2014-06-30T15:44:51-05:00 2013-09-30 410746749 CLIFTONLARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2012-10-01 410880871 GOOD SHEPHERD LUTHERAN HOME GOOD 5078647714 PO BOX 747 RUSHFORD MN 559710747 ED BERKLEY 5078647714 2014-05-23 1 TRENT FAST P00692704 5074347000 2012 2015-11-30 17:44:51Z ED BERKLEY 5954 ROCK RD HOUSTON MN 55943 5657085 0 X WWW.GOODSHEP-RUSHFORD.ORG X 1965 MN TO PROVIDE NURSING HOME CARE AND ASSISTED LIVING CARE SERVICES TO THE ELDERLY OF RUSHFORD, MINNESOTA AND THE SURROUNDING AREA AND ALSO TO PROVIDE CHILD CARE SERVICES FOR EMPLOYEES AND THE PUBLIC. 10 10 184 0 238419 0 28108 60015 5702582 5554994 18888 13864 18828 22266 5768406 5651139 0 0 0 0 3640300 3557535 0 0 0 1925600 1864125 5565900 5421660 202506 229479 4113381 4313683 1862266 1809946 2251115 2503737 TO PROVIDE NURSING HOME CARE AND ASSISTED LIVING CARE SERVICES TO THE ELDERLY OF RUSHFORD, MINNESOTA AND THE SURROUNDING AREA AND ALSO TO PROVIDE CHILD CARE SERVICES FOR EMPLOYEES AND THE PUBLIC. 0 0 4905466 5316575 TO PROVIDE NURSING HOME CARE AND ASSISTED LIVING CARE SERVICES TO THE ELDERLY AND YOUNG OF RUSHFORD, MINNESOTA AND THE SURROUNDING AREA THROUGH THE OPERATION OF A 75 BED NURSING HOME, 32 APARTMENT UNITS, A 15 UNIT ASSISTED LIVING FACILITY, AND CHILDCARE ALL LOCATED ON ONE CAMPUS. 4905466 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 6 0 184 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X RHONDA SPECE 5078647714 800 HOME STREET RUSHFORD MN 55971 PEGGY PETERSEN 0.50 X 0 0 0 JEANNE FELDMEIER 0.50 X X 0 0 0 STEVE GILSETH 0.50 X X 0 0 0 BARB MENSINK 0.50 X 0 0 0 RACHEL BOYUM 0.50 X 0 0 0 BILL GRINDLAND 0.50 X X 0 0 0 MARGIE BREVIG 0.50 X 0 0 0 PAUL MAGAARD 0.50 X 0 0 0 JOAN VITSE 0.50 X 0 0 0 ARNIE AGRIMSON 0.50 X 0 0 0 TOM LINDH 40.00 X 58144 0 17344 RHONDA SPECE 40.00 X 45975 0 17031 104119 0 34375 0 0 0 0 THERAPY NETWORK 66 SHADY OAK CT WINONA MN 55987 THERAPY 347366 1 1250 58765 60015 MEDICARE/MEDICAID PMTS 623000 3014572 3014572 RESIDENT REVENUE 623000 1839620 1839620 APARTMENT REVENUE 623000 366566 366566 DAY CARE REVENUE 624410 301796 63377 238419 MGMT CONTRACT REVENUE 561000 25480 25480 6960 6960 5554994 19810 19810 373 373 5946 -5946 -5946 -5946 BEAUTY SHOP REVENUE 812900 13520 13520 GUEST/EMPLOYEE MEALS 900099 8373 8373 21893 5651139 5316575 238419 36130 138494 138494 2653515 2517184 136331 27245 26210 1035 543357 524990 18367 194924 188457 6467 66930 66930 37819 34628 3191 8514 422 8092 219454 194118 25336 222003 222003 3657 3657 13730 8882 4848 53162 53162 231844 231844 58544 58544 THERAPY EXPENSE 347367 347367 FOOD COSTS 224593 224593 MEDICAL CARE SURCHARGE 211125 211125 OTHER MEDICAL EXPENSE 79963 79963 85420 40518 44902 5421660 4905466 516194 0 47078 40928 843977 909968 450411 585255 23516 19696 28074 73460 6845214 4673410 2259711 2171804 200063 230248 260551 282324 4113381 4313683 352075 312721 1395275 1382339 114916 114886 1862266 1809946 X 2195788 2426694 55327 77043 2251115 2503737 4113381 4313683 229479 23143 0 X X 0 1 X 1 0 X 84602 77937 62520 28108 60015 313182 5305135 5395059 5474338 5702582 5554994 27432108 5389737 5472996 5536858 5730690 5615009 27745290 61995 62387 48020 28108 60015 260525 1409697 1406636 1635290 1695641 1464754 7612018 1471692 1469023 1683310 1723749 1524769 7872543 19872747 31845 54977 38888 19744 20183 165637 31845 54977 38888 19744 20183 165637 17215 18828 21893 57936 5421582 5527973 5592961 5769262 5657085 27968863 0.71050 0.70600 0.00590 0.00610 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 31559 31559 4111007 2973302 1137705 2522288 1539267 983021 180360 160841 19519 2171804 GUARANTY FUND CERTIFICATE 117870 DEFERRED FINANCING COSTS 31037 LAND & MINERAL RIGHTS 8731 DUE FROM RELATED PARTY 77043 EQUITY IN COOPERATIVE 43890 OTHER ASSETS 3753 282324 RENTAL DEPOSITS 9976 RESIDENT TRUST FUND 5988 ASSET RETIREMENT OBLIGATION 32922 DUE TO RELATED PARTY 66000 114886 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOME AND APARTMENTS HAVE BEEN GRANTED EXEMPT STATUS FROM FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION HAS ADOPTED THE ACCOUNTING STANDARD RELATED TO INCOME TAXES REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE IMPLEMENTATION OF THE STANDARD HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. THE TAX FILINGS OF THE HOME AND APARTMENTS FOR THE 2010 TO 2012 TAX YEARS ARE OPEN TO EXAMINATION. FORM 990, PART VI, SECTION A, LINE 6 THE ELEVEN AREA EVANGELICAL LUTHERAN CHURCHES ARE MEMBERS OF THE LUTHERAN HOME. FORM 990, PART VI, SECTION A, LINE 7A THE ELEVEN EVANGELICAL LUTHERAN CHURCHES NOMINATE AND ELECT MEMBERS OF THE GOVERNING BODY AT THE ANNUAL MEETING. EACH CHURCH SENDS TWO REPRESENTATIVES TO THE ANNUAL MEETING TO VOTE ON BEHALF OF THEIR CONGREGATION. AT THE ANNUAL MEETING BUT PRIOR TO VOTING, EACH MEMBER REPRESENTATIVE IS ALLOWED TO NOMINATE NEW CANDIDATES FOR THE GOVERNING BODY TO BE PUT ON THE BALLOT. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO BEING FILED WITH THE IRS, A COPY OF FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE BOARD PRESIDENT OR ACTING DIRECTOR AND THE CFO, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF THE APPROPRIATE DOCUMENTATION. UPON COMPLETION OF THE REVIEW, THE FORMS ARE REVIEWED AND VOTED ON AT A BOARD MEETING PRIOR TO SUBMITTAL TO THE IRS. THE ELECTED OFFICERS WILL SIGN THE FORMS WHERE NEEDED. FORM 990, PART VI, SECTION B, LINE 12C IF ANYONE REASONABLY BELIEVES THAT A POLICY, PRACTICE OR ACTIVITY OF GOOD SHEPHERD LUTHERAN SERVICES IS IN VIOLATION OF LAW, A WRITTEN COMPLAINT MUST BE FILED BY THE PERSON TO THEIR MANAGER, UP TO AND INCLUDING THE HUMAN RESOURCES DIRECTOR, ADMINISTRATOR OR A BOARD MEMBER OF GOOD SHEPHERD LUTHERAN SERVICES. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS FOR DETERMINING ADMINISTRATOR COMPENSATION IS REVIEWED ANNUALLY BY THE GOVERNING BODY. ALSO, THE BOARD WILL VOTE ON WHETHER TO APPROVE THE MINNESOTA COST OF LIVING ADJUSTMENT. IN THE CASE MINNESOTA DOES RECOMMEND A COST OF LIVING ADJUSTMENT, THE GOVERNING BODY WILL VOTE ON WHETHER TO APPROVE THE COST OF LIVING ADJUSTMENT FOR ALL EMPLOYEES OF THE HOME. THIS PROCESS WAS LAST CONDUCTED IN 2011 FOR ADMINISTRATOR COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL MADE AVAILABLE TO THE PUBLIC IN THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATIONS BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. GOOD SHEPHERD SENIOR APARTMENTS PO BOX 747 RUSHFORD MN 55971 411757528 TO PROVIDE LOW INCOME HOUSING TO THE ELDERLY OR HANDICAPPED MN 501(C)(3) LINE 9 GOOD SHEPHERD LUTHERAN SERVICES 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 NO TRANSACTIONS OVER 50000