STRATEGY STUDIO / PUBLIC DATA EXPLORER

SINSINAWA NURSING INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SINSINAWA NURSING INC (EIN 39-1958028)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-15
IRS object ID
202341359349305139
Schema version
2021v4.2
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

FieldValueIRS element (for citing)
Return2023-05-15T10:56:35-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18215 GREENWAY BOULEVARD SUITE 600AddressLine1Txt
CityMIDDLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53562ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391958028EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SINSINAWA NURSING INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSINSBusinessNameControlTxt
Phone9202064930PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 HILL STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53098ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNICOLE CHWALAPersonNm
Person TitleCFOPersonTitleTxt
Phone9202064930PhoneNum
Signature2023-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstNICOLEPersonFirstNm
Person LastCHWALAPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIMBERLY ANDERSONPreparerPersonNm
PTINP00188889PTIN
Phone6086628600PhoneNum
Preparation2023-05-12PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMATTHEW MAUTHEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 HILL STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53098ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,005,227GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionORGANIZE, OPERATE AND MAINTAIN A CARE CENTER IN SOUTHWESTERN WISCONSIN FOR THE ELDERLY AND INFIRM.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$281,112PYContributionsGrantsAmt
CY Contributions Grants$410,414CYContributionsGrantsAmt
PY Program Service Revenue$3,966,650PYProgramServiceRevenueAmt
CY Program Service Revenue$3,594,810CYProgramServiceRevenueAmt
PY Investment Income$91PYInvestmentIncomeAmt
CY Investment Income$3CYInvestmentIncomeAmt
PY Other Revenue$3,037,859PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$7,285,712PYTotalRevenueAmt
CY Total Revenue$4,005,227CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,417,629PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,508,067CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,158,820PYOtherExpensesAmt
CY Other Expenses$2,211,293CYOtherExpensesAmt
PY Total Expenses$4,576,449PYTotalExpensesAmt
CY Total Expenses$3,719,360CYTotalExpensesAmt
PY Revenues Less Expenses$2,709,263PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$285,867CYRevenuesLessExpensesAmt
Total Assets BOY$3,412,383TotalAssetsBOYAmt
Total Assets EOY$3,459,336TotalAssetsEOYAmt
Total Liabilities BOY$703,120TotalLiabilitiesBOYAmt
Total Liabilities EOY$464,206TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,709,263NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,995,130NetAssetsOrFundBalancesEOYAmt
MissionORGANIZE, CONSTRUST, OPERATE AND MAINTAIN A CARE CENTER IN SOUTHWESTERN WISCONSIN FOR THE ELDERLY AND INFIRM.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,951,056ExpenseAmt
Revenue$3,594,810RevenueAmt
DescOPERATE AND MAINTAIN A CARE CENTER IN SOUTHWEST WISCONSIN FOR THE ELDERLY AND INFIRM.Desc
Total Program Service Expenses$2,951,056TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NICOLE CHWALABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9202064930PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 HILL STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53098ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
NICOLE CHWALA
SECRETARY5.0035.00Yes (X)Yes (X)$0$164,057$0
DOUG ROGERS
BOARD CHAIR1.001.00Yes (X)Yes (X)$0$0$0
MATT MAUTHE
PRESIDENT/CEO5.0035.00Yes (X)Yes (X)$0$516,650$40,348
JESS SOOKOCHOFF
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
MICHAEL LIBBY
BOARD MEMBER5.0035.00Yes (X)$0$290,278$36,357
DAN ROHRBACH
BOARD MEMBER1.001.00Yes (X)$0$0$0
LOU SCHWEIGERT
BOARD MEMBER1.001.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$970,985TotReportableCompRltdOrgAmt
Total Other Compensation$76,705TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MARQUARDT MANAGEMENT SERVICES
1045 HILL STREETWATERTOWNWI53098MGMT & ADMIN FEES & PAYROLL BILLBACK$687,056
NEW HORIZON FOODS
PO BOX 860246MINNEAPOLISMN55486DIETARY LABOR & SERVICES$417,674
SOUTHWEST HEALTH CENTER
1400 EAST SIDE ROADPLATTEVILLEWI53818THERAPY, LAB, XRAY ETC PROVIDER$166,777
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$410,144GovernmentGrantsAmt
All Other Contributions$270AllOtherContributionsAmt
Total Contributions$410,414TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNURSING/MEDICAL CAREDesc
Business623000BusinessCd
Total Revenue Column$3,594,810TotalRevenueColumnAmt
Related Or Exempt Func Income$3,594,810RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$3,594,810TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3TotalRevenueColumnAmt
Exclusion$3ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,005,227TotalRevenueColumnAmt
Related Or Exempt Func Income$3,594,810RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,260,308TotalAmt
Program Services$1,028,726ProgramServicesAmt
Management And General$231,582ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$17,570TotalAmt
Program Services$17,570ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$126,706TotalAmt
Program Services$126,706ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$103,483TotalAmt
