2018-10-03T08:26:27-05:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-01-01 411310487 LYNGBLOMSTEN CARE CENTER INC LYNG 6516462941 1415 ALMOND AVENUE ST PAUL MN 55108 BRADLEY J JACOBSON CFO 6516462941 2018-09-25 1 CORY RUTLEDGE P01329381 6123764500 2018-09-25 67.137.57.251 2018-09-25 12:54:11 CD P 06C6282D018575128FE0891D0F3A4E057D2D2323 3018D2C7A8EF8E88940F980D8F52F9F97466C021 2017 2018-06-14 16:35:46Z JEFF HEINECKE 1415 ALMOND AVENUE ST PAUL MN 55108 26367372 0 9386 X WWW.LYNGBLOMSTEN.ORG X 1976 MN TO PROVIDE A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS. 15 14 563 916 122587 -93608 53126 60250 24262361 24607068 207605 248945 249221 203296 24772313 25119559 1303622 1993372 0 0 17367550 18201684 0 0 0 5846101 6140170 24517273 26335226 255040 -1215667 12953866 12036666 1643194 1792805 11310672 10243861 X INFLUENCED BY CHRIST, LYNGBLOMSTEN PROVIDES A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS IN ORDER TO PRESERVE AND ENHANCE THEIR QUALITY OF LIFE. 1 0 23341938 1993372 24484481 THE LYNGBLOMSTEN CARE CENTER, A 237-BED SKILLED NURSING FACILITY, PROVIDES BOTH SHORT-TERM REHABILITATION AND LONG-TERM HEALTHCARE, INCLUDING SPECIALIZED CARE FOR ALZHEIMER'S DISEASE AND OTHER DEMENTIAS, PARKINSON'S DISEASE, AND PALLIATIVE CARE. IN 2017, 774 PERSONS RECEIVED CARE. CHAPLAINS, VOLUNTEERS, AND PROFESSIONAL STAFF ENSURE RESIDENTS RECEIVE QUALITY HEALTH CARE IN A DIGNIFIED MANNER. ALTHOUGH HEALTH ISSUES PREVENT THESE OLDER ADULTS FROM ENJOYING LIVING IN THEIR OWN HOMES, LYNGBLOMSTEN PROMOTES PERSON-CENTERED CARE, GIVING OLDER ADULTS AS MANY CHOICES AND COMFORTS OF HOME AS POSSIBLE. PROGRAMMING (INCLUDING THE ARTS) AND SOCIAL EVENTS ARE HOSTED TO ENHANCE THE LIVES OF THESE OLDER ADULTS AND THEIR FAMILIES. LYNGBLOMSTEN CONTINUED TO PARTICIPATE IN ALLINA'S NEXT GENERATION ACCOUNTABLE CARE ORGANIZATION (ACO), PROVIDING SKILLED CARE TO ELDERS IN THE ALLINA SYSTEM. ACOS ARE GROUPS OF DOCTORS, HOSPITALS, AND HEALTHCARE PROVIDERS THAT COORDINATE HIGH-QUALITY CARE FOR MEDICARE PATIENTS.IN 2017, LYNGBLOMSTEN'S COMMITMENT TO PROVIDING EXCELLENT CARE EARNED THE CARE CENTER A FIVE-STAR QUALITY RATING FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.LYNGBLOMSTEN CARE CENTER, INC. IS AFFILIATED WITH LYNGBLOMSTEN AND THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. 152011 0 122587 EMENUCHOICE IS THE WEB-BASED SOFTWARE TOOL DEVELOPED ORIGINALLY BY LYNGBLOMSTEN FOR IMPROVING ITS RESIDENT DINING EXPERIENCE. THE TOOL REDUCES COMMUNICATION BARRIERS FOR RESIDENT MEAL ORDERING WHILE ENABLING PERSON-CENTERED CHOICES, MAXIMIZING ACCURACY, STREAMLINING KITCHEN MEAL PREP, AND REDUCING WASTE. IN 2017, EMENUCHOICE WON BRONZE IN THE INNOVATOR OF THE YEAR AWARD CATEGORY AT THE NATIONAL MCKNIGHT'S TECHNOLOGY AWARDS. THE AWARD RECOGNIZES SENIOR CARE ORGANIZATIONS THAT USE TECHNOLOGY TO IMPROVE QUALITY OF CARE AND COST SAVINGS. EMENUCHOICE ALSO EXPANDED ITS CLIENT BASE FROM 12 TO 48 SITES LOCATED IN SEVEN STATES. ENHANCEMENTS MADE TO EMENUCHOICE IN 2017 ALLOWED INTEGRATION WITH RESIDEX ASSISTED LIVING SOFTWARE, IMPROVEMENTS TO BILLING TOOLS, THE ADDITION OF A LA CARTE PRICING, AND THE INCLUSION OF MEAL CREDIT FEATURES FOR CUSTOMERS. 