2023-11-02T16:44:48-05:00 2023-06-30 450250958 Eide Bailly LLP 1730 Burnt Boat Loop Ste 100 Bismarck ND 585030886 990 2022-07-01 450277267 Lutheran Home of the Good Shepherd Inc LUTH 7019472944 1226 First Avenue North New Rockford ND 58356 Kim Jensrud Administrator 7019472944 2023-11-01 1 Kim Jensrud 999009999 1 Lisa Chaffee CPA P00193453 7012551091 2023-11-01 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Kim Jensrud 1226 First Avenue North New Rockford ND 58356 9340387 0 9386 X www.lhgs.org X 1958 ND Nursing facility attending to the residential, health, social and other needs of the elderly and their families in New Rockford, ND. 9 9 132 7 0 0 1072878 38537 6157548 7169621 55371 117088 0 2015141 7285797 9340387 0 0 0 0 3823507 4075984 0 0 0 2958225 3559554 6781732 7635538 504065 1704849 11199931 12938340 4332674 4246995 6867257 8691345 The mission of the Lutheran Home of the Good Shepherd shall be to provide, in the name of Christ, high-quality long-term care and other services and programs which address the needs of the senior citizen and special needs individual. 0 0 5981867 6805602 The Lutheran Home of the Good Shepherd is an 80-bed care facility with 51 skilled beds and 10 basic care beds that provides routine and ancillary services to its residents in a nondiscriminatory fashion without regard to ability to pay. The home reported 16,323 resident days related to skilled care beds or an occupancy of 88% for the end of 2022. The home reported 2,340 resident days related to basic care beds or an occupancy rate of 64.2%. 257183 247347 Heritage House is a 16-unit assisted living facility. The facility had an annual occupancy rate of 88%. 87423 116672 Westview Apartments is located in New Rockford, ND. It is a 22-unit apartment building for low-income individuals. The facility had an annual occupancy rate of 98%. 6326473 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 132 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Kim Jensrud 7019472944 1226 First Avenue North New Rockford ND 58356 Jeff Labrensz President 3.00 X X 0 0 0 Lona Lutz Vice President 3.00 X X 0 0 0 Mindy Rau Secretary 3.00 X X 0 0 0 Kathleen O'Conner Treasurer 3.00 X X 0 0 0 Dianne Allmaras Director 3.00 X 0 0 0 Richard Rau Director 3.00 X 0 0 0 Kurt Bollingberg Director 3.00 X 0 0 0 Karen Anderson Director 3.00 X 0 0 0 Reed Ystaas Director (Nov-Jun) 3.00 X 0 0 0 Carol Wolkenhauer Director (Jul-Oct) 2.50 X 0 0 0 Josh Guler Director (Jul-Oct) 2.50 X 0 0 0 Amanda Hegland Director (Jul-Oct) 2.50 X 0 0 0 Lori Parson Director (Jul-Aug) 2.50 X 0 0 0 Karen Birkeland Director (Jul-Jan) 2.50 X 0 0 0 Kim Jensrud Administrator 40.00 X 103099 0 16215 Tressa Lesmeister Accountant 40.00 X 46760 0 1401 149859 0 17616 1 0 0 0 DTN Staffing Inc 1200 Collins Ave Mandan ND 58554 Nursing Contract Services 403534 ProCare Staffing Service 300 2nd Ave NE Jamestown ND 58401 Nursing Contract Services 233853 Prime Time Healthcare LLC PO Box 3544 Omaha NE 68103 Nursing Contract Services 105577 3 38537 38537 Resident Service Revenue 623000 6929828 6929828 Child Care 624410 80839 80839 Cafeteria 900099 21852 21852 137102 137102 7169621 117088 117088 ERC Revenue 900099 2015141 2015141 2015141 9340387 7169621 0 2132229 X 174107 174107 3219005 2821181 397824 58711 53015 5696 390358 333753 56605 233803 195209 38594 156287 156287 87396 87396 16553 16553 1503852 1480462 23390 12219 546 11673 209545 136185 73360 82285 82285 353819 293408 60411 36119 27084 9035 179403 165853 13550 433585 403430 30155 86365 14991 71374 Food 248346 248346 Medical Supplies 124335 124335 Bad Debt Expense 11283 11283 18162 17392 770 7635538 6326473 1309065 0 3368539 897057 415117 2496640 34363 39566 40303 34738 14802482 10453510 4434795 4348972 2906814 5121367 11199931 12938340 442728 654857 37047 41470 3852899 3550668 4332674 4246995 X 6857257 8691345 10000 0 6867257 8691345 11199931 12938340 1704849 119239 0 X 0 1 X 1 1 1 X 16768 72637 1823071 1072878 38537 3023891 6217825 6477893 6468958 6157548 7169621 32491845 6234593 6550530 8292029 7230426 7208158 35515736 0 1273207 1123077 864598 2506408 974795 6742085 1273207 1123077 864598 2506408 974795 6742085 28773651 66325 70382 62960 55371 117088 372126 66325 70382 62960 55371 117088 372126 6300918 6620912 8354989 7285797 7325246 35887862 0.80180 0.80440 0.01040 0.00790 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 48885 48885 