HAVEN PARK CHRISTIAN HOUSING AND: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- HAVEN PARK CHRISTIAN HOUSING AND (EIN 38-3026594)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-16
- IRS object ID
- 201543209349305994
- Schema version
- 2014v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-16T11:19:29-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383026594 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAVEN PARK CHRISTIAN HOUSING AND | BusinessNameLine1Txt |
| Business Name Line2 | NURSING ASSOCIATION OF ZEELAND | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAVE | BusinessNameControlTxt |
| Phone | 7083428100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 NORTH CREEK DRIVE | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM DEYOUNG | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7083428100 | PhoneNum |
| Signature | 2015-11-14 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LARRY J OTTE | PreparerPersonNm |
| PTIN | P01427347 | PTIN |
| Preparation | 2015-11-16 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,477,083 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HAVENPARK.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | CARE OF THE ELDERLY AND SICK | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 301 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,254,106 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,254,045 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $223,038 | CYOtherRevenueAmt |
| PY Total Revenue | $13,254,106 | PYTotalRevenueAmt |
| CY Total Revenue | $12,477,083 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,772,734 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,859,545 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,645,840 | PYOtherExpensesAmt |
| CY Other Expenses | $6,485,687 | CYOtherExpensesAmt |
| PY Total Expenses | $13,418,574 | PYTotalExpensesAmt |
| CY Total Expenses | $13,345,232 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$164,468 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$868,149 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,812,497 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,089,845 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,040,823 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,186,320 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $771,674 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$96,475 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CARE OF THE ELDERLY AND SICK | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $12,222,925 | ExpenseAmt |
| Desc | TO PROVIDE THE GENERAL PUBLIC LONG-TERM HEALTHCARE FACILITIES AND SERVICES FOR THE SICK, INJURED &/OR AGED. | Desc |
| Total Program Service Expenses | $12,222,925 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 301 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE LIFE SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7083428100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 NORTH CREEK DRIVE | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| AARDEMA NORM | |||||||
| CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CLOUSING SHARON | |||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| HOFF HOWARD | |||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| TAMELING CAL | |||||||
| SEC/TREAS | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VAN HATTEM RICH | |||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| KATS JUSTIN | |||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| BREEMS TIM | |||||||
| 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SCHUTT RICHARD | |||||||
| CEO | 5.00 | 45.00 | Yes (X) | $0 | $478,050 | $147,668 | |
| DEYOUNG WILLLIAM | |||||||
| CFO | 5.00 | 45.00 | Yes (X) | $0 | $318,136 | $71,199 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $796,186 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $218,867 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| REST HAVEN ILLIANA CHRISTIAN | |||||
| 18601 NORTH CREEK DR | TINLEY PARK | IL | 60477 | MGMT, EDUC MKTG | $1,230,033 |
| PRIORITY HEALTH | |||||
| 3915 MOMEMTUM PLACE | CHICAGO | IL | 60689 | HEALTH INS | $249,636 |
| AGILITY HEALTH LLC | |||||
| PO BOX 5509 | CAROL STREAM | IL | 60197 | THERAPY | $189,621 |
| GORDON FOOD SERVICE | |||||
| 520 79TH ST SE | GRAND RAPIDS | MI | 49508 | DIETARY | $140,433 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTHCARE | Desc |
| Total Revenue Column | $12,254,045 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,254,045 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,254,045 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RENTAL INCOME | Desc |
| Total Revenue Column | $223,038 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $223,038 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $223,038 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,477,083 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,477,083 | RelatedOrExemptFuncIncomeAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,773,205 | TotalAmt |
| Program Services | $5,773,205 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,811 | TotalAmt |
