2017-10-25T12:53:15-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2016-01-01 410693872 MINNESOTA MASONIC HOME CARE CENTER MINN 9529487000 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 SUE MORK CFO 9529487000 2017-08-04 1 JEFF VRIEZE P01273590 6123764500 67.137.57.251 2017-08-04 15:12:07 CD P 1FBCD4AA4D8DA69ACB92FF11632DDFE988DCF009 F3F329DFBA37A4C14C73FD596159B47BC051605F 2016 2021-01-29 14:40:06Z ERIC J NEETENBEEK 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 33108965 0 X WWW.MNMASONICHOMES.ORG X 1908 MN TO PROVIDE NURSING/CARE FOR THE ELDERLY. 7 7 725 240 0 0 0 0 28864530 32440240 473646 2280 834325 666445 30172501 33108965 0 0 0 0 20190173 21918295 0 0 0 8253922 8499399 28444095 30417694 1728406 2691271 25304573 27262358 9829732 9008401 15474841 18253957 X MINNESOTA MASONIC CHARITIES AND AFFILIATES' PURPOSES ARE TO HELP, AID AND ASSIST THE MASONIC FAMILY AND OTHERS, GUIDED BY THE MASONIC PRINCIPLES OF BROTHERLY LOVE, RELIEF AND TRUTH, BY (A) PROVIDING FACILITIES FOR NURSING CARE AND ELDERLY HOUSING; FACILITIES AND PROGRAMS FOR COMMUNITY, HEALTH, SOCIAL SERVICES AND EDUCATION OF OLDER PERSONS AND THEIR FAMILIES; AND PROFESSIONALS WHO SERVE OLDER PERSONS; (B) PROMOTING RESEARCH AND OTHER ACTIVITIES RELATED TO THE TREATMENT AND CURE OF CANCER; (C) ASSISTING STUDENTS IN OBTAINING HIGHER EDUCATION; (D) THE COLLECTION, PRESERVATION AND DISSEMINATION OF HISTORICAL KNOWLEDGE ABOUT MASONRY IN MINNESOTA; AND (E) TO ENGAGE IN, PROMOTE, AND ADMINISTER CHARITABLE CAUSES AND PROJECTS THAT AID, ASSIST, AND CONTRIBUTE TO THE SUPPORT OF CORPORATIONS, TRUST, ASSOCIATIONS, AND FOUNDATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXES. 0 0 27817887 0 32440240 MINNESOTA MASONIC HOME CARE CENTER OWNS AND OPERATES A 214 BED NURSING HOME FACILITY AND A 45 UNIT ASSISTED LIVING COMPLEX PROVIDING PROFESSIONAL CARE TO ITS NURSING FACILITY RESIDENTS. THE NURSING HOME AND ASSISTED LIVING HAD 93.56% AND 98.3% OCCUPANCY RESPECTIVELY IN 2016. 27817887 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 725 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X SUE MORK CFO 9529486205 11501 MASONIC HOME DR BLOOMINGTON MN 55437 STEVEN R JOHNSON CHAIRMAN 1.00 4.00 X X 0 0 0 JAMES C SHIRELY CHAIRMAN - THROUGH JAN 2016 1.00 4.00 X X 0 0 0 JOYCE D MCCURDY VICE CHAIRMAN 1.00 4.00 X X 0 0 0 CARL F LIDSTROM SECRETARY 1.00 4.00 X X 0 0 0 DOUGLAS J CAMPBELL TREASURER 1.00 4.00 X X 0 0 0 BARBARA BRIHN DIRECTOR 1.00 4.00 X 0 0 0 BURNETT G SULLIVAN DIRECTOR 1.00 4.00 X 0 0 0 RUSSELL W TROUT DIRECTOR 1.00 4.00 X 0 0 0 ERIC J NEETENBEEK PRESIDENT/CEO-CHARITIES 4.00 36.00 X 0 377641 35660 SUE MORK CFO-CHARITIES 4.00 36.00 X 0 148842 21800 PATRICIA LARUE HR DIRECTOR 40.00 0.00 X 117673 0 17355 SHELLY WIGGIN ADMINISTRATOR 40.00 0.00 X 122797 0 7574 DILYARA KADYMOVA DIRECTOR OF NURSING 40.00 0.00 X 125669 0 11767 366139 526483 94156 3 0 1 0 G & K SERVICES 685 OLIVE STREET ST PAUL MN 55437 LAUNDRY SERVICES 185396 ON CALL CLINICIANS 5861 CEDAR LAKE ROAD ST LOUIS PARK MN 55485 NURSING SERVICES 120547 PRESCRIPTION LANDSCAPE PO BOX 856827 MINNEAPOLIS MN 55485 LAWN AND SNOW REMOVAL 113333 PATHWAY HEALTH SERVICES 11240 STILLWATER BLVD LAKE ELMO MN 