2017-05-15T12:59:57-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2016-01-01 390838135 ODD FELLOW REBEKAH HOME ASSOCIATION INC ODDF 9205937000 1207 SOUTH JACKSON STREET GREEN BAY WI 54301 CHARLENE EVERETT CEO 9205937000 2017-05-01 1 KACIE MCEWEN P01599614 6123764500 67.137.57.251 2017-05-01 16:32:11 CD P 977139128611A4E36F514149905081B6C9A4065F B3EA28BB1009F9E462E5A3B6A3DA5A80F0A4DDDC 2016 2021-01-29 14:40:06Z CHARLENE EVERETT 1207 SOUTH JACKSON STREET GREEN BAY WI 54301 10810582 0 X WWW.OFRHA.ORG X 1889 WI ELDERLY AND DISABLED HOUSING AND HEALTH SERVICES 8 7 162 34 0 0 124 19140 8241241 8293000 202720 183057 17343 19917 8461428 8515114 0 0 0 0 4532689 4743910 0 0 0 3079449 3466221 7612138 8210131 849290 304983 15233478 15371329 5305389 5040918 9928089 10330411 X ELDERLY AND DISABLED HOUSING AND HEALTH SERVICES AT OR BELOW THE LOW/LOW-MEDIAN RATES FOR OUR CONSUMER AREA. INCLUDES UNDER FUNDED CARE FOR LOW INCOME COUNTY PLACED TENANTS. 0 1 5817732 0 6617882 ODD FELLOW HOME:A 74 BED SKILLED NURSING AND REHABILITATION FACILITY FOR THE ELDERLY OF BROWN COUNTY, WISCONSIN AND SURROUNDING AREA. A FIVE-STAR CMS PROGRAM, WITH THE MAJORITY OF THE CLIENTS BEING MEDICAID UNDERFUNDED. REHAB SEES A LARGE PERCENTAGE OF OUR CLIENTS RETURNING TO THEIR HOMES. 724458 0 788312 HERITAGE GARDENS: A 18 BED MEMORY CARE COMMUNITY BASED RESIDENTIAL FACILITY. IT FEATURES 24-HOUR STAFF AND HEALTH MONITORING BY LICENSED NURSES IN A CALMING RESIDENTIAL ATMOSPHERE. 737548 0 886806 REBEKAH HAVEN:A 20 BED RESIDENTIAL CARE APARTMENT COMPLEX, IN GREEN BAY, WISCONSIN. SENIOR PRIVATE APARTMENTS WITH 24 HOUR SERVICES PROVIDED, TO ALLOW INDEPENDENCE, CHOICE AND QUALITY OF LIFE IN A SAFE ENVIRONMENT. COUNTY FUNDING HELPS COVER TENANTS WITHOUT FUNDS FOR SERVICES 7279738 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 32 0 162 1 0 0 0 0 0 0 0 0 0 0 X 8 7 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X X JAMIE STROHSCHEIN 9205937000 1207 SOUTH JACKSON STREET GREEN BAY WI 54301 LOREN CUNNINGHAM BOARD PRESIDENT 1.00 X X 0 0 0 PATRICIA MOTT VICE PRESIDENT 1.00 X X 0 0 0 DENISE OLSEN SECRETARY 1.00 X X 0 0 0 SHARON CUNNINGHAM GRAND MASTER/DIRECTOR 1.00 X 0 0 0 ROBERTA BIERHALS DIRECTOR/PRESIDENT THRU 6/7/16 1.00 X X 0 0 0 RICHARD PROULX DIRECTOR 5.00 20.00 X 0 6300 0 TOM REED DIRECTOR/VICE PRESIDENT THRU 6/7/16 1.00 X X 0 0 0 ELLEN TEWS DIRECTOR 1.00 X 0 0 0 CHARLENE EVERETT CEO 40.00 X 157524 0 9601 JAMIE STROHSCHEIN CFO 32.00 X 83175 0 7984 240699 6300 17585 1 0 1 0 NEW HORIZON FOODS INC PO BOX 860246 MINNEAPOLIS MN 55486 CONTRACTED DIETARY 722575 MJ CARE INC PO BOX 88438 MILWAUKEE WI 53288 CONTRACTED THERAPY 490046 BERNERS-SCHOBER ASSOCIATES INC 310 PINE STREET GREEN BAY WI 54301 CONTRACTED ARCHITECTURAL AND DESIGN 369710 BSG MAINTENANCE INC PO BOX 165 NEWBURG WI 53060 CONTRACTED LAUNDRY & HOUSEKEEPING 242725 4 5325 13815 19140 RESIDENCY FEES 623000 8293000 8293000 8293000 98067 98067 2380458 2289490 5978 90968 -5978 84990 84990 OTHER REVENUE 900099 18117 18117 MEAL REVENUE 624210 1395 1395 CABLE/TV/PHONE 900099 405 405 19917 8515114 8293000 0 202974 X 258284 258284 3894347 3566340 328007 49272 48623 649 240078 216109 23969 301929 260414 41515 4798 4798 33713 33713 19528 19528 1508307 1439518 68789 15140 14816 324 97381 32377 65004 241783 236690 5093 29089 29089 130849 128049 2800 458283 448476 9807 82939 