2013-04-11T13:28:27-05:00 2012-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2011-07-01 411704381 ST THERESE FOUNDATION INC STTH 7635315000 8000 BASS LAKE ROAD NEW HOPE MN 55428 MIKE WARDEN 7635315000 2013-03-15 1 JEFF VRIEZE P01273590 6123764500 2011 2016-02-25 16:41:14Z BARB RODE 8000 BASS LAKE ROAD NEW HOPE MN 55428 8202638 0 X WWW.STTHERESEMN.ORG X 1991 MN PROVIDING FUNDRAISING, PLANNING, AND OTHER SUPPORT TO AFFILIATED ORGANIZATIONS. 20 20 0 31 0 0 481946 3054690 0 606165 252320 237045 -30131 -15612 704135 3882288 86070 65692 0 0 131661 761368 16657 0 40524 94403 180046 328791 1007106 375344 2875182 5566918 17549980 168987 9822175 5397931 7727805 X PROVIDING FUNDRAISING, PLANNING, AND OTHER SUPPORT TO AFFILIATED ORGANIZATIONS. 1 0 263820 65692 0 FROM THE VERY BEGINING, ST. THERESE HAS TAKEN PRIDE IN THE FACT THAT IT HAS ALWAYS BEEN A GOOD MEMBER OF THE COMMUNITY. AS A NON-PROIT ORGANIZATION, ST. THERESE STRIVES TO HELP OTHER WITHIN OUR IMMEDIATE NEIGHBORHOOD AND BEYOND. WE BELIEVE IT IS ALSO IMPORTANT TO COMMUNICATE OUR OUTREACH AND SUPPORT OF THE GREATER COMMUNITY AS PART OF OUR MISSION. ST. THERESE FOUNDATION PROVIDES FUNDRAISING, LONG-RANGE PLANNING, AND OTHER SUPPORT TO AFFILIATED TAX EXEMPT ORGANIZATIONS. ST. THERESE FOUNDATION IS AFFILIATED WITH ST. THERESE HOME, WHICH OPERATES A 302-BED NURSING FACILITY AND A 221-UNIT RETIREMENT APARTMENT COMPLEX. THE FOUNDATION IS ALSO AFFILIATED WITH ST. THERESE AT OXBOW LAKE, A 142-UNIT SENIOR HOUSING PROJECT CONSISTING OF 82 INDEPENDENT UNITS, 41 ASSISTED LIVING UNITS, AND 19 MEMORY CARE UNITS.IN FISCAL YEAR 2011 - 2012, ST. THERESE FOUNDATION TRANSFERRED OVER $65,000 TO SUPPORT THE MISSIONS OF ST. THERESE HOME AND ST. THERESE OF OXBOW LAKE. 422103 0 606165 ST. THERESE AT HOMES SOLUTIONS, LLC WAS PURCHASED IN DECEMBER 2011 TO PROVIDE PRIVATE DUTY HOME CARE SERVICES TO THE SURROUNDING COMMUNITY. 0 0 0 OXBOW LAKE CARE CENTER, LLC WAS CREATED TO OWN AND OPERATE THE CARE SUITES WHICH WILL BE LICENSED AS A SKILLED NURSING FACILITY ON THE EXISTING CAMPUS OF OXBOW LAKE (CARE SUITES) AND PLANNED TO OPEN IN THE FALL OF 2012. 685923 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 7 0 0 0 0 0 0 1 1 1 1 0 0 0 1 0 X 20 20 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 MN X LARRY GROTZ 7635315476 8000 BASS LAKE ROAD NEW HOPE MN 55428 KAYE FOLEY 1.00 X X 0 0 0 DR CHRISTOPHER DOWNEY 1.00 X X 0 0 0 MARY ORTIZCAZARIN 1.00 X X 0 0 0 DAVID M HOFFMANN 1.00 X X 0 0 0 JOSEPH AMBERGMD 1.00 X 0 0 0 PATRICK J BORAN 1.00 X 0 0 0 FR MICHAEL BYRON 1.00 X 0 0 0 JERRY J CHOROMANSKI 1.00 X 0 0 0 LYNN CHOROMANSKI 1.00 X 0 0 0 RICHARD G FABER 1.00 X 0 0 0 FR JOSEPH GILLESPIE 1.00 X 0 0 0 STEPHEN G IMHOLTE 1.00 X 0 0 0 DAVID KRENN 1.00 X 0 0 0 JANE MCCROSSAN 1.00 X 0 0 0 SR KAREN SAMES 1.00 X 0 0 0 WAYNE H THALHUBER 1.00 X 0 0 0 RICHARD D THEILMANN 1.00 X 0 0 0 C DWIGHT TOWNES MD 1.00 X 0 0 0 PAUL VOGEL 1.00 X 0 0 0 JENNIFER SCHALTZ 1.00 X 0 0 0 KRISTIN KOPP 1.00 X 0 0 0 JOHN C MANION MD 1.00 X 0 0 0 BARBARA RODE 8.00 X 0 207522 6196 MIKE WARDEN 10.00 X 0 169533 2661 JOHN LEBLANC 30.00 X 0 123992 13031 0 501047 21888 0 0 1 0 0 222627 2455214 376849 3054690 CAREGIVER/CNA SERVICES 623000 606165 606165 606165 153144 153144 4364724 4280823 83901 83901 83901 23915 222627 39527 -15612 -15612 