ELMWOOD NURSING HOME INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: ELMWOOD NURSING HOME INC (EIN 39-1190907)
Tax period: 2020-07-01 to 2021-06-30
Filed: 2022-03-24
IRS object ID: 202210839349300206
Schema version: 2020v4.2
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-03-24T07:34:11-05:00	ReturnTs
Tax Period End	2021-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390758449	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1502 LONDON ROAD SUITE 200	AddressLine1Txt
City	DULUTH	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55812	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	391190907	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ELMWOOD NURSING HOME INC	BusinessNameLine1Txt
Business Name Line2	HERITAGE OF ELMWOOD	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	ELMW	BusinessNameControlTxt
Phone	7158323003	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	232 E SPRINGER AVE	AddressLine1Txt
City	ELMWOOD	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54740	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	AMY DUHR	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	7158323003	PhoneNum
Signature	2022-02-03	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	AMY	PersonFirstNm
Person Last	DUHR	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MICHAEL J PETERSON CPA	PreparerPersonNm
PTIN	P01833529	PTIN
Phone	2187224705	PhoneNum
Preparation	2022-02-03	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	AMY DUHR	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3410 SKY PARK BLVD	AddressLine1Txt
City	EAU CLAIRE	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54701	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$2,523,725	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTP://HERITAGEOFELMWOOD.COM/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Other Organization Dsc	WISCONSIN NO	OtherOrganizationDsc
Formation	1972	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	TO RESPOND TO THE SPIRITUAL, PHYSICAL, AND SOCIAL NEEDS OF PEOPLE IN ORDER TO ENHANCE HUMAN DIGNITY AND GROWTH BY PROVIDING HIGH QUALITY SERVICE.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	62	TotalEmployeeCnt
Total Volunteers	7	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$61,001	PYContributionsGrantsAmt
CY Contributions Grants	$256,792	CYContributionsGrantsAmt
PY Program Service Revenue	$2,283,802	PYProgramServiceRevenueAmt
CY Program Service Revenue	$2,251,675	CYProgramServiceRevenueAmt
PY Investment Income	$15,464	PYInvestmentIncomeAmt
CY Investment Income	$15,258	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$2,360,267	PYTotalRevenueAmt
CY Total Revenue	$2,523,725	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,511,425	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$1,575,164	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$864,682	PYOtherExpensesAmt
CY Other Expenses	$914,303	CYOtherExpensesAmt
PY Total Expenses	$2,376,107	PYTotalExpensesAmt
CY Total Expenses	$2,489,467	CYTotalExpensesAmt
PY Revenues Less Expenses	-$15,840	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$34,258	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,182,679	TotalAssetsBOYAmt
Total Assets EOY	$3,082,696	TotalAssetsEOYAmt
Total Liabilities BOY	$857,476	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$723,235	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,325,203	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,359,461	NetAssetsOrFundBalancesEOYAmt
Mission	TO RESPOND TO THE SPIRITUAL, PHYSICAL, AND SOCIAL NEEDS OF PEOPLE IN ORDER TO ENHANCE HUMAN DIGNITY AND GROWTH BY PROVIDING HIGH QUALITY SERVICE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$2,208,042	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$2,251,675	RevenueAmt
Desc	THE PRIMARY ACTIVITY OF THE NURSING HOME IS TO PROVIDE SKILLED NURSING CARE FOR THE AGED AND DISABLED OF THE SURROUNDING AREA. THE NURSING HOME SERVES THE ELMWOOD, WISCONSIN AREA COMMUNITY BY OPERATING A 34-BED SKILLED NURSING FACILITY. THE NURSING HOME PROVIDED 7,744 RESIDENT DAYS OF CARE IN FISCAL YEAR 2021. THE NURSING HOME OFFERS LONG-TERM AND SHORT-TERM CARE ALONG WITH REHABILITATIVE SERVICES TO THEIR SENIOR RESIDENTS. SOME OF THE SPECIALIZED CARE SERVICES INCLUDE PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, IV AND OXYGEN THERAPY, RESTORATIVE CARE, AND TRACHEOTOMY CARE.	Desc
Total Program Service Expenses	$2,208,042	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	15	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	62	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KELLY LARSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7158323003	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3410 SKY PARK BLVD	AddressLine1Txt
City	EAU CLAIRE	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54701	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ELLEN THOMPSON
ADMINISTRATOR	40.00	Yes (X)	$0	$0	$0
AMY DUHR
INTERIM CEO	10.00	Yes (X)	$0	$0	$0
RAYMOND WEISS
CEO (THRU APRIL)	10.00	Yes (X)	$0	$0	$0
DOLORES RADTKE
PRESIDENT	0.50	Yes (X)	$0	$0	$0	Yes (X)
DAN SCHULER
VICE PRESIDENT	0.50	Yes (X)	$0	$0	$0	Yes (X)
JAMIE REITZ
SECRETARY/TREASURER	0.50	Yes (X)	$0	$0	$0	Yes (X)
MARGE BINKOWSKI
TRUSTEE	0.50		$0	$0	$0	Yes (X)
DONNA LIEN
TRUSTEE	0.50		$0	$0	$0	Yes (X)
SUSAN PELZEL
TRUSTEE	0.50		$0	$0	$0	Yes (X)
DONETTE STEWART
TRUSTEE	0.50		$0	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GRACE LUTHERAN FOUNDATION INC	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3410 SKY PARK BLVD	AddressLine1Txt
