2014-07-29T10:05:17-05:00 2013-12-31 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2013-01-01 450274012 American Lutheran Homes Inc AMER 7012393000 201 South University Drive Fargo ND 58103 Shawn Stuhaug President/CEO 7012393000 2014-07-22 1 LISA CHAFFEE CPA P00193453 7012398500 2014-07-22 2013 2015-11-30 17:44:51Z Bethany On University Shawn Stuhaug 201 South University Drive Fargo ND 58103 18935384 0 X www.bethanynd.org X 1959 ND Provide long term care services 11 11 1013 115 0 0 5643 1489 18431542 18828233 19143 105662 -564 0 18455764 18935384 129151 2165293 0 0 12105707 13020415 0 0 0 5715852 5499399 17950710 20685107 505054 -1749723 26535130 23296216 13303502 11259487 13231628 12036729 X To provide living opportunities in a senior community shaped by Christian values. 0 1 18350262 2165293 18828233 Service to the communityAmerican Lutheran Homes, Inc. (ALH) operates as a charitable organization consistent with the requirements of Internal Revenue Code Section 501(c)(3). ALH provides long term care services including skilled nursing care, assisted living, basic care and independent senior housing. ALH does not discriminate against individuals in the admissions process or in the delivery of care with regard to ability to pay for services. The assisted living facilities operated by ALH primarily serve low-income elderly residents. The Organization's cash reserves are generally applied to expansion and replacement of existing facilities and equipment, amortization of mortgages, improvement in resident care, training and education, and community benefit activities. The governing board of ALH is made up of leaders in the Fargo-Moorhead business community. Consistent with its charitable mission, ALH provides community benefit to the area served. In 2013, community benefit activities included:- Speaker's bureau services - provides free educational sessions to agencies and individuals in the community on topics such as: Bethany on the Grow Careers in Long Term Care Early Dementia Care Activities with a Purpose The A, B, C, D's Of Medicare Seniors and Spirituality Managing Your Resources - Estate Planning Activity With A Purpose Volunteerism - The Rewards Of Giving Yourself- Groups to which our speaker's bureau presented information included service clubs, churches, parish nurse groups, and senior centers.- Endings and Beginnings - a support group for family members dealing with a loved one diagnosed with Alzheimer's disease - Provides virtual dementia / sensitivity training to employees and community members. This training program teaches participants about the challenges and frustrations of an elderly nursing home resident in managing day-to-day tasks and activities. Participants learn through active involvement in a simulation exercise what is it like to be challenged by issues like hearing impairment, deteriorating vision, dementia, loss of control of their environment, communication difficulties, etc.- Volunteerism - coordinates a volunteer program that included approximately 115 volunteers giving over 12,150 hours of service, providing mental stimulation and emotional support to ALH's 352 elderly residents. Volunteers included members of sponsoring churches, Experience Works program volunteers, and many student volunteers from the community's schools - elementary, middle, high schools and colleges.- Tuition assistance - ALH recognizes that to continuously improve the Organization's value to our community and our residents, to encourage life-long learning among employees and to achieve an "employer of choice" status, it is in our best interest to provide opportunities that will assist eligible employees in pursuing formal, healthcare-related educational opportunities. ALH administers two internal scholarship programs, funded by donations. These programs provide scholarship opportunities to Bethany employees pursuing nursing education.- School Partnerships - ALH works with area nursing and other healthcare-related programs to provide on-site training opportunities for students. In 2013, we had approximately 400 nursing students complete clinical experiences at our facility. We provide a CNA training program for individuals in the Fargo-Moorhead community interested in pursuing a career as a nursing assistant. We also provided clinical site experience for an outside CNA training program and dietetic students, and internship opportunities for students in social worker programs, LTC administration and pre-med students for observation of Alzheimer's residents. We hosted visiting students from several higher education classes including: gender and aging class from North Dakota State University (NDSU) Department of Human Development; NDSU Dietetics class; University of Jamestown Physical Therapy; Minnesota State University - Moorhead Gerontology class; long term care planning class from NDSU's interior design program; Concordia College class from the long term care administration program. - Assessment and referral services - our staff help to refer individuals needing long term care services to the appropriate agency in the community. ALH licensed social workers provide guidance with medical assistance applications for residents/families.- Through in-kind gifts of equipment and other materials, ALH helps support the work of the following agencies: Project HERO Great Plains Food Bank Dakota Boys' and Girls' Ranch New Life Center Rape and Abuse Crisis Center YWCA programs- Community support - ALH provides meeting room space and accommodations for non-profit organizations and community groups. Several of our resident activity programs are open to community members. In 2013, these activities included an outdoor concert, carnival, special Christmas events, wellness fair and several food festivals. ALH also supports and sponsors the Northern Plains Conference on Aging and Disability, as well as sponsoring the RSVP+ program. Facility space is open to use by outside groups for meetings, performances, activities, funeral/memorials services, music recitals, etc. Meals are provided for family members of ALH residents at a reduced cost.- Other - in addition to the activities above, ALH also organizes employee participation in fundraising activities for Cass-Clay United Way and the Alzheimer's Association. There are also representatives from ALH on non-profit boards and civic organizations that work to improve the quality of life in the Fargo-Moorhead area. ALH's President/CEO serves on HERO's (Health Equipment Recycling Organization) Board of Directors and the Fargo Dome Finance Committee. He also serves on various committees of the North Dakota Long Term Care Association (NDLTCA). The Senior Executive of Resident Care serves as Director of Region VI of the National Association of Directors of Nursing Association (NADONA), Resident Issues Committee of the NDLTCA, and as a NCLEX test reviewer/item review for the National Boards of Nursing. ALH's Chief Financial Officer serves on the board of Hospice of the Red River Valley and the Funding/Reimbursement Committee of the NDLTCA. The Senior Executive of Medicare/Contracted Services serves on the board for the (NADONA). ALH's Senior Executive of Support Services is on the Dietetics Advisory Committee for North Dakota State University. The Senior Executive of Housing/Assisted Living is a Board member of the Fargo West Rotary service club, serves as the Assisted Living Director at Large on the NDLTCA Board, represents North Dakota as a State Leader for NCAL (National Center for Assisted Living), and serves on the NCAL Quality and Non-Profit Committees. The Senior Executive of Development and Community Relations serves on the Education Committee and chairs the Senior Level Task Force for the Association of Lutheran Development Executives. ALH's Director of Bethany Personal Care Services is on the Advisory Board for the North Dakota State University Nursing program and the Senior Executive of Resident Care is on the NADONA membership committee.The following is specific information relating to ALHs' care provided:Bethany on University skilled care - services provided, 172 nursing home beds: 62,149 days of care and 546,794 employee hours (total expenses including management and general = 15,068,749)Bethany Towers I - assisted living services, 14 beds - 759 days of care (Jan-Apr only); basic care services, 39 beds (Jan-Apr) and 53 beds (May-Dec) - 16,508 days of care. BT I had 45,895 employee hours (total expenses including management and general = 1,750,717) Bethany Towers I was completely converted to Basic Care May 1, 2013.Bethany Towers II - assisted living services, 90 units - 28,173 days of care and 18,157 employee hours (total expenses including management and general = 1,712,712)Bethany Kinder House Independent Senior Housing, 35 units - 8,859 days of care and 2,101 employee hours (total expenses including management and general = 262,905). Bethany Kinder House was sold on November 14, 2013. 18350262 1 0 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 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 36 0 1 1013 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X Jane Kelly 7012393226 201 South University Drive Fargo ND 58103 X Martha Leclerc Chair (Jan-Mar) 1.00 3.00 X X 0 0 0 Lloyd Smith Vice Chair(Jan-Mar)/Chair 1.00 3.00 X X 0 0 0 John Hertsgaard Trustee (Jan-Mar)/Vice Chair 1.00 3.00 X X 0 0 0 Roger Olson Trustee (Jan-Mar)/Treasurer 1.00 3.00 X X 0 0 0 Jean Bokinskie Trustee (Jan-Mar)/Secretary 1.00 3.00 X X 0 0 0 Janice Nelson Treasurer (Apr-Dec) 1.00 3.00 X X 0 0 0 David Glatt Secretary (Jan-Mar)/Trustee 2.00 4.00 X X 8280 3720 0 Shannon Charpentier Trustee 1.00 3.00 X 0 0 0 Harriette McCaul Trustee 1.00 3.00 X 0 0 0 Paul Wilson Trustee (Jan-Mar) 1.00 3.00 X 0 0 0 Jerilynn Brantner-Adams Trustee 1.00 3.00 X 0 0 0 Al Erickson Trustee (Apr-Dec) 1.00 3.00 X 0 0 0 Stacie Heiden Trustee (Apr-Dec) 1.00 3.00 X 0 0 0 Linda O'Halloran Trustee (Apr-Dec) 1.00 3.00 X 0 0 0 Shawn Stuhaug President/CEO 23.00 27.00 X 214193 0 28449 Jane Kelly CFO 25.00 25.00 X 163834 0 16124 386307 3720 44573 2 0 1 0 YHR Partners 420 Main Ave Moorhead MN 56560 Campus Remodel Design 689976 RehabCare Group Inc PO Box 503534 St Louis MO 631503534 Contract Therapy 459743 2 1489 1489 Resident Service Revenue 623000 18828233 18828233 18828233 15275 15275 90387 0 90387 90387 90387 18935384 18828233 0 105662 2165293 2165293 431117 8280 422837 10361778 9659485 702293 176760 156967 19793 1266309 1052517 213792 784451 706036 78415 141678 141678 5500 5500 566988 566988 1899584 1434254 465330 598896 598896 52834 52834 73667 52033 21634 138865 138865 1137761 1137761 235867 235867 Medical Supplies 554310 554310 Bad Debt Expense 53842 53842 Memberships 27706 27706 11901 11901 20685107 18350262 2334845 0 5463059 3168823 1374355 1101616 6081272 5923180 158950 142328 192177 318359 27956588 19188630 9728155 8767958 686673 799782 849710 671544 2000779 2402626 26535130 23296216 2727176 2407219 8832126 7473591 36857 37187 742234 710669 263109 230821 702000 400000 13303502 11259487 X 13231628 12036729 13231628 12036729 26535130 23296216 -1749723 554824 0 X 0 1 X 1 0 X 428364 192964 14396 5643 1489 642856 17242225 17409120 18526794 18431542 18828233 90437914 17670589 17602084 18541190 18437185 18829722 91080770 0 0 0 91080770 21661 14720 20555 22619 15275 94830 21661 14720 20555 22619 15275 94830 110069 -542 -564 108963 17692250 17726873 18561203 18459240 18844997 91284563 0.99780 0.99680 0.00100 0.00200 X 0 1 X 241438 1023011 1264449 18497399 14243422 4253977 6532967 4543108 1989859 1661773 402100 1259673 8767958 Related Party Receivables 2160174 Deferred Financing Costs 12952 Bed Licenses 229500 2402626 Asset Remediation Obligation 400000 400000 X 18935384 0 18935384 0 18935384 20685107 0 20685107 0 20685107 Part IV, Line 2b: The Organization acts as custodian for the funds of the residents. These funds are included in cash and cash equivalents and a corresponding liability is included in accounts payable-trade in the financial statements. Resident trust funds totaled $36,857 and $37,187 at December 31, 2012 and 2013. Part X, Line 2: Bethany on University is a North Dakota nonprofit corporation located in Fargo, North Dakota and has been recognized by the Internal Revenue Service 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, it is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. The organization has determined they are not subject to unrelated business income tax and have not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. Bethany on University believes that it has appropriate support for any tax positions taken affecting the annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. Bethany on University 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. 1 Bethany on 42nd 201 S University Drive Fargo ND 58103 261087740 501(c)(3) 2165293 Funding for Building Project; further exempt purpose 1 0 Part I, Line 2: The Organization provides funds to related organizations to help further their exempt purposes and can regularly monitor the use of the funds due to the relationship. X X X X 0 0 0 0 0 0 0 1 0 Shawn Stuhaug President/CEO 176802 0 37391 0 0 0 7183 0 21397 0 242773 0 0 0 Jane Kelly CFO 139512 0 24322 0 0 0 6681 0 9550 0 180065 0 0 0 Part I, Line 7 CEO and CFO received a bonus as determined by the Board of Directors. The bonus is based on review of performance and progress related to a specific work plan. A Cass County North Dakota 456002205 2004-12-31 4607000 Refunding Revenue Bonds-Series 2004A to Refund 1996, 1998, 2001 Bonds 0 0 0 B Cass County North Dakota 456002205 2010-10-01 6400000 Construct & Equip Retirement Living Campus 0 0 0 A 1445000 4607000 38881 4568119 2004 1 0 1 1 B 6400000 54857 6345143 2010 0 0 1 1 B 0 0 0 0 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 Form 990, Part III, line 3 In November of 2013 the organization sold Bethany Kinder House, a 35 unit independent living facility. Form 990, Part VI, Section A, line 6 Bethany Homes, Inc. is the sole member of the Corporation. Form 990, Part VI, Section A, line 7a The Board of Directors is elected at the annual meeting of the Board of Trustees of the Member. The Member has the right to fill any vacancies during the year. The Member may also remove any directors with or without cause. Form 990, Part VI, Section A, line 7b The following actions by the Board of Directors require the approval of the Board of Trustees of the Member: - Establishment of annual operating budget - Sale, lease or encumbrance of any corporation real property - Unbudgeted capital expenditures exceeding amounts for which the President/CEO is specifically authorized to approve Form 990, Part VI, Section A, line 8b There are no committees with the broad authority to act on behalf of the governing board. Form 990, Part VI, Section B, line 11 The Form 990 is reviewed by the CFO and CEO and then provided to the Finance Committee for their review and approval. A draft copy of the Form 990 is provided to the board prior to filing. Form 990, Part VI, Section B, line 12c Board officers and directors, as well as officers of the Organization, complete a conflict of interest questionnaire on an annual basis. The Board reviews the conflicts to determine if a conflict exists. The individual with the conflict is required to abstain from voting if the conflict comes up in the board meeting where a decision needs to be made. This is a standing agenda item at each board meeting. Form 990, Part VI, Section B, line 15 The Executive Committee of the board meets to determine the compensation of the President/CEO. Compensation is determined by gathering comparable data, including salary surveys, personal contacts, 990 data, and evaluating criteria such as knowledge/experience, longevity, job performance, etc. Periodically, a consultant is brought in to assist in the evaluation process to test for fairness and reasonableness of compensation levels. Consultant involvement was last implemented in 2011. The Executive Committee reviews the data and recommends the compensation package, which is reviewed and approved at the full board level. The process for determining compensation for the President/CEO is implemented on an annual basis. The President/CEO determines the CFO compensation in the same manner the Executive Committee determines compensation for the President/CEO. The President/CEO also reviews the information with the Executive Committee. The process for determining compensation for the CFO is implemented on an annual basis. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part VII, Section A: David Glatt serves as a board member 1 hour per week. He serves an additional two total hours per week as a Medical Director for both Bethany on 42nd and American Lutheran Homes. Compensation shown on Part VII, Column D is compensation paid to Sanford Health for his services as Medical Director to American Lutheran Homes, Inc. Compensation shown on Part VII, Column E is compensation paid to Sanford Health for his services as Medical Director to Bethany on 42nd. Bethany Home Health Care 201 S University Drive Fargo ND 58103 450433045 Promotion of health ND 501(c)(3) Line 9 Bethany Homes Inc 1 Bethany on 42nd 201 S University Drive Fargo ND 58103 261087740 Long-term care services/Assisted living/Independent living ND 501(c)(3) Line 9 Bethany Homes Inc 1 Bethany Homes Inc 201 S University Drive Fargo ND 58103 450394181 Fundraising ND 501(c)(3) Line 9 N/A 1 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 Bethany on 42nd B 2165293 General Ledger Bethany on 42nd Q 7582283 General Ledger Bethany Homes Inc Q 171363 General Ledger Bethany Home Health Care Q 593705 General Ledger