11972108 8428905 3543203 2621607 1895967 725640 159882 128638 31244 4348972 X 9443073 119239 119239 9323834 16553 16553 9340387 7618985 0 7618985 16553 16553 7635538 Part IV, Line 2b: The Home acts as custodian for the funds of the nursing facility residents. The Home also holds security deposits for tenants of the assisted living and apartments. These funds are included in cash and cash equivalents and accounts payable in the financial statements. Resident trust funds and tenant security deposits totaled $41,470 and $37,047 at June 30, 2023 and 2022. Part X, Line 2: The Home 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 Home 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. Form 990, Part VI, Section A, line 1a The Executive Committee consists of the President, Vice President, Treasurer and Secretary. They have the authority of the Board in the management of the affairs of the Corporation between meetings. Form 990, Part VI, Section A, line 2 Mindi Rau and Richard Rau have a family relationship. Form 990, Part VI, Section A, line 6 Area churches are members of the organization and are all members of the same class. Form 990, Part VI, Section A, line 7a The member delegates vote for the Board of Directors at the annual meeting. Form 990, Part VI, Section B, line 11b The Administrator will review a draft copy of the Form 990 prior to presenting the draft Form 990 at a board meeting. The Form 990 will then be reviewed and approved by the Board of Directors prior to it being finalized and filed. Form 990, Part VI, Section B, line 12c Every October board members and officers of the organization are asked to disclose any potential conflicts. The Administrator reviews the forms and each potential conflict is taken to the board. The board will then determine whether or not the member with the potential conflict should be allowed to vote on the issue. If it is determined he or she should not be allowed to vote then they are asked to abstain from voting and leave the meeting. Form 990, Part VI, Section B, line 15a Annually the Executive Committee meets to evaluate the Administrator's performance and compensation. The committee makes recommendations that are brought to the full board. The full Board of Directors approves the Administrator's compensation. The Administrator's compensation is compared with administrators of similar sized nursing homes in North Dakota. This information is obtained from a survey put out by the North Dakota Long Term Care Association. The Administrator evaluates and approves the compensation of the Accounting Officer. The Accounting Officer and all other employees' compensation are based on a pay scale. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part IX, line 11g CNA Contracted Services: Program service expenses 830,921. Management and general expenses 0. Fundraising expenses 0. Total expenses 830,921. Maintenance Contracted Services: Program service expenses 51,046. Management and general expenses 0. Fundraising expenses 0. Total expenses 51,046. Physical Therapy Consultant: Program service expenses 16,228. Management and general expenses 0. Fundraising expenses 0. Total expenses 16,228. PT - Medicare: Program service expenses 4,629. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,629. Lab & Radiology - Medicare: Program service expenses 5,811. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,811. Dietary Consultant: Program service expenses 6,200. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,200. Occupational Therapy Consultant: Program service expenses 2,622. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,622. Speech Therapy Consultant: Program service expenses 1,538. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,538. Therapy: Program service expenses 33,383. Management and general expenses 0. Fundraising expenses 0. Total expenses 33,383. Pharmacy Consultant: Program service expenses 9,600. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,600. Contracted Nursing Services: Program service expenses 518,437. Management and general expenses 0. Fundraising expenses 0. Total expenses 518,437. OT - Medicare: Program service expenses 47. Management and general expenses 0. Fundraising expenses 0. Total expenses 47. Consulltant Mileage: Program service expenses 0. Management and general expenses 23,390. Fundraising expenses 0. Total expenses 23,390.