2025-11-11T10:06:12-06:00 2024-12-31 331498605 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2024-01-01 362382853 REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME REST 7083428100 18670 GRAPHICS DRIVE SUITE 106 TINLEY PARK IL 60477 LARRY OTTE VP OF FINANCE 7083428100 2025-11-10 1 1 DAVID LOWENTHAL P00378651 3122071040 2025-11-10 2024 2025-03-06 01:10:19Z PROVIDENCE LIFE SERVICES RICHARD SCHUTT 18670 GRAPHICS DRIVE SUITE 106 TINLEY PARK IL 60477 49744111 0 X WWW.PROVIDENCELIFESERVICES.COM X 1956 IL REST HAVEN'S PURPOSE IS TO PROVIDE SERVICES FOR THE AGED INCLUDING SKILLED NURSING AND REHAB SERVICES, HOME HEALTH CARE, TOWNHOME LIVING, INDEPENDENT AND ASSISTED LIVING. 16 15 527 120 606126 13426 1870729 2164604 40622131 37080351 -1224733 215440 -91226 -125767 41176901 39334628 0 0 0 0 23024328 21467308 0 0 408487 23868279 18250167 46892607 39717475 -5715706 -382847 57755855 46713294 42021309 39214428 15734546 7498866 X REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME D/B/A PROVIDENCE LIFE SERVICES (REST HAVEN) IS A NOT-FOR-PROFIT ILLINOIS CORPORATION WHOSE PURPOSE IS TO PROVIDE NURSING AND RESIDENTIAL LIVING ARRANGEMENTS FOR THE AGED INCLUDING SKILLED NURSING AND REHABILITATION SERVICES, HOME HEALTH CARE, TOWNHOME LIVING, INDEPENDENT LIVING, AND ASSISTED LIVING. 0 0 31696529 36474225 TO PROVIDE PROPER CARE FOR THE SICK AND ELDERLY. 379 BEDS/UNITS WITH OCCUPANCY OVER 95% ON THE FULL CONTINUUM OF CARE. 31696529 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 77 0 1 527 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 16 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X BARRY VANDERGENUGTEN 7083428100 18670 GRAPHICS DRIVE SUITE 106 TINLEY PARK IL 60477 RICH SCHUTT DIRECTOR & CEO 40.00 5.00 X X 626743 0 30072 PAUL BUIKEMA CHAIR 1.00 2.00 X X 0 0 0 JAKE GROENEWOLD CHAIR (THRU 4/2024) 1.00 2.00 X X 0 0 0 KEN HOVING VICE CHAIR 1.00 2.00 X X 0 0 0 KAREN HUIZENGA SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 DARREN VAN ESSEN ASST. SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 TIM BREEMS DIRECTOR 1.00 2.00 X 0 0 0 EDWARD DAMSTRA III DIRECTOR 1.00 2.00 X 0 0 0 DAVE DEGRAFF DIRECTOR 1.00 2.00 X 0 0 0 TED FEENSTRA DIRECTOR 1.00 2.00 X 0 0 0 SHERYL HAMMER DIRECTOR (THRU 4/2024) 1.00 2.00 X 0 0 0 PATTI JABAAY DIRECTOR 1.00 2.00 X 0 0 0 ARNOLD KOLDENHOVEN DIRECTOR 1.00 2.00 X 0 0 0 GARY LEO DIRECTOR 1.00 2.00 X 0 0 0 EMILY MCMASTER DIRECTOR (THRU 4/2024) 1.00 2.00 X 0 0 0 ROB PETROELJE DIRECTOR 1.00 2.00 X 0 0 0 DAVID VOSS DIRECTOR 1.00 2.00 X 0 0 0 ERIC WOO DIRECTOR 1.00 2.00 X 0 0 0 KYLE YONKER DIRECTOR 1.00 2.00 X 0 0 0 WILLIAM DEYOUNG COO 40.00 5.00 X 418786 0 81129 BARRY VANDERGENUGTEN CFO 40.00 5.00 X 456582 0 24359 LARRY OTTE VP OF FINANCE 40.00 5.00 X 214913 0 32693 SUSAN ENRIGHT VP HOME & COMMUNITY BASED SERVICES 40.00 0.00 X 237330 0 17411 JOHANNA ZANDSTRA VP OF OPERATIONS 40.00 5.00 X 199159 0 23985 MEGAN TENGERSTROM VP OF OPERATIONS 40.00 5.00 X 218843 0 23500 SCOTT STUDEBAKER VP MINISTRY ADVANCEMENT & DEVELOPMENT 40.00 5.00 X 190397 0 21679 2562753 0 254828 34 0 1 0 SYMBRIA REHAB 28100 TORCH PARKWAY WARRENVILLE IL 60555 THERAPY 2577588 CREATIVE DINING SERVICES 1 ROYAL PARK DR 3 ZEELAND MI 49464 DINING SERVICES 1437404 PROVIDENCE MGMT & DEVELOPMENT (DBA PROVI 18645 WEST CREEK DRIVE TINLEY PARK IL 60477 IT SERVICES 964991 SYSCO CHICAGO INC 250 WIEBOLDT DRIVE DES PLAINES IL 60016 DINING SERVICES 696204 MCDONALD HOPKINS 39533 WOODWARD AVE 318 BLOOMFIELD HILLS MI 48304 LEGAL SERVICES 432899 20 185546 424629 1554429 2164604 NET RESIDENT SERVICE REVENUE 623000 33928988 33928988 ANCILLARY REVENUE 623000 3151363 2545237 606126 37080351 214091 214091 10031649 10030300 1349 1349 1349 253416 185546 379183 -125767 -125767 39334628 36474225 606126 89673 1637670 1637670 16164556 12405471 3429922 329163 378407 197039 169137 12231 2041024 1835455 162738 42831 1245651 996852 224537 24262 235298 235298 3412349 2148736 1263613 433832 427793 6039 649065 515402 133663 922359 922359 2181520 1979505 202015 1721668 1654399 67269 1749604 1647954 101650 993399 924270 69129 FOOD & DIETARY EXPENSE 1975781 1974832 949 NURSING EXPENSE 1289333 1289333 PHARMACY EXPENSE 912699 878470 34229 UBI TAX 19186 19186 1754074 1644175 109899 39717475 31696529 7612459 408487 472065 285947 127528 131991 2054775 2588888 691059 626865 53186108 25574580 27928477 27611528 6277743 1235719 318932 318932 19885276 13913424 57755855 46713294 6186912 5420646 627285 256288 32086314 31283783 3120798 2253711 42021309 39214428 X 15223469 7167438 511077 331428 15734546 7498866 57755855 46713294 X -382847 8384 -7861217 X 0 1 X 1 0 X 5887369 6552517 2783625 1870729 1739975 18834215 56204654 56161018 48837276 40126419 36474225 237803592 62092023 62713535 51620901 41997148 38214200 256637807 155395 202321 319476 301546 585803 1564541 0 155395 202321 319476 301546 585803 1564541 255073266 483540 364052 311057 596451 214091 1969191 22547 18963 29383 62311 14426 147630 506087 383015 340440 658762 228517 2116821 62598110 63096550 51961341 42655910 38442717 258754628 0.98580 0.98810 0.00820 0.00820 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4810562 4810562 44910540 22779792 22130748 3350678 2722552 628126 114328 72236 42092 27611528 GROUND LEASE RECEIVABLES 973836 ASSETS LIMITED TO USE 731058 DUE FROM AFFILIATES 4599481 OTHER ASSETS 81916 LEGAL LIABILITY INS RECOVERIES 1484795 DEFERRED COMP GRANTOR TRUST 670735 INTEREST RATE SWAP VALUE 1115803 CASH RESERVES 3800938 OPERATING LEASE - RIGHT OF USE ASSET 454862 13913424 ESTIMATED SELF-INS LIABILITIES 1683841 ASSET RETIREMENT OBLIGATION 63053 RESIDENT NOTES AND DEPOSITS 40925 ACCRUED INTEREST PAYABLE 65366 OPERATING LEASE OBLIGATION - LT 400526 2253711 BANQUET 235729 93901 141828 238374 GOLF OUTING 170265 75765 94500 114234 1 32968 15880 17088 26575 438962 