2011-02-07T11:36:35-06:00 2010-09-30 LARSONALLEN LLP PO BOX 217 AUSTIN MN 55912 990 2009-10-01 410859026 ST LUKES LUTHERAN CARE CENTER STLU 5075262184 1219 SOUTH RAMSEY BLUE EARTH MN 56013 JOHN HUISMAN 5075262184 2011-01-14 1 Trent Fast 5074347000 2011-01-14 2009 2016-02-24 21:20:13Z LEAH KILLIAN-SMITH 1219 SOUTH RAMSEY BLUE EARTH MN 56013 9036763 0 X WWW.STLCARE.COM X 1963 MN TO PROVIDE ELDERLY AND HANDICAPPED PEOPLE WITH HOUSING FACILITIES AND SERVICES. 12 11 290 237 0 0 183133 168571 8603962 8745686 15480 -56317 119274 108273 8921849 8966213 0 0 6008773 5736098 0 0 2920074 3020033 8928847 8756131 -6998 210082 9208556 9951378 7571956 8104696 1636600 1846682 ST. LUKE'S LUTHERAN CARE CENTER PROVIDES ELDERLY AND HANDICAPPED PEOPLE WITH HOUSING FACILITIES AND SERVICES AND IS SPECIALLY DESIGNED TO MEET THE PHYSICAL, SOCIAL, AND PSYCHOLOGICAL NEEDS OF THE RESIDENTS AND TO CONTRIBUTE TO THEIR HEALTH, SECURITY AND HAPPINESS. 0 0 7947533 8701699 PROVISION OF CARE AND HOUSING FOR THE ELDERLY AND HANDICAPPED BY OPERATING A 127-BED LICENSED NURSING FACILITY AND A 28-UNIT ASSISTED LIVING FACILITY IN BLUE EARTH, MINNESOTA. 56045 43987 PROVISION OF LICENSED ADULT DAY CARE SERVICE FOR 10 INDIVIDUALS PER DAY 8003578 1 1 0 0 0 0 0 0 0 1 0 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 1 1 0 0 1 14 0 1 290 1 0 0 0 0 0 0 0 0 0 1 12 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 0 0 MN X ERIN FARLAND 5075262184 1219 SOUTH RAMSEY BLUE EARTH MN 56013 JOHN HUISMAN 1.00 X X 0 0 0 CAROLYN HALVORSON 1.00 X X 0 0 0 DONNIS MATTHEWS 1.00 X X 0 0 0 PAT COUPANGER 1.00 X 0 0 0 ROGER HOLLAND 1.00 X 0 0 0 ROGER LEGRED 1.00 X 0 0 0 EVERETT WESSELS 1.00 X 0 0 0 HENRIK HENDRICKSEN 1.00 X 0 0 0 SONJA WILLMERT 1.00 X 0 0 0 SHARON HOFFMAN 1.00 X 0 0 0 KATHY SATRE 1.00 X 0 0 0 AUDREY KIIHN 1.00 X 0 0 0 GENE NELSON 40.00 X 120410 0 11353 ERIN FARLAND 40.00 X 57941 0 14310 178351 0 25663 1 0 0 0 REHABCARE GROUP PO Box 503534 ST LOUIS MO 631503534 THERAPY SERVICES 342650 WAGNER CONSTRUCTION PO BOX 698 AUSTIN MN 55912 GENERAL CONTRACTOR 283514 TSP 1500 HIGHWAY 52 NORTH ROCHESTER MN 55901 ARCHITECT 112511 TEXTILE CARE SERVICES 225 Woodlake Drive Se ROCHESTER MN 559045530 LINEN/LAUNDRY SERVICES 101787 4 140700 27871 168571 MEDICARE/MEDICAID PMTS 623000 4541322 4541322 RESIDENT REVENUE 623000 3348636 3348636 FRIENDSHIP COURT REV 623000 677046 677046 SOUTHVIEW ESTATES REV 623000 91249 91249 ADULT DAY CARE REV 623000 43987 43987 43446 43446 8745686 2578 2578 58895 -58895 -58895 -58895 20440 11655 8785 8785 BEAUTY SHOP REVENUE 812900 49674 49674 MISCELLANEOUS INCOME 900099 32270 32270 GUEST/EMPLOYEE MEALS 900099 17544 17544 99488 8966213 8745686 0 51956 116046 116046 4324203 4074555 249648 35543 32700 2843 910206 837390 72816 350100 322095 28005 3244 3244 22651 275 22376 145391 145391 13342 13342 584940 524038 60902 266353 266353 4878 4878 30400 10364 20036 293734 293734 478201 478201 95186 95186 NURSING HOME ASSESSMENT 357505 357505 THERAPY EXPENSE 339836 339836 FOOD COSTS 290079 290079 MISCELLANEOUS 33952 33952 PRE-ADMISSION SCREENING 22457 22457 37884 