2025-08-13T12:21:25-05:00 2024-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 410711606 HARMONY COMMUNITY HEALTHCARE HARM 5078866544 815 MAIN AVENUE S HARMONY MN 55939 BRENDA MOSER FINANCE ADMINISTRATOR 5078866544 2025-08-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-08-06 2023 2025-03-06 01:10:19Z GUNDERSEN HARMONY CARE CENTER BRENDA MOSER 815 MAIN AVENUE S HARMONY MN 55939 4979131 0 X HTTPS://WWW.GUNDERSENHEALTH.ORG/LOCATIONS/GUNDERS X 1948 MN TO PROVIDE CARE TO THE ELDERLY. 7 3 78 5 0 0 37263 498439 3222703 4460353 4347 20339 0 0 3264313 4979131 0 0 0 0 2285725 3527561 0 0 0 931666 1285711 3217391 4813272 46922 165859 2059124 2133287 979268 885191 1079856 1248096 HARMONY COMMUNITY HEALTHCARE IS COMMITTED TO ENHANCING THE QUALITY OF LIFE OF THOSE WE SERVICE. 0 0 3476485 0 4460353 THE ORGANIZATION PROVIDES HOUSING AND NURSING CARE TO THE ELDERLY BY OPERATING A 42-BED NURSING FACILITY IN HARMONY, MN. DURING FY24, THERE WERE 11,156 RESIDENT DAYS. 3476485 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 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 1 0 0 0 1 15 0 78 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 3 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 MN X BRENDA MOSER 5078866544 815 MAIN AVENUE S HARMONY MN 55939 VICKI BAKALARS PRESIDENT 2.00 48.00 X X 0 151403 46248 CHUCK JOHNSON VICE PRESIDENT 2.00 48.00 X X 0 150958 49570 CHRIS SKAALEN DIRECTOR 2.00 X 0 0 0 JEN BERENDES DIRECTOR THRU (12/2023) 2.00 40.00 X 0 111090 38432 MANDI PERICAK SECRETARY/TREASURER 2.00 48.00 X X 0 119202 40172 DONNA SCHEEVEL SECRETARY/TREASURER (BEG. 01/2024) 2.00 X X 0 0 0 KAREN JOHNSON DIRECTOR 2.00 X 0 0 0 SARAH MELDE DIRECTOR 2.00 48.00 X 0 89971 31941 MICHELLE BORRESON ADMIN./CEO (THRU 03/2024) 25.00 25.00 X 0 128057 56645 JOHN CEELEN CFO-BGHS (BEG. 02/2024) 2.00 48.00 X 0 0 0 THOMAS WOAHLOE INTERIM ADMIN. (03/24 THRU 12/24) 25.00 25.00 X 0 0 0 BRENDA MOSER FINANCE ADMINISTRATOR 4.00 46.00 X 0 177022 51157 SCOTT RATHGABER CEO-BGHS 2.00 48.00 X 0 1644221 68728 STEVE LITTLE CFO-BGHS (THRU 02/2024) 2.00 48.00 X 0 333317 0 SUE LENZ DIRECTOR OF NURSING 50.00 X 116344 0 19885 GERALD OETZEL FORMER CFO-BGHS 0.00 0.00 X 0 555068 18108 116344 3460309 420886 1 1 1 0 STAFFENCY 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 STAFFING 330570 AEGIS THERAPIES INC PO BOX 936653 ATLANTA GA 311936653 CONTRACTED PT, OT & ST SERVICES 233736 MARTIN BROTHERS DISTRIBUTING COMPANY 406 VIKING ROAD CEDAR FALLS IA 50613 FOOD DISTRIBUTOR 124912 3 300000 191386 7053 498439 RESIDENT SERVICE REVEN 623000 4372255 4372255 RENTAL REVENUE 900099 83088 83088 5010 5010 4460353 20339 20339 4979131 4460353 0 20339 2933741 2236157 697584 172351 132499 39852 261108 170558 90550 160361 120253 40108 99540 99540 538 538 12450 12450 264878 228894 35984 2132 244 1888 41298 10863 30435 1503 1503 202212 196152 6060 1620 832 788 8531 8276 255 133648 105795 27853 13825 13825 FOOD EXPENSE 136256 136256 DHS SURCHARGE 121045 121045 MEDICAL SUPPLIES 118753 117633 1120 BAD DEBT EXPENSE 51219 51219 76263 10570 65693 4813272 3476485 1336787 0 651404 642441 265015 443457 21877 21653 3274508 2296828 1063129 977680 57699 48056 2059124 2133287 304815 499367 198855 342993 3169 2611 300000 0 172429 40220 979268 885191 X 1043413 1209272 36443 38824 1079856 1248096 2059124 2133287 X 165859 2381 X 0 1 X 1 1 1 X 339334 110302 359256 37263 498439 1344594 3402808 3170925 3341514 3222703 4460353 17598303 3742142 3281227 3700770 3259966 4958792 18942897 0 1571306 1365479 1042839 1513332 1621494 7114450 1571306 1365479 1042839 1513332 1621494 7114450 11828447 2935 2564 3886 4347 20339 34071 2935 2564 3886 4347 20339 34071 3745077 3283791 3704656 3264313 4979131 18976968 0.62330 0.62720 0.00180 0.00090 X PART III, SHORT YEAR EXPLANATION: THE 2022 COLUMN OF PART III REPRESENTS A SHORT-YEAR PERIOD FROM JANUARY 1, 2023 THROUGH SEPTEMBER 30, 2023 DUE TO A CHANGE IN YEAR END. THE REASON FOR THIS CHANGE IS DUE TO A MERGER WITH THE BELLIN GUNDERSEN HEALTH SYSTEM. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 24650 24650 2579466 1720758 858708 670392 576070 94322 977680 DUE TO AFFILIATES 29176 ADVANCE COVID PAYMENTS 11044 40220 X PART X, LINE 2: THE SYSTEM HAS REVIEWED TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS. THE SYSTEM'S INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR 2018 AND PRIOR YEARS. 0 0 0 0 0 0 0 0 0 SCOTT RATHGABER CEO-BGHS 0 1274504 0 200000 0 169717 0 45225 0 23503 0 1712949 0 0 GERALD OETZEL FORMER CFO-BGHS 0 480094 0 70000 0 4974 0 12220 0 5888 0 573176 0 0 STEVE LITTLE CFO-BGHS (THRU 02/2024) 0 258317 0 75000 0 0 0 0 0 0 0 333317 0 0 BRENDA MOSER FINANCE ADMINISTRATOR 0 170926 0 5736 0 360 0 26423 0 24734 0 228179 0 0 CHUCK JOHNSON VICE PRESIDENT 0 143632 0 533 0 6793 0 22566 0 27004 0 200528 0 0 VICKI BAKALARS PRESIDENT 0 151089 0 314 0 0 0 22564 0 23684 0 197651 0 0 MICHELLE BORRESON ADMIN./CEO (THRU 03/2024) 0 128033 0 24 0 0 0 19759 0 36886 0 184702 0 0 MANDI PERICAK SECRETARY/TREASURER 0 118290 0 751 0 161 0 17732 0 22440 0 159374 0 0 PART I, LINE 3 A RELATED ORGANIZATION OF THE FILING ORGANIZATION USES ONE OR MORE OF THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY, AND -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PLEASE REFER TO THE FORM 990, PART VI, LINE 15A DISCLOSURE IN SCHEDULE O FOR ADDITIONAL DETAILS ON HOW COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE VOTING MEMBER OF HARMONY COMMUNITY HEALTHCARE, INC. IS GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A FOUR OUT OF THE SEVEN DIRECTORS SHALL BE ELECTED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.'S BOARD OF GOVERNORS AND BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.'S FINANCE COMMITTEE APPROVES THE BUDGET AND CAPITAL BUDGET. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT FORM 990 WILL FIRST BE REVIEWED BY THE CEO/ADMINISTRATOR AND FINANCE ADMINISTRATOR. THE RETURN WILL THEN BE PROVIDED TO THE BOARD OF DIRECTORS AFTER FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS AND OFFICERS. BOARD MEMBERS ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS AS THEY ARISE. IF THE BOARD OF DIRECTORS DETERMINES THERE IS A CONFLICT THE BOARD MEMBER WITH THE CONFLICT MUST REFRAIN FROM VOTING. A STATEMENT OF CONFLICT OF INTEREST DISCLOSURE IS MADE ON AN ANNUAL BASIS BY OFFICERS AND DIRECTORS. THE DISCLOSURE FORMS ARE REVIEWED BY HARMONY COMMUNITY HEALTHCARE'S COMPLIANCE COMMITTEE ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR IS COMPENSATED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., WHO USES YEARS OF SERVICE, SALARY SURVEY DATA AND INTERNAL EQUITY TO DETERMINE THE COMPENSATION RATE. THERE IS A WRITTEN CONTRACT IN PLACE FOR THE ADMINISTRATOR. COMPENSATION IS REVIEWED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN FOUNDATION 2,381. BELLIN GUNDERSEN HEALTH SYSTEM INC 1836 SOUTH AVENUE LA CROSSE WI 54601 920504278 PARENT WI 501(C)(3) LINE 12B, II N/A 0 BELLIN HEALTH SYSTEMS INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 391512904 SUPPORT OF HEALTHCARE ORGANIZATIONS WI 501(C)(3) LINE 12B, II BELLIN GUNDERSEN HEALTH SYSTEMS INC 1 BELLIN COLLEGE INC 3201 EATON ROAD GREEN BAY WI 54311 391620530 NURSING AND RADIOLOGIC SCIENCE COLLEGE WI 501(C)(3) LINE 2 BELLIN HEALTH SYSTEMS INC 1 LAKE MICHIGAN HEALTH SERVICES INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 391512903 SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITAL WI 501(C)(3) LINE 12B, II BELLIN HEALTH SYSTEMS INC 1 THE BELLIN HEALTH FOUNDATION INC PO BOX 23400 GREEN BAY WI 54301 391809171 FOUNDATION WI 501(C)(3) LINE 7 BELLIN HEALTH SYSTEMS INC 1 BELLIN PSYCHIATRIC CENTER INC PO BOX 23725 GREEN BAY WI 54305 391657627 PSYCHIATRIC HOSPITAL WI 501(C)(3) LINE 3 BELLIN HEALTH SYSTEMS INC 1 BELLIN MEMORIAL HOSPITAL INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 390884478 HEALTH CARE WI 501(C)(3) LINE 3 BELLIN HEALTH SYSTEMS INC 1 OCONTO HOSPITAL & MEDICAL CENTER INC 820 ARBUTUS AVENUE OCONTO WI 54153 061745397 HEALTH CARE WI 501(C)(3) LINE 3 BELLIN MEMORIAL HOSPITAL INC 1 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391866425 SUPPORTING ORGANIZATION WI 501(C)(3) LINE 12B, II BELLIN GUNDERSEN HEALTH SYSTEMS INC 1 GUNDERSEN LUTHERAN MEDICAL CENTER INC 1910 SOUTH AVENUE LA CROSSE WI 54601 390813416 HEALTH CARE WI 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 GUNDERSEN CLINIC LTD 1910 SOUTH AVENUE LA CROSSE WI 54601 391028657 HEALTH CARE WI 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES INC 1910 SOUTH AVENUE LA CROSSE WI 54601 391606449 SUPPORTING ORGANIZATION WI 501(C)(3) LINE 12B, II GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391249705 FOUNDATION WI 501(C)(3) LINE 7 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 TWEETEN LUTHERAN HEALTHCARE CENTER INC 125 FIFTH AVENUE SE SPRING GROVE MN 55974 411565003 HEALTH CARE MN 501(C)(3) LINE 10 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 TRI-STATE AMBULANCE INC 235 CAUSEWAY BLVD LA CROSSE WI 54601 391965415 MEDICAL TRANSPORTATION WI 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 TRI-STATE REGIONAL AMBULANCE INC 235 CAUSEWAY BLVD LA CROSSE WI 54603 391962965 MEDICAL TRANSPORTATION WI 501(C)(3) LINE 11 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 LUTHERAN REAL ESTATE HOLDING CORP 1910 SOUTH AVENUE LA CROSSE WI 54601 391480826 HOUSING WI 501(C)(3) LINE 12C, III-FI GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 COMMUNITY HOUSING OF LA CROSSE INC 1900 SOUTH AVENUE LA CROSSE WI 54601 391586700 INDEPENDENT LIVING WI 501(C)(3) LINE 10 LUTHERAN REAL ESTATE HOLDING CORP 1 LUTHERAN HOUSING OF LA CROSSE INC 1900 SOUTH AVENUE LA CROSSE WI 54601 391751934 INDEPENDENT LIVING WI 501(C)(3) LINE 10 LUTHERAN REAL ESTATE HOLDING CORP 1 ST JOSEPH'S MEMORIAL FOUNDATION INC 400 WATER AVE HILLSBORO WI 54634 391455787 FOUNDATION WI 501(C)(3) LINE 12A, I ST JOSEPH'S HEALTH SERVICES INC 1 TRI-COUNTY MEMORIAL HOSPITAL INC 18601 LINCOLN STREET WHITEHALL WI 54773 390704510 HEALTH CARE WI 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 TRI-COUNTY MEMORIAL FOUNDATION INC 18601 LINCOLN STREET WHITEHALL WI 54773 300093022 FOUNDATION WI 501(C)(3) LINE 12A, I TRI-COUNTY MEMORIAL HOSPITAL INC 1 MEMORIAL HOSPITAL OF BOSCOBEL 205 PARKER STREET BOSCOBEL WI 53805 390845590 HEALTH CARE WI 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 PALMER LUTHERAN HEALTH CENTER 112 JEFFERSON STREET WEST UNION IA 52175 421320763 HEALTH CARE IA 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 MEMORIAL HEALTHCARE FOUNDATION INC PO BOX 40 FRIENDSHIP WI 53934 391775074 FOUNDATION WI 501(C)(3) LINE 12A, I MOUNDVIEW MEMORIAL HOSPITAL & CLINICS INC 1 MOUNDVIEW MEMORIAL HOSPITAL & CLINICS INC 402 W LAKE STREET FRIENDSHIP WI 53934 390944012 HEALTH CARE WI 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 SAINT ELIZABETH'S HOSPITAL OF WABASHA 1200 GRANT BLVD WEST WABASHA MN 55981 410693877 HEALTH CARE MN 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 ST JOSEPH'S HEALTH SERVICES PO BOX 527 400 WATER AVENUE HILLSBORO WI 54634 390929538 HEALTH CARE WI 501(C)(3) LINE 3 GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1 BEL-REGIONAL HOME MEDICAL INC 617 S ROOSEVELT GREEN BAY WI 54301 391504766 DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS WI N/A C 0 BG ASSURANCE COMPANY 20 GENESIS CLOSE PO BOX 30600 GEORGE TOWN GRAND CAYMAN, KY1 CJ SELF INSURANCE CJ N/A C 0 GUNDERSEN EDGE LLC 1836 SOUTH AVENUE LA CROSSE WI 54601 921783811 INNOVATION WI N/A C 0 GUNDERSEN LUTHERAN ENVISION LLC 1836 SOUTH AVENUE LA CROSSE WI 54601 264706546 RENEWABLE ENERGY WI N/A C 0 0 0 1 0 1 0 0 0 0 1 1 1 1 1 1 1 1 0 0 BELLIN GUNDERSEN HEALTH SYSTEM INC C 300000 COST