FURP.ORG / PUBLIC DATA EXPLORER

ST LUKES HOME: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ST LUKES HOME (EIN 45-0347147)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-10-06
IRS object ID
201122799349300132
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-10-06T13:41:45-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1914AddressLine1
CityBISMARCKCity
StateNDState
ZIP Code58502ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN450347147EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST LUKE'S HOMEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTLUNameControl
Phone7014835000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1242 WEST 10TH STREETAddressLine1
CityDICKINSONCity
StateNDState
ZIP Code58601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKAREN BOULDENName
TitleADMINISTRATORTitle
Phone7014835000Phone
Date Signed2011-09-27DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLISA CHAFFEE CPAName
Phone7012551091Phone
Date Prepared2011-09-19DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKAREN BOULDENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1242 WEST 10TH STREETAddressLine1
CityDICKINSONCity
StateNDState
ZIP Code58601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6897752GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number9386GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STLUKESHOME.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileNDStateLegalDomicile
Activity Or Mission DescriptionST. LUKE'S HOME AND IT'S ASSISTED LIVING FACILITY, PARK AVENUE VILLA, EXIST TO PROVIDE A CONTINUUM OF QUALITY CARE TO GOD'S PEOPLE, CREATING A COMPASSIONATE, COMFORTABLE, AND FAMILY ORIENTED ATMOSPHERE, STRIVING TO ENHANCE THE DIGNITY AND RESPECT OF EACH PERSON WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees256TotalNbrEmployees
Total Nbr Volunteers125TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year209589ContributionsGrantsPriorYear
Contributions Grants Current Year92038ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6603360ProgramServiceRevenuePriorYear
Program Service Revenue CY6797600ProgramServiceRevenueCY
Investment Income Prior Year3237InvestmentIncomePriorYear
Investment Income Current Year6009InvestmentIncomeCurrentYear
Other Revenue Prior Year375OtherRevenuePriorYear
Other Revenue Current Year2030OtherRevenueCurrentYear
Total Revenue Prior Year6816561TotalRevenuePriorYear
Total Revenue Current Year6897677TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year912GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4141372SalariesEtcPriorYear
Salaries Etc Current Year4339017SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1747712OtherExpensePriorYear
Other Expenses Current Year1995011OtherExpensesCurrentYear
Total Expenses Prior Year5889996TotalExpensesPriorYear
Total Expenses Current Year6334028TotalExpensesCurrentYear
Revenues Less Expenses Prior Year926565RevenuesLessExpensesPriorYear
Revenues Less Expenses CY563649RevenuesLessExpensesCY
Total Assets BOY5158263TotalAssetsBOY
Total Assets EOY11438504TotalAssetsEOY
Total Liabilities BOY3133587TotalLiabilitiesBOY
Total Liabilities EOY8850179TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2024676NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2588325NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionST. LUKE'S HOME AND IT'S ASSISTED LIVING FACILITY, PARK AVENUE VILLA, EXIST TO PROVIDE A CONTINUUM OF QUALITY CARE TO GOD'S PEOPLE, CREATING A COMPASSIONATE, COMFORTABLE, AND FAMILY ORIENTED ATMOSPHERE, STRIVING TO ENHANCE THE DIGNITY AND RESPECT OF EACH PERSON WE SERVE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5795765Expense
Revenue6797600Revenue
DescriptionST. LUKE'S HOME IS AN 84 BED NURSING HOME AND A 38-UNIT ASSITED LIVING FACILITY LOCATED IN DICKINSON, ND. ST. LUKE'S HOME WAS ORGANIZED IN 1957 BY THE AMERICAN LUTHERAN CHURCH AND THE CONGREGATIONS IN THE SOUTHWESTERN PART OF NORTH DAKOTA. THE PURPOSE, AT THE TIME, WAS TO PROVIDE NURSING CARE FOR THE COMFORT AND WELL-BEING OF THE CHRONICALLY ILL, OF THE AGED AND OF THE INFIRM OF THE AREA, REGARDLESS OF RACE, COLOR OR CREED. AS NURSING HOME SERVICES CONTINUED TO EVOLVE, ST. LUKE'S BECAME MEDICARE/MEDICAID CERTIFIED AND TODAY OFFERS A WIDE RANGE OF SERVICES INCLUDING A FULL RANGE OF THERAPY SERVICES, HOSPICE, IV THERAPY, AND TUBE FEEDING AS WELL AS RESPITE CARE. WHILE WE CONTINUE TO SERVE THOSE IN NEED, PLANS ARE IN PLACE TO TRANSITION FROM THE "NURSING HOME" MODEL TO PERSON CENTERED CARE IN A NEW ATMOSPHERE WHICH WILL REINVIGORATE AND EMPHASIZE RETENTION OF DIGNITY AND QUALITY OF LIFE FOR THOSE WE SERVE.Description
Total Program Service Expense5795765TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer1OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees256NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KAREN BOULDEN ADMINISTRATORBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7014835000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1242 W 10TH STREETAddressLine1
CityDICKINSONCity
StateNDState
ZIP Code58601ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JEFF BRIGGS
PRESIDENT0.40XX000
CB HAAS
VICE PRESIDENT0.40XX000
STEVEN SCHOU
SECRETARY0.40XX000
VAL MACK
TREASURER0.40XX000
KRISTIN FEHR
MEMBER0.40X000
DAWN PRUITT
MEMBER0.50X000
JIM OZBUN
MEMBER0.40X000
TODD OTTO
MEMBER0.40X000
JAN FIELDS
MEMBER0.40X000
TIM PRIEBE
MEMBER0.40X000
KAREN BOULDEN
ADMINISTRATOR, CEO60.00X79234014063
FieldValueIRS element (for citing)
