LYNGBLOMSTEN CARE CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LYNGBLOMSTEN CARE CENTER INC (EIN 41-1310487)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-08
IRS object ID
201332209349300443
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

FieldValueIRS element (for citing)
Timestamp2013-08-08T11:58:44-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411310487EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LYNGBLOMSTEN CARE CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLYNGNameControl
Phone6516462941Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11415 ALMOND AVENUEAddressLine1
CityST PAULCity
StateMNState
ZIP Code55108ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRADLEY J JACOBSONName
TitleCFOTitle
Phone6516462941Phone
Date Signed2013-07-26DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCORY RUTLEDGEName
PTINP01329381PTIN
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPAUL MIKELSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11415 ALMOND AVENUEAddressLine1
CityST PAULCity
StateMNState
ZIP Code55108ZIPCode
FieldValueIRS element (for citing)
Gross Receipts19402915GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number9386GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.LYNGBLOMSTEN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees497TotalNbrEmployees
Total Nbr Volunteers1278TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year73053ContributionsGrantsPriorYear
Contributions Grants Current Year155222ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19138746ProgramServiceRevenuePriorYear
Program Service Revenue CY18558754ProgramServiceRevenueCY
Investment Income Prior Year154544InvestmentIncomePriorYear
Investment Income Current Year78355InvestmentIncomeCurrentYear
Other Revenue Prior Year224504OtherRevenuePriorYear
Other Revenue Current Year106927OtherRevenueCurrentYear
Total Revenue Prior Year19590847TotalRevenuePriorYear
Total Revenue Current Year18899258TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1000000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY100000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year13499275SalariesEtcPriorYear
Salaries Etc Current Year13242554SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4925026OtherExpensePriorYear
Other Expenses Current Year5351923OtherExpensesCurrentYear
Total Expenses Prior Year19424301TotalExpensesPriorYear
Total Expenses Current Year18694477TotalExpensesCurrentYear
Revenues Less Expenses Prior Year166546RevenuesLessExpensesPriorYear
Revenues Less Expenses CY204781RevenuesLessExpensesCY
Total Assets BOY14126890TotalAssetsBOY
Total Assets EOY12898378TotalAssetsEOY
Total Liabilities BOY4039753TotalLiabilitiesBOY
Total Liabilities EOY2348822TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10087137NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10549556NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionINFLUENCED BY CHRIST, LYNGBLOMSTEN PROVIDES A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS IN ORDER TO PRESERVE AND ENHANCE THEIR QUALITY OF LIFE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense16761650Expense
Grants100000Grants
Revenue18558754Revenue
DescriptionTHE LYNGBLOMSTEN CARE CENTER, A 237-BED SKILLED NURSING FACILITY, PROVIDES BOTH SHORT-TERM REHABILITATION AND LONG-TERM HEALTHCARE, INCLUDING ALZHEIMER'S AND PARKINSON'S CARE. IN 2012, 696 PERSONS RECEIVED CARE-AN INCREASE OF 15% OVER THE PREVIOUS YEAR. CHAPLAINS, VOLUNTEERS, AND PROFESSIONAL STAFF ENSURE RESIDENTS RECEIVE QUALITY HEALTH CARE IN A DIGNIFIED MANNER. ALTHOUGH HEALTH ISSUES PREVENT THESE SENIORS FROM ENJOYING LIVING IN THEIR OWN HOMES, LYNGBLOMSTEN PROMOTES PERSON-CENTERED CARE, GIVING THESE OLDER ADULTS AS MANY CHOICES AND COMFORTS OF HOME AS POSSIBLE. EDUCATIONAL (INCLUDING THE ARTS) AND SOCIAL EVENTS ARE HOSTED TO ENHANCE THE LIVES OF THESE SENIORS AND THEIR FAMILIES.WHILE MANY PROJECTS WERE IN PROGRESS IN 2012 (INCLUDING, FOR EXAMPLE, LAUNCHING A PALLIATIVE CARE PROGRAM), A MAJOR THEME WAS INCREASING UTILIZATION OF TECHNOLOGY. THESE INITIATIVES INCLUDED THE IMPLEMENTATION OF ELECTRONIC MEDICATION ADMINISTRATION RECORDS, INSTALLATION OF A MEDICATION DISPENSING SYSTEM (LIKE A CUSTOMIZED ON-SITE MINI PHARMACY), PREPARATION FOR PAPERLESS CHARTING OF CARES GIVEN TO PATIENTS AND RESIDENTS, EXPANSION OF THE RESIDENT-FAMILY COMMUNICATION WEB TOOL (HOMESTREAM), AND CONCEPTUALIZING AN ELECTRONIC MENU ORDERING SYSTEM.LYNGBLOMSTEN CARE CENTER, INC. IS AFFILIATED WITH LYNGBLOMSTEN AND THE EVANGELICAL LUTHERAN CHURCH IN AMERICA.Description
Total Program Service Expense16761650TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109636NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees497NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BRADLEY J JACOBSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6516325310TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11415 ALMOND AVENUEAddressLine1
CityST PAULCity
StateMNState
ZIP Code55108ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
CAROL PLETCHER
CHAIR1.004.00XX000
CHARLES NORTON
VICE CHAIR1.004.00XX000
WILLIAM STACEY
TREASURER1.003.00XX000
WESLEY JOHNSON
SECRETARY1.003.00XX000
PAUL MIKELSON
CEO30.209.80XX1373074455717292
REV CARL BUETTEMEIR
DIRECTOR1.001.00X000
ELIZABETH DETLIE
DIRECTOR1.001.00X000
KIM DURKEE
DIRECTOR1.001.00X000
LEONARD EILTS
DIRECTOR1.001.00X000
GINGER FISCHER
DIRECTOR1.001.00X000
LESLIE GRANT
DIRECTOR1.001.00X000
ANDREW LOWTHER
DIRECTOR1.001.00X000
BETCHEN OBERDORFER
DIRECTOR1.001.00X000
BILL SANDEN
DIRECTOR1.001.00X000
TOM SCHULTZ
DIRECTOR1.001.00X000
REV PAM STOFFERAHN
DIRECTOR1.001.00X000
ESTHER TATLEY
DIRECTOR1.002.00X000
KAREN VENINGA
DIRECTOR1.001.00X000
HOWARD OSTREM
