2021-11-11T08:40:38-06:00 2020-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2020-01-01 391087412 ST JOSEPH RESIDENCE INC STJO 9209825354 107 E BECKERT RD NEW LONDON WI 54961 GIDGET BLANK CEO/EXECUTIVE DIRECTOR 9209825354 2021-11-09 1 GIDGET BLANK 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2021-11-03 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z RITA THIEL 107 E BECKERT RD NEW LONDON WI 54961 7967511 0 X WWW.STJOSEPHRESIDENCE.COM X 1965 WI A LIFE PLAN COMMUNITY COMMITTED TO PROVIDING ELDERLY HOUSING AND HEALTH CARE SERVICES INCLUDING INDEPENDENT APARTMENTS, ASSISTED LIVING, SHORT TERM REHABILITATION, LONG TERM CARE, MEMORY CARE ASSISTED LIVING, AND OUTPATIENT THERAPY. 10 10 220 15 0 0 12748 1522243 6139696 6046137 -152782 9775 68865 61702 6068527 7639857 0 0 0 0 3685340 3922125 0 0 0 2788444 2685177 6473784 6607302 -405257 1032555 16449777 16982915 9451640 8957709 6998137 8025206 X ST. JOSEPH RESIDENCE, A SKILLED NURSING HOME, AND MARIAN HEIGHTS APARTMENTS, A RESIDENTIAL APARTMENT FACILITY, AND TRINITY TERRACE, A COMMUNITY-BASED RESIDENTIAL FACILITY SPONSORED BY CATHOLIC HEALTH INTERNATIONAL, IS A CHRISTIAN COMMUNITY OF CARING PEOPLE DEDICATED TO THE HEALING MISSION OF THE CHURCH, SERVING THE ELDERLY AND SICK OF THE NEW LONDON AREA. 0 0 4498190 0 3700205 SKILLED NURSING FACILITY PROVIDED 14,410 DAYS OF CARE IN 2020, AN AVERAGE DAILY CENSUS OF 39.48. OUR GOAL IS TO HAVE AN AVERAGE DAILY CENSUS OF 45-48; HOWEVER, COVID19 SIGNIFICANTLY AFFECTED OUR ABILITY TO ADMIT RESIDENTS/PATIENTS THROUGHOUT SEVERAL MONTHS OF 2020. OUR ORGANIZATION IS COMMITTED TO SERVING THOSE IN FINANCIAL NEED IN OUR COMMUNITY. OUR SKILLED NURSING FACILITY SERVES APPROXIMATELY A 64% MEDICAID GOVERNMENT FUNDED POPULATION. WE OPENED A SHORT TERM COMPLEX MEDICAL CARE & REHAB UNIT WITH 10 BEDS DEDICATED TO SHORT TERM REHABILITATION. THE SKILLED NURSING FACILITY REMAINED A CMS FIVE STAR QUALITY CARE FACILITY IN 2020. 982983 0 1157312 COMMUNITY BASED RESIDENTIAL FACILITY ASSISTED LIVING PROVIDED 9,488 DAYS OF CARE DURING 2020 WITH 28% OF CARE THAT IS MEDICAID GOVERNMENT FUNDED. THE CBRF PARTICIPATES IN A SPECIAL NEEDS PROGRAM, ALONG WITH THE SKILLED NURSING FACILITY, THAT PERMITS CARE TRANSITIONS BETWEEN THE CBRF AND THE SKILLED NURSING FACILITY RATHER THAN REQUIRING THE RESIDENT TO NEED TO BE SENT TO THE HOSPITAL. 696267 0 857466 MONARCH MEADOWS MEMORY CARE ASSISTED LIVING GREW ITS OCCUPANCY TO AN AVERAGE OF 15 RESIDENTS PER DAY, 5,455 PATIENT DAYS WITH 38% OF THE DAYS FUNDED BY MEDICAL ASSISTANCE. THIS PROGRAM SERVES RESIDENTS WITH DEMENTIA DIAGNOSIS WHO BENEFIT FROM A SECURE ENVIRONMENT WITH AN INCREASED LEVEL OF CAREGIVERS TO MEET PSYCHOSOCIAL AND PHYSICAL NEEDS WITH ACTIVITY ENGAGING PROGRAMMING. 285268 0 331154 INDEPENDENT NON-LICENSED SENIOR APARTMENT COMPLEX 26 UNITS THE NUMBER OF DAYS OF CARE DURING 2020 WAS 8,688 DAYS. 285268 0 331154 6462708 1 1 0 0 0 0 0 1 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 19 0 220 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 WI X GIDGET BLANK 9209825354 107 E BECKERT RD NEW LONDON WI 54961 GIDGET BLANK CEO/EXECUTIVE DIRECTOR 20.00 20.00 X 113879 0 17213 RITA THIEL PRESIDENT 1.00 X X 0 0 0 ROGER STEINGRABER PAST PRESIDENT 1.00 X X 0 0 0 KATHY GWIDT VICE PRESIDENT 1.00 X X 0 0 0 STEVE DYRESON SECRETARY/TREASURER 1.00 X X 0 0 0 WILLIAM HEIGES BOARD MEMBER 1.00 X 0 0 0 JOSEPH MARQUARDT BOARD MEMBER 1.00 X 0 0 0 CAROL RADTKE BOARD MEMBER 1.00 X 0 0 0 DAVID RUSCH BOARD MEMBER 1.00 X 0 0 0 KEITH STECKBAUER BOARD MEMBER 1.00 0.25 X 0 0 0 JANICE YOUNG BOARD MEMBER 1.00 X 0 0 0 113879 0 17213 1 0 0 0 HEALTH CARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 3000 BENSALEM PA 19020 LAUNDRY/HOUSEKEEPING SERVICE 322069 REHABCARE PO BOX 503534 ST LOUIS MO 631503534 THERAPY SERVICES 186505 2 1517969 4274 1522243 NURSING HOME 623000 3700205 3700205 CBRF (TRINITY TERRACE) 623000 1157312 1157312 ASSISTED LIVING 623000 857466 857466 RESIDENTIAL CARE APT 623000 331154 