Total Reportable Comp From Org79234TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation14063TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Related Organizations17393RelatedOrganizations
All Other Contributions74645AllOtherContributions
Total Contributions92038TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REV.62300060231646023164
RESIDENT RENTAL REV.623000758235758235

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column16201TotalRevenueColumn
Related Or Exempt Function Income16201RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6797600TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6084TotalRevenueColumn
Exclusion$6,084ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column2030TotalRevenueColumn
Exclusion$2,030ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other75Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-75Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-75TotalRevenueColumn
Exclusion-$75ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6897677TotalRevenueColumn
Related Or Exempt Function Income6797600RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$8,039ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total93297Total
Management And General93297ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3758987Total
Program Services3546144ProgramServices
Management And General212843ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total47192Total
Program Services39435ProgramServices
Management And General7757ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total163194Total
Program Services150496ProgramServices
Management And General12698ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total276347Total
Program Services255452ProgramServices
Management And General20895ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total26993Total
Management And General26993ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total41500Total
Management And General41500ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total231654Total
Program Services229154ProgramServices
Management And General2500ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total9582Total
Program Services112ProgramServices
Management And General9470ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total482060Total
Program Services417407ProgramServices
Management And General64653ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total12361Total
Management And General12361ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total274805Total
Program Services274805ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total15095Total
Program Services10950ProgramServices
Management And General4145ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total19588Total
Program Services19588ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total112078Total
Program Services112078ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total272228Total
Program Services272228ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
FOOD EXPENSE326491326491
MEDICARE A EXPENSE5027650276
REPAIRS37527310136514
MED B THERAPIES2101821018
ELDER CARE - MINI BUS1281012810

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total48945Total
Program Services26308ProgramServices
Management And General22637ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6334028Total
Program Services5795765ProgramServices
Management And General538263ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY13246BOY
EOY14652EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY389532BOY
EOY966167EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY324120BOY
EOY395098EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY44324BOY
EOY43799EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY43269BOY
EOY32670EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis13056259LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4453318LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3579399BOY
EOY8602941EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY494450BOY
EOY797535EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY269923BOY
EOY585642EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5158263BOY
EOY11438504EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY648082BOY
EOY1635620EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY2435000BOY
EOY7158243EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY48740BOY
EOY55032EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY1765BOY
EOY1284EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3133587BOY
EOY8850179EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2024676BOY
EOY2588325EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2024676BOY
EOY2588325EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5158263BOY
EOY11438504EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses563649ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years46636CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18006CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4369CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year209589CurrentTaxYearMinus1Year
Current Tax Year92038CurrentTaxYear
Total370638Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5634026CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5991754CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6182573CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6603360CurrentTaxYearMinus1Year
Current Tax Year6797600CurrentTaxYear
Total31209313Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5680662CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6009760CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6186942CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6812949CurrentTaxYearMinus1Year
