SANFORD-GOOD SAMARITAN COMMUNITY HEALTH: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
SANFORD-GOOD SAMARITAN COMMUNITY HEALTH (EIN 37-1834045)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-12
IRS object ID
201803169349302275
Schema version
2017v2.3
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)
Return2018-11-12T10:39:32-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN371834045EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SANFORD-GOOD SAMARITAN COMMUNITY HEALTHBusinessNameLine1Txt
Business Name Line2SERVICES LLCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSANFBusinessNameControlTxt
Phone6053623100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14800 W 57TH ST PO BOX 5038AddressLine1Txt
CitySOUIX FALLSCityNm
State AbbreviationSDStateAbbreviationCd
ZIP571175038ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS A SYVERSONPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone6053623100PhoneNum
Signature2018-11-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKACIE MCEWENPreparerPersonNm
PTINP01599614PTIN
Phone6123764500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-08IPDt
IP Tm13:35:56IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id912999D8D5E4D9097136BAD3000543774677FD22AtSubmissionCreationDeviceId
At Submission Filing Device Id3018D2C7A8EF8E88940F980D8F52F9F97466C021AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Initial ReturnYes (X)InitialReturnInd

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PROSPERABusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTHOMAS A SYVERSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14800 W 57TH ST PO BOX 5038AddressLine1Txt
CitySOUIX FALLSCityNm
State AbbreviationSDStateAbbreviationCd
ZIP571175038ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$43,493,051GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Other Organization DscLIMITED LIABILTY COMPANYOtherOrganizationDsc
Formation2016FormationYr
Legal Domicile StateNDLegalDomicileStateCd
Activity Or MissionOPERATE, FINANCE AND DEVELOP LONG-TERM CARE, SENIOR LIVING, AND POST-ACUTE FACILITIES IN A MANNER CONSISTENT WITH THE MEMBERS CHARITABLE PURPOSES.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee959TotalEmployeeCnt
Total Volunteers93TotalVolunteersCnt
Total Gross UBI$115,273TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$20,690NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$24,666CYContributionsGrantsAmt
CY Program Service Revenue$43,259,104CYProgramServiceRevenueAmt
CY Investment Income$6,987CYInvestmentIncomeAmt
CY Other Revenue$199,861CYOtherRevenueAmt
CY Total Revenue$43,490,618CYTotalRevenueAmt
CY Grants And Similar Paid$4,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$27,748,346CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
CY Other Expenses$18,838,984CYOtherExpensesAmt
CY Total Expenses$46,591,330CYTotalExpensesAmt
CY Revenues Less Expenses-$3,100,712CYRevenuesLessExpensesAmt
Total Assets EOY$44,498,348TotalAssetsEOYAmt
Total Liabilities EOY$27,149,282TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances EOY$17,349,066NetAssetsOrFundBalancesEOYAmt
MissionOPERATE, FINANCE AND DEVELOP LONG-TERM CARE, SENIOR LIVING, AND POST-ACUTE FACILITIES IN A MANNER CONSISTENT WITH THE MEMBERS CHARITABLE PURPOSES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$39,770,391ExpenseAmt
Grant$4,000GrantAmt
Revenue$43,259,104RevenueAmt
DescPROVIDE LONG-TERM CARE, SENIOR LIVING AND POST ACUTE SERVICES FOR OLDER PERSONS AND OTHERS IN NEED. PROVIDED SERVICES FOR 127,188 SKILLED NURSING DAYS, 10,521 ASSISTED LIVING DAYS, AND 30,179 SENIOR HOUSING DAYS.Desc
Total Program Service Expenses$39,770,391TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document31IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee959EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonG GRANT TRIBBLEPersonNm
Phone6053623100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14800 W 57TH STAddressLine1Txt
CitySIOUX FALLSCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57108ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
THOMAS A SYVERSON
PRESIDENT & CHAIRPERSON0.10Yes (X)Yes (X)$0$0$0
CRAIG LAMBRECHT
VICE PRESIDENT & DIRECTOR0.10Yes (X)Yes (X)$0$0$0
G GRANT TRIBBLE
TREASURER & DIRECTOR0.10Yes (X)Yes (X)$0$0$0
KIRK CRISTY
DIRECTOR0.10Yes (X)$0$0$0
CLINT GRAYBILL
DIRECTOR0.10Yes (X)$0$0$0
BERGEN PETERSON
DIRECTOR0.10Yes (X)$0$0$0
MISTY HAM-QUICK
SECRETARY0.10Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
THE EVANGELICAL LUTHERAN GOOD SAMARITAN
4800 WEST 57TH STREETSIOUX FALLSSD57108MANAGEMENT FEES & SHARED EMPLOYEES$2,411,409
DAKOTA TRAVEL NURSE INC
1200 COLLINS AVENUEMANDANND58554POOL STAFF SERVICES$1,607,040
INFINITY REHAB
25117 SW PARKWAY STE DWILSONVILLEOR97070CONTRACT THERAPY SERVICES$1,537,630
PRIME TIME HEALTHCARE LLC
PO BOX 3544OMAHANE681030544POOL STAFF SERVICES$767,562
SANFORD HEALTH
PO BOX 5074SIOUX FALLSSD571175074LAB SERVICES$150,274
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$24,666AllOtherContributionsAmt
Total Contributions$24,666TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHOUSING AND RESIDENT SERVICESDesc
Business623000BusinessCd
Total Revenue Column$43,259,104TotalRevenueColumnAmt
Related Or Exempt Func Income$43,259,104RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$43,259,104TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,987TotalRevenueColumnAmt