TREASURER (FORMER)1.003.00XX000
LARRY GRAY
SECRETARY (FORMER)1.003.00XX000
FERYLE BORGESON
DIRECTOR (FORMER)1.001.00X000
REV JAY EBERTH
DIRECTOR (FORMER)1.001.00X000
BRADLEY J JACOBSON
CFO36.004.00X105858014338
JEFF HEINECKE
ADMINISTRATOR40.000.00X97577020725
FieldValueIRS element (for citing)
Total Reportable Comp From Org340742TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs44557TotalReportableCompFrmRltdOrgs
Total Other Compensation52355TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Related Organizations155222RelatedOrganizations
Total Contributions155222TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column18558754TotalRevenueColumn
Related Or Exempt Function Income18558754RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue18558754TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column115389TotalRevenueColumn
Exclusion$115,389ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities460787Securities
Other5836Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities498952Securities
Other4705Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-38165Securities
Other1131Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-37034TotalRevenueColumn
Exclusion-$37,034ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
BEAUTY SHOP REVENUE900099107028$107,028
SATELITE TV REVENUE90009926365$26,365
TELEPHONE REVENUE90009921938$21,938

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-48404TotalRevenueColumn
Exclusion-$48,404ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue106927TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18899258TotalRevenueColumn
Related Or Exempt Function Income18558754RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$185,282ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total100000Total
Program Services100000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total388860Total
Management And General388860ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10239769Total
Program Services9632719ProgramServices
Management And General607050ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total261613Total
Program Services247496ProgramServices
Management And General14117ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1539941Total
Program Services1415372ProgramServices
Management And General124569ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total812371Total
Program Services730327ProgramServices
Management And General82044ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total17307Total
Management And General17307ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48700Total
Management And General48700ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total865343Total
Program Services725755ProgramServices
Management And General139588ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total30195Total
Management And General30195ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total555124Total
Program Services414019ProgramServices
Management And General141105ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total88809Total
Management And General88809ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total404085Total
Program Services362529ProgramServices
Management And General41556ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total48683Total
Program Services19161ProgramServices
Management And General29522ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1576Total
Program Services1414ProgramServices
Management And General162ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total925376Total
Program Services830210ProgramServices
Management And General95166ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total90849Total
Program Services81506ProgramServices
Management And General9343ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL SUPPLIES822274822274
LICENSE SURCHARGE667155667155
FOOD626428626428
PREADMISSION SCREENING5997759977

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total100042Total
Program Services25308ProgramServices
Management And General74734ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18694477Total
Program Services16761650ProgramServices
Management And General1932827ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1466051BOY
EOY1568843EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1462033BOY
EOY64189EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1409536BOY
EOY1667450EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY62942BOY
EOY15522EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis22490405LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec16020567LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7015224BOY
EOY6469838EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1984380BOY
EOY2372048EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY399180BOY
EOY399180EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY67042BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY260502BOY
EOY341308EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY14126890BOY
EOY12898378EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1427524BOY
EOY1619497EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY39126BOY
EOY51187EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2472612BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY100491BOY
EOY678138EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4039753BOY
EOY2348822EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10030860BOY
EOY10410724EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY56277BOY
EOY138832EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10087137BOY
EOY10549556EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14126890BOY
EOY12898378EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses204781ReconcilationRevenueExpenses
Reconciliation Unrealized Invest257636ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years428379CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years401086CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years49929CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year73053CurrentTaxYearMinus1Year
Current Tax Year155222CurrentTaxYear
Total1107669Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18084374CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18418142CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18345039CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19138746CurrentTaxYearMinus1Year
Current Tax Year18558754CurrentTaxYear
Total92545055Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18512753CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18819228CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18394968CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19211799CurrentTaxYearMinus1Year
Current Tax Year18713976CurrentTaxYear
Total93652724Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50993652724PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years147375CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years125937CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years179367CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year137185CurrentTaxYearMinus1Year
Current Tax Year115389CurrentTaxYear
Total705253Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years147375CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years125937CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years179367CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year137185CurrentTaxYearMinus1Year
Current Tax Year115389CurrentTaxYear
Total705253Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years56623CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years-187122CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years89336CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year224504CurrentTaxYearMinus1Year
Current Tax Year183055CurrentTaxYear
Total366396Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18716751CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18758043CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18663671CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19573488CurrentTaxYearMinus1Year
Current Tax Year19012420CurrentTaxYear
Total94724373Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98870PublicSupportPercentage509
Prior Year Support Percentage0.98910PriorYearSupportPercentage
Investment Income Percentage0.00740InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00850PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY SHOP REVENUE SATELITE TV REVENUE TELEPHONE REVENUE MISCELLANEOUS REVENUEGeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis94767OtherCostOrOtherBasis
Book Value94767BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis19706771OtherCostOrOtherBasis
Depreciation14087439Depreciation
Book Value5619332BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2591976OtherCostOrOtherBasis
Depreciation1867382Depreciation
Book Value724594BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis96891OtherCostOrOtherBasis
Depreciation65746Depreciation
Book Value31145BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6469838TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
CAPITAL LEASE OBLIGATION$5,853
ASSET RETIREMENT OBLIGATION$66,552
DEFERRED COMPENSATION PLAN$105,733
DUE TO RELATED PARTY$500,000
FieldValueIRS element (for citing)
Total Of Amounts678138TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 2B:THE CORPORATION IS THE TRUSTEE OF VARIOUS RESIDENT AND TENANT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. THESE FUNDS ARE ON DEPOSIT IN SEPARATE BANK ACCOUNTS AND INVESTMENTS.
PART X, LINE 2:THE CORPORATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE CORPORATION'S FINANCIAL STATEMENTS. THE CORPORATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2009 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1LYNGBLOMSTEN SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11415 ALMOND AVENUEAddressLine1
CityST PAULCity
StateMNState
ZIP Code55108ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient411760448EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant100000AmountOfCashGrant
Purpose Of GrantSUPPORT FOR COMMUNITY HOME BASED SERVICES TO THE ELDERLY.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: LYNGBLOMSTEN CARE CENTER MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. ALL RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITORS THE USE OF THESE FUNDS THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonPAUL MIKELSONNamePerson
TitleCEOTitle
Base Compensation Filing Org117249BaseCompensationFilingOrg
Comp Based On Related Orgs38048CompBasedOnRelatedOrgs
Bonus Filing Org7301BonusFilingOrg
Bonus Related Orgs2370BonusRelatedOrgs
Other Compensation Filing Org12757OtherCompensationFilingOrg
Other Compensation Related Orgs4139OtherCompensationRelatedOrgs
Deferred Comp Filing Org5054DeferredCompFilingOrg
Deferred Comp Related Orgs1640DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org8001NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs2597NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org150362TotalCompensationFilingOrg
Total Compensation Related Orgs48794TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE IS MADE UP THE CHAIR, VICE CHAIR, TREASURER, AND SECRETARY OF THE BOARD ALONG WITH PRESIDENT/CEO OF THE CORPORATION. ALL ITEMS APPROVED BY THE EXECUTIVE COMMITTEE ARE REAFFIRMED BY THE FULL BOARD AT THEIR NEXT MEETING.
