2017-11-02T09:05:34-05:00 2016-12-31 390758449 Wipfli LLP 7601 France Avenue South Suite 400 Minneapolis MN 55435 990 2016-01-01 410706110 Episcopal Church Home of Minnesota EPIS 6516460622 1879 Feronia Avenue St Paul MN 55104 Marvin Plakut President & CEO 6512098529 2017-10-10 1 Michael J Peterson CPA P01833529 9525483400 2017-10-10 50.249.107.123 2017-10-10 10:45:53 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BB3069DA9F6047B5836CE2952E0AE234800C2778 2016 2021-01-29 14:40:06Z Marvin Plakut 1879 Feronia Avenue St Paul MN 55104 14782201 0 1194 X WWW.EHOMESMN.ORG X 1894 MN PROVIDE SKILLED CARE IN THE OPERATION OF NURSING HOME. 15 15 651 116 0 0 156539 61670 12719120 14487439 45177 108019 156017 125073 13076853 14782201 122773 0 0 0 7675224 8608376 0 0 0 5747252 6730338 13545249 15338714 -468396 -556513 15572463 14524194 12307247 11455604 3265216 3068590 Our mission is to enhance the quality of life for senior adults by providing homes and services that support each individuals physical, social and spiritual needs. 0 0 13788295 0 14533338 Episcopal Church Home provides 24-hour skilled nursing care in pleasant, home-like settings called Households. Residents live in comfortable, private rooms within Household Communities. Each Household has its own team of qualified, caring staff members. The services included are On-site physicians, nurse practitioners, podiatrists, dentists, optometrists, psychologist and hearing aid specialists. There is also spiritual wellness provided by on-staff chaplains, with a variety of ministry and worship services in two on-site chapels. The Episcopal Church Home has 81 skilled nursing beds and 50 board and care beds. 13788295 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 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 1 1 0 0 1 11 0 1 651 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Tom Henry 6512098529 490 E lynnhurst avenue st paul MN 55104 Mary Clem Director 0.10 1.10 X 0 0 0 Lois Cutler Director 0.10 1.10 X 0 0 0 Amy Fistler Director 0.10 1.10 X 0 0 0 Carol Forbes Director 0.10 1.10 X 0 0 0 Peter Gove Director 0.10 1.10 X 0 0 0 Mary Lilja Director 0.10 1.10 X 0 0 0 Cathy McCallister Director 0.10 1.10 X 0 0 0 Robert McClay Director 0.10 1.10 X 0 0 0 The Rev Diane McGowan Director 0.10 1.10 X 0 0 0 The Rev Rex McKee Director (Thru November) 0.10 1.10 X 0 0 0 Catherine Myers Director (Thru November) 0.10 1.10 X 0 0 0 Sarah Nowlin Director (Thru August) 0.10 1.10 X 0 0 0 Brian Ostenso Director 0.10 1.10 X 0 0 0 Jerome O'Brien Slawik Director 0.10 1.10 X 0 0 0 Cynthia Verhey Director (Thru November) 0.10 1.10 X 0 0 0 Jim Wenker Director (Thru November) 0.10 1.10 X 0 0 0 Rick Rinkoff Director (Thru November) 0.10 1.10 X 0 0 0 Denise Cole Chair 0.10 1.10 X X 0 0 0 Tom Hove Vice Chair 0.10 1.10 X X 0 0 0 James Johnson Vice Chair (Thru June) 0.10 1.10 X X 0 0 0 Chris Howard Secretary 0.10 1.10 X X 0 0 0 Bob Stupka Treasurer 0.10 1.10 X X 0 0 0 Marvin Plakut President/CEO 3.00 37.00 X 174843 0 29732 John T Henry CFO 3.00 37.00 X 117403 0 31239 Steven Mork COO 3.00 37.00 X 132730 0 2364 Mike Karel Administrator (Thru January) 3.00 37.00 X 49549 0 1752 474525 0 65087 3 0 1 0 EH Services 490 Lynnhurst Avenue East St Paul MN 55104 Management Services 1001556 1 8443 53227 61670 Patient Service Revenue 531110 14479105 14479105 Other Resident Charges 900099 8334 8334 14487439 108019 108019 Cafe Revenue 722210 45899 45899 79174 79174 125073 14782201 14533338 0 187193 X 539612 321517 218095 6650819 6650819 33902 33902 856644 856644 527399 513165 14234 1001566 97703 903863 20632 20632 29949 29949 1568346 1521484 46862 8154 8154 269025 187455 81570 122909 400 122509 221146 221146 7645 5154 2491 18843 14849 3994 545521 545521 759348 759348 106048 106048 Medical Supplies and Dr 857871 857871 Food Services 556825 556825 DHS Surcharge 228050 228050 Equipment