Exclusion$6,987ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$6,653RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$6,653RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,653TotalRevenueColumnAmt
Exclusion$6,653ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$11,036GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,036TotalRevenueColumnAmt
Exclusion$11,036ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$4,961GrossSalesOfInventoryAmt
Cost Of Goods Sold$2,433CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,528TotalRevenueColumnAmt
Exclusion$2,528ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
MEALS722320$115,273$115,273
CABLE TV900099$38,050$38,050
BARBER & BEAUTY SHOP623990$11,327$11,327

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,994TotalRevenueColumnAmt
Exclusion$14,994ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$179,644OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,490,618TotalRevenueColumnAmt
Related Or Exempt Func Income$43,259,104RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$115,273UnrelatedBusinessRevenueAmt
Exclusion$91,575ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$4,000TotalAmt
Program Services$4,000ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$22,371,758TotalAmt
Program Services$21,231,528ProgramServicesAmt
Management And General$1,140,230ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$502,120TotalAmt
Program Services$465,292ProgramServicesAmt
Management And General$36,828ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,208,730TotalAmt
Program Services$3,045,252ProgramServicesAmt
Management And General$163,478ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,665,738TotalAmt
Program Services$1,572,744ProgramServicesAmt
Management And General$92,994ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,692,421TotalAmt
Management And General$2,692,421ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$12,196TotalAmt
Management And General$12,196ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,761,210TotalAmt
Program Services$5,367,452ProgramServicesAmt
Management And General$393,758ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$27,934TotalAmt
Management And General$27,934ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$154,093TotalAmt
Program Services$7,072ProgramServicesAmt
Management And General$147,021ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$32,139TotalAmt
Management And General$32,139ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,238,620TotalAmt
Program Services$4,238,620ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$80,328TotalAmt
Program Services$52,845ProgramServicesAmt
Management And General$27,483ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$255,702TotalAmt
Management And General$255,702ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,017,154TotalAmt
Management And General$1,017,154ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$84,968TotalAmt
Management And General$84,968ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
FOOD$1,358,826$1,358,826
MEDICAL SUPPLIES$1,335,457$1,335,457
DRUGS$757,026$757,026
BAD DEBT EXPENSE$452,034$452,034

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$578,876TotalAmt
Program Services$334,277ProgramServicesAmt
Management And General$244,599ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$46,591,330TotalAmt
Program Services$39,770,391ProgramServicesAmt
Management And General$6,820,939ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$634,152EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$29,389EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$5,204,283EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$87,689EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$5,928EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$31,534,836LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$999,816LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$30,535,020EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$8,000,131EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,756EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$44,498,348EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$5,888,537EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$19,892,352EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
EOY$29,389EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,339,004EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$27,149,282EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
EOY$17,324,400EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$24,666EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$17,349,066EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$44,498,348EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,100,712ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$20,449,778OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations2SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
45022805510Yes (1)$0$0
SANFORD LIVING CENTERS
4504164543Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,060,465OtherCostOrOtherBasisAmt
Book Value$2,060,465BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,815,857OtherCostOrOtherBasisAmt
Depreciation$510,521DepreciationAmt
Book Value$23,305,336BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,637,770OtherCostOrOtherBasisAmt
Depreciation$35,515DepreciationAmt
Book Value$1,602,255BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,921,590OtherCostOrOtherBasisAmt
