2020-11-04T13:44:59-06:00 2019-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2019-01-01 391087412 ST JOSEPH RESIDENCE INC STJO 9209825354 107 E BECKERT RD NEW LONDON WI 54961 GIDGET BLANK CEO/EXECUTIVE DIRECTOR 9209825354 2020-11-03 1 MICHAEL J PETERSON CPA P01833529 2187224705 2020-11-02 2019 2022-09-23 18:48:47Z RITA THIEL 107 E BECKERT RD NEW LONDON WI 54961 6266847 0 X WWW.STJOSEPHRESIDENCE.COM X 1965 WI A LIFE PLAN COMMUNITY COMMITTED TO PROVIDING ELDERLY HOUSING AND HEALTH CARE SERVICES INCLUDING INDEPENDENT APARTMENTS, ASSISTED LIVING, SHORT TERM REHABILITATION, LONG TERM CARE, MEMORY CARE ASISTED LIVING, AND OUTPATIENT THERAPY.AT THE END OF 2017 WE FINISHED MAJOR RENVOATION TO OUR 50+ YEAR OLD SKILLED NURSING FACILITY. IN FEBRUARY OF THIS YEAR WE OPENED A 24 BED MEMORY CARE ASSISTED LIVING TO SERVE THOSE IN NEED OF CARE AND SERVICES RELATED TO COGNITIVE IMPAIRMENT AND MEMORY LOSS. THE NEW DESIGN OF OUR BUILDING SUPPORTS SHORT TERM REHABILITATION AND COMPLEX MEDICAL CARE. WE CREATED PARTNERSHIPS THAT ALLOW US TO FOLLOW RESIDENTS FROM SHORT TERM REHAB CARE TO HOME WITH OUTPATIENT SERVICES. WE REMAINED A CMS 5 STAR COMMUNITY WITH EXCELLENT QUALITY MEASURES. 8 8 215 45 0 0 3210 12748 5225143 6139696 18790 -152782 45019 68865 5292162 6068527 0 0 0 0 3465912 3685340 0 0 0 2394520 2788444 5860432 6473784 -568270 -405257 16426922 16449777 9080587 9451640 7346335 6998137 X ST. JOSEPH RESIDENCE, A SKILLED NURSING HOME, AND MARIAN HEIGHTS APARTMENTS, A RESIDENTIAL APARTMENT FACILITY, AND TRINITY TERRACE, A COMMUNITY-BASED RESIDENTIAL FACILITY SPONSORED BY CATHOLIC HEALTH INTERNATIONAL, IS A CHRISTIAN COMMUNITY OF CARING PEOPLE DEDICATED TO THE HEALING MISSION OF THE CHURCH, SERVING THE ELDERLY AND SICK OF THE NEW LONDON AREA. 0 0 4582236 0 4142599 SKILLED NURSING FACILITY PROVIDED 16,284 DAYS OF CARE IN 2019. OUR ORGANIZATION IS COMMITTED TO SERVING THOSE IN FINANCIAL NEED IN OUR COMMUNITY. OUR SKILLED NURSING FACILITY SERVES APPROXIMATELY A 68% MEDICAID GOVERNMENT FUNDED POPULATION. WE OPENED A SHORT TERM COMPLEX MEDICAL CARE & REHAB UNIT WITH 10 BEDS DEDICATED TO SHORT TERM REHABILITATION. 857206 0 1141652 COMMUNITY BASED RESIDENTIAL FACILITY AND ASSISTED LIVING PROVIDED 9,349 DAYS OF CARE DURING 2019 WITH 27% OF CARE THAT IS MEDICAID GOVERNMENT FUNDED. THE CBRF PARTICIPATES IN A SPECIAL NEEDS PROGRAM, ALONG WITH THE SKILLED NURSING FACILITY, THAT PERMITS CARE TRANSITIONS BETWEEN THE CBRF AND THE SKILLED NURSING FACILITY RATHER THAN REQUIRING THE RESIDENT TO NEED TO BE SENT TO THE HOSPITAL. 510827 0 290809 INDEPENDENT NON-LICENSED SENIOR APARTMENT COMPLEX 26 UNITS THE NUMBER OF DAYS OF CARE DURING 2019 WAS 9,244 DAYS. 210727 0 564636 THIS YEAR OUR COMMUNITY OPENED A 24 BED MEMORY CARE ASSISTED LIVING DEDICATED TO CARE FOR COMMUNITY MEMBERS WITH COGNITIVE IMPAIRMENT AND MEMORY LOSS CONDITIONS. THIS COMMUNITY ALSO ACCEPTS MEDICAID GOVERNMENT FUNDING TO PAY FOR CARE FOR THOSE WHO CANNOT AFFORD CARE. 210727 0 564636 6160996 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 215 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 WI X GIDGET BLANK 9209825354 107 E BECKERT RD NEW LONDON WI 54961 GIDGET BLANK CEO/EXECUTIVE DIRECTOR 20.00 20.00 X 112544 0 17334 RITA THIEL VICE PRESIDENT/PRESIDENT 1.00 X X 0 0 0 STEVE DYRESON SECRETARY/TREASURER 1.00 X X 0 0 0 MARK GROSSMAN VICE PRESIDENT 1.00 0.25 X X 0 0 0 ROGER STEINGRABER BOARD MEMBER 1.00 X 0 0 0 KATHY GWIDT BOARD MEMBER 1.00 X 0 0 0 WILLIAM HEIGES BOARD MEMBER 1.00 X 0 0 0 CAROL RADTKE BOARD MEMBER 1.00 X 0 0 0 DAVID RUSCH BOARD MEMBER 1.00 X 0 0 0 112544 0 17334 1 0 0 0 HEALTH CARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 3000 BENSALEM PA 19020 LAUNDRY/HOUSEKEEPING SERVICE 290516 REHABCARE PO BOX 503534 ST LOUIS MO 631503534 THERAPY SERVICES 281125 2 12748 12748 PATIENT/RESIDENT SERVICES 623000 6139696 6139696 6139696 18386 18386 1600 0 1600 1600 1600 27152 28821 169499 -1669 -169499 -171168 -171168 67265 67265 67265 6068527 6139696 0 -83917 112544 10129 102415 3080061 3067852 12209 258633 258089 544 234102 234102 2111 2111 40956 40956 6690 6690 94147 70302 23845 38041 38041 8490 8490 75826 75826 1477 1477 309511 309511 17028 17028 284859 284859 521128 521128 18392 18392 LAUNDRY SUPPLIES 291613 291613 THERAPY SUPPLIES 278699 278699 PATIENT SERVICE SUPPLIE 271539 271539 DIETARY SUPPLIES 178449 178449 349488 345716 3772 6473784 6160996 312788 0 900 900 2965718 2938264 321678 506630 38162 35794 8840 8991 15890042 6402376 9801563 9487666 508270 533320 2781791 2938212 16426922 16449777 447024 609216 25729 132072 7695530 8319400 414500 377364 489231 0 8573 13588 9080587 9451640 X 6802876 6710174 543459 287963 7346335 6998137 16426922 16449777 -405257 57059 0 X 0 1 X 1 0 X 4615 3851 1028310 3210 12748 1052734 7405725 7515682 6592424 5225143 6139696 32878670 7410340 7519533 7620734 5228353 6152444 33931404 0 0 0 33931404 19711 22858 27778 21390 19986 111723 19711 22858 27778 21390 19986 111723 36252 41968 33693 37341 67265 216519 7466303 7584359 7682205 5287084 6239695 34259646 0.99040 0.99150 0.00330 0.00340 X 0 1 X 33972 148070 182042 10422867 3366314 7056553 3832483 2208081 1624402 1452650 827981 624669 9487666 DUE FROM RELATED PARTY 2794430 BENEFICIAL INTEREST IN COMMUNITY FOUNDATION 22575 RESIDENT TRUST FUND 13588 UNEMPLOYMENT CERTIFICATE OF DEPOSIT 107619 2938212 RESIDENT TRUST FUND 13588 13588 PART IV, LINE 2B: THE ORGANIZATIONS LEASE HOUSING UNITS TO TENANTS UNDER CONTRACTS WHICH UNDER DIFFERENT TIME PERIODS AND UNITS HAS AMOUNTED TO SECURITY DEPOSITS HELD AS AN ASSET AND OFF SETTING LIABILITY. THE CONTRACT DICTATES HOW THOSE DEPOSITS ARE REFUNDED. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2017-08-30 8442360 REFUNDING BOND 0 0 0 A 8442360 168550 8273810 2018 0 1 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION ARE LIMITED TO THOSE PERSONS THAT HAVE BEEN ADMITTED AS MEMBERS OF THE CORPORATION BY THE MEMBERS OF THE CORPORATION AND SHALL BE COMPRISED OF SEVEN MEMBERS, AT LEAST FOUR OF WHOM SHALL BE RELIGIOUS HOSPITALLERS OF ST. JOSEPH. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE CORPORATION APPOINT THE BOARD OF DIRECTORS AND THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OF THE CORPORATION HAVE THE FOLLOWING RESPONSIBILITIES APPROVE ANY CHANGE IN THE PHILOSOPHY, PURPOSE OR NATURE OF THE CORPORATION, AMEND ARTICLES OF INCORPORATION AND BYLAWS, APPOINT THE BOARD OF DIRECTORS, APPOINT OR DISMISS THE EXECUTIVE DIRECTOR IN CONCLUSION WITH OR ON RECOMMENDATION OF THE BOARD OF DIRECTORS, ACQUIRE OR DISPOSE OF REAL ESTATE OF THE CORPORATION, REVIEW THE AUDITED FINANCIAL STATEMENTS OF THE CORPORATION AND TO APPOINT THE AUDITOR, APPROVE THE ANNUAL CAPITAL AND OPERATING BUDGET OF THE CORPORATION UPON THE RECOMMENDATION OF THE BOARD, TO APPROVE OR DISAPPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 IN DRAFT FORMAT BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REQUIRES AN ANNUAL CONFLICT OF INTEREST STATEMENT IT REQUIRES THE BOARD MEMBERS TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION FOLLOWS THE LEADING AGE AGE SURVEY TO ALIGN THEIR COMPENSATION PLAN FOR ALL POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THESE RECORDS AVAILABLE TO THE PUBLIC UPON REQUEST. THE WASHINGTON CENTER INC 500 W WASHINGTON STREET NEW LONDON WI 54961 200349479 ASSISTED LIVING, ADULT DAY CARE, SENIOR CENTER WI 501(C)(3) LINE 10 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 ST JOSEPH RESIDENCE-THE WASHINGTON CENTER INC D 2797430 COST