LUTHERAN HOME OF THE GOOD SHEPHERD: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- LUTHERAN HOME OF THE GOOD SHEPHERD (EIN 45-0277267)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2019-11-01
- IRS object ID
- 201913059349301676
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-01T13:34:39-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4310 17TH AVE S PO BOX 2545 | AddressLine1Txt |
| City | FARGO | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 581082545 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450277267 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lutheran Home of the Good Shepherd Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LUTH | BusinessNameControlTxt |
| Phone | 7019472944 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1226 First Avenue North | AddressLine1Txt |
| City | New Rockford | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58356 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kim Jensrud | PersonNm |
| Person Title | Administrator | PersonTitleTxt |
| Phone | 7019472944 | PhoneNum |
| Signature | 2019-10-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Lisa Chaffee CPA | PreparerPersonNm |
| PTIN | P00193453 | PTIN |
| Phone | 7012398500 | PhoneNum |
| Preparation | 2019-10-29 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.147.181.45 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-10-29 | IPDt |
| IP Tm | 13:33:02 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 5A0D2E3E53F79CEC94D1A01C1036EDA8081E530F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3F1B4C4A1C1F32CA3CD03C05270CE62742EA9E6E | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-01-14 16:20:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kim Jensrud | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1226 First Avenue North | AddressLine1Txt |
| City | New Rockford | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58356 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,300,918 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 9386 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lhgs.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | Nursing facility attending to the residential, health, social and other needs of the elderly and their families in New Rockford, ND. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 180 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $38,370 | PYContributionsGrantsAmt |
| CY Contributions Grants | $16,768 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,827,349 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,217,825 | CYProgramServiceRevenueAmt |
| PY Investment Income | $25,690 | PYInvestmentIncomeAmt |
| CY Investment Income | $66,325 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $6,891,409 | PYTotalRevenueAmt |
| CY Total Revenue | $6,300,918 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,603,605 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,443,661 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,610,185 | PYOtherExpensesAmt |
| CY Other Expenses | $2,358,989 | CYOtherExpensesAmt |
| PY Total Expenses | $7,213,790 | PYTotalExpensesAmt |
| CY Total Expenses | $6,802,650 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$322,381 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$501,732 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,194,755 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,444,462 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,462,792 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,194,890 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,731,963 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,249,572 | NetAssetsOrFundBalancesEOYAmt |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,594,071 | ExpenseAmt |
| Revenue | $5,895,392 | RevenueAmt |
| Desc | The Lutheran Home of the Good Shepherd is an 80-bed care facility with 74 skilled beds and 6 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 21,975 resident days related to skilled care beds or an occupancy rate of 81% for the recently ended fiscal year. The home reported 1,997 resident days related to basic care beds or an occupancy rate of 91%. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $222,692 | ExpenseAmt |
| Revenue | $237,728 | RevenueAmt |
| Desc | Heritage House is a 16-unit assisted living facility. The facility had an annual occupancy rate of 98%. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $70,167 | ExpenseAmt |
| Revenue | $84,705 | RevenueAmt |
| Desc | Westview Apartments, located in New Rockford, ND, is a 22-unit apartment building for low income individuals. The facility had an annual occupancy rate of 89%. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $5,886,930 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 180 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kim JensrudIrene Cudworth | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7019472944 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1226 First Avenue North | AddressLine1Txt |
| City | New Rockford | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58356 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Sandy Rudolph | ||||||
| President | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Dianne Allmaras | ||||||
| Vice President | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Kathryn Fleming | ||||||
| Secretary | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Stanley Kruger | ||||||
| Treasurer | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Kathleen O'Connor | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Jane Forde | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Lona Lutz | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Nancy Bollingberg | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Elvie Jones | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Jeff Labrensz | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Travis Peterson | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Bruce Gedrose | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Dennis Swanson | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Carol Wolkenhauer | ||||||
| Director | 2.50 | Yes (X) | $0 | $0 | $0 | |
| Kim Jensrud | ||||||
| Administrator | 40.00 | Yes (X) | $92,081 | $0 | $14,468 | |
| Irene Cudworth | ||||||
| Accounting Office | 40.00 | Yes (X) | $56,630 | $0 | $8,903 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $148,711 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $23,371 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Alliance Medical Staffing | |||||
| 5660 N 103rd St | Omaha | NE | 68138 | Travel Nurse & CNA services | $204,847 |
| Prime Time Healthcare | |||||
| 14811 Shephard St | Omaha | NE | 68138 | Travel Nurse & CNA services | $139,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $16,768 | AllOtherContributionsAmt |
| Total Contributions | $16,768 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Resident Service Reven | 623000 | $6,101,235 | $6,101,235 |
| Child Care | 624410 | $49,782 | $49,782 |
| Cafeteria | 900099 | $29,507 | $29,507 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,301 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,301 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,217,825 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,325 | TotalRevenueColumnAmt |
| Exclusion | $66,325 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,300,918 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,217,825 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $66,325 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,476 | TotalAmt |
| Management And General | $172,476 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,542,774 | TotalAmt |
| Program Services | $3,213,978 | ProgramServicesAmt |
| Management And General | $328,796 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,044 | TotalAmt |
| Program Services | $63,182 | ProgramServicesAmt |
| Management And General | $4,862 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,671 | TotalAmt |
| Program Services | $357,583 | ProgramServicesAmt |
| Management And General | $41,088 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,696 | TotalAmt |
| Program Services | $227,452 | ProgramServicesAmt |
| Management And General | $34,244 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,894 | TotalAmt |
