LAKELAND HOSPICE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LAKELAND HOSPICE INC (EIN 36-3255877)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201203199349306035
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T16:30:21-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4310 17TH AVE S PO BOX 2545 | AddressLine1 |
| City | FARGO | City |
| State | ND | State |
| ZIP Code | 581082545 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363255877 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKELAND HOSPICE AND HOME CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAKE | NameControl |
| Phone | 2189981400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 EAST CHANNING | AddressLine1 |
| City | FERGUS FALLS | City |
| State | MN | State |
| ZIP Code | 56537 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ED STRAND | Name |
| Title | TREASURER | Title |
| Phone | 2189981400 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LISA CHAFFEE CPA | Name |
| PTIN | P00193453 | PTIN |
| Phone | 7012398500 | Phone |
| Date Prepared | 2012-11-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | NATHAN JOHNSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 EAST CHANNING | AddressLine1 |
| City | FERGUS FALLS | City |
| State | MN | State |
| ZIP Code | 56537 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5660025 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LAKELANDHOSPICE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | PATIENT SUPPORT | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 112 | TotalNbrEmployees |
| Total Nbr Volunteers | 75 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 592019 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 226915 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4103510 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3823819 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1892 | InvestmentIncomePriorYear |
| Investment Income Current Year | -1349353 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4693637 | TotalRevenuePriorYear |
| Total Revenue Current Year | 2701381 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3106836 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2635933 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 16992 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1712540 | OtherExpensePriorYear |
| Other Expenses Current Year | 1658943 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4819376 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4294876 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -125739 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1593495 | RevenuesLessExpensesCY |
| Total Assets BOY | 3711567 | TotalAssetsBOY |
| Total Assets EOY | 600484 | TotalAssetsEOY |
| Total Liabilities BOY | 2461779 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 944191 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1249788 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -343707 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE PURPOSE OF LAKELAND HOSPICE & HOME CARE IS TO PROVIDE COMPASSIONATE, EMOTIONAL, SPIRITUAL, AND QUALITY HEALTHCARE TO EACH PATIENT, PROMOTING INDEPENDENCE, COMFORT, AND DIGNITY IN ALL STAGES OF LIFE'S JOURNEY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 2237291 | Expense |
| Revenue | 2651122 | Revenue |
| Description | HOSPICE: TO PROVIDE COMPASSIONATE COMFORT CARE AND SUPPORT FOR PATIENTS OF ALL TYPES OF ILLNESSES AND ALL AGES. SERVICES PROVIDED INCLUDE HOME HEALTH AIDES, SOCIAL WORKERS, SPIRITUAL CARE, VOLUNTEERS AND GRIEF SUPPORT. LAKELAND HOSPICE SERVICES COVER 16 COUNTIES IN THE AREA. AS PART OF THE HOSPICE PROGRAM, AN 8 BED HOSPICE HOUSE IS ALSO OPERATED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1040825 | Expense |
| Revenue | 1172697 | Revenue |
| Description | HOME CARE ASSISTS INDIVIDUALS TO REMAIN IN THEIR OWN HOME SETTING WITH THE FOCUS OF RETURNING EACH INDIVIDUAL TO THEIR BEST LEVEL OF FUNCTIONING THROUGH ASSESSMENTS AND INTERVENTIONS OF SKILLED NURSING, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, A MEDICAL SOCIAL WORKER AND HOME HEALTH AIDS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 3278116 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 1 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 112 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAWN TROSVIG | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2189981400 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 EAST CHANNING | AddressLine1 |
| City | FERGUS FALLS | City |
| State | MN | State |
| ZIP Code | 56537 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| NATHAN JOHNSON | ||||||
| PRESIDENT | 0.50 | X | X | 0 | 0 | 0 |
| REBECCA ODDEN VICE PRESIDENT THRU | ||||||
| JULY)/INTERIM ADMIN (STARTING IN AUG) | 0.50 | X | X | 0 | 0 | 0 |
| CAROL JUUL | ||||||
| SECRETARY | 0.50 | X | X | 0 | 0 | 0 |
| EDWARD STRAND | ||||||
| TREASURER | 0.50 | X | X | 0 | 0 | 0 |