55042 HEALTH CARE CONSULTING 105802 4 RESIDENT SERVICES 621610 32440240 32440240 32440240 2280 2280 159929 0 159929 159929 159929 109919 0 109919 109919 MEALS/CATERING 621610 239873 239873 BARBER & BEAUTY 621610 86079 86079 MISCELLANEOUS 621610 45351 45351 25294 25294 396597 33108965 32440240 0 668725 18473929 17785441 688488 240225 229191 11034 1835919 1751591 84328 1368222 1305376 62846 950000 950000 5241 5241 46249 46249 1027253 837127 190126 5033 5033 1002456 892766 109690 677797 634022 43775 8787 8787 97306 91740 5566 1094058 1031476 62582 212160 200024 12136 PHARMACY 1408894 1408894 FOOD 829327 829327 LICENSE SURCHARGE 602410 602410 MISCELLANEOUS EXPENSES 382380 218502 163878 150048 150048 30417694 27817887 2599807 0 3151 3151 3028931 3920287 140233 134027 63109 170887 42118134 30262668 11792303 11855466 15000 15000 70326 60279 10191520 11103261 25304573 27262358 1887287 2122904 7655000 6600000 143691 141743 143754 143754 9829732 9008401 X 15412910 18123439 61931 130518 15474841 18253957 25304573 27262358 X 2691271 87845 X 0 1 X 1 0 X 25850 11311 13930 51091 26625876 27393839 29107975 28864530 32440240 144432460 387609 592611 623150 586059 461165 2650594 27039335 27997761 29745055 29450589 32901405 147134145 0 0 0 147134145 169246 170221 187484 179261 162209 868421 169246 170221 187484 179261 162209 868421 -990682 41523 40191 70196 45351 -793421 26217899 28209505 29972730 29700046 33108965 147209145 0.99950 0.99940 0.00590 0.00610 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS LOSS ON REFINANCING TERMINATION OF TOTAL RETURN SWAP 0 1 X 81638 81638 27272793 17321872 9950921 2975951 2700362 275589 11787752 10240434 1547318 11855466 RESIDENT TRUST FUNDS 7465 DUE FROM AFFILIATES 11095796 11103261 ASSET RETIREMENT OBLIGATION 143754 143754 X 33108965 0 33108965 0 33108965 30417694 0 30417694 0 30417694 PART IV, LINE 2B: THE ORGANIZATION IS THE TRUSTEE OF VARIOUS TRUST FUNDS ON BEHALF OF THE RESIDENTS. THE ASSISTED LIVING COMPLEX REQUIRES ITS RESIDENTS TO PAY SECURITY AND RESERVATION DEPOSITS. THE ORGANIZATION ACCRUES 1% SIMPLE INTEREST ON THE DEPOSITS FROM THE DATE OF RECEIPT. PART X, LINE 2: THE ORGANIZATION QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATION IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE ORGANIZATION IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER SECTION 509(A)(2) OF THE CODE AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS A CHARITABLE TAX DEDUCTION BY THE CONTRIBUTOR. THE ORGANIZATION'S ANNUAL TAX FILINGS ARE SUBJECT TO REVIEW BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OTHER TAXES. 0 0 0 0 0 0 0 0 0 ERIC J NEETENBEEK PRESIDENT/CEO-CHARITIES 0 281626 0 75000 0 21015 0 16065 0 19595 0 413301 0 0 SUE MORK CFO-CHARITIES 0 129142 0 0 0 19700 0 9227 0 12573 0 170642 0 0 PART I, LINE 3 COMPENSATION FOR THE PRESIDENT/CEO IS DETERMINED BY A RELATED ORGANIZATION THAT USES THE FOLLOWING METHODS: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEY OR STUDY 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A CITY OF BLOOMINGTON MN 416004990 094788AS5 2012-12-05 11075000 REFINANCING OF DEBT 0 0 0 A 4475000 11075000 84615 10990385 2012 1 0 1 1 A 0 0 0 0 0 0 1 A 1 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE INCLUDES THE CHAIRMAN, THE PRESIDENT/CEO, THE VICE-CHAIRMAN, THE TREASURER, AND THE SECRETARY. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD IN MANAGEMENT OF THE BUSINESS OF THIS ORGANIZATION IN THE INTERVAL BETWEEN BOARD MEETINGS, AND THE EXECUTIVE COMMITTEE IS AT ALL TIMES SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD. THE EXECUTIVE COMMITTEE HAS SUCH OTHER DUTIES AS ARE PRESCRIBED BY THE BOARD FROM TIME TO TIME. FORM 990, PART VI, SECTION A, LINE 3 MINNESOTA MASONIC ELDER SERVICES PROVIDES MANAGEMENT SERVICES, INCLUDING EXECUTIVE MANAGEMENT, TO ITS RELATED MINNESOTA MASONIC CHARITIES ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS CORPORATION, WITH VOTING RIGHTS, IS MINNESOTA MASONIC CHARITIES, A MINNESOTA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF THE SOLE MEMBER, MINNESOTA MASONIC CHARITIES SHALL ELECT ALL DIRECTORS AT ITS ANNUAL ORGANIZATIONAL MEETING AFTER CONSIDERATION OF A SLATE OF NOMINEES APPROVED BY THE NOMINATING COMMITTEE. THE GRAND MASTER OF THE GRAND LODGE OF ANCIENT FREE AND ACCEPTED MASONS OF MINNESOTA MAY NOMINATE ONE PERSON FOR THE CONSIDERATION OF THE BOARD OF DIRECTORS AND THE NOMINATING COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, MINNESOTA MASONIC CHARITIES SHALL HAVE THE RIGHT AND POWER TO APPROVE ANY OF THE FOLLOWING, AS PROPOSED BY THE BOARD, PRIOR TO THE ACT OR ACTION TAKING EFFECT OR BEING IMPLEMENTED: (A) ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THIS CORPORATION; (B) ALL CAPITAL BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THE CORPORATION, AND ALL MAJOR CAPITAL EXPENDITURES BEFORE FUNDS ARE EXPENDED THEREFOR (FOR THESE PURPOSES A MAJOR CAPITAL EXPENDITURE SHALL BE DEFINED BY MINNESOTA MASONIC CHARITIES' BYLAWS THEN IN EFFECT); (C) ALL OPERATING BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, BEFORE AUTHORIZED EXPENDITURES MAY BE MADE THEREFROM; (D) STRATEGIC PLANS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION; (E) THE INCURRING OF ANY LONG TERM DEBT OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, OTHER THAN INTRA-SYSTEM OR REFINANCING DEBT; (F) ALL HUMAN RESOURCES AND BENEFITS POLICIES OF THIS CORPORATION; (G) ANY MAJOR RISK CONTRACTING AGREEMENTS, WHICH FOR THESE PURPOSES MEANS ANY CONTRACT WHICH DEALS WITH CAPITATION OR SIMILAR RISK BEARING CONCEPT; (H) ANY MERGER, CONSOLIDATION, OR TOTAL OR PARTIAL DISSOLUTION INVOLVING THIS CORPORATION; (I) THE NUMBER OF DIRECTORS OF THIS CORPORATION; AND (J) ANY GOVERNANCE AND ACTION OF THE TYPE SET FORTH IN SUBPARAGRAPH (A) AND SUBPARAGRAPHS (F) THROUGH (I) ABOVE AS PROPOSED BY THE BOARD OF DIRECTORS OF ANY CORPORATION, PARTNERSHIP OR OTHER LEGAL ENTITIES DIRECTLY CONTROLLED BY THIS CORPORATION AS A MEMBER, SHAREHOLDER OR OTHERWISE, TO THE EXTENT THAT THE GOVERNING DOCUMENTS OF SUCH CORPORATION, PARTNERSHIP OR OTHER LEGAL ENTITIES GIVE THIS CORPORATION OR THE BOARD A RIGHT OF APPROVAL OVER SUCH GOVERNANCE ACTION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WAS REVIEWED BY MANAGEMENT AND WAS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL STAFF, BOARD OF DIRECTORS AND PROFESSIONAL SERVICES