2015-04-09T16:36:05-05:00 2014-09-30 450250958 Eide Bailly LLP 4310 17th Ave S PO Box 2545 Fargo ND 581082545 990 2013-10-01 410721640 Eventide EVEN 2182337508 2405 8th St No A Moorhead MN 56560 Jon Riewer President/CEO 2182337508 2015-04-03 1 LISA CHAFFEE CPA P00193453 7012398500 2015-04-03 2013 2016-02-25 16:41:14Z Jon Riewer 2405 8th St No A Moorhead MN 56560 43363268 0 X www.eventide.org X 1951 MN To sponsor, encourage, promote, and advance the delivery of health care. 13 13 1208 305 281350 -3394 75073 128817 40391321 38357806 199148 4823820 48270 40007 40713812 43350450 17000 17524 0 0 23537727 24223812 0 0 3526 15245575 13979746 38800302 38221082 1913510 5129368 50570712 53024779 30322565 27624325 20248147 25400454 X To enhance the quality of life for those we serve reflecting our Christian values. 0 0 12834406 17524 15215316 Eventide Lutheran Home of Moorhead operated a 195-bed nursing facility. The occupancy percentage for the year was 96.00%. 9103380 10207504 Eventide at Hi Acres operated a 142-bed nursing home. The occupancy percentage for the year was 90.37%. 6293366 6984346 Eventide Sheyenne Crossings Care Center operated a 64-bed nursing home. The occupancy percentage for the year was 97.47%. 4478901 5950640 Eventide Linden Tree South Living operated a 53-unit elderly housing facility. The occupancy percentage for the year was 96.55%.Eventide, The Fairmont, operated a 88-unit elderly housing facility. The occupancy percentage for the year was 91.96%.Eventide Linden Tree North operated a 66-unit assisted living facility. The occupancy percentage for the year was 97.69%. 4478901 5950640 32710053 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 49 0 1 1208 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X Wade Stubson 2182912216 2405 8th St S Suite A Moorhead MN 56560 Don Stieha Chair 0.20 0.60 X X 0 0 0 Leann Wright Vice Chair 0.20 0.60 X X 0 0 0 Peter Seljevold Treasurer 0.20 0.60 X X 0 0 0 Dennis Edwards Director 0.20 0.60 X 0 0 0 Anne Brakke Secretary 0.20 0.60 X X 0 0 0 John Erickstad Director 0.20 0.60 X 0 0 0 Herb Dahlsad Director 0.20 0.60 X 0 0 0 Don Pingree Director 0.20 0.60 X 0 0 0 Duane Nelson Director 0.20 0.60 X 0 0 0 Marjorie Matthees Director 0.20 0.60 X 0 0 0 K Thor Thompson Director 0.20 0.60 X 0 0 0 Vern Lolting Director 0.20 0.60 X 0 0 0 David Rogers Director 0.20 0.60 X 0 0 0 Jon Riewer President/CEO 10.00 30.00 X 299073 0 15172 Wade Stubson CFO 10.00 30.00 X 181605 0 12114 Janelle Klinke VP of HR 10.00 30.00 X 111570 0 12342 Melissa Heesch VP of Operations 10.00 30.00 X 164266 0 13395 Douglas Panchot Administrator - Jamestown Campus 10.00 30.00 X 137142 0 12445 893656 0 65468 5 0 1 0 RehabCare Group Inc PO Box 503534 St Louis MO 631503534 Therapy contract 1627249 MedNational LLC 4265 45th ST S Fargo ND 58104 Architect 1141931 Midwest Mechanical Construction 4402 2nd Ave S Suite 17 Fargo ND 58078 Mechanical Contractor 205321 Paces Lodging Corporation 4265 45th St Ste 200 Fargo ND 58104 Development Construction 201785 Zerr Berg Architects 510 4th Ave N Fargo ND 58102 Architect 121937 6 128817 128817 Resident Services 623000 36993467 36993467 Catering 721000 603608 322258 281350 Other Income 900099 486779 486779 Management Fees 561000 273952 273952 38357806 318912 318912 4504908 0 4504908 4504908 4504908 52825 12818 40007 40007 43350450 38076456 281350 4863827 17524 17524 571506 571506 19167171 16607581 2559590 146128 126614 19514 2890385 2504402 385983 1448622 1221224 227398 12324 12324 47760 47760 21593 21593 3247836 3213874 33962 188309 188309 594210 3189 591021 45103 45103 1295581 1295581 129745 420 129325 252286 252286 1210964 1210964 2533713 2533117 596 290825 290825 Medical Supplies 1540613 1540613 Licenses & Permits 571558 571558 Bad Debt Expense 37388 37388 Community Relations 13161 13161 1946777 1918428 25419 2930 38221082 32710053 5507503 3526 2833725 1822201 2922784 2830126 88298 92035 191427 244609 62884883 26821630 33375513 36063253 5312350 8702561 2196500 2196500 3650115 1073494 50570712 53024779 3204241 4564077 18156030 17261520 214493 216015 5676187 5570991 3071614 11722 30322565 27624325 X 19583692 24617849 518678 636828 145777 