2022-08-11T10:32:59-05:00 2021-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2020-10-01 410845402 MINNEWASKA LUTHERAN HOME MINN 3202392217 605 MAIN STREET STARBUCK MN 56381 KAYO ASLAGSON BOARD CHAIR 3202392217 2022-08-08 1 KAYO ASLAGSON 999009999 TYLER SWENSON P01329381 6123764500 2022-08-04 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MINNEWASKA COMMUNITY HEALTH SERVICES CHRISTOPHER KNOLL 605 MAIN STREET STARBUCK MN 56381 9903773 0 X WWW.MCHS-HEALTHCARE.ORG X 1958 MN NURSING HOME - A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE. 10 10 250 75 662067 0 141371 241636 7271401 8789284 -2252 22043 629978 865398 8040498 9918361 24867 2993 0 0 5339381 5864328 0 0 0 3751694 3925928 9115942 9793249 -1075444 125112 13050379 11844976 13148721 11802644 -98342 42332 X A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE THAT ENCOURAGES ALL PEOPLE TO REACH THEIR HIGHEST POTENTIAL. 1 0 3605483 2993 3746750 MINNEWASKA LUTHERAN HOME, A 39-BED SKILLED NURSING FACILITY, PROMOTES HEALTH TO THE COMMUNITY BY PROVIDING SKILLED NURSING CARE AND PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY SERVICES. ADDITIONAL PROGRAMS WHICH BENEFIT THE COMMUNITY INCLUDE: OUTPATIENT THERAPY SERVICES: MINNEWASKA LUTHERAN HOME PROVIDES PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY TO COMMUNITY MEMBERS IN NEED OF THESE SERVICES ALLOWING THEM TO RESUME THEIR NORMAL ACTIVITIES OF DAILY LIVING. MINNEWASKA LUTHERAN HOME IS GOVERNED BY A TEN PERSON INDEPENDENT BOARD MADE UP OF ONE AT-LARGE COMMUNITY LEADER AND NINE CHURCH MEMBERS FROM THE STARBUCK, MN AND HOFFMAN, MN AREAS. THE BOARD HAS A HISTORY OF COMMITMENT TO ACTING WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO ENSURE THE ORGANIZATION CONTINUES TO OPERATE AT ITS MAXIMUM POTENTIAL FOR THE BENEFIT OF THE CLIENTS WE SERVE AND THE COMMUNITIES WE SERVE. 1592024 0 1441925 HOLLY RIDGE MANOR OPERATED A 41 UNIT ASSISTED LIVING FACILITY SERVING RESIDENTS OF STARBUCK AND THE SURROUNDING AREA. 1105823 0 1221854 HOFFMAN SENIOR LIVING OPERATES A 10-UNIT ASSISTED LIVING FACILTY AND A 10-UNIT MEMORY CARE ASSISTED LIVING FACILITY SERVING RESIDENTS OF HOFFMAN AND THE SURROUNDING AREA. 619359 0 1022667 GLACIAL TRAILS MEMORY CARE: GLACIAL CARE MEMORY CARE OPERATED A 16-UNIT MEMORY CARE ASSISTED LIVING FACILITY SERVING RESIDENTS OF STARBUCK AND THE SURROUNDING AREA. 1064322 0 1276714 MINNEWASKA COMMUNITY HOME CARE, LLC LEASES AND OPERATES COUNTRY VIEW SENIOR LIVING COMMUNITY, A 28-UNIT ASSISTED LIVING FACILITY IN WALNUT GROVE, MN AND LAKEVIEW ASSISTED LVING, A 28-UNIT ASSISTED LVIING FACILITY IN BALATON, MN. THE LAKEVIEW ASSISTED LIVING LEASE ENDED DECEMBER 31, 2021. 80394 0 79374 MINNEWASKA PROJECT, LLC (THE PROJECT), OWNS AND OPERATES A 21-UNIT APARTMENT COMPLEX THAT OFFERS SUBSIDIZED HOUSING. 1764075 0 2378755 8067405 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 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 26 0 1 250 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 0 1 1 0 MN X CAROLINE HENDREN 3202392217 605 MAIN STREET STARBUCK MN 56381 CHRISTOPHER KNOLL ADMINISTRATOR 37.00 3.00 X 132782 0 20763 CAROLINE HENDREN DIRECTOR OF FINANCE 35.00 5.00 X 94743 0 1991 KAYO ASLAGSON CHAIR 1.50 0.50 X X 0 0 0 JOHN SAMUELSON SECRETARY 1.50 0.50 X X 0 0 0 FAITH ANDERSON DIRECTOR 1.50 0.50 X 0 0 