2017-08-14T08:55:30-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2016-01-01 411310487 LYNGBLOMSTEN CARE CENTER INC LYNG 6516462941 1415 ALMOND AVENUE ST PAUL MN 55108 BRADLEY J JACOBSON CFO 6516462941 2017-07-25 1 CORY RUTLEDGE P01329381 6123764500 67.137.57.251 2017-07-25 10:48:15 CD P 725FFE5B03C807F63A0DD773D253EB4B7C5C9EE3 4A6DB1B1FC9DBA9B5F2864C6E754A05CFDE1F644 2016 2021-01-29 14:40:06Z JEFF HEINECKE 1415 ALMOND AVENUE ST PAUL MN 55108 24987691 0 9386 X WWW.LYNGBLOMSTEN.ORG X 1976 MN TO PROVIDE A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS. 18 17 533 1341 1292 -172545 181690 53126 19949802 24262361 187357 207605 225851 249221 20544700 24772313 435000 1303622 0 0 15088748 17367550 0 0 0 5421696 5846101 20945444 24517273 -400744 255040 12695539 12953866 1726490 1643194 10969049 11310672 X INFLUENCED BY CHRIST, LYNGBLOMSTEN PROVIDES A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS IN ORDER TO PRESERVE AND ENHANCE THEIR QUALITY OF LIFE. 1 0 21741019 1303622 24261069 THE LYNGBLOMSTEN CARE CENTER, A 237-BED SKILLED NURSING FACILITY, PROVIDES BOTH SHORT-TERM REHABILITATION AND LONG-TERM HEALTHCARE, INCLUDING SPECIALIZED CARE FOR ALZHEIMER'S DISEASE AND OTHER DEMENTIAS, PARKINSON'S DISEASE, AND PALLIATIVE CARE. IN 2016, 754 PERSONS RECEIVED CARE. CHAPLAINS, VOLUNTEERS, AND PROFESSIONAL STAFF ENSURE RESIDENTS RECEIVE QUALITY HEALTH CARE IN A DIGNIFIED MANNER. ALTHOUGH HEALTH ISSUES PREVENT THESE OLDER ADULTS FROM ENJOYING LIVING IN THEIR OWN HOMES, LYNGBLOMSTEN PROMOTES PERSON-CENTERED CARE, GIVING OLDER ADULTS AS MANY CHOICES AND COMFORTS OF HOME AS POSSIBLE. PROGRAMMING (INCLUDING THE ARTS) AND SOCIAL EVENTS ARE HOSTED TO ENHANCE THE LIVES OF THESE OLDER ADULTS AND THEIR FAMILIES. IN 2016, LYNGBLOMSTEN COMPLETED ITS PARTICIPATION IN THE RESIDENT CARE CENTERED CAREFORCE DEVELOPMENT (RCCD) GRANT PROJECT TO IMPROVE OVERALL RESIDENT CARE THROUGH INCREASING STAFF RETENTION RATES, PROVIDING QUALITY TRAINING AND MENTORING OPPORTUNITIES TO STAFF, AND INCORPORATING TECHNOLOGIES TO IMPROVE EFFICIENCIES IN CARE DELIVERY. LYNGBLOMSTEN CONTINUED TO PARTICIPATE IN THE PERSON CENTERED CARE CONNECTIONS (PCCC) GRANT. IN AN EFFORT TO DECREASE RE-HOSPITALIZATIONS, THE PROGRAM'S GOAL IS TO HELP PATIENTS SUCCESSFULLY TRANSITION FROM LYNGBLOMSTEN'S TRANSITIONAL CARE UNIT BACK HOME. LYNGBLOMSTEN CARE CENTER, INC. IS AFFILIATED WITH LYNGBLOMSTEN AND THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. 