2013-11-13T16:00:21-07:00 2012-12-31 990 2012-01-01 411539761 ELIM HOMES INC ELIM 9522594500 7485 Office Ridge Circle Eden Prairie MN 553443690 Kathy Youngquist 9522594500 2013-11-13 2012 2016-02-25 16:41:14Z Robert M Dahl 7485 Office Ridge Circle Eden Prairie MN 55344 40277510 0 X www.elimcare.org X 1985 MN Provide nursing home care and housing for the elderly. This includes programs and services specifically designed to meet the residents' primary needs for housing, healthcare (including in-house therapy) and nourishment. 5 5 1093 586 0 0 0 0 36267758 37667719 134813 222386 2059167 2025730 38461738 39915835 52813 27815 0 0 28122397 29151497 0 0 0 8638995 9282624 36814205 38461936 1647533 1453899 33925100 35274953 20065516 19824110 13859584 15450843 See Part I, Line 1 0 0 24187967 7500 28825968 Elim Homes Inc. provides skilled long-term care services to the elderly, handicapped and other having specialized needs. The organization owns and operates four long-term care facilities in Princeton, MN (113 beds), Milaca, MN (98 beds), Watertown, MN (51 beds) and Fargo, ND (136 beds). Utilization by payor source was as follows: 57.0% Medicaid, 28.7% Private, 10.7% Medicare and 3.6% HMO. 7392627 20315 7693751 Elim Homes, Inc. operates a therapy division (Progressive Rehabilitation Options) that provides physical, occupational and speech therapy to related organizations and other organizations located in Minnesota, North Dakota and Iowa. 775647 0 853838 Elim Homes, Inc. operates an assisted living facility (Caley House) located in Princeton, MN. The facility has 30 units and occupancy was 98.92% in 2012. 185106 0 294162 Other program services include Adult Day Care and Elderly Independent Living. 185106 0 294162 32541347 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 61 0 1 1093 1 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Kathy L Youngquist 9522594500 7485 Office Ridge Circle Eden Prairie MN 553443690 Pat Nuss 0.11 0.39 X X 0 0 0 Terry Kern 0.11 0.39 X 0 0 0 Stann Leff 0.11 0.31 X X 0 0 0 Kevin Bergman 0.11 0.31 X 0 0 0 Dr Guy Tangedahl 0.11 0.54 X X 0 0 0 Ronald Sanford 3.99 37.55 X 219236 0 42450 Robert M Dahl 3.84 36.16 X 312172 0 86309 Kathy L Youngquist 3.84 36.16 X 184502 0 64725 Jeffrey Dagen 42.87 0 X 467604 0 77486 Angela Brown 14.19 22 X 173262 0 45850 Timothy Hager 39.81 0.19 X 146280 0 34851 Michael Krueger 16.41 25.44 X 119513 0 32482 Patricia Zahler 41.88 0 X 112802 0 21239 Christine Eilertson 16.29 25.25 X 213082 0 56309 1948453 0 461701 14 0 1 0 CliftonLarsonAllen LLP 220 South Sixth Street Suite 300 Minneapolis MN 554021436 Accounting Services 100389 Clinical Excellence Constortium 7485 Officer Ridge Circle Eden Prairie MN 55344 Consulting Services 100506 2 0 Nursing Home Services 623000 28825968 28825968 0 0 Therapy Services 621300 7693751 7693751 0 0 Assisted Living Services 623000 853838 853838 0 0 Adult Daycare Services 624100 182408 182408 0 0 Apartment Rental 531110 111754 111754 0 0 0 0 0 0 37667719 151551 0 0 151551 0 0 0 0 0 0 0 0 6632 0 0 0 6632 0 6632 0 0 6632 429285 3225 361675 0 67610 3225 70835 0 0 70835 Management Fees 541610 2013633 0 0 2013633 Cable TV 900099 4941 0 0 4941 Miscellaneous 900099 524 0 0 524 0 0 0 0 2019098 39915835 37667719 0 2248116 27815 27815 0 0 0 0 0 0 1193667 0 1193667 0 0 0 0 0 22521953 20126544 2395409 0 566167 480484 85683 0 3119605 2647490 472115 0 1750105 1485248 264857 0 0 0 0 0 46757 0 46757 0 42859 0 42859 0 0 0 0 0 0 0 63601 0 63601 0 384939 328025 56914 0 100410 0 