2019-07-31T11:48:03-05:00 2018-09-30 450250958 EIDE BAILLY LLP 1545 ASSOCIATES DR STE 101 DUBUQUE IA 52002 990 2017-10-01 752999939 Sisters of Mary of the Presentation Long Term Care SIST 7012379290 1202 Page Drive SW Fargo ND 581060007 Aaron K Alton President/CEO 7012379290 2019-07-24 1 Carmen Krantz P00031958 5635561790 2019-07-09 199.247.44.184 2019-07-24 16:49:43 CD P B602D594AFD2B0B327E07A06F36CA6A7E42546D0 6ECD4448988750106123FDC789D6ADA2AEDCDED1 2017 2019-02-21 02:37:17Z Aaron K Alton 1202 Page Drive SW Fargo ND 581060007 58449243 0 0928 X www.smphs.org X 2002 ND To provide extended care and medically related services 9 7 1523 293 0 25581 389603 490978 54904098 57316393 387852 535560 67084 88244 55748637 58431175 1306 8250 0 0 39505419 40525825 0 0 92308 16665025 17242330 56171750 57776405 -423113 654770 65740548 66999575 37658097 37417665 28082451 29581910 X Sisters of Mary of the Presentation Long Term Care, in union with the Sisters of Mary of the Presentation, works for the glory of God by bringing the Word and Healing of Jesus Christ to all, with a special concern for the poor. The organization and its affiliates, through the shared ministry with the laity, participates in the health care mission in the work of healing which is the work of God. Our individual inspiration is Jesus and His Gospel message. Permeated with the Charism of the Sisters of Mary of the Presentation, we minister to one another and to all who come to us for care: those who suffer from physical, psychological, and social woundedness. 0 0 53131517 8250 57356393 Sisters of Mary of the Presentation - LTC (SMP-LTC) is sponsored by the Sisters of Mary of the Presentation, a religious order located in Valley City, North Dakota. The Sisters of Mary of the Presentation belong to a larger religious community founded in 1828 in Broons, France by two sisters Louise and Laurence LeMarch.SMP - LTC is part of the Sisters of Mary of the Presentation Health System Corporation. Sisters of Mary of the Presentation Health Corporation is located in Fargo, North Dakota. SMP - LTC operates five (5) Skilled Nursing Facilities in the State of North Dakota, and the specific purposes are: (continued on Schedule O)1. To operate facilities for those aged and other individuals who are in need of housing where 24/7 skilled nursing care and medical support can be provided; 2. To establish, support, manage and furnish facilities, personnel and services to provide extended care and medically related services to the sick, injured, disabled and other persons in need of such services without regard to race, creed, color, sex or national origin; 3. To carry on such activities related to rendering health care services or the promotion of health, which in the opinion of the Board of Directors, may be justified by the facilities, personnel, funds or other requirements that are or can be made available; 4. To engage in any and all activities consistent with or in furtherance of the above purposes.The mission is congruent with the core values of the Sisters of Mary of the Presentation to include: Simplicity, keeping our ministry centered on God and service to people. We are simple and direct in our relationships; Hospitality, being open and welcoming all; Compassionate Care, manifesting God's presence by our concerned approach for the dignity and worth of each person as we give excellent personalized care to those we serve; Concern and Care of the Poor, supporting the cause of the poor and the elderly in ways manifested to us and to the extent our human and financial resources allow; Shared Ministry, collaborating as partners with those who share our ministry. We are united to serve the Mission and, as a team, build communities within our ministry; Stewardship, being responsible stewards of our resources: human, physical, and financial.Today, SMP - LTC in conjunction with Sisters of Mary of the Presentation carries out the mission to provide skilled nursing care services to those who are less fortunate and in need. As a not-for-profit, Catholic healthcare organization, we treat residents, regardless of their ability to pay. This is consistent with our mission and the Core Values of the Sisters. In addition, SMP-LTC provided thousands of dollars in resources, including time and contributions to many throughout the region. Community service is a vital component of SMP-LTC since its inception. 53131517 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 65 0 1 1523 1 1 1 0 0 0 0 0 0 0 0 0 X 9 7 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X Gary Bakke 7012379290 1202 Page Drive SW Fargo ND 58103 Sr Marlyss Dionne Chair 0.50 1.30 X X 0 0 0 Gregory Thompson Vice Chair 0.50 0.00 X X 0 0 0 Sr Suzanne Stahl Secretary 0.50 1.30 X 0 0 0 Sr Rose Therese Sevigny Director 0.50 0.00 X 0 0 0 Lynette Schmitz Director 0.50 0.00 X 0 0 0 Fr James Meyer Director 0.50 0.00 X 0 0 0 Pastor David Montecuollo Director 0.50 0.00 X 0 0 0 Frank Redlin Director 0.50 0.00 X 0 0 0 Aaron K Alton President/CEO-SMPHS 17.00 42.00 X X 0 755218 53895 Gary Bakke Vice President Finance-SMPHS 24.00 41.00 X X 0 392238 56225 Craig Christianson President/CEO-Sheyenne Car 40.00 0.00 X 0 191506 37367 Anthony Keelin President/CEO Rosewood on Broadway & Villa Maria 40.00 0.00 X 0 229047 40574 Timothy Burchill President/CEO-Ave Maria Village 40.00 0.00 X 0 167744 35839 Nancy Farnham President/CEO-Maryhill Manor 40.00 0.00 X 0 135794 30743 Chris Albertson President/CEO-Presentation Med Ctr 40.00 0.00 X 0 40000 9326 Mark Kerr - Former Officer President/CEO-Presentation Med Ctr 0.00 0.00 X 0 161827 27766 0 2073374 291735 0 1 1 0 CD Inc 112 N Roberts Street Ste 300 Fargo ND 58102 Construction Management 3817853 Sisters of Mary of the Presentation Heal 1202 Page Drive SW Fargo ND 58103 Administrative services 2948919 AEGIS Therapies Inc PO Box 8103 Fort Smith AR 72902 Resident therapy services 553300 Thiegles Therapy 119 Main St NW Lamoure ND 58458 Contracted therapy 455053 Prime Time Healthcare 14811 Shepard St Omaha NE 68138 Contract travel nurses 242228 5 20000 19343 451635 490978 Resident Service Revenue 623000 55845370 55845370 Management Services 561000 923589 923589 Cafeteria/Senior Meals 900099 224108 224108 Adult Daycare Services 624120 126868 126868 Child Daycare Services 624410 54021 54021 142437 142437 57316393 498482 498482 42910 13336 29574 29574 29574 41810 4732 37078 37078 37078 Sale of bed license 900099 40000 40000 Insurance Recoveries 900099 18670 18670 58670 58431175 57356393 0 583804 1100 1100 7150 7150 32524973 31386862 1078804 59307 701571 673998 25668 1905 4951977 4795971 138960 17046 2347304 2264647 78397 4260 4894 4894 24236 24236 7056 7056 5431849 2650775 2780449 625 35635 20275 12462 2898 1338966 1086586 246151 6229 146688 146688 999760 993900 5860 197302 180834 16430 38 70882 50670 20212 1249057 1249057 3561088 3561088 420246 420246 Food 1946969 1946969 Medical Supplies 1271703 1271703 Repairs and maintenance 359469 329104 30365 Bad Debt Expense 77838 77838 98692 16056 82636 57776405 53131517 4552580 92308 1463231 1051598 11150 3000 3827889 4665204 158051 141895 138583 129297 79461060 37440868 42328637 42020192 60681 61197 17085416 18073804 118000 118000 548910 735388 65740548 66999575 2988295 3321323 16609 16609 134958 108516 89278 80627 33217366 32944212 125921 243951 1085670 702427 37658097 37417665 X 27085876 28433167 372075 524243 624500 624500 28082451 29581910 65740548 66999575 X 654770 859455 -14766 X X 0 1 X 0 0 X 203580 228366 215398 389603 490978 1527925 49623973 52124213 55065537 54923216 57356393 269093332 1300 1092 29966 18670 51028 49827553 52353879 55282027 55342785 57866041 270672285 10305 1690 11995 0 10305 1690 11995 270660290 391754 472569 495151 438705 541392 2339571 391754 472569 495151 438705 541392 2339571 50219307 52826448 55777178 55781490 58407433 273011856 0.99140 0.99190 0.00860 0.00800 X 0 0 0 0 0 1 7056 0 0 0 7056 0 Part II-B, Line 1: Sisters of Mary of the Presentation Long Term Care pays North Dakota Long Term Care Association for membership dues. The amount listed is Sisters of Mary of the Presentation Long Term Care's portion of lobby expenses paid through membership dues. 0 1 X 205878 5528 211406 179720 15000 11158 205878 173619 6101 179720 187904 -14285 173619 172411 15493 187904 0.00000 0.78000 0.22000 0 0 1818210 1818210 58635442 29492870 29142572 7704550 5690041 2014509 11302858 2257957 9044901 42020192 SMPHS pooled investment funds 18073804 F 18073804 Construction Accounts Payable 575986 Interest Payable 99545 Estimated third-party payor settlements 26896 702427 X 59211658 859455 859455 58352203 78972 78972 58431175 57697433 -78972 -78972 57776405 0 57776405 Part IV, Line 2b: Resident trusts funds are assets of the residents of SMPLTC over which SMPLTC has little or no discretion over the use of those resources. Part V, Line 4: Rosewood on Broadway was named beneficiary of an irrevocable gift of $150,000 from a donor's estate. The endowment gift will be held in perpetuity with the distributions from the fund to be restricted to providing financial support in furtherance of educational needs of nurses and nurse assistants. Part X, Line 2: SMPLTC is organized as a North Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). SMPLTC is annually required to file a Return of Organization Exempt from Income Tax(Form 990) with the IRS. In addition, SMPLTC is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose, if applicable. SMPLTC 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 combined financial statements. SMPLTC 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 4b - Other Adjustments: Dakota Heights rental expense included in revenue for Form 990 -13,336. Fundraising expense included in revenue for Form 990 92,308. Part XII, Line 2d - Other Adjustments: Dakota Heights rental expense included in revenue for Form 990 13,336. Fundraising expense included in revenue for Form 990 -92,308. 1 Educational Scholarships 18 7150 Part I, Line 2: Most disbursements in furtherance of the Organization's exempt programs are made directly in the active conduct of the activities constituting the exempt purpose or function for which the institution is organized and operated. Otherwise, disbursements in furtherance of the institution's exempt programs are made in accordance with procedures or subject to conditions established by the institution's governing board designed to insure that individuals and organizations receiving disbursements from the organization in furtherance of its exempt programs are adequately investigated to insure that they are qualified recipients. 0 0 0 0 0 0 0 0 0 Aaron K Alton President/CEO-SMPHS 0 621590 0 65206 0 68422 0 28386 0 31883 0 815487 0 0 Gary Bakke Vice President Finance-SMPHS 0 329790 0 34596 0 27852 0 27611 0 31857 0 451706 0 0 Craig Christianson President/CEO-Sheyenne Car 0 159960 0 16467 0 15079 0 10694 0 29146 0 231346 0 0 Anthony Keelin President/CEO Rosewood on Broadway & 0 206595 0 14854 0 7598 0 14746 0 28495 0 272288 0 0 Timothy Burchill President/CEO-Ave Maria Village 0 140100 0 16482 0 11162 0 8908 0 29096 0 205748 0 0 Nancy Farnham President/CEO-Maryhill Manor 0 114330 0 7847 0 13617 0 5812 0 26801 0 168407 0 0 Mark Kerr - Former Officer President/CEO-Presentation Med Ctr 0 129838 0 19031 0 12958 0 8614 0 20998 0 191439 0 0 Schedule J, Part I, Question 3: Sisters of Mary of the Presentation Long Term Care does not pay compensation to the President/CEOs. Sisters of Mary of the Presentation Health System uses the methods on Part I, question 3 to determine compensation. Sisters of Mary of the Presentation Long Term Care has five related long-term care facilities with a President/CEO at each facility. These individuals are compensated by Sisters of Mary of the Presentation Health System, a related organization, for services provided to Sisters of Mary of the Presentation Long Term Care and the other related organizations. Aaron K. Alton performs services for the related hospitals, home health agency, and the five related long-term care facilities. Form 990, Part VI, Section A, line 2 Aaron Alton and Gary Bakke have business relationships with Craig Christianson, Anthony Keelin, Timothy Burchill, Mark Kerr, and Nancy Farnham. Form 990, Part VI, Section A, line 6 The sole member of the organization is the Sisters of Mary of the Presentation Health System. Form 990, Part VI, Section A, line 7a The Member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The Member is also entitled to one vote on every other matter to be voted on by the Member. Votes cast on behalf of the Member are cast by the Chief Executive Officer of Sisters of Mary of the Presentation Health System. Form 990, Part VI, Section A, line 7b The authority to act on the following matters is exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer. Form 990, Part VI, Section A, line 8b The Organization does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body before it is filed. The President/CEO and Vice President of Finance of Sisters of Mary of the Presentation Health System, a related organization, review the Form 990 before it is filed. Form 990, Part VI, Section B, line 12c Each Director must submit in writing to the Chairperson of the Board and the Chief Executive Officer a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chairperson of the Board reviews the statements of the Directors and the Vice Chairperson of the Board reviews the statement filed by the Chairperson. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chairperson of the Board as authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chairperson, the Vice Chairperson has authority to require the Chairperson remove himself in the same matter. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he will not participate in the deliberations or vote on it. Form 990, Part VI, Section B, line 15 The President/CEO and Vice President of Finance of Sisters of Mary of the Presentation Health System, a related organization, oversee the operations of Sisters of Mary of the Presentation Long Term Care. The compensation reflects responsibility of supervising the management, administration and operations of Sisters of Mary of the Presentation Health System and the related facilities. Each facility within Sisters of Mary of the Presentation Long Term Care has their own respective President/CEO. The compensation process for all the top management officials is determined by Sisters of Mary of the Presentation Health System. The Sisters of Mary of the Presentation Health System Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. The Sisters of Mary of the Presentation Health System Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes. Form 990, Part VI, Section C, line 19 Information regarding the Organization's governing documents, conflict of interest policy, and financial statements can be obtained by contacting the Department of Human Services and by viewing the cost report. Financial information can also be obtained through the public disclosure copy of the 990. Form 990, Part XI, line 9: Equity transfers to related parties -14,766. Form 990, Part XII, Line 2c: The governing board of Sisters of Mary of the Presentation Health System assumes responsibility for oversight of the audit for Sisters of Mary of the Presentation Long Term Care. Sisters of Mary of the Presentation Health System 1202 Page Drive SW Fargo ND 58103 450359620 Facilitates mangagement and operations of ten related facilities ND 501(c)(3) Line 12a, I SMP Health Ministry 0 Presentation Medical Center 213 2nd Avenue NE Rolla ND 583670759 450227391 Provision of health care services ND 501(c)(3) Line 3 SMP Health System 0 St Aloisius Hospital 325 East Brewster Street Harvey ND 58341 450226729 Provision of health care services ND 501(c)(3) Line 3 SMP Health System 0 St Margaret's Hospital 600 East First Street Spring Valley IL 61362 362167884 Provision of health care services IL 501(c)(3) Line 3 SMP Health System 0 St Andrew's Hospital 316 Ohmer Street Bottineau ND 58318 450226426 Provision of health care services ND 501(c)(3) Line 3 SMP Health System 0 St Andrew's Hospital Foundation 316 Ohmer Street Bottineau ND 58318 450413201 Assist St. Andrew's Hospital in fund raising and fund management ND 501(c)(3) Line 12a, I SMP Health System 0 Prairieland Home Care 1102 Page Drive SW Fargo ND 581060007 450391192 Home health and supportive services ND 501(c)(3) Line 10 SMP Health System 0 St Margaret's Hospital Foundation 600 East First Street Spring Valley IL 61362 364042262 Provide support to St. Margaret's Hospital IL 501(c)(3) Line 12a, I SMP Health System 0 St Andrew's Bottineau Clinic LLC 316 Ohmer Street Bottineau ND 58318 450451306 Provision of health care services ND N/A Valley Regional Health Services L3C 4391 Venture Drive Peru IL 613541014 273891281 Outpatient oncology services IL N/A SMP Enterprises PO Box 10007 Fargo ND 581060007 363486506 Collection agency ND N/A C 0 SMP Enterprises - IL 600 E 1st Street Spring Valley IL 61362 363456566 Healthcare management IL N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0