331154 6046137 7987 7987 329442 326404 1250 3038 -1250 1788 1788 61702 61702 61702 7639857 6046137 0 71477 131092 27462 103630 3301241 3297078 4163 2999 2805 194 255575 253032 2543 231218 231218 1833 1833 65139 65139 4423 4423 157853 146923 10930 28052 28052 32389 16535 15854 59482 59482 3725 3725 302947 302947 7027 7027 305405 305405 547064 547064 19506 19506 LAUNDRY SUPPLIES 299944 299944 PATIENT SERVICE SUPPLIE 220057 220057 DIETARY SUPPLIES 206656 206656 THERAPY SUPPLIES 175114 175114 248561 245704 2857 6607302 6462708 144594 0 900 900 2938264 4224068 506630 326967 35794 97790 8991 44154 16116446 6943876 9487666 9172570 533320 205409 2938212 2911057 16449777 16982915 609216 507259 132072 131826 8319400 8281661 377364 13500 13588 23463 9451640 8957709 X 6710174 8001370 287963 23836 6998137 8025206 16449777 16982915 1032555 -5486 0 X 0 1 X 1 0 X 3851 1028310 3210 12748 1522243 2570362 7515682 6592424 5225143 6139696 6046137 31519082 41968 33693 37341 67265 61702 241969 7561501 7654427 5265694 6219709 7630082 34331413 0 0 0 34331413 22858 27778 21390 19986 7987 99999 22858 27778 21390 19986 7987 99999 7584359 7682205 5287084 6239695 7638069 34431412 0.99710 0.99040 0.00290 0.00330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 1 X 33972 148070 182042 14442653 5959359 8483294 1491751 984517 507234 9172570 DUE FROM RELATED PARTY 2755260 BENEFICIAL INTEREST IN COMMUNITY FOUNDATION 23798 RESIDENT TRUST FUND 23463 UNEMPLOYMENT CERTIFICATE OF DEPOSIT 108536 2911057 RESIDENT TRUST FUND 23463 23463 PART IV, LINE 2B: THE ORGANIZATIONS LEASE HOUSING UNITS TO TENANTS UNDER CONTRACTS WHICH UNDER DIFFERENT TIME PERIODS AND UNITS HAS AMOUNTED TO SECURITY DEPOSITS HELD AS AN ASSET AND OFF SETTING LIABILITY. THE CONTRACT DICTATES HOW THOSE DEPOSITS ARE REFUNDED. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2017-08-30 8442360 REFUNDING BOND 0 0 0 A 8442360 168550 8273810 2018 0 1 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION ARE LIMITED TO THOSE PERSONS THAT HAVE BEEN ADMITTED AS MEMBERS OF THE CORPORATION BY THE MEMBERS OF THE CORPORATION AND SHALL BE COMPRISED OF SEVEN MEMBERS, AT LEAST FOUR OF WHOM SHALL BE RELIGIOUS HOSPITALLERS OF ST. JOSEPH. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE CORPORATION APPOINT THE BOARD OF DIRECTORS AND THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OF THE CORPORATION HAVE THE FOLLOWING RESPONSIBILITIES APPROVE ANY CHANGE IN THE PHILOSOPHY, PURPOSE OR NATURE OF THE CORPORATION, AMEND ARTICLES OF INCORPORATION AND BYLAWS, APPOINT THE BOARD OF DIRECTORS, APPOINT OR DISMISS THE EXECUTIVE DIRECTOR IN CONCLUSION WITH OR ON RECOMMENDATION OF THE BOARD OF DIRECTORS, ACQUIRE OR DISPOSE OF REAL ESTATE OF THE CORPORATION, REVIEW THE AUDITED FINANCIAL STATEMENTS OF THE CORPORATION AND TO APPOINT THE AUDITOR, APPROVE THE ANNUAL CAPITAL AND OPERATING BUDGET OF THE CORPORATION UPON THE RECOMMENDATION OF THE BOARD, TO APPROVE OR DISAPPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 IN DRAFT FORMAT BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS ARE REQUIRED TO SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT. THE STATEMENT REQUIRES BOARD MEMBERS TO DISCLOSE ANY CONFLICTS OF INTEREST THAT MAY ARISE. THE PRESIDENT AND CHI MEMBER WOULD REVIEW POTENTIAL CONFLICT OF INTEREST ITEMS SUBMITTED AND DETERMINE IF THERE IS IN FACT A CONFLICT OF INTEREST THAT WOULD DISALLOW THEM FROM SERVING ON THE BOARD OR FROM PARTICIPATING IN VOTING ON FINAL DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION FOLLOWS THE LEADING AGE AGE SURVEY TO ALIGN THEIR COMPENSATION PLAN FOR ALL POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THESE RECORDS AVAILABLE TO THE PUBLIC UPON REQUEST. THE WASHINGTON CENTER INC 500 W WASHINGTON STREET NEW LONDON WI 54961 200349479 ASSISTED LIVING, ADULT DAY CARE, SENIOR CENTER WI 501(C)(3) LINE 10 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 1 0 ST JOSEPH RESIDENCE-THE WASHINGTON CENTER INC D 2755260 COST