2020-10-23T09:11:01-05:00 2019-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH STREET SUITE 500 SIOUX FALLS SD 57104 990 2019-01-01 201115155 WINFIELD GOOD SAMARITAN HOUSING INC WINF 6053331000 PO BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 BILL MARLETTE CFO & TREASURER 6053331000 2020-10-22 1 LAURIE HANSON P00851848 6053391999 2020-10-22 67.130.171.59 2020-10-22 08:55:55 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A8DB27B0CC75174FC7797F8E3D6A96021CEF41AE 2019 2021-01-29 14:40:06Z X WHEAT RIDGE HEIGHTS NATHAN SCHEMA 4800 W 57TH ST SIOUX FALLS SD 57117 143583 0 X WWW.SANFORDHEALTH.ORG X 2004 SD TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 5 5 1 6 0 0 0 471 139425 143055 55 57 0 0 139480 143583 0 0 0 0 42885 44921 0 0 0 159614 153250 202499 198171 -63019 -54588 1297770 1246239 27649 30706 1270121 1215533 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 0 0 127369 143055 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 7,182 RESIDENT DAYS IN 2019. 127369 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 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 1 0 0 0 1 3 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 1 0 1 1 1 1 0 0 0 0 1 1 1 1 1 0 0 0 X BILL MARLETTE 6053331000 2301 E 60TH ST SIOUX FALLS SD 57104 BILL MARLETTE TREASURER BEG. 1/19 0.02 59.98 X 0 1391177 1355 BILL MARLETTE DEF COMP TREASURER BEG. 1/19 0.02 59.98 X 0 0 221323 RANDY E BURY CHAIRPERSON BEG. 1/19 0.02 54.98 X X 0 1145407 133334 ERIC L VANDEN HULL VICE PRESIDENT BEG. 1/19 0.02 54.98 X 0 447915 29711 THOMAS A SYVERSON PRESIDENT UNTIL 10/19 0.02 54.98 X 0 341279 29960 CHAD JUNGMAN SECRETARY BEG. 1/19 0.02 59.98 X 0 281738 12816 TERRY PARKER VICE PRESIDENT UNTIL 9/19 0.02 54.98 X 0 223084 8630 NATHAN SCHEMA PRESIDENT BEG. 10/19 0.02 54.98 X 0 199828 24576 MISTY HAM-QUICK ASSISTANT SECRETARY UNTIL 10/19 0.02 44.98 X 0 64726 4754 SCOTT C PETERSEN VICE CHAIRPERSON BEG. 6/19 0.10 3.90 X X 0 0 0 GWEN WAGSTROM HALAAS VICE CHAIRPERSON UNTIL 6/19 0.10 3.90 X X 0 0 0 NORVAL DEAN BUCKNEBERG DIRECTOR 0.10 3.90 X 0 0 0 DARRELL SCHMITH DIRECTOR BEG. 6/19 0.10 3.90 X 0 0 0 DAVID B AUSTAD DIRECTOR BEG. 6/19 0.10 3.90 X 0 0 0 TOMISHA JO JORDAN DIRECTOR 0.10 0.00 X 0 0 0 0 4095154 466459 0 0 1 0 0 471 471 RENTAL CHARGES 624100 141514 141514 ANCILLARY CHARGES 624100 1541 1541 143055 57 57 143583 143055 0 57 35476 12920 22556 1059 376 683 5938 7 5931 2448 930 1518 9548 9548 952 952 7678 7678 15673 15673 1927 1927 9161 9161 30187 30187 1668 1668 67276 67276 8335 8335 BAD DEBT 845 845 198171 127369 70802 0 9345 20817 645 719 1747 1436 2026726 869750 1224245 1156976 61788 66291 1297770 1246239 14519 9912 24 13130 20770 27649 30706 X -708779 -763367 1978900 1978900 1270121 1215533 1297770 1246239 -54588 0 X 0 1 X 1 1 1 X 471 471 143570 138913 141040 139425 143055 706003 143570 138913 141040 139425 143526 706474 0 36333 35141 37111 28010 37749 174344 36333 35141 37111 28010 37749 174344 532130 38 66 52 55 57 268 38 66 52 55 57 268 143608 138979 141092 139480 143583 706742 0.75290 0.76660 0.00040 0.00040 X 91203 91203 1792544 779537 1013007 51231 39660 11571 91748 50553 41195 1156976 TENANT SECURITY DEPOSITS 6450 RESTRICTED DEPOSITS 56497 RESIDUAL RECEIPTS 3344 66291 RELATED PARTY PAYABLE 14320 TENANT SECURITY DEPOSIT 6450 20770 X 143583 0 143583 0 143583 198171 0 198171 0 198171 PART X, LINE 2: THE PROJECT BELIEVES 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 PROJECT WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF INCURRED. 