INDEPENDENT CONTRACTORS ARE REQUIRED TO COMPLETE AND SUBMIT A CONFIDENTIAL DISCLOSURE STATEMENT TO THE CEO OR CHAIRMAN OF THE MINNESOTA MASONIC CHARITIES BOARD OF DIRECTORS BY MAY 1 OF EACH YEAR. IF ANY DISCLOSURE STATEMENT INDICATES THE POTENTIAL FOR A CONFLICT OF INTEREST, THE CEO AND, IF NECESSARY, THE CHAIRMAN OF THE BOARD WILL MEET WITH THE AFFECTED INDIVIDUAL TO RESOLVE HOW THE INDIVIDUAL MAY PARTICIPATE IN GOVERNANCE OR MANAGEMENT ACTIVITIES ASSOCIATED WITH THE POTENTIAL CONFLICT OF INTEREST. EACH STAFF PERSON WILL VOLUNTARILY ABSTAIN FROM PARTICIPATION IN ANY MINNESOTA MASONIC CHARITIES ACTIVITY IN WHICH A POTENTIAL CONFLICT OF INTEREST MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION OF THE PRESIDENT/CEO IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE, COMPRISED ENTIRELY OF INDEPENDENT INDIVIDUALS, OF THE BOARD OF DIRECTORS OF MINNESOTA MASONIC CHARITIES. A MARKET ANALYSIS IS COMPLETED BY AN INDEPENDENT CONSULTANT, ALONG WITH A PERFORMANCE REVIEW. ANY ADJUSTMENTS IN COMPENSATION ARE APPROVED BY THE BOARD OF DIRECTORS OF MINNESOTA MASONIC CHARITIES. WE HAVE ANSWERED YES TO LINE 15A BECAUSE OUR BOARD OF DIRECTORS AND COMPENSATION COMMITTEE ARE IDENTICAL TO THOSE OF MINNESOTA MASONIC CHARITIES. THE PRESIDENT/CEO ANNUALLY REVIEWS THE COMPENSATION OF THE MANAGEMENT STAFF. ANY ADJUSTMENTS IN COMPENSATION ARE WITHIN THE PARAMETERS SET BY THE BOARD OF DIRECTORS. COMPENSATION REVIEWS FOR ALL POSITIONS WERE LAST CONDUCTED IN 2016. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATES 87,845. MINNESOTA MASONIC CHARITIES 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 411495325 FUNDRAISING MN 501(C)(3) LINE 7 N/A 0 MINNESOTA MASONIC HOME NORTH RIDGE 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 411921948 NURSING HOME MN 501(C)(3) LINE 10 MINNESOTA MASONIC CHARITIES 0 MINNESOTA MASONIC CHARITIES FUNDS 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 411495321 INVESTMENTS MN 501(C)(3) LINE 12A, I MINNESOTA MASONIC CHARITIES 0 MINNESOTA MASONIC HOME CLUSTER HOMES 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 411694835 SENIOR HOUSING MN 501(C)(3) LINE 10 MINNESOTA MASONIC CHARITIES 0 MINNESOTA MASONIC HOME SENIOR OUTREACH SERVICES 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 411486229 ADULT DAY CARE MN 501(C)(3) LINE 10 MINNESOTA MASONIC CHARITIES 0 MINNESOTA MASONIC ELDER SERVICES 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 411756132 MANAGEMENT MN 501(C)(3) LINE 12A, I MINNESOTA MASONIC CHARITIES 0 MASONIC CANCER CENTER FUND INC 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 410849479 FUNDRAISING MN 501(C)(3) LINE 7 MINNESOTA MASONIC CHARITIES 0 MINNESOTA MASONIC HISTORICAL SOCIETY AND MUSEUM 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 411788642 EDUCATION MN 501(C)(3) LINE 12A, I MINNESOTA MASONIC CHARITIES 0 MINNESOTA MASONIC CHARITIES HOLDING CORP 11501 MASONIC HOME DRIVE BLOOMINGTON MN 55437 452102682 REAL ESTATE HOLDINGS MN 501(C)(2) MINNESOTA MASONIC CHARITIES 0 MINNESOTA MASONIC HOMES MANAGEMENT CONSULTING SERVICES 11501 MASONIC DRIVE BLOOMINGTON MN 55437 411963774 CONSULTING SERVICES MN N/A C 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 1