2019-09-16T17:59:02-05:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP PO BOX 23819 GREEN BAY WI 543053819 990 2018-01-01 391087412 ST JOSEPH RESIDENCE INC STJO 9209825354 107 E BECKERT ROAD NEW LONDON WI 54961 GIDGET BLANK EXECUTIVE DIRECTOR 9209825354 2019-09-10 1 PAUL G DENIS P00240969 9204367800 2019-09-09 67.137.57.251 2019-09-10 08:19:19 CD P 201AC506A6DA8D9D4516FED2DD8E9342B88F33A9 BB8AB9AE7453044FA57DC1EB30BDBDBAE6F564AD 2018 2019-02-21 02:37:17Z ROGER STEINGRABER 107 E BECKERT ROAD NEW LONDON WI 54961 5562842 0 X WWW.STJOSEPHRESIDENCE.COM X 1965 WI TO PROVIDE ELDERLY HEALTHCARE AND HOUSING 8 8 211 55 0 0 1028310 3210 6592424 5225143 29558 23868 36493 39941 7686785 5292162 0 0 0 0 4255686 3465912 0 0 0 2713212 2394520 6968898 5860432 717887 -568270 14184517 16426922 6225131 9080587 7959386 7346335 X TO PROVIDE ELDERLY HOUSING AND VARIOUS LEVELS OF ASSISTANCE AND HEALTH CARE SERVICES INCLUDING INDEPENDENT APARTMENTS, ASSISTED LIVING, SHORT TERM REHABILITAITON, LONG TERM CARE, AND OUTPATIENT THERAPY. 0 0 4067381 3800728 SKILLED NURSING FACILITY PROVIDED 17,121 DAYS OF CARE IN 2018. 810007 1122927 COMMUNITY BASED RESIDENTIAL FACILITY AND ASSISTED LIVING PROVIDED 9,708 DAYS OF CARE DURING 2018. 169435 301488 INDEPENDENT NON-LICENSED SENIOR APARTMENT COMPLEX: 26 UNITS. THE NUMBER OF DAYS OF CARE DURING 2018 WAS 9,289 DAYS. 2589 MEMORY CARE FACILITY OPENING IN 2019 2589 5049412 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 0 0 1 0 0 0 1 33 0 211 1 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 0 0 WI X GIDGET BLANK 9209825354 107 E BECKERT ROAD NEW LONDON WI 54961 ROGER STEINGRABER PRESIDENT 1.00 X X 0 0 0 RITA THIEL VICE PRESIDENT 1.00 X X 0 0 0 STEVE DYRESON SECRETARY/TREASURER 1.00 X X 0 0 0 KATHY GWIDT BOARD MEMBER 1.00 X 0 0 0 MARK GROSSMAN BOARD MEMBER 1.00 X 0 0 0 DAVID RUSCH BOARD MEMBER 1.00 X 0 0 0 CHARLES HARTZHEIM BOARD MEMBER 1.00 X 0 0 0 GIDGET BLANK CEO/EXECUTIVEDIRECTOR 40.00 X 94100 0 5646 SUSAN WOLFE FINANCE DIRECTOR 40.00 X 14635 0 4878 108735 0 10524 0 0 0 0 COMMUNITY LIVING SOLUTIONS 2801 E ENTERPRISE AVE APPLETON WI 54913 CONSTRUCTION/GENERAL CONTRACOTR 2163012 US BANK PO BOX 70870 ST PAUL MN 55170 LOAN INTEREST 317409 HEALTH CARE SERVICES GROUP 3220 TILLMAN DRIVE BENSALEM PA 19020 LAUNDRY/HOUSKEEPING SERVICES 287640 4 DESIGN W175 N 11081 STONEWOOD DR GERMANTOWN WI 53022 FURNISHINGS FOR SNF 274391 REHABCARE PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 263463 9 3210 3210 PATIENT/RESIDENT SERVI 623000 5225143 5225143 5225143 18790 18790 2600 0 2600 2600 2600 275758 270680 5078 5078 5078 MISCELLANEOUS REVENUES 623000 37341 37341 37341 5292162 5225143 0 63809 119259 10524 108735 2832753 2679231 153522 1412 1412 512488 512488 6993 6993 162746 162746 25666 25666 20441 20441 465799 353316 112483 16259 16259 76829 76829 285684 285684 45463 45463 LAUNDRY SUPPLIES 301322 301322 PATIENT SERVICE SUPPLIE 285467 285467 0 THERAPY SUPPLIES 242410 242410 DIETARY SUPPLIES 197772 197772 261669 57494 204175 5860432 5049412 811020 0 0 0 3598474 