| Program Services | $83,811 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $608,294 | TotalAmt |
| Program Services | $608,294 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $394,235 | TotalAmt |
| Program Services | $394,235 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $969,110 | TotalAmt |
| Management And General | $969,110 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,133 | TotalAmt |
| Program Services | $17,133 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,498 | TotalAmt |
| Program Services | $92,498 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,717 | TotalAmt |
| Program Services | $27,717 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,791 | TotalAmt |
| Program Services | $66,791 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,197 | TotalAmt |
| Management And General | $153,197 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,718,553 | TotalAmt |
| Program Services | $1,718,553 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,000 | TotalAmt |
| Program Services | $36,000 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,794 | TotalAmt |
| Program Services | $96,794 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PROVIDER TAXES | $1,024,145 | $1,024,145 |
| BAD DEBT EXPENSE | $551,827 | $551,827 |
| NURSING THERAPY | $353,647 | $353,647 |
| NURSING SUPPLIES | $326,956 | $326,956 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,051,319 | TotalAmt |
| Program Services | $1,051,319 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,345,232 | TotalAmt |
| Program Services | $12,222,925 | ProgramServicesAmt |
| Management And General | $1,122,307 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $736,957 | BOYAmt |
| EOY | $475,196 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,454,653 | BOYAmt |
| EOY | $984,209 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,304 | BOYAmt |
| EOY | $11,945 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,594 | BOYAmt |
| EOY | $3,906 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $689,229 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $129,240 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $595,989 | BOYAmt |
| EOY | $559,989 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $54,600 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,812,497 | BOYAmt |
| EOY | $2,089,845 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,040,823 | BOYAmt |
| EOY | $2,186,320 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,040,823 | BOYAmt |
| EOY | $2,186,320 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $771,674 | BOYAmt |
| EOY | -$96,475 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $771,674 | BOYAmt |
| EOY | -$96,475 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,812,497 | BOYAmt |
| EOY | $2,089,845 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$868,149 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
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 | $11,993 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,901 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,100 | CurrentTaxYearMinus2YearsAmt |
| Total | $26,994 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,035,649 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,449,511 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,632,780 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,254,106 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,477,083 | CurrentTaxYearAmt |
| Total | $59,849,129 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,047,642 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,461,412 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,635,880 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,254,106 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,477,083 | CurrentTaxYearAmt |
| Total | $59,876,123 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $59,876,123 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $39,737 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,415 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $67 | CurrentTaxYearMinus2YearsAmt |
| Total | $76,219 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $39,737 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $36,415 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $67 | CurrentTaxYearMinus2YearsAmt |
| Total | $76,219 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,087,379 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,497,827 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,635,947 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,254,106 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,477,083 | CurrentTaxYearAmt |
| Total | $59,952,342 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99870 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99790 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $689,229 | OtherCostOrOtherBasisAmt |
| Depreciation | $129,240 | DepreciationAmt |
| Book Value | $559,989 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $559,989 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|