Rental 206286 173649 32637 202174 136745 65429 15338714 13788295 1550419 0 477421 120504 567822 423718 1031335 1340830 207355 56722 18567018 9992765 9030108 8574253 65 4258357 4008167 15572463 14524194 1123808 1343526 10516000 9993984 9665 10915 657774 107179 12307247 11455604 X 2846035 2465315 214149 398243 205032 205032 3265216 3068590 15572463 14524194 -556513 359887 0 X X 0 1 X 1 0 X 52845 54509 289953 156539 61670 615516 11769964 12002831 12485813 12784881 14533338 63576827 44108 40854 43174 90256 79174 297566 11866917 12098194 12818940 13031676 14674182 64489909 0 0 0 64489909 27683 32853 25124 45177 108019 238856 27683 32853 25124 45177 108019 238856 11894600 12131047 12844064 13076853 14782201 64728765 0.99630 0.99750 0.00370 0.00250 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 181281 181281 16445258 8489057 7956201 1940479 1503708 436771 8574253 Interest in Net Assets of EHF 533705 Related Party Receivables 609716 Investments Held by Foundation 2156855 Assets limited as to use - held by EHF 707891 4008167 Asset Retirement Obligation Liability 107179 107179 14734776 0 14734776 47425 47425 14782201 15292815 -45899 -45899 15338714 0 15338714 Part IV, Line 2b: The organization is the trustee of resident funds and has fiduciary responsibility for the administration and distribution of these funds for residents of the Organization. Part XI, Line 4b - Other Adjustments: Contribution to unrestricted net assets 2,500. Net assets released from restrictions -974. Cafeteria Revenue Recorded as Expense 45,899. Part XII, Line 2d - Other Adjustments: Cafeteria Revenue Recorded as Expense -45,899. X X X 1 0 0 0 0 0 0 0 0 Marvin Plakut President/CEO 174843 0 0 0 0 0 5281 0 24451 0 204575 0 0 0 Part I, Line 4a Mike Karel received severence pay of $26,156. A Housing and redevelopment authority of the City of St Paul MN 416005521 792893FE4 2006-11-02 8591616 Remodeling and expansion of Nursing Home 0 0 0 B Housing and redevelopment authority of the City of St Paul MN 521440935 792908CB9 2012-11-15 10216876 Refunding of 1999 bond issue, and reserves related to campus expansion 0 0 0 A 1630000 8591616 168500 8256500 2008 0 0 1 1 B 446876 10216876 652417 6370776 205000 2988683 2013 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 1 B 1 Part III, Line 9 & Part V The Organization would consult with bond counsel to address any violations of federal tax requirements and related remediation. Form 990, Schedule K, Part I, Issuer B The organization shares the proceeds and purpose of the funds from this bond with a related organization, Iris Park Commons. At the end of tax year, 12/31/2015, the outstanding balance of the bond for Episcopal Church Home of Minnesota and Iris Park Commons was $3,486,000 and $6,474,000 respectively. Form 990, Part VI, Section A, line 3 EH Services, Inc. is a related, 501(c)(3) organization that is responsible for managing the organization. Form 990, Part VI, Section A, line 6 The organization has a sole member, Episcopal Homes of Minnesota, a Minnesota nonprofit corporation. Form 990, Part VI, Section A, line 7a The sole member of the corporation, Episcopal Homes of Minnesota, has the voting rights of the organization and therefore the ability to elect and appoint all members of the governing body. All board members of Episcopal Homes of Minnesota, are board members of the organization. Form 990, Part VI, Section A, line 7b The sole member of the corporation, Episcopal Homes of Minnesota, has the ability to elect and appoint all members of the governing body and therefore are reserved the right to make governance decisions for the organization. All board members of Episcopal Homes of Minnesota, are board members of the organization. Form 990, Part VI, Section B, line 11b The 990 is prepared by the CPA firm hired by the organization to perform the audit using information