EBENEZER LAKES ASSISTED LIVING: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
EBENEZER LAKES ASSISTED LIVING (EIN 41-2012560)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-11-10
IRS object ID
202533149349303178
Schema version
2024v5.1
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

FieldValueIRS element (for citing)
Return2025-11-10T11:54:33+00:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN412012560EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ebenezer Lakes Assisted LivingBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEBENBusinessNameControlTxt
Phone6128743460PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17505 Metro Boulevard Suite 100AddressLine1Txt
CityEdinaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBrett AndersonPersonNm
Person TitlePresidentPersonTitleTxt
Signature2025-11-10SignatureDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Meadows on FairviewBusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Brett AndersonBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line17505 Metro Boulevard Suite 100AddressLine1Txt
CityEdinaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,684,589GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EBENEZERCARES.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionProvide assisted living services to improve the quality of life for the elderly and disabled.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$226,945PYContributionsGrantsAmt
CY Contributions Grants$170,427CYContributionsGrantsAmt
PY Program Service Revenue$6,639,404PYProgramServiceRevenueAmt
CY Program Service Revenue$7,504,513CYProgramServiceRevenueAmt
PY Investment Income$1,808PYInvestmentIncomeAmt
CY Investment Income$1,715CYInvestmentIncomeAmt
PY Other Revenue$175,759PYOtherRevenueAmt
CY Other Revenue$7,934CYOtherRevenueAmt
PY Total Revenue$7,043,916PYTotalRevenueAmt
CY Total Revenue$7,684,589CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,543,913PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,411,387CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,471,269PYOtherExpensesAmt
CY Other Expenses$2,386,244CYOtherExpensesAmt
PY Total Expenses$7,015,182PYTotalExpensesAmt
CY Total Expenses$6,797,631CYTotalExpensesAmt
PY Revenues Less Expenses$28,734PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$886,958CYRevenuesLessExpensesAmt
Total Assets BOY$6,392,551TotalAssetsBOYAmt
Total Assets EOY$6,262,123TotalAssetsEOYAmt
Total Liabilities BOY$9,750,292TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,732,902TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,357,741NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$2,470,779NetAssetsOrFundBalancesEOYAmt
MissionEbenezer Lakes Assisted Living is part of Ebenezer Society. Ebenezer Society helps older adults and others make their lives more independent, healthful, meaningful and secure. Building on our Lutheran heritage, we respond to physical, psychological, social and spiritual dimensions of the whole person. We welcome persons of diverse cultures and faith traditions. We practice responsible stewardship of humans, property, and financial resources and encourage continual learning and innovation to strive for excellence.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,822,961ExpenseAmt
Revenue$4,359,747RevenueAmt
DescTo provide assisted living for the elderly and disabled through a HUD sponsored program. The facility has 61 units and welcomes persons of diverse cultures and faith traditions. We practice responsible stewardship of humans, property and financial resources and encourage continual learning and innovation to strive for excellence.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,591,224ExpenseAmt
Revenue$3,144,766RevenueAmt
DescTo provide transitional care for the elderly and disabled through a HUD sponsored program. The TCU has 14 units for the benefit of individuals leaving the hospital until they are strong enough to go home.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$5,414,185TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingYes (true)CreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Policies Reference ChaptersfalsePoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Todd WillettBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6128743460PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17505 Metro Blvd Suite 100AddressLine1Txt
CityEdinaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
James Hereford
Ex-Officio2.040.0Yes (X)Yes (X)$0$4,854,478$805,007
Jonathan Lundberg
President, end 9-20242.040.0Yes (X)Yes (X)$0$450,816$70,974
Scott Wordelman
Chair0.31.5Yes (X)Yes (X)$0$0$0
Todd Willett
CFO, Treasurer2.040.0Yes (X)Yes (X)$0$418,412$40,678
Carolyn Jacobson
Director0.31.5Yes (X)$0$0$0
Gayle Kvenvold
Director, began 5-20240.31.5Yes (X)$0$0$0
