2025-03-21T11:47:53-05:00 2024-03-31 410746749 CLIFTONLARSONALLEN LLP 10401 W INNOVATION DR STE 300 WAUWATOSA WI 53226 990 2023-07-01 391020547 CLEMENT MANOR INC CLEM 4143211800 3939 S 92ND STREET GREENFIELD WI 53228 DENNIS FERGER PRESIDENT/CEO 4143211800 2025-03-19 1 0 KRISTEN DONLEVY P01670215 4144761880 2025-03-19 2023 2025-03-06 01:10:19Z DENNIS FERGER 3939 S 92ND STREET GREENFIELD WI 53228 13733490 0 X WWW.CLEMENTMANOR.COM X 1963 WI CLEMENT MANOR IS A HEALTHCARE ORGANIZATION SPONSORED BY THE SCHOOL SISTERS OF ST. FRANCIS THAT IS COMMITTED TO PROVIDING A CONTINUUM OF CARE AND FOSTERING THE HIGHEST POTENTIAL FOR WELL BEING OF EACH INDIVIDUAL ON OUR CAMPUSES AND IN OUR COMMUNITIEIS THROUGH THE VALUES DEEPLY ROOTED IN THE FRANCISCAN VALUE SYSTEM. CLEMENT MANOR'S RETIREMENT COMMUNITY OFFERS A FULL CONTINUUM OF SERVICES TO PROMOTE THE HEALTHY AGING OF CLIENTS IN THEIR FACILITIES AND THE COMMUNITY SINCE 1982, CLEMENT MANOR HAS STOOD BY THE VALUES OF RESPECT, COLLABORATION AND QUALITY SERVICE, MAINTAINING A TRADITION OF SERVICE EXCELLENCE AND THE PURSUIT OF QUALITY. CLEMENT MANOR'S STAFF AND ADMINISTRATION ARE DEDICATED TO THE CLIENTS THEY SERVE, ALWAYS KEEPING THE FACILITY AT THE FOREFRONT OF IMPORVEMENTS IN THE LONG TERM CARE INDUSTRY TO ENSURE THE BEST CARE POSSIBLE. 9 8 495 38 0 0 130378 102867 16543256 13581490 29300 37022 -20040 -3027 16682894 13718352 0 0 0 0 8904096 7251557 0 0 0 8858385 6901079 17762481 14152636 -1079587 -434284 17291999 15517884 21960286 20620455 -4668287 -5102571 X CLEMENT MANOR IS A HEALTHCARE ORGANIZATION SPONSORED BY THE SCHOOL SISTERS OF ST. FRANCIS THAT IS COMMITTED TO PROVIDING A CONTINUUM OF CARE AND FOSTERING THE HIGHEST POTENTIAL FOR WELL BEING OF EACH INDIVIDUAL ON OUR CAMPUSES AND IN OUR COMMUNITIES THROUGH THE VALUES OF RESPECT, COLLABORATION AND QUALITY SERVICE. 0 0 13428397 1245360 CLEMENT MANOR, INC. OPERATES A SKILLED NURSING FACILITY AND A CONTINUING CARE FACILITY. AS PART OF ITS CATHOLIC HERITAGE, CLEMENT MANOR IS DEDICATED TO PROVIDING BOTH SERVICES AND LEADERSHIP IN THE COMMUNITY FOR CARE OF THE POOR ALSO, CLEMENT MANOR, INC. PROVIDES CARE TO THE INDIGENT UNDER THE MEDICAID PROGRAM. THE COST NECESSARY TO PROVIDE CARE TO THESE RESIDENTS GENERALLY EXCEEDS MEDICAID REIMBURSEMENT. UNREIMBURSED CHARGES FOR THE MEDICAID RESIDENTS IN FISCAL 2024 WAS APPROXIMATELY $1,815,057. IN ADDITION, CLEMENT PROVIDED APPROXIMATELY $42,298.46 OF CHARITY CARE SERVICES TO THE NEEDY IN FISCAL 2024. 13428397 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 14 0 1 495 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X KWASI OFORI-TANO 4143211800 3939 SOUTH 92ND STREET GREENFIELD WI 53228 DENNIS FERGER PRESIDENT/CEO 40.00 X X 220749 0 8843 SISTER JUDEEN SCHULTE BOARD SECRETARY 0.30 X X 0 0 0 PHILIP DOUGHERTY JR BOARD CHAIR 0.30 X X 0 0 0 KRISTA PANKOP BOARD MEMBER 0.30 X 0 0 0 ANN MAHER VICE CHAIR 0.30 X X 0 0 0 DAVID NILES BOARD MEMBER 0.30 X 0 0 0 SISTER ELIZABETH SCHMITZ BOARD MEMBER 0.30 X 0 0 0 JOHN HEINDEL TREASURER 0.30 X X 0 0 0 CATHLEEN KELLING BOARD MEMBER 0.30 X 0 0 0 TERESA GATTO COO 40.00 X 122276 0 10536 TRISHA ATKINSON DIRECTOR OF NURSING 40.00 X 112320 0 8778 DEBORAH SAFFORD ASSISTANT DIRECTOR OF NURS 40.00 X 103220 0 1680 DINESE ROBERTS REGISTERED NURSE 40.00 