2017-02-14T11:07:48-06:00 2016-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 W RESEARCH DRIVE STE 200 MILWAUKEE WI 53226 990 2015-07-01 391126946 MARQUARDT MEMORIAL MANOR INC MARQ 9202610400 1045 HILL STREET WATERTOWN WI 530983099 JULIE MARKS CFO 9202610400 2017-02-13 1 KIMBERLY ANDERSON CPA P00188889 4144761880 2017-02-13 2015 2021-01-29 14:40:06Z X MATTHEW MAUTHE 1045 HILL STREET WATERTOWN WI 530983099 12439432 0 X WWW.MARQUARDTVILLAGE.ORG X 1966 WI THE ORGANIZATION'S EXEMPT PURPOSE IS TO PROVIDE EXTENDED NURSING, CONVALESCENT, AND REHABILITATIVE CARE TO THE ELDERLY. 9 9 331 140 0 0 2823 0 11912152 12437583 308963 1849 0 0 12223938 12439432 3000 0 0 0 6029962 6584996 0 0 0 4699044 4586005 10732006 11171001 1491932 1268431 10782220 12065397 849304 864050 9932916 11201347 GROUNDED IN FAITH, WE PROMOTE THE HEALTH AND WELL-BEING OF EACH INDIVIDUAL WE SERVE 0 0 9827973 12437583 MARQUARDT MEMORIAL MANOR, INC IS A 140 BED SKILLED NURSING FACILITY. 9827973 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 331 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JULIE MARKS 9202610400 1045 HILL STREET WATERTOWN WI 530983099 MITZI CASS BOARD MEMBER 0.50 3.00 X 0 0 0 JEFF HACKEL BOARD MEMBER 0.50 3.00 X 0 0 0 JAMES HICKS BOARD MEMBER 0.50 3.00 X 0 0 0 DR JEFF HORKAN BOARD MEMBER 0.50 3.00 X 0 0 0 TOM KASTEN BOARD MEMBER 0.50 3.00 X 0 0 0 KAY WIPPERFURTH VICE PRESIDENT 0.50 3.00 X X 0 0 0 WILLIAM KIESSLING JR PRESIDENT 0.50 3.00 X X 0 0 0 NELSON FISCHER SECRETARY/TREASURER 0.50 3.00 X X 0 0 0 WILLIAM OSWALD ASST SECRETARY/TREASURER 0.50 3.00 X X 0 0 0 TODD FISCHER ASST SECRETARY/TREASURER 0.50 3.00 X X 0 0 0 MARK PIETROWIAK BOARD MEMBER 0.50 3.00 X 0 0 0 MATTHEW MAUTHE CEO 5.00 35.00 X 231431 0 30467 JULIE MARKS CFO 5.00 35.00 X 125024 0 28644 MICHAEL LIBBY COO 5.00 35.00 X 137134 0 28224 SHERRY CIRA DIRECTOR OF ORGANIZATIONAL ADVANCEMENT 5.00 35.00 X 105483 0 3805 CHERYL MEYER ASST DIRECTOR 5.00 35.00 X 100043 0 14719 699115 0 105859 5 0 1 0 ALLIANCE REHAB 28100 TORCH PARKWAY STE 600 WARRENVILLE IL 60555 THERAPY SERVICES 821270 NEW HORIZON FOODS PO BOX 860246 MINNEAPOLIS MN 554860246 DINING SERVICES 246498 2 SKILLED NURSING FACILITIES 623000 10588129 10588129 ALLOCATED REVENUES 623000 1005368 1005368 INSURANCE/HMO 623000 347352 347352 496734 496734 12437583 1849 1849 12439432 12437583 0 1849 X 599072 599072 4813271 4813271 82915 82915 1089738 1089738 744633 744633 14351 14351 10113 10113 1414317 1401837 12480 43246 43246 61917 61917 347441 50195 297246 5308 5308 25840 25840 414001 414001 78430 78430 MEDICARE PART A & B EXP 1048098 1048098 MEDICAID BED ASSESSMENT 285600 285600 DUES AND SUBSCRIPTIONS 45123 45123 BAD DEBT EXPENSE 36027 36027 11560 11560 11171001 9827973 1343028 0 250 250 990986 1048890 47918 59697 11562328 8312828 3499098 3249500 6243968 7707060 10782220 12065397 847699 864050 1605 0 849304 864050 X 9932916 11201347 9932916 11201347 10782220 12065397 1268431 0 X X 0 1 X 1 0 X 34008 51252 2777 2822 0 90859 11436634 10722333 11320713 11912153 12437583 57829416 374252 607352 0 0 0 981604 11844894 11380937 11323490 11914975 12437583 58901879 0 11118 11118 11118 11118 58890761 69727 59557 43921 6312 1849 181366 69727 59557 43921 6312 1849 181366 11914621 11440494 11367411 11921287 12439432 59083245 0.99670 0.99610 0.00310 0.00390 X 133147 133147 7531739 5357965 2173774 420246 370853 49393 3390381 2523567 866814 86815 60443 26372 3249500 UNEMPLOYMENT RESERVE FUND 145614 DUE FROM AFFILIATES 7561446 7707060 X PART X, LINE 2: MARQUARDT VILLAGE AND EACH AFFILIATE ARE TAX-EXEMPT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A)(1) OF THE