2014-11-11T13:07:29-06:00 2014-06-30 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY EAU CLAIRE WI 54701 990 2013-07-01 390993000 SPRING VALLEY HEALTH CARE SERVICES INC SPRI 7157785545 S830 WESTLAND DRIVE SPRING VALLEY WI 54767 KEVIN LARSON ADMINISTRATOR 7157785545 2014-11-10 1 HOLLY POKRANDT CPA P00449155 7158323407 2014-11-10 2013 2015-11-30 17:44:51Z KEVIN LARSON S830 WESTLAND DRIVE SPRING VALLEY WI 54767 5702766 0 X WWW.SVHCS.ORG X 1970 WI THE MISSION OF SPRING VALLEY HEALTH CARE SERVICES, INC. IS TO PROVIDE HEALTH AND ASSISTIVE SERVICES TO ELDERLY AND DISABLED PERSONS IN NEED OF THE SPRING VALLEY HEALTH CARE SERVICES, INC.'S PROGRAMS IN A MANNER THAT IS CHARITABLE AND WITH A SPIRIT OF BENEVOLENCE SO THAT AN INDIVIDUAL MAY MAINTAIN THE HIGHEST PRACTICABLE QUALITY OF LIFE, THE UTMOST INDEPENDENCE, AND THE MOST REASONABLE SAFE AND HEALTHY LIFESTYLE. 3 3 196 97 183520 -91076 5644 6077 5492642 5550396 2018 -7258 112568 112568 5612872 5661783 0 0 0 0 3950901 3351465 0 0 0 1890198 2076536 5841099 5428001 -228227 233782 10840617 10565706 10184671 9675978 655946 889728 X THE MISSION OF SPRING VALLEY HEALTH CARE SERVICES, INC. IS TO PROVIDE HEALTH AND ASSISTIVE SERVICES TO ELDERLY AND DISABLED PERSONS IN NEED OF THE SPRING VALLEY HEALTH CARE SERVICES, INC.'S PROGRAMS IN A MANNER THAT IS CHARITABLE AND WITH A SPIRIT OF BENEVOLENCE SO THAT AN INDIVIDUAL MAY MAINTAIN THE HIGHEST PRACTICABLE QUALITY OF LIFE, THE UTMOST INDEPENDENCE, AND THE MOST REASONABLE SAFE AND HEALTHY LIFESTYLE. 0 0 3504190 4111278 SPRING VALLEY HEALTH CARE SERVICES, INC. OPERATES A 50-BED SKILLED NURSING FACILITY WHICH IS AVAILABLE TO RESIDENTS OF SPRING VALLEY AND THE SURROUNDING AREAS. PERSONALIZED NURSING CARE, REHABILITATIVE SERVICES, AND SUPPORTIVE SERVICES ARE OFFERED TO PROMOTE AND ASSIST RESIDENTS RECUPERATION FROM ILLNESS, INJURY, OR SURGERY. DURING FISCAL YEAR 2014, THE NURSING FACILITY PROVIDED 16,288 RESIDENT DAYS. 579902 610615 SPRING VALLEY HEALTH CARE SERVICES, INC. ALSO PROVIDES HOME HEALTH CARE SERVICES TO MEMBERS OF THE COMMUNITY AND SURROUNDING AREAS. 641493 757551 SPRING VALLEY HEALTH CARE SERVICES, INC IS THE SOLE CORPORATE MEMBER OF VALLEY VILLAS, LLC. VALLEY VILLAS, LLC WAS ORGANIZED AS A DISREGARDED ENTITY FOR THE PURPOSE OF OPERATING A 20-UNIT RESIDENTIAL CARE APARTMENT COMPLEX. 263665 183520 SPRING VALLEY HEALTH CARE SERVICES, INC. PROVIDES CHILD CARE SERVICES TO CHILDREN RANGING IN AGE FROM 6 WEEKS TO 6 YEARS THROUGH ITS LICENSED DAY CARE, SUNSHINE CHILD CARE AND LEARNING CENTER. 