23493949 1 1 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 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 27 0 563 1 1 1 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X BRADLEY J JACOBSON 6516325310 1415 ALMOND AVENUE ST PAUL MN 55108 WILLIAM C SANDEN CHAIR (THRU NOV 2017) 1.00 4.00 X X 3071 0 0 ANDREW LOWTHER CHAIR 1.00 4.00 X X 0 0 0 PAM DRAGSETH VICE CHAIR 1.00 1.00 X X 0 0 0 WILLIAM STACEY TREASURER 1.00 3.00 X X 0 0 0 JANE DANIELSON SECRETARY 1.00 3.00 X X 0 0 0 JEFF HEINECKE PRESIDENT & CEO 36.00 4.00 X X 170731 0 36764 REV CARL BUETTEMEIER DIRECTOR (THRU MAY 2017) 1.00 1.00 X 0 0 0 DAVID CHRISTIANSON DIRECTOR 1.00 1.00 X 0 0 0 DR ELIZABETH DETLIE DIRECTOR 1.00 1.00 X 0 0 0 REV MARTY ERICSON DIRECTOR 1.00 1.00 X 0 0 0 DR LESLIE GRANT DIRECTOR 1.00 1.00 X 0 0 0 REV JOY JOHNSON DIRECTOR 1.00 1.00 X 0 0 0 CHARLES NORTON DIRECTOR 1.00 1.00 X 0 0 0 BETCHEN OBERDORFER DIRECTOR (THRU MAY 2017) 1.00 1.00 X 0 0 0 JOHN PECK DIRECTOR 1.00 1.00 X 0 0 0 THOMAS J SCHULTZ DIRECTOR (THRU MAY 2017) 1.00 1.00 X 0 0 0 JIM STENDER DIRECTOR 1.00 1.00 X 0 0 0 REV PAM STOFFERAHN DIRECTOR 1.00 1.00 X 0 0 0 TRUPTI STORLI DIRECTOR 1.00 1.00 X 0 0 0 BRADLEY J JACOBSON CFO 36.00 4.00 X 135565 0 34827 BRENDA JOHNSON ADMINISTRATOR 40.00 X 132097 0 32384 TODD FLIFLET CONTROLLER 40.00 X 101527 0 28391 MATTHEW STENERSON CHIEF TECHNOLOGY OFFICER 40.00 X 121334 0 21223 GREGORY WAINMAN DIRECTOR OF NURSING 40.00 X 127590 0 32196 VIELKA SANCHEZ LPN 40.00 X 117046 0 28139 MICHELLE MARTINSON RN CLINICAL MANAGER 40.00 X 107797 0 11800 1016758 0 225724 8 0 1 0 PRO REHAB 200 LEWIS AVENUE SOUTH SUITE 210 WATERTOWN MN 55388 THERAPY 809488 MERWIN LTC PHARMACY PO BOX 856706 MINNEAPOLIS MN 55485 PHARMACY 431085 IDEACOM MID-AMERICA INCORPORATED 30 WEST WATER STREET ST PAUL MN 55107 TELEPHONE/COMMUNICATION 365410 HORTY ELVING ASSOCIATES 332 MINNESOTA STREET SUITE W2000 ST PAUL MN 55101 ARCHITECTURE/ENGINEERING SERVICES 119066 CLIFTONLARSONALLEN 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 FINANCIAL/CONSULTING 103033 5 60250 60250 RESIDENT SERVICES 623000 24484481 24484481 EMENUCHOICE 541511 122587 122587 24607068 132131 132131 1362796 1831 1244210 3603 118586 -1772 116814 116814 MISCELLANEOUS REVENUE 900099 87209 87209 BEAUTY SHOP REVENUE 900099 68426 68426 SATELLITE TV REVENUE 900099 22790 22790 24871 24871 203296 25119559 24484481 