2025-11-05T09:59:31-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 10401 W INNOVATION DR STE 300 WAUWATOSA WI 53226 990 2024-01-01 391448325 CARMEL RESIDENCE INC CARM 9202354653 220 NORTH WESTFIELD STREET OSHKOSH WI 54902 THERESA M BERTRAM PRESIDENT & CEO 9202325228 2025-10-28 1 1 KRISTEN DONLEVY P01670215 4144761880 2025-10-28 2024 2025-03-06 01:10:19Z THERESA M BERTRAM 220 NORTH WESTFIELD STREET OSHKOSH WI 54902 1095883 0 9386 X WWW.MIRAVIDALIVING.COM X 1988 WI TO PROVIDE HOUSING FOR AGING PERSONS. 9 9 0 9 0 0 37722 0 926849 1045909 32221 47115 3116 2859 999908 1095883 0 0 0 0 298624 298644 0 0 0 675374 685224 973998 983868 25910 112015 4063048 3984302 2884301 2693540 1178747 1290762 CARMEL RESIDENCE, INC., IS PART OF A FAMILY OF HEALTHCARE AND RESIDENTIAL SERVICE ORGANIZATIONS COMMITTED TO PROVIDING QUALITY CARE AND LIFE ENRICHING OPPORTUNITIES TO THE AGING AND THOSE IN NEED OF A CARING, CHRISTIAN ENVIRONMENT. 0 0 770183 0 1045909 CARMEL RESIDENCE, INC., PROVIDES INDEPENDENT LIVING FACILITIES FOR AGING PERSONS. THE ENTITY HAS 72 INDEPENDENT LIVING UNITS. 770183 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X KIM MAKI 9202325238 225 NORTH EAGLE STREET OSHKOSH WI 54902 MARK BEECHER CHAIR 0.20 1.40 X X 0 0 0 NATE OLSON VICE CHAIR 0.20 1.40 X X 0 0 0 JAMIE BONELL SECRETARY 0.20 1.40 X X 0 0 0 MARK BOETTCHER BOARD MEMBER 0.20 1.40 X 0 0 0 DIANE LANGDON BOARD MEMBER 0.20 1.40 X 0 0 0 STEW RIECKMAN BOARD MEMBER 0.20 1.40 X 0 0 0 JASON LOWE BOARD MEMBER 0.20 1.40 X 0 0 0 DR PAULA MCNIEL BOARD MEMBER 0.20 1.40 X 0 0 0 JIM STAPEL BOARD MEMBER 0.20 1.40 X 0 0 0 THERESA BERTRAM PRESIDENT & CEO 4.00 34.00 X 0 363150 0 0 363150 0 0 0 1 0 0 APARTMENT OPERATIONS 623990 877979 877979 ENTRANCE FEE REVENUES 623990 106593 106593 GARAGE RENT 623990 31347 31347 OFFICE RENT 623990 22500 22500 GUEST ROOM RENT 623990 7490 7490 1045909 47115 47115 BEAUTY SHOP REVENUE 900099 2230 2230 MISCELLANEOUS 900099 496 496 LAUNDRY REVENUE 900099 133 133 2859 1095883 1045909 0 49974 298644 114468 184176 57996 57996 9448 9448 66035 65872 163 7893 7893 6696 6696 3529 3529 158347 158347 344398 344398 16766 16766 MISCELLANEOUS EXPENSES 12466 11610 856 RESIDENT EXPENSES 887 887 FOOD 601 564 37 NON DISPOSABLE SUPPLIES 162 162 983868 770183 213685 0 28391 21730 1932495 1895556 2807 8963 3376 1143 8877779 6820869 2095979 2056910 4063048 3984302 18549 33837 426324 305041 2019123 1996326 420305 358336 2884301 2693540 X 1178747 1290762 1178747 1290762 4063048 3984302 112015 0 X 0 1 X 1 0 X 63484 182964 37722 0 284170 746593 643224 723198 926849 1045909 4085773 746593 706708 906162 964571 1045909 4369943 0 268597 244934 220857 346902 399338 1480628 268597 244934 220857 346902 399338 1480628 2889315 48827 29296 4317 32221 47115 161776 48827 29296 4317 32221 47115 161776 1239 1570 2870 3116 2859 11654 796659 737574 913349 999908 1095883 4543373 0.63590 0.64740 0.03560 0.03750 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: LAUNDRY REVENUE - 2020 AMOUNT: $ 35. 2021 AMOUNT: $ 252. 2022 AMOUNT: $ 199. 2023 AMOUNT: $ 416. 2024 AMOUNT: $ 133. BEAUTY SHOP - 2020 AMOUNT: $ 679. 2021 AMOUNT: $ 1,093. 2022 AMOUNT: $ 2,397. 2023 AMOUNT: $ 2,331. 2024 AMOUNT: $ 2,230. MISCELLANEOUS INCOME - 2020 AMOUNT: $ 525. 2021 AMOUNT: $ 225. 2022 AMOUNT: $ 274. 2023 AMOUNT: $ 369. 2024 AMOUNT: $ 496. 0 1 X 43875 43875 5010866 4525904 484962 232218 178328 53890 3590820 2116637 1474183 2056910 DUE TO AFFILIATES 358336 358336 X PART IV, LINE 2B: CARMEL RESIDENCE OFFERS RESIDENT(S) THREE ENTRANCE OPTIONS UPON RESIDENCY. THE RESIDENT(S) MAY CHOOSE TO MAKE OPTION #1 OR #2, NON-INTEREST-BEARING EARLY INVESTMENT DEPOSITS, OF WHICH THE REFUND AMOUNT IS REDUCED BY 10% ANNUALLY AND PAYABLE WITHIN 90 DAYS OF TERMINATION OF OCCUPANCY TO THE RESIDENT OR THEIR PERSONAL REPRESENTATIVE. OPTION #3 IS A MONTHLY OPERATION FEE PAYMENT WITH THE FIRST AND LAST MONTH'S FEES DUE BEFORE MOVE-IN. UNTIL RECOGNIZED AS REVENUE, DEPOSITS ARE REPORTED IN FORM 990, PART X, LINE 19 AS DEFERRED REVENUE OR LINE 21 AS ESCROW ACCOUNTS. PART X, LINE 2: THE ORGANIZATION FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THE INCOME TAX STANDARD HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. 