2011-11-09T14:43:43-06:00 2011-06-30 EIDE BAILLY LLP 3999 PENNSYLVANIA AVE SUITE 100 DUBUQUE IA 52002 990 2010-07-01 510141775 STONEHILL FRANCISCAN SERVICES STON 5635577180 3485 WINDSOR AVENUE DUBUQUE IA 520011312 ERIC THOMAS 5635577180 2011-11-04 1 CARMEN KRANTZ 5635561790 2010 2016-02-24 21:20:13Z ERIC THOMAS 3485 WINDSOR AVENUE DUBUQUE IA 520011312 15646813 0 0928 X WWW.STONEHILLDBQ.COM X 1985 IA PROVIDE QUALITY RESIDENTIAL, RESPITE, AND HEALTH SERVICES FOR OLDER ADULTS 15 13 429 100 0 0 284122 473943 14042140 15153169 11465 -18461 6453 1773 14344180 15610424 0 5197 0 0 9606911 10116083 0 0 0 4677140 4910853 14284051 15032133 60129 578291 10679422 11194269 8103352 8008515 2576070 3185754 X WE, THE STONEHILL FRANCISCAN SERVICES COMMUNITY, IN THE SPIRIT OF ST. FRANCIS, OFFER QUALITY RESIDENTIAL, RESPITE AND HEALTH SERVICES IN DAILY CELEBRATION OF THE DIGNITY OF OLDER ADULTS IN AN ENVIRONMENT THAT RESPECTS FAMILIES, STAFF AND VOLUNTEERS. 0 0 14274045 5197 15153169 THROUGHOUT THE YEAR EACH OF THE MINISTRIES PROVIDED UNREIMBURSED CARE TO THE PUBLIC FOR A COMMUNITY BENEFIT TOTAL OF APPROXIMATELY $1,162,508. APPROXIMATELY 35.5% OF RESIDENTS AND PARTICIPANTS SERVED ARE OFFERED DISCOUNTS FROM A 177 BED SKILLED NURSING FACILITY, 41 BED RESIDENTIAL CARE FACILITY, 51 UNIT INDEPENDENT & ASSISTED LIVING FACILITY, AND 21 GUEST CAPACITY ADULT DAY CARE CENTER. EACH MEMBER OF THE ADULT CENTER STAFF, INCLUDING NURSE ASSISTANTS AND MEDICATION AIDS, ARE FULLY CERTIFIED FROM THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF). STONEHILL FRANCISCAN SERVICES EXISTS TO ENABLE SENIORS TO ENJOY AN OUTSTANDING QUALITY OF LIFE. THE SUPPORT SERVICES ARE DESIGNED TO PROMOTE INDEPENDENCE AND COMPLIMENT THE EFFORTS OF FAMILY CAREGIVERS.THE CAMPUS PROVIDES A COMPLETE CONTINUUM OF CARE DESIGNED TO CREATE QUALITY OF LIFE FOR RESIDENTS WITH EVERY LEVEL OF NEED. STAFF MEMBERS BRING A HIGH DEGREE OF PERSONAL COMMITMENT TO THE TASK OF CARING FOR EACH INDIVIDUAL. MEDICAL THERAPY SERVICES INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY.ASSISI VILLAGE GIVES EVERY RESIDENT THE CLOSENESS TO OTHERS THAT ADDS GREATLY TO OVERALL QUALITY OF LIFE, WITHOUT GIVING UP PERSONAL SPACE AND A FEELING OF INDEPENDENCE.THE ADULT DAYCARE SERVICES OFFER A WIDE RANGE OF ACTIVITIES THAT ARE CONDUCTED EACH DAY. FROM TRIPS TO LOCAL SHOPPING MALLS TO MUSIC AND COOK-OUTS. ASSISI VILLAGE'S WELL-STRUCTURED AND SUPERVISED DAILY ACTIVITIES ARE A WELCOME ALTERNATIVE TO STAYING AT HOME. 14274045 1 1 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 18 0 1 429 1 0 0 0 0 0 0 0 0 0 0 X 15 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IA X CALVIN SHELANGOSKI 5635570849 3485 WINDSOR AVENUE DUBUQUE IA 52001 NANCY DUNKEL 0.50 X X 0 0 0 MICHAEL BERG 0.50 X X 0 0 0 SR MARGARET WICK 0.50 X X 0 0 0 TERRY FRIEDMAN 0.50 X 0 0 0 SR JANE HOSCH OSF 0.50 X 0 0 0 KEVIN CIESIELSKI 0.50 X 0 0 0 SR MARIE CIGRAND OSF 0.50 X 0 0 0 SR HELEN HUEWE OSF 0.50 X 0 0 0 MSGR WAYNE RESSLER 0.50 X 0 0 0 SR JOAN STOFFEL OSF 0.50 X 0 0 0 JIM WEBER 0.50 X 0 0 0 KURT WEDEWER CEBS RPA 0.50 X 0 0 0 