2019-11-25T14:48:21-06:00 2019-06-30 430352985 KERBER ECK & BRAECKEL LLP 125 SOUTH 84TH STREET SUITE 100 MILWAUKEE WI 53214 990 2018-07-01 390826123 ST MARY'S HOME FOR THE AGEDINC STMA 9206847171 1635 SOUTH 21ST STREET MANITOWOC WI 542205652 FRANK SOLTYS PRESIDENT/CEO 9206847171 2019-11-20 1 CHRISTIAN A SLAATS CPA P00963303 4144561099 2019-11-20 216.84.173.86 2019-11-20 14:03:21 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B505E11BB90FB4CD9827D34B83DF4EF10642CEC2 2018 2020-03-31 21:24:44Z FRANK SOLTYS 1635 SOUTH 21ST STREET MANITOWOC WI 542205652 15075001 0 0928 X WWW.FELICIANVILLAGE.ORG X 1956 WI TO CONTINUE THE HEALING MINISTRY OF JESUS WITH PARTICULAR ATTENTION TO THE NEEDS OF THE POOR, AS WE PROVIDE SKILLED NURSING CARE AND HOUSING FOR SENIORS. 15 14 440 127 0 0 259992 147636 13181484 14916229 44480 11136 0 0 13485956 15075001 0 0 0 0 7867320 8386037 0 0 141102 5614928 6404291 13482248 14790328 3708 284673 30011908 29520017 27339398 26544161 2672510 2975856 X AS A FACILITY THAT PROVIDES SKILLED NURSING, REHABILITATION AND ASSISTED LIVING, ST. MARY'S CONTINUES THE HEALING MINISTRY OF JESUS BY PROVIDING COMPASSIONATE CARE THAT SUPPORTS THE VALUES OF RESPECT FOR HUMAN DIGNITY, COMPASSION, TRANSFORMATION, SOLIDARITY WITH THE POOR AND JUSTICE AND PEACE. 0 0 12786699 14916229 ST. MARY'S EMPLOYS 440 PEOPLE IN DIRECT CARE AND SUPPORT RESPONSIBILITIES, REPRESENTING APPROXIMATELY 94,000 RESIDENT DAYS PER YEAR. CARE IS PROVIDED IN SKILLED NURSING AND ASSISTED LIVING. VOLUNTEERS PROVIDE MORE THAN 11,000HOURS OF SERVICE PER YEAR. SIGNIFICANT COMMUNITY SERVICE IS PROVIDED BY BOTH INDIVIDUALS SERVING ON BOARDS AND COMMITTEES AND BY THE ORGANIZATION'S SUPPORT OF VARIOUS EDUCATIONAL INSTITUTIONS AND CARE PROVIDERS IN THE COMMUNITY.DURING 2018-2019, ST MARY'S HOME PROVIDED IN EXCESS OF $3.6 MILLION IN UNREIMBURSED SERVICES FOR MEDICAID, FAMILY CARE, MEDICARE, AND MANAGED CARE RESIDENTS. IN ADDITION, ST. MARY'S PROVIDED TO THE PUBLIC AND ITS RESIDENTS, AT NO CHARGE, 21 COMMUNITY EDUCATIONAL SEMINARS TO INCLUDE DEMENTIA EDUCATION INCLUDING VIRTUAL DEMENTIA TOURS, WELLNESS SEMINARS, AND EXERCISE CLASSES FOR BETTER BALANCE TO HELP REDUCE FALLS. MEMORY SCREENS WERE OFFERED FREE OF CHARGE IN ADDITION TO AN EMPLOYEE INVOLVED IN VARIOUS COMMUNITY ACTIVITIES FOR THE ALZHEIMER'S ASSOCIATION. TIME WAS SPENT TO DEVELOP A DEMENTIA CLINIC IN THE COMMUNITY FOR THE INCREASED NUMBER OF ELDERLY IN MANITOWOC COUNTY.ALSO INCLUDED WERE THREE CERTIFIED NURSING ASSISTANT CLASSES WHICH PROVIDED TRAINING FOR 16 STUDENTS. ST. MARY'S PROVIDED A CLINICAL SITE FOR THOSE STUDENTS AS WELL AT LAKESHORE TECHNICAL COLLEGE STUDENTS. FINALLY, HUNDREDS OF HOURS WERE DONATED TO AREA AGENCIES IN SUPPORT OF COMMUNITY ORGANIZATIONS AND EVENTS THAT BENEFIT RESIDENTS OF THE ENTIRE COUNTY. AMONG THE ORGANIZATIONS SUPPORTED THROUGH STAFF INVOLVEMENT ARE: AGING & DISABILITY RESOURCE CENTER, ROTARY MANITOWOC, TWO RIVERS AND SHEBOYGAN, LAKESHORE TECHNICAL COLLEGE, ST. FRANCIS OF ASSISI PARISH, YMCA MANITOWOC/TWO RIVERS, MANITOWOC SENIOR CENTER, TWO RIVERS SENIOR CENTER, AURORA HEALTH CARE, HOLY FAMILY MEMORIAL, FIRST PRESBYTERIAN CHURCH, SALVATION ARMY CLINIC, SILVER LAKE COLLEGE, ALZHEIMER'S ASSOCIATION, HEALTHIEST MANITOWOC COUNTY 2020, CHAMBER OF MANITOWOC COUNTY, AND LEADING AGE WISCONSIN.ESTIMATED COSTS TO PROVIDE ALL THE ABOVE OPPORTUNITIES IS $62,157. 