145777 20248147 25400454 50570712 53024779 5129368 22939 0 X 0 1 X 1 0 X 84107 103131 66516 75073 128817 457644 23441164 38711669 39621637 40184259 38129281 180088010 23525271 38814800 39688153 40259332 38258098 180545654 0 0 0 180545654 130513 140577 143272 260874 318912 994148 5186 4778 9964 135699 145355 143272 260874 318912 1004112 23660970 38960155 39831425 40520206 38577010 181549766 0.99450 0.99510 0.00550 0.00490 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 31650 31650 0 Part II-B, Line 1: Eventide hired an attorney to work for the organization to bring special legislation to the state of Minnesota with regards to rates and the difference between facilities in bordering States (MN and ND). $31,650 was paid in FY 2014. 0 1 X 604014 20024 66054 36628 653464 748436 10420 59057 37082 176817 604014 632989 41873 73574 748436 584805 40000 8184 632989 575487 9318 584805 0.27000 0.51000 0.22000 0 0 193130 10760623 10953753 40958114 20485714 20472400 8867607 6296541 2571066 2105409 39375 2066034 36063253 Annuities Payable 11722 11722 X 43245118 0 43245118 105332 105332 43350450 38233900 12818 12818 38221082 0 38221082 Part IV, Line 2b: The Organization is the trustee of various resident trust funds and has a fiduciary responsibility for the administration and distribution of these funds for the residents. Tenant security deposits represent amounts received from tenants subject to the terms of their lease agreements. These funds are refunded to tenants based on compliance with the requirements of the lease agreement. The resident trust funds and tenant security deposits are held in segregated deposit accounts. Part V, Line 4: To provide a permanent source of income for operations, chaplaincy and volunteer operating purposes. Part X, Line 2: Eventide is organized as Minnesota nonprofit organizations has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). Eventide Fargo and Eventide Jamestown are organized as North Dakota nonprofit organizations and derive their federal tax exempt status from Eventide's nonprofit tax exempt determination. Eventide is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. Eventide Jamestown and Eventide Fargo, as LLCs, are included in the 990 filing of Eventide. In addition, the Organization is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. The Organization files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Organization believes that is 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 consolidated financial statements. The Organization 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. The Organization's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2010. Part XI, Line 4b - Other Adjustments: Special Events Expenses Included in Expenses Per F/S -12,818. Restricted Contributions Recorded in Fund Balance Per F/S 88,724. Change in Temporarily Restricted Endowment Recorded in Fund Balance for F/S 29,426. Part XII, Line 2d - Other Adjustments: Special Events Expenses Included in Revenue Per Form 990 12,818. Benefit Auction 52825 52825 10332 2486 52825 52825 10332 2486 12818 40007 1 Scholarships 14 17524 Part I, Line 2: The Organization requires written receipts of the expenditure of the scholarship for education purposes. X X X 0 0 0 0 0 1 1 0 0 Jon Riewer President/CEO 299073 0 0 0 0 0 6072 0 13231 0 318376 0 0 0 Wade Stubson CFO 181605 0 0 0 0 0 3716 0 10926 0 196247 0 0 0 Melissa Heesch VP of Operations 164266 0 0 0 0 0 3385 0 12313 0 179964 0 0 0 Douglas Panchot Administrator - Jamestown Campus 137142 0 0 0 0 0 2435 0 11666 0 151243 0 0 0 Part I, Line 6 Bonuses were accrued for the President, VPs, and administrators based on established goals. 