2013-11-01T11:47:17-05:00 2013-06-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2012-07-01 391501353 MARYHILL MANOR INC MARY 7152513172 501 MADISON AVENUE NIAGARA WI 54151 JOAN ROEHRIG 7152513172 2013-10-22 1 TERRI REXRODE CPA MST P00096513 9206620016 2013-10-22 2012 2015-11-30 17:44:51Z JOAN ROEHRIG 501 MADISON AVENUE NIAGARA WI 54151 5826656 0 0928 X MARYHILLMANOR.ORG X 1964 WI SKILLED NURSING HOME FOR THE ELDERLY. MARYHILL MANOR ("THE ORGANIZATION") IS AN AWARD-WINNING REHABILITATION AND SKILLED NURSING CENTER WHICH IS PROUD TO BE THE HANDS AND FACE OF THE SCHOOL SISTER'S MISSION OF COMPASSIONATE CARE. OUR EDUCATIONAL OUTREACH IS WELL RESPECTED, AND WE ARE A CLINICAL SITE FOR THE BAY COLLEGE WEST NURSING PROGRAM AND THE NORTHEAST WISCONSIN TECHNICAL COLLEGE FOR NIAGARA BASED PRACTICAL NURSING, NURSING ASSISTANT, AND DEMENTIA CARE CERTIFICATION COURSES.FOCUSED ON THE FUTURE, WE HAVE BEGUN THE JOURNEY INTO THE SOCIAL MODEL OF CARE. WHILE MAINTAINING OUR FOCUS ON THE PHYSICAL NEEDS OF OUR RESIDENTS, MARYHILL'S RESIDENTS DETERMINE THEIR OWN GOALS, AND THE TEAM COLLABORATES WITH EACH PERSON TO EMPOWER THEM TO THEIR HIGHEST LEVEL OF WELLNESS. 12 12 161 51 0 0 4877 99624 5135607 5718626 10220 7448 0 0 5150704 5825698 0 0 0 0 3116327 3295941 0 0 0 1831438 2074169 4947765 5370110 202939 455588 4275235 4725986 2414512 2390784 1860723 2335202 X WE ARE A COMMUNITY FOCUSED PROVIDER OF REHABILITATIVE AND LONG TERM CARE SERVICES, ASSISTING OUR CLIENTS TO ACHIEVE THEIR GOALS IN AN ENVIRONMENT OF RESPECT AND COMPASSION WHICH PRESERVES THEIR INDIVIDUALITY. DEDICATED TO MEETING EACH PERSON'S SPIRITUAL, EMOTIONAL, AND PHYSICAL NEEDS THROUGH PROFESSIONAL AND TECHNICAL EXCELLENCE, WE PROMOTE THE HEALING MISSION OF THE SCHOOL SISTERS OF ST. FRANCIS AND THE CATHOLIC CHURCH. 0 0 4396281 5717374 MARYHILL MANOR, INC. IS A 75-BED NURSING HOME THAT PROVIDES SKILLED AND INTERMEDIATE CARE FOR ITS RESIDENTS. MARYHILL SERVES THE ELDERLY WITHOUT DISCRIMINATION FOR THE PURPOSE OF HEALTH CARE, CHARITABLE, RELIGIOUS, EDUCATIONAL, AND SCIENTIFIC ENDEAVORS. THE PRIMARY INTEREST IS IN PROVIDING HIGH QUALITY CARE TO RESIDENTS, EDUCATION FOR STAFF, AND IMPROVEMENT IN COMMUNITY HEALTH. 4396281 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 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 0 0 1 0 0 0 1 8 0 1 161 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JOAN ROEHRIG 7152513172 501 MADISON AVENUE NIAGARA WI 54151 JON PRYOR 0.10 X X 0 0 0 HENRY 'HANK' MCROBERTS 0.10 X X 0 0 0 ALLYN THORNBERRY 0.10 X X 0 0 0 LEILA CANAVERA 0.10 X X 0 0 0 MARY JEAN ELDRIDGE 0.10 X 0 0 0 S REGINA PACIS MESERVEY 0.10 X 0 0 0 TIM LONDON 0.10 X 0 0 0 PAUL BEAUCHAMP 0.10 X 0 0 0 STEVE FEIRA 0.10 X 0 0 0 SR ROSEMARY HERRIGES 0.10 X 0 0 0 DR ROBERT PULTZ 0.10 X 0 0 0 SHAWN STAPLES 0.10 X 0 0 0 JOAN ROEHRIG 40.00 X 90900 0 14427 90900 0 14427 0 0 0 0 AEGIS THERAPIES INC PO BOX 8103 FORT SMITH AR 729028103 THERAPY 375647 SHOPKORX CARE 3701 E EVERGREEN DRIVE STE 1000 APPLETON WI 549137409 PHARMACY 142522 2 99624 99624 RESIDENT SERVICE REVEN 623000 5714674 5714674 TESTING AND SCREENING 623000 2700 2700 OTHER REVENUES 623000 1252 1252 5718626 8406 8406 958 -958 -958 -958 5825698 5717374 0 8700 X 105327 105327 2705105 2448199 256906 45309 45309 198432 190636 7796 241768 225750 16018 6698 6698 31255 31255 623400 612009 11391 25576 55 25521 449629 417487 32142 44465 44465 141296 103026 38270 15096 11682 3414 93459 58973 34486 175273 82904 92369 128622 1525 127097 BED ASSESSMENTS 153000 153000 LOSS ON REFINANCING 67199 67199 MISCELLANEOUS 43091 9152 33939 BAD DEBT EXPENSE 34796 34796 41314 1778 39536 5370110 4396281 973829 0 722792 789957 1502537 1884119 408631 446026 85095 53813 4377060 2843259 1463017 1533801 93163 18270 4275235 4725986 284280 275950 1945000 1962716 185232 152118 2414512 2390784 X 1840192 2317737 20531 17465 1860723 2335202 4275235 4725986 X 455588 18891 X X 0 1 X 1 0 X 7833 1375 3018 4877 99624 116727 4636115 4597684 4884952 5133768 5717374 24969893 7664 1202 871 1839 1252 12828 4651612 4600261 4888841 