2020-05-14T18:33:00-05:00 2019-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 225 S 6TH ST 2300 MINNEAPOLIS MN 55402 990 2018-07-01 300186547 THE HOMESTEAD AT ROCHESTER INC HOME 9529410305 7485 OFFICE RIDGE CIRCLE EDEN PRAIRIE MN 55344 NANCY GAVIN VP FINANCIAL SERVICES 9529410305 2020-05-06 1 LAWRENCE H MOHR CPA P00447603 6128764500 38.88.188.75 2020-05-06 15:45:16 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EDB264CAD7F9F6CD2E19D356927987B2A35A11B0 2018 2020-09-23 17:36:50Z X JOSEPH BUDZYNSKI 1660 DUKE STREET ALEXANDRIA VA 22314 19860691 0 X WWW.VOA.ORG X 2003 MN SEE SCHEDULE O 15 14 289 396 0 0 805684 1508882 16447265 18210182 119499 141281 0 0 17372448 19860345 10807 27676 0 0 5597951 6026235 0 0 0 14112848 14599195 19721606 20653106 -2349158 -792761 87962782 86414854 85217408 84462241 2745374 1952613 X SEE SCHEDULE O 0 0 19666294 27676 18210182 THE HOMESTEAD AT ROCHESTER, INC. PROVIDES INDEPENDENT AND ASSISTED LIVING SERVICES AND NURSING AND LONG-TERM CARE SERVICES FOR SENIORS IN MINNESOTA. 19666294 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 64 0 289 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X NANCY GAVIN 6124287840 7485 OFFICE RIDGE CIRCLE EDEN PRAIRIE MN 55344 BURKS JANE BOARD CHAIR 0.10 2.00 X X 0 0 0 KIKUMOTO C DAVID VICE CHAIRMAN 0.10 2.00 X X 0 0 0 CARRINGTON EDWINA SECRETARY 0.10 2.00 X X 0 0 0 ARNOLDPATTI TREASURER 0.10 2.00 X X 0 0 0 BLOOM SHAWN DIRECTOR 0.10 2.00 X 0 0 0 DALE KAREN DIRECTOR 0.10 2.00 X 0 0 0 DOLAN THOMAS DIRECTOR 0.10 2.00 X 0 0 0 EDEBURN ANDREW DIRECTOR 0.10 2.00 X 0 0 0 KNAPP KEITH DIRECTOR 0.10 2.00 X 0 0 0 LEBLANC JAMES DIRECTOR 0.10 2.00 X 0 0 0 PETERSEN JEANNE DIRECTOR 0.10 2.00 X 0 0 0 RASE NANCY DIRECTOR 0.10 2.00 X 0 0 0 SULLIVAN MICHAEL DIRECTOR 0.10 2.00 X 0 0 0 WAKEFIELD STEPHEN DIRECTOR 0.10 2.00 X 0 0 0 KING MICHAEL W PRESIDENT 3.00 40.00 X X 0 464708 150782 WILSON GENO SHARON ASST. 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SECRETARY/TREASURER 3.00 40.00 X 0 114887 18629 OLSON WAYNE C EVP - HEALTHCARE 3.00 40.00 X 0 252566 79043 OTTO DENA L EXECUTIVE DIRECTOR 40.00 X 101080 0 5269 101080 2156463 727814 1 0 1 0 CENTREX REHAB 8120 PENN AVE S SUITE 227 BLOOMINGTON MN 55431 CONTRACT THERAPY PROVIDER 1365441 VOLUNTEERS OF AMERICA NATIONAL SERVICES 7485 OFFICE RIDGE CIRCLE EDEN PRAIRIE MN 55344 MANAGEMENT SERVICES 780496 A'VIANDS LLC PO BOX 1450 MINNEAPOLIS MN 55485 PROVIDER OF DIETARY SERVICES 381876 PATHWAY HEALTH SERVICES INC 2025 FOURTH STREET WHITE BEAR LAKE MN 55110 NURSING CONSULTANTS 292794 4 1500000 8882 1508882 NURSING/THERAPY 623000 18210182 18210182 18210182 141627 141627 346 -346 -346 -346 19860345 18210182 0 141281 X 27676 27676 4842917 4734688 108229 24780 24780 769791 750310 19481 388747 388747 8279 8279 16770 16770 3134328 2321242 813086 50964 50964 373622 373622 142943 142943 1228619 1215435 13184 108571 108571 6698 6698 4614345 4612830 1515 2692241 2666481 25760 247507 245032 2475 FOOD 725870 725870 NURSING SUPPLIES 589799 589799 REPAIRS & MAINTENANCE 277824 274742 3082 LICENSES 168799 168799 212016 212016 20653106 19666294 986812 0 2296706 3092383 1695863 1468402 948293 941503 64372 