2024-05-15T11:15:20-05:00 2023-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-07-01 390993000 SPRING VALLEY HEALTH CARE SERVICES INC SPRI 7157785545 S830 WESTLAND DRIVE SPRING VALLEY WI 54767 JIM TORGERSON ADMINISTRATOR 7157785545 2024-05-15 1 JIM TORGERSON 999009999 0 MICHAEL J PETERSON CPA P01833529 2187224705 2024-05-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JIM TORGERSON S830 WESTLAND DRIVE SPRING VALLEY WI 54767 4552850 0 X WWW.SVHCS.ORG X 1970 WI THE MISSION OF SPRING VALLEY HEALTH CARE SERVICES, INC. IS TO PROVIDE HEALTH AND ASSISTIVE SERVICES TO ELDERLY AND DISABLED PERSONS IN NEED OF SPRING VALLEY HEALTH CARE SERVICES, INC.'S PROGRAMS IN A MANNER THAT IS CHARITABLE AND WITH A SPIRIT OF BENEVOLENCE SO THAT AN INDIVIDUAL MAY MAINTAIN THE HIGHEST PRACTICABLE QUALITY OF LIFE, THE UTMOST INDEPENDENCE, AND THE MOST REASONABLE SAFE AND HEALTHY LIFESTYLE. 4 4 110 34 0 0 105351 62822 3120091 4289579 1091 27356 105351 173093 3331884 4552850 0 0 0 0 2148499 2588222 0 0 0 1287320 2235595 3435819 4823817 -103935 -270967 2901413 2913522 1839063 2135930 1062350 777592 X THE MISSION OF SPRING VALLEY HEALTH CARE SERVICES, INC. IS TO PROVIDE HEALTH AND ASSISTIVE SERVICES TO ELDERLY AND DISABLED PERSONS IN NEED OF SPRING VALLEY HEALTH CARE SERVICES, INC.'S PROGRAMS IN A MANNER THAT IS CHARITABLE AND WITH A SPIRIT OF BENEVOLENCE SO THAT AN INDIVIDUAL MAY MAINTAIN THE HIGHEST PRACTICABLE QUALITY OF LIFE, THE UTMOST INDEPENDENCE, AND THE MOST REASONABLE SAFE AND HEALTHY LIFESTYLE. 0 1 3351569 0 3601134 SPRING VALLEY HEALTH CARE SERVICES, INC. OPERATES A 40-BED SKILLED NURSING FACILITY WHICH IS AVAILABLE TO RESIDENTS OF SPRING VALLEY AND THE SURROUNDING AREAS. PERSONALIZED NURSING CARE, REHABILITATIVE SERVICES, AND SUPPORTIVE SERVICES ARE OFFERED TO PROMOTE AND ASSIST RESIDENTS RECUPERATING FROM ILLNESS, INJURY, OR SURGERY. 710469 0 750267 SPRING VALLEY HEALTH CARE SERVICES, INC. IS THE SOLE CORPORATE MEMBER OF VALLEY VILLAS, LLC. VALLEY VILLAS, LLC. WAS ORGANIZED AS A DISREGARDED ENTITY FOR THE PURPOSE OF OPERATING A 20-UNIT RESIDENTIAL CARE APARTMENT COMPLEX. 0 0 0 SPRING VALLEY HEALTH CARE SERVICES, INC. MANAGES AND OPERATES SPRING VALLEY HEALTH AND REHABILITATION CENTER OWNED BY THE VILLAGE OF SPRING VALLEY. 4062038 1 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 9 0 110 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 0 0 WI X HEALTH DIMENSIONS GROUP 7635375700 12900 WHITEWATER DRIVE SUITE 201 MINNEAPOLIS WI 55343 MARSHA BRUNKHORST PRESIDENT 4.00 X X 0 0 0 JULIE DUCKLOW TREASURER 3.00 X X 0 0 0 JAY RICHARDSON SECRETARY 3.00 X X 0 0 0 JAY ARNESON ADVISORY MEMBER 2.00 X 0 0 0 KEVIN LARSON CEO/ADMINISTRATOR 40.00 X 77910 0 12671 TRACY REITZ DIRECTOR-NURSING & CLINICAL SERVICES 40.00 X 101959 0 0 179869 0 12671 1 0 0 0 0 62822 62822 NURSING HOME REVENUE 623000 3539312 3539312 ASSISTED LIVING REVENU 623990 750267 750267 4289579 481 481 26875 0 26875 26875 26875 173093 173093 173093 4552850 4289579 0 200449 X 179869 101959 77910 2041895 1982050 59845 692 692 204772 192076 12696 160994 151012 9982 92072 92072 24247 24247 158511 158511 93 93 545110 545110 6271 6271 63565 63565 22285 22285 383912 383912 20650 20650 9074 9074 88642 88642 88035 88035 43608 43608 FOOD AND SUPPLIES 320895 320895 FINES AND PENALTIES 123744 123744 BAD DEBT EXPENSE 83634 83634 NURSING HOME BED TAX 81600 81600 79647 79054 593 4823817 4062038 761779 0 199596 433141 277572 80765 716934 536659 0 60573 3023271 1352248 1711160 1671023 -3849 131361 2901413 2913522 320883 1037030 9500 9000 1031111 1089900 477569 0 1839063 2135930 X 1062350 777592 1062350 777592 2901413 2913522 -270967 -13791 0 X 0 0 0 X 4198281 331692 1067937 105351 62822 5766083 3440463 3047906 3096578 3120091 4289579 16994617 27468 70597 96187 105351 173093 472696 7666212 3450195 4260702 3330793 4525494 23233396 0 0 0 23233396 281 1193 247 1091 481 3293 281 1193 247 1091 481 3293 412630 412630 7666493 3864018 4260949 3331884 4525975 23649319 0.98240 0.98170 0.00010 0.00010 X 0 0 0 0 0 0 0 0 1 93 93 0 PART II-B, LINE 1: SPRING VALLEY HEALTH CARE SERVICES, INC. PAYS ANNUAL ASSOCIATION DUES TO WISCONSIN HEALTH CARE ASSOCIATION, INC. AND AMERICAN HEALTH CARE ASSOCIATION, INC. 