2017-02-08T13:44:42-06:00 2016-06-30 390758449 Wipfli LLP 3703 Oakwood Hills Pkwy Eau Claire WI 54701 990 2015-07-01 390970024 Park View Home Inc PARK 7156982451 220 N Lockwood Street Woodville WI 54028 Melissa Walthall Administrator 7156982451 2017-02-03 1 Holly Pokrandt CPA P00449155 7158323407 2017-02-03 2015 2021-01-29 14:40:06Z Melissa Walthall 220 N Lockwood Street Woodville WI 54028 4873709 0 X WWW.PARKVIEW-CC.COM X 1959 WI Park View Community Campus is committed in its efforts to provide an integrated Long Term Care Campus to the surrounding area and aggressively delivering the highest quality of care to our four facilities. We are receptive to the needs and concerns of our staff, residents, tenants, family members, children and the community. They are crucial cornerstones in implementing our philosophy that is based on strongly held beliefs; beliefs that are committed to excellence, compassion and improving the care of the community. 5 5 117 80 293631 -66876 4153 8767 4902701 4861832 3055 3110 0 0 4909909 4873709 0 0 0 0 2752505 2931463 0 0 0 2235802 2222937 4988307 5154400 -78398 -280691 9686625 9270735 8379489 8244290 1307136 1026445 X Provide and furnish aid and relief to the distressed and hardship cases of aged members of society and to administer to the needs of the aged. 0 0 3971897 4105513 Park View Home, Inc.'s goal is to help residents care for themselves and to assist them in returning home whenever possible. Park View Home, Inc. has 32 beds in private rooms and 18 beds in semi-private rooms and provides 24 hour continuous skilled nursing care for either short-term rehabilitation or long-term stays. 16,290 days of resident care were provided in 2016. 195961 462688 Park Place Assisted Living Facility, Woodville, WI, is licensed by the State of Wisconsin as a residential care apartment complex (RCAC). It is designed to support residents who can no longer live alone but do not require full-time skilled nursing care. Park Place is a 27-unit apartment complex. Our dedicated staff can provide security and 24-hour assistance with medications, dressing, grooming, and hygiene. We encourage an appropriate level of independence while helping with daily living activities. Occupancy in the assisted living facility averaged 94% in 2016. 258058 204881 Park View Home, Inc. is licensed to provide child day care services to as many as 50 children on any given day. 88223 88750 Park View Home, Inc. provides 4K instruction for as many as 50 children. 88223 88750 4514139 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 18 0 117 1 1 1 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 0 1 1 0 0 WI X Melissa Walthall 7156982451 220 N lockwood street woodville WI 54028 JASON NILSSEN Secretary 0.50 X X 0 0 0 Lois Davis Board member 0.50 X 0 0 0 Greg Luecke President 0.50 X X 0 0 0 Larry Knegendorf Vice president 0.50 X X 0 0 0 Greg JACOBSON Treasurer 0.50 X X 0 0 0 ROGER HUMPHREY SECRETARY (TERM EXPIRED OCT 2015) 0.50 X 0 0 0 Melissa Walthall Administrator 40.00 X 137715 0 33195 137715 0 33195 1 0 1 0 DIRECT SOURCE THERAPY INC 812 HIGHLANDER TRAIL HUDSON WI 540167977 THERAPY 271451 Wipfli LLP 3703 Oakwood Hills Pkwy Eau Claire WI 54701 Accounting/IT/AR 118508 2 8767 8767 Nursing Home 623000 4105513 4105513 Assisted Living 623000 462688 462688 Day Care 624410 204881 204881 four-year old kinderga 611110 88750 88750 4861832 3110 3110 4873709 4568201 293631 3110 158910 158910 2337879 2210925 126954 44798 42365 2433 209022 197671 11351 180854 161519 19335 1355 1355 99521 99521 118001 96472 21529 46312 46312 120879 78915 41964 31921 31921 462330 462330 9894 3107 6787 18524 5940 12584 477339 477339 55770 55770 Medical Services & supp 486161 486161 Food 144505 141583 