2015-08-05T11:59:26-05:00 2014-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2013-10-01 410845402 MINNEWASKA LUTHERAN HOME MINN 3202392217 PO BOX 40 STARBUCK MN 56381 KAYO ASLAGSON BOARD CHAIR 3202397121 2015-07-29 1 CORY RUTLEDGE P01329381 6123764500 2013 2016-03-07 17:11:31Z X CHRISTOPHER KNOLL PO BOX 40 STARBUCK MN 56381 4374343 0 X WWW.MCHS-HEALTHCARE.ORG X 1958 MN NURSING HOME - A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE. 9 8 184 75 0 0 37807 47370 4351067 4285328 10598 12948 19993 28697 4419465 4374343 21031 8570 0 0 2961650 2966984 0 0 0 1404708 1384058 4387389 4359612 32076 14731 5113727 4956954 2799551 2624431 2314176 2332523 X A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE THAT ENCOURAGES ALL PEOPLE TO REACH THEIR HIGHEST POTENTIAL. 0 0 3876414 8570 4285328 MINNEWASKA LUTHERAN HOME, A 65-BED SKILLED NURSING FACILITY, PROMOTES HEALTH TO THE COMMUNITY BY PROVIDING SKILLED NURSING CARE AND PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES. ADDITIONAL PROGRAMS WHICH BENEFIT THE COMMUNITY INCLUDE:OUTPATIENT THERAPY SERVICES: MINNEWASKA LUTHERAN HOME PROVIDES PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY TO COMMUNITY MEMBERS IN NEED OF THESE SERVICES ALLOWING THEM TO RESUME THEIR NORMAL ACTIVITIES OF DAILY LIVING. MINNEWASKA LUTHERAN HOME IS GOVERNED BY A NINE PERSON INDEPENDENT BOARD MADE UP OF ONE AT-LARGE COMMUNITY LEADER AND EIGHT AREA CHURCH MEMBERS. THE BOARD HAS A HISTORY OF COMMITMENT TO ACTING WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO ENSURE THE ORGANIZATION CONTINUES TO OPERATE AT ITS MAXIMUM POTENTIAL FOR THE BENEFIT OF THE CLIENTS WE SERVE AND THE COMMUNITY. 3 0 0 COMMUNITY OUTREACH EXERCISE PROGRAM: EXERCISE PROGRAM THAT STRESSES STRENGTH AND STABILITY. THIS PROGRAM IS OFFERED THREE TIMES PER WEEK TO COMMUNITY MEMBERS AT NO CHARGE. 0 0 0 ROAD TO AGING GRACEFULLY: FREE MONTHLY EDUCATION TO ANY PERSON IN THE COMMUNITY. ALL PROGRAMS RELATE TO THE MANAGEMENT OF CHRONIC DISEASES AND OTHER AGING HEALTH RELATED ISSUES. ALL INSTRUCTORS ARE LOCAL AND REGIONAL EXPERTS IN THEIR RELATED FIELD OFFERING THEIR SERVICES AT A REDUCED OR FREE CHARGE. 0 0 0 NO PLACE LIKE HOME: GOAL IS TO MAINTAIN LEVEL OF INDIVIDUALS HEALTH AFTER DISCHARGE TO REMAIN IN THEIR HOME SETTING WITHOUT NEEDING TO BE RETURNED TO THE NURSING HOME OR HOSPITAL. 0 0 0 3876417 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 15 0 184 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 0 0 MN X BRIAN ENGLER 3202397121 605 MAIN STREET STARBUCK MN 56381 KAYO ASLAGSON CHAIR 0.50 1.50 X X 0 0 0 LAURIS JOHNSHOY VICE CHAIR 0.50 1.50 X X 0 0 0 JOHN SAMUELSON SECRETARY 0.50 1.50 X X 0 0 0 ARNE STOEN TREASURER 0.50 1.50 X X 0 0 0 LONNIE ANDERSON DIRECTOR 0.50 1.50 X 0 0 0 RONALD FIEGUM DIRECTOR 0.50 1.50 X 0 0 0 WARREN HAGESTUEN DIRECTOR 0.50 1.50 X 0 0 0 ROBERT HENDRICKSON DIRECTOR 0.50 1.50 X 0 0 0 ALICE REESE DIRECTOR 0.50 1.50 