26184 11700 8756131 8003578 752553 0 128499 834307 333049 143658 666111 598240 55962 56339 132357 45891 13976384 5809455 7767344 8166929 33413 71479 58895 32926 34535 9208556 9951378 726137 931216 6657812 7014834 188007 158646 7571956 8104696 X 1636600 1846682 1636600 1846682 9208556 9951378 X 0 1 1 X 1 1 X 105948 49177 38562 72373 75879 341939 7369481 8001538 8276022 8603962 8745686 40996689 7475429 8050715 8314584 8676335 8821565 41338628 155813 148733 108272 153792 140700 707310 0 155813 148733 108272 153792 140700 707310 40631318 156743 166759 132604 126240 95270 677616 156743 166759 132604 126240 95270 677616 7632172 8217474 8447188 8802575 8916835 42016244 0.96700 0.95860 0.01610 0.01600 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 97373 97373 11473673 4594199 6879474 1358220 1031824 326396 1047118 183432 863686 8166929 RESIDENT TRUST PAYABLE 4867 DUE TO RELATED PARTY 100000 ASSET RETIREMENT OBLIGATION 38326 SECURITY DEPOSITS 15453 158646 Part X: Description of Uncertain Tax Positions Under FIN 48: St. Luke's Lutheran Care Center and Affiliates follows the income tax standard for uncertain tax positions. No liability has been recognized as a result of this standard. Each entity 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, 2008, and 2009 tax years are open for examination by the IRS. Form 990, Part VI, Section B, line 11 BOARD HAS DIRECTED THE MANAGEMENT OF THE CARE CENTER TO REVIEW THE FORM 990 PRIOR TO SIGNING BY THE CARE CENTER BOARD CHAIR. Form 990, Part VI, Section B, line 12c All Board Members annually review and sign new conflict of interest and confidentiality agreements. Care Center administration monitors for compliance with established policies & procedures. Form 990, Part VI, Section B, line 15a The process used to set the Administrators annual salary is based on a combination of comparison to comparable organizations through use of compensation surveys as well as the experience and performance of the administrator as determined by the Board of Directors. This is only for the CEO/Administrator. Other Key Employees, including CFO, have their salaries set by the administrator and are also eligible and receive any COST OF LIVING ADJUSTMENTS (COLA) set by the state of Minnesota. The administrator does not receive the COLA. Form 990, Part VI, Section C, line 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AT REQUEST IN THE ADMINISTRATIVE OFFICE. FORM 990, PART XI, Line 2c: THE ORGANIZATIONS BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. SOUTHVIEW ESTATES 1219 SOUTH RAMSEY BLUE EARTH MN 56013 411845740 ELDERLY & HANDICAPPED HOUSING MN 501(C)(3) 9 St Lukes Lutheran Care Center ST LUKE'S NURSING HOME FOUNDATION 1219 SOUTH RAMSEY BLUE EARTH MN 56013 411483909 SUPPORT ST. LUKE'S LUTHERAN CARE CENTER MN 501(C)(3) 11a, I st Lukes Lutheran Care Center NEW LIFE MANOR INC 1219 SOUTH RAMSEY BLUE EARTH MN 56013 411401396 ELDERLY & HANDICAPPED HOUSING MN 501(C)(3) 9 st Lukes Lutheran Care Center 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 ST LUKE'S NURSING HOME FOUNDATION C 140700