City	EAU CLAIRE	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54701	ZIPCd

Field	Value	IRS element (for citing)
Services	MANAGEMENT SERVICES	ServicesDesc
Compensation	$181,778	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Government Grants	$256,513	GovernmentGrantsAmt
All Other Contributions	$279	AllOtherContributionsAmt
Total Contributions	$256,792	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NURSING CARE & HOUSING	623000	$2,197,954	$2,197,954
RENTAL INCOME	532000	$35,094	$35,094
SENIOR MEALS PROGRAM	624210	$8,651	$8,651
TRANSPORTATION REVENUE	480000	$5,015	$5,015

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,961	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,961	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$2,251,675	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,258	TotalRevenueColumnAmt
Exclusion	$15,258	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,523,725	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,251,675	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$15,258	ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,287,520	TotalAmt
Program Services	$1,277,924	ProgramServicesAmt
Management And General	$9,596	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$18,203	TotalAmt
Program Services	$18,080	ProgramServicesAmt
Management And General	$123	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$174,119	TotalAmt
Program Services	$172,946	ProgramServicesAmt
Management And General	$1,173	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$95,322	TotalAmt
Program Services	$94,679	ProgramServicesAmt
Management And General	$643	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$181,778	TotalAmt
Management And General	$181,778	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$842	TotalAmt
Management And General	$842	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$22,160	TotalAmt
Management And General	$22,160	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$151,130	TotalAmt
Program Services	$150,297	ProgramServicesAmt
Management And General	$833	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,167	TotalAmt
Management And General	$1,167	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,124	TotalAmt
Program Services	$388	ProgramServicesAmt
Management And General	$3,736	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$3,146	TotalAmt
Management And General	$3,146	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$96,206	TotalAmt
Program Services	$64,831	ProgramServicesAmt
Management And General	$31,375	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$6,968	TotalAmt
Program Services	$5,014	ProgramServicesAmt
Management And General	$1,954	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,640	TotalAmt
Program Services	$2,455	ProgramServicesAmt
Management And General	$185	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$113,213	TotalAmt
Program Services	$112,158	ProgramServicesAmt
Management And General	$1,055	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$44,585	TotalAmt
Program Services	$43,914	ProgramServicesAmt
Management And General	$671	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUPPLIES AND OTHER	$111,002	$97,703	$13,299
FOOD AND DIETARY EXPENS	$80,929	$80,929
NH ASSESSMENT	$69,360	$69,360
BAD DEBT EXPENSE	$12,000	$12,000

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$13,053	TotalAmt
Program Services	$5,364	ProgramServicesAmt
Management And General	$7,689	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,489,467	TotalAmt
Program Services	$2,208,042	ProgramServicesAmt
Management And General	$281,425	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,349	BOYAmt
EOY	$1,130	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,645,824	BOYAmt
EOY	$1,610,143	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$163,561	BOYAmt
EOY	$199,158	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$18,541	BOYAmt
EOY	$16,947	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$3,855,951	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,600,633	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,353,404	BOYAmt
EOY	$1,255,318	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,182,679	BOYAmt
EOY	$3,082,696	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$179,313	BOYAmt
EOY	$196,796	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$138,152	BOYAmt
EOY	$28,029	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$3,232	BOYAmt
EOY	$3,268	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$536,779	BOYAmt
EOY	$495,142	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$857,476	BOYAmt
EOY	$723,235	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,325,203	BOYAmt
EOY	$2,359,461	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,325,203	BOYAmt
EOY	$2,359,461	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,182,679	BOYAmt
EOY	$3,082,696	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$34,258	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,360	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$562	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$866	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$61,001	CurrentTaxYearMinus1YearAmt
Current Tax Year	$256,792	CurrentTaxYearAmt
Total	$321,581	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,248,555	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,349,698	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,390,117	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,283,802	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,251,675	CurrentTaxYearAmt
