2016-02-15T00:00:00-06:00 2015-09-30 410746749 CLIFTONLARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2014-10-01 410847708 ST JOHN'S LUTHERAN HOME STJO 5073738226 901 LUTHER PLACE ALBERT LEA MN 56007 SCOT SPATES CEO 5073738226 2016-02-04 1 TRENT FAST P00692704 5074347000 2014 2016-08-17 19:52:53Z ST JOHN'S LUTHERAN COMMUNITY SCOT SPATES 901 LUTHER PLACE ALBERT LEA MN 56007 12160628 0 9386 X WWW.STJOHNSOFALBERTLEA.ORG X 1957 MN ST. JOHN'S LUTHERAN HOME WAS ORGANIZED FOR THE PURPOSE OF BUILDING, ERECTING, ESTABLISHING, MAINTAINING, EQUIPPING, MANAGING, OPERATING, AND ENDOWING A CHRISTIAN HOME MINISTERING TO THE PHYSICAL, SPIRITUAL, EMOTIONAL, AND SOCIAL NEEDS OF AGING MEN AND WOMEN. PROVISION OF NURSING CARE AND HOUSING TO THE ELDERLY AND HANDICAPPED BY OPERATING A 170-BED LICENSED NURSING FACILITY AND A 48-UNIT APARTMENT COMPLEX. 10 10 320 100 22733 -3207 343474 763513 11842431 11329899 18335 30416 45167 36800 12249407 12160628 0 0 0 0 7566615 7461058 0 34932 34932 4272827 4261590 11839442 11757580 409965 403048 11388449 48610585 4912508 41821513 6475941 6789072 TO PROVIDE PHYSICAL, EMOTIONAL, SOCIAL AND CHRISTIAN CARE FOR ALL PEOPLE, WITH DIGNITY AND RESPECT, IN AN ENVIRONMENT OF GOD'S GRACE. 0 0 10706275 11307166 ST JOHN'S LUTHERAN HOME WAS ORGANIZED FOR THE PURPOSE OF BUILDING, ERECTING, ESTABLISHING, MAINTAINING, EQUIPPING , MANAGING, OPERATING, AND ENDOWING A CHRISTIAN HOME MINISTERING TO THE PHYSICAL, SPIRITUAL, EMOTIONAL AND SOCIAL NEEDS OF AGING MEN AND WOMEN. PROVISION OF NURSING CARE AND HOUSING TO THE ELDERLY AND HANDICAPPED BY OPERATING A 170-BED LICENSED NURSING FACILITY AND A 48-UNIT APARTMENT COMPLEX. 10706275 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 24 0 320 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MN X DUANE MALLON 5074731015 901 LUTHER PL ALBERT LEA MN 56007 DARRYL MEYER CHAIRMAN 1.00 X X 0 0 0 LANCE SKOV VICE CHAIRMAN 1.00 X X 0 0 0 DONNA NELSON SECRETARY 1.00 X X 0 0 0 REV WENDY ANDERSON TREASURER 1.00 X X 0 0 0 JOEL ERICKSON DIRECTOR 1.00 X 0 0 0 DAVE OLSON DIRECTOR 1.00 X 0 0 0 CHARLES REINDAL DIRECTOR 1.00 X 0 0 0 ORVILLE SIMONSEN DIRECTOR 1.00 X 0 0 0 LARRY TRAMPEL DIRECTOR 1.00 X 0 0 0 STEVEN ZENK DIRECTOR 1.00 X 0 0 0 SCOT SPATES CEO 40.00 X 105142 0 34395 DUANE MALLON CFO 38.00 X 70273 0 22360 175415 0 56755 1 0 0 0 HORTY ELVING & ASSOCIATES 505 EAST GRANT STREET MINNEAPOLIS MN 55404 ARCHITECTURE 807611 REHAB CARE PO BOX 503534 ST LOUIS MO 631503534 THERAPY SERVICES 505235 2 318185 445328 763513 RESIDENT REVENUE 623000 9980553 9980553 MEDICARE/MEDICAID PAYMENTS 623000 1321683 1321683 MANAGEMENT INCOME 561700 22733 22733 MISCELLANEOUS REVENUE 623000 4672 4672 PHONE RENTAL 623000 258 258 11329899 30416 30416 BEAUTY SHOP 623000 25698 25698 MISCELLANEOUS INCOME 900099 7859 7859 NON-RESIDENT MEALS 623000 2745 2745 498 498 36800 12160628 11307166 22733 67216 232170 232170 5969104 5719558 249546 185234 184408 826 614023 611683 2340 460527 428290 32237 7403 7403 70353 70353 34932 34932 312334 273388 38946 53379 53379 573506 494208 79298 406521 406521 4092 2383 1709 37215 32787 4428 139881 139881 646082 646082 29518 29518 FOOD COSTS 547444 547444 TAXES & LICENSES 535411 535411 THERAPY EXPENSE 432099 432099 MISCELLANEOUS EXPENSE 121453 121453 344899 252132 92767 11757580 10706275 1016373 34932 478931 741032 3270137 29840098 276164 1287034 1006706 127245 87197 31351733 14824419 6120702 16527314 100290 100217 4110 31857 11388449 48610585 1045145 4215887 3360000 37096468 507363 509158 4912508 41821513 X 6475941 6363632 425440 6475941 6789072 11388449 48610585 X 403048 -1895 -88022 X X 0 1 X 1 0 X 356782 338960 324449 343474 763513 2127178 11888860 11435201 11285848 11842431 11329899 57782239 12245642 11774161 11610297 12185905 12093412 59909417 342070 326285 312069 308631 318185 1607240 0 342070 326285 312069 308631 318185 1607240 58302177 88830 46766 38888 18335 30416 223235 88830 46766 38888 18335 30416 223235 46357 46917 44868 45167 36800 220109 12380829 11867844 11694053 12249407 12160628 60352761 0.96600 0.96520 0.00370 0.00470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 424462 424462 11673297 9603427 2069870 6114624 4760424 1354200 13139350 460568 12678782 16527314 LEASE DEPOSITS 46998 PATIENT TRUST FUNDS 10732 ASSET RETIREMENT OBLIGATION 451428 509158 X 11645271 -1895 -1895 11647166 513462 513462 12160628 11757580 0 11757580 0 11757580 PART X, LINE 2: THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE ORGANIZATION AS A RESULT OF THIS STANDARD. PART XI, LINE 4B - OTHER ADJUSTMENTS: TEMP RESTRICTED CAMPAIGN 425,440. LOSS ON EXTUBGYHUSHMENT OF DEBT 88,022. 1 AHNEMANN ASSOCIATES 6505 ALLISON AVENUE WINDSOR HEIGHTS IA 50324 CONSULTING 0 445328 34932 410396 445328 34932 410396 MN SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE PAYMENTS WERE FOR A FUNDRAISING CONSULTANT/PLANNER ONLY. A CITY OF HAYWARD MN HOUSING AND HC BONDS 410241036 421307AM1 2014-12-04 17556988 CONSTRUCTION AND REFINANCE EXISTING DEBT 0 0 0 B CITY OF HAYWARD MN BOND ANTICIPATION NOTES 410241036 421306AD3 2015-07-01 19535000 CONSTRUCTION 0 0 0 A 17556988 1242819 276761 318870 5202984 2650664 7864890 1 0 1 1 B 19535000 270094 2238186 17026720 0 0 1 1 A 1 0 0 0 0 0 B 1 0 0 0 0 0 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 2 CHARLES REINDAL AND DONNA NELSON - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO BEING FILED WITH THE IRS, THE BOARD CHAIRMAN AND CEO REVIEW IN DETAIL A COPY OF THE FORM 990, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF APPROPRIATE CHANGES. FORM 990, PART VI, SECTION B, LINE 12C A CORPORATE COMPLIANCE PROGRAM IS REVIEWED WITH ALL NEW HIRES AND WITH NEW BOARD MEMBERS. BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY COMPLETE A SURVEY RELATED TO BUSINESS RELATIONSHIPS AND FAMILY MEMBERS THAT COULD OR DO CREATE A CONFLICT OF INTEREST. THESE ARE SUMMARIZED AND FILED ALONG WITH BOARD MEETING MINUTES. CONFLICTS OF INTEREST ARE DETERMINED BY A REVIEW OF THE POTENTIAL CONFLICTS BY THE ADMINISTRATOR AND BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS USED TO SET THE ADMINISTRATOR'S ANNUAL SALARY IS BASED ON A COMPARISON TO COMPARABLE ORGANIZATIONS. THE BOARD OF DIRECTORS REVIEWS THE MINNESOTA SENIOR HOUSING TRADE ASSOCIATION'S ANNUAL WAGE SURVEY. THIS SURVEY INCLUDES INFORMATION RELATED TO THE SIZE OF THE ORGANIZATION AND THE NOT-FOR-PROFIT STATUS OF THE ORGANIZATION. IN ADDITION TO THIS, THE 990'S FROM COMPARABLE SENIOR HOUSING CAMPUSES ARE REVIEWED BY THE BOARD OF DIRECTORS AND USED TO ESTABLISH THE ADMINISTRATOR'S WAGE. THIS PROCESS WAS REVIEWED IN 2015 AND RESULTED IN AN INCREASE TO THE ADMINISTRATORS WAGE IN 2015. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS ON EXTINGUISHMENT OF DEBT -88,022. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. ST JOHNS FOUNDATION C/O ST JOHNS HOME HWY 13 ALBERT LEA MN 56007 416054307 TO PROVIDE SUPPORT TO ST. JOHN'S LUTHERAN HOME MN 501(C)(3) 11A N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0