2013-08-14T09:02:28-05:00 2012-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2011-10-01 411465334 PRESBYTERIAN HOMES FOUNDATION PRES 6516316120 2845 NORTH HAMLINE AVENUE ROSEVILLE MN 55113 MARK MEYER 6516316120 2013-08-13 1 TERRANCE O'REILLY P00068340 6123764500 2011 2016-02-24 21:20:13Z DAN LINDH 2845 NORTH HAMLINE AVENUE ROSEVILLE MN 55113 9287969 0 X WWW.PRESHOMES.ORG X 1982 MN TO ENRICH THE LIVES OF OLDER ADULTS THROUGH SERVICES & COMMUNITIES THAT REFLECT THE LOVE OF GOD. 3 1 0 1 0 0 9356199 2515258 0 0 717615 6772711 0 0 10073814 9287969 8210645 3525185 0 0 0 0 0 0 0 2269979 2675900 10480624 6201085 -406810 3086884 41104717 46106703 6665928 8582862 34438789 37523841 THE MISSION OF PRESBYTERIAN HOMES FOUNDATION IS TO ENRICH THE LIVES OF OLDER ADULTS THROUGH SERVICES AND COMMUNITIES THAT REFLECT THE LOVE OF GOD. 0 0 5171104 5171104 0 THE FOUNDATION IS FORMED TO AID, SUPPORT, AND PROMOTE THE 501(C)(3) PURPOSES OF THE PRESBYTERIAN HOMES AND ITS AFFILIATES. SPECIFICALLY, THE FOUNDATION PROVIDED $5,171,104 IN AWARDS TO AFFILIATED ORGANIZATIONS DURING THE YEAR ENDED SEPTEMBER 30, 2012. THESE AWARDS ARE USED TO PROVIDE HOUSING AND OTHER CARE SERVICES TO THE ELDERLY IN ACCORDANCE WITH THE EXEMPT PURPOSES OF THE RECIPIENT CHARITABLE AFFILIATES. 5171104 1 1 0 0 0 0 0 0 0 1 0 1 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 11 0 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X HEIDI PETERSON 6516316162 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 SCOTT WEICHT 1.00 X 0 0 0 DAN LINDH 40.00 X X 0 541112 98853 MARK MEYER 40.00 X X 0 299540 16678 JOHN MEHRKENS 40.00 X 0 237199 14662 SHARON KLEFSAAS 40.00 X 0 245580 12398 KAREN MCKENNA 40.00 X 0 219810 7051 CATHY BERGLAND 40.00 X 0 203199 10492 0 1746440 160134 0 1 1 0 PHS MANAGEMENT LLC 2845 HAMLINE AVE N ROSEVILLE MN 55113 MANAGEMENT FEES 1645919 1 2515258 720739 2515258 2963134 2963134 3809577 0 3809577 3809577 3809577 9287969 0 0 6772711 3515185 3515185 10000 10000 1645919 1645919 2578 2578 WRITE OFF OF PROJECTS 640000 640000 MISCELLANEOUS EXPENSES 384403 384403 EMPLOYEE BENEVOLENCE 3000 3000 6201085 5171104 1029981 0 476213 851088 1141489 10000 33099719 39034002 6387296 6211613 41104717 46106703 170631 503243 6495297 8079619 6665928 8582862 X -1773380 1311884 6308315 1897715 29903854 34314242 34438789 37523841 41104717 46106703 X 3086884 -1832 X 0 1 1 X 0 X 4933000 1335771 5438493 9356199 2515258 23578721 4933000 1335771 5438493 9356199 2515258 23578721 5208713 18370008 1679000 1232623 1389700 2105355 2963134 9369812 32948533 0.55750 0.59850 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 32532198 600665 6332974 -1135738 38330099 33609934 940086 -811570 -1206252 32532198 31212047 350486 3131856 -1084455 33609934 32502594 225598 -319898 1196247 31212047 0.05000 0.95000 0.00000 0 0 0 ENDOWMENT FUNDS 38330100 F MISSION BENEVOLENT INVESTMENT 334279 F CHARITABLE GIFT ANNUITY CASH 369623 F 39034002 INVESTMENT IN OAKCREST 2324000 NOTES, PROJECT COSTS, AND OTHER RECEIVABLES 3887613 6211613 DUE TO AFFILIATES 7710658 CHARITABLE GIFT ANNUITY 368961 8079619 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: PRESBYTERIAN HOMES FOUNDATION ENDOWMENT FUNDS WILL BE USED AS DIRECTED BY THE DONOR'S RESTRICTIONS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION AND ITS AFFILIATES ARE GENERALLY EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE SECTIONS OF THE STATE STATUTES; CONSEQUENTLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. HOWEVER, THERE ARE IMMATERIAL AMOUNTS OF UNRELATED BUSINESS INCOME IN CERTAIN AFFILIATES THAT ARE TAXABLE. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INFORMATION RETURNS AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. THE ORGANIZATION'S TAX RETURNS FOR THE 2009, 2010, AND 2011 FISCAL YEARS ARE OPEN TO EXAMINATION BY THE IRS. 0 0 0 0 0 0 0 0 0 0 EAST ASIA AND THE PACIFIC NURSING SCHOLARSHIPS 10000 CHECK 1 0 0 0 0 0 0 0 1 PRESBYTERIAN HOMES OF ARDEN HILLS INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 411482075 501C3 1736644 FURTHER EXEMPT PURPOSE PRESBYTERIAN HOMES BLOOMINGTON CARE CENTER INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 411862259 501C3 7806 FURTHER EXEMPT PURPOSE PRESBYTERIAN HOMES MILL POND CARE CENTER INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 311581714 501C3 130340 FURTHER EXEMPT PURPOSE PRESBYTERIAN HOMES OF NORTH OAKS INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 300054296 501C3 42302 FURTHER EXEMPT PURPOSE PRESBYTERIAN HOMES AND SERVICES INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 410758756 501C3 137259 FURTHER EXEMPT PURPOSE PHS LAKE MINNETONKA LLC 2845 HAMLINE AVE N ROSEVILLE MN 55113 272377256 501C3 14328 FURTHER EXEMPT PURPOSE PLYMOUTH SENIOR HOUSING LLC 2845 HAMLINE AVE N ROSEVILLE MN 55113 412011416 501C3 13528 FURTHER EXEMPT PURPOSE AVALON SQUARE INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 311662044 501C3 252200 FURTHER EXEMPT PURPOSE GRANDVIEW CHRISTIAN HOME 2845 HAMLINE AVE N ROSEVILLE MN 55113 410844893 501C3 20728 FURTHER EXEMPT PURPOSE AMERICAN ASSOCIATION OF HOMES & SERVICES FOR THE AGING 2519 CONNECTICUT AVENUE NW WASHINGTON DC 20008 136213525 501C3 25000 FURTHER EXEMPT PURPOSE VALLEY SENIOR SERVICES ALLIANCE 2845 HAMLINE AVE N ROSEVILLE MN 55113 411915023 501C3 241235 FURTHER EXEMPT PURPOSE PHS HOMES CARE CENTER INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 411500288 501C3 5621 FURTHER EXEMPT PURPOSE WILLIAMBURG RETIREMENT COMMUNITY 2845 HAMLINE AVE N ROSEVILLE MN 55113 753033211 501C3 9950 FURTHER EXEMPT PURPOSE PHMNEW RICHMOND SENIOR HOUSING INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 411883153 501C3 63562 FURTHER EXEMPT PURPOSE MARANATHA CONSERVATIVE BAPTIST HOME INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 410855713 501C3 401939 FURTHER EXEMPT PURPOSE CROIXDALE 2845 HAMLINE AVE N ROSEVILLE MN 55113 410843106 501C3 5322 FURTHER EXEMPT PURPOSE PHSCOTTAGE GROVE INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 300227875 501C3 168341 FURTHER EXEMPT PURPOSE PHSWOODBURY INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 311630828 501C3 9775 FURTHER EXEMPT PURPOSE KIRKLAND CROSSING 2845 HAMLINE AVE N ROSEVILLE MN 55113 311662039 501C3 7608 FURTHER EXEMPT PURPOSE PRESBYTERIAN HOMES HOSPICE INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 260766609 501C3 8780 FURTHER EXEMPT PURPOSE