2021-08-13T08:59:15-05:00 2020-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2019-10-01 411463801 PRESBYTERIAN HOMES HOUSING & ASSISTED LIVING INC PRES 6516316162 2845 NORTH HAMLINE AVENUE ROSEVILLE MN 55113 MARK MEYER CFO 6516316162 2021-08-12 1 CHRISTOPHER STEINHOFF P01587351 6123764500 2021-08-05 2019 2022-09-23 18:48:47Z DANIEL LINDH 2845 NORTH HAMLINE AVENUE ROSEVILLE MN 55113 82087093 0 X WWW.PRESHOMES.ORG X 1984 MN TO HONOR GOD BY ENRICHING THE LIVES AND TOUCHING THE HEARTS OF OLDER ADULTS. 3 0 9006 264 7903566 0 8624473 5216909 64581479 65666950 8499133 8504790 1845598 1644073 83550683 81032722 3285962 15602009 0 0 36307917 37917387 0 0 1333750 22343710 23132784 61937589 76652180 21613094 4380542 170116835 160067467 84264113 89118130 85852722 70949337 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 59329673 15602009 57695760 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. 59329673 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 12 0 9006 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 898680 0 23795 MARK MEYER CFO 39.00 1.00 X X 434244 0 27331 MICHAEL BINGHAM VP OPTAGE 39.00 1.00 X 340041 0 19840 JONATHAN FLECTCHER VP DEVELOPMENT 40.00 0.00 X 326768 0 15893 TERESA LARSON VP HUMAN RESOURCES 39.00 1.00 X 312117 0 19162 DUANE LARSON VP SITE OPERATIONS 39.00 1.00 X X 278468 0 26773 MARTHA HURR ERTL VP OF TRANSFORMATION SYSTE 39.00 1.00 X 277794 0 12714 JANNA SEVERANCE LEGAL COUNSEL 39.00 1.00 X 274477 0 17940 HEIDI PETERSON CONTROLLER 39.00 1.00 X 264615 0 24496 WILLIAM HAGSTROM VP DEVELOPMENT DIRECTOR THRU 12/19 39.00 1.00 X 256717 0 18803 RANDY KIRSCH VP INFORMATION TECHNOLOGY 40.00 0.00 X 240292 0 17810 3904213 0 224557 46 0 1 0 CERIDIAN PO BOX 10989 NEWARK NJ 07193 PAYROLL SOFTWARE 1135190 SHI INTERNATIONAL CORP PO BOX 952121 DALLAS TX 75395 IT SERVICES 514359 VJS CONSTRUCTION SERVICES INC W233 N 2847 ROUNDY CIRCLE W PEWAUKEE WI 53072 CONSTRUCTION 513647 POINTCLICKCARE TECHNOLOGIES PO BOX 674802 DETROIT MI 48267 SOFTWARE SUBSCRIPTION 510066 RYAN LLC PO BOX 848351 DALLAS TX 75284 CONSTRUCTION 477643 36 4182035 918665 116209 5216909 RESIDENT SERVICES 623990 28204161 28204161 MANAGEMENT 541610 20051888 19999888 52000 DESIGN & PROCUREMENT 541900 16535334 9491711 7043623 RESEARCH 541900 875567 875567 65666950 8504790 8504790 912590 980214 -67624 -67624 -67624 94717 74157 20560 20560 MISCELLANEOUS INCOME 900099 758913 758913 CHILDCARE INCOME 900001 511032 511032 MEALS REVENUE 900099 421192 421192 1691137 81032722 57695760 7903566 10216487 15557324 15557324 44685 44685 31412057 24605931 5809752 996374 1095483 878760 172313 44410 3225587 2588505 557895 79187 2184260 1727120 394023 63117 35531 26400 9131 127727 55713 72014 1195431 760699 434732 201208 84603 43283 73322 686227 156885 495717 33625 911130 377125 504305 29700 2999221 2807958 191263 322108 220131 101977 75656 62729 12927 2073248 1369434 703814 3697217 3644200 53017 -1538070 20129 -1558199 DESIGN AND PROCUREMENT 7511064 7511064 OTHER EXPENSES 1474872 1095774 365083 14015 REPAIRS & MAINTENANCE 1248939 1248939 CULINARY EXPENSE 1070422 1070422 1040853 926207 114646 76652180 59329673 15988757 1333750 -110667908 -142266962 7521291 8403912 417371 767090 97688443 37878510 61413727 59809933 26615779 32658996 26899966 29461823 157916609 171232675 