2024-09-12T08:34:08-05:00 2023-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2023-01-01 814879204 ST JOSEPH'S ELDER SERVICES INC STJO 4023721118 540 E WASHINGTON ST WEST POINT NE 68788 SAMUEL PROKOPEC EXECUTIVE DIRECTOR 4023721118 2024-09-04 1 1 WENDY R COOLEY CPA P01523804 4023302660 2024-09-04 2023 2024-08-08 14:25:15Z SAMUEL PROKOPEC 540 E WASHINGTON ST WEST POINT NE 68788 8596590 0 0928 X WWW.SJESWP.COM X 2017 NE TO LIVE AND PROMOTE THE HEALING MISSION OF JESUS CHRIST. 7 6 164 52 0 0 707949 318314 6929124 8040486 0 1491 0 236299 7637073 8596590 0 0 0 0 4597758 5380281 0 0 0 4272404 3821433 8870162 9201714 -1233089 -605124 10312334 9577238 1369485 1238211 8942849 8339027 X THE MISSION OF ST. JOSEPH'S ELDER SERVICE (SJES) IS TO LIVE AND PROMOTE THE HEALING MISSION OF JESUS CHRIST. WE DO THIS THROUGH OUR COMMITMENT TO A CHRISTIAN ETHIC AND SPIRITUAL GROWTH BY RESPECTING ALL STAGES IN LIFE AND PROVIDING COMPASSIONATE CARE FOR THE POOR, ELDERLY, AND THOSE IN NEED. SJES IS RESPONSIVE TO THOSE SERVED BY TREATING ALL WITH RESPECT, DEMONSTRATING ADAPTABILITY AND FLEXIBILITY TO CARES, AND DEDICATION TO SERVICE EXCELLENCE. SJES PRACTICES STEWARDSHIP BY MANAGING FISCAL AND HUMAN RESOURCES WITH HONESTY AND INTEGRITY. 0 1 8190175 8276785 ST. JOSEPH'S ELDER SERVICE (SJES) PROVIDES QUALITY CARE IN A 54-BED SKILLED NURSING FACILITY. SERVICES OFFERED ARE NURSING CARE, SOCIAL SERVICES, THREE NUTRITIOUS MEALS PER DAY, THERAPY, LEISURE ACTIVITIES, AS WELL AS SPIRITUAL CARE. A NUMBER OF RESIDENTS RECEIVE FINANCIAL ASSISTANCE THROUGH GOVERNMENTAL FUNDING AND ARE A SHORTFALL OF COVERING COSTS OF CARE. SJES ALSO PROVIDES ASSISTED LIVING TO RESIDENTS IN THEIR APARTMENTS, WHILE ENCOURAGING THEIR MAXIMUM LEVEL OF INDEPENDENCE. SERVICES OFFERED IN THE ASSISTED LIVING INCLUDE NURSING SUPPORT, LEISURE ACTIVITIES, THREE DELICIOUS AND NUTRITIOUS MEALS PER DAY, TRANSPORTATION, SPIRITUAL CARE, AND SOCIAL SERVICES. THESE SERVICES ARE OFFERED BASED ON NEED AND MULTIPLE RESIDENTS RECEIVE GOVERNMENT ASSISTANCE. 8190175 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 164 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SAMUEL PROKOPEC EXECUTIVE DIRECTOR 4023721118 540 E WASHINGTON STREET WEST POINT NE 68788 SAMUEL PROKOPEC EXECUTIVE DIRECTOR 45.00 0.00 X X 119854 0 36402 BRIAN REIMERS BOARD CHAIR 0.50 0.00 X X 0 0 0 DIANE FALK TREASURER 0.50 0.00 X X 0 0 0 DIANE WHITE SECRETARY 0.50 0.00 X X 0 0 0 SISTER JOY ROSE BOARD MEMBER 0.50 0.00 X 0 0 0 WILLIAM KREIKEMEIER BOARD MEMBER 0.50 0.00 X 0 0 0 HEATH GRAYBEAL BOARD MEMBER 0.50 0.00 X 0 0 0 KELLY JOHNSON CHIEF NURSING OFFICER 40.00 0.00 X 116922 0 33860 TINA VOELKER NURSING 40.00 0.00 X 145461 0 31314 TERESA POWLEY NURSING 40.00 0.00 X 104248 0 12233 486485 0 113809 4 0 1 0 FUSION MEDICAL STAFFING LLC PO BOX 30131 OMAHA NE 681031231 AGENCY STAFFING 842707 SHIFTKEY LLC PO BOX 735913 DALLAS TX 753735913 AGENCY STAFFING 204012 FRANCISCAN HEALTHCARE 430 N MONITOR ST WEST POINT NE 68788 THERAPY SERVICES 195947 SOURCE MEDICAL STAFFING PO BOX 3544 OMAHA NE 681030544 AGENCY STAFFING 189779 PRIME TIME HEALTHCARE 18010 BURT STREET ELKHORN NE 68022 AGENCY STAFFING 121208 7 138055 180259 318314 RESIDENT SERVICE REVEN 623000 7956515 7956515 MEALS ON WHEELS 624210 65256 65256 VENDING/GIFT SHOP REVE 459420 