2012-12-20T15:06:49-06:00 2012-06-30 CONWAY DEUTH & SCHMIESING PLLP 401 ATLANTIC AVE MORRIS MN 562671324 990 2011-07-01 411879639 CHISHOLM HEALTH CENTER CHIS 2182545765 321 NE 6TH STREET CHISHOLM MN 55719 LUVERNE HOFFMAN 2182545765 2012-12-17 true JAMES A GILMAN CPA 3205892602 2012-12-17 2011 2016-02-24 21:20:13Z LUVERNE HOFFMAN 801 NEVADA AVE MORRIS MN 56267 6183076 false X WWW.SFHS.ORG X 1997 MN WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES CHISHOLM HEALTH CENTER AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE AGREE TO PROMOTE THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. 13 13 153 0 2198 2919 6441664 6151072 -798 398 47896 27454 6490960 6181843 8097 0 0 3499380 3489153 0 0 2239665 2116578 5747142 5605731 743818 576112 6265397 6504056 4865982 4528529 1399415 1975527 X WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES CHISHOLM HEALTH CENTER AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE AGREE TO PROMOTE THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. false false 4988748 6183075 CHISHOLM HEALTH CENTER IS A 85 BED SKILLED NURSING FACILITY LOCATED IN RURAL MINNESOTA. THE FACILITY PROVIDES MEDICAL, SOCIAL, AND SPIRITUAL CARE TO ITS RESIDENTS WITHOUT REGARD TO RACE, COLOR, CREED, OR NATIONAL ORIGIN, IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT STATUS. DURING THE CURRENT REPORTING YEAR, THE ORGANIZATION HAD 27,938 PATIENT DAYS AND PROVIDED SERVICES TO MORE THAN 217 PATIENTS. ALSO DURING THIS TIME PERIOD, THE ORGANIZATION EMPLOYED ABOUT 93 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 2.8 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE VERY LIMITED. 4988748 true false false false false false false false true false true false false false true false false true false false false false false false false false false false false true true false false false false false false false false true false false false false false false true false false false false true 12 0 true 153 true false false false false false false X 13 13 false true false false true false false true true false false false true true true true true true true false MN X SHERRY WAGNER 3205894919 801 NEVADA AVENUE MORRIS MN 56267 X DON GIESELMANN 1.00 X X 0 0 0 STEVE LIENEMANN 1.00 X 0 0 0 KATIE ERDMAN 1.00 X 0 0 0 MAGGIE FLETCHER 1.00 X 0 0 0 BARBARA SPAULDING 1.00 X 0 0 0 DOUGLAS WARTNER 1.00 X 0 0 0 ANDY LOPEZ 1.00 X X 0 0 0 KENNY WESTBROCK 1.00 X 0 0 0 KEN KELLER 1.00 X 0 0 0 RANDY SUTTER 1.00 X X 0 0 0 FATHER ROBERT KIEFFER 1.00 X 0 0 0 ROSE MURPHY 1.00 X 0 0 0 NEIL SCHMIDGALL 1.00 X 0 0 0 LUVERNE HOFFMAN 1.00 X 0 208017 23442 CAROL RAW X 0 146550 14696 ROBERT WIKAN 1.00 X 0 108023 5481 DENNIS LINDOR X 0 90876 14783 SHERRY WAGNER 1.00 X 0 72058 3802 JUNE SCHELDE X 0 115588 15084 SCOTT JACKSON X 0 107465 6870 848577 84158 false true false ST FRANCIS HEALTH SERVICES 801 NEVADA AVE MORRIS MN 56267 MANAGEMENT FEES 358600 JOHNSON WILSON CONTRACTORS INC PO BOX 16006 DULUTH MN 55816 CONSTRUCTION 152871 2 2919 2919 NET RESIDENT SERVICE REVENUE 6151072 6151072 6151072 398 398 2172 1233 939 APARTMENT RENTAL 17170 17170 GUEST, EMPLOYEE & APT MEALS 6682 6682 MISCELLANEOUS 