2020-05-05T11:26:57-05:00 2019-06-30 411539592 CONWAY DEUTH & SCHMIESING PLLP 331 3RD ST SW WILLMAR MN 562013322 990 2018-07-01 202581924 RENVILLE HEALTH SERVICES RENV 3205894902 205 SE ELM AVE RENVILLE MN 56284 WILLIAM MONCRIEF CFO 3205894902 2020-04-24 true KELLY M DEMUTH P00947751 3202353311 2020-04-24 66.77.118.76 2020-05-05 11:26:57 CD P 90ACA0B3E6261688B3EAA4489A5CB5D7A661B12F 19F3CFFFF21FA08CC79383AABC15801047A657C5 2018 2020-09-23 17:36:50Z CAROL RAW 801 NVADA AVENUE MORRIS MN 56267 6999749 false X WWW.SFHS.ORG X 2005 MN WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. 13 13 168 35 43774 5443 13329 5266755 6772299 99 481 150395 213640 5422692 6999749 9880 8926 0 2877959 4048736 0 756 2236685 2664539 5124524 6722201 298168 277548 9021844 8686183 7615542 7002333 1406302 1683850 X WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. false false 5855814 8926 6772299 RENVILLE HEALTH SERVICES CONSISTS OF A 55 BED SKILLED NURSING FACILITY AND 2 INDEPENDENT/ASSISTED LIVING CENTERS WITH 72 UNITS IN RURUAL MINNESOTA. THE FACILITY PROVIDES MEDICAL, SOCIAL, AND SPIRITUAL CARE TO ITS RESIDENTS WITHOUT REGARD TO RACE, COLOR, CREED, OR NATIONAL ORIGIN, IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT STATUS. DURING THE CURRENT REPORTING YEAR, THE ORGANIZATION HAD 39,302 PATIENT DAYS AND PROVIDED SERVICES TO MORE THAN 90 PATIENTS IN THE NURSING HOME AND PROVIDED HOUSING FOR MORE THAN 80 TENANTS AT THE INDEPENDENT/ASSISTED LIVING CENTER. ALSO DURING THIS TIME PERIOD, THE ORGANIZATION EMPLOYED ABOUT 78 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 3.0 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE LIMITED. MANAGEMENT SERVICES PROVIDED TO RELATED ORGANIZATIONS IN SUPPORT OF EACH ORGANIZATION'S EXEMPT PURPOSE. 5855814 true false false false false false false false true false true false false false true false false true false false false false false false false false false false true true true false false false false false false false false true false false false false false false true false false false true 11 0 true 168 true true true false false false false false false false X 13 13 false true false false true false false true true false false false true true true true true true true false MN X WILLIAM MONCRIEF 3205894902 801 NEVADA AVENUE SUITE 100 MORRIS MN 56267 TAMELA SPERR DIRECTOR 1.00 14.00 X 0 0 0 DANIEL DRIPPS DIRECTOR 1.00 14.00 X 0 0 0 VIVIAN HELTEMES DIRECTOR 1.00 14.00 X 0 0 0 REV TODD SCHNEIDER DIRECTOR 1.00 14.00 X 0 0 0 ELIZABETH MEICHSNER DIRECTOR 1.00 14.00 X 0 0 0 CARLA RILEY VICE CHAIR 1.00 14.00 X X 0 0 0 KEITH DAVIDSON DIRECTOR 1.00 14.00 X 0 0 0 PATRICK NELSON DIRECTOR 1.00 14.00 X 0 0 0 PAUL LETENDRE DIRECTOR 1.00 14.00 X 0 0 0 LORI WIESE SECR. / TRES 1.00 14.00 X X 0 0 0 KENNETH WESTBROCK DIRECTOR 1.00 14.00 X 0 0 0 MONSERRAT VAZQUEZ DIRECTOR 1.00 14.00 X 0 0 0 ALYSSA THOOFT CHAIR 1.00 14.00 X X 0 0 0 CAROL RAW PRES/CEO 1.00 39.00 X 0 226171 25765 SCOT ALLEN VP SENIOR SE 1.00 39.00 X 0 