0 0 0 0 0 0 0 0 0 BILL MARLETTE TREASURER BEG. 1/19 0 1019856 0 172511 0 198810 0 0 0 1355 0 1392532 0 0 BILL MARLETTE DEF COMP TREASURER BEG. 1/19 0 0 0 0 0 0 0 221323 0 0 0 221323 0 0 RANDY E BURY CHAIRPERSON BEG. 1/19 0 857021 0 128500 0 159886 0 126009 0 7325 0 1278741 0 0 ERIC L VANDEN HULL VICE PRESIDENT BEG. 1/19 0 350132 0 50300 0 47483 0 0 0 29711 0 477626 0 0 THOMAS A SYVERSON PRESIDENT UNTIL 10/19 0 337055 0 3642 0 582 0 0 0 29960 0 371239 0 0 CHAD JUNGMAN SECRETARY BEG. 1/19 0 266438 0 15300 0 0 0 0 0 12816 0 294554 0 0 TERRY PARKER VICE PRESIDENT UNTIL 9/19 0 95157 0 909 0 127018 0 0 0 8630 0 231714 0 0 NATHAN SCHEMA PRESIDENT BEG. 10/19 0 182843 0 16877 0 108 0 0 0 24576 0 224404 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE MANAGEMENT DUTIES OF THE PROJECT HAVE BEEN DELEGATED TO THE PROJECT'S SPONSOR, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (TELGSS). TELGSS IS PAID A MANAGEMENT FEE EQUAL TO A PERCENTAGE OF REVENUE OTHER THAN INVESTMENT AND GIFT INCOME. THE FEE HAS BEEN APPROVED BY THE US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. FORM 990, PART VI, SECTION A, LINE 4 ON JANUARY 1, 2019, SANFORD BECAME THE SOLE CORPORATE MEMBER OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (THE SOCIETY), A NORTH DAKOTA NONPROFIT CORPORATION HEADQUARTERED IN SIOUX FALLS, SOUTH DAKOTA. THE SOCIETY, TOGETHER WITH ITS AFFILIATES, PROVIDES SENIOR CARE SERVICES ACROSS THE UNITED STATES AND OPERATES SKILLED NURSING FACILITIES, RESIDENTIAL HOUSING FOR SENIORS, HOME AND COMMUNITY BASED HEALTH SERVICES AND AFFORDABLE HOUSING PROJECTS. FORM 990, PART VI, SECTION A, LINE 6 ON JANUARY 1, 2019, SANFORD BECAME THE CLASS A CORPORATE MEMBER OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. AT THAT TIME, THE EXISTING MEMBERSHIP OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (THE "SOCIETY") BECAME THE CLASS B MEMBER THAT RETAINED THE ABILITY TO RECOMMEND MEMBERS OF THE SOCIETY BOARD OF DIRECTORS FOR APPOINTMENT BY THE CLASS A CORPORATE MEMBER, SANFORD. THE SOCIETY BOARD OF DIRECTORS ADMINISTERS THE AFFAIRS OF THE SOCIETY, INCLUDING BUDGET DEVELOPMENT AND PROVIDING ADVICE AND CONSENT TO SANFORD IN SELECTING AND EVALUATING THE SOCIETY PRESIDENT. SOME ACTIONS OF THE SOCIETY BOARD OF DIRECTORS REQUIRE APPROVAL OF THE SANFORD BOARD OF TRUSTEES (SEE PART VI, LINE 7B). FORM 990, PART VI, SECTION A, LINE 7A THE BOARD MEMBERS ARE APPOINTED BY THE DIRECTORS OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. FORM 990, PART VI, SECTION A, LINE 7B ARTICLES OF INCORPORATION AND BY-LAW CHANGES REQUIRE THE APPROVAL OF THE BOARD OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE TAX DEPARTMENT WITH THE MANAGING AGENT, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY AND SANFORD, REVIEW THE 990 IN DETAIL PRIOR TO IT BEING FILED. ANY QUESTIONS ARE RESOLVED WITH THE CFO & TREASURER OF THE CORPORATION PRIOR TO THE 990 BEING FILED. A COPY OF THE 990 IS PROVIDED TO THE CORPORATION'S OFFICERS PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT COVERS SUBSTANTIALLY ALL EMPLOYEES. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS TO THE APPROPRIATE INDIVIDUAL AS INDICATED IN THE POLICY. ALL POTENTIAL CONFLICTS ARE INVESTIGATED TO DETERMINE IF A CONFLICT EXISTS. IF APPROVAL IS GIVEN TO PROCEED WITH THE ACTION, A COPY OF THE APPROVAL IS DOCUMENTED IN THE EMPLOYEE'S PERSONNEL FILE. THE ORGANIZATION ASKS THAT ALL OFFICERS AND DIRECTORS COMPLY WITH THE IRS CONFLICT OF INTEREST AND DISCLOSURE CERTIFICATION. THE ORGANIZATION REQUIRES ALL OFFICERS AND DIRECTORS TO PROVIDE A SIGNED COPY TO THE CORPORATION'S MAIN OFFICE ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT EMPLOY A CEO, AN EXECUTIVE DIRECTOR, A TOP MANAGEMENT OFFICIAL, OR ANY KEY EMPLOYEES. THE MANAGEMENT FUNCTIONS OF THE ORGANIZATION HAVE BEEN OUTSOURCED TO THE ORGANIZATION'S SPONSOR, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. FORM 990, PART VI, SECTION C, LINE 19 THE PROJECT MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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