ALICE VONTALGE 0.50 X 0 0 0 RICHARD RUNDE 0.50 X 0 0 0 ERIC THOMAS 40.00 X X 155704 0 14252 CALVIN SHELANGOSKI 40.00 X 73309 0 4373 229013 0 18625 1 0 1 0 AGILITY HEALTH PROFESSIONALS 16301 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 HEALTH CARE SERVICES 711054 MORRISON MANAGEMENT PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICE MANAGEMENT 142352 2 469338 4605 473943 RESIDENT SERVICE REVEN 623000 14958704 14958704 SUPPORTING REVENUE 900099 116071 116071 AMORT OF ADVANCE FEES 900099 78394 78394 15153169 14764 14764 962 962 3975 3164 811 811 811 33225 -33225 -33225 -33225 15610424 15153169 0 -16688 5197 5197 256353 256353 8022268 7786956 235312 100359 95653 4706 1139575 1087596 51979 597528 562630 34898 15551 15551 23830 23830 1311791 1274531 37260 63758 57397 6361 1677657 1641575 36082 59205 49007 10198 544443 544443 41055 31271 9784 3017 3017 193367 193367 851130 851130 116918 86553 30365 9131 3722 5409 15032133 14274045 758088 0 276817 288969 888125 872341 66053 70530 64698 79668 22414265 13212053 8735017 9202212 553447 609598 95265 70951 10679422 11194269 1152812 1166422 232370 245476 4473795 4232007 21181 15243 301379 283741 1921815 2065626 8103352 8008515 X 2576070 3185754 2576070 3185754 10679422 11194269 X 578291 31393 X 0 1 1 X 0 X 922757 572000 445954 284122 473943 2698776 10259348 11790521 12094538 14042140 15153169 63339716 11182105 12362521 12540492 14326262 15627112 66038492 0 0 0 66038492 64460 138340 31732 21056 18739 274327 64460 138340 31732 21056 18739 274327 1954 2529 1498 943 962 7886 11248519 12503390 12573722 14348261 15646813 66320705 0.99570 0.99510 0.00410 0.00480 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 191250 191250 18721342 11210722 7510620 2414666 1702335 712331 1087007 298996 788011 9202212 REFUNDABLE ADVANCE FEES 1728952 HEALTH CLAIMS PAYABLE 213000 CONSTRUCTION ACCOUNTS PAYABLE 99674 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 24000 2065626 PART IV, LINE 2B: RESIDENT TRUST PAYABLE DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: STONEHILL FRANCISCAN SERVICES, INC. BELIEVES THAT THEY HAVE APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. THE FEDERAL FORM 990T FILINGS BY THE ORGANIZATION ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY AUTHORITIES FOR YEARS BEFORE 2008. 1 STONEHILL BENEVOLENT FOUNDATION 3485 WINDSOR AVENUE DUBUQUE IA 520011312 421337556 501(C)(3) 5197 DONATION FOR COFFEE SHOP FURNITURE 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: STONEHILL FRANCISCAN SERVICES AUXILIARY PROVIDES ASSISTANCE TO STONEHILL BENEVOLENT FOUNDATION. THE AUXILIARY OPERATES UNDER THE FEDERAL IDENTIFICATION NUMBER OF STONEHILL FRANCISCAN SERVICES AND THE FINANCIAL ACTIVITY IS REPORTED ON THE BOOKS OF STONEHILL FRANCISCAN SERVICES. THEREFORE, GRANTS TO THE FOUNDATION ARE RECORDED ON THE 990 OF STONEHILL FRANCISCAN SERVICES. THE AUXILIARY GIVES DONATIONS TO THE FOUNDATION FOR SPECIFIC PURPOSES AND THE FOUNDATION PROVIDES PROOF THE FUNDS WERE USED APPROPRIATELY. X X X 0 0 0 0 0 0 0 0 0 ERIC THOMAS 154759 0 0 0 945 0 3991 0 10261 0 169956 