2023-10-10T10:25:12-05:00 2022-12-31 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2022-01-01 410907322 EDGEBROOK CARE CENTER EDGE 5074427121 505 W TROSKY RD EDGERTON MN 56128 DENNIS BLEYENBURG PRESIDENT 5074427121 2023-09-25 0 DENNIS BLEYENBURG 999009999 1 LAURIE HANSON CPA P00851848 6053391999 2023-09-25 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z DENNIS BLEYENBURG 505 W TROSKY RD EDGERTON MN 56128 5945614 0 X WWW.SANFORDHEALTH.ORG X 1966 MN OPERATION OF A LONG-TERM CARE FACILITY, ASSISTED LIVING FACILITY, AND SENIOR APARTMENT FACILITY. 9 9 138 45 0 0 167813 11129 5268758 5918406 3091 15367 207 712 5439869 5945614 17739 18306 0 0 3323834 3516035 0 0 0 1843803 2126006 5185376 5660347 254493 285267 8126655 8356532 1150720 1199842 6975935 7156690 X TO PROVIDE CARE FOR ALL THOSE WHO FOR VARIOUS REASONS MUST RELY ON OTHERS TO CARE FOR THEM. THIS CARE IS BASED ON CHRISTIAN LOVE AND CONCERN WITH AN EMPHASIS ON MEETING THE NEEDS OF THE WHOLE PERSON WHILE RESPECTING INDIVIDUAL RIGHTS AND PERSONAL DIGNITY. EVERYONE INVOLVED IN THIS CARE, INCLUDING FAMILY MEMBERS, FRIENDS, CHURCH FAMILY, VOLUNTEERS, AND STAFF, SEEK TO SHARE THIS COMMON GOAL OF REACHING OUT TO THE RESIDENTS AS AMBASSADORS OF A LOVING GOD. 0 0 4707862 18306 5833535 ROUTINE RESIDENT CARE BY OPERATION OF A 56 BED LONG-TERM CARE UNIT, A 16 BED ASSISTED LIVING FACILITY, AND A 21-UNIT SENIOR APARTMENT FACILITY; THE NUMBER OF RESIDENT DAYS DURING 2022 WAS 30,563. 4707862 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 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 0 0 0 0 0 1 10 0 1 138 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 MN X STACY MERTENS 5074427121 505 WEST TROSKY ROAD EDGERTON MN 56128 X RANDY LANDHUIS PRESIDENT THROUGH DEC 2022 0.50 X X 0 0 0 GORDON DYK VICE PRESIDENT THROUGH DEC 2022 0.50 X X 0 0 0 ORA BOBELDYK SECRETARY/TREASURER 0.50 X X 0 0 0 DONNA HANENBURG DIRECTOR 0.50 X 0 0 0 EILEEN ROZEBOOM DIRECTOR 0.50 X 0 0 0 BILL SANDBULTE DIRECTOR 0.50 X 0 0 0 LOIS SCHMIDT DIRECTOR 0.50 X 0 0 0 GLENDA VAN HILL DIRECTOR 0.50 X 0 0 0 DENNIS BLEYENBURG DIRECTOR 0.50 X 0 0 0 SYDNEY ROBERTS ADMINISTRATOR 40.00 X 0 0 0 0 0 0 0 0 0 0 THE EVANGELICAL LUTHERAN GOOD SAMARITAN 4800 WEST 57TH STREET SIOUX FALLS SD 57108 MANAGEMENT FEES & SHARED EMPLOYEES 322039 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET OMAHA NE 68154 POOL STAFF SERVICES 228273 2 11129 11129 RESIDENT ROUTINE CARE 623000 5274554 5274554 ANCILLARY CHARGES 623000 545271 545271 MEALS - STAFF & GUEST 624210 85583 85583 OTHER REVENUE 623000 12998 12998 5918406 15367 15367 712 0 712 712 712 5945614 5833535 0 100950 18306 18306 2767603 2537222 230381 52008 50068 1940 491450 473156 18294 204974 197328 7646 322878 322878 443689 389738 53951 534 534 49616 19247 30369 270189 267377 2812 18004 18004 22946 22946 209 209 328969 325772 3197 74223 60122 14101 PROGRAM SUPPLIES 311432 311432 STATE BED SURCHARGE 146380 146380 BAD DEBT 70802 70802 EMPLOYEE AND PUBLIC REL 23955 15568 8387 42180 833 41347 5660347 4707862 952485 0 3836496 4096138 243908 457964 17403 30195 66465 99009 9241398 5568172 3962383 3673226 8126655 8356532 404570 430700 5650 27042 740500 742100 1150720 1199842 X 6967820 7148575 8115 8115 6975935 7156690 8126655 8356532 285267 -104512 0 X 0 1 X 1 0 X 1705 278 398744 167813 11129 579669 5213434 5739391 5633957 5224288 5833535 27644605 32598 28755 24901 44677 85583 216514 5247737 5768424 6057602 5436778 5930247 28440788 0 1161029 1547882 573339 319268 1490313 5091831 1161029 1547882 573339 319268 1490313 5091831 23348957 15484 21688 8276 4446 15367 65261 15484 21688 8276 4446 15367 65261 5263221 5790112 6065878 5441224 5945614 28506049 0.81910 0.82960 0.00230 0.00220 X 7030 7030 7488440 4460500 3027940 1494928 886903 608025 251000 220769 30231 3673226 TENANT SECURITY DEPOSITS 22100 HOUSING ENTRY FEE 720000 742100 X 5787219 -104512 16919 -87593 5874812 70802 70802 5945614 5606464 16919 16919 5589545 70802 70802 5660347 PART X, LINE 2: THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: EMPLOYEE RETENTION CREDIT 16,919. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT 70,802. PART XII, LINE 2D - OTHER ADJUSTMENTS: EMPLOYEE RETENTION CREDIT 16,919. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT 70,802. 1 SCHOLARSHIPS 19 18306 PART I, LINE 2: THE SCHOLARSHIPS WERE PAID DIRECTLY TO THE UNIVERSITY BY THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS DELEGATED MANAGEMENT DUTIES TO THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, AN UNRELATED ORGANIZATION. SYDNEY ROBERTS, ADMINISTRATOR, RECEIVED $94,676 IN COMPENSATION AND $14,148 IN OTHER BENEFITS FOR MANAGEMENT SERVICES PROVIDED TO EDGEBROOK CARE CENTER IN 2022. FORM 990, PART VI, SECTION A, LINE 8B AS A WHOLE THERE WERE NO COMMITTEE MEETINGS TO MAKE ANY FORMAL DECISIONS WITHOUT BRINGING RECOMMENDATIONS TO THE BOARD. THE COMMITTEES WERE USED PRIMARILY FOR GUIDANCE BY THE ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY AT LEAST ONE WEEK PRIOR TO THE FILING DATE AND A DETAILED REVIEW IS COMPLETED BY THE ADMINISTRATOR AND BOARD PRESIDENT. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND THE ADMINISTRATOR ARE COVERED BY THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT OF INTEREST IS DISCOVERED OR SUSPECTED, THAT BOARD MEMBER WILL BE ASKED TO ABSTAIN FROM VOTING ON THAT TOPIC. THEY MAY PROVIDE INFORMATION ON THE TOPIC THAT IS BEING DISCUSSED. FORM 990, PART VI, SECTION B, LINE 15 THE ADMINISTRATOR FOR THE ORGANIZATION IS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH AN UNRELATED MANAGEMENT COMPANY, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. THE COMPENSATION IS REVIEWED AND DETERMINED BY THE UNRELATED MANAGEMENT COMPANY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.