BETHANY ON 42ND: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- BETHANY ON 42ND (EIN 26-1087740)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-01
- IRS object ID
- 201322139349300632
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-01T13:35:54-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4310 17TH AVE S PO BOX 2545 | AddressLine1 |
| City | FARGO | City |
| State | ND | State |
| ZIP Code | 581082545 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261087740 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bethany on 42nd | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BETH | NameControl |
| Phone | 7012393000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 South University Drive | AddressLine1 |
| City | Fargo | City |
| State | ND | State |
| ZIP Code | 58103 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Shawn Stuhaug | Name |
| Title | President/CEO | Title |
| Phone | 7012393000 | Phone |
| Date Signed | 2013-07-30 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LISA CHAFFEE CPA | Name |
| PTIN | P00193453 | PTIN |
| Phone | 7012398500 | Phone |
| Date Prepared | 2013-07-30 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Shawn Stuhaug | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 South University Drive | AddressLine1 |
| City | Fargo | City |
| State | ND | State |
| ZIP Code | 58103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9971825 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.bethanynd.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2007 | YearFormation |
| State Legal Domicile | ND | StateLegalDomicile |
| Activity Or Mission Description | Provide long term care services | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 100 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 224894 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 300383 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9449579 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9645689 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -718 | InvestmentIncomePriorYear |
| Investment Income Current Year | -1382 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 29228 | OtherRevenuePriorYear |
| Other Revenue Current Year | 24778 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9702983 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9969468 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5087365 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5176649 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4689856 | OtherExpensePriorYear |
| Other Expenses Current Year | 4782820 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9777221 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9959469 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -74238 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9999 | RevenuesLessExpensesCY |
| Total Assets BOY | 26987148 | TotalAssetsBOY |
| Total Assets EOY | 26973808 | TotalAssetsEOY |
| Total Liabilities BOY | 24366468 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 24405597 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2620680 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2568211 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide living opportunities in a senior community shaped by Christian values. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 9209561 | Expense |
| Revenue | 9645689 | Revenue |
| Description | Bethany on 42nd operates as a charitable organization consistent with the requirements of Internal Revenue Code Section 501(c)(3). Bethany on 42nd provides long term care services including skilled nursing care, transitional care services, and senior housing with services. Bethany on 42nd does not discriminate against individuals in the admissions process or in the delivery of care with regard to ability to pay for services. 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 Bethany on 42nd is made up of prominent leaders in the Fargo-Moorhead community. Volunteerism - coordinates a volunteer program that included 100 volunteers giving 5,750 hours of service, providing mental stimulation and emotional support to Bethany on 42's 118 residents and patients. 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.Assessment and referral services - our staff help to refer individuals needing long term care services to the appropriate agency in the community. Bethany on 42nd's licensed social workers provide guidance with medical assistance applications for residents/families.Community support - Bethany on 42nd provides meeting room space and accommodations for non-profit organizations and community groups. Several of our resident activity programs are open to community members. 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 Bethany on 42nd residents at a reduced cost. Bethany on 42nd organizes employee participation in fundraising activities for United Way and the Alzheimer's Association. There are also representatives from Bethany on 42nd on non-profit boards and civic organizations that work to improve the quality of life in the Fargo-Moorhead area. Bethany's President/CEO serves on HERO's (Health Equipment Recycling Organization) Board of Directors and the Fargo Dome Finance Committee. He also serves as the Region VI Director on the Board of the North Dakota Long Term Care Association. Bethany's CFO serves on the Board of Hospice of the Red River Valley. The Senior Executive of Medicare/Contracted Services serves on the board for the National Association of Directors of Nursing Association (NADONA). He also serves on the Care Transitions Focus Group affiliated with Sanford Health Systems. Bethany's Senior Executive of Support Services is on the Dietetics Advisory Committee for North Dakota State University and the Advisory Board for the Culinary Arts Program at Minnesota State Moorhead. Bethany's Senior Executive of Resident Care serves on the Resident Issues Committee of the ND Long Term Care Association, the Partners Investing in Nursing consortium, and the Care Transitions Focus Group, a collaborative project with Sanford Health Systems. She also serves as Region VI Director for NADONA of ND. Bethany's Director of Social Services serves on the board of the Long Term Care Social Workers of ND.The following is specific information relating to Bethany on 42nd's care provided:Bethany on 42nd Skilled/TCU Care - services provided, 65 nursing home beds: 23,690 days of care, and 13 TCU beds: 4,366 days of care. Total Skilled/TCU employee hours - 250,682. (Total Expenses = 8,813,182)Bethany Gables - senior housing with services, 40 units - 13,567 days of care and 13,874 employee hours (total expenses = 1,142,877)Bethany on 42nd served approximately 454 individuals in 2012. | Description |
| Total Program Service Expense | 9209561 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 11 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Kelly | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7012393226 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 South University Drive | AddressLine1 |
| City | Fargo | City |
| State | ND | State |
| ZIP Code | 58103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|---|
| Mary Johnson | |||||||
| Chair (Jan-Mar) | 1.00 | 3.00 | X | X | 0 | 0 | 0 |
| Martha Leclerc | |||||||
| Vice Chair (Jan-Mar)/Chair (Apr-Dec) | 1.00 | 3.00 | X | X | 0 | 0 | 0 |
| Lloyd Smith | |||||||
| Treas. (Jan-Mar)/Vice Chair (Apr-Dec) | 1.00 | 3.00 | X | X | 0 | 0 | 0 |
| Janice Nelson | |||||||
| Secretary (Jan-Mar)/Treas. (Apr-Dec) | 1.00 | 3.00 | X | X | 0 | 0 | 0 |
| David Glatt | |||||||
| Trustee(Jan-Mar)/Secretary (Apr-Dec) | 2.00 | 4.00 | X | X | 3744 | 8256 | 0 |
| Shannon Charpentier | |||||||
| Trustee | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Neal Eriksmoen | |||||||
| Trustee (Jan-Mar) | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Robin Pratt | |||||||
| Trustee (Jan-Mar) | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Harriette McCaul | |||||||
| Trustee | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Paul Wilson | |||||||
| Trustee | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Jerilynn Brantner-Adams | |||||||
| Trustee | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Jean Bokinskie | |||||||
| Trustee (Apr-Dec) | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| John Hertsgaard | |||||||
| Trustee (Apr-Dec) | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Roger Olson | |||||||
| Trustee (Apr-Dec) | 1.00 | 3.00 | X | 0 | 0 | 0 | |
| Shawn Stuhaug | |||||||
| President/CEO | 23.00 | 27.00 | X | 0 | 216507 | 9640 | |
| Jane Kelly | |||||||
| CFO | 20.00 | 30.00 | X | 0 | 151811 | 25357 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3744 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 376574 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 34997 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| YHR Partners | |||||
| 420 Main Ave | Moorhead | MN | 56560 | Design of 42nd Skilled Expansion | 336933 |
| RehabCare Group Inc | |||||
| PO Box 503534 | St Louis | MO | 631503534 | Contract Therapy | 192316 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Related Organizations | 203151 | RelatedOrganizations |
| All Other Contributions | 97232 | AllOtherContributions |
| Total Contributions | 300383 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Resident Service Rev | 623000 | 9642259 | 9642259 |
| Other Income | 900099 | 3430 | 3430 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9645689 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 975 | TotalRevenueColumn |
| Exclusion | $975 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 24778 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 24778 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24778 | TotalRevenueColumn |
| Exclusion | $24,778 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2357 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -2357 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2357 | TotalRevenueColumn |
| Exclusion | -$2,357 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9969468 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9645689 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $23,396 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3744 | Total |
| Program Services | 3744 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4336710 | Total |
| Program Services | 3996343 | ProgramServices |
| Management And General | 340367 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49834 | Total |
| Program Services | 40709 | ProgramServices |
| Management And General | 9125 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 470851 | Total |
| Program Services | 431009 | ProgramServices |
| Management And General | 39842 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 315510 | Total |
| Program Services | 290688 | ProgramServices |
| Management And General | 24822 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41004 | Total |
| Management And General | 41004 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 639915 | Total |
| Program Services | 639915 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 680514 | Total |
| Program Services | 500860 | ProgramServices |
| Management And General | 179654 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 468832 | Total |
| Program Services | 468832 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50553 | Total |
| Program Services | 50553 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29563 | Total |
| Program Services | 24399 | ProgramServices |
| Management And General | 5164 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 991824 | Total |
| Program Services | 991824 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1216035 | Total |
| Program Services | 1216035 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99970 | Total |
| Management And General | 99970 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 362599 | 362599 | |
| Bad Debt Expense | 192051 | 192051 | |
| Memberships | 9718 | 9718 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242 | Total |
| Management And General | 242 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9959469 | Total |
| Program Services | 9209561 | ProgramServices |
| Management And General | 749908 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 874259 | BOY |
| EOY | 782879 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 916884 | BOY |
| EOY | 826825 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84333 | BOY |
| EOY | 88845 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77561 | BOY |
| EOY | 91995 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 27208447 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3391661 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23682558 | BOY |
| EOY | 23816786 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 298525 | BOY |
| EOY | 236057 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1053028 | BOY |
| EOY | 1130421 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26987148 | BOY |
| EOY | 26973808 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 646455 | BOY |
| EOY | 723431 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15766928 | BOY |
| EOY | 15483838 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 3804 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 18491 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 347423 | BOY |
| EOY | 420232 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7605662 | BOY |
| EOY | 7755801 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24366468 | BOY |
| EOY | 24405597 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2322155 | BOY |
| EOY | 2332154 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 298525 | BOY |
| EOY | 236057 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2620680 | BOY |
| EOY | 2568211 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26987148 | BOY |
| EOY | 26973808 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9999 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -62468 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3644075 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 917669 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1992 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 224894 | CurrentTaxYearMinus1Year |
| Current Tax Year | 300383 | CurrentTaxYear |
| Total | 5089013 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 6900816 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9449579 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9645689 | CurrentTaxYear |
| Total | 25996084 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3644075 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 917669 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6902808 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9674473 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9946072 | CurrentTaxYear |
| Total | 31085097 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 237586 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 173925 | CurrentTaxYearMinus1Year |
| Current Tax Year | 89059 | CurrentTaxYear |
| Total | 500570 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 237586 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 173925 | CurrentTaxYearMinus1Year |
| Current Tax Year | 89059 | CurrentTaxYear |
| Total | 500570 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 30584527 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 19281 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30153 | CurrentTaxYearMinus1Year |
| Current Tax Year | 25753 | CurrentTaxYear |
| Total | 75187 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 19281 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30153 | CurrentTaxYearMinus1Year |
| Current Tax Year | 25753 | CurrentTaxYear |
| Total | 75187 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3644075 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 917669 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6922089 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9704626 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9971825 | CurrentTaxYear |
| Total | 31160284 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.98150 | PublicSupportPercentage509 |
| Investment Income Percentage | 0.00240 | InvestmentIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
| Explanation In Part XIII | X | ExplanationInPartXIII |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 897206 | OtherCostOrOtherBasis |
| Book Value | 897206 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21558271 | OtherCostOrOtherBasis |
| Depreciation | 2344934 | Depreciation |
| Book Value | 19213337 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2729848 | OtherCostOrOtherBasis |
| Depreciation | 871060 | Depreciation |
| Book Value | 1858788 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2023122 | OtherCostOrOtherBasis |
| Depreciation | 175667 | Depreciation |
| Book Value | 1847455 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 23816786 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Related Party Payable | $1,674,530 |
| Related Entity Note Payable | $6,081,271 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7755801 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 9757696 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 9757696 | RevenueSubtotal |
| Other Revenues Not Included | 211772 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 211772 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9969468 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 9956064 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -3405 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -3405 | ExpensesNotRptdF990 |
| Expenses Subtotal | 9959469 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 9959469 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 $3,804 at December 31, 2012. | |
| Part X, Line 2: | Bethany on 42nd is a North Dakota nonprofit corporations 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, the Organization is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. The Organization has deteremined they are not subject to unrelated business income tax and have not filed an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS. Bethany believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. Bethany 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. | Description of Uncertain Tax Positions Under FIN 48: |
| Contributions recorded in fund balance for financial statement 208,367. Sales revenue recorded in expenses for financial statement 3,405. | Part XI, Line 4b - Other Adjustments: | |
| Sales revenue recorded in expenses for financial statement -3,405. | Part XII, Line 2d - Other Adjustments: |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David Glatt | ||||||||||||||
| Trustee(Jan-Mar)/Secretary (Apr-Dec) | 3744 | 8256 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3744 | 8256 | 0 | 0 |
| Shawn Stuhaug | ||||||||||||||
| President/CEO | 0 | 176348 | 0 | 40159 | 0 | 0 | 0 | 7078 | 0 | 2694 | 0 | 226279 | 0 | 0 |
| Jane Kelly | ||||||||||||||
| CFO | 0 | 126811 | 0 | 25000 | 0 | 0 | 0 | 6403 | 0 | 19060 | 0 | 177274 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | Part I, Line 3: The President/CEO is paid by a related organization which has a process in place for establishing compensation using methods identified in question 3. In conjuction with American Lutheran Homes, Inc. a related organization, Bethany on 42nd has an agreement with Sanford Health for Medical Director services provided by David Glatt. Compensation noted in Schedule J Part II is the fee paid to Sanford Health for his services provided to Bethany on 42nd. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| Cass County North Dakota | |||||||
| A | 456002205 | 2010-10-01 | 16000000 | Construct & Equip Retirement Living Campus | 0 | 0 | 0 |
| Cass County North Dakota | |||||||
| B | 456002205 | 2012-08-28 | 3000000 | Construct & Equip 38 Skilled Nursing Bed Addition & Small Kitchen Facility | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|
| A | 16000000 | 137143 | 15862857 | 2010 | 0 | 0 | 1 | 1 | |
| B | 3000000 | 59755 | 16317 | 0 | 0 | 0 | 1 | 2923928 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 1 |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
| B | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 0 |
| B | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | The CEO, CFO and Board all have a business relationship with each other, as the CEO and CFO are employed by another related nonprofit of which the board members serve as well. The Board serves all of the related organizations listed on Schedule R. | |
| 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 that occur 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. | |
| Compensation for the CEO is paid by a related organization. That Organization has a process for determining compensation that includes review by the independent board using comparability data and substantiation of the deliberation and decision. | ||
| 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 | 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 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 Bethany on 42nd. Compensation shown on Part VII, Column E is compensation paid to Sanford Health for his services as Medical Director to American Lutheran Homes, Inc. | |
| Form 990, Part XI, line 9: | Decrease in Interest in Bethany Homes, Inc -62,468. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| American Lutheran Homes Inc | |||||||||||
| 201 S University Drive | Fargo | ND | 58103 | 450274012 | Long-term care services, assisted living, independent living | ND | 501(c)(3) | Line 9 | Bethany Homes Inc | 1 | |
| 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 Homes Inc | |||||||||||
| 201 S University Drive | Fargo | ND | 58103 | 450394181 | Fundraising | ND | 501(c)(3) | Line 9 | 1 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| American Lutheran Homes Inc | ||
| P | 7803467 | General Ledger |
| Bethany Homes Inc | ||
| C | 163143 | General Ledger |
| American Lutheran Homes Inc | ||
| C | 129151 | General Ledger |
| American Lutheran Homes Inc | ||
| E | General Ledger | |
Comments