2017-11-09T15:14:11-07:00 2017-06-30 990 2016-07-01 450448164 VALLEY MEMORIAL HOMES VALL 7017877912 2900 14th Ave S Grand Forks ND 58201 Garth Rydland President/CEO 7017877905 2017-11-09 174.217.20.1 2016 2017-02-10 21:41:12Z Garth Rydland 2900 14th Ave S Grand Forks ND 58201 2702452 0 X www.valleymemorial.org X 1997 ND To provide management, nursing, chaplaincy and other support services to related healthcare entities. 32 31 1144 250 0 0 0 0 2617013 2702452 0 0 0 0 2617013 2702452 0 0 0 0 2073502 2164961 0 0 0 543511 537491 2617013 2702452 0 0 757151 623909 739721 606479 17430 17430 Valley Memorial Homes provides compassionate care and service from a Christian perspective to enhance the quality of life for those we serve. 0 0 2348627 0 0 Management support services including the following: Administration, Finance, IT, Human Resources and Transportation. Providing services to related organizations, who combined serve up to 549 residents and tenants on a daily basis and employs approximately 800 employees. 194484 0 0 Skilled Nursing Facility Support Services including Nursing-Admissions, Executive Director of Resident Care and Medical Records for up to 330 skilled residents a day. 159341 0 0 Chaplaincy services provided to related long term care facilities: skilled nursing, assisted living and basic care. 0 0 0 2702452 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 12 0 1 1144 1 0 0 0 0 0 0 0 0 0 0 0 0 X 32 31 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 X Lorilee Bott 7017877912 2900 14th Ave S Grand Forks ND 58201 Susan Kuster Director 0 0 X 0 0 0 Ron Holte Director 0 0 X 0 0 0 Jacky Jones Director 0 0 X 0 0 0 Arvin Kvasager Director 0 0 X 0 0 0 Marilyn Nyberg Director 0 0 X 0 0 0 Olive Weber Director 0 0 X 0 0 0 Eunice Vold Director 0 0 X 0 0 0 Jeff Awes Director 0 0 X 0 0 0 Gary Masilko Director 0 0 X 0 0 0 Milt Kinzler Director 0 0 X 0 0 0 Diane Lindseth Director 0 0 X 0 0 0 Roger Stadstad Director 0 0 X 0 0 0 Sharon Bakke Director 0 0 X 0 0 0 Sharon Gustafson Director 0 0 X 0 0 0 Carol Snortland Director 0 0 X 0 0 0 Chad Erickson Director 0 0 X 0 0 0 Lawrence Heuchert Director 0 0 X 0 0 0 Duane Hanson Director 0 0 X 0 0 0 Ellis Larson Director 0 0 X 0 0 0 JoAnn Miller Director 0 0 X 0 0 0 Lisa Piche Director 0 0 X 0 0 0 JoAnn Becker Director 0 0 X 0 0 0 Sheila Wurden Director 0 0 X 0 0 0 Darlene Hanson Director 0 0 X 0 0 0 Cheryl Swanson Director 0 0 X 0 0 0 David Loer Director 0 0 X 0 0 0 John Snustad Director 0 0 X 0 0 0 Kevin Beito Chair 0 0 X X 0 0 0 Bruce Newhouse Vice Chair 0 0 X X 0 0 0 Clark Piepkorn Treasurer 0 0 X X 0 0 0 Charles Johnson Board Secretary 0 0 X X 0 0 0 Garth Rydland President/CEO 40 0 X X 204220 0 19019 Lorilee Bott CFO 40 0 X 132227 0 6420 Jodi Carlson Executive Director of Resident Care 40 0 X X 128965 0 7774 Mindy Marcus Executive Director of Housing 40 0 X 102813 0 20898 568225 0 54111 4 1 1 0 Industrial Contract Services PO Box 13158 Grand Forks ND 582083158 General Contractor - Construction 1507033 Altru Health Systems PO Box 13780 Grand Forks ND 58201 Contracted Therapies and Chaplaincy Service for Valley Homes and Services and 4000 Valley Square Inc 1197196 Widseth Smith Nolting PO Box 14546 Grand Forks ND 582084546 Architectural, engineering, project management 596009 C&R Laundry 1010 N 5th Street Grand Forks ND 58201 Laundry Purchased Services for Valley Homes and Services and 4000 Valley Square Inc 324986 Networking Specialists 2397 Demers Ave Suite D Grand Forks ND 58201 IT - Managed