2013-11-14T15:19:17-06:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2012-01-01 410873335 ASSUMPTION HOME INC ASSU 3206853693 715 NORTH 1ST STREET COLD SPRING MN 56320 JAN LUTHENS 3206853693 2013-11-11 1 GORDON J VETSCH P00047306 6123764500 2012 2016-02-24 21:20:13Z JAN LUTHENS 715 NORTH 1ST STREET COLD SPRING MN 56320 7990622 0 0928 X WWW.ASSUMPTIONHOME.ORG X 1963 MN PROVIDING A CONTINUUM OF HEALTH AND RESIDENTIAL SERVICES IN A CHRISTIAN ENVIRONMENT. 15 15 311 274 0 0 77627 43823 6944932 7545352 69945 57375 8164 334192 7100668 7980742 0 0 0 0 3943578 4181679 0 0 0 3487128 3940195 7430706 8121874 -330038 -141132 20200250 19452567 15164788 14489710 5035462 4962857 X PURSUE EXCELLENCE IN PROVIDING A CONTINUUM OF HEALTH AND RESIDENTIAL SERVICES IN A CHRISTIAN ENVIRONMENT. 0 0 6319023 0 6329899 ASSUMPTION HOME, INC., OPERATES AN 82-BED LONG-TERM HEALTH CARE FACILITY IN COLD SPRING, MN, WHICH PROVIDES CARE TO RESIDENTS ON A DAILY BASIS. ASSUMPTION HOME IS RENOWNED FOR BEING A CHRISTIAN HEALTH CARE FACILITY THAT STRIVES TO PROVIDE LONG TERM AND REHABILITATIVE CARE FOR OLDER ADULTS. ASSUMPTION HOME IS A SINGLE STORY STRUCTURE, CONVENIENTLY LOCATED IN THE CENTER OF COLD SPRING, AND IS BORDERED BY NUMEROUS PICTURESQUE SCENES INCLUDING A GARDEN, PARK, AND THE MIDDLE SCHOOL PLAYGROUND. ASSUMPTION HOME OFFERS THE OLDER ADULT AND THEIR FAMILIES NUMEROUD SERVICES AND ASPECTS OF MEDICAL CARE INCLUDING SEVERAL ROUNDING ONSITE PRIMARY PHYSICIANS, NUMEROUS CONSULTING PHYSICIANS INCLUDING AN AUDIOLOGIST AND PODIATRIST, AND A LOCAL PHARMACY TO PROVIDE MEDICATIONS. ASSUMPTION HOME IS ALSO ABLE TO COORDINATE YOUR LOVED ONE'S CARE WITH OTHER CLINICS AND MEDICAL PROFESSIONS AS NEEDED. 1199553 0 1215454 ASSUMPTION COURT IS A 59-UNIT APARTMENT COMPLEX ADJACENT TO ASSUMPTION HOME. INCLUDED ARE BOTH CONGREGATE SENIOR HOUSING AND HOUSING WITH SERVICES. THESE UNITS PROVIDE HOUSING FOR OLDER ADULTS IN A SAFE AND SECURE ENVIRONMENT. 7518576 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 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 14 0 311 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X X BRENDA WELLER 3206853693 715 NORTH 1ST STREET COLD SPRING MN 56320 DALE JOB 1.00 2.00 X 0 0 0 ROXANNE DORWEILER 1.00 2.00 X 0 0 0 JUDY KEARIN 1.00 2.00 X 0 0 0 REV CLETUS CONNORS 1.00 2.00 X 0 0 0 MARY WENNER 1.00 2.00 X 0 0 0 DOROTHY PFLIPSEN 1.00 2.00 X 0 0 0 SISTER JUDY SCHAFFER 1.00 2.00 X 0 0 0 DON EIKMEIER 1.00 2.00 X 0 0 0 RICHARD KRUEGER 1.00 2.00 X 0 0 0 ADAH EBELING 1.00 2.00 X 0 0 0 ROD PAUSER 1.00 2.00 X 0 0 0 SISTER MIRIAM ARDOLF 1.00 2.00 X 0 0 0 BEVERLY LAHR 1.00 2.00 X 0 0 0 JACK BELL 1.00 2.00 X 0 0 0 CLARENCE DINGMANN 1.00 2.00 X 0 0 0 JAN LUTHENS 31.00 9.00 X 87242 0 10144 87242 0 10144 0 0 0 0 CLIFTONLARSONALLEN LLP PO BOX 86 MINNEAPOLIS MN 55486 ACCOUNTING 129941 1 43823 43823 RESIDENT SERVICES 623000 6295807 6295807 APARTMENT REVENUE 623000 733229 733229 OTHER SERVICES 623000 516316 516316 7545352 35112 35112 2975 0 2975 2975 2975 22263 0 22263 22263 22263 16643 7038 9605 9605 692 2842 -2150 -2150 CONTRACT SERVICES 561000 175923 175923 EMPLOYEE MEAL INCOME 722210 83667 83667 MANAGEMENT FEE 541610 55792 55792 8380 8380 323762 7980742 7545352 0 391567 97386 97386 3430499 3365947 64552 57149 55034 2115 286470 245647 40823 310175 263644 46531 129941 129941 579633 359221 220412 78306 76257 2049 163394 103703 59691 242201 241380 821 9067 4181 4886 929989 926683 3306 727173 724588 2585 86912 86783 