2021-11-16T13:53:00-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2020-01-01 390832605 MORROW MEMORIAL HOME FOR THE AGED INC MORR 6082693168 331 SOUTH WATER STREET SPARTA WI 54656 DANIEL MEYER CEO 6082693168 2021-11-11 1 DANIEL MEYER 999009999 KIMBERLY ANDERSON CPA P00188889 6086628600 2021-11-08 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DANIEL MEYER 331 SOUTH WATER STREET SPARTA WI 54656 12318376 0 X WWW.MORROWHOME.ORG X 1917 WI THE ORGANIZATION OWNS AND OPERATES A NURSING FACILITY, ASSISTED LIVING UNITS, INDEPENDENT HOUSING WITH SERVICES UNITS, AND A COMMUNITY BASED RESIDENTIAL FACILITY. 24 24 295 868 0 0 114558 1355487 10725203 10640543 65619 4546 148191 197534 11053571 12198110 0 0 0 0 7358498 7978969 0 0 0 2827260 2827630 10185758 10806599 867813 1391511 14807617 19091720 7282458 9952638 7525159 9139082 THE ORGANIZATION OWNS AND OPERATES AN 85 BED NURSING FACILITY, 48 ASSISTED LIVING UNITS, 22 INDEPENDENT AND HOUSING WITH SERVICES UNITS, AND A 28 UNIT COMMUNITY BASED RESIDENTIAL FACILITY. 0 0 9440462 10640543 NURSING HOME SERVICES: PROVIDE SKILLED AND INTERMEDIATE NURSING CARE SERVICES FOR PRIVATE PAY, MEDICARE, AND MEDICAID PATIENTS. CONGREGATE LIVING SERVICES: PROVIDE INDEPENDENT LIVING SERVICES FOR THE ELDERLY. OWNS AND OPERATES AN 85 BED NURSING FACILITY, 48 ASSISTED LIVING UNITS, 22 INDEPENDENT AND HOUSING WITH SERVICES UNITS, AND A 28 UNIT COMMUNITY BASED RESIDENTIAL FACILITY. PROVIDES MEALS ON WHEELS PROGRAM TO HOME-BOUND SENIORS ON WEEKDAYS. 9440462 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 295 1 0 0 0 0 0 0 0 0 0 0 0 0 X 24 24 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X DANIEL MEYER 6082693168 331 SOUTH WATER STREET SPARTA WI 54656 BRYAN SIMONSON RESIDENT COMMITTEE 1.00 X 0 0 0 CHERYL WEBER PERSONNEL COMMITTEE 1.00 X 0 0 0 DEB SMITH DEVELOPMENT COMMITTEE 1.00 X 0 0 0 DICK GAJEWSKY PROPERTY COMMITTEE 1.00 X 0 0 0 GARY EDWARDS FINANCE COMMITTEE 3.00 X 0 0 0 JIM DEVOE PROPERTY COMMITTEE 1.00 X 0 0 0 JOHN BUDIN FINANCE COMMITTEE 1.00 X 0 0 0 KATHY ROWAN FINANCE COMMITTEE 1.00 X 0 0 0 KURT MARSHAUS DEVELOPMENT COMMITTEE/MEMB 1.00 X 0 0 0 LORETTA WAUGHTAL CHAPLAIN 2.00 X 0 0 0 LOUIS GEIGER PROPERTY COMMITTEE 1.00 X 0 0 0 MARJORIE LAKOWSKE PERSONNEL COMMITTEE 1.00 X 0 0 0 MAXINE GUDBAUR RESIDENT SERVICES COMMITTEE 1.00 X 0 0 0 MIKE KELLY PERSONNEL COMMITTEE 1.00 X 0 0 0 MIKE MCALPINE VICE PRESIDENT 1.00 X X 0 0 0 PAM PHILLIPS RESIDENT COMMITTEE 1.00 X 0 0 0 PATTY HEROLD SECRETARY/TREASURER 1.00 X X 0 0 0 PEGGY WRIGHT PERSONNEL COMMITTEE 1.00 X 0 0 0 PETE FOSS PRESIDENT 2.00 X X 0 0 0 RANDY ABBOTT DEVELOPMENT COMMITTEE 1.00 X 0 0 0 RICK SMITH PROPERTY COMMITTEE 1.00 X 0 0 0 TODD PAGE FINANCE COMMITTEE 1.00 X 0 0 0 TOM SCHAUER DEVELOPMENT CHAIR 1.00 X 0 0 0 TONI POLKOSKI RESIDENT SERVICES CHAIR 2.00 X 0 0 0 DANIEL MEYER CEO 40.00 X 147969 0 7542 JENNIFER BRIESKE NURSING HOME ADMIN 40.00 X 125313 0 6265 MALLORY YORK KEMNITZ DIRECTOR OF NURSING 40.00 X 118906 0 11539 NIKKI SUND FINANCE DIRECTOR 40.00 X 102566 0 5128 494754 0 30474 4 0 1 0 REHABCARE GROUP PO BOX 503534 ST LOUIS MO 53150 THERAPY SERVICES 799708 CLA 220 S 6TH ST UNIT 300 MINNEAPOLIS MN 55402 MARKET FEASIBILITY STUDY/TAX AND AUDIT S 107861 2 1296465 59022 1355487 RESIDENT REVENUE 623000 7425609 7425609 ADVANCED MEMORY CARE 623000 1476626 1476626 APARTMENT REVENUE 623000 1153022 1153022 ASSISTED LIVING 623000 585286 585286 10640543 70944 70944 9134 75532 -66398 -66398 -66398 64106 44734 19372 19372 OTHER REVENUE 900099 95925 95925 MEALS INCOME 900099 69357 69357 BEAUTY SHOP REVENUE 900099 12880 12880 178162 12198110 10640543 0 202080 155511 155511 6518536 5826968 691568 173215 155130 18085 710547 609810 100737 421160 361451 59709 7286 7286 34130 34130 28697 28697 23224 6899 16325 255435 255435 3832 1953 1879 209490 209490 743011 743011 114384 114384 FOOD COSTS 775535 775535 SUPPLIES 561419 528717 32702 BED SURCHARGE 174930 174930 PURCHASED SERVICES 157473 106161 51312 -261216 -315028 53812 10806599 9440462 1366137 0 1532648 697740 1535174 810461 914586 8396 2477 25044410 13186538 8840104 11857872 3605068 4072525 10940 11346 14807617 19091720 789634 1066345 0 992001 6346343 7760905 146481 133387 7282458 9952638 X 7525159 9139082 7525159 9139082 14807617 19091720 1391511 222412 0 X 0 1 X 1 0 X 108958 101002 117664 114558 1355487 1797669 10922956 10326261 10354173 10725203 10704649 53033242 82237 82237 11031914 10427263 10471837 10839761 12142373 54913148 0 0 0 54913148 56901 65927 57087 73653 70944 324512 56901 65927 57087 73653 70944 324512 120615 209431 186705 148191 95925 760867 11209430 10702621 10715629 11061605 12309242 55998527 0.98060 0.98050 0.00580 0.00550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 612747 612747 17081446 10470260 6611186 2872083 2129092 742991 4478134 587186 3890948 11857872 UNITED METHODIST FOUNDATION COMMON 4071454 F CO-OP OIL STOCK CERTIFICATE 1071 C 4072525 SECURITY DEPOSITS 47225 RESIDENT TRUST FUNDS 11346 ASSET RETIREMENT OBLIGATION 74816 133387 X 12420522 222412 222412 12198110 0 12198110 10806599 0 10806599 0 10806599 PART X, LINE 2: THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER CODE SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD RELATED TO INCOME TAXES REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE APPLICATION OF THE STANDARD HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. THE ORGANIZATION IS ALSO NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. 0 0 0 0 0 0 0 0 0 DANIEL MEYER CEO 147969 0 0 0 0 0 7542 0 0 0 155511 0 0 0 A HOUSING AUTHORITY OF THE CITY OF SPARTA WI 396005610 2013-05-10 9139000 REFUND VARIOUS DEBT ISSUES 0 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2020-07-16 18250000 CONSTRUCTION AND REMODELING PROJECT FUNDING, REFUNDING 2013 BONDS 0 0 0 A 9139000 9139000 117714 588636 8432650 2013 1 0 1 1 B 8198405 437500 5710 7755195 2020 0 1 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 1 0 0 0 0 B 0 0 0 1 1 0 0 0 0 A 1 B 1 SCHEDULE K PART II LINE 3 BOND ISSUE IS LESS THAN THE FULL ISSUE PRICE AS THE FULL AMOUNT HAS NOT BEEN TAKEN. TOTAL BONDS ISSUED WERE $18,250,000 AND THE ORGANIZATION IS DRAWING ON THE BOND PROCEEDS AS NEEDED. AS OF 12/31/2020, ONLY $8,198,405 WAS DRAWN. FORM 990, PART VI, SECTION A, LINE 8B ALL MEETING HELD BY THE BOARD OF DIRECTORS ARE DOCUMENTED AND AVAILABLE UPON REQUEST. THERE IS NO OTHER COMMITEE WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO BEING FILED WITH THE IRS, A COPY OF THE IRS FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE EXECUTIVE DIRECTOR, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF APPROPRIATE CHANGES. UPON COMPLETION OF THE EXECUTIVE DIRECTOR'S REVIEW, THE FORMS ARE REVIEWED AND APPROVED AT A BOARD MEETING PRIOR TO SUBMITTAL TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE ASKED TO DISCLOSE ANNUALLY BUSINESS RELATIONSHIPS AND FAMILY MEMBERS THAT COULD, OR DO, CREATE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST ARE DETERMINED BY A REVIEW OF THE POTENTIAL CONFLICTS BY THE ADMINISTRATOR AND THE BOARD OF DIRECTORS. IF A CONFLICT EXISTS, THEN THE CONFLICTED BOARD MEMBER OR KEY EMPLOYEE IS EXCLUDED FROM DISCUSSIONS AND VOTES RELATED TO ANY POTENTIAL OR EXISTING RELATIONSHIPS INVOLVING THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS USED TO SET THE CEO'S ANNUAL SALARY IS BASED ON A COMBINATION OF COMPARISON TO COMPARABLE ORGANIZATIONS THROUGH USE OF OUR TRADE ORGANIZATION'S ANNUAL COMPENSATION SURVEY AND ATTAINMENT IN THE CURRENT YEAR OF PREDEFINED PERFORMANCE OBJECTIVES SET FOR THE CEO PERSONALLY AND THE ORGANIZATION. THIS PROCESS IS PERFORMED ANNUALLY BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.