2663 2663 26515 6181843 6177587 398 2869968 2801375 68593 93965 91719 2246 309456 302060 7396 215764 210607 5157 358600 358600 427 427 6235 6235 11363 11363 22930 22930 143192 143192 2643 2643 3523 1668 1855 175284 175284 282131 282131 56833 56833 SUPPLIES 477040 477040 MEDICAL SURCHARGE 248658 248658 MEDICAL PROF. FEES 111858 84609 27249 CONSULTING 74350 74350 141511 96055 45456 5605731 4988748 616983 0 1006334 581062 552329 719698 35069 36409 8152123 3091570 4556133 5060553 115532 106334 6265397 6504056 475751 484313 4280529 3984365 9702 9542 100000 50309 4865982 4528529 X 1399415 1975527 1399415 1975527 6265397 6504056 576112 X false true true X false X 500 2198 2919 5617 6167190 6600929 6675129 6491058 6179759 32114065 6167690 6600929 6675129 6493256 6182678 32119682 255065 163875 353316 290457 478975 1541688 255065 163875 353316 290457 478975 1541688 30577994 31416 4568 2472 984 398 39838 31416 4568 2472 984 398 39838 6199106 6605497 6677601 6494240 6183076 32159520 0.95080 0.95660 0.00000 X false false false false false true 9702 25605 -25765 9542 true false false false 10000 10000 6921417 2720402 4201015 452636 371168 81468 768070 768070 5060553 DUE TO RELATED PARTY 50309 50309 EXPLANATION FOR UNREPORTED CONTRIBUTIONS OR ASSETS SCHEDULE D, PAGE 2, PART IV, LINE 1B THE ORGANIZATION ACTS AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS. ESCROW LIABILITY ARRANGEMENT EXPLANATION SCHEDULE D, PAGE 2, PART IV, LINE 2B THE ORGANIZATION ACTS AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS. X X false false false false false false false false false LUVERNE HOFFMAN 208017 9641 13801 231459 CAROL RAW 146550 7461 7235 161246 BREMER BANK HCF REV NOTE 2009A 416005047 2009-10-21 1143804 REFINANCING TAXABLE false false false false false false false false false false false false false false false false false false false false PURPOSE OF ISSUE DESCRIPTION SCHEDULE K BREMER BANK INDEBTEDNESS INCURRED TO FINANCE GENERAL REMODELING INFRASTRUCTURE IMPROVEMENTS AND WINDOW REPLACEMENT AT CHC MARK HOFFMAN FAMILY TO 54006 EMPLOYED IN false LUVERNE HOFFMAN MAINTENANCE false PRES & CEO false ELIZABETH LETICH DAUGHTER OF 64272 EMPLOYED AS AN false CAROL RAW ADMINISTRATOR false VICE PRESIDENT false ANDREW RAW SON OF 26945 EMPLOYED IN false CAROL RAW MAINTENANCE false VICE PRESIDENT false ADDITIONAL INFORMATION SCHEDULE L PART V DURING THE YEAR THE ORGANIZATION MAY EMPLOYEE INDIVIDUALS WHO MAY BE RELATED TO AN OFFICER DIRECTOR TRUSTEE OR KEY EMPLOYEE PAYMENTS FOR SERVICES WOULD BE MADE ACCORDING TO EMPLOYMENT POLICY AND DONE AT ARMS LENGTH DUE TO THE RURAL LOCATION OF THE ORGANIZATION AND THE NEED TO FIND QUALIFIED STAFF THESE EMPLOYMENT RELATIONSHIPS WOULD BE NECESSARY TO FURTHER THE ORGANIZATIONS EXEMPT PURPOSE ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION WE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES CHISHOLM HEALTH CENTER AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE AGREE TO PROMOTE THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES. FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A EMPLOYMENT OPPORTUNITIES ARE VERY LIMITED. MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION WITH COMMON CONTROL) MANAGES THE FACILITY. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 THE ORGANIZATION IS ORGANIZED WITH MEMBERS. THE MEMBERS OF THE CORPORATION SHALL CONSIST OF THE BOARD OF DIRECTORS OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE CFO OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC REVIEWS THE TAX RETURN AS PART OF THE MANAGEMENT SERVICES. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY THE ORGANIZATION CONDUCTS IN-SERVICE TRAINING REVIEWING THE POLICY ON CONFLICTS OF INTEREST AND REQUIRES THE BOARD MEMBERS, MANAGEMENT STAFF, AND KEY EMPLOYEES TO DISCLOSE CONFLICTS. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR THE CEO - ANNUALLY THE HR DIRECTOR SUBMITS THE CEO'S JOB DESCRIPTION, PERFORMANCE EVALUATION FORM, ST. FRANCIS HEALTH SERVICES OF MORRIS, INC'S PAY GRADE SCHEDULE AND COMPARABLE WAGE SURVEY(S) TO THE CHAIRMAN OF THE BOARD. THE CHAIRMAN AND THE EVALUATION COMMITTEE OF THE BOARD REVIEWS THE PERFORMANCE AND DETERMINES THE SALARY OF THE CEO. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR OFFICERS - CEO AND THE HR DIRECTOR REVIEWS COMPARABLE WAGE SURVEY INFORMATION, REVIEWS PERFORMANCE (WITH INPUT FROM THE VP, IF APPROPRIATE) AND DETERMINES SALARY. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON AN AS REQUESTED BASIS. RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII ST. FRANCIS HEALTH SERVICES OF MORRIS, INC HAS A MANAGEMENT AGREEMENT WITH THE RELATED ENTITY. AITKIN HEALTH SERVICES 301 MINNESOTA AVENUE AITKIN MN 56431 203367397 CAREGIVER MN 501C3 9 SFHS false BROWNS VALLEY HEALTH CENTER RR 1 BOX 182D SOUTH JEFFERSON BROWNS VALLEY MN 56219 411668347 CAREGIVER MN 501C3 9 SFHS false FRANCISCAN HEALTH CENTER 3910 MINNESOTA AVENUE DULUTH MN 55802 411799268 CAREGIVER MN 501C3 9 SFHS false FARMINGTON HEALTH SERVICES 3410 23RD STREET W FARMINGTON MN 55024 200100365 CAREGIVER MN 501C3 9 SFHS false GUARDIAN ANGELS HEALTH & REHAB CENT 1500 3RD AVENUE E HIBBING MN 55746 411810369 CAREGIVER MN 501C3 9 SFHS false PRAIRIE COMMUNITY SERVICES 801 NEVADA AVENUE MORRIS MN 56267 411598442 CAREGIVER MN 501C3 9 SFHS false PENNINGTON HEALTH SERVICES 130 LABREE AVENUE S THIEF RIVER FALLS MN 56701 205617275 CAREGIVER MN 501C3 9 SFHS false RENVILLE HEALTH SERVICES 205 SE ELM AVENUE RENVILLE MN 56284 202581924 CAREGIVER MN 501C3 9 SFHS false ST FRANCIS HEALTH SERVICES (SFHS) 801 NEVADA AVENUE MORRIS MN 56267 411484416 MGMT COMP MN 501C3 9 N/A false VIEWCREST HEALTH CENTER 3111 CHURCH PLACE DULUTH MN 55811 411843283 CAREGIVER MN 501C3 9 SFHS false WEST WIND VILLAGE 1001 SCOTT AVENUE MORRIS MN 56267 237625632 CAREGIVER MN 501C3 9 SFHS false ZUMBROTA HEALTH SERVICES 433 MILL STREET ZUMBROTA MN 55992 510487275 CAREGIVER MN 501C3 9 SFHS false false false false false false false false false false false false true false true false false false false ST FRANCIS HEALTH SERVICES OF MORR L 358600 AMOUNT PAID OR ACCRUED ADDITIONAL INFORMATION SCHEDULE R ST FRANCIS HEALTH SERVICES OF MORRIS INC HAS GUARANTEED EXISTING LOANS OF 3984364 AS SHOWN IN FORM 990 PART X LINE 20 THERE WERE NO NEW LOAN GUARANTEES DURING THE FISCAL YEAR