Services, Support and Equipment 217653 0 2702452 2702452 0 0 2702452 0 0 0 0 0 2702452 2702452 0 0 568225 568225 0 0 0 0 0 0 1184553 1184553 0 0 96520 96520 0 0 172933 172933 0 0 142730 142730 0 0 0 0 0 0 9322 9322 0 0 8925 8925 0 0 45002 45002 0 0 34411 34411 0 0 44002 44002 0 0 11216 11216 0 0 7522 7522 0 0 1686 1686 0 0 70487 70487 0 0 25133 25133 0 0 Purchased Services-Chapl, IT, Adm 250440 250440 0 0 Repairs/Maint 6627 6627 0 0 Dues Subscriptions, employee exp 16366 16366 0 0 6352 6352 2702452 2702452 0 0 238439 162344 3897 3064 399 399 158016 69998 987823 733463 268708 254360 87692 133744 757151 623909 313073 262856 426648 343623 739721 606479 X 17430 17430 0 0 0 0 17430 17430 757151 623909 0 0 0 0 0 0 X 0 0 0 X X 3 Valley Memorial Foundation 450392710 7 1 0 0 Valley Homes and Services 450229071 9 1 1686811 0 4000 Valley Square Inc 311558826 9 1 1015641 0 3 2702452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Part IV, Section A, Line 1 Valley Memorial Homes bylaws indicate as part of its corporate purpose to promote the interest of other organizations formally affiliated with it which fall within the category of Section 501 (c)(3) of the Code. Valley Memorial Homes is the sole corporate member of both Valley Homes and Services and 4000 Valley Square. 0 0 0 0 0 0 0 0 0 0 0 0 987823 733463 254360 0 0 0 0 254360 457b Plan 133744 133744 0 Note Payable 35877 457b Plan 133729 Intercompany 174017 343623 X X X X 1 1 0 0 0 0 0 0 0 Garth Rydland President/CEO 184671 0 19549 0 0 0 12431 0 6588 0 223239 0 203107 0 Jodi Carlson Executive Director of Resident Care 125177 0 3788 0 7774 0 0 0 0 0 136739 0 124569 0 Schedule J, Part I, Line 3 Compensation is determined by the compensation committee. Base salary is evaluated by comparison to others of similar size and function. Schedule J, Part I, Line 4 4a) Valley Memorial Homes paid $125,000 in connection with the Resignation Agreement and Release of Claims with Jodi Carlson. 4b) Valley Memorial Homes participates in a 457b Plan. Form 990, Part VI, Section A, Line 9 Kevin Beito, 1328 21st St NW, East Grand Forks, MN 56721; Bruce Newhouse, 27093 350th Ave SW, Fisher, MN 56723; Charles Johnson, 3008 Legend Lane, Grand Forks, ND 58201; Clark Piepkorn, 3021 Olson Drive, Grand Forks, ND 58201; John Snustad, PO Box 13318, Grand Forks, ND 58208-3318; David Loer, 2250 Sunnyside Ct NW, East Grand Forks, MN 56721; Darlene Hanson, 430 Oxford Road, Box 9025 University Station, Grand Forks, ND 58202-9025; Cheryl Swanson, 1200 42nd St, Grand Forks, ND 58201; Marilyn Nyberg, 697 Mighty Acres Dr, Grand Fokrs, ND 58201; Carol Snortland, 3802 Cherry St K-43, Grand Forks, ND 58201; Chad Erickson, 19274 445th Ave SW, East Grand Forks, MN 56721; Jeff Awes, 1025 Cottonwood Street, Grand Forks, ND 58201; Sheila Wurden, 40916 245th St SW, Fisher, MN 56723; Duane Hanson, 710 Goodwin Avenue, Thompson, ND 58278; Diane Lindseth, 1736 9th Ave NE, Thompson, ND 58278-9215; Ellis Larson, 1034 10th Ave SWE, East Grand Forks, MN 56721; Roger Stadstad, 2742 18th St NE, Manvel, ND 58256; Sharon Bakke, 2331 25th St NE, Mekinock, ND 58258; Lawrence Heuchert, 2230 7th Ave N, Grand Forks, ND 58203; Olive Weber, 4634 Belmont Road, Grand Forks ND 58201; Sharon Gustafson, 510 Woodland Drive, Thompson, ND 58278; Susan Kuster, 313 7th Ave, Reynolds, ND 58275; Milt Kinzler, 2725 Knight Dr, Grand Forks, ND 58201; JoAnn Miller, 748 Great Plains Court, Grand Forks, ND 58201; Lisa Piche, 1307 Truesdale Drive, Manvel, ND 58256; Gary Masilko, 