2014-11-07T09:47:32-07:00 2014-06-30 990 2013-07-01 450448164 VALLEY MEMORIAL HOMES VALL 7017877912 2900 14th Ave S Grand Forks ND 58201 Garth Rydland President/CEO 7017877905 2014-11-07 2013 2015-11-30 17:44:51Z Garth Rydland 2900 14th Ave S Grand Forks ND 58201 2406011 0 X www.valleymemorial.org X 1997 ND To provide management, nursing, chaplaincy and other support services to related healthcare entities. 34 33 938 50 0 0 0 0 2243601 2406011 0 0 0 0 2243601 2406011 0 0 0 0 1651508 1756622 0 0 0 592093 649389 2243601 2406011 0 0 547695 663826 530265 646396 17430 17430 Valley Memorial Homes provides compassionate care and service from a Christian perspective to enhance the quality of life for those we serve. 0 0 2085576 0 0 Management support services including the following: Administration, Finance, IT, Human Resources and Transportation. Providing services to related organizations, who combined serve up to 520 residents and tenants on a daily basis and employee nearly 700 employees. 170699 0 0 Skilled Nursing Facility Support Services including Nursing-Admissions and Medical Records for up to 330 skilled residents a day. 149736 0 0 Chaplaincy services provided to related long term care facilities: skilled nursing, assisted living and basic care. 0 0 0 2406011 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 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 1 0 0 0 1 10 0 1 938 1 0 0 0 0 0 0 0 0 0 0 0 0 X 34 33 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 X Lorilee Bott 7017877912 2900 14th Ave S Grand Forks ND 58201 Olive Weber Director 0 0 X 0 0 0 Arvin Kvasager Director 0 0 X 0 0 0 Eunice Vold Director 0 0 X 0 0 0 Sheryl Cariveau Director 0 0 X 0 0 0 Marlys Kennedy Director 0 0 X 0 0 0 Jeff Awes Director 0 0 X 0 0 0 Dorothy Johnson Director 0 0 X 0 0 0 Arlet Phillips Director 0 0 X 0 0 0 Gary Masilko Director 0 0 X 0 0 0 Milt Kinzler Director 0 0 X 0 0 0 Donna Frohlich Director 0 0 X 0 0 0 Elizabeth York Director 0 0 X 0 0 0 Susan Larson Director 0 0 X 0 0 0 Marlyce Ballingrud Director 0 0 X 0 0 0 Gerry Eggers Director 0 0 X 0 0 0 Diane Lindseth Director 0 0 X 0 0 0 Lawrence Heuchert Director 0 0 X 0 0 0 Roger Stadstad Director 0 0 X 0 0 0 Sharon Bakke Director 0 0 X 0 0 0 Sharon Gustafson Director 0 0 X 0 0 0 Susan Kuster Director 0 0 X 0 0 0 Ron Holte Director 0 0 X 0 0 0 Jacky Jones Director 0 0 X 0 0 0 Iola Kvasager Director 0 0 X 0 0 0 Charles Johnson Director 0 0 X 0 0 0 Muriel Stadstad Director 0 0 X 0 0 0 John Halstenson Director 0 0 X 0 0 0 Clark Piepkorn Director 0 0 X 0 0 0 Kevin Beito Chair 0 0 X X 0 0 0 Bruce Newhouse Vice Chair 0 0 X X 0 0 0 Michael Porter Treasurer 0 0 X X 0 0 0 Dawn Botsford Board Secretary 0 0 X X 0 0 0 Greg Hanson President/CEO 40 0 X X 189866 0 23446 Garth Rydland Administrator-Woodside Village & President/CEO 40 0 X X 0 119581 12913 Lorilee Bott CFO 0 0 X 122963 0 7767 Nancy Andrews Executive Director of Housing and Assisted Living 40 0 X 101411 0 11800 414240 119581 55926 4 0 1 0 Altru Health Systems PO Box 13780 Grand Forks ND 58201 Contracted Therapies and Chaplaincy Service for Valley Homes and Services and 4000 Valley Square Inc 1148516 Industrical Contract Services PO Box 13158 Grand Forks ND 582083158 General Contractor - construction/remodeling 513822 C&R Laundry 1010 N 5th Street Grand Forks ND 58201 Laundry Purchased Services for