2024-02-15T15:21:51-06:00 2022-03-31 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2021-04-01 221529791 HOLLAND CHRISTIAN HOME ASSOCIATION HOLL 5164265974 151 GRAHAM AVENUE NORTH HALEDON NJ 07508 ANDREW VAN ORDEN VP/ADMINISTRATOR 5164265974 2024-02-14 1 ANDREW VAN ORDEN XXX-XX-XXXX KERRI N BOGDA CPA P00760402 7177404863 2024-02-14 X 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z STEVEN DUMKE 151 GRAHAM AVENUE NORTH HALEDON NJ 07508 13788451 0 X HCHNJ.ORG X 1960 NJ A RETIREMENT AND SUPPORT SERVICE COMMUNITY OF MEN AND WOMEN. 13 12 186 14 0 0 1367449 5267092 8665696 7963539 263359 353087 0 7914 10296504 13591632 0 0 0 0 7901902 7409122 0 0 0 3624216 3414570 11526118 10823692 -1229614 2767940 26557744 28851243 37100702 35980591 -10542958 -7129348 X THE HOLLAND CHRISTIAN HOME ASSOCIATION (THE "ASSOCIATION") HAS PROUDLY SERVED THE NEEDS OF THE SENIOR COMMUNITY FOR MORE THAN A CENTURY. AT THE CORE OF ITS MISSION IS LIFE CARE - A CONTINUUM OF CARE THAT ESSENTIALLY ALLOWS ITS RESIDENTS TO PAY ONE FEE ON ENTRANCE AND LIVE WORRY-FREE, ASSURED OF SKILLED NURSING CARE SHOULD THEY NEED IT. SIMILAR TO LIFE CARE, THE ASSOCIATION ALSO OFFERS A LIMITED NUMBER OF CARE ROOMS FOR RESIDENTS WHO REQUIRE A HELPING HAND WITH THEIR DAILY ROUTINE. IT ALSO OFFERS RESPITE CARE IN ITS MOUNTAIN VIEW NURSING UNIT FOR INDIVIDUALS WHO NEED SHORT- OR LONG TERM CARE OR ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. 0 0 8977162 0 7963539 THE HOLLAND CHRISTIAN HOME ASSOCIATION PROUDLY SERVES THE NEEDS OF THE SENIOR COMMUNITY FOR MORE THAN OVER CENTURY. AT THE CORE OF ITS MISSION IS LIFE CARE - A CONTINUUM OF CARE THAT ESSENTIALLY ALLOWS ITS RESIDENTS TO PAY ONE FEE ON ENTRANCE AND LIVE WORRY-FREE, ASSURED OF SKILLED NURSING CARE SHOULD THEY NEED IT. IN ADDITION, THE ASSOCIATION ALSO OFFERS PER DIEM AND RESPITE CARE. IT ALSO OFFERS RESPITE CARE IN ITS MOUNTAIN VIEW NURSING UNIT FOR INDIVIDUALS WHO NEED SHORT OR LONG-TERM SKILLED NURSING CARE OR ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. 8977162 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 186 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 0 NJ X ANDREW VAN ORDEN VPADMINISTRATOR 9734274087 151 GRAHAM AVENUE NORTH HALEDON NJ 07508 STEVEN EICHHORN PRESIDENT 5.00 5.00 X X 0 0 0 ABE VAN WINGERDEN VICE PRESIDENT 5.00 5.00 X X 0 0 0 RANDALL VEENSTRA SECRETARY 5.00 0.00 X X 0 0 0 BEVERLY CUSACK TREASURER 5.00 0.00 X X 0 0 0 RAYMOND BROEK ASSISTANT TREASURER 5.00 0.00 X X 0 0 0 PAUL LYMAN RESIDENT REPRESENTATIVE 5.00 0.00 X X 0 0 0 JOHN BELANUS BOARD MEMBER 5.00 0.00 X 0 0 0 PAUL HEEREMA BOARD MEMBER 5.00 0.00 X 0 0 0 WILLIAM HEMSTEAD BOARD MEMBER 5.00 0.00 X 0 0 0 VIRGINIA HOOGSTRA BOARD MEMBER 5.00 0.00 X 0 0 0 MICHAEL KUKOL BOARD MEMBER 5.00 5.00 X 0 0 0 THOMAS ROSE BOARD MEMBER 5.00 0.00 X 0 0 0 BEVERLY TEN KATE BOARD MEMBER 5.00 0.00 X 0 0 0 JAMES VANDER PLAAT BOARD MEMBER (UNTIL 9/2/21) 5.00 0.00 X 0 0 0 BRENT SJAARDEMA BOARD MEMBER (UNTIL 5/16/21 5.00 0.00 X 0 0 0 JOHN DE HAAN BOARD MEMBER (UNTIL 5/16/21 5.00 0.00 X 0 0 0 ESTREDIDA MARTIN EXECUTIVE DIRECTOR 35.00 0.00 X 167136 0 27192 MICHAEL SICO DIRECTOR OF FINANCE 35.00 0.00 X 115328 0 4302 NELLY HOLGUIN DIRECTOR OF NURSING 40.00 0.00 X 122425 0 15464 404889 0 46958 3 0 1 0 VISBEEN CONSTRUCTION CO 555 GOFFLE RD STE 100 RIDGEWOOD NJ 07450 CONSTRUCTION 659464 1 9015 3681393 1479075 97609 5267092 