| JIM WORNER | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| LARRY SCHULZ | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| JOHN ZWIERS | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| TOM PETERSON | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| JOHN RICHARDS | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| PAT KREKELBERG | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| ANGELO GREIGO | ||||||
| DIRECTOR (SERVED 1ST HALF OF YEAR) | 0.50 | X | 0 | 0 | 0 | |
| PATRICIA SKOGEN | ||||||
| INTERIM ADMINISTRATOR (THRU AUGUST) | 24.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 226915 | AllOtherContributions |
| Total Contributions | 226915 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 623000 | 3754919 | 3754919 |
| CONTRACTED SERVICES | 561000 | 68204 | 68204 |
| MISCELLANEOUS REVENUE | 900099 | 696 | 696 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3823819 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 97 | TotalRevenueColumn |
| Exclusion | $97 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1609194 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2958644 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -1349450 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1349450 | TotalRevenueColumn |
| Exclusion | -$1,349,450 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2701381 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3823819 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$1,349,353 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2278003 | Total |
| Program Services | 1507895 | ProgramServices |
| Management And General | 770108 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150996 | Total |
| Program Services | 99950 | ProgramServices |
| Management And General | 51046 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 206934 | Total |
| Program Services | 136977 | ProgramServices |
| Management And General | 69957 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49396 | Total |
| Management And General | 49396 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28251 | Total |
| Management And General | 28251 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 285789 | Total |
| Program Services | 285789 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19587 | Total |
| Program Services | 7941 | ProgramServices |
| Fundraising | 11646 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145392 | Total |
| Program Services | 116353 | ProgramServices |
| Management And General | 29039 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151171 | Total |
| Program Services | 151171 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115029 | Total |
| Program Services | 114668 | ProgramServices |
| Management And General | 361 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4891 | Total |
| Program Services | 3281 | ProgramServices |
| Management And General | 1610 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85546 | Total |
| Program Services | 85546 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 211026 | Total |
| Program Services | 211026 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18441 | Total |
| Program Services | 18441 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | FundraisingFundraising |
|---|---|---|---|
| NURSING HOME AND HOSPIC | 298317 | 298317 | |
| MEDICAL SUPPLIES | 230875 | 230875 | |
| BEREAVEMENT EXPENSE | 8927 | 8927 | |
| PROGRAM DEVELOPMENT | 5346 | 5346 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 959 | Total |
| Program Services | 959 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4294876 | Total |
| Program Services | 3278116 | ProgramServices |
| Management And General | 999768 | ManagementAndGeneral |
| Fundraising | 16992 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43603 | BOY |
| EOY | 26820 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 474480 | BOY |
| EOY | 572917 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21648 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48327 | BOY |
| EOY | 208 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 0 | LandBuildingsEquipmentBasis |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3123509 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 539 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3711567 | BOY |
| EOY | 600484 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 624605 | BOY |
| EOY | 700246 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1837174 | BOY |
| EOY | 243945 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2461779 | BOY |
| EOY | 944191 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1249788 | BOY |
| EOY | -343707 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1249788 | BOY |
| EOY | -343707 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3711567 | BOY |
| EOY | 600484 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1593495 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 222990 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 465061 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1078796 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 592019 | CurrentTaxYearMinus1Year |
| Current Tax Year | 226915 | CurrentTaxYear |