12786699 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 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 1 0 0 0 1 39 0 1 440 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X JOANNE BARTZ 9206847171 1635 SOUTH 21ST STREET MANITOWOC WI 54220 DAVID WARD DIRECTOR 2.00 X 0 240649 25695 KATHY ZUCCHI DIRECTOR 1.00 X 0 0 0 BETSY BENZ CHAIR 1.00 X 0 0 0 MARY MAURER DIRECTOR 1.00 X X 0 0 0 JERILYN DIETZ DIRECTOR 1.00 X 0 0 0 KAREN NICHOLS DIRECTOR 1.00 X 0 0 0 ROBERT VOLLENDORF DIRECTOR 1.00 X 0 0 0 EDGAR HANSEN DIRECTOR 1.00 X 0 0 0 MICHAEL ETHERIDGE VICE-CHAIR 1.00 X 0 0 0 REV MATTHEW SAUER DIRECTOR 1.00 X 0 0 0 REV GERALD FOLEY DIRECTOR 1.00 X 0 0 0 DENNIS SWETLIK DIRECTOR 1.00 X 0 0 0 DR TRACY SHERMAN DIRECTOR 1.00 X 0 0 0 THOMAS VEESER DIRECTOR 1.00 X 0 0 0 FRANK SOLTYS CEO/PRESIDENT 40.00 0.00 X 187554 0 15377 JOANNE BARTZ TREASURER 40.00 0.00 X 67723 0 22074 255277 240649 63146 1 0 1 0 GREENFIELD REHAB AGENCY 19395 W CAPITOL DR SUITE 200 BROOKFIELD WI 53045 PATIENT THERAPY 931327 SYSCO EASTERN WISCONSIN ONE SYSCO DRIVE JACKSON WI 530379226 FOOD SERVICE 728523 JCD RENOVATIONS 3209 NORTH COUNTY ROAD J REEDSVILLE WI 54230 RENOVATIONS 217857 GUNDERSON 41 MAIN STREET MENASHA WI 549523198 LAUNDRY 196864 OMNICARE INC DEPT 781668 PO BOX 78000 DETROIT MI 482781668 PHARMACY 191569 5 47500 100136 147636 RESIDENT CARE SERVICES 623000 14916229 14916229 14916229 11136 11136 15075001 14916229 0 11136 X 250361 250361 6366026 5520323 760899 84804 23846 19895 3645 306 1332475 1111741 203657 17077 413329 344857 63174 5298 20549 20549 53044 53044 790277 790277 136717 132408 4309 301473 209292 80451 11730 31007 31007 833053 731626 94284 7143 23194 9483 12379 1332 27939 1316 26623 764936 733175 29524 2237 1576875 1538211 35941 2723 159958 141005 17618 1335 FOOD SERVICE 752222 744588 7616 18 RESIDENT CARE SERVICES 586394 577074 9320 HR/FINANCE SERVICES 257240 107033 150207 BAD DEBT 59000 59000 30413 15395 7919 7099 14790328 12786699 1862527 141102 2072410 2505779 265334 93730 69850 45450 906776 991632 232902 184516 46490877 21204270 26256318 25286607 208318 412303 30011908 29520017 1557316 1543080 10427 8132 25771655 24992949 27339398 26544161 X 1942394 2249818 256464 220005 473652 506033 2672510 2975856 30011908 29520017 284673 18673 0 X X 0 1 X 1 0 X 229679 172932 360036 259992 147636 1170275 11181449 11439281 11356239 13181484 14916229 62074682 11411128 11612213 11716275 13441476 15063865 63244957 0 0 0 63244957 10519 1883 7785 44480 11136 75803 10519 1883 7785 44480 11136 75803 11421647 11614096 11724060 13485956 15075001 63320760 0.99880 0.99930 0.00120 0.00070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 473652 15990 16396 506038 424282 33773 15597 473652 285410 123918 14954 424282 261533 24128 -251 285410 217882 34250 9401 261533 0.00000 1.00000 0.00000 1 0 593771 593771 42871481 19212359 23659122 3025625 1991911 1033714 25286607 X 15093674 18673 18673 15075001 0 15075001 14790328 0 14790328 0 14790328 PART IV, LINE 2B: THE