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 411649721 HOLLY RIDGE MANOR INC HOLL 3202394775 500 HOLLY RIDGE DRIVE STARBUCK MN 56381 KAYO ASLAGSON BOARD CHAIR 3202394775 2015-07-29 1 CORY RUTLEDGE P01329381 6123764500 2013 2016-03-07 17:11:31Z CHRISTOPHER KNOLL 500 HOLLY RIDGE DRIVE STARBUCK MN 56381 424800 0 X WWW.MCHS-HEALTHCARE.ORG X 1989 MN A COMMUNITY OF SERVICES GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE. 9 9 0 10 0 0 380 1296 347309 382264 101 113 38220 41127 386010 424800 0 0 0 0 206258 217178 0 0 0 175530 190381 381788 407559 4222 17241 501841 523524 39686 44128 462155 479396 X A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE THAT ENCOURAGES ALL PEOPLE TO REACH THEIR HIGHEST POTENTIAL. 0 0 391148 0 382264 HOLLY RIDGE MANOR IS A 20-UNIT HOUSING FACILITY OFFERING BOTH ONE AND TWO BEDROOM APARTMENTS TO THE COMMUNITY MEMBERS IT SERVES. HOLLY RIDGE MANOR PROVIDES BOTH INDEPENDENT HOUSING AND ASSISTED LIVING HOUSING AND SERVICES FOR SENIORS AND THOSE NOT CAPABLE OF LIVING INDEPENDENTLY OF OTHERS IN A SAFE AND SECURE SETTING. HOLLY RIDGE MANOR OFFERS DAILY EXERCISE PROGRAMS AS WELL AS THE ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. HOLLY RIDGE MANOR ALSO OFFERS UP TO THREE MEALS DAILY, HOUSEKEEPING SERVICES AND SKILLED NURSING SERVICES SPECIFIC TO EACH CLIENTS NEEDS. HOLLY RIDGE MANOR 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. 391148 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 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 FEIGUM 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 2.00 38.00 X 0 0 0 MURRAY FINGER ADMINISTRATOR 1.50 38.50 X 0 79320 287 CHRISTOPHER KNOLL ADMINISTRATOR 2.00 38.00 X 0 0 0 BRIAN ENGLER DIRECTOR OF FINANCE 4.00 36.00 X 0 48860 4762 0 128180 5049 0 0 0 0 0 1296 1296 RESIDENT REVENUE 623000 382264 382264 382264 113 113 4128 0 4128 4128 4128 MEALS REVENUE 722210 35843 35843 BEAUTY SHOP 812900 1020 1020 OTHER INCOME 900099 136 136 36999 424800 382264 0 41240 192018 183631 8387 10505 10046 459 14655 14015 640 3459 3459 3338 3338 6735 4235 2500 4152 4152 58610 58610 1649 1649 50308 50308 10854 10854 FOOD 41946 41946 RESIDENT SUPPLIES 4976 4976 MISCELLANEOUS 2555 2555 LICENSES AND TAXES 1200 1200 599 326 273 407559 391148 16411 0 123823 166286 9228 11726 1308166 969585 361582 338581 7208 6931 501841 523524 1883 895 6500 6250 31303 36983 39686 44128 X 462155 479396 462155 479396 501841 523524 17241 0 X 0 1 X 1 0 X X X X 0 0 0 MINNEWASKA LUTHERAN HOME 410845402 9 0 1 1 0 1 0 0 1 X 24500 24500 1084277 791699 292578 199389 177886 21503 338581 RELATED PARTY PAYABLES 36983 36983 X PART IV, LINE 2B: THE FACILITY HAS A SEPARATE BANK ACCOUNT TO HOLD THE FUNDS WHILE THE RESIDENT IS LIVING AT HOLLY RIDGE. WHEN THE RESIDENT VACATES THE APARTMENT HOLLY RIDGE REFUNDS THE SECURITY DEPOSIT PLUS INTEREST CALCULATED BASED ON STATE OF MINNESOTA RULES LESS ANY FORFEITURES FOR REPAIRS, IF ANY WITHIN 30 DAYS OF TURNING IN THE KEYS. 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. THE 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. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF HOLLY RIDGE MANOR 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 MINNEWASKA 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 OR THE BYLAWS REQUIRE AN AFFIRMATIVE VOTE OF A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE MANAGEMENT TEAM WILL DISCUSS THE COMPLETED F0RM 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 C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. MINNEWASKA LUTHERAN HOME 605 MAIN STREET STARBUCK MN 56381 410845402 SKILLED NURSING FACILITY MN 501(C)(3) 9 N/A 1 MINNEWASKA HOME CARE 605 MAIN STREET STARBUCK MN 56381 331124162 HOME CARE MN 501(C)(3) 9 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 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0