Current Tax Year6889638CurrentTaxYear
Total31579951Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years140284CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years94580CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years66873CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year304017CurrentTaxYearMinus1Year
Current Tax Year293465CurrentTaxYear
Total899219Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years140284CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years94580CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years66873CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year304017CurrentTaxYearMinus1Year
Current Tax Year293465CurrentTaxYear
Total899219Total
FieldValueIRS element (for citing)
Public Support Total50930680732PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22244CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years24830CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7901CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5567CurrentTaxYearMinus1Year
Current Tax Year8114CurrentTaxYear
Total68656Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22244CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years24830CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7901CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5567CurrentTaxYearMinus1Year
Current Tax Year8114CurrentTaxYear
Total68656Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5702906CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6034590CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6194843CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6818516CurrentTaxYearMinus1Year
Current Tax Year6897752CurrentTaxYear
Total31648607Total
FieldValueIRS element (for citing)
Public Support Percentage5090.96940PublicSupportPercentage509
Prior Year Support Percentage0.97360PriorYearSupportPercentage
Investment Income Percentage0.00220InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00250PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis41627OtherCostOrOtherBasis
Book Value41627BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5216756OtherCostOrOtherBasis
Depreciation3595880Depreciation
Book Value1620876BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis860798OtherCostOrOtherBasis
Depreciation733529Depreciation
Book Value127269BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6937078OtherCostOrOtherBasis
Depreciation123909Depreciation
Book Value6813169BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8602941TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING COST573041
MINERAL RIGHTS12601
FieldValueIRS element (for citing)
Total Book Value Other Assets585642TotalBookValueOtherAssets
Total Revenue6897677TotalRevenue
Total Expenses6334028TotalExpenses
Excess Or Deficit For Year563649ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS563649ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt6897677TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal6897677RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9906897677TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt6334028TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal6334028ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9906334028TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 2B:THE RESIDENT TRUST FUND IS AN ACCOUNT SET UP TO KEEP PRIVATE FUNDS FOR EACH OF OUR RESIDENTS TO USE FOR PERSONAL MATTERS. UPON ADMISSION THEY ARE GIVEN THE OPPORTUNITY TO DEPOSIT MONEY OF THEIR OWN INTO AN ACCOUNT THAT WE TRACK FOR THEM. THIS MONEY IS KEPT IN THE OFFICE AND CAN BE ACCESSED WHENEVER THEY WANT. WE KEEP A CERTAIN AMOUNT AVAILABLE FOR WITHDRAWALS AND THE REST IS DEPOSITED INTO AN INTEREST BEARING ACCOUNT. THE INTEREST IS DIVIDED BETWEEN THE ACCOUNTS, BASED ON THE AMOUNT EARNED AND THE AMOUNT EACH RESIDENT HAS IN THEIR ACCOUNT. UPON DISCHARGE, THE BALANCE, INCLUDING INTEREST IS REFUNDED.
PART X:THE ORGANIZATION UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THESE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES, AS DEFINED BY THE ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA (GAAP). THE ORGANIZATION BELIEVES THAT THEY ARE COMPLIANT WITH ALL IRS TAX REGULATIONS AND AS OF DECEMBER 31, 2010 HAVE NOT RECORDED LIABILITIES FOR INCOME TAXES. THE ORGANIZATION WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES IN INCOME TAX EXPENSE IF INCURRED. UNDER NORMAL CIRCUMSTANCES, THE ORGANIZATION IS NO LONGER SUBJECT TO FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2007.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
CITY OF DICKINSON
45600205525325NAS32005-06-162891038REFINANCE 1997, SERIES 2005A100
ST LUKE'S HOME
4503471472009-11-1313690000CONSTRUCTION SKILLED NURSING FACILITY010

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFundCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceeds
289103828348355620320060111
136900005113302011010149869766712276008746

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000010.000000.000000.000001
000010.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
100000
000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6THE CORPORATION SHALL HAVE ONE MEMBER. DICKINSON ST. LUKE'S HOMES, INC., A NORTH DAKOTA NONPROFIT CORPORATION, SHALL BE THE SOLE MEMBER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATEN DIRECTORS SHALL BE APPOINTED BY DICKINSON ST. LUKE'S HOMES, INC., TO SERVE ONE-YEAR TERMS, WITH UNLIMITED SUCCESSION.