100410 0 546032 226995 319037 0 124301 0 124301 0 0 0 0 0 739546 702569 36977 0 241716 0 241716 0 0 0 0 0 114639 0 114639 0 613676 582992 30684 0 0 0 0 0 1441695 1369610 72085 0 100000 95000 5000 0 Supplies 2334510 2317990 16520 0 License Surcharge 745975 745975 0 0 Food 701345 701345 0 0 Maintenance Contracts/Purchased Services 318925 302979 15946 0 621698 400286 221412 0 38461936 32541347 5920589 0 3043589 3416535 1432203 1358629 3707323 3862274 159257 156858 40226960 21536661 13530650 18690299 4693470 4709416 7358608 3080942 33925100 35274953 5727718 4834931 13614698 14560714 723100 428465 20065516 19824110 X 13609557 15145572 250027 305271 0 0 13859584 15450843 33925100 35274953 X 1453899 313761 0 0 -12566 -163835 X 0 1 X 1 0 X 0 0 0 0 34427133 35382457 36216267 36267758 37667719 179961334 34427133 35382457 36216267 36267758 37667719 179961334 0 0 0 0 0 0 0 0 179961334 117808 106193 147678 173293 158183 703155 117808 106193 147678 173293 158183 703155 1514518 1700899 1879364 2052640 2019098 9166519 36059459 37189549 38243309 38493691 39845000 189831008 0.94801 0.94963 0.00370 0.00393 X Part III, Line 12: Management Fee (2008-$1,514,407; 2009-$1,700,747; 2010-$1,903,112; 2011-$2,035,546; 2012-$2,013,633); Sale of Miscellaneous Minor Equipment (2008-$111, 2009-$152, 2010-$736, 2011-$11,732, 2012-$524); Loss on Refinancing of Debt (2010-$(24,484)); Cable TV Income (2011-$5,362, 2012-$4,941) 0 443425 443425 0 29555607 14370990 15184617 0 318369 107140 211229 0 9189569 6784912 2404657 0 719990 273619 446371 18690299 Interest Receivable 35800 Financing Costs 279171 Deferred Development 14954 Resident Trust Funds 55035 Due from Affiliate 2695982 3080942 0 Resident Trust Reserve 55035 Due to Affiliate 20954 Asset Retirement Obligation 132610 Deferred Compensation Payable 219866 428465 39737167 0 0 0 43718 43718 39693449 0 222386 222386 39915835 38518220 0 0 0 56284 56284 38461936 0 0 0 38461936 SchD_P11_S00_L02d Schedule D, Part XI, Line 2d Net Assets Released from Restriction $56,284; Prior Year Adjustments $(12,566) SchD_P11_S00_L04b Schedule D, Part XI, Line 4b Interest Income $151,551; Gain on Sale of Investments $67,610; Gain on Sale of Fixed Asset $3,225 SchD_P12_S00_L02d Schedule D, Part XII, Line 2d Expenses purchased using donated funds. 1 Evangelical Free Church of America 901 East 78th Street Minneapolis MN 554201300 410721672 501(c)3 7500 0 N/A N/A Program to connect EFCA churches to senior services. Lyngblomsten Foundation 1415 Almond Avenue St Paul MN 551082507 363371887 501(c)3 5800 0 N/A N/A To support the social ministry of providing quality care to seniors. Guardian Angels of Elk River Inc 400 Evans Avenue NW Elk River MN 55330 411459252 501(c)3 7080 0 N/A N/A To support the social ministry of providing quality care to seniors. 3 0 SchI_P01_S00_L02 Schedule I, Part I, Line 2 Due to the relatively low amounts of grants, the organization does not generally monitor the use of the grant funds. X 1 1 X X X X 0 1 0 0 0 1 1 0 0 Robert M Dahl 245955 0 62865 0 3352 0 71130 0 15179 0 398481 0 59726 0 Ronald Sanford 163109 0 52348 0 3779 0 24871 0 17579 0 261686 0 19464 0 Kathy L Youngquist 149804 0 33321 0 1377 0 43289 0 21436 0 249227 0 32700 0 Jeffrey Dagen 219678 0 247236 0 690 0 64199 0 13287 0 545090 0 143930 0 Christine Eilertson 94103 0 118404 0 575 0 39230 0 17078 0 269390 0 10908 0 Angela Brown 79865 0 92702 0 695 0 27630 0 18220 0 219112 0 9505 0 Timothy Hager 129600 0 15272 0 1408 0 20348 0 14503 0 181131 0 15300 0 Michael Krueger 104980 0 13168 0 1365 0 15796 0 16686 0 151995 0 12168 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a A set percentage is paid to certain employees of the organization to help cover the taxes on personal auto usage. This amount is treated as a taxable benefit. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Certain employees of the organization participate in a 457(f) Deferred Compensation Plan. For 2012 the amount of deferred compensation was as follows: Robert Dahl $33,674; Kathy Youngquist $18,921; Jeffrey Dagen $31,524; Christine Eilertson $24,390; Angela Brown $12,723 SchJ_P01_S00_L06 Schedule J, Part I, Line 6 Robert Dahl, Ronald Sanford, Kathy Youngquist, Christine Eilertson, Angela Brown and Mike Krueger accrued incentive bonuses at 12/31/2012 that were contingent on the comined net income of the organization and its related organizations. Jeffrey Dagen and Timothy Hager accrued incentive bonuses at 12/31/2012 that were contingent on the net income of separate divisions within the organization. A City of Princeton 416005471 000000000 2003-05-13 9000000 Moratorium Construction projects 0 0 0 B Cass County 456002205 000000000 2010-12-16 6300000 Facility Renovations and refinancing of old debt 0 0 0 C City of Milaca 416005370 000000000 2011-04-28 1116522 Refinancing of 1996 issue 0 0 0 A 0 0 9000000 0 0 0 180000 0 0 8820000 0 0 2004 0 0 1 1 B 666977 0 6300000 0 0 0 126000 0 0 5507023 0 0 2012 1 0 1 1 C 1116522 0 1116522 0 0 0 0 0 0 0 0 0 2011 1 0 1 1 A 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 0 1 A 0 1 0 1 1 0 0 0 1 B 0 1 0 1 1 0 0 0 1 C 0 1 0 1 1 0 0 0 1 A 1 B 1 C 1 SchK_P04_S00_L02c Schedule K, Part IV, Line 2c A. There were no investment earning on any bond proceeds. B. Five year anniversary has not occurred yet. C. Five year anniversary has not occurred yet. F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 Elim Care, Inc. is the sole member of Elim Homes, Inc. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a Board members of Elim Homes, Inc. are approved by the Elim Care, Inc. (parent company) board. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b Decisions of Elim Homes, Inc. are subject to approval by the Elim Care, Inc. board. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The Form 990 Tax Return and all related schedules were prepared by the Director of Finance. The Chief Financial Officer reviewed the return prior to signing. Board members were given a copy of the Form 990 prior to the filing via email. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The organization annually requests a conflict of interest disclosure from each board member and officer. Also, annual questionnaires are sent out to get updates on new situations that may have arisen during the year. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The board of directors routinely retains the services of a compensation consultant to review the curent wage and benefit levels of similar positions in similar organizations. The compensation committee uses this information to make a recommendation to the board of directors. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policy and financial statements are generally not made available to the public. Some are made available upon request. F990_P11_S00_L09 Form 990, Part XI, Line 9 Other changes in Net Assets are as follows: Transfers from Affiliate $202,464; Contribution Distributions $(56,284); Transfers to Affiliates $(310,806); Restricted Interest Income $800; Rounding $(9) Park Terrace Assisted Living Inc 7485 Office Ridge Circle Eden Prairie MN 55344 204063752 Senior Housing MN 501c3 9 N/A 0 New Harmony Care Center 7485 Office Ridge Circle Eden Prairie MN 55344 411821882 Nursing Home MN 501c3 9 N/A 0 Park View Care Center Inc 7485 Office Ridge Circle Eden Prairie MN 55344 410855707 Nursing Home MN 501c3 9 N/A 0 Redeemer Residence Inc 7485 Office Ridge Circle Eden Prairie MN 55344 410711597 Nursing Home MN 501c3 9 N/A 0 Cornerstone Assisted Living of Plymouth Inc 7485 Office Ridge Circle Eden Prairie MN 55344 412013927 Senior Housing MN 501c3 9 N/A 0 Park Lane Apartments Inc 7485 Office Ridge Circle Eden Prairie MN 55344 410972384 HUD Housing MN 501c3 9 N/A 0 Elim Children's Center Inc 7485 Office Ridge Circle Eden Prairie MN 55344 411974507 Child Daycare MN 501c3 9 N/A 0 Elim Care Inc 7485 Office Ridge Circle Eden Prairie MN 55344 411694818 Parent Company/Fundraising MN 501c3 7 N/A 0 Lake Ridge Care Center of Buffalo Inc 7485 Office Ridge Circle Eden Prairie MN 55344 200507069 Nursing Home/Senior Housing MN 501c3 9 N/A 0 Evangelical Retirement Homes Inc 7485 Office Ridge Circle Eden Prairie MN 55344 420868449 Nursing Home/Senior Housing IA 501c3 9 N/A 0 Elim Shores Inc 7485 Office Ridge Circle Eden Prairie MN 55344 411625095 Senior Housing MN 501c3 9 N/A 0 Newton Village Inc 7485 Office Ridge Circle Eden Prairie MN 55344 200044030 Senior Housing MN 501c3 9 N/A 0 Country Meadows of Milaca Inc 7485 Office Ridge Circle Eden Prairie MN 55344 201723948 Senior Housing MN 501c3 9 N/A 0 Pioneer House Assisted Living Inc 7485 Office Ridge Circle Eden Prairie MN 55344 411927112 Senior Housing MN 501c3 9 N/A 0 Village Assisted Living Inc 7485 Office Ridge Circle Eden Prairie MN 55344 262086933 Senior Housing MN 501c3 9 N/A 0 Elim Care Foundation 7485 Office Ridge Circle Eden Prairie MN 55344 411694817 Longterm Investing MN 501c3 11 N/A 0 Community Health Foundation of Wright County 7485 Office Ridge Circle Eden Prairie MN 55344 363546789 Fund Raising MN 501c3 7 N/A 0 Baptist Home Inc 7485 Office Ridge Circle Eden Prairie MN 55344 450232943 Nursing Home ND 501c3 9 N/A 0 The Baptist Apartments Inc 7485 Office Ridge Circle Eden Prairie MN 55344 450359794 Senior Housing ND 501c3 9 N/A 0 Elim Preferred Services Inc 7485 Office Ridge Circle Eden Prairie MN 55344 411681856 Medical Equipment and Supplies Sales MN N/A C 0 Preferred Senior Services Inc 7485 Office Ridge Circle Eden Prairie MN 55344 411942480 Management Services MN N/A C 0 0 0 0 1 1 0 0 1 0 0 1 1 1 1 1 0 1 1 1 Evangelical Retirement Homes Inc d 1294580 Book Value Village Assisted Living Inc d 5433281 Book Value Pioneer House Assisted Living Inc k 62452 Book Value Elim Care Foundation r 300000 Book Value Elim Preferred Services Inc h 1014065 Book Value New Harmony Care Center l 526595 Book Value Lake Ridge Care Center of Buffalo Inc l 548362 Book Value Evangelical Retirement Homes Inc l 537335 Book Value Redeemer Residence Inc l 645348 Book Value Park View Care Center Inc l 848691 Book Value Elim Preferred Services Inc l 95000 Book Value Cornerstone Assisted Living of Plymouth Inc l 91716 Book Value Newton Village Inc l 64960 Book Value Park Terrace Assisted Living Inc l 52417 Book Value Village Assisted Living Inc l 52029 Book Value Baptist Home Inc l 886832 Book Value Pioneer House Assisted Living Inc l 52513 Book Value Country Meadows of Milaca Inc q 155935 Book Value Elim Care Inc s 202464 Book Value Elim Care Inc e 6218145 Book Value