PINE HAVEN CHRISTIAN HOME INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PINE HAVEN CHRISTIAN HOME INC (EIN 39-0816900)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2017-11-06
- IRS object ID
- 201723109349301592
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-06T13:38:29-06:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 391173131 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHENCK SC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 712 RIVERFRONT DRIVE STE 301 | AddressLine1Txt |
| City | SHEBOYGAN | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53081 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390816900 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PINE HAVEN CHRISTIAN HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PINE | BusinessNameControlTxt |
| Phone | 9204672401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVENUE | AddressLine1Txt |
| City | SHEBOYGAN FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53085 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARTIN HALVERSON | PersonNm |
| Person Title | OFFICER | PersonTitleTxt |
| Phone | 9204672401 | PhoneNum |
| Signature | 2017-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRY T STRITTMATER CPA | PreparerPersonNm |
| PTIN | P00012661 | PTIN |
| Phone | 9204580341 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 74.142.163.66 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-10-31 | IPDt |
| IP Tm | 12:21:00 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9475B8F64D5A719E781C043AAC9DC26B2B2E8E16 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A2332E9BA041B4FC086FC95AEC67015C51811E2D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARTIN HALVERSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVENUE | AddressLine1Txt |
| City | SHEBOYGAN FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,249,345 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PINEHAVEN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | PINE HAVEN CHRISTIAN COMMUNITIES WILL PROVIDE THE AGING POPULATION WE SERVE AN ENVIRONMENT THAT IS A CHRIST-CENTERED, SAFE HAVEN OFFERING QUALITY, COMPASSIONATE CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 448 | TotalEmployeeCnt |
| Total Volunteers | 171 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,098,178 | PYContributionsGrantsAmt |
| CY Contributions Grants | $230,821 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,611,212 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,942,320 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$103,492 | PYInvestmentIncomeAmt |
| CY Investment Income | $54,394 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $21,810 | CYOtherRevenueAmt |
| PY Total Revenue | $17,605,898 | PYTotalRevenueAmt |
| CY Total Revenue | $17,249,345 | 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 | $9,547,752 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,675,585 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,000 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,587,344 | PYOtherExpensesAmt |
| CY Other Expenses | $7,080,460 | CYOtherExpensesAmt |
| PY Total Expenses | $17,135,096 | PYTotalExpensesAmt |
| CY Total Expenses | $16,756,045 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $470,802 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $493,300 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $43,277,168 | TotalAssetsBOYAmt |
| Total Assets EOY | $42,495,160 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,836,157 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,512,853 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,441,011 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,982,307 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PINE HAVEN CHRISTIAN COMMUNITIES WILL PROVIDE THE AGING POPULATION WE SERVE AN ENVIRONMENT THAT IS A CHRIST-CENTERED, SAFE HAVEN OFFERING QUALITY, COMPASSIONATE CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,686,822 | ExpenseAmt |
| Revenue | $16,942,320 | RevenueAmt |
| Desc | PROVIDING HOUSING, HEALTH CARE AND OTHER RELATED SERVICES TO RESIDENTS IN A NON-PROFIT NURSING HOME AND ASSISTED LIVING FACILITIES. | Desc |
| Total Program Service Expenses | $14,686,822 | 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 | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 58 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 448 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | 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 | Yes (1) | 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 | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | MARTIN HALVERSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9204672401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVENUE | AddressLine1Txt |
| City | SHEBOYGAN FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53085 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| CHRISTINE TEMPAS | ||||||
| PRESIDENT | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GENNY TEN PAS | ||||||
| VICE PRESIDENT | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROBERT DESMIDT | ||||||
| SECRETARY | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JACK HOFFMANN | ||||||
| TREASURER | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DAVE BRASSER | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JANE BUTEYN | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GLENN LEMMENES | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BETTY MOODY | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| NORENE HUIBREGTSE | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MIKE FOLEY | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LARRY LORENZ | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| WENDY BAACKES | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RANDY TEUNISSEN | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JEFF BROETZMANN | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROGER BUYZE | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KEN KOEHLER | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DAN NEERHOFF | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BOB NYHUIS | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GENE JENTINK | ||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RON WALVOORT | ||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $144,472 | $0 | $20,576 | |
