2018-11-06T13:11:04-06:00 2017-12-31 391173131 SCHENCK SC PO BOX 23819 GREEN BAY WI 543053819 990 2017-01-01 813724993 LAKELAND CARE INCORPORATED LAKE 9209065100 N6654 ROLLING MEADOWS DRIVE FOND DU LAC WI 54937 DAN BIZUB CHIEF FINANCIAL OFFICER 9209065100 2018-11-01 1 DAVID L MACCOUX P00239034 9204367800 2018-11-01 74.142.163.66 2018-11-01 06:42:35 CD P B602D594AFD2B0B327E07A06F36CA6A7E42546D0 AAA3AE9BDF6734101642B97DAF1FCA69E104ADE4 2017 2018-06-14 16:35:46Z X DAN BIZUB N6654 ROLLING MEADOWS DRIVE FOND DU LAC WI 54937 207708941 0 X WWW.LAKELANDCAREINC.COM X 2000 WI ENRICHING INDIVIDUAL'S LIVES BY HONORING THEIR VALUES THROUGH HIGH QUALITY, COST EFFECTIVE CARE AND SUPPORT. 9 9 346 0 0 0 178479899 25882564 13057 3333421 207708941 0 0 23526344 0 0 181874240 205400584 2308357 34473160 18423827 16049333 X ENRICHING INDIVIDUAL'S LIVES BY HONORING THEIR VALUES THROUGH HIGH QUALITY, COST EFFECTIVE CARE AND SUPPORT. 0 0 195381761 25882564 LAKELAND CARE, INC. IS A NONPROFIT ORGANIZATION THAT IS MEMBER-CENTERED AND MISSION DRIVEN. LAKELAND CARE WAS ONE OF THE FIRST MANAGED CARE ORGANIZATIONS TO PROVIDE THE FAMILY CARE PROGRAM IN THE STATE OF WISCONSIN MORE THAN 18 YEARS AGO. FAMILY CARE HELPS ELIGIBLE ELDERS AND ADULTS WITH DISABILITIES LIVE INDEPENDENTLY AT HOME AND IN THEIR COMMUNITY. OUR MEMBERS PARTNER WITH CARE TEAMS AND LOCAL PROVIDERS TO GET THE SUPPORT AND SERVICES THEY NEED TO ACHIEVE THEIR GOALS. MEMBERS MAY CHOOSE TO SELF-DIRECT MOST SERVICES, AND INVITE FAMILY MEMBERS OR OTHERS TO BE PART OF THEIR CARE TEAM. LAKELAND CARE SERVES MORE THAN 5,000 MEMBERS THROUGHOUT 22 COUNTIES IN THE FOX VALLEY, NORTHEAST AND NORTH CENTRAL WISCONSIN. NINETY-FIVE CENTS OF EVERY FAMILY CARE DOLLAR DIRECTLY SUPPORTS CARE FOR OUR MEMBERS. OUR FAMILY CARE PROGRAM OFFERS A WIDE ARRAY OF BENEFITS AND SERVICES TO MEET LONG-TERM CARE NEEDS. EXAMPLES OF SERVICES INCLUDE: CARE MANAGEMENT SERVICES PERSONAL CARE (BATH, DRESSING, ETC.) TRANSPORTATION MEAL PREP MONEY MANAGEMENT MEDICAL EQUIPMENT AND SUPPLIES THERAPY SERVICES HOME HEALTH SERVICES OUTPATIENT MENTAL HEALTH SERVICES NURSING HOME CARE SUPPORTIVE HOME CARE RESIDENTIAL CAREWHEN MEMBERS ENROLL WITH LAKELAND CARE, THEY WILL HAVE ACCESS TO AN EXTENSIVE NETWORK OF PROVIDERS ALLOWING THEM TO HAVE CHOICES FOR THE SERVICES THEY NEED. LAKELAND CARE PARTNERS WITH OVER 1,000 PROVIDERS THROUGHOUT TWENTY-TWO COUNTIES. LAKELAND CARE HAS CONSISTENTLY RECEIVED HIGH MARKS FROM THE STATE'S EXTERNAL QUALITY REVIEW ORGANIZATION, BOTH FOR QUALITY CARE STANDARDS AND MEMBER RECORDS. LAKELAND CARE IS A PERSON-CENTERED ORGANIZATION THAT COORDINATES CARE AND SUPPORTS TO BUILD AND SUSTAIN INDIVIDUALS' SUCCESS BY: DELIVERING HIGH QUALITY, COST-EFFECTIVE OPTIONS EXPANDING INDIVIDUALS' ACCESS AND CHOICES ENHANCING PARTNERSHIPS AND RESOURCES