Depreciation$453,780DepreciationAmt
Book Value$3,467,810BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$99,154OtherCostOrOtherBasisAmt
Book Value$99,154BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,535,020TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
RELATED PARTY PAYABLE$516,807
RESIDENT SECURITY DEPOSITS$17,500
ENTRANCE FEE$209,889
SPECIAL ASSESSMENT PAYABLE$594,808
FieldValueIRS element (for citing)
Total Liability$1,339,004TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$43,471,759TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$43,471,759RevenueSubtotalAmt
Other Revenues Not Included$18,859OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$18,859RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$43,490,618TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$46,598,231TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$6,901OtherExpensesIncludedAmt
Expenses Not Reported$6,901ExpensesNotReportedAmt
Expenses Subtotal$46,591,330ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$46,591,330TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:AS SET FORTH BY FEDERAL AND STATE REGULATIONS, SANFORD-GOOD SAMARITAN COMMUNITY HEALTH SERVICES PROVIDES RESIDENT TRUST ACCOUNT (RTA) SERVICES FOR RESIDENTS. THESE RTA FUNDS ARE NOT COMMINGLED WITH THE ORGANZIATION'S FUNDS, ARE ACCESSIBLE FOR RESIDENTS' USE, HAVE DETAILED ACCOUNTING RECORDS MAINTAINED ON AN INDIVIDUAL RESIDENT BASIS, AND FOLLOW BOTH FEDERAL AND STATE REGULATIONS REGARDING THE HANDLING AND DOCUMENTATION OF ACTIVITY. AS RTA FUNDS ARE HELD IN TRUST FOR RESIDENTS, A RESIDENT MAY AUTHORIZE THAT THEIR RTA FUNDS BE RETURNED TO THE RESIDENT OR THEIR DESIGNEE (REPRESENTATIVE PAYEE, FINANCIAL POWER OF ATTORNEY, GUARDIAN, ETC.) AT ANY TIME. ADDITIONALLY, WHEN A RESIDENT IS DISCHARGED FROM A FACILITY, THEIR RTA FUNDS ARE RETURNED TO THE RESIDENT OR THEIR AUTHORIZED DESIGNEE. IF A RESIDENT EXPIRES WITH RTA FUNDS ON HAND, SPECIFIC STATE REGULATIONS ALONG WITH STATE AND/OR FEDERAL AGENCIES GUIDELINES ARE REVIEWED TO ENSURE THESE RTA FUNDS ARE MANAGED APPROPRIATELY.
PART X, LINE 2:THE ORGANIZATION IS A NONPROFIT LIMITED LIABILITY CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THIS STANDARD 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 ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:INTEREST INCOME 1,094. GIFT SHOP EXPENSES -2,433. TEMPORARILY RESTRICTED CONTRIBUTIONS 24,666. VENDING MACHINE EXPENSES -4,468.
PART XII, LINE 2D - OTHER ADJUSTMENTS:GIFT SHOP EXPENSES 2,433. VENDING MACHINE EXPENSES 4,468.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MORTON COUNTY NORTH DAKOTABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN456002226BondIssuerEIN
Bond Issued2017-08-04BondIssuedDt
Issue Price$20,470,000IssuePriceAmt
PurposeFUND PURCHASE OF MILLER POINTE IN MANDAN, NDPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$178,883RetiredAmt
Total Proceeds$20,470,000TotalProceedsAmt
Issuance Costs From Proceeds$368,253IssuanceCostsFromProceedsAmt
Capital Expenditures$20,101,747CapitalExpendituresAmt
Substantial Completion2017SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (THE SOCIETY) HAS BEEN DELEGATED CONTROL OVER THE MANAGEMENT OF THE ORGANIZATION. THE SOCIETY HAS BEEN COMPENSATED $2,183,077 FOR MANAGEMENT SERVICES RENDERED IN 2017.
FORM 990, PART VI, SECTION A, LINE 6THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY AND SANFORD LIVING CENTERS ARE THE MEMBERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AEACH MEMBER CAN ELECT THREE MEMBERS TO THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION DOES NOT HAVE ANY COMMITTEES.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS REVIEWED AND APPROVED BY THE BOARD PRIOR TO ITS FILING. THE ORGANIZATION'S OFFICERS AND MANAGEMENT WERE AN INTEGRAL PART OF THE PREPARATION OF THE FORM 990. THEREFORE, THEY HAD AN ON-GOING REVIEW OF THE INFORMATION AS IT WAS PREPARED FOR THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CMEMBERS AND OFFICERS ARE COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THEY ARE REQUIRED AT LEAST ANNUALLY TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST TO THE ORGANIZATION'S SECRETARY. ANY CONFLICT IS BROUGHT TO THE BOARD FOR REVIEW AND VOTE TO DETERMINE IF AN ACTUAL CONFLICT EXISTS. IF A CONFLICT DOES IN FACT EXIST, THE BOARD WILL FOLLOW THE STEPS IDENTIFIED IN THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15ATHE EXECUTIVE DIRECTOR FOR THE ORGANIZATION IS COMPENSATED BY ONE OF THE MEMBERS, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. A COMPENSATION STUDY WAS USED TO DETERMINE THE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIALS STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GCONTRACT SERVICES: PROGRAM SERVICE EXPENSES 5,220,473. MANAGEMENT AND GENERAL EXPENSES 384,771. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,605,244. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 44,141. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,141. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 102,838. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,838. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,987. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,987.
FORM 990, PART XI, LINE 9:EQUITY TRANSFER - THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 10,224,889. EQUITY TRANSFER - SANFORD LIVING CENTERS 10,224,889.

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