STRATEGY STUDIO / PUBLIC DATA EXPLORER

ELMWOOD NURSING HOME INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
ELMWOOD NURSING HOME INC (EIN 39-1190907)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-02-26
IRS object ID
201800579349300205
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-02-26T10:09:37-06:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Wipfli LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13703 Oakwood Hills PkwyAddressLine1Txt
CityEau ClaireCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391190907EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Elmwood Nursing Home IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlELMWBusinessNameControlTxt
Phone7158323003PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1232 E Springer AveAddressLine1Txt
CityElmwoodCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54740ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMike ChristensenPersonNm
Person TitleCEOPersonTitleTxt
Phone7158323003PhoneNum
Signature2018-02-19SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHOLLY POKRANDT CPAPreparerPersonNm
PTINP00449155PTIN
Phone7158323407PhoneNum
Preparation2018-02-19PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address12.86.94.170IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-02-19IPDt
IP Tm13:30:02IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id2F3CDBAF1037015F68690DD19EBC2430D808C728AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HERITAGE OF ELMWOOD NURSING HOMEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerMike ChristensenPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13410 Sky Park BlvdAddressLine1Txt
CityEau ClaireCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,300,049GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://heritageofelmwood.com/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Other Organization DscWisconsin NoOtherOrganizationDsc
Formation1972FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTo respond to the spiritual, physical, and social needs of people in order to enhance human dignity and growth by providing high quality service.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee103TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$49,501PYContributionsGrantsAmt
CY Contributions Grants$2,360CYContributionsGrantsAmt
PY Program Service Revenue$2,499,351PYProgramServiceRevenueAmt
CY Program Service Revenue$2,225,061CYProgramServiceRevenueAmt
PY Investment Income$18,463PYInvestmentIncomeAmt
CY Investment Income$15,137CYInvestmentIncomeAmt
PY Other Revenue$88,773PYOtherRevenueAmt
CY Other Revenue$57,491CYOtherRevenueAmt
PY Total Revenue$2,656,088PYTotalRevenueAmt
CY Total Revenue$2,300,049CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,923,842PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,556,376CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$916,326PYOtherExpensesAmt
CY Other Expenses$880,363CYOtherExpensesAmt
PY Total Expenses$2,840,168PYTotalExpensesAmt
CY Total Expenses$2,436,739CYTotalExpensesAmt
PY Revenues Less Expenses-$184,080PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$136,690CYRevenuesLessExpensesAmt
Total Assets BOY$2,600,039TotalAssetsBOYAmt
Total Assets EOY$2,394,101TotalAssetsEOYAmt
Total Liabilities BOY$387,748TotalLiabilitiesBOYAmt
Total Liabilities EOY$318,500TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,212,291NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,075,601NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTo respond to the spiritual, physical, and social needs of people in order to enhance human dignity and growth by providing high quality service.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$2,248,533ExpenseAmt
Revenue$2,225,061RevenueAmt
DescThe 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 46-bed skilled nursing facility. The nursing home provided 9,473 resident days of care in fiscal year 2017. 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. Effective June 14, 2017, the Nursing Home decreased its bed license from 46 beds to 34 beds.Desc
Total Program Service Expenses$2,248,533TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee103EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
DAF Excess Business Holdings0DAFExcessBusinessHoldingsInd
Taxable Distributions0TaxableDistributionsInd
Distribution To Donor0DistributionToDonorInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kelly LarsonBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7158323003PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13410 Sky Park BlvdAddressLine1Txt
CityEau ClaireCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54701ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
Jamie Reitz
Secretary/Treasurer0.50Yes (X)Yes (X)$0$0$0
Dan Schuler
Vice President0.50Yes (X)Yes (X)$0$0$0
Dolores Radtke
President0.50Yes (X)Yes (X)$0$0$0
Neil Boltik
Village Board Representati0.50Yes (X)$0$0$0
Donette Stewart
Trustee0.50Yes (X)$0$0$0
Donna Lien
Trustee0.50Yes (X)$0$0$0
Susan Pelzel
Trustee0.50Yes (X)$0$0$0
Mike Christensen
CEO10.00Yes (X)$0$184,140$32,98130.00
MARTY METTENS
COO10.00Yes (X)$0$107,123$6,49830.00
Ellen Thompson
Administrator40.00Yes (X)$0$32,596$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$323,859TotReportableCompRltdOrgAmt
