2016-11-08T13:08:28-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2015-01-01 420794364 CEDAR FALLS LUTHERAN HOME CEDA 3192680401 7511 UNIVERSITY AVENUE CEDAR FALLS IA 50613 DAWN BENGEN CFO 3192680401 2016-11-07 1 JEFF VRIEZE P01273590 6123764500 2015 2017-02-10 21:41:12Z NEWALDAYA LIFESCAPES DAVE DEAVER 7511 UNIVERSITY AVENUE CEDAR FALLS IA 50613 15837948 0 X WWW.NEWALDAYA.ORG X 1958 IA ENHANCING THE LIVES OF SENIORS THROUGH A COMMITMENT TO INDIVIDUALIZED, CHRISTIAN CARE. 12 12 476 100 0 0 521307 181556 14957838 14999650 208855 166274 130701 155334 15818701 15502814 0 0 0 0 9274373 10378131 0 0 13044 5779808 5211059 15054181 15589190 764520 -86376 27124037 26883164 17486892 17510746 9637145 9372418 CHRISTIAN CARING - ENHANCING LIVES THROUGH A COMMITMENT TO INDIVIDUALIZED CARE IN A HOME EMPOWERED BY GOD'S LOVE. 0 0 13524797 0 14999650 WE OFFER CHRISTIAN CARING THROUGHOUT OUR 135-BED NURSING FACILITY, 42-UNIT ASSISTED LIVING FACILITY AND 106 INDEPENDENT LIVING UNITS. WE ARE COMMITTED TO QUALITY FIRST, A PHILOSOPHY OF QUALITY AND A FRAMEWORK FOR EARNING PUBLIC TRUST IN AGING SERVICES. WE CONTINUE OUR JOURNEY TO PROMOTE RESIDENT-CENTERED, CONSUMER DRIVEN SERVICE. WE OFFER WELLNESS PROGRAMMING THAT INCLUDES MUSIC, ART AND HORTICULTURE THERAPIES. THE CORPORATION IS ALSO THE SOLE OWNER OF HOME CONNECTIONS, LLC, A HOME HEALTH AGENCY, OPERATING IN CEDAR FALLS, IOWA. 13524797 1 1 0 0 0 0 1 0 1 1 1 0 0 0 1 1 0 1 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 0 1 0 0 0 0 1 37 0 476 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X DAWN M BENGEN CPA 3192680401 7511 UNIVERSITY AVENUE CEDAR FALLS IA 50613 DAVE DEAVER PRESIDENT 3.00 X X 0 0 0 DEON SENCHINA VICE PRESIDENT 2.00 X X 0 0 0 KATHY DUKE TREASURER THRU MAY 2015 2.00 X X 0 0 0 EDWARD JUHL TREASURER 2.00 X X 0 0 0 LISA NELSON SECRETARY 2.00 X X 0 0 0 GLENN BEHRENDS BOARD MEMBER 1.00 X 0 0 0 JANE CHRISTENSEN BOARD MEMBER 1.00 X 0 0 0 LAVERYL DLOUHY BOARD MEMBER 1.00 X 0 0 0 JERRY HAGEMAN BOARD MEMBER 1.00 X 0 0 0 DUANE HAMILTON BOARD MEMBER 1.00 X 0 0 0 DIANE KESTNER BOARD MEMBER 1.00 X 0 0 0 DONNA KIRSCHENMANN BOARD MEMBER 1.00 X 0 0 0 ROBERT NELSON BOARD MEMBER THRU MAY 2015 1.00 X 0 0 0 PAUL PIETSCH BOARD MEMBER THRU JAN 2015 1.00 X 0 0 0 WENDY VAN GORP BOARD MEMBER 1.00 X 0 0 0 MILLISA TIERNEY CHIEF EXECUTIVE OFFICER 40.00 X 123733 0 25006 DAWN BENGEN CHIEF FINANCIAL OFFICER 40.00 X 99416 0 13480 223149 0 38486 1 0 0 0 ARAMARK UNIFORM SERVICES 600 LINDEN AVENUE WATERLOO IA 50703 LAUNDRY SERVICES 175287 RESTORE HEALTH CARE LLC 508 KAITLYNN AVE ANAMOSA IA 52205 NURSING POOL 156853 2 181556 181556 NURSING FACILITY 623000 11819467 11819467 ASSISTED LIVING 623000 1724945 1724945 APARTMENT REVENUE 623000 1174243 1174243 ENTRANCE FEES 623000 220853 220853 OTHER ACTIVITIES 623990 60142 60142 14999650 161629 161629 16600 0 16600 16600 16600 314024 13251 314080 8550 -56 4701 4645 4645 14148 12504 1644 1644 MAIN STREET REVENUE 623000 84820 84820 CATERING INCOME 623000 38548 38548 MEAL INCOME 623000 7089 7089 6633 6633 137090 15502814 14999650 0 321608 261635 261635 8445494 7437323 1008171 288625 288625 708861 696798 12063 673516 590988 82528 60443 60443 14714 14714 690047 