135115 21212 WILLIAM MONCRIEF CFO 1.00 39.00 X 0 118382 16368 GEOFFREY RYAN SEN SVC REG 1.00 39.00 X 0 145134 17706 PRISCILLA SCHILLING DIRECTOR OF 1.00 39.00 X 0 122234 16561 CAMILLA PETERSON-DEVRIES VP CORP COMP 1.00 39.00 X 0 119746 16437 CHAD MEYER VP BEH DEV S 1.00 39.00 X 0 115340 19314 SHANE ROCHE ADMIN - GAHR 0.00 40.00 X 0 115141 26224 1097263 159587 false true false ST FRANCIS HEALTH SERVICES OF MORRI 801 NEVADA AVE MORRIS MN 56267 MGMT FEES & OTH 958809 AEGIS THERAPIES INC PO BOX 8103 FORT SMITH AR 72902 THERAPY 313592 2 13329 13329 RESIDENT SERVICE REVENUE 6728525 6728525 MANAGEMENT AGENT 561000 43774 43774 6772299 481 481 1751 1751 1751 RENTAL 108905 108905 MEALS 102392 102392 OTHER 592 592 211889 6999749 6940414 43774 2232 8926 8926 3060937 2683405 377532 94995 83278 11717 512336 449145 63191 380468 333542 46926 198000 198000 8581 8581 8089 8089 12169 12015 154 22579 22579 242415 242415 10537 10537 8211 4771 3440 211221 211221 464648 464648 46071 35563 10508 SUPPLIES 419761 419761 MEDICAL PROFESSIONAL FEES 370088 370088 MEDICAL SURCHARGE 146441 146441 REPAIRS AND MAINTENANCE 142894 142894 352834 259716 92516 602 6722201 5855814 865631 756 283427 459901 1046128 954608 41910 29488 11491028 4327861 7565136 7163167 85243 79019 9021844 8686183 379471 412592 4860428 4430725 27506 33761 2140603 2055255 207534 70000 7615542 7002333 X 1406302 1683850 1406302 1683850 9021844 8686183 277548 X false true X true false X 14121 2678 26467 5443 13329 62038 5223014 5263940 5614580 5372173 6940414 28414121 5237135 5266618 5641047 5377616 6953743 28476159 1090538 1461995 1023603 1223073 899096 5698305 1090538 1461995 1023603 1223073 899096 5698305 22777854 74 21 1154 99 481 1829 74 21 1154 99 481 1829 614 2281 2895 5237209 5267253 5642201 5379996 6954224 28480883 0.79980 0.78980 0.00000 0.00000 X true 27506 40479 34224 33761 true X 223539 223539 10465236 3721849 6743387 679080 491745 187335 123173 114267 8906 7163167 DUE TO RELATED PARTY 70000 70000 SCHEDULE D, PAGE 2, PART IV, LINE 1B THE ORGANIZATION ACTED AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS. SCHEDULE D, PAGE 2, PART IV, LINE 2B THE ORGANIZATION ACTED AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS. true SCHOLARSHIP 7 8926 FMV X X false false false false false false false false false CAROL RAW PRES/CEO 226171 25765 251936 SCOT ALLEN VP SENIOR SERVICES 135115 21212 156327 GEOFFREY RYAN SEN SVC REG DIRECTOR 145134 17706 162840 A MINNWEST BANK REV NOTE 2009B 416005015 2009-12-10 5165000 REFINANCING TAXABLE false false false B MINNWEST BANK REV NOTE 2009B 416005015 2009-12-10 2445000 REFINANCING TAXABLE false false false A 291026 false false true true B 138677 false false true true A false false false false false false true B false false false false false false true A true true false false false true B true true false false false true A true B true SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION MINNWEST BANK INDEBTEDNESS INCURRED TO FINANCE (A) ACQUISITION