2017-03-24T11:25:58-05:00 2016-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2015-07-01 411704381 ST THERESE FOUNDATION INC STTH 9522832213 1660 HIGHWAY 100 S SUITE 103 ST LOUIS PARK MN 55416 MIKE WARDEN CHIEF FINANCIAL OFFICER 9522832213 2017-03-10 1 JEFF VRIEZE P01273590 6123764500 2015 2021-01-29 14:40:06Z BARB RODE 1660 HIGHWAY 100 S SUITE 103 ST LOUIS PARK MN 55416 26801065 0 X WWW.STTHERESEMN.ORG X 1991 MN PROVIDING FUNDRAISING, PLANNING, AND OTHER SUPPORT TO AFFILIATED ORGANIZATIONS. 25 25 0 41 0 0 5694195 1594126 7560842 16477622 529985 471997 44702 1822974 13829724 20366719 157826 783851 0 0 4796003 11497508 0 0 22486 3571011 8574669 8524840 20856028 5304884 -489309 107638575 113974808 91520998 98888297 16117577 15086511 X PROVIDING FUNDRAISING, PLANNING, AND OTHER SUPPORT TO AFFILIATED ORGANIZATIONS. 1 0 988110 775266 0 SAINT THERESE IS A NONPROFIT FAITH-BASED ORGANIZATION THAT HAS FOCUSED ON THE WELL-BEING OF INDIVIDUALS SINCE IT OPENED IN 1968. WE PROVIDE SECURE, STRESS-FREE LIVING AND THE VERY BEST IN SENIOR CARE AND HOUSING WITH A COMMITMENT TO EACH INDIVIDUAL. SAINT THERESE OFFERS A TRUE CONTINUUM OF PROGRAMS AND SERVICES THAT ARE AVAILABLE IN YOUR OWN HOME OR IN ONE OF OUR COMMUNITY SETTINGS. SAINT THERESE SERVES THE TWIN CITIES METRO AREA WITH CAMPUSES LOCATED IN NEW HOPE, BROOKLYN PARK, SHOREVIEW, AND WOODBURY. TO LEARN MORE VISIT WWW.STTHERESEMN.ORG.ST. THERESE FOUNDATION, INC INCLUDES THE FOLLOWING ENTITIES:-OXBOW LAKE CARE CENTER, LLC.-ST. THERESE AT HOME SOLUTIONS, LLC.-ST. THERESE OF WOODBURY, LLC.-ST. THERESE TCU NORTH, LLC.-ST. THERESE REDWWOODS, LLC. 10833719 8585 12396679 OXBOW LAKE CARE CENTER, LLC D/B/A SAINT THERESE AT OXBOW LAKEA MASTER-PLANNED COMMUNITY OFFERING HIGH QUALITY CARE AND SERVICES, THE SAINT THERESE AT OXBOW LAKE CAMPUS SERVES INDIVIDUALS AT EVERY STAGE IN THE AGING PROCESS. OLDER ADULTS WILL FIND THE DIGNIFIED CARE AND SUPPORT THEY DESERVE IN A WARM AND COMFORTING ENVIRONMENT.INDEPENDENT UNITS - 82ASSISTED LIVING UNITS - 41MEMORY CARE UNITS - 19CARE SUITES - 64 3128401 0 3184105 AT HOME SOLUTIONS BY SAINT THERESE CAN GIVE CAREGIVERS AND THEIR LOVED ONES THE EXTRA SUPPORT THEY NEED IN THEIR OWN HOME - FROM SIMPLE ERRANDS AND MEDICATION REMINDERS TO SKILLED NURSING AND DEMENTIA CARE. AT HOME SOLUTIONS BY SAINT THERESE IS AVAILABLE FROM 2 TO 24 HOURS A DAY TO SERVE INDIVIDUALS AS THEY AGE IN PLACE. 1379665 0 596493 ST. THERESE OF WOODBURY, LLC (WOODBURY) WAS CREATED IN AUGUST 2013 TO OWN AND OPERATE A FULL CONTINUUM OF CARE SENIOR COMMUNITY CONSISTING OF A 102 INDEPENDENT LIVING UNITS, 38 ASSISTED LIVING UNITS, 20 MEMORY CARE UNITS (WOODBURY CAMPUS) AND A 56-BED LICENSED NURSING FACILITY (WOODBURY CARE SUITES). CONSTRUCTION OF THE INDEPENDENT LIVING, ASSISTED LIVING AND MEMORY CARE UNITS WAS COMPLETED IN FEBRUARY OF 2016 AND BEGAN OPERATIONS IN MARCH OF 2016. CONSTRUCTION OF THE LICENSED NURSING FACILITY WAS COMPLETED IN JUNE OF 2016 AND BEGAN OPERATIONS IN JULY OF 2016. 