2026-05-11T09:23:50-05:00 2025-06-30 410746749 CLIFTONLARSONALLEN LLP 10401 W INNOVATION DR STE 300 WAUWATOSA WI 53226 990 2024-07-01 396069188 SHEBOYGAN SENIOR COMMUNITY INC SHEB 9204582137 3505 COUNTY ROAD Y SHEBOYGAN WI 53083 TARA HOLZEM OFFICER 9204582137 2026-05-08 1 0 KRISTEN DONLEVY P01670215 4144761880 2026-05-06 2024 2025-03-06 01:10:19Z TARA HOLZEM 3505 COUNTY ROAD Y SHEBOYGAN WI 53083 10631445 0 X WWW.SSCNONPROFIT.ORG X 1962 WI TO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS. 9 9 226 0 0 0 15737 489190 9884068 10127321 16026 14934 0 0 9915831 10631445 0 0 0 0 7117549 7305678 0 0 0 2796723 3028096 9914272 10333774 1559 297671 15339052 15261528 14237639 13862444 1101413 1399084 X TO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS, WHICH SHALL ENHANCE, HONOR AND PRESERVE THE DIGNITY OF THE INDIVIDUAL, AND WHERE SPIRITUAL, PHYSICAL AND SOCIAL NEEDS ARE SUPPLIED IN A SPIRIT OF CHRISTIAN LOVE AND CONCERN WITHOUT REGARD TO AGE, SEX, RACE, CREED OR COLOR. 0 0 8450658 0 10127321 OPERATION OF A FULL-TIME SKILLED NURSING HOME AND RESIDENTIAL CARE CENTER. TOTAL PATIENT DAYS: 29,466. 8450658 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 1 0 1 226 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X TARA HOLZEM 9204582137 3505 CTY RD Y SHEBOYGAN WI 53083 ERIC STUART CHAIRPERSON 0.75 0.25 X X 0 0 0 LARRY SAMET VICE-CHAIRPERSON 0.50 0.25 X X 0 0 0 DAMON WENIG SECRETARY 0.50 0.25 X X 0 0 0 TOM BRICKLEY TREASURER 0.50 0.25 X X 0 0 0 PASTOR RUTH HALLSTEAD DIRECTOR 0.50 0.25 X 0 0 0 SANTINO LASTER DIRECTOR 0.50 0.25 X 0 0 0 CONNIE MEYER DIRECTOR 0.50 0.25 X 0 0 0 EMILY RENDALL-ARAUJO DIRECTOR 0.50 0.25 X 0 0 0 MATTHEW HALL DIRECTOR 0.50 0.25 X 0 0 0 PAUL TREFFERT CEO 39.75 0.25 X 139567 0 28000 TARA HOLZEM BUSINESS OFFICE MANAGER 39.75 0.25 X 81143 0 2650 220710 0 30650 1 0 1 0 0 489190 244148 489190 SKILLED NURSING FACILITY 623000 8297180 8297180 RESIDENTIAL CENTER 623000 1750270 1750270 OTHER SERVICES 623000 64855 64855 BEAUTY SHOP 812900 15016 15016 10127321 14934 14934 10631445 10127321 0 14934 251360 251360 5660618 4982366 678252 1393700 1173394 220306 1045 1045 29192 29192 278329 278329 77327 77327 22472 22472 208352 202958 5394 416188 416188 696260 567941 128319 106915 106915 SUPPLIES 1026875 1000896 25979 DUES AND SUBSCRIPTIONS 115096 115096 EMPLOYMENT COSTS 49072 49072 LICENSES 973 973 10333774 8450658 1883116 0 517937 130328 197189 329137 12000 716508 975277 43857 44254 89221 89232 18758180 5819414 12999429 12938766 774911 742534 15339052 15261528 533868 635893 12094269 11662546 1609502 1564005 14237639 13862444 X 1101204 1365539 209 33545 1101413 1399084 15339052 15261528 297671 0 X 0 1 X 1 0 X 1195829 165810 660843 15737 489190 2527409 7301009 8317192 9133570 9884068 10127321 44763160 8496838 8483002 9794413 9899805 10616511 47290569 0 414826 438159 402388 684616 525365 2465354 414826 438159 402388 684616 525365 2465354 44825215 2863 668 949 16026 14934 35440 2863 668 949 16026 14934 35440 281533 183220 464753 8781234 8666890 9795362 9915831 10631445 47790762 0.93790 0.92650 0.00070 0.00050 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - CHANGE IN PRESENT VALUE OF DEVELOPMENT INCENTIVE RECEIVABLE - MILESTONES INCOME - 2020 AMOUNT: $ 281,533. 