OF RHS; (B) CAPITAL IMPROVEMENTS TO RHS, AND (C) CONSTRUCTION OF A 24-BED ATRIUM ADDITION TO RHS AND RELATED REMODELING AND SITE IMPROVEMENTS. MINNWEST BANK INDEBTEDNESS INCURRED TO FINANCE (A) ACQUISITION OF RHS; (B) CAPITAL IMPROVEMENTS TO RHS, AND (C) CONSTRUCTION OF A 24-BED ATRIUM ADDITION TO RHS AND RELATED REMODELING AND SITE IMPROVEMENTS. ELIZABETH LETICH DAUGHTER OF CAROL RAW, CEO 86489 EMPL - ADMIN FHS false ANDY RAW SON OF CAROL RAW, CEO 42684 EMPL - MAINT BVHS false KAITLYN PENISKA RELATIVE OF LAURIE PENISKA DON 27997 EMPL -NUR ASSIT BVHS false TARREN MCALISTER SON OF KERRI HICKS 31692 EMPL - NURSE ASST false KERRI HICKS NEICE OF CAROL RAW, CEO 54645 EMPL - DIR. OF HR false RILEIGH PORT DAUGHTER OF LANA PORT, DON 24863 EMPL - NURSE ASST false BAILEY HAGEN DAUGHTER OF CHRISTINE HAGEN, DON 2551 EMPL - HSK AID false CHERI BROUSE SISTER OF LANA PORT, DON 51364 EMPL - HR false SCHEDULE L, PART V DURING THE YEAR, THE ORGANIZATION EMPLOYS INDIVIDUALS WHO MAY BE RELATED TO AN OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE. PAYMENTS FOR SERVICES ARE MADE ACCORDING TO EMPLOYMENT POLICY AND DONE AT ARMS LENGTH. DUE TO THE RURAL LOCATION OF THE ORGANIZATION AND THE NEED TO FIND QUALIFIED STAFF, THESE EMPLOYEMENT RELATIONSHIPS ARE NECESSARY TO FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. FORM 990 - ORGANIZATION'S MISSION WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. FORM 990, PAGE 2, PART III, LINE 4A RENVILLE HEALTH SERVICES CONSISTS OF A 55 BED SKILLED NURSING FACILITY AND 2 INDEPENDENT/ASSISTED LIVING CENTERS WITH 72 UNITS IN RURUAL MINNESOTA. THE FACILITY PROVIDES MEDICAL, SOCIAL, AND SPIRITUAL CARE TO ITS RESIDENTS WITHOUT REGARD TO RACE, COLOR, CREED, OR NATIONAL ORIGIN, IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT STATUS. DURING THE CURRENT REPORTING YEAR, THE ORGANIZATION HAD 39,302 PATIENT DAYS AND PROVIDED SERVICES TO MORE THAN 90 PATIENTS IN THE NURSING HOME AND PROVIDED HOUSING FOR MORE THAN 80 TENANTS AT THE INDEPENDENT/ASSISTED LIVING CENTER. ALSO DURING THIS TIME PERIOD, THE ORGANIZATION EMPLOYED ABOUT 78 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 3.0 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE LIMITED. FORM 990, PAGE 2, PART III, LINE 4D MANAGEMENT SERVICES PROVIDED TO RELATED ORGANIZATIONS IN SUPPORT OF EACH ORGANIZATION'S EXEMPT PURPOSE. FORM 990, PAGE 6, PART VI, LINE 3 ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION WITH COMMON CONTROL) MANAGES THE FACILITY. FORM 990, PAGE 6, PART VI, LINE 6 THE ORGANIZATION IS ORGANIZED WITH MEMBERS. THE MEMBERS OF THE CORPORATION SHALL CONSIST OF THE BOARD OF DIRECTORS OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC. FORM 990, PAGE 6, PART VI, LINE 11B THE CFO OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC REVIEWS THE TAX RETURN AS PART OF THE MANAGEMENT SERVICES. FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY THE ORGANIZATION CONDUCTS IN-SERVICE TRAINING REVIEWING THE POLICY ON