2014-02-13T15:26:44-06:00 2013-06-30 CONWAY DEUTH & SCHMIESING PLLP 401 ATLANTIC AVE MORRIS MN 562671324 990 2012-07-01 202581924 RENVILLE HEALTH SERVICES RENV 3205894902 205 SE ELM AVE RENVILLE MN 56284 LUVERNE HOFFMAN 3205894902 2014-02-09 true JAMES A GILMAN CPA 3205892602 2014-02-09 2012 2015-11-30 17:44:51Z LUVERNE HOFFMAN 801 NEVADA AVE MORRIS MN 56267 4719349 false X WWW.SFHS.ORG X 2005 MN WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. 13 13 159 100 39642 6359 1450 4844185 4707228 -1516 75 8271 4849028 4717024 6000 8785 0 2138715 2237773 0 2613 2545968 2446976 4690683 4693534 158345 23490 8656149 8513802 7333938 7568101 1322211 945701 X WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. false false 4235133 8785 4717024 RENVILLE HEALTH SERVICES CONSISTS OF A 52 BED SKILLED NURSING FACILITY, A 42 UNIT INDEPENDENT LIVING CENTER/ASSISTED LIVING CENTER IN RURUAL MINNESOTA. THE FACILITY PROVIDES MEDICAL, SOCIAL, AND SPIRITUAL CARE TO ITS RESIDENTS WITHOUT REGARD TO RACE, COLOR, CREED, OR NATIONAL ORIGIN, IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT STATUS. DURING THE CURRENT REPORTING YEAR, THE ORGANIZATION HAD 31,123 PATIENT DAYS AND PROVIDED SERVICES TO MORE THAN 89 PATIENTS IN THE NURSING HOME AND PROVIDED HOUSING FOR MORE THAN 49 TENANTS AT THE INDEPENDENT/ASSISTED LIVING CENTER. ALSO DURING THIS TIME PERIOD, THE ORGANIZATION EMPLOYED ABOUT 66 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 1.8 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE LIMITED. MANAGEMENT SERVICES PROVIDED TO RELATED ORGANIZATIONS IN SUPPORT OF EACH ORGANIZATION'S EXEMPT PURPOSE. 4235133 true false false false false false false false true false true false false false false false false true false false false false false false false false false false true true true false false false false false false false false true false false false false false false true false false false true 19 0 true 159 true true true false false false false false X 13 13 false true false false true false false true true false false false true true true true true true true false MN X SHERRY WAGNER 3205894919 801 NEVADA AVENUE MORRIS MN 56267 X DON GIESELMANN 1.00 X X 0 0 0 MAGGIE FLETCHER 1.00 X 0 0 0 STEVE LIENEMANN 1.00 X 0 0 0 KATIE ERDMAN 1.00 X 0 0 0 VIVIAN HELTEMES 1.00 X 0 0 0 BARBARA SPAULDING 1.00 X 0 0 0 DOUGLAS WARTNER 1.00 X 0 0 0 ANDY LOPEZ 1.00 X X 0 0 0 KENNY WESTBROCK 1.00 X 0 0 0 KEN KELLER 1.00 X 0 0 0 RANDY SUTTER 1.00 X X 0 0 0 REV ROBERT KIEFFER 1.00 X 0 0 0 ROSE MURPHY 1.00 X 0 0 0 NEIL SCHMIDGALL X 0 0 0 LUVERNE HOFFMAN 1.00 39.00 X 0 352011 44716 CAROL RAW 40.00 X 0 131574 17328 SHERRY WAGNER 1.00 39.00 X 0 101964 6040 DENNIS LINDOR 40.00 X 0 81155 20832 GEOFFREY RYAN 40.00 X 0 116061 5770 SCOTT JACKSON 40.00 X 0 104821 12646 887586 107332 false true false ST FRANCIS HEALTH SERVICES OF MORRI 801 NEVADA AVE MORRIS MN 56267 MGMT FEES & OTH 373879 AEGIS THERAPIES INC PO BOX 8103 FORT SMITH AR 72902 THERAPY 356030 2 1450 1450 RESIDENT SERVICE REVENUE 4537389 4537389 MEALS 121732 121732 MANAGEMENT AGENT 561000 39642 39642 RENTAL 5675 5675 OTHER 2790 2790 4707228 75 75 10596 2325 8271 8271 4717024 4667586 39642 8346 8785 8785 1821231 1756395 64836 38212 36881 1331 239578 231231 8347 138752 133918 4834 243600 243600 6420 415 6005 9230 2400 6830 22876 9441 13435 19092 2232 16860 229946 229946 5613 612 5001 5389 550 4839 307344 307344 380771 380771 62575 42057 20518 MEDICAL PROFESSIONAL FEES 445787 445787 SUPPLIES 232678 