Valley Homes and Services and 4000 Valley Square Inc 343255 Networking Specialists 2397 Demers Ave Suite D Grand Forks ND 58201 IT - Managed Services, Support and Equipment 245778 4 0 2406011 2406011 0 0 2406011 0 0 0 0 0 2406011 2406011 0 0 414240 414240 1022613 1022613 72436 72436 137199 137199 110134 110134 7625 7625 25562 25562 39648 39648 43445 43445 27373 27373 9101 9101 15046 15046 3219 3219 55589 55589 23087 23087 Purch Serv-Chap, IT MR, Adm 258731 258731 0 0 Repairs/Maintence/Fuel - Trans 29892 29892 0 0 Dues, subscr, empl exp 65877 65877 0 0 Other Supplies-Trans, Chap, MR 7864 7864 0 0 37330 37330 2406011 2406011 0 0 304049 325754 3977 2662 399 399 66512 111083 734932 571119 153585 163813 19173 60115 547695 663826 392361 257361 137904 389035 530265 646396 X 17430 17430 0 0 0 0 17430 17430 547695 663826 0 0 0 0 0 0 X 0 0 0 X X 0 0 0 Valley Memorial Foundation 450392710 Line 7 1 1 0 Valley Homes and Services 450229071 Line 9 1 1 1484993 4000 Valley Square Inc 311558826 Line 9 1 1 921018 3 2406011 0 0 0 0 0 0 0 0 0 0 0 0 734932 571119 163813 0 0 0 0 163813 457b Plan 60115 60115 0 457b Plan 60115 Note Payable 76110 Intercompany Payable 252810 389035 Schedule D, Part X, Line 1 Other liabilities include Vehicle Loans, 457 B Plan, and Intercompany Payable. 4000 Valley Square and Valley Homes and Services transferred money prior to 6/30/2014 to cover related expenses that were processed after 7/1/2014. X X X 0 1 0 0 0 0 0 0 0 Greg Hanson President/CEO 185066 0 0 0 4800 0 11749 0 11697 0 213312 0 8413 0 Schedule J, Part I, Line 3 Compensation is determined by the compensation committee. Base salary is evaluated by comparison to others of similar size and function. Schedule J, Part I, Line 4 Valley Memorial Homes participated in a 457B Plan. employee contribution/deductions $9668, Employer contributions $7832. Form 990, Part VI, Section A, Line 9 Kevin Beito, 1328 21st St NW, East Grand Forks, MN 56721; Bruce Newhouse, 27093 350th Ave SW, Fisher, MN 56723; Dawn Botsford, 707 Reeves Drive, Grand Forks, ND 58201; Michael Porter, 6100 Kings View Dr #105, Grand Forks, ND 58201; John Halstenson, 2300 Library Circle, Grand Forks, ND 58201; Charles Johnson, 3008 Legend Lane, Grand Forks, ND 58201; Muriel Stadstad, 1774 22nd Ave NE, Grand Forks, ND 58203; Clark Piepkorn, 3021 Olson Dr, Grand Forks, ND 58201; Dorothy Johnson, PO Box 248, Emerado, ND 58228; Marlyce Ballingrud, 423 N 3rd St, Grand Forks, ND 58203; Elizabeth York, 175 Columbia Rd, Grand Forks, ND 58203; Jeff Awes, 1025 Cottonwood St, Grand Forks, ND 58201; Arlet Philips, 21512 400th Ave SW, East Grand Forks, MN 56721; Donna Frohlich, 1135 McKinley Ave, Grand Forks, ND 58201; Susan Larson, 867 7th Ave NE, Thompson, ND 58278; Diane Lindseth, 1736 9th Ave NE, Thompson, ND 58278; Sheryl Cariveau, 424 Crestwood Ct SE, East Grand Forks, MN 56721; Roger Stadstad, 2742 18th St NE, Manvel, ND 58256; Sharon Bakke, 2331 25th St NE, Mekinock, ND 58258; Gerry Eggers, 14 James Circle SE, East Grand Forks, MN 56721; Lawrence Heuchert, 2230 7th Ave N, Grand Forks, ND 58203; Olive Weber, 4634 Belmount Road, Grand Forks, ND 58201; Sharon Gustafson, PO Box 204, Thompson, ND 58278; Susan Kuster, 313 7th Ave, Reynolds, ND 58275; Milt Kinzler, 2725 Knight Dr, Grand Forks, ND 58201; Marlys Kennedy, 608 park Drive, Manvel, ND 58256; Gary Masilko, 210 Circle Hills Dr, Grand Forks, ND 58201; Arvin Kvasager, 2521 9th Ave N, Grand Forks, ND 58203; Ron Holte, PO Box 293, Thompson, ND 58278; Jacky Jones, PO Box 203, Oslo, MN 56744; Eunice Vold, 411 22nd Ave S, Grand Forks, ND 58201; Iola Kvasager, 2521 9th Ave N, Grand Forks, ND 58203 Form 990, Part VI, Section B, Line 11b The CFO with the assistance of the President/CEO prepares the Form 990. A draft of the Form 990 and all applicable schedules are sent to the Board of Directors' Executive Committee for review prior to a metting held the first Thursday of November. The CFO explains any changes, specifically reviews Part VI and answers any questions. The Form 990 is electronically filed after Executive Committee approval. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is stated in Article 8 of the bylaws. It is reviewed with board members at Board Orientation. Board members are presented the policy and sign off annually. Form 990, Part VI, Section B, Line 15 The President/CEO's compensation is determined as follows. The compensation committee reviews the ND Long Term Care Association's state compensation each year to assess how Valley Memorials' CEO's salary compares with other of similar size and function. This survey provides the committee with a guage when it considers changes in base compensation. The committee then reviews the organization's performance and strategic plan goals to develop an incentive compensation plan in addition to the base salary. Compensation for the executive management includes performance appraisal completed by the President/CEO or their direct supervisors. Employees are eligible for annual inflationary increase to their base salary. the percentage is based upon the approved annual budget or other board approved changes. ND Long Term Care salary surveys are reviewed and adjustments are made to base salaries if the survey demonstrates underpayment compared to like sized operations. Form 990, Part VI, Section C, Line 19 Valley Memorial Homes' governing documents, conflict of interest policy and financial statements are available upon request. Requests should be made to the CFO at Valley Memorial Homes' corporate office, located at Valley Eldercare Center, 2900 14th Ave S, Grand Forks ND 58201 between the hours of 8:30-4:30 Monday through Friday. Valley Homes and Services 2900 14th Ave S Grand Forks ND 58201 450229071 Sk Nursing Fac, Asst Liv, Basic Care ND 501 (c) 3 Line 9 N/A 0 4000 Valley Square Inc 4000 24th Ave S Grand Forks ND 58201 311558826 Sk Nursing Fac, Asst Liv, & Housing ND 501 (c) 3 Line 9 N/A 0 Valley Memorial Foundation 2900 14th Ave S Grand Forks ND 58201 450392710 Seek and accept gifts to support LTC facilities ND 501 (c) 3 Line 7 N/A 0 Cherrywood Village 2900 14th Ave S Grand Forks ND 58201 454276187 Low Income Senior Apartments ND 501 (c) 3 Line 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 Valley Homes and Services q 1484993 Actual expenses-Direct Costs or Allocated 4000 Valley Square Inc q 921018 Actual expenses - Direct Cost or Allocated Schedule R, Part V, Line 2 The amounts involved in transaction "m", "n" and "o" are included in transaction "q". Valley Memorial Homes' expenses are direct costed or allocated to Valley Homes and Services and 4000 Valley Square Inc. based upon allocation methodologies prescribed by the ND Department of Human Services.