2019-10-25T14:02:51-05:00 2018-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2018-01-01 460225023 BETHESDA OF BERESFORD BETH 6057632050 606 WEST CEDAR BERESFORD SD 57004 CHERILYN HALLAWAY ADMINISTRATOR 6057632050 2019-10-16 1 LAURIE HANSON P00851848 6053391999 2019-10-16 216.147.181.46 2019-10-16 10:19:51 CD P C5ADF3E96DC5FD5E5884512D59AB882B10EDFEC1 58563A860C08994041E53A5B7FE60D5BE488C1AC 2018 2020-01-14 16:20:31Z CHERILYN HALLAWAY 606 WEST CEDAR BERESFORD SD 57004 5072207 0 X WWW.BETHESDASD.COM X 1971 SD ELDERLY HOUSING AND CARE. 9 9 133 30 0 0 0 0 4110169 4098710 35133 13978 0 0 4145302 4112688 878 0 0 0 2538208 2583582 0 0 0 2071532 1910292 4610618 4493874 -465316 -381186 3818742 3384513 545890 592662 3272852 2791851 BETHESDA OF BERESFORD IS A CHRISTIAN COMMUNITY DEDICATED TO THE ART OF HEALING AND THE JOY OF CARING. 0 0 4072812 4098710 THE ORGANIZATION PROVIDES FACILITIES AND SERVICES FOR THE ELDERLY THROUGH THE OPERATION OF A 67-BED SKILLED NURSING AND 4-BED ASSISTED LIVING FACILITY. THE ORGANIZATION ALSO PROVIDES FACILITIES AND SERVICES THROUGH THE OPERATION OF A 16-UNIT ELDERLY APARTMENT COMPLEX AND AN OUTPATIENT THERAPY DEPARTMENT. THE FACILITY OPERATES A "LIFE-LINE" TO THE SURROUNDING COMMUNITY, WHICH PROVIDES A SAFER ENVIRONMENT AT HOME FOR THE ELDERLY IN THE AREA. THE FACILITY IS OPERATED TO MEET THE HEALTH AND HOUSING NEEDS OF ITS RESIDENTS. NUMBER OF RESIDENT DAYS 24,376; NUMBER OF ADMISSIONS 63. 4072812 1 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 133 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 0 X CHERILYN HALLAWAY 6057632050 606 WEST CEDAR BERESFORD SD 57004 X DON LERSETH CHAIRPERSON 0.30 X X 0 0 0 CINDY MUHLENKORT CHAIRPERSON AT LARGE 0.30 X X 0 0 0 WAYNE AKLAND VICE-CHAIRPERSON (UNTIL 3/2018) 0.30 X X 0 0 0 CLAIRE ANTONSON SECRETARY/TREASURER (UNTIL 3/2018) 0.30 X X 0 0 0 CLAURICE PAULSON VICE-CHAIRPERSON 0.30 X X 0 0 0 PASTOR JARROD HYLDEN SECRETARY/TREASURER 0.30 X X 0 0 0 ANITA KOSTBOTH DIRECTOR 0.30 X 0 0 0 JOHN FAHLBERG AT LARGE DIRECTOR 0.30 X 0 0 0 PASTOR STEVE MARTENS DIRECTOR 0.30 X 0 0 0 JOYCE JENSEN DIRECTOR (BEG 3/2018) 0.30 X 0 0 0 TONI FJEERSTAD DIRECTOR (BEG 3/2018) 0.30 X 0 0 0 CHERILYN HALLAWAY ADMINISTRATOR 40.00 X 0 0 0 0 0 0 0 0 0 0 US FOODS 9399 WEST HIGGINS ROAD SUITE 500 ROSEMONT IL 60018 DIETARY 173906 TRI-STATE NURSING PO BOX 5074 OMAHA NE 68104 TEMP STAFFING 133047 SANFORD HEALTH PO BOX 5074 SIOUX FALLS SD 57117 ADMINISTRATION 129006 3 RESIDENT SERVICE REVEN 623000 3859595 3859595 APARTMENT REVENUE 900099 191270 191270 47845 47845 4098710 30439 30439 943058 948375 11144 -5317 -11144 -16461 -16461 4112688 4098710 0 13978 X 2165021 2056853 108168 9451 9111 340 255564 242843 12721 153546 145557 7989 131265 131265 650232 619592 30640 12692 2015 10677 48729 32744 15985 131665 116720 14945 3089 2736 353 2113 2113 198106 175620 22486 43252 38343 4909 MEDICAL SUPPLIES 209291 209291 BAD DEBT 200721 200721 FOOD AND DIETARY COST 178989 178989 REPAIRS AND MAINTENANCE 44704 39564 5140 55444 55444 4493874 4072812 421062 0 119925 152415 399926 326859 14349 17226 6447298 4721430 1888812 1725868 1387810 1154225 7920 7920 3818742 3384513 526298 573145 2540 3530 17052 15987 545890 592662 X 3272852 2791851 3272852 2791851 3818742 3384513 -381186 -99815 0 X 0 1 X 1 0 X 5369 17495 22864 4030819 3814233 4047104 4110169 4098710 20101035 4036188 3814233 4064599 4110169 4098710 20123899 0 819329 698864 868530 1213611 1304810 4905144 819329 698864 868530 1213611 1304810 4905144 15218755 26954 37899 30348 40156 30439 165796 26954 37899 30348 40156 30439 165796 4063142 3852132 4094947 4150325 4129149 20289695 0.75010 0.77810 0.00820 0.00810 X 0 1 X 86713 86713 4640054 3461170 1178884 1549543 1136546 412997 170988 123714 47274 1725868 TENANT SECURITY DEPOSITS 15987 15987 X 4012873 -99815 -99815 4112688 0 4112688 4493874 0 4493874 0 4493874 PART IV, LINE 2B: THE ESCROW ACCOUNT LIABILITY IS INCLUDED ON THE BALANCE SHEET. PART X LINE 21 INCLUDES FUNDS HELD FOR NURSING HOME RESIDENTS FOR ANCILLARY PURCHASES. PART X, LINE 2: THE HOME IS ORGANIZED AS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOME IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THEY ARE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOME HAS DETERMINED THEY ARE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE HOME BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIRMENTS, 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 3 THE ORGANIZATION HAS A MANAGEMENT CONTRACT WITH SANFORD HEALTH NETWORK. THE ADMINISTRATOR, CHERILYN HALLAWAY, IS AN EMPLOYEE OF SANFORD HEALTH. CHERILYN HALLAWAY RECEIVED COMPENSATION AND BENEFITS IN THE AMOUNT OF $83,532 AND $12,453, RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE ORGANIZATION CONSIST OF 13 LUTHERAN CHURCHES. THERE IS ONLY ONE CLASS OF MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A ALL MEMBERS HAVE THE SAME VOTING RIGHTS. THE MEMBERS' ROLE IS TO ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B CHANGES TO BYLAWS REQUIRE APPROVAL OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B BETHESDA OF BERESFORD DOES NOT UTILIZE COMMITTEES IN CONJUNCTION WITH ITS BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATOR REVIEWS FORM 990 PRIOR TO ITS SUBMISSION. THE BOARD MEMBERS WILL REVIEW THE FORM 990 PRIOR TO ITS SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C PERSONS COVERED BY THE POLICY INCLUDE EVERY BOARD MEMBER, EVERY MEMBER OF ANY BOARD COMMITTEE, ALL OFFICERS OF THE HOME, AND ALL MANAGEMENT PERSONNEL OF THE HOME. COVERED MEMBERS ARE REQUIRED TO SIGN THE CONFLICT OF INTEREST STATEMENT EACH YEAR. THE ADMINISTRATOR RECEIVES AND REVIEWS ALL OF THE ANNUAL CONFLICT OF INTEREST STATEMENTS WHICH LIST ANY AND ALL FINANCIAL AND CONFLICTING INTERESTS. THE CHAIRPERSON OF THE BOARD IS THEN FAMILIARIZED WITH ALL DISCLOSURES IN CASE A CONFLICT ARISES, AND THE VICE CHAIRPERSON OF THE BOARD IS FAMILIARIZED WITH THE CHAIRPERSON'S DISCLOSURE. IF A CONFLICT ARISES, THE BOARD CHAIRPERSON, BOARD COMMITTEE OR THE BOARD MAY ASK THE INTERESTED PERSON TO LEAVE THE MEETING DURING DISCUSSIONS OF THE MATTER, AND THE BOARD MUST APPROVE THE MATTER BY A MAJORITY VOTE, NOT INCLUDING A VOTE OF THE INTERESTED PERSON. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAD ONE OFFICER PAID BY A MANAGEMENT COMPANY, SANFORD HEALTH. SANFORD HEALTH USES A NATIONAL COMPENSATION SURVEY ALONG WITH A PERFORMANCE REVIEW. SANFORD HEALTH REVIEWS THE COMPENSATION SURVEY AND PERFORMANCE EVALUATION WITH THE BOARD OF DIRECTORS TO DETERMINE PROPER COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G DON SALARY AND BENEFITS : PROGRAM SERVICE EXPENSES 94,405. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 94,405. NURSE TEMPS : PROGRAM SERVICE EXPENSES 65,609. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,609. NURSE AIDE TEMPS : PROGRAM SERVICE EXPENSES 282,436. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 282,436. PROFESSIONAL FEES/NURSING : PROGRAM SERVICE EXPENSES 9,446. MANAGEMENT AND GENERAL EXPENSES 23,093. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,539. MED/A LABS/PROCEDURES : PROGRAM SERVICE EXPENSES 15,841. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,841. MISCELLANEOUS CONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 144,520. MANAGEMENT AND GENERAL EXPENSES 7,547. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 152,067. DIETARY CONSULTANT : PROGRAM SERVICE EXPENSES 7,314. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,314. RESIDENT PURCHASES : PROGRAM SERVICE EXPENSES 21. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21.