| SCHUTT RICHARD | ||||||
| CEO | $418,374 | $43,020 | $16,656 | $113,894 | $33,774 | $625,718 |
| DEYOUNG WILLLIAM | ||||||
| CFO | $277,099 | $29,039 | $11,998 | $36,422 | $34,777 | $389,335 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART III | FormAndLineReferenceDesc |
| Explanation | QUESTION 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. DOCUMENTATION OF ATTENDANCE AT THE ANNUAL CONVENTION IS REQUIRED. THE ORGANIZATIN HAS ESTABLISHED A SENIOR EXECUTIVE MANAGEMENT PROGRAM WHICH ALLOWS STATED EMPLOYEES TO JOIN A FITNESS CENTER. ELIGIBLE EMPLOYEES THAT ENROLL ARE REQUIRED TO BE ACTIVELY UTILIZING THE FITNESS CENTER. QUESTION 4B REST HAVEN HAS ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN IN AN EFFORT TO RETAIN SELECTED OFFICERS ON A LONG TERM BASIS. THE FOLLOWING IS A SCHEDULE OF THE OFFICERS AND THE ANNUAL CONTRIBUTION TO THE PLAN: RICHARD SCHUTT 96,226 WILLIAM DEYOUNG 24,206 IN 2005, THE BOARD OF DIRECTORS ESTABLISHED A RETENTION INCENTIVE PLAN FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES 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 FUTURE DATE. THE OPRGANIZATIONS PAYMENTS INTO THE PLAN ARE RECORDED ON THE 990 AS DEFERRED COMPENSATION. HOWEVER, THE EXECUTIVE HAS NOT RECEIVED THESE MONIES AND WILL ONLY BE ELIGIBLE TO RECEIVE THEM 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 SUBJUECT TO A FULL RISK FORFEITURE BY THE INDIVIDUAL. QUESTIONS 5A AND 6A 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 ORGANIZATIONS COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS THE ORGANIZATIONS GOALS. THE VARIABLE PAY IS AWARDED BASED UPON A SPECIFIC REVIEW OF GOALS AND OBJECTIVES (INCLUDING THOSE WHICH RELATE TO MISSION, OPERATIONAL EFFICIENCY, FINANCIAL EFFECTIVENESS, AND STRATEGIC GOALS). SEMI-ANNUALLY THE COMPENSATION COMMITTEE REVIEWS, ASSESSES AND DETERMINES ANY AWARD UNDER THE VARIABLE PAY COMPONENT. EXECUTIVE EMPLOYEE BENEFITS ARE REVIEWED BY THE COMPENSATION COMMITTEE AND OUTSIDE CONSULTANTS TO INSURE THEY ARE COMPETIVIE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE RECIEVES AND EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATIONS EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|
| LINDA SCHUTT | ||
| SPOUSE OF CEO | EMPLOYMENT COMP | false |
| ALLISON | ||
| DAUGHTER OF CEO | EMPLOYMENT COMP | false |
| BONNIE | ||
| SISTER OF CEO | EMPLOYMENT COMP | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | THE TRANSACTIONS REPORTED ABOVE INVOLVING INTEREST PERSONS ARE REVIEWED ANNUALLY BY THE BOARDS COMPENSATION COMMITTEE AND HAVE BEEN DEEMED APPROPRIATE BASED ON THE POSITIONS EMPLOYED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 3 | RESPONSIBILITIES PAID THROUGH MANAGEMENT FEES TO REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME DBA PROVIDENCE LIFE SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 6 | MEMBERS OF THE ASSOCIATION |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE MEMBERS ELECT THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE BOARD OF DIRECTORS IS EMPOWERED ON BEHALF OF THE CORPORATION TO DO AND PERFORM ALL ACTS REASONABLY NECESSARY, APPROPRIATE, OR INCIDENT TO THE ACCOMPLISHMENT OF THE PURPOSES OF THE CORPORATION, AS DETERMINED BY THE BOARD OF DIRECTORS IN ITS SOLE DISCRETION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A DRAFT OF THE 990 IS PREPARED AND REVIEWED BY THE CONTROLLER, VP OF FINANCE AND CFO. UPON THEIR REVIEW AND APPROVAL, THE FINAL DRAFT IS FORWARDED TO THE EXECUTIVE COMMITTEE BEFORE SUBMISSION. A COMPLETED COPY OF THE 990 IS PROVIDED TO THE FULL BOARD AT THE SUBSEQUENT BOARD MEETING, AFTER FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS ANNUALLY REVIEW AND UPDATE THEIR CONFLICT OF INTEREST STATEMENTS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIO 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 REASONABLENSS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIO 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 REASONABLENSS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RPPII LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 NORTH CREEK DRIVE | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Total Income | $99,931 | TotalIncomeAmt |
| End Of Year Assets | $729,315 | EndOfYearAssetsAmt |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REST HAVEN ILLIANA CHRISTIAN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 N CREEK DRIVE | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362382853 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 7 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE MANAGMENT & DEVELOPMENT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18601 N CREEK DR | AddressLine1Txt |
| City | TINLEY PARK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60477 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363774205 | EIN |
| Primary Activities | MGMT & IT | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROVIDENCE MGMT & DEVELOPMENT | ||
| P | $153,197 | FMV |
| REST HAVEN ILLIANA CHRISTIAN | ||
| P | $1,230,033 | FMV |
| REST HAVEN ILLIANA CHRISTIAN | ||
| K | $1,303,033 | FMV |