X 120731 0 2016 679296 0 31853 5 1 1 0 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 606941985 THERAPY SERVICES 562388 GRAPE TREE MEDICAL STAFFING LLC PO BOX 5340 SIOUX FALLS SD 571175340 STAFFING AGENCY 289140 MAXIM HEALTHCARE STAFFING SERVICES INC 12558 COLLECTIONS CENTER DRIVE CHICAGO IL 60611 STAFFING AGENCY 214843 FAVORITE HEALTHCARE STAFFING PO BOX 26225 OVERLAND PARK KS 66225 STAFFING AGENCY 179240 REINHART BOERNER VAN DEUREN SC 1000 N WATER STREET SUITE 1700 MILWAUKEE WI 53202 LEGAL SERVICES 150176 5 44570 58297 102867 RESIDENT SERVICE REVENUE 623000 11738453 11738453 DIETARY SALES 623000 781891 781891 RESIDENT ADMINISTRATIVE SERVICE R 623000 658468 658468 RESIDENT FEES 623000 190359 58439 131920 BEAUTY/BARBER SHOP REVENUE 623000 38166 38166 174153 174153 13581490 37022 37022 12111 44570 15138 -3027 -3027 13718352 12455360 0 1160125 X 343025 171513 171512 5499324 5499324 71775 71775 911318 911318 426115 426115 372984 372984 67644 67644 1514329 1402230 112099 139617 139617 129118 129118 517100 517100 13454 13454 571638 571638 900854 900854 198257 198257 FOOD 1445036 1445036 OTHER SUPPLIES 544853 544853 MISCELLANEOUS 364849 364849 BAD DEBT EXPENSE 121346 121346 14152636 13428397 724239 0 4214906 3333381 993748 857832 130220 165952 112159 185082 43986400 34679910 9863758 9306490 1977208 1669147 17291999 15517884 2226085 1867367 813962 584304 15392098 15097304 3528141 3071480 21960286 20620455 X -4668287 -5102571 -4668287 -5102571 17291999 15517884 -434284 0 X 0 0 0 X 554714 3294508 1461496 130378 114978 5556074 14857502 13672955 13616172 15581725 12455360 70183714 425614 205862 908733 961531 1126130 3627870 15837830 17173325 15986401 16673634 13696468 79367658 0 0 0 79367658 61808 1579 5732 29300 37022 135441 61808 1579 5732 29300 37022 135441 15899638 17174904 15992133 16702934 13733490 79503099 0.99830 0.99870 0.00170 0.00130 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 PART II-B, LINE 1: PORTION OF DUES PAID TO AHCA, WICAL, AND WHCA EXPENSED FOR LOBBYING PURPOSES. 416932 416932 32980260 26140103 6840157 10305912 8266422 2039490 283296 273385 9911 9306490 BOND ESCROW FUNDS 1412917 ROU ASSETS - FINANCING LEASES 228086 ROU ASSETS - OPERATING LEASES 28144 1669147 DEFERRED REVENUE FROM ADVANCE FEES 2807807 ST FINANCING LEASE LIABILITY 9017 LT FINANCING LEASE LIABILITY 226512 ST OPERATING LEASE LIABILITY 9201 LT OPERATING LEASE LIABILITY 18943 3071480 GOLF OUTING 56681 44570 12111 13482 1656 56681 44570 12111 13482 1656 15138 -3027 X X 0 0 0 0 0 0 0 0 0 DENNIS FERGER PRESIDENT/CEO 217642 0 3107 0 0 0 1547 0 7296 0 229592 0 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DW40 2019-07-31 16514438 SEE PART VI 0 0 0 A 600000 16386941 1059075 330289 4539216 8738483 1273720 2022 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, PART I, BOND ISSUES: (F) DESCRIPTION OF PURPOSE: THE FUNDS WERE USED TO REFUND THE DEBT OBLIGATIONS WITH TCF BANK (SERIES 2013A TAX-EXEMPT BONDS, CONSTRUCTION TERM LOAN AND LINE OF CREDIT) AND TO PAY FOR CONSTRUCTION OF A NEW BUILDING WING AND CAPITAL IMPROVEMENTS AS THEY COME UP. FORM 990, PART VI, SECTION A, LINE 2 SUSAN SAJDAK AND JAMES SAJDAK HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION IS A SPONSORED MINISTRY OF THE SCHOOL SISTERS OF ST FRANCIS OF ST JOSEPH'S CONVENT, MILWAUKEE, WISCONSIN, INC US PROVINCE (SSSF U.S. PROVINCE). THE ELECTED LEADERS OF THE SSSF U.S. PROVINCE AND ITS TREASURER SERVE AS CORPORATE MEMBERS AND EXERCISE CONTROL OF THIS SUBSIDIARY CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE CURRENT BOARD MEMBERS RECRUIT, ELECT, AND VOTE FOR NEW BOARD MEMBERS AND THE FINAL VOTE IS FROM THE SCHOOL SISTERS OF ST FRANCIS. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD DOES MAKE SOME DECISIONS WITHOUT APPROVAL, HOWEVER, CERTAIN ITEMS REQUIRE FINAL APPROVAL BY THE SCHOOL SISTERS OF ST FRANCIS (SSSF). THE SSSF HAVE THE POWER TO SAFEGUARD THE PURPOSES OF THE CORPORATION AND TO ANNUALLY MEET WITH THE BOARD OF DIRECTORS AND REVIEW THE FUNCTION OF THE BOARD AND THE OPERATIONS OF THE CORPORATION IN ACCORD WITH THE SSSF PHILOSOPHY, VALUES AND HERITAGE. TO APPOINT MEMBERS TO THE BOARD OF DIRECTORS. TO SAFEGUARD ALL ACTIVITIES IN ACCORDANCE WITH THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH SERVICES AS PROMULGATED BY THE NATIONAL CONFERENCE OF CATHOLIC BISHOPS. TO APPROVE THE STATEMENTS OF PHILOSOPHY AND MISSION OF THE CORPORATION. TO AMEND, RESTATE, OR MODIFY THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE CORPORATION. TO APPROVE THE BYLAWS OF ALL ORGANIZATIONS UNDER THE AUSPICES OF THE CORPORATION. TO APPOINT AND TERMINATE THE CEO OF THE CORPORATION, AS RECOMMENDED BY THE BOARD OF DIRECTORS. TO APPROVE CAPITAL AND OPERATING BUDGETS FOR THE CORPORATION. TO APPROVE ANY CONTRACT UNDERTAKEN WITH A MANAGEMENT FIRM FOR GENERAL ADMINISTRATION SERVICES OR FULL OPERATION OF THE CORPORATION. TO APPROVE THE AUDITING FIRM REQUIRED FOR INSTITUTIONS SPONSORED BY SSSF. TO APPROVE ALL MAJOR (OVER $250,000) DEBT OBLIGATION INCURRED BY THE CORPORATION. TO APPROVE ALL MAJOR FUND DRIVES AND THE ESTABLISHMENT OF ENDOWMENTS TO HOLD EXCLUSIVE AUTHORITY FOR THE DISSOLUTION, SALE PLEDGE, TRANSFER OR OTHER DISPOSITION OF THE ASSETS OF THE CORPORATION OR ITS MERGER WITH ANOTHER CORPORATION. TO APPOINT ONE SSSF TO SERVE ON ANY CEO SELECTION COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B ONCE CLEMENT MANOR RECEIVES THE COMPLETED FORM 990, THEY SEND A COPY TO THE EXECUTIVE COMMITTEE OF THEIR BOARD OF DIRECTORS. IT IS THEN DISCUSSED AND APPROVED AT A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C CLEMENT MANOR HAS ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES SIGN THE CONFLICT OF INTEREST STATEMENTS ANNUALLY, DISCLOSING ALL CONFLICTS OF INTEREST. CONFLICT OF INTEREST POLICY: DIRECTORS, OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS SHALL NOT DIVULGE OR COMMUNICATE TO ANY PERSON(S) ANY CONFIDENTIAL INFORMATION OF ANY KIND CONCERNING ANY MATTERS AFFECTING OR RELATING TO THE BUSINESS OF CLEMENT MANOR AND ITS PARTICIPATING ORGANIZATIONS. IF ONE IS NOT SURE IF INFORMATION IS CONFIDENTIAL, SUCH PERSON SHOULD REQUEST A DETERMINATION BY THE BOARD, THE CHAIRPERSON OF THE BOARD OR THE PRESIDENT, CEO OR ADMINISTRATOR. TRANSACTIONS INVOLVING CONFLICTS OF INTEREST INCLUDE BUT ARE NOT LIMITED TO: 1. THE SALE, PURCHASE, LEASE OR RENTAL OF ANY PROPERTY OR OTHER ASSET, 2. EMPLOYMENT OR RENDITION OF SERVICES, PERSONAL OR OTHERWISE, 3. THE AWARD OF ANY GRANT, CONTRACT, OR SUBCONTRACT, OR 4. THE INVESTMENT OR DEPOSIT