2012-03-06T13:08:42-06:00 2011-06-30 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY EAU CLAIRE WI 54701 990 2010-07-01 390993000 SPRING VALLEY HEALTH CARE SERVICES INC SPRI 7157785545 S830 WESTLAND DRIVE SPRING VALLEY WI 54767 KEVIN LARSON 7157785545 2012-03-06 1 HOLLY POKRANDT CPA 7158323407 2012-03-06 2010 2016-02-24 21:20:13Z X KEVIN LARSON S830 WESTLAND DRIVE SPRING VALLEY WI 54767 4881304 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 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 3 194 150 110750 -96780 95720 5603 4572865 4874758 1399 943 0 0 4669984 4881304 0 0 0 0 3505793 3931892 0 0 0 880647 1192519 4386440 5124411 283544 -243107 4432336 9819857 3373348 9003976 1058988 815881 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 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. 1 0 2933156 3018539 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. DURING FISCAL YEAR 2011, THE NURSING FACILITY PROVIDED 14,143 RESIDENT DAYS. 1071063 1414773 SPRING VALLEY HEALTH CARE SERVICES, INC. ALSO PROVIDES HOME HEALTH CARE SERVICES TO MEMBERS OF THE COMMUNITY AND SURROUNDING AREAS. 531920 330696 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, WHICH OPENED IN JULY 2010. 200442 110750 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. 200442 110750 4736581 1 0 0 1 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 0 1 18 0 1 194 1 1 1 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 WI X KEVIN LARSON 7157785545 S830 WESTLAND DRIVE SPRING VALLEY WI 54767 ROSS KEEHR 1.00 X 0 0 0 BRIAN DUCKLOW 1.00 X 0 0 0 MARSHA BRUNKHORST 1.00 X 0 0 0 KEVIN LARSON 40.00 X 74712 0 11332 74712 0 11332 0 0 0 0 COMMUNITY LIVING SOLUTIONS 2801 E ENTERPRISE AVE STE 202 APPLETON WI 54913 ARCHITECTURE DEVELOPMENT MANAGEMENT SERV 316265 1 5603 5603 NURSING HOME REVENUE 623000 3018539 3018539 HOME HEALTH REVENUE 621610 1414773 1414773 ASSISTED LIVING REVENU 623990 330696 330696 CHILD CARE REVENUE 624410 110750 110750 4874758 943 943 4881304 4764008 110750 943 84898 84898 3075555 3009055 66500 532057 519221 12836 239382 228735 10647 5557 5557 2455 2455 67245 67245 80065 80065 10222 10222 394283 319470 74813 263042 263042 25303 22654 2649 1643 232 1411 38977 38977 176969 176969 40844 40844 NURSING HOME BED TAX 102000 102000 EDUCATION AND DUES/SUBS 7753 7753 REPAIRS AND MAINTENANCE 6366 6366 (CREDIT)PROVISION FOR B -30205 -30205 5124411 4736581 387830 0 89327 137441 192488 190318 454121 604580 32508 33214 57334 73689 9808862 1140120 3469781 8668742 136777 111873 4432336 9819857 1362992 440337 1936786 6788047 3570 12920 70000 1762672 3373348 9003976 X 1058988 815881 1058988 815881 4432336 9819857 -243107 0 X X 0 1 0 X 1 1 X 0 0 0 0 0 0 0 0 1 230 230 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: 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. 221174 221174 3465767 834918 2630849 479842 305202 174640 5642079 5642079 8668742 MEDICAL CLAIMS PAYABLE 75000 WHEDA TAX CREDIT 1687672 1762672 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE TAXES ON RELATED INCOME. VALLEY VILLAS, LLC IS A SINGLE-MEMBER LIMITED LIABILITY COMPANY AND AS SUCH, IT IS A DISREGARDED ENTITY FOR INCOME TAX PURPOSES AND IS INCLUDED UNDER TAX REPORTING WITH SPRING VALLEY HEALTH CARE SERVICES, INC. EACH YEAR AN EVALUATION IS COMPLETED TO DETERMINE WHETHER THEIR INCOME OR A PORTION OF THEIR INCOME SHOULD BE CONSIDERED AS UNRELATED BUSINESS INCOME AND, AS SUCH, WOULD BE SUBJECT TO FEDERAL AND STATE INCOME TAXES. IF ANY TAX PROVISIONS OR CREDITS ARE DETERMINED TO BE NECESSARY, THE ORGANIZATION RECORDS THESE AMOUNTS IN THE CONSOLIDATED FINANCIAL STATEMENTS THE ORGANIZATION IS ALSO ENGAGED, TO A LIMITED EXTENT, IN ACTIVITIES WHICH THE INTERNAL REVENUE SERVICE CONSIDERS UNRELATED TO THE ORGANIZATION'S EXEMPT PURPOSE AND, THEREFORE, TAXABLE. THESE ACTIVITIES, HOWEVER, ANNUALLY RESULT IN NET OPERATING LOSSES FOR INCOME TAX PURPOSES. THE ORGANIZATION DOES NOT PRESENTLY ANTICIPATE THAT A TAX BENEFIT FROM THESE NET OPERATING LOSSES WILL BE REALIZED IN THE FUTURE. ACCORDINGLY, ANY POTENTIAL DEFERRED TAX ASSET RESULTING FROM THE AVAILABILITY OF NET OPERATING LOSS CARRYFORWARDS IS OFFSET BY A VALUATION ALLOWANCE OF EQUAL AMOUNT. NO DEFERRED TAX ASSETS AND LIABILITIES HAVE BEEN RECOGNIZED SINCE NO OTHER DIFFERENCES EXIST BETWEEN THE FINANCIAL AND TAX BASES OF REPORTING THE ORGANIZATION'S ASSETS AND LIABILITIES. THE ORGANIZATION'S POLICY IS TO RECOGNIZE INTEREST AND ANY PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE WHEN INCURRED. AS OF AND FOR THE YEARS ENDED JUNE 30, 2011 AND 2010, THERE WAS NO INCOME TAX EXPENSE, TAX PENALTIES, OR INTEREST RELATED TO TAX PENALTIES RECORDED BY THE ORGANIZATION IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2011 AND 2010. FEDERAL RETURNS FOR THE YEARS ENDED JUNE 30, 2008 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 IN JULY 2010, A 20-UNIT ASSISTED LIVING FACILITY WAS OPENED. THIS FACILITY OFFERS A PLACE FOR INDIVIDUALS TO LIVE WHO ARE NOT YET READY FOR A NURSING HOME BUT SHOULD NOT LIVE INDEPENDENTLY ANYMORE. 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. HOWEVER, IF THE TIMING OF THE BOARD MEETING DOESN'T MAKE IT POSSIBLE TO REVIEW THE 990 BEFORE THE SUBMISSION, THE 990 WILL BE DISTRIBUTED TO BOARD MEMBERS AT THE NEXT POSSIBLE MEETING. 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. WHISTLEBLOWER POLICY FORM 990, PART VI, SECTION B, LINE 13 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 SAFE-GUARDS IS THE PROTECTION OF THOSE STAFF PERSONS FROM RETRIBUTION OR RETALIATION AS RESULT OF THEM PROVIDING INFORMATION OR AID. DOCUMENT RETENTION AND DESTRUCTION POLICY FORM 990, PART VI, SECTION B, LINE 14 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. OVERSIGHT OF THE AUDIT: FORM 990, PART XII, LINE 2C 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 330696 3129872 SPRING VALLEY HEALTH CARE SERVICES