5140484 5818250 25099448 0 0 0 25099448 19148 15786 12684 10220 8406 66244 19148 15786 12684 10220 8406 66244 4670760 4616047 4901525 5150704 5826656 25165692 0.99740 0.97730 0.00260 0.00430 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20531 4624 7690 17465 28180 4877 12526 20531 26942 3018 1780 28180 30098 1375 4531 26942 23268 7833 1003 30098 1.00000 0 0 105165 105165 3010750 1864624 1146126 89286 60345 28941 1171859 918290 253569 1533801 MINIMUM PENSION LIABILITY 152118 152118 X 5753875 -67199 -67199 5821074 4624 4624 5825698 5302911 0 5302911 67199 67199 5370110 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION INTENDS TO USE ENDOWMENT FUNDS FOR THEIR DESIGNATED PURPOSES INCLUDING FACILITY EXPENSES, RESIDENT ACTIVITES, CONTINUING EDUCATION, LANDSCAPING, AND OTHERS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. MARYHILL RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR RECOGNIZED TAX BENEFITS. FEDERAL AND STATE INCOME TAX RETURNS FOR 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON REFINANCING -67,199. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS 3,644. SPECIAL EVENT REVENUE 980. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON REFINANCING 67,199. A WHEFA REVENUE BONDS SERIES 2012 391337855 NONEAVAIL 2012-10-17 2055000 REFUNDING 0 0 0 A 2055000 1880461 41100 133439 2013 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION IS OWNED BY THE SCHOOL SISTERS OF ST. FRANCIS. FORM 990, PART VI, SECTION A, LINE 7A THE SCHOOL SISTERS OF ST. FRANCIS MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE SCHOOL SISTERS OF ST. FRANCIS WHO MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY: APPROVE ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS; APPROVE ANY SUBSIDIARY, APPROVE ANY MANAGEMENT SERVICES CONTRACT; DESIGNATE THE AUDITING FIRM; APPROVE DEBT OBLIGATIONS OVER A THRESHOLD THEY ESTABLISH; APPROVE REORGANIZATIONS; APPROVE MAJOR FUND DRIVES; APPROVE PURCHASE, SALE, LEASE, OR TRANSFER OF REAL ESTATE; AND APPROVE COMPENSATION AND FRINGE BENEFITS FOR THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS HAS GIVEN THE CEO AND BUSINESS OFFICE MANAGER AUTHORITY TO REVIEW FORM 990. PRIOR TO FILING, THE BOARD OF DIRECTORS WILL BE PROVIDED A COPY OF FORM 990 EITHER BY MAIL OR E-MAIL AND THEY ARE TO ACKNOWLEDGE RECEIPT OF FORM 990 VIA E-MAIL OR TELEPHONE. FORM 990, PART VI, SECTION B, LINE 12C MARYHILL MANOR HAS AN ANNUAL BOARD OF DIRECTOR'S MEETING IN WHICH THEY DISCUSS CORPORATE COMPLIANCE AND CONFLICT OF INTEREST. AT THIS TIME THEY HAVE THE BOARD OF DIRECTORS SIGN AND RETURN A COPY OF THE CONFLICT OF INTEREST POLICY. THE SAME IS DONE FOR THE LEADERSHIP GROUP AT MARYHILL. THE SIGNED FORMS ARE KEPT ON FILE IN THE BUSINESS OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE TEAM CALLS A MEETING TO PERFORM THE CEO'S PERFORMANCE EVALUATION. THE EXECUTIVE TEAM IS WITHOUT CONFLICT OF INTEREST AND THEY DETERMINE WHAT PROGRESS SHE HAS MADE ON HER GOALS FOR THE YEAR AND HOW SHE HAS ACCOMPLISHED THEM. THEY USE COMPARATIVE SURVEYS (WASHA) TO DETERMINE HOW MUCH OF AN INCREASE IS ACCEPTABLE AND DOCUMENT ALL OF THIS INFORMATION IN HER FILE. FORM 990, PART VI, SECTION C, LINE 19 MARYHILL MANOR, INC. PROVIDES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G CONTRACTED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 612,009. MANAGEMENT AND GENERAL EXPENSES 11,391. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 623,400. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION OBLIGATION 18,891. OVERSIGHT OF THE AUDIT FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS AND SCHOOL SISTERS OF ST. FRANCIS SELECT THE COMPANY TO DO THE AUDIT. THE BOARD OF DIRECTORS OVERSEE THE AUDIT. THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. SCHOOL SISTERS OF ST FRANCIS 1501 S LAYTON BLVD MILWAUKEE WI 53215 391594407 RELIGIOUS ORDER WI 501(C)(3) 1 N/A 0 CLEMENT MANOR 3939 S 92ND ST GREENFIELD WI 53228 391020547 NURSING HOME WI 501(C)(3) 9 SCHOOL SISTERS OF ST FRANCIS 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0