2015-08-14T15:08:46-05:00 2014-09-30 450250958 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2013-10-01 411936536 WINONA SENIOR SERVICES INC WINO 5074543650 855 MANKATO AVENUE WINONA MN 55987 JAN BROSNAHAN CFO 5074543650 2015-08-12 1 KIM HUNWARDSEN CPA P00484560 6122536500 2015-08-11 2013 2016-02-25 16:41:14Z RACHELLE HEISING-SCHULTZ 855 MANKATO AVENUE WINONA MN 55987 15394853 0 X WWW.WINONAHEALTH.ORG X 1999 MN EXTENDED CARE FACILITY 17 12 348 204 0 0 88128 87860 14626219 15271925 41104 33923 565 1145 14756016 15394853 0 0 0 0 9599492 10315000 0 0 0 5937157 6550427 15536649 16865427 -780633 -1470574 9826187 8150606 2641451 2499331 7184736 5651275 X DEVOTED TO IMPROVING THE HEALTH AND WELL-BEING OF OUR FAMILY, FRIENDS AND NEIGHBORS. 0 0 15510631 15271925 WINONA SENIOR SERVICES, INC. (WSS) SUPPORTS AND SERVES THE HEALTHCARE NEEDS OF SENIOR CITIZENS LIVING IN THE WINONA, MINNESOTA, REGION. IT INCLUDES THE FOLLOWING SERVICES:* LAKE WINONA MANOR, A 134 BED SKILLED, LONG-TERM CARE NURSING FACILITY* WATKINS MANOR, AN ASSISTED LIVING FACILITY WITH 59 UNITS. * ADITH MILLER AND ROGER METZ MANORS, MEMORY CARE RESIDENCES THAT PROVIDE A HOME TO UP TO 20 DEMENTIA-AFFECTED INDIVIDUALS. * WINONA HEALTH HOME CARE, PROVIDING CONVALESCENT, REHABILITATIVE, AND SUPPORTIVE HOME HEALTH SERVICES, COMPLETING 9,876 VISITS IN FY 2014 * WINONA AREA HOSPICE SERVICES, CARING FOR AN AVERAGE OF 32 RESIDENTS PER DAY WITH TERMINAL ILLNESSESADDITIONAL PROGRAMS THAT BENEFIT THE COMMUNITY INCLUDE:HEALTH PROFESSIONAL TRAINING: WINONA HEALTH SENIOR SERVICES (WHSS) WORKS CLOSELY WITH NURSE EDUCATION PROGRAMS IN THE COMMUNITY TO PROVIDE CLINICAL SITES FOR LPNS, RNS, AND CNAS FOR ASSISTANCE AND TRAINING COMPLETION WITH OUR RESIDENTS. STUDENTS PROVIDE SUPERVISED NURSING CARE. WE ALSO PROVIDE PRACTICUMS FOR THE THERAPEUTIC RECREATION AND SOCIAL WORK STUDENTS THROUGH WINONA STATE UNIVERSITY. PREVENTIVE CARE: WHSS ENCOURAGES PREVENTIVE CARE THROUGH A NUMBER OF RESOURCES. WHSS PARTICIPATES IN A NUMBER OF EDUCATIONAL OPPORTUNITIES FOR THE COMMUNITY ON TOPICS RELATING TO CARE OF THE AGING PARENT, HOME CARE, HOSPICE AND CHOOSING INDEPENDENT OR ASSISTIVE LIVING. WHSS PARTICIPATES ON MANY COMMUNITY-WIDE EVENTS, PROVIDING FREE EDUCATION AND COUNSELING ADVICE ON SENIOR SERVICE TOPICS. COMMUNITY RELATIONS: WHSS WORKS WITH MANY AREA NONPROFIT ORGANIZATIONS TO SUPPORT THE CARE OF THE ELDERLY AND HEALTH-RELATED ACTIVITIES. MANY STAFF SPEAK TO OUTSIDE CIVIC, EDUCATIONAL AND NON-PROFIT GROUPS, AS WELL AS ACTIVELY PARTICIPATING IN COMMUNITY EVENTS. WHSS STAFF ALSO DELIVERS MEALS TO COMMUNITY MEMBERS THROUGH A LOCAL MEAL DELIVERY PROGRAM.COMMUNITY EDUCATION: WHSS STAFF SPONSORS A SUPPORT GROUP FOR THOSE DEALING WITH ALZHEIMER'S AND OTHER DEMENTIA-RELATED ILLNESSES; 53 INDIVIDUALS ATTENDED THE ALZHEIMER'S SUPPORT GROUP IN FY 2014. IN ADDITION, IT OFFERS A GRIEF SUPPORT GROUP THAT SERVED 13 INDIVIDUALS. WSS STAFF SPOKE ON TOPICS OF INTEREST TO SENIORS AT VARIOUS LOCATIONS IN THE AREA SUCH AS THE SENIOR FRIENDSHIP CENTER, THE LEARNING CLUB AND WINONA VOLUNTEER SERVICES. STAFF ARE ALSO ACTIVE IN AREA EVENTS SUCH AS LADIES NIGHT OUT WHERE BLOOD PRESSURES AND BLOOD SUGARS ARE OFFERED FREE AND CHOLESTEROL CHECKS ARE OFFERED AT LOW COST. CHARITY CARE: WSS PROVIDES MEDICAL CARE TO THE COMMUNITY REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. TOTAL CHARITY CARE COST FOR FY 2014 WAS $18,850. 