2013-10-18T12:41:22-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2012-01-01 410841103 HAMMER RESIDENCES INC HAMM 9524731261 1909 EAST WAYZATA BOULEVARD WAYZATA MN 55391 JOHN ESTREM 9524731261 2013-10-14 1 CHAD LASSEN P01587992 6123764500 2012 2016-02-24 21:20:13Z JOHN ESTREM 1909 EAST WAYZATA BOULEVARD WAYZATA MN 55391 21169842 0 X WWW.HAMMER.ORG X 1960 MN GIVE PEOPLE WITH DEVELOPMENTAL DISABILITIES THE OPPORTUNITY TO EXPERIENCE LIFE TO ITS FULLEST. 18 18 571 638 0 0 845806 667603 17960258 20309705 147467 171247 2382 -15443 18955913 21133112 18746 27281 0 0 13683429 15326279 0 0 147666 5257348 5999216 18959523 21352776 -3610 -219664 18401922 18341866 6344745 6090617 12057177 12251249 X TO PROVIDE PEOPLE WITH DEVELOPMENTAL DISABILITIES THE OPPORTUNITY TO EXPERIENCE LIFE TO ITS FULLEST. 1 0 18562538 27281 20042766 RESIDENTIAL SERVICES:HAMMER PROVIDES A HOLISTIC AND PERSON-CENTERED APPROACH TO RESIDENTIAL AND SUPPORT SERVICES FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. EACH INDIVIDUAL LIVING AT HAMMER IS ENCOURAGED TO UNCOVER WHAT LIVING LIFE TO ITS FULLEST MEANS TO THEM. HAMMER PROGRAMS ARE DESIGNED TO MEET THE PHYSICAL WELL-BEING, PSYCHOLOGICAL, SOCIAL, SPIRITUAL, EDUCATIONAL, AND RECREATIONAL NEEDS OF EACH PERSON WE SUPPORT. OUR FULL-TIME NURSES PROVIDE OVERSIGHT TO EACH PERSON'S HEALTH CARE NEEDS. HAMMER PARTNERS WITH EACH INDIVIDUAL AND HIS/HER FAMILY TO CREATE A LIFE EXPERIENCE THAT IS FULLFILLING AND MEANINGFUL. 0 CUSTOMIZED SUPPORT SERVICES:HAMMER PROVIDES NUMEROUS CUSTOMIZED SUPPORT SERVICES TO INDIVIDUALS WITH DISABILITIES IN MINNSOTA. THROUGH A CONTRACT WITH HENNEPIN COUNTY, HAMMER PROVIDES CASE MANAGEMENT SERVICES TO PEOPLE THROUGHOUT THE STATE. HAMMER CASE MANAGERS PROVIDE SUPPORT IN ACCESSING AND COORDINATING SERVICES FOR INDIVIDUALS. WE ALSO PROVIDE SUPPORT PLANNING SERVICES. OUR SUPPORT PLANNERS HELP DEVELOP, MONITOR AND ASSIST WITH REVISIONS TO EACH PERSON'S COMMUNITY SUPPORT PLAN. ANOTHER AREA IN OUR CUSTOMIZED SUPPORT SERVICES IS A MANAGED CARE CONTRACT UNDER WHICH WE PROVIDE CARE COORDINATION OF THE INDIVIDUAL'S HEALTH SERVICES. 595974 0 266939 TRAVEL PROGRAM:HAMMER HAS DEVELOPED AN EXTENSION IN ITS MISSION WHICH PROVIDES TRAVEL EXPERIENCES FOR PEOPLE WITH DISABILITIES. THIS SERVICE HELPS WITH THE PLANNING AND COORDINATION OF TRAVEL ARRANGEMENTS FOR THE DISABLED INDIVIDUAL. THESE EXPERIENCES HELP DEVELOP THE INDIVIDUAL'S LIVING SKILLS. THE OFFERINGS TEACH INDEPENDENCE, TRAVEL ABILITIES, MANAGEMENT OF CIRCUMSTANCES AND LIFE EXPERIENCES FOR BOTH THE DISABLED INDIVIDUAL AS WELL AS THE CARE GIVER. THIS HELPS DEVELOP LIFE SKILLS. THE SERVICE IS PROVIDED BY HAMMER TRAVEL, LLC WHICH IS A SINGLE MEMBER LLC IN WHICH HAMMER RESIDENCES IS THE SOLE MEMBER. 19158512 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 64 0 571 1 0 0 0 0 0 1 1 0 0 0 0 X 18 18 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 MN X X JAMES LANDT 9522772439 1909 E WAYZATA BLVD WAYZATA MN 55391 JON MATEJCEK 5.00 X X 0 0 0 BARBARA TUCKNER 3.00 X X 0 0 0 JOE REIS 5.00 X X 0 0 0 WILLIAM YOUNG 3.00 X X 0 0 0 LISA ANDERSON 2.00 X 0 0 0 SONDRA DAHMER 2.00 X 0 0 0 LISA DONGOSKA 2.00 X 0 0 0 BETH FONDELL 2.00 X 0 0 0 REBECCA FURNIVAL 2.00 X 0 0 0 LINDA HOLMEN 2.00 X 0 0 0 DAY JAMES 2.00 X 0 0 0 STEPHEN LEVOIR 2.00 X 0 0 0 MICHELLE LUREEN 2.00 X 0 0 0 JANE SHAFFER 2.00 X 0 0 0 TOM SILVER 2.00 X 0 0 0 DONALD SMITHMIER 2.00 X 0 0 0 BRUCE VOLKART 2.00 X 0 0 0 ALAN WILENSKY 2.00 X 0 0 0 JOHN ESTREM 40.00 X 114164 0 5133 LISBETH ARMSTRONG 40.00 X 27672 0 2480 JAMES LANDT 40.00 X 93612 0 12825 235448 0 20438 1 0 0 0 0 100702 566901 667603 RESIDENT REVENUE 623990 20042766 20042766 TRAVEL PROGRAM 623990 266939 266939 20309705 171247 171247 14000 100702 36730 -22730 -22730 MISECELLANEOUS REVENUE 900099 7287 7287 7287 21133112 20309705 0 155804 27281 27281 254086 23859 204950 25277 12194453 11380684 777430 36339 161537 147716 12120 1701 1816429 1661017 136286 19126 899774 801378 84063 14333 12124 12124 38123 38123 518076 398361 106111 13604 90822 12729 75507 2586 440013 326057 95029 18927 1855499 1810905 35409 9185 378202 370293 7021 888 196 196 131574 126369 5205 810483 806300 4183 83506 79677 3829 FOOD 779126 773139 5987 RECREATION ACTIVITIES 228223 3363 224860 DUES & SUBCRIPTIONS 96959 81355 15109 495 LICENSES & PERMITS 90067 90067 446223 237962 208261 21352776 19158512 2046598 147666 216077 139382 1711344 1747074 54721 107790 20101369 9195372 11187159 10905997 4933149 5297332 152655 0 101910 84499 44907 59792 18401922 18341866 1945877 1942137 3708231 2635280 199200 662579 491437 850621 6344745 6090617 X 11108040 11272616 435535 394816 513602 583817 12057177 12251249 18401922 18341866 -219664 413736 0 X 0 1 X 1 1 1 X 571999 468177 603498 845806 667603 3157083 571999 468177 603498 845806 667603 3157083 194306 2962777 180878 208237 171338 147467 171247 879167 141616 96395 97865 12925 7287 356088 4392338 85560707 0.67450 0.60370 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 147658 99862 0 513602 20156 64264 14205 583817 494571 27731 8920 17620 513602 438082 11174 58542 13227 494571 378912 5556 67840 14226 438082 483505 16956 -105175 16374 378912 0.00000 1.00000 0.00000 0 0 1363002 1363002 12886946 5238540 7648406 958351 140060 818291 4893070 3816772 1076298 10905997 PROPERTY ASSESSMENTS 13621 LINE OF CREDIT 837000 850621 X 20042766 36730 36730 20006036 1127076 1127076 21133112 21205110 36730 36730 21168380 184396 184396 21352776 PART IV, LINE 1B: THE ORGANIZATION IS CUSTODIAN FOR RESIDENTS' PERSONAL FUNDS HELD IN SAFEKEEPING. MINNESOTA STATUTES REGULATE ACCOUNTING AND REPORTING PROCEDURES. THE FIDUCIARY LIABILITY FOR RESIDENTS' PERSONAL FUNDS AT DECEMBER 31, 2012 AND 2011 WAS $99,862 AND $147,658, RESPECTIVELY. THESE ACCOUNTS ARE NOT REPORTED IN THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENTS ARE INTENDED FOR THE TRAINING AND EDUCATION OF HAMMER STAFF, RESIDENTS, AND FOR THE GENERAL OPERATIONS OF HAMMER RESIDENCES, INC. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS ORGANIZED AS A MINNESOTA NONPROFIT CORPORATION AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS ADOPTED THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE IMPLEMENTATION OF THE ACCOUNTING STANDARDS REGARDING UNCERTAIN TAX PROVISIONS HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION FILES ALL PROPER RETURNS RELATED TO UNRELATED BUSINESS INCOME AND PROPERLY DISCLOSES SUCH ACTIVITIES. THE TAX FILINGS FOR THE YEARS 2009 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 36,730. PART XI, LINE 4B - OTHER ADJUSTMENTS: UNRESTRICTED PUBLIC SUPPORT 412,646. OTHER INCOME 274,226. UNRESTRICTED INVESTMENT INCOME 121,188. TEMPORARILY RESTRICTED CONTRIBUTIONS 248,801. PERMANENTLY RESTRICTED CONTRIBUTIONS 20,156. PERMANENTLY RESTRICTED NET INVESTMENT INCOME 50,059. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 36,730. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 184,396. REACH FOR RALPH 114702 100702 14000 1000 18268 6008 9454 2000 114702 100702 14000 1000 18268 6008 9454 2000 36730 -22730 1 SCHOLARSHIPS 2 27281 N/A N/A PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: EDUCATIONAL EXPENSE RELATED VOUCHERS AND EXPENSES ARE SUBMITTED AND VERIFIED. A CITY OF WAYZATA MINNESOTA 416005630 2006-12-27 2500000 FACILITY ACQUISITION 0 0 0 B CITY OF GOLDEN VALLEY MINNESOTA 2008-01-17 800000 FACILITY ACQUISITION 0 0 0 C CITY OF WAYZATA MINNESOTA 416005630 2010-07-01 1302945 REFINANCING 0 0 0 A 1357750 2500000 36351 2463649 0 0 1 1 B 315230 800000 32162 767838 0 0 1 1 C 294685 1302945 68975 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 0 NORTH AMERICAN BANKING COMPANY FORMER BOARD MEMBER/CURRENT MEMBER OF THE FINANCE COMMITTEE 1500000 DENNIS BILSKI IS THE VICE PRESIDENT OF NORTH AMERICAN BANKING COMPANY WHICH ISSUED LINE OF CREDIT OF $1,500,000 TO THE ORGANIZATION. THE OUTSTANDING BALANCE AS OF 12/31/12 WAS $837,000. 0 NORTH AMERICAN BANKING COMPANY FORMER BOARD MEMBER/CURRENT MEMBER OF THE FINANCE COMMITTEE 53903 THE TOTAL INTEREST EXPENSE FOR 2012 PAID TO NORTH AMERICAN BANKING COMPANY WAS $53,903 FOR THE LINE OF CREDIT OF 1,500,000. 0 NORTH AMERICAN BANKING COMPANY FORMER BOARD MEMBER/CURRENT MEMBER OF THE FINANCE COMMITTEE 554679 DENNIS BILSKI IS THE VICE PRESIDENT OF NORTH AMERICAN BANKING COMPANY WHICH GAVE LOAN OF $750,000 TO THE ORGANZATION. THE OUTSTANDING BALANCE AS OF 12/31/12 IS $554,679. 0 NORTH AMERICAN BANKING COMPANY FORMER BOARD MEMBER/CURRENT MEMBER OF THE FINANCE COMMITTEE 32922 THE TOTAL INTEREST EXPENSE FOR 2012 PAID TO NORTH AMERICAN BANKING COMPANY WAS $32,922 FOR THE LOAN PAYABLE OF $554,679. 0 CONTINUATION OF ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 EACH PERSON LIVING AT HAMMER IS PROVIDED THE PRIVACY OF HAVING HIS OR HER OWN BEDROOM AS WELL AS AMPLE SHARED LIVING SPACE. HAMMER HOMES ARE CONTINUALLY ADAPTED TO MEET THE CHANGING PHYSICAL NEEDS OF OUR RESIDENTS. HAMMER ALSO OFFERS SKILLED, PART-TIME IN-HOME SUPPORT STAFF TO FAMILIES WHO HAVE DECIDED TO KEEP THEIR LOVED ONE, MOST OFTEN A CHILD, IN THE HOME. HAMMER ALSO OFFERS CASE MANAGEMENT