2015-02-05T12:40:42-06:00 2014-09-30 410746749 CLIFTONLARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2013-10-01 410847708 ST JOHN'S LUTHERAN HOME STJO 5073738226 901 LUTHER PLACE ALBERT LEA MN 56007 SCOT SPATES CEO 5073738226 2015-01-29 1 TRENT FAST P00692704 5074347000 2013 2016-02-25 16:41:14Z ST JOHN'S LUTHERAN COMMUNITY SCOT SPATES 901 LUTHER PLACE ALBERT LEA MN 56007 12249407 0 9386 X WWW.STJOHNSOFALBERTLEA.ORG X 1957 MN ST. JOHN'S LUTHERAN HOME WAS ORGANIZED FOR THE PURPOSE OF BUILDING, ERECTING, ESTABLISHING, MAINTAINING, EQUIPPING, MANAGING, OPERATING, AND ENDOWING A CHRISTIAN HOME MINISTERING TO THE PHYSICAL, SPIRITUAL, EMOTIONAL, AND SOCIAL NEEDS OF AGING MEN AND WOMEN. 10 10 320 125 22769 -3587 328404 343474 11285848 11842431 38888 18335 44868 45167 11698008 12249407 0 0 0 0 7501326 7566615 0 0 0 4043280 4272827 11544606 11839442 153402 409965 11370576 11388449 5304600 4912508 6065976 6475941 TO PROVIDE PHYSICAL, EMOTIONAL, SOCIAL AND CHRISTIAN CARE FOR ALL PEOPLE, WITH DIGNITY AND RESPECT, IN AN ENVIRONMENT OF GOD'S GRACE. 0 0 10794306 11819662 ST JOHN'S LUTHERAN HOME WAS ORGANIZED FOR THE PURPOSE OF BUILDING, ERECTING, ESTABLISHING, MAINTAINING, EQUIPPING , MANAGING, OPERATING, AND ENDOWING A CHRISTIAN HOME MINISTERING TO THE PHYSICAL, SPIRITUAL, EMOTIONAL AND SOCIAL NEEDS OF AGING MEN AND WOMEN. PROVISION OF NURSING CARE AND HOUSING TO THE ELDERLY AND HANDICAPPED BY OPERATING A 170-BED LICENSED NURSING FACILITY AND A 48-UNIT APARTMENT COMPLEX. 10794306 1 1 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 23 0 320 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MN X DUANE MALLON 5074731015 901 LUTHER PL ALBERT LEA MN 56007 LANCE SKOV DIRECTOR 1.00 X 0 0 0 STEVEN ZENK DIRECTOR 1.00 X 0 0 0 DAVE OLSON TREASURER 1.00 X 0 0 0 DARRYL MEYER SECRETARY 1.00 X 0 0 0 ORVILLE SIMONSEN CHAIRMAN 1.00 X 0 0 0 REV WENDY ANDERSON VICE CHAIRMAN 1.00 X 0 0 0 CHARLES REINDAL DIRECTOR 1.00 X 0 0 0 JOEL ERICKSON DIRECTOR 1.00 X 0 0 0 DONNA NELSON DIRECTOR 1.00 X 0 0 0 LARRY TRAMPEL DIRECTOR 1.00 X 0 0 0 SCOT SPATES CEO 40.00 X 102307 0 33026 DUANE MALLON CFO 38.00 X 69359 0 23045 171666 0 56071 1 0 0 0 HORTY ELVING & ASSOCIATES 505 EAST GRANT STREET MINNEAPOLIS MN 55404 ARCHITECTURE 503363 REHAB CARE PO BOX 503534 ST LOUIS MO 631503534 THERAPY SERVICES 468395 2 308631 34843 343474 RESIDENT REVENUE 623000 10230185 10230185 MEDICARE/MEDICAID PAYMENTS 623000 1586903 1586903 MANAGEMENT INCOME 561700 22769 22769 MISCELLANEOUS REVENUE 623000 2127 2127 PHONE RENTAL 623000 447 447 11842431 18335 18335 BEAUTY SHOP 623000 32490 32490 MISCELLANEOUS INCOME 900099 9301 9301 NON-RESIDENT MEALS 623000 2567 2567 809 809 45167 12249407 11819662 22769 63502 227737 227737 6029377 5770357 259020 120518 110877 9641 736181 677287 58894 452802 416578 36224 6022 6022 65501 65501 256651 205820 50831 50322 50322 596231 523662 72569 423658 423658 5855 4816 1039 38144 32965 5179 157917 157917 670006 670006 79978 79978 FOOD COSTS 551614 551614 TAXES & LICENSES 525899 525899 THERAPY EXPENSE 428672 428672 PHARMACY 173912 173912 242445 120266 122179 11839442 10794306 1045136 0 684427 478931 3323105 3270137 1468877 1287034 89528 127245 20311847 14191145 5701047 