170116835 160067467 -1981384 6673660 25544001 24115034 6652996 6763490 26741363 24103159 27307137 27462787 84264113 89118130 X 85852722 70949337 85852722 70949337 170116835 160067467 X 4380542 -19283927 X X 0 1 X 1 1 0 X 993626 1839539 2796730 8624473 5216909 19471277 57956997 59199859 63414108 59290366 59564436 299425766 1206316 1181129 1125111 1218552 1026941 5758049 60156939 62220527 67335949 69133391 65808286 324655092 0 0 0 324655092 4938200 5053197 5981995 8290985 8504790 32769167 351599 1001694 1353293 4938200 5404796 6983689 8290985 8504790 34122460 1088735 1090140 869264 823181 758913 4630233 66183874 68715463 75188902 78247557 75071989 363407785 0.89340 0.90160 0.09390 0.08480 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 58633555 25987721 32645834 2526170 1578232 947938 20375108 10312557 10062551 1870566 1870566 59809933 RESERVE FUNDS 247796 F INVESTMENTS BY AGREEMENTS WITH TRUSTEES & OTHERS 7585317 F RESTRICTED FUNDS 24825883 F 32658996 INVESTMENTS IN AFFILIATES 29461823 C 29461823 OTHER ASSETS 9442140 DUE FROM AFFILIATES 161790535 171232675 WORKERS COMPENSATION & OTHER 6717477 DUE TO AFFILIATES 18686510 RESIDENT NOTES 2058800 27462787 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 $74,562 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) 110000 TO SUPPORT GENERAL OPERATIONS WAYZATA BAY PLAZA RETAIL LLC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 900996742 C CORP 800000 TO SUPPORT GENERAL OPERATIONS PRESBYTERIAN HOMES CARE CENTERES INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 411500288 501(C)(3) 12000000 TO SUPPORT GENERAL OPERATIONS PHW GERMANTOWN INC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 811502691 501(C)(3) 2150000 TO SUPPORT GENERAL OPERATIONS PHS INTERLUDE FRIDLEY LLC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 462904490 501(C)(3) 497324 TO SUPPORT GENERAL OPERATIONS 4 3 SCHOLARSHIPS 11 44685 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 898680 0 0 0 0 0 14000 0 9795 0 922475 0 0 0 MARK MEYER CFO 434244 0 0 0 0 0 14000 0 13331 0 461575 0 0 0 MICHAEL BINGHAM VP OPTAGE 340041 0 0 0 0 0 13618 0 6222 0 359881 0 0 0 JONATHAN FLECTCHER VP DEVELOPMENT 326768 0 0 0 0 0 4915 0 10978 0 342661 0 0 0 TERESA LARSON VP HUMAN RESOURCES 312117 0 0 0 0 0 14000 0 5162 0 331279 0 0 0 DUANE LARSON VP SITE OPERATIONS 278468 0 0 0 0 0 13442 0 13331 0 305241 0 0 0 MARTHA HURR ERTL VP OF TRANSFORMATION SYSTE 277794 0 0 0 0 0 12714 0 0 0 290508 0 0 0 JANNA SEVERANCE LEGAL COUNSEL 274477 0 0 0 0 0 12778 0 5162 0 292417 0 0 0 HEIDI PETERSON CONTROLLER 264615 0 0 0 0 0 13709 0 10787 0 289111 0 0 0 WILLIAM HAGSTROM VP DEVELOPMENT DIRECTOR THRU 12/19 256717 0 0 0 0 0 13073 0 5730 0 275520 0 0 0 RANDY KIRSCH VP INFORMATION TECHNOLOGY 240292 0 0 0 0 0 9884 0 7926 0 258102 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 2055000 5765000 241955 115300 5408597 2010 1 0 1 1 B 2349348 9300000 139163 9160838 2014 1 0 1 1 C 2349348 9300000 139163 9160838 2014 1 0 1 1 D 2349348 9300000 139163 9160838 2014 1 0 1 1 A 1 0 0 0 0 0 1 B 1 1 0 1 0 0 0 1 C 1 1 0 1 0 0 0 1 D 1 1 0 1 0 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. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS FROM RELATED PARTY UPON DISSOLUTION -19,283,927. 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