2024-08-30T15:24:27-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 8390 EAST CRESCENT PARKWAY SUITE 300 GREENWOOD VILLAGE CO 80111 990 2023-01-01 840194430 EBEN EZER LUTHERAN CARE CENTER EBEN 9708422861 122 HOSPITAL ROAD BRUSH CO 80723 SHELLY GRIFFITH CEO 9708422861 2024-08-26 1 1 SARAH HINTZ P00492291 3037795710 2024-08-26 2023 2024-08-08 14:25:15Z SHELLY GRIFFITH 122 HOSPITAL ROAD BRUSH CO 80723 14062364 0 X WWW.EBENEZER-CARES.ORG X 1903 CO PROVIDE SKILLED NURSING CARE AND RELATED SERVICES TO THE ELDERLY AND PERSONS WITH SPECIALS NEEDS. 11 11 209 265 0 0 4408523 448710 12397554 12547290 -25132 506334 18107 2235 16799052 13504569 3135 3933 0 0 7148111 7568630 0 0 56423 8000209 8091005 15151455 15663568 1647597 -2158999 42878928 40079724 32932567 32275265 9946361 7804459 X THE EBEN EZER LUTHERAN CARE CENTER (THE CARE CENTER) WAS ESTABLISHED TO PROVIDE SKILLED NURSING CARE, RESPITE CARE, ASSISTED LIVING, INDEPENDENT LIVING, AND LIFELINE EMERGENCY RESPONSE SERVICES TO THE SEE SCHEDULE O FOR CONTINUATIONELDERLY AND PERSONS WITH SPECIAL NEEDS. THE CARE CENTER IS CERTIFIED FOR MEDICARE AND MEDICAID AND IS AFFILIATED WITH THE EVANGELICAL LUTHERAN CHURCH OF AMERICA. 0 0 13905220 3933 12547290 PROVIDING SKILLED NURSING CARE, RESPITE CARE, ASSISTED LIVING, INDEPENDENT LIVING, AND LIFELINE EMERGENCY RESPONSE SERVICES TO THE ELDERLY AND PERSONS WITH SPECIAL NEEDS. THE CARE CENTER PROVIDED ELECTRONIC MONITORING SERVICES TO MORE THAN 300 PERSONS IN THEIR HOME. 13905220 1 1 0 0 0 0 0 0 1 1 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 1 0 0 1 21 0 1 209 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CO X LESLIE MASON 9708422861 122 HOSPITAL RD BRUSH CO 80723 SHELLY GRIFFITH CEO 30.00 10.00 X 207076 0 29655 LESLIE MASON CFO 39.00 1.00 X 144931 0 24616 MARK FRASIER CHAIR 1.00 1.00 X X 0 0 0 MIKE BERRYHILL VICE CHAIR 1.00 1.00 X X 0 0 0 MICHAEL LEE SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 SONYA BASS DIRECTOR 1.00 2.00 X 0 0 0 ROBERT CHAPIN DIRECTOR 1.00 2.00 X 0 0 0 PASTOR JOHN KNUTSON DIRECTOR 1.00 1.00 X 0 0 0 PASTOR ROBERT RITZEN DIRECTOR 1.00 2.00 X 0 0 0 NANCY SAMPLES DIRECTOR 1.00 1.00 X 0 0 0 ROGER SCHAEFER DIRECTOR 1.00 2.00 X 0 0 0 JENNIFER THISTLE DIRECTOR 1.00 0.00 X 0 0 0 DOUGLAS VANNOY DIRECTOR 1.00 1.00 X 0 0 0 352007 0 54271 2 0 1 0 UNIDINE CORPORATION PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES 1894576 G2 ROOFING 6920 S JORDAN ROAD UNIT F ENGLEWOOD CO 80112 ROOFING CONTRACTOR 1448359 MARVEL MEDICAL STAFFING PO BOX 201424 DALLAS TX 75320 STAFFING AGENCY 336208 PREMERE REHAB LLC INFINITY REHAB 8100 SW NYBERG STREET SUITE 200 TUALATIN OR 97062 REHAB CONTRACTOR 250644 CLIFTONLARSONALLEN LLP PO BOX 31001-2443 PASADENA CA 91110 ACCOUNTING SERVICES 230810 7 444783 3927 448710 PATIENT SERVICE REV. 623000 12450238 12450238 MEALS/CATERING 623000 47826 47826 TELEPHONE 623000 15840 15840 BEAUTY SHOP 623000 14595 14595 MISCELLANEOUS 623000 11424 11424 7367 7367 12547290 230969 230969 5875 3640 2235 2235 2235 25232 804288 0 554155 25232 250133 275365 275365 13504569 12547290 0 508569 X 3933 3933 406278 406278 6193039 5856799 284360 51880 50366 44947 4378 1041 496951 492242 4709 421996 400126 18733 3137 8876 8876 63549 63549 2388607 2378363 10244 20502 20502 310 310 365 365 728357 579753 148604 13214 5480 7734 