2015-10-29T09:18:32-05:00 2014-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2014-01-01 460332387 BETHESDA HOME INC BETH 6053453331 129 WEST HIGHWAY 12 WEBSTER SD 57274 MICHAEL EWALT ADMINISTRATOR 6053453331 2015-10-22 1 LAURIE HANSON P00851848 6053391999 2015-10-22 2014 2016-02-25 16:41:14Z DAVID ROGERS 129 WEST HIGHWAY 12 WEBSTER SD 57274 3087317 0 X WWW.BETHESDANURSINGHOME.COM X 1956 SD NURSING HOME AND CONGREGATE LIVING. 10 10 115 11 0 0 105918 30630 3070164 3056274 -18139 -823 0 0 3157943 3086081 0 0 0 0 2021123 2047538 0 0 0 1019987 1112541 3041110 3160079 116833 -73998 1959688 1720936 1357694 1192940 601994 527996 A CHRISTIAN HOME OF HEALTH, HEALING, HEART AND HOPE. 0 0 2687339 3056274 THE ORGANIZATION OPERATES A 50-BED NURSING HOME AND A 24-UNIT CONGREGATE HOUSING COMPLEX, WHICH ALLOWS IT TO PROVIDE A CHRISTIAN HOME FOR AGING PERSONS. THE TOTAL NURSING HOME RESIDENT DAYS WAS 17,725. 2687339 1 1 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 16 0 1 115 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL EWALT 6053453331 129 WEST HIGHWAY 12 WEBSTER SD 57274 X NYLA AMUNDSON PRESIDENT 1.00 0.00 X X 0 0 0 JOHN SIGDESTAD VICE PRESIDENT 1.00 1.00 X X 0 0 0 LINDA WITT SEC/TREASURER 1.00 0.00 X X 0 0 0 DONALD OLSON DIRECTOR 1.00 0.00 X X 0 0 0 STANLEY BOE DIRECTOR 1.00 0.00 X 0 0 0 VIRGINIA TUNHEIM DIRECTOR 1.00 0.00 X 0 0 0 BRENT ZIMMERMAN DIRECTOR 1.00 1.00 X 0 0 0 JIM ROOD DIRECTOR 1.00 1.00 X 0 0 0 ROBERT COYNE DIRECTOR 1.00 0.00 X 0 0 0 BRYAN ANDERSON DIRECTOR 1.00 0.00 X 0 0 0 DAVID ROGERS CEO 10.00 0.00 X 0 0 0 MICHAEL EWALT ADMINISTRATOR 40.00 1.00 X 0 0 0 0 0 0 0 0 0 0 SANFORD HEALTH PO BOX 5039 SIOUX FALLS SD 57117 ADMINISTRATIVE SERVICES 213521 1 27290 3340 30630 RESIDENT SERVICES 623000 3000760 3000760 MEAL SALES 722210 23843 23843 MISCELLANEOUS 623000 22141 22141 LAUNDRY 812300 9530 9530 3056274 413 413 1236 -1236 -1236 -1236 3086081 3056274 0 -823 1718493 1560178 158315 212438 192867 19571 116607 105865 10742 182384 69839 112545 2234 2234 29230 29230 110272 59001 51271 9330 9330 92907 63643 29264 13843 13843 148749 148749 9358 7410 1948 14898 12328 2570 26851 26851 136479 136479 47393 2250 45143 FOOD 177293 177293 MEDICAL SUPPLIES 87884 87884 TAXES AND FEES 21426 21426 2010 1433 577 3160079 2687339 472740 0 675846 446091 146272 127200 21318 27103 608 405 4367310 3262199 1103182 1105111 12462 15026 1959688 1720936 213541 153894 760000 675000 7802 10020 207930 201261 168421 152765 1357694 1192940 X 601994 527996 601994 527996 1959688 1720936 -73998 0 X 0 1 X 1 0 X 16692 148102 36400 105918 30630 337742 2913366 2994762 3076386 3018761 3056274 15059549 7088 11796 12305 17419 48608 2937146 3154660 3125091 3142098 3086904 15445899 0 947882 764884 976199 953877 993508 4636350 947882 764884 976199 953877 993508 4636350 10809549 466 482 507 459 413 2327 8826 2280 3324 8834 23264 9292 2762 3831 9293 413 25591 2946438 3157422 3128922 3151391 3087317 15471490 0.69870 0.72530 0.00170 0.00160 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 21424 21424 3688745 2783741 905004 636127 472390 163737 21014 6068 14946 1105111 NOTES PAYABLE - FOUNDATION 152765 152765 X PART IV, LINE 2B: RESIDENTS SECURITY DEPOSITS. PART X, LINE 2: BETHESDA HOME, INC. IS ORGANIZED AS A SOUTH DAKOTA 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 ORGANIZATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE ORGANIZATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. BETHESDA HOME, INC. FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS IN 2013 AND PRIOR YEARS. BEGINNING IN 2014, THE HOME HAS