210 Circle Hills Dr, Grand Forks, ND 58201; Arvin Kvasager, 2521 9th Ave N, Grand Forks, ND 58203; Ron Holte, PO Box 293, Thompson, ND 58278; Jacky Jones, PO Box 203, Oslo, MN 56744; Eunice Vold, 411 22nd Ave S, Grand Forks, ND 58201; Joanne Becker, 3633 Lynnwood Circle, Grand Forks, ND 58203 Form 990, Part VI, Section B, Line 11b The CFO with the assistance of the President/CEO prepares the Form 990. A draft of the Form 990 and all applicable schedules are sent to the Board of Directors' Executive Committee for review prior to a meeting held the first Thursday in November. The CFO explains any changes, specifically reviews Part VI and answers and questions. The Form 990 is electronically filed after Executive Committee approval. Form 990, Part VI, Section B, Line 12c the conflict of interest policy is stated in Article 8 of the bylaws. It is reviewed with board members at Board Orientation. Board members are presented the policy and sign off annually. Form 990, Part VI, Section B, Line 15 The President/CEO's compensation is determined as follows: The compensation committee reviews the ND Long Term Care Association's state compensation survey each year to assess how Valley Memorial Home's CEO's salary compares with other of similar size and function. this survey provides the committee with a gauge when it considers base compensation. The committee then reviews the organization's performance and strategic plan goals to develop an incentive compensation plan in addition to the base salary. Compensation for executive management includes a performance appraisal completed by the President/CEO or their direct supervisor. Employees are eligible for annual inflationary increase to their base salary. The percentage is based upon the approval of annual budget or other board approved changes. The ND Long Term Care salary surveys are reviewed and adjustments are made to base salaries if the survey demonstrates underpayment compared to like sized organizations. Executive managements' compensation is determined in similar manner as President/CEO's. Form 990, Part VI, Section C, Line 19 Valley Memorial Homes governing documents, conflict of interest policy and financial statements are available upon request. Requests should be made to the CFO at Valley Memorial Homes' corporate office, located at Valley Eldercare Center, 2900 14th Ave S, Grand Forks, ND 58201 between the hours of 8:30-4:30 Monday through Friday. Valley Homes and Services 2900 14th Ave S Grand Forks ND 58201 450229071 Skilled Nursing & Basic Care Fac ND 501 (c) 3 Line 9 N/A 0 4000 Valley Square Inc 4000 24th Ave S Grand Forks ND 58201 311558826 Sk Nursing Fac, Asst Liv, & Housing ND 501 (c) 3 Line 9 N/A 0 Valley Memorial Foundation 2900 14th Ave S Grand Forks ND 58201 450392710 Seek and accept gifts to support LTC facilities ND 501 (c) 3 Line 7 N/A 0 Cherrywood Village 2900 14th Ave S Grand Forks ND 58201 454276187 Low Income Senior Apartments ND 501 (c) 3 Line 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 Valley Homes and Services q 1686811 Actual expense - direct cost or allocated. 4000 Valley Square Inc q 1015641 Actual expense - direct cost or allocated. Schedule R, Part V, Line 2 The amounts involved in transactions "m", "n" and "o" are included in the transaction "q". Valley Memorial Homes' expenses are direct costed or allocated to Valley Homes and Services and 4000 Valley Square Inc based upon allocation methodologies prescribed by the ND Department of Human Services.