2019-07-30T11:34:43-05:00 2018-09-30 411765929 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2017-10-01 410872240 Glenwood Village Care Center Inc GLEN 3206345131 719 2nd Street SE Glenwood MN 56334 Mary Krueger Chief Executive Officer 3206345131 2019-07-25 1 Deb Nelson P00978242 6122536500 2019-06-26 199.247.44.26 2019-07-25 10:29:50 CD P B602D594AFD2B0B327E07A06F36CA6A7E42546D0 EFC25E59FA7409AE560978A003AFB9E955B778C6 2017 2019-02-21 02:37:17Z Glenwood Retirement Village Mary Krueger 719 2nd Street SE Glenwood MN 56334 6945457 0 9386 X www.grvillage.org X 1963 MN Nursing Home and Assisted Living Services 11 11 187 70 0 0 6376 8949 6569956 6933006 3056 3502 0 0 6579388 6945457 50004 49369 0 0 3835839 4305351 0 0 1009 2659620 2764049 6545463 7118769 33925 -173312 8522579 8265426 7043678 6842434 1478901 1422992 The Glenwood Retirement Village exists to fulfill the call of our Lord Jesus Christ to serve others with a primary mission to enhance the quality of life of those we serve through innovative health, housing, spiritual, and social services. 0 0 5641119 49369 6067407 The Glenwood Village Care Center is a 64-bed skilled nursing facility that had total resident days numbering 21,986. An average of 60 residents per day were served with a total of 77 admissions in the fiscal year. Glenwood Village Care Center is certified for Medicare and Medical Assistance. Services include nursing, dietary, activities, social services, on-site chaplain and physical, occupational and speech therapy. Both in-patient and out-patient therapy is available. 804783 0 865599 Parkview Court is a 32-unit apartment building attached to the Glenwood Village Care Center. It is registered as a "Housing with Services and licensed as a Comprehensive Home Care Agency. It is fully staffed 24 hours a day. Private pay and Elderly Waiver funds are accepted. Optional meal plans and service packages are available and customized to meet the needs of the client. Housekeeping services and activities are available daily. Parkview Court is an Equal Housing Opportunity provider. 6445902 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 22 0 1 187 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Deb Moorer 3206345761 719 2nd Street SE Glenwood MN 56334 Dick Benson Chair 0.30 0.60 X X 0 0 0 Sharon Isdahl Vice Chair 0.30 0.60 X X 0 0 0 Marian Pladson Secretary/Treasurer 0.30 0.60 X X 0 0 0 Earl Hauge Director 0.30 0.60 X 0 0 0 Warren Thompson Director 0.30 0.60 X 0 0 0 Wendy Peterson thru Mar 2018 Director 0.30 0.60 X 0 0 0 Tom Talle Director 0.30 0.60 X 0 0 0 June Tweit Director 0.30 0.60 X 0 0 0 Deb Dahlseng Director 0.30 0.60 X 0 0 0 Laura Jergenson Director 0.30 0.60 X 0 0 0 Douglas Bogie Director 0.30 0.60 X 0 0 0 Harold Rippe from Mar 2018 Director 0.30 0.60 X 0 0 0 Mary Krueger Chief Executive Officer 38.00 2.00 X 93355 0 3734 Deb Moorer Business Manager 38.00 2.00 X 45948 0 9139 139303 0 12873 0 0 0 0 Advantage Rehab 1236 Bridgeport Court Alexandria MN 56308 Therapy 340109 AYA Healthcare Inc PO Box 123519 Dallas TX 753123519 Contract Staff-RN,LPN,CAN 183539 2 8949 8949 Net Resident Service R 623000 5941741 5941741 Assisted Living Rent 623000 846334 846334 Other Revenue 900099 144931 144931 6933006 3502 3502 6945457 6933006 0 3502 8880 8880 40489 40489 164102 10094 152999 1009 3446168 3171536 274632 52422 51252 1170 419559 380274 39285 223100 197463 25637 5019 5019 20626 20626 278658 238894 39764 18996 11228 7768 174859 158792 16067 46039 46039 284276 284276 6024 6024 18413 18413 200268 200268 526606 526606 63932 23081 40851 Medical Supplies 519529 519529 Food 265204 265204 DHS Bed Surcharge 180160 180160 Bad Debt 91940 91940 63500 61499 2001 7118769 6445902 671858 1009 372576 397185 1542792 1440312 71612 78698 13702448 7472378 6425198 6230070 8366 83280 90565 27121 20230 8522579 8265426 996340 1055622 6001825 5752497 45513 34315 7043678 6842434 X 1478901 1422992 1478901 1422992 8522579 8265426 X -173312 12984 104419 X 0 1 X 0 0 X 8252 6007 6991 6376 8949 36575 5028739 5321996 6245858 6569956 6933006 30099555 5036991 5328003 6252849 6576332 6941955 30136130 0 467365 502385 661144 759517 804129 3194540 467365 502385 661144 759517 804129 3194540 26941590 2169 2759 2502 2931 3502 13863 2169 2759 2502 2931 3502 13863 5039160 5330762 6255351 6579263 6945457 30149993 0.89360 0.88590 0.00050 0.00050 X 1 3941 7590 9415 2116 1 X 75074 75074 10872088 5389408 5482680 2755286 2082970 672316 6230070 X 6950851 12984 12984 6937867 7590 7590 6945457 7109354 0 7109354 9415 9415 7118769 Part IV, Line 1b: The assets of the Glenwood Retirement Village Auxiliary are held by the Glenwood Village Care Center. Part IV, Line 2b: The Nursing Home of the organization acts as custodian for certain funds of the residents. These funds are included in cash and cash equivalents and accounts payable in the financial statements. As a condiditon of the rental agreement with Parkview Court, residents are required to make a refundable security deposit equal to one month's rent. These amounts are deposited in an interest bearing account. The security deposits plus interest are included in other assets and liabilities in the combined financial statements. Part X, Line 2: Glenwood Village Care Center, Inc. is organized as a Minnesota 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). Glenwood Village Care Center, Inc. is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the organization is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. Glenwood Village Care Center, Inc. 