SPRING VALLEY HEALTH CARE CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: SPRING VALLEY HEALTH CARE CENTER INC (EIN 39-0993000)
Tax period: 2021-07-01 to 2022-06-30
Filed: 2023-05-15
IRS object ID: 202341359349313909
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-05-15T15:19:46-05:00	ReturnTs
Tax Period End	2022-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390758449	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1502 LONDON ROAD SUITE 200	AddressLine1Txt
City	DULUTH	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55812	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390993000	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SPRING VALLEY HEALTH CARE SERVICES INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SPRI	BusinessNameControlTxt
Phone	7157785545	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	S830 WESTLAND DRIVE	AddressLine1Txt
City	SPRING VALLEY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54767	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	KEVIN LARSON	PersonNm
Person Title	ADMINISTRATOR	PersonTitleTxt
Phone	7157785545	PhoneNum
Signature	2023-05-12	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	KEVIN	PersonFirstNm
Person Last	LARSON	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MICHAEL J PETERSON CPA	PreparerPersonNm
PTIN	P01833529	PTIN
Phone	2187224705	PhoneNum
Preparation	2023-05-11	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	KEVIN LARSON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	S830 WESTLAND DRIVE	AddressLine1Txt
City	SPRING VALLEY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54767	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$3,331,884	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SVHCS.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1970	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	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.	ActivityOrMissionDesc
Voting Members Governing Body	4	VotingMembersGoverningBodyCnt
Voting Members Independent	4	VotingMembersIndependentCnt
Total Employee	132	TotalEmployeeCnt
Total Volunteers	30	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,067,937	PYContributionsGrantsAmt
CY Contributions Grants	$105,351	CYContributionsGrantsAmt
PY Program Service Revenue	$3,096,578	PYProgramServiceRevenueAmt
CY Program Service Revenue	$3,120,091	CYProgramServiceRevenueAmt
PY Investment Income	$247	PYInvestmentIncomeAmt
CY Investment Income	$1,091	CYInvestmentIncomeAmt
PY Other Revenue	$96,187	PYOtherRevenueAmt
CY Other Revenue	$105,351	CYOtherRevenueAmt
PY Total Revenue	$4,260,949	PYTotalRevenueAmt
CY Total Revenue	$3,331,884	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$2,394,125	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$2,148,499	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,497,309	PYOtherExpensesAmt
CY Other Expenses	$1,287,320	CYOtherExpensesAmt
PY Total Expenses	$3,891,434	PYTotalExpensesAmt
CY Total Expenses	$3,435,819	CYTotalExpensesAmt
PY Revenues Less Expenses	$369,515	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$103,935	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,240,100	TotalAssetsBOYAmt
Total Assets EOY	$2,901,413	TotalAssetsEOYAmt
Total Liabilities BOY	$2,061,724	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,839,063	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,178,376	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,062,350	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	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.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$2,563,396	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$2,621,665	RevenueAmt
Desc	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. DURING FISCAL YEAR 2021-22, THE NURSING FACILITY PROVIDED 9,156 RESIDENT DAYS, AN OCCUPANCY RATE OF 63%. EVEN THOUGH THE ORGANIZATION IS CLEARLY DISTRESSED FINANCIALLY DUE TO INADEQUATE REIMBURSEMENTS FROM THE MEDICARE AND MEDICAID SYSTEMS, A 4 STAR RATING, AS DETERMINED THE US DHHS CENTERS FOR MEDICARE AND MEDICAID SERVICES, HAS BEEN DUTIFULLY AND CONSISTENTLY MAINTAINED BY THE ORGANIZATION.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$463,881	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$474,426	RevenueAmt
Desc	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.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$23,467	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$24,000	RevenueAmt
Desc	SPRING VALLEY HEALTH CARE SERVICES, INC. MANAGES AND OPERATES SPRING VALLEY HEALTH AND REHABILITATION CENTER OWNED BY THE VILLAGE OF SPRING VALLEY.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$3,050,744	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	Yes (1)	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	10	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	132	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	4	GoverningBodyVotingMembersCnt
Independent Voting Member	4	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	KEVIN LARSON	PersonNm
Phone	7157785545	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	S830 WESTLAND DRIVE	AddressLine1Txt
City	SPRING VALLEY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54767	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
MARSHA BRUNKHORST
PRESIDENT	4.00	Yes (X)	Yes (X)	$0	$0	$0
JULIE DUCKLOW
TREASURER	3.00	Yes (X)	Yes (X)	$0	$0	$0
JAY RICHARDSON
SECRETARY	3.00	Yes (X)	Yes (X)	$0	$0	$0
JAY ARNESON
ADVISORY MEMBER	2.00	Yes (X)		$0	$0	$0
KEVIN LARSON
CEO/ADMINISTRATOR	40.00		Yes (X)	$77,602	$0	$12,671

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$77,602	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$12,671	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MIDWEST PHYSICAL THERAPY	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 176	AddressLine1Txt
City	BLOOMER	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54724	ZIPCd

Field	Value	IRS element (for citing)
Services	THERAPY SERVICES	ServicesDesc
Compensation	$106,488	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Government Grants	$84,426	GovernmentGrantsAmt
All Other Contributions	$20,925	AllOtherContributionsAmt
Total Contributions	$105,351	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NURSING HOME REVENUE	623000	$2,620,405	$2,620,405
ASSISTED LIVING REVENU	623990	$474,426	$474,426
MANAGEMENT FEES	541900	$24,000	$24,000