926198 478684 447514 2766874 2766874 372355 165297 207058 SUPPLIES 487088 436819 50269 MISCELLANEOUS 64897 64897 BAD DEBT 46327 46327 FOOD 38793 38793 164693 125074 39619 15663568 13905220 1701925 56423 1542190 1437496 2556960 4308659 2842760 0 1156709 1056759 92779 84499 421663 330296 52231909 20702679 33150821 31529230 334375 371875 780671 960910 42878928 40079724 736463 611534 4360 4657 45763 38295 31864370 31308861 281611 311918 32932567 32275265 X 9946361 7804459 9946361 7804459 42878928 40079724 -2158999 17097 0 X X 0 1 X 1 1 1 X 910504 3421983 1019387 4408523 448710 10209107 13133364 12252681 12336791 12397554 12547290 62667680 14043868 15674664 13356178 16806077 12996000 72876787 0 0 0 72876787 39991 45855 14646 9780 236844 347116 39991 45855 14646 9780 236844 347116 129730 101292 100287 15866 347175 14213589 15821811 13471111 16831723 13232844 73571078 0.99060 0.98990 0.00470 0.00240 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MEAL TICKETS / GUEST MEALS - 2019 AMOUNT: $ 47,967. 2020 AMOUNT: $ 28,677. BEAUTY SHOP - 2019 AMOUNT: $ 15,589. 2020 AMOUNT: $ 10,756. TELEPHONE - 2019 AMOUNT: $ 16,802. 2020 AMOUNT: $ 16,522. MISCELLANEOUS - 2019 AMOUNT: $ 35,258. 2020 AMOUNT: $ 40,838. 2021 AMOUNT: $ 100,287. 2022 AMOUNT: $ 15,866. TRANSPORTATION - 2019 AMOUNT: $ 14,114. 2020 AMOUNT: $ 4,499. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 655119 24 655143 655095 24 655119 655071 91198 91174 655095 655071 91355 91355 655071 611907 123801 80637 655071 0.00000 1.00000 0.00000 0 1 1 66372 66372 44583728 15178060 29405668 7549045 5524619 2024426 32764 32764 31529230 ASSET RETIREMENT OBLIGATION 311918 311918 X 15874223 17097 2348917 2366014 13508209 -3640 -3640 13504569 15980891 317323 317323 15663568 0 15663568 PART IV, LINE 2B: THE CARE CENTER IS THE TRUSTEE OF FUNDS RECEIVED ON BEHALF OF VARIOUS RESIDENTS IN THE SKILLED NURSING FACILITY. PART V, LINE 4: ENDOWMENTS ARE HELD BY EBEN EZER LUTHERAN CARE CENTER FOUNDATION, A RELATED ORGANIZATION. THE ENDOWMENT CONSISTS OF THREE INDIVIDUAL FUNDS ESTABLISHED TO SUPPORT THE OPERATIONS OF THE ORGANIZATION. PART X, LINE 2: THE ORGANIZATION EVALUATES THEIR UNCERTAIN TAX POSITIONS, IF ANY, ON A CONTINUAL BASIS THROUGH REVIEW OF THEIR POLICIES AND PROCEDURES, REVIEW OF THEIR REGULAR TAX FILINGS, AND DISCUSSIONS WITH OUTSIDE EXPERTS. AS OF DECEMBER 31, 2023 AND 2022, THE ORGANIZATION DID NOT HAVE ANY UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION REVENUE NOT INCLUDED 2,459,911. HOUSING CENTER REVENUE NOT INCLUDED 362,312. ELIMINATING ENTRY TO CONSOLIDATE FINANCIAL STATEMENTS -473,306. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE RECLASSED TO REVENUE -3,640. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE RECLASSED TO REVENUE 3,640. FOUNDATION EXPENSES NOT INCLUDED 494,169. HOUSING CENTER EXPENSES NOT INCLUDED 292,820. ELIMINATING ENTRY TO CONSOLIDATE FINANCIAL STATEMENTS -473,306. X X X X 0 0 0 0 0 0 0 0 0 SHELLY GRIFFITH CEO 177076 0 30000 0 0 0 4498 0 25157 0 236731 0 0 0 LESLIE MASON CFO 126931 0 18000 0 0 0 4720 0 19896 0 169547 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE BOARD AND SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD, PROVIDED THAT ANY ACTION TAKEN SHALL NOT BE IN CONFLICT WITH THE POLICIES, OR ANY PRIOR ACTION OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD. IT SHALL CONSIDER ALL MATTERS REFERRED TO IT BY THE BOARD AND SHALL ACT FOR THE BOARD IN EMERGENCIES. THE EXECUTIVE COMMITTEE SHALL NOT ACT WITHOUT BOARD APPROVAL IN THE FOLLOWING MATTERS: (I) ANY SALE OR PURCHASE OF LAND OR BUILDINGS, (II) ANY FUNDING FOR CAPITAL IMPROVEMENTS THROUGH EITHER MORTGAGE FUNDING OR A FUND CAMPAIGN, (III) ANY ESTABLISHMENT OF ADMINISTRATIVE POSITIONS, INCLUDING POSITION DESCRIPTIONS AND FILLING OF SAID POSITIONS. FORM 990, PART VI, SECTION A, LINE 2 SHELLY GRIFFITH, CEO, AND SONYA BASS, DIRECTOR, HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE INDEPENDENT CPA FIRM WITH INFORMATION PROVIDED BY MANGEMENT. WHEN PREPARATION IS COMPLETED AND A DRAFT IS AVAILABLE THE AUDIT COMMITTEE REVIEWS THE FORM 990 IN DETAIL BEFORE IT IS FILED AND APPROVES THE FILING OF THE RETURN. THE BOARD OF DIRECTORS THEN IS PROVIDED WITH A COPY OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT APPLIES TO BOARD MEMBERS. AT EVERY BOARD MEETING, THE MEMBERS ARE ASKED IF THERE HAS BEEN A CHANGE IN THEIR INDEPENDENCE WITH THE ORGANIZATION. CONTRACTS AND OTHER TRANSACTIONS WHICH MAY INVOLVE A DIRECT OR INDIRECT CONFLICT OF INTEREST BETWEEN THE BOARD MEMBER AND EBEN EZER SHALL BE VALID, BINDING AND ENFORCEABLE AND SHALL NOT BE VOIDABLE BY EBEN EZER IF (1) THE MATERIAL FACTS OF THE INTEREST ARE FULLY DISCLOSED IN ADVANCE TO THE BOARD OF DIRECTORS OF EBEN EZER, AND (2) AFTER ASCERTAINMENT IN GOOD FAITH OF THE FAIRNESS OF THE TRANSACTION, EVEN THOUGH THE NUMBER OF DISINTERESTED BOARD MEMBERS MAY BE LESS THAN A QUORUM. A BOARD MEMBER WITH A CONFLICT SHOULD NOT ONLY REFRAIN FROM VOTING BUT SHOULD ALSO BE EXCUSED, IF POSSIBLE, FROM ANY BOARD DISCUSSION INVOLVING THE PROPOSED TRANSACTION. MOREOVER, THAT BOARD MEMBER SHOULD NOT PARTICIPATE IN NEGOTIATING THE TERMS OF THE PROPOSED TRANSACTION. ANY CONFLICTS ARE DOCUMENTED WITHIN THE MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS SURVEYS FROM OTHER SIMILAR ORGANIZATIONS ON COMPENSATION LEVELS. THE BOARD REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO BASED ON COMPARABLE COMPENSATION. THE ORGANIZATION MAINTAINS THE APPROPRIATE DOCUMENTATION OF HOW THE COMPENSATION IS SET. 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 / OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING EXPENSES: PROGRAM SERVICE EXPENSES 24,143. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,143. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 2,033,377. MANAGEMENT AND GENERAL EXPENSES 10,244. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,043,621. ANCILLARY SERVICES: PROGRAM SERVICE EXPENSES 320,843. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 320,843. FORM 990, PAGE 12, PART XII, LINE 2C - SELECTION OF INDEPENDENT ACCOUNTANT THE PROCESS FOR OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. EBEN EZER LUTHERAN CARE CENTER FOUNDATION 122 HOSPITAL ROAD BRUSH CO 80723 742480396 SUPPORT CO 501(C)(3) LINE 12A, I EBEN EZER LUTHERAN CARE CENTER 1 EBEN EZER LUTHERAN HOUSING CENTER 1900 EDISON STREET BRUSH CO 80723 840884015 HOUSING CO 501(C)(3) LINE 10 EBEN EZER LUTHERAN CARE CENTER 1 0 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 EBEN EZER LUTHERAN CARE CENTER FOUNDATION C 444783 FMV EBEN EZER LUTHERAN CARE CENTER FOUNDATION D 622599 FMV