2021 AMOUNT: $ 183,220. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 572217 572217 268000 14936722 4052723 11151999 2172272 1766691 405581 808969 808969 12938766 FINANCING LEASE LIABILITIES 199717 DUE TO AFFILIATE 1364288 1564005 X X 0 0 0 0 0 0 0 0 0 PAUL TREFFERT CEO 139567 0 0 0 0 0 0 0 28000 0 167567 0 0 0 PART I, LINE 3 SHEBOYGAN SENIOR COMMUNITY, INC. USES DATA GATHERED FOR THEIR STATE ASSOCIATION (WISCONSIN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) BY MANAGEMENT RESOURCE ASSOCIATES (MRA), A THIRD PARTY INDEPENDENT, NOT FOR PROFIT, MANAGEMENT CONSULTING GROUP. THE DATA IS GATHERED FROM PARTICIPATING NOT FOR PROFIT HOMES THROUGHOUT THE STATE OF WISCONSIN. CLIFTONLARSONALLEN ALSO COMPLETED A COMPENSATION BENCHMARK REPORT FOR A CEO POSITION. SALARY RECOMMENDATIONS FOR THE EXECUTIVE DIRECTOR ARE REVIEWED AND SET BY THE EXECUTIVE COMMITTEE IN AN EXECUTIVE SESSION WITHOUT THE EXECUTIVE DIRECTOR'S PRESENCE AFTER THE FULL ANNUAL PERFORMANCE EVALUATION, UTILIZING THE DATA DESCRIBED ABOVE. NO OTHER MANAGEMENT STAFF ARE REVIEWED IN THIS MANNER, THOUGH ALL SALARY AND EXPENSE DATA IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD IN THEIR ANNUAL BUDGET PREPARATION AND APPROVAL. X 1 244148 FMV 0 0 0 0 PART I, COLUMN (B): THE AMOUNT IN COLUMN B IS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 3 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, THE VICE-CHAIR, THE SECRETARY AND THE TREASURER. THE CHAIRPERSON SHALL BE THE CHAIR OF THE EXECUTIVE COMMITTEE. A QUORUM SHALL CONSIST OF THREE (3) MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION, EXCEPT ACTION IN RESPECT TO ELECTION OF BOARD OFFICERS, OFFICERS, THE FILLING OF VACANCIES IN THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE, OR OTHER MATTERS SPECIFICALLY RESERVED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL FIX ITS OWN RULES GOVERNING THE CONDUCT OF ITS ACTIVITIES AND SHALL MAKE SUCH REPORTS TO THE BOARD OF DIRECTORS OF ITS ACTIVITIES AS THE BOARD OF DIRECTORS MAY REQUEST. SECTION 5 - FINANCE COMMITTEE: SHALL BE COMPOSED OF THREE (3) BUT NO MORE THAN FIVE (5) MEMBERS, AT LEAST THREE (3) OF WHOM SHALL BE DIRECTORS. THE BOARD TREASURER SHALL BE THE CHAIR OF THE FINANCE COMMITTEE. IT SHALL BE THE DUTY OF THE COMMITTEE TO SUBMIT AT THE ANNUAL MEETING AND AT EACH MEETING OF THE BOARD OF DIRECTORS, A FINANCIAL REPORT AND ANY OTHER REPORTS AS REQUESTED BY THE BOARD OR AS DEEMED NECESSARY IN THE OPERATION OF THE CORPORATION. IN ADDITION, THE COMMITTEE SHALL, PREPARE AN ANNUAL BUDGET, SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS AND