMPLOYEES. THEREFORE, A PROCESS FOR DETERMINING COMPENSATION HAS NOT BEEN ESTABLISHED. FORM 990, PART VI, SECTION C, LINE 19 INDIVIDUALS MAY REQUEST MOSAIC'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS THROUGH AN E-MAIL REQUEST FORM, WHICH IS AVAILABLE ON MOSAIC'S PUBLIC WEBSITE (WWW.MOSAICINFO.ORG). FORM 990, PART XII, LINE 2C: THE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC 4980 S 118 ST OMAHA NE 68137 113669999 SERVICES FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES NE 501(C)(3) LINE 10 N/A 0 MOSAIC FOUNDATION 4980 S 118 ST OMAHA NE 68137 363837360 FUNDRAISING & INVESTMENT ASSET MANAGEMENT NE 501(C)(3) LINE 12A, I MOSAIC 1 MOSAIC HOUSING CORP I 4980 S 118 ST OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP II 4980 S 118 ST OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP IV 4980 S 118 ST OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP VII 4980 S 118 ST OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP VIII 4980 S 118 ST OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP IX 4980 S 118 ST OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP X 4980 S 118 ST OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XI 4980 S 118 ST OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XII 4980 S 118 ST OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XIII 4980 S 118 ST OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XIV - ROCKFORD 4980 S 118 ST OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XV - COUNCIL BLUFFS 4980 S 118 ST OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XVI - FARMINGTON 4980 S 118 ST OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XVII - BEATRICE 4980 S 118 ST OMAHA NE 68137 261710013 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XVIII - OSCEOLA-WAUKON 4980 S 118 ST OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XIX - WINFIELD 4980 S 118 ST OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XX - GARDEN CITY 4980 S 118 ST OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XXI - MEMPHIS 4980 S 118 ST OMAHA NE 68137 264555313 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORP XXII - LOGAN 4980 S 118 ST OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXIII - AUSTIN 4980 S 118 ST OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING I 4980 S 118 ST OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING II 4980 S 118 ST OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING AT MACOMB I 4980 S 118 ST OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING AT ROCKFORD I 4980 S 118 ST OMAHA NE 68137 204841856 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC VEBA 4980 S 118 ST OMAHA NE 68137 363831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 1 MOSAIC SENIOR SERVICES INC 4980 S 118 ST OMAHA NE 68137 831746407 SENIOR LIVING SERVICES AZ 501(C)(3) LINE 12A, I MOSAIC 1 MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A EASE-E MEDICAL INC 731 SOUTH 8TH STREET CANON CITY CO 81212 470842353 MEDICAL EQUIPMENT/SUPPLIES SALES NE N/A C 1 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE N/A C 1 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD N/A C 1 CHARITABLE REMAINDER TRUSTS (5) INVESTMENT MANAGEMENT NE N/A T 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0