2021-08-06T11:58:00-05:00 2020-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2019-10-01 411837022 SHOLOM COMMUNITY ALLIANCE SHOL 9529356311 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 DAVID BERRYMAN CFO 9529356311 2021-07-20 1 RYAN STRUSZ P01604381 6123764500 2019 2022-09-23 18:48:47Z BARB KLICK 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 13489978 0 X WWW.SHOLOM.COM X 1995 MN SHOLOM COMMUNITY ALLIANCE SUPPORTS RELATED ENTITIES IN PROVIDING CARE FOR THE ELDERLY. 19 19 87 19 0 0 6017866 3721064 10289013 9599067 76445 65754 107194 104093 16490518 13489978 0 0 0 0 4354309 4293645 0 0 0 7359037 7054073 11713346 11347718 4777172 2142260 25829032 25823653 13159742 13974036 12669290 11849617 SHOLOM IS A NOT-FOR-PROFIT ORGANIZATION PROVIDING A BROAD CONTINUUM OF RESIDENTIAL, SOCIAL SERVICE, AND HEALTH CARE SERVICES PRIMARILY FOR OLDER ADULTS AND WITHIN A JEWISH ENVIRONMENT. 0 0 7033524 0 5522768 SHOLOM COMMUNITY ALLIANCE SUPPORTS THE EFFORTS OF RELATED ENTITIES THAT PROVIDE NURSING HOME, HOUSING, AND COMMUNITY BASED SERVICES PRIMARILY TO THE ELDERLY. THE ALLIANCE IS COMMITTED TO ENHANCING THE QUALITY OF LIFE OF THE PEOPLE IT SERVES AND SERVING THOSE WHO DESIRE TO RECEIVE CARE IN THE ENVIRONMENT GUIDED BY THE DOCTRINE AND PRACTICES OF JUDAISM. 4100780 0 4076299 SHOLOM COMMUNITY ALLIANCE, LLC IS A 52-UNIT ASSISTED LIVING AND 24-UNIT MEMORY CARE FACILITY KNOWN AS THE ROITENBERG FAMILY ASSISTED LIVING RESIDENCE PROVIDING HOUSING AND RELATED SERVIES TO SENIOR CITIZENS. 11134304 1 1 0 1 0 0 0 0 1 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 20 0 87 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 19 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X DAVID BERRYMAN 9529391600 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 BARB KLICK CEO 5.00 35.00 X 365748 0 12084 DAVID BERRYMAN CFO 5.00 35.00 X 234721 0 14112 ANN THOLE COO 5.00 35.00 X 227443 0 3673 ESTELLE WRIGHT DIRECTOR OF HR 40.00 0.00 X 157327 0 7425 CATHY ZARSKE DIRECTOR OF IT 40.00 0.00 X 142665 0 5017 MARY MELLENBACH DIRECTOR OF CLINICAL SERVI 40.00 0.00 X 124040 0 11241 JAMIE MADDEAUX DIRECTOR OF MARKETING 40.00 0.00 X 120648 0 7299 DOUG WYCKOFF CONTROLLER 40.00 0.00 X 112492 0 6944 NEIL BORENSTEIN PRESIDENT 1.00 1.00 X X 0 0 0 SCOTT SEILER VICE PRESIDENT 1.00 0.00 X X 0 0 0 DAVID NIRENSTEIN TREASURER 1.00 2.00 X X 0 0 0 BOB HELD SECRETARY 1.00 0.00 X X 0 0 0 TOM BOMBERG DIRECTOR 1.00 0.00 X 0 0 0 LISA EDSTROM DIRECTOR 1.00 0.00 X 0 0 0 ADAM FINK DIRECTOR 1.00 0.00 X 0 0 0 MARK FREEMAN DIRECTOR 1.00 1.00 X 0 0 0 JON GORDON DIRECTOR 1.00 2.00 X 0 0 0 STEVE GOTTLIEB DIRECTOR 1.00 1.00 X 0 0 0 BOB MEICHES DIRECTOR 1.00 0.00 X 0 0 0 LAYNE ROSEN DIRECTOR 1.00 0.00 X 0 0 0 JERRY RUDICK DIRECTOR 1.00 1.00 X 0 0 0 SHERYL RUTZICK DIRECTOR 1.00 2.00 X 0 0 0 MICHAEL SAXON DIRECTOR 1.00 1.00 X 0 0 0 PAUL SCHANFIELD DIRECTOR 1.00 0.00 X 0 0 0 CHUCK SELCER DIRECTOR 1.00 1.00 X 0 0 0 MARGIE SOLOMON DIRECTOR 1.00 0.00 X 0 0 0 LINDA STEIN DIRECTOR 1.00 0.00 X 0 0 0 1485084 0 67795 8 0 1 0 IMPACT GROUP 3435 LABORE RD ST PAUL MN 55110 IT SUPPORT SERVICES 664877 ADP INC PO BOX 842875 BOSTON MA 02284 PAYROLL SERVICES 246179 CLIFTONLARSONALLEN 220 SOUTH SIXTH ST SUITE 300 MINNEAPOLIS MN 55402 AUDIT/TAX SERVICES 202975 3 448046 3273018 356352 3721064 MANAGEMENT FEE REVENUES 541610 5522768 5522768 PROGRAM SERVICE 623000 4076299 4076299 9599067 65754 65754 40884 0 40884 40884 40884 MISCELLANEOUS 623000 49545 49545 BEAUTY SHOP 623000 7440 7440 MEALS 623000 4033 4033 2191 2191 63209 13489978 9599067 0 169847 843599 843599 2848505 2689699 158806 31017 30045 972 298344 285782 12562 272180 258867 13313 17591 14269 3322 141153 141153 6000 6000 682098 672542 9556 167523 167523 3168506 3157570 10936 969096 969096 713599 711529 2070 47667 47667 16112 16112 64802 64802 680361 680361 FOOD 206322 206322 MISCELLANEOUS EXPENSES 135320 133501 1819 EQUIP/MAINT/REPAIR 28080 28022 58 BEAUTY SHOP SERVICES 6443 6443 3400 3400 11347718 11134304 213414 0 498292 1301397 683655 291365 4878299 4315280 36391 38603 113962 190706 19237500 9844864 9733320 9392636 2856715 2382452 5874501 5943045 1153897 1968169 25829032 25823653 1046982 1689885 2752 4901 10041739 9900496 55667 53610 106042 155776 1906560 2169368 13159742 13974036 X -529922 -682677 13199212 12532294 12669290 11849617 25829032 25823653 X 2142260 -2961933 X 0 1 X 1 0 X X 8 SHOLOM HOME EAST INC 410695462 10 1 2663297 0 SHOLOM HOME WEST INC 363570759 10 1 2422228 0 COMMUNITY HOUSING & SERVICE CORP 410982770 10 1 453223 0 KNOLLWOOD COMMUNITY HOUSING & SERVICES 411518579 10 1 38963 0 MENORAH PLAZA HOUSING CORPORATION 363512438 10 1 137407 0 SCA HOME HEALTH CARE 010628051 10 0 1255767 0 SHOLOM ST PAUL SENIOR HOUSING 204844785 10 0 48812 0 SHOLOM FOUNDATION 363411361 7 0 99176 0 8 7118873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 PART IV, SECTION A, LINE 1 THERE ARE THREE SUPPORTED ORGANIZATIONS THAT AREN'T INCLUDED IN SHOLOM COMMUNITY ALLIANCE'S ("SCA") GOVERNING DOCUMENTS BY NAME. THEY ARE SCA HOME HEALTH CARE, SHOLOM ST. PAUL SENIOR HOUSING, AND SHOLOM FOUNDATION. THESE ORGANIZATIONS ARE DESIGNATED BY THEIR PURPOSE AND THE CLASS OF INDIVIDUALS SERVED AS DESCRIBED BELOW. SCA'S PURPOSE IS TO SUPPORT ORGANIZATIONS THAT PROVIDE, IN ACCORDANCE WITH THE DOCTRINES, PRACTICES, AND REQUIREMENTS OF JUDAISM, NURSING HOME AND RESIDENTIAL FACILITIES AND OTHER SERVICES DESIGNED TO SATISFY THE PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, AND RELIGIOUS NEEDS OF ELDERLY PERSONS. SCA HOME HEALTH CARE FURTHER SUPPORTS THE PURPOSE OF SCA AND ITS RELATED AFFILIATES BY PROVIDING HOME HEALTH CARE SERVICES TO THE RESIDENTS OF THE FACILITIES OWNED AND OPERATED BY SCA AND ITS RELATED AFFILIATES, SHOLOM ST. PAUL SENIOR HOUSING IS PART OF THE SHOLOM HOME EAST'S CAMPUS AND PROVIDES LOW-INCOME HOUSING FOR THE ELDERLY IN A JEWISH ENVIRONMENT, AND THE SHOLOM FOUNDATION RAISES FUNDS TO SUPPORT THE OPERATIONS OF SCA AND ITS RELATED AFFILIATES LISTED IN SCHEDULE A, PART I, LINE 12G. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 6000 0 0 6000 0 0 1 X 982027 982027 14233749 6481895 7751854 3987773 3362969 624804 33951 33951 9392636 INTEREST IN NET ASSETS OF AFFILIATE FOUNDATION 5943045 F 5943045 DUE FROM AFFILIATES 1447559 RESIDENT TRUST FUND 5169 TENANT SECURITY DEPOSITS 53211 DEBT SERVICE RESERVE FUND 310590 BOND INTEREST FUND 37593 BOND PRINCIPAL FUND 12501 LOAN FUND 1286 CAPITAL CAMPAIGN 100260 1968169 DUE TO AFFILIATES 2169368 2169368 X PART IV, LINE 2B: ESCROW LIABILITIES RELATE TO AMOUNTS ON DEPOSIT FOR TENANT SECURITY DEPOSITS AND RESIDENT TRUST FUNDS. AMOUNTS ARE REFUNDABLE TO RESIDENTS AND TENANTS WITH CERTAIN EXCEPTIONS. PART X, LINE 2: SHOLOM AND ITS AFFILIATES QUALIFY AS TAX-EXEMPT ENTITIES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE ORGANIZATIONS ARE CLASSIFIED AS PUBLICLY SUPPORTED CHARITABLE ORGANIZATIONS UNDER EITHER SECTION 509(A)(1), 509(A)(2) OR SECTION 509(A)(3) OF THE CODE AND CONTRIBUTIONS TO THE ORGANIZATIONS QUALIFY AS A CHARITABLE TAX DEDUCTION BY THE CONTRIBUTOR. SHOLOM COMMUNITY ALLIANCE, LLC'S NET INCOME (LOSS) FOR FEDERAL AND STATE INCOME TAX PURPOSES IS INCLUDED IN THE INCOME TAX RETURN OF ITS SOLE MEMBER. NO PROVISION FOR INCOME TAXES IS REFLECTED IN THESE CONSOLIDATED FINANCIAL STATEMENTS. SHOLOM'S ANNUAL TAX FILINGS ARE SUBJECT TO REVIEW BY FEDERAL, STATE, AND LOCAL AUTHORITIES. SHOLOM IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. SHOLOM IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OTHER TAXES. X X X X X 0 0 0 0 0 0 0 0 0 BARB KLICK CEO 365748 0 0 0 0 0 0 0 12084 0 377832 0 0 0 DAVID BERRYMAN CFO 234721 0 0 0 0 0 3521 0 10591 0 248833 0 0 0 ANN THOLE COO 227443 0 0 0 0 0 3412 0 261 0 231116 0 0 0 ESTELLE WRIGHT DIRECTOR OF HR 157327 0 0 0 0 0 2360 0 5065 0 164752 0 0 0 A CITY OF ST LOUIS PARK SERIES 2017 REVENUE BONDS 416005519 85230FCE7 2017-10-31 10500000 RETIRE SERIES 2006 REVENUE BONDS 0 0 0 A 320000 10500000 308434 210000 9981565 1 0 1 1 A 0 1 0 0 0 0 0 0 1 A 1 X 4146 356352 FMV 0 0 0 PART I, COLUMN (B): PART 1, LINE 9, PLESE NOTE 4,146 IS THE TOTAL AMOUNT OF SECURITIES. FORM 990, PART VI, SECTION A, LINE 2 THE BUDGET AND FINANCE COMMITTEE HAS BEEN DELEGATED THE AUTHORITY TO APPROVE THE 990 TAX RETURN ON BEHALF OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO CLASSES OF MEMBERSHIP: LIFE MEMBERS AND GENERAL MEMBERS. LIFE MEMBERS INCLUDE: (I) ALL PAST PRESIDENTS OF THE BOARD OF DIRECTORS OF THE CORPORATION SHOLOM HOME, INC., AND COMMUNITY HOUSING AND SERVICE CORPORATION; (II) LIFE MEMBERS OF THE CORPORATION WHO ARE IN GOOD STANDING; AND (III) ALL PERSONS WHO ARE ADMITTED AS LIFE MEMBERS FROM TIME TO TIME BY ACTION OF THE BOARD OF DIRECTORS. GENERAL MEMBERS INCLUDE: (I) GENERAL MEMBERS OF THE CORPORATION WHO ARE IN GOOD STANDING, AND (II) THOSE PERSONS WHO ARE ADMITTED AS SUCH FROM TIME TO TIME BY ACTION OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS ARE ELECTED BY MAJORITY VOTE OF THE MEMBERS AT THE ANNUAL MEETING. IN ADDITION, ONE PERSON IS APPOINTED TO THE BOARD FROM EACH OF THE FOLLOWING ORGANIZATIONS: MINNEAPOLIS JEWISH FEDERATION, ST. PAUL UNITED JEWISH FUND AND COUNCIL, SHOLOM HOME AUXILIARY, AND SHOLOM FOUNDATION FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 TAX RETURN WAS REVIEWED BY MANAGEMENT IN DETAIL, REVIEWED AND APPROVED BY A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, AND PROVIDED TO THE FULL BOARD OF DIRECTORS ELECTRONICALLY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND EMPLOYEES SIGN FOR RECEIPT OF POLICY WHICH COVERS ALL EMPLOYEES AND OFFICERS. COMPLIANCE IS MONITORED VIA VARIOUS MEANS INCLUDING FINANCIAL AUDIT, BOARD MINUTES, AND INVESTIGATION OF COMPLAINTS. ANY POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED AT THE TIME