| MARTIN HALVERSON | ||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $93,992 | $0 | $20,576 | |
| STEVE HENDRIKSE | ||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $78,552 | $0 | $12,860 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $317,016 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $54,012 | 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 (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| REHAB CARE GROUP EAST INC | |||||
| PO BOX 503534 | SAINT LOUIS | MO | 631503534 | THERAPY | $923,408 |
| ELITE NURSES INC | |||||
| 1987 SCHEUERING RD 8 | DE PERE | WI | 54115 | NURSING SERVICES | $235,137 |
| LEADERSTAT | |||||
| 1322B MANNING PKWY | POWELL | OH | 43065 | PROFESSIONAL AGENCY | $121,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $181,160 | RelatedOrganizationsAmt |
| All Other Contributions | $49,661 | AllOtherContributionsAmt |
| Total Contributions | $230,821 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENTIAL CENTERS | 623000 | $9,893,646 | $9,893,646 |
| NURSING HOME | 623000 | $5,164,764 | $5,164,764 |
| RESIDENTIAL CARE APMT COMPLEX | 623000 | $1,883,910 | $1,883,910 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,942,320 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,394 | TotalRevenueColumnAmt |
| Exclusion | $54,394 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $21,810 | TotalRevenueColumnAmt |
| Exclusion | $21,810 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $21,810 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,249,345 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,942,320 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $76,204 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $400,310 | TotalAmt |
| Management And General | $400,310 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,580,968 | TotalAmt |
| Program Services | $6,770,031 | ProgramServicesAmt |
| Management And General | $810,937 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,567 | TotalAmt |
| Program Services | $77,557 | ProgramServicesAmt |
| Management And General | $14,010 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,019,095 | TotalAmt |
| Program Services | $904,616 | ProgramServicesAmt |
| Management And General | $114,479 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $583,645 | TotalAmt |
| Program Services | $494,351 | ProgramServicesAmt |
| Management And General | $89,294 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,646 | TotalAmt |
| Management And General | $12,646 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,050 | TotalAmt |
| Management And General | $25,050 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,564 | TotalAmt |
| Management And General | $15,564 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,124 | TotalAmt |
| Management And General | $33,124 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,794 | TotalAmt |
| Management And General | $86,794 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,779 | TotalAmt |
| Management And General | $119,779 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,240 | TotalAmt |
| Program Services | $237,545 | ProgramServicesAmt |
| Fundraising | $695 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,986 | TotalAmt |
| Management And General | $93,986 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $916,901 | TotalAmt |
| Program Services | $916,901 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,605,963 | TotalAmt |
| Program Services | $1,605,658 | ProgramServicesAmt |
| Fundraising | $305 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,372 | TotalAmt |
| Program Services | $165,372 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| NURSING AND MEDICAL | $1,532,367 | $1,532,367 | |
| DIETARY - FOOD | $772,286 | $772,286 | |
| UTILITIES | $434,761 | $386,944 | $47,817 |
| SUPPLIES | $211,071 | $161,435 | $49,636 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $816,556 | TotalAmt |
| Program Services | $661,759 | ProgramServicesAmt |
| Management And General | $154,797 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,756,045 | TotalAmt |
| Program Services | $14,686,822 | ProgramServicesAmt |
| Management And General | $2,068,223 | ManagementAndGeneralAmt |
| Fundraising | $1,000 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | Yes (X) | JointCostsInd |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,877,780 | BOYAmt |
| EOY | $2,552,280 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,126,521 | BOYAmt |
| EOY | $873,881 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,920 | BOYAmt |
| EOY | $10,588 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,111 | BOYAmt |
| EOY | $110,963 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $44,136,218 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,583,902 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,126,705 | BOYAmt |
| EOY | $32,552,316 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,491,772 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,209,827 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $890,304 | BOYAmt |
| EOY | $903,360 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,277,168 | BOYAmt |
| EOY | $42,495,160 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,971,844 | BOYAmt |
| EOY | $1,210,765 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,864,313 | BOYAmt |
| EOY | $27,302,088 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,836,157 | BOYAmt |
| EOY | $28,512,853 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,551,606 | BOYAmt |
| EOY | $13,081,203 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $889,405 | BOYAmt |
| EOY | $901,104 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,441,011 | BOYAmt |
| EOY | $13,982,307 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,277,168 | BOYAmt |
| EOY | $42,495,160 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $493,300 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $47,996 | 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 | $14,118 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,658 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,729 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,098,178 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $230,821 | CurrentTaxYearAmt |