0 0 0 DUBUQUE COUNTY IOWA 426004597 2008-08-21 4950000 FUNDS FOR RENOVATING, REMODELING, & EQUIPMENT IN THE CARE CENTER 0 0 0 4950000 2688937 88397 2192666 2008 1 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 0 0 0 0 WEBER PAPER & SUPPLY OWNER & PRESIDENT IS BOARD MEMBER OF ORGANIZATION 259142 SERVICES AND SUPPLIES 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE CORPORATION AND THE PRESIDENT/CEO OF THE FACILITY. THIS COMMITTEE MAY EXERCISE ALL POWERS OF THE BOARD OF DIRECTORS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. THE COMMITTEE MAY MAKE RULINGS ON ALL QUESTIONS REQUIRING IMMEDIATE ACTION, AND THEIR RULING IS BINDING UNLESS ACTION IS TAKEN BY THE BOARD OF DIRECTORS. THE COMMITTEE REPORTS ALL ITS RULINGS TO THE BOARD OF DIRECTORS AT THE NEXT REGULAR OR SPECIAL MEETING OF THE BOARD. THE EXECUTIVE COMMITTEE DOES NOT HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN REFERENCE TO AMENDING THE ARTICLES OF INCORPORATION, ADOPTING A PLAN OF MERGING OR CONSOLIDATION, RECOMMENDING TO DIRECTORS THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF BUSINESS. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS REVIEWED BY THE ENTIRE BOARD BEFORE IT IS FILED. THE PRESIDENT/CEO AND FINANCE DIRECTOR REVIEW THE 990. FORM 990, PART VI, SECTION B, LINE 12C STONEHILL FRANCISCAN SERVICES HAS CONFLICT OF INTEREST POLICIES COMPLETED EACH YEAR BY ALL BOARD MEMBERS THUS MONITORING ANY POTENTIAL CONFLICTS. THE BOARD CHAIRPERSON REVIEWS THE STATEMENTS AND FOLLOWS UP ON ANY POTENTIAL CONFLICTS. ANY ACTUAL OR POTENTIAL DUALITY OR CONFLICT OF INTEREST INCLUDING BUT NOT LIMITED TO OWNERSHIP OR CONTROL OF ANY ENTITY THAT CONTRACTS WITH THE STONEHILL FRANCISCAN SERVICES FOR ANY PRODUCTS OR SERVICES SHALL BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD AND MADE A MATTER OF RECORD IN THE MINUTES WHEN THE SUBJECT OF SUCH INTEREST BECOMES A MATTER OF BOARD ACTION. WHEN A CONFLICT ARISES, THE BOARD MEMBER IS NOT ALLOWED TO VOTE ON THE ISSUE AND MAY BE EXCUSED FROM THE MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO'S COMPENSATION IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD WITH SALARY ADJUSTMENT RECOMMENDATIONS BASED ON AN ANNUAL PERFORMANCE EVALUATION AND COMPARABILITY DATA. THE FINANCE DIRECTOR'S COMPENSATION IS DETERMINED BY THE PRESIDENT/CEO WITH APPROVAL BY THE BOARD OF DIRECTOR'S WITH SALARY ADJUSTMENT RECOMMENDATIONS BASED ON AN ANNUAL PERFORMANCE EVALUATION AND COMPARABILITY DATA. THE ORGANIZATION DOCUMENTS AND PROVIDES SUBSTANTIATION FOR THEIR COMPENSATION PROCESS. THE PROCESS IS COMPLETED YEARLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 31,393. FORM 990, PAGE 7, PART VII: THE FOLLOWING INDIVIDUALS DEVOTED TIME PROVIDING SERVICES TO STONEHILL BENEVOLENT FOUNDATION, A RELATED ORGANIZATION. ERIC THOMAS, PRESIDENT/CEO 4 HOURS PER WEEK RICHARD RUNDE, DIRECTOR .5 HOURS PER WEEK STONEHILL BENEVOLENT FOUNDATION 3485 WINDSOR AVENUE DUBUQUE IA 520011312 421337556 PROVIDE SUPPORT FOR STONEHILL FRANCISCAN SERVICES IA 501(C)(3) 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0