81164 1775 MEDICAL SUPPLIES/DRUGS 491998 491998 BED TAX 150960 150960 EQUIPMENT RENTAL & REPA 106352 104076 2276 PROVISION FOR BAD DEBT 46231 46231 48870 13897 34973 8210131 7279738 930393 0 797191 305228 12504 5884 629745 735918 97467 109291 16085520 6289783 9557260 9795737 4051626 4336864 87685 82407 15233478 15371329 434038 626024 4866974 4409210 4377 5684 5305389 5040918 X 9792386 10194708 135703 135703 9928089 10330411 15233478 15371329 304983 97339 0 X 0 1 X 0 0 X 2653 939 87546 124 19140 110402 6751866 7075318 7738798 8241241 8293000 38100223 6754519 7076257 7826344 8241365 8312140 38210625 0 816953 974218 622356 809433 904231 4127191 816953 974218 622356 809433 904231 4127191 34083434 123195 132761 87302 99091 98067 540416 123195 132761 87302 99091 98067 540416 19608 192705 15881 16343 19917 264454 6897322 7401723 7929527 8356799 8430124 39015495 0.87360 0.86680 0.01390 0.01510 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MEAL REVENUE - 2012 AMOUNT: $ 514. 2013 AMOUNT: $ 604. 2014 AMOUNT: $ 1,879. 2015 AMOUNT: $ 215. 2016 AMOUNT: $ 1,395. OTHER INCOME - 2012 AMOUNT: $ 19,094. 2013 AMOUNT: $ 192,101. 2014 AMOUNT: $ 14,002. 2015 AMOUNT: $ 16,128. 2016 AMOUNT: $ 18,117. CABLE/TV/PHONE - 2016 AMOUNT: $ 405. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 135703 0 0 135703 135703 135703 135703 2741 2741 135703 135703 20039 20039 135703 135703 15298 15298 135703 0.00000 1.00000 0.00000 0 0 748139 748139 12895896 4851313 8044583 91332 72237 19095 1665219 1366233 298986 684934 684934 9795737 X 8312917 0 8312917 202197 202197 8515114 8190603 0 8190603 19528 19528 8210131 PART IV, LINE 2B: RESIDENT TRUST FUNDS ARE OFFERED TO ALL RESIDENTS AT ODD FELLOW HOME. THE FUNDS ARE NOT CO-MINGLED WITH ANY OTHER ORGANIZATION FUNDS. ONLY THE RESIDENT OR THE RESIDENTS AUTHORIZED INDIVIDUAL MAY ACCESS THESE FUNDS. RESIDENTS RECEIVE AT LEAST A QUARTERLY STATEMENT OF THEIR FUND ACTIVITY. FUNDS ARE KEPT IN AN INTEREST BEARING ACCOUNT. RESIDENTS WITH ACCOUNT BALANCES ABOVE $50 WILL EARN INTEREST AT THE CURRENT BANK RATE. STAFF HANDLING THE FUNDS WILL BE BONDED. THE BOND BENEFICIARY IS THE STATE OF WISCONSIN. PART V, LINE 4: THE ORGANIZATION HAS ADOPTED AN INVESTMENT POLICY FOR THE ENDOWMENT FUND THAT ATTEMPTS TO PROVIDE A BALANCE OF LONG-TERM CAPITAL APPRECIATION, PRESERVATION OF CAPITAL, AND INCOME PRODUCTION TO SUPPORT ADDITIONAL RESOURCES FOR THE CONTINUATION AND EXPANSION OF THE CHARITABLE MISSION OF THE ORGANIZATION. PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND WISCONSIN STATE INCOME TAXES ON RELATEDINCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. NO LIABILITY IS RECOGNIZED BY THE ORGANIZATION BY APPLICATION OF THIS STANDARD. THE ORGANIZATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE TAXING AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS 19,140. INVESTMENT INCOME 189,035. GAIN ON DISPOSAL OF PROPERTY AND EQUIPMENT -5,978. X X X 0 0 0 0 0 0 0 0 0 CHARLENE EVERETT CEO 152181 0 0 0 5343 0 4533 0 5068 0 167125 0 0 0 A WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 2010-08-01 7075000 NEW CONSTRUCTION AND REFINANCE EXISTING BOND AND DEBT 0 0 0 A 2665790 1754182 7075000 89314 57061 5292654 1635971 2011 1 0 1 1 A 1 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 FORM 990, PART III, LINE 3 HERITAGE GARDENS, OUR MEMORY CARE CBRF, CLOSED 11/14/16 TO BE RENOVATED AND RE-OPENED IN 2017 AS A SKILLED NURSING REHAB FACILITY. THIS WILL BE AN EXPANSION OF OUR CURRENT ODD FELLOW HOME FACILITY. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD PRESIDENT HAS THE AUTHORITY TO BREAK A TIE VOTE. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS MADE UP OF TWO BOARD MEMBERS TO OVERSEE AND ASSIST IN THE TRANSITION OF OUR CEO. THE COMMITTEE WAS DOSSOLVED 4/22/16. FORM 990, PART VI, SECTION A, LINE 2 LOREN CUNNINGHAM & SHARON CUNNINGHAM ARE HUSBAND AND WIFE. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION HAS TWO CLASSES OF MEMBERS: 1. ALL THIRD-DEGREE ODD FELLOWS IN GOOD STANDING IN THE STATE OF WISCONSIN. 2. ALL REBEKAHS IN GOOD STANDING IN THE STATE OF WISCONSIN. FORM 990, PART VI, SECTION A, LINE 7A THE GRAND MASTER OF THE GRAND LODGE OF THE STATE OF WISCONSIN AND THE ASSEMBLY PRESIDENT OF THE REBEKAH ASSEMBLY OF WISCONSIN ARE ELECTED AS DIRECTORS BY VIRTUE OF THEIR OFFICES. THE OTHER DIRECTORS ARE ELECTED BY THE MEMBERS IN GOOD STANDING. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS ARE SUBJECT TO MEMBERSHIP APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 HAS BEEN REVIEWED AT A BOARD MEETING. COPIES WERE MAILED TO ALL BOARD MEMBERS PRIOR TO THE MEETING WITH THE AGENDA. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS THE BOARD OF DIRECTORS AND KEY MANAGEMENT STAFF. TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: 1. THE CONFLICTING INTEREST IS FULLY DISCLOSED; 2. THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; 3. A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS; AND 4. THE BOARD HAS DECIDED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. DISCLOSURE IN THIS ORGANIZATION SHOULD BE MADE TO THE CEO, WHO SHALL BRING THE MATTER TO THE BOARD. DISCLOSURES INVOLVING THE BOARD MEMBERS WILL BE BROUGHT TO THE BOARD PRESIDENT, OR TO THE VICE-PRESIDENT IN HIS OR HER ABSENCE, THEN TO THE BOARD. THE BOARD SHALL DETERMINE IF A CONFLICT EXISTS AND IN THE CASE OF A CONFLICT, WHETHER THE TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE THE DECISION OF THE BOARD ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION AND THEIR CONCERN MUST BE THE WELFARE OF THE ORGANIZATION. ALL PROCEEDINGS ARE DOCUMENTED IN THE MEETING MINUTES OR AS OTHERWISE APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS. THE PROCESS INCLUDES REVIEWING SALARIES IN COMPARISON TO LOCAL WAGE PREVALENCE RATES AND LEADING AGE WISCONSIN WAGE SURVEY BASED ON THE LONG TERM CARE HEALTH INDUSTRY. THE LAST PROCESS WAS LAST UNDERTAKEN FOR THE CEO IN OCTOBER 2016. OTHER EMPLOYEES SALARIES ARE COMPARED TO LEADING AGE WISCONSIN AND LOCAL LONG TERM CARE DATABASES. THE CFO AND OTHER EMPLOYEE SALARIES ARE APPROVED BY THE CEO BASED ON DIRECTIVE OF PERCENTAGE INCREASE AND COMPARISON RANGE THE BOARD OF DIRECTORS WANTS TO MEET. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE POSTED IN FACILITIES, NEWSLETTERS, ANNUAL REPORTS AND IN CONTRACT PARTICIPATION. FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 1,439,518. MANAGEMENT AND GENERAL EXPENSES 68,789. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,508,307. THE GRAND LODGE OF THE STATE OF WI INDEP ORDER OF ODD FELLOWS 490 TYROLIAN DRIVE GREEN BAY WI 54302 390366558 FRATERNAL SOCIETY WI 501(C)(8) N/A N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0