2012-03-05T14:40:45-06:00 2011-09-30 CLIFTONLARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2010-10-01 410859697 ST MARK'S LUTHERAN HOME STMA 5074374594 400 15TH AVENUE SW AUSTIN MN 55912 MARTY HELLE 5074374594 2012-03-02 1 TRENT FAST 5074347000 2010 2016-02-24 21:20:13Z CHRIS SCHULZ 400 15TH AVENUE SW AUSTIN MN 55912 6698957 0 9386 X WWW.STMARKSAUSTINMN.ORG X 1963 MN ST. MARK'S IS DEDICATED TO PROVIDE A CONTINUUM OF SERVICES IN THE SPIRIT OF GOD'S LOVE. THESE SERVICES ARE DESIGNED TO PROMOTE PHYSICAL, EMOTIONAL, MENTAL, SOCIAL, AND SPIRITUAL HEALTH. 11 11 238 9 0 0 13340 408769 8114164 6077821 5654 3130 111028 209237 8244186 6698957 0 0 0 0 5083691 4366299 0 0 0 3385332 3443216 8469023 7809515 -224837 -1110558 5633149 4248195 2521731 2327793 3111418 1920402 ST. MARK'S IS DEDICATED TO PROVIDE A CONTINUUM OF SERVICES IN THE SPIRIT OF GOD'S LOVE. THESE SERVICES ARE DESIGNED TO PROMOTE PHYSICAL, EMOTIONAL, MENTAL, SOCIAL, AND SPIRITUAL HEALTH. 0 0 6822571 6077821 PROVISION OF HOUSING AND NURSING CARE TO THE ELDERLY BY OPERATING A 106-BED LICENSED NURSING FACILITY AND AN INDEPENDENT HOUSING PROJECT. 6822571 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 16 0 1 238 1 0 0 0 0 0 0 0 0 0 0 X 11 11 1 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 MN X ECUMEN SERVICES INC 6517664300 3530 LEXINGTON AVENUE N SHOREVIEW MN 551268164 MARTY HELLE 1.00 X 0 0 0 BRAD JOHNSON 1.00 X 0 0 0 DANA MILLER 1.00 X 0 0 0 MARK HAUGLAND 1.00 X 0 0 0 MIKE GOSHA 1.00 X 0 0 0 REV JEFF FORBES 1.00 X 0 0 0 CATHIE SAYLES 1.00 X 0 0 0 PHIL GARDNER 1.00 X 0 0 0 GENE LEITER 1.00 X 0 0 0 JOAN SKOV 1.00 X 0 0 0 JACKIE HOLST 1.00 X 0 0 0 CHRISTINE HARRIS 40.00 X 105822 0 12332 MIKE MILLER 40.00 X 0 0 0 105822 0 12332 1 0 0 1 REHABCARE GROUP INC 7733 FORSYTH BLVD SUITE 1700 ST LOUIS MO 63105 THERAPY SERVICES 236040 ECUMEN SERVICES INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 551268164 ADMINISTRATOR & OTHER CONSULTING 235319 ALL TEMPORARIES MIDWEST INC 3638 CENTRAL AVE MINNEAPOLIS MN 55418 NA AND LPN STAFFING 182118 MCKESSON PO BOX 630693 CINCINNATI OH 54263 SUPPLY SERVICES 136866 KKE ARCHITECTS INC 520 NICOLLET MALL SUITE 200 MINNEAPOLIS MN 55402 BUILDING PROJECT 128829 6 400000 8769 408769 RESIDENT REVENUE 623000 5648243 5648243 SMA REVENUES 623000 425520 425520 LAUNDRY REVENUE 623000 4058 4058 6077821 3130 3130 MISCELLANEOUS INCOME 900099 210330 210330 BEAUTY SHOP INCOME 812900 19790 19790 EMPLOYEE/GUEST MEALS 900099 5956 5956 -26839 -26839 209237 6698957 6077821 0 212367 3674896 3354214 320682 151365 139302 12063 284167 261685 22482 255871 235582 20289 300446 300446 11936 11936 20665 20665 309773 303624 6149 15940 15940 38564 38564 330468 300030 30438 4160 4160 5289 5289 87668 87668 836243 836243 83512 5307 78205 BED SURCHARGE 298390 298390 FOOD COST 229057 229057 PATIENT CARE SUPPLIES 186003 186003 CONTRACT MEALS 132948 132948 PHARMACY 122627 122627 