2018-05-31T15:46:54-05:00 2017-09-30 410746749 CLIFTONLARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2016-10-01 410874740 LAKEVIEW METHODIST HEALTH CARE CENTER LAKE 5072356606 610 SUMMIT DRIVE FAIRMONT MN 56031 DEBORAH M BARNES EXECUTIVE DIRECTOR 5072356606 2018-05-15 1 TRENT FAST P00692704 5074347000 2018-05-14 2016 2022-09-23 18:48:47Z DEBORAH M BARNES 610 SUMMIT DRIVE FAIRMONT MN 56031 7315616 0 X WWW.LAKEVIEWMETHODIST.ORG X 1985 MN THE MISSION OF LAKEVIEW IS TO DEMONSTRATE GOD'S LOVE FOR HIS PEOPLE THROUGH A CONTINUUM OF LIFE ENHANCING SUPPORTIVE SERVICES FOR OLDER ADULTS AND THEIR FAMILIES. 9 9 182 84 0 0 0 17338 6546363 7241359 -3895 1908 43369 55011 6585837 7315616 76893 64296 0 0 4167476 4300234 0 0 0 2168736 2477010 6413105 6841540 172732 474076 5412835 5560657 2476651 2155823 2936184 3404834 X THE MISSION OF LAKEVIEW IS TO DEMONSTRATE GOD'S LOVE FOR HIS PEOPLE THROUGH A CONTINUUM OF LIFE ENHANCING SUPPORTIVE SERVICES FOR OLDER ADULTS AND THEIR FAMILIES. 1 0 6188501 64296 7250159 LAKEVIEW METHODIST HEALTH CARE CENTER OFFERS SKILLED NURSING CARE FOR THE ELDERLY BY OPERATING A 82 BED LICENSED FACILITY IN FAIRMONT, MN. THE ORGANIZATION PROVIDES SHORT-TERM STAYS WITH EXTENSIVE REHABILITATION SERVICES, LONG-TERM PLACEMENT, AND HOUSES A CHILD DAY CARE CENTER. DURING THE FISCAL YEAR THE CARE CENTER PROVIDED 21,424 INPATIENT SERVICE DAYS. THE ORGANIZATION ALSO MANAGES AN ASSISTED LIVING AND A HOUSING UNIT FOR THE ELDERLY. 6188501 1 1 0 0 0 0 0 0 1 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 182 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X DEBORAH M BARNES 5072356606 610 SUMMIT DRIVE FAIRMONT MN 56031 TOM HAWKINS DIRECTOR 1.00 X X 0 0 0 VICKI PASKEY SECRETARY/TREASURER 1.00 X X 0 0 0 DARIN HAUGEN DIRECTOR 1.00 X 0 0 0 BRAD MUSSER PRESIDENT 1.00 X X 0 0 0 JAN BREMER DIRECTOR - PART YEAR 1.00 X 0 0 0 NANCY NORDSTROM DIRECTOR 1.00 X 0 0 0 COURTNEY CUTLER VICE PRESIDENT 1.00 X X 0 0 0 DR JOHN LUND DIRECTOR 1.00 X 0 0 0 JERRY EVELSIZER DIRECTOR 1.00 X 0 0 0 LES ANDERSON DIRECTOR 1.00 X 0 0 0 DEBORAH BARNES EXECUTIVE DIRECTOR 32.00 X 100609 0 1032 KRIS ISENBERG FINANCIAL DIRECTOR 36.00 X 48946 0 10016 DEB ALLEN LPN 40.00 X 111101 0 10621 260656 0 21669 2 0 0 0 US FOODS PO BOX 1450 MINNEAPOLIS MN 55485 FOOD-DIETARY 284280 AEGIS THERAPIES PO BOX 8103 FORT SMITH AR 72902 THERAPY 272094 STERLING LTC 1601 STATE AVE NW OWATONNA MN 55060 PHARMACY SERVICES 104528 3 17338 17338 RESIDENT CARE 623000 6971486 6971486 MANAGEMENT FEES 624210 185910 185910 CHILD DAYCARE CENTER 624410 47044 47044 MEALS ON WHEELS 561000 36919 36919 7241359 1908 1908 8800 0 8800 8800 8800 OTHER INCOME 623990 46211 46211 46211 7315616 7250159 0 48119 64296 64296 282325 282325 3184300 2902009 282291 31638 29062 2576 568198 521929 46269 233773 214737 19036 15000 15000 5317 5317 21734 21734 600878 596963 3915 23293 15676 7617 25560 25560 205934 174182 31752 15951 15951 69015 69015 340544 340544 80473 80473 FOOD 394885 394885 SURCHARGE 204088 204088 SUPPLIES 138542 138542 AL EXPENSES 80446 80446 255350 159802 95548 6841540 6188501 653039 0 34232 153629 95027 95526 438869 572753 44389 65140 11207844 7354386 4028091 3853458 565409 559981 206818 260170 5412835 5560657 527422 540071 6310 9867 1647429 1295395 295490 310490 2476651 2155823 X 2439375 2873329 227706 262402 269103 269103 2936184 3404834 5412835 5560657 X 474076 -5426 X X 0 1 X 1 0 X 197677 248445 11685 2322 460129 6770591 6347068 5969943 6546363 7241359 32875324 