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. 0 1 X 79800 79800 2727739 1308676 1419063 215732 43572 172160 1671023 PART IV, LINE 2B: THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR THEIR NURSING HOME AND ASSISTED LIVING ROOMS FOR THE TENANTS. FORM 990, PART III, LINE 3 THE ORGANIZATION DISCONTINUED USE OF THEIR SKILLED NURSING FACILITY IN DECEMBER 2022. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES OF THE BOARD OF DIRECTORS WHICH HAVE AUTHORITY TO ACT ON BEHALF OF THE ENTIRE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 HAS BEEN PREPARED BY THE ORGANIZATIONS PAID PREPARER WITH INFORMATION PROVIDED BY THE ORGANIZATION AND REVIEWED BY LEADERSHIP PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C SPRING VALLEY HEALTH CARE SERVICES, INC. REQUIRES ITS BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15A THE SPRING VALLEY HEALTH CARE SERVICES, INC.'S BOARD OF DIRECTORS SETS THE SALARY AND BENEFIT PACKAGE FOR THE ADMINISTRATOR/CEO. THE BOARD OF DIRECTORS UTILIZES MULTIPLE SOURCES FOR SETTING THE COMPENSATION INCLUDING VARIOUS SALARY SURVEYS FROM THIRD PARTY SOURCES SUCH AS THE AMERICAN COLLEGE OF HEALTH CARE ADMINISTRATORS, THE LONG TERM CARE NEWS, AND AMERICAN HEALTH CARE ASSOCIATION PROVIDER PUBLICATION. THE SALARY AND BENEFIT PACKAGE FOR OTHER MANAGEMENT-SENIOR LEVEL STAFF PERSONS IS DETERMINED BY THE ADMINISTRATOR WITH CONSULTATION FROM THE BOARD OF DIRECTORS AND WITHIN THE PARAMETERS OF THE ORGANIZATION'S OPERATING BUDGET WHICH IS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 SPRING VALLEY HEALTH CARE SERVICES, INC. MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC ON A PER REQUEST BASIS. FORM 990, PART VI, SECTION B, LINE 14, DOCUMENT RETENTION AND DESTRUCTION POLICY: SPRING VALLEY HEALTH CARE SERVICES, INC. DOES NOT HAVE A FORMAL DOCUMENT RETENTION AND DESTRUCTION POLICY. HOWEVER, SPRING VALLEY HEALTH CARE SERVICES, INC. FOLLOWS ALL STATUTORY REQUIREMENTS GOVERNING RECORD RETENTION. THE STANDARD GUIDELINE UTILIZED IS THE 7 YEAR RETENTION PERIOD FOR RECORDS AND FILES. THE 7 YEAR PERIOD BEGINS WITH THE CLOSING OF THE FILE OR RECORD. STAFF EMPLOYMENT RECORDS CONTAINING ANY MEDICAL OR HEALTH INFORMATION ARE MAINTAINED FOR 30 YEARS ACCORDING TO STATUTORY REQUIREMENTS. FORM 990, PART VI, SECTION B, LINE 13, WHISTLEBLOWER POLICY: SPRING VALLEY HEALTH CARE SERVICES, INC. DOES NOT HAVE A FORMAL WHISTLEBLOWER POLICY. HOWEVER, SPRING VALLEY HEALTH CARE SERVICE, INC.'S ANTI-FRAUD PROTECTIONS INCLUDE SAFE-GUARDS AFFORDED TO THOSE INDIVIDUALS REPORTING OR PROVIDING INFORMATION OR ASSISTANCE WITH CONCERNS OR SITUATIONS RELATED TO POSSIBLE FRAUD, THEFT, ABUSE, OR DETRIMENTAL ACTIVITY BY STAFF PERSONS OR INDIVIDUALS WHO MAY BE AFFILIATED OR ASSOCIATED WITH THE OPERATIONS OF SPRING VALLEY HEALTH CARE SERVICES, INC. THE CRITICAL ELEMENT WITH THE SAFEGUARDS IS THE PROTECTION OF THOSE STAFF PERSONS FROM RETRIBUTION OR RETALIATION AS A RESULT OF THEM PROVIDING INFORMATION OR AID. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 84,154. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,154. NURSING SERVICES: PROGRAM SERVICE EXPENSES 460,956. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 460,956. VALLEY VILLAS LLC S820 WESTLAND DRIVE SPRING VALLEY WI 54767 263498120 DEVELOPMENT AND OPERATION OF ASSISTED LIVING FACILITY WI 337916 1752314 SPRING VALLEY HEALTH CARE SERVICES INC