122587 452241 1580000 1580000 413372 413372 545439 545439 13702482 12799230 903252 342714 320025 22689 2534171 2316038 218133 1076878 952100 124778 14820 14820 11940 11940 62328 62328 1102403 1005493 96910 16578 16578 600519 414066 186453 108212 108212 424061 380450 43611 62273 35659 26614 1960 1758 202 808570 724871 83699 34689 31122 3567 MEDICAL SUPPLIES 1147183 1147183 FOOD 678198 678198 LICENSE SURCHARGE 667155 667155 BAD DEBT EXPENSE 336257 336257 63024 27229 35795 26335226 23493949 2841277 0 2240525 1553271 24634 24698 2430391 2625487 19714 58489 24849481 19877402 4969511 4972079 2440867 1957238 399180 399180 429044 446224 12953866 12036666 1482217 1638763 5518 58405 52726 102572 95798 1643194 1792805 X 11256932 10190358 53740 53503 11310672 10243861 12953866 12036666 -1215667 148856 0 X 0 1 X 1 0 X 565513 206707 181690 53126 60250 1067286 18949573 19857394 19949802 24262361 24607068 107626198 19515086 20064101 20131492 24315487 24667318 108693484 0 0 0 108693484 71821 132639 181871 228068 132131 746530 71821 132639 181871 228068 132131 746530 266119 181469 225851 249221 203295 1125955 19853026 20378209 20539214 24792776 25002744 110565969 0.98310 0.98240 0.00680 0.00700 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY SHOP REVENUE SATELLITE TV REVENUE TELEPHONE REVENUE GUEST MEAL REVENUE MISCELLANEOUS REVENUE 0 1 X 94767 94767 20739682 17206993 3532689 3777368 2597023 1180345 237664 73386 164278 4972079 CAPITAL LEASE OBLIGATION 12922 ASSET RETIREMENT OBLIGATION 82876 95798 X PART IV, LINE 2B: THE CORPORATION IS THE TRUSTEE OF VARIOUS RESIDENT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. THESE FUNDS ARE ON DEPOSIT IN SEPARATE BANK ACCOUNTS. PART X, LINE 2: THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. 1 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVENUE ST PAUL MN 55108 363371887 501(C)(3) 1580000 TO SUPPORT GENERAL OPERATIONS. 1 0 SCHOLARSHIPS 53 413372 PART I, LINE 2: LYNGBLOMSTEN CARE CENTER MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. ALL RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITORS THE USE OF THESE FUNDS THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS. LYNGBLOMSTEN SCHOLARSHIPS WILL BE AWARDED TO EMPLOYEES ENTERING AND/OR FURTHERING THEIR EDUCATION IN LONG TERM HEALTH CARE. THE FOLLOWING PROCEDURES MUST BE FOLLOWED IN ORDER TO RECEIVE SUCH A SCHOLARSHIP. 1. A FULLY COMPLETED APPLICATION PACKET MUST BE SUBMITTED TO HUMAN RESOURCES ON OR BEFORE PAYMENT OR THIRD PARTY BILLING FORMS WILL BE COMPLETED. 2. ALL EMPLOYEES EXCEPT THE ADMINISTRATOR ARE ELIGIBLE. 3. APPLICANT MUST BE CURRENTLY EMPLOYED BY LYNGBLOMSTEN AND HAVE COMPLETED 1040 HOURS OF SERVICE PRIOR TO APPLYING. IF EMPLOYMENT IS TERMINATED WITHIN 90 DAYS OF RECEIVING SCHOLARSHIP FUNDS, THEY MUST BE RETURNED TO LYNGBLOMSTEN. ALL FUNDS GRANTED MUST BE USED FOR STATED PURPOSE OF APPLICATION, OTHERWISE THEY MUST BE RETURNED TO LYNGBLOMSTEN. 