2019-03-28T18:34:05-05:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-07-01 410871261 ST WILLIAM'S LIVING CENTER STWI 2183384671 212 WEST SOO STREET PARKERS PRAIRIE MN 56361 TIM KELLY ADMINISTRATOR 2183384671 2019-03-21 1 EMILY SCHEEVEL P01814921 6123764500 67.137.57.251 2019-03-21 08:51:48 CD P 0F6CED516730F26F6D929EFCCC55701A57CAC9CA 92465E57DADAD6C24A7EB17F4905229B30516652 2017 2019-02-21 02:37:17Z TIM KELLY 212 WEST SOO STREET PARKERS PRAIRIE MN 56361 6938554 0 X WWW.STWILLIAMSLIVINGCENTER.COM X 1963 MN TO PROVIDE NURSING HOME AND ASSISTED LIVING CARE FOR THE ELDERLY AND DISABLED. 7 7 163 30 0 0 5417 13170 5610651 6099456 53472 120346 45327 47295 5714867 6280267 0 0 0 0 3883401 3975226 0 0 0 1602717 1650480 5486118 5625706 228749 654561 7748813 8870603 891836 1373794 6856977 7496809 X THE MISSION OF ST. WILLIAM'S LIVING CENTER IS TO PROVIDE A BROAD CONTINUUM OF CARE TO MEET THE NEEDS OF OUR COMMUNITY. WE DO SO UNDER THE GUIDANCE OF CATHOLIC HEALTH CARE PHILOSOPHY. OUR SERVICES ARE OF THE HIGHEST QUALITY AND DESIGNED TO PROMOTE DIGNITY, WELL-BEING AND INDEPENDENCE. 0 0 3766847 0 4556683 NURSING HOME: ST. WILLIAMS CENTER OPERATES A 53 BED NURSING HOME WHICH PROVIDES INDIVIDUALIZED CARE SERVICES THAT ARE DEVELOPED THROUGH CARE CONFERENCING WHERE EVERY ASPECT OF DAILY LIVING IS EXPLORED. THE SERVICES PROVIDED BY THE SKILLED NURSING HOME ARE MEDICAL SERVICES, 24 HOUR NURSING SERVICES, REHABILITATION SERVICES, CHAPLAIN SERVICES, DIETETIC AND NUTRITIONAL SERVICES, PHARMACEUTICAL SERVICES, LAUNDRY, HOUSEKEEPING, MEDICATION ADMINISTRATION, AND AUDIOLOGY SERVICES. THE NURSING HOME ALSO HAS A BEAUTY SHOP, COMMUNITY ROOM, MUSIC EVENTS, AND VARIOUS ACTIVITIES FOR RESIDENTS. 423857 0 482135 ASSISTED LIVING: ST. WILLIAMS LIVING CENTER ALSO OPERATIONS A 14 UNIT ASSISTED LIVING CENTER. THIS INCLUDES 3 MEALS SERVED DAILY, BUILDING AND GROUNDS MAINTENANCE, WEEKLY LIGHT HOUSEKEEPING FOR LINEN AND TRASH REMOVAL, GROUP SOCIAL AND RECREATIONAL ACTIVITIES, HOME CARE PROVIDER STAFF AVAILABLE 24 HOURS A DAY, AND WIRELESS EMERGENCY CALL SYSTEMS. THEY ALSO PROVIDE THE FOLLOWING OPTIONAL SERVICES: MEDICATION ASSISTANCE, ASSISTANCE WITH PERSONAL CARE NEED IN BATHING, AMBULATION, OR DRESSING, PERSONAL LAUNDRY, HOUSEKEEPING, APPOINTMENT ARRANGEMENTS, SKIN AND WOUND CARE, AND REHABILITATION THERAPIES. 90641 0 896885 FOSTER CARE: ST WILLIAMS HAS A FOSTER CARE AND COMMUNITY SUPPORT PROGRAM FOR THE HOUSING AND TRAINING OF ELIGIBLE ADULTS IN AN ATTEMPT TO DEVELOP SKILLS TO ACHIEVE INDEPENDENT LIVING STATUS. 10105 0 163753 ADULT RESIDENTIAL MENTAL HEALTH SERVICES 10105 0 163753 4291450 1 1 0 0 0 0 0 0 1 0 1 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 0 0 0 0 0 0 0 1 0 0 0 1 11 0 163 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 0 0 0 MN X TIM KELLY 2183384671 PO BOX 30 PARKERS PRAIRIE MN 56361 RICHARD GAPPA PRESIDENT 2.00 X X 1800 0 0 DAVID VASKE VICE PRESIDENT 2.00 X X 1870 0 0 VIOLA DORN SECRETARY 2.00 X X 2600 0 0 DAWN JAKUBIEC DIRECTOR 2.00 X 2334 0 0 JUDY KLEIN DIRECTOR 2.00 X 2816 0 0 MIKE LIBBY DIRECTOR 2.00 X 2772 0 0 FR PETER VANDERWEYST DIRECTOR 2.00 X 1800 0 0 TIM KELLY ADMINISTRATOR/TREASURER 40.00 X 96664 0 3904 112656 0 3904 0 0 0 0 REHABCARE GROUP INC 680 SOUTH FOURTH STREET LOUISVILLE KY 40202 THERAPY SERVICES 222201 1 13170 13170 NURSING HOME 623000 4292961 4292961 FOSTER CARE 623000 896885 896885 ASSISTED LIVING 623000 482135 482135 PHYSICAL THERAPY 623000 208446 208446 MENTAL HEALTH CARE 623000 163753 163753 55276 55276 6099456 53070 53070 725563 658287 67276 67276 67276 MISCELLANEOUS 900099 38690 38690 MEALS/VENDING 900099 8605 8605 47295 6280267 6099456 0 167641 115710 115710 3123075 2548018 575057 80875 66628 