10% of their accrued bonus was related to the net earnings of the company. A Moorhead Economic Development Authority 411671510 616151DS2 2006-11-30 7488591 Refund bonds issued 5/13/1999 0 0 0 B Moorhead Economic Development Authority 411671510 616151EF9 2007-01-17 4350000 Refund bonds issued 5/13/1998 0 0 0 C Clay County Minnesota 416005575 2006-12-01 2039402 Acquire land for expansion 0 0 0 D Moorhead Economic Development Authority 411671510 2008-12-30 8790000 Construction of facility for Sheyenne Crossings 0 0 0 A 1590000 7488591 149800 7338791 2006 1 0 1 1 B 2570000 4350000 62332 4287668 2007 1 0 1 1 C 553240 2039402 39402 2000000 2006 0 0 1 1 D 694639 8790000 279906 125000 8385094 2010 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 C 0 0 0 1 0 0 0 0 0 D 0 0 0 1 1 0 0 0 0 A 0 B 0 C 0 D 0 Date Rebate Computation Performed Issuer Name: Moorhead Economic Development Authority Date the Rebate Computation was Performed: 08/11/2011 Issuer Name: Moorhead Economic Development Authority Date the Rebate Computation was Performed: 02/20/2012 Issuer Name: Clay County Minnesota Date the Rebate Computation was Performed: 08/11/2011 Issuer Name: Moorhead Economic Development Authority Date the Rebate Computation was Performed: 10/28/2013 Schedule K, Part II, Line 1 Amount of Bonds Retired, Bond C & D The amount of bonds retired reported for Bond C and Bond D reflect the difference between the issue price and the balance outstanding at the end of the Organization's tax year. Form 990, Part VI, Section A, line 1 There is an Executive Committee that has the power to act on behalf of the entire Board of Directors. This committee is made up of at least five but not more than six persons, all of whom shall be members of the Board of Directors. The President shall be an advisory, non-voting member of the Executive Committee. Form 990, Part VI, Section A, line 6 Members consist of churches and other organizations. There is only one class of membership. Form 990, Part VI, Section A, line 7a Delegates from the member churches serve on the board and elect the Board of Directors. Each member church has one vote for every 1,000 members of the church. Each member church also has one additional vote which may be cast by one of its pastors present at the meeting. Each member of the organization's Board of Directors is entitled to one vote. Form 990, Part VI, Section B, line 11 The CFO and Controller will review a draft of the Form 990. The reviewed copy will be presented and approved at a board meeting. Form 990, Part VI, Section B, line 12c Board members, management level employees and up are covered by the policy. The senior management/CFO determines if a conflict of interest exists and reviews conflicts. Eventide has various restrictions in place to keep the individual with the conflict from acting on their own behalf instead of Eventide's best interest. Individuals with a conflict must abstain from voting on the issue. Form 990, Part VI, Section B, line 15a An annual evaluation of the CEO is done by the Executive Committee team. A comparability study was done in October 2011. The comparability study considers the region, total revenue and FTE's. The market adjustment took effect in fiscal year beginning October 1, 2011. The last review done was in January 2014 for fiscal year 2015. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available to the public upon request. Eventide Jamestown LLC dba Hi Acres 1405 7th Street South Moorhead MN 56560 272608086 Senior Living Community ND 10207524 6503324 Eventide Eventide Fargo LLC 3225 51 ST S Fargo ND 58104 463364672 Senior Living Community ND 0 7304344 Eventide Eventide Senior Living Communities LLC dba Sheyenne Crossings 2405 8th St S Suite A Moorhead MN 56560 204531061 Senior Living Community MN 501(c)(3) Line 9 Eventide 1 Eventide Living Center 2405 8th St S Suite A Moorhead MN 56560 411486796 HUD Elderly Housing MN 501(c)(3) Line 9 Eventide 1 Lake Region Lutheran Home 2405 8th St S Suite A Moorhead MN 56560 450275011 Skilled Nursing Facility ND 501(c)(3) Line 9 Eventide 1 BEK Care LLC (dba Ethos Home Care) 2877 45th St S Suite 201 Fargo ND 58104 464681716 Home Care Agency ND Eventide Related -43785 56218 0 0 0.33330 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 Eventide Senior Living Communities LLC Q 4211741 Accrual Eventide Senior Living Communities LLC R 4507324 Accrual Lake Region Lutheran Home Inc Q 1692990 Accrual Lake Region Lutheran Home Inc R 1082414 Accrual BEK Care LLC B 100000 Accrual Eventide Living Center R 55607 Accrual Eventide Living Center Q 60001 Accrual Eventide Senior Living Communities LLC O 109730 Accrual