OF ANY FUNDS OF THE CORPORATION. THIS PROHIBITION SHALL NOT, HOWEVER, PREVENT THE DISCLOSURE OF CONFIDENTIAL INFORMATION TO AN OFFICER OR DIRECTOR OR AN ORGANIZATION THAT CONTROLS CLEMENT MANOR. CONFLICT OF INTEREST PROCEDURES: 1. EVERY DIRECTOR, OFFICER, AND EMPLOYEE IS FAMILIARIZED WITH THE CONFIDENTIALITY POLICY DURING THEIR ORIENTATION PERIOD OR PRIOR TO ASSUMING THEIR DUTIES OR TERMS OF OFFICE, 2. WHENEVER A DIRECTOR, OFFICER, OR EMPLOYEE FEELS THAT A CONFLICT OF INTEREST SITUATION IS OR MAY BE INVOLVED, THE FACTS ARE TO BE PROMPTLY DISCLOSED A) IN THE CASE OF AN EMPLOYEE THE FACTS SHOULD BE KNOWN TO THE CHIEF EXECUTIVE OFFICER, B) IN THE CASE OF A DIRECTOR THE FACTS SHOULD BE KNOWN TO THE PRESIDENT OF THE BOARD OF DIRECTORS. THEREAFTER THE DIRECTOR SHALL REFRAIN FROM DISCUSSING OR VOTING ON THE PARTICULAR TRANSACTION IN WHICH HE HAS AN INTEREST OR OTHERWISE ATTEMPTING TO EXERT ANY INFLUENCE ON THE CORPORATION, ITS BOARD OF DIRECTORS, OR ITS COMMITTEES, TO AFFECT ITS DECISION TO PARTICIPATE IN SUCH TRANSACTION. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE, AND THE ABSTENTION FROM DISCUSSION AND VOTING ON THE PARTICULAR TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND KEY MANAGEMENT STAFF REVIEW ALL EMPLOYEES' WAGES AND THE BOARD COMPENSATION COMMITTEE REVIEWS THE CEO'S SALARY WITHOUT CONFLICT OF INTEREST. CLEMENT MANOR HAS ESTABLISHED WAGE RANGES FOR EVERY POSITION. EVERY YEAR, THEY COMPARE THE JOB RANGES TO A WAGE SURVEY THAT LEADING AGE PUTS TOGETHER. CLEMENT MANOR'S GOAL IS TO REMAIN AROUND THE 75TH PERCENTILE OF THE SURVEY. IF THEY ARE BELOW, THE CEO AND KEY MANAGEMENT STAFF DECIDE IF THEY NEED TO INCLUDE AN ADJUSTMENT TO THE WAGE RANGE. THEY THEN INCLUDE THE FISCAL IMPACT IN THE BUDGET TO BE APPROVED BY THE BOARD OF DIRECTORS. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL MAKE THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G THERAPY SERVICES: PROGRAM SERVICE EXPENSES 449,460. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 449,460. RELIGIOUS SERVICES: PROGRAM SERVICE EXPENSES 4,093. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,093. CLEANING/LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 115,119. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 115,119. MAINTENANCE: PROGRAM SERVICE EXPENSES 739,309. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 739,309. CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 109,705. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,705. DATA PROCESSING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,394. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,394. OTHER SERVICES : PROGRAM SERVICE EXPENSES 94,249. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 94,249. THE SCHOOL SISTERS OF ST FRANCIS OF ST JOSEPH'S CONVENT 1515 S LAYTON BLVD MILWAUKEE WI 53215 390806266 RELIGIOUS ORDER WI 501(C)(3) LINE 1 N/A 0 MARYHILL MANOR 501 MADISON AVENUE NIAGARA WI 54151 391501353 NURSING HOME WI 501(C)(3) LINE 10 US PROVINCE OF THE SCHOOL SISTERS OF ST FRANCIS 0 OUR LADY OF THE ANGELS 3995 S 92ND STREET GREENFIELD WI 53228 271566571 RELIGIOUS ORDER WI 501(C)(3) LINE 1 US PROVINCE OF THE SCHOOL SISTERS OF ST FRANCIS AND CENTRAL PACIFIC PROV 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0