2020-06-04T14:02:31-05:00 2019-06-30 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2018-07-01 391506910 MASONIC CENTER FOR HEALTH AND REHAB INC MASO 2629652111 410 N MAIN STREET DOUSMAN WI 531189348 JEAN FREUCK CFO 2629652111 2020-06-04 1 KIMBERLY ANDERSON P00188889 6086628600 2020-06-04 67.137.57.251 2020-06-04 14:00:25 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7592AC715573C48FEBDB1D9F8033ACF6A371561D 2018 2020-09-23 17:36:50Z MARK STRAUTMAN 410 N MAIN STREET DOUSMAN WI 531189348 7933657 0 X WWW.THREEPILLARS.ORG X 1984 WI MASONIC CENTER FOR HEALTH AND REHAB, INC., SPONSORED BY THE MASONIC FRATERNITY, MEETS THE SOCIAL, PHYSICAL, AND SPIRITUAL NEEDS OF OLDER ADULTS BY PROVIDING HIGH QUALITY HOUSING AND SERVICES IN A SKILLED NURSING FACILILTY. 3 1 147 39 0 0 45761 4150 8407630 7899501 5637 10293 20346 19713 8479374 7933657 0 0 0 0 5875460 5995222 0 0 0 4045258 3768224 9920718 9763446 -1441344 -1829789 9281958 8624009 14465836 15637676 -5183878 -7013667 MASONIC CENTER FOR HEALTH AND REHAB, INC., SPONSORED BY THE MASONIC FRATERNITY, MEETS THE SOCIAL, PHYSICAL, AND SPIRITUAL NEEDS OF OLDER ADULTS BY PROVIDING HIGH QUALITY HOUSING AND SERVICES IN A SKILLED NURSING FACILILTY. 0 0 8278517 7840224 SKILLED NURSING AND REHABILITATION SERVICES - THE ORGANIZATION PROVIDES SKILLED NURSING AND REHABILITATION SERVICES FOR THE FRAIL AND ELDERLY, INCLUDING SOCIAL AND ACTIVITY THERAPY IN A MEDICARE AND MEDICAID CERTIFIED FACILITY. DURING THE YEAR, AN AVERAGE OF 69 RESIDENTS PER DAY FOR A TOTAL OF 25,163 DAYS OF CARE WERE PROVIDED. 65942 59277 WELLNESS SERVICES - WE OFFER SPECIALIZED PROGRAMMING AND EQUIPMENT DESIGNED FOR FITNESS AND WELLNESS FOR ACTIVE ADULTS AGED 55 AND UP. 8344459 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 1 1 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 1 0 0 0 1 0 0 147 1 0 0 0 0 0 0 0 0 0 0 X 3 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X X JEAN FREUCK 2629657203 410 N MAIN ST DOUSMAN WI 53118 X ROBERT STRADER BOARD CHAIR 1.00 1.00 X X 0 0 0 MARK STRAUTMANN PRESIDENT & CEO 18.00 22.00 X X 0 198090 38474 JEAN FREUCK SECRETARY/TREASURER & CFO 18.00 22.00 X X 0 145980 32141 DAVE RADEMACHER COO 21.00 19.00 X 0 131252 5875 JOSH VAN DEN BERG CHIEF MARKETING OFFICER 11.00 29.00 X 0 62230 13926 KATHY BERNADEN CHIEF HR OFFICER 22.00 18.00 X 0 95744 16315 0 633296 106731 0 0 1 0 LIDENGROVE INC 18650 W CORPORATE DRIVE 303 BROOKFIELD WI 53045 THERAPY 538434 CASPIAN TECHNOLOGIES PO BOX 147 PEWAUKEE WI 53072 INFORMATION TECHNOLOGY 315042 LYONS ELECTRIC 75 ENTERPRISE RD DELAFIELD WI 53018 ELECTRICAL SERVICES 289966 PAT'S HEATING & AC INC 1833 EXECUTIVE DR OCONOMOWOC WI 53066 HEATING AND COOLING 140898 CLIFTONLARSONALLEN LLP 10401 INNOVATION DRIVE MILWAUKEE WI 53226 AUDIT AND ADVISORY 106688 6 4150 4150 SKILLED NURSING SERVIC 623000 7840224 7840224 WELLNESS CENTER 623000 59277 59277 7899501 10293 10293 MEAL REVENUE 623000 18390 18390 MISCELLANEOUS REVENUE 623000 1323 1323 19713 7933657 7899501 