2019-04-22T08:24:03-05:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2017-07-01 390813463 WISCONSIN MASONIC HOME INC WISC 2629652111 410 N MAIN STREET DOUSMAN WI 531189348 JEAN FREUCK CFO 2629652111 2019-04-04 1 KIMBERLY ANDERSON CPA P00188889 6086628600 2019-03-28 67.137.57.251 2019-04-04 16:33:27 CD P 17A7653D3E03680D17212B91FE73DB0ACEF0D795 E6A0C83F9AD34C566D8707BD1B63F824EA830523 2017 2019-02-21 02:37:17Z MARK STRAUTMAN 410 N MAIN STREET DOUSMAN WI 531189348 13238158 0 X WWW.THREEPILLARS.ORG X 1953 WI WISCONSIN MASONIC HOME, INC., SPONSORED BY THE MASONIC FRATERNITY, PROVIDES FOR THE SOCIAL, PHYSICAL, AND SPIRITUAL NEEDS OF OLDER ADULTS THROUGH HIGH QUALITY HOUSING AND SERVICES. 16 16 174 38 0 0 472707 276975 5401022 5522837 744147 1114766 12403 18727 6630279 6933305 7687 46766 0 0 2927393 3149309 0 0 106059 2772515 2837972 5707595 6034047 922684 899258 71444885 73897239 13292822 13074348 58152063 60822891 WISCONSIN MASONIC HOME, INC., SPONSORED BY THE MASONIC FRATERNITY, PROVIDES FOR THE SOCIAL, PHYSICAL, AND SPIRITUAL NEEDS OF OLDER ADULTS THROUGH HIGH QUALITY HOUSING AND SERVICES. 0 0 3059013 46766 4034619 COMPASS POINT - AN ASSISTED LIVING OPTION IS AVAILABLE FOR PERSONS AGED 55 AND OLDER IN A RESIDENTIAL CARE APARTMENT COMPLEX. THIS PROGRAM PROVIDES ASSISTED LIVING SERVICES, INCLUDING MEALS, WELLNESS SERVICES, SOCIAL ASSISTANCE, HOUSEKEEPING, AND ASSISTANCE WITH ACTIVITIES OF DAILY LIVING AND MEDICAL NEEDS. ON AVERAGE, 78 RESIDENTS ARE SERVED ON A DAILY BASIS, AND 8% OF THE RESIDENTS ARE ABLE TO CONTINUE LIVING WITH A SPOUSE. A MEALS ON WHEELS PROGRAM IS ALSO AVAILABLE TO THE NON RESIDENT COMMUNITY AND PROVIDED 2,675 MEALS DURING THE YEAR. 966889 1171175 RIVERSIDE LODGE - AN ASSISTED LIVING OPTION IS AVAILABLE FOR PERSONS AGED 55 AND OLDER IN A COMMUNITY BASED RESIDENTIAL FACILITY. THIS PROGRAM PROVIDES SERVICES SIMILAR TO THE ASSISTED LIVING IDENTIFIED ABOVE, WITH A FOCUS ON MEMORY CARE IN A SECURE ENVIRONMENT. ON AN AVERAGE DAY, 17 RESIDENTS ARE SERVED. 404254 317043 MASONWOODS - AN INDEPENDENT LIVING OPTION IS AVAILABE FOR PERSONS 55 AND OLDER. SOCIAL INTERACTION AND SECURITY ARE IMPORTANT TO THE 45 RESIDENTS LIVING IN THE FACILITY ON AN AVERAGE DAILY BASIS, AND 37% OF THE UNITS ARE OCCUPIED BY COUPLES. 4430156 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 69 0 1 174 1 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JEAN FREUCK 2629657203 410 N MAIN ST DOUSMAN WI 531189348 X FRANK GLOWINSKI DIRECTOR 1.00 X 0 0 0 TERRY BROWN DIRECTOR 1.00 X 0 0 0 WILLIAM FRAZIER DIRECTOR 1.00 X 0 0 0 ALLAN IDING DIRECTOR 1.00 X 0 0 0 LARRY NINES DIRECTOR 1.00 X 0 0 0 SCOTT PEDLEY DIRECTOR 1.00 1.00 X 0 0 0 ROBERT HAGGARTY III DIRECTOR 1.00 X 0 0 0 BARBARA RITCHIE DIRECTOR 1.00 X 0 0 0 ARBY L HUMPHREY DIRECTOR 1.00 X 0 0 0 GARY BEIER DIRECTOR 1.00 1.00 X 0 0 0 JOHN BENEDICT DIRECTOR 1.00 X 0 0 0 TOM KAPKE DIRECTOR 1.00 X 0 0 0 KEN GORGEN DIRECTOR 1.00 X 0 0 0 JESSICA