4. APPLICANT MUST BE WORKING AN AVERAGE OF 10 HOURS PER WEEK THE 6 MONTH PERIOD PRIOR TO THE SEMESTER OR QUARTER FUNDS ARE APPLIED FOR. 5. APPLICANT MAY BE FROM ANY DEPARTMENT/PROGRAM WITHIN LYNGBLOMSTEN. 6. APPLICANT MUST BE ENROLLED IN AND/OR ACCEPTED IN AN EDUCATIONAL PROGRAM THAT WILL PREPARE THEM FOR POSITIONS COMMON TO LONG TERM CARE. 7. SCHOLARSHIPS MAY BE AWARDED FOR AMOUNTS COVERING FULL TUITION AND BOOK FEES FOR ALL APPLICANTS. 8. SCHOLARSHIPS MAY BE AWARDED MORE THAN ONCE PER YEAR, BUT A NEW APPLICATION PACKET MUST BE COMPLETED WITH EACH REQUEST FOR FUNDS. 9. AWARDED SCHOLARSHIP MONEY WILL BE SENT DIRECTLY TO THE INSTITUTION, WHEN POSSIBLE. 10. ALL SCHOLARSHIPS AWARDED BY LYNGBLOMSTEN ARE INTENDED FOR SCHOOL TUITION AND BOOKS ONLY. OTHER GRANTS AND SCHOLARSHIPS MUST BE AWARDED, PRIOR TO THE LYNGBLOMSTEN SCHOLARSHIP. IF LYNGBLOMSTEN SCHOLARSHIP DOLLARS ARE IN EXCESS, THEY MUST BE RETURNED TO LYNGBLOMSTEN IMMEDIATELY. FAILURE TO DO SO WILL RESULT IN REPAYMENT AND/OR DISCIPLINE UP TO AND INCLUDING TERMINATION. X X X X 0 0 0 0 0 0 0 0 0 JEFF HEINECKE PRESIDENT & CEO 162813 0 2937 0 4981 0 7216 0 29548 0 207495 0 0 0 BRADLEY J JACOBSON CFO 131092 0 4473 0 0 0 5794 0 29033 0 170392 0 0 0 BRENDA JOHNSON ADMINISTRATOR 128663 0 3434 0 0 0 5567 0 26817 0 164481 0 0 0 GREGORY WAINMAN DIRECTOR OF NURSING 126481 0 1109 0 0 0 5387 0 26809 0 159786 0 0 0 DAN SHAUGHNESSY BROTHER IN-LAW TO PRESIDENT/CEO 31690 CONTRACT WORKER/CONSULTANT 0 FORM 990, PART III, LINE 2 LYNGBLOMSTEN ROLLED OUT ITS DINING EXPERIENCE COORDINATOR PROGRAM IN EARLY 2017, PROVIDING HANDS-ON CUSTOMER-FOCUSED ASSISTANCE IN DINING ROOMS FOR BREAKFAST AND LUNCH. IN CONJUNCTION WITH THIS PROGRAM, NEW PLATES AND TABLE SETTINGS DEBUTED TO ENHANCE THE DINING EXPERIENCE FOR RESIDENTS. THE CARE CENTER BEGAN A PARTNERSHIP WITH METRO STATE AND THE MINNESOTA ALLIANCE FOR NURSING EDUCATION IN 2017. THROUGH THIS PARTNERSHIP, LYNGBLOMSTEN HOSTS NURSING STUDENTS FOR A CAPSTONE PRACTICUM EXPERIENCE AS THEY COMPLETE TRAINING TO BECOME REGISTERED NURSES THROUGH UNDERGRADUATE PROGRAMS. THE CARE CENTER ALSO HOSTS STUDENTS FOR THEIR LONG-TERM CARE CLINICAL ROTATION. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS MADE UP THE CHAIR, VICE CHAIR, TREASURER, AND SECRETARY OF THE BOARD ALONG WITH PRESIDENT/CEO OF THE CORPORATION. ALL ITEMS APPROVED BY THE EXECUTIVE COMMITTEE ARE REAFFIRMED BY THE FULL BOARD AT THEIR NEXT MEETING. FORM 990, PART VI, SECTION A, LINE 6 THE BOARD OF DIRECTORS OF LYNGBLOMSTEN ARE THE MEMBERS OF LYNGBLOMSTEN CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE CONGREGATIONS SEND DELEGATES TO THE