2020-08-13T15:23:24-05:00 2019-09-30 450250958 EIDE BAILLY LLP PO BOX 5126 SIOUX FALLS SD 571175126 990 2018-10-01 460347728 WAKONDA HERITAGE MANOR WAKO 6052672081 PO BOX 327 5TH AND OHIO WAKONDA SD 57073 ROBIN STOCKLAND ADMINISTRATOR 6052672081 2020-08-12 1 LAURIE HANSON P00851848 6053391999 2020-08-12 96.2.77.247 2020-08-12 07:49:10 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 87C603189A7DF35062A6A77CB1DDE10F911D97AB 2018 2020-09-23 17:36:50Z ROBIN STOCKLAND PO BOX 327 5TH AND OHIO WAKONDA SD 57073 2439389 0 X AVERA.ORG/WAKONDA-HERITAGE-MANOR X 1976 SD TO PROVIDE RESIDENT NURSING HOME CARE. 9 9 67 125 0 0 100 0 2344479 2425802 6566 13587 0 0 2351145 2439389 0 0 0 0 1251304 1360851 0 0 0 1101068 1022762 2352372 2383613 -1227 55776 2367829 2431422 130609 137979 2237220 2293443 X WAKONDA HERITAGE MANOR SHALL PROVIDE DESIRABLE HEALTH SERVICES TO THE AREA WITH A CHRISTIAN ATMOSPHERE OF PATIENCE, LOVE AND CONCERN FOR THOSE IT SERVES. WAKONDA HERITAGE MANOR IS COMMITTED TO BEING A FINANCIALLY PRUDENT ORGANIZATION WHICH PARTICIPATES IN THE DEVELOPMENT AND DELIVERY OF HEALTHCARE SERVICES FOR ITS SERVICE AREA WHILE EMPHASIZING CARE THAT MAINTAINS THE DIGNITY OF EACH INDIVIDUAL. 0 0 2068532 2425802 WAKONDA HERITAGE MANOR (MANOR) OPERATES A 40-BED NURSING FACILITY, A 6 UNIT ASSISTED-LIVING FACILITY AND AN ELDERLY APARTMENT COMPLEX, LOCATED IN WAKONDA, SOUTH DAKOTA. FOR THE YEAR ENDED SEPTEMBER 30, 2019, WAKONDA HERITAGE MANOR PROVIDED 11,824 NURSING HOME AND ASSISTED LIVING RESIDENT DAYS AND 1,624 ASSISTED LIVING DAYS. 2068532 1 0 0 0 0 0 0 0 1 0 1 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 0 1 11 0 1 67 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X ROBIN STOCKLAND 6052672081 515 OHIO ST WAKONDA SD 57073 X ROBIN STOCKLAND ADMINISTRATOR 20.00 X 0 0 0 RON PETERSON PRESIDENT 0.50 X X 0 0 0 RON HUOT VICE PRESIDENT 0.50 X X 0 0 0 DONNA HENRIKSEN SECRETARY/TREASURER 0.50 X X 0 0 0 CHERYL KNUDSON DIRECTOR 0.50 X 0 0 0 MARGO DEVINE MCCUE DIRECTOR 0.50 X 0 0 0 JILL JOHNSON DIRECTOR 0.50 X 0 0 0 KEN GIRARD DIRECTOR 0.50 X 0 0 0 DARBY GANSCHOW DIRECTOR 0.50 X 0 0 0 JULIE NELSEN DIRECTOR 0.50 X 0 0 0 0 0 0 0 0 0 0 AEGIS THERAPIES INC 2601 NETWORK BLVD STE 102 FRISCO TX 75034 THERAPY SERVICES 151484 HELPING HANDS NURSING SOLUTIONS INC 4300 S LAKEPORT ST SUITE 106 SIOUX CITY IA 51106 CONTRACTED NURSING SERVICES 147656 AVERA SACRED HEART HOSPITAL 501 SUMMIT STREET YANKTON SD 57078 MANAGEMENT & OTHER SERVICES 107033 3 RESIDENT SERVICE INCOM 623000 2417096 2417096 MISC REVENUE 900099 8706 8706 2425802 13587 13587 2439389 2425802 0 13587 X 1151791 1109804 41987 12667 12205 462 105888 102028 3860 90505 87206 3299 100675 100675 19543 19543 368868 364812 4056 6628 6628 19084 19084 18894 18894 74188 74188 6215 1435 4780 96365 93471 2894 33522 33522 SUPPLIES 193681 189919 3762 PROVISION FOR BAD DEBTS 41160 41160 EQUIP, LEASE & MAINT 28686 28686 CONTINUING EDUCATION 5463 2211 3252 9790 2567 7223 2383613 2068532 315081 0 190334 202903 379931 336831 26343 28305 5142 6000 3075954 2352651 599081 723303 1059947 1026582 