LONDON DIRECTOR 1.00 X 0 0 0 ROBERT STRADER DIRECTOR 1.00 X 0 0 0 JAMES MCLEER DIRECTOR 1.00 X 0 0 0 MARK STRAUTMAN CEO 17.00 23.00 X 174596 0 30416 JEAN FREUCK CFO 18.00 22.00 X 143412 0 29126 318008 0 59542 2 0 1 0 0 276975 276975 RESIDENT SVC REVENUE 623000 5522837 5522837 5522837 592285 592285 6826934 400 6304853 0 522081 400 522481 522481 MISCELLANEOUS NON-OPERATING REVEN 623000 18727 18727 18727 6933305 5522837 0 1133493 46766 46766 174035 174035 2521229 1809557 626471 85201 77854 56229 18978 2647 110608 88250 18203 4155 265583 179961 77149 8473 14492 14492 16499 16499 91714 91714 299227 207747 94962 -3482 59042 59042 162390 93450 62984 5956 53127 53127 380483 296635 83848 16988 11116 5872 458781 458611 170 894025 894025 28344 28344 DINING SERVICES FOOD PU 239195 239195 LINCENSE, PERMITS, DUES 40027 40027 OTHER EXPENSES 34403 0 31294 3109 MEDICAL SUPPLIES 25553 25553 23682 23061 621 6034047 4430156 1497832 106059 435954 550890 1461497 1119912 18340 500 108461 86689 23343 9488 45416 134398 24060880 11394430 13053937 12666450 31211405 32590260 14773323 15021998 10313209 11716654 71444885 73897239 869963 944310 10605859 10387038 1817000 1743000 13292822 13074348 X 38567822 40897036 8482438 8777093 11101803 11148762 58152063 60822891 71444885 73897239 X 899258 804656 966914 X X 0 1 X 1 0 X 145542 715230 159356 472707 276975 1769810 5165867 4802090 5457393 5401022 5522837 26349209 6115 6490 6819 12403 18727 50554 5317524 5523810 5623568 5886132 5818539 28169573 0 0 0 28169573 538659 700306 536726 529590 592285 2897566 538659 700306 536726 529590 592285 2897566 5856183 6224116 6160294 6415722 6410824 31067139 0.90670 0.90840 0.09330 0.09160 X 1298192 49943 49943 1298192 1298192 16854 16854 1298192 1298192 49495 49495 1298192 1298192 21131 21131 1298192 1298192 19549 19549 1298192 1.00000 1 1 1 504824 504824 19731026 8842622 10888404 1461911 855068 606843 2064624 1536756 527868 298495 159984 138511 12666450 POOLED INVESTMENTS 31888282 F FUNDS HELD BY TRUSTEES UNDER BOND 701978 F 32590260 INVESTMENT IN NET ASSETS OF WISCONSIN MASONIC FOUNDATION 15021998 F 15021998 RELATED PARTY RECEIVABLE 11072511 TRUST & ESTATES RECEIVABLE 644143 11716654 REFUNDABLE RESIDENCY FEES 1743000 1743000 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS INCLUDE THE FOLLOWING: WISCONSIN MASONIC FOUNDATION - HOME ENDOWMENT FUND: THESE FUNDS ARE HELD BY THE RELATED ORGANIZATION, WISCONSIN MASONIC FOUNDATION. THE INTEREST IN THE NET ASSETS OF THE FOUNDATION IS REFLECTED ON THE BALANCE SHEET OF WISCONSIN MASONIC HOME. THESE FUNDS AVAILABLE FOR USE BY WISCONSIN MASONIC HOME ARE USED FOR GENERAL OPERATING PURPOSES, AND SUPPORT THE CHARITABLE MISSION OF WISCONSIN MASONIC HOME. THE OHDE FUND: THIS FUND IS INCLUDED IN THE NET ASSETS OF WISCONSIN MASONIC HOME. THE FUNDS UNDER THE OHDE ENDOWMENT ARE TO BE USED FOR PRESENT AND FUTURE RESIDENTS OF THE WISCONSIN MASONIC HOME, COMPASS POINT AND THE RIVERSIDE LODGE, WHO