678721 0 300345 ST. THERESE TCU NORTH, LLC (TCU NORTH) WAS CREATED IN AUGUST OF 2014 TO OPERATE 32 TRANSITIONAL CARE LICENSED NURSING BEDS IN LEASED SPACE WHICH BEGAN OPERATIONS IN FEBRUARY OF 2016. 0 0 0 ST. THERESE REDWOODS, LLC (REDWOODS) WAS CREATED IN JUNE OF 2016 TO OWN AND OPERATE 64 INDEPENDENT LIVING UNITS LOCATED ADJACENT TO WOODBURY. THE DEVELOPMENT IS CURRENTLY UNDER CONSTRUCTION. 2058386 0 896838 17008616 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 7 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 25 25 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 0 0 0 MN X STEVE BODE 9522832213 1660 S HIGHWAY 100 SUITE 103 ST LOUIS PARK MN 55416 KAYE FOLEY CHAIR 1.00 2.00 X X 0 0 0 PAUL L VOGEL VICE CHAIR EFFECTIVE DEC 2015 1.00 1.00 X X 0 0 0 FR J MICHAEL BYRON VICE CHAIR THRU DEC 2015 1.00 X X 0 0 0 JANE MCCROSSAN SECRETARY 1.00 1.00 X X 0 0 0 DAVID M HOFFMANN TREASURER 1.00 X X 0 0 0 JOSEPH AMBERG MD DIRECTOR THRU MAY 2016 1.00 1.00 X 0 0 0 ANN TINUCCI ANDERSON DIRECTOR 1.00 X 0 0 0 LYNN CHOROMANSKI DIRECTOR 1.00 1.00 X 0 0 0 RITA DEGNAN DIRECTOR 1.00 X 0 0 0 WM CHRISTOPHER DOWNEY MD DIRECTOR 1.00 1.00 X 0 0 0 RICHARD G FABER DIRECTOR 1.00 1.00 X 0 0 0 CAREN GAYTKO DIRECTOR 1.00 X 0 0 0 FR JOSEPH GILLESPIE DIRECTOR 1.00 1.00 X 0 0 0 DAVID KRENN DIRECTOR 1.00 X 0 0 0 CRAIG L LEITER DIRECTOR 1.00 1.00 X 0 0 0 BRIAN MCDONALD DIRECTOR 1.00 X 0 0 0 TERRI MCENANEY DIRECTOR 1.00 X 0 0 0 STEVE MEADS DIRECTOR 1.00 X 0 0 0 TOM SCHMITT DIRECTOR 1.00 X 0 0 0 JENNIFER J SHALTZ DIRECTOR 1.00 X 0 0 0 MARCIA SUTHERLAND DIRECTOR 1.00 X 0 0 0 PATRICK L TAFFE DIRECTOR 1.00 1.00 X 0 0 0 C DWIGHT TOWNES MD DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL J VARPNESS DIRECTOR 1.00 X 0 0 0 MIKE WARREN DIRECTOR 1.00 X 0 0 0 KATHRYN WORNSON DIRECTOR 1.00 1.00 X 0 0 0 BARB RODE PRESIDENT AND CEO 14.00 26.00 X 0 257059 7912 MIKE WARDEN CFO 20.00 20.00 X 0 158209 2567 0 415268 10479 0 0 1 0 0 111167 1108980 373979 1594126 RESIDENT REVENUE 623000 11329060 11329060 REHAB SERVICES 623000 2581639 2581639 CAREGIVER/CNA SERVICES 623000 2566923 2566923 16477622 535400 535400 231144 231144 24265 0 24265 24265 24265 6331221 6394624 -63403 -63403 -63403 28001 111167 39722 -11721 -11721 1126 0 1126 1126 LABOR CONTRACT 812900 507017 507017 MEAL INCOME 722210 461662 461662 FITNESS 900099 225613 225613 383868 383868 1578160 20366719 16477622 0 2294971 782851 782851 1000 1000 9352589 7817098 1535491 119523 105669 13854 1233748 1048686 185062 791648 672901 118747 757585 757585 41855 3163 38692 69218 66709 1825 684 1650155 1617284 32871 567934 567934 316531 222058 72671 21802 57654 562 57092 1035235 1030355 4880 39823 6496 33327 25530 7342 18188 1242817 1227507 15310 1445681 1331558 114123 89743 87523 2220 FOOD 541262 533285 7977 0 MEDICAL SUPPLIES 359258 359258 EQUIPMENT RENTAL & REPA 214047 49009 165038 DUES & SUBSCRIPTIONS 53034 3153 49881 67307 35149 32158 20856028 17008616 3824926 22486 3027694 1408570 438845 