Kenneth Ashton-Piper
Director0.31.5Yes (X)$0$0$0
Kimberly Faust
Director2.040.0Yes (X)$0$434,556$36,253
Margaret Milius
Director, began 5-20240.31.5Yes (X)$0$0$0
Mark Landreville
Secretary, began 2-20240.31.5Yes (X)$0$0$0
Robb Gruman
Director, ended 8-20240.31.5Yes (X)$0$0$0
Robert Walker
Director0.31.5Yes (X)$0$0$0
Susan Carlson-Weinberg
Vice Chair0.31.5Yes (X)$0$0$0
Thomas Hokr
Secretary, ended 5-20240.31.5Yes (X)$0$0$0
Brett Anderson
President2.040.0Yes (X)$0$179,724$5,645
Gretchen Blaufuss
Campus Director of Nursing40.00.0$0$131,401$15,720Yes (X)
Kayla Lurass
Campus Administrator40.00.0$0$134,652$24,469Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,604,039TotReportableCompRltdOrgAmt
Total Other Compensation$998,746TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$8,715RelatedOrganizationsAmt
Government Grants$161,712GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$170,427TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Elderly Services Revenue623990$6,093,195$6,093,195
Rent Revenue531110$1,249,035$1,249,035
Meal Revenue722514$162,283$162,283
$0$0
$0$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,504,513TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,715TotalRevenueColumnAmt
Exclusion$1,715ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Ancillary Services900099$7,934$7,934
$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,934OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,684,589TotalRevenueColumnAmt
Related Or Exempt Func Income$7,504,513RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$9,649ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,593,138TotalAmt
Program Services$3,049,433ProgramServicesAmt
Management And General$543,705ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$91,540TotalAmt
Program Services$71,439ProgramServicesAmt
Management And General$20,101ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$476,061TotalAmt
Program Services$416,194ProgramServicesAmt
Management And General$59,867ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$250,648TotalAmt
Program Services$212,481ProgramServicesAmt
Management And General$38,167ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$137,478TotalAmt
Management And General$137,478ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$29,190TotalAmt
Management And General$29,190ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$579,615TotalAmt
Program Services$541,777ProgramServicesAmt
Management And General$37,838ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$30,749TotalAmt
Management And General$30,749ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$57,449TotalAmt
Program Services$33,043ProgramServicesAmt
Management And General$24,406ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$345,843TotalAmt
Program Services$344,896ProgramServicesAmt
Management And General$947ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,781TotalAmt
Program Services$2,064ProgramServicesAmt
Management And General$4,717ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$9,704TotalAmt
Program Services$3,149ProgramServicesAmt
Management And General$6,555ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$161,608TotalAmt
Management And General$161,608ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$221,554TotalAmt
Management And General$221,554ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies$581,302$570,467$10,835
Bad Debt Expense$117,484$117,484
Repairs & Maintenance$11,519$11,519
Licenses$77,147$40,047$37,100

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,821TotalAmt
Program Services$192ProgramServicesAmt
Management And General$18,629ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,797,631TotalAmt
Program Services$5,414,185ProgramServicesAmt
Management And General$1,383,446ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$77,982BOYAmt
EOY$291,499EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$362,539BOYAmt
EOY$324,293EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,174,078BOYAmt
EOY$961,573EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$26,748BOYAmt
EOY$52,696EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,357,226LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,778,590LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,698,277BOYAmt
EOY$4,578,636EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$52,927BOYAmt
EOY$53,426EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,392,551BOYAmt
EOY$6,262,123EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$372,205BOYAmt
EOY$494,316EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$66,022BOYAmt
EOY$18,360EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$52,947BOYAmt
EOY$53,427EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,875,939BOYAmt
EOY$4,708,606EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,383,179BOYAmt
