2023-04-15T09:09:13-05:00 2022-12-31 411431613 BERGANKDV LTD 12100 MEREDITH DR SUITE 200 URBANDALE IA 50323 990 2022-01-01 421056708 ST FRANCIS MANOR STFR 6412367592 2021 4TH AVENUE GRINNELL IA 50112 DION SCHRACK ADMINISTRATOR 6412367592 2023-04-04 1 DION SCHRACK 999009999 0 BRENT L ALEXANDER CPA P00075113 5157275700 2023-04-04 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z DION SCHRACK 2021 4TH AVENUE GRINNELL IA 50112 9085615 0 X N/A X 1976 IA CONTINUING CARE RETIREMENT COMMUNITY 9 8 212 9 0 0 1599496 111130 7642788 8663161 -646 -4046 292668 304189 9534306 9074434 0 0 0 0 5462874 6465749 0 0 13713 3625252 3581879 9088126 10047628 446180 -973194 22667691 22014134 17768897 18088534 4898794 3925600 OPERATE CONTINUING CARE RETIREMENT COMMUNITY TO CARE FOR ELDERLY 0 0 8957638 8967350 OPERATE CONTINUING CARE RETIREMENT COMMUNITY TO CARE FOR ELDERLY 8957638 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 30 0 1 212 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DION SCHRACK 6412367592 2021 4TH AVE GRINNELL IA 50112 X KENT BROWN CHAIRPERSON 1.00 X X 0 0 0 FRAN CONN VICE-CHAIRPERSON 1.00 X X 0 0 0 LEE MCFEE SECRETARY/TREASURER 1.00 X X 0 0 0 SAMMI BRYAN DIRECTOR, HC MGR. 41.00 X 117582 0 7860 CONNIE SCURR DIRECTOR 1.00 X 0 0 0 LINDSEY WARNICK DIRECTOR 1.00 X 0 0 0 MIKE THORNDIKE DIRECTOR 1.00 X 0 0 0 GARY SHEBECK DIRECTOR 1.00 X 0 0 0 TERYL VER PLOEG DIRECTOR 1.00 X 0 0 0 DION SCHRACK ADMINISTRATOR 55.00 X 201246 0 35617 DENISE CHENEY NURSE 40.00 X 100882 0 0 LEILA KUNTZ NURSE AIDE 40.00 X 118205 0 19339 KORY PROBASCO DIRECTOR OF NURSING 40.00 X 117838 0 19731 ROSALIND VANGORP NURSE 40.00 X 100029 0 0 755782 0 82547 6 0 1 0 0 111130 111130 NURSING CARE 623000 7056870 7056870 DEFERRED REVENUE RECOG 900099 882457 882457 ANCILLARY SERVICES 621610 447876 447876 OTHER OPERATING SERVIC 900099 275958 275958 8663161 7135 7135 11181 -11181 -11181 -11181 CONTRACT REVENUE 900099 304189 304189 304189 9074434 8967350 0 -4046 362305 125442 235726 1137 5374923 5030787 338186 5950 230913 221058 9714 141 497608 451445 45628 535 8424 8424 105334 105334 39578 11317 22998 5263 13545 13545 84798 84798 222601 213055 9546 140794 140794 1247336 1223528 23808 87131 87131 SUPPLIES 992245 992245 FOOD 320592 320592 REPAIRS AND MAINTENANCE 130932 130932 MISCELLANEOUS 62055 61368 687 126514 96443 30071 10047628 8957638 1076277 13713 190192 815921 2735070 1645978 506050 497221 81308 128201 39297 37095 32980 34891 36387575 17532748 19082794 18854827 22667691 22014134 471923 596823 12204928 12494276 5060389 4964185 31657 33250 17768897 18088534 X 4894639 3925100 4155 500 4898794 3925600 22667691 22014134 -973194 0 X X 0 1 X 1 0 X 240322 96252 1013421 1599496 111130 3060621 6714192 7815473 7910100 7927956 8967350 39335071 6954514 7911725 8923521 9527452 9078480 42395692 0 60936 51365 284579 315714 364382 1076976 60936 51365 284579 315714 364382 1076976 41318716 1895 1819 3214 3986 7135 18049 1895 1819 