IMPROVING THE HEALTH AND WELL-BEING OF INDIVIDUALS, FAMILIES AND COMMUNITIESEVERYONE AT LAKELAND CARE FOLLOWS THE GUIDING PRINCIPLES OF TEAMWORK, RESPECT, ACCOUNTABILITY, CUSTOMER SERVICE, AND COMMUNICATION TO DELIVER OUR MISSION.LAKELAND CARE IS EXCITED TO BE WORKING WITH INDEPENDENT CARE HEALTH PLAN, A WISCONSIN-BASED, MISSION-FOCUSED PARTNER TO OFFER AN INNOVATIVE NEW MEDICARE ADVANTAGE SPECIAL NEEDS PLAN LAKELAND CARE+HEALTH (LC+H). LC+H IS AN OPTION AVAILABLE TO ELIGIBLE LOW-INCOME MEDICARE RECIPIENTS. LAKELAND CARE'S CARE TEAM IS ABLE TO PROVIDE ENROLLED INDIVIDUALS MORE INTEGRATED CARE FOCUSING ON AN INDIVIDUAL'S HEALTH CARE AND, WHERE ELIGIBLE, LONG-TERM CARE NEEDS. 195381761 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 0 0 1 89 0 1 346 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X DAN BIZUB 9209065100 N6654 ROLLING MEADOWS DRIVE FOND DU LAC WI 54937 JIM BREY DIRECTOR 1.00 X 1535 0 0 ALLEN BUECHEL DIRECTOR 1.00 X 450 0 0 JUDY GOLDSMITH DIRECTOR 1.00 X 650 0 0 JIM KOZICZKOWSKI DIRECTOR 1.00 X 1145 0 0 LARRY LAUTENSCHLAGER DIRECTOR 1.00 X 664 0 0 TODD MOELY DIRECTOR 1.00 X 550 0 0 TOM OTTO DIRECTOR 1.00 X 700 0 0 JUDY RUGGIRELLO DIRECTOR 1.00 X 1365 0 0 BOB ZIEGELBAUER DIRECTOR 1.00 X 738 0 0 KATIE MNUK CHIEF EXECUTIVE OFFICER 40.00 X 177995 0 24000 DANIEL BIZUB CHIEF FINANCIAL OFFICER 40.00 X 122456 0 15141 SARA MUHLBAUER CHIEF OPERATING OFFICER 40.00 X 119575 0 12580 SUZANNE SINJAKOVIC CHIEF TECHNOLOGY COMMERCIALIZATION 40.00 X 105594 0 5176 533417 0 56897 4 0 1 0 HOMES FOR INDEPENDENT LIVING POBOX 278 DOUSMAN WI 54220 ADULT FAMILY HOME, 3-4 BEDS 11813463 CLARITY CARE INC 424 WASHINGTON AVENUE OSHKOSH WI 54901 COMMUNITY BASED RESIDENTIAL FACILITY 11402448 REM WISCONSIN II INC 2005 W BELTLINE HWY STE 203 MADISON WI 53713 ADULT FAMILY HOME, 3-4 BEDS 6776490 INNOVATIVE WISCONSIN INC 445 S MADISON STREET GREEN BAY WI 54304 ADULT FAMILY HOME, 3-4 BEDS 6556407 GT FINANCIAL SERVICES 215 BRODUS STREET STURGIS MI 49091 SELF-DIRECTED PERSONAL CARE SERVICES 4149712 259 178479899 178479899 ROOM AND BOARD 900099 16505136 16505136 COST SHARE 900099 6391896 6391896 RETRO RATE ADJUSTMENTS 900099 2913393 2913393 THIRD PARTY 900099 72139 72139 25882564 13057 13057 MISCELLANEOUS REVENUE 900099 3333421 3333421 3333421 207708941 25882564 0 3346478 347389 52108 295281 15830685 13168232 2662453 623639 260476 363163 5358273 2248473 3109800 1366358 570689 795669 162092 37281 124811 55765 12826 42939 1197073 47038 1150035 85529 19672 65857 73425 16888 56537 807877 555937 251940 1197469 550835 646634 104366 24004 80362 538440 431392 107048 7019 1614 5405 304885 207322 97563 50017 19607 30410 PROVIDER CARE FAMILY SE 161165343 161165343 IBNR CLAIMS EXPENSE 15930679 15930679 SUPPLIES EXPENSE 97893 22515 75378 RENTAL EQUIPMENT 73783 33635 40148 22585 5195 17390 205400584 195381761 10018823 0 25843828 2893771 4415958 257398 2836337 1844629 0 991708 0 70497 0 34473160 0 18419484 4343 0 18423827 X 12126452 3922881 0 16049333 0 34473160 X 2308357 13740976 X 0 1 X 0 0 X 178479899 178479899 178479899 178479899 178479899 13057 13057 3333421 3333421 181826377 25882564 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2017 AMOUNT: $ 3,333,421. 