3073217 425061 321678 36743 38162 19164 8840 16851185 7049622 6712385 9801563 610048 508270 2782642 2675192 14184517 16426922 383028 447024 25729 4860078 7695530 489231 489231 492794 423073 6225131 9080587 X 6852369 6802876 1107017 543459 7959386 7346335 14184517 16426922 -568270 -44781 0 X X 0 1 X 1 0 X 8330 4615 3851 1028310 3210 1048316 7569523 7405725 7515682 6592424 5225143 34308497 7577853 7410340 7519533 7620734 5228353 35356813 0 0 0 35356813 29107 19711 22858 27778 21390 120844 29107 19711 22858 27778 21390 120844 34412 36252 41968 33693 37341 183666 7641372 7466303 7584359 7682205 5287084 35661323 0.99150 0.99180 0.00340 0.00300 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2014 AMOUNT: $ 34,412. 2015 AMOUNT: $ 36,252. 2016 AMOUNT: $ 41,968. 2017 AMOUNT: $ 33,693. 2018 AMOUNT: $ 37,341. 33972 148070 182042 12759470 3955105 8804365 164081 142202 21879 3745592 2952315 793277 9801563 DUE FROM RELATED COMPANY 2643074 BENEFICIAL INTEREST IN COMMUNITY FOUNDATION 20212 RESIDENT TRUST FUND 11906 2675192 SECURITY DEPOSITS 414500 RESIDENT TRUST FUND 8573 423073 X 5240388 -44781 -44781 5285169 6993 6993 5292162 5853439 0 5853439 6993 6993 5860432 PART X, LINE 2: ST. JOSEPH RESIDENCE, INC. IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE ORGANIZATION'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION ON UNRELATED BUSINESS INCOME. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(II) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). THE ORGANIZATION IS ALSO EXEMPT FROM WISCONSIN INCOME TAX. PENALTIES AND INTEREST ASSESSED BY INCOME TAXING AUTHORITIES ARE INCLUDED IN MANAGEMENT AND GENERAL EXPENSES, IF APPLICABLE. THE ORGANIZATION HAD NO INTEREST OR PENALTIES RELATED TO INCOME TAXES FOR THE YEAR ENDED DECEMBER 31, 2017. THE ORGANIZATION'S FEDERAL RETURNS ARE SUBJECT TO EXAMINATION GENERALLY FOR THREE YEARS AFTER THEY ARE FILED AND ITS STATE RETURNS ARE SUBJECT TO EXAMINATION GENERALLY FOR FOUR YEARS AFTER THEY ARE FILED. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 2017-08-30 99 REFUNDING BOND 0 0 0 A 556462 63117 1 0 1 1 A 1 0 0 0 0 0 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. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OF THE CORPORATION HAVE THE FOLLOWING RESPONSIBILITIES: APPROVE ANY CHANGE IN THE PHILOSPHY, PURPOSE OR NATURE OF THE CORPORATION; AMEND THE 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 OR THE MORTGAGING OR PLEDGING AS SECURITY OF ANY OF THE ASSETS 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 15A THE ORGANIZATION FOLLOWS THE LEADING AGE WAGE SURVEY TO ALIGN THEIR COMPENSATION PLAN FOR TOP MANAGEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THESE RECORDS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR THE PROCESS USED TO SELECT AN INDEPENDENT ACCOUNTANT. THE WASHINGTON CENTER INC 500 W WASHINGTON NEW LONDON WI 54961 200349479 ASSISTED LIVING, ADULT DAY CARE, SENIOR CENTER WI 501 (C) 3 509(A)(2) 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 THE WASHINGTON CENTER INC D 2643074 COST