2012-08-27T08:39:31-05:00 2011-12-31 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2011-01-01 450274012 American Lutheran Homes Inc AMER 7012393000 201 S University Drive Fargo ND 58103 Shawn Stuhaug 7012393000 2012-08-20 1 KIM C HUNWARDSEN P00484560 7012398500 2012-08-20 2011 2016-02-24 21:20:13Z Bethany On University Shawn Stuhaug 201 S University Drive Fargo ND 58103 18561203 0 X www.bethanynd.org X 1959 ND Long term care services 11 11 930 214 0 0 192964 14396 17409120 18526794 15143 -1354 110069 -542 17727296 18539294 5000 0 0 0 11800826 11482107 0 0 0 5370665 5403767 17176491 16885874 550805 1653420 24778842 25861572 13705688 13134998 11073154 12726574 X To provide living opportunities in a senior community shaped by Christian values. 0 0 14930545 18526794 Service to the communityAmerican Lutheran Homes, Inc. (ALH) operates as a charitable organization consistent with the requirements of Internal Revenue Code Section 501(c)(3). ALH provides long term care services including skilled nursing care, assisted living, basic care and independent senior housing. ALH does not discriminate against individuals in the admissions process or in the delivery of care with regard to ability to pay for services. The assisted living facilities operated by ALH primarily serve low-income elderly residents. The Organization's cash reserves are generally applied to expansion and replacement of existing facilities and equipment, amortization of mortgages, improvement in resident care, training and education, and community benefit activities. The governing board of ALH is made up of leaders in the Fargo-Moorhead business community. Consistent with its charitable mission, ALH provides community benefit to the area served. In 2011, community benefit activities included:- Speaker's bureau services - provides free educational sessions to agencies and individuals in the community on topics such as: From Independent Living to Skilled Care - A LTC Overview 10 Things You Want To Know About Nursing Homes Early Dementia Care HIPAA - Protecting Information About You The A, B, C, D's Of Medicare Seniors and Spirituality Managing Your Resources - Estate Planning Activity With A Purpose Volunteerism - The Rewards Of Giving Yourself- Groups to which our speaker's bureau presented information included service clubs, churches, parish nurse groups, and senior centers.- Endings and Beginnings - a support group for family members dealing with a loved one diagnosed with Alzheimer's disease - Provides virtual dementia / sensitivity training to employees and community members. This training program teaches participants about the challenges and frustrations of an elderly nursing home resident in managing day-to-day tasks and activities. Participants learn through active involvement in a simulation exercise what is it like to be challenged by issues like hearing impairment, deteriorating vision, dementia, loss of control of their environment, communication difficulties, etc.- Volunteerism - coordinates a volunteer program that included approximately 214 volunteers giving over 16,800 hours of service, providing mental stimulation and emotional support to ALH's 352 elderly residents. Volunteers included members of sponsoring churches, experience works program volunteers, and many student volunteers from the community's schools - elementary, middle, high schools and colleges. ALH provides meeting space for the community's Director of Volunteer Services Association.- Tuition assistance - ALH recognizes that to continuously improve the Organization's value to our community and our residents, to encourage life-long learning among employees and to achieve an "employer of choice" status, it is in our best interest to provide opportunities that will assist eligible employees in pursuing formal, healthcare-related educational opportunities. ALH administers two internal scholarship programs, funded by donations. These programs provide schlarship opportunities to Bethany employees pursuing nursing education.- School Partnerships - ALH works with area nursing and other healthcare-related programs to provide on-site training opportunities for students. In 2011, we had approximately 150 nursing students complete clinical experiences at our facility. We also provided clinical site experience for the CNA training program and dietetic students, and internship opportunities for students in social worker programs, LTC administration and pre-med students for observation of Alzheimer's residents. We hosted visiting students from several higher education classes including: gender and aging class from North Dakota State University (NDSU) Department of Human Development; long term care planning class from NDSU's interior design program; Concordia College class from the long term care administration program.- Assessment and referral services - our staff help to refer individuals needing long term care services to the appropriate agency in the community. ALH licensed social workers provide guidance with medical assistance applications for residents/families.- Through in-kind gifts of equipment and other materials, ALH helps support the work of the following agencies: Project HERO Dakota Boys' and Girls' Ranch New Life Center Rape and Abuse Crisis Center YWCA programs- Community support - ALH provides meeting room space and accommodations for non-profit organizations and community groups. Several of our resident activity programs are open to community members. In 2011, these activities included an outdoor concert, carnival, special Christmas events, and several food festivals. ALH also supports and sponsors the Northern Plains Conference on Aging and Disability, as well as sponsoring the RSVP program. Facility space is open to use by outside groups for meetings, performances, activities, funeral/memorials services, music recitals, etc. Meals are provided for family members of ALH residents at a reduced cost.- Other - in addition to the activities above, ALH also organizes employee participation in fundraising activities for Cass-Clay United Way and the Alzheimer's association. There are also representatives from ALH on non-profit boards and civic organizations that work to improve the quality of life in the Fargo-Moorhead area. ALH's President/CEO serves on HERO's (Health Equipment Recycling Organization) Board of Directors and the Fargo Dome Finance Committee. He also serves as the Region VI director on the board of the North Dakota Long Term Care Association. ALH's Chief Financial Officer serves on the board of Hospice of the Red River Valley. The Senior Executive of Medicare/Contracted Services serves on the board for the National Association of Directors of Nursing Association (NADONA). ALH's Senior Executive of Support Services is on the Dietetics Advisory Committee for North Dakota State University. The Senior Executive of Housing/Assisted Living is a Board member of the Fargo West Rotary service club, serves as the Assisted Living Director at Large on the NDLTCA Board, and represents North Dakota as a State Leader for NCAL (National Center for Assisted Living). ALH's Director of Bethany Personal Care Services is on the Advisory Board for the North Dakota State University Nursing program and the Senior Executive of Resident Care is on the NADONA membership committee.The following is specific information relating to ALHs' care provided:Bethany on University skilled care - services provided, 172 nursing home beds: 62,415 days of care and 531,573 employee hours (total expenses = 13,501,968)Bethany Towers I - assisted living services, 17 beds - 4,783 days of care; basic care services, 36 beds - 11,772 days of care. BT I had 32,277 employee hours (total expenses = 1,346,964)Bethany Towers II - assisted living services, 92 units - 30,715 days of care and 17,759 employee hours (total expenses = 1,685,434)Bethany Kinder House Independent Senior Housing, 35 units - 11,139 days of care and 3,099 employee hours (total expenses = 351,508) 14930545 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 30 0 1 930 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Jane Kelly 7012393226 201 South University Drive Fargo ND 58103 Robert McConn 1.00 X X 0 0 0 Mary Johnson Board Vice Chair Jan- 1.00 X X 0 0 0 Martha Leclerc Board Treasurer Jan- 1.00 X X 0 0 0 Lloyd Smith Board Secretary Jan- 1.00 X X 0 0 0 Janice Nelson Board TrusteeJan- 1.00 X X 0 0 0 Shannon Charpentier 1.00 X 0 0 0 Neal Eriksmoen 1.00 X 0 0 0 David Glatt 3.00 X 8256 0 0 Robin Pratt 1.00 X 0 0 0 Harriet McCaul 1.00 X 0 0 0 Paul Wilson 1.00 X 0 0 0 Jerilynn Brantner-Adams 1.00 X 0 0 0 Shawn Stuhaug 23.00 X 199313 0 7806 Jane Kelly 25.00 X 151045 0 19796 358614 0 27602 2 0 1 1 RehabCare Group Inc PO Box 503534 St Louis MO 631503534 Contract Therapy 486139 1 3000 11396 14396 Resident Service Reven 623000 18526794 18526794 18526794 20555 20555 21909 -21909 -21909 -21909 Other Revenue 900099 -542 -542 -542 18539294 18526794 0 -1896 386454 8256 378198 9322438 8704408 618030 140265 126198 14067 931750 853555 78195 701200 629787 71413 94665 94665 602879 602879 1660929 1298114 362815 580769 580769 73666 55867 17799 171704 171704 1168243 1168243 293068 293068 Medical Supplies 559725 559725 Bad Debt Expense 168153 168153 Memberships 27079 27079 Flood Expenses 2887 2887 16885874 14930545 1955329 0 1871111 4496683 2002038 1420537 6376612 6231813 149553 155092 174873 189022 28492541 18550710 10551024 9941831 615735 661636 1008465 846624 2029431 1918334 24778842 25861572 2568580 2420854 9608909 9228733 29002 31581 803547 773133 344671 335718 350979 344979 13705688 13134998 X 11073154 12726574 11073154 12726574 24778842 25861572 1653420 0 X 0 1 1 X 0 X 300871 19846 428364 192964 4396 946441 15318329 16195912 17242225 17409120 18526794 84692380 15619200 16215758 17670589 17602084 18531190 85638821 0 0 0 85638821 293936 96611 21661 14720 20555 447483 293936 96611 21661 14720 20555 447483 110069 9458 119527 15913136 16312369 17692250 17726873 18561203 86205831 0.99340 0.99000 0.00520 0.00870 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1230011 1230011 20273885 13993890 6279995 6225051 4206188 2018863 763594 350632 412962 9941831 Related Party Receivables 1451579 Deferred Financing Costs 25526 Land Held for Expansion 441229 1918334 Related Entity Note Payable 308000 Related Party Payable 36979 344979 18539294 16885874 1653420 1653420 18539294 0 18539294 0 18539294 16885874 0 16885874 0 16885874 Part IV, Line 2b: The Organization acts as custodian for the funds of the residents. These funds are included in cash and cash equivalents and a corresponding liability is included in accounts payable-trade in the financial statements. Resident trust funds totaled $31,581 and $29,002 at December 31, 2011 and 2010. Description of Uncertain Tax Positions Under FIN 48: Part X: Bethany believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. Bethany would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. X X X X X 0 0 0 0 0 0 0 1 0 David Glatt 8256 0 0 0 0 0 0 0 0 0 8256 0 0 0 Shawn Stuhaug 160323 0 38990 0 0 0 7491 0 447 0 207251 0 0 0 Jane Kelly 124644 0 26401 0 0 0 6172 0 13730 0 170947 0 0 0 Part I, Line 7 CEO and CFO received a bonus as determined by the Board of Directors. The bonus is based on review of performance and progress related to a specific work plan. Supplemental Information Part III In conjuction with Bethany on 42nd, a related organization, American Lutheran Homes, Inc. has an agreement with Sanford Health for Medical Director services provided by David Glatt. Compensation noted in Schedule J Part II is the fee paid to Sanford Health for his services provided to American Lutheran Homes, Inc. Cass County North Dakota 456002205 2004-12-31 4607000 Health Care Facilities Refunding Revenue Bonds-Series 2004A 0 0 0 Cass County North Dakota 456002205 2010-10-01 6400000 Housing and health care facility revenue bonds 0 0 0 4607000 38881 4568119 2004 1 0 1 1 6400000 54857 6345143 2010 0 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 1 0 0 0 0 0 0 Form 990, Part VI, Section A, line 6 Bethany Homes, Inc. is the sole member of the Corporation. Form 990, Part VI, Section A, line 7a The Board of Directors is elected at the annual meeting of the Board of Trustees of the Member. The member has the right to fill any vacancies during the year. The member may also remove any directors with or without cause. Form 990, Part VI, Section A, line 7b The following actions by the Board of Directors require the approval of the Board of Trustees of the Member: - Establishment of annual operating budget - Sale, lease or encumbrance of any corporation real property - Unbudgeted capital expenditures exceeding amounts for which the President/CEO is specifically authorized to approve Form 990, Part VI, Section B, line 11 The Form 990 is reviewed by the CFO and CEO and then provided to the Finance Committee for their review and approval. A draft copy of the Form 990 is provided to the board prior to filing. Form 990, Part VI, Section B, line 12c Board officers and directors, as well as officers of the Organization, complete a conflict of interest questionnaire on an annual basis. The Board reviews the conflicts to determine if a conflict exists. The individual with the conflict is required to abstain from voting if the conflict comes up in the board meeting where a decision needs to be made. This is a standing agenda item at each board meeting. Form 990, Part VI, Section B, line 15 The Executive Committee of the board meets to determine the compensation of the President/CEO. Compensation is determined by gathering comparable data, including salary surveys, personal contacts, 990 data, and evaluating criteria such as knowledge/experience, longevity, job performance, etc. Every three to five years, a consultant is brought in to assist in the evaluation process to test for fairness and reasonableness of compensation levels. The Executive Committee reviews the data and recommends the compensation package, which is reviewed and approved at the full board level. The process for determining compensation for the President/CEO is implemented on an annual basis. The President/CEO determines the CFO compensation and reviews the information with the Executive Committee. The process for determining compensation for the CFO is implemented on an annual basis. For the current year, a consultant reviewed the CFO compensation and and provided comparable data. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part VII, Section A: The CEO and CFO are compensated by American Lutheran Homes, Inc. for their services provided to American Lutheran Homes, Inc. and other related entities. The CEO serves approximately 27 hours per week to the other related entities. The CFO serves approximately 25 hours per week to the other related entities. All board members serve Bethany Homes, Inc. and Bethany on 42nd an additional 1 hour per week for each entity. The following individuals serve Bethany Home Health Care, Inc. an additional 1 hour per week: Neal Ericksmoen, Janice Nelson, Shannon Charpentier, Robin Pratt, and Harriette McCaul. David Glatt serves as a board member 1 hour per week. He serves an additional two hours per week as a Medical Director. Compensation shown on Part VII is compensation paid to Sanford Health for his services as Medical Director to American Lutheran Homes. Bethany Home Health Care Inc 201 S University Drive Fargo ND 58103 450433045 Promotion of health ND 501(c)(3) 9 Bethany Homes Inc 1 Bethany on 42nd 201 S University Drive Fargo ND 58103 261087740 Long-term care services/Assisted living/Independent living ND 501(c)(3) 9 Bethany Homes Inc 1 Bethany Homes Inc 201 S University Drive Fargo ND 58103 450394181 Fundraising ND 501(c)(3) 9 Bethany Homes Inc 1 0 0 1 1 1 0 0 0 0 0 1 1 1 0 0 1 0 1 Bethany Homes Inc C 0 General Ledger Bethany on 42nd D 423120 General Ledger Bethany on 42nd P 7476779 General Ledger Bethany Homes Inc P 118097 General Ledger Bethany Home Health Care Inc P 576213 General Ledger Bethany Home Health Care Inc M 0 General Ledger