2013-08-14T12:39:48-05:00 2012-09-30 450250958 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2011-10-01 411936536 WINONA SENIOR SERVICES INC WINO 5074543650 855 MANKATO AVENUE WINONA MN 55987 MICHAEL ALLEN 5074543650 2013-08-12 1 KIM HUNWARDSEN CPA P00484560 6122536500 2013-08-12 2011 2016-02-24 21:20:13Z RACHELLE HEISING-SCHULTZ 855 MANKATO AVENUE WINONA MN 55987 15738424 0 X WWW.WINONAHEALTH.ORG X 1999 MN EXTENDED CARE FACILITY 17 12 320 85 0 0 147797 110812 14514335 14943528 32564 33560 0 0 14694696 15087900 0 0 0 0 8941665 9205258 0 0 0 5697010 6149639 14638675 15354897 56021 -266997 10518358 10399538 2379190 2462439 8139168 7937099 X DEVOTED TO IMPROVING THE HEALTH AND WELL-BEING OF OUR FAMILY, FRIENDS AND NEIGHBORS. 0 0 14105506 14943528 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 8,339 VISITS IN FY 2012 * WINONA AREA HOSPICE SERVICES, CARING FOR AN AVERAGE OF 28 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; 96 INDIVIDUALS ATTENDED THE ALZHEIMER'S SUPPORT GROUP IN FY 2012. 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 THE WELLNESS WORKS EVENT AND THE BETTER LIVING SHOW 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 2012 WAS $10,733. 14105506 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 0 1 21 0 1 320 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 MICHAEL ALLEN 5074543650 855 MANKATO AVENUE WINONA MN 55987 X GARY EVANS 2.00 X X 0 0 0 JAN BROSNHAN 2.00 X 0 0 0 SCOTT BIESANZ 2.00 X 0 0 0 SCOTT BIRDSALL MD 2.00 X 0 332815 52228 MATTHEW BROGHAMMER MD 2.00 X 0 347069 62309 VICKI DECKER 2.00 X 0 0 0 RICHARD FERRIS MD 2.00 X 0 224969 58855 JIM KILLIAN 2.00 X 0 0 0 HERB HIGHUM 2.00 X 0 0 0 RICK IGLESIAS 2.00 X 0 0 0 KEN MOGREN 2.00 X 0 0 0 HUGH MILLER 2.00 X 0 0 0 KIM SCHWAB 2.00 X 0 0 0 DANIEL PARKER MD 2.00 X 0 225707 43606 MARK WAGNER 2.00 X 0 0 0 STEVE BLUE 2.00 X 0 0 0 RACHELLE HEISING-SCHULTZ 4.00 X X 0 411144 66873 MICHAEL ALLEN 4.00 X 0 231857 46214 MARY MILLER-HYLAND 40.00 X 127263 0 18536 127263 1773561 348621 1 0 1 0 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 CONTRACT THERAPIES 687277 1 108647 2165 110812 PATIENT SERVICE REVENU 623990 14849538 14849538 SUPPORTING REVENUE 900099 93990 93990 14943528 22524 22524 661560 643345 7179 18215 -7179 11036 11036 15087900 14943528 0 33560 6925934 6098943 826991 207778 182968 24810 1584413 1395235 189178 487133 428969 58164 2630 2630 2497 2497 2908489 2872609 35880 4991 4991 773927 740280 33647 148554 148554 85008 85008 47790 46284 1506 71096 71096 625410 623320 2090 78741 77839 902 FACILITY COSTS 926082 926082 MEDICAL SUPPLIES 474204 474204 220 220 15354897 14105506 1249391 0 309162 312259 1627527 2074822 37403 53244 15721300 9899353 6384961 5821947 881857 981611 1277448 1155655 10518358 10399538 953364 1079534 1414213 1371313 11613 11592 2379190 2462439 X 8139168 7937099 8139168 7937099 10518358 10399538 X -266997 64928 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 104683 104683 12798242 7824223 4974019 2580248 1916386 663862 238127 158744 79383 5821947 DUE FROM AFFILIATES 1155655 1155655 PART IV, LINE 2B: THE ORGANIZATION HOLDS FUNDS IN TRUST ON BEHALF OF ITS RESIDENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION AND