AMORTIZATION FEES 623000 5582425 5582425 RESIDENT FEES 623000 2381114 2381114 7963539 56095 56095 493811 196819 296992 296992 296992 MISCELLANEOUS INCOME 900099 5113 5113 REFUNDS & REIMBURSEMENTS 900099 2801 2801 7914 13591632 7963539 0 361001 363411 301249 62162 5569118 4573589 995529 67138 50523 16615 732954 647411 85543 676501 575150 101351 70128 70128 40619 40619 307071 258865 48206 162381 598 161783 88249 88249 17341 17341 244717 244717 3215 3215 600 600 198206 198206 839327 839327 322206 322206 DIETARY EXPENSES 404768 404768 RESIDENCE EXPENSES 276500 276500 REPAIRS AND MAINTENANCE 168250 168250 MISCELLANEOUS 158931 7167 151764 112061 104821 7240 10823692 8977162 1846530 0 6449 1706014 1888154 229003 599089 143720 112577 32408998 12396793 20477175 20012205 4001832 5902467 0 330302 26557744 28851243 910352 661971 20805463 17621434 2000000 2000000 2688500 6004177 1479075 9217312 9693009 37100702 35980591 X -10559189 -7145579 16231 16231 -10542958 -7129348 26557744 28851243 2767940 -124316 769986 0 X 0 0 0 X 833560 423826 1334012 1367449 5267092 9225939 9910928 9518048 8074213 8665696 7963539 44132424 10744488 9941874 9408225 10033145 13230631 53358363 0 0 0 53358363 202035 180399 138240 80652 56095 657421 202035 180399 138240 80652 56095 657421 7914 7914 10946523 10122273 9546465 10113797 13294640 54023698 0.98770 0.98300 0.01220 0.01530 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2021 AMOUNT: $ 5,113. REFUNDS REIMBURSEMENTS - 2021 AMOUNT: $ 2,801. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25335 25335 30858803 11283971 19574832 1524860 1112822 412038 20012205 LIABILITY FOR FUTURE CARE 9693009 9693009 X 0 0 0 0 0 0 0 0 0 ESTREDIDA MARTIN EXECUTIVE DIRECTOR 167136 0 0 0 0 0 11272 0 15920 0 194328 0 0 0 ABE VAN WINGERDEN VICE PRESIDENT PERSONAL X 2000000 2000000 0 1 1 2000000 FORM 990, PART VI, SECTION A, LINE 6 THE ASSOCIATION HAS MEMBERS WHO ELECT THE BOARD AND APPROVE THE ANNUAL OPERATING BUDGET. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS HAVE THE RIGHT TO VOTE ON THE ELECTION OF BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS HAVE THE RIGHT TO APPROVE THE ANNUAL OPERATING BUDGET. FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO OTHER COMMITTEE THAT HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEW AND APPROVE THE FORM 990 PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS AND THE EXECUTIVE TEAM ARE REQUIRED TO SIGN THE CONFLICT OF INTEREST POLICY ANNUALLY. THE EXECUTIVE DIRECTOR/ADMINISTRATOR AND SENIOR MANAGEMENT STAFF REVIEWS ALL STATEMENTS AND ANY POTENTIAL CONFLICT IS BROUGHT TO THE ATTENTION OF THE BOARD OF TRUSTEES. IF A CONFLICT EXISTS FOR A BOARD MEMBER, THE MEMBER IS ASKED TO ABSTAIN FROM ANY VOTE ASSOCIATED WITH THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE CONFLICT OF INTEREST POLICY WHEN ADDRESSING WHO IS AN INTERESTED PERSON. FORM 990, PART VI, SECTION B, LINE 15 A REVIEW IS CONDUCTED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD OF DIRECTORS AND COMPENSATION IS DETERMINED ACCORDINGLY. THE PROCESS IS DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE HOLLAND CHRISTIAN HOME FOUNDATION 151 GRAHAM AVEUNUE NORTH HALEDON NJ 07508 200286031 FUNDRAISING NJ 501(C)(3) LINE 12A, I HOLLAND CHRISTIAN HOME ASSOCIATION 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 THE HOLLAND CHRISTIAN HOME FOUNDATION C 3681393 COST