X 0 0 0 JIM BROICH ADMINISTRATOR 36.00 4.00 X 0 0 0 MURRAY FINGER ADMINISTRATOR 36.00 4.00 X 79320 0 287 CHRISTOPHER KNOLL ADMINISTRATOR 36.00 4.00 X 0 0 0 BRIAN ENGLER DIRECTOR OF FINANCE 28.00 12.00 X 48860 0 4762 128180 0 5049 0 0 0 0 MILLER ARCHITECTS & BUILDERS 3335 W ST GERMAINE STREET PO BOX ST CLOUD MN 56302 ARCHITECT & CONTRACTOR FEES 305923 1 38170 9200 47370 RESIDENT REVENUES 623000 4285328 4285328 4285328 12948 12948 MISCELLANEOUS INCOME 900099 11609 11609 MEALS REVENUE 722210 10235 10235 CABLE TV REVENUE 900099 6853 6853 28697 4374343 4285328 0 41645 8570 8570 120273 120273 2420513 2278695 141818 12237 10975 1262 231990 208059 23931 181971 163200 18771 13944 13944 24788 24788 36781 27533 9248 10998 10998 146430 131526 14904 43698 43698 150486 150486 7481 5767 1714 1320 1320 81335 81335 297196 297196 29755 29755 LICENSE SURCHARGE 191189 191189 MEDICAL SUPPLIES 135148 135148 FOOD 127593 127593 BAD DEBTS 67656 67656 18260 4449 13811 4359612 3876417 483195 0 25 25 1068733 1157507 519071 429703 22451 27218 8259887 5213452 3221745 3046435 152435 165486 2000 2000 66246 59994 61021 68586 5113727 4956954 316556 325226 6987 6364 2476008 2292841 2799551 2624431 X 2312576 2330922 1600 1601 2314176 2332523 5113727 4956954 14731 3616 0 X 0 1 X 1 0 X 26365 35736 18589 37807 47370 165867 4217590 4393422 4394214 4351067 4285328 21641621 4243955 4429158 4412803 4388874 4332698 21807488 5000 5000 1489768 1546737 1637269 1610998 1573236 7858008 1489768 1546737 1642269 1610998 1573236 7863008 13944480 17970 13298 10687 10598 12948 65501 17970 13298 10687 10598 12948 65501 58508 76092 23195 19993 28697 206485 4320433 4518548 4446685 4419465 4374343 22079474 0.63160 0.65580 0.00300 0.00310 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME CABLE TV REVENUE MISCELLANEOUS INCOME MEALS REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 228026 228026 6367683 3844686 2522997 124900 52925 71975 1539278 1315841 223437 3046435 X PART IV, LINE 2B: RESIDENT DEPOSITS CONSIST OF RESIDENT TRUST FUNDS HELD BY THE ORGANIZATION FOR THE RESIDENTS OF THE HOME. PART X, LINE 2: FROM NOTE 1 TO THE ORGANIZATION'S FINANCIAL STATEMENTS: THE HOME, MHD, HOLLY RIDGE, AND HOME CARE HAVE ALL BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) AND APPLICABLE STATE STATUTES. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF ANY OF ITS ENTITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE INCOME TAX RETURNS OF HOME, MHD, HOLLY RIDGE, AND HOME CARE FOR THE FISCAL YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. 