61299 121295 166707 85868590 15725996 72460658 70142594 10375595 10541966 87962782 86414854 2141605 2110233 73748794 72965338 39874 30614 9287135 9356056 85217408 84462241 X 2745374 1952613 2745374 1952613 87962782 86414854 -792761 0 X 0 1 X 1 0 X 3062 4229 706701 805684 1508882 3028558 4982749 10112793 14348360 16447265 18210182 64101349 4985811 10117022 15055061 17252949 19719064 67129907 0 0 0 67129907 4150 65801 176660 119004 141627 507242 4150 65801 176660 119004 141627 507242 4989961 10182823 15231721 17371953 19860691 67637149 0.99250 0.99290 0.00750 0.00710 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2775500 2775500 75647950 12101198 63546752 1179249 427167 752082 6158681 3156591 3002090 107210 41040 66170 70142594 BOND TRUST FUNDS 6873212 BED RIGHTS 795000 INTERCOMPANY RECEIVABLE 2873754 10541966 ENTRANCE DEPOSITS 8567215 RELATED PARTY LOAN PAYABLE 750000 THIRD PARTY PAYORS 38841 9356056 X 19860345 0 19860345 0 19860345 20653106 0 20653106 0 20653106 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)3 OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE STATUTES. THE ORGANIZATION HAS EVALUATED ITS TAX POSITIONS FOR UNCERTAINTY AND HAS NO UNRECOGNIZED TAX MATTERS THAT ARE REQUIRED TO BE DISCLOSED. THE ORGANIZATION HAD NO INCOME TAX EXPENSE AND THERE WERE NO CASH PAYMENTS FOR INCOME TAXES IN 2019 AND 2018. 1 SCHOLARSHIPS 8 27676 PART I, LINE 2: THE PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE US IS ADMINISTERED IN ONE OF TWO WAYS: 1. THE EMPLOYEE PAYS FOR THE EDUCATION, SUBMITS DOCUMENTATION, AND VOA REIMBURSES THEM FOR THEIR ALLOWABLE COSTS. 2. THE EMPLOYEE SUBMITS A REQUEST TO PAY THE TUITION DIRECTLY TO THE SCHOOL. IN THIS CASE, DOCUMENTATION REGARDING THE COST IS ALSO REQUIRED. 0 0 0 0 0 0 0 0 0 KING MICHAEL W PRESIDENT 0 448407 0 128 0 16173 0 86014 0 64768 0 615490 0 0 WILSON GENO SHARON ASST. SECRETARY/TREASURER, COO 0 276105 0 132 0 2135 0 64417 0 35599 0 378388 0 0 BUDZYNSKI JOSEPH A ASST. SECRETARY/TREASURER, CFO 0 267051 0 132 0 1999 0 28800 0 34171 0 332153 0 0 SHERIDAN PATRICK N ASST. SECRETARY 0 226876 0 132 0 3091 0 46219 0 3475 0 279793 0 0 KELLER CYNTHIA R ASST. SECRETARY 0 136958 0 128 0 1663 0 33795 0 79248 0 251792 0 0 GAVIN NANCY A ASST. SECRETARY/TREASURER 0 136521 0 139 0 1085 0 28409 0 58067 0 224221 0 0 GIBSON ROBERT ASST. SECRETARY/TREASURER 0 268124 0 132 0 1899 0 28800 0 33091 0 332046 0 0 OLSON WAYNE C EVP - HEALTHCARE 0 250160 0 139 0 2267 0 28442 0 50601 0 331609 0 0 PART I, LINE 3 THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION, VOLUNTEERS OF AMERICA, INC., TO DETERMINE THE COMPENSATION FOR THE PRESIDENT AND CEO, OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATION USED THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION: 1. COMPENSATION COMMITTEE 2. COMPENSATION SURVEY OR STUDY 3. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A CITY OF ROCHESTER MINNESOTA 416005494 771906CV4 2013-11-22 46805732 FINANCE MULTIFAMILY RENTAL HOUSING 0 0 0 B CITY OF ROCHESTER MINNESOTA 416005494 771906DC5 2015-11-18 32596411 FINANCE SENIOR HOUSING CAMPUS EXPANSION PROJECT AND REFINANCE EXISTING DEBT 0 0 0 A 1515000 46805732 3609875 17782913 936115 20216042 2015 1 0 1 1 B 2845000 32596411 1970276 2992150 651928 26171516 810541 2017 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 0 B 0 PART I, LINE 1 AND PART III, LINE 1: THE HOMESTEAD AT ROCHESTER, INC. WAS FORMED IN 2003 TO ESTABLISH AND PROVIDE FOR ELDERLY AND HANDICAPPED PERSONS' HOUSING, ASSISTED LIVING, MEDICAL CARE AND OTHER SERVICES. THESE SERVICES ARE SPECIFICALLY DESIGNED TO MEET THEIR PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS, AND TO CONTRIBUTE TO THEIR HEALTH, SECURITY, AND HAPPINESS IN LONGER LIVING. FORM 990, PART VI, SECTION A, LINE 2 MICHAEL KING, SHARON WILSON GENO, ROBERT GIBSON, JOSEPH BUDZYNSKI, PATRICK SHERIDAN, CYNTHIA KELLER, NANCY GAVIN, DEBORAH PERRY, FAITH NUTZ, AND WAYNE OLSON HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER, BECAUSE THEY SERVE AS DIRECTORS, OFFICERS, AND/OR KEY EMPLOYEES OF VOLUNTEERS OF AMERICA, INC., VOLUNTEERS OF AMERICA NATIONAL SERVICES, AND/OR THEIR RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 VOLUNTEERS OF AMERICA CARE FACILITIES IS A MEMBER. VOLUNTEERS OF AMERICA NATIONAL SERVICES IS A MEMBER OF VOLUNTEERS OF AMERICA CARE FACILITIES. FORM 990, PART VI, SECTION A, LINE 7A VOA NATIONAL SERVICES HAS THE RIGHT TO ELECT OR APPOINT DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B VOA NATIONAL SERVICES APPROVES AMENDMENTS TO THE ARTICLES AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE BOARD HAS 5 DAYS TO REVIEW AND GIVE COMMENTS ON THE RETURN. AFTER THE COMMENT PERIOD, ANY CHANGES WILL BE MADE TO THE RETURN. THE BOARD OF DIRECTORS IS THEN PROVIDED A COMPLETE COPY OF THE FINAL RETURN UPON FILING. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY REQUIRES OFFICERS, DIRECTORS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE POLICY AND DISCLOSURE FORM ARE DISTRIBUTED AND COLLECTED ANNUALLY, AND INDIVIDUALS ARE REQUIRED TO UPDATE THE DISCLOSURE FORM THROUGHOUT THE YEAR IN THE EVENT POTENTIAL CONFLICTS ARISE. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE BOARD OF DIRECTORS AND MAY REQUIRE SAID OFFICER, DIRECTOR AND KEY EMPLOYEE TO RECUSE FROM PARTICIPATION TO AVOID A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S PRESIDENT AND CEO IS NOT COMPENSATED BY THE ORGANIZATION BUT IS COMPENSATED BY A RELATED ORGANIZATION, VOLUNTEERS OF AMERICA, INC. VOLUNTEERS OF AMERICA'S PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S PRESIDENT AND CEO, OFFICERS, AND KEY EMPLOYEES INCLUDES REVIEW AND APPROVAL BY A COMPENSATION COMMITTEE FORMED OF INDEPENDENT MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE CONDUCTS A MARKET COMPENSATION ANALYSIS REVIEW EVERY YEAR AND REPORTS THEIR CONCLUSIONS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 50,723. TOTAL EXPENSES 50,723. MANAGEMENT: MANAGEMENT AND GENERAL EXPENSES 813,086. TOTAL EXPENSES 813,086. PURCHASED SERVICES FROM VOA AFFILIATES: PROGRAM SERVICE EXPENSES 724,594. TOTAL EXPENSES 724,594. CONSULTING: PROGRAM SERVICE EXPENSES 1,521,944. TOTAL EXPENSES 1,521,944. PAYROLL PROCESSING: PROGRAM SERVICE EXPENSES 23,981. TOTAL EXPENSES 23,981. 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