provided by the organization. The CFO reviews the return and approves. The Form 990 is made available to the Board of Directors prior to submission to the Internal Revenue Service. Form 990, Part VI, Section B, line 12c All members are responsible to - without request - make a prompt, full, and frank disclosure of his or her conflict of interest therein to the entire Board prior to any action upon the matter, contract, or transaction that causes conflict. If the board determines that a conflict of interest exists, the person shall remove them self from the meeting room or from the communication means by which the meeting is being held. Form 990, Part VI, Section B, line 15 The Executive Committee of the Board of Directors annually reviews the accomplishments of the CEO compared to the goals set for the year. Market research is also done annually to compare the compensation of the CEO to the compensation of other CEO's in our industry. The CEO is responsible for reviewing and approving the compensation of other officers and key employees. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request to CEO or Director of Finance. Form 990, Part IX, line 11g Other Professional Fees: Program service expenses 282,666. Management and general expenses 46,862. Fundraising expenses 0. Total expenses 329,528. Therapists and other non physician services: Program service expenses 1,238,818. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,238,818. Form 990, Part XII, Line 2c The Board of Directors finance committee is responsible for the oversight of the audit and the selection of the independent accountant. This process has not changed from the prior year. Episcopal Homes of Minnesota 490 Lynnhurst Avenue East St Paul MN 55104 911983254 Provision of Senior Housing and Care Services MN 501(c)(3) Line 1 N/A 0 Carty Heights 412 Dunlap Street N St Paul MN 55104 204250735 Senior Housing MN 501(c)(3) Line 10 Episcopal Homes of Minnesota 1 Cornelia House 490 Lynnhurst Avenue East St Paul MN 55104 061692748 senior Housing MN 501(c)(3) Line 10 Episcopal Homes of Minnesota 1 EH Services INC 490 Lynnhurst Avenue East St Paul MN 55104 455322401 Facilities Managment MN 501(c)(3) Line 12a, I Episcopal Homes of Minnesota 1 Episcopal Home Care and Services 490 Lynnhurst Avenue East St Paul MN 55104 270907277 Home Care MN 501(c)(3) Line 10 Episcopal Homes of Minnesota 1 Episcopal Homes Foundation of Minnesota 490 Lynnhurst Avenue East St Paul MN 55104 411703612 Fundraising MN 501(c)(3) Line 7 Episcopal Homes of Minnesota 1 Iris Park Commons 1850 University Avenue West St Paul MN 55104 411433860 Assisted Living MN 501(c)(3) Line 10 Episcopal Homes of Minnesota 1 Kings Crossing Apartments 490 Lynnhurst Avenue East St Paul MN 55104 264270887 Senior Housing MN 501(c)(3) Line 10 Episcopal Homes of Minnesota 1 Midway Pointe 490 Lynnhurst Avenue East St Paul MN 55104 454788152 Low Income Housing MN 501(c)(3) Line 10 Episcopal Homes of Minnesota 1 Seabury 1830 University Avenue West St Paul MN 55104 411997880 Low Income Housing MN 501(c)(3) Line 10 Episcopal Homes of Minnesota 1 Episcopal Homes Management Services of Minnesota Inc 490 Lynnhurst Avenue East St Paul MN 55104 411695916 Management MN N/A C 0 Episcopal Homes Owners Association 490 Lynnhurst Avenue East St Paul MN 55104 413917931 Management MN N/A C 0 0 1 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 0 0 EH Services M 1001566 Book Value Iris Park Commons Q 433251 Book Value Cornelia House Q 23642 Book Value EH Services Q 2370449 Book Value Cornelia House Q 82625 Book Value Carty Heights Q 117137 Book Value Episcopal Home Care & Services Q 5151889 BOok Value Iris Park Commons Q 568626 BOok Value Kings Crossing Q 84120 Book Value Seabury Q 164234 Book Value Midway Pointe Q 59371 Book Value Episcopal Homes Management Services of Minnesota Q 86545 Book Value