2023-03-30T13:04:06-05:00 2022-06-30 450250958 Eide Bailly LLP 1730 Burnt Boat Loop Ste 100 Bismarck ND 585030886 990 2021-07-01 450230141 Bethel Lutheran Nursing & Rehabilitation Center BETH 7015726766 1515 2nd Ave W Williston ND 58801 Tiffany Sickinger CFO 7015726766 2023-03-29 1 Tiffany Sickinger 999009999 Lisa Chaffee CPA P00193453 7012551091 2023-03-29 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z Belinda Moen 1515 2nd Ave W Williston ND 58801 14723278 0 X www.blnrc.com X 1948 ND Provide Christian care to residents in a senior living center in Williston, ND. 9 9 257 13 0 0 2470635 164832 14053496 13716913 103036 95386 26770 721293 16653937 14698424 0 0 0 0 8549596 9310581 0 0 0 6412475 7036390 14962071 16346971 1691866 -1648547 16209444 14740286 1124540 1303929 15084904 13436357 Bethel Lutheran Nursing & Rehabilitation Center exists for the purpose of providing Christian care in its truest form, ministering to the physical, spiritual, and emotional needs of each person as a work of love and mercy. 0 0 14843528 13716913 Bethel Lutheran Nursing & Rehabilitation Center provides resident and tenant services in a long-term setting (skilled nursing and basic care) and apartment setting (assisted living). Bethel Lutheran Nursing & Rehabilitation Center provided 48,374 days of resident and tenant care in the year ended June 30, 2022. Bethel Lutheran Nursing & Rehabilitation Center provides short-term rehabilitative care, respite care, adult daycare, and a memory care neighborhood. 14843528 1 1 0 0 0 0 0 0 1 0 1 0 0 0 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 1 0 0 0 1 8 0 1 257 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Tiffany Sickinger 7015726766 1515 2nd Ave W Williston ND 58801 Aaron Schmit Chairperson 2.00 0.00 X X 0 0 0 Grant Carns Vice Chair 1.00 0.00 X X 0 0 0 Peggy Sundet Secretary/Treasurer 1.00 2.00 X X 0 0 0 Ruth Carlson Director 1.00 0.00 X 0 0 0 Alvina Skogen Director 1.00 0.00 X 0 0 0 Arlis Haug Director (Left Sept 2021) 1.00 0.00 X 0 0 0 Joel Wilt Director (Left Sept 2021) 1.00 0.00 X 0 0 0 Patti Stewart Director 1.00 0.00 X 0 0 0 Lyle Kuester Director (Left Sept 2021) 1.00 0.00 X 0 0 0 Kelsey Geltel Director (Joined in Oct 2021) 1.00 0.00 X 0 0 0 Tina Hanson Director (Joined in Oct 2021) 1.00 2.00 X 0 0 0 Kendra Richards Director (Oct 21 - Apr 22) 1.00 0.00 X 0 0 0 Rick Braaten Director (Joined in May 2022) 1.00 0.00 X 0 0 0 Tammra Peterson Administrator (Left Jan 2022) 40.00 0.00 X 162812 0 31233 Andrew Downer Dir of Finance (Left Aug 2021) 40.00 0.00 X 66778 0 7439 Belinda Boen Interim Administrator-Join Sept 22 40.00 0.00 X 27624 0 811 Cynthia Sorenson Interim Dir of Fin (Aug-Nov 2021) 40.00 0.00 X 221 0 0 Tiffany Sickinger CFO-Joined Nov 21 40.00 0.00 X 11760 0 1146 Edith Cha-Ong Registered Nurse 46.00 0.00 X 103865 0 7113 Sheila Johnson LPN 67.00 0.00 X 102053 0 27389 Tanya Giese Director of Nursing 40.00 0.00 X 109299 0 490 584412 0 75621 4 0 1 0 Fusion Medical Staffing LLC PO Box 30133 Omaha NE 68103 Contracted nursing staff 1629983 RehabVisions 11623 Arbor St Suite 101 Omaha NE 68144 Therapy Services 420230 Arvant Healthcare Professionals LLC PO Box 744554 Atlanta GA 30374 Contracted nursing staff 409366 LRS Healthcare PO Box 850781 Minneapolis MN 55485 Contracted nursing staff 373056 Titan Nurse Staffing LLC 2110 S 169th Plaza Suite 100 Omaha NE 68130 Contracted nursing staff 364850 9 16439 148393 164832 Skilled Nursing Care Revenue 623000 12076639 12076639 Assisted Living Revenue 623990 1171008 1171008 Basic Nursing Care Revenue 623000 348996 348996 Therapy Services Revenue 623000 97530 97530 Employee and Guest Meals 623000 15855 15855 6885 6885 13716913 96342 96342 19275 23898 -4623 -4623 -4623 956 -956 -956 -956 Gain on Insurance Claims 900999 725916 725916 725916 14698424 13716913 0 816679 X 321849 11227 310622 7584170 7255584 328586 200775 191771 9004 683280 628645 54635 520507 478888 41619 32284 32284 28920 28920 3634728 3580369 54359 3172 3172 573727 535632 38095 159155 16675 142480 60888 60888 25531 9092 16439 6190 3300 2890 544 22 522 653976 628647 25329 154786 28745 126041 Food 576149 576149 Plant Management 404002 388106 15896 Bad Debt Expense 274969 274969 Repairs and Maintenance 192405 10034 182371 254964 164785 90179 16346971 14843528 1503443 0 8332432 2792486 1871827 1427932 147522 151360 146907 63693 36699 25689188 20092389 5742133 5596799 4534105 47999 57836 16209444 14740286 1028539 1235342 77086 58266 18915 10321 1124540 1303929 X 15084904 13436357 15084904 13436357 16209444 14740286 -1648547 0 X 0 1 X 0 0 X 19846 