Program Services$84,856ProgramServicesAmt
Management And General$18,627ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$340,510TotalAmt
Management And General$340,510ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,378TotalAmt
Management And General$2,378ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$19,078TotalAmt
Management And General$19,078ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$736,313TotalAmt
Program Services$646,286ProgramServicesAmt
Management And General$90,027ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$55,094TotalAmt
Program Services$53,658ProgramServicesAmt
Management And General$1,436ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$30,886TotalAmt
Program Services$3,110ProgramServicesAmt
Management And General$27,776ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$84,635TotalAmt
Program Services$84,635ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$103,634TotalAmt
Program Services$103,634ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,013TotalAmt
Program Services$1,013ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$8,751TotalAmt
Management And General$8,751ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$198,517TotalAmt
Program Services$198,517ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$52,737TotalAmt
Program Services$52,737ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
RESIDENT CARE SUPPLIES$222,552$222,552
DIRECT LABOR- THERAPY$146,949$146,949
PROVIDER BED TAX$108,120$108,120
REPAIRS AND MAINTENANCE$71,987$71,987

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$28,139TotalAmt
Management And General$28,139ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,719,360TotalAmt
Program Services$2,951,056ProgramServicesAmt
Management And General$768,304ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$500BOYAmt
EOY$500EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$254,991BOYAmt
EOY$436,650EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,424BOYAmt
EOY$855EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,313,230LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,501,129LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,974,069BOYAmt
EOY$2,812,101EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$181,399BOYAmt
EOY$209,230EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,412,383BOYAmt
EOY$3,459,336EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$405,923BOYAmt
EOY$444,286EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$283,612BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,585BOYAmt
EOY$19,920EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$703,120BOYAmt
EOY$464,206EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,709,263BOYAmt
EOY$2,995,130EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,709,263BOYAmt
EOY$2,995,130EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,412,383BOYAmt
EOY$3,459,336EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$285,867ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$3,517,831CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$281,112CurrentTaxYearMinus1YearAmt
Current Tax Year$410,414CurrentTaxYearAmt
Total$4,209,357TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$3,517,831CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$281,112CurrentTaxYearMinus1YearAmt
Current Tax Year$410,414CurrentTaxYearAmt
Total$4,209,357TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$4,209,357PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$299CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$445CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$381CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$91CurrentTaxYearMinus1YearAmt
Current Tax Year$3CurrentTaxYearAmt
Total$1,219TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$7,614CurrentTaxYearMinus2YearsAmt
Total$7,614TotalAmt
FieldValueIRS element (for citing)
Total Support$4,218,190TotalSupportAmt
Gross Receipts Rltd Activities$11,087,286GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99790PublicSupportCY170Pct
Public Support PY1700.99960PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,000OtherCostOrOtherBasisAmt
Book Value$15,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,783,259OtherCostOrOtherBasisAmt
Depreciation$3,501,129DepreciationAmt
Book Value$2,282,130BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,050OtherCostOrOtherBasisAmt
Book Value$3,050BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$511,921OtherCostOrOtherBasisAmt
Book Value$511,921BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,812,101TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescINTERCOMPANY DUE TO/FROMDesc
Book Value$209,230BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$209,230TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$19,920Amt
FieldValueIRS element (for citing)
Total Liability$19,920TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MATT MAUTHE
PRESIDENT/CEO$0$448,088$0$68,562$0$0$0$0$0$40,348$0$556,998$0$0
MICHAEL LIBBY
BOARD MEMBER$0$265,557$0$24,721$0$0$0$0$0$36,357$0$326,635$0$0
NICOLE CHWALA
SECRETARY$0$147,873$0$16,184$0$0$0$0$0$0$0$164,057$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationRELATED ORGANIZATIONS USE THE FOLLOWING TO ESTABLISH COMPENSATION FOR OFFICERS: INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEEExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION IS PART OF THE MARQUARDT VILLAGE AFFILIATES AND DELEGATES MANAGEMENT DUTIES TO MARQARDT.
