2011-08-09T11:19:47-05:00 2010-09-30 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2009-10-01 411852308 GUARDIAN ANGELS - ELIM HOME CARE INC GUAR 7632414445 400 EVANS AVENUE nw ELK RIVER MN 55330 JAMES C BARTZ 7632414445 2011-07-07 1 6123764500 2009 2016-02-24 21:20:13Z GARY HJELMSTAD 400 EVANS AVENUE nw ELK RIVER MN 55330 6475148 0 X www.guardianangelsmn.org X 1996 MN PROVISION OF HOME HEALTH CARE SERVICES TO ELDERLY AND OTHER PERSONS WHO NEED SUCH SERVICES DUE TO ILLNESS OR DISABILITY. 8 8 137 0 0 0 11809 4742 5786604 6446558 2630 1726 19974 14050 5821017 6467076 0 0 3535139 3796633 0 0 2056294 2524992 5591433 6321625 229584 145451 1583796 1922032 414736 607521 1169060 1314511 PROVISION OF HOME HEALTH CARE SERVICES TO ELDERLY AND OTHER PERSONS WHO NEED SUCH SERVICES DUE TO ILLNESS OR DISABILITY. 0 0 4945915 6446558 GUARDIAN ANGELS ELIM HOME CARE INC. IS A NON-PROFIT 501(C)(3) COMPANY. IT PROVIDES COMMUNITY HOME CARE, HOSPICE, AND HOME CARE SERVICES TO TENANTS AT TWO HUD BUILDINGS AND ONE MARKET RATE APARTMENT, ALL HOUSING WITH SERVICES CERTIFIED ON THE MAIN CAMPUS OF GUARDIAN ANGELS. OUR HOME CARE AGENCY HAS ITS MAIN OFFICE IN ELK RIVER MINNESOTA, AND TWO BRANCH OFFICES LOCATED IN CAMBRIDGE AND BUFFALO MINNESOTA. WE SERVE PRIMARILY OLDER ADULTS WITH HOME CARE AND HOSPICE SERVICES IN ALL THREE LOCATIONS.WE ACCEPT PAYMENT FROM MEDICARE, PRIVATE PAY, MEDICAL ASSISTANCE, HEALTH PLANS, AND PRIVATE INSURANCE. OUR CLIENT BASE IS A MIX OF PRIVATE PAY, LOW INCOME, AND MEDICARE ELIGIBLE BENEFICIARIES.IN OUR SERVICES WITH HOME CARE AND HOSPICE WE OFTEN DO VISITS WHICH WE DO NOT BILL THE CLIENT OR PATIENT. IN 2010 WE DID 1,288 UNBILLABLE VISITS WHICH WE DID NOT CHARGE FOR NOR DO WE GET REIMBURSED FOR THOSE VISITS. AT $70.50 PER VISIT THAT IS $91,126 FREE VISITS.IN OUR WORK IN THE HOUSING FOR GUARDIAN ANGELS WE GIVE FREE BLOOD PRESSURE, MANY TIMES ASKED QUESTIONS BY TENANTS THAT WE DO NOT CHARGE THEM. WE ALSO DO MANY FREE BLOOD PRESSURE CLINICS AT NO COST TO THE TENANTS COVERING CAMBRIDGE, BUFFALO, AND ELK RIVER. WE HAVE 31 TELEHEALTH UNITS THAT ARE IN FULL USE AND WE GIVE THAT SERVICE TO THOSE WHO WOULD BENEFIT FROM IT AT NO CHARGE. WE HAVE PROVIDED SERVICES TO CLIENTS THAT WE DID NOT CHARGE FOR THE SERVICE GIVEN BECAUSE THEY COULD NOT AFFORD IT. WE OFFERED FREE HOSPICE CARE TO A FAMILY WHOSE FATHER AND HUSBAND HAD NO PAYMENT SOURCE. OUR MISSION IS TO SERVE ALL CLIENTS NO MATTER WHAT THEIR PAYMENT SOURCE OR BACKGROUND IF WE CAN PROVIDE THAT SERVICE.ANY REVENUE EARNED IS TURNED BACK INTO OUR BUSINESS TO PROVIDE OTHER SERVICES TO OUR COMMUNITIES. WE HAVE TWO FUNDRAISERS PER YEAR. IN JULY WE HAVE A BUTTERFLY RELEASE, AND IN DECEMBER WE HAVE THE TREE OF LIGHTS TO HONOR THOSE PATIENTS WE HAVE SERVED OVER THE PAST YEAR.ALL OF OUR DONATIONS ARE USED TO SUPPORT THE HOME CARE AND HOSPICE PROGRAM SUCH AS MASSAGE THERAPY WHICH IS A SERVICE PROVIDED BUT NOT COVERED AS A BENEFIT TO HOSPICE PATIENTS. OUR CHAPLAIN PROGRAM IS ANOTHER SERVICE STARTED WITH DONATED MONEY AND WE ARE LOOKING SOON TO PET THERAPY ANOTHER SERVICE NOT COVERED UNDER THE MEDICARE BENEFIT.GUARDIAN ANGELS ELIM HOME CARE INC. FOCUSES ALL OF THEIR REVENUE IN SERVICE TO PATIENTS AND NO INDIVIDUAL PERSON BENEFITS THROUGH REVENUE SHARING OR ANY DISTRIBUTION IN THE FORM OF A PROFIT SHARING ARRANGEMENT OR PRIVATE CORPORATION. 4945915 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 137 1 0 0 0 0 0 0 0 0 0 0 0 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X JAMES C BARTZ 7632414445 280 EVANS AVE NW ELK RIVER MN 55330 RONALD SANFORD 1.00 X 0 0 0 DANIEL C DIXON 1.00 X 0 0 0 DAN FAIR 1.00 X 0 0 0 ARLENE SYRING 1.00 X 0 0 0 ROBERT DAHL 1.00 X 0 0 0 JAMES C BARTZ 1.00 X 0 0 0 ELDON WARKENTIN 1.00 X 0 0 0 KATHY YOUNGQUIST 1.00 X 0 0 0 GARY HJELMSTAD 40.00 X 88720 0 24404 88720 0 24404 0 0 0 0 PRO REHAB 200 LEWIS AVENUE SOUTH SUITE 210 WATERTOWN MN 55388 THERAPY SERVICES 417420 1 4742 4742 MEDICARE/MEDICAID PAYM 623000 3845207 3845207 PATIENT SERVICES 623000 2598951 2598951 MANAGEMENT SERVICES 623990 2400 2400 6446558 1726 1726 8296 8072 224 224 MISCELLANEOUS REVENUE 900099 13826 13826 13826 6467076 6446558 0 15776 113124 113124 2902956 2401898 501058 99335 79468 19867 438262 350610 87652 242956 194365 48591 60000 60000 25 25 7010 7010 430321 280877 149444 55713 55713 97268 97268 94706 94706 90632 90632 213641 191943 21698 56758 50943 5815 41731 41731 11029 11029 THERAPY SERVICES 561743 561743 HOSPICE INPATIENT SERVI 382777 382777 PHARMACY/DRUGS EXPENSE 136918 136918 MEDICAL SUPPLIES 132564 132564 MEDICAL EQUIPMENT 71290 71290 80866 68788 12078 6321625 4945915 1375710 0 786875 656710 50063 683764 1074988 1600 1600 382798 244127 111557 138671 1583796 1922032 410028 590907 4708 16614 414736 607521 X 1169060 1314511 1169060 1314511 1583796 1922032 X 0 1 1 X 0 X 23503 9643 11319 11809 4742 61016 3294035 4696444 5635574 5786604 6454854 25867511 3317538 4706087 5646893 5798413 6459596 25928527 0 0 0 25928527 591 800 1931 2630 1726 7678 591 800 1931 2630 1726 7678 13826 13826 3318129 4706887 5648824 5801043 6475148 25950031 0.99920 0.99970 0.00030 0.00030 X 382798 244127 138671 138671 DUE TO OTHER ENTITIES 16614 16614 6467076 6321625 145451 0 145451 6467076 0 6467076 0 6467076 6321625 0 6321625 0 6321625 Part X: Description of Uncertain Tax Positions Under FIN 48: THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE ORGANIZATION AS A RESULT OF THIS STANDARD. THE ORGANIZATION FILES 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 2007 THROUGH 2010 TAX YEARS ARE OPEN TO EXAMINATION BY THE IRS. Form 990, Part VI, Section B, line 11 PRIOR TO BEING FILED WITH THE IRS, A COPY OF THE IRS FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE PRESIDENT AND THE TREASURER, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF APPROPRIATE CHANGES. UPON COMPLETION OF THE PRESIDENT'S AND TREASURER'S REVIEW, THE FORMS ARE REVIEWED AND APPROVED BY THE BOARD PRIOR TO SUBMITTAL TO THE IRS. Form 990, Part VI, Section B, line 12c EACH BOARD MEMBER AND DIRECTOR FILL OUT A CONFLICT OF INTEREST FORM. IF A CONFLICT EXISTS IT IS ADDRESSED BY THE BOARD AND MANAGEMENT ON A CASE BY CASE BASIS. Form 990, Part VI, Section B, line 15a THE PROCESS USED TO SET UP TOP MANAGEMENT'S ANNUAL SALARY IS BASED ON A COMBINATION OF COMPARISON TO COMPARABLE ORGANIZATIONS THROUGH THE USE OF OUR TRADE ORGANIZATION'S ANNUAL COMPENSATION SURVEY AND ATTAINMENT IN THE CURRENT YEAR OF PREDEFINED PERFORMANCE OBJECTIVES SET FOR TOP MANAGEMENT PERSONALLY AND THE ORGANIZATION. ALSO, THE STATE OF MINNESOTA HAS IN MOST YEARS DETERMINED AN AMOUNT OF PAY INCREASE, IF ANY, THAT CAN BE GIVEN TO EMPLOYEES AND WE HAVE ALSO CONSIDERED THIS AMOUNT IN DETERMINING TOP MANAGEMENT COMPENSATION. THIS PROCESS IS PERFORMED BY THE BOARD OF DIRECTORS EACH YEAR THROUGH A BUDGETING PROCESS AND APPROVAL. THIS PROCESS IS NORMALLY DONE PRIOR TO THE FISCAL YEAR START OF OCTOBER 1ST EACH YEAR. Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.