2018-05-14T08:28:28-05:00 2017-06-30 390758449 Wipfli LLP PO Box 12237 Green Bay WI 543072237 990 2016-07-01 391034534 Bay Area Lutheran Homes Inc BAYA 9204991481 1040 Pilgrim Way Green Bay WI 54304 Lori Glynn Director of Finance 9204991481 2018-05-11 1 Terri Rexrode CPA MST P00096513 9206620016 2018-04-27 2016 2022-09-23 18:48:47Z WOODSIDE SENIOR COMMUNITIES LORI GLYNN 1040 Pilgrim Way Green Bay WI 54304 22841306 0 9386 X www.woodsideseniorcommunities.org X 1968 WI PROVIDING SUPERVISED CARE FOR ELDERLY RESIDENTS THROUGH A REHABILITATION/SKILLED NURSING FACILITY AND AN ASSISTED LIVING FACILITY. 11 11 486 65 0 0 5270 6946 17023747 19750557 306954 389603 0 0 17335971 20147106 0 0 0 0 10339077 10622535 0 0 0 6748876 8179311 17087953 18801846 248018 1345260 37643309 38900421 14148232 13743803 23495077 25156618 X To be the leader in delivering and advancing senior care and/or rehabilitation for Green Bay and the surrounding communities by meeting the needs of the whole senior person; social, medical, psychological, cognitive, and spiritual, maximizing each individual's highest level of independence. 0 0 13267355 13739125 Woodside Lutheran Home is a 130-Bed facility that offers long-term skilled nursing care and short-term rehabilitation care. In Fiscal Year 2017, Woodside Lutheran Home provided approximately 43,700 total days of care. Of that, over 46% of those residents served were through the Wisconsin Medicaid Program, which reimburses the Home at deeply discounted rates. Woodside Lutheran Home provided over $3.2 million in care to the Medicaid population over the past year. Woodside is unique in that it is the only faith-based nonprofit senior living campus in the Greater Green Bay area. As such, Woodside employs a full-time Chaplain to serve the spiritual needs of the Woodside community. 3100750 4518320 Woodside Manor is a 97-unit apartment facility that offers Class C CBRF services, including supervision and dispensing of medications and assistance with daily living activities. In Fiscal Year 2017, Woodside Manor provided approximately 32,800 days of care. 536420 1227484 Woodside Villa is a 20-unit apartment facility that offers Class C CBRF services, including supervision and dispensing of medications and assistance with daily living activities. The population served in this setting are largely those with memory issues. 16904525 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 17 0 486 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Scott Ross 9204991481 1040 Pilgrim Way Green Bay WI 54304 SUE MAY PRESIDENT 1.00 1.00 X X 0 0 0 RANDY FRAILING VICE-PRESIDENT 1.00 0.50 X X 0 0 0 SHARON BARCHACKY SECRETARY 1.00 0.50 X X 0 0 0 RON PIGEON BOARD MEMBER 0.50 X 0 0 0 PASTOR DENNIS SCHATT BOARD MEMBER 0.50 0.50 X 0 0 0 BARB BRAUN BOARD MEMBER 0.50 0.50 X 0 0 0 JEFFREY MARTINSON Member/Current Treasurer 1.00 0.50 X X 0 0 0 PHYLLIS HOPPE BOARD MEMBER 0.50 0.50 X 0 0 0 Larry Frazier BOARD MEMBER 0.50 0.50 X 0 0 0 Max Roth Board Member 0.50 0.50 X 0 0 0 Ruth Bloesl BOARD MEMBER 0.50 1.00 X 0 0 0 SCOTT ROSS EXECUTIVE DIRECTOR 36.00 4.00 X 175006 0 2681 JULIE GRACEFFA CHIEF FINANCIAL OFFICER 36.00 4.00 X 103582 0 32242 278588 0 34923 2 0 1 0 Rehabcare Group Inc SRS Division St Louis MO 631503534 Rehab Services for residents 1680408 BSG Maintenance Inc PO Box 165 Newburg WI 53060 Housekeeping and Laundry services 158719 Nurses PRN 1101 E South River Street Appleton WI 54915 Staffing Services 100782 3 6946 6946 Woodside Lutheran Home 623000 13683961 13683961 Woodside Manor 623000 4518320 4518320 Woodside Villa 623000 1227484 1227484 OTHER OPERATING INCOME 623000 265628 265628 Affiliate Admin Revenue 623000 55164 55164 19750557 210869 210869 2872934 2686670 7530 186264 -7530 178734 178734 20147106 19484929 0 655231 X 312719 312719 8664249 7998851 665398 70029 65909 4120 917477 841823 75654 658061 584343 73718 22186 1867 20319 30962 30962 56746 56746 3247905 3247905 40879 40879 1532945 1408841 124104 218981 211369 7612 435476 353802 81674 40362 35875 4487 40012 21316 18696 417013 349286 67727 1539323 1256820 282503 216704 133751 82953 Provider Tax 225838 225838 BAD DEBT EXPENSE 66450 66450 Dues and Licenses 26731 26731 Recruitment 17203 17203 3595 2854 741 18801846 16904525 1897321 0 45061 44525 3100442 4252526 1442983 1682755 23251 23251 374050 533726 36612793 13795463 23765311 22817330 8850353 9502725 41858 43583 37643309 38900421 1359788 1200177 12781820 12538302 6624 5324 14148232 13743803 X 23495077 25156618 23495077 25156618 37643309 38900421 1345260 316281 0 X X 0 1 X 1 0 X 26062 31189 6373 5270 6946 75840 13914924 13934509 14295902 16762510 19429765 78337610 218010 194453 202567 261237 265628 1141895 14158996 14160151 14504842 17029017 19702339 79555345 0 0 0 79555345 226731 244034 187457 198228 210869 1067319 226731 244034 187457 198228 210869 1067319 14385727 14404185 14692299 17227245 19913208 80622664 0.98680 0.98620 0.01320 0.01380 X 0 0 0 0 0 0 0 0 1 1245 1245 0 Part II-B, Line 1: Leading Age Membership Fees of $1245 used for Lobbying Activities. Leading Age is an organization that educates long-term care organizations on various topics including trends in the industry and regulatory matters. As legislation is being debated/introduced, LeadingAge reviews legislation and advocates for the long-term care industry. Both state and federal matters are monitored. 