682213 185306 496907 2154124 1659323 494801 991708 X 207708941 0 207708941 0 207708941 205400584 0 205400584 0 205400584 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX 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 AS UNRELATED BUSINESS INCOME. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION. THE ORGANIZATION IS ALSO EXEMPT FROM WISCONSIN INCOME TAXES. THE ORGANIZATION FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTIES IN INCOME TAXES WHICH IS PART OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. THIS GUIDANCE INCREASES THE RELEVANCY AND COMPARABILITY OF FINANCIAL REPORTING BY CLARIFYING THE WAY COMPANIES ACCOUNT FOR UNCERTAINTIES IN INCOME TAXES FOR TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN. IT MAKES RECOGNITION AND MEASUREMENT MORE CONSISTENT AS WELL AS OFFERING A CLEAR CRITERIA FOR SUBSEQUENTLY RECOGNIZING, DERECOGNIZING AND MEASURING SUCH TAX POSITIONS FOR FINANCIAL STATEMENT PURPOSES. PENALTIES AND INTEREST ASSESSED BY THE TAXING AUTHORITIES ARE INCLUDED IN MANAGEMENT AND GENERAL EXPENSES, IF APPLICABLE. THE ORGANIZATION HAD NO INTEREST AND 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. X 0 0 0 0 0 0 0 0 0 KATIE MNUK CHIEF EXECUTIVE OFFICER 177995 0 0 0 0 0 0 0 24000 0 201995 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE 990 AND ITS CONTENTS IS REVIEWED BY THE BOARD FOLLOWING CONFIRMATION OF THE FILING OF FORM. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS IS REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. ADDITIONALLY, STAFF ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 15A PER THE TERMS OF LAKELAND CARE, INC.'S CEO SALARY ADMINISTRATION PROCEDURE, IT IS LCI'S POLICY TO ESTABLISH THE CHIEF EXECUTIVE OFFICER COMPENSATION ACCORDING TO OBJECTIVE CRITERIA EVALUATED AND APPLIED BY PERSONS WITHOUT A CONFLICT OF INTEREST. COMPENSATION IS EVALUATED IN STRICT CONFORMANCE WITH GUIDELINES ESTABLISHED BY THE INTERNAL REVENUE SERVICE FOR TAX-EXEMPT ORGANIZATIONS. SPECIFICALLY, THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO INCLUDES: APPROVAL BY PERSONS WITHOUT A CONFLICT OF INTEREST, USE OF COMPARABILITY DATA, TIMELY SUBSTANTIATION OF THE DELIVERATION AND DECISION, AND RECORDS COMPENSATION DELIBERATIONS IN THE BOARD OF DIRECTORS' MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: PRIOR YEAR NET POSITION FROM GOVERNMENT ENTITY - CONVERTED TO 501(C)(3) 13,740,976.