2023-05-11T09:52:19-05:00 2022-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2021-07-01 391516772 COMMUNITY HEALTH SERVICES CORPORATION COMM 6083268471 700 S FREMONT STREET PRAIRIE DU CHIEN WI 53821 DR MARK GRUNWALD CHAIRPERSON 6083268471 2023-04-26 1 DR MARK GRUNWALD 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2023-04-26 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z X DR MARK GRUNWALD 700 S FREMONT STREET PRAIRIE DU CHIEN WI 53821 7275155 0 X WWW.CHSCWI.ORG X 1984 WI COMMUNITY HEALTH SERVICES CORPORATION IS A COMMUNITY OWNED ORGANIZATION WHICH WAS CREATED TO OVERSEE THE ACQUISITION, CONSTRUCTION, MAINTENANCE, AND OPERATION OF SKILLED NURSING, ASSISTED LIVING, AND INDEPENDENT LIVING FACILITIES AND PROVIDE SERVICES NECESSARY TO ENHANCE OUR RESIDENTS/TENANTS EXPERIENCE. 8 8 135 9 0 0 1345595 143297 6946466 7077354 26102 29798 0 24706 8318163 7275155 0 0 0 0 5012114 4592693 0 0 0 3119812 3035821 8131926 7628514 186237 -353359 14559175 14172835 855913 822932 13703262 13349903 X TO HONOR THOSE ENTRUSTED TO OUR CARE WITH A WELCOME, CLEAN, COMFORTABLE ENVIRONMENT - A PLACE THEY WANT TO BE. 0 0 4959255 0 5326945 COMMUNITY HEALTH SERVICES CORPORATION OPERATES ONE SKILLED NURSING FACILITY. PRAIRIE NURSING FACILITY, LLC (PRAIRIE MAISON) IS A 50-BED FACILITY LOCATED IN PRAIRIE DU CHIEN, WISCONSIN. THIS FACILITY OFFERS AROUND-THE-CLOCK CARE FOR PERSONS WHO REQUIRE THE SERVICES OF PROFESSIONAL NURSING STAFF OR ARE UNABLE TO LIVE INDEPENDENTLY. THE NURSING STAFF INCLUDES REGISTERED AND LICENSED NURSES, AS WELL AS CERTIFIED NURSING ASSISTANTS, WORKING AS A TEAM TO PROVIDE THE HIGHEST QUALITY CLINICAL AND PERSONAL CARE. SKILLED AND INTERMEDIATE SERVICES INCLUDE CARE FOR THOSE NEEDING LONG-TERM CARE, AND THOSE NEEDING OBSERVATION BY LICENSED NURSING STAFF AND/OR PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY SERVICES. SKILLED AND INTERMEDIATE RESIDENTS ADDITIONALLY ENJOY A PERSON-CENTERED ACTIVITY PROGRAM, AN EXCEPTIONAL DINING PROGRAM, AND THE SERVICES OF A LICENSED SOCIAL WORKER. PRAIRIE MAISON HAD A TOTAL OF 18,726 RESIDENT DAYS FOR THE YEAR THROUGH DECEMBER 31, 2021. AS AN EXTENSION OF SERVING THE NEEDS OF SENIORS IN THE LOCAL COMMUNITIES, THE NURSING FACILITY PREPARE MEALS TO SERVE AT A SENIOR MEAL SITE, AND SOME ARE DELIVERED TO THE HOMEBOUND. 1693120 0 1775115 COMMUNITY HEALTH SERVICES CORPORATION OPERATES PRAIRIE MEMORIAL HOUSING, LLC LOCATED IN PRAIRIE DU CHIEN, WISCONSIN. PRAIRIE MEMORIAL HOUSING, LLC IS AN ASSISTED LIVING FACILITY WITH 24 RESIDENTIAL CARE APARTMENT COMPLEX UNITS AND 20 COMMUNITY BASED RESIDENTIAL FACILITY UNITS. THE ASSISTED LIVING COMBINES THE CARE OF ATTENTIVE STAFF WITH A SECURE AND SOOTHING ENVIRONMENT. PRIVATE BEDROOMS ARE ARRANGED AROUND A CENTRAL DINING AREA, KITCHEN AND LIVING ROOM, WITH WIDE HALLWAYS AND ROOMS THAT ARE EASY TO RECOGNIZE AND NAVIGATE. A SECURE COURTYARD ENABLES RESIDENTS TO ENJOY FRESH AIR, GARDENS