CANNOT AFFORD TO PAY FOR THEIR OWN CARE. THE CUMMINGS FUND: THIS FUND IS INCLUDED IN THE NET ASSETS OF WISCONSIN MASONIC HOME. THE FUNDS UNDER THE CUMMINGS ENDOWMENT ARE TO BE USED TO PROVIDE SERVICES WHICH WILL IMPROVE RESIDENT QUALITY OF LIFE. EXAMPLES OF THESE SERVICES INCLUDE (1) MEDICAL ASSESSMENT AND CARE, (2) SPIRITUAL ACTIVITY, AND (3) ACTIVITIES, LEADERSHIP AND COMMUNITY EVENTS. ACTIVITIES, LEADERSHIP AND COMMUNITY EVENTS WOULD INCLUDE STAFF AND PROGRAMS THAT WOULD PROVIDE ATTENTION TO EDUCATION, ENTERTAINMENT, TRANSPORTATION, PERSONAL DEVELOPMENT, AND OTHER ACTIVITIES RELATING TO RESIDENT PREFERENCES. THE BUTLER PERPETUAL TRUST: THE BUTLER PERPETUAL TRUST HAS BEEN ESTABLISHED FROM AN ESTATE, AND IS CURRENTLY REFLECTED ON THE BALANCE SHEET OF WISCONSIN MASONIC HOME AS PART OF RESTRICTED NET ASSETS. WISCONSIN MASONIC HOME EXERTS NO INFLUENCE OR CONTROL OVER THE INVESTMENTS. THIS ENDOWMENT WILL BE USED TO SUPPORT THE CHARITABLE MISSION OF WISCONSIN MASONIC HOME. 1 VILLAGE ON THE SQUARE 410 N MAIN STREET DOUSMAN WI 53118 391662636 501(C)(3) 7880 INCOME ON RESTRICTED FUND PAID TO VILLAGE ON THE SQUARE INC. IN SUPPORT OF CERTAIN CATEGORIES OF FINANCIAL ASSISTANCE FOR CARE MASONIC CENTER FOR HEALTH AND REHAB INC 410 N MAIN STREET DOUSMAN WI 53118 391506910 501(C)(3) 38886 INCOME ON RESTRICTED FUND PAID TO MASONIC CENTER FOR HEALTH AND REHAB, INC. IN SUPPORT OF CERTAIN CATEGORIES OF FINANCIAL ASSISTANCE FOR CARE 2 PART I, LINE 2: ON AN ANNUAL BASIS, THE AUDIT AND FINANCE COMMITTEE OF THE ORGANIZATION MAY REVIEW THE FINANCIAL STATEMENTS AND GENERAL LEDGER OF THE DONEE, A RELATED ORGANIZATION, TO CONFIRM THAT THE GRANTS ARE USED FOR THE SPECIFIC PURPOSES AS INTENDED. X X X 0 0 0 0 0 0 0 0 0 MARK STRAUTMAN CEO 165356 0 2550 0 6690 0 7711 0 22705 0 205012 0 0 0 JEAN FREUCK CFO 136722 0 0 0 6690 0 6421 0 22705 0 172538 0 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DBH8 2013-06-07 10553424 REFINANCE 0 0 0 A 742600 12490111 701978 11556198 238921 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 SCHEDULE K, PART II, COLUMN A: TOTAL PROCEEDS VS. ISSUE PRICE: TOTAL PROCEEDS OF THE ISSUANCE FOR THE REFUNDING REVENUE BONDS SERIES 2014 INCLUDED IN SCHEDULE K, PART II, COLUMN A, LINE 3 IS DIFFERENT FROM THE ISSUE PRICE INCLUDED IN SCHEDULE K, PART I, COLUMN B, LINE A DUE TO A NET ORIGINAL ISSUE PREMIUM, RELEASED FUNDS FROM THE BONDS THAT WERE RETIRED, AND AN EQUITY CONTRIBUTION. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE ORGANIZATION ARE THE MEMBERS OF THE WISCONSIN MASONIC BENEVOLENT ACTIVITIES BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS SHALL CONSIST OF 16 MEMBERS, 12 OF WHOM ARE ELECTED BY THE MEMBERS, AND 4 OF WHOM SERVE POSITIONS IN THE MASONIC FRATERNITY. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS HAVE CERTAIN RESERVE POWERS OVER THE DECISIONS OF THE BOARD OF DIRECTORS. THESE POWERS INCLUDE: 1)POLICY MAKING BODY FOR ALL BENEVOLENT ACTIVITIES. 