2018-08-13T14:33:46-05:00 2017-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2016-10-01 411649721 HOLLY RIDGE MANOR INC HOLL 3202394775 PO BOX 40 STARBUCK MN 56381 KAYO ASLAGSON BOARD CHAIR 3202394775 2018-08-09 1 CORY RUTLEDGE P01329381 6123764500 2016 2022-09-23 18:48:47Z X CHRISTOPHER KNOLL PO BOX 40 STARBUCK MN 56381 642974 0 X WWW.MCHS-HEALTHCARE.ORG X 1989 MN A COMMUNITY OF SERVICES GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE. 10 10 0 10 0 0 2585 187 535018 622370 151 229 19772 20188 557526 642974 0 0 0 0 299651 359367 0 0 0 201976 202879 501627 562246 55899 80728 653704 738800 63856 68224 589848 670576 X A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE THAT ENCOURAGES ALL PEOPLE TO REACH THEIR HIGHEST POTENTIAL. 0 0 540234 0 622370 HOLLY RIDGE MANOR IS A 20-UNIT HOUSING FACILITY OFFERING BOTH ONE AND TWO BEDROOM APARTMENTS TO THE COMMUNITY MEMBERS IT SERVES. HOLLY RIDGE MANOR PROVIDES BOTH INDEPENDENT HOUSING AND ASSISTED LIVING HOUSING AND SERVICES FOR SENIORS AND THOSE NOT CAPABLE OF LIVING INDEPENDENTLY OF OTHERS IN A SAFE AND SECURE SETTING. HOLLY RIDGE MANOR OFFERS DAILY EXERCISE PROGRAMS AS WELL AS THE ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. HOLLY RIDGE MANOR ALSO OFFERS UP TO THREE MEALS DAILY, HOUSEKEEPING SERVICES AND SKILLED NURSING SERVICES SPECIFIC TO EACH CLIENTS' NEEDS. HOLLY RIDGE MANOR IS GOVERNED BY A TEN PERSON INDEPENDENT BOARD MADE UP OF ONE AT-LARGE COMMUNITY LEADER AND NINE AREA CHURCH MEMBERS. THE BOARD HAS A HISTORY OF COMMITMENT TO ACTING WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO ENSURE THE ORGANIZATION CONTINUES TO OPERATE AT ITS MAXIMUM POTENTIAL FOR THE BENEFIT OF THE CLIENTS WE SERVE. 540234 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 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 1 1 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 0 0 0 0 MN X CAROLINE HENDREN 3202392217 605 MAIN STREET STARBUCK MN 56381 KAYO ASLAGSON CHAIR 0.50 1.50 X X 0 0 0 LAURIS JOHNSHOY VICE CHAIR 0.50 1.50 X X 0 0 0 JOHN SAMUELSON SECRETARY 0.50 1.50 X X 0 0 0 ARNE STOEN TREASURER 0.50 1.50 X X 0 0 0 PETER BRANDT DIRECTOR 0.50 1.50 X 0 0 0 RONALD FEIGUM DIRECTOR 0.50 1.50 X 0 0 0 WARREN HAGESTUEN DIRECTOR 0.50 1.50 X 0 0 0 ROBERT HENDRICKSON DIRECTOR 0.50 1.50 X 0 0 0 ALICE REESE DIRECTOR 0.50 1.50 X 0 0 0 STAN STARK DIRECTOR 0.50 1.50 X 0 0 0 CHRISTOPHER KNOLL ADMINISTRATOR 2.00 38.00 X 0 83596 16828 BRIAN ENGLER DIRECTOR OF FINANCE 3.00 37.00 X 0 67065 4451 0 150661 21279 0 0 0 0 0 187 187 RESIDENT REVENUE 623000 622370 622370 622370 229 229 3351 0 3351 3351 3351 MEALS REVENUE 722210 15727 15727 OTHER INCOME 900099 630 630 BEAUTY SHOP 812900 480 480 16837 642974 622370 0 20417 299721 289266 10455 36612 35335 1277 23034 22231 803 6121 6121 2427 2427 8478 3915 4563 3757 3757 61872 61872 941 941 4658 4658 52233 52233 5951 5951 FOOD 44026 44026 RESIDENT SUPPLIES 7988 7988 LICENSES AND TAXES 2411 2411 MISCELLANEOUS 1281 1281 735 519 216 562246 540234 22012 0 247873 375692 13786 14140 1461139 1122767 383298 338372 8747 10596 653704 738800 1696 2497 8120 10005 54040 55722 63856 68224 X 589848 670576 589848 670576 653704 738800 80728 0 X 0 1 X 1 0 X X X 1 MINNEWASKA LUTHERAN HOME 410845402 10 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 SECTION A LINE 1 ACCORDING TO ARTICLE II OF THE ARTICLES OF INCORPORATION, THE PURPOSE OF THIS CORPORATION INCLUDES PROVIDING SUPPORT AND ASSISTANCE TO OTHER ORGANIZATIONS WITH SIMILAR MISSIONS AND TO SUCH OTHER FACILITIES OR PROGRAMS AS MAY FROM TIME TO TIME BE APPROPRIATE TO THE ACCOMPLISHMENT OF THIS CORPORATION'S CHARITABLE PURPOSES. THIS CORPORATION SUPPORTS MINNEWASKA LUTHERAN HOME BECAUSE ITS MISSION STATING, "ESTABLISHING, MAINTAINING, ENDOWING AND OPERATING WITHIN A FORTY-FIVE MILE RADIUS OF STARBUCK, MN, PROGRAMS AND SERVICES FOR AGING OR DISABLED MEN AND WOMEN THROUGH WHICH RELIEF, SUPPORT, COMFORT, AND NURSING CARE MAY BE PROVIDED" IS IN LINE WITH THE MISSION AND PURPOSE OF THIS ORGANIZATION. 