2011-09-29T10:44:17-05:00 2010-12-31 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2010-01-01 460332387 BETHESDA HOME INC BETH 6053453331 129 WEST HIGHWAY 12 WEBSTER SD 57274 DAVID ROGERS 6053453331 2011-09-09 1 LAURIE HANSON 6053391999 2011-09-09 2010 2016-03-07 17:11:31Z KYLE RICHARDS 129 WEST HIGHWAY 12 WEBSTER SD 57274 2971467 0 X WWW.BETHESDANURSINGHOME.COM X 1956 SD NURSING HOME AND CONGREGATE LIVING. 9 9 129 12 33855 0 185145 16692 3028597 2954309 283 466 0 0 3214025 2971467 0 0 0 0 2033215 1880220 0 0 0 891821 978232 2925036 2858452 288989 113015 1420021 1350484 1547396 1364844 -127375 -14360 A CHRISTIAN HOME OF HEALTH, HEALING, HEART AND HOPE. 0 0 2293127 2913366 THE ORGANIZATION OPERATES A 50-BED NURSING HOME AND A 24-UNIT CONGREGATE HOUSING COMPLEX, WHICH ALLOWS IT TO PROVIDE A CHRISTIAN HOME FOR AGING PERSONS. TOTAL RESIDENT DAYS 17,377. 2293127 1 1 0 0 0 0 0 0 0 1 0 0 0 0 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 1 0 0 0 1 8 0 129 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X KYLE RICHARDS 6053453331 129 WEST HIGHWAY 12 WEBSTER SD 57274 JOHN HISEL 1.00 X X 0 0 0 JOHN SIGDESTAD 1.00 X X 0 0 0 PAT SASS 1.00 X X 0 0 0 STANLEY BOE 1.00 X 0 0 0 MARILYN HEMMINGSON 1.00 X 0 0 0 JIM ROOD 1.00 X 0 0 0 BRENT ZIMMERMAN 1.00 X 0 0 0 VIRGINIA TUNHEIM 1.00 X 0 0 0 NYLA AMUNDSON 1.00 X 0 0 0 NORMAN ANDERSON 1.00 X 0 0 0 KYLE RICHARDS 10.00 X 63244 0 7860 DAVID ROGERS 40.00 X 66102 0 4714 129346 0 12574 0 0 0 1 SANFORD HEALTH 1305 WEST 18TH STREET SIOUX FALLS SD 57105 MGMT/CONSULTING 208139 1 16692 16692 RESIDENT SERVICES 623000 2913366 2913366 MEAL SALES 722210 24706 22426 2280 LAUNDRY 812300 11429 11429 MISCELLANEOUS 623000 4808 4808 2954309 466 466 2971467 2913366 33855 7554 143031 143031 1487147 1320053 167094 20000 17753 2247 102716 92444 10272 127326 114593 12733 65108 65108 25874 25874 208752 190479 18273 4151 4151 29223 9865 19358 3225 3225 129320 129320 8419 7368 1051 6761 3048 3713 35205 35205 111200 111200 50851 3600 47251 SUPPLIES 217950 202693 15257 REPAIRS & MAINTENANCE 68106 51017 17089 TAXES AND FEES 8472 8472 BAD DEBT EXPENSE 4169 4169 1446 320 1126 2858452 2293127 565325 0 167819 278263 230621 148416 18244 22113 29929 2420 3906760 3007488 973408 899272 1420021 1350484 250308 162877 1035000 975000 228998 226967 33090 0 1547396 1364844 X -127375 -14360 -127375 -14360 1420021 1350484 113015 0 X 0 1 1 X 0 X 86531 72675 33500 185145 16692 394543 2348416 2607704 2666594 2928031 2913366 13464111 52089 44583 47046 69869 7088 220675 2487036 2724962 2747140 3183045 2937146 14079329 0 836322 819427 845755 607666 947882 4057052 836322 819427 845755 607666 947882 4057052 10022277 7180 8863 589 283 466 17381 5028 14174 8826 28028 7180 13891 14763 283 9292 45409 2494216 2738853 2761903 3183328 2946438 14124738 0.70960 0.72410 0.00320 0.00300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21424 21424 3289050 2514903 774147 575272 490930 84342 21014 1655 19359 899272 2971467 2858452 113015 0 113015 2971467 0 2971467 0 2971467 2858452 0 2858452 0 2858452 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION HAS ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION SECTION ASC 740-10 (PREVIOUSLY FINANCIAL INTERPRETATION NO. 48, ACCOUNTING FOR UNVERTAINTY IN INCOME TAXES), ON JANUARY 1, 2009. THE IMPLEMENTATION OF THIS STANDARD HAS NO IMPACT ON THE FINANCIAL STATEMENTS. AS OF BOTH THE DATE OF ADOPTION, AND AS OF DECEMBER 31, 2010, THE UNRECOGNIZED TAX BENEFIT ACCRUAL WAS ZERO. THE ORGANIZATION WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INCOME TAX EXPENSE IF INCURRED. THE ORGANIZATION IS NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2007. 