63218 63218 32950952 11882124 21068828 983062 550966 432096 2456853 1243136 1213717 158708 119237 39471 22817330 TENANT DEPOSITS HELD IN TRUST 5324 5324 20035196 0 20035196 56746 55164 111910 20147106 18689936 0 18689936 56746 55164 111910 18801846 Part XI, Line 4b - Other Adjustments: Affiliate Admin Fees 55,164. Part XII, Line 4b - Other Adjustments: Affiliate Admin Fee 55,164. X X X X 0 0 0 0 0 0 0 0 0 SCOTT ROSS EXECUTIVE DIRECTOR 165006 0 10000 0 0 0 2063 0 618 0 177687 0 0 0 Part I, Line 3 The organization utilizes Leading Age data for all employee compensation (comparable data). The executive committee of the board of directors approves the executive director compensation. The full board of directors approves the wage range for employees. The executive director has discretion to determine and approve other officers and key employee compensation through the board-approved wage range. These decisions are made by those without conflict of interest and documentation is kept for all decisions made. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 NONEAVAIL 2014-07-11 13000000 FINANCE RENOVATIONS TO HEALTH CARE FACILITY 0 0 0 A 13000000 20000 13000000 2016 0 0 0 1 A 0 0 1 1 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 Form 990, Part VI, Section A, line 6 The corporate membership of the organization consists of congregations of the green bay conference of the east central synod of the evangelical Lutheran church in America. The membership of the organization may include other organizations; however, a majority of the corporate members shall consist of Lutheran congregations of the evangelical Lutheran church of America, or its successor. Form 990, Part VI, Section A, line 7a Each of the members has the ability to nominate one or more delegates based on the congregation levels of each respective church. Each delegate nominated has the authority to nominate one board member. No one church has the ability to nominate more than 50% of the delegates. Form 990, Part VI, Section B, line 11b The board of directors has delegated the detailed review of the form 990 to management. The form 990 is presented to the full board of directors for review and final approval. Form 990, Part VI, Section B, line 12c At least on an annual basis, the organizations require that a conflict of interest statement be signed, with all potential conflicts listed and discussed. Each board member completes this form, and all potential conflicts are discussed during a board meeting. Board members decide the appropriate course of action for each conflict. Some conflicts are immaterial enough to warrant no follow-up, others are resolved by not allowing the member with a conflict to vote on decisions related to the conflict. Form 990, Part VI, Section B, line 15 The organization utilizes Leading Age data for all employee compensation (comparable data). The executive committee of the board of directors approves the executive director compensation. The full board of directors approves the wage range for employees. The executive director has discretion to determine and approve other officers and key employee compensation through the board-approved wage range. These decisions are made by those without conflict of interest and documentation is kept for all decisions made. Form 990, Part VI, Section C, line 19 The organization believes its governing documents, conflict of interest policy, and financial statements are the property of the organization and does not make them available to the public. Form 990, Part IX, line 11g pharmacy contracted services: Program service expenses 637,924. Management and general expenses 0. Fundraising expenses 0. Total expenses 637,924. therapy contracted services: Program service expenses 1,794,902. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,794,902. housekeeping contracted services: Program service expenses 260,910. Management and general expenses 0. Fundraising expenses 0. Total expenses 260,910. nursing contract labor: Program service expenses 123,048. Management and general expenses 0. Fundraising expenses 0. Total expenses 123,048. other purchased services: Program service expenses 431,121. Management and general expenses 0. Fundraising expenses 0. Total expenses 431,121. Form 990, Part XII, Line 2c: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. Woodside Oaks Inc 1040 Pilgrim Way Green Bay WI 54304 421552326 Senior Housing WI 501(C)(3) Line 10 BAY AREA LUTHERAN HOMES INC 1 Woodside Haven Inc 1040 Pilgrim Way Green Bay WI 54304 300071529 Housing for low-income, elderly, or physically handicapped WI 501(C)(3) Line 10 BAY AREA LUTHERAN HOMES INC 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 Woodside Oaks Inc E 13000000 Actual Value Woodside Oaks Inc Q 148409 FMV