SERVICES FOR HENNEPIN COUNTY CLIENTS, HELPING FAMILIES FIND SERVICES THAT BEST MEET THEIR NEEDS. HAMMER PROGRAMS ARE DESIGNED TO MEET THE PSYCHOLOGICAL, SOCIAL, RELIGIOUS, EDUCATIONAL, VOCATION AND RECREATIONAL NEEDS OF EACH INDIVIDUAL RESIDENT. HAMMER'S DEDICATED TEAMS OF PROGRAM, NURSING, MAINTENANCE, AND ADMINISTRATIVE STAFF MEMBERS ARE ALL COMMITTED TO PROVIDING WHATEVER SUPPORT WE CAN--TRAINING, ACCESSIBILITY, ENCOURAGEMENT, EVEN FINANCIAL ASSISTANCE, WHEN POSSIBLE--TO HELP THE PEOPLE WE SERVE PURSUE THEIR OWN UNIQUE INTERESTS AND DREAMS. NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 IN CONJUNCTION WITH MEDICA, HAMMER ADDED HEALTH CARE COORDINATION/MANAGED CARE SERVICES, OUR HEALTH CARE COORDINATORS WORK WITH INDIVIDUALS TO COORDINATE THEIR HEALTH CARE NEEDS. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE, CONSISTING OF THE OFFICERS OF THE BOARD AND THE IMMEDIATE PAST PRESIDENT. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD IN THE GOVERNANCE OF THE BUSINESS OF THE ORGANIZATION, INCLUDING THE AUTHORITY TO DO WHAT IT DEEMS NECESSARY AND PROPER FOR THE CONDUCT OF THE ORGANIZATION'S AFFAIRS AND THE MANAGEMENT OF ITS PROPERTY. FORM 990, PART VI, SECTION A, LINE 6 PARENTS OR GUARDIANS OF HAMMER RESIDENTS ARE DEEMED MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS RATIFY THE BOARD OF DIRECTORS' ACTIONS AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD'S FINANCE COMMITTEE REVIEWED AND APPROVED THE FORM 990. A FINAL COPY WAS PROVIDED TO THE BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER SHALL ANNUALLY COMPLETE A DISCLOSURE FORM IDENTIFYING ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES IN WHICH THE BOARD MEMBER IS INVOLVED THAT HE OR SHE BELIEVES COULD CONTRIBUTE TO A CONFLICT OF INTEREST ARISING. THIS POLICY SHALL BE REVIEWED ANNUALLY BY EACH MEMBER OF THE BOARD OF DIRECTORS. PRIOR TO DISCUSSING ANY TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST, THE CONFLICTED INDIVIDUAL DISCLOSES ALL MATERIAL FACTS. SUCH DISCLOSURE IS REFLECTED IN THE BOARD MINUTES. THE CONFLICTED INDIVIDUAL MUST LEAVE THE ROOM FOR THE REMAINING DISCUSSION OF THE TRANSACTION AND FOR ANY VOTES CONCERNING THE TRANSACTION. IF IT IS UNCLEAR WHETHER A CONFLICT EXISTS, THE DECISION IS MADE BY THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD'S EXECUTIVE COMMITTEE DETERMINES THE COMPENSATION OF THE CEO BY REVIEWING HIS PERFORMANCE RELATIVE TO GOALS AND TAKING INTO ACCOUNT PREVAILING MARKET GUIDELINES AND PRACTICES. THE PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2012, HIS DATE OF HIRE. AN INDEPENDENT STUDY WAS CONDUCTED BY PROFESSIONAL CONSULTANTS IN 2008, WITH SUBSEQUENT ANNUAL EVALUATIONS BASED ON AVAILABLE MARKET DATA FOR DETERMINING COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE LOCATED IN PUBLIC REFERENCE SOURCES AND ARE MADE AVAILABLE UPON REQUEST. HAMMER TRAVEL LLC 1909 EAST WAYZATA BOULEVARD WAYZATA MN 55391 270539859 TRAVEL SERVICES FOR DEVELOPMENTALLY DISABLED MN 269939 91785 HAMMER RESIDENCES INC