107051 107498 2367829 2431422 130609 137979 130609 137979 X 2218260 2274332 4729 4880 14231 14231 2237220 2293443 2367829 2431422 X 55776 447 X 1 X 0 1 0 X 100 100 1932432 2035635 2151397 2344479 2425802 10889745 1932432 2035635 2151397 2344579 2425802 10889845 0 1005618 713347 885470 1103031 1119544 4827010 1005618 713347 885470 1103031 1119544 4827010 6062835 3781 4507 3280 6566 13587 31721 3781 4507 3280 6566 13587 31721 1936213 2040142 2154677 2351145 2439389 10921566 0.55510 0.59460 0.00290 0.00210 X 1 17895 193880 199398 12377 0 18960 151 19111 17941 1019 18960 17941 17941 0.00000 0.74460 0.25540 1 0 5000 5000 2135740 1803616 332124 672366 549035 123331 262848 262848 723303 X PART IV, LINE 1B: THIS REPRESENTS RESIDENT TRUST FUNDS KEPT FOR RESIDENTS' SPENDING. THIS IS NOT AN ASSET OF THE MANOR. PART V, LINE 4: THE FUNDS ARE TO BE USED FOR IMPROVEMENTS AT WAKONDA HERITAGE MANOR. PART X, LINE 2: THE MANOR IS ORGANIZED AS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE MANOR IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE MANOR IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE MANOR HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE MANOR BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE MANOR WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. FORM 990, PART VI, SECTION A, LINE 3 AVERA SACRED HEART HEALTH SERVICES PROVIDES MANAGEMENT SERVICES TO WAKONDA HERITAGE MANOR, INC. ROBIN STOCKLAND, ADMINISTRATOR WAS PAID THROUGH AVERA SACRED HEART HEALTH SERVICES AND PRESIDED OVER THE DAY-TO-DAY OPERATIONS OF WAKONDA HERITAGE MANOR, INC. COMPENSATION PROVIDED TO ROBIN FOR SERVICES TO WAKONDA HERITAGE MANOR WAS AS FOLLOWS: ROBIN STOCKLAND: COMPENSATION $47,206 NONTAXABLE BENEFITS $10,373 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATOR REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE IRS AND PROVIDES A COPY TO THE BOARD PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS ARE COVERED BY THE CONFLICT OF INTEREST POLICY. THE FULL BOARD IS RESPONSIBLE FOR DETERMINING WHETHER A CONFLICT EXISTS AND FOR REVIEWING THE ACTUAL CONFLICTS. THE DETERMINATIONS ARE MADE ON A CASE BY CASE BASIS. THE DIRECTORS WITH CONFLICTS ABSTAIN FROM DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR IS EMPLOYED BY AVERA SACRED HEART HEALTH SERVICES. PERFORMANCE AND SALARY ARE REVIEWED ANNUALLY BY AVERA SACRED HEART HEALTH SERVICES AND THE WAKONDA HERITAGE MANOR BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED THERAPY SERVICES: PROGRAM SERVICE EXPENSES 180,773. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,773. NURSING AND PHYSICIAN PERSONNEL: PROGRAM SERVICE EXPENSES 147,027. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 147,027. OTHER CONTRACT AND CONSULTING FEES: PROGRAM SERVICE EXPENSES 37,012. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,012. PROFESSIONAL AND OTHER EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,056. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,056. FORM 990, PART XI, LINE 9: CHANGE IN NET INTEREST OF THE FOUNDATION 447.