FORM 990, PART VI, SECTION A, LINE 8BTHERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD.
FORM 990, PART VI, SECTION B, LINE 11THE ADMINISTRATOR AND LEGAL ADVISOR WILL REVIEW A DRAFT OF THE FULL FORM 990 BEFORE IT IS FINALIZED. IN ADDITION, A PUBLIC DISCLOSURE COPY OF THE FORM 990 WILL BE PROVIDED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENT PRIOR TO ITS FILING WITH THE IRS.
THE ORGANIZATION ANNUALLY RE-ADOPTS A CONFLICT OF INTEREST POLICY. ANY PERCEIVED CONFLICT OF INTEREST ON THE PART OF A BOARD MEMBER SHALL BE DISCLOSED TO THE BOARD OF DIRECTORS PRIOR TO THE BOARD'S DECISION ON THE ISSUE TO WHICH THE PERCEIVED CONFLICT RELATES. WHEN SUCH A DISCLOSURE HAS BEEN MADE AND ACKNOWLEDGED, AND THE BOARD HAS CONCURRED THAT A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER INVOLVED SHALL ABSTAIN FROM VOTING ON THE ISSUE. THE BOARD MEMBER SHALL REFRAIN FROM PARTICIPATING IN THE DISCUSSION OTHER THAN TO PROVIDE FACTUAL INFORMATION ABOUT THE APPLICANT, ORGANIZATION OR VENDOR IN QUESTION. ANY ABSTENTIONS FROM VOTING WILL BE RECORDED IN THE MINUTES OF THE MEETING.FORM 990, PART VI, SECTION B, LINE 12C
ANNUALLY,A COMMITTEE PERFORMS AN EVALUATION OF THE COMPENSATION AND SENDS EVALUATION FORMS TO THE BOARD OF DIRECTORS. THEY COMPILE THE RESPONSES AND REVIEW AREA WAGES PROVIDED BY THE ND LONG TERM CARE ASSOCIATION. THE BOARD OF DIRECTORS VOTES ON THE COMPENSATION AMOUNTS. A VOTE IS CONDUCTED DURING EACH FILING YEAR. THIS PROCESS IS DOCUMENTED IN THE MEETING MINUTES.FORM 990, PART VI, SECTION B, LINE 15A
THE ORGANIZATION DOES NOT MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
THERE IS A FINANCE COMMITTEE IN PLACE THAT CONSISTS OF CURRENT BOARD MEMBERS. THEY REVIEW THE FINANCIAL STATEMENTS AND THE FULL BOARD APPROVES THEM.FORM 990, PART XII, LINE 2C:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
ST LUKE'S HOME FOUNDATION
242 10TH STREET WESTDICKINSONND58601450409966TO RAISE FUNDS TO SUPPORT THE ACTIVITIES OF ST. LUKE'S HOMEND501(C)(3)11BDICKINSON ST LUKE'S HOME INC1
DICKINSON ST LUKE'S HOME INC
242 10TH STREET WESTDICKINSONND58601450409965SUPPORT IN ESTABLISHING, OPERATING, & MAINTAINING RETIREMENT & NURSING HOMESND501(C)(3)11B1N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeMethod Of Amt DeterminationMethodOfAmtDetermination
ST LUKE'S HOME FOUNDATION INC
CACCRUAL
ST LUKE'S HOME FOUNDATION INC
MACCRUAL
ST LUKE'S HOME FOUNDATION INC
QACCRUAL
ST LUKE'S HOME FOUNDATION INC
RACCRUAL