Total Other Compensation$39,479TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Grace Lutheran Foundation Inc
3410 Sky Park BLVDEau ClaireWI54701Management Services$140,854
GENESIS REHABILITATION SERVICES
PO BOX 821322PHILADELPHIAPA19182THERAPY SERVICES$119,391
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$2,360AllOtherContributionsAmt
Total Contributions$2,360TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNursing Care and HousiDesc
Business623000BusinessCd
Total Revenue Column$2,225,061TotalRevenueColumnAmt
Related Or Exempt Func Income$2,225,061RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,225,061TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,137TotalRevenueColumnAmt
Exclusion$15,137ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$33,997RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$33,997RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$33,997TotalRevenueColumnAmt
Related Or Exempt Func Income$33,997RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Other Revenue811000$10,236$10,236
Transportation Revenue480000$8,909$8,909
Senior Meals Program624210$4,349$4,349
FieldValueIRS element (for citing)
Other Revenue Total$23,494OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,300,049TotalRevenueColumnAmt
Related Or Exempt Func Income$2,282,552RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$15,137ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,320,112TotalAmt
Program Services$1,259,842ProgramServicesAmt
Management And General$60,270ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$145,418TotalAmt
Program Services$145,418ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$90,846TotalAmt
Program Services$90,846ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$80,868TotalAmt
Management And General$80,868ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,380TotalAmt
Management And General$1,380ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$18,466TotalAmt
Management And General$18,466ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$190,818TotalAmt
Program Services$190,818ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$4,936TotalAmt
Management And General$4,936ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$26,230TotalAmt
Program Services$7,875ProgramServicesAmt
Management And General$18,355ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,555TotalAmt
Management And General$3,555ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$86,755TotalAmt
Program Services$86,755ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,814TotalAmt
Program Services$8,814ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$77,885TotalAmt
Program Services$77,885ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$49,886TotalAmt
Program Services$49,886ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies and Other$107,336$107,236$100
Food and Dietary Expens$104,170$104,170
NH Assessment$93,840$93,840
Bad Debt Expense - Prog$12,000$12,000

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$13,424TotalAmt
Program Services$13,148ProgramServicesAmt
Management And General$276ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,436,739TotalAmt
Program Services$2,248,533ProgramServicesAmt
Management And General$188,206ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$10,868BOYAmt
EOY$2,104EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,839,555BOYAmt
EOY$1,700,194EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$191,173BOYAmt
EOY$153,943EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$12,927BOYAmt
EOY$10,183EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$18,094BOYAmt
EOY$21,992EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,770,989LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,265,304LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$527,422BOYAmt
EOY$505,685EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,600,039BOYAmt
EOY$2,394,101EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$171,695BOYAmt
EOY$149,626EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$216,053BOYAmt
EOY$168,874EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$387,748BOYAmt
EOY$318,500EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$2,212,291BOYAmt
EOY$2,075,601EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,212,291BOYAmt
EOY$2,075,601EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,600,039BOYAmt
EOY$2,394,101EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$136,690ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,573CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,051CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,641CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,437CurrentTaxYearMinus1YearAmt
Current Tax Year$2,360CurrentTaxYearAmt
Total$21,062TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,811,004CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,721,794CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,848,438CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,499,351CurrentTaxYearMinus1YearAmt
Current Tax Year$2,225,061CurrentTaxYearAmt
Total$13,105,648TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,814,577CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,726,845CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,854,079CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,503,788CurrentTaxYearMinus1YearAmt