0 0 0 0 0 0 0 0 0 KYLE RICHARDS 63244 0 0 0 0 0 1867 0 5993 0 71104 0 0 0 DAVID ROGERS 66102 0 0 0 0 0 661 0 4164 0 70927 0 0 0 SUPPLEMENTAL INFORMATION PART III THE CEO OF THE ORGANIZATION, KYLE RICHARDS, AND THE ADMINISTRATOR OF THE ORGANIZATION, DAVID ROGERS, ARE PAID THROUGH A MANAGEMENT AGREEMENT WITH SANFORD HEALTH, SIOUX FALLS, SD. AS SUCH, PART I OF SCHEDULE J HAS BEEN LEFT BLANK AS THE MANAGEMENT COMPANY DETERMINES THE CEO'S COMPENSATION AND BENEFITS. FORM 990, PART VI, SECTION A, LINE 3 SANFORD HEALTH PROVIDES MANAGEMENT SERVICES THROUGH A CONTRACT INVOLVING THE CEO AND THE ADMINISTRATOR. THE CEO SPENDS APPROXIMATELY 10 HOURS PER WEEK AT THE HOME. THE REMAINDER OF HIS TIME IS SPENT AT AN UNRELATED ENTITY. THE ADMINISTRATOR SPENDS 100% OF HIS TIME WORKING FOR THE HOME. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THIS CORPORATION SHALL CONSIST OF THE VOTING MEMBERS OF NINE CONGREGATIONS OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA'S PRAIRIE COTEAU CONFERENCE OF THE SOUTH DAKOTA SYNOD OR ITS SUCCESSOR VOTING TO PARTICIPATE AND OF OTHER LUTHERAN CONGREGATIONS THAT BECOME MEMBERS BY INVITATION TO THIS CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A BETHESDA HOME, INC. HAS AFFILIATIONS WITH AREA CHURCHES, AND IN TURN EACH AFFILIATED CHURCH ELECTS A REPRESENTATIVE FROM THEIR RESPECTIVE CONGREGATION TO SIT ON THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE AFFILIATED CHURCHES EACH SEND TWO REPRESENTATIVES TO BETHESDA HOME'S ANNUAL MEETING AS THEIR VOICE ON DECISIONS MADE BY THE BOARD OF DIRECTORS SUCH AS CHANGES TO GOVERNING DOCUMENTS, ETC. FORM 990, PART VI, SECTION A, LINE 8B THE EXECUTIVE COMMITTEE MEETS BEFORE REGULAR BOARD MEETINGS, BUT HAS NO AUTHORITY TO ACT WITHOUT THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 11 A COPY WILL BE MAILED TO THE BOARD MEMBERS. THEY WILL APPROVE THE 990 AT THE FOLLOWING BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO READ, ACCEPT AND SIGN THE CONFLICT OF INTEREST STATEMENT EACH YEAR. THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS. A POSSIBLE CONFLICT MUST BE DISCLOSED IMMEDIATELY IN WRITING TO THE BOARD PRESIDENT. THE WRITTEN DISCLOSURE IS THEN PRESENTED TO THE BOARD, AS A WHOLE, AND DETERMINATION IS MADE, BY A MAJORITY VOTE, AS TO WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT EXISTS. IF A CONFLICT IS DETERMINED TO EXIST, THE INTERESTED PERSON MAY GIVE A PRESENTATION TO THE REST OF THE BOARD, BUT AFTER THE PRESENTATION, THE INTERESTED PERSON MUST LEAVE THE MEETING DURING THE DISCUSSION AND VOTING PROCESS OF THE DISCLOSED MATTER. FORM 990, PART VI, SECTION B, LINE 15 SANFORD LOOKS AT COMPARABLE ORGANIZATIONS. SDAHO PROVIDES SALARY GUIDELINES, AS WELL AS NATIONAL ORGANIZATIONS. THE SALARY GUIDELINES ARE BASED ON SIZE, LOCATION AND REVENUE OF THE ORGANIZATION. THIS METHOD OF DETERMINING COMPENSATION IS USED FOR ALL ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST WITH BOARD APPROVAL. BETHESDA HOME FOUNDATION 129 WEST HIGHWAY 12 WEBSTER SD 57274 460397029 PROVIDE MONETARY SUPPORT FOR THE HOME SD 501(C)(3) LINE 11D, III-O N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0