0 PETER BRANDT DIRECTOR 1.50 0.50 X 0 0 0 WARREN HAGESTUEN DIRECTOR 1.50 0.50 X 0 0 0 ROBERT HENDRICKSON DIRECTOR 1.50 0.50 X 0 0 0 ALICE REESE DIRECTOR 1.50 0.50 X 0 0 0 STAN STARK DIRECTOR 1.50 0.50 X 0 0 0 ROBERT RANUM DIRECTOR 1.50 0.50 X 0 0 0 MELODY SLETTEN DIRECTOR 1.50 0.50 X 0 0 0 227525 0 22754 1 0 1 0 MEDICAL SOLUTIONS LLC PO BOX 310737 DES MOINES IA 50331 POOL NURSING STAFF 285201 DTN STAFFING 1200 COLLINGS AVE MANDAN ND 58554 NUSRING STAFF 185069 PRO REHAB 200 LEWIS AVE S STE 210 WATERTOWN MN 55388 THERAPY SERVICES 158893 3 12167 216823 12646 241636 RESIDENT REVENUES 623000 8789284 8789284 8789284 7455 7455 -14588 14588 14588 14588 MANAGEMENT FEE REVENUE 541200 662067 662067 MISCELLANEOUS INCOME 900099 115159 115159 MEALS REVENUE 722210 88172 88172 865398 9918361 8789284 662067 225374 2993 2993 226252 226252 4936168 4001872 934296 19646 12751 6895 342668 260969 81699 339594 268932 70662 11624 11624 6382 570 5812 55264 55264 324793 312147 12646 84199 81593 2606 420613 393060 27553 133248 99088 34160 476315 445342 30973 3193 2029 1164 14718 6023 8695 403281 366308 36973 923611 836700 86911 151944 89090 62854 UBIT PRIOR YEAR EXPENSE 2691 2691 FOOD 337522 337522 MEDICAL SUPPLIES 155791 155791 REAL ESTATE TAXES 149453 149453 271286 233548 37738 9793249 8067405 1725844 0 1212437 856824 411025 292728 699229 678039 26995 21649 33497 40416 18817037 9368136 9732240 9448901 209321 244261 2000 2000 723635 260158 13050379 11844976 597666 1341703 393281 179355 51494 58378 11409898 10234015 696382 -10807 13148721 11802644 X -98342 42332 -98342 42332 13050379 11844976 125112 15562 0 X X 0 1 X 1 0 X 57780 27192 6233 141371 241636 474212 4115945 4185818 5670192 7271401 8789284 30032640 4173725 4213010 5676425 7412772 9030920 30506852 0 1715332 889244 1204901 999813 668369 5477659 1715332 889244 1204901 999813 668369 5477659 25029193 8367 8955 16152 11646 7455 52575 8367 8955 16152 11646 7455 52575 29510 59300 106502 616080 203331 1014723 4211602 4281265 5799079 8040498 9241706 31574150 0.79270 0.73060 0.00170 0.00200 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME CABLE TV REVENUE MISCELLANEOUS INCOME MEALS REVENUE SALE OF BEDS MANAGEMENT FEE REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 406199 406199 16118332 7956985 8161347 170051 115452 54599 1715927 1295699 420228 406528 406528 9448901 DUE TO RELATED PARTY -10807 -10807 X PART IV, LINE 2B: RESIDENT DEPOSITS CONSIST OF RESIDENT TRUST FUNDS HELD BY THE ORGANIZATION FOR THE RESIDENTS OF THE HOME. THE FACILITY HAS A SEPARATE BANK ACCOUNT TO HOLD THE FUNDS WHILE THE RESIDENT IS LIVING AT GLACIAL TRAILS. WHEN THE RESIDENT VACATES THE APARTMENT, GLACIAL TRAILS REFUNDS THE SECURITY DEPOSIT PLUS INTEREST CALCULATED BASED ON STATE OF MINNESOTA RULES LESS ANY FORFEITURES FOR REPAIRS, IF ANY WITHIN 30 DAYS OF TURNING IN THE KEYS. PART X, LINE 2: FROM NOTE 1 TO THE ORGANIZATION'S FINANCIAL STATEMENTS: THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR INCOME TAXES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF ANY OF ITS ENTITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. X X 0 0 0 0 0 0 0 0 0 CHRISTOPHER KNOLL ADMINISTRATOR 126732 0 225 0 5825 0 0 0 20763 0 153545 0 0 0 FORM 990, PART III, LINE 2 DURING THIS TAX YEAR, OUR ORGANIZATION BECAME THE MANAGEMENT COMPANY FOR KENYON SENIOR LIVING IN KENYON MN. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF MINNEWASKA LUTHERAN HOME CONSIST OF CERTAIN CONGREGATIONS LOCATED IN THE GENERAL COMMUNITY OF STARBUCK, MINNESOTA AND HOFFMAN, MN. EACH MEMBER CONGREGATION MAY APPOINT ONE INDIVIDUAL TO ACT AS A DELEGATE ON ITS BEHALF. THE PRESENT MEMBERS ARE: FRON LUTHERAN CHURCH - STARBUCK, MINNESOTA MINEWASKA LUTHERAN CHURCH - STARBUCK, MINNESOTA ST. JOHN'S LUTHERAN CHURCH - STARBUCK, MINNESOTA IMMANUEL LUTHERAN CHURCH - STARBUCK, MINNESOTA INDHERRED LUTHERAN CHURCH - STARBUCK, MINNESOTA EAST ZION LUTHERAN CHURCH - STARBUCK, MINNESOTA WEST ZION LUTHERAN CHURCH - HANCOCK, MINNESOTA TRINITY LUTHERAN CHURCH - CYRUS, MINNESOTA MESSIAH LUTHERAN CHURCH - HOFFMAN, MINNESOTA FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS ARE ELECTED BY A MAJORITY VOTE OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ARTICLES OF INCORPORATION AND/OR THE BYLAWS REQUIRE AN AFFIRMATIVE VOTE OF A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE MANAGEMENT TEAM AND BOARD MEMBERS WILL REVIEW AND COMMENT ON THE FORM 990 PRIOR TO FILING THE REPORT AND GIVE ANY INPUT TO CAROLINE HENDREN, DIRECTOR OF FINANCE, AND CHRISTOPHER KNOLL, ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF COMMITTEE WITH BOARD-DELEGATED POWERS. ANY INDIVIDUAL WITH AN ACTUAL OR POTENTIAL CONFLICT IS REQUIRED TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD OR COMMITTEE. AFTER DISCLOSURE OF THE MATERIAL FACTS, THE REMAINING BOARD OR COMMITTEE MEMBERS DETERMINE BY MAJORITY VOTE WHETHER A CONFLICT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE BOARD OR COMMITTEE SEEKS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY POSSIBLE, THE BOARD OR COMMITTEE DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. THE INDIVIDUAL MAY NOT BE PRESENT FOR A DISCUSSION OF, OR VOTE ON, WHETHER TO ENTER THE TRANSACTION. THE RELEVANT FACTS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. ADDITIONALLY, BOARD MEMBERS ARE REQUIRED TO ANNUALLY SIGN STATEMENTS DISCLOSING EXISTING CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. EVERY YEAR THE CEO PRESENTS A PROPOSAL FOR COMPENSATION TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN USES A CURRENT SALARY SURVEY (DONE BY LEADINGAGE OF MN) TO COMPARE TO THE PROPOSAL AND THEN COMES TO A CONCLUSION ON WHAT THE COMPENSATION WILL BE. THIS IS INCORPORATED INTO THE CEO'S COMPENSATION REVIEW, WHICH IS PERFORMED ANNUALLY. THE ORGANIZATION HAS A WAGE SCALE ESTABLISHED FOR DETERMINING WAGES FOR ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE WAGES ARE ESTABLISHED ON THE CURRENT SALARY SURVEY BOOK PROVIDED BY LEADINGAGE OF MN. THIS PROCESS IS DONE ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. MINNEWASKA PROJECT LLC (DBA MINNEWASKA APARTMENTS) 27634 STATE HIGHWAY 28 STARBUCK MN 56381 411983249 SUBSIDIZED APARTMENT COMPLEX MN -14587 451432 MINNEWASKA LUTHERAN HOME INC MINNEWASKA COMMUNITY HOME CARE LLC 605 MAIN STREET STARBUCK MN 56381 410845402 LEASES AND OPERATES ASSISTED LIVING FACILITIES MN 190573 95518 MINNEWASKA LUTHERAN HOME INC MINNEWASKA HOME DEVELOPMENT PO BOX 40 STARBUCK MN 56381 411504339 FUNDRAISING MN 501(C)(3) LINE 12B, II MINNEWASKA LUTHERAN HOME INC 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 1 MINNEWASKA HOME DEVELOPMENT C 12617 ACTUAL