SKAALEN NURSING AND REHABILITATION CENTER INC: Form 990, tax year 2021
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- Organization
- SKAALEN NURSING AND REHABILITATION CENTER INC (EIN 39-1104331)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-08
- IRS object ID
- 202213129349302876
- Schema version
- 2021v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-08T14:03:10-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 261588174 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JT AND ASSOCIATES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 PILGRIM PARKWAY SUITE 200 | AddressLine1Txt |
| City | ELM GROVE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53122 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391104331 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SKAALEN NURSING AND REHABILITATION | BusinessNameLine1Txt |
| Business Name Line2 | CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SKAA | BusinessNameControlTxt |
| Phone | 6088735651 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH MORRIS STREET | AddressLine1Txt |
| City | STOUGHTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53589 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KRIS KRENTZ | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 6088735651 | PhoneNum |
| Signature | 2022-11-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KRIS | PersonFirstNm |
| Person Last | KRENTZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK JANKE | PreparerPersonNm |
| PTIN | P00737129 | PTIN |
| Phone | 2627899945 | PhoneNum |
| Preparation | 2022-11-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KRIS KRENTZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 N MORRIS ST | AddressLine1Txt |
| City | STOUGHTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53589 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,881,900 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SKAALEN.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1900 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE NURSING, PATIENT CARE AND REHABILITATION SERVICES TO ALL INDIVIDUALS REGARDLESS OF SOURCE OF PAYMENT, AND ABILITY TO PAY FROM THEIR OWN FUNDS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 313 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,480,509 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,115,622 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,891,223 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,864,317 | CYProgramServiceRevenueAmt |
| PY Investment Income | $432,089 | PYInvestmentIncomeAmt |
| CY Investment Income | $974,879 | CYInvestmentIncomeAmt |
| CY Other Revenue | -$72,918 | CYOtherRevenueAmt |
| PY Total Revenue | $12,803,821 | PYTotalRevenueAmt |
| CY Total Revenue | $12,881,900 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,039,594 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,724,659 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,900,166 | PYOtherExpensesAmt |
| CY Other Expenses | $5,119,098 | CYOtherExpensesAmt |
| PY Total Expenses | $12,939,760 | PYTotalExpensesAmt |
| CY Total Expenses | $12,843,757 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$135,939 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $38,143 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,137,849 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,293,843 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,092,773 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,210,624 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,045,076 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,083,219 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE NURSING, PATIENT CARE AND REHABILITATION SERVICES TO ALL INDIVIDUALS REGARDLESS OF SOURCE OF PAYMENT, AND ABILITY TO PAY FROM THEIR OWN FUNDS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $6,243,138 | ExpenseAmt |
| Grant | $1,900,547 | GrantAmt |
| Revenue | $5,967,146 | RevenueAmt |
| Desc | SKILLED NURSING FACILITY (SNF)- SKAALEN OWNS AND OPERATES A 91 BED NURSING HOME LOCATED IN STOUGHTON, WISCONSIN. THE SNF OFFERS SPECIALIZED RESTORATIVE REHABILITATION FOR SHORT TERM STAYS, NURSING CARE FOR LONG-TERM STAYS, AND END STAGE HOSPICE CARE. A SUBSTANTIAL PORTION OF ITS CARE IS PROVIDED TO RESIDENTS ON MEDICAID WHICH DOES NOT PROVIDE ADEQUATE REIMBURSEMENT TO COVER THE COSTS OF CARE AND HOUSING. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $968,000 | ExpenseAmt |
| Revenue | $1,247,166 | RevenueAmt |
| Desc | ANCILLARY SERVICES RELATING TO SNF - ANCILLARY SERVICES ARE PROVIDED TO THE RESIDENTS OF THE SNF SUCH AS PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. OTHER ANCILLARY SERVICES INCLUDE THE DRUGS AND MEDICAL SUPPLIES AS WELL AS ACTIVITY AND REHABILITATION PROGRAMS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,845,826 | ExpenseAmt |
| Revenue | $2,628,579 | RevenueAmt |
| Desc | COMMUNITY BASED RESIDENTIAL FACILITY (CBRF) AND RESIDENTIAL APARTMENTS. SKAALEN OWNS AND OPERATES A 50 BED CBRF, 18 BED MEMORY CARE CBRF, AND 8 APARTMENT UNITS FOR THE ELDERLY. THE CBRF FACILITIES ARE DESIGNED TO PROVIDE CARE TO THE ELDERLY IN A HOME-LIKE SETTING. RESIDENTS RECEIVE MEALS, MEDICAL MANAGEMENT, HOUSEKEEPING, AND OTHER DAILY LIVING SERVICES BASED ON THEIR NEEDS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,056,964 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 313 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SKAALEN NURSING AND REHABILITATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6088735651 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH MORRIS STREET | AddressLine1Txt |