| Total | $1,367,504 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,978,233 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,210,591 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,452,767 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,611,212 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,942,320 | CurrentTaxYearAmt |
| Total | $74,195,123 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,992,351 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,230,249 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,457,496 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,709,390 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,173,141 | CurrentTaxYearAmt |
| Total | $75,562,627 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $75,562,627 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $42,678 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30,190 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,914 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,159 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $54,394 | CurrentTaxYearAmt |
| Total | $167,335 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $42,678 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30,190 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,914 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,159 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $54,394 | CurrentTaxYearAmt |
| Total | $167,335 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,412 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,060 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,401 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $21,810 | CurrentTaxYearAmt |
| Total | $48,683 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,046,441 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,268,499 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,478,811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,735,549 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,249,345 | CurrentTaxYearAmt |
| Total | $75,778,645 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99710 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99700 | PublicSupportPY509Pct |
| Investment Income CY | 0.00220 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00250 | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,345,944 | OtherCostOrOtherBasisAmt |
| Book Value | $1,345,944 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,210,922 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,292,993 | DepreciationAmt |
| Book Value | $28,917,929 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,820,075 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,876,548 | DepreciationAmt |
| Book Value | $1,943,527 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $759,277 | OtherCostOrOtherBasisAmt |
| Depreciation | $414,361 | DepreciationAmt |
| Book Value | $344,916 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $32,552,316 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $17,288,867 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $47,996 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $7,090 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $55,086 | RevenueNotReportedAmt |
| Revenue Subtotal | $17,233,781 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $15,564 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $15,564 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $17,249,345 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,747,571 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $7,090 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $7,090 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,740,481 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $15,564 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $15,564 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $16,756,045 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | RON WALVOORT | PersonNm |
| Title | CHIEF EXECUTIVE OFFICER | TitleTxt |
| Base Compensation Filing Org | $144,472 | 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 | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $20,576 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $165,048 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY - SERIES 2014 A | |||||||
| A | 391337855 | 2014-05-01 | $10,000,000 | REFINANCE 2009 BONDS | 0 | 0 | 0 |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY - SERIES 2014 B | |||||||
| B | 391337855 | 2014-05-01 | $18,100,000 | NEW PROJECT | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|
| A | $10,000,000 | 2015 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $18,100,000 | 2015 | 0 | 0 | Yes (1) | Yes (1) | $18,100,000 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $49,661 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | PINE HAVEN CHRISTIAN HOME HAS A BOARD OF DIRECTORS APPROVED EMPLOYEE HANDBOOK CONTAINING A POLICY REGARDING CONFLICTS OF INTEREST. EMPLOYEES SIGN OFF ACKNOWLEDGING RECEIPT OF THE EMPLOYEE HANDBOOK WHEN HIRED. BOARD OF DIRECTORS SIGN OFF ON A CONFLICT OF INTEREST ACKNOWLEDGMENT AT THE TIME OF "NEW" BOARD MEMBER ORIENTATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION FOR THE CEO AND OTHER KEY EMPLOYEES IS COMPARED TO INDUSTRY DATA COMPILED BY LEADING AGE WISCONSIN. THE SURVEY COMPARES COMPENSATION BASED ON THREE CRITERIA: GROSS REVENUES, GEOGRAPHIC AREA AND TOTAL BED RESPONSIBILITIES. THE CEO HAS AN ANNUAL REVIEW COMPLETED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVALIABLE TO THE PUBLIC AT THIS TIME. |
| FORM 990, PART XII, LINE 2C | THERE IS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PINE HAVEN CHRISTIAN HOME FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 GIDDINGS AVE | AddressLine1Txt |
| City | SHEBOYGAN FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391963866 | EIN |
| Primary Activities | RAISE/RECEIVE FUNDS FOR THE GENERAL SUPPORT OF THIS ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 12 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | 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 (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PINE HAVEN CHRISTIAN HOME FOUNDATION INC | ||
| C | $181,160 | ACTUAL AMOUNT RECEIVED |
| PINE HAVEN CHRISTIAN HOME FOUNDATION INC | ||
| D | $2,256 | ACTUAL AMOUNT BORROWED |
| PINE HAVEN CHRISTIAN HOME FOUNDATION INC | ||
| O | $7,141 | ALLOCATION BASED ON HOURS WORKED |