2013-08-08T11:58:44-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2012-01-01 411310487 LYNGBLOMSTEN CARE CENTER INC LYNG 6516462941 1415 ALMOND AVENUE ST PAUL MN 55108 BRADLEY J JACOBSON 6516462941 2013-07-26 1 CORY RUTLEDGE P01329381 6123764500 2012 2016-02-24 21:20:13Z PAUL MIKELSON 1415 ALMOND AVENUE ST PAUL MN 55108 19402915 0 9386 X WWW.LYNGBLOMSTEN.ORG X 1976 MN TO PROVIDE A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS. 18 17 497 1278 0 0 73053 155222 19138746 18558754 154544 78355 224504 106927 19590847 18899258 1000000 100000 0 0 13499275 13242554 0 0 0 4925026 5351923 19424301 18694477 166546 204781 14126890 12898378 4039753 2348822 10087137 10549556 X INFLUENCED 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. 0 0 16761650 100000 18558754 THE 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. 16761650 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 36 0 497 1 0 0 0 0 0 0 0 0 0 0 X 18 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X BRADLEY J JACOBSON 6516325310 1415 ALMOND AVENUE ST PAUL MN 55108 CAROL PLETCHER 1.00 4.00 X X 0 0 0 CHARLES NORTON 1.00 4.00 X X 0 0 0 WILLIAM STACEY 1.00 3.00 X X 0 0 0 WESLEY JOHNSON 1.00 3.00 X X 0 0 0 PAUL MIKELSON 30.20 9.80 X X 137307 44557 17292 REV CARL BUETTEMEIR 1.00 1.00 X 0 0 0 ELIZABETH DETLIE 1.00 1.00 X 0 0 0 KIM DURKEE 1.00 1.00 X 0 0 0 LEONARD EILTS 1.00 1.00 X 0 0 0 GINGER FISCHER 1.00 1.00 X 0 0 0 LESLIE GRANT 1.00 1.00 X 0 0 0 ANDREW LOWTHER 1.00 1.00 X 0 0 0 BETCHEN OBERDORFER 1.00 1.00 X 0 0 0 BILL SANDEN 1.00 1.00 X 0 0 0 TOM SCHULTZ 1.00 1.00 X 0 0 0 REV PAM STOFFERAHN 1.00 1.00 X 0 0 0 ESTHER TATLEY 1.00 2.00 X 0 0 0 KAREN VENINGA 1.00 1.00 X 0 0 0 HOWARD OSTREM 1.00 3.00 X X 0 0 0 LARRY GRAY 1.00 3.00 X X 0 0 0 FERYLE BORGESON 1.00 1.00 X 0 0 0 REV JAY EBERTH 1.00 1.00 X 0 0 0 BRADLEY J JACOBSON 36.00 4.00 X 105858 0 14338 JEFF HEINECKE 40.00 0.00 X 97577 0 20725 340742 44557 52355 2 0 1 0 0 155222 155222 RESIDENT SERVICES 623000 18558754 18558754 18558754 115389 115389 460787 5836 498952 4705 -38165 1131 -37034 -37034 BEAUTY SHOP REVENUE 900099 107028 107028 SATELITE TV REVENUE 900099 26365 26365 TELEPHONE REVENUE 900099 21938 21938 -48404 -48404 106927 18899258 18558754 0 185282 100000 100000 388860 388860 10239769 9632719 607050 261613 247496 14117 1539941 1415372 124569 812371 730327 82044 17307 17307 48700 48700 865343 725755 139588 30195 30195 555124 414019 141105 88809 88809 404085 362529 41556 48683 19161 29522 1576 1414 162 925376 830210 95166 90849 81506 9343 MEDICAL SUPPLIES 822274 822274 LICENSE SURCHARGE 667155 667155 FOOD 626428 626428 PREADMISSION SCREENING 59977 59977 100042 25308 74734 18694477 16761650 1932827 0 1466051 1568843 1462033 64189 1409536 1667450 62942 15522 22490405 16020567 7015224 6469838 1984380 2372048 399180 399180 67042 0 260502 341308 14126890 12898378 1427524 1619497 39126 51187 2472612 0 100491 678138 4039753 2348822 X 10030860 10410724 56277 138832 10087137 10549556 14126890 12898378 204781 257636 0 X 0 1 X 1 0 X 428379 401086 49929 73053 155222 1107669 18084374 18418142 18345039 19138746 18558754 92545055 18512753 18819228 18394968 19211799 18713976 93652724 0 0 0 93652724 147375 125937 179367 137185 115389 705253 147375 125937 179367 137185 115389 705253 56623 -187122 89336 224504 183055 366396 18716751 18758043 18663671 19573488 19012420 94724373 0.98870 0.98910 0.00740 0.00850 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY SHOP REVENUE SATELITE TV REVENUE TELEPHONE REVENUE MISCELLANEOUS REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 94767 94767 19706771 14087439 5619332 2591976 1867382 724594 96891 65746 31145 6469838 CAPITAL LEASE OBLIGATION 5853 ASSET RETIREMENT OBLIGATION 66552 DEFERRED COMPENSATION PLAN 105733 DUE TO RELATED PARTY 500000 678138 X 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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. 1 LYNGBLOMSTEN SERVICES INC 1415 ALMOND AVENUE ST PAUL MN 55108 411760448 501(C)(3) 100000 SUPPORT FOR COMMUNITY HOME BASED SERVICES TO THE ELDERLY. 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE 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. X X X X 0 0 0 0 0 0 0 0 0 PAUL MIKELSON 117249 38048 7301 2370 12757 4139 5054 1640 8001 2597 150362 48794 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE 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 6 THE BOARD OF DIRECTORS OF THE LYNGBLOMSTEN CORPORATION ARE THE MEMBERS OF LYNGBLOMSTEN CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE 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 7B CHANGES IN THE BYLAWS AND ARTICLES OF INCORPORATION REQUIRE MEMBERSHIP APPROVAL. FORM 990, PART VI, SECTION B, LINE 11 THE 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 12C AN 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 15A LYNGBLOMSTEN 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 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. LYNGBLOMSTEN APARTMENTS INC 1455 ALMOND AVE ST PAUL MN 55108 411327121 LOW INCOME SENIOR HOUSING MN 501(C)3 9 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 HERITAGE APARTMENTS INC 1440 MIDWAY PARKWAY ST PAUL MN 55108 411913420 MARKET RATE SENIOR HOUSING, ASSISTED LIVING SERVIES MN 501(C)3 9 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVE ST PAUL MN 55108 363371887 FUNDRAISING FOR LYNGBLOMSTEN MN 501(C)3 7 LYNGBLOMSTEN 0 LYNGBLOMSTEN SERVICES INC 1415 ALMOND AVE ST PAUL MN 55108 411760448 SENIOR CENTER, COMMUNITY SERVICES, HOME HEALTH MN 501(C)3 9 LYNGBLOMSTEN 0 LYNGBLOMSTEN 1415 ALMOND AVE ST PAUL MN 55108 410693865 MANAGEMENT OVERSIGHT SERVICES TO ALL LYNGBLOMSTEN ORGANIZATIONS MN 501(C)3 9 N/A 0 LYNGBLOMSTEN SENIOR HOUSING INC 1415 ALMOND AVE ST PAUL MN 55108 411913422 MANAGEMENT OVERSIGHT SERVICES TO LYNGBLOMSTEN APTS & HERITAGE APTS MN 501(C)3 9 LYNGBLOMSTEN 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1