| City | STOUGHTON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53589 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| KRIS KRENTZ | |||||||
| PRESIDENT/CE | 40.00 | Yes (X) | $200,065 | $0 | $33,934 | ||
| CYNTHIA BUTZLAFF | |||||||
| NURSE MANAGE | 40.00 | $155,399 | $0 | $5,330 | Yes (X) | ||
| MARSHA BORLING | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DIANE MATSON | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CINDY MCGLYNN | |||||||
| CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DR DAVE NELSON | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CATHY RIGDON | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| MATT ROETHE | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| MARK SCHUBRING | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| REV JERRY TEWS | |||||||
| VICE CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| MEG VEEK | |||||||
| SECRETARY/TR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $355,464 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $39,264 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $1,900,547 | GovernmentGrantsAmt |
| All Other Contributions | $215,075 | AllOtherContributionsAmt |
| Total Contributions | $2,115,622 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICES | Desc |
| Total Revenue Column | $9,864,317 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,864,317 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,864,317 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $974,879 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $974,879 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LOSS ON DEBT REFINANCING | Desc |
| Total Revenue Column | -$72,918 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$72,918 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$72,918 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,881,900 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,766,278 | RelatedOrExemptFuncIncomeAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,787,213 | TotalAmt |
| Program Services | $4,372,533 | ProgramServicesAmt |
| Management And General | $1,414,680 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,540 | TotalAmt |
| Program Services | $172,441 | ProgramServicesAmt |
| Management And General | $61,099 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,184,787 | TotalAmt |
| Program Services | $874,820 | ProgramServicesAmt |
| Management And General | $309,967 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $519,119 | TotalAmt |
| Program Services | $383,306 | ProgramServicesAmt |
| Management And General | $135,813 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,079 | TotalAmt |
| Management And General | $87,079 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,550 | TotalAmt |
| Management And General | $26,550 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,125 | TotalAmt |
| Management And General | $64,125 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,808 | TotalAmt |
| Program Services | $240,808 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,924 | TotalAmt |
| Program Services | $167,924 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,881 | TotalAmt |
| Management And General | $4,881 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $508,833 | TotalAmt |
| Program Services | $508,833 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $754,542 | TotalAmt |
| Program Services | $754,542 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,459 | TotalAmt |
| Management And General | $79,459 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| ANCILLARY EXPENSES | $834,691 | $834,691 | |
| ADMINISTRATIVE | $673,644 | $70,504 | $603,140 |
| NURSING | $467,934 | $467,934 | |
| DIETARY | $423,072 | $423,072 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $785,556 | TotalAmt |
| Program Services | $785,556 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,843,757 | TotalAmt |
| Program Services | $10,056,964 | ProgramServicesAmt |
| Management And General | $2,786,793 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,371,407 | BOYAmt |
| EOY | $229,169 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,085,696 | BOYAmt |
| EOY | $5,899,954 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,089,614 | BOYAmt |
| EOY | $862,509 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,451 | BOYAmt |
| EOY | $190,951 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,260,802 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,500,835 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,369,137 | BOYAmt |
| EOY | $8,759,967 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,084,544 | BOYAmt |
| EOY | $2,351,293 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,137,849 | BOYAmt |
| EOY | $18,293,843 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $926,573 | BOYAmt |
| EOY | $1,037,721 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $642,458 | BOYAmt |
| EOY | $640,032 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,332,907 | BOYAmt |
| EOY | $2,468,391 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,514,200 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,676,635 | BOYAmt |
| EOY | $10,064,480 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,092,773 | BOYAmt |
| EOY | $14,210,624 | 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 | $2,673,815 | BOYAmt |
| EOY | $2,887,475 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,371,261 | BOYAmt |
| EOY | $1,195,744 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,045,076 | BOYAmt |