429527 329891 99636 7809515 6822571 986944 0 902585 297420 404120 402445 668916 425280 13589 11557 87878 53313 12979034 10219015 3245148 2760019 310913 298161 5633149 4248195 637048 497191 28213 1603407 1447932 281276 354457 2521731 2327793 X 3111418 1920402 3111418 1920402 5633149 4248195 X -1110558 -80458 X X 0 1 1 X 0 X 2543 7247 10229 13340 383361 416720 9220926 9216654 9469476 8112944 6077821 42097821 9223469 9223901 9479705 8126284 6461182 42514541 400000 400000 217204 217204 217204 400000 617204 41897337 32819 22305 5316 5654 28538 94632 32819 22305 5316 5654 28538 94632 209237 209237 9256288 9246206 9485021 8131938 6698957 42818410 0.97850 0.99300 0.00220 0.00190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 77063 77063 9133529 7255501 1878028 3768442 2963514 804928 2760019 SECURITY DEPOSITS 32045 DEFERRED FINANCING COSTS 38412 RESIDENT TRUST 4867 UNDER MORTGAGE AGREEMENTS 222837 298161 RESIDENT TRUST FUNDS 23927 TENANT SECURITY DEPOSITS 10112 NET PENSION LIABILITY - UNION 239930 ASSET RETIREMENT OBLIGATION 80488 354457 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ST. MARK'S LUTHERAN HOME AND ITS AFFILIATE HAVE BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. ST. MARK'S LUTHERAN HOME AND AFFILIATE FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED AS A RESULT OF THIS STANDARD. EACH ENTITY FILES 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 2008, 2009, AND 2010 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS. 0 0 0 0 0 0 0 0 0 SUPPLEMENTAL INFORMATION PART III ST. MARK'S LUTHERAN HOME DOES NOT PAY IT'S ADMINISTRATOR DIRECTLY, RATHER THE HOME IS PAYING THE ADMINISTRATOR THROUGH AN INDEPENDENT CONTRACTOR ARRANGEMENT WITH A MANAGEMENT COMPANY NAMED ECUMEN SERVICES, INC. THE HOME IS CONTRACTED TO PAY ECUMEN SERVICES, INC. FOR THE ADMINISTRATOR POSITION AND OTHER MANAGEMENT CONSULTING SERVICES. THE COMPENSATION INFORMATION ON FORM 990 IS THE AMOUNT OF COMPENSATION THAT ECUMEN PAID THE ADMINISTRATOR AND AS A RESULT THE COMPENSATION INFORMATION PROVIDED IS NOT THE AMOUNT THE HOME PAID TO ECUMEN UNDER THE MANAGEMENT CONTRACT ARRANGEMENT. PER THE IRS INSTRUCTIONS THE COMPENSATION INFORMATION IS FOR THE CALENDAR YEAR 2010. ECUMEN PREPARES A STUDY OF COMPARABLE SENIOR CARE FACILITIES OF SIMILAR SIZE TO DETERMINE THE COMPENSATION APPLICABLE FOR PROVIDING THE ADMINISTRATOR POSITION TO THE HOME. SUPPLEMENTAL INFORMATION PART III CHRISTINE HARRIS WAS PAID WAGES IN THE AMOUNT OF $105,822, DEFERRED COMPENSATION IN THE AMOUNT OF $6,377 AND BENEFITS IN THE AMOUNT OF $5,955 FROM ECUMEN SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 2 BRAD JOHNSON & DANA MILLER - BUSINESS RELATIONSHIP - BRAD & DANA ARE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS. BOTH ARE MEMBERS OF THE ELK'S LODGE, AUSTIN, MN. FORM 990, PART VI, SECTION A, LINE 3 ST. MARK'S LUTHERAN HOME DOES NOT PAY IT'S ADMINISTRATOR