3214 3986 7135 18049 6956409 7913544 8926735 9531438 9085615 42413741 0.97420 0.98070 0.00040 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 791891 791891 30314832 13557816 16757016 2030007 1583509 446498 3250845 2391423 859422 18854827 RESIDENT DEPOSITS HELD 33250 33250 X X X 0 0 0 0 0 0 0 0 0 DION SCHRACK ADMINISTRATOR 201246 0 0 0 0 0 0 0 35617 0 236863 0 0 0 PART I, LINE 3 THE FINANCE COMMITTEE MET TO CONSIDER THE APPROPRIATE RAISE FOR THE ADMINISTRATOR; THE RAISE WAS BASED UPON OTHER ORGANIZATIONS ADMINISTRATIVE SALARY AND THE RESPONSIBILITIES THE ADMINISTRATOR PERFORMS. A CITY OF GRINNELL IOWA 426004734 2010-12-17 1250000 HEALTH CARE FACILITY REVENUE BOND (ST. FRANCIS MANOR PROJECT) SERIES 2010 0 1 0 A 1250000 36962 1250000 2012 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 SHELLEY SCHRACK ADMINISTRATOR'S WIFE 70540 PAYROLL & BENEFITS 0 MADISON SCHRACK ADMINISTRATOR'S DAUGHTER 14499 PAYROLL, NO BENEFITS 0 DONALD SCHRACK ADMINISTRATOR'S BROTHER 9905 PAYROLL, NO BENEFITS 0 FORM 990, PART VI, SECTION B, LINE 11B THE ST. FRANCIS MANOR, INC. FINANCE COMMITTEE REVIEWED THE 990 AND APPROVED THE RETURN BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C SFM CONDUCTS PERIODIC REVIEWS INCLUDING WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARMS-LENGTH BARGAINING AND WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CHARITABLE PURPOSES OF SFM AND DO NOT RESULT IN INUREMENT OR IMPERMISSABLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15 SFM'S ADMINISTRATOR'S COMPENSATION IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 18 ST. FRANCIS MANOR, INC. WILL PROVIDE A COPY OF ITS 990 UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 ST. FRANCIS MANOR, INC. WILL PROVIDE A COPY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 4: SAMMI BRYAN WAS COMPENSATED FOR SERVICES AS AN EMPLOYEE AT HAMMOND CENTER, AND NOT AS A MEMBER OF THE BOARD OF DIRECTORS. 990 PT XII LINE 2C NO CHANGE HAS OCCURRED IN THE ORGANIZATION'S SELECTION OR OVERSIGHT PROCESS OF THE AUDIT PROCESS OF THE ORGANIZATION'S FINANCIAL STATEMENTS. COMMUNITY SERVICES OF ST FRANCIS 2021 4TH STREET GRINNELL IA 50112 205825952 TO PROVIDE HOME HEALTH CARE AND HOME REPAIR IA 133647 28346 ST FRANCIS MANOR INC HAMMOND CENTER OF ST FRANCIS 2021 4TH STREET GRINNELL IA 50112 812043570 TO PROVIDE ASSISTED LIVING FACILITY FOR THE ELDERLY IA 1260733 4400386 ST FRANCIS MANOR INC ST FRANCIS MANOR FOUNDATION 2021 FOURTH AVENUE GRINNELL IA 50112 262179671 RECEIVE, MAINTAIN & ACCEPT GIFTS FOR THE SOLE PURPOSE OF CONTRIBUTING TO SFM IA 501(C)(3) PUBLIC CHARITY ST FRANCIS MANOR INC 1 SEELAND PARK 2021 4TH AVENUE GRINNELL IA 50112 421337462 MANAGE, OPERATE AND MAINTAIN THE COMMON PROPERTY OF SEELAND PARK IA ST FRANCIS MANOR INC C 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 ST FRANCIS MANOR FOUNDATION C 110998 CASH CONTRIBUTION SEELAND PARK M 130650 MONTHLY FEE SEELAND PARK Q 324588 ACTUAL COSTS PAID