EOY$3,458,193EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,750,292BOYAmt
EOY$8,732,902EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$3,357,741BOYAmt
EOY-$2,470,779EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,357,741BOYAmt
EOY-$2,470,779EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,392,551BOYAmt
EOY$6,262,123EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$886,958ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$4OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$25,287CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$334,069CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$34,217CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$226,945CurrentTaxYearMinus1YearAmt
Current Tax Year$170,427CurrentTaxYearAmt
Total$790,945TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,381,728CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,473,803CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,756,626CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,639,404CurrentTaxYearMinus1YearAmt
Current Tax Year$7,504,513CurrentTaxYearAmt
Total$30,756,074TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,231CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$23,958CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$67,170CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$175,759CurrentTaxYearMinus1YearAmt
Current Tax Year$7,934CurrentTaxYearAmt
Total$285,052TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,417,246CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,831,830CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,858,013CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,042,108CurrentTaxYearMinus1YearAmt
Current Tax Year$7,682,874CurrentTaxYearAmt
Total$31,832,071TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$31,832,071PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,733CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,773CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,613CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,808CurrentTaxYearMinus1YearAmt
Current Tax Year$1,715CurrentTaxYearAmt
Total$10,642TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,733CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,773CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,613CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,808CurrentTaxYearMinus1YearAmt
Current Tax Year$1,715CurrentTaxYearAmt
Total$10,642TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,420,979CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,833,603CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,859,626CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,043,916CurrentTaxYearMinus1YearAmt
Current Tax Year$7,684,589CurrentTaxYearAmt
Total$31,842,713TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99967PublicSupportCY509Pct
Public Support PY5090.99966PublicSupportPY509Pct
Investment Income CY0InvestmentIncomeCYPct
Investment Income PY0.0InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (true)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,265OtherCostOrOtherBasisAmt
Book Value$29,265BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,628,517OtherCostOrOtherBasisAmt
Depreciation$4,359,740DepreciationAmt
Book Value$4,268,777BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$186,074OtherCostOrOtherBasisAmt
Depreciation$102,532DepreciationAmt
Book Value$83,542BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$513,370OtherCostOrOtherBasisAmt
Depreciation$316,318DepreciationAmt
Book Value$197,052BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,578,636TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Federal Income Taxes
Related Party Payable$3,458,193
FieldValueIRS element (for citing)
Total Liability$3,458,193TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$7,681,476TotalRevEtcAuditedFinclStmtAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$7,681,476RevenueSubtotalAmt
Other Revenues Not Included$3,113OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$3,113RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$7,684,589TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,794,516TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$6,794,516ExpensesSubtotalAmt
Other Expenses Not Included$3,115OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,115ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,797,631TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part XI, Line 4(b)The difference between the revenue amount reported on the audited financial statements and the Form 990 is a rounding difference.
Schedule D, Part XII, Line 4(b)The difference between the expense amount reported on the audited financial statements and the Form 990 is a rounding difference.