0 0 0 0 0 0 0 0 0 THERESA BERTRAM PRESIDENT & CEO 0 363150 0 0 0 0 0 0 0 0 0 363150 0 0 PART I, LINE 3 THE COMPENSATION OF THE PRESIDENT & CEO IS DETERMINED BY THE ORGANIZATION'S SOLE MEMBER, MIRAVIDA LIVING, INC. THE FOLLOWING METHODS WERE USED BY MIRAVIDA LIVING, INC. TO ESTABLISH THE PRESIDENT & CEO'S COMPENSATION: 1. COMPENSATION SURVEY OR STUDY 2. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS PLUS TWO OTHER MEMBERS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE AGENDA FOR THE BOARD AND VOTING MEMBERSHIP MEETINGS. THIS COMMITTEE SHALL KEEP ITSELF INFORMED OF THE ENTIRE OPERATION OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS, AND SHALL EXECUTE SUCH ACTIONS AS MAY BE ASSIGNED TO IT BY THE BOARD. THE COMMITTEE SHALL ALSO CONCERN ITSELF WITH MATTERS NOT ASSIGNED TO OTHER COMMITTEES. FORM 990, PART VI, SECTION A, LINE 6 MIRAVIDA LIVING, INC., IS THE SOLE MEMBER OF CARMEL RESIDENCE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF CARMEL RESIDENCE, INC. ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC. FORM 990, PART VI, SECTION A, LINE 7B MAJOR STANDARD OPERATING PROCEDURES, MAJOR POLICIES, AND PROGRAMS OF CARMEL RESIDENCE, INC. ARE SUBMITTED TO THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC. FOR APPROVAL AND IMPLEMENTATION. AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS REQUIRE THAT APPROVAL OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MIRAVIDA LIVING, INC. FORM 990, PART VI, SECTION B, LINE 11B BEFORE IT WAS FILED, THE FORM 990 WAS REVIEWED BY THE CEO, THEN DISTRIBUTED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST FORM TO EACH MEMBER OF THE BOARD OF DIRECTORS AND VARIOUS COMMITTEE MEMBERS NOT ON THE BOARD THAT REQUIRES EACH TO IDENTIFY POTENTIAL CONFLICTS OR OTHER RELATED PARTY INTERESTS. THE REPORTS ARE REVIEWED BY THE SECRETARY AND CEO AND ANY CONFLICTS ARE BROUGHT TO THE BOARD'S ATTENTION. A MEMBER OF THE BOARD WHO HAS A CONFLICT OF INTEREST MAY NOT VOTE ON ANY SUCH ISSUE BEFORE THE BOARD. ANY QUESTION OF WHETHER THERE IS A CONFLICT IS RESOLVED BY THE BOARD OF DIRECTORS. IF THE BOARD OF DIRECTORS DETERMINES THAT A DIRECTOR HAS COMMITTED A SUBSTANTIAL VIOLATION OF THE CONFLICT OF INTEREST POLICY, THE INDIVIDUAL IS REMOVED FROM THE OFFICE OF DIRECTOR. IN ADDITION, ALL MANAGEMENT AND SUPERVISORY EMPLOYEES ARE INFORMED OF THE ORGANIZATION'S POLICY REGARDING RELATED PARTY TRANSACTIONS AND CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. MIRAVIDA LIVING INC 225 NORTH EAGLE STREET OSHKOSH WI 54902 391032234 MANAGEMENT SERVICES WI 501(C)(3) LINE 10 N/A 0 BETHEL HOME INC 225 NORTH EAGLE STREET OSHKOSH WI 54902 391209707 SKILLED NURSING FACILITY WI 501(C)(3) LINE 10 MIRAVIDA LIVINGINC 0 GABRIEL'S VILLA INC 215 NORTH WESTFIELD STREET OSHKOSH WI 54902 391857036 SENIOR HOUSING WI 501(C)(3) LINE 10 MIRAVIDA LIVINGINC 0 SIMEANNA APARTMENTS INC 155 NORTH EAGLE STREET OSHKOSH WI 54902 237148097 SENIOR HOUSING WI 501(C)(3) LINE 10 MIRAVIDA LIVINGINC 0 SIMEANNA SOUTH INC 225 NORTH EAGLE STREET OSHKOSH WI 54902 391238670 SENIOR HOUSING WI 501(C)(3) LINE 10 MIRAVIDA LIVINGINC 0 SIMEANNA III INC 225 NORTH EAGLE STREET OSHKOSH WI 54902 391270056 SENIOR HOUSING WI 501(C)(3) LINE 10 MIRAVIDA LIVINGINC 0 MIRAVIDA LIVING FOUNDATION INC 225 NORTH EAGLE STREET OSHKOSH WI 54902 010938793 FUNDRAISING WI 501(C)(3) LINE 12A, I MIRAVIDA LIVINGINC 0 EDEN REHABILIATION SUITES AND GREENHOUSE HOMES INC 3151 EDEN COURT OSHKOSH WI 54904 900506872 SKILLED NURSING FACILITY WI 501(C)(3) LINE 10 MIRAVIDA LIVINGINC 0 0 0 1 1 1 0 0 0 0 1 1 0 1 1 1 1 1 0 0