| EOY | $4,083,219 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,137,849 | BOYAmt |
| EOY | $18,293,843 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $38,143 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Church | Yes (X) | ChurchInd |
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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,224,940 | BeginningYearBalanceAmt |
| Contributions | $27,363 | ContributionsAmt |
| Investment Earnings Or Losses | $904,618 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $280,061 | OtherExpendituresAmt |
| End Year Balance | $4,876,860 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,882,815 | BeginningYearBalanceAmt |
| Contributions | $34,092 | ContributionsAmt |
| Investment Earnings Or Losses | $396,025 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $87,992 | OtherExpendituresAmt |
| End Year Balance | $4,224,940 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,173,577 | BeginningYearBalanceAmt |
| Contributions | $149,768 | ContributionsAmt |
| Investment Earnings Or Losses | $653,279 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $93,809 | OtherExpendituresAmt |
| End Year Balance | $3,882,815 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,362,241 | BeginningYearBalanceAmt |
| Contributions | $38,506 | ContributionsAmt |
| Investment Earnings Or Losses | -$218,698 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $8,472 | OtherExpendituresAmt |
| End Year Balance | $3,173,577 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,894,536 | BeginningYearBalanceAmt |
| Contributions | $41,321 | ContributionsAmt |
| Investment Earnings Or Losses | $387,283 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $39,101 | OtherExpendituresAmt |
| End Year Balance | $3,362,241 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.76000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.01000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.23000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,014,379 | OtherCostOrOtherBasisAmt |
| Book Value | $1,014,379 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,899,011 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,510,883 | DepreciationAmt |
| Book Value | $7,388,128 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,347,412 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,989,952 | DepreciationAmt |
| Book Value | $357,460 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,759,967 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| AMOUNTS DUE FROM AFFILIATES | $1,411,103 |
| RESTRICTED CASH | $905,334 |
| OTHER RECEIVABLES | $34,856 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,351,293 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO VENNOVOLL | $6,882,105 |
| DUE TO SKAALENDAL | $3,077,042 |
| DUE TO SKAALEN VILLAGE | $200,000 |
| DEFERRED FINANCE FEES | -$94,667 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,064,480 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 2, PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | INCOME FROM THE PERMANENTLY RESTRICTED ENDOWMENT FUND IS NOT RESTRICTED. ENDOWMENT FUNDS RELATED TO QUASI RESTRICTED FUNDS ARE GENERALLY TO BE USED FOR BENEVOLENT CARE. THE VAST MAJORITY OF ENDOWMENT FUNDS THAT ARE TEMPORARILY RESTRICTED ARE ALSO TO BE USED FOR BENEVOLENT CARE. THE REMAINDER OF THE TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE TO BE USED FOR PROGRAMS RELATING TO PROFESSIONAL DEVELOPMENT, RECOGNITION, RECRUITMENT, AND RETENTION OF NURSING STAFF. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| KRIS KRENTZ | ||||
| PRESIDENT/CEO | $200,065 | $6,900 | $27,034 | $233,999 |
| CYNTHIA BUTZLAFF | ||||
| NURSE MANAGER | $155,399 | $5,330 | $160,729 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | MEMBERS OF THE CORPORATION ARE 29 LUTHERAN CHURCHES AND 1 METHODIST CHURCH IN AND AROUND THE STOUGHTON AREA. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE CORPORATE CHURCHES SEND ONE DELEGATE, WHOSE VOTE IS WEIGHTED DEPENDENT UPON CONGREGATION CENSUS, TO THE ANNUAL MEETING HELD IN MARCH EACH YEAR. THE DELEGATES ELECT THE NINE PERSON BOARD OF DIRECTORS AT THE ANNUAL MEETING. EACH DIRECTOR IS LIMITED TO TWO THREE YEAR TERMS. TERMS ARE STAGGERED SO ONE-THIRD OF THE BOARD IS ELECTED OR RE-ELECTED EACH YEAR. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED BY THE CEO AND FULL BOARD BEFORE IT IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. IF A CONFLICT IS DISCLOSED, THEY ARE PROHIBITED FROM DISCUSSION AND VOTING ON THE MATTER BY BOARD BYLAWS AND THE CEO'S EMPLOYMENT CONTRACT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE COMMITTEE, WITH INPUT FROM THE FULL BOARD AND STAFF, CONDUCTS A PERFORMANCE REVIEW OF THE CEO IN JANUARY OF EACH YEAR AT A REGULAR BOARD MEETING. SALARY AND BENEFIT INFORMATION FROM LEADING AGE NATIONAL AND LEADING AGE WISCONSIN ANNUAL SURVEYS ARE USED TO DETERMINE AN APPROPRIATE SALARY AND BENEFIT RANGE FOR THE CEO. THE BOARD APPROVES ANY CHANGES TO THE CEO SALARY AND BENEFIT PACKAGE. A WRITTEN LETTER OF SUCH CHANGES IS PROVIDED BY THE BOARD CHAIR TO THE CEO AND HUMAN RESOURCE DIRECTOR. IN ADDITION,THE YEARLY WRITTEN GOALS AND OBJECTIVES SET FOR THE CEO ARE REVIEWED AND A NEW SET OF GOALS AND OBJECTIVES FOR THE CURRENT YEAR ARE DISCUSSSED AND APPROVED. |
| FORM 990, PAGE 6, PART VI, LINE 15B | CURRENT SALARY AND BENEFITS OF ALL DEPARTMENT HEADS AND MANAGERS IS PROVIDED TO THE BOARD FOR THEIR REVIEW AND APPROVAL DURING THE BUDGET PROCESS IN FALL OF EACH YEAR. |
| FORM 990, PAGE 6, PART VI, LINE 19 | ANNUAL REPORT, GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |