2024-07-29T17:50:11-05:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 2689 COMMERCE DRIVE NW SUITE 201 ROCHESTER MN 55901 990 2022-10-01 410959382 STEWARTVILLE NURSING HOME INC STEW 5075334288 120 FOURTH STREET NE STEWARTVILLE MN 55976 JENNIFER NOGOSEK ADMINISTRATOR 5075334288 2024-07-25 1 0 KATHERINE LUTZKE CPA P01760889 5072802300 2024-07-25 2022 2024-08-08 14:25:15Z JENNIFER NOGOSEK 120 FOURTH STREET NE STEWARTVILLE MN 55976 6859227 0 X WWW.STEWARTVILLECARECENTER.COM X 1969 MN PROVIDE NURSING HOME CARE & SENIOR HOUSING SERVICES TO THE ELDERLY OF STEWARTVILLE, MN 7 7 94 2 0 0 280157 42596 6241827 6815792 283 839 0 0 6522267 6859227 0 0 0 0 3593052 3376660 0 0 0 2686324 3038517 6279376 6415177 242891 444050 3060059 3268605 1773461 1537957 1286598 1730648 TO PROVIDE NURSING HOME CARE AND SENIOR INDEPENDENT HOUSING SERVICES TO THE ELDERLY OF STEWARTVILLE, MN AND THE SURROUNDING AREA. 0 0 5583070 0 6815792 STEWARTVILLE NURSING HOME, INC. (ORGANIZATION) OPERATES STEWARTVILLE CARE CENTER, STEWARTVILLA SENIOR HOUSING, ROOT RIVER ESTATES, SENIOR VAN SERVICES, AND GARDEN COTTAGES. THESE ENTITIES PROVIDE SERVICES TO THE ELDERLY THROUGH THE OPERATION OF AN 85-BED LICENSED NURSING HOME (58 BEDS ACTIVE), SENIOR HOUSING, ASSISTED LIVING UNITS AND VAN SERVICES, ALL LOCATED IN STEWARTVILLE, MINNESOTA. THE MARKET FOR THE ORGANIZATION'S SERVICES IS LIMITED TO SOUTHEASTERN MINNESOTA. BY ITS NATURE, THE ORGANIZATION'S OPERATIONS AND LABOR INTENSIVE. THE ORGANIZATION'S SOURCE OF LABOR IS ALSO GENERALLY LIMITED TO THE SOUTHEASTERN MINNESOTA MARKET. 5583070 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 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 0 0 0 0 1 12 0 94 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 MN X JENNIFER NOGOSEK 5075334288 120 4TH ST NE STEWARTVILLE MN 55976 JARETT JONES PRESIDENT 0.50 X X 0 0 0 MARGARET NELSON VICE PRESIDENT 0.50 X X 0 0 0 CONNIE GRISIM SECRETARY 0.50 X X 0 0 0 DAVID THOMPSON DIRECTOR 0.50 X 0 0 0 BRUCE TRULSON DIRECTOR 0.50 X 0 0 0 LAURA NORDSTROM DIRECTOR 0.50 X 0 0 0 DICK UPTAGRAFFT DIRECTOR 0.50 X 0 0 0 EUGENE GUSTASON ADMINISTRATOR 40.00 X 139296 0 12000 JENNIFER NOGOSEK DIRECTOR OF NURSING/ADMINISTRATOR 40.00 X 105760 0 7250 245056 0 19250 2 0 1 0 HEALTHCARE SERVICES GROUP PO BOX 829677 PHILADELPHIA PA 19020 DIETARY SERVICES 546292 AEGIS THERAPIES PO BOX 936653 ATLANTA GA 31193 PT, OT, ST THERAPY SERVICES 258222 2 41025 1571 42596 RESIDENT REVENUE 623000 6237774 6237774 APARTMENT REVENUE 623000 576119 576119 OTHER SERVICE REVENUE 623000 1899 1899 6815792 839 839 6859227 6815792 0 839 X 94056 94056 2761570 2495731 265839 19155 16792 2363 276822 242607 34215 225057 197240 27817 9978 9978 48672 48672 1037826 1026537 11289 6452 6452 8422 8422 258192 258192 8116 8116 45732 45732 370331 370331 82592 82592 MISCELLANEOUS EXPENSE 456762 355052 101710 FOOD AND SUPPLIES 242841 222415 20426 MAINTENANCE AND REPAIRS 209431 209431 UTILITIES 134588 134588 118582 118582 6415177 5583070 832107 0 241671 638685 28145 28387 631887 647464 31738 19350 12654060 10978005 1910987 1676055 215631 258664 3060059 3268605 457134 368167 187959 1259673 741096 56654 240735 1773461 1537957 X 1286598 1730648 1286598 1730648 3060059 3268605 444050 0 X 0 1 X 1 0 X 7426 2665 1003189 280157 42596 1336033 6716936 6133142 5678149 6241827 6815792 31585846 6724362 6135807 6681338 6521984 6858388 32921879 0 0 0 32921879 1799 5769 3320 283 839 12010 1799 5769 3320 283 839 12010 101767 101767 6827928 6141576 6684658 6522267 6859227 33035656 0.99660 0.99240 0.00040 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 58354 58354 6580557 5837552 743005 4014116 3312841 701275 1543532 1405043 138489 457501 422569 34932 1676055 TENANT SECURITY DEPOSITS 62086 RESIDENTS' TRUST AGREEMENT 12093 FAMILY COUNCIL FUND 2481 LEASE AGREEMENT - BOND FUNDS 168724 ROU ASSETS 13280 258664 FAMILY COUNCIL FUNDS 2475 RESIDENTS' TRUST FUNDS 12093 TENANTS' SECURITY DEPOSITS 56442 LEASE LIABILITY 169725 240735 X 6775170 0 6775170 84057 84057 6859227 6331120 0 6331120 84057 84057 6415177 PART X, LINE 2: THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER CODE SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE ORGANIZATION AS A RESULT OF THIS STANDARD. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: EXPENSES NETTED WITH REVENUES 84,057. PART XII, LINE 4B - OTHER ADJUSTMENTS: REVENUES NETTED WITH EXPENSES 84,057. 0 0 0 0 0 0 0 0 0 EUGENE GUSTASON ADMINISTRATOR 139296 0 0 0 0 0 12000 0 0 0 151296 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO BEING FILED WITH THE IRS, A COPY OF THE IRS FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE ADMINISTRATOR, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF APPROPRIATE CHANGES. UPON COMPLETION OF THE ADMINISTRATOR'S REVIEW, A COPY OF THE 990 WAS APPROVED BY THE BOARD PRIOR TO SUBMITTAL TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY COMPLETE A SURVEY RELATED TO BUSINESS RELATIONSHIPS AND FAMILY MEMBERS THAT COULD, OR DO, CREATE A CONFLICT OF INTEREST. THESE ARE SUMMARIZED AND FILED ALONG WITH BOARD MEETING MINUTES. CONFLICTS OF INTEREST ARE DETERMINED BY A REVIEW OF THE POTENTIAL CONFLICTS BY THE ADMINISTRATOR AND BOARD OF DIRECTORS. IF A CONFLICT EXISTS, THEN THE CONFLICTED BOARD MEMBER OF KEY EMPLOYEE IS EXCLUDED FROM DISCUSSIONS AND VOTES RELATED TO ANY POTENTIAL OR EXISTING RELATIONSHIPS INVOLVING THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS USED TO SET THE ADMINISTRATOR'S ANNUAL SALARY IS BASED ON A COMBINATION OF COMPARISON TO COMPARABLE ORGANIZATIONS THROUGH USE OF OUR TRADE ORGANIZATION'S ANNUAL COMPENSATION SURVEY AND ATTAINMENT IN THE CURRENT YEAR OF PREDEFINED PERFORMANCE OBJECTIVES SET FOR THE ADMINISTRATOR PERSONALLY AND THE ORGANIZATION. ALSO, THE STATE OF MINNESOTA HAS IN MOST YEARS DETERMINED AN AMOUNT OF PAY INCREASE, IF ANY, THAT CAN BE GIVEN TO EMPLOYEES AND WE HAVE ALSO CONSIDERED THIS AMOUNT IN DETERMINING TOP MANAGEMENT COMPENSATION. THIS PROCESS IS PERFORMED BY THE BOARD AND DOCUMENTED IN THE PRIVATE BOARD MINUTES & EMPLOYEE PERSONNEL FILE. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED NURSING: PROGRAM SERVICE EXPENSES 249,504. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 249,504. CONSULTING: PROGRAM SERVICE EXPENSES 26,938. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,938. DIETICIAN CONSULTANT: PROGRAM SERVICE EXPENSES 3,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,870. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 746,225. MANAGEMENT AND GENERAL EXPENSES 11,289. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 757,514.