439866 567521 1071748 62500 202782 89533305 8563256 52582375 80970049 8798703 6394624 4069506 4803470 38091431 18683699 107638575 113974808 3498575 3283522 992373 4362283 84262488 83228806 2385 2004 0 6517502 2765177 1494180 91520998 98888297 X 15257817 13967821 462980 616038 396780 502652 16117577 15086511 107638575 113974808 -489309 -541757 0 X 0 1 X 1 0 X 3054690 2613112 2661609 5740318 1622127 15691856 3054690 2613112 2661609 5740318 1622127 15691856 340265 15351591 153144 167669 248189 218659 790809 1578470 18025 54035 44825 1579286 1696171 18966497 35291483 0.80940 0.90800 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME FROM VARIOUS SOURCES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1861385 103483 2388 1967256 1435370 427104 -1089 1861385 1289797 146864 -1291 1435370 689800 599997 10052 10052 1289797 354147 335653 2889 2889 689800 0.60600 0.17700 0.21700 1 0 5046537 5046537 70509866 8398172 62111694 4193076 102112 4090964 8686243 62972 8623271 1097583 1097583 80970049 ASSETS HELD BY CATHOLIC COMMUNITY FOUNDATION 206623 SECURITY DEPOSIT 9139 RESIDENT TRUST FUND 3305 LEASE DEPOSITS 2574641 CURRENT PORTION ASSETS LIMITED TO USE 1566356 ASSETS HELD UNDER BOND INDENTURE 12539848 DUE TO AFFILIATES 1783787 18683699 DUE TO AFFILIATES 1126893 SECURITY DEPOSITS 137767 DERIVATIVE INSTRUMENT 229520 1494180 X PART IV, LINE 2B: RESIDENT TRUST FUNDS ARE RESIDENT'S FUNDS HELD BY OXBOW LAKE CARE CENTER, LLC IN A SEGREGATED BANK ACCOUNT FOR THE USE BY RESIDENTS. PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO FURTHER THE MISSION OF ST. THERESE HOME, INC. AND OXBOW LAKE CARE CENTER, WHICH INCLUDES PROVIDING HOUSING, NURSING CARE AND PASTORAL CARE TO THE ELDERLY. 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 FEDERAL INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION IN THE U.S. FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES OR MAY JEOPARDIZE ITS TAX-EXEMPT STATUS. ASSOCIATE DINNER 70517 54936 15581 1444 14603 150 3167 GOLF EVENT 49590 37170 12420 3888 5383 3835 1 19061 19061 700 125 6426 139168 111167 28001 5332 20686 275 13428 39721 -11720 1 ST THERESE HOME INC 8000 BASS LAKE ROAD NEW HOPE MN 55428 410888641 501(C)(3) 775266 GENERAL OPERATING SUPPORT 1 0 PART I, LINE 2: ALL GRANTS ARE MADE TO RELATED ORGANIZATIONS THAT ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITOR THE ACTIVITIES, REVENUES AND EXPENDITURES OF THE RELATED ORGANIZATIONS. 0 0 0 0 0 0 0 0 0 BARB RODE PRESIDENT AND CEO 0 216892 0 25979 0 14188 0 6327 0 1585 0 264971 0 0 MIKE WARDEN CFO 0 144446 0 13763 0 0 0 2171 0 396 0 160776 0 0 PART I, LINE 3 THE CEO'S COMPENSATION IS DETERMINED BY ST. THERESE HOME, INC., AN AFFILIATED ORGANIZATION. ST. THERESE HOME, INC. USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEY OR STUDY 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A CITY OF BROOKLYN PARK MINNESOTA 416008804 2011-07-19 10000000 FACILITY EXPANSION PROJECT 0 0 0 B CITY OF CHAMPLIN MINNESOTA 