263665 183520 4989250 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 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 1 0 0 0 0 1 18 0 196 1 1 1 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 0 0 X KEVIN LARSON 7157785545 S830 WESTLAND DRIVE SPRING VALLEY WI 54767 ROSS KEEHR PRESIDENT 1.00 X X 0 0 0 JULIE DUCKLOW SECRETARY 1.00 X X 0 0 0 MARSHA BRUNKHORST TREASURER 1.00 X X 0 0 0 KEVIN LARSON CEO/ADMINISTRATOR 40.00 X 79314 0 10887 79314 0 10887 0 0 0 0 0 6077 6077 NURSING HOME REVENUE 623000 4090211 4090211 ASSISTED LIVING REVENU 623990 644983 644983 HOME HEALTH REVENUE 621610 610615 610615 CHILD CARE REVENUE 624410 183520 183520 NURSING ASSISTANT TRAI 623000 21067 21067 5550396 6445 6445 27280 40983 -13703 -13703 -13703 WHEDA LOAN FORGIVENESS 623990 112568 112568 112568 5661783 5479444 183520 -7258 96348 96348 2650389 2594440 55949 381033 373176 7857 223695 212241 11454 10294 10294 2114 2114 76935 76935 202302 202302 15190 15190 96920 96920 623209 623209 17087 15318 1769 4044 2698 1346 380829 380829 54323 54323 FOOD AND SUPPLIES 374736 374736 NURSING HOME BED TAX 102000 102000 BAD DEBT EXPENSE 70232 70232 REPAIRS AND MAINTENANCE 24059 24059 22262 14010 8252 5428001 4989250 438751 0 182174 182355 198817 246094 516595 628563 83802 34548 10583636 1263140 9699097 9320496 160132 153650 10840617 10565706 436858 303438 8165554 7958935 39722 33636 1542537 1379969 10184671 9675978 X 655946 889728 655946 889728 10840617 10565706 233782 0 X X 0 1 X 0 0 X 95720 5603 82494 5644 6077 195538 4466014 4764008 5678352 5350139 5366876 25625389 4561734 4769611 5760846 5355783 5372953 25820927 0 0 0 25820927 1399 943 447 418 6445 9652 1399 943 447 418 6445 9652 4563133 4770554 5761293 5356201 5379398 25830579 0.99960 0.00040 X 0 0 0 0 0 0 0 0 1 739 739 0 PART II-B, LINE 1: SPRING VALLEY HEALTH CARE SERVICES, INC. PAYS ANNUAL ASSOCIATION DUES TO WISCONSIN HEALTH CARE ASSOCIATION, INC. AND AMERICAN HEALTH CARE ASSOCIATION, INC. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATION MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL INDUSTRY ENVIRONMENT. 210300 210300 9430230 896210 8534020 943106 366930 576176 9320496 MEDICAL CLAIMS PAYABLE 30000 WHEDA TAX CREDIT NOTE PAYABLE 1349969 1379969 X PART X, LINE 2: SPRING VALLEY HEALTH CARE SERVICES, INC. IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. SPRING VALLEY HEALTH CARE SERVICES, INC. IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SIMILAR STATE OF WISCONSIN TAX LAWS. SPRING VALLEY HEALTH CARE SERVICES, INC. IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). UBI IS NOT SIGNIFICANT. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS IN 2013 OR 2012. FEDERAL TAX RETURNS FOR TAX YEARS 2011 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES OF THE BOARD OF DIRECTORS WHICH HAVE AUTHORITY TO ACT ON BEHALF OF THE ENTIRE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS AS PART OF THE BOARD PACKET FOR REVIEW AT THE BOARD MEETING PRIOR TO THE 990 BEING SUBMITTED. FORM 990, PART VI, SECTION B, LINE 12C SPRING VALLEY HEALTH CARE SERVICES, INC. REQUIRES ITS BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A THE SPRING VALLEY HEALTH CARE SERVICES, INC.'S BOARD OF DIRECTORS SETS THE SALARY AND BENEFIT PACKAGE FOR THE ADMINISTRATOR/CEO. THE BOARD OF DIRECTORS UTILIZES MULTIPLE SOURCES FOR SETTING THE COMPENSATION INCLUDING VARIOUS SALARY SURVEYS FROM THIRD PARTY SOURCES SUCH AS THE AMERICAN COLLEGE OF HEALTH CARE ADMINISTRATORS, THE LONG TERM CARE NEWS, AND AMERICAN HEALTH CARE ASSOCIATION PROVIDER PUBLICATION. THE SALARY AND BENEFIT PACKAGE FOR OTHER MANAGEMENT-SENIOR LEVEL STAFF PERSONS IS DETERMINED BY THE ADMINISTRATOR WITH CONSULTATION FROM THE BOARD OF DIRECTORS AND WITHIN THE PARAMETERS OF THE ORGANIZATION'S OPERATING BUDGET WHICH IS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 SPRING VALLEY HEALTH CARE SERVICES, INC. MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC ON A PER REQUEST BASIS. FORM 990, PART VI, SECTION B, LINE 13, WHISTLEBLOWER POLICY: SPRING VALLEY HEALTH CARE SERVICES, INC. DOES NOT HAVE A FORMAL WHISTLEBLOWER POLICY. HOWEVER, SPRING VALLEY HEALTH CARE SERVICE, INC.'S ANTI-FRAUD PROTECTIONS INCLUDE SAFE-GUARDS AFFORDED TO THOSE INDIVIDUALS REPORTING OR PROVIDING INFORMATION OR ASSISTANCE WITH CONCERNS OR SITUATIONS RELATED TO POSSIBLE FRAUD, THEFT, ABUSE, OR DETRIMENTAL ACTIVITY BY STAFF PERSONS OR INDIVIDUALS WHO MAY BE AFFILIATED OR ASSOCIATED WITH THE OPERATIONS OF SPRING VALLEY HEALTH CARE SERVICES, INC. THE CRITICAL ELEMENT WITH THE SAFEGUARDS IS THE PROTECTION OF THOSE STAFF PERSONS FROM RETRIBUTION OR RETALIATION AS A RESULT OF THEM PROVIDING INFORMATION OR AID. FORM 990, PART VI, SECTION B, LINE 14, DOCUMENT RETENTION AND DESTRUCTION POLICY: SPRING VALLEY HEALTH CARE SERVICES, INC. DOES NOT HAVE A FORMAL DOCUMENT RENTENTION AND DESTRUCTION POLICY. HOWEVER, SPRING VALLEY HEALTH CARE SERVICES, INC. FOLLOWS ALL STATUTORY REQUIREMENTS GOVERNING RECORD RETENTION. THE STANDARD GUIDELINE UTILIZED IS THE 7 YEAR RETENTION PERIOD FOR RECORDS AND FILES. THE 7 YEAR PERIOD BEGINS WITH THE CLOSING OF THE FILE OR RECORD. STAFF EMPLOYMENT RECORDS CONTAINING ANY MEDICAL OR HEALTH INFORMATION ARE MAINTAINED FOR 30 YEARS ACCORDING TO STATUTORY REQUIREMENTS. FORM 990, PART XII, LINE 2C, OVERSIGHT OF THE AUDIT: THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT AUDITOR AND MANAGEMENT OVERSEES THE AUDIT PROCESS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. VALLEY VILLAS LLC S820 WESTLAND DRIVE SPRING VALLEY WI 54767 263498120 DEVELOPMENT AND OPERATION OF ASSISTED LIVING FACILITY WI 757551 SPRING VALLEY HEALTH CARE SERVICES INC