2011-08-11T15:22:59-05:00 2010-09-30 Eide Bailly LLP 5601 Green Valley Drive Ste 700 Minneapolis MN 554371145 990 2009-10-01 411263433 Knute Nelson KNUT 3207636653 420 12th Avenue East Alexandria MN 56308 Mark Anderson 3207636653 2011-08-09 1 Kim Hunwardsen CPA 9529446166 2011-08-10 2009 2016-02-24 21:20:13Z Mark Anderson 420 12th Avenue East Alexandria MN 56308 15412030 0 9386 X www.knutenelson.org X 1969 MN Operation of Nursing Home 9 9 408 280 0 0 1393110 3000 15032966 15370181 60584 38849 0 16486660 15412030 58752 45246 0 8931405 9890143 0 3770 5826186 5237662 14816343 15173051 1670317 238979 18369087 42485395 7903483 28349372 10465604 14136023 The mission of Knute Nelson is to provide a full continuum of services for older adults to enhance their quality of life. Our vision is to be the recognized leader of quality and innovative services for older adults. 0 0 13274395 45246 15370181 Knute Nelson, an affiliate of Evangelical Lutheran Church of America, provides a full continuum of services for older adults to enhance their quality of life through a 140-bed skilled nursing facility, 59 assisted living units, and home care agency. Knute Nelson has 300+ employees and over 280 volunteers making it one of the top ten employers within the City of Alexandria. Within the skilled nursing facility, we have a short-term stay unit, rehabilitation program, care suites for end-of-life programming and provide hospice care in partnership with local hospice providers for terminally-ill residents. We also have a wellness program that provides classes for residents, activities, and a chaplaincy program; all which enhance their quality of living. Our chaplaincy program is guided by Christian principles. All faiths are celebrated here and our chaplain provides a wide range of spiritual care through worship service, Bible study groups, and resident and family support. The skilled nursing facility had 342 admissions and 338 discharges from 10/01/09 to 09/30/10. An increasing area of focus is our short-term stay program where individuals will receive necessary physical, speech, and occupational therapies and return back to their home. Knute Nelson accepts all payor sources: Medicare, Medicaid, Insurance, and Private Pay. If a resident is unable to pay for their services, we will work with you to find a means to pay for their services and help them facilitate the application process for medical assistance through family members, Knute Nelson and Douglas County Social Services. The goal of the Knute Nelson Home Care program is to help individuals stay in their own home as long as safely possible. We are able to help individuals of any age with skilled nursing services, physical, speech and occupational therapies, IV therapy, wound care, private duty nursing, home health aide, or assessment and management of your medical needs. We serve individuals within a 60-mile radius of Alexandria with offices in Morris, Elbow Lake, Long Prairie, and Osakis. Our assisted living facility, Nelson Gables, promotes independence, security and quality of life. Daily coffee hour, restaurant style meal program, active aging wellness classes, parties and outings keep residents as active as they wish to be. A 24-hour staff, under the direction of a registered nurse, is ready to offer assistance with medication management, medication administration, bathing, and personal care.Grand Arbor, registered through Knute Nelson Senior Living Campus, LLC, is an enhanced continuing care retirement community that encourages active lifestyles with a town center and wellness center set among independent living apartments; general and high acuity assisted living apartments; and memory care assisted living apartments. A 24-hour licensed staff, under the direction of a registered nurse, is able to offer assistance with medication management, medication administration, bathing, and other personal cares. 13274395 1 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 17 0 1 408 1 0 0 0 0 0 0 0 0 0 9 9 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X Marnie Gugisberg CFO 3207631164 420 12th Avenue East Alexandria MN 56308 Roger Blank 1.00 X X 0 0 0 Tom Anderson 1.00 X X 0 0 0 Mary Jane Reif 1.00 X X 0 0 0 Bill Leuthner 1.00 X X 0 0 0 Dennis Schmidt 1.00 X X 0 0 0 Ruth Nagle 1.00 X 0 0 0 Jerry Hansen 1.00 X 0 0 0 Eileen Eiser 1.00 X 0 0 0 Kathy Nohre 1.00 X 0 0 0 Yvonne Kinney-Hockert 1.00 X 0 0 0 Ron Sletto 1.00 X 0 0 0 Mark Anderson 35.00 X 127189 0 20915 Marnie Gugisberg 39.00 X 74365 0 8359 201554 0 29274 1 0 0 0 Rehabcare Group Inc PO Box 503534 St Louis MO 631053534 Therapy Contractor 1157012 Pope & Associates 1255 Energy Park Drive St Paul MN 551085518 Architect 213134 Senior Housing Partners 2845 Hamline Ave North Roseville MN 55113 Developer 139517 3 3000 3000 Resident Service Reven 623000 15081223 15081223 Other Revenue 900099 200213 200213 Auxiliary and Coffee S 721000 88745 88745 15370181 38849 38849 15412030 15370181 0 38849 45246 45246 230942 230942 8022583 7447399 575184 86794 84553 2241 893280 826827 66453 656544 594341 62203 8814 8814 16711 16711 815751 624601 191150 93293 89523 3770 1329162 1119493 209669 630387 630387 120186 120186 28361 28361 215712 215712 1051540 1051540 159959 159959 Surcharge & pre screen 441424 441424 Food 122456 122456 Coffee Shop 49844 49844 Licenses & Permits 47816 15171 32645 Education 39578 18790 20788 66668 36455 30213 15173051 13274395 1894886 3770 1197070 1507344 1597626 1369727 2135 1424 85767 110093 27205291 12319691 9270066 14885600 1522822 20859473 2012702 2695072 292500 2680899 764162 18369087 42485395 1179464 1472714 4003995 25189394 37634 36164 177308 2682390 1473792 7903483 28349372 X 10037269 13043514 428335 1092509 10465604 14136023 18369087 42485395 X 0 1 1 X 0 X 33000 84294 99570 1393110 3000 1612974 11743427 12736009 14297953 15032966 15508181 69318536 11776427 12820303 14397523 16426076 15511181 70931510 0 0 0 70931510 104255 206171 155822 60584 38773 565605 104255 206171 155822 60584 38773 565605 11880682 13026474 14553345 16486660 15549954 71497115 0.99210 0.99120 0.00790 0.00880 X 0 1 2268577 2268577 15867001 8658809 7208192 4243277 3187700 1055577 4826436 473182 4353254 14885600 Careventures Cooperative 5000 F Interest in Knute Nelson Foundation 2690072 F 2695072 Insurance Reserve 124770 Construction Payable 1260855 Reservation Deposits 46500 Non-compete Agreement Payable 41667 1473792 15412030 15173051 238979 11950 2737120 682370 3431440 3670419 15412030 0 15412030 0 15412030 15173051 0 15173051 0 15173051 Part IV, Line 2b: The organization acts as a custodian for the funds of the residents of the Home and assisted living. Part X: Description of Uncertain Tax Positions Under FIN 48: During 2010, the Corporation adopted the provisions of Accounting Standards Codification (ASC) 740-10 (previously Financial Interpretation No. 48, Accounting for Uncertainty in Income Taxes). The Corporation undergoes an annual analysis of its various tax positions, assessing the likelihood of those positions being upheld upon examination with relevant tax authorities. The implementation of this standard had no material impact on the financial statements. As of both the date of adoption and as of September 30, 2010, no amounts were recorded as a result of this analysis. The Corporation is no longer subject to Federal and State tax examinations by tax authorities for years before 2007. Part XI, Line 8 - Other Adjustments: Change in Value of Foundation: 682370. 1 scholarships 17 45246 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Knute Nelson makes payments directly to the school and directly to the individuals, depending on the circumstance. For payments made directly to individuals, a receipt must be provided showing book or tuition expense before the scholarship is issued. City of Alexandria Minnesota 416004926 015185AL5 2010-07-08 19865000 Build Senior Housing Campus 0 0 City of Alexandria Minnesota 416004926 2006-06-08 4300000 Assisted Living Facility 0 0 City of Alexandria Minnesota 416004926 2010-07-08 4500000 Skilled Nursing Facility Project 0 0 19865000 1505500 17788564 570936 2011 0 0 0 1 4300000 1010742 83118 3206140 2007 1 0 1 1 4500000 3036626 1463374 2010 0 0 0 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 Form 990, Part VI, Section A, line 2 Tom Anderson and Eileen Eiser have a business relationship. Form 990, Part VI, Section A, line 6 The membership of the organization is made up of fourteen area Lutheran churches which are elected as members by the Board of Directors of the organization. At all times, the majority of members of the organization are required to be congregations of the Evangelical Lutheran Church in America, or its successor. Form 990, Part VI, Section A, line 7a The organization's nominating committee, which consist of two voting delegates of members elected by the members at the annual meeting of members, the President of the Auxiliary/Friends of Knute, and two directors appointed by the Board of Directors, makes recommendations for elections to the Board of Directors. The Board of Directors is then elected by its members at an annual meeting. Form 990, Part VI, Section B, line 11 The return is reviewed initially by the CFO and CEO. The Finance & Audit committee then reviews and makes a recommendation to the Board of Directors to approve the return. Form 990, Part VI, Section B, line 12c Each officer, director, and key employee is required to fill out a conflict of interest form annually. The form is reviewed initially by the President of the Board of Directors and the CEO for potential conflicts. If a conflict exists, it is reviewed by the Board of Directors. Any person with a conflict is restricted from voting on related matters. Form 990, Part VI, Section B, line 15a The Board determines the compensation of the CEO based on comparability data. The CEO is reviewed annually by the executive board which then reports back to the full board of directors. The decision is noted in the board minutes. The CEO determines the compensation of the CFO based on comparability data and presents this information to the Executive Team of the Board of Directors. This process takes place on an annual basis. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part VII, Section A: In addition to the hours served at Knute Nelson, the Directors also serve 1 hour per week at the Knute Nelson Foundation, a related organization. The CEO and CFO also serve 5 hours and 1 hour per week respectively to the Knute Nelson Foundation. Knute Nelson Senior Living Campus LLC 420 12th Avenue East Alexandria MN 56308 272940787 Senior Housing MN 76 26794916 N/A Knute Nelson Foundation 420 12th Avenue East Alexandria MN 56308 411451486 Fundraising MN 501(c)(3) 11A N/A 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 Knute Nelson Foundation 0