SHALL ARRANGE FOR AN INDEPENDENT AUDIT OF ALL RECEIPTS AND EXPENDITURES, SAID AUDIT TO BE DONE AT LEAST ANNUALLY AT THE CLOSE OF THE FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA WITH INFORMATION PROVIDED BY MANAGEMENT. WHEN THE FORM HAS BEEN COMPLETED, A PDF COPY OF FORM 990 IS EMAILED TO THE BUSINESS MANAGER. THE BUSINESS MANAGER FORWARDS THE EMAIL TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. THE 990 IS REVIEWED BY THE BUSINESS MANAGER, CEO, AND DIRECTOR OF OPERATIONS PRIOR TO FILING. THE BUSINESS MANAGER CHECKS FORM 990 WITH INTERNAL REPORTS. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE SHALL DISCLOSE TO THE BOARD OF TRUSTEES DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST, WHENEVER THE DUALITY OR CONFLICT PERTAINS TO A MATTER BEING CONSIDERED BY THE BOARD. ANY TRUSTEE HAVING DUALITY OF INTEREST OR CONFLICT OF INTEREST ON ANY MATTER, SHALL ABSTAIN FROM VOTING ON THE MATTER AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE VOTE ON THE MATTER. THE MINUTES OF THE MEETING INVOLVING ANY SUCH SITUATION SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING AND THE QUORUM SITUATION. FAILURE TO DISCLOSE DUALITY OF INTEREST OR CONFLICT OF INTEREST WHILE PARTICIPATING IN THE VOTE FOR BOARD ACTION SHALL BE REASON FOR REMOVAL FROM OFFICE. IF A TRUSTEE IS UNCERTAIN AS TO WHETHER HE OR SHE HAS A DUALITY OR CONFLICT OF INTEREST WHICH REQUIRES ABSTENTION, OR IF A TRUSTEE ASSERTS THAT ANOTHER TRUSTEE HAS SUCH DUALITY OR CONFLICT, THE BOARD, BY MAJORITY VOTE OF THOSE PRESENT, OTHER THAN THE TRUSTEE HAVING THE POSSIBLE CONFLICT, SHALL DECIDE WHETHER ABSTENTION IS REQUIRED. IF SO, THE TRUSTEE SHALL BE DEEMED TO HAVE ABSTAINED. FORM 990, PART VI, SECTION B, LINE 15A SHEBOYGAN SENIOR COMMUNITY, INC. USES DATA GATHERED FOR THEIR STATE ASSOCIATION (WISCONSIN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) BY MANAGEMENT RESOURCE ASSOCIATES (MRA), A THIRD PARTY INDEPENDENT, NOT FOR PROFIT, MANAGEMENT CONSULTING GROUP. THE DATA IS GATHERED FROM PARTICIPATING NOT FOR PROFIT HOMES THROUGHOUT THE STATE OF WISCONSIN. CLIFTONLARSONALLEN ALSO COMPLETED A COMPENSATION BENCHMARK REPORT FOR A CEO POSITION. SALARY RECOMMENDATIONS FOR THE EXECUTIVE DIRECTOR ARE REVIEWED AND SET BY THE EXECUTIVE COMMITTEE IN AN EXECUTIVE SESSION WITHOUT THE EXECUTIVE DIRECTOR'S PRESENCE AFTER THE FULL ANNUAL PERFORMANCE EVALUATION, UTILIZING THE DATA DESCRIBED ABOVE. NO OTHER MANAGEMENT STAFF ARE REVIEWED IN THIS MANNER, THOUGH ALL SALARY AND EXPENSE DATA IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD IN THEIR ANNUAL BUDGET PREPARATION AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. SHEBOYGAN SENIOR COMMUNITY FOUNDATION 3505 CTY RD Y SHEBOYGAN WI 53083 391450846 RAISE/RECEIVE FUNDS TO BE USED FOR GENERAL SUPPORT OF THIS ORGANIZATION WI 501(C)(3) LINE 12B, II SHEBOYGAN SENIOR COMMUNITY INC 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0