2019-08-14T13:28:49-05:00 2018-09-30 450250958 EIDE BAILLY LLP PO BOX 5126 SIOUX FALLS SD 571175126 990 2017-10-01 460347728 WAKONDA HERITAGE MANOR WAKO 6052672081 515 OHIO ST WAKONDA SD 57073 ROBIN STOCKLAND ADMINISTRATOR 6052672081 2019-08-13 1 LAURIE HANSON P00851848 6053391999 2019-08-13 199.247.46.31 2019-08-13 15:55:51 CD P BCC7DF2A838E86703654F11017E75D232FBEC976 2498296C43E1E89153AA0CA2385E379BE62769D4 2017 2019-02-21 02:37:17Z ROBIN STOCKLAND 515 OHIO ST WAKONDA SD 57073 2351145 0 X AVERA.ORG/WAKONDA-HERITAGE-MANOR X 1976 SD TO PROVIDE RESIDENT NURSING HOME CARE. 9 9 60 30 0 0 0 100 2151397 2344479 3280 6566 0 0 2154677 2351145 0 0 0 0 1294890 1251304 0 0 0 957665 1101068 2252555 2352372 -97878 -1227 2446004 2367829 213008 130609 2232996 2237220 X WAKONDA HERITAGE MANOR SHALL PROVIDE DESIRABLE HEALTH SERVICES TO THE AREA WITH A CHRISTIAN ATMOSPHERE OF PATIENCE, LOVE AND CONCERN FOR THOSE IT SERVES. WAKONDA HERITAGE MANOR IS COMMITTED TO BEING A FINANCIALLY PRUDENT ORGANIZATION WHICH PARTICIPATES IN THE DEVELOPMENT AND DELIVERY OF HEALTHCARE SERVICES FOR ITS SERVICE AREA WHILE EMPHASIZING CARE THAT MAINTAINS THE DIGNITY OF EACH INDIVIDUAL. 0 0 2129049 2344479 WAKONDA HERITAGE MANOR (MANOR) OPERATES A 41-BED NURSING FACILITY, A 6 UNIT ASSISTED-LIVING FACILITY AND AN ELDERLY APARTMENT COMPLEX, LOCATED IN WAKONDA, SOUTH DAKOTA. FOR THE YEAR ENDED SEPTEMBER 30, 2018, WAKONDA HERITAGE MANOR PROVIDED 12,066 NURSING HOME AND ASSISTED LIVING RESIDENT DAYS AND 1,884 ASSISTED LIVING DAYS. 2129049 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 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 0 0 0 0 0 1 5 0 1 60 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X ROBIN STOCKLAND 6052672081 515 OHIO ST WAKONDA SD 57073 X RON PETERSON PRESIDENT 0.50 X X 0 0 0 RON HUOT VICE PRESIDENT 0.50 X X 0 0 0 DONNA HENRIKSEN SECRETARY/TREASURER 0.50 X X 0 0 0 CHERYL KNUDSON DIRECTOR 0.50 X 0 0 0 MARGO DEVINE MCCUE DIRECTOR 0.50 X 0 0 0 JILL JOHNSON DIRECTOR 0.50 X 0 0 0 KEN GIRARD DIRECTOR 0.50 X 0 0 0 DARBY GANSCHOW DIRECTOR 0.50 X 0 0 0 JULIE NELSEN DIRECTOR 0.50 X 0 0 0 JEREMY KLINKHAMMER ADMINISTRATOR UNTIL OCT. 2017 20.00 X 0 0 0 VERONICA SCHMIDT ADMINISTRATOR FROM OCT. - NOV. 2017 20.00 X 0 0 0 ROBIN STOCKLAND ADMINISTRATOR BEGAN NOV. 2017 20.00 X 0 0 0 0 0 0 0 0 0 0 AEGIS THERAPIES INC 2601 NETWORK BLVD STE 102 FRISCO TX 75034 THERAPY SERVICES 220368 AVERA SACRED HEART HOSPITAL 501 SUMMIT STREET YANKTON SD 57078 MANAGEMENT & OTHER SERVICES 114455 2 100 100 RESIDENT SERVICE INCOM 623000 2330102 2330102 MISC REVENUE 900099 14377 14377 2344479 6566 6566 2351145 2344479 0 6566 X 1051179 1014580 36599 10199 9844 355 106077 102384 3693 83849 80930 2919 105946 105946 18265 18265 462099 459896 2203 7546 7546 17573 17573 13073 13073 80591 80591 5870 1040 4830 110533 110533 32029 32029 SUPPLIES 194288 194288 EQUIP, LEASE & MAINT 24797 23578 1219 CONTINUING EDUCATION 3340 1689 1651 25118 17667 7451 2352372 2129049 223323 0 174055 190334 487441 379931 23525 26343 5777 5142 2906227 2307146 599290 599081 1054316 1059947 101600 107051 2446004 2367829 150300 130609 62708 0 213008 130609 X 2215055 2218260 3710 4729 14231 14231 2232996 2237220 2446004 2367829 X -1227 5451 X 1 X 0 1 0 X 1260 100 1360 2023228 1932432 2035635 