2022-08-11T12:06:26-05:00 2021-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2020-10-01 411463801 PRESBYTERIAN HOMES HOUSING & ASSISTED LIVING INC PRES 6516316162 2845 NORTH HAMLINE AVENUE ROSEVILLE MN 55113 MARK MEYER CFO 6516316162 2022-08-09 1 MARK MEYER 999009999 CHRISTOPHER STEINHOFF P01587351 6123764500 2022-08-03 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DANIEL LINDH 2845 NORTH HAMLINE AVENUE ROSEVILLE MN 55113 80712096 0 X WWW.PRESHOMES.ORG X 1984 MN TO HONOR GOD BY ENRICHING THE LIVES AND TOUCHING THE HEARTS OF OLDER ADULTS. 3 0 9409 119 9462941 1113754 5216909 6188129 65666950 62670581 8504790 7139285 1644073 1983819 81032722 77981814 15602009 10290922 0 0 37917387 35962402 0 0 1260349 23132784 22945144 76652180 69198468 4380542 8783346 302334429 328963538 231385092 249230855 70949337 79732683 X THE MISSION OF PRESBYTERIAN HOMES HOUSING & ASSISTED LIVING, INC. IS TO HONOR GOD BY ENRICHING THE LIVES AND TOUCHING THE HEARTS OF OLDER ADULTS. 0 0 53274057 10290922 53267268 PRESBYTERIAN HOMES HOUSING & ASSISTED LIVING, INC. OPERATES SEVERAL SENIOR HOUSING FACILITIES IN MINNESOTA AND IOWA. CAMPUS IN SPRING PARK, MN CONSISTS OF 111 BED SKILLED NURSING FACILITY, 52 TRADITIONAL ASSISTED LIVING APARTMENTS, 18 MEMORY CARE SPECIFIC ASSISTED LIVING APARTMENTS, 165 INDEPENDENT SENIOR LIVING APARTMENTS, AND 125 MULTIFAMILY EMPLOYEE HOUSING APARTMENTS. CAMPUS IN LITTLE CANADA, MN CONSISTING OF 93 INDPENDENT SENIOR LIVING APARTMENTS. A CAMPUS IN PLYMOUTH, MN CONSISTING OF 24 MEMORY CARE SPECIFIC ASSISTED LIVING APARTMENTS, 28 TRADITIONAL ASSISTED LIVING APARTMENTS, AND 68 INDEPENDENT SENIOR LIVING APARTMENTS. A CAMPUS IN BURNSVILLE, MN WITH 40 BED ASSISTED LIVING FACILITY AND 20 MEMORY CARE SPECIFIC ASSISTED LIVING APARMTENTS. A CAMPUS IN ST. PAUL, MN CONSISTING OF 197 INDEPENDENT SENIOR LIVING APARTMENTS. 53274057 1 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 11 0 1 9409 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X HEIDI PETERSON 6516316149 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 DANIEL LINDH CEO 39.00 1.00 X X 907103 0 23520 MARK MEYER CFO 39.00 1.00 X X 442068 0 26889 DUANE LARSON VP SITE OPERATIONS 39.00 1.00 X X 315866 0 26889 JONATHAN FLECTCHER VP DEVELOPMENT 39.00 1.00 X 329215 0 19912 TERESA LARSON VP HUMAN RESOURCES 39.00 1.00 X 324499 0 19241 MICHAEL BINGHAM VP OPTAGE 39.00 1.00 X 346096 0 19765 MARTHA HURR ERTL VP OF TRANSFORMATION SYSTE 39.00 1.00 X 284581 0 13440 JANNA SEVERANCE LEGAL COUNSEL 39.00 1.00 X 281371 0 18699 HEIDI PETERSON CONTROLLER 39.00 1.00 X 275830 0 18695 WILLIAM HAGSTROM VP DEVELOPMENT 39.00 1.00 X 259457 0 12981 3766086 0 200031 42 0 1 0 RYAN LLC PO BOX 848351 DALLAS TX 75284 CONSTRUCTION 1457296 CERIDIAN PO BOX 10989 NEWARK NJ 07193 PAYROLL SOFTWARE 1363737 POINTCLICKCARE TECHNOLOGIES PO BOX 674802 DETROIT MI 48267 SOFTWARE SUBSCRIPTION 644097 LARSON BUILDING INC 200 1ST ST S BUFFALO MN 55313 CONSTRUCTION 478607 RAYCO CONSTRUCTION 3030 GRANADA AVE N OAKDALE MN 55128 CONSTRUCTION 433375 26 5187537 1000592 6188129 RESIDENT SERVICES 623990 24051965 24051965 MANAGEMENT 541610 20689084 