CODE. THEY ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE CORPORATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. X X X X 0 0 0 0 0 0 0 0 0 MATTHEW MAUTHE CEO 231431 0 0 0 0 0 5817 0 24650 0 261898 0 0 0 JULIE MARKS CFO 125024 0 0 0 0 0 3399 0 25245 0 153668 0 0 0 MICHAEL LIBBY COO 137134 0 0 0 0 0 2977 0 25247 0 165358 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE A SINGLE CLASS OF VOTING MEMBERS, AND THE SOLE MEMBER OF THAT CLASS SHALL BE MARQUARDT VILLAGE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER SHALL APPOINT UP TO EIGHT (8) DIRECTORS. THE APPOINTED DIRECTORS SHALL BE INCLUDED IN THE TOTAL NUMBER OF AUTHORIZED DIRECTORS, SHALL BE ENTITLED TO VOTE, AND SHALL BE COUNTED FOR PURPOSES OF DETERMINING WHETHER A QUORUM IS PRESENT. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MAY BE TAKEN ONLY BY THE MEMBER AMENDMENT OF THE ARTICLES OF INCORPORATION, AMENDMENT OF THE BYLAWS, MERGER, CONSOLIDATION, OR DISSOLUTION, THE CREATION OF ANY SUBSIDIARIES OR AFFILIATES. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 990 IS GIVEN TO EACH BOARD MEMBER TO REVIEW AND COMMENT ON BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. THE CEO AND THE CFO ALSO REVIEW AND APPROVE THE 990 RETURNS BEFORE THEY ARE FILED. 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 ARISE, THE PERSON AFFECTED IS ASKED TO EXCUSE THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 BOARD AND CEO REVIEW COMPARABILITY DATA AND APPROVE COMPENSATION ANNUALLY. THE BOARD REVIEWS AND APPROVES COMPENSATION FOR THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PHARMACY : PROGRAM SERVICE EXPENSES 54,802. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,802. MEDICAL SUPPLIES : PROGRAM SERVICE EXPENSES 867,471. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 867,471. CONTRACT SERVICES : PROGRAM SERVICE EXPENSES 373,291. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 373,291. THERAPY : PROGRAM SERVICE EXPENSES 55,341. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 55,341. X-RAY : PROGRAM SERVICE EXPENSES 16,710. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,710. LAB : PROGRAM SERVICE EXPENSES 34,222. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,222. MEDICAL DIRECTOR FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 12,480. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,480. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ZINZENDORF HALL INC 1045 HILL STREET WATERTOWN WI 53098 391647409 ASSISTED LIVING WI 501(C)(3) LINE 9 MARQUARDT VILLAGE INC 0 MARQUARDT MANAGEMENT SERVICES INC 1045 HILL STREET WATERTOWN WI 53098 391756037 SENIOR HOUSING WI 501(C)(3) LINE 9 MARQUARDT VILLAGE INC 0 MORAVIAN HOMES INC 1045 HILL STREET WATERTOWN WI 53098 391324889 SENIOR HOUSING WI 501(C)(3) LINE 9 MARQUARDT VILLAGE INC 0 MUELLER APARTMENTS INC 1045 HILL STREET WATERTOWN WI 53098 391294266 LOW INCOME HOUSING WI 501(C)(3) LINE 9 MARQUARDT VILLAGE INC 0 MARQUARDT FOUNDATION INC 1045 HILL STREET WATERTOWN WI 53098 391563808 SUPPORT MARQUARDT VILLAGE INC AND AFFILIATES WI 501(C)(3) LINE 7 MARQUARDT VILLAGE INC 0 MARQUARDT VILLAGE INC 1045 HILL STREET WATERTOWN WI 53098 391704732 MANAGEMENT SERVICES WI 501(C)(3) LINE 9 N/A 0 MARQUARDT HOME AND COMMUNITY BASED SERVICES INC 1045 HILL STREET WATERTOWN WI 53098 391940920 HOME HEALTH, HOSPICE AND EMERGENCY RESPONSE SERVICES WI 501(C)(3) LINE 9 MARQUARDT VILLAGE INC 0 MARQUARDT INVESTMENTS INC 1045 HILL STREET WATERTOWN WI 53098 475473378 INVESTMENTS WI MARQUARDT FOUNDATION INC C 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 MARQUARDT VILLAGE INC P 781053 REIMBURSEMENT