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. Glenwood Village Care Center, Inc. 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: Auxiliary revenue combined for tax purposes. 7,590. Part XII, Line 4b - Other Adjustments: Auxiliary expenses combined for tax purposes. 9,415. 1 Glenwood Retirement Home Foundation Inc 719 S 2nd Street Glenwood MN 56334 411453070 501(c)(3) 8880 The Foundation supports the Glenwood Village Care Center and Plaza. 1 0 Education Scholarships 36 40489 Part I, Line 2: DHS Scholarship Grants are given to employees who meet the requirements set forth in legislative language. The employee must work an average of 20 hours per week to be eligible. 26 weeks of the most recent work history is used to verify eligibility. Payments are made directly to the educational institution for the amount of tuition and books. The amount is capped each fiscal year as determined by the rate sheet from DHS. Each recipient must turn in tuition invoices that show the classes the student is enrolled in and books to be purchased. Semester grades or licensure is proof of completion. A City of Glenwood Minnesota 416005188 2013-10-11 6500000 Refinance 7/16/1998 bond and finance an addition and remodeling project. 0 0 0 A 485303 6320105 3924396 2395709 2014 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 0 Schedule K, Part II, Line 3 The bond proceeds were advanced on a cost reimbursement basis. Part I, column (e) represents the total amount authorized for the issue while Part II, line 3 represents the actual amount of bond proceeds used to pay project costs. Form 990, Part VI, Section A, line 1 The Board of Directors may designate two or more of their members to constitute an Executive Committee. To the extent determined by the Board, the Executive Committee shall have the authority of the Board in the management of the business of the corporation. The Executive Committee shall act only in the interval between meetings of the Board, and at all times is subject to the control and direction of the Board. Form 990, Part VI, Section A, line 6 The non-voting members of the Corporation shall consist of Christian congregations electing to participate. Fifty-one percent or more of such congregations shall be affiliated with the Evangelical Lutheran Church in America. Voting members consist of all the pastors of the congregations electing to participate and at least two lay-delegates for each such congregation. Said congregations having 200 or more confirmed members may have one additional voting member for each 100 confirmed members or a major fraction thereof over the first 200. Form 990, Part VI, Section A, line 7a Each of our affiliated churches chooses one member to be on the Board of Directors. Form 990, Part VI, Section A, line 7b The members vote on changes to the Bylaws. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CEO and Business Manager and is then presented to the Board prior to filing. Form 990, Part VI, Section B, line 12c All employees and Board Members are covered by the conflict of interest policy. Management will determine if a conflict exists. If a conflict exists, the individual will refrain from participating in the discussion and vote. Each individual is required to complete a conflict of interest form annually. Form 990, Part VI, Section B, line 15 The Board of Directors uses the Leading Age of MN Wage and Benefit Survey to determine the CEO's wage. The Business Manager's salary is determined by the CEO using comparability data from Aging Services of Minnesota and is approved by the Board of Directors. This was last done in October 2017 and is documented in the Board's meeting minutes. 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 XI, line 9: Auxiliary Net Income Combined for Tax Purposes 1,825. Transfer from related party. 102,594. Glenwood Retirement Home Foundation Inc 719 SE 2nd Street Glenwood MN 56334 411453070 Fundraising and Support of Related Organizations MN 501(c)(3) Line 7 N/A 1 Glenwood Plaza Inc 719 SE 2nd Street Glenwood MN 56334 411477434 Independent Senior Housing MN 501(c)(3) Line 10 N/A 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 Glenwood Retirement Home Foundation R 102594 FMV Schedule R, Part II, Column (f): Glenwood Retirement Village, Glenwood Retirement Home Foundation, Inc., and Glenwood Plaza, Inc. have 100% board overlap. Therefore, these organizations are both controlled and controlling per Section 512(b)(13).