ORGANIZATION HOLDS CASH ON BEHALF OF CERTAIN RESIDENTS IN A SEPERATE CHECKING ACCOUNT, WHICH IS USED TO PAY FOR THE RESIDENTS' INCIDENTAL EXPENSES. PART V, LINE 4: THE HOME ESTABLISHED THE ST. MARY'S HOME ENDOWMENT FUND AS A PERMANENTLY RESTRICTED PERPETUAL ENDOWMENT FUND TO PROVIDE SUPPORT TO THE CHARITABLE MISSIONS OF ST. MARY'S AT FELICIAN VILLAGE, THE COURT AT FELICIAN VILLAGE, THE VILLA AT FELICIAN VILLAGE, AND THE GARDENS AT FELICIAN VILLAGE. THE ENDOWMENT CONSISTS OF INVESTMENTS ESTABLISHED TO FUND ITS MISSIONS AND IS DONOR-RESTRICTED. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. PART X, LINE 2: ST. MARY'S HOME FOR THE AGED, INC., IS A NOT FOR PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE CODE. THE HOME FOLLOWS THE ACCOUNTING STANDARDS FOR UNCERTAINTY IN INCOME TAXES. THESE STANDARDS REQUIRE ENTITIES TO DISCLOSE IN THEIR FINANCIAL STATEMENTS THE NATURE OF ANY UNCERTAINTIES IN THEIR TAX POSITION. AREAS THAT THE INTERNAL REVENUE SERVICE AND STATE TAX AUTHORITIES CONSIDER WHEN EXAMINING TAX AND INFORMATION RETURNS OF A TAX-EXEMPT ENTITY INCLUDE, BUT ARE NOT LIMITED TO, TAX-EXEMPT STATUS AND THE EXISTENCE AND AMOUNT OF UNRELATED BUSINESS INCOME. THE HOME DOES NOT BELIEVE THAT IT HAS ANY UNCERTAIN TAX POSITIONS WITH RESPECT TO THESE OR OTHER MATTERS, AND HAS NOT RECORDED ANY UNRECOGNIZED TAX BENEFITS OR LIABILITY FOR PENALTIES OR INTEREST. X X 0 0 0 0 0 0 0 0 0 DAVID WARD DIRECTOR 0 240649 0 0 0 0 0 15753 0 9942 0 266344 0 0 FRANK SOLTYS CEO/PRESIDENT 187554 0 0 0 0 0 0 0 15377 0 202931 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER (FELICIAN SERVICES, INC.) HOLDS RESERVED POWERS IN ELECTING MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE MEMBER (FELICIAN SERVICES, INC.) HOLDS RESERVED POWERS REGARDING SPECIFIC DECISIONS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, FORM 990 WAS DISTRIBUTED VIA EMAIL TO EACH DIRECTOR FOR REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS OR TRUSTEES AND KEY EMPLOYEES MUST PROVIDE WRITTEN DISCLOSURE REGARDING INTERESTS THAT COULD GIVE RISE TO CONFLICT DURING THE ANNUAL BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE CORPORATE MEMBER (FELICIAN SERVICES, INC.) OBTAINED COMPARABILITY DATA IN DETERMINING COMPENSATION OF THE CEO AND TOP MANAGEMENT OFFICIALS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE UPON WRITTEN REQUEST TO THE CONTACT LISTED IN PART VI, SECTION C, LINE 20. FELICIAN SERVICES INC 3800 W PETERSON AVENUE CHICAGO IL 60659 363685438 SOLE CORPORATE MEMBER OF NON-PROFIT RELIGIOUS SPONSORED ENTITIES IL 501(C)(3) LINE 1 CONGREGATION OF THE SISTERS OF ST FELIX OF CANTALICE 0 FELICIAN SISTERS OF NORTH AMERICA INC 871 MERCER ROAD BEAVER FALLS PA 05010 271282473 RELIGIOUS CONGREGATION PA 501(C)(3) LINE 1 N/A 0 VILLA ST FRANCIS INC 1910 WEST OHIO STREET MILWAUKEE WI 53215 391606945 INDEPENDENT AND ASSISTED LIVING HOUSING WI 501(C)(3) LINE 10 FELICIAN SERVICES INC 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 SCHEDULE R, PART II, COLUMN A THE REPORTING ORGANIZATION AND ALL RELATED ORGANIZATIONS OF THE CONGREGATION OF THE SISTERS OF ST. FELIX OF CANTALICE ARE INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY.