2011-05-31T09:57:58-05:00 2010-08-31 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2009-09-01 410706155 AMERICAN BAPTIST HOMES OF THE MIDWEST INC AMER 9529413175 14850 scenic heights road No 125 EDEN PRAIRIE MN 55344 Jeff Hongslo 9529413175 2011-05-26 1 6123764500 2009 2016-02-24 21:20:13Z David Zwickey 14850 scenic heights road No 125 EDEN PRAIRIE MN 55344 46680881 0 X www.abhomes.net X 1930 MN TO PROVIDE NURSING HOME CARE AND HOUSING TO LOW INCOME, ELDERLY, AND DISABLED PERSONS. 19 18 1438 270 0 0 133239 108518 44886288 45868768 182019 296399 0 45201546 46273685 0 0 30027628 30681720 0 0 16112583 16378400 46140211 47060120 -938665 -786435 43071673 74244818 46493603 78368597 -3421930 -4123779 TO PROVIDE NURSING HOME CARE AND HOUSING TO LOW INCOME, ELDERLY, AND DISABLED PERSONS. 0 0 41188699 45868768 Skilled Nursing Facilities: The skilled nursing facilities of the Obligated Group (including board & care and basic care units) provide health care and convalescent treatment primarily for in-patient elderly persons, including those admitted as an intermediate step after hospitalization and before returning to their homes, as well as those admitted for long-term residency. The skilled nursing facilities are licensed under the regulations of the state in which they operate, and are certified as nursing facilities under both the state Medicaid and federal Medicare programs. Certification requires that the facilities provide continuous registered nurse supervision and specific ratios of nursing personnel per resident.The skilled nursing facility residents receive 24-hour nursing care, all meals (and special diets as required) and such drugs and therapy as may be prescribed by the resident's physician. Three balanced meals are provided to each resident daily, in the resident's room or at a central dining location. Light snacks are provided during the day and at bedtime. Each skilled nursing facility is administered on location by a full-time administrator licensed by the state. A Director of Nursing Services, who is a certified nurse, is responsible for supervising the registered nurses, licensed practical nurses and registered nursing assistants working at the skilled nursing facilities. Social service programs are provided by social workers under the supervision of a licensed staff member or guided by a consulting social worker and assisted by volunteer auxiliary groups. Each of the skilled nursing facilities has a consulting physician on call who is available to the residents at the facility. In addition, the skilled nursing facilities arrange with hospitals for transfer of residents between the facilities and hospitals when necessary.The skilled nursing facilities provide resident rooms designed principally for two beds, but also include some one-bed rooms. Each skilled nursing facility contains one or more dining rooms, one or more recreation areas, day rooms, therapy area, fully-equipped kitchen and laundry facilities. All skilled nursing facilities have approved fire detection and alarm systems. Each skilled nursing facility provides a beauty and barber shop on location.Assisted Living Facilities: The assisted living facilities are designed and operated to allow senior adults to live and enjoy an independent lifestyle in a secure and convenient community atmosphere. Full-time professional managers provide assistance to residents. A nurse call system monitored 24 hours daily puts the residents in contact with nursing service staff. Daily housekeeping, included in the cost of rent, helps the residents with cleaning chores and provides an opportunity for facility staff to monitor the well-being of the residents. Social and activity programs provide residents with the opportunity to fully enjoy the facilities and are designed to meet the social and emotional needs of the residents. Additional services provided include: physical therapy, transportation, laundry services and blood pressure checks. Meal service is included in the monthly fee for the assisted living facilities. Independent Living Communities: The independent living communities offer a continuum of services on a campus setting. These independent living facilities are designed and operated to allow senior adults to live and enjoy an independent lifestyle in a secure and convenient community atmosphere. Full-time professional managers provide assistance to residents. The Obligated Group's independent living communities provide or assist in arrangements for additional services such as visiting nurses, chore services, or other personal need services. All independent living settings have a planned activity program, a variety of meal plans available, weekly housekeeping and transportation services provided. Specialized programs for health and wellness are also available for a nominal fee or will be available soon. Visitor quarters are available for family members and meals may be purchased for visitors as needed. An emergency call system monitored 24 hours daily puts the residents in contact with emergency medical services. Group Homes for Developmentally Disabled (Crest Services): Crest Services, a division of ABHM, provides residential services to persons with disabilities in Iowa and Minnesota. The majority of the individuals served are those with a primary diagnosis of mental retardation, others may have some type of brain injury or other type of developmental disability. Services are provided in a variety of settings including the individual's own apartment under the Home and Community Based Services (HCBS) program or a small group home setting with two to four individuals (typically, a modestly sized home located in a residential neighborhood). Crest Services does maintain one larger group home serving fifteen individuals in Ottumwa, Iowa. The Crest Services staff works in conjunction with the primary consumer, their family, the medical team, county and state social service staff to provide tailored services for the individual. Services provided include health care and assistance with activities of daily living (bathing, grooming, dressing, etc), development of job or social skills, recreational activities, budgeting and basic financial planning. Respite services are also provided as needed. The primary funding source is through certification in the HCBS waiver programs, which waives the cost of certain healthcare services, although there are several waiver programs funded with federal dollars, i.e., Mental Retardation, Brain Injury, Elderly. Persons with a developmental disability (DD), other than mental retardation (excluding mental illness) are served under the county paid Chapter 24 certified programs in both Iowa and Minnesota. Minnesota provides a parenting program for families in need of training and support in order to keep families intact using county funding. Crest Services also provides psychological counseling service to children using private insurance coverage and Medicaid funding.Just as ABHM seeks to fulfill our mission through those we serve, we also understand that mission calls us to contribute to the greater communities in which we live and work. This dual commitment both describes our past and defines our future by reinforcing the core principles and faith that guide our work.The information that follows is a detailed description and estimated value of all charitable contributions given in fiscal year 2010 by ABHM, its continuing care retirement communities, nursing homes and affordable housing retirement communities.Resident subsidies by ABHM (continuing care resident contracts and other discounts) during fiscal year 2010 were $92,000. Included are non-contract allowances, administrative discounts, permanent transfers to different levels of care credit, below market discounts, health center free days credit and medical insurance subsidies. Direct benevolence to continuing care residents by ABHM during fiscal year 2010 was $24,500. Adjustments of $965,000 were made to ABHM residents during fiscal year 2010 representing Medicaid contracts that did not pay the full amount for their care. Community Benefits to Residents, Employees and Community - total $27,000 Thorne Crest: provided religious services to residents, a Caregiver Group, a Senior Shop for residents, RSVP Tax Services, John Ulland Music gathering, a Wellness Fair, 6th Annual Car Show, Tractor parade, Whistle stop Music gathering, made baskets for the Relay for Life and invited the Emergency Services personnel in for lunch.Elm Crest: provided a Hospitality room for family members of residents and provided the McKee Community room for various eventsTudor Oaks: invited the public to bring items needing shredding and attend a presentation by a local police officer, hosted educational events, presented several seminars to the community and donated to various organization throughout the year.Use of the Community Facilities - total $36,500Thorne Crest, Elm Crest and Trail Ridge hosted events and provided space for various groups including the following: the doll club, chess club, Kiwanis club, boys scouts and 4h club.Other Benefits to the Broader Community - total $37,800Volunteer and other Services to Community Organizations by Residents and Staff of ABHM and its Communities: staff service on an Advisory Board for Nursing, volunteered on a Home Health Advisor group at a local hospital, supported a local fundraiser for Senior Volunteers and Seniors with Disabilities, raised funds for whitnall park rotary club, participated in the Senior Lifestyle Conference, hosted fair for the benefit of seniors, presented various seminars and provided accounting services for murrow indian children's home. 41188699 1 1 0 0 0 0 0 0 0 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 0 0 1 297 0 1 1438 1 0 0 0 0 0 0 0 0 0 19 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Jeff Bredt 9522531459 14850 scenic heights road No 125 EDEN PRAIRIE MN 55344 David Zwickey 40.00 X X 276619 0 9378 ted hertel 1.00 X 0 0 0 REV EUGENE ALLEN 1.00 X 0 0 0 JAN DEWITT 1.00 X 0 0 0 REV ONNIE DRAIN 1.00 X 0 0 0 MARK GRIES 1.00 X 0 0 0 GARY GROGAN 1.00 X 0 0 0 MERLE JOHNSON 1.00 X 0 0 0 REV KEVIN LOWE 1.00 X 0 0 0 JERE MADDUX 1.00 X 0 0 0 REV KARLA MCGRAY 1.00 X 0 0 0 BILL MILLS 1.00 X 0 0 0 REV ARLO REICHTER 1.00 X 0 0 0 DR WALLACE SANDERS 1.00 X 0 0 0 ROBERT SLECHTA 1.00 X 0 0 0 BARBARA WOODS 1.00 X 0 0 0 Judy Zea 1.00 X 0 0 0 philip hanson 1.00 X 0 0 0 rev dr steven van ostran 1.00 X 0 0 0 Jeff Hongslo 40.00 X 164955 0 16418 Tim O'Brien 40.00 X 96871 0 7194 Jeff Amann 40.00 X 177813 0 16986 claudia rardin 40.00 X 135594 0 8102 roger hennen 40.00 X 131386 0 8018 dave charron 40.00 X 119318 0 2527 donna wlaschin 40.00 X 107396 0 5257 1209952 0 73880 7 0 1 0 rehab care group inc PO Box 503534 st louis MO 63150 therapy Provider 472894 Rehabvisions 11623 Arbor Street Omaha NE 68144 Therapy Provider 186318 larson allen llp PO Box 86 minneapolis MN 55486 audit 183267 carmen porco 7 n pickney st 344 madison WI 53703 management 176303 bmw consulting 9912 Rockbrook rd omaha NE 68124 consulting 104907 5 108518 108518 RESIDENT REVENUE 623000 39810615 39810615 Management Fees 623990 4264601 4264601 ACCOMODATION FEES 623990 1272731 1272731 Other Revenue 623990 521821 521821 Insurance Proceeds 623990 -1000 -1000 45868768 162960 162960 427243 113392 407196 20047 113392 133439 133439 46273685 45868768 0 296399 589269 589269 25021490 24980084 41406 178439 178143 296 3161656 3156360 5296 1730866 1727996 2870 2298744 2298744 222378 222378 25081 25081 761702 739025 22677 497357 497357 2181910 1124159 1057751 1834972 1490076 344896 201733 201733 1481940 1438032 43908 2099021 2036830 62191 617530 599234 18296 miscellaneous 1880840 862908 1017932 food 1463515 1463515 pharmacy 495343 495343 repairs 289056 280492 8564 27278 27233 45 47060120 41188699 5871421 0 1191723 1323881 3473347 4329182 285206 276365 639125 758769 76716942 31171504 30049174 45545438 1742635 1869948 5000 5000 861601 1722312 4823862 18413923 43071673 74244818 8750783 12165886 8008458 9740516 20620000 47953537 3125104 3056409 5989258 5452249 46493603 78368597 X -3460370 -4205789 38440 82010 -3421930 -4123779 43071673 74244818 X 0 1 1 X 0 X 225103 235707 179391 133239 108518 881958 48811163 40204022 45074963 44886288 45868768 224845204 49036266 40439729 45254354 45019527 45977286 225727162 0 0 0 225727162 198069 269547 321141 182568 162960 1134285 198069 269547 321141 182568 162960 1134285 49234335 40709276 45575495 45202095 46140246 226861447 0.99500 0.99550 0.00500 0.00450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1386708 