2151397 2344479 10487171 2024488 1932432 2035635 2151397 2344579 10488531 0 530943 1005618 713347 885470 1103031 4238409 530943 1005618 713347 885470 1103031 4238409 6250122 4035 3781 4507 3280 6566 22169 4035 3781 4507 3280 6566 22169 2028523 1936213 2040142 2154677 2351145 10510700 0.59460 0.60770 0.00210 0.00220 X 1 17084 141002 140191 17895 0 17941 1019 18960 17941 17941 0.00000 0.75060 0.24940 1 0 5000 5000 2118168 1735478 382690 699787 571668 128119 83272 83272 599081 X PART IV, LINE 1B: THIS REPRESENTS RESIDENT TRUST FUNDS KEPT FOR RESIDENTS' SPENDING. THIS IS NOT AN ASSET OF THE MANOR. PART V, LINE 4: THE FUNDS ARE TO BE USED FOR IMPROVEMENTS AT WAKONDA HERITAGE MANOR. PART X, LINE 2: THE MANOR IS ORGANIZED AS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE MANOR IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE MANOR IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE MANOR HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE MANOR BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE MANOR WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. FORM 990, PART VI, SECTION A, LINE 3 AVERA SACRED HEART HEALTH SERVICES PROVIDES MANAGEMENT SERVICES TO WAKONDA HERITAGE MANOR, INC. JEREMY KLINKHAMMER, ADMINISTRATOR UNTIL OCT. 2017, VERONICA SCHMIDT, INTERIM ADMINISTRATOR OCT.-NOV. 2017, AND ROBIN STOCKLAND, ADMINISTRATOR FROM NOV. 2017 FORWARD WERE PAID THROUGH AVERA SACRED HEART HEALTH SERVICES AND PRESIDED OVER THE DAY-TO-DAY OPERATIONS OF WAKONDA HERITAGE MANOR, INC. COMPENSATION PROVIDED TO JEREMY, VERONICA, AND ROBIN FOR SERVICES TO WAKONDA HERITAGE MANOR WERE AS FOLLOWS: JEREMY KLINKHAMMER: COMPENSATION $4,228 NONTAXABLE BENEFITS $965 VERONICA SCHMIDT: COMPENSATION $22,756 NONTAXABLE BENEFITS $169 ROBIN STOCKLAND: COMPENSATION $40,211 NONTAXABLE BENEFITS $8,071 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATOR REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE IRS AND PROVIDES A COPY TO THE BOARD PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS ARE COVERED BY THE CONFLICT OF INTEREST POLICY. THE FULL BOARD IS RESPONSIBLE FOR DETERMINING WHETHER A CONFLICT EXISTS AND FOR REVIEWING THE ACTUAL CONFLICTS. THE DETERMINATIONS ARE MADE ON A CASE BY CASE BASIS. THE DIRECTORS WITH CONFLICTS ABSTAIN FROM DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR IS EMPLOYED BY SACRED HEART HEALTH SERVICES BUT IS A COMMON LAW EMPLOYEE OF WAKONDA HERITAGE MANOR. PERFORMANCE AND SALARY ARE REVIEWED ANNUALLY BY SACRED HEART HEALTH SERVICES AND THE WAKONDA HERITAGE MANOR BOARD OF DIRECTORS. ANY INCREASE IS APPROVED BY THE WAKONDA HERITAGE MANOR BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED THERAPY SERVICES : PROGRAM SERVICE EXPENSES 177,358. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 177,358. NURSING AND PHYSICIAN PERSONNEL : PROGRAM SERVICE EXPENSES 236,639. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 236,639. OTHER CONTRACT AND CONSULTING FEES : PROGRAM SERVICE EXPENSES 45,899. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,899. PROFESSIONAL AND OTHER EXPENSE : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,203. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,203. FORM 990, PART XI, LINE 9: CHANGE IN NET INTEREST OF THE FOUNDATION 5,451.