2021-04-15T16:00:26-05:00 2020-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2019-07-01 391190907 ELMWOOD NURSING HOME INC HERITAGE OF ELMWOOD ELMW 7158323003 232 E SPRINGER AVE ELMWOOD WI 54740 RAYMOND WEISS CEO 7158323003 2021-03-25 1 MICHAEL J PETERSON CPA P01833529 2187224705 2021-03-25 2019 2022-09-23 18:48:47Z RAYMOND WEISS 3410 SKY PARK BLVD EAU CLAIRE WI 54701 2360267 0 X HTTP://HERITAGEOFELMWOOD.COM/ X WISCONSIN NO 1972 WI TO RESPOND TO THE SPIRITUAL, PHYSICAL, AND SOCIAL NEEDS OF PEOPLE IN ORDER TO ENHANCE HUMAN DIGNITY AND GROWTH BY PROVIDING HIGH QUALITY SERVICE. 7 7 63 7 0 0 866 61001 2390117 2283802 14406 15464 0 0 2405389 2360267 0 0 0 0 1381125 1511425 0 0 0 882169 864682 2263294 2376107 142095 -15840 3087037 3182679 745994 857476 2341043 2325203 TO RESPOND TO THE SPIRITUAL, PHYSICAL, AND SOCIAL NEEDS OF PEOPLE IN ORDER TO ENHANCE HUMAN DIGNITY AND GROWTH BY PROVIDING HIGH QUALITY SERVICE. 0 0 2116058 0 2283802 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 8,717 RESIDENT DAYS OF CARE IN FISCAL YEAR 2020. 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. 2116058 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 63 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 1 1 0 1 0 0 0 1 1 1 1 0 1 1 1 0 WI X KELLY LARSON 7158323003 3410 SKY PARK BLVD EAU CLAIRE WI 54701 X ELLEN THOMPSON ADMINISTRATOR 40.00 X 0 0 0 RAYMOND WEISS CEO 10.00 X 0 0 0 RANDOLPH BESTUL INTERIM CEO (THRU JULY) 10.00 X 0 0 0 MARTY METTEN COO (THRU DECEMBER) 10.00 X 0 0 0 DOLORES RADTKE PRESIDENT 0.50 X X 0 0 0 DAN SCHULER VICE PRESIDENT 0.50 X X 0 0 0 JAMIE REITZ SECRETARY/TREASURER 0.50 X X 0 0 0 MARGE BINKOWSKI TRUSTEE 0.50 X 0 0 0 DONNA LIEN TRUSTEE 0.50 X 0 0 0 SUSAN PELZEL TRUSTEE 0.50 X 0 0 0 DONETTE STEWART TRUSTEE 0.50 X 0 0 0 0 0 0 0 0 0 0 GRACE LUTHERAN FOUNDATION INC 3410 SKY PARK BLVD EAU CLAIRE WI 54701 MANAGEMENT SERVICES 170067 1 59750 1251 61001 NURSING CARE AND HOUSI 623000 2237129 2237129 RENTAL INCOME 532000 34921 34921 SENIOR MEALS PROGRAM 624210 5805 5805 TRANSPORTATION REVENUE 480000 3180 3180 2767 2767 2283802 15464 15464 2360267 2283802 0 15464 1239894 1233010 6884 20372 20372 160629 159276 1353 90530 90023 507 170067 170067 1553 1553 19310 19310 134914 132506 2408 2094 2094 11321 6439 4882 2476 2476 85733 57258 28475 8560 6644 1916 2191 2088 103 85777 84978 799 45001 44322 679 FOOD AND DIETARY EXPENS 100885 100885 SUPPLIES AND OTHER 97541 88982 8559 NH ASSESSMENT 69360 69360 BAD DEBT EXPENSE 12000 12000 15899 7915 7984 2376107 2116058 260049 0 2909 1349 1594323 1645824 147293 163561 12838 0 18633 18541 3840824 2487420 1311041 1353404 3087037 3182679 164268 179313 0 138152 2309 3232 579417 536779 745994 857476 X 2341043 2325203 2341043 2325203 3087037 3182679 -15840 0 X 0 1 X 1 0 X 4437 2360 562 866 61001 69226 2499351 2225061 2256382 2390117 2283801 11654712 2503788 2227421 2256944 2390983 2344802 11723938 0 0 0 11723938 18463 15137 15978 14406 15464 79448 18463 15137 15978 14406 15464 79448 2522251 2242558 2272922 2405389 2360266 11803386 0.99330 0.99080 0.00670 0.00920 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1530 1530 0 PART II-B, LINE 1: 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. 0 1 X 7000 7000 2825690 1596745 1228945 989240 890675 98565 18894 18894 1353404 2360267 0 2360267 0 2360267 2376107 0 2376107 0 2376107 PART IV, LINE 2B: THE ORGANIZATION HOLDS RESIDENT TRUST FUNDS AS DEPOSITS. THESE TRUST FUNDS ARE NOT AVAILABLE FOR USE IN DAILY OPERATIONS OF THE NURSING HOME. 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.