15510631 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 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 0 0 0 1 24 0 1 348 1 0 0 0 0 0 0 0 0 0 0 X 17 12 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 MN X JAN BROSNAHAN 5074543650 855 MANKATO AVENUE WINONA MN 55987 KEN MOGREN CHAIR 1.00 4.00 X X 0 0 0 SCOTT BIESANZ DIRECTOR 1.00 2.00 X 0 0 0 SCOTT BIRDSALL MD DIRECTOR 1.00 40.00 X 0 342140 56128 STEVE BLUE DIRECTOR 1.00 2.00 X 0 0 0 MATTHEW BROGHAMMER MD DIRECTOR 1.00 40.00 X 0 459857 78163 VICKI DECKER DIRECTOR 1.00 2.00 X 0 0 0 GARY EVANS DIRECTOR 1.00 2.00 X 0 0 0 RICHARD FERRIS DIRECTOR 1.00 40.00 X 0 221839 68267 HERB HIGHUM DIRECTOR 1.00 2.00 X 0 0 0 RICK IGLESIAS DIRECTOR 1.00 2.00 X 0 0 0 JIM KILLIAN DIRECTOR 1.00 2.00 X 0 0 0 HUGH MILLER DIRECTOR 1.00 2.00 X 0 0 0 DANIEL PARKER MD DIRECTOR 1.00 40.00 X 0 234882 60939 KIM SCHWAB DIRECTOR 1.00 2.00 X 0 0 0 MARK WAGNER DIRECTOR 1.00 2.00 X 0 0 0 ROD BAKER DIRECTOR 1.00 2.00 X 0 0 0 RACHELLE HEISING-SCHULTZ PRESIDENT/CEO/DIRECTOR 2.00 46.00 X X 0 467819 58572 JAN BROSNAHANDIRECTOR DIRECTOR/CFO/TREASURER 1.00 46.00 X 0 52090 19286 MARY MILLER-HYLAND ADMINISTRATOR 40.00 0.00 X 129915 0 18719 MICHAEL ALLEN FORMER CFO/TREASURER 0.00 0.00 X 0 325389 32477 129915 2104016 392551 4 1 1 0 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 CONTRACT THERAPIES 944135 ALL TRADES SERVICE LLC 74 KANSAS ST WINONA MN 55987 CONTRACTOR 128946 2 74210 13650 4995 87860 PATIENT SERVICE REVENUE 623990 15208911 15208911 SUPPORTING REVENUE 900099 63014 63014 15271925 9314 9314 1145 0 1145 1145 1145 4778 19831 0 0 4778 19831 24609 24609 15394853 15271925 0 35068 X 7491877 6624850 867027 224757 198746 26011 2071424 1831767 239657 526942 465975 60967 10463 10463 1448 1448 3154309 3123609 30700 50 50 701090 658026 43064 162589 162589 97868 97868 59820 53758 6062 67103 67103 627187 625852 1335 90201 89242 959 FACILITY COSTS 1108695 1108695 MEDICAL SUPPLIES 443139 443139 BAD DEBT EXPENSE 26440 26440 25 25 16865427 15510631 1354796 0 316154 163538 2159476 1944337 61687 59768 16635116 11115258 5764788 5519858 1045901 839 478181 462266 9826187 8150606 1303133 1208608 1326763 1280013 11555 10710 2641451 2499331 X 7184736 5651275 7184736 5651275 9826187 8150606 -1470574 -62887 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 74774 74774 13244595 8748758 4495837 3077620 2191648 885972 238127 174852 63275 5519858 DUE FROM AFFILIATES 462266 462266 X PART IV, LINE 2B: THE ORGANIZATION HOLDS FUNDS IN TRUST ON BEHALF OF ITS RESIDENTS. PART X, LINE 2: THE CORPORATION AND ITS CONSOLIDATED ENTITIES ARE ORGANIZED AS MINNESOTA NONPROFIT ENTITIES AND ARE ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, ALL ENTITIES ARE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVIITES THAT ARE UNRELATED TO THEIR EXEMPT PURPOSE. THE CORPORATION FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THE CORPORATION 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 CORPORATION 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. THE CORPORATION'S FEDERAL FORM 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATION BY TAX AUTHORITIES FOR YEARS BEFORE SEPTEMBER 30, 2011. 0 1 0 0 0 0 0 0 0 SCOTT BIRDSALL MD DIRECTOR 0 316385 0 9609 0 16146 0 29656 0 29937 0 401733 0 0 MATTHEW BROGHAMMER MD DIRECTOR 0 387760 0 47109 0 24988 0 51691 0 27570 0 539118 0 0 RICHARD FERRIS DIRECTOR 0 203917 0 10234 0 7688 0 42277 0 26928 0 291044 0 0 DANIEL PARKER MD DIRECTOR 0 211265 0 10234 0 13383 0 33096 0 28867 0 296845 0 0 RACHELLE HEISING-SCHULTZ PRESIDENT/CEO/DIRECTOR 0 366148 0 93800 0 7871 0 28503 0 33553 0 529875 0 0 MARY MILLER-HYLAND ADMINISTRATOR 114104 0 15312 0 499 0 7879 0 12875 0 150669 0 0 0 MICHAEL ALLEN FORMER CFO/TREASURER 0 201723 0 0 0 123666 0 12406 0 20788 0 358583 0 0 PART I, LINE 3: THE CEO IS COMPENSATED BY WINONA HEALTH SERVICES, A RELATED ORGANIZATION. WINONA HEALTH SERVICES USED ONE OR MORE OF THE METHODS ON PART I, LINE 3 TO DETERMINE THE CEO'S COMPENSATION. PART I, LINE 4B: THE FOLLOWING INDIVIDUALS RECEIVED EMPLOYER CONTRIBUTIONS TO A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: MATTHEW BROGHAMMER $12,025 THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IS AVAILABLE TO EXECUTIVES, PHYSICIANS, AND MID-LEVEL PROVIDERS AS DETERMINED BY THE BOARD OF DIRECTORS. IT IS FUNDED BY EMPLOYER CONTRIBUTIONS, AND EMPLOYEES ARE VESTED WITHIN FIVE YEARS. AN ALTERNATIVE PLAN IS AVAILABLE WHICH IS FUNDED BY EMPLOYEE CONTRIBUTIONS AND NOT SUBJECT TO FORFEITURE. A CITY OF WINONA 416005651 975232BQ1 2007-07-31 1579539 SEE BELOW FOR COMPLETE DESCRIPTION 0 0 0 A 288375 1579539 114677 20644 660000 784194 2007 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF WINONA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/14/2012 PART I, LINE A: SCHEDULE K INCLUDES THE ALLOCABLE SHARE OF THE SERIES 2007 TAX-EXEMPT BOND. THE REMAINING SHARE IS REPORTED ON RELATED ORGANIZATION SCHEDULE K, WINONA HEALTH SERVICES, EIN - 41-0713914. PART I, LINE A, COLUMN (F): REFUNDING OF PRIOR REVENUE BONDS ORIGINALLY ISSUED 8/1/2000 AND 7/1/2004 AND RENOVATION AND ACQUISITION OF PROPERTY ON SARNIA STREET AND PARKS AVENUE. FORM 990, PART VI, SECTION A, LINE 1 1. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR TRANSACTING THE BUSINESS OF THE BOARD OF DIRECTORS IN THE INTERIM BETWEEN MEETINGS OF THE FULL BOARD SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. 2. THE COMMITTEE SHALL ACT ON MATTERS WHICH CANNOT REASONABLY AWAIT ACTION BY THE FULL BOARD OF DIRECTORS. 3. OTHER MATTERS MAY BE DELEGATED TO THE EXECUTIVE COMMITTEE BY THE BOARD OF DIRECTORS, FOR EXAMPLE: - RECRUITMENT, SELECTION, AND EVALUATION OF THE CEO; - REVIEW AND APPROVAL OF A SENIOR EXECUTIVE DEVELOPMENT PLAN AND A CEO SUCCESSION PLAN; - REVIEW AND APPROVAL OF THE INCENTIVE EXPECTATIONS FOR THE EXECUTIVE STAFF; - REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE'S RECOMMENDATIONS; 4. CONDUCT OTHER ACTIVITIES WITHIN THE SCOPE OF THE COMMITTEE'S PURPOSE AND AUTHORITY AS THE BOARD MAY FROM TIME TO TIME DETERMINE; 5. PERIODICALLY REVIEW THE COMMITTEE CHARTER AND MAKE RECOMMENDATIONS TO THE BOARD WITH REGARD TO ANY CHANGES TO THE CHARTER THAT THE COMMITTEE BELIEVES WOULD BE DESIRABLE. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS HAVE BUSINESS RELATIONSHIPS: SCOTT BIESANZ WITH KEN MOGREN GARY EVANS WITH HUGH MILLER SCOTT BIRDSALL WITH RACHELLE HEISING-SCHULTZ AND STEVE BLUE RACHELLE HEISING-SCHULTZ WITH GARY EVANS, STEVE BLUE, AND SCOTT BIRDSALL MATT BROGHAMMER WITH DAN PARKER JIM KILLIAN WITH HUGH MILLER FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS WINONA HEALTH SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS AUTHORITY TO ELECT ALL AT-LARGE DIRECTORS TO THE CORPORATION'S BOARD OF DIRECTORS AND REMOVE THEM, WITH OR WITHOUT CAUSE. THE SOLE MEMBER ALSO HAS THE RIGHT TO APPOINT THE CHAIR AND THE PRESIDENT/CEO OF THE CORPORATION, AND REMOVE THEM, WITH OR WITHOUT CAUSE, SUBJECT TO ANY CONTRACT RIGHTS THAT MAY APPLY. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE SOLE MEMBER: (A) APPROVING THE AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION AND BYLAWS. (B) APPROVING ALL MISSION AND/OR VISION STATEMENTS AND ALL STRATEGIC OR LONG-TERM PLANS OF THE CORPORATION. (C) APPROVING THE CREATION OR ACQUISITION OF ANY AND ALL SUBSIDIARIES OR CONTROLLED AFFILIATES; ANY MERGERS OR CONSOLIDATIONS; ANY PERMANENT OR LONG-TERM AFFILIATIONS; AND ALL JOINT VENTURES OF THE CORPORATION INVOLVING CAPITAL INVESTMENTS IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS ($100,000). (D) APPROVING THE SALE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF THE CORPORATION AND ALL LONG-TERM DEBT IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS ($100,000). (E) APPROVING THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY MATERIAL AMENDMENTS THERETO OR DEVIATIONS THERE FROM. (F) APPROVING THE DISSOLUTION OF THE CORPORATION OR ANY PARTIAL OR COMPLETE LIQUIDATION OF ITS ASSETS. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS REVIEWED INITIALLY BY THE CFO AND DIRECTOR OF FINANCIAL OPERATIONS. IT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL SENIOR LEADERS, DIRECTORS, OFFICERS, AND BOARD COMMITTEE MEMBERS. THE POLICY IS SIGNED ANNUALLY AND REVIEWED BY THE CEO FOR CONFLICTS. ANY CONFLICTS ARE BROUGHT TO THE BOARD FOR DISCUSSION. IF A BOARD MEMBER HAS A POTENTIAL CONFLICT, THEY MUST ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND CFO ARE COMPENSATED BY A RELATED ORGANIZATION. THE EXECUTIVE COMMITTEE HAS A PROCESS IN PLACE FOR DETERMINING COMPENSATION FOR THE CEO AND CFO BASED ON RESULTS OF A COMPENSATION STUDY, APPROVAL AND DOCUMENTATION BY THE BOARD/COMMITTEE MEMBERS AND THE USE OF INDEPENDENT CONSULTING EVERY 3 YEARS. THE BOARD REVIEWS COMPENSATION FOR THESE INDIVIDUALS ANNUALLY. 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 REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 59,499. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 59,499. CONSULTING FEES: PROGRAM SERVICE EXPENSES 12,433. MANAGEMENT AND GENERAL EXPENSES 15,700. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,133. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,157,044. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,157,044. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,894,633. MANAGEMENT AND GENERAL EXPENSES 15,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,909,633. WINONA HEALTH SERVICES 855 MANKATO AVENUE WINONA MN 55987 410713914 HEALTH CARE SERVICES MN 501(C)(3) LINE 3 N/A 0 WINONA HEALTH FOUNDATION 855 MANKATO AVENUE WINONA MN 55987 411879744 FUNDRAISING MN 501(C)(3) LINE 7 WINONA HEALTH SERVICES 0 WINONA HEALTH PHYSICIAN CLINICS 420 E SARNIA WINONA MN 55987 411767741 HEALTH CARE SERVICES MN 501(C)(3) LINE 9 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1