Schedule D, Part XI, Line 4(b) OTHER REVENUEROUNGING - $2 BOOK TO TAX DIFFERENCE - GRANT REVENUE $3,115
Schedule D, Part XII, Line 4(b) OTHER EXPENSESBOOK TO TAX DIFFERENCE - GRANT EXPENSE - $3,115
Schedule D, Part IV, Line 2b Explanation of escrow agreementEbenezer Lakes Assisted Living holds in trust deposit amounts received by tenants upon move-in. The tenant deposits are maintained in an interest-bearing account separate from Ebenezer Lakes Assisted Living's accounts. Deposits are refunded, minus any amounts for repairs, when the tenant leaves the facility.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteThe Project is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code and applicable Minnesota Statutes. Consequently, no provision has been made for income taxes. The Project's annual tax filings are subject to review by federal, state, and local authorities. The Project is not aware of any activities that would jeopardize its tax-exempt status. The Project is not aware of any activities that are subject to tax on unrelated business income or excise taxes.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 9903115 -
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statementsBOOK TO TAX DIFFERENCE - GRANT REVENUE - 3115 ROUNDING - -2
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statementsBOOK TO TAX DIFFERENCE - GRANT REVENUE - 3115

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Todd Willett
CFO, Treasurer$0$336,459$0$67,435$0$14,518$0$13,826$0$26,852$0$459,090$0$0
Jonathan Lundberg
President, end 9-2024$0$270,325$0$129,473$0$51,018$0$61,242$0$9,732$0$521,790$0$47,984
James Hereford
Ex-Officio$0$1,948,464$0$2,156,120$0$749,894$0$786,517$0$18,490$0$5,659,485$0$731,606
Kimberly Faust
Director$0$346,396$0$85,737$0$2,423$0$13,800$0$22,453$0$470,809$0$0
Brett Anderson
President$0$159,502$0$20,000$0$222$0$1,027$0$4,618$0$185,369$0$0
Kayla Lurass
Campus Administrator$0$102,627$0$18,702$0$13,323$0$6,519$0$17,950$0$159,121$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD, JONATHAN LUNDBERG DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD $731,606 JONATHAN LUNDBERG $47,984
Schedule J, Part I, Line 7 Non-fixed paymentsFairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.
Schedule J, Part I, Line 3 Related Org to establish compensationTHE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.
Schedule J, Part III Other Additional InformationThe non-qualified plan (the plan) is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualitied retirement plans. Participants may not elect to defer compensation. Contributions will be made in the form of a credit to the participant's account, within 60 days after a participant becomes vested in a contribution. The plan shall pay to the participant an amount equal to the amount the participant is required to pay federal, state, local and foreign income taxes and employment taxes due to the vesting. The remaining amount in the participant's account shall not be paid until the separation from services payment date. A participant's account shall be distributed in cash. The plan complies with Section 457(f) of the IRS code.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1a Additional InformationAll cash disbursements are centralized through a related organization, Ebenezer Society. Therefore the related organization, Ebenezer Society, makes the payment and files the related Form 1099's and Form 1096 instead of this organization.
Form 990, Part V, Line 2a Additional InformationEbenezer Lakes Assisted Living leases employees from a related organization, Ebenezer Society, a 501(c)(3) tax-exempt, non-profit organization. Therefore, Ebenezer Society files the appropriate W-3 and related W-2 tax forms for these individuals instead of Ebenezer Lakes Assisted Living. The leased employee compensation on the Ebenezer Lakes Assisted Living Form 990 Part VII and Schedule J is reported as compensation paid by related organization, Ebenezer Society.
Form 990, Part V, Line 15 SECTION 4960 TAXFAIRVIEW HEALTH SERVICES, A RELATED 501(C)3 TAX-EXEMPT ORGANIZATION, FILES AND REMITS ALL RELATED SECTION 4960 EXCISE TAX ON FORM 4720 FOR THE SYSTEM.
Form 990, Part VI, Line 3 Delegation of management dutiesEbenezer Lakes Assisted Living is managed by Ebenezer Society employees.
Form 990, Part VI, Line 6 Classes of members or stockholdersEbenezer Society, a Minnesota Nonprofit Organization, is the sole member of Ebenezer Lakes Assisted Living.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE CHAIR OF THE CORPORATION SHALL BE ELECTED FROM AND BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SHALL ELECT MEMBERS TO DIRECTOR POSITIONS AND FILL VACANCIES IN ELECTED DIRECTOR POSITIONS. THE BOARD OF DIRECTORS OF THIS CORPORATION SHALL ELECT MEMBERS FROM THE NOMINEES MADE FROM THE BOARDS OF EACH OF THE CONSTITUENT ORGANIZATIONS AS LISTED IN THE BYLAWS OF THIS CORPORATION."