129 FOOD 341826 341826 LICENSES 266247 265397 850 REPAIRS 160475 159904 571 SUPPLIES 147582 147582 77449 53413 24036 8121874 7518576 603298 0 355981 396029 1042432 973714 751432 970061 14251 9082 20028034 6530191 14109147 13497843 1058288 1159899 2868719 2445939 20200250 19452567 1405431 1025674 13485391 13265563 32987 34553 177558 115038 63421 48882 15164788 14489710 X 5035462 4962857 5035462 4962857 20200250 19452567 -141132 68527 0 X 0 1 X 1 0 X 49292 50693 39309 77627 43823 260744 6875864 7086337 7365184 6944932 7545353 35817670 6925156 7137030 7404493 7022559 7589176 36078414 0 0 0 36078414 95189 64410 51594 40052 38087 289332 95189 64410 51594 40052 38087 289332 3662 9474 7522 8164 341097 369919 7024007 7210914 7463609 7070775 7968360 36737665 0.98210 0.98860 0.00790 0.01040 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2008 AMOUNT: $ 3,662. 2009 AMOUNT: $ 9,474. 2010 AMOUNT: $ 7,522. 2011 AMOUNT: $ 8,164. 2012 AMOUNT: $ 341,097. 0 1 X 438018 438018 17332106 4804146 12527960 168661 86367 82294 2089249 1639678 449571 13497843 BOND ISSUANCE COSTS 340077 BOND INDENTURE AGREEMENTS 1654344 RESIDENT TRUST FUNDS 4556 SECURITY DEPOSITS 29997 DUE FROM RELATED PARTY 416965 2445939 401K PAYABLE 48169 DUE TO RELATED PARTY 713 48882 X 7865454 0 7865454 115289 115289 7980743 8131757 9884 9884 8121873 0 8121873 PART IV, LINE 2B: THE ORGANIZATION HOLDS IN TRUST, SECURITY DEPOSITS ADVANCED BY THE TENANTS OF ASSUMPTION COURT. THE ORGANIZATION RECORDS THESE DEPOSITS, PLUS 1% SIMPLE INTEREST, AS A LIABILITY. THE ORGANIZATION IS ALSO THE TRUSTEE OF VARIOUS RESIDENT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION DISTRIBUTION OF THESE FUNDS FOR THE RESIDENTS. THESE FUNDS ARE ON DEPOSIT IN A SEPARATE BANK ACCOUNT. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A MINNESOTA NONPROFIT CORPORATION THAT IS EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS A CHARITABLE TAX DEDUCTION BY THE DONOR. THE ORGANIZATION FOLLOWS THE APPLICABLE PROVISIONS OF FASB ASC 740-10 REGARDING ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INFORMATION RETURNS 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 ORGANIZATION'S 2009, 2010 AND 2011 TAX YEARS ARE OPEN TO EXAMINATION BY THE IRS. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 57,375. CONTRIBUTIONS 60,466. OTHER INCOME 7,328. GIFT SHOP COGS -2,842. SPECIAL EVENT EXPENSES -7,038. PART XII, LINE 2D - OTHER ADJUSTMENTS: GIFT SHOP COGS 2,842. SPECIAL EVENT EXPENSES 7,042. HARVEST MOON BENEFIT CONCERT 16643 16643 2171 1692 2550 626 16643 16643 2171 1692 2550 626 7039 9604 A CITY OF COLD SPRING MINNESOTA 416005064 193024AS5 2005-03-31 6550000 REFUND SERIES 1996 BONDS & FACILITY CONSTRUCTION 0 0 0 B CITY OF COLD SPRING MINNESOTA 416005064 193014AM9 2008-10-29 7987331 FACILITY CONSTRUCTION 0 0 0 A 955000 6550000 535168 131000 3793439 2090393 2005 0 0 0 1 B 205000 7987331 600082 159746 7227503 2008 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0 0 0 A 1 1 0 0 0 B 1 1 0 0 0 0 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 1 DIFFERENCES IN VOTING RIGHTS: THREE DIRECTORS - THE PASTOR AND TWO TRUSTEES OF ST. BONIFACE CATHOLIC CHURCH, COLD SPRING, MN - ALSO SERVE AS MEMBERS OF THE ORGANIZATION. AS MEMBERS, THESE THREE INDIVIDUALS HAVE THE POWER TO PROPOSE AND VOTE ON THE APPOINTMENT OF THE OTHER EIGHT DIRECTORS. ADDITIONALLY, THESE SAME THREE DIRECTORS/MEMBERS HAVE THE POWER TO DISCHARGE ANY DIRECTOR THROUGH A MAJORITY VOTE OF THE FIVE