LUTHERAN BRETHREN WOODLAND LODGE INC: Form 990PF, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- LUTHERAN BRETHREN WOODLAND LODGE INC (EIN 45-3342446)
- Tax period
- 2022-05-01 to 2023-04-30
- Filed
- 2024-03-13
- IRS object ID
- 202410739349101226
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Accounting Fees Schedule
- Land Etc Schedule2
- Legal Fees Schedule
- Mortgages And Notes Payable Sch
- Other Assets Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Liabilities Schedule
- Other Professional Fees Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-03-13T15:55:51-05:00 | ReturnTs |
| Tax Period End | 2023-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2022-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453342446 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lutheran Brethren Woodland Lodge Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LUTH | BusinessNameControlTxt |
| Phone | 2189981400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 824 South Sheridan Street | AddressLine1Txt |
| City | Fergus Falls | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56537 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Leland R Rogness | PersonNm |
| Person Title | Chairman/President | PersonTitleTxt |
| Phone | 2189981400 | PhoneNum |
| Signature | 2024-03-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Leland | PersonFirstNm |
| Person Last | Rogness | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Deb Nelson CPA | PreparerPersonNm |
| PTIN | P01264758 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2024-03-13 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return Former Pub Chrty | Yes (X) | InitialReturnFormerPubChrtyInd |
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $3,144,749 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $38 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $38 | InterestOnSavNetInvstIncmAmt |
| Interest On Savings Adj Net Incm | $38 | InterestOnSavingsAdjNetIncmAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Other Income Rev And Expnss | $1,444,750 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $0 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $1,444,750 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $1,444,788 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $38 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $1,444,788 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $0 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $670,933 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $0 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $618,948 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $69,441 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $69,441 | PensionEmplBnftAdjNetIncmAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $0 | PensionEmplBnftDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $9,126 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $0 | LegalFeesNetInvstIncmAmt |
| Legal Fees Adj Net Incm | $9,126 | LegalFeesAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $40,326 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $40,326 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $0 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $714,053 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $0 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $714,053 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Rev And Expnss | $76,163 | InterestRevAndExpnssAmt |
| Interest Net Invst Incm | $0 | InterestNetInvstIncmAmt |
| Interest Adj Net Incm | $76,163 | InterestAdjNetIncmAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $43,723 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $0 | TaxesNetInvstIncmAmt |
| Taxes Adj Net Incm | $43,723 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $125,583 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Deprec And Dpltn Adj Net Incm | $125,583 | DeprecAndDpltnAdjNetIncmAmt |
| Occupancy Rev And Expnss | $115,761 | OccupancyRevAndExpnssAmt |
| Occupancy Net Invst Incm | $0 | OccupancyNetInvstIncmAmt |
| Occupancy Adj Net Incm | $115,761 | OccupancyAdjNetIncmAmt |
| Occupancy Dsbrs Chrtbl | $0 | OccupancyDsbrsChrtblAmt |
| Trav Conf Meeting Rev And Expnss | $2,044 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $2,044 | TravConfMeetingAdjNetIncmAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $0 | TravConfMeetingDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $153,628 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $50 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $153,578 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $0 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $2,020,781 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $50 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $1,349,798 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $618,948 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $0 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $2,020,781 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $50 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $1,349,798 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $618,948 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$575,993 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $94,990 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $11,863 | CashBOYAmt |
| Sav And Temp Cash Invst BOY | $300 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $900 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $900 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl | $33,500 | AcctRcvblAmt |
| Acct Rcvbl BOY | $35,216 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $33,500 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $33,500 | AcctRcvblEOYFMVAmt |
| Prepaid Expenses BOY | $16,031 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $4,846 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $4,846 | PrepaidExpensesEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $4,083,895 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,367,790 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $2,839,662 | LandBOYAmt |
| Land EOY | $2,716,105 | LandEOYAmt |
| Land EOYFMV | $2,716,105 | LandEOYFMVAmt |
| Other Assets BOY | $0 | OtherAssetsBOYAmt |
| Other Assets EOY | $389,398 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $389,398 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $2,903,072 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,144,749 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,144,749 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $162,366 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $190,682 | AccountsPayableEOYAmt |
| Mortgages And Notes Payable BOY | $2,156,874 | MortgagesAndNotesPayableBOYAmt |
| Mortgages And Notes Payable EOY | $1,203,569 | MortgagesAndNotesPayableEOYAmt |
| Other Liabilities BOY | $2,987,566 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $4,730,225 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $5,306,806 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,124,476 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | -$2,403,734 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | -$2,979,727 | NoDonorRstrNetAssestsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | -$2,403,734 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | -$2,979,727 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $2,903,072 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,144,749 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | -$2,403,734 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$575,993 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | -$2,979,727 | SubtotalAmt |
| Other Decreases | $0 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | -$2,979,727 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $0 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $0 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Extsn Request Income Tax Paid | $0 | ExtsnRequestIncomeTaxPaidAmt |
| Backup Withholding Withheld | $0 | BackupWithholdingWithheldAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Tax Due | $0 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | 0 | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | MN | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (1) | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | lbhomes.org | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John Zwiers | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2189981400 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 824 South Sheridan Street | AddressLine1Txt |
| City | Fergus Falls | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56537 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | 0 | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | 0 | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | 0 | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| John Zwiers | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | CEO | 0.20 | $0 | $0 | $0 |
| David Lilja | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Controller | 1.20 | $0 | $0 | $0 |
| Leland Rogness | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Chairman/President | 0.20 | $0 | $0 | $0 |
| Tom Moline | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Vice Chairman | 0.20 | $0 | $0 | $0 |
| Ron Fuhrman | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Secretary | 0.20 | $0 | $0 | $0 |
| Gaylord Folder | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Director | 0.20 | $0 | $0 | $0 |
| Paul Larson | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Director | 0.20 | $0 | $0 | $0 |
| John Austin | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Director | 0.20 | $0 | $0 | $0 |
Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee BenefitsEmployeeBenefitsAmt | Expense AccountExpenseAccountAmt |
|---|---|---|---|---|---|---|---|---|
| Hallie Olson | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Assisted Living Dire | 35.00 | $97,543 | $12,120 | $0 |
| Stephanie Anderson | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | RN Assisted Living | 35.00 | $66,276 | $11,424 | $0 |
| Sandra Benjaminson | ||||||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Cook | 35.00 | $59,561 | $7,592 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Service TypeServiceTypeTxt | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PrimeTime Healthcare | |||||
| PO Box 3544 | Omaha | NE | 68103 | Nursing Services | $187,729 |
| Lutheran Brethren Homes Inc | |||||
| 824 South Sheridan Street | Fergus Falls | MN | 56537 | Management Fees | $126,000 |
| Marvel Medical Staffing | |||||
| 9394 W Dodge Rd Suite 300 | Omaha | NE | 68114 | Nursing Services | $52,233 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | Assisted Living. | Description1Txt |
| Expenses1 | $1,349,798 | Expenses1Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $14,705 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $14,705 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $14,705 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $221 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $14,484 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $724 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $618,948 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $618,948 | QualifyingDistributionsAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $724 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $724 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $615 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $615 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $618,948 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $618,948 | TotalAmt |
Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $618,948 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $618,948 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $483 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $483 | TotalAmt |
Total Support TotalSupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Public Support Type PublicSupportType
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Largest Support From EO LargestSupportFromEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Investment Income GrossInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
| Total Grant Or Contri Pd Dur Yr | $0 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Program Service Revenue Dtl ProgramServiceRevenueDtl (2 entries)
| DescDesc | Related Or Exempt Function IncmRelatedOrExemptFunctionIncmAmt |
|---|---|
| Assisted and Independent Living | $1,049,102 |
| Other Revenue | $6,250 |
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $38 | ExclusionAmt |
Other Revenue Described OtherRevenueDescribedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Employee Retention Credit | Desc |
| Exclusion | 01 | ExclusionCd |
| Exclusion | $389,398 | ExclusionAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $389,436 | ExclusionAmt |
| Related Or Exempt Function Incm | $1,055,352 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $1,444,788 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp (2 entries)
| Line NumberLineNumberTxt | Relationship StatementRelationshipStatementTxt |
|---|---|
| 1a | Payment from Residents for Assisted Living Care |
| 1b | Other revenues are from resident payments for vending and beauty shop. |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Accounting Fees | CategoryTxt |
| Amt | $40,326 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $40,326 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtcGrp (3 entries)
| Category Or ItemCategoryOrItemTxt | Cost Or Other BasisCostOrOtherBasisAmt | Accumulated DepreciationAccumulatedDepreciationAmt | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|---|
| Land | $102,218 | $0 | $102,218 | $102,218 |
| Buildings & Improvements | $3,803,240 | $1,199,041 | $2,604,199 | $2,604,199 |
| Equipment & Furnishings | $178,437 | $168,749 | $9,688 | $9,688 |
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | Legal Fees | CategoryTxt |
| Legal Fees | $9,126 | LegalFeesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $9,126 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |
Mortgages And Notes Payable Sch MortgagesAndNotesPayableSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mortgage | $1,203,569 | MortgageAmt |
Note Payable NotePayableGrp
Lender Name LenderNameGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bremer Bank | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Insider Relationship | None | InsiderRelationshipTxt |
| Loan Original | $2,528,647 | LoanOriginalAmt |
| Balance Due | $1,203,569 | BalanceDueAmt |
| Note | 2018-12 | NoteDt |
| Loan Maturity | 2036-12 | LoanMaturityDt |
| Repayment Terms | Monthly | RepaymentTermsTxt |
| Interest | 3.396000000000 | InterestRt |
| Security Provided Borrower | Mortage | SecurityProvidedBorrowerTxt |
| Loan Purpose | Mortgage | LoanPurposeTxt |
| Lender Consideration | None | LenderConsiderationDesc |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ERC Receivable | Desc |
| BOY Book Value | $0 | BOYBookValueAmt |
| EOY Book Value | $389,398 | EOYBookValueAmt |
| EOYFMV | $389,398 | EOYFMVAmt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| Advertising Expense | $639 | $0 | $639 | $0 |
| Office Expense | $36,037 | $0 | $36,037 | $0 |
| Insurance Expense | $23,748 | $0 | $23,748 | $0 |
| Medical Supplies | $1,698 | $0 | $1,698 | $0 |
| Repairs and Maintenance | $10,447 | $0 | $10,447 | $0 |
| Food | $74,504 | $0 | $74,504 | $0 |
| Miscellaneous Expenses | $6,555 | $50 | $6,505 | $0 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (3 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|
| Assisted and Independent Living | $1,049,102 | $1,049,102 |
| Other Revenue | $6,250 | $6,250 |
| Employee Retention Credit | $389,398 | $389,398 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Affiliates | Desc |
| BOY Book Value | $2,987,566 | BOYBookValueAmt |
| EOY Book Value | $4,730,225 | EOYBookValueAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| Management Fees | $494,975 | $0 | $494,975 | $0 |
| Purchased Services | $213,973 | $0 | $213,973 | $0 |
| Other Fees | $5,105 | $0 | $5,105 | $0 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | FICA Tax | CategoryTxt |
| Amt | $43,723 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $43,723 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $0 | DisbursementsCharitablePrpsAmt |