SHEPHERD'S PATH SENIOR HOUSING INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 300225161 501C3 6853 FURTHER EXEMPT PURPOSE 21 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS TO AFFILIATES ARE THE TEMPORARY RESTRICTED GIFTS FROM THE ORIGINAL DONORS WHICH ARE TO BE USED AS INTENDED BY THE DONOR. FUND BALANCES ARE MAINTAINED TO SHOW EACH GIFTS RESTRICTIONS. THE FOUNDATION PROVIDES A LIST OF RESTRICTIONS TO EACH AFFILIATE AT THE TIME OF DONATION AND THE CAMPUS ADMINISTRATOR FOR EACH AFFILIATE IS RESPONSIBLE FOR ENSURING THAT THE FUNDS ARE USED IN ACCORDANCE WITH THE FOUNDATION'S/DONOR'S DIRECTION. SOME OF THE GRANTS LISTED ARE ENDOWMENT DISTRIBUTIONS, WHICH ARE APPROVED BY THE BOARD OF DIRECTORS. 0 0 0 0 0 0 0 0 0 DAN LINDH 0 541112 0 0 0 0 0 91233 0 7620 0 639965 0 0 MARK MEYER 0 299540 0 0 0 0 0 8986 0 7692 0 316218 0 0 JOHN MEHRKENS 0 237199 0 0 0 0 0 7116 0 7546 0 251861 0 0 SHARON KLEFSAAS 0 245580 0 0 0 0 0 7367 0 5031 0 257978 0 0 KAREN MCKENNA 0 219810 0 0 0 0 0 6594 0 457 0 226861 0 0 CATHY BERGLAND 0 203199 0 0 0 0 0 6096 0 4396 0 213691 0 0 PART I, LINE 3 THE COMPENSATION IS DETERMINED BY THE RELATED ORGANIZATION AND THE ORGANIZATION USES A)COMPENSATION COMMITTEE B)INDEPENDENT COMPENSATION CONSULTANTS C)COMPENSATION SURVEY OR STUDY AND D)APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE COMPENSATION. X 9305 500739 PRICE AT DAY OF SALE X 1680 120000 RECENT SALES IN AREA 0 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE AMOUNT OF PUBLICLY TRADED SECURITIES CONTRIBUTED WAS MEASURED BY NUMBER OF SHARES. THE AMOUNT OF COMMERICAL REAL ESTATE CONTRIBUTED WAS MEASURED BY NUMBER OF ACRES. FORM 990, PART VI, SECTION A, LINE 3 PHS MANAGEMENT, LLC PROVIDES MANAGEMENT SERVICES FOR PRESBYTERIAN HOMES FOUNDATION. PHS MANAGEMENT, LLC PROVIDES FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, STAFFING FOR FUND DEVELOPMENT, AND NEW BUSINESS DEVELOPMENT. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF PRESBYTERIAN HOMES FOUNDATION IS PRESBYTERIAN HOMES AND SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION ELECT THE MEMBERS OF THE GOVERNING BODY, BUT NOT IF THE PERSONS ON THE GOVERNING BODY ARE THE ORGANIZATION'S ONLY MEMBERS OR THEIR DELEGATES. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S FORM 990 IS PROVIDED TO VOTING MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE IRS. OFFICERS AND MANAGEMENT OF THE ORGANIZATION HAVE BEEN INVOLVED IN THE PREPARATION OF THE FORM 990 AND HAVE REVIEWED IT THROUGHOUT THE PROCESS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION OBTAINS ANNUALLY WRITTEN DISCLOSURES FROM GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. MANAGEMENT AND OFFICERS REVIEW THESE DISCLOSURES AND EVALUATE WHETHER THE INTEREST COULD RESULT IN A CONFLICT AND THEN TAKE THE NECESSARY STEPS TO REMEDIATE ANY SUCH CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: ROUNDING ADJUSTMENT TO THE FINANCIAL STATEMENTS -1,832. TOTAL TO FORM 990, PART XI, LINE 5: -1,832. SHARING OF HOURS FORM 990, PART VII, SECTION A OFFICERS & KEY EMPLOYEES SHARE THEIR HOURS BETWEEN THE FILING ORGANIZATION AND ITS RELATED ORGANIZATIONS. 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