2023-03-07T14:39:22-06:00 2022-09-30 410746749 CLIFTONLARSONALLEN LLP 2689 COMMERCE DRIVE NW SUITE 201 ROCHESTER MN 55901 990 2021-10-01 410880871 GOOD SHEPHERD LUTHERAN HOME GOOD 5078647714 PO BOX 747 RUSHFORD MN 559710747 DAVID U'REN BOARD PRESIDENT 5078647714 2023-02-14 1 DAVID UREN 999009999 KATHERINE LUTZKE CPA P01760889 5072802300 2023-02-14 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAVID U'REN PO BOX 747 RUSHFORD MN 559710747 7322702 0 X WWW.GOODSHEP-RUSHFORD.ORG X 1965 MN PROVIDE NURSING HOME/ASSISTED LIVING CARE SERVICES TO THE ELDERLY 9 9 201 9 259121 0 447627 444256 6762850 6765905 61125 61479 60247 50344 7331849 7321984 0 0 0 0 4740549 5107767 0 0 0 2591131 2047555 7331680 7155322 169 166662 5632546 5235289 1590194 1334258 4042352 3901031 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 6375900 0 6506784 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. 6375900 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 X RHONDA SPECE 5078647714 800 HOME STREET RUSHFORD MN 55971 DAVID U'REN PRESIDENT 0.19 0.19 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 DICK JOHNSON DIRECTOR 0.19 0.19 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 DARLENE CHIGLO DIRECTOR 0.19 0.19 X 0 0 0 DARREL HIGHUM DIRECTOR 0.19 0.19 X 0 0 0 SAMANTHA COLBENSON ADMINISTRATOR 30.00 10.00 X 84566 0 18819 RHONDA SPECE CHIEF FINANCIAL OFFICER 30.00 10.00 X 67502 0 21318 152068 0 40137 0 0 0 0 AEGIS THERAPIES INC PO BOX 936653 ATLANTA GA 31193 THERAPY CHARGES 183153 ACCOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS TX 75373 TRAVEL STAFF 152487 2 392459 51797 444256 RESIDENT REVENUE 623000 6026369 6026369 APARTMENT REVENUE 623000 422349 422349 DAY CARE REVENUE 624410 291147 32026 259121 MGMT CONTRACT REVENUE 561000 26040 26040 6765905 61527 61527 46 46 670 718 -48 -48 -48 BEAUTY SHOP REVENUE 812900 25020 25020 MISCELLANEOUS REVENUE 900099 19564 19564 GUEST/EMPLOYEE MEALS 900099 5714 5714 50298 7321984 6506784 259121 111823 218973 218973 3777450 3698750 78700 36682 33949 2733 786594 728010 58584 288068 266607 21461 33968 33968 561023 415935 145088 15513 15513 14678 14678 416474 402487 13987 8529 8529 41416 41416 36225 36225 229138 229138 72938 72938 SUPPLIES 308359 308359 FOOD COSTS 177400 177400 BAD DEBT EXPENSE 86396 86396 CHILD DAY CARE 27113 27113 18385 10511 7874 7155322 6375900 779422 0 11645 10753 1502384 1782153 601153 470371 23994 0 37882 30296 169385 121088 7143519 5834479 1477950 1309040 1474757 1160852 333396 350736 5632546 5235289 338761 360361 212638 932444 868989 106351 104908 1590194 1334258 X 3921877 3772091 120475 128940 4042352 3901031 5632546 5235289 X 166662 -307977 -6 X X 0 1 X 1 0 X 79301 74219 979409 447627 444256 2024812 6592000 6990865 6858011 6488294 6506784 33435954 39488 38181 29480 28198 25020 160367 6710789 7103265 7866900 6964119 6976060 35621133 79301 74219 66968 98506 49725 368719 2348666 2257295 1930646 2409267 2853917 11799791 2427967 2331514 1997614 2507773 2903642 12168510 23452623 18561 27141 36881 61180 61573 205336 291754 289558 251969 274556 259121 1366958 310315 316699 288850 335736 320694 1572294 9053 15578 35116 31994 25278 117019 7030157 7435542 8190866 7331849 7322032 37310446 0.62860 0.67170 0.04210 0.04340 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 45109 45109 4213477 3733708 479769 2820216 2047217 772999 64717 53554 11163 1309040 DUE FROM RELATED PARTY 128940 GUARANTY FUND CERTIFICATE 117870 LAND & MINERAL RIGHTS 8731 EQUITY IN COOPERATIVE 54862 OTHER ASSETS 40333 350736 RESIDENT TRUST FUND 5435 RENTAL DEPOSITS 7271 ASSET RETIREMENT OBLIGATION 26202 DUE TO RELATED PARTY 66000 104908 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 ELEVEN 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. 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 XI, LINE 9: ROUNDING -6. FORM 990, PART XII, LINE 2C: THE ORGANIZATIONS BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. 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 NO TRANSACTIONS OVER 50000