3882288 606165 0 221433 65692 65692 694066 471071 222995 506 301 205 21589 18351 3238 45207 38426 6781 15526 15526 39839 39839 24772 15409 9363 5163 5163 45011 7135 37876 155 155 7934 3367 4567 2226 2226 1070 637 433 1887 1065 822 EQUIPMENT LEASE 29278 29278 MISCELLANEOUS 2768 2487 281 FOOD 2258 110 2148 ASSOCIATION DUES 1231 1231 928 428 500 1007106 685923 280659 40524 265919 422734 48058 134171 132304 24 13142 11930713 59450 0 11871263 4858371 4618351 419942 151618 181001 5566918 17549980 16035 1753495 7225294 2400 152952 840986 168987 9822175 X 4582801 6617506 641623 1068840 173507 41459 5397931 7727805 5566918 17549980 X 2875182 -545308 X 0 1 1 X 0 X 399405 335864 364396 481946 3054690 4636301 399405 335864 364396 481946 3054690 4636301 157602 4478699 182736 170117 162341 142994 153144 811332 1024 10 1034 5448667 704507 0.82200 0.69150 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME FROM VARIOUS SOURCES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 354147 335653 2889 2889 689800 324447 29700 22177 22177 354147 257180 67267 12448 12448 324447 100000 157180 1718 1718 257180 0.70000 0.30000 1 0 618214 618214 66960 59450 7510 11245539 11245539 11871263 DUE TO AFFILIATES 840986 840986 PART IV, LINE 2B: OXBOW LAKE CARE CENTER, LLC COLLECTS A SECURITY DEPOSIT FROM TENANTS UPON ENTERING THE FACILITY. THE FEE IS FULLY REFUNDABLE WITH INTEREST WHEN THE RESIDENT MOVES OUT. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO FURTHER THE MISSION OF ST. THERESE HOME, INC. AND ST. THERESE AT OXBOW LAKE, INC., WHICH INCLUDES PROVIDING HOUSING, NURSING CARE AND PASTORAL CARE TO THE ELDERLY. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION IN THE U.S. FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES THAT MAY JEOPARDIZE ITS TAX-EXEMPT STATUS. THE TAX RETURNS FOR THE YEARS 2008 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. ASSOCIATE DINNER 136145 122870 13275 15165 1500 5685 GOLF EVENT 89365 78725 10640 165 10863 2014 1 21032 21032 4135 246542 222627 23915 165 26028 1500 11834 39527 -15612 1 ST THERESE HOME INC 8000 BASS LAKE ROAD NEW HOPE MN 55428 410888641 501(C)(3) 63422 GENERAL OPERATING SUPPORT 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS ARE MADE TO RELATED ORGANIZATIONS THAT ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITOR THE ACTIVITIES, REVENUES AND EXPENDITURES OF THE RELATED ORGANIZATIONS. 0 0 0 0 0 0 0 0 0 BARBARA RODE 0 199522 0 8000 0 0 0 5759 0 437 0 213718 0 0 MIKE WARDEN 0 150490 0 19043 0 0 0 2013 0 648 0 172194 0 0 SUPPLEMENTAL INFORMATION PART III PART I, LINE 3 THE CEO'S COMPENSATION IS DETERMINED BY ST. THERESE HOME, INC., AN AFFILIATED ORGANIZATION. ST. THERESE HOME, INC. USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEY OR STUDY 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE KRISTIN KOPP KRISTIN KOPP IS A FORMER DIRECTOR OF ST. THERESE FOUNDATION, INC. 175000 ST. THERESE AT HOME SOLUTIONS, LLC, A WHOLLY OWNED SUBSIDIARY OF ST. THERESE FOUNDATION, INC. PURCHASED AT HOME SOLUTIONS, LLC. OF WHICH KRISTIN KOPP WAS THE OWNER. 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 ST. THERESE AT HOMES SOLUTIONS, LLC WAS PURCHASED IN DECEMBER 2011 TO PROVIDE PRIVATE DUTY HOME CARE SERVICES TO THE SURROUNDING COMMUNITY. OXBOW LAKE CARE CENTER, LLC WAS CREATED TO OWN AND OPERATE THE CARE SUITES WHICH WILL BE LICENSED AS A SKILLED NURSING FACILITY ON THE EXISTING CAMPUS OF OXBOW LAKE (CARE SUITES) AND PLANNED TO OPEN IN THE FALL OF 2012. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS ENTIRELY COMPOSED OF THE GOVERNING BODY MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS OF THIS CORPORATION IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, AND THE EXECUTIVE COMMITTEE SHALL AT ALL TIMES BE SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 JERRY J. CHOROMANSKI AND LYNN CHOROMANSKI - FAMILY RELATIONSHIP FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE AND IS SUBMITTED FOR BOARD APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS AND KEY MANAGEMENT EMPLOYEES ARE ANNUALLY REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. THE DISCLOSURES ARE REPORTED TO THE BOARD OF DIRECTORS. INDIVIDUALS HAVING MATERIAL CONFLICTS OF INTEREST ARE ASKED TO REFRAIN FROM VOTING ON ANY ACTION THAT MAY BE INFLUENCED BY THE CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -545,308. AVERAGE WEEKLY HOURS FORM 990, PART VII, SECTION A THE COMPENSATED OFFICERS OF ST. THERESE FOUNDATION, INC. ALSO SPEND TIME EACH WEEK SERVING THE FOUNDATION'S AFFILIATED ORGANIZATIONS. THE TIME OF BARB RODE, PRESIDENT & CEO, WAS SPENT AS FOLLOWS: ST. THERESE FOUNDATION, INC.: 8 HOURS ST. THERESE HOME, INC.: 24 HOURS ST. THERESE AT OXBOW LAKE, INC.: 8 HOURS THE TIME OF MIKE WARDEN, CFO, WAS SPENT AS FOLLOWS: ST. THERESE FOUNDATION, INC.: 10 HOURS ST. THERESE HOME, INC.: 20 HOURS ST. THERESE AT OXBOW LAKE, INC.: 10 HOURS THE TIME OF JOHN LEBLANC, FOUNDATION DIRECTOR, WAS SPENT AS FOLLOWS: ST. THERESE FOUNDATION, INC.: 30 HOURS ST. THERESE HOME, INC.: 10 HOURS IN ADDITION TO THE ABOVE, KAYE FOLEY ALSO SERVED AS A BOARD MEMBER OF ST. THERESE HOME, INC. AND ST. THERESE AT OXBOW LAKE, INC. ON AVERAGE SHE SPENT ONE HOUR PER WEEK IN THE SERVICE OF EACH ENTITY. IN ADDITION TO THE ABOVE, JOSEPH AMBERG, LYNN CHOROMANSKI, STEPHEN IMHOLTE, JENNIFER SHALTZ, WAYNE THALHUBER, AND JOHN MANION ALSO SERVED AS A BOARD MEMBER OF ST. THERESE HOME, INC. ON AVERAGE EACH BOARD MEMBER SPENT ONE HOUR PER WEEK IN THE SERVICE OF EACH ENTITY. IN ADDITION TO THE ABOVE, PATRICK BORAN, JERRY CHOROMANSKI, WM CHRISTOPHER DOWNEY, FR. JOSEPH GILLESPIE, JANE MCCROSSAN, SR. KAREN SAMES, AND C DWIGHT TOWNES ALSO SERVED AS A BOARD MEMBER OF ST. THERESE AT OXBOW LAKE, INC. ON AVERAGE EACH BOARD MEMBER SPENT ONE HOUR PER WEEK IN THE SERVICE OF EACH ENTITY. OXBOW LAKE CARE CENTER LLC 8000 BASS LAKE ROAD NEW HOPE MN 55428 273308934 SKILLED NURSING FACILITY MN 0 12777418 ST THERESE FOUNDATION INC ST THERESE AT HOME SOLUTIONS LLC 8000 BASS LAKE ROAD NEW HOPE MN 55428 454049467 PRIVATE DUTY HOME SERVICES MN 606175 338577 ST THERESE FOUNDATION INC ST THERESE HOME INC 8000 BASS LAKE ROAD NEW HOPE MN 55428 410888641 HOUSING & NURSING CARE FOR THE ELDERLY MN 501(C)(3) 9 ST THERESE FOUNDATION INC 1 ST THERESE AT OXBOW LAKE INC 8000 BASS LAKE ROAD NEW HOPE MN 55428 205835911 HOUSING & NURSING CARE FOR THE ELDERLY MN 501(C)(3) 7 ST THERESE FOUNDATION INC 1 0 1 1 0 0 1 0 0 0 0 1 1 1 1 1 0 1 0 ST THERESE HOME INC B 63422 CASH TRANSFER ST THERESE HOME INC C 1000000 EQUITY TRANSFER ST THERESE AT OXBOW LAKE INC C 1455214 EQUITY TRANSFER