Total	$11,523,847	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,250,915	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,350,260	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,390,983	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,344,803	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,508,467	CurrentTaxYearAmt
Total	$11,845,428	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$11,845,428	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$49,134	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$51,313	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$14,406	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$15,464	CurrentTaxYearMinus1YearAmt
Current Tax Year	$15,258	CurrentTaxYearAmt
Total	$145,575	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$49,134	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$51,313	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$14,406	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$15,464	CurrentTaxYearMinus1YearAmt
Current Tax Year	$15,258	CurrentTaxYearAmt
Total	$145,575	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,300,049	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,401,573	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,405,389	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,360,267	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,523,725	CurrentTaxYearAmt
Total	$11,991,003	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.98790	PublicSupportCY509Pct
Public Support PY509	0.99330	PublicSupportPY509Pct
Investment Income CY	0.01210	InvestmentIncomeCYPct
Investment Income PY	0.00670	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$1,555	OtherActivitiesAmt
Total Lobbying Expenditures	$1,555	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	ELMWOOD NURSING HOME INC. HERITAGE OF ELMWOOD PAYS ANNUAL ASSOCIATION DUES TO LEADINGAGE WISCONSIN. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATION MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL INDUSTRY ENVIRONMENT.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,000	OtherCostOrOtherBasisAmt
Book Value	$7,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,829,996	OtherCostOrOtherBasisAmt
Depreciation	$1,694,441	DepreciationAmt
Book Value	$1,135,555	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,000,061	OtherCostOrOtherBasisAmt
Depreciation	$906,192	DepreciationAmt
Book Value	$93,869	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$18,894	OtherCostOrOtherBasisAmt
Book Value	$18,894	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,255,318	TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt	$2,523,725	TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$2,523,725	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$2,523,725	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$2,489,467	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$2,489,467	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$2,489,467	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART IV, LINE 2B:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION HOLDS RESIDENT TRUST FUNDS AS DEPOSITS. THESE TRUST FUNDS ARE NOT AVAILABLE FOR USE IN DAILY OPERATIONS OF THE NURSING HOME.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3	EFFECTIVE JANUARY 1, 2016, ELMWOOD NURSING HOME ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION, INC. (GLF), AN UNRELATED, NON-PROFIT, RELIGIOUS BASED SENIOR HEALTHCARE SERVICES ORGANIZATION BASED IN EAU CLAIRE, WISCONSIN. UNDER THIS AGREEMENT, GLF PROVIDES GENERAL ADMINISTRATIVE, CONSULTING, ACCOUNTING, HUMAN RESOURCES, AND FACILITY MANAGEMENT SERVICES UNDER THE DIRECTION OF THE BOARD OF DIRECTORS OF ELMWOOD NURSING HOME. UNDER THE MANAGEMENT AGREEMENT, GLF IS ALSO RESPONSIBLE FOR THE SELECTION AND REVIEW OF THE ADMINISTRATOR OF ELMWOOD NURSING HOME.
FORM 990, PART VI, SECTION A, LINE 6	THE NURSING HOME HAS MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7A	THE NURSING HOME'S MEMBERS ELECT THE GOVERNING BOARD.
FORM 990, PART VI, SECTION A, LINE 8B	THE NURSING HOME DOES NOT APPOINT ANY COMMITTEES TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B	A COPY OF THE FORM 990 WAS MADE AVAILABLE TO THE MEMBERS OF THE NURSING HOME'S GOVERNING BODY PRIOR TO THE SUBMISSION OF THE RETURN. THE FORM 990 WAS ALSO REVIEWED BY MANAGEMENT PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12C	THE NURSING HOME ANNUALLY REVIEWS UPDATED CONFLICT OF INTEREST STATEMENTS FROM MEMBERS OF THE BOARD OF DIRECTORS. ANY NOTED CONFLICTS ARE DISCUSSED, AND DURING THE YEAR, IF CONFLICTS ARE NOTED DURING VOTES, THOSE CONFLICTING MEMBERS ABSTAIN FROM VOTING.
FORM 990, PART VI, SECTION B, LINE 15	THE NURSING HOME'S EXECUTIVE LEVEL EMPLOYEES AND KEY EMPLOYEES ARE PROVIDED UNDER THE MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION, INC. (AN UNRELATED NOT-FOR PROFIT ORGANIZATION WHICH SPECIALIZES IN SKILLED NURSING, LONG-TERM CARE, AND HOUSING SERVICES FOR ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY). THE CONTRACT TERMS ARE RENEWED ANNUALLY. THE BOARD OF DIRECTORS OF THE NURSING HOME, REVIEWS THE CONTRACT TERMS TO ENSURE THAT QUALITY SERVICES ARE BEING ACHIEVED AT THE LOWEST POSSIBLE COST FOR THE PROGRAMS BEING PROVIDED. THE BOARD ALSO CONSULTS WITH OTHER WISCONSIN NURSING HOME ASSOCIATION MEMBERS TO ENSURE THAT THE AMOUNTS BEING PAID ARE CONSISTENT FOR ADMINISTRATIVE SERVICES OF THOSE PAID THROUGHOUT THE REGION.
FORM 990, PART VI, SECTION C, LINE 19	THE NURSING HOME MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION.