2011-11-14T09:32:22-06:00 2010-12-31 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2010-01-01 411310487 LYNGBLOMSTEN CARE CENTER INC LYNG 6516462941 1415 ALMOND AVENUE ST PAUL MN 55108 BRADLEY J JACOBSON 6516462941 2011-11-03 1 6123764500 2010 2016-03-07 17:11:31Z PAUL MIKELSON 1415 ALMOND AVENUE ST PAUL MN 55108 18749964 0 9386 X WWW.LYNGBLOMSTEN.ORG X 1976 MN TO PROVIDE A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS. 17 16 508 777 0 0 401086 49929 18418142 18345039 126801 159964 -187122 89336 18758907 18644268 0 0 0 0 13349972 13342140 0 0 0 4525683 4778895 17875655 18121035 883252 523233 14121279 14689973 4711697 4615698 9409582 10074275 X INFLUENCED BY CHRIST, LYNGBLOMSTEN PROVIDES A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS IN ORDER TO PRESERVE AND ENHANCE THEIR QUALITY OF LIFE. 0 0 16465937 0 18345039 THE LYNGBLOMSTEN CARE CENTER, A 237-BED SKILLED NURSING FACILITY, PROVIDES BOTH SHORT-TERM REHABILITATION AND LONG-TERM HEALTHCARE, INCLUDING ALZHEIMER'S CARE. IN 2010, 529 PERSONS RECEIVED CARE. CHAPLAINS, VOLUNTEERS, AND PROFESSIONAL STAFF ENSURE RESIDENTS RECEIVE QUALITY HEALTH CARE IN A DIGNIFIED MANNER. ALTHOUGH HEALTH ISSUES PREVENT THESE SENIORS FROM ENJOYING LIVING IN THEIR OWN HOMES, LYNGBLOMSTEN PROMOTES PERSON-CENTERED CARE, GIVING THESE OLDER ADULTS AS MANY CHOICES AND COMFORTS OF HOME AS POSSIBLE. EDUCATIONAL AND SOCIAL EVENTS ARE HOSTED TO ENHANCE THE LIVES OF THESE SENIORS AND THEIR FAMILIES. A PALS (PASSING ALONG LIFE'S STORIES) PROGRAM WAS RECENTLY INITIATED, WHERE EMPLOYEES FROM ACROSS THE ORGANIZATION ARE PAIRED WITH A RESIDENT FOR WEEKLY VISITS ENHANCING THE LIVES OF BOTH THE RESIDENTS AND THE EMPLOYEES. IN 2010:-THE TRANSITIONAL CARE UNIT WAS EXPANDED FROM 21 TO 30 BEDS, AND TWO SERVICE HOUSE PROGRAMS WERE MODIFIED TO BETTER ACCOMMODATE THE MORE DEPENDENT CARE LEVEL OF THOSE RESIDENTS.-THREE MAJOR PHYSICAL UPGRADES OCCURRED: ELEVATORS UPGRADED, EXTERIOR BRICK FACADE REPLACED, AND TUB/SHOWER ROOMS WERE RENOVATED.-THE CARE CENTER WAS AWARDED A GRANT FROM THE STATE OF MINNESOTA TO REDUCE RE-HOSPITALIZATIONS, TO IMPROVE INFORMATION FLOW FROM HOSPITAL TO NURSING HOME, TO ESTABLISH PROTOCOLS FOR THE CARE OF RESIDENTS WITH CERTAIN CHRONIC CONDITIONS, AND TO IMPROVE PALLIATIVE CARE.LYNGBLOMSTEN CARE CENTER, INC. IS AFFILIATED WITH LYNGBLOMSTEN AND THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. 16465937 1 1 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 27 0 508 1 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X BRADLEY J JACOBSON 6516325310 1415 ALMOND AVENUE ST PAUL MN 55108 ESTHER TATLEY 1.00 X X 0 0 0 CAROL PLETCHER 1.00 X X 0 0 0 CHARLES NORTON 1.00 X X 0 0 0 HOWARD OSTREM 1.00 X X 0 0 0 FERYLE BORGESON 1.00 X 0 0 0 KIM DURKEE 1.00 X 0 0 0 REV JAY EBERTH 1.00 X 0 0 0 LISA EDSTROM 1.00 X 0 0 0 LEONARD EILTS 1.00 X 0 0 0 GINGER FISCHER 1.00 X 0 0 0 LESLIE GRANT 1.00 X 0 0 0 LARRY GRAY 1.00 X 0 0 0 MAYNARD JACOBSON 1.00 X 0 0 0 BILL SANDEN 1.00 X 0 0 0 JEANETTE SEVERSON 1.00 X 0 0 0 DON WALCH 1.00 X 0 0 0 PAUL MIKELSON 30.30 X X 131269 42333 13638 BRADLEY J JACOBSON 36.00 X 94168 0 10711 JEFF HEINECKE 40.00 X 94992 0 18669 320429 42333 43018 1 0 1 0 0 49929 49929 RESIDENT SERVICES 623000 18345039 18345039 18345039 179367 179367 86293 105696 -19403 -19403 -19403 MISCELLANEOUS REVENUE 900099 43405 43405 SATELITE TV REVENUE 900099 24509 24509 TELEPHONE REVENUE 900099 21422 21422 89336 18644268 18345039 0 249300 360122 360122 9909137 9419435 489702 229352 218475 10877 1978519 1809205 169314 865010 780384 84626 325 325 52147 52147 615900 588538 27362 36763 36763 1317532 1098048 219484 383798 316395 67403 25037 25037 136204 122197 14007 816623 732641 83982 135621 121674 13947 LICENSE SURCHARGE 667155 667155 FOOD 591790 591790 18121035 16465937 1655098 0 860958 1600498 1638963 1453919 1575245 1340185 38332 155828 21868074 14364997 7102264 7503077 1176312 1806398 399180 399180 90028 78535 1239997 352353 14121279 14689973 1425393 1664707 58442 41640 3168985 2828625 58877 80726 4711697 4615698 X 9317676 10004102 91906 70173 9409582 10074275 14121279 14689973 X 523233 141460 X 0 1 1 X 0 X 211880 261128 428379 401086 49929 1352402 16981190 17687892 18084374 18418142 18345039 89516637 17193070 17949020 18512753 18819228 18394968 90869039 0 0 0 90869039 188362 205455 147375 125937 179367 846496 188362 205455 147375 125937 179367 846496 9512 45684 56623 -187122 89336 14033 17390944 18200159 18716751 18758043 18663671 91729568 0.99060 0.99210 0.00920 0.00860 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 94767 94767 19411436 12693976 6717460 2288485 1614925 673560 73386 56096 17290 7503077 CAPITAL LEASE OBLIGATION 1672 ASSET RETIREMENT OBLIGATION 12888 DEFERRED COMPENSATION PLAN 66166 80726 PART IV, LINE 2B: THE CORPORATION IS THE TRUSTEE OF VARIOUS RESIDENT AND TENANT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. THESE FUNDS ARE ON DEPOSIT IN SEPARATE BANK ACCOUNTS AND INVESTMENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE CORPORATION'S FINANCIAL STATEMENTS. THE CORPORATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2007 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. X X X X 0 0 0 0 0 0 0 0 0 PAUL MIKELSON 119533 38551 648 208 11088 3574 4837 1559 5477 1765 141583 45657 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS MADE UP THE CHAIR, VICE CHAIR, TREASURER, AND SECRETARY OF THE BOARD ALONG WITH PRESIDENT/CEO OF THE CORPORATION. ALL ITEMS APPROVED BY THE EXECUTIVE COMMITTEE ARE REAFFIRMED BY THE FULL BOARD AT THEIR NEXT MEETING. FORM 990, PART VI, SECTION A, LINE 6 THE BOARD OF DIRECTORS OF THE LYNGBLOMSTEN CORPORATION ARE THE MEMBERS OF LYNGBLOMSTEN CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE CONGERGATIONS SEND DELEGATES TO THE LYNGBLOMSTEN ANNUAL MEETING, WHO AS MEMBERS OF THE LYNGBLOMSTEN CORPORATION ELECT THE LYNGBLOMSEN CORPORATE BOARD. THE LYNGBLOMSTEN CORPORATE BOARD OF DIRECTORS SERVE AS THE MEMEBERS OF LYNGBLOMSTEN CARE CENTER, INC. AND ELECT THAT BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B CHANGES IN THE BYLAWS AND ARTICLES OF INCORPORATION REQUIRE MEMBERSHIP APPROVAL. FORM 990, PART VI, SECTION B, LINE 11 THE CFO AND CEO REVIEW THE DOCUMENT, WHICH IS EMAILED TO THE FINANCE COMMITTEE OF THE BOARD PRIOR TO THEIR MEETING FOR REVIEW AND COMMENT. THE BOARD RECEIVES THE DOCUMENT PRIOR TO THEIR BOARD MEETING BY EMAIL OR POSTING TO THEIR INTERNAL WEBSITE. PAPER COPIES ARE AVAILABLE AT THE BOARD MEETING FOR FURTHER DISCUSSION AND BOARD APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C AN UPDATED CONFLICT OF INTEREST POLICY IS SIGNED BY ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ANNUALLY. THIS POLICY IS MONITORED BY THE CEO AND IF ANY CONFLICTS OF INTERESTS EXIST THAT INDIVIDUAL IS EXCLUDED FROM PARTICIPATION AND VOTING ON RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15A LYNGBLOMSTEN CARE CENTER, INC. RELIES ON THE LYNGBLOMSTEN CORPORATE BOARD'S EXECUTIVE COMMITTEE WHO REVIEWS AND SETS CEO'S COMPENSATION. THE CEO SETS THE ANNUAL EVALUATION PROCESS FOR OTHER OFFICERS AND KEY EMPLOYEES AND THE LYNGBLOMSTEN CARE CENTER, INC. BOARD APPROVES THE ANNUAL BUDGET. THE COMPENSATION REVIEW PROCESS IS CONDUCTED EACH YEAR IN JANUARY AND WAS LAST CONDUCTED IN JANUARY 2010. THE CORPORATE BOARD'S EXECUTIVE COMMITTEE ALSO PERFORMS A COMPENSATION STUDY APROXIMATELY EVERY 5 YEARS, LAST COMPLETED IN 2006. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 141,460. EXPLANATION OF HOURS WORKED FORM 990, PART VII, SECTION A PAUL MIKELSON, CEO, DEVOTED APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: LYMBLOMSTEN CARE CENTER: 30.25 HOURS LYNGBLOMSTEN APARTMENTS: 1.75 HOURS HERITAGE APARTMENTS, INC.: 1.42 HOURS LYNGBLOMSTEN FOUNDATION: 6 HOURS LYNGBLOMSTEN SERVICES: 0.58 HOURS BRADLEY J. JACOBSON, CFO, DEVOTED APPROXIMATELY 40 HOURS PER WEEK AS FOLLOWS: LYMBLOMSTEN CARE CENTER: 36 HOURS LYNGBLOMSTEN APARTMENTS: 1 HOUR HERITAGE APARTMENTS, INC.: 1 HOUR LYNGBLOMSTEN FOUNDATION: 1 HOUR LYNGBLOMSTEN SERVICES: 1 HOUR LYNGBLOMSTEN APARTMENTS INC 1455 ALMOND AVE ST PAUL MN 55108 411327121 LOW INCOME SENIOR HOUSING MN 501(C)3 9 LYNGBLOMSTEN 0 HERITAGE APARTMENTS INC 1440 MIDWAY PARKWAY ST PAUL MN 55108 411913420 MARKET RATE SENIOR HOUSING, ASSISTED LIVING SERVIES MN 501(C)3 9 LYNGBLOMSTEN 0 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVE ST PAUL MN 55108 363371887 FUNDRAISING FOR LYNGBLOMSTEN MN 501(C)3 7 LYNGBLOMSTEN 0 LYNGBLOMSTEN SERVICES INC 1415 ALMOND AVE ST PAUL MN 55108 411760448 SENIOR CENTER, COMMUNITY SERVICES, HOME HEALTH MN 501(C)3 9 LYNGBLOMSTEN 0 LYNGBLOMSTEN 1415 ALMOND AVE ST PAUL MN 55108 410693865 MANAGEMENT OVERSIGHT SERVICES TO ALL LYNGBLOMSTEN ORGANIZATIONS MN 501(C)3 9 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1