3594 3594 15121 15121 8040486 1491 1491 BUSINESS INTERRUPTION 900099 220443 220443 INSURANCE PROCEEDS 900099 15856 15856 236299 8596590 8276785 0 1491 156256 36402 119854 4286997 3980941 306056 591797 591797 345231 288768 56463 11400 11400 268344 54368 213976 14607 1568 13039 235357 223145 12212 450726 423814 26912 10438 7745 2693 10230 7861 2369 32441 32441 868134 850772 17362 148000 148000 AGENCY STAFFING 762330 762330 FOOD 412731 412731 MEDICAL SUPPLIES 219847 219847 MINOR EQUIPMENT 142784 126302 16482 234064 53784 180280 9201714 8190175 1011539 0 241294 181999 1 810 208290 232075 24471 23983 34744 37858 13990512 4970041 9725374 9020471 78160 80042 10312334 9577238 919485 833093 450000 405118 1369485 1238211 X 8920183 8339027 22666 0 8942849 8339027 10312334 9577238 -605124 1302 0 X X 0 1 X 1 0 X 710000 988583 410736 707949 318314 3135582 4111902 5497998 5593034 6929124 8040486 30172544 4821902 6486581 6003770 7637073 8358800 33308126 700000 34500 670465 172866 1577831 1104759 1104759 700000 34500 670465 1277625 2682590 30625536 2527 1491 4018 2527 1491 4018 236299 236299 4824429 6486581 6003770 7637073 8596590 33548443 0.91290 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 222696 222696 9980551 2907561 7072990 3648946 1941828 1707118 138319 120652 17667 9020471 X X 0 0 0 0 0 0 0 0 0 TINA VOELKER NURSING 135024 0 10437 0 0 0 3637 0 27677 0 176775 0 0 0 SAMUEL PROKOPEC EXECUTIVE DIRECTOR 93784 0 26070 0 0 0 2775 0 33627 0 156256 0 0 0 KELLY JOHNSON CHIEF NURSING OFFICER 104132 0 12790 0 0 0 2923 0 30937 0 150782 0 0 0 FORM 990, PART III, LINE 3 MEMORY CARE SERVICES WITHIN THE RETIREMENT CENTER CEASED JANUARY OF 2023. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY TO ACCOMPLISH THOSE TASKS ASSIGNED BY THE BOARD OF DIRECTORS AND TO TRANSACT THE ESSENTIAL BUSINESS OF THE BOARD, PROVIDED THAT NO ACTION TAKEN AT MEETINGS SHALL BE IN CONFLICT WITH BOARD POLICIES. SPECIAL COMMITTEES MAY BE APPOINTED AND SHALL HAVE ONLY SUCH POWER TO ACT AS MAY BE SPECIFICALLY CONFERRED BY THE CHAIRMAN OF THE BOARD OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS CORPORATION IS FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., A WISCONSIN CORPORATION ("THE MEMBER"). FORM 990, PART VI, SECTION A, LINE 7A THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., SHALL APPOINT THE BOARD OF DIRECTORS AND MAY REMOVE A DIRECTOR AT ANY TIME. FORM 990, PART VI, SECTION A, LINE 7B THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., A WISCONSIN NON-STOCK, NON PROFIT CORPORATION HAS THE FOLLOWING RESERVED POWERS OVER ST. JOSEPH'S ELDER SERVICES, INC.: A) APPROVAL OF THE PHILOSOPHY, MISSION AND VALUES STATEMENTS OF THE CORPORATION. B) AMENDMENT OF ARTICLES OF INCORPORATION AND BY-LAWS OF THE CORPORATION. C) APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS. D) APPROVAL OF THE CREATION AND DISSOLUTION OF THIS CORPORATION OR ANY SUBSIDIARY CORPORATIONS, AS WELL AS APPROVAL OF ANY MERGER, CONSOLIDATION, AFFILIATION, JOINT VENTURE OR OTHER FORM OF CORPORATE REORGANIZATION OF THIS CORPORATION OR ANY SUBSIDIARY OF WHICH THIS CORPORATION IS THE MEMBER OR CONTROLLING SHAREHOLDER. E) APPOINTMENT, EVALUATION AND DISCHARGE OF THE PRESIDENT OF THE CORPORATION. F) APPROVAL OF BORROWING IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER. G) APPROVAL OF PURCHASE, MORTGAGE OR SALE OF REAL ESTATE, OR LEASE OF REAL ESTATE, BY OR TO THE CORPORATION FOR LONGER THAN ONE YEAR. H) IMPLEMENTATION OF SPONSOR APPOINTMENT, SALARY NEGOTIATION, AND REASSIGNMENT PROCESSES FOR FRANCISCAN SISTER PERSONNEL WITHIN THIS CORPORATION. I) APPROVAL OF CAPITAL AND OPERATING BUDGETS. J) REQUIREMENT OF A CERTIFIED AUDIT OF CORPORATE FUNDS AT ANY TIME AND APPROVAL OF THE FISCAL AUDITOR OF THE CORPORATION ANNUALLY. K) APPROVAL OF ALL INSURANCE CARRIERS AND INSURANCE COVERAGE FOR THE CORPORATION. L) APPROVAL OF LONG-RANGE OR STRATEGIC PLANS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED AND APPROVED BY THE ADMINISTRATOR. FOLLOWING THE REVIEW OF THE FORM 990 BY THE ADMINISTRATOR, COPIES WILL BE PROVIDED TO THE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, EACH DIRECTOR WILL EXECUTE AND DELIVER TO SJES A DISCLOSURE REGARDING CONFLICT OF INTEREST. AT ANY TIME DURING THE YEAR IF A NEW CONFLICT ARISES, THE CORPORATE COMPLIANCE OFFICER SHALL BE NOTIFIED AND A NEW DISCLOSURE FORM IS FILED WITH THE CORPORATE COMPLIANCE OFFICER. BEFORE ANY ACTION IS TAKEN AT ANY BOARD OF DIRECTORS MEETING, THE BOARD SHALL IDENTIFY WHETHER ANY DIRECTOR (INSIDER) HAS A FINANCIAL INTEREST IN THE MATTER BEING ACTED ON (THE ARRANGEMENT). BASED ON THE FACTS SURROUNDING THE CONFLICT, THE BOARD SHALL DETERMINE IF IT RESULTS IN A TRUE CONFLICT OF INTEREST. ALL CONFLICTS OF INTEREST AND POTENTIAL CONFLICTS OF INTEREST SHALL BE DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION B, LINE 15 COMPARABLE DATA IS REVIEWED TO DETERMINE COMPENSATION FOR BOTH THE EXECUTIVE DIRECTOR AND CERTIFIED NURSING OFFICER. THE BOARD REVIEWS AND APPROVES THE COMPENSATION FOR THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 SJES MAKES ALL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: AN INDEPENDENT BOARD MEMBER OF ST. JOSEPH'S ELDER SERVICES REPRESENTS THE ORGANIZATION ON ITS MEMBER'S SYSTEM AUDIT COMMITTEE. THE SYSTEM AUDIT COMMITTEE IS COMPOSED OF ONE INDEPENDENT BOARD MEMBER OF THE MEMBER AND ONE INDEPENDENT BOARD MEMBER OF EACH RELATED ORGANIZATION. THE COMMITTEE'S PURPOSE IS TO ASSIST IN THE ASSURANCE OF THE QUALITY AND INTEGRITY OF THE FINANCIAL REPORTS. SPECIFIC RESPONSIBILITIES OF THE COMMITTEE INCLUDE REVIEWING AND RECOMMENDING THE SELECTION OF THE INDEPENDENT AUDITORS, DISCUSSING THE SCOPE AND PLAN OF THE ENGAGEMENT WITH THE AUDITORS, AND REVIEWING THE ANNUAL REPORTS AND REQUIRED COMMUNICATIONS PROVIDED BY THE AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES 2413 SOUTH ALVERNO ROAD MANITOWOC WI 54220 391530622 HEALTHCARE MINISTRY WI 501(C)(3) LINE 1 SEE LINE 2 0 HOLY FAMILY CONVENT OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY 2409 SOUTH ALVERNO ROAD MANITOWOC WI 54220 390808523 HEALTH CARE AND HIGHER EDUCATION WI 501(C)(3) LINE 1 N/A 0 FRANCISCAN CARE SERVICES INC 430 NORTH MONITOR STREET WEST POINT NE 68788 470486026 HEALTH CARE NE 501(C)(3) LINE 3 SEE LINE 1 0 GOOD SAMARITAN MEDICAL CENTER 800 FOREST AVENUE ZANESVILLE OH 43701 314379479 HOLDING COMPANY OH 501(C)(3) LINE 1 SEE LINE 1 0 ST PAUL ELDER SERVICES INC 316 EAST 14TH STREET KAUKAUNA WI 54130 391029149 ELDER CARE WI 501(C)(3) LINE 10 SEE LINE 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 1 1 1 0 0