OF KNOWLEDGE OF THE POTENTIAL CONFLICT TO THE PRESIDENT OF THE BOARD OF DIRECTORS, OR, IF APPROPRIATE, THE CHAIR OF THE COMMITTEE EVALUATING THE PARTICULAR MATTER AND THE CEO. THE PRESIDENT OF THE BOARD OF DIRECTORS OR ANY DESIGNEE WILL EVALUATE THE APPROPRIATENESS OF THE BOARD MEMBER TO BE INVOLVED IN ANY DISCUSSIONS AND/OR VOTING ON THE POTENTIAL CONFLICT OF INTEREST ISSUE. FORM 990, PART VI, SECTION B, LINE 15 HUMAN RESOURCES REVIEWS MARKET DATA AMONG COMPETITORS TO ALIGN COMPENSATION FOR OFFICER AND SENIOR LEADERSHIP POSITIONS. MARKET DATA COLLECTED IS FROM A VARIETY OF SOURCES, AND FOCUSES ON COMPANIES OF A NON-PROFIT STATUS WITHIN A SIMILAR INDUSTRY, SIZE, AND/OR REVENUE. THE BOARD OF DIRECTORS USE THIS INFORMATION TO REVIEW AND SET THE COMPENSATION FOR THE CEO, CFO, AND COO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT OPEN TO PUBLIC INSPECTION. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 118,033. AFFILIATE TRANSFERS -3,079,966. SHOLOM COMMUNITY ALLIANCE LLC 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 412007919 ASSISTED LIVING FACILITY DE 4771613 11589375 SHOLOM COMMUNITY ALLIANCE SHOLOM HOME EAST INC 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 410695462 NURSING HOME FOR THE ELDERLY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 1 SHOLOM HOME WEST INC 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 363570759 NURSING HOME FOR THE ELDERLY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 1 COMMUNITY HOUSING & SERVICE CORP 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 410982770 PROVIDE HOUSING FOR THE ELDERLY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 1 KNOLLWOOD COMMUNITY HOUSING CORP 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 411518579 LOW INCOME HOUSING MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE AND COMMUNITY HOUSING AND SERVICE CORP 1 MENORAH PLAZA HOUSING CORP 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 363512438 LOW INCOME HOUSING MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE AND COMMUNITY HOUSING AND SERVICE CORP 1 SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 010628051 PROVIDE HOME HEALTH CARE AND HOSPICE SERVICES TO THE COMMUNITY. MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 1 SHOLOM ST PAUL 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 300256100 INACTIVE SHELL COMPANY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 1 SHOLOM ST PAUL SENIOR HOUSING INC 760 PERLMAN STREET ST PAUL MN 55102 204844785 LOW INCOME HOUSING MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 1 SHOLOM FOUNDATION 3610 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 363411361 SUPPORT AFFILIATES THROUGH FUNDRAISING MN 501(C)(3) LINE 7 N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 SHOLOM FOUNDATION C 448046 CASH SHOLOM HOME EAST INC L 2081215 PERCENT OF REVENUES SHOLOM HOME WEST INC L 1892833 PERCENT OF REVENUES COMMUNITY HOUSING & SERVICE CORPORATION L 354167 PERCENT OF REVENUES SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE L 981311 PERCENT OF REVENUES MENORAH PLAZA HOUSING CORPORATION L 107376 PERCENT OF REVENUES SHOLOM HOME WEST INC B 48938 CASH COMMUNITY HOUSING & SERVICE CORPORATION B 2977227 CASH SHOLOM HOME EAST INC B 45060 CASH