2922 Nursing Home Assessment 102000 102000 Repairs and Maintenance 35976 35363 613 12449 12449 5154400 4514139 640261 0 90973 134277 908962 857184 369349 390566 12689 10015 11907861 4106637 8166915 7801224 137737 77469 9686625 9270735 486760 595570 7814743 7571251 77986 77469 8379489 8244290 X 1307136 1026445 1307136 1026445 9686625 9270735 -280691 0 X X 0 1 X 1 0 X 18320 14795 8782 4153 8767 54817 4417185 4397636 4431196 4565760 4568201 22379978 4435505 4412431 4439978 4569913 4576968 22434795 0 0 0 22434795 6772 6315 1137 3055 3110 20389 6772 6315 1137 3055 3110 20389 659 659 4442936 4418746 4441115 4572968 4580078 22455843 0.99910 0.99880 0.00090 0.00120 X 0 0 0 0 0 0 0 0 1 714 714 0 Part II-B, Line 1: PARK VIEW HOME, INC PAYS ANNUAL ASSOCIATION DUES TO THE WISCONSIN HEALTH CARE ASSOCIATION (WHCA). 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 ENVIRONMENT. 153726 153726 10639620 3487198 7152422 1114515 619439 495076 7801224 Deferred Compensation Plan Liability 77469 77469 4873709 0 4873709 0 4873709 5154400 0 5154400 0 5154400 X 1 0 X X 0 0 0 0 0 0 0 0 0 Melissa Walthall Administrator 137715 0 0 0 0 0 3854 0 29341 0 170910 0 0 0 SCHEDULE J, PART II, LINE 1 PARK VIEW HOME, INC. PROVIDES MELISSA WALTHALL, AS PART OF HER EMPLOYMENT AGREEMENT, A RESIDENCE FOR PERSONAL USE. THE RESIDENCE IS ON PARK VIEW HOME, INC.'S BUSINESS PREMISE AND IS FURNISHED FOR THE EMPLOYER'S CONVENIENCE. THE ESTIMATED ANNUAL VALUE OF THIS BENEFIT IS $12,000. THIS AMOUNT WAS NOT INCLUDED IN HER TAXABLE WAGES AND IS THEREFORE, NOT A TAXABLE BENEFIT. Eric Walthall Family member of Melissa Walthall, Administrator 39360 Employment Compensation 0 Form 990, Part VI, Section A, line 6 A member is any person who is a U.S. Citizen and pays one dollar annually or $50 for a life-time membership. There were 12 members during the year. Members of the Organization receive a vote for electing the board of directors. A member receives no compensation. Form 990, Part VI, Section A, line 7a The members are responsible for electing the board of directors. Form 990, Part VI, Section B, line 11 The Form 990 is reviewed by the administrator and a final draft is provided to the board of directors for their review and approval prior to submission. Form 990, Part VI, Section B, line 12c The officers, directors and trustees follow the conflict of interest policy in the bylaws and abstain from decisions where there may be a conflict of interest. The officers, directors and trustees sign an annual conflict of interest statement. The organization's conflict of interest policy is monitored and enforced through self-disclosure when necessary and also due to the small size of the organization through the knowledge each of the officers has regarding the interest of their fellow members. Form 990, Part VI, Section B, line 15a The Board of Directors review the administrator's salary on an annual basis and approve all changes in compensation. Form 990, Part VI, Section C, line 19 Park View Home, Inc. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION. Form 990, PART VI, SECTION B, LINE 15B The administrator annually proposes the wages of all other employees of the organization to the board of directors. A survey of wages in the surrounding area is used as a basis for the wages of all the other employees. FORM 990, PART XII, LINE 2C, EXPLANATION OF AUDIT OVERSIGHT PROCESS: THE BOARD OF DIRECTORS OF Park View Home, INC. REVIEWS THE AUDITED FINANCIAL STATEMENTS AT ITS BOARD MEETING AND IS RESPONSIBLE FOR THE OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE BOARD ALSO TAKES TIME DURING THE PRESENTATION OF THE ANNUAL FINANCIAL STATEMENTS TO MEET WITH THE INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.