AND GRASS. SERVICES AND AMENITIES PROVIDED AT BLUFF HAVEN INCLUDE 24 HOUR NURSING CARE, ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, LAUNDRY, HOUSEKEEPING, PERSON-CENTERED ACTIVITIES, NURSING ASSISTANCE, CARE PLANNING, MEDICATION MANAGEMENT, NURSE CALL SYSTEM, SECURE ENVIRONMENT, AND AN OUTDOOR ENCLOSED PATIO AREA. THOSE NEEDING SKILLED CARE CAN TRANSITION TO THE SKILLED NURSING FACILITY LOCATED IN THE SAME BUILDING.COMMUNITY HEALTH SERVICES CORPORATION ALSO OPERATES LABATISSE APARTMENTS LOCATED IN PRAIRIE DU CHIEN, WISCONSIN. LABATISSE IS DESIGNED AS AN ELDERLY HOUSING OPTION FOR THOSE 50 YEARS OF AGE AND OLDER WHO ARE CAPABLE OF INDEPENDENT LIVING. THE APARTMENTS FEATURE A SECURE ENTRY, ON-SITE COIN OPERATED LAUNDRY, AND OFF STREET ASSIGNED PARKING. THE COMMUNITY ROOM AND SUNROOM ALLOW SPACIOUS AREAS FOR TENANTS TO SOCIALIZE AND GATHER WITH FRIENDS AND FAMILY. LABATISSE OFFERS 22 ONE BEDROOM APARTMENTS AND 2 TWO BEDROOM APARTMENTS. 6652375 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 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 1 1 0 0 0 1 14 0 135 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 WI X CIERRA SNITKER 6083263200 700 S FREMONT STREET PRAIRIE DU CHIEN WI 53821 DR MARK GRUNWALD CHAIRPERSON/TRUSTEE 2.00 X X 0 0 0 ROBERT SEVERSON VICE CHAIRSPERSON 1.00 X X 0 0 0 BRAD BERTHIAUME TREASURER 2.00 X X 0 0 0 DR JOYCE CZAJKOWSKI SECRETARY 1.00 X X 0 0 0 JOE FRIAR TRUSTEE 1.00 X 0 0 0 STEVE JANSEN TRUSTEE (THRU OCT) 1.00 X 0 0 0 ILLENE OLSON TRUSTEE 1.00 X 0 0 0 LYNN SCHRECK TRUSTEE 1.00 X 0 0 0 CASEY ZIMPAL TRUSTEE 1.00 X 0 0 0 RITA MOORE MANAGING DIRECTOR/N.H. ADMINISTRATOR 45.00 X 119544 0 6981 DANA COTA ASSISTED LIVING ADMINISTRATOR 45.00 X 84289 0 5954 203833 0 12935 1 0 0 0 MJ CARE PO BOX 6584 CAROL STREAM IL 60197 THERAPY 328276 PRIME TIME HEALTHCARE PO BOX 3544 OMAHA NE 68103 CONTRACTED NURSING 206342 WIPFLI 1000 W INNOVATION DR SUITE 250 MILWAUKEE WI 53226 CONTRACTED ADMINISTRATION 136363 3 143297 143297 NURSING HOME REVENUE 623000 5191250 5191250 ELDERLY HOUSING REVENU 623000 1726293 1726293 APARTMENT REVENUE 623990 159811 159811 7077354 24298 24298 5500 0 5500 5500 5500 BAD DEBT RECOVERIES 900999 24706 24706 24706 7275155 7102060 0 29798 236141 236141 3484792 3207320 277472 19508 18827 681 573669 506025 67644 278583 241005 37578 6328 6328 35775 35775 652447 586508 65939 8575 8575 34966 22953 12013 205525 197482 8043 24713 11628 13085 509940 478732 31208 81779 81779 SUPPLIES 713666 683891 29775 FOOD 293556 293556 HRSA FUND PAYMENT 225000 225000 BED ASSESSMENT 111520 111520 132031 67928 64103 7628514 6652375 976139 0 1491916 1427562 3533693 3521785 411138 409085 22976 15517 15526345 6739806 9087105 8786539 12347 12347 14559175 14172835 754903 580352 84368 225000 16642 17580 855913 822932 X 13703262 13349903 13703262 13349903 14559175 14172835 -353359 0 X X 0 1 X 1 0 X 1721 1000 1345595 143297 1491613 8224254 6944838 7190489 6946466 7077354 36383401 8225975 6945838 7190489 8292061 7220651 37875014 0 314434 591180 922080 1827694 314434 591180 922080 1827694 36047320 3679 17150 43097 26102 24298 114326 3679 17150 43097 26102 24298 114326 24706 24706 8229654 6962988 7233586 8318163 7269655 38014046 0.94830 0.97550 0.00300 0.00230 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 706 706 0 PART II-B, LINE 1: COMMUNITY HEALTH SERVICES CORPORATION PAYS ANNUAL ASSOCIATION DUES TO LEADINGAGE WISCONSIN, INC AND WISCONSIN HEALTH CARE ASSOCIATION. 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 334462 334462 12497737 4769055 7728682 2694146 1970751 723395 8786539 PART IV, LINE 2B: THE ORGANIZATION COLLECTS SECURITY DEPOSITS FROM THEIR RESIDENTS WHEN THEY MOVE IN. THE DEPOSIT WILL BE HELD UNTIL THE RESIDENT MOVES OUT. A FULL REFUND WILL BE GIVEN AFTER MOVING OUT PER THE EXCEPTION OF FEES FOR CLEANING. 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 IS DISTRIBUTED TO THE BOARD OF DIRECTORS FOR REVIEW AT THE BOARD MEETING PRIOR TO THE 990 BEING SUBMITTED. FORM 990, PART VI, SECTION B, LINE 12C KEY EMPLOYEE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE EXECUTIVE TEAM AND BOARD OF DIRECTORS. BOARD OF DIRECTOR'S CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE PRESIDENT AND BOARD OF DIRECTORS. IF A CONFLICT IS DEEMED TO EXIST, THE MEMBER MUST EXCUSE THEMSELVES FROM DISCUSSION AND VOTING ON THE TOPIC. FORM 990, PART VI, SECTION B, LINE 15 COMMUNITY HEALTH SERVICES CORPORATION'S BOARD OF DIRECTORS SETS THE INITIAL SALARY AND BENEFIT PACKAGE FOR THE ADMINISTRATORS AND MANAGING DIRECTOR WHEN THEY ARE HIRED. MARKET DATA AND COMPARABILITY DATA ARE USED TO DETERMINE A COMPETITIVE SALARY AND BENEFIT PACKAGE. IN YEARS SUBSEQUENT TO INITIAL HIRE, ADMINISTRATIVE PERSONNEL RECEIVE THE SAME COST OF LIVING SALARY INCREASE AS THE REST OF COMMUNITY HEALTH SERVICES CORPORATION'S EMPLOYEES WHICH IS APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C: OVERSIGHT OF THE INDEPENDENT ACCOUNTANT: THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SERVICES CORPORATION REVIEWS THE AUDITED FINANCIAL STATEMENTS AT ITS BOARD MEETING AND IS RESPONSIBLE FOR THE OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE BOARD ALSO TAKES TIME DURING THE PRESENTATION OF THE ANNUAL FINANCIAL STATEMENTS TO MEET WITH THE INDEPENDENT AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PRAIRIE NURSING FACILITY LLC 700 S FREMONT ST PRAIRIE DU CHIEN WI 53821 201532236 NURSING HOME WI 5338035 1297288 COMMUNITY HEALTH SERVICES CORPORATION PRAIRIE MEMORIAL HOUSING LLC 720 S FREMONT ST PRAIRIE DU CHIEN WI 53821 391516772 ELDERLY HOUSING WI 1902186 2626993 COMMUNITY HEALTH SERVICES CORPORATION COMMUNITY HEALTH SERVICES FOUNDATION INC 720 FREMONT ST PRAIRIE DU CHIEN WI 53821 814044374 FOUNDATION WI 501(C)(3) LINE 7 COMMUNITY HEALTH SERVICES CORPORATION 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0