2017-10-30T09:36:19-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2016-01-01 391674718 LINCOLN LUTHERAN COMMUNITY CARE CORPORATION INC LINC 2626391100 1045 HILL STREET WATERTOWN WI 53098 JULIE MARKS CFO 2626391100 2017-10-26 1 KIMBERLY ANDERSON CPA P00188889 6086628600 2017-10-19 67.137.57.251 2017-10-26 09:35:58 CD P 3E979F80BB8F399C9CB7D5D916B34B85DDD844F4 A31C9CF149F1011D1AE90BD803FF4F5DDEF2DCBC 2016 2018-03-14 21:41:22Z X BECKER SHOOP CENTER MATT MAUTHE 1045 HILL STREET WATERTOWN WI 53098 7280945 0 X N/A X 1989 WI BECKER SHOOP PROVIDES SKILLED NURSING CARE FOCUSED ON CARING FOR INDIVIDUALS WITH DEMENTIA IN A FACILITY WITH 106 BEDS. 3 3 168 30 0 0 2419 0 6831021 7271857 9 9 205949 9079 7039398 7280945 0 0 0 0 2861970 2649244 0 0 0 3976234 5325923 6838204 7975167 201194 -694222 2600144 2435084 2102924 2632086 497220 -197002 THE ORGANIZATION'S EXEMPT PURPOSE IS TO PROVIDE SKILLED NURSING CARE FOCUSED ON REHABILITATION SERVICES AND CARING FOR INDIVIDUALS WITH DEMENTIA IN A SKILLED NURSING FACILITY. 0 0 5438917 7280936 BECKER SHOOP IS A 71 BED SKILLED NURSING FACILITY THAT IS MEDICARE AND MEDICAID CERTIFIED AND OFFERS ROUND-THE-CLOCK NURSING CARE FOR SHORT AND LONG TERM STAYS. 5438917 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 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 1 0 0 0 1 0 0 168 1 0 0 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X THE ORGANIZATION 2626377486 6101 16TH STREET RACINE WI 53406 X MATTHEW MAUTHE PRESIDENT 1.00 3.00 X X 0 0 0 JEFF HOFFMANN VICE PRESIDENT 1.00 3.00 X X 0 0 0 GERALD KELM FORMER SECRETARY/TREASURER 1.00 3.00 X X 0 0 0 ROBERT MEIDENBAUER SECRETARY/TREASURER AS OF 12/16/16 1.00 3.00 X X 0 0 0 JULIE MARKS CFO 1.00 3.00 X 0 0 0 0 0 0 0 0 0 0 REHABCARE PO BOX 503534 ST LOUIS MO 631503534 REHAB SERVICES 510324 NEW HORIZON FOODS PO BOX 860246 MINNEAPOLIS MN 554860246 DINING SERVICES 478713 ALLIANCE REHAB 28100 TORCH PARKWAY SUITE 600 WARRENVILLE IL 60555 REHAB SERVICES 466398 MARQUARDT MANAGEMENT SERVICES INC 1045 HILL STREET WATERTOWN WI 53098 MANAGEMENT SERVICES 301853 NURSING CENTERS 155 X EXECUTIVE DRIVE SUITE 105 BROOKFIELD WI 53005 TEMP STAFFING 122461 6 NURSING HOME REVENUE 623000 7271857 7271857 7271857 9 9 OBRA REIMB - SCREENS 623000 6600 6600 TRANSPORTATION 623000 2155 2155 GUEST MEALS/VENDING 623000 324 324 9079 7280945 7280936 0 9 2256633 2125294 131339 18811 18811 88427 88427 285373 285373 686355 686355 90168 90168 15670 15670 441075 436554 4521 3287 3287 17748 17748 91536 91536 160045 110683 49362 38666 38666 32821 32821 155766 155766 41064 41064 NURSING/ANCILIARY EXPEN 1737613 1737613 BAD DEBT 720682 720682 DIETARY 635558 635558 REPAIRS/MAINTENANCE 183461 183461 274408 209754 64654 7975167 5438917 2536250 0 255 250 1116477 1048655 14885 43741 5325331 4000127 1438152 1325204 30375 17234 2600144 2435084 1358243 1996570 714305 618282 30376 17234 2102924 2632086 X 497220 -197002 497220 -197002 2600144 2435084 -694222 0 X X 0 1 X 1 0 X 13479 7979 3411 2419 0 27288 6112599 6026824 5679593 6831021 7271857 31921894 6126078 6034803 5683004 6833440 7271857 31949182 0 376597 156281 295191 113699 941768 376597 156281 295191 113699 941768 31007414 249 769 41 2109 9 3177 249 769 41 2109 9 3177 29568 37434 74196 203849 9079 354126 6155895 6073006 5757241 7039398 7280945 32306485 0.95980 0.95370 0.00010 0.00010 X 90361 90361 1445212 1359109 86103 1952646 1182603 770043 1831207 1458415 372792 5905 5905 1325204 RESIDENT TRUST FUND 17234 17234 X 7280945 0 7280945 0 7280945 7975167 0 7975167 0 7975167 PART X, LINE 2: THE CORPORATION IS A TAX-EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATION IS ALSO EXEMPT FROM STATE INCOME TAX ON RELATED INCOME. MANAGEMENT OF THE CORPORATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT MATERIAL TO THE FINANCIAL STATEMENTS. THE CORPORATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE CORPORATION'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. FORM 990, PART VI, SECTION A, LINE 3 MARQUARDT MANAGEMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 6 THERE IS ONE CLASS OF MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS ELECTS OTHER MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS GIVEN TO EACH BOARD MEMBER TO REVIEW AND COMMENT ON BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE BOARD MUST ATTEST THAT THEY DO NOT HAVE ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST; OR THEY MUST DISCLOSE ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT. SHOULD A CONFLICT ARIES, THE PERSON AFFECTED IS ASKED TO EXCUSE THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 BOARD AND CEO REVIEW COMPARABILTIY DATA AND APPROVE COMPENSATION ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION HAS THIS INFORMATION AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS PROCESSES FROM PRIOR YEARS. ATRIUM OF RACINE INC 1045 HILL STREET WATERTOWN WI 53098 391615970 ASSISTED LIVING WI 501(C)(3) LINE 10 N/A 0 LINCOLN VILLAS NORTH INC 1045 HILL STREET WATERTOWN WI 53098 391363010 LOW INCOME HOUSING WI 501(C)(3) LINE 10 N/A 0 TRINITY TERRACE INC 1045 HILL STREET WATERTOWN WI 53098 391667734 INDEPENDENT LIVING WI 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0