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,260	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,260	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$3,120,091	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,091	TotalRevenueColumnAmt
Exclusion	$1,091	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$105,351	TotalRevenueColumnAmt
Exclusion	$105,351	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$105,351	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,331,884	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,120,091	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$106,442	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$90,273	TotalAmt
Management And General	$90,273	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,724,614	TotalAmt
Program Services	$1,668,048	ProgramServicesAmt
Management And General	$56,566	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$189,435	TotalAmt
Program Services	$187,060	ProgramServicesAmt
Management And General	$2,375	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$144,177	TotalAmt
Program Services	$133,444	ProgramServicesAmt
Management And General	$10,733	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$11,855	TotalAmt
Management And General	$11,855	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,450	TotalAmt
Management And General	$3,450	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$67,854	TotalAmt
Management And General	$67,854	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$331,056	TotalAmt
Program Services	$331,056	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$8,107	TotalAmt
Management And General	$8,107	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$53,919	TotalAmt
Management And General	$53,919	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$30,536	TotalAmt
Program Services	$30,418	ProgramServicesAmt
Management And General	$118	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$191,649	TotalAmt
Program Services	$191,649	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,911	TotalAmt
Program Services	$2,394	ProgramServicesAmt
Management And General	$517	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$53	TotalAmt
Program Services	$53	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$74,464	TotalAmt
Program Services	$74,464	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$40,800	TotalAmt
Management And General	$40,800	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
FOOD AND SUPPLIES	$288,682	$288,682
NURSING HOME BED TAX	$74,800	$74,800
REPAIRS AND MAINTENANCE	$57,487	$57,487
FINES AND PENALTIES	$33,890		$33,890

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$15,807	TotalAmt
Program Services	$11,189	ProgramServicesAmt
Management And General	$4,618	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,435,819	TotalAmt
Program Services	$3,050,744	ProgramServicesAmt
Management And General	$385,075	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$851,702	BOYAmt
EOY	$199,596	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$243,334	BOYAmt
EOY	$277,572	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$342,047	BOYAmt
EOY	$716,934	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$19,595	BOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$2,950,690	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,239,530	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,785,017	BOYAmt
EOY	$1,711,160	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	-$1,595	BOYAmt
EOY	-$3,849	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,240,100	BOYAmt
EOY	$2,901,413	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$401,187	BOYAmt
EOY	$320,883	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$8,500	BOYAmt
EOY	$9,500	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,090,042	BOYAmt
EOY	$1,031,111	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$561,995	BOYAmt
EOY	$477,569	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,061,724	BOYAmt
EOY	$1,839,063	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,178,376	BOYAmt
EOY	$1,062,350	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,178,376	BOYAmt
EOY	$1,062,350	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,240,100	BOYAmt
EOY	$2,901,413	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$103,935	ReconcilationRevenueExpnssAmt
Prior Period Adjustments	-$12,091	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$32,878	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,198,281	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$331,692	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$1,067,937	CurrentTaxYearMinus1YearAmt
Current Tax Year	$105,351	CurrentTaxYearAmt
Total	$5,736,139	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,614,724	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$3,440,463	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$3,047,906	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$3,096,578	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,120,091	CurrentTaxYearAmt
Total	$16,319,762	TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus3 Years	$27,468	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$70,597	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$96,187	CurrentTaxYearMinus1YearAmt
Current Tax Year	$105,351	CurrentTaxYearAmt
Total	$299,603	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,647,602	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$7,666,212	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$3,450,195	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,260,702	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,330,793	CurrentTaxYearAmt
Total	$22,355,504	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$22,355,504	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$153	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$281	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,193	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$247	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,091	CurrentTaxYearAmt
Total	$2,965	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$153	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$281	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,193	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$247	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,091	CurrentTaxYearAmt
Total	$2,965	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	$412,630	CurrentTaxYearMinus2YearsAmt
Total	$412,630	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,647,755	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$7,666,493	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$3,864,018	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,260,949	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,331,884	CurrentTaxYearAmt
Total	$22,771,099	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.98170	PublicSupportCY509Pct
Public Support PY509	0.98220	PublicSupportPY509Pct
Investment Income CY	0.00010	InvestmentIncomeCYPct
Investment Income PY	0.00010	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$550	OtherActivitiesAmt
Total Lobbying Expenditures	$550	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$79,800	OtherCostOrOtherBasisAmt
Book Value	$79,800	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,675,296	OtherCostOrOtherBasisAmt
Depreciation	$1,198,462	DepreciationAmt
Book Value	$1,476,834	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$195,594	OtherCostOrOtherBasisAmt
Depreciation	$41,068	DepreciationAmt
Book Value	$154,526	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,711,160	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	WHEDA TAX CREDIT NOTE PAYABLE	Desc
Amt	$477,569	Amt

Field	Value	IRS element (for citing)
Total Liability	$477,569	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART IV, LINE 2B:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR THEIR NURSING HOME AND ASSISTED LIVING ROOMS FOR THE TENANTS.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS VIA EMAIL AHEAD OF A VIRTUAL MEETING TO REVIEW AND APPROVE PRIOR TO THE FORM 990 BEING SUBMITTED.
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.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	VALLEY VILLAS LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	S820 WESTLAND DRIVE	AddressLine1Txt
City	SPRING VALLEY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54767	ZIPCd

Field	Value	IRS element (for citing)
EIN	263498120	EIN
Primary Activities	DEVELOPMENT AND OPERATION OF ASSISTED LIVING FACILITY	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd
Total Income	$377,077	TotalIncomeAmt
End Of Year Assets	$1,896,128	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SPRING VALLEY HEALTH CARE SERVICES INC	BusinessNameLine1Txt