1 SCHOLARSHIPS 3 8570 PART I, LINE 2: AFTER THE EMPLOYEE HAS BEEN APPROVED FOR A SCHOLARSHIP HE/SHE MUST PAY FOR ALL EXPENSES FOR EACH SEMESTER OF SCHOOL. AFTER EACH SEMESTER THE EMPLOYEE TURNS IN ALL ELIGIBLE EXPENSES UNDER THE SCHOLARSHIP AGREEMENT. REPORTS ARE RUN TO VERIFY THE EMPLOYEE MET THE REQUIRED HOURS FOR THE SAME DATES OF THE SEMESTER. ONCE THIS IS DONE IF THE EMPLOYEE HAS MET THE REQUIREMENTS HE/SHE IS REIMBURSED FOR THE ELIGIBLE EXPENSES. CORA STOEN MOTHER OF BOARD MEMBER 62013 ROOM & BOARD 0 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF MINNEWASKA LUTHERAN HOME CONSIST OF CERTAIN CONGREGATIONS LOCATED IN THE GENERAL COMMUNITY OF STARBUCK, MINNESOTA. EACH MEMBER CONGREGATION MAY APPOINT ONE INDIVIDUAL TO ACT AS A DELEGATE ON ITS BEHALF. THE PRESENT MEMBERS ARE: FRON LUTHERAN CHURCH - STARBUCK, MINNESOTA MINEWASKA LUTHERAN CHURCH - STARBUCK, MINNESOTA ST. JOHN'S LUTHERAN CHURCH - STARBUCK, MINNESOTA IMMANUEL LUTHERAN CHURCH - STARBUCK, MINNESOTA INDHERRED LUTHERAN CHURCH - STARBUCK, MINNESOTA EAST ZION LUTHERAN CHURCH - STARBUCK, MINNESOTA WEST ZION LUTHERAN CHURCH - HANCOCK, MINNESOTA TRINITY LUTHERAN CHURCH - CYRUS, MINNESOTA FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS ARE ELECTED BY A MAJORITY VOTE OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ARTICLES OF INCORPORATION AND/OR THE BYLAWS REQUIRE AN AFFIRMATIVE VOTE OF A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE MANAGEMENT TEAM AND BOARD MEMBERS WILL DISCUSS THE COMPLETED FORM 990 AT THE JULY 29, 2015 BOARD MEETING BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF COMMITTEE WITH BOARD-DELEGATED POWERS. ANY INDIVIDUAL WITH AN ACTUAL OR POTENTIAL CONFLICT IS REQUIRED TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD OR COMMITTEE. AFTER DISCLOSURE OF THE MATERIAL FACTS, THE REMAINING BOARD OR COMMITTEE MEMBERS DETERMINE BY MAJORITY VOTE WHETHER A CONFLICT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE BOARD OR COMMITTEE SEEKS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY POSSIBLE, THE BOARD OR COMMITTEE DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. THE INDIVIDUAL MAY NOT BE PRESENT FOR A DISCUSSION OF, OR VOTE ON, WHETHER TO ENTER THE TRANSACTION. THE RELEVANT FACTS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. ADDITIONALLY, BOARD MEMBERS ARE REQUIRED TO ANNUALLY SIGN STATEMENTS DISCLOSING EXISTING CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. EVERY YEAR, THE ADMINISTRATOR PRESENTS A PROPOSAL FOR COMPENSATION TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN USES A CURRENT SALARY SURVEY (DONE BY LEADINGAGE OF MN) TO COMPARE TO THE PROPOSAL AND THEN COMES TO A CONCLUSION ON WHAT THE COMPENSATION WILL BE. THIS IS THEN INCORPORATED IN THE BOARD MINUTES AND ADMINISTRATOR'S ANNUAL REVIEW. THE PROCESS LAST OCCURRED 12/15/10. 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. MINNEWASKA HOME CARE 605 MAIN STREET STARBUCK MN 56381 331124162 HOME CARE MN 501(C)(3) 9 N/A 1 HOLLY RIDGE MANOR 500 HOLLY RIDGE DRIVE STARBUCK MN 56381 411649721 ASSISTED LIVING MN 501(C)(3) 11 - TYPE 2 N/A 1 MINNEWASKA HOME DEVELOPMENT 605 MAIN STREET STARBUCK MN 56381 411504339 FUNDRAISING MN 501(C)(3) 11 - TYPE 2 N/A 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 1