1386708 44819963 21147927 23672036 954880 539182 415698 12154611 9484395 2670216 17400780 17400780 45545438 CASH SURRENDER VALUE LIFE INS 374536 DUE FROM RELATED ORGANIZATIONS 1037956 SECURITY DEPOSITS 1213878 BOND FUNDS 15787553 18413923 REFUNDABLE ACCOMMODATION FEES 3697793 RESERVE FOR GIFT ANNUITIES 79455 LOANS AGAINST CSV OF LIFE INSURANCE 272931 ASSET RETIREMENT OBLIGATION 183057 Resident deposits 1219013 5452249 X X X 0 0 0 0 0 0 0 0 0 David Zwickey 244481 0 24500 0 7638 0 3438 0 5940 0 285997 0 0 0 Jeff Hongslo 146567 0 18388 0 0 0 2973 0 13445 0 181373 0 0 0 Jeff Amann 155108 0 19425 0 3280 0 3541 0 13445 0 194799 0 0 0 Colorado Health Facilities Authority 840752932 19648AEX9 2007-08-01 19134153 Refinance existing debt, capital expenditures and operational reserve fund 0 0 colorado Health Facilities Authority 840752932 19648ASD8 2009-12-23 27136159 construct new independent living units 0 0 21085000 1748799 1202203 626121 2813755 2010 1 1 1 1 28115000 13750886 913656 11605887 2011 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 royal bank of canada 8.000000000000 1 0 0 1 0 0 1 Calyon 2.000000000000 1 0 0 Form 990, Part VI, Section A, line 1 AN EXECUTIVE COMMITTEE, COMPOSED OF THE CHAIR, VICE CHAIR, PRESIDENT/CEO AND THREE ADDITIONAL DIRECTORS, EXERCISES ALL OF THE POWERS OF THE BOARD OF DIRECTORS, BUT ONLY DURING THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. ANY ACTIONS OF THE EXECUTIVE COMMITTEE ARE REPORTED TO THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 11 The finance committee reviewed the Form 990 at their quarterly meeting prior to filing. They received copies of the draft and the detail was reviewed at that time. Copies of the 990 were then provided to Board Members. Form 990, Part VI, Section B, line 12c A conflict of interest form is signed by all board directors, administrators, home office directors and vice presidents. At that time, any potential conflict of interest is noted on the form. The information is given to the CEO, Board President and Audit Committee Chair. At that time, any potential conflicts are reviewed. Form 990, Part VI, Section B, line 15 The Board of Directors has a management review committee that reviews the CEO's compensation. The committee determines any compensation adjustments to the CEO. The CEO, executive directors and other top management positions are compared to the most recent CEMO study to determine how their compensation compares to peer organizations. The information is then reviewed by the senior leadership team. This process last included review and approval by independent persons, comparability data and contemporaneous substantiation in 2010. Form 990, Part VI, Section C, line 19 The organization's financial statements are available to the public upon request. The organization's governing documents and conflict of interest policy are not available to the public. FORM 990, PART VII, SECTION A AVERAGE WEEKLY HOURS THE INDIVIDUALS COMPENSATED BY AMERICAN BAPTIST HOMES OF THE MIDWEST ("ABHM") ALSO SERVE ABHM'S RELATED ORGANIZATIONS. EACH INDIVIDUAL SPENDS 40+ HOURS EACH WEEK SERVING ABHM AND ITS RELATED ORGANIZATIONS. Baptist Home Association of the Rocky Mountains 4800 tabor st wheat ridge CO 80033 840528764 provide housing and care for the elderly CO 501(c)(3) 9 N/A residence at franklin park inc 1535 franklin st Denver CO 80218 840630940 HOUSING FOR LOW-INCOME SENIORS CO 501(C)(4) BAPTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS american baptist homes of the midwest foundation 14850 scenic heights rd 125 eden prairie MN 55344 411803304 philanthropy MN 501(c)(3) 11 TYPE 1 N/A Baptist home assoc of the rocky mountains - affiliates 14850 scenic heights rd 125 eden prairie MN 55344 742755828 housing and care for the elderly CO 501(c)(3) 9 bapTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS the crossing at tudor oaks 14850 scenic heights rd 125 eden prairie MN 55344 203346875 inactive MN 501(c)(3) 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 Baptist Home Association of the Rocky Mountains P 11128415 Residences at Franklin Park Inc P 716700 american baptist homes of the midwest foundation R 96102