LYNGBLOMSTEN ANNUAL MEETING, WHO, AS MEMBERS OF LYNGBLOMSTEN, ELECT THE LYNGBLOMSTEN BOARD. THE BOARD OF DIRECTORS OF LYNGBLOMSTEN CARE CENTER CONSISTS SOLELY OF DULY ELECTED AND QUALIFIED MEMBERS OF THE BOARD OF DIRECTORS OF LYNGBLOMSTEN. ELECTION AS A DIRECTOR OF LYNGBLOMSTEN CONSTITUTES ELECTION AS A DIRECTOR OF LYNGBLOMSTEN CARE CENTER FOR THE SAME TERM. FORM 990, PART VI, SECTION A, LINE 7B CHANGES IN THE BYLAWS AND ARTICLES OF INCORPORATION REQUIRE MEMBERSHIP APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B THE CEO, CFO, AND CONTROLLER REVIEW THE DOCUMENT, WHICH IS EMAILED TO THE FINANCE COMMITTEE OF THE BOARD PRIOR TO THEIR MEETING FOR REVIEW AND COMMENT. THE BOARD RECEIVES THE DOCUMENT PRIOR TO THEIR BOARD MEETING BY EMAIL. PAPER COPIES ARE AVAILABLE AT THE BOARD MEETING FOR FURTHER DISCUSSION AND BOARD APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C AN UPDATED CONFLICT OF INTEREST POLICY IS SIGNED BY ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. THIS POLICY IS MONITORED BY THE CORPORATE COMPLIANCE OFFICER AND IF ANY CONFLICTS OF INTERESTS EXIST THAT INDIVIDUAL IS EXCLUDED FROM PARTICIPATION AND VOTING ON RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15A THE LYNGBLOMSTEN BOARD'S EXECUTIVE COMMITTEE REVIEWS AND SETS THE CEO'S COMPENSATION ANNUALLY AND PERFORMS A COMPENSATION STUDY APPROXIMATELY EVERY 5 YEARS, LAST COMPLETED IN 2013. THE CEO SETS THE ANNUAL EVALUATION PROCESS FOR OTHER OFFICERS AND KEY EMPLOYEES AND THE LYNGBLOMSTEN CARE CENTER, INC. BOARD APPROVES THE ANNUAL BUDGET. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. EMENUCHOICE LLC 1415 ALMOND AVENUE ST PAUL MN 55108 320473417 MAINTAINS, DEVELOPS, AND OFFERS WEB-BASED MEAL AND DIEATARY SOFTWARE PROGRAM MN 122587 106671 LYNGBLOMSTEN CARE CENTER INC LYNGBLOMSTEN APARTMENTS INC 1455 ALMOND AVE ST PAUL MN 55108 411327121 LOW INCOME SENIOR HOUSING MN 501(C)3 LINE 10 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 HERITAGE APARTMENTS INC 1440 MIDWAY PARKWAY ST PAUL MN 55108 411913420 MARKET RATE SENIOR HOUSING, ASSISTED LIVING SERVIES MN 501(C)3 LINE 10 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVE ST PAUL MN 55108 363371887 FUNDRAISING FOR LYNGBLOMSTEN MN 501(C)3 LINE 7 LYNGBLOMSTEN 0 LYNGBLOMSTEN SERVICES INC 1415 ALMOND AVE ST PAUL MN 55108 411760448 SENIOR CENTER, COMMUNITY SERVICES, HOME HEALTH MN 501(C)3 LINE 10 LYNGBLOMSTEN 0 LYNGBLOMSTEN 1415 ALMOND AVE ST PAUL MN 55108 410693865 MANAGEMENT OVERSIGHT SERVICES TO ALL LYNGBLOMSTEN ORGANIZATIONS MN 501(C)3 LINE 10 N/A 0 LYNGBLOMSTEN SENIOR HOUSING INC 1415 ALMOND AVE ST PAUL MN 55108 411913422 MANAGEMENT OVERSIGHT SERVICES TO LYNGBLOMSTEN APTS & HERITAGE APTS MN 501(C)3 LINE 10 LYNGBLOMSTEN 0 0 1 1 0 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1