2011-08-12T16:13:59-05:00 2010-09-30 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2009-10-01 411465334 PRESBYTERIAN HOMES FOUNDATION PRES 6516316300 2845 HAMLINE AVENUE North ROSEVILLE MN 55113 MARK MEYER 6516316300 2011-08-11 1 Terrance O'Reilly 6123764500 2009 2016-02-24 21:20:13Z Dan Lindh 2845 HAMLINE AVENUE North ROSEVILLE MN 55113 6828193 0 X WWW.PRESHOMES.ORG X 1982 MN TO ENRICH THE LIVES OF OLDER ADULTS THROUGH SERVICES & COMMUNITIES THAT REFLECT THE LOVE OF GOD. 3 1 0 1 0 0 1335771 5438493 0 1232623 1389700 0 2568394 6828193 2494174 5813303 0 0 0 0 2858882 1065187 5353056 6878490 -2784662 -50297 39716000 42138284 4755000 6194119 34961000 35944165 The mission of Presbyterian Homes Foundation is to entrich the lives of older adults through services and communities that reflect the love of God. 0 0 5847422 5813303 0 The Foundation is formed to aid, Support, and promote the 501C(3) purposes of the Presbyterian Homes and its affiliates. Specifically, the Foundation provided more than $5.8 million in awards to affiliated organizations during the year ended September 30, 2010. These awards are used to provide housing and other care services to the elderly in accordance with the exempt purposes of the recipient charitabl e affiliates. 5847422 1 1 0 0 0 0 0 0 1 1 0 1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 0 0 0 0 0 0 0 1 2 0 0 3 1 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X HEIDI PETERSON 6516316162 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 X larry carlson 1.00 X X 0 0 0 dan lindh 40.00 X X 0 506343 21023 mark meyer 40.00 X X 0 275033 14444 Janna Severance 40.00 X 0 221370 12678 Cathy Bergland 40.00 X 0 242039 9689 Sharon Klefsaas 40.00 X 0 181459 10196 karen mckenna 40.00 X 0 204429 6311 PHil Hanson 40.00 X 0 158524 14870 0 1789197 89211 0 1 1 0 0 5438493 5438493 1389700 1389700 6828193 0 0 1389700 5813303 5813303 1027748 1027748 3320 3320 MISCELLANEOUS EXPENSES 34119 34119 6878490 5847422 1031068 0 380000 472133 1889000 1519999 -18649 31565000 34109733 5882000 6055068 39716000 42138284 1100000 603949 3655000 5590170 4755000 6194119 X 1766000 -268519 4348000 5655676 28847000 30557008 34961000 35944165 39716000 42138284 X 0 1 1 X 0 X 757000 2057000 4933000 1335771 5438493 14521264 757000 2057000 4933000 1335771 5438493 14521264 14521264 902000 992000 1679000 1232623 1389700 6195323 20716587 0.70090 0.70120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 31212047 350486 3131856 -1084455 33609934 32502594 225598 -319898 1196247 31212047 0.05000 0.95000 0.00000 0 0 0 endowment funds 33609934 F MISSION BENEVOLENT INVESTMENT 381371 F CHARITABLE GIFT ANNUITY CASH 118428 F 34109733 investment in oakcrest 2324000 notes, project costs, and other receivables 3731068 6055068 due to affiliates 5471742 CHaritable Gift Annuity 118428 5590170 Part V, Line 4: Description of Intended Use of Endowment Funds: Presbyterian Homes Foundation endowment funds will be used as directed by the donor's restrictions. Part X: Description of Uncertain Tax Positions Under FIN 48: The Organization follows the accounting standard for contingencies in evaluating uncertain tax positions. The Organization files information returns 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 Organization's 2006, 2007, and 2008 tax years are open to examination by the IRS. 1 0 0 0 0 0 east asia and the pacific nursing scholarships 10000 check 0 1 1 Presbyterian homes of arden hills inc 2845 hamline ave N roseville MN 55113 411482075 501c3 1406400 further exempt purpose presbyterian homes bloomington care center inc 2845 hamline ave N roseville MN 55113 411862259 501c3 27174 further exempt purpose presbyterian homes mill pond care center inc 2845 hamline ave N roseville MN 55113 311581714 501c3 10481 further exempt purpose presbyterian homes of north oaks inc 2845 hamline ave N roseville MN 55113 300054296 501c3 822664 further exempt purpose presbyterian homes care centers inc 2845 hamline ave N roseville MN 55113 411500288 501c3 5438 further exempt purpose croixdale 2845 hamline ave N roseville MN 55113 410843106 501c3 6785 further exempt purpose PHSInver Grove Inc 2845 hamline ave N roseville MN 55113 311725017 501c3 8113 further exempt purpose phs lake minnetonka llc 2845 hamline ave N roseville MN 55113 