ITS CONSOLIDATED ENTITIES ARE ORGANIZED AS MINNESOTA NONPROFIT ENTITIES, EXCEPT FOR THE PHARMACY, 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 CORPORTAION'S FEDERAL FORM 990T FILING FOR THE YEAR ENDING SEPTEMBER 30, 2011 IS SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES. 0 1 0 0 0 0 0 0 0 SCOTT BIRDSALL MD 0 325065 0 7750 0 0 0 30120 0 27241 0 390176 0 0 MATTHEW BROGHAMMER MD 0 339319 0 7750 0 0 0 40202 0 23142 0 410413 0 0 RICHARD FERRIS MD 0 217219 0 7750 0 0 0 36747 0 23142 0 284858 0 0 DANIEL PARKER MD 0 216480 0 9227 0 0 0 20314 0 24326 0 270347 0 0 RACHELLE HEISING-SCHULTZ 0 348746 0 52678 0 9720 0 41169 0 29740 0 482053 0 0 MICHAEL ALLEN 0 207101 0 20580 0 4176 0 20936 0 27308 0 280101 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED EMPLOYER CONTRIBUTIONS TO A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: MATTHEW BROGHAMMER $8,627 SCOTT BIRDSALL $ 421 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. SUPPLEMENTAL INFORMATION PART III 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. SUPPLEMENTAL INFORMATION PART III PART II: MATTHEW BROGHAMMER, MD, SCOTT BIRDSALL, MD, RICHARD FERRIS, MD, AND DANIEL PARKER, MD ARE COMPENSATED BY WINONA HEALTH SERVICES, A RELATED ORGANIZATION, FOR PHYSICIAN SERVICES PROVIDED TO THAT ORGANIZATION. RACHELLE HEISING-SCHULTZ AND MICHAEL ALLEN ARE COMPENSATED BY WINONA HEALTH SERVICES, A RELATED ORGANIZATION, FOR SERVICES TO THAT ORGANIZATION AND RELATED ORGANIZATIONS. CITY OF WINONA 416005651 975232BQ1 2007-07-31 1579539 SEE BELOW FOR COMPLETE DESCRIPTION 0 0 0 200200 1579539 114677 20644 660000 784194 2007 1 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 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 HUGH MILLER WITH ANDY BLOMSNESS RACHELLE HEISING-SCHULTZ WITH GARY EVANS SCOTT BIRDSALL, MD, MATTHEW BROGHAMMER, MD, RICHARD FERRIS, MD, AND DAN PARKER, MD HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. RACHELLE HEISING-SCHULTZ, MICHAEL ALLEN, SCOTT BIRDSALL, MD, MATTHEW BROGHAMMER, MD, RICHARD FERRIS, MD, AND DANIEL PARKER, MD HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. 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 REMOVING 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 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 VII, SECTION A: THE FOLLOWING INDIVIDUALS DEVOTED TIME PROVIDING SERVICES TO RELATED ORGANIZATIONS. GARY EVANS 5 HOURS PER WEEK JAN BROSNHAN 5 HOURS PER WEEK SCOTT BIESANZ 5 HOURS PER WEEK SCOTT BIRDSALL, MD 45 HOURS PER WEEK MATTHEW BROGHAMMER, MD 45 HOURS PER WEEK VICKI DECKER 5 HOURS PER WEEK RICHARD FERRIS, MD 45 HOURS PER WEEK JIM KILLIAN 5 HOURS PER WEEK HERB HIGHUM 5 HOURS PER WEEK RICK IGLESIAS 5 HOURS PER WEEK KEN MOGREN 6 HOURS PER WEEK HUGH MILLER 5 HOURS PER WEEK KIM SCHWAB 5 HOURS PER WEEK DANIEL PARKER, MD 45 HOURS PER WEEK MARK WAGNER 5 HOURS PER WEEK STEVE BLUE 7 HOURS PER WEEK RACHELLE HEISING-SCHULTZ 44 HOURS PER WEEK MICHAEL ALLEN 44 HOURS PER WEEK CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 64,928. 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 PARKVIEW PHARMACY 825 MANKATO AVENUE WINONA MN 55987 411552964 PHARMACY MN N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1