0 30006 X 365708 365708 4408483 3998163 410320 76304 72788 3516 837857 799253 38604 306870 292731 14139 11063 11063 26163 26163 698 698 1098276 973503 124773 68633 68633 124141 75279 48862 106926 106926 246002 209002 37000 17308 7760 9548 295344 295344 706516 706516 85189 21450 63739 MEDICAL SUPPLIES 270576 270576 PHARMACY / DRUGS 250690 250690 DINING SERVICES 193023 193023 MEDICAID BED TAX 171360 171360 96316 7021 89295 9763446 8344459 1418987 0 255238 87519 10777 33500 651999 528684 8720 8720 48080 29016 15641646 8178583 7825944 7463063 458980 468698 22220 4809 9281958 8624009 629396 642025 6791451 6645635 22220 4809 7022769 8345207 14465836 15637676 X -3742534 -7013667 -5183878 -7013667 9281958 8624009 -1829789 0 X 0 1 X 1 0 X 3255 4950 2120 45761 4150 60236 8003268 8943677 8682870 8407630 7899501 41936946 27828 26232 17708 20346 19713 111827 8034351 8974859 8702698 8473737 7923364 42109009 0 2096414 2216548 2284442 2686228 2952512 12236144 2096414 2216548 2284442 2686228 2952512 12236144 29872865 534 1558 2556 5637 10293 20578 534 1558 2556 5637 10293 20578 8034885 8976417 8705254 8479374 7933657 42129587 0.70910 0.73880 0.00050 0.00030 X 0 1 X 2910 2910 11751482 5763363 5988119 3109046 2062064 1046982 778208 353156 425052 7463063 INTERCOMPANY ACCOUNT 8345207 8345207 7933657 0 7933657 0 7933657 9763446 0 9763446 0 9763446 PART IV, LINE 2B: RESIDENT FUNDS ARE REQUIRED TO BE ESTABLISHED AND ARE HELD FOR SAFEKEEPING BY THE CENTER. THESE AMOUNTS CAN BE WITHDRAWN AT ANY TIME BY THE RESIDENTS, AND ARE HELD IN ONE BANK ACCOUNT. 0 0 0 0 0 0 0 0 0 MARK STRAUTMANN PRESIDENT & CEO 0 187000 0 10400 0 690 0 8600 0 29874 0 236564 0 0 JEAN FREUCK SECRETARY/TREASURER & CFO 0 144690 0 0 0 1290 0 6792 0 25349 0 178121 0 0 PART I, LINE 3 MASONIC CENTER FOR HEALTH AND REHAB IS RELATED TO THREE PILLARS, A GROUP OF NON-PROFIT ORGANIZATIONS. WISCONSIN MASONIC HOME IS A RELATED PARTY, WHICH PAYS THE CFO AND CEO OF THREE PILLARS. MASONIC CENTER FOR HEALTH AND REHAB THEN REIMBURSES WISCONSIN MASONIC HOME FOR THEIR PORTION OF THE SALARY EXPENSE. IN ORDER TO DETERMINE COMPENSATION, A GOVERNANCE COMMITTEE OF WISCONSIN MASONIC HOME'S BOARD DETERMINES THE SALARY OF THE CEO USING A COMPENSATION SURVEY. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGLY AND TIMELY DOCUMENTED. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DBH8 2013-06-07 6780381 REFUND WHEF SERIES 2003, 2004A, 2004B, AND 2009 REVENUE BONDS 0 0 0 A 620000 6780381 468698 7555994 156218 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, SCHEDULE K, PART II, COLUMN A: TOTAL PROCEEDS OF THE ISSUANCE FOR THE REFUNDING REVENUE BONDS SERIES 2013 INCLUDED IN SCHEDULE K, PART II, COLUMN A, LINE 3 IS DIFFERENT FROM THE ISSUE PRICE INCLUDED IN SCHEDULE K, PART I, COLUMN B, LINE A DUE TO A NET ORIGINAL ISSUE PREMIUM, RELEASED FUNDS FROM RETIRED BONDS, AND AN EQUITY CONTRIBUTION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF MASONIC CENTER FOR HEALTH AND REHAB, INC. IS WISCONSIN MASONIC HOME, INC. FORM 990, PART VI, SECTION A, LINE 7A WISCONSIN MASONIC HOME, INC. ELECTS THE OUTSIDE DIRECTOR. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER HAS CERTAIN RESERVED POWERS OVER THE DECISIONS MADE BY THE BOARD OF DIRECTORS OF MASONIC CENTER FOR HEALTH AND REHAB, INC. THESE POWERS INCLUDE: 1) ELECTION OF THE BOARD OF DIRECTORS 2) ACTIONS REQUIRING APPROVAL BY A MEMBER BY LAY OR AS SET FORTH IN THESE BYLAWS, AND 3) AMENDMENTS TO THE BYLAWS AND ARTICLES OF INCORPORATION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE POSTED TO THE ORGANIZATION'S BOARD PORTAL AND HARD COPIES WILL BE MADE AVAILABLE ON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES SIGN A WRITTEN CONFLICT OF INTEREST FORM AT THE ANNUAL MEETING. IF A CONFLICT EXISTS WITH A MEETING'S AGENDA, THAT DIRECTOR OR OFFICER WILL ABSTAIN FROM DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15A AN EXECUTIVE COMMITTEE OF THE MEMBER'S BOARD DETERMINES THE SALARY OF THE CEO USING EXTERNAL SOURCES AS INDICATED ON SCHEDULE J. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF MASONIC CENTER FOR HEALTH AND REHAB, INC. ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, LINE 1 MARK STRAUTMAN, CEO, DEVOTES APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: WISCONSIN MASONIC HOME - 16 HOURS, MASONIC CENTER FOR HEALTH AND REHAB, INC - 18 HOURS, VILLAGE ON THE SQUARE - 6 HOURS. JEAN FREUCK, CFO, DEVOTES APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: WISCONSIN MASONIC HOME 16 HOURS, MASONIC CENTER FOR HEALTH AND REHAB, INC - 18 HOURS, VILLAGE ON THE SQUARE - 6 HOURS. DAVE RADEMACHER, COO, DEVOTES APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: WISCONSIN MASONIC HOME - 12 HOURS, MASONIC CENTER FOR HEALTH AND REHAB, INC - 21 HOURS, VILLAGE ON THE SQUARE - 7 HOURS. JOSH VAN DEN BERG, CHIEF MARKETING OFFICER, DEVOTES APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: WISCONSIN MASONIC HOME - 15 HOURS, MASONIC CENTER FOR HEALTH AND REHAB, INC - 11 HOURS, VILLAGE ON THE SQUARE - 14 HOURS. KATHY BERNADEN, CHIEF HR OFFICER, DEVOTES APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: WISCONSIN MASONIC HOME - 14 HOURS, MASONIC CENTER FOR HEALTH AND REHAB, INC - 22 HOURS, VILLAGE ON THE SQUARE - 5 HOURS. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 973,503. MANAGEMENT AND GENERAL EXPENSES 124,773. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,098,276. VILLAGE ON THE SQUARE INC 410 MAIN STREET DOUSMAN WI 53118 391662636 INDIVIDUAL LIVING FACILITIES WI 501(C)(3) LINE 10 WICONSIN MASONIC HOME 0 WISCONSIN MASONIC HOME INC 410 MAIN STREET DOUSMAN WI 53118 390813463 SENIOR ASSISTED LIVING WI 501(C)(3) LINE 10 N/A 0 GRAND LODGE FREE & ACCEPTED MASONS OF WISCONSIN 36275 SUNSET DRIVE DOUSMAN WI 53118 390129695 FRATERNAL ORGANIZATION WI 501(C)(8) & (C)(10) N/A 0 WISCONSIN MASONIC FOUNDATION 36275 SUNSET DRIVE DOUSMAN WI 53118 396044637 SCHOLARSHIP PROVIDER WI 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0