Current Tax Year$2,227,421CurrentTaxYearAmt
Total$13,126,710TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$13,126,710PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$49,729CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$52,180CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$49,483CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,463CurrentTaxYearMinus1YearAmt
Current Tax Year$15,137CurrentTaxYearAmt
Total$184,992TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$49,729CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$52,180CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$49,483CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,463CurrentTaxYearMinus1YearAmt
Current Tax Year$15,137CurrentTaxYearAmt
Total$184,992TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,864,306CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,779,025CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,903,562CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,522,251CurrentTaxYearMinus1YearAmt
Current Tax Year$2,242,558CurrentTaxYearAmt
Total$13,311,702TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98610PublicSupportCY509Pct
Public Support PY5090.98390PublicSupportPY509Pct
Investment Income CY0.01390InvestmentIncomeCYPct
Investment Income PY0.01610InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$215OtherActivitiesAmt
Total Lobbying Expenditures$215TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationElmwood Nursing Home Inc Heritage of Elmwood Nursing Home pays annual association dues to the Leading Age. 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 envrionment.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,000OtherCostOrOtherBasisAmt
Book Value$7,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,795,310OtherCostOrOtherBasisAmt
Depreciation$1,462,984DepreciationAmt
Book Value$332,326BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$926,246OtherCostOrOtherBasisAmt
Depreciation$802,320DepreciationAmt
Book Value$123,926BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$42,433OtherCostOrOtherBasisAmt
Book Value$42,433BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$505,685TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$2,302,375TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,326NetUnrealizedGainsInvstAmt
Revenue Not Reported$2,326RevenueNotReportedAmt
Revenue Subtotal$2,300,049RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,300,049TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,436,739TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$2,436,739ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,436,739TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonMike ChristensenPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$184,140CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$184,140TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Dan SchulerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionCurrent OfficerRelationshipDescriptionTxt
Transaction$49,209TransactionAmt
TransactionPurchased propertyTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule L, Part IVFormAndLineReferenceDesc
Explanation(A) Name of person: Dan Schuler (B) Relationship between interested person and organization: current officer secretary - treasurer (C) Amount of transaction: 49,209 (D) Description of transaction: purchased property, liability, and directors and officers insurance from United Heartland through insurance agent Dan Schuler (E) Sharing of organization revenues? = NoExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 3Effective June 14, 2017, the nursing home decreased its bed license from 46 beds to 34 beds.
Form 990, Part VI, Section A, line 3EFFECTIVE 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 AUGUSTA AREA HOME. UNDER THE MANGEMENT AGREEMENT, GLF IS ALSO RESPONSIBLE FOR THE SELECTION AND REVIEW OF THE ADMINISTRATOR OF ELMWOOD NURSING HOME.
Form 990, Part VI, Section A, line 6The nursing home has members.
Form 990, Part VI, Section A, line 7aThe nursing home's members elect the governing board.
Form 990, Part VI, Section A, line 8bThe nursing home does not appoint any committees to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bA 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 12cThe 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 15The 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 througout the region.
Form 990, Part VI, Section C, line 19The nursing home makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at its business location.
Form 990 Part VII, Section A:EXPLANATION FOR HOURS WORKED BY OFFICERS: MIKE CHRISTENSEN AND Marty Metten ARE EMPLOYED BY THE MANAGEMENT SERVICES ORGANIZATION, GRACE LUTHERAN FOUNDATION, INC., AND AS SUCH A PART OF THEIR DUTIES IS TO PROVIDE MANAGEMENT AND OVERSIGHT TO ALL OF THE ENTITIES THAT GRACE LUTHERAN FOUNDATION HAS MANAGEMENT CONTRACT WITH, INCLUDING ELMWOOD NURSING HOME. PART VII OF THE FORM 990 INCLUDES AN APPROXIMATE AMOUNT OF TIME DEVOTED EACH WEEK TO THE ELMWOOD NURSING HOME, HOWEVER, THESE INDIVIDUALS OFTEN WORK WELL IN EXCESS OF THE AMOUNT OF HOURS LISTED IN ORDER TO SUPPORT AND FURTHER THE MISSION OF THE ELMWOOD NURSING HOME.