2025-07-01T09:59:06-05:00 2024-09-30 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2023-10-01 390829541 SHADY LANE INC SHAD 9206828254 1235 SOUTH 24TH STREET MANITOWOC WI 542205516 AARON SCONZERT CFO 9206828254 2025-06-17 1 1 SOLOMON MARDAKHAEV P01806552 6105653930 2025-06-17 2023 2025-03-06 01:10:19Z AARON SCONZERT 1235 SOUTH 24TH STREET MANITOWOC WI 542205516 11508085 0 X WWW.SHADYLANEINC.COM X 1950 WI NURSING CARE FOR THE AGED AND DISABLED. 12 12 287 19 0 0 14421 10245 9197722 11361676 72550 26237 2312 0 9287005 11398158 0 0 0 0 6216041 6846119 0 0 0 4675103 5026682 10891144 11872801 -1604139 -474643 12135844 11476696 6412322 5958663 5723522 5518033 X SHADY LANE STRIVES TO PROVIDE OLDER ADULTS IN MANITOWOC COUNTY THE HIGHEST QUALITY RESIDENTIAL CARE AT A REASONABLE COST. RESIDENTS OF SHADY LANE CAN EXPECT TO ENJOY A HOME-LIKE SETTING WITH A SUPPORTIVE ATMOSPHERE THAT RESPECTS INDIVIDUALITY, PROMOTES PHYSICAL AND EMOTIONAL WELLBEING, AND ENCOURAGES INDEPENDENCE. 0 0 5948022 0 6338939 SKILLED NURSING SERVICES ARE OFFERED TO THE SENIOR POPULATION. THESE ARE THE HIGHER ACUITY POPULATION NEEDING THE MOST INTENSE SKILLED NURSING SERVICES. RESIDENTS TREATED CAN INCLUDE THE PRIVATE PAY RESIDENTS, AND THE RESIDENTS ON GOVERNMENT FUNDING (MEDICARE AND MEDICAID). NUMBER OF RESIDENTS TREATED IN PLAN YEAR WERE 236. 4079481 0 4818832 ASSISTED LIVING SERVICES ARE OFFERED TO THE LIGHTER CARE ASSISTED LIVING POPULATION. THESE RESIDENTS CAN MAINTAIN AN AMOUNT OF INDEPENDENCE WHILE STILL RECEIVING THE NECESSARY NURSING SERVICE TO MAINTAIN A QUALITY OF LIFE. RESIDENTS IN THE ASSISTED LIVING CAN INCLUDE THE PRIVATE PAY RESIDENTS AND RESIDENTS RECEIVING GOVERNMENT FUNDING. NUMBER OF RESIDENTS TREATED IN PLAN YEAR WERE 162. 10027503 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 287 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X AARON SCONZERT 9206828254 1235 S 24TH STREET MANITOWOC WI 54220 SANDY HARDRATH BOARD CHAIR (THRU DEC. 23') 0.50 X X 0 0 0 MONICA NICHTER BOARD CHAIR 0.50 X X 0 0 0 JEREMY SEHLOFF BOARD VICE CHAIR (THRU DEC. 23') 0.50 X X 0 0 0 JODY NEILSON BOARD VICE CHAIR 0.50 X X 0 0 0 DAVID LESS BOARD SECRETARY 0.50 X X 0 0 0 KAY AVCI BOARD MEMBER 0.50 X 0 0 0 JUDY CAREY BOARD MEMBER (THRU DEC. 23') 0.50 X 0 0 0 HEATHER GARCIA BOARD MEMBER 0.50 X 0 0 0 DAYNA GOETZ BOARD MEMBER 0.50 X 0 0 0 MARY GOVIER BOARD MEMBER 0.50 X 0 0 0 CHRIS HERZOG BOARD MEMBER 0.50 X 0 0 0 STANLEY JOHNSON BOARD MEMBER (THRU DEC. 23') 0.50 X 0 0 0 NANCY MUSIAL BOARD MEMBER (THRU DEC. 23') 0.50 X 0 0 0 MATTHEW NEU BOARD MEMBER (THRU DEC. 23') 0.50 X 0 0 0 KAREN O'LEARY BOARD MEMBER 0.50 X 0 0 0 TINA PRIGGE BOARD MEMBER (THRU DEC. 23') 0.50 X 0 0 0 KATHERINE REYNOLDS BOARD MEMBER 0.50 X 0 0 0 DENNIS TIENOR BOARD MEMBER 0.50 X 0 0 0 AMY FRICKE-WEIGEL BOARD MEMBER 0.50 X 0 0 0 TODD MEERDINK CEO 40.00 X 150803 0 35251 KASANDRA PAIDER CFO 40.00 X 112825 0 12763 YUMIKO RAPISARDA-DOERFLER NURSE 40.00 X 122820 0 15846 386448 0 63860 3 0 1 0 HOMECARE HEALTH SERVICES AND HOSPICE 1004 WASHINGTON ST MANITOWOC WI 54220 THERAPY SERVICES 406699 FUSION MEDICAL STAFFING PO BOX 30131 OMAHA NE 68103 HEALTHCARE SERVICES 383261 ELITE PO BOX 100173 FORT WORTH TX 76185 HEALTHCARE SERVICES 135182 PRN HEALTHCARE 1101 E SOUTH RIVER ST APPLETON WI 54915 HEALTHCARE SERVICES 114144 4 10245 10245 SKILLED NURSING FACILITY 623000 6338939 6338939 ASSISTED LIVING FACILITY 623000 4818832 4818832 OTHER 623000 193212 193212 BEAUTY & BARBER SHOP 623000 6077 6077 CAFETERIA REVENUES 623000 4616 4616 11361676 7499 7499 128665 109927 18738 18738 18738 11398158 11157771 0 230142 X 287609 287609 5624836 5151738 473098 51950 45560 6390 442418 408795 33623 439306 385271 54035 102405 102405 36706 36706 2650 2650 1498187 1231179 267008 124101 124101 979155 685678 293477 362299 328967 33332 348 69 279 168575 153070 15505 873539 793196 80343 195728 171653 24075 MEDICAL SUPPLIES 301398 301398 BAD DEBT EXPENSE 163093 163093 BED ASSESSMENT 102000 102000 REPAIRS AND MAINTENANCE 76591 76591 39907 29245 10662 11872801 10027503 1845298 0 112180 496155 120892 