| Total | 2585781 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 222990 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 465061 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1078796 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 592019 | CurrentTaxYearMinus1Year |
| Current Tax Year | 226915 | CurrentTaxYear |
| Total | 2585781 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 2585781 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12660 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3849 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2203 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 60 | CurrentTaxYearMinus1Year |
| Current Tax Year | 97 | CurrentTaxYear |
| Total | 18869 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10542 | CurrentTaxYearMinus4Years |
| Total | 10542 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 2615192 | TotalSupport |
| Gross Receipts From Admissions Etc | 22413239 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.98880 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.96850 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule N IRS990ScheduleN
Disposition Table DispositionTable (3 entries)
| Description Of AssetDescriptionOfAsset | Date Of DistributionDateOfDistribution | FMV Of AssetFMVOfAsset | Method Of FMV DeterminationMethodOfFMVDetermination | EINEIN | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | IRC SectionIRCSection |
|---|---|---|---|---|---|---|---|---|---|
| SEE SCHEDULE O FOR RECIPIENT | |||||||||
| BUILDING AND EQUIPMENT | 2011-12-31 | 1100000 | BID-OUTSTANDING OFFERS | 453342446 | 805 E CHANNING AVE | FERGUS FALLS | MN | 56537 | 501(C)(3) |
| SEE SCHEDULE O FOR RECIPIENT | |||||||||
| HOSPICE CARE EQUIPMENT AND LICENSES | 2011-12-31 | 252097 | BID-OUTSTANDING OFFERS | 453342092 | 805 E CHANNING AVE | FERGUS FALLS | MN | 56537 | 501(C)(3) |
| SEE SCHEDULE O FOR RECIPIENT | |||||||||
| HOMECARE EQUIPMENT AND LICENSES | 2011-12-31 | 257097 | BID-OUTSTANDING OFFERS | 453342172 | 805 E CHANNING AVE | FERGUS FALLS | MN | 56537 | 501(C)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 0 | DirectorOfSuccessor2 |
| Employee Of Successor2 | 0 | EmployeeOfSuccessor2 |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2 |
| Receive Compensation2 | 0 | ReceiveCompensation2 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CHANGES IN PROGRAM SERVICES | FORM 990, PART III, LINE 3 | AS OF 12/31/11 THE ORGANIZATION NO LONGER PROVIDES HOSPICE OR HOME CARE ACTIVITIES. THE HOSPICE AND HOME CARE EQUIPMENT AND LICENSES WERE SOLD AS OF 12/31/11. THE ENTITY IS STILL IN EXISTENCE IN ORDER TO WRAP UP DISCONTINUED OPERATIONS. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE BYLAWS ALLOW FOR AN EXECUTIVE COMMITTEE. THE DULY-ELECTED OFFICERS OF THE CORPORATION SHALL CONSTITUTE THE EXECUTIVE COMMITTEE OF THE CORPORATION. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD IN MANAGEMENT OF THE BUSINESS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL ACT ONLY IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD AND AT ALL TIMES IS SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD, BUT UNLESS ITS AUTHORITY IS LIMITED, IT SHALL EXERCISE THE FULL POWERS OF THE BOARD UPON THE BASIS OF THIS BYLAW PROVISION AND WITHOUT SPECIFIC DELEGATION OF SUCH AUTHORITY BY THE BOARD. | |
| FORM 990, PART VI, SECTION A, LINE 2 | ED STRAND, LARRY SCHULTZ, ANGELO GRIEGO AND JIM WORNER HAVE A BUSINESS RELATIONSHIP. | |
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION PAID A CONTRACTING COMPANY, PATHWAY HEALTH SERVICES, INC., FOR INTERIM ADMINISTRATOR SERVICES THROUGH AUGUST 2011. IN AUGUST, LUTHERAN BRETHREN STEPPED IN AND REBECCA ODDEN WAS THE NEW INTERIM ADMINISTRATOR AT THAT TIME PROVIDING CONSULTING SERVICES ON A VOLUNTEER BASIS. THE BOARD OF DIRECTORS HAD FULL CONTROL OF ALL BUSINESS DECISIONS AND THE MONITORING OF BUSINESS OPERATIONS. | |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE BUT THE COMMITTEE DID NOT MEET DURING THE YEAR. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ACCOUNTANT AND TREASURER REVIEWED THE FORM 990. AFTER THEIR REVIEW THE BOARD WAS PROVIDED THE FORM 990 ELECTRONICALLY BEFORE BEING FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE ASKED TO DISCLOSE CONFLICTS ANNUALLY. IF THERE IS A CONFLICT THE BOARD MEMBER IS ASKED TO ABSTAIN FROM VOTING. THE ADMINISTRATOR AND BOARD PRESIDENT REVIEW ANY CONFLICTS DISCLOSED. THEY MAKE KNOWN TO THE FULL BOARD ANY CONFLICTS DISCLOSED. | |
| THROUGH AUGUST, 2011, THE INTERIM ADMINISTRATOR, PATRICIA SKOGEN, WAS PAID ON A CONTRACTED BASIS THROUGH PATHWAY HEALTH SERVICES, INC. IN AUGUST, REBECCA ODIN BEGAN PROVIDING INTERIM ADMINISTRATOR SERVICES ON A VOLUNTEER BASIS THROUGH LUTHERAN BRETHREN. | ||
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990, SCHEDULE N, PART II, LINE 1(F): | BUILDING AND EQUIPMENT - LUTHERAN BRETHREN WOODLAND LODGE, INC. HOSPICE CARE EQUIPMENT AND LICENSES - LUTHERAN BRETHREN HOSPICE CARE SERVICES, INC. HOMECARE EQUIPMENT AND LICENSES - LUTHERAN BRETHREN HOME HEALTH SERVICES, INC. |
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