DETERMINED IT IS NO LONGER REQUIRED TO FILE FORM 990T. THE ORGANIZATION 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 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. BETHESDA HOME, INC.'S FEDERAL FORM 990-T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES BEFORE 2011. FORM 990, PART VI, SECTION A, LINE 3 SANFORD HEALTH, AN UNRELATED ORGANIZATION, PROVIDES MANAGEMENT SERVICES THROUGH A CONTRACT INVOLVING THE CEO AND THE ADMINISTRATOR. SANFORD HEALTH IS LOCATED AT 1305 W 18TH STREET, SIOUX FALLS, SD. THE HOME PAID SANFORD HEALTH FOR SERVICES PROVIDED BY DAVID ROGERS, CEO, AND MICHAEL EWALT, ADMINISTRATOR. THE CEO SPENDS APPROXIMATELY 10 HOURS PER WEEK AT THE HOME. THE REMAINDER OF HIS TIME IS SPENT AT AN UNRELATED ENTITY. THE ADMINISTRATOR SPENDS 100% OF HIS TIME WORKING FOR THE HOME. COMPENSATION AND BENEFITS FOR THE CEO WERE $31,881 AND $3,218 RESPECTIVELY, AND COMPENSATION AND BENEFITS FOR THE ADMINISTRATOR WERE $53,699 AND $23,747 RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THIS CORPORATION SHALL CONSIST OF THE VOTING MEMBERS OF NINE CONGREGATIONS OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA'S PRAIRIE COTEAU CONFERENCE OF THE SOUTH DAKOTA SYNOD OR ITS SUCCESSOR VOTING TO PARTICIPATE AND OF OTHER LUTHERAN CONGREGATIONS THAT BECOME MEMBERS BY INVITATION TO THIS CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A BETHESDA HOME, INC. HAS AFFILIATIONS WITH AREA CHURCHES, AND IN TURN EACH AFFILIATED CHURCH ELECTS A REPRESENTATIVE FROM THEIR RESPECTIVE CONGREGATION TO SIT ON THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE AFFILIATED CHURCHES EACH SEND TWO REPRESENTATIVES TO BETHESDA HOME'S ANNUAL MEETING AS THEIR VOICE ON DECISIONS MADE BY THE BOARD OF DIRECTORS SUCH AS CHANGES TO GOVERNING DOCUMENTS, ETC. FORM 990, PART VI, SECTION A, LINE 8B THE EXECUTIVE COMMITTEE MEETS BEFORE REGULAR BOARD MEETINGS, BUT HAS NO AUTHORITY TO ACT WITHOUT THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 WILL BE PROVIDED TO THE BOARD MEMBERS AT A MONTHLY MEETING. FORM 990 WILL BE FILED WITH THE IRS AFTER REVIEWED AND APPROVED BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO READ, ACCEPT AND SIGN THE CONFLICT OF INTEREST STATEMENT EACH YEAR. THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS. A POSSIBLE CONFLICT MUST BE DISCLOSED IMMEDIATELY IN WRITING TO THE BOARD PRESIDENT. THE WRITTEN DISCLOSURE IS THEN PRESENTED TO THE BOARD, AS A WHOLE, AND DETERMINATION IS MADE, BY A MAJORITY VOTE, AS TO WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT EXISTS. IF A CONFLICT IS DETERMINED TO EXIST, THE INTERESTED PERSON MAY GIVE A PRESENTATION TO THE REST OF THE BOARD, BUT AFTER THE PRESENTATION, THE INTERESTED PERSON MUST LEAVE THE MEETING DURING THE DISCUSSION AND VOTING PROCESS OF THE DISCLOSED MATTER. FORM 990, PART VI, SECTION B, LINE 15 SANFORD HEALTH LOOKS AT COMPARABLE ORGANIZATIONS, SDAHO SALARY GUIDELINES, AND NATIONAL ORGANIZATIONS. THE SALARY GUIDELINES ARE BASED ON SIZE, LOCATION AND REVENUE OF THE ORGANIZATION. THIS METHOD OF DETERMINING COMPENSATION IS USED FOR ALL POSITIONS ON AN ANNUAL BASIS. THE BOARD OF DIRECTORS OF BETHESDA HOME, INC., APPROVES THE COMPENSATION AMOUNT THROUGH THEIR ACCEPTANCE OF THE MANAGEMENT AGREEMENT. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST WITH BOARD APPROVAL. BETHESDA HOME FOUNDATION 129 WEST HIGHWAY 12 WEBSTER SD 57274 460397029 PROVIDE MONETARY SUPPORT FOR THE HOME SD 501(C)(3) LINE 11D, III-O BETHESDA HOME INC 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 BETHANY HOME FOUNDATION INC E 152770 BOOK VALUE