6968268 6595513 5981628 6546363 7243681 33335453 0 15133 15133 15133 15133 33320320 11884 19285 16620 376 16924 65089 11884 19285 16620 376 16924 65089 14829 29321 37148 43369 46211 170878 6994981 6644119 6035396 6590108 7306816 33571420 0.99250 0.99360 0.00190 0.00180 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 25645 25645 8722988 5266560 3456428 671062 637862 33200 1779167 1449964 329203 8982 8982 3853458 INTEREST IN NET ASSETS OF FOUNDATION 559981 F 559981 DUE TO RELATED PARTY 247191 OTHER LIABILITIES 48299 SECURITY DEPOSITS 15000 310490 X PART IV, LINE 2B: THE ESCROW ACCOUNT LIABILITY INCLUDES RESIDENT FUNDS AND RESIDENT COUNCIL AMOUNTS PAYABLE. THE ORGANIZATION IS THE TRUSTEE OF RESIDENTS' FUNDS AND HAS A FIDUCIARY RESPONSIBLITY FOR THE ADMINISTRATION AND DISTRIBUTION OF THESE FUNDS FOR RESIDENTS. PART X, LINE 2: LAKEVIEW UNITED METHODIST CARE CENTER, INC., LAKEVIEW UNITED METHODIST HEALTH CARE FOUNDATION, INC. AND MAPLEWOOD RESIDENT, INC. ARE TAX EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND CONSEQUENTLY RECORDS NO PROVISION FOR INCOME TAXES. LAKEVIEW UNITED METHODIST HEALTH SERVICES, INC. AND AFFILIATES FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED AS A RESULT OF THIS STANDARD. EACH ENTITY FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. 1 NURSING SCHOLARSHIP 21 64296 SCHEDULE I, PART III, LINE 1 SCHOLARSHIP RECIPIENTS MUST BE AN EMPLOYEE WORK A MINIMUM OF 10 HOURS PER WEEK AND BE IN GOOD STANDING. RECIPIENTS SUBMIT A WRITTEN APPLICATION FORM AND ATTEND A PERSONAL INTERVIEW WITH THE SCHOLARSHIP COMMITTEE. TRANSCRIPT OF GRADES, PROGRESS REPORTS, AND ACCOUNTABILITY OF FUNDS MUST ALSO BE SUBMITTED TO THE SCHOLARSHIP COMMITTEE. FORM 990, PART III, LINE 2 CHILD DAYCARE CENTER FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR LEADS THE REVIEW BY THE BOARD OF DIRECTORS AT THE BOD MEETING AFTER THE 990 HAS BEEN COMPLETED AND PRIOR TO DUE DATE AND SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C AS BOARD MEMBERS ARE CHOSEN TO SERVE, THE NOMINATING COMMITTEE REVIEWS POLICYS WITH THEM AND POTENTIAL CONFLICTS OF BANKING, FINANCIAL OR COMPETITIVE NATURE ARE REVIEWED BEFORE OFFERS ARE GIVEN. IF A CONFLICT ARISES DURING A DISCUSSION, BOARD MEMBER WITH CONFLICT PLEDGES TO ABSTAIN. FORM 990, PART VI, SECTION B, LINE 15A THE CHAIR OF THE BOARD OF DIRECTORS INITIATES A REVIEW PROCESS OF THE EXECUTIVE DIRECTOR WITH THE OTHER BOARD MEMBERS. CHAIR OBTAINS COMPARATIVE SALARY INFORMATION FROM LEADING AGE OF MINNESOTA FOR THE CURRENT YEAR AND DECIDES WITH THE BOARD WHERE COMPENSATION SHOULD BE. CHAIR THEN MEETS WITH EXECUTIVE DIRECTOR TO DISCUSS AREAS OF THE REVIEW AND UPCOMING YEAR'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE IN THE ADMINISTRATIVE OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSET OF FOUNDATION -5,428. ROUNDING 2. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. LAKEVIEW UNITED METHODIST HEALTH SERVICES INC 610 SUMMIT DRIVE FAIRMONT MN 56031 363358840 PARENT ORGANIZATION WITH NO ACTIVITY MN 501(C)3 LINE 11A-I N/A 0 LAKEVIEW METHODIST HEALTH CARE FOUNDATION 610 SUMMIT DRIVE FAIRMONT MN 56031 411456428 SUPPORTS LAKEVIEW METHODIST HEALTH CARE CENTER MN 501(C)3 LINE 11B-II LAKEVIEW UNITED METHODIST HEALTH SERVICES INC 0 MAPLEWOOD RESIDENCE INC 620 SUMMIT DRIVE FAIRMONT MN 56031 363361594 HOUSING FOR THE ELDERLY MN 501(C)3 LINE 9 LAKEVIEW UNITED METHODIST HEALTH SERVICES INC 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1