| Management And General | $3,894 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,288 | TotalAmt |
| Management And General | $40,288 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,409 | TotalAmt |
| Program Services | $11,606 | ProgramServicesAmt |
| Management And General | $5,803 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $588,832 | TotalAmt |
| Program Services | $572,061 | ProgramServicesAmt |
| Management And General | $16,771 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,867 | TotalAmt |
| Program Services | $153 | ProgramServicesAmt |
| Management And General | $16,714 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,429 | TotalAmt |
| Program Services | $123,745 | ProgramServicesAmt |
| Management And General | $91,684 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,128 | TotalAmt |
| Management And General | $49,128 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,952 | TotalAmt |
| Program Services | $214,517 | ProgramServicesAmt |
| Management And General | $13,435 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,376 | TotalAmt |
| Program Services | $18,570 | ProgramServicesAmt |
| Management And General | $8,806 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,876 | TotalAmt |
| Program Services | $218,986 | ProgramServicesAmt |
| Management And General | $17,890 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $493,099 | TotalAmt |
| Program Services | $461,037 | ProgramServicesAmt |
| Management And General | $32,062 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,802 | TotalAmt |
| Program Services | $14,991 | ProgramServicesAmt |
| Management And General | $36,811 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Food | $246,621 | $246,621 |
| Medical Supplies | $109,563 | $109,563 |
| Bad Debt Expense | $20,374 | $20,374 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,479 | TotalAmt |
| Program Services | $12,511 | ProgramServicesAmt |
| Management And General | $968 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,802,650 | TotalAmt |
| Program Services | $5,886,930 | ProgramServicesAmt |
| Management And General | $915,720 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,534,323 | BOYAmt |
| EOY | $2,044,601 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $409,536 | BOYAmt |
| EOY | $309,679 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,571 | BOYAmt |
| EOY | $37,898 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,020 | BOYAmt |
| EOY | $32,922 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,852,952 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,618,194 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,664,112 | BOYAmt |
| EOY | $5,234,758 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,495,193 | BOYAmt |
| EOY | $2,784,604 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,194,755 | BOYAmt |
| EOY | $10,444,462 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $492,967 | BOYAmt |
| EOY | $476,893 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,897 | BOYAmt |
| EOY | $37,913 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,929,928 | BOYAmt |
| EOY | $4,680,084 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,462,792 | BOYAmt |
| EOY | $5,194,890 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,717,703 | BOYAmt |
| EOY | $5,249,572 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,260 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,731,963 | BOYAmt |
| EOY | $5,249,572 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,194,755 | BOYAmt |
| EOY | $10,444,462 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$501,732 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $19,341 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $196,163 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $268,444 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,794 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $38,370 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,768 | CurrentTaxYearAmt |
| Total | $552,539 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,081,442 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,810,976 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,750,328 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,827,349 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,217,825 | CurrentTaxYearAmt |
| Total | $33,687,920 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,277,605 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,079,420 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,783,122 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,865,719 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,234,593 | CurrentTaxYearAmt |
| Total | $34,240,459 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $771,421 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $703,669 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $746,540 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $886,732 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,273,207 | CurrentTaxYearAmt |
| Total | $4,381,569 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $771,421 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $703,669 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $746,540 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $886,732 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,273,207 | CurrentTaxYearAmt |
| Total | $4,381,569 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $29,858,890 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,104 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $56,887 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,714 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25,690 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,325 | CurrentTaxYearAmt |
| Total | $229,720 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,104 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $56,887 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,714 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25,690 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,325 | CurrentTaxYearAmt |
| Total | $229,720 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,305,709 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,136,307 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,835,836 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,891,409 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,300,918 | CurrentTaxYearAmt |
| Total | $34,470,179 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.86620 | PublicSupportCY509Pct |
| Public Support PY509 | 0.88350 | PublicSupportPY509Pct |
| Investment Income CY | 0.00670 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00480 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,885 | OtherCostOrOtherBasisAmt |
| Book Value | $48,885 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,747,703 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,926,045 | DepreciationAmt |
| Book Value | $4,821,658 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,887,790 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,585,597 | DepreciationAmt |
| Book Value | $302,193 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $168,574 | OtherCostOrOtherBasisAmt |
| Depreciation | $106,552 | DepreciationAmt |
| Book Value | $62,022 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,234,758 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,320,259 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $19,341 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $19,341 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,300,918 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,300,918 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,802,650 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,802,650 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,802,650 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $37,913 and $39,897 at June 30, 2019 and 2018. |
| Part X, Line 2: | The Home is organized as a North 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, the Home is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Home has determined it is 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 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | 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 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. |
Comments