FORM 990, PART VI, SECTION A, LINE 6THE BOARD OF DIRECTORS OF THE LYNGBLOMSTEN CORPORATION ARE THE MEMBERS OF LYNGBLOMSTEN CARE CENTER, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE CORPORATE CONGREGATIONS SEND DELEGATES TO THE LYNGBLOMSTEN ANNUAL MEETING, WHO AS MEMBERS OF THE LYNGBLOMSTEN CORPORATION ELECT THE LYNGBLOMSTEN CORPORATE BOARD. THE BOARD OF DIRECTORS OF LYNGBLOMSTEN CARE CENTER CONSISTS SOLELY OF DULY ELECTED AND QUALIFIED MEMBERS OF THE BOARD OF DIRECTORS OF THE LYNGBLOMSTEN CORPORATION. ELECTION AS A DIRECTOR OF THE LYNGBLOMSTEN CORPORATION CONSTITUTES ELECTION AS A DIRECTOR OF LYNGBLOMSTEN CARE CENTER FOR THE SAME TERM.
FORM 990, PART VI, SECTION A, LINE 7BCHANGES IN THE BYLAWS AND ARTICLES OF INCORPORATION REQUIRE MEMBERSHIP APPROVAL.
FORM 990, PART VI, SECTION B, LINE 11THE CFO AND CEO REVIEW THE DOCUMENT, WHICH IS EMAILED TO THE FINANCE COMMITTEE OF THE BOARD PRIOR TO THEIR MEETING FOR REVIEW AND COMMENT. THE BOARD RECEIVES THE DOCUMENT PRIOR TO THEIR BOARD MEETING BY EMAIL OR POSTING TO THEIR INTERNAL WEBSITE. PAPER COPIES ARE AVAILABLE AT THE BOARD MEETING FOR FURTHER DISCUSSION AND BOARD APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CAN UPDATED CONFLICT OF INTEREST POLICY IS SIGNED BY ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. THIS POLICY IS MONITORED BY THE CORPORATE COMPLIANCE OFFICER AND IF ANY CONFLICTS OF INTERESTS EXIST THAT INDIVIDUAL IS EXCLUDED FROM PARTICIPATION AND VOTING ON RELATED TRANSACTIONS.
FORM 990, PART VI, SECTION B, LINE 15ALYNGBLOMSTEN CARE CENTER, INC. RELIES ON THE LYNGBLOMSTEN CORPORATE BOARD'S EXECUTIVE COMMITTEE WHO REVIEWS AND SETS CEO'S COMPENSATION. THE CEO SETS THE ANNUAL EVALUATION PROCESS FOR OTHER OFFICERS AND KEY EMPLOYEES AND THE LYNGBLOMSTEN CARE CENTER, INC. BOARD APPROVES THE ANNUAL BUDGET. THE COMPENSATION REVIEW PROCESS IS CONDUCTED EACH YEAR IN JANUARY AND WAS LAST CONDUCTED IN JANUARY 2011. THE CORPORATE BOARD'S EXECUTIVE COMMITTEE ALSO PERFORMS A COMPENSATION STUDY APROXIMATELY EVERY 5 YEARS, LAST COMPLETED IN 2011.
FORM 990, PART VI, SECTION C, LINE 19ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
LYNGBLOMSTEN APARTMENTS INC
1455 ALMOND AVEST PAULMN55108411327121LOW INCOME SENIOR HOUSINGMN501(C)39LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC0
HERITAGE APARTMENTS INC
1440 MIDWAY PARKWAYST PAULMN55108411913420MARKET RATE SENIOR HOUSING, ASSISTED LIVING SERVIESMN501(C)39LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC0
LYNGBLOMSTEN FOUNDATION
1415 ALMOND AVEST PAULMN55108363371887FUNDRAISING FOR LYNGBLOMSTENMN501(C)37LYNGBLOMSTEN0
LYNGBLOMSTEN SERVICES INC
1415 ALMOND AVEST PAULMN55108411760448SENIOR CENTER, COMMUNITY SERVICES, HOME HEALTHMN501(C)39LYNGBLOMSTEN0
LYNGBLOMSTEN
1415 ALMOND AVEST PAULMN55108410693865MANAGEMENT OVERSIGHT SERVICES TO ALL LYNGBLOMSTEN ORGANIZATIONSMN501(C)390N/A
LYNGBLOMSTEN SENIOR HOUSING INC
1415 ALMOND AVEST PAULMN55108411913422MANAGEMENT OVERSIGHT SERVICES TO LYNGBLOMSTEN APTS & HERITAGE APTSMN501(C)39LYNGBLOMSTEN0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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