131136 959172 1002231 661 0 83844 131062 23910935 15845708 8898794 8065227 384549 306157 1575752 1344728 12135844 11476696 1058179 1112325 5354143 4846338 6412322 5958663 X 5698522 5493033 25000 25000 5723522 5518033 12135844 11476696 X -474643 178 268976 X X 0 1 X 1 0 X 1562565 794809 412501 14422 10245 2794542 8903544 8628230 8074131 9072224 11157771 45835900 154615 106129 127611 125498 203905 717758 10620724 9529168 8614243 9212144 11371921 49348200 0 20235 64274 309004 404197 471287 1268997 20235 64274 309004 404197 471287 1268997 48079203 42432 36702 28356 14199 7499 129188 42432 36702 28356 14199 7499 129188 10663156 9565870 8642599 9226343 11379420 49477388 0.97170 0.97910 0.00260 0.00370 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 25000 25000 25000 25000 25000 25000 25000 25000 25000 25000 0.00000 1.00000 0.00000 0 0 216216 216216 20904386 14022531 6881855 2790333 1823177 967156 8065227 INVESTMENT IN LAKESHORE COMMUNITY FOUNDATION 1344728 1344728 11664662 178 268976 269154 11395508 2650 2650 11398158 11870151 0 11870151 2650 2650 11872801 PART IV, LINE 2B: RESIDENTS' FUNDS HELD IN TRUST CONSIST OF AMOUNTS ON DEPOSIT WITH THE ORGANIZATION BY RESIDENTS FOR SAFEKEEPING. THESE FUNDS CAN BE WITHDRAWN AT ANY TIME BY THE RESIDENTS. PART V, LINE 4: PERMANENTLY RESTRICTED NET ASSETS AT SEPTEMBER 30, 2024 REPRESENT A DONOR-RESTRICTED ENDOWMENT FUND. THE INCOME FROM THE ENDOWMENT FUND IS EXPENDABLE TO SUPPORT INCIDENTAL EXPENSES OF RESIDENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN LAKESHORE COMMUNITY FOUNDATION 268,976. X X X 0 0 0 0 0 0 0 0 0 TODD MEERDINK CEO 150803 0 0 0 0 0 4787 0 30464 0 186054 0 0 0 A WISCONSIN HEALTH AND EDUCATION FINANCE AUTHORITY SERIES 2016 391337855 2016-12-23 6000000 0 0 0 A 1105404 6000000 64525 5935475 2016 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE ORGANIZATIONS' BOARD OF DIRECTORS EXECUTIVE COMMITTEE BEFORE IT WAS FILED. THE FINAL FORM 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS. THE EXECUTIVE COMMITTEE DESIGNATES THE DETAIL REVIEW OF THE FORM 990 TO MANAGEMENT, BUT HAS FINAL APPROVAL OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS AUTHORIZES THE OFFICERS OF THE ORGANIZATION TO PERIODICALLY, BUT NOT LESS THAN ANNUALLY, SURVEY THE BOARD MEMBERS REGARDING ANY POTENTIAL CONFLICTS, TO MAINTAIN SUCH INFORMATION AND REPORT BACK TO THE BOARD REGARDING ANY POTENTIAL CONFLICTS OF INTEREST. BOARD MEMBERS HAVE THE DUTY TO FULLY DISCLOSE TO THE BOARD, PRIOR TO DELIBERATIONS, THE NATURE AND EXTENT OF ANY INTEREST IN ANY TRANSACTION BEING CONSIDERED. AFTER THE DISCLOSURE IS MADE AND THE INTERESTED PARTY ANSWERS ALL APPROPRIATE QUESTIONS, HE SHALL DEPART FROM THE PORTION OF THE MEETING IN WHICH THE TRANSACTION IS BEING CONSIDERED AND SHALL NOT PARTICIPATE IN FURTHER DISCUSSION OF OR VOTE ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR THE OFFICERS AND OTHER KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) REVIEW AND APPROVAL BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS (THOSE WITHOUT CONFLICT); 2) USE OF DATA AS TO COMPARABLE COMPENSATION; AND 3) CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION BELIEVES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE THE PROPERTY OF THE ORGANIZATION AND DOES NOT MAKE THEM AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G MEDICAL CONSULTANTS: PROGRAM SERVICE EXPENSES 64,457. MANAGEMENT AND GENERAL EXPENSES 6,600. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 71,057. MAINTENANCE CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 59,130. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 59,130. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 700,069. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 700,069. THERAPY CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 407,523. MANAGEMENT AND GENERAL EXPENSES 260,408. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 667,931. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN LAKESHORE COMMUNITY FOUNDATION 268,976. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.