MEMBERS. EXECUTIVE COMMITTEE: THE BOARD OF DIRECTORS DESIGNATED THREE OF ITS MEMBERS TO CONSTITUTE AN EXECUTIVE COMMITTEE. TO THE EXTENT DETERMINED BY THE BOARD OF DIRECTORS, THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS AND THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL ACT ONLY IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION ARE AS FOLLOWS: 1. THE BISHOP OF THE DIOCESE OF ST. CLOUD, OR THE PERSON WHO, IN HIS STEAD, EXERCISES ORDINARY JURISDICTION OVER THE SPIRITUAL AND TEMPORAL AFFAIRS OF THE DIOCESE OF ST. CLOUD, IN ACCORDANCE WITH THE LEGISLATION OF THE ROMAN CATHOLIC CHURCH; 2. THE VICAR GENERAL OF THE DIOCESE OF ST. CLOUD, WHO HAS BEEN APPOINTED TO BE A MEMBER EX-OFFICIO OF THE CORPORATION OF THE DIOCESE OF ST. CLOUD. IN THE EVENT OF A VACANCY IN THE OFFICE OF THE BISHOP, OR IN THOSE CASES IN WHICH THE VICAR GENERAL'S OFFICE CEASES, THEN AND IN SUCH EVENT THE PERSON WHO WAS THE VICAR GENERAL SHALL CONTINUE TO BE A MEMBER EX-OFFICIO OF THIS CORPORATION WITH ALL THE RIGHTS AND POWERS INCIDENT THERETO, BUT HIS MEMBERSHIP SHALL CEASE AT ONCE WHEN THE OFFICE OF VICAR GENERAL HAS BEEN FILLED; 3. THE PASTOR OF ST. BONIFACE CATHOLIC CHURCH, COLD SPRING, MINNESOTA; 4. THE TWO TRUSTEES OF ST. BONIFACE CATHOLIC CHURCH, COLD SPRING, MINNESOTA, WHICH HAVE BEEN DESIGNATED AS THE TRUSTEES OF SAID PARISH PURSUANT TO THE PROVISIONS OF SECTION 315.15 OF THE MINNESOTA STATUTES, AND THEIR SUCCESSORS. FORM 990, PART VI, SECTION A, LINE 7A THREE DIRECTORS - THE PASTOR AND TWO TRUSTEES OF ST. BONIFACE CATHOLIC CHURCH, COLD SPRING, MN - ALSO SERVE AS MEMBERS OF THE ORGANIZATION. AS MEMBERS, THESE THREE INDIVIDUALS HAVE THE POWER TO PROPOSE AND VOTE ON THE APPOINTMENT OF THE OTHER EIGHT DIRECTORS. ADDITIONALLY, THESE SAME THREE DIRECTORS/MEMBERS HAVE THE POWER TO DISCHARGE ANY DIRECTOR THROUGH A MAJORITY VOTE OF THE FIVE MEMBERS. IN ADDITION TO THE THREE BOARD MEMBERS INCLUDED ABOVE, THE OTHER EIGHT DIRECTORS ARE ELECTED BY THE MEMBERS OF THE CORPORATION AND SHALL SERVE IN THAT CAPACITY AT THE PLEASURE OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS MADE TO THE ARTICLES OF INCORPORATION AND BYLAWS MUST BE APPROVED BY A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM AND IS REVIEWED BY BOTH THE ADMINISTRATOR AND THE DIRECTOR OF FINANCE. AFTER THEIR REVIEW, THE 990 IS EMAILED TO THE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS. THE ADMINISTRATOR ANNUALLY REVIEWS THE BOARD MEMBERS' ASSOCIATIONS FOR CONFLICTS OF INTEREST. THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE ADMINISTRATOR'S ASSOCIATIONS FOR CONFLICTS OF INTEREST. IF A CONFLICT ARISES, DEPENDING ON THE CIRCUMSTANCES, THE CONFLICTED INDIVIDUAL ABSTAINS FROM VOTING, STEPS DOWN FROM THE BOARD OR TERMINATES THEIR ASSOCIATION WITH THE OTHER PARTY. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS USES COMPARABILITY DATA ANNUALLY TO ENSURE THAT THE COMPENSATION FOR THE ADMINISTRATOR IS FAIR. DETERMINATION OF COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION IS DONE USING MN AGING COMPARISON REPORTS. THE LAST ADMINISTRATOR REVIEW WAS PERFORMED IN 2012. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PIONEER HOUSING DEVELOPMENT INC 200 8TH AVENUE NORTH COLD SPRING MN 56320 411367392 HOUSING MN 501(C)(3) 9 N/A 0 ASSUMPTION COMMUNITY SERVICES 715 1ST ST NORTH COLD SPRING MN 56320 800276405 HOME CARE SERVICES MN 501(C)(3) 9 N/A 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 0 1 0 0