CONFLICTS OF INTEREST AND REQUIRES THE BOARD MEMBERS, MANAGEMENT STAFF, AND KEY EMPLOYEES TO DISCLOSE CONFLICTS. FORM 990, PAGE 6, PART VI, LINE 15A THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR THE CEO - ANNUALLY THE HR DIRECTOR SUBMITS THE CEO'S JOB DESCRIPTION, PERFORMANCE EVALUATION FORM, ST. FRANCIS HEALTH SERVICES OF MORRIS, INC'S PAY GRADE SCHEDULE AND COMPARABLE WAGE SURVEY(S) TO THE CHAIRMAN OF THE BOARD. THE CHAIRMAN AND THE EVALUATION COMMITTEE OF THE BOARD REVIEWS THE PERFORMANCE AND DETERMINES THE SALARY OF THE CEO. FORM 990, PAGE 6, PART VI, LINE 15B THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR OFFICERS - CEO AND THE HR DIRECTOR REVIEWS COMPARABLE WAGE SURVEY INFORMATION, REVIEWS PERFORMANCE (WITH INPUT FROM THE VP, IF APPROPRIATE) AND DETERMINES SALARY. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON AN AS REQUESTED BASIS AITKIN HEALTH SERVICES 301 MINNESOTA AVENUE AITKIN MN 56431 203367397 CAREGIVER MN 501C3 10 SFHS false BROWNS VALLEY HEALTH CENTER RR 1 BOX 182D SOUTH JEFFERSON BROWNS VALLEY MN 56219 411668347 CAREGIVER MN 501C3 10 SFHS false CHISHOLM HEALTH CENTER 321 NE 8TH STREET CHISHOLM MN 55719 411879639 CAREGIVER MN 501C3 10 SFHS false DULUTH HEALTH SERVICES 3111 CHRUCH PLACE DULUTH MN 55811 411843283 CAREGIVER MN 501C3 10 SFHS false FARMINGTON HEALTH SERVICES 3410 23RD STREET W FARMINGTON MN 55024 200100365 CAREGIVER MN 501C3 10 SFHS false FRANCISCAN HEALTH CENTER 3910 MINNESOTA AVENUE DULUTH MN 55802 411799268 CAREGIVER MN 501C3 10 SFHS false GUARDIAN ANGELS HEALTH & REHAB CENT 1500 3RD AVENUE E HIBBING MN 55746 411810369 CAREGIVER MN 501C3 10 SFHS false KOOCHICHING HEALTH SERVICES 901 MAIN STREET LITTLEFORK MN 56653 810910949 CAREGIVER MN 501C3 10 SFHS false LITTLE FALLS HEALTH SERVICES 1200 NE 1ST AVE LITTLE FALLS MN 56345 463626109 CAREGIVER MN 501C3 10 SFHS false MORRIS HEALTH SERVICES 1001 SCOTT AVENUE MORRIS MN 56267 237625632 CAREGIVER MN 501C3 10 SFHS false PENNINGTON HEALTH SERVICES 2001 EASTWOOD DR THIEF RIVER FALLS MN 56701 205617275 CAREGIVER MN 501C3 10 SFHS false PRAIRIE COMMUNITY SERVICES 801 NEVADA AVENUE MORRIS MN 56267 411598442 CAREGIVER MN 501C3 10 SFHS false ST FRANCIS HEALTH SERVICES (SFHS) 801 NEVADA AVENUE MORRIS MN 56267 411484416 MGMT COMP MN 501C3 12B N/A false ZUMBROTA HEALTH SERVICES 433 MILL STREET ZUMBROTA MN 55992 510487275 CAREGIVER MN 501C3 10 SFHS false false false false false false false false false false false false false true false false false false false false ST FRANCIS HEALTH SERVICES OF MORR M 198000 AMOUNT PAID OR ACCRUED SCHEDULE R ST. FRANCIS HEALTH SERVICES OF MORRIS, INC HAS GUARANTEED LOANS OF 4,430,725 AS SHOWN IN FORM 990, PART X, LINE 20 AND THERE WAS ONE NEW LOAN GUARANTEE DURING THIS FISCAL YEAR. THE ORGANIZATION ALSO HAS INTERCOMPANY LOAN PAYABLE TO ST. FRANCIS HEALTH SERVICES OF MORRIS, INC. OF 2,055,255 AS SHOWN ON 990, PART X, LINE 24. THE ORGANIZATION HAS PAID INTEREST OF 76,596 TO ST. FRANCIS HEALTH SERVICES OF MORRIS, INC.