232678 PURCHASED SERVICES 135437 135437 MEDICAL SURCHARGE 133712 133712 206506 144541 59352 2613 4693534 4235133 455788 2613 471114 482710 351190 416271 22557 19889 9644882 2166315 7688699 7478567 122589 116365 8656149 8513802 299074 307948 6971716 6700107 30464 33537 526509 32684 7333938 7568101 X 1322211 945701 1322211 945701 8656149 8513802 23490 -400000 X false true X true false X 21318 16185 8891 6359 1450 54203 4194721 4156315 4535723 4808733 4667586 22363078 4216039 4172500 4544614 4815092 4669036 22417281 1003639 811708 828005 758038 793156 4194546 1003639 811708 828005 758038 793156 4194546 18222735 22 75 97 22 75 97 5658 5658 4216039 4172500 4544614 4815114 4674769 22423036 0.81270 0.81900 0.00000 X true 30464 21614 18541 33537 true X 144534 144534 8851711 1757551 7094160 536555 357455 179100 112082 51309 60773 7478567 EXPLANATION FOR UNREPORTED CONTRIBUTIONS OR ASSETS SCHEDULE D, PAGE 2, PART IV, LINE 1B THE ORGANIZATION ACTED AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS. ESCROW LIABILITY ARRANGEMENT EXPLANATION SCHEDULE D, PAGE 2, PART IV, LINE 2B THE ORGANIZATION ACTED AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS. true SCHOLARSHIP 3 8785 X X false false false false false false false false false LUVERNE HOFFMAN 352011 27716 17000 396727 A MINNWEST BANK REV NOTE 2009B 416005015 2009-12-10 5165000 REFINANCING TAXABLE false false false B MINNWEST BANK REV NOTE 2009B 416005015 2009-12-10 2445000 REFINANCING TAXABLE false false false A false false false false B false false false false A false false false false false false false false B false false false false false false false false A false false false false false false false false false B false false false false false false false false false A false PURPOSE OF ISSUE DESCRIPTION SCHEDULE K MINNWEST BANK INDEBTEDNESS INCURRED TO FINANCE A ACQUISITION OF RHS B CAPITAL IMPROVEMENTS TO RHS AND C CONSTRUCTION OF A 24BED ATRIUM ADDITION TO RHS AND RELATED REMODELING AND SITE IMPROVEMENTS MINNWEST BANK INDEBTEDNESS INCURRED TO FINANCE A ACQUISITION OF RHS B CAPITAL IMPROVEMENTS TO RHS AND C CONSTRUCTION OF A 24BED ATRIUM ADDITION TO RHS AND RELATED REMODELING AND SITE IMPROVEMENTS MARK HOFFMAN SON OF 45483 EMPLOYED IN false LUVERNE HOFFMAN MAINTENANCE false PRES & CEO false ELIZABETH LETICH DAUGHTER OF 77642 EMPLOYED AS AN false CAROL RAW, VP ADMINISTRATOR false ANDREW RAW SON OF 32010 EMPLOYED IN false CAROL RAW, VP MAINTENANCE false DAWN BJORGE WIFE OF DENNIS 71331 EMPLOYED AS RN/PD false LINDOR, VP OF false BEHAV. SVC false ADDITIONAL INFORMATION SCHEDULE L PART V DURING THE YEAR THE ORGANIZATION MAY EMPLOY INDIVIDUALS WHO MAY BE RELATED TO AN OFFICER DIRECTOR TRUSTEE OR KEY EMPLOYEE PAYMENTS FOR SERVICES WOULD BE MADE ACCORDING TO EMPLOYMENT POLICY AND DONE AT ARMS LENGTH DUE TO THE RURAL LOCATION OF THE ORGANIZATION AND THE NEED TO FIND QUALIFIED STAFF THESE EMPLOYEMENT RELATIONSHIPS WOULD BE NECESSARY TO FURTHER THE ORGANIZATIONS EXEMPT PURPOSE ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A THE ORGANIZATION EMPLOYED ABOUT 66 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 1.8 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE LIMITED. ALL OTHER ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4D MANAGEMENT SERVICES PROVIDED TO RELATED ORGANIZATIONS IN SUPPORT OF EACH ORGANIZATION'S EXEMPT PURPOSE. MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION WITH COMMON CONTROL) MANAGES THE FACILITY. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 THE ORGANIZATION IS ORGANIZED WITH MEMBERS. THE MEMBERS OF THE CORPORATION SHALL CONSIST OF THE BOARD OF DIRECTORS OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE CFO OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC REVIEWS THE TAX RETURN AS PART OF THE MANAGEMENT SERVICES. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY THE ORGANIZATION CONDUCTS IN-SERVICE TRAINING REVIEWING THE POLICY ON CONFLICTS OF INTEREST AND REQUIRES THE BOARD MEMBERS, MANAGEMENT STAFF, AND KEY EMPLOYEES TO DISCLOSE CONFLICTS. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR THE CEO - ANNUALLY THE HR DIRECTOR SUBMITS THE CEO'S JOB DESCRIPTION, PERFORMANCE EVALUATION FORM, ST. FRANCIS HEALTH SERVICES OF MORRIS, INC'S PAY GRADE SCHEDULE AND COMPARABLE WAGE SURVEY(S) TO THE CHAIRMAN OF THE BOARD. THE CHAIRMAN AND THE EVALUATION COMMITTEE OF THE BOARD REVIEWS THE PERFORMANCE AND DETERMINES THE SALARY OF THE CEO. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR OFFICERS - CEO AND THE HR DIRECTOR REVIEWS COMPARABLE WAGE SURVEY INFORMATION, REVIEWS PERFORMANCE (WITH INPUT FROM THE VP, IF APPROPRIATE) AND DETERMINES SALARY. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON AN AS REQUESTED BASIS RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII ST. FRANCIS HEALTH SERVICES OF MORRIS, INC HAS A MANAGEMENT AGREEMENT WITH THE RELATED ENTITY. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 INTERCOMPANY TRANSFER 400,000 AITKIN HEALTH SERVICES 301 MINNESOTA AVENUE AITKIN MN 56431 203367397 CAREGIVER MN 501C3 9 SFHS false BROWNS VALLEY HEALTH CENTER RR 1 BOX 182D SOUTH JEFFERSON BROWNS VALLEY MN 56219 411668347 CAREGIVER MN 501C3 9 SFHS false FRANCISCAN HEALTH CENTER 3910 MINNESOTA AVENUE DULUTH MN 55802 411799268 CAREGIVER MN 501C3 9 SFHS false FARMINGTON HEALTH SERVICES 3410 23RD STREET W FARMINGTON MN 55024 200100365 CAREGIVER MN 501C3 9 SFHS false GUARDIAN ANGELS HEALTH & REHAB CENT 1500 3RD AVENUE E HIBBING MN 55746 411810369 CAREGIVER MN 501C3 9 SFHS false PRAIRIE COMMUNITY SERVICES 801 NEVADA AVENUE MORRIS MN 56267 411598442 CAREGIVER MN 501C3 9 SFHS false PENNINGTON HEALTH SERVICES 130 LABREE AVENUE S THIEF RIVER FALLS MN 56701 205617275 CAREGIVER MN 501C3 9 SFHS false ST FRANCIS HEALTH SERVICES (SFHS) 801 NEVADA AVENUE MORRIS MN 56267 411484416 MGMT COMP MN 501C3 9 N/A false WEST WIND VILLAGE 1001 SCOTT AVENUE MORRIS MN 56267 237625632 CAREGIVER MN 501C3 9 SFHS false ZUMBROTA HEALTH SERVICES 433 MILL STREET ZUMBROTA MN 55992 510487275 CAREGIVER MN 501C3 9 SFHS false CHISHOLM HEALTH CENTER 321 NE 8TH STREET CHISHOLM MN 55719 411879639 CAREGIVER MN 501C3 9 SFHS false VIEWCREST HEALTH CENTER 3111 CHRUCH PLACE DULUTH MN 55811 411843283 CAREGIVER MN 501C3 9 SFHS false false false false false true false false false false false false false true false false false false true false ST FRANCIS HEALTH SERVICES OF MORR M 243600 AMOUNT PAID OR ACCRUED ST FRANCIS HEALTH SERVICES OF MORR R 400000 AMOUNT PAID OR ACCRUED ST FRANCIS HEALTH SERVICES OF MORR E 545000 AMOUNT PAID OR ACCRUED ADDITIONAL INFORMATION SCHEDULE R ST FRANCIS HEALTH SERVICES OF MORRIS INC HAS GUARANTEED LOANS OF 6700107 AS SHOWN IN FORM 990 PART X LINE 20 AND THERE WERE NO NEW LOAN GUARANTEES DURING THIS FISCAL YEAR THE ORGANIZATION ALSO HAS INTERCOMPANY LOAN PAYABLE TO ST FRANCIS HEALTH SERVICES OF MORRIS INC OF 526509 AS SHOWN ON 990 PART X LINE 24 THE ORGANIZATION HAS PAID 14758 TO ST FRANCIS HEALTH SERVICES OF MORRIS INC