6120702 100361 100290 3231 4110 11370576 11388449 1049202 1045145 3745000 3360000 510398 507363 5304600 4912508 X 6065976 6475941 6065976 6475941 11370576 11388449 409965 0 X X 0 1 X 1 0 X 359580 356782 338960 324449 343474 1723245 11929680 11888860 11435201 11285848 11842431 58382020 12289260 12245642 11774161 11610297 12185905 60105265 346727 342070 326285 312069 308631 1635782 0 346727 342070 326285 312069 308631 1635782 58469483 94075 88830 46766 38888 18335 286894 94075 88830 46766 38888 18335 286894 46357 46917 44868 45167 183309 12383335 12380829 11867844 11694053 12249407 60575468 0.96520 0.96360 0.00470 0.00670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 424462 424462 11640277 9241822 2398455 6028889 4512484 1516405 2218219 436839 1781380 6120702 LEASE DEPOSITS 45790 PATIENT TRUST FUNDS 10145 ASSET RETIREMENT OBLIGATION 451428 507363 X 12249407 0 12249407 0 12249407 11839442 0 11839442 0 11839442 PART X, LINE 2: THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE ORGANIZATION AS A RESULT OF THIS STANDARD. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. THE 2011, 2012, AND 2013 TAX YEARS OF THE ORGANIZATION ARE OPEN FOR EXAMINATION BY THE IRS. A CITY OF ALBERT LEA MINNESOTA 416004922 012797BL9 2006-02-22 645000 IMPROVE THE FACILITIES 0 0 0 B CITY OF ALBERT LEA MINNESOTA 416004922 012797BK1 2006-02-22 5315000 REFINANCING 0 0 0 A 645000 45000 600000 2007 0 0 1 1 B 2600000 5315000 282755 156189 4876056 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 1 1 0 0 0 0 B 1 1 0 0 0 0 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 2 CHARLES REINDAL AND DONNA NELSON - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO BEING FILED WITH THE IRS, THE BOARD CHAIRMAN AND CEO REVIEW IN DETAIL A COPY OF THE FORM 990, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF APPROPRIATE CHANGES. FORM 990, PART VI, SECTION B, LINE 12C A CORPORATE COMPLIANCE PROGRAM IS REVIEWED WITH ALL NEW HIRES AND WITH NEW BOARD MEMBERS. BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY COMPLETE A SURVEY RELATED TO BUSINESS RELATIONSHIPS AND FAMILY MEMBERS THAT COULD OR DO CREATE A CONFLICT OF INTEREST. THESE ARE SUMMARIZED AND FILED ALONG WITH BOARD MEETING MINUTES. CONFLICTS OF INTEREST ARE DETERMINED BY A REVIEW OF THE POTENTIAL CONFLICTS BY THE ADMINISTRATOR AND BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS USED TO SET THE ADMINISTRATOR'S ANNUAL SALARY IS BASED ON A COMPARISON TO COMPARABLE ORGANIZATIONS. THE BOARD OF DIRECTORS REVIEWS THE MINNESOTA SENIOR HOUSING TRADE ASSOCIATION'S ANNUAL WAGE SURVEY. THIS SURVEY INCLUDES INFORMATION RELATED TO THE SIZE OF THE ORGANIZATION AND THE NOT-FOR-PROFIT STATUS OF THE ORGANIZATION. IN ADDITION TO THIS, THE 990'S FROM COMPARABLE SENIOR HOUSING CAMPUSES ARE REVIEWED BY THE BOARD OF DIRECTORS AND USED TO ESTABLISH THE ADMINISTRATOR'S WAGE. THIS PROCESS WAS REVIEWED IN 2013 AND RESULTED IN AN INCREASE TO THE ADMINISTRATORS WAGE IN 2013. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. ST JOHNS FOUNDATION C/O ST JOHNS HOME HWY 13 ALBERT LEA MN 56007 416054307 TO PROVIDE SUPPORT TO ST. JOHN'S LUTHERAN HOME MN 501(C)(3) 11A N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0