2014-07-08T09:53:21-05:00 2013-08-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2012-09-01 410706155 AMERICAN BAPTIST HOMES OF THE MIDWEST AMER 9529413175 14850 SCENIC HEIGHTS ROAD NO 125 EDEN PRAIRIE MN 55344 JEFF HONGSLO 9529413175 2014-05-22 1 JEFF VRIEZE P01273590 6123764500 2012 2015-11-30 17:44:51Z DAVID ZWICKEY 14850 SCENIC HEIGHTS ROAD NO 125 EDEN PRAIRIE MN 55344 54465534 0 X WWW.ABHOMES.NET X 1930 MN TO PROVIDE NURSING HOME CARE AND HOUSING TO LOW INCOME, ELDERLY, AND DISABLED PERSONS. 20 19 1575 675 0 0 341093 752624 50391603 53423635 162806 101925 216757 -23839 51112259 54254345 0 0 0 0 32572952 32901399 0 0 0 21281332 21977354 53854284 54878753 -2742025 -624408 77160495 78154456 87203038 88816506 -10042543 -10662050 X AMERICAN BAPTIST HOMES OF THE MIDWEST, EMBRACING OUR CHRISTIAN HERITAGE AND MISSION, SEEKS TO CREATE AND ENCOURAGE CARING COMMUNITIES OFFERING HEALTH CARE, HOUSING, AND SUPPORTIVE SERVICES TO PEOPLE OF MANY AGES, CULTURES AND CONDITIONS. WE ENDEAVOR TO PROVIDE ENVIRONMENTS WHICH NURTHER SELF-WORTH, HOPE AND DIGNITY. 0 0 47821546 0 53423635 SKILLED NURSING FACILITIES: THE SKILLED NURSING FACILITIES OF THE OBLIGATED GROUP (INCLUDING BOARD & CARE AND BASIC CARE UNITS) PROVIDE HEALTH CARE AND CONVALESCENT TREATMENT PRIMARILY FOR IN-PATIENT ELDERLY PERSONS, INCLUDING THOSE ADMITTED AS AN INTERMEDIATE STEP AFTER HOSPITALIZATION AND BEFORE RETURNING TO THEIR HOMES, AS WELL AS THOSE ADMITTED FOR LONG-TERM RESIDENCY. THE SKILLED NURSING FACILITIES ARE LICENSED UNDER THE REGULATIONS OF THE STATE IN WHICH THEY OPERATE, AND ARE CERTIFIED AS NURSING FACILITIES UNDER BOTH THE STATE MEDICAID AND FEDERAL MEDICARE PROGRAMS. CERTIFICATION REQUIRES THAT THE FACILITIES PROVIDE CONTINUOUS REGISTERED NURSE SUPERVISION AND SPECIFIC RATIOS OF NURSING PERSONNEL PER RESIDENT.THE SKILLED NURSING FACILITY RESIDENTS RECEIVE 24-HOUR NURSING CARE, ALL MEALS (AND SPECIAL DIETS AS REQUIRED) AND SUCH DRUGS AND THERAPY AS MAY BE PRESCRIBED BY THE RESIDENT'S PHYSICIAN. THREE BALANCED MEALS ARE PROVIDED TO EACH RESIDENT DAILY, IN THE RESIDENT'S ROOM OR AT A CENTRAL DINING LOCATION. LIGHT SNACKS ARE PROVIDED DURING THE DAY AND AT BEDTIME. EACH SKILLED NURSING FACILITY IS ADMINISTERED ON LOCATION BY A FULL-TIME ADMINISTRATOR LICENSED BY THE STATE. A DIRECTOR OF NURSING SERVICES, WHO IS A CERTIFIED NURSE, IS RESPONSIBLE FOR SUPERVISING THE REGISTERED NURSES, LICENSED PRACTICAL NURSES AND REGISTERED NURSING ASSISTANTS WORKING AT THE SKILLED NURSING FACILITIES. SOCIAL SERVICE PROGRAMS ARE PROVIDED BY SOCIAL WORKERS UNDER THE SUPERVISION OF A LICENSED STAFF MEMBER OR GUIDED BY A CONSULTING SOCIAL WORKER AND ASSISTED BY VOLUNTEER AUXILIARY GROUPS. EACH OF THE SKILLED NURSING FACILITIES HAS A CONSULTING PHYSICIAN ON CALL WHO IS AVAILABLE TO THE RESIDENTS AT THE FACILITY. IN ADDITION, THE SKILLED NURSING FACILITIES ARRANGE WITH HOSPITALS FOR TRANSFER OF RESIDENTS BETWEEN THE FACILITIES AND HOSPITALS WHEN NECESSARY.THE SKILLED NURSING FACILITIES PROVIDE RESIDENT ROOMS DESIGNED PRINCIPALLY FOR TWO BEDS, BUT ALSO INCLUDE SOME ONE-BED ROOMS. EACH SKILLED NURSING FACILITY CONTAINS ONE OR MORE DINING ROOMS, ONE OR MORE RECREATION AREAS, DAY ROOMS, THERAPY AREA, FULLY-EQUIPPED KITCHEN AND LAUNDRY FACILITIES. ALL SKILLED NURSING FACILITIES HAVE APPROVED FIRE DETECTION AND ALARM SYSTEMS. EACH SKILLED NURSING FACILITY PROVIDES A BEAUTY AND BARBER SHOP ON LOCATION.ASSISTED LIVING FACILITIES: THE ASSISTED LIVING FACILITIES ARE DESIGNED AND OPERATED TO ALLOW SENIOR ADULTS TO LIVE AND ENJOY AN INDEPENDENT LIFESTYLE IN A SECURE AND CONVENIENT COMMUNITY ATMOSPHERE. FULL-TIME PROFESSIONAL MANAGERS PROVIDE ASSISTANCE TO RESIDENTS. A NURSE CALL SYSTEM MONITORED 24 HOURS DAILY PUTS THE RESIDENTS IN CONTACT WITH NURSING SERVICE STAFF. DAILY HOUSEKEEPING, INCLUDED IN THE COST OF RENT, HELPS THE RESIDENTS WITH CLEANING CHORES AND PROVIDES AN OPPORTUNITY FOR FACILITY STAFF TO MONITOR THE WELL-BEING OF THE RESIDENTS. SOCIAL AND ACTIVITY PROGRAMS PROVIDE RESIDENTS WITH THE OPPORTUNITY TO FULLY ENJOY THE FACILITIES AND ARE DESIGNED TO MEET THE SOCIAL AND EMOTIONAL NEEDS OF THE RESIDENTS. ADDITIONAL SERVICES PROVIDED INCLUDE: PHYSICAL THERAPY, TRANSPORTATION, LAUNDRY SERVICES AND BLOOD PRESSURE CHECKS. MEAL SERVICE IS INCLUDED IN THE MONTHLY FEE FOR THE ASSISTED LIVING FACILITIES. INDEPENDENT LIVING COMMUNITIES: THE INDEPENDENT LIVING COMMUNITIES OFFER A CONTINUUM OF SERVICES ON A CAMPUS SETTING. THESE INDEPENDENT LIVING FACILITIES ARE DESIGNED AND OPERATED TO ALLOW SENIOR ADULTS TO LIVE AND ENJOY AN INDEPENDENT LIFESTYLE IN A SECURE AND CONVENIENT COMMUNITY ATMOSPHERE. FULL-TIME PROFESSIONAL MANAGERS PROVIDE ASSISTANCE TO RESIDENTS. THE OBLIGATED GROUP'S INDEPENDENT LIVING COMMUNITIES PROVIDE OR ASSIST IN ARRANGEMENTS FOR ADDITIONAL SERVICES SUCH AS VISITING NURSES, CHORE SERVICES, OR OTHER PERSONAL NEED SERVICES. ALL INDEPENDENT LIVING SETTINGS HAVE A PLANNED ACTIVITY PROGRAM, A VARIETY OF MEAL PLANS AVAILABLE, WEEKLY HOUSEKEEPING AND TRANSPORTATION SERVICES PROVIDED. SPECIALIZED PROGRAMS FOR HEALTH AND WELLNESS ARE ALSO AVAILABLE FOR A NOMINAL FEE OR