14247 415604 327615 87989 239962 189018 50944 32449 32449 13157 13157 307408 307408 50132 50132 112028 33655 78373 206916 177710 29206 12374 289 12085 72 72 15553 10423 5130 17214 17214 218248 218248 37829 37829 FOOD EXPENSE 203190 203190 MCH SURCHARGE 124329 124329 MEDICAL SUPPLIES 108139 108139 0 ACTIVITY EXPENSE 76318 76318 115124 45994 69130 5625706 4291450 1334256 0 384602 517145 1803231 1823882 579108 919339 26544 36441 9672928 5490873 3633844 4182055 1321484 1391741 7748813 8870603 393325 576505 2531 1625 495980 795664 891836 1373794 X 6856977 7496809 6856977 7496809 7748813 8870603 654561 -14729 0 X 0 1 X 1 0 X 3375 4098 62929 5417 13170 88989 4402378 4996816 5507406 5610651 6099456 26616707 4405753 5000914 5570335 5616068 6112626 26705696 0 664393 682793 589649 1936835 664393 682793 589649 1936835 24768861 32274 39275 41883 41712 53070 208214 32274 39275 41883 41712 53070 208214 13185 45327 47295 105807 4438027 5040189 5625403 5703107 6212991 27019717 0.91670 0.93650 0.00770 0.00740 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MEALS/VENDING MISCELLANEOUS 0 1 X 290616 290616 6583772 4301117 2282655 1821174 1189756 631418 977366 977366 4182055 X 6252382 -14728 -13157 -27885 6280267 0 6280267 5612549 0 5612549 13157 13157 5625706 PART IV, LINE 2B: THE ORGANIZATION HOLDS A SEPARATE CHECKING ACCOUNTING IN WHICH RESIDENTS MAY DEPOSIT MONEY. EACH RESIDENT MAY ACCESS THEIR MONEY UPON REQUEST. PART X, LINE 2: THE ORGANIZATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE ORGANIZATION IS REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS ANNUALLY. THE ORGANIZATION HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THE ANNUAL 990 FILING REQUIREMENT, AND AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSES -13,157. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS FIVE MEMBERS: THE BISHOP AND VICAR GENERAL OF THE DIOCESE OF ST. CLOUD, MINNESOTA, AND THE PASTOR AND TWO TRUSTEES OF ST. WILLIAM'S CATHOLIC CHURCH IN PARKERS PRAIRIE, MINNESOTA. FORM 990, PART VI, SECTION A, LINE 7A THE PASTOR OF ST. WILLIAM'S CATHOLIC CHURCH IN PARKERS PRAIRIE, MINNESOTA, IS AUTOMATICALLY DESIGNATED AS A VOTING MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE OTHER SIX MEMBERS ARE ELECTED BY THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS MAY ONLY BE AMENDED BY MAJORITY VOTE OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE ADMINISTRATOR AND MAILED TO ALL BOARD MEMBERS PRIOR TO FILING. IT WILL BE REVIEWED AND APPROVED BY THE BOARD AT THE NEXT MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS THE ORGANIZATION'S CONFLICT OF INTERESTS ON AN ANNUAL BASIS OR AS THEY ARISE. ANY CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD IN A CONFLICT OF INTEREST DISCLOSURE COMPLETED BY EACH BOARD MEMBER. IF A CONFLICT OF INTEREST IS DISCLOSED IT IS REVIEWED AND APPROVED OR RATIFIED BY A MAJORITY OF THE BOARD OF DIRECTORS OR COMMITTEE MEMBERS CURRENTLY HOLDING OFFICE. THE INTERESTED BOARD MEMBER MAY NOT VOTE AND IS NOT CONSIDERED PRESENT FOR PURPOSES OF A QUORUM WHEN VOTING ON THE CONFLICTED CONTRACT OR TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ADMINISTRATOR'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE PROCESS INCLUDES REVIEW AND APPROVAL BY INDEPENDENT PERSONS AND CONTEMPORANEOUS SUBSTANTIATION, BUT DOES NOT INCLUDE COMPARABILITY DATA. THE LAST REVIEW OCCURRED IN JULY 2017. THE NEXT REVIEW WILL BE IN 2018 PRIOR TO WAGE INCREASE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AT THE OFFICE OF THE ORGANIZATION. ROMAN CATHOLIC DIOCESE OF SAINT CLOUD 214 3RD AVENUE SOUTH ST CLOUD MN 56301 410693981 CHURCH MN 501(C)(3) LINE 1 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0