FORM 990, PART VI, SECTION B, LINE 11BTHE TREASURER REVIEWS THE FORM 990 IN DETAIL BEFORE SUBMITTING IT TO THE OTHER OFFICERS FOR REVIEW.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE ONLY AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GCONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 90,027. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90,027. X-RAY: PROGRAM SERVICE EXPENSES 1,042. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,042. PHARMACY: PROGRAM SERVICE EXPENSES 49,621. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,621. LABORATORY : PROGRAM SERVICE EXPENSES 14,361. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,361. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 32,468. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,468. DINING SERVICES: PROGRAM SERVICE EXPENSES 286,074. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 286,074. STAFFING: PROGRAM SERVICE EXPENSES 202,695. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 202,695. OTHER SERVICES: PROGRAM SERVICE EXPENSES 60,025. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,025.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ZINZENDORF HALL INC
1045 HILL STREETWATERTOWNWI53098391647409ASSISTED LIVINGWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
MARQUARDT MANAGEMENT SERVICES INC
1045 HILL STREETWATERTOWNWI53098391756037SENIOR HOUSINGWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
MORAVIAN HOMES INC
1045 HILL STREETWATERTOWNWI53098391324889SENIOR HOUSINGWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
MUELLER APARTMENTS INC
1045 HILL STREETWATERTOWNWI53098391294266LOW INCOME HOUSINGWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
MARQUARDT MEMORIAL MANOR INC
1045 HILL STREETWATERTOWNWI53098391126946SKILLED NURSING FACILITYWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
MARQUARDT VILLAGE INC
1045 HILL STREETWATERTOWNWI53098391704732MANAGEMENT SERVICESWI501(C)(3)LINE 12B, II0N/A
MARQUARDT HOME AND COMMUNITY BASED SERVICES INC
1045 HILL STREETWATERTOWNWI53098391940920HOME HEALTH, HOSPICE AND EMERGENCY RESPONSE SERVICESWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
THE HILLS AT CORTLAND RIDGE
1045 HILL STREETWATERTOWNWI53098611517711DEVELOPMENT OF RETIREMENT COMMUNITIESWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
ST ANNES'S HOME FOR THE ELDERLY MILWAUKEE
1045 HILL STREETWATERTOWNWI53098390985045LONG TERM CARE FOR THE ELDERLYWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
SASC INC
1045 HILL STREETWATERTOWNWI53098262512451LONG TERM CARE FOR THE ELDERLYWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
LINCOLN VILLAS NORTH INC
1045 HILL STREETWATERTOWNWI53098391363010LOW INCOME SENIOR HOUSINGWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
TRINITY TERRACE INC
1045 HILL STREETWATERTOWNWI53098391667734LOW INCOME HOUSINGWI501(C)(3)LINE 10MARQUARDT VILLAGE INC0
SWRI INC
1045 HILL STREETWATERTOWNWI53098851449153SENIOR HOUSINGWI501(C)(3)LINE 7MARQUARDT VILLAGE INC0
MARQUARDT FOUNDATION INC
1045 HILL STREETWATERTOWNWI53098391563808SUPPORT MARQUARDT VILLAGE INC & AFFILIATESWI501(C)(3)LINE 7MARQUARDT VILLAGE INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MARQUARDT INVESTMENTS INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 HILL STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53098ZIPCd
FieldValueIRS element (for citing)
EIN475473378EIN
Primary ActivitiesINVESTMENTSPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MARQUARDT FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd