2014-02-14T15:51:29-06:00 2013-09-30 410746749 CLIFTONLARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2012-10-01 410847708 ST JOHN'S LUTHERAN HOME STJO 5073738226 901 LUTHER PLACE ALBERT LEA MN 56007 SCOT SPATES 5073738226 2014-02-05 1 TRENT FAST P00692704 5074347000 2012 2015-11-30 17:44:51Z SCOT SPATES 901 LUTHER PLACE ALBERT LEA MN 56007 11698008 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 10 334 128 20671 -4000 338960 328404 11435201 11285848 46766 38888 46917 44868 11867844 11698008 0 0 0 0 7653842 7501326 0 0 0 4200005 4043280 11853847 11544606 13997 153402 11471659 11370576 5559385 5304600 5912274 6065976 TO PROVIDE PHYSICAL, EMOTIONAL, SOCIAL AND CHRISTIAN CARE FOR ALL PEOPLE, WITH DIGNITY AND RESPECT, IN AN ENVIRONMENT OF GOD'S GRACE. 0 0 10545989 11290452 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. 10545989 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 0 334 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 0 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 1.00 X 0 0 0 THERESA JACKSON 1.00 X 0 0 0 STEVEN ZENK 1.00 X 0 0 0 DAVE OLSON 1.00 X 0 0 0 DARRYL MEYER 1.00 X 0 0 0 SONJA JOHNSON 1.00 X 0 0 0 ORVILLE SIMONSEN 1.00 X 0 0 0 REV WENDY ANDERSON 1.00 X 0 0 0 CHARLES REINDAL 1.00 X 0 0 0 LOIS STOTTS 1.00 X 0 0 0 SCOT SPATES 40.00 X 102610 0 26101 DUANE MALLON 38.00 X 70723 0 21241 173333 0 47342 1 0 0 0 HORTY ELVING & ASSOCIATES 505 EAST GRANT STREET MINNEAPOLIS MN 55404 ARCHITECTURE 478623 REHAB CARE PO BOX 503534 ST LOUIS MO 631503534 THERAPY SERVICES 475326 2 312069 16335 328404 RESIDENT REVENUE 623000 9792626 9792626 MEDICARE/MEDICAID PAYMENTS 623000 1468499 1468499 MANAGEMENT INCOME 561700 20671 20671 MISCELLANEOUS REVENUE 623000 3599 3599 PHONE RENTAL 623000 453 453 11285848 38888 38888 BEAUTY SHOP 623000 32523 32523 MISCELLANEOUS INCOME 900099 8456 8456 NON-RESIDENT MEALS 623000 3343 3343 546 546 44868 11698008 11265177 20671 83756 220675 220675 5888540 5644073 244467 159484 146725 12759 787850 724822 63028 444777 409195 35582 4843 4843 66340 66340 177491 150956 26535 41118 41118 621414 551332 70082 354765 354765 5777 3946 1831 34840 26805 8035 174435 174435 697773 697773 31334 6927 24407 TAXES & LICENSES 532755 532755 FOOD COSTS 493303 493303 THERAPY EXPENSE 405141 405141 PHARMACY 122263 122263 279688 100773 178915 11544606 10545989 998617 0 488326 684427 3942893 3323105 1264556 1468877 74558 89528 19235067 13534020 5595525 5701047 100533 100361 5268 3231 11471659 11370576 935365 1049202 4115000 3745000 509020 510398 5559385 5304600 X 5912274 6065976 5912274 6065976 11471659 11370576 153402 300 0 X X 0 1 X 1 0 X 351259 359580 356782 338960 324449 1731030 11807257 11929680 11888860 11435201 11285848 58346846 12158516 12289260 12245642 11774161 11610297 60077876 335560 346727 342070 326285 312069 1662711 0 335560 346727 342070 326285 312069 1662711 58415165 138653 94075 88830 46766 38888 407212 138653 94075 88830 46766 38888 407212 46357 46917 44868 138142 12297169 12383335 12380829 11867844 11694053 60623230 0.96360 0.96120 0.00670 0.00910 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 424462 424462 11600302 8873115 2727187 5891364 4247052 1644312 1318939 413853 905086 5701047 LEASE DEPOSITS 46115 PATIENT TRUST FUNDS 12855 ASSET RETIREMENT OBLIGATION 451428 510398 X 11698308 300 300 11698008 0 11698008 11544606 0 11544606 0 11544606 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 2010, 2011, AND 2012 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 2215000 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 0 B 0 PART V THE ORGANIZATION IS IN THE PROCESS OF ADOPTING THESE POLICIES. 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 NOT REVIEWED IN 2011. THERE WAS NOT AN INCREASE IN THE ADMINISTRATOR'S WAGE IN 2011 DUE TO A CAMPUS WIDE WAGE FREEZE. 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