2018-11-09T11:38:17-06:00 2017-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2017-01-01 460225023 BETHESDA OF BERESFORD BETH 6057632050 606 WEST CEDAR BERESFORD SD 57004 CHERILYN HALLAWAY ADMINISTRATOR 6057632050 2018-10-31 1 LAURIE HANSON P00851848 6053391999 2018-10-31 8.39.233.43 2018-10-31 11:40:41 CD P 27B5425C9C23CB5B55D8DA2EDCCE42DD005DD81A 401A7809F2AA56B1FE621E55666FA95C3E42E950 2017 2019-02-21 02:37:17Z CHERILYN HALLAWAY 606 WEST CEDAR BERESFORD SD 57004 4790978 0 X WWW.BETHESDASD.COM X 1971 SD ELDERLY HOUSING AND CARE. 9 9 133 34 0 0 17495 0 4047104 4110169 26197 35133 0 0 4090796 4145302 1550 878 0 0 2462658 2538208 0 0 0 1856039 2071532 4320247 4610618 -229451 -465316 3976164 3818742 339904 545890 3636260 3272852 BETHESDA OF BERESFORD IS A CHRISTIAN COMMUNITY DEDICATED TO THE ART OF HEALING AND THE JOY OF CARING. 0 0 4248258 878 4110169 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 21,568; NUMBER OF ADMISSIONS 43. 4248258 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 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 0.30 X X 0 0 0 CLAIRE ANTONSON SECRETARY/TREASURER 0.30 X X 0 0 0 ELMER HAMMER DIRECTOR - LEFT 3/2017 0.30 X 0 0 0 ANITA KOSTBOTH DIRECTOR - JOINED 3/2017 0.30 X 0 0 0 JOHN FAHLBERG AT LARGE DIRECTOR 0.30 X 0 0 0 CLAURICE PAULSON DIRECTOR - JOINED 3/2017 0.30 X 0 0 0 DRDONALD ABRAHAM DIRECTOR - LEFT 2/2017 0.30 X 0 0 0 PASTOR MATT STYLES DIRECTOR - LEFT 1/2017 0.30 X 0 0 0 PASTOR JARROD HYLDEN DIRECTOR - JOINED 3/2017 0.30 X 0 0 0 PASTOR STEVE MARTENS DIRECTOR 0.30 X 0 0 0 SCOTT LARSON ADMINISTRATOR - LEFT 7/2017 20.00 X 0 0 0 CHERILYN HALLAWAY ADMINISTRATOR - JOINED 7/2017 40.00 X 0 0 0 0 0 0 0 0 0 0 HELPING HANDS NURSING SOLUTIONS 4300 S LAKEPORT ST STE 106 SIOUX CITY IA 51106 TEMP STAFFING 150686 US FOODS 9399 WEST HIGGINS ROAD SUITE 500 ROSEMONT IL 60018 DIETARY 147325 CARLSON ENTERPRISES LLC 106 N 14TH ST BERESFORD SD 57004 COOLING 143797 AVERA EDUCATION & STAFFING 1000 W 4TH ST 9 YANKTON SD 57078 TEMP STAFFING 138354 SANFORD HEALTH PO BOX 5074 SIOUX FALLS SD 57117 ADMINISTRATION 134515 8 RESIDENT SERVICE REVEN 623000 3852704 3852704 APARTMENT REVENUE 900099 220972 220972 36493 36493 4110169 40156 40156 640653 637098 8578 3555 -8578 -5023 -5023 4145302 4110169 0 35133 X 878 878 2205137 2116887 88250 17485 16785 700 153825 147669 6156 161761 155317 6444 83070 83070 899180 892683 6497 14401 815 13586 71621 49296 22325 131456 131456 1068 970 98 7176 7133 43 209945 209945 87988 87988 FOOD AND DIETARY COST 190812 190812 MEDICAL SUPPLIES 179175 179175 BAD DEBT EXPENSE 111428 111428 REPAIRS AND MAINTENANCE 37009 37009 47203 47203 4610618 4248258 362360 0 121345 119925 412199 399926 14023 14349 6412136 4523324 1933466 1888812 1487211 1387810 7920 7920 3976164 3818742 323470 526298 16434 2540 0 17052 339904 545890 X 3636260 3272852 3636260 3272852 3976164 3818742 -465316 101908 0 X 0 1 X 1 0 X 7192 5369 17495 30056 3984670 4030819 3814233 4047104 4110169 19986995 3991862 4036188 3814233 4064599 4110169 20017051 0 715744 819329 698864 868530 1213611 4316078 715744 819329 698864 868530 1213611 4316078 15700973 27174 26954 37899 30348 40156 162531 27174 26954 37899 30348 40156 162531 4019036 4063142 3852132 4094947 4150325 20179582 0.77810 0.77890 0.00810 0.00750 X 0 1 X 86713 86713 4640054 3350339 1289715 1503238 1056636 446602 182131 116349 65782 1888812 TENANT SECURITY DEPOSITS 17052 17052 X 4247210 101908 101908 4145302 0 4145302 4610618 0 4610618 0 4610618 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 ADMINISTRATORS, SCOTT LARSON AND CHERILYN HALLAWAY, ARE EMPLOYEES OF SANFORD HEALTH. SCOTT LARSON RECEIVED COMPENSATION IN THE FOLLOWING AMOUNTS FOR HIS SERVICES TO THE ORGANIZATION: SALARY OF $34,738 AND BENEFITS OF $3,911. CHERILYN HALLAWAY RECEIVED COMPENSATION IN THE FOLLOWING AMOUNTS FOR HER SERVICES TO THE ORGANIZATION: SALARY OF $43,124 AND BENEFITS OF $3,387. 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 TWO OFFICERS 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 81,079. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,079. NURSE TEMPS : PROGRAM SERVICE EXPENSES 62,140. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,140. NURSE AIDE TEMPS : PROGRAM SERVICE EXPENSES 601,308. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 601,308. PROFESSIONAL FEES/NURSING : PROGRAM SERVICE EXPENSES 4,119. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,119. MED/A LABS/PROCEDURES : PROGRAM SERVICE EXPENSES 12,862. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,862. MISCELLANEOUS CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 121,979. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 121,979. DIETARY CONSULTANT : PROGRAM SERVICE EXPENSES 9,196. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,196. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 6,497. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,497.