2017-08-15T12:11:25-05:00 2016-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2015-10-01 410845402 MINNEWASKA LUTHERAN HOME MINN 3202392217 PO BOX 40 STARBUCK MN 56381 KAYO ASLAGSON BOARD CHAIR 3202392217 2017-08-14 1 CORY RUTLEDGE P01329381 6123764500 2015 2021-01-29 14:40:06Z CHRISTOPHER KNOLL PO BOX 40 STARBUCK MN 56381 4490757 0 X WWW.MCHS-HEALTHCARE.ORG X 1958 MN NURSING HOME - A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE. 10 10 197 75 0 0 55641 11493 4215836 3999500 7176 7948 19785 471816 4298438 4490757 0 21913 0 0 3063837 2681489 0 0 0 1449645 1323493 4513482 4026895 -215044 463862 4478224 4916849 2373657 2340784 2104567 2576065 X A COMMUNITY OF SERVICES, GROUNDED IN FAITH, PROVIDING PERSON CENTERED CARE THAT ENCOURAGES ALL PEOPLE TO REACH THEIR HIGHEST POTENTIAL. 0 1 3552064 21913 3999500 MINNEWASKA LUTHERAN HOME, A 43-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 AREA 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 COMMUNITY. 0 0 0 COMMUNITY OUTREACH EXERCISE PROGRAM: EXERCISE PROGRAM THAT STRESSES STRENGTH AND STABILITY. THIS PROGRAM IS OFFERED THREE TIMES PER WEEK TO COMMUNITY MEMBERS AT NO CHARGE. 0 0 0 THIS PROJECT IS BASED ON IMPROVING EMPLOYEE RECRUITMENT, RETENTION & TURNOVER. CONTINUITY OF STAFF HAS A DIRECT EFFECT ON QUALITY OF RESIDENT CARE. THE LONGER THE EMPLOYEE WORKS WITH A RESIDENT, THE MORE HE OR SHE GETS TO KNOW THE UNIQUE NEEDS & COMMUNICATION STRATEGIES OF THE RESIDENT. STABLE STAFFING BETTER ALLOWS THE RESIDENT TO FORM A MEANINGFUL RELATIONSHIP WITH HIS OR HER CAREGIVER, WHICH IN TURN, RESULTS IN BETTER CARE. ADDRESSING STAFFING DEFICIENCIES IS OFTEN ACCOMPLISHED WITH OVERTIME & INCREASES IN PATIENT LOAD, BOTH OF WHICH DECREASE QUALITY OF CARE & INCREASE NEGATIVE CLINICAL OUTCOMES. IMPROVEMENTS IN RETENTION & TURNOVER CAN ALSO BE A SUBSTANTIAL FINANCIAL SAVINGS TO FACILITIES. 3552064 1 1 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 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 16 0 197 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 0 1 0 0 MN X BRIAN ENGLER 3202397121 605 MAIN STREET STARBUCK MN 56381 KAYO ASLAGSON CHAIR 0.50 1.50 X X 0 0 0 LAURIS JOHNSHOY VICE CHAIR 0.50 1.50 X X 0 0 0 JOHN SAMUELSON SECRETARY 0.50 1.50 X X 0 0 0 ARNE STOEN TREASURER 0.50 1.50 X X 0 0 0 PETER BRANDT DIRECTOR 0.50 1.50 X 0 0 0 RONALD FEIGUM DIRECTOR 0.50 1.50 X 0 0 0 WARREN HAGESTUEN DIRECTOR 0.50 1.50 X 0 0 0 ROBERT HENDRICKSON DIRECTOR 0.50 1.50 X 0 0 0 ALICE REESE DIRECTOR 0.50 1.50 X 0 0 0 STAN STARK DIRECTOR 0.50 1.50 X 0 0 0 CHRISTOPHER KNOLL ADMINISTRATOR 36.00 4.00 X 73345 0 5522 BRIAN ENGLER DIRECTOR OF FINANCE 28.00 12.00 X 56740 0 5618 130085 0 11140 0 0 1 0 PROREHAB 200 LEWIS AVE S STE 210 WATERTOWN MN 55388 PHYSICAL & OCCUPATIONAL SERVICES 138002 MILLER ARCHITECTS & BUILDERS PO BOX 1228 ST CLOUD MN 56302 ARCHITECTURAL & BUILDING SERVICES 125005 CLIFTONLARSONALLEN LLP 220 S 6TH ST STE 300 MINNEAPOLIS MN 55402 ACCOUNTING SERVICES 112575 3 3388 8105 11493 RESIDENT REVENUES 623000 3999500 3999500 3999500 7858 7858 90 0 90 90 90 SALE OF BED RIGHTS 900099 450000 450000 MISCELLANEOUS INCOME 900099 11052 11052 MEALS REVENUE 722210 10764 10764 471816 4490757 3999500 0 479764 21913 21913 172787 172787 2109652 1956208 153444 11518 10330 1188 219980 208219 11761 167552 150268 17284 19409 19409 25512 25512 129553 118042 11511 5479 5479 159213 144469 14744 51065 51065 108202 108202 5798 5798 2405 2405 68657 68657 