2012-11-14T16:30:21-06:00 2011-12-31 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2011-01-01 363255877 LAKELAND HOSPICE AND HOME CARE INC LAKE 2189981400 805 EAST CHANNING FERGUS FALLS MN 56537 ED STRAND 2189981400 2012-11-14 1 LISA CHAFFEE CPA P00193453 7012398500 2012-11-14 2011 2016-02-24 21:20:13Z X NATHAN JOHNSON 805 EAST CHANNING FERGUS FALLS MN 56537 5660025 0 X WWW.LAKELANDHOSPICE.ORG X 1984 MN PATIENT SUPPORT 8 8 112 75 0 0 592019 226915 4103510 3823819 -1892 -1349353 0 0 4693637 2701381 0 0 0 0 3106836 2635933 0 0 16992 1712540 1658943 4819376 4294876 -125739 -1593495 3711567 600484 2461779 944191 1249788 -343707 X 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. 0 1 2237291 2651122 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. 1040825 1172697 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. 3278116 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 5 0 1 112 1 0 0 0 0 0 0 0 0 0 0 X 8 8 1 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 MN X DAWN TROSVIG 2189981400 805 EAST CHANNING FERGUS FALLS MN 56537 X NATHAN JOHNSON 0.50 X X 0 0 0 REBECCA ODDEN VICE PRESIDENT THRU 0.50 X X 0 0 0 CAROL JUUL 0.50 X X 0 0 0 EDWARD STRAND 0.50 X X 0 0 0 JIM WORNER 0.50 X 0 0 0 LARRY SCHULZ 0.50 X 0 0 0 JOHN ZWIERS 0.50 X 0 0 0 TOM PETERSON 0.50 X 0 0 0 JOHN RICHARDS 0.50 X 0 0 0 PAT KREKELBERG 0.50 X 0 0 0 ANGELO GREIGO 0.50 X 0 0 0 PATRICIA SKOGEN 24.00 X 0 0 0 0 0 0 0 0 0 0 0 226915 226915 NET PATIENT REVENUE 623000 3754919 3754919 CONTRACTED SERVICES 561000 68204 68204 MISCELLANEOUS REVENUE 900099 696 696 3823819 97 97 1609194 2958644 -1349450 -1349450 -1349450 2701381 3823819 0 -1349353 2278003 1507895 770108 150996 99950 51046 206934 136977 69957 49396 49396 28251 28251 285789 285789 19587 7941 11646 145392 116353 29039 151171 151171 115029 114668 361 4891 3281 1610 85546 85546 211026 211026 18441 18441 NURSING HOME AND HOSPIC 298317 298317 MEDICAL SUPPLIES 230875 230875 BEREAVEMENT EXPENSE 8927 8927 PROGRAM DEVELOPMENT 5346 5346 959 959 4294876 3278116 999768 16992 43603 26820 474480 572917 21648 0 48327 208 0 3123509 0 539 3711567 600484 624605 700246 1837174 243945 2461779 944191 X 1249788 -343707 1249788 -343707 3711567 600484 -1593495 0 X 0 0 0 X 222990 465061 1078796 592019 226915 2585781 222990 465061 1078796 592019 226915 2585781 2585781 12660 3849 2203 60 97 18869 10542 10542 2615192 22413239 0.98880 0.96850 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED BUILDING AND EQUIPMENT 2011-12-31 1100000 BID-OUTSTANDING OFFERS 453342446 SEE SCHEDULE O FOR RECIPIENT 805 E CHANNING AVE FERGUS FALLS MN 56537 501(C)(3) HOSPICE CARE EQUIPMENT AND LICENSES 2011-12-31 252097 BID-OUTSTANDING OFFERS 453342092 SEE SCHEDULE O FOR RECIPIENT 805 E CHANNING AVE FERGUS FALLS MN 56537 501(C)(3) HOMECARE EQUIPMENT AND LICENSES 2011-12-31 257097 BID-OUTSTANDING OFFERS 453342172 SEE SCHEDULE O FOR RECIPIENT 805 E CHANNING AVE FERGUS FALLS MN 56537 501(C)(3) 0 0 0 0 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.