185546 253416 379183 379183 -125767 FORM 990, SCHEDULE G, PART II: THE ORGANIZATION HOSTS EVENTS FOR PUBLIC RELATIONS AND FUNDRAISING PURPOSES. THESE EVENTS ARE OFTEN UNDERWRITTEN BY LEADERSHIP SPONSORS OF WHICH THEIR SPONSORSHIPS ARE ALLOCATED AMONGST THE VARIOUS EVENTS. THE COMBINED GROSS RECEIPTS OF THE EVENTS TOTALED $438,962 FOR 2024. THE COMBINED COSTS OF THE EVENTS TOTALED $379,183. THE NET INCOME TO THE ORGANIZATION FOR HOSTING ALL OF THE EVENTS WAS $59,779. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 RICH SCHUTT DIRECTOR & CEO 581196 0 24000 0 21547 0 13308 0 16764 0 656815 0 0 0 WILLIAM DEYOUNG COO 403346 0 0 0 15440 0 62990 0 18139 0 499915 0 0 0 BARRY VANDERGENUGTEN CFO 336749 0 100000 0 19833 0 9279 0 15080 0 480941 0 0 0 SUSAN ENRIGHT VP HOME & COMMUNITY BASED SERVICES 222797 0 11139 0 3394 0 9357 0 8054 0 254741 0 0 0 LARRY OTTE VP OF FINANCE 189161 0 12850 0 12902 0 7931 0 24762 0 247606 0 0 0 MEGAN TENGERSTROM VP OF OPERATIONS 206007 0 10865 0 1971 0 6741 0 16759 0 242343 0 0 0 JOHANNA ZANDSTRA VP OF OPERATIONS 183700 0 5000 0 10459 0 7348 0 16637 0 223144 0 0 0 SCOTT STUDEBAKER VP MINISTRY ADVANCEMENT & DEVELOPMEN 179297 0 0 0 11100 0 7172 0 14507 0 212076 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDES AN ALLOWANCE FOR UP TO 10 BOARD MEMBERS TO ATTEND THE ANNUAL ASSOCIATION CONVENTION TO PROVIDE MORE IN DEPTH KNOWLEDGE OF THE SENIOR CARE INDUSTRY. THE COST OF TRAVEL FOR SPOUSES IS PERMITTED AS LONG AS THE TOTAL DOES NOT EXCEED THE ESTABLISHED ALLOWANCE AMOUNT. THE BENEFIT OF SPOUSAL TRAVEL IS INCLUDED IN TAXABLE COMPENSATION. DOCUMENTATION OF ATTENDANCE AT THE ANNUAL CONVENTION IS REQUIRED. PART I, LINE 4B REST HAVEN HAS ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN IN AN EFFORT TO RETAIN SELECTED OFFICERS ON A LONG TERM BASIS. WILLIAM DEYOUNG PARTICIPATES IN THE PLAN. IN 2024, THERE WERE NO DISTRIBUTIONS FROM OR AMOUNTS VESTED IN THE ACCOUNT. THE PLAN WAS ORIGINALLY SET UP IN 2005 BY THE BOARD OF DIRECTORS TO ESTABLISH A RETENTION INITIATIVE FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES AND ESTABLISHES AN INCENTIVE FOR THEM TO CONTINUE THEIR EMPLOYMENT WITH THE ORGANIZATION UNTIL NORMAL RETIREMENT AGE. AMONG VARIOUS CRITERIA, IN ORDER TO QUALIFY FOR THE BENEFIT, THE EXECUTIVE WILL NEED TO BE CONTINUOUSLY 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 THE ACHIEVEMENT OR SATISFACTION OF SOME FUTURE EVENTS. THE PLAN CONTRIBUTIONS ARE NOT UNDER THE CONTROL OF THE EXECUTIVE, THEY REMAIN THE ASSET OF THE ORGANIZATION, AND THE ENTIRE PLAN IS SUBJECT TO A FULL RISK OF 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 CAPABILITIES 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 ENSURE THEY ARE COMPETITIVE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE ROUTINELY RECEIVES AN EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATION'S EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY AND SCALE OF OPERATIONS. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET. BETHANY VAN SOLKEMA DAUGHTER OF CEO 22844 EMPLOYMENT COMPENSATION 0 ALLISON OLESHKO DAUGHTER OF CEO 12461 EMPLOYMENT COMPENSATION 0 CONNOR VANDERGENUGTEN SON OF CFO 18803 EMPLOYMENT COMPENSATION 0 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 POSITION EMPLOYED. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE 990 WAS PREPARED AND SENT FOR INITIAL REVIEW BY THE VP OF FINANCE, CFO AND CEO. UPON REVIEW AND APPROVAL, THE 990 WAS MADE AVAILABLE TO THE ENTIRE BOARD PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT UPON BEGINNING THEIR POSITION. THEREAFTER, THE CONFLICT OF INTEREST STATEMENTS ARE UPDATED ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS ARE REVIEWED AND ADDRESSED BY THE BOARD AS NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION PROGRAM'S PRIMARY OBJECTIVE IS TO PROVIDE COMPETITVE 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, INCLUDING THAT OF THE CEO AND OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, 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, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER OF EQUITY TO RELATED ENTITIES -7,553,222. UNREALIZED GAIN ON INTEREST RATE SWAP -307,995. PROVIDENCE DEVELOPMENT GROUP 18601 N CREEK DRIVE TINLEY PARK IL 60477 DEVELOPMENT IL 0 2382328 REST HAVEN PARK PLACE REALTY GROUP LLC 18601 N CREEK DRIVE TINLEY PARK IL 60477 REAL ESTATE IL 38875 39902 REST HAVEN PROVIDENCE OPERATIONS LLC 18601 N CREEK DRIVE TINLEY PARK IL 60477 OPERATIONS IL 35168 -130970 REST HAVEN PROVIDENCE DOWNERS GROVE LLC 18601 N CREEK DRIVE TINLEY PARK IL 60477 REAL ESTATE IL 0 0 PROVIDENCE TENANT LLC ROYAL PARK PLACE II LLC 18601 N CREEK DRIVE TINLEY PARK IL 60477 OPERATIONS IL 418774 -5678356 REST HAVEN CHRISTIAN HEALTHCARE FOUNDATION NFP 18601 N CREEK DRIVE TINLEY PARK IL 60477 200722359 RESEARCH IL 501(C)(3) LINE 10 REST HAVEN 1 CHRISTIAN LIVING CAMPUS NFP 18601 N CREEK DRIVE TINLEY PARK IL 60477 200226221 SENIOR LIVING IL 501(C)(3) LINE 10 REST HAVEN 1 TIMOTHY PLACE NFP 18601 N CREEK DRIVE TINLEY PARK IL 60477 201835089 SENIOR LIVING IL 501(C)(3) LINE 10 REST HAVEN 1 PARK PLACE CHRISTIAN COMMUNITY OF ST JOHN INC 18601 N CREEK DRIVE TINLEY PARK IN 60477 201834903 SENIOR LIVING IN 501(C)(3) LINE 10 REST HAVEN 1 HUDSONVILLE PARK PLACE INC 18601 N CREEK DRIVE TINLEY PARK IL 60477 201834667 SENIOR LIVING IL 501(C)(3) LINE 10 REST HAVEN 1 PROVIDENCE MGMT & DEVELOPMENT 18601 N CREEK DRIVE TINLEY PARK IL 60477 363774205 IT SERVICES IL N/A C -497409 227564 1.00000 1 PROVIDENCE HOUSING CORPORATION 18601 N CREEK DRIVE TINLEY PARK IL 60477 461379112 HOUSING IL REST HAVEN C 36317 1469174 1.00000 1 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1 PROVIDENCE MGMT & DEVELOPMENT P 922359 FMV PROVIDENCE MGMT & DEVELOPMENT Q 606126 FMV TIMOTHY PLACE Q 360000 FMV PARK PLACE OF ST JOHN Q 1306937 FMV