416007831 2011-07-19 3320000 FACILITY EXPANSION PROJECT 0 0 0 C HOUSING & REDEVELOPMENT AUTHORITY IN & FOR THE CITY OF WOODBURY MN 371573995 2014-10-30 53484887 FACILITY CONSTRUCTION 0 0 0 D CITY OF BROOKLYN PARK MINNESOTA 416008804 2015-06-09 17717258 REFINCANCE SERIES 2005 BONDS 0 0 0 A 830020 10000000 532570 9467430 2012 0 0 1 1 B 274442 3320000 3320000 2012 0 0 1 1 C 53484887 3329356 3397900 1064900 1597350 44095381 0 0 0 0 D 634348 17717258 17717258 2006 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 FORM 990, PART III, LINE 2 ST. THERESE TCU NORTH, LLC (TCU NORTH) WAS CREATED IN AUGUST OF 2014 TO OPERATE 32 TRANSITIONAL CARE LICENSED NURSING BEDS IN LEASED SPACE WHICH BEGAN OPERATIONS IN FEBRUARY OF 2016. ST. THERESE REDWOODS, LLC (REDWOODS) WAS CREATED IN JUNE OF 2016 TO OWN AND OPERATE 64 INDEPENDENT LIVING UNITS LOCATED ADJACENT TO WOODBURY. THE DEVELOPMENT IS CURRENTLY UNDER CONSTRUCTION. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS ENTIRELY COMPOSED OF THE GOVERNING BODY MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS OF THIS CORPORATION IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, AND THE EXECUTIVE COMMITTEE SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE AND BOARD OF DIRECTORS PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS AND KEY MANAGEMENT EMPLOYEES ARE ANNUALLY REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. THE DISCLOSURES ARE REPORTED TO THE BOARD OF DIRECTORS. INDIVIDUALS HAVING MATERIAL CONFLICTS OF INTEREST ARE ASKED TO REFRAIN FROM VOTING ON ANY ACTION THAT MAY BE INFLUENCED BY THE CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE PROVIDED TO THE BOND TRUSTEE, WHO DISTRIBUTES THEM TO THE ELECTRONIC MUNICIPAL MARKET ACCESS SYSTEM. OXBOW LAKE CARE CENTER LLC 1660 S HWY 100 SUITE 103 ST LOUIS PARK MN 55416 273308934 SKILLED NURSING FACILITY MN 14182728 33799674 ST THERESE FOUNDATION INC ST THERESE AT HOME SOLUTIONS LLC 1660 S HWY 100 SUITE 103 ST LOUIS PARK MN 55416 454049467 PRIVATE DUTY HOME SERVICES MN 4991569 886085 ST THERESE FOUNDATION INC ST THERESE AT WOODBURY LLC 1660 S HWY 100 SUITE 103 ST LOUIS PARK MN 55416 463330004 SENIOR CARE COMMUNITY MN 1009829 63224892 ST THERESE FOUNDATION INC ST THERESE TCU NORTH LLC 1660 S HWY 100 SUITE 103 ST LOUIS PARK MN 55416 471966105 TCU MN 323882 3561301 ST THERESE FOUNDATION INC ST THERESE REDWOODS LLC 1660 S HWY 100 SUITE 103 ST LOUIS PARK MN 55416 811768413 SENIOR CARE COMMUNITY MN 97 6764869 ST THERESE FOUNDATION INC ST THERESE HOME INC 1660 S HWY 100 SUITE 103 NEW HOPE MN 55428 410888641 HOUSING & NURSING CARE FOR THE ELDERLY MN 501(C)(3) 9 ST THERESE FOUNDATION INC 1 ST THERESE AT OXBOW LAKE INC 1660 S HWY 100 SUITE 103 NEW HOPE MN 55428 205835911 HOUSING & NURSING CARE FOR THE ELDERLY MN 501(C)(3) 9 ST THERESE FOUNDATION INC 1 0 1 1 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 ST THERESE AT OXBOW LAKE B 749780 FMV ST THERESE HOME B 359200 FMV ST THERESE HOME C 775266 FMV