14337 975355 2470635 164832 3645005 15630545 15778019 14641790 14053490 13716913 73820757 35964 29572 30394 19692 115622 15686355 15821928 15647539 16543817 13881745 77581384 0 0 0 77581384 83413 117987 131610 103036 115617 551663 83413 117987 131610 103036 115617 551663 15769768 15939915 15779149 16646853 13997362 78133047 0.99290 0.99420 0.00710 0.00610 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1074423 1074423 459407 21322361 17705619 4076149 2832997 2386770 446227 5596799 Lease Payable 10321 10321 X 14698424 0 14698424 0 14698424 16346971 0 16346971 0 16346971 Part IV, Line 2b: The Organization acts as custodian for funds of the residents and security deposits. These funds are included in cash and accounts payable in the financial statements. Resident trust funds totaled $36,891 and $56,388 at June 30, 2022 and 2021. Security Deposits totaled $21,375 and $20,561 at June 30, 2022 and 2021. Part X, Line 2: The Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. X X 0 0 0 0 0 0 0 0 0 Tammra Peterson Administrator (Left Jan 2022) 145185 0 2116 0 15511 0 25244 0 5989 0 194045 0 0 0 Form 990, Part VI, Section A, line 6 At least a majority of the members of the organization must consist of congregations which are members of the Upper Missouri Conference of the Western North Dakota Synod of the Evangelical Lutheran Church in America. Other congregations may also be members of this corporation upon written application and approval by the members of the organization at an annual or special meeting of the organization. Voting members at the annual and special meetings consists of all pastors serving congregations who are members of the corporation and one lay delegate for each 100 confirmed members of that congregation. Each member congregation selects their delegates in accordance to their own qualifications. Form 990, Part VI, Section A, line 7a The Lutheran congregation/owners elect delegates from their congregations. The delegates elect the board members at Bethel Lutheran Nursing & Rehabilitation Center's annual meeting. Membership of the Board of Directors shall consist of at least 5 members of Lutheran Congregations which are members of the Upper Missouri Conference of the Western North Dakota Synod of the Evangelical Lutheran Church in America. Form 990, Part VI, Section A, line 7b The Lutheran congregation/owners elect delegates from their congregations to vote on corporate matters at the Bethal Lutheran Nursing & Rehabilitation Center's annual meeting. Form 990, Part VI, Section A, line 8b Committees do not have authority to act on behalf of the governing body. Committees make recommendations to the Board of Directors. Form 990, Part VI, Section B, line 11b The Form 990 will be provided to the board of directors at a board meeting prior to filng with the IRS. Form 990, Part VI, Section B, line 12c Annually the board of directors and officers of the organization review the conflict of interest policy. When an individual becomes aware that an issue, event or situation may involve a confict of interest, that individual reports the conflict to the board of directors. The board of directors will review the potential conflict and make a determination regarding the potential conflict. Form 990, Part VI, Section B, line 15a The Personnel Committee of the Board of Directors annually compares the compensation of the Administrator with comparable positions. The Personnel Committee brings their recommendations to the independent Board of Directors for review and approval. The Administrator used comparability data to review and approve the compensation for the CFO. Form 990, Part VI, Section C, line 19 Audited year-end financial statements are available at the Bethel Lutheran Nursing & Rehabilitation Center annual meeting, as well as published on the organization's website. The financial statements and conflict of interest policy are also available upon request. Form 990, Part IX, line 11g Consultants: Program service expenses 10,015. Management and general expenses 54,359. Fundraising expenses 0. Total expenses 64,374. Contracted Services: Program service expenses 3,485,831. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,485,831. Purchased Services: Program service expenses 84,523. Management and general expenses 0. Fundraising expenses 0. Total expenses 84,523. Bethel Lutheran Foundation 1705 3rd Ave W Williston ND 58801 450390238 Provide support to Bethel Lutheran Nursing & Rehabilitation Center ND 501(c)(3) Line 12c, III-FI N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0