DIRECTLY, RATHER THE HOME IS PAYING THE ADMINISTRATOR THROUGH AN INDEPENDENT CONTRACTOR ARRANGEMENT WITH A MANAGEMENT COMPANY NAMED ECUMEN SERVICES, INC. THE HOME IS CONTRACTED TO PAY ECUMEN SERVICES, INC. FOR THE ADMINISTRATOR POSITION AND OTHER MANAGEMENT CONSULTING SERVICES. THE COMPENSATION INFORMATION ON FORM 990 IS THE AMOUNT OF COMPENSATION THAT ECUMEN PAID THE ADMINISTRATOR AND AS A RESULT THE COMPENSATION INFORMATION PROVIDED IS NOT THE AMOUNT THE HOME PAID TO ECUMEN UNDER THE MANAGEMENT CONTRACT ARRANGEMENT. PER THE IRS INSTRUCTIONS THE COMPENSATION INFORMATION IS FOR THE CALENDAR YEAR 2010. ECUMEN PREPARES A STUDY OF COMPARABLE SENIOR CARE FACILITIES OF SIMILAR SIZE TO DETERMINE THE COMPENSATION APPLICABLE FOR PROVIDING THE ADMINISTRATOR POSITION TO THE HOME. FORM 990, PART VI, SECTION B, LINE 11 A MOTION WAS PASSED BY THE BOARD OF DIRECTORS TO HAVE THE BOARD PRESIDENT REVIEW AND APPROVE THE FORM 990 BEFORE IT IS SIGNED AND SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EMPLOYEES ANNUALLY COMPLETE A SURVEY RELATED TO BUSINESS RELATIONSHIPS AND FAMILY MEMBERS THAT COULD, OR DO, CREATE A CONFLICT OF INTEREST. THESE ARE SUMMARIZED AND FILED ALONG WITH THE BOARD MEETING MINUTES. CONFLICTS OF INTEREST ARE DETERMINED BY A REVIEW OF THE POTENTIAL CONFLICTS BY THE ADMINISTRATOR AND THE BOARD OF DIRECTORS. IF A CONFLICT EXISTS, THEN THE CONFLICTED BOARD MEMBER OR KEY EMPLOYEE IS EXCLUDED FROM DISCUSSION AND VOTES RELATED TO ANY POTENTIAL OR EXISTING RELATIONSHIPS INVOLVING THE CONFLICT OF INTEREST. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST WAS INTENTIONALLY HIDDEN BY A BOARD MEMBER, THEN THE SITUATION WOULD BE INVESTIGATED AND THE BOARD MEMBER COULD BE SUSPENDED AND SUBJECT TO DISMISSAL. ADDITIONALLY, THE REMAINING BOARD MEMBERS AND KEY EMPLOYEES WILL REVIEW, FOR FAIRNESS, ALL TRANSACTIONS BACK TO THE TIME THE CONFLICT BECAME RELEVANT. IF A TRANSACTION APPEARS TO LACK ARMS-LENGTH, EITHER TO THE DETRIMENT OF THE ORGANIZATION, OR TO THE UNFAIR ADVANTAGE OF THE BOARD MEMBER, THEN ALL LEGAL REMEDIES WILL BE CONSIDERED. FORM 990, PART VI, SECTION B, LINE 15A ECUMEN SERVICES, INC. PREPARES A STUDY OF COMPARABLE SENIOR CARE FACILITIES OF SIMILAR SIZE TO DETERMINE THE COMPENSATION APPLICABLE FOR PROVIDING THE ADMINISTRATOR POSITION TO THE HOME. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE IN THE ADMINISTRATIVE OFFICE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGE IN DEFINED BENEFIT PENSION PLAN -80,458. TOTAL TO FORM 990, PART XI, LINE 5: -80,458. FORM 990, PART XI, 2C: THE ORGANIZATIONS BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. ST MARK'S FOUNDATION INC 400 15TH AVENUE SW AUSTIN MN 55912 411374304 PROVISION OF BENEFITS AND SUPPORT TO ST. MARK'S LUTHERAN HOME MN 501(C)(3) 11A - TYPE I ST MARK'S LUTHERAN HOME 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ST MARK'S FOUNDATION INC C 400000 CASH GRANT