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersThe following actions must be approved by Ebenezer Society, the sole member: (A) All amendments to the articles of incorporation and bylaws; (B) All capital budgets of the organization and all other entities directly or indirectly controlled by this organization, and all major capital expenditures before funds are expended therefore; (C) All operating budgets of this organization and all other entities directly or indirectly controlled by this organization, before authorized expenditures may be made therefrom; (D) Strategic plans of this organization and all other entities directly or indirectly controlled by this organization; (E) The incurring of any long term debt of this organization and all other entities directly or indirectly controlled by this organization, other than intra-system of refinancing debt; (F) All human resources and benefit policies;(G) Any major risk contracting agreements, which for these purposes means any contract that deals with capitation or a similar risk bearing concept; (H) Any merger, consolidation, or total or partial dissolution; (I) The number of directors; and (J) Any governance and action of the type set forth in subparagraphs (A) and (F) through (I) above as proposed by the board of directors of any entity directly controlled by this organization to the extent that the governing documents of such entity give this organization or the board a right to approval over such governance action.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyThe Tax Department conducts a detailed review of the completed return. The return is also reviewed by the President and CFO. The Form 990 is subsequently presented to the Board of Directors. Upon approval from the Board of Directors, the Form 990 is filed.
Form 990, Part VI, Line 12c Conflict of interest policyManagers, Directors and senior management are required to annually complete a Duty of Loyalty and Conflict of Interest Statement in compliance with Fairview's system Conflict of Interest Policy. Disclosures are reviewed by the compliance department. Any conflicts of interest by board members are brought to the board for review.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialThe determination of executive compensation of the organization is processed by the Fairview System Human Resources Committee and includes a review of comparability data, review by independent experts and contemporaneous substantiation of the deliberation and decision process.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesThe determination of executive compensation of the organization is processed by the Fairview System Human Resources Committee and includes a review of comparability data, review by independent experts and contemporaneous substantiation of the deliberation and decision process.
Form 990, Part VI, Line 19 Required documents available to the publicThis organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request and inspection of the documents is available at the corporate finance department.
Form 990, Part VII, Section B, Line 1 Additional InformationForm 1099's were filed by a related organization Ebenezer Society, a 501(c)(3) non-profit, tax-exempt organizations. Ebenezer Society reports the five highest compensated independent contractors for the system.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesRounding - 4; Total - 4;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Fairview Health Services
2450 Riverside AvenueMinneapolisMN55454410991680HospitalMN501(c)(3)3nafalse
Ebenezer Society
7505 Metro Boulevard Suite 100EdinaMN55439410706141NursingMN501(c)(3)10Fairview Health Servicesfalse
Ebenezer Ridges Assisted Living
7505 Metro Boulevard Suite 100EdinaMN55439411964691AssistedMN501(c)(3)10Ebenezer Societyfalse
Ebenezer Ridges
7505 Metro Boulevard Suite 100EdinaMN55439411287792NursingMN501(c)(3)10Ebenezer Societyfalse
Ebenezer Society Foundation
7505 Metro Boulevard Suite 100EdinaMN55439411356565FoundationMN501(c)(3)7Ebenezer Societyfalse
Ebenezer Ridge Point Apartments
7505 Metro Boulevard Suite 100EdinaMN55439411769727HousingMN501(c)(3)10Ebenezer Societyfalse
Ebenezer Towers
7505 Metro Boulevard Suite 100EdinaMN55439237005359HousingMN501(c)(3)10Ebenezer Societyfalse
Ebenezer Lakes Senior Housing
7505 Metro Boulevard Suite 100EdinaMN55439320190409HousingMN501(c)(3)10Ebenezer Societyfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Ebenezer Management Services Inc
7505 Metro Boulevard Suite 100EdinaMN55439411567046Mgmt SvcsMNEbenezer SocietyC Corporationfalse
Ebenezer Development Inc
7505 Metro Blvd Suite 100EdinaMN55439883201659Property ManagementMNEbenezer SocietyC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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