257485 257485 27285 27285 LICENSE SURCHARGE 186436 186436 FOOD 117499 117499 MEDICAL SUPPLIES 101477 101477 MISCELLANEOUS EXPENSE 40516 40517 -1 17502 17502 4026895 3552064 474831 0 25 25 914657 1054386 378271 349974 23782 29746 8792577 5719438 2858338 3073139 161621 174069 2000 2000 53742 47490 85788 186020 4478224 4916849 266018 428234 4311 5076 2103328 1907474 2373657 2340784 X 2102964 2574461 1603 1604 2104567 2576065 4478224 4916849 463862 7636 0 X 0 1 X 1 0 X 18589 37807 47370 55641 11493 170900 4394214 4351067 4285328 4215836 3999500 21245945 4412803 4388874 4332698 4271477 4010993 21416845 5000 5000 1637269 1610998 1573236 1543752 1080566 7445821 1642269 1610998 1573236 1543752 1080566 7450821 13966024 10687 10598 12948 12013 7858 54104 10687 10598 12948 12013 7858 54104 23195 19993 28697 19785 471816 563486 4446685 4419465 4374343 4303275 4490667 22034435 0.63380 0.63090 0.00250 0.00270 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME CABLE TV REVENUE MISCELLANEOUS INCOME MEALS REVENUE SALE OF BEDS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 228026 228026 6455232 4256600 2198632 124900 67317 57583 1579395 1395521 183874 405024 405024 3073139 X PART IV, LINE 2B: RESIDENT DEPOSITS CONSIST OF RESIDENT TRUST FUNDS HELD BY THE ORGANIZATION FOR THE RESIDENTS OF THE HOME. PART X, LINE 2: FROM NOTE 1 TO THE ORGANIZATION'S FINANCIAL STATEMENTS: THE HOME, MHD, HOLLY RIDGE, AND HOME CARE HAVE ALL BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) AND APPLICABLE STATE STATUTES. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. 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. 1 SCHOLARSHIPS 17 21913 PART I, LINE 2: FOR THE DHS SCHOLARSHIPS WE WILL NOW PAY FOR THE NAR CLASS AND TEST FOR THE POTENTIAL EMPLOYEE. FOR ANY OTHER ELIGIBLE DHS SCHOLARSHIP THE EMPLOYEE WILL GO TO THE HR DIRECTOR AND COMPLETE A FORM, THE EMPLOYEE THEN SIGNS THAT FORM ALONG WITH THE HR DIRECTOR AND THE ADMINISTRATOR. A COPY OF THAT FORM IS THEN GIVEN TO THE DIRECTOR OF FINANCE. ONCE THE EMPLOYEE COMPLETES A SEMESTER IN THE PROGRAM THEY HAVE APPLIED FOR THAT EMPLOYEE WILL THEN COMPLETE A SCHOLARSHIP REQUEST FORM AND GIVE COPIES OF ALL INFORMATION RELATING TO THE DATES OF THE SEMESTER AND ALL CHARGES. THE EMPLOYEE WILL ALSO COMPLETE THE DHS MILEAGE AND/OR DAY CARE SHEETS FOR THE RELATED TIME PERIOD OF THE SEMESTER. AFTER THE EMPLOYEE HAS COMPLETED THAT FORM THE DIRECTOR OF FINANCE WILL RUN A PAYROLL TIME CLOCK HISTORY REPORT FOR THE EXACT DATES OF THE SEMESTER TO VERIFY THAT THE EMPLOYEE MET THE 10 HOUR MINIMUM HOURS/WK REQUIREMENT. IF THAT HAS BEEN MET THEN THE DIRECTOR OF FINANCE WILL CUT AN A/P CHECK TO THE EMPLOYEE FOR ALL ELIGIBLE EXPENSES. 0 0 0 0 0 0 0 0 0 FORM 990, PART III, LINE 3 MINNEWASKA LUTHERAN HOME TOOK 8 BEDS OUT OF LAYAWAY STATUS BRINGING US TO 73 LICENSED BEDS AND THEN SOLD 30 BEDS TO PRESBYTERIAN HOMES DROPPING US TO 43 LICENSED BEDS. AFTER THE SALE OF THOSE 30 BEDS THE AREA THAT WE HAD THOSE BEDS WAS CONVERTED INTO A MEMORY CARE ASSISTED LIVING. THIS WAS EFFECTIVE 6/14/16. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED TO ADD A NEW MEMBER, MESSIAH LUTHERAN CHURCH OF HOFFMAN, MINNESOTA. 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 11 DUE TO THE DELAY IN GETTING THE CHECKLISTS SUBMITTED, THE MANAGEMENT TEAM AND BOARD MEMBERS WILL DISCUSS THE COMPLETED AND SUBMITTED FORM 990 AT THE AUGUST 30, 2017 BOARD MEETING AFTER THE RETURN IS FILED. THE REVