2016-02-12T15:33:18-06:00 2015-09-30 411765929 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2014-10-01 411456124 Cokato Charitable Trust CO Cokato Manor COKA 3202862158 182 Sunset Avenue NW Cokato MN 55321 James Broich Administrator 3202862158 2016-02-12 1 Deb Nelson CPA P01264758 6122536500 2016-02-08 2014 2016-08-17 19:52:53Z James Broich 182 Sunset Avenue NW Cokato MN 55321 6566072 0 X www.cokatoseniorcare.com X 1983 MN Provide elderly persons housing and services to meet physical, social, and psychological needs. 8 8 246 141 0 0 1172 4281 6155004 6523496 31596 38295 15000 0 6202772 6566072 946 2500 0 0 3367724 3723924 0 0 0 2788605 2753594 6157275 6480018 45497 86054 10411336 10103000 8832019 8452307 1579317 1650693 X The purpose of Cokato Charitable Trust division is to provide quality health and housing services that enhance the quality of life and maintain a maximum level of functioning for our customers. 0 0 3808123 2500 4240272 Cokato Manor provides skilled nursing care for older adults who need health care and support services including physical, occupational and speech therapy. Cokato Manor is Medicare and Medicaid certified. Cokato Manor offers long-term, short-term, adult day care and home health care. Cokato Manor provides living space for 56 residents in double and private rooms. Cokato Manor is committed to providing services in a caring environment that enhances the quality of life and maintains the maximum level of functioning. Cokato Manor is a restraint-free facility and has a reputation for its excellence in quality of care.Cokato Manor exists to effectively meet the needs of the resident in a caring manner and offers the following services: -Nursing -Dietary -Social Service -Activities -Laundry -Housekeeping -Religious Services -Maintenance -Rehabilitation services including Physical Therapy, Occupational Therapy and Speech Therapy 511539 587115 Brookridge is an assisted living residence that holds the key to comfortable and affordable senior housing with a health care touch. At Brookridge, our goal is to provide residents with all the possiblities so they remain vital and active. Our staff strives to help residents achieve the highest possible level of good health, self-care and independence. As a member of the Brookridge community, their neighbors are their friends. Residents experience the sense of family that truly encourages them to feel right at home.Brookridge offers the following services to its residents:-Paid utilities (telephone not included) -Free cable television -Three meals a day, including snacks -24-hour emergency response system -Staffing around-the-clock and an RN available 24-hours a day -Full laundry services, including linens -Housekeeping including refuse removal -Non-emergency scheduled transportation -Fireplace lounge for gatherings, companionship and entertaining -Central air conditioniong -Direct access to Chapel -Sprinklers and alarms for fire safety -Convenient, indoor mail drop -Centrally-located elevator -Apartment-sized refrigerator and microwave provided -Barber/beauty shop -Exciting activities program -Off-street parking for you and your guests -Handicap-accessible showers -Daily checking on tenants -Local professional management 454701 587115 Cokato Manor Home Health (CMHH) is another component of the continuum of care to provide the community with comprehensive and compassionate care whereby health, social and supportive services are provided to the individuals in their own home. Our goal in home health is to maximize the level of independence, while minimizing the effects of disabilities and illness.CMHH is licensed by the Minnesota Department of Health as a Comprehensive Home Care Provider and is Medicare Certified and is a contracted provider of most private insurance.Cokato Manor Home Health provides the following services:-Skilled nursing-Physical assessments (ordered by physicians) -Post-hospitalization care -Wound evaluation with dressing changes -Cardiac and respiratory assessments-Medication instruction and follow-up -At-home therapy -Restorative nursing -Physical therapy -Occupational therapy -Speech therapy Home Health Aide-Personal care assistance under the supervision of a RN; bathing, dressing, nutrition assistance -Light housekeeping tasks and meal preparation -Assistance with maintaining safety and independence in the home 909402 1108994 Cokato Charitable Trust operates and manages Cokato Manor, a 56-bed skilled nursing facility; Heritage Place, a 10-unit housing project for individuals with Alzheimers and related disorders; Edgewood Gables, a 30-unit independent living apartment for the elderly; Brookridge, a 16-unit assisted living facility; and Cokato Manor Home Health, a home health care service agency for the elderly.In addition to operating and managing those facilities, Cokato Charitable Trust offers senior day services, Meals on Wheels, congregate dining, rehab services and child day care. 909402 1108994 5683765 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 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 0 0 0 0 0 1 4 0 1 246 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 MN X James Broich 3202862158 182 Sunset Avenue Cokato MN 55321 Steven Hanson Chair 0.30 X X 0 0 0 Jim Nelson Vice Chair 0.30 X X 0 0 0 Peggy Carlson Secretary/Treasurer 0.30 X X 0 0 0 Allan Anderson Trustee 0.30 X 0 0 0 Suzanne Kaczmarek Trustee 0.30 X 0 0 0 Lyle Severson Trustee 0.30 X 0 0 0 Peter Forsman Trustee 0.30 X 0 0 0 Peter Bortnem Trustee 0.30 X 0 0 0 Kathy Kratz Office Manager (thru Nov 2014) 40.00 X 60844 0 2970 James Broich Administrator 40.00 X 59346 0 7032 120190 0 10002 0 0 0 0 Rehab Care Group Inc PO Box 503534 St Louis MO 63150 Therapy 257586 1 4281 4281 Net Resident Service R 623000 6401504 6401504 Day Care Program 624100 42432 42432 Senior Day Services 624100 29038 29038 Other Revenue 900099 27984 27984 Meal Revenue 900099 22538 22538 6523496 38295 38295 6566072 6523496 0 38295 2500 2500 131723 131723 3152936 3014423 138513 186845 185667 1178 252420 232685 19735 620 620 14385 14385 391445 364359 27086 40771 40771 95627 30379 65248 337087 307955 29132 38187 2941 35246 32831 14707 18124 337551 337551 488554 488554 79664 79664 Medical Supplies 638499 638499 Medical Surcharge 157640 157640 Bad Debt Expense 52184 52184 Dues & Subscriptions 35251 35251 13298 11361 1937 6480018 5683765 796253 0 1695700 1611015 772453 774768 36359 46993 44548 11507509 6584779 5218199 4922730 2428586 2552963 213046 196976 10411336 10103000 502300 507910 8320000 7935000 9397 9397 322 8832019 8452307 X 1579317 1650693 1579317 1650693 10411336 10103000 86054 -14678 0 X 0 1 X 1 0 X 5015 1377 10110 1172 4281 21955 6613935 6521234 6480470 6155004 6523496 32294139 6618950 6522611 6490580 6156176 6527777 32316094 0 132247 33855 87450 169475 104515 527542 132247 33855 87450 169475 104515 527542 31788552 41230 46484 48611 49674 38295 224294 41230 46484 48611 49674 38295 224294 6660180 6569095 6539191 6205850 6566072 32540388 0.97690 0.97280 0.00690 0.00810 X 0 1 X 190625 190625 9672987 5562196 4110791 128846 72919 55927 1325039 843568 481471 190012 106096 83916 4922730 X 6551394 -14678 -14678 6566072 0 6566072 6480018 0 6480018 0 6480018 Part IV, Line 2b: The Trust acts as custodian for the funds of the residents. Part X, Line 2: The Trust is organized as a Minnesota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Trust is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Trust is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. The Trust believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and, as such, does not have any uncertain tax positions that are material to the financial statements. The Trust would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense, if such interest and penalties are incurred. A City of Cokato 416005063 192634CU5 2012-12-27 4052282 Refund bonds issued 4/29/2004 0 0 0 B City of Cokato 416005063 192634CC5 2006-11-01 5077872 Refund bonds issued 7/8/1999 & renovations to nursing facility 0 0 0 A 472282 4052282 175051 81046 3796185 2012 1 0 1 1 B 722872 5077872 387828 96244 101557 2100000 2392243 2008 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 A 0 B 0 Date Rebate Computation Performed Issuer Name: City of Cokato Date the Rebate Computation was Performed: 12/02/2011 Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the board. Form 990, Part VI, Section B, line 11 The Administrator reviews the Form 990, addressing any comments or changes. Before the return is filed, a copy is provided to the board. Form 990, Part VI, Section B, line 12c Cokato Charitable Trust (CCT) has a conflict of interest policy to protect the interest of the organization when contemplating entering into a transaction or arrangement that might benefit the private interest of a member of the Board or key staff of CCT or might result in a possible excess benefit transaction. On an annual basis interested persons, any board member or staff member of CCT who has a direct or indirect financial interest, disclose any conflicts. After disclosure of a financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the governing board meeting while the determination of a conflict of interest is discussed and voted upon. Any disclosed conflicts are addressed by the governing board that determines if the transaction or arrangement is in CCT's best interest, for its own benefit, and whether it is fair and reasonable. Form 990, Part VI, Section B, line 15a The Board of Directors used comparative salary information from other non-profit organizations, data compiled by Aging Services of Minnesota, and 990 information from area facilities in determining compensation. This was completed during this fiscal year. Form 990, Part VI, Section C, line 19 The organization does not make these documents available to the general public.