WILL BE AVAILABLE SOON. VISITOR QUARTERS ARE AVAILABLE FOR FAMILY MEMBERS AND MEALS MAY BE PURCHASED FOR VISITORS AS NEEDED. AN EMERGENCY CALL SYSTEM MONITORED 24 HOURS DAILY PUTS THE RESIDENTS IN CONTACT WITH EMERGENCY MEDICAL SERVICES. GROUP HOMES FOR DEVELOPMENTALLY DISABLED (CREST SERVICES): CREST SERVICES, A DIVISION OF ABHM, PROVIDES RESIDENTIAL SERVICES TO PERSONS WITH DISABILITIES IN IOWA AND MINNESOTA. THE MAJORITY OF THE INDIVIDUALS SERVED ARE THOSE WITH A PRIMARY DIAGNOSIS OF MENTAL RETARDATION, OTHERS MAY HAVE SOME TYPE OF BRAIN INJURY OR OTHER TYPE OF DEVELOPMENTAL DISABILITY. SERVICES ARE PROVIDED IN A VARIETY OF SETTINGS INCLUDING THE INDIVIDUAL'S OWN APARTMENT UNDER THE HOME AND COMMUNITY BASED SERVICES (HCBS) PROGRAM OR A SMALL GROUP HOME SETTING WITH TWO TO FOUR INDIVIDUALS (TYPICALLY, A MODESTLY SIZED HOME LOCATED IN A RESIDENTIAL NEIGHBORHOOD). CREST SERVICES DOES MAINTAIN ONE LARGER GROUP HOME SERVING FIFTEEN INDIVIDUALS IN OTTUMWA, IOWA. THE CREST SERVICES STAFF WORKS IN CONJUNCTION WITH THE PRIMARY CONSUMER, THEIR FAMILY, THE MEDICAL TEAM, COUNTY AND STATE SOCIAL SERVICE STAFF TO PROVIDE TAILORED SERVICES FOR THE INDIVIDUAL. SERVICES PROVIDED INCLUDE HEALTH CARE AND ASSISTANCE WITH ACTIVITIES OF DAILY LIVING (BATHING, GROOMING, DRESSING, ETC), DEVELOPMENT OF JOB OR SOCIAL SKILLS, RECREATIONAL ACTIVITIES, BUDGETING AND BASIC FINANCIAL PLANNING. RESPITE SERVICES ARE ALSO PROVIDED AS NEEDED. THE PRIMARY FUNDING SOURCE IS THROUGH CERTIFICATION IN THE HCBS WAIVER PROGRAMS, WHICH WAIVES THE COST OF CERTAIN HEALTHCARE SERVICES, ALTHOUGH THERE ARE SEVERAL WAIVER PROGRAMS FUNDED WITH FEDERAL DOLLARS, I.E., MENTAL RETARDATION, BRAIN INJURY, ELDERLY. PERSONS WITH A DEVELOPMENTAL DISABILITY (DD), OTHER THAN MENTAL RETARDATION (EXCLUDING MENTAL ILLNESS) ARE SERVED UNDER THE COUNTY PAID CHAPTER 24 CERTIFIED PROGRAMS IN BOTH IOWA AND MINNESOTA. MINNESOTA PROVIDES A PARENTING PROGRAM FOR FAMILIES IN NEED OF TRAINING AND SUPPORT IN ORDER TO KEEP FAMILIES INTACT USING COUNTY FUNDING.JUST AS ABHM SEEKS TO FULFILL OUR MISSION THROUGH THOSE WE SERVE, WE ALSO UNDERSTAND THAT MISSION CALLS US TO CONTRIBUTE TO THE GREATER COMMUNITIES IN WHICH WE LIVE AND WORK. THIS DUAL COMMITMENT BOTH DESCRIBES OUR PAST AND DEFINES OUR FUTURE BY REINFORCING THE CORE PRINCIPLES AND FAITH THAT GUIDE OUR WORK.THE INFORMATION THAT FOLLOWS IS A DETAILED DESCRIPTION AND ESTIMATED VALUE OF ALL CHARITABLE CONTRIBUTIONS GIVEN IN FISCAL YEAR 2013 BY ABHM, ITS CONTINUING CARE RETIREMENT COMMUNITIES, NURSING HOMES AND AFFORDABLE HOUSING RETIREMENT COMMUNITIES.DIRECT BENEVOLENCE TO CONTINUING CARE RESIDENTS BY ABHM DURING FISCAL YEAR 2013 WAS $600. ADJUSTMENTS OF $495,000 WERE MADE TO ABHM RESIDENTS DURING FISCAL YEAR 2013 REPRESENTING MEDICAID CONTRACTS THAT DID NOT PAY THE FULL AMOUNT FOR THEIR CARE.COMMUNITY BENEFITS TO RESIDENTS, EMPLOYEES AND COMMUNITY:THORNE CREST: PROVIDED RELIGIOUS SERVICES TO RESIDENTS, A CAREGIVER GROUP, RSVP TAX SERVICES, VETERAN'S BIRTHDAYS,JOHN ULLAND MUSIC GATHERING, TTH ANNUAL CAR SHOW, HAWTHORNE SCHOOL SINGING GROUP, ESTATE PLANNING SEMINARE, TRACTOR PARADE, SPONSORED PRESENTATIONS ON SENIOR SCAM.ELM CREST: PROVIDED A HOSPITALITY ROOM FOR FAMILY MEMBERS OF RESIDENTS AND PROVIDED THE MCKEE COMMUNITY ROOM FOR VARIOUS EVENTS.MAPLE CREST: PROVIDED RELIGIOUS SERVICES FOR THE COMMUNITY AND EDUCATIONAL ACTIVITIES FOR RESIDENTS AND COMMUNITY OUTREACH SUPPORT, VOLUNTEER APPRECIATION TEA, ESTATE PLANNING SEMINAR, PHILANTHROPIC PROJECTS, PASTOR APPRECIATION DAY AND HOLIDAY GIFT BASKETS.TRAIL RIDGE: PROVIDED MEMORIAL SERVICES, PRESENTATIONS ON RETIREMENT LIVING, HEALTH FAIR AND SHOPPING EXTRAVAGANZA, SALUTE TO VETERANS, SENIOR RESOURCE FAIR AND 'LISTEN AND LEARN' LUNCHES.TUDOR OAKS: PROVIDED WELLNESS CENTER ACCESS TO GUESTS AND STAFF, SWIM CALSS TO ARTHRITIS ASSOCIATION, LUNCH AND LEARN FOR SOCIAL WORKERS, PRESENTATION TO MUSKEGO WOMAN'S GROUP AND YOUNG AT HEART GROUP USE OF THE COMMUNITY FACILITIES - THORNE CREST, ELM CREST, TUDOR OAKS AND TRAIL RIDGE HOSTED EVENTS AND PROVIDED SPACE FOR VARIOUS GROUPS INCLUDING THE FOLLOWING: THE DOLL CLUB, FIRE DEPARTMENT, CHURCH MEETINGS, MINISTERIAL ASSOCIATION, OSHER LIFE LONG LEARNING, ART CART PROJECT, PARKINSON'S ASSOCIATION ANNUAL MEETING, PIANO RECITALS, POLLING PLACE, BOOK CLUBS, BIBLE STUDIES, AMERICAN LEGION, BENSON BOARD MEETING, OMAHA WOMEN'S MINISTRIES AND BESSY'S HOPE.OTHER BENEFITS TO THE BROADER COMMUNITYVOLUNTEER AND OTHER SERVICES TO COMMUNITY ORGANIZATIONS BY RESIDENTS AND STAFF OF ABHM AND ITS COMMUNITIES: STAFF SERVICE ON AN ADVISORY BOARD FOR NURSING, VOLUNTEERED ON A HOME HEALTH ADVISOR GROUP AT A LOCAL HOSPITAL, RELAY FOR LIFE, COALITIONS ON AGING, OSHER LIFELONG LEARNING, HOSTED MINNESOTA TWINS CARAVAN, AMERICAN LEGION FLAG CEREMONY, PRESENTED VARIOUS SEMINARS AND PROVIDED ACCOUNTING SERVICES FOR MURROW INDIAN CHILDREN'S HOME. 47821546 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 236 0 1 1575 1 0 0 0 0 0 0 0 0 0 0 X 20 19 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 MN X JEFF BREDT 9522531459 14850 SCENIC HEIGHTS ROAD NO 125 EDEN PRAIRIE MN 55344 DAVID ZWICKEY 29.00 11.00 X X 266306 0 27018 BOB SLECHTA 1.00 0.00 X X 0 0 0 JERE MADDUX 1.00 1.00 X X 0 0 0 TED HERTEL JR 1.00 0.00 X X 0 0 0 EUGENE ALLEN 1.00 0.00 X 0 0 0 RYAN ALLEN 1.00 0.00 X 0 0 0 BOB CASELLI 1.00 1.00 X 0 0 0 ROGER DAVIDSON 1.00 0.00 X 0 0 0 ASHLEY FORD 1.00 0.00 X 0 0 0 BILL GOLSON 1.00 1.00 X 0 0 0 GARY GROGAN 1.00 0.00 X 0 0 0 PHILIP HANSON 1.00 0.00 X 0 0 0 JIM JOHNSON 1.00 0.00 X 0 0 0 WALTER LANIER 1.00 0.00 X 0 0 0 REV KEVIN LOWE 1.00 3.00 X 0 0 0 JIM O'DELL 1.00 4.00 X 0 0 0 MARSHALL PETERS 1.00 0.00 X 0 0 0 STEVEN VAN OSTRAN 1.00 1.00 X 0 0 0 BRUCE WHITAKER 1.00 0.00 X 0 0 0 BARBARA WOODS 1.00 0.00 X 0 0 0 JUDY ZEA 1.00 0.00 X 0 0 0 JEFF HONGSLO 17.00 23.00 X 154161 0 30470 TIM O'BRIEN 10.00 30.00 X 107566 0 11103 DEBORAH CLARK 40.00 0.00 X 103971 0 8376 ROGER HENNEN 25.00 15.00 X 118147 0 12579 ANDREA BLATNIK 25.00 15.00 X 100468 0 2660 DONNA WLASCHIN 25.00 15.00 X 100024 0 9517 950643 0 101723 7 0 1 0 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY 1103896 INTEGRITY LANDSCAPE SERVICES LLC 11217 W FOREST HOME AVE FRANKLIN WI 53132 CONTRACTOR 639386 JOHN MAREK INC PO BOX 270463 MILWAUKEE WI 53227 CONTRACTOR 450682 WAGNER CONSTRUCTION CO PO BOX 698 AUSTIN MN 55912 CONTRACTOR 368794 REHABVISIONS 11623 ARBOR STRETT SUITE 201 OMAHA NE 68144 THERAPY 347071 14 752624 752624 RESIDENT REVENUE 623000 46103357 46103357 MANAGEMENT FEES 623990 4657109 4657109 ACCOMODATION FEES 623990 1888880 1888880 OTHER RESIDENT SERVICES 623990 774622 774622 INSURANCE PROCEEDS 623990 -333 -333 53423635 113523 113523 199591 186239 24950 13352 -24950 -11598 -11598 LOSS FROM DISCONTINUED OPERATION 900099 -23839 -23839 -23839 54254345 53423635 0 78086 603982 603982 27698940 27652958 45982 158096 157831 265 2504029 2499724 4305 1936352 1933106 3246 2659440 2659440 731984 731984 19478 19478 919345 842307 77038 443375 443375 2284164 1217972 1066192 2377307 1966626 410681 208386 208386 3496781 3393176 103605 3579154 3473108 106046 715427 694230 21197 MISCELLANEOUS 1991175 845219 1145956 FOOD 1620718 1620718 PHARMACY 564527 564527 REPAIRS 336891 326909 9982 29202 29153 49 54878753 47821546 7057207 0 1296481 3038913 6155401 4807511 256642 245659 222049 260465 93304315 38645424 53975016 54658891 1940910 2005540 5000 5000 2208199 2064822 11100797 11067655 77160495 78154456 8773485 8438025 23339793 25568438 47254055 46632016 191378 104188 3108039 4026953 4536288 4046886 87203038 88816506 X -10062540 -10676898 19997 14848 -10042543 -10662050 77160495 78154456 -624408 4901 0 X 0 1 X 1 0 X 133239 108518 274467 341093 752624 1609941 44886288 45868768 47035739 50391603 53423635 241606033 45019527 45977286 47310206 50732696 54176259 243215974 0 0 0 243215974 182568 162960 87945 100382 113523 647378 182568 162960 87945 100382 113523 647378 216757 -23839 192918 45202095 46140246 47398151 51049835 54265943 244056270 0.99660 0.99540 0.00270 0.00360 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: LOSS ON DISCONTINUED OPERATION OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1324210 1324210 71944740 26546913 45397827 2655308 918955 1736353 15640933 10992883 4648050 1739124 186673 1552451 54658891 CASH SURRENDER VALUE LIFE INS 145095 SECURITY DEPOSITS 104188 BOND FUNDS 10818372 11067655 REFUNDABLE ACCOMMODATION FEES 2217147 RESERVE FOR GIFT ANNUITIES 70673 ASSET RETIREMENT OBLIGATION 2060423 DUE TO RELATED PARTIES -301357 4046886 X PART IV, LINE 2B: THE ORGANIZATION IS THE TRUSTEE OF VARIOUS TRUST FUNDS ON BEHALF OF THE RESIDENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION FOLLOWS THE STANDARD FOR CONTINGENCIES IN EVALUATING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE FISCAL YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL AND STATE AUTHORITIES. X X X X X 0 0 0 0 0 0 0 0 0 DAVID ZWICKEY 260050 0 0 0 6256 0 5000 0 22018 0 293324 0 0 0 JEFF HONGSLO 154134 0 0 0 27 0 3282 0 27188 0 184631 0 0 0 A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648AEX9 2007-08-01 19135698 REFINANCE EXISTING DEBT, CAPITAL EXPENDITURES AND OPERATIONAL RESERVE FUND 0 0 0 B COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648ASD8 2009-12-23 27136159 CONSTRUCT NEW INDEPENDENT LIVING UNITS 0 0 0 A 19135698 1368077 382714 17384907 2010 1 1 1 1 B 15000 27136159 2454750 3079550 542723 21059136 2011 0 0 1 1 A 0 1 0 0 0.00760 0.00760 0 0 1 B 0 1 0 0 0.00340 0.00340 0 0 1 A 0 0 0 1 0 0 1 ROYAL BANK OF CANADA 8.000000000000 1 0 1 B 0 1 0 0 0 0 1 CALYON 2.000000000000 1 0 1 A 1 B 1 SCHEDULE K PART IV, ARBITRAGE, LINE 2C DATE REBATE COMPUTATION PERFORMED ISSUER NAME: COLORADO HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/20/2012 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CHAIR, THE VICE CHAIR, THE PRESIDENT/CEO OF THE CORPORATION AND THREE ADDITIONAL DIRECTORS. THE EXECUTIVE COMMITTEE SHALL EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS, BUT ONLY DURING THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. ANY ACTIONS OF TEH EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 EUGEN ALLEN AND RYAN ALLEN, BOARD MEMBERS, HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE REVIEWED THE FORM 990 AT THEIR QUARTERLY MEETING PRIOR TO FILING. THEY RECEIVED COPIES OF THE DRAFT AND THE DETAIL WAS REVIEWED AT THAT TIME. COPIES OF THE 990 WERE THEN PROVIDED TO BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST FORM IS SIGNED BY ALL BOARD DIRECTORS, ADMINISTRATORS, HOME OFFICE DIRECTORS, AND VICE PRESIDENTS. AT THAT TIME, ANY POTENTIAL CONFLICT OF INTEREST IS NOTED ON THE FORM. THE INFORMATION IS GIVEN TO THE CEO, BOARD PRESIDENT AND AUDIT COMMITTEE CHAIR. AT THAT TIME, ANY POTENTIAL CONFLICTS ARE REVIEWED. IF A CONFLICT EXISTS, THE CONFLICTED INDIVIDUAL EITHER HAS TO CORRECT THE CONFLICT OF INTEREST OR MUST ABSTAIN FROM PARTICIPATION REGARDING THE CONFLICT OF INTEREST TOPIC. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS HAS A MANAGEMENT REVIEW COMMITTEE THAT REVIEWS THE CEO'S COMPENSATION. THE COMMITTEE DETERMINES ANY COMPENSATION ADJUSTMENTS TO THE CEO. THE CEO, EXECUTIVE DIRECTORS AND OTHER TOP MANAGEMENT POSITIONS ARE COMPARED TO THE MOST RECENT CEMO STUDY TO DETERMINE HOW THEIR COMPENSATION COMPARES TO PEER ORGANIZATIONS. THE CEO DETERMINES ANY COMPENSATION ADJUSTMENTS TO SENIOR MANAGEMENT. THE CEO, EXECUTIVE DIRECTORS AND OTHER TOP MANAGEMENT POSITIONS ARE COMPARED TO THE MOST RECENT CEMO STUDY TO DETERMINE HOW THEIR COMPENSATION COMPARES TO PEER ORGANIZATIONS. THIS PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2013. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. BAPTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS 14850 SCENIC HEIGHTS RD 125 EDEN PRAIRIE MN 55344 840528764 PROVIDE HOUSING AND CARE FOR THE ELDERLY CO 501(C)(3) 9 ABHM 1 THE RESIDENCES AT FRANKLIN PARK INC 14850 SCENIC HEIGHTS RD 125 EDEN PRAIRIE MN 55344 840630940 HOUSING FOR LOW-INCOME SENIORS CO 501(C)(4) N/A ABHM BHARM 1 AMERICAN BAPTIST HOMES OF THE MIDWEST FOUNDATION 14850 SCENIC HEIGHTS RD 125 EDEN PRAIRIE MN 55344 411803304 PHILANTHROPY MN 501(C)(3) 11 TYPE 1 ABHM 1 BAPTIST HOME ASSOC OF THE ROCKY MOUNTAINS - AFFILIATES 14850 SCENIC HEIGHTS RD 125 EDEN PRAIRIE MN 55344 742755828 HOUSING AND CARE FOR THE ELDERLY CO 501(C)(3) 9 ABHM BHARM 1 THE CROSSING AT TUDOR OAKS 14850 SCENIC HEIGHTS RD 125 EDEN PRAIRIE MN 55344 203346875 INACTIVE MN 501(C)(3) 9 ABHM 1 DENVER APARTMENTS PARTNERS LLC 1535 FRANKLIN STREET DENVER CO 80218 261776678 HOUSING FOR LOW-INCOME SENIORS NE N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 BAPTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS-AFFILIATES Q 17485321 ACTUAL COST AMERICAN BAPTIST HOMES OF THE MIDWEST - FOUNDATION Q 111543 ACTUAL COST