141270 0 1292 EMENUCHOICE IS THE WEB-BASED SOFTWARE TOOL DEVELOPED ORIGINALLY BY LYNGBLOMSTEN FOR IMPROVING ITS RESIDENT DINING EXPERIENCE. THE TOOL REDUCES COMMUNICATION BARRIERS FOR RESIDENT MEAL ORDERING WHILE ENABLING PERSON-CENTERED CHOICES, MAXIMIZING ACCURACY, STREAMLINING KITCHEN MEAL PREP, AND REDUCING WASTE. IN 2016, DEVELOPMENTS TO THE SOFTWARE ENHANCED SEVERAL AREAS, INCLUDING MEAL TICKET PRINTING FOR KITCHEN STAFF, BILLING REPORTS FOR ADMINISTRATIVE STAFF, AND LISTS OF MENU ITEM MODIFIERS FOR SERVERS AND CONSUMERS. SALES TO SENIOR LIVING COMMUNITIES OUTSIDE OF LYNGBLOMSTEN BEGAN IN EARNEST. BY THE END OF THE YEAR, 11 SITES (NINE SENIOR HOUSING AND TWO SKILLED NURSING) WERE USING EMENUCHOICE FOR THEIR FOODSERVICE MANAGEMENT-UP FROM TWO SITES AT THE BEGINNING OF THE YEAR. SITES WERE IN MINNESOTA AND TEXAS. PROJECTIONS SHOW THAT APPROXIMATELY 40 SITES WILL BE USING EMENUCHOICE BY MID-YEAR 2017. 21882289 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 25 0 533 1 1 1 0 0 0 0 0 0 0 0 0 X 18 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X BRADLEY J JACOBSON 6516325310 1415 ALMOND AVENUE ST PAUL MN 55108 WILLIAM C SANDEN CHAIR 1.00 4.00 X X 0 0 0 ANDREW LOWTHER VICE CHAIR 1.00 4.00 X X 0 0 0 WILLIAM STACEY TREASURER 1.00 3.00 X X 0 0 0 JANE DANIELSON SECRETARY 1.00 3.00 X X 0 0 0 JEFF HEINECKE PRESIDENT & CEO 36.00 4.00 X X 174493 0 32057 REV CARL BUETTEMEIR DIRECTOR 1.00 1.00 X 0 0 0 DAVID CHRISTIANSON DIRECTOR 1.00 1.00 X 0 0 0 DR ELIZABETH DETLIE DIRECTOR 1.00 1.00 X 0 0 0 PAM DRAGSETH DIRECTOR 1.00 1.00 X 0 0 0 REV MARTY ERICSON DIRECTOR 1.00 1.00 X 0 0 0 KIM DURKEE FORMER DIRECTOR (THROUGH MAY) 1.00 1.00 X 0 0 0 LEONARD EILTS FORMER DIRECTOR (THROUGH MAY) 1.00 1.00 X 0 0 0 GINGER FISCHER FORMER DIRECTOR (THROUGH MAY) 1.00 1.00 X 0 0 0 DR LESLIE GRANT DIRECTOR 1.00 1.00 X 0 0 0 REV JOY JOHNSON DIRECTOR 1.00 1.00 X 0 0 0 BETCHEN OBERDORFER DIRECTOR 1.00 1.00 X 0 0 0 JOHN PECK DIRECTOR 1.00 1.00 X 0 0 0 THOMAS J SCHULTZ DIRECTOR 1.00 1.00 X 0 0 0 JIM STENDER DIRECTOR 1.00 1.00 X 0 0 0 REV PAM STOFFERAHN DIRECTOR 1.00 1.00 X 0 0 0 TRUPTI STORLI DIRECTOR 1.00 1.00 X 0 0 0 BRADLEY J JACOBSON CFO 36.00 4.00 X 140470 0 32609 BRENDA JOHNSON ADMINISTRATOR 40.00 0.00 X 134894 0 29921 TODD FLIFLET CONTROLLER 40.00 0.00 X 106855 0 22562 MATTHEW STENERSON CHIEF TECHNOLOGY OFFICER 40.00 0.00 X 118648 0 14765 GREGORY WAINMAN DIRECTOR OF NURSING 40.00 0.00 X 130151 0 30144 805511 0 162058 6 0 1 0 PRO REHAB 200 LEWIS AVENUE SOUTH SUITE 210 WATERTOWN MN 55388 THERAPY 795235 MERWIN LTC PHARMACY 1811 OLD HWY 8 NW SUITE B NEW BRIGHTON MN 55112 MEDICAL/PHARMACY 380361 MERWIN IV & SPECIALTY PHARMACY 1811 OLD HWY 8 NW SUITE B NEW BRIGHTON MN 55112 MEDICAL/PHARMACY 127514 3 53126 53126 RESIDENT SERVICES 623000 24261069 24261069 EMENUCHOICE 541511 1292 1292 24262361 228068 228068 194036 879 212289 3089 -18253 -2210 -20463 -20463 MISCELLANEOUS REVENUE 900099 126077 126077 BEAUTY SHOP REVENUE 900099 72757 72757 SATELLITE TV REVENUE 900099 22503 22503 27884 27884 249221 24772313 24261069 1292 456826 1000000 1000000 303622 303622 544444 544444 13364667 12471374 893293 335782 312842 22940 2070444 1893102 177342 1052213 928143 124070 12130 12130 2843 2843 49686 49686 1030249 970170 60079 31077 31077 537136 372628 164508 92142 92142 419936 376750 43186 50776 25973 24803 2418 2169 249 884224 792745 91479 39573 35503 4070 MEDICAL SUPPLIES 1016843 1016843 FOOD 686454 686454 LICENSE SURCHARGE 667155 667155 BAD DEBT EXPENSE 244699 244699 78760 26816 51944 24517273 21882289 2634984 0 1803359 2240525 64559 24634 1873512 2430391 14215 19714 24187614 19218103 5591731 4969511 2705684 2440867 399180 399180 243299 429044 12695539 12953866 1559333 1482217 55077 58405 112080 102572 1726490 1643194 X 10933638 11256932 35411 53740 10969049 11310672 12695539 12953866 255040 86583 0 X 0 1 X 1 0 X 155222 565513 206707 181690 53126 1162258 18558754 18949573 19857394 19949802 24262361 101577884 18713976 19515086 20064101 20131492 24315487 102740142 0 0 0 102740142 115389 71821 132639 181871 228068 729788 115389 71821 132639 181871 228068 729788 183055 266119 181469 225851 249221 1105715 19012420 19853026 20378209 20539214 24792776 104575645 0.98240 0.98270 0.00700 0.00640 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY SHOP REVENUE SATELLITE TV REVENUE TELEPHONE REVENUE GUEST MEAL REVENUE MISCELLANEOUS REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 94767 94767 20749180 16709646 4039534 3260227 2435071 825156 83440 73386 10054 4969511 CAPITAL LEASE OBLIGATION 23287 ASSET RETIREMENT OBLIGATION 79285 102572 X PART IV, LINE 2B: THE CORPORATION IS THE TRUSTEE OF VARIOUS RESIDENT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. THESE FUNDS ARE ON DEPOSIT IN SEPARATE BANK ACCOUNTS. 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 INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER 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 APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. 1 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVENUE ST PAUL MN 55108 363371887 501(C)(3) 1000000 TO SUPPORT GENERAL OPERATIONS. 1 0 SCHOLARSHIPS 59 303622 PART I, LINE 2: LYNGBLOMSTEN CARE CENTER MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. ALL RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITORS THE USE OF THESE FUNDS THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS. LYNGBLOMSTEN SCHOLARSHIPS WILL BE AWARDED TO EMPLOYEES ENTERING AND/OR FURTHERING THEIR EDUCATION IN LONG TERM HEALTH CARE. THE FOLLOWING PROCEDURES MUST BE FOLLOWED IN ORDER TO RECEIVE SUCH A SCHOLARSHIP. 1. A FULLY COMPLETED APPLICATION PACKET MUST BE SUBMITTED TO HUMAN RESOURCES ON OR BEFORE PAYMENT OR THIRD PARTY BILLING FORMS WILL BE COMPLETED. 2. ALL EMPLOYEES EXCEPT THE ADMINISTRATOR ARE ELIGIBLE. 3. APPLICANT MUST BE CURRENTLY EMPLOYED BY LYNGBLOMSTEN AND HAVE COMPLETED 1040 HOURS OF SERVICE PRIOR TO APPLYING. IF EMPLOYMENT IS TERMINATED WITHIN 90 DAYS OF RECEIVING SCHOLARSHIP FUNDS, THEY MUST BE RETURNED TO LYNGBLOMSTEN. ALL FUNDS GRANTED MUST BE USED FOR STATED PURPOSE OF APPLICATION, OTHERWISE THEY MUST BE RETURNED TO LYNGBLOMSTEN. 4. APPLICANT MUST BE WORKING AN AVERAGE OF 10 HOURS PER WEEK THE 6 MONTH PERIOD PRIOR TO THE SEMESTER OR QUARTER FUNDS ARE APPLIED FOR. 5. APPLICANT MAY BE FROM ANY DEPARTMENT/PROGRAM WITHIN LYNGBLOMSTEN. 6. APPLICANT MUST BE ENROLLED IN AND/OR ACCEPTED IN AN EDUCATIONAL PROGRAM THAT WILL PREPARE THEM FOR POSITIONS COMMON TO LONG TERM CARE. 7. SCHOLARSHIPS MAY BE AWARDED FOR AMOUNTS COVERING FULL TUITION AND BOOK FEES FOR ALL APPLICANTS. 8. SCHOLARSHIPS MAY BE AWARDED MORE THAN ONCE PER YEAR, BUT A NEW APPLICATION PACKET MUST BE COMPLETED WITH EACH REQUEST FOR FUNDS. 9. AWARDED SCHOLARSHIP MONEY WILL BE SENT DIRECTLY TO THE INSTITUTION, WHEN POSSIBLE. 10. ALL SCHOLARSHIPS AWARDED BY LYNGBLOMSTEN ARE INTENDED FOR SCHOOL TUITION AND BOOKS ONLY. OTHER GRANTS AND SCHOLARSHIPS MUST BE AWARDED, PRIOR TO THE LYNGBLOMSTEN SCHOLARSHIP. IF LYNGBLOMSTEN SCHOLARSHIP DOLLARS ARE IN EXCESS, THEY MUST BE RETURNED TO LYNGBLOMSTEN IMMEDIATELY. FAILURE TO DO SO WILL RESULT IN REPAYMENT AND/OR DISCIPLINE UP TO AND INCLUDING TERMINATION. X X X X 0 0 0 0 0 0 0 0 0 JEFF HEINECKE PRESIDENT & CEO 160900 0 10369 0 3224 0 7250 0 24807 0 206550 0 0 0 BRADLEY J JACOBSON CFO 127730 0 10797 0 1943 0 5967 0 26642 0 173079 0 0 0 BRENDA JOHNSON ADMINISTRATOR 125586 0 9308 0 0 0 5650 0 24271 0 164815 0 0 0 GREGORY WAINMAN DIRECTOR OF NURSING 123184 0 6967 0 0 0 5476 0 24668 0 160295 0 0 0 FORM 990, PART III, LINE 2 LYNGBLOMSTEN WAS ONE OF 23 SKILLED NURSING FACILITIES ASKED BY ALLINA HEALTH TO BE A PART OF ITS NEXT GENERATION ACCOUNTABLE CARE ORGANIZATION. ACOS ARE GROUPS OF DOCTORS, HOSPITALS, AND HEALTHCARE PROVIDERS THAT COORDINATE HIGH-QUALITY CARE FOR MEDICARE PATIENTS. WITH THE INCREASING WAY DATA DRIVES THE SENIOR CARE INDUSTRY, THE CARE CENTER ADDED A QUALITY ASSURANCE/DATA ANALYTICS NURSE POSITION. ALREADY, FINDINGS FROM THIS NURSE'S WORK HAVE HELPED STAFF DEVELOP AND IMPLEMENT PLANS TO IMPROVE RESIDENT CARE. LYNGBLOMSTEN IMPLEMENTED THE MUSIC & MEMORY PROGRAM FOR CARE CENTER RESIDENTS IN MAY. THE PROGRAM HELPS PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA BENEFIT FROM THE THERAPEUTIC POTENTIAL OF MUSIC THROUGH PERSONALIZED PLAYLISTS ON IPODS. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS MADE UP THE CHAIR, VICE CHAIR, TREASURER, AND SECRETARY OF THE BOARD ALONG WITH PRESIDENT/CEO OF THE CORPORATION. ALL ITEMS APPROVED BY THE EXECUTIVE COMMITTEE ARE REAFFIRMED BY THE FULL BOARD AT THEIR NEXT MEETING. FORM 990, PART VI, SECTION A, LINE 6 THE BOARD OF DIRECTORS OF LYNGBLOMSTEN ARE THE MEMBERS OF LYNGBLOMSTEN CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE CONGREGATIONS SEND DELEGATES TO THE LYNGBLOMSTEN ANNUAL MEETING, WHO, AS MEMBERS OF LYNGBLOMSTEN, ELECT THE LYNGBLOMSTEN BOARD. THE BOARD OF DIRECTORS OF LYNGBLOMSTEN CARE CENTER CONSISTS SOLELY OF DULY ELECTED AND QUALIFIED MEMBERS OF THE BOARD OF DIRECTORS OF LYNGBLOMSTEN. ELECTION AS A DIRECTOR OF LYNGBLOMSTEN CONSTITUTES ELECTION AS A DIRECTOR OF LYNGBLOMSTEN CARE CENTER FOR THE SAME TERM. FORM 990, PART VI, SECTION A, LINE 7B CHANGES IN THE BYLAWS AND ARTICLES OF INCORPORATION REQUIRE MEMBERSHIP APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND CEO REVIEW THE DOCUMENT, WHICH IS EMAILED TO THE FINANCE COMMITTEE OF THE BOARD PRIOR TO THEIR MEETING FOR REVIEW AND COMMENT. THE BOARD RECEIVES THE DOCUMENT PRIOR TO THEIR BOARD MEETING BY EMAIL. PAPER COPIES ARE AVAILABLE AT THE BOARD MEETING FOR FURTHER DISCUSSION AND BOARD APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C AN UPDATED CONFLICT OF INTEREST POLICY IS SIGNED BY ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. THIS POLICY IS MONITORED BY THE CORPORATE COMPLIANCE OFFICER AND IF ANY CONFLICTS OF INTERESTS EXIST THAT INDIVIDUAL IS EXCLUDED FROM PARTICIPATION AND VOTING ON RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15A THE LYNGBLOMSTEN BOARD'S EXECUTIVE COMMITTEE REVIEWS AND SETS THE CEO'S COMPENSATION ANNUALLY AND PERFORMS A COMPENSATION STUDY APPROXIMATELY EVERY 5 YEARS, LAST COMPLETED IN 2013. THE CEO SETS THE ANNUAL EVALUATION PROCESS FOR OTHER OFFICERS AND KEY EMPLOYEES AND THE LYNGBLOMSTEN CARE CENTER, INC. BOARD APPROVES THE ANNUAL BUDGET. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. EMENUCHOICE LLC 1415 ALMOND AVENUE ST PAUL MN 55108 320473417 MAINTAINS, DEVELOPS, AND OFFERS WEB-BASED MEAL AND DIEATARY SOFTWARE PROGRAM MN 1292 3102 LYNGBLOMSTEN CARE CENTER INC LYNGBLOMSTEN APARTMENTS INC 1455 ALMOND AVE ST PAUL MN 55108 411327121 LOW INCOME SENIOR HOUSING MN 501(C)3 9 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 HERITAGE APARTMENTS INC 1440 MIDWAY PARKWAY ST PAUL MN 55108 411913420 MARKET RATE SENIOR HOUSING, ASSISTED LIVING SERVIES MN 501(C)3 9 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVE ST PAUL MN 55108 363371887 FUNDRAISING FOR LYNGBLOMSTEN MN 501(C)3 7 LYNGBLOMSTEN 0 LYNGBLOMSTEN SERVICES INC 1415 ALMOND AVE ST PAUL MN 55108 411760448 SENIOR CENTER, COMMUNITY SERVICES, HOME HEALTH MN 501(C)3 9 LYNGBLOMSTEN 0 LYNGBLOMSTEN 1415 ALMOND AVE ST PAUL MN 55108 410693865 MANAGEMENT OVERSIGHT SERVICES TO ALL LYNGBLOMSTEN ORGANIZATIONS MN 501(C)3 9 N/A 0 LYNGBLOMSTEN SENIOR HOUSING INC 1415 ALMOND AVE ST PAUL MN 55108 411913422 MANAGEMENT OVERSIGHT SERVICES TO LYNGBLOMSTEN APTS & HERITAGE APTS MN 501(C)3 9 LYNGBLOMSTEN 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1