0 1 X 136173 136173 1114987 931113 183874 209979 191654 18325 338372 RELATED PARTY PAYABLES 55722 55722 X PART IV, LINE 2B: THE FACILITY HAS A SEPARATE BANK ACCOUNT TO HOLD THE FUNDS WHILE THE RESIDENT IS LIVING AT HOLLY RIDGE. WHEN THE RESIDENT VACATES THE APARTMENT HOLLY RIDGE REFUNDS THE SECURITY DEPOSIT PLUS INTEREST CALCULATED BASED ON STATE OF MINNESOTA RULES LESS ANY FORFEITURES FOR REPAIRS, IF ANY WITHIN 30 DAYS OF TURNING IN THE KEYS. PART X, LINE 2: FROM NOTE 1 TO THE ORGANIZATION'S FINANCIAL STATEMENTS: THE HOME, MHD, HOLLY RIDGE, AND HOME CARE HAVE ALL BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) AND APPLICABLE STATE STATUTES. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF ANY OF ITS ENTITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN DECEMBER 2016 TO REMOVE THE MAXIMUM LIMIT OF CONSECUTIVE TERMS EACH DIRECTOR CAN SERVE. FORM 990, PART VI, SECTION A, LINE 6 MINNEWASKA LUTHERAN HOME IS THE SOLE MEMBER OF HOLLY RIDGE MANOR, INC. THE MEMBERS OF MINNEWASKA LUTHERAN HOME CONSIST OF CERTAIN CONGREGATIONS LOCATED IN THE GENERAL COMMUNITY OF STARBUCK, MINNESOTA AND HOFFMAN, MN. EACH MEMBER CONGREGATION MAY APPOINT ONE INDIVIDUAL TO ACT AS A DELEGATE ON ITS BEHALF. THE PRESENT MEMBERS ARE: FRON LUTHERAN CHURCH - STARBUCK, MINNESOTA MINNEWASKA LUTHERAN CHURCH - STARBUCK, MINNESOTA ST. JOHN'S LUTHERAN CHURCH - STARBUCK, MINNESOTA IMMANUEL LUTHERAN CHURCH - STARBUCK, MINNESOTA INDHERRED LUTHERAN CHURCH - STARBUCK, MINNESOTA EAST ZION LUTHERAN CHURCH - STARBUCK, MINNESOTA WEST ZION LUTHERAN CHURCH - HANCOCK, MINNESOTA TRINITY LUTHERAN CHURCH - CYRUS, MINNESOTA MESSIAH LUTHERAN CHURCH - HOFFMAN, MINNESOTA FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS ARE ELECTED BY A MAJORITY VOTE OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ARTICLES OF INCORPORATION OR THE BYLAWS REQUIRE AN AFFIRMATIVE VOTE OF A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE MANAGEMENT TEAM WILL DISCUSS THE COMPLETED FROM 990 AT THE AUGUST 29, 2018 BOARD MEETING AFTER IT IS FILED. THE PROCESS WILL BE LEAD BY CAROLNE HENDREN, DIRECTOR OF FINANCE AND CHRISTOPHER KNOLL, ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF COMMITTEE WITH BOARD-DELEGATED POWERS. ANY INDIVIDUAL WITH AN ACTUAL OR POTENTIAL CONFLICT IS REQUIRED TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD OR COMMITTEE. AFTER DISCLOSURE OF THE MATERIAL FACTS, THE REMAINING BOARD OR COMMITTEE MEMBERS DETERMINE BY MAJORITY VOTE WHETHER A CONFLICT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE BOARD OR COMMITTEE SEEKS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY POSSIBLE, THE BOARD OR COMMITTEE DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. THE INDIVIDUAL MAY NOT BE PRESENT FOR A DISCUSSION OF, OR VOTE ON, WHETHER TO ENTER THE TRANSACTION. THE RELEVANT FACTS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. ADDITIONALLY, BOARD MEMBERS ARE REQUIRED TO ANNUALLY SIGN STATEMENTS DISCLOSING EXISTING CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. MINNEWASKA LUTHERAN HOME PO BOX 40 STARBUCK MN 56381 410845402 SKILLED NURSING FACILITY MN 501(C)(3) LINE 10 N/A 1 MINNEWASKA HOME CARE PO BOX 40 STARBUCK MN 56381 331124162 HOME CARE MN 501(C)(3) LINE 10 N/A 1 MINNEWASKA HOME DEVELOPMENT PO BOX 40 STARBUCK MN 56381 411504339 FUNDRAISING MN 501(C)(3) LINE 12B, II N/A 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0