20484662 204422 DESIGN & PROCUREMENT 541900 16942742 8730641 8212101 RESEARCH 541900 986790 986790 62670581 8824668 8824668 1371085 965312 405773 405773 59628 346145 1685383 -1685383 -1685383 -1685383 95951 79587 16364 16364 CHILDCARE INCOME 900001 616891 616891 MISCELLANEOUS INCOME 900099 604209 604209 MEALS REVENUE 900099 340582 340582 1561682 77981814 53267268 9462941 9063476 10271394 10271394 19528 19528 2426202 2426202 27145091 23032620 3199215 913256 1014661 869410 103099 42152 3352867 2790369 484017 78481 2023581 1582127 384010 57444 70656 47337 23319 136281 59237 77044 1146816 740556 405867 393 270271 106661 63347 100263 621756 166676 423048 32032 967872 436110 508867 22895 2989101 2884988 104113 230625 159270 71355 35310 32100 3210 2019482 1304435 715047 3596692 3544455 52237 -314841 27973 -342814 DESIGN AND PROCUREMENT 5399895 5399895 OTHER EXPENSES 2804683 2228266 562984 13433 REPAIRS & MAINTENANCE 1356531 1356531 CULINARY EXPENSE 912393 912393 701621 701621 69198468 53274057 14664062 1260349 8403912 9129366 767090 333443 96519813 39188669 59809933 57331144 32658996 44382996 29461823 32963234 171232675 184823355 302334429 328963538 6673660 6506429 24115034 22632556 6763490 7759242 24103159 22103483 169729749 190229145 231385092 249230855 X 70949337 77732683 2000000 70949337 79732683 302334429 328963538 8783346 0 X X 0 1 X 1 1 1 X 1839539 2796730 8624473 5216909 6188129 24665780 59199859 63414108 59290366 59564436 53267268 294736037 1181129 1125111 1218552 1026941 1053424 5605157 62220527 67335949 69133391 65808286 60508821 325006974 0 11725893 11725893 11725893 11725893 313281081 5053197 5981995 8290985 8504790 9271745 37102712 351599 1001694 3416994 4770287 5404796 6983689 8290985 8504790 12688739 41872999 1090140 869264 823181 758913 604209 4145707 68715463 75188902 78247557 75071989 73801769 371025680 0.84440 0.89340 0.11290 0.09390 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 14283044 14283044 58992391 27870165 31122226 2458126 1614323 843803 20776906 9704181 11072725 9346 9346 57331144 RESERVE FUNDS 1485934 F INVESTMENTS BY AGREEMENTS WITH TRUSTEES & OTHERS 7343300 F RESTRICTED FUNDS 35553762 F 44382996 INVESTMENTS IN AFFILIATES 32963234 C 32963234 OTHER ASSETS 7496003 DUE FROM AFFILIATES 177327352 184823355 WORKERS COMPENSATION & OTHER 6523932 DUE TO AFFILIATES 19227315 RESIDENT NOTES 2138339 CHECKS IN EXCESS OF CASH 162339559 190229145 X PART IV, LINE 2B: THE REPAIRS AND REPLACEMENT RESERVES AND THE RESIDENT NOTES ARE REPORTED AS LONG TERM ASSET AND LIABILITY, RESPECTIVELY ON THE CONSOLIDATED STATEMENTS OF THE FINANCIAL POSITION. AT EACH OF THE FACILITIES, THE CONTRACTS WITH THE RESIDENTS LIMIT THE TOTAL AMOUNT OF DEPOSITS THAT THE ORGANIZATION MUST RETURN AT ANY ONE TIME. THE MAXIMUM AMOUNTS AT EACH OF THE FACILITIES RANGE FROM $100,000 TO $2,000,000. IF AT ANY TIME THE NET AMOUNT IT HAS RETURNED TO FORMER RESIDENTS EXCEEDS THE AMOUNT THAT IT HAS RECEIVED FROM NEW TENANTS BY THE APPLICABLE MAXIMUM AMOUNT, THE ORGANIZATION IS NOT REQUIRED TO REFUND ADDITIONAL DEPOSITS UNTIL NEW DEPOSITS ARE COLLECTED BRINGING THE AMOUNT OWED UNDER MAXIMUM AMOUNT. THE SECURITY DEPOSIT AND RESIDENT TRUST FUND BALANCES TOTALED $80,727. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE SECTIONS OF THE STATES STATUTES; CONSEQUENTLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. HOWEVER, THERE ARE IMMATERIAL AMOUNTS OF UNRELATED BUSINESS INCOME IN CERTAIN AFFILIATES THAT ARE TAXABLE. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INFORMATION RETURNS AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. 1 PHMNEW RICHMOND SENIOR HOUSING INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 411883153 501(C)(3) 400000 N/A N/A TO SUPPORT GENERAL OPERATIONS WAYZATA BAY PLAZA RETAIL LLC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 900996742 C CORP 1000000 N/A N/A TO SUPPORT GENERAL OPERATIONS PHW GERMANTOWN INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 811502691 501(C)(3) 1300000 N/A N/A TO SUPPORT GENERAL OPERATIONS PHS INTERLUDE FRIDLEY LLC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 462904490 501(C)(3) 275000 N/A N/A TO SUPPORT GENERAL OPERATIONS PHS WALNUT RIDGE LLC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 455534580 C CORP 775000 N/A N/A TO SUPPORT GENERAL OPERATIONS PHW OCONOMOWOC INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 825492636 501(C)(3) 300000 N/A N/A TO SUPPORT GENERAL OPERATIONS PHS MARANATHA INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 410855713 501(C)(3) 646394 N/A N/A TO SUPPORT GENERAL OPERATIONS PHS COUNCIL BLUFFS INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 823917566 501(C)(3) 5250000 N/A N/A TO SUPPORT GENERAL OPERATIONS CROSBY SENIOR SERVICES 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 204631039 501(C)(3) 150000 N/A N/A TO SUPPORT GENERAL OPERATIONS PHW WEST HEALTH INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 412017315 501(C)(3) 175000 N/A N/A TO SUPPORT GENERAL OPERATIONS 8 2 SCHOLARSHIPS 8 19528 N/A N/A PART I, LINE 2: INDIVIDUAL SCHOLARSHIP RECEIPIENTS MUST BE EMPLOYED BY PHS FOR AT LEAST ONE YEAR, WORK AN AVERAGE OF 20 HOURS A WEEK, MAINTAIN AN EXCELLENT WORK RECORD, PROVIDE PROOF OF ACCEPTANCE OR ENROLLMENT IN A LPN/RN PROGRAM, RECEIVE THE ENDORSEMENT OF THEIR CLINICAL ADMINISTRATOR/DIRECTOR OF HOMECARE AND ADMINISTRATOR, AND BE SELECTED BY CORPORATE HUMAN RESOURCES. TRANSFERS TO RELATED ORGANIZATIONS ARE TRACKED THROUGH PHHAL'S INTERNAL FINANCIAL REPORTING PROCESS BECAUSE BOTH ENTITIES ARE UNDER COMMON MANAGEMENT. X X X 0 0 0 0 0 0 0 0 0 DANIEL LINDH CEO 907103 0 0 0 0 0 14250 0 9270 0 930623 0 0 0 MARK MEYER CFO 442068 0 0 0 0 0 14250 0 12639 0 468957 0 0 0 MICHAEL BINGHAM VP OPTAGE 346096 0 0 0 0 0 13863 0 5902 0 365861 0 0 0 JONATHAN FLECTCHER VP DEVELOPMENT 329215 0 0 0 0 0 9813 0 10099 0 349127 0 0 0 TERESA LARSON VP HUMAN RESOURCES 324499 0 0 0 0 0 14250 0 4991 0 343740 0 0 0 DUANE LARSON VP SITE OPERATIONS 315866 0 0 0 0 0 14250 0 12639 0 342755 0 0 0 JANNA SEVERANCE LEGAL COUNSEL 281371 0 0 0 0 0 14099 0 4600 0 300070 0 0 0 MARTHA HURR ERTL VP OF TRANSFORMATION SYSTE 284581 0 0 0 0 0 13440 0 0 0 298021 0 0 0 HEIDI PETERSON CONTROLLER 275830 0 0 0 0 0 8568 0 10127 