2024-04-02T11:23:37-05:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 2689 COMMERCE DRIVE NW SUITE 201 ROCHESTER MN 55901 990 2022-10-01 410880871 GOOD SHEPHERD LUTHERAN HOME GOOD 5078647714 PO BOX 747 RUSHFORD MN 559710747 JACK CULHANE BOARD PRESIDENT 5078647714 2024-02-19 1 JACK CULHANE 999009999 0 KATHERINE LUTZKE CPA P01760889 5072802300 2024-02-19 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JACK CULHANE PO BOX 747 RUSHFORD MN 559710747 7022276 0 X WWW.GOODSHEP-RUSHFORD.ORG X 1965 MN TO ENHANCE THE QUALITY OF LIFE BY MEETING PEOPLE'S NEEDS, EXCEEDING EXPECTATIONS AND ENRICHING LIFE EXPERIENCES TO THOSE CONNECTED BY THE COMMUNITY. 9 9 201 9 288522 0 444256 92887 6765905 6824222 61479 67947 50344 36342 7321984 7021398 0 0 0 0 5107767 4967173 0 0 0 2047555 2358578 7155322 7325751 166662 -304353 5235289 5341866 1334258 1594640 3901031 3747226 TO PROVIDE NURSING HOME CARE AND ASSISTED LIVING CARE SERVICES TO ENHANCE THE QUALITY OF LIFE BY MEETING PEOPLE'S NEEDS, EXCEEDING EXPECTATIONS AND ENRICHING LIFE EXPERIENCES TO THOSE CONNECTED BY THIS COMMUNITY. 0 0 6566028 0 6824222 PROVIDE SERVICES TO THE ELDERLY THROUGH THE OPERATION OF A 65-BED NURSING HOME, A 15-UNIT ASSISTED LIVING COMPLEX, A 32-UNIT SUBSIDIZED APARTMENT BUILDING, AND A CHILD DAY CARE IN RUSHFORD, MINNESOTA. 6566028 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 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 0 1 16 0 201 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 1 0 0 MN X RHONDA SPECE 5078647714 800 HOME ST RUSHFORD MN 55971 JACK CULHANE PRESIDENT 1.50 0.00 X X 0 0 0 NANCY SNYDER VICE PRESIDENT 0.19 0.19 X X 0 0 0 KAREN EICH SECRETARY/TREASURER 0.19 0.19 X X 0 0 0 LOUIS BOEHMKE DIRECTOR 0.19 0.19 X 0 0 0 SONJA COOK DIRECTOR 0.19 0.19 X 0 0 0 LUANNE DVORAK DIRECTOR 0.19 0.19 X 0 0 0 DARREL HIGHUM DIRECTOR 0.19 0.19 X 0 0 0 KATHIE INGRAM DIRECTOR 1.50 0.00 X 0 0 0 BARB ZOELLE-JOHNSON DIRECTOR 0.19 0.00 X 0 0 0 SAMANTHA COLBENSON ADMINISTRATOR 30.00 10.00 X 106406 0 1100 RHONDA SPECE CHIEF FINANCIAL OFFICER 30.00 10.00 X 84075 0 24241 190481 0 25341 1 0 0 0 MARTIN BROS DISTRIBUTING 406 VIKING ROAD CEDAR FALLS IA 50613 DIETARY SUPPLIES 259766 AEGIS THERAPIES INC PO BOX 936653 ATLANTA GA 31193 THERAPY CHARGES 182054 2 37664 55223 92887 RESIDENT REVENUE 623000 6080082 6080082 APARTMENT REVENUE 623000 404489 404489 DAY CARE REVENUE 624410 313611 25089 288522 MGMT CONTRACT REVENUE 561000 26040 26040 6824222 68825 68825 68 68 878 -878 -878 -878 BEAUTY SHOP REVENUE 812900 18371 18371 MISCELLANEOUS REVENUE 900099 15589 15589 GUEST/EMPLOYEE MEALS 900099 2314 2314 36274 7021398 6535700 288522 104289 X 223503 223503 3612422 3523150 89272 35686 35686 819825 819825 275737 275737 47339 47339 890913 697811 193102 21061 1359 19702 217077 180663 36414 250812 250812 4081 4081 9699 4149 5550 33204 33204 216221 216221 79907 79907 FOOD COSTS 243891 243891 MEDICAL CARE SURCHARGE 182975 182975 MISCELLANEOUS EXPENSE 53936 36328 17608 OTHER MEDICAL EXPENSE 35381 34531 850 72081 62890 9191 7325751 6566028 759723 0 10753 33698 1782153 1779297 470371 388602 30296 42256 121088 109041 7195274 5922305 1309040 1272969 1160852 1353687 350736 362316 5235289 5341866 360361 449004 243037 868989 802514 104908 100085 1334258 1594640 X 3772091 3613687 128940 133539 3901031 3747226 5235289 5341866 -304353 150548 0 X 0 1 X 1 0 X 74219 979409 447627 444256 92887 2038398 6990865 6858011 6488294 6506784 6535700 33379654 38181 29480 28198 25020 18371 139250 7103265 7866900 6964119 6976060 6646958 35557302 74219 66968 98506 49725 53252 342670 2257295 1930646 2409267 2853917 3221770 12672895 2331514 1997614 2507773 2903642 3275022 13015565 22541737 27141 36881 61180 61573 68893 255668 289558 251969 274556 259121 288522 1363726 316699 288850 335736 320694 357415 1619394 15578 35116 31994 25278 17903 125869 7435542 8190866 7331849 7322032 7022276 37302565 0.60430 0.62860 0.04340 0.04210 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 45109 45109 4338502 3794177 544325 2744446 2073812 670634 67217 54316 12901 1272969 DUE FROM RELATED PARTY 133539 GUARANTY FUND CERTIFICATE 117870 LAND & MINERAL RIGHTS 8731 EQUITY IN COOPERATIVE 57701 OTHER ASSETS 44475 362316 RESIDENT TRUST FUND 7164 RENTAL DEPOSITS 7175 ASSET RETIREMENT OBLIGATION 19746 DUE TO RELATED PARTY 66000 100085 X PART X, LINE 2: THE HOME HAS BEEN GRANTED EXEMPT STATUS FROM FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE HOME OR APARTMENTS AS A RESULT OF THIS STANDARD. THE HOME AND APARTMENTS FILE AS TAX-EXEMPT ORGANIZATIONS. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION A, LINE 6 THE NINE AREA EVANGELICAL LUTHERAN CHURCHES ARE MEMBERS OF THE LUTHERAN HOME. FORM 990, PART VI, SECTION A, LINE 7A THE NINE EVANGELICAL LUTHERAN CHURCHES NOMINATE AND ELECT MEMBERS OF THE GOVERNING BODY AT THE ANNUAL MEETING. EACH CHURCH SENDS TWO REPRESENTATIVES TO THE ANNUAL MEETING TO VOTE ON BEHALF OF THEIR CONGREGATION. AT THE ANNUAL MEETING BUT PRIOR TO VOTING, EACH MEMBER REPRESENTATIVE IS ALLOWED TO NOMINATE NEW CANDIDATES FOR THE GOVERNING BODY TO BE PUT ON THE BALLOT. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO BEING FILED WITH THE IRS, A COPY OF FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE BOARD PRESIDENT OR ACTING DIRECTOR AND THE CFO, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF THE APPROPRIATE DOCUMENTATION. UPON COMPLETION OF THE REVIEW, THE FORMS ARE REVIEWED AND VOTED ON AT A BOARD MEETING PRIOR TO SUBMITTAL TO THE IRS. THE ELECTED OFFICERS WILL SIGN THE FORMS WHERE NEEDED. FORM 990, PART VI, SECTION B, LINE 12C IF ANYONE REASONABLY BELIEVES THAT A POLICY, PRACTICE OR ACTIVITY OF GOOD SHEPHERD LUTHERAN SERVICES IS IN VIOLATION OF LAW, A WRITTEN COMPLAINT MUST BE FILED BY THE PERSON TO THEIR MANAGER, UP TO AND INCLUDING THE ADMINISTRATOR OR A BOARD MEMBER OF GOOD SHEPHERD LUTHERAN SERVICES. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS FOR DETERMINING THE ADMINISTRATOR COMPENSATION IS REVIEWED ANNUALLY BY THE GOVERNING BODY. ALSO, THE BOARD WILL VOTE ON WHETHER TO APPROVE THE MINNESOTA COST OF LIVING ADJUSTMENT. IN THE CASE MINNESOTA DOES RECOMMEND A COST OF LIVING ADJUSTMENT, THE GOVERNING BODY WILL VOTE ON WHETHER TO APPROVE THE COST OF LIVING ADJUSTMENT FOR ALL EMPLOYEES OF THE HOME. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALL MADE AVAILABLE TO THE PUBLIC IN THE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G DATA PROCESSING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 68,808. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,808. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 57,404. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,404. PHARMACY CONSULTANT & EXPENSE: PROGRAM SERVICE EXPENSES 9,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,870. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 117,367. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 117,367. SPEECH THERAPY: PROGRAM SERVICE EXPENSES 9,749. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,749. OTHER PURCHASED/PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,032. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,032. LAUNDRY: PROGRAM SERVICE EXPENSES 21,531. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,531. DIETICIAN: PROGRAM SERVICE EXPENSES 5,562. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,562. MAINTENANCE & SERVICE CONTRACT: PROGRAM SERVICE EXPENSES 23,957. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,957. NURSING: PROGRAM SERVICE EXPENSES 451,339. MANAGEMENT AND GENERAL EXPENSES 114,835. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 566,174. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 9,459. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,459. GOOD SHEPHERD SENIOR APARTMENTS PO BOX 747 RUSHFORD MN 55971 411757528 TO PROVIDE LOW INCOME HOUSING TO THE ELDERLY OR HANDICAPPED MN 501(C)(3) LINE 11 GOOD SHEPHERD LUTHERAN SERVICES 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0