2011-01-26T11:01:47-06:00 2010-09-30 LARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2009-10-01 410880871 GOOD SHEPHERD LUTHERAN HOME GOOD 5078647714 PO BOX 747 RUSHFORD MN 559710747 ED BERKLEY 5078647714 2011-01-17 1 Trent Fast 5074347000 2011-01-12 2009 2016-02-24 21:20:13Z ED BERKLEY 3873 WEST 9TH WINONA MN 55987 5545999 0 X www.goodshep-rushford.org X 1965 MN TO PROVIDE NURSING HOME CARE AND ASSISTED LIVING CARE SERVICES TO THE ELDERLY OF RUSHFORD, MINNESOTA AND THE SURROUNDING AREA AND ALSO TO PROVIDE CHILD CARE SERVICES FOR EMPLOYEES AND THE PUBLIC. 9 9 197 124 210425 -171 84602 77937 5305135 5395059 31295 53918 15545 18026 5436577 5544940 0 0 3586964 3652132 0 0 1621688 1727419 5208652 5379551 227925 165389 3386686 3463082 1704034 1614157 1682652 1848925 TO PROVIDE NURSING HOME CARE AND ASSISTED LIVING CARE SERVICES TO THE ELDERLY OF RUSHFORD, MINNESOTA AND THE SURROUNDING AREA AND ALSO TO PROVIDE CHILD CARE SERVICES FOR EMPLOYEES AND THE PUBLIC. 0 0 4836457 5184634 TO PROVIDE NURSING HOME CARE AND ASSISTED LIVING CARE SERVICES TO THE ELDERLY OF RUSHFORD, MINNESOTA AND THE SURROUNDING AREA THROUGH THE OPERATION OF A 75 BED NURSING HOME, 32 APARTMENT UNITS AND A 15 UNIT ASSISTED LIVING FACILITY ALL LOCATED ON ONE CAMPUS. 4836457 1 1 0 0 0 0 0 0 0 1 0 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 1 1 0 0 1 5 0 1 197 1 1 1 0 0 0 0 0 0 0 0 9 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X RHONDA SPECE 5078647714 800 HOME STREET RUSHFORD MN 55971 ED BERKLEY 0.50 X X 0 0 0 ANN SPARTZ 0.50 X X 0 0 0 WANDA OLSON 0.50 X X 0 0 0 BILL GRINDLAND 0.50 X 0 0 0 JEANNE FELDMEIER 0.50 X 0 0 0 LYLE MELDAHL 0.50 X 0 0 0 MERLE EVENSON 0.50 X 0 0 0 LYLE NELSON 0.50 X 0 0 0 STEVE GILSETH 0.50 X 0 0 0 TOM LINDH 40.00 X 65127 0 13441 RHONDA SPECE 40.00 X 44461 0 13962 109588 0 27403 0 0 0 0 THERAPY NETWORK 66 SHADY OAK CT WINONA MN 55987 THERAPY SERVICES 283306 1 15550 62387 77937 MEDICARE/MEDICAID PMTS 623000 2964593 2964593 RESIDENT REVENUE 623000 1821144 1821144 APARTMENT REVENUE 623000 299935 299935 DAY CARE REVENUE 623990 275967 65542 210425 MGMT CONTRACT REVENUE 561000 26460 26460 6960 6960 5395059 54977 54977 1059 -1059 -1059 -1059 BEAUTY SHOP REVENUE 812900 12128 12128 GUEST/EMPLOYEE MEALS 900099 5327 5327 MISCELLANEOUS REVENUE 900099 571 571 18026 5544940 5184634 210425 71944 76244 76244 2682533 2479791 202742 28288 25459 2829 674237 606813 67424 190830 171747 19083 57878 57878 37644 37068 576 5630 1379 4251 190121 169921 20200 170718 170718 4523 4523 12480 8997 3483 61515 61515 208114 208114 64377 64377 THERAPY EXPENSE 332395 332395 MEDICAL CARE SURCHARGE 211125 211125 FOOD COSTS 209785 209785 OTHER MEDICAL EXPENSE 99535 99535 TAXES & LICENSES 26979 26979 34600 15116 19484 5379551 4836457 543094 0 31410 37400 533938 555545 340298 494709 17419 19131 27412 21811 6051009 4153239 2014626 1897770 164149 174875 257434 261841 3386686 3463082 225222 292542 1431165 1267472 47647 54143 1704034 1614157 X 1646237 1801903 36415 47022 1682652 1848925 3386686 3463082 X 0 1 1 X 0 X 127231 79313 157363 84602 77937 526446 4513438 4777525 4845202 5305135 5395059 24836359 4640669 4856838 5002565 5389737 5472996 25362805 121613 77313 89666 61995 62387 412974 1261180 1266790 1397411 1409697 1406636 6741714 1382793 1344103 1487077 1471692 1469023 7154688 18208117 15020 14089 21553 31845 54977 137484 15020 14089 21553 31845 54977 137484 4655689 4870927 5024118 5421582 5527973 25500289 0.71400 0.72130 0.00540 0.00390 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 31559 31559 4041164 2638357 1402807 1793393 1358205 435188 184893 156677 28216 1897770 GUARANTY FUND CERTIFICATE 117870 DEFERRED FINANCING COSTS 38562 LAND & MINERAL RIGHTS 8731 DUE FROM RELATED PARTY 47022 EQUITY IN COOPERATIVE 49656 261841 RENTAL DEPOSITS 12062 RESIDENT TRUST FUND 5354 ASSET RETIREMENT OBLIGATION 36727 54143 Part X: Description of Uncertain Tax Positions Under FIN 48: The Home and Apartments follow the income tax standard for uncertain tax positions. No liability has been recognized by the Home or Apartments as a result of this standard. Both the Home and Apartments file as tax-exempt organizations. Should that status be challenged in the future, all years since inception could be subject to review by the IRS. The 2007 through 2010 tax years of the Home and Apartments are open to examination by the IRS. Form 990, Part VI, Section A, line 6 THE ELEVEN AREA EVANGELICAL LUTHERAN CHURCHES ARE MEMBERS OF THE LUTHERAN HOME. Form 990, Part VI, Section A, line 7a THE ELEVEN EVANGELICAL LUTHERAN CHURCHES NOMINATE AND ELECT MEMBERS OF THE GOVERNING BODY AT THE ANNUAL MEETING. EACH CHURCH SENDS TWO REPRESENTATIVES TO THE ANNUAL MEETING TO VOTE ON BEHALF OF THEIR CONGREGATION. AT THE ANNUAL MEETING BUT PRIOR TO VOTING, EACH MEMBER REPRESENTATIVE IS ALLOWED TO NOMINATE NEW CANDIDATES FOR THE GOVERNING BODY TO BE PUT ON THE BALLOT. Form 990, Part VI, Section B, line 11 Prior to being filed with the IRS, a copy of FORM 990 and related schedules are reviewed by the Board President or acting Director and the CFO, including a confirmation of the accuracy of EVERY answer and oversight of the appropriate documentation. Upon completion of the review, the forms ARE reviewed and voted on at a Board meeting prior to submittal to the IRS. The elected officers will sign the forms where needed. Form 990, Part VI, Section B, line 12c If anyone reasonably believes that A policy, practice or activity of Good Shepherd Lutheran Services is in violatiOn of law, a written complaint must be filed by the person to their manager, up to and including the Human Resources Director, Administrator or a Board Member of Good Shepherd Lutheran Services. Form 990, Part VI, Section B, line 15a THE PROCESS FOR DETERMINING ADMINISTRATOR COMPENSATION IS REVIEWED ANNUALLY BY THE GOVERNING BODY. ALSO, THE BOARD WILL VOTE ON WHETHER TO APPROVE THE MINNESOTA COST OF LIVING ADJUSTMENT. IN THE CASE MINNESOTA DOES RECOMMEND A COST OF LIVING ADJUSTMENT, THE GOVERNING BODY WILL VOTE ON WHETHER TO APPROVE THE COST OF LIVING ADJUSTMENT FOR ALL EMPLOYEES OF THE HOME. THIS PROCESS WAS LAST CONDUCTED IN 2010 FOR ADMINISTRATOR COMPENSATION. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL MADE AVAILABLE TO THE PUBLIC IN THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 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. GOOD SHEPHERD SENIOR APARTMENTS PO BOX 747 RUSHFORD MN 55971 411757528 TO PROVIDE LOW INCOME HOUSING TO THE ELDERLY OR HANDICAPPED MN 501(C)(3) Line 9 GOOD SHEPHERD LUTHERAN SERVICES 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 no transactions over 50000