2) OVERSEE LONG RANGE PLANNING BY EACH MASONIC BENEVOLENCE AND ENCOURAGES INCREASED VISABILITY AND INVOLVEMENT BY THE FRATERNITY. 3) PROVIDE AN ORGANZATION TO IMPROVE COORDINATION OF INVESTMENT OBJECTIVES AND STRATEGIES TO ACHIEVE THEM. 4) ENCHANCE THE CONTINUITY OF BENEVOLENT ACTIVITIES IN AN INCREASINGLY COMPLEX SOCIAL, REGULATORY, AND FINANCIAL ENVIRONMENT. 5) UTILIZE LOCAL CONTROL AND INVOLVEMENT IN FUTURE REGIONAL MASONIC BENEVOLENT ACTIVITIES. 6) ELECT DIRECTORS OF WISCONSIN MASONIC HOME, INC. AND 7) APPROVE ANNUAL BUDGET OF WISCONSIN MASONIC HOME, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE POSTED TO THE ORGANIZATION'S BOARD PORTAL AND HARD COPIES WILL BE MADE AVAILABLE ON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES SIGN A WRITTEN CONFLICT OF INTEREST FORM AT THE ANNUAL MEETING. IF A CONFLICT EXISTS WITH A MEETING'S AGENDA, THAT DIRECTOR OR OFFICER WILL ABSTAIN FROM DISCUSSION AND VOTING. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE GOVERNANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 AN EXECUTIVE COMMITTEE OF THE MEMBER'S BOARD DETERMINES THE SALARY OF THE CEO, USING EXTERNAL SOURCES AS INDICATED ON SCHEDUE J. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THE CFO'S SALARY WAS DETERMINED INTERNALLY, BASED ON MARKET COMPARISONS TO CONFIRM THAT TOTAL COMPENSATION TO BE PAID WAS REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THIS PROCESS IS COMPLETED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL INFORMATION OF WISCONSIN MASONIC HOME, INC. ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, LINE 1: MARK STRAUTMAN, CEO, DEVOTES APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: WISCONSIN MASONIC HOME - 17 HOURS, MASONIC CENTER FOR HEALTH AND REHAB, INC - 17 HOURS, VILLAGE ON THE SQUARE - 6 HOURS. JEAN FREUCK, CFO, DEVOTES APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: WISCONSIN MASONIC HOME - 18 HOURS, MASONIC CENTER FOR HEALTH AND REHAB, INC - 16 HOURS, VILLAGE ON THE SQUARE - 6 HOURS. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF WISCONSIN MASONIC FOUNDATION 963,869. CHANGE IN VALUE OF PERPETUAL TRUST 3,045. FORM 990, PART XII, LINE 2C: NO CHANGES HAVE BEEN MADE FROM THE PRIOR YEAR REGARDING THE COMMITTEE OVERSEEING THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT. MASONIC CENTER FOR HEALTH AND REHAB INC 410 N MAIN STREET DOUSMAN WI 53118 391506910 REHABILITATION SERVICES WI 501(C)(3) LINE 10 WISCONSIN MASONIC HOME INC 1 VILLAGE ON THE SQUARE INC 410 N MAIN STREET DOUSMAN WI 53118 391662636 SENIOR ASSISTED LIVING WI 501(C)(3) LINE 10 WISCONSIN MASONIC HOME INC 1 GRAND LODGE FREE & ACCEPTED MASONS OF WISCONSIN 36275 SUNSET DRIVE DOUSMAN WI 53118 390129695 FRATERNAL ORGANIZATION WI 501(C)(8) & (C)(10) N/A 0 WISCONSIN MASONIC FOUNDATION 36275 SUNSET DRIVE DOUSMAN WI 53118 396044637 SCHOLARSHIP PROVIDER WI 501(C)(3) LINE 7 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0