0 294525 0 0 0 WILLIAM HAGSTROM VP DEVELOPMENT 259457 0 0 0 0 0 12981 0 0 0 272438 0 0 0 PART I, LINE 3 THE CEO'S COMPENSATION IS DETERMINED BY PRESBYTERIAN HOMES AND SERVICES, A RELATED ORGANIZATION. PRESBYTERIAN HOMES AND SERVICES USES THE FOLLOWING TO DETERMINE THE CEO'S COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A CITY OF LITTLE CANADA MN 410973960 53702CAR4 2010-12-09 5765000 REFINANCE SERIES 1999 BONDS 0 0 0 B CITY OF SPRING PARK MN 416008586 2014-06-03 9300000 REFINANCE SERIES 2010 BONDS 0 0 0 C CITY OF CHANHASSEN MN 410885332 2014-06-03 9300000 REFINANCE SERIES 2010 BONDS 0 0 0 D CITY OF ST BONIFACIUS MN 411253357 2014-06-03 9300000 REFINANCE SERIES 2010 BONDS 0 0 0 A 2325000 5765000 240846 115300 5408597 2010 1 0 1 1 B 2766325 9300000 139163 9160838 2014 1 0 1 1 C 2766325 9300000 139163 9160838 2014 1 0 1 1 D 2766325 9300000 139163 9160838 2014 1 0 1 1 A 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 B 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 C 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 D 1 1 0 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS MAY BY RESOLUTION ORGANIZE ITSELF INTO COMMITTEES. THE BOARD OF DIRECTORS MAY BY RESOLUTION APPOINT COMMITTEES, OF DEFINITE OR INDEFINITE DURATION, FOR SPECIFIC TASKS OR OTHERWISE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF PRESBYTERIAN HOMES HOUSING & ASSISTED LIVING, INC. IS PRESBYTERIAN HOMES AND SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION ELECT THE MEMBERS OF THE GOVERNING BODY, BUT NOT IF THE PERSONS ON THE GOVERNING BODY ARE THE ORGANIZATION'S ONLY MEMBERS OR THEIR DELEGATES. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PROVIDED TO VOTING MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE IRS. OFFICERS AND MANAGEMENT OF THE ORGANIZATION HAVE BEEN INVOLVED IN THE PREPARATION OF THE FORM 990 AND HAVE REVIEWED IT THROUGHOUT THE PROCESS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION OBTAINS ANNUALLY WRITTEN DISCLOSURES FROM GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. MANAGEMENT AND OFFICERS REVIEW THESE DISCLOSURES AND EVALUATE WHETHER THE INTEREST COULD RESULT IN A CONFLICT AND THEN TAKE THE NECESSARY STEPS TO REMEDIATE ANY SUCH CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE PRESBYTERIAN HOMES & SERVICES BOARD OF DIRECTORS IS RESPONSIBLE FOR THE GOVERNANCE AND STRUCTURE OF COMPENSATION PLANS AND FOR ENSURING REGULATORY COMPLIANCE OF THESE PLANS. CEO, SENIOR MANAGEMENT, EXECUTIVES AND OFFICERS' COMPENSATION SYSTEMS ARE MANAGED BY THE EXECUTIVE COMMITTEE AND PRESBYTERIAN HOMES & SERVICES BOARD OF DIRECTORS. SYSTEMS ARE REVIEWED ANUALLY AND THE ORGANIZATION ENGAGES AN EXTERNAL INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE A FAIR MARKET VALUE OPINION. THE TARGET FOR TOTAL COMPENSATION FOR EXECUTIVE STAFF WHO MEET PERFORMANCE EXPECTATIONS IS SET AT 105% OF THE MIDPOINT IN EACH RESPECTIVE MARKET PRICE PAY RANGE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. PART XII, LINE 2C THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. 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