497602 192445 139263 139263 594524 421032 173492 447953 447953 13728 13728 570255 570255 956622 956622 114606 110413 4193 MEDICAL SUPPLIES 956653 956653 FOOD 550533 550533 BAD DEBTS 83216 83216 FUNDRAISING 13044 13044 5458 5458 15589190 13524797 2051349 13044 3483460 572635 292378 2596923 286367 205136 1121036 1304386 5628 4828 76666 79807 29358686 11211987 15132789 18146699 2738765 2672596 313476 299936 3673472 1000218 27124037 26883164 1701402 1402834 4483107 5023099 10916456 10758818 126966 133745 71754 54166 187207 138084 17486892 17510746 X 7069566 6756050 29912 30403 2537667 2585965 9637145 9372418 27124037 26883164 X -86376 -227677 49326 X 0 1 X 1 0 X 451908 259377 372412 521301 181556 1786554 14242606 14482945 14800281 14957838 14999650 73483320 14694514 14742322 15172693 15479139 15181206 75269874 28911 11796 5250 9000 54957 0 28911 11796 5250 9000 54957 75214917 109120 110479 139854 177381 178229 715063 109120 110479 139854 177381 178229 715063 132169 151238 283407 14803634 14852801 15312547 15788689 15510673 76268344 0.98620 0.98910 0.00940 0.00840 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MAIN STREET REVENUES CATERING REVENUE MISCELLANEOUS REVENUE EMPLOYEE/GUEST MEALS GIFT SHOP RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X X 1 0.33 0 1 0 5.00 130 0 1 X 2537667 48298 2585965 2531478 6189 2537667 2521958 9520 2531478 2516608 5350 2521958 2512111 4497 2516608 0.00000 1.00000 0.00000 0 0 256890 256890 25040221 8850250 16189971 4031201 2361737 1669464 30374 30374 18146699 ANNUITY INTEREST PAYABLE 1483 ASSET RETIREMENT OBLIGATION 114624 FAIR VALUE OF DERIVATIVE INSTRUMENT 21977 138084 X PART II, LINE 9: LISTED UNDER MAINTENANCE DEPARTMENT; VERY SMALL AND DOESN'T REQUIRE MUCH MAINTENANCE. PART IV, LINE 2B: CONTRACT ARRANGEMENTS BETWEEN THE CORPORATION AND CERTAIN OF ITS RESIDENTS REQUIRE PAYMENTS UPON OCCUPANCY. THE TERMS OF THE CONTRACTS PROVIDE FOR A PARTIAL REFUND OF DEFERRED ENTRANCE FEES ON A PRO RATA BASIS IF THE RESIDENT DIES OR VOLUNTARILY VACATES THE UNIT WITHIN A SPECIFIED TIME PERIOD - IN ALL CASES TEN YEARS OR LESS. THE REFUNDS ARE PAID WITH RE-OCCUPANCY PROCEEDS FROM RESALE OF THE UNITS. THE ORGANIZATION IS THE TRUSTEE OF VARIOUS RESIDENT AND SECURITY DEPOSITS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION AND DISTRIBUTION OF THESE FUNDS FOR THE RESIDENTS. THESE FUNDS ARE ON DEPOSIT IN A SEPARATE BANK ACCOUNT, CONSISTING OF CASH AND CASH EQUIVALENTS. PART V, LINE 4: THE CORPORATION HAS A POLICY, BASED UPON THE INTENT OF THE DONOR-RESTRICTED ENDOWED ASSETS, TO SPEND THE EARNINGS FROM THE ENDOWMENT FUND FOR CURRENT OPERATIONS TO SUPPORT THE HEALTH CARE SERVICES AT CEDAR FALLS LUTHERAN HOME. PART X, LINE 2: THE CORPORTION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. A CITY OF EVANSDALE IOWA 426006424 299218AR8 2010-08-12 8201220 BUILDING IMPROVEMENTS, EXPANSIONS, AND REFINANCING 2005 BONDS 0 0 0 B CITY OF EVANSDALE IOWA 426006424 2014-12-18 3155000 BUILDING IMPROVEMENTS & EXPANSIONS 0 0 0 A 610000 8265000 697346 164024 2863957 4530346 2011 1 0 1 1 B 85185 3155198 25155 3130043 2015 0 0 1 1 A 0 0 0 0 0.07100 0.07100 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 1 0 0 0 0 1 B 0 0 1 1 1 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF EVANSDALE, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 07/31/2015 ISSUER NAME: CITY OF EVANSDALE, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/31/2015 SCHEDULE K, PART II, LINE 3 THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART IV, LINE 2B BECAUSE THE BOND PROCEEDS HAVE BEEN SPENT, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS MADE UP OF THE PRESIDENT, VICE PRESIDENT, TREASURER AND SECRETARY. THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS TO MAKE DECISIONS WHEN THE TIMING IS SUCH THAT A DECISION CANNOT WAIT UNTIL THE NEXT BOARD MEETING. THEY ALSO APPROVE COMPENSATION FOR THE EXECUTIVE DIRECTOR. DURING VOTES OF THE BOARD OF DIRECTORS, THE BOARD PRESIDENT ONLY CASTS A VOTE IN THE EVENT OF A TIE. FORM 990, PART VI, SECTION A, LINE 6 THE SEVEN MEMBERS WE HAVE ARE OUR SEVEN SPONSORING LUTHERAN CHURCHES. EACH MEMBER AND THE NEWALDAYA LIFESCAPES RESIDENTS EACH PRESENT ONE OF ITS PASTORS TO BE A VOTING DELEGATE AT THE CORPORATION'S ANNUAL MEETING. IN ADDITION, ANY MEMBER WITH A CONGREGATION MEMBERSHIP LARGER THAN 2,000 BAPTIZED MEMBERS MAY PRESENT ONE ADDITIONAL DELEGATE FOR EACH 1,000 MEMBERS IN EXCESS OF 2,000 MEMBERS AS OF JANUARY FIRST OF THE YEAR IN WHICH THE ANNUAL MEETING IS TO BE HELD. THE NEWALDAYA LIFESCAPES RESIDENTS SELECT TWO VOTING DELEGATES FROM THEIR MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION ELECT THE MEMBERS OF THE BOARD OF DIRECTORS AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7B ANY CHANGE TO THE ORGANIZATION'S NAME OR AMENDMENTS TO THE ORGANIZATION'S BYLAWS REQUIRES THE APPROVAL OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED BY THE BOARD OF DIRECTORS WITH THE CFO BEFORE IT WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AT A BOARD MEETING AND ALL BOARD MEMBERS SIGN TO INDICATE THEY UNDERSTAND THE POLICY. BOARD MEMBERS ARE TO IMMEDIATELY REPORT ANY ACTIVITY THAT COULD APPEAR TO BE A CONFLICT OF INTEREST. IF THERE IS A CONFLICT OF INTEREST, THEY ARE TO PUBLICLY DISCLOSE IT TO THE COMMITTEE AND/OR BOARD, AND REFRAIN FROM DISCUSSING OR TAKING ANY OFFICIAL ACTION THAT WOULD AFFECT THE DECISION MAKING PROCESS. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD'S PERSONNEL COMMITTEE MEETS WITH THE HUMAN RESOURCE DIRECTOR AND CHIEF FINANCIAL OFFICER TO REVIEW WAGE SURVEYS FROM LEADINGAGE IOWA AND LEADINGAGE. THE PERSONNEL CHAIRPERSON AND THE EXECUTIVE COMMITTEE MEET TO DETERMINE THE FINAL COMPENSATION PACKAGE. THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER IS DETERMINED BY THE EXECUTIVE DIRECTOR. THE CFO REPORTS TO THE CEO AND PERFORMANCE EVALUATIONS ARE COMPLETED BY THE CEO. THE CEO MEETS WITH THE HUMAN RESOURCE DIRECTOR TO REVIEW WAGE SURVEYS FROM LEADINGAGE IOWA AND LEADINGAGE. THE CEO MEETS WITH CFO TO DISCUSS GOALS, PERFORMANCE, AND WAGE SURVEYS. FINAL COMPENSATION IS THEN FORWARDED TO THE PAYROLL SPECIALIST. COMPENSATION REVIEW PROCESS IS DONE EVERY OCTOBER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENT 49,326. HOME CONNECTIONS LLC 7517 UNIVERSITY AVE CEDAR FALLS IA 50613 205472733 IN-HOME SERVICES IA 5044 1015 CEDAR FALLS LUTHERAN HOME