272377256 501c3 25525 further exempt purpose plymouth senior housing llc 2845 hamline ave N roseville MN 55113 412011416 501c3 8962 further exempt purpose avalon square inc 2845 hamline ave N roseville MN 55113 311662044 501c3 112825 further exempt purpose kirkland crossings inc 2845 hamline ave N roseville MN 55113 311662039 501c3 16169 further exempt purpose grandview christian home 2845 hamline ave N roseville MN 55113 410844893 501c3 58186 further exempt purpose presbyterian homes housing & assisted living inc 2845 hamline ave N roseville MN 55113 411463801 501c3 2100000 further exempt purpose american association of homes & services for the aging 2519 CONNECTICUT AVENUE NW WASHINGTON DC 20008 136213525 501c3 25000 further exempt purpose valley senior services alliance 2845 hamline ave N roseville MN 55113 411915023 501c3 108143 further exempt purpose 15 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Grants to affiliates are the temporary restricted gifts from the original donors which are to be used as intended by the donor. Fund balances are maintained to show each gifts restrictions. The Foundation provides a list of restrictions to each affiliate at the time of donation and the campus administrator for each affiliate is responsible for ensuring that the funds are used in accordance with the Foundation's/Donor's direction. Some of the grants listed are endowment distributions, which are approved by the board of directors. 1 0 0 0 0 0 0 0 0 dan lindh 0 506343 0 0 0 0 0 14505 0 6518 0 527366 0 0 mark meyer 0 275033 0 0 0 0 0 7755 0 6689 0 289477 0 0 Janna Severance 0 221370 0 0 0 0 0 8440 0 4238 0 234048 0 0 Cathy Bergland 0 242039 0 0 0 0 0 5505 0 4184 0 251728 0 0 Sharon Klefsaas 0 181459 0 0 0 0 0 5955 0 4241 0 191655 0 0 karen mckenna 0 204429 0 0 0 0 0 6000 0 311 0 210740 0 0 PHil Hanson 0 158524 0 0 0 0 0 9000 0 5870 0 173394 0 0 Part I, Line 4a: Phil Hanson - $3,899 Grossed up wages to cover benefits. Supplemental Information Part III PART I, LINE 3: THE COMPENSATION IS DETERMINED BY THE RELATED ORGANIZATION AND THE ORGANIZATION USES a) COMMISSION COMMITTEE b) INDEPENDENT COMPENSATION CONSULTANTS C)COMPENSATION SURVEY OR STUDY AND D)APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE COMPENSATION. Form 990, Part VI, Section A, line 6 The sole member of Presbyterian Homes Foundation is Presbyterian Homes and Services. Form 990, Part VI, Section A, line 7a The members of the organization elect the members of the governing body, but not if the persons on the governing body are the organization's only members or their delegates. Form 990, Part VI, Section B, line 11 The organization's Form 990 is provided to voting members of the governing body prior to filing with the IRS. Officers and management of the organization have been involved in the preparation of the Form 990 and have reviewed it throughout the process. Form 990, Part VI, Section B, line 12c The organization obtains annually written disclosures from governing body members, officers, and key employees. Management and officers review these disclosures and evaluate whether the interest could result in a conflict and then take the necessary steps to remediate any such conflict. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A SHARING OF HOURS OFFICERS & KEY EMPLOYEES SHARE THEIR HOURS BETWEEN THE FILING ORGANIZATION AND ITS RELATED ORGANIZATIONS. presbyterian homes of arden hills 2845 hamline avenue north roseville MN 55113 411482075 care of the elderly MN 501(c)(3) Line 9 N/A castle ridge care center 2845 hamline avenue north roseville MN 55113 510171801 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes of andover 2845 hamline avenue north roseville MN 55113 411891862 care of the elderly MN 501(c)(3) Line 9 N/A PHSBeacon Hill inc 2845 hamline avenue north roseville MN 55113 300093682 care of the elderly MN 501(c)(3) Line 9 N/A Presbyterian homes of bloomington care center inc 2845 hamline avenue north roseville MN 55113 411862259 care of the elderly MN 501(c)(3) Line 9 N/A PHS eaglecrest 2845 hamline avenue north roseville MN 55113 311604817 care of the elderly MN 501(c)(3) Line 9 N/A Gideon Pond housing corp 2845 hamline avenue north roseville MN 55113 411428336 care of the elderly MN 501(c)(3) Line 9 N/A GIDEON POND WEST INC 2845 hamline avenue north Roseville MN 55113 411671887 Care of the elderly MN 501(c)(3) Line 9 N/A PHSHAMLINE INC 2845 hamline avenue north Roseville MN 55113 300225325 CAre of the elderly MN 501(c)(3) Line 9 N/A phsinver grove inc 2845 hamline avenue north roseville MN 55113 311725017 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes mill pond apartments inc 2845 hamline avenue north roseville MN 55113 311581710 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes mill pond care center inc 2845 hamline avenue north roseville MN 55113 311581714 care of the elderly MN 501(c)(3) Line 9 N/A phsmonticello inc 2845 hamline avenue north roseville MN 55113 411819439 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes of north oaks inc 2845 hamline avenue north roseville MN 55113 300054296 care of the elderly MN 501(c)(3) Line 9 N/A phsoakdale inc 2845 hamline avenue north roseville MN 55113 411832098 care of the elderly MN 501(c)(3) Line 9 N/A phsshoreview inc 2845 hamline avenue north roseville MN 55113 311631264 care of the elderly MN 501(c)(3) Line 9 N/A phmwashington glen inc 2845 hamline avenue north roseville MN 55113 300060683 care of the elderly MN 501(c)(3) Line 9 N/A phswoodbury 2845 hamline avenue north roseville MN 55113 311630828 care of the elderly MN 501(c)(3) Line 9 N/A center park senior apartments inc 2845 hamline avenue north roseville MN 55113 411685829 care of the elderly MN 501(c)(3) Line 9 N/A maranatha conservative baptist home 2845 hamline avenue north roseville MN 55113 410855713 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes management and services 2845 hamline avenue north roseville MN 55113 411499595 care of the elderly MN 501(c)(3) Line 11b, II N/A phs cottage grove inc 2845 hamline avenue north roseville MN 55113 300227875 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes housing and assisted living inc 2845 hamline avenue north roseville MN 55113 411463801 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes and services 2845 hamline avenue north roseville MN 55113 410758756 care of the elderly MN 501(c)(3) Line 9 N/A broadmoor apartments inc 2845 hamline avenue north roseville MN 55113 201112603 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes of bloominton inc 2845 hamline avenue north roseville MN 55113 411871732 care of the elderly ME 501(c)(3) Line 9 N/A presbyterian homes care centers inc 2845 hamline avenue north roseville MN 55113 411500288 care of the elderly MN 501(c)(3) Line 9 N/A avalon square inc 2845 hamline avenue north roseville MN 55113 311662044 care of the elderly MN 501(c)(3) Line 9 N/A kirkland crossings inc 2845 hamline avenue north roseville MN 55113 311662039 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes of wisconsin inc 2845 hamline avenue north roseville MN 55113 396054152 care of the elderly MN 501(c)(3) Line 9 N/A grandview christian home 2845 hamline avenue north roseville MN 55113 410844893 care of the elderly MN 501(c)(3) Line 9 N/A grandview christian ministries 2845 hamline avenue north roseville MN 55113 411526031 care of the elderly MN 501(c)(3) Line 9 N/A grandview west inc 2845 hamline avenue north roseville MN 55113 311608246 care of the elderly MN 501(c)(3) Line 9 N/A mill ridge commons 2845 hamline avenue north roseville MN 55113 363545892 care of the elderly MN 501(c)(3) Line 9 N/A croixdale 2845 hamline avenue north roseville MN 55113 410843106 care of the elderly MN 501(c)(3) Line 9 N/A noahs ark affordable housing inc 2845 hamline avenue north roseville MN 55113 411777250 care of the elderly MN 501(c)(3) Line 9 N/A phschanhassen inc 2845 hamline avenue north roseville MN 55113 311725630 care of the elderly MN 501(c)(3) Line 9 N/A valley senior service alliance 2845 hamline avenue north roseville MN 55113 411915023 care of the elderly MN 501(c)(3) Line 9 N/A williamsburg retirement community 2845 hamline avenue north roseville MN 55113 753033211 care of the elderly MN 501(c)(3) Line 9 N/A presbyterian homes hospice inc 2845 hamline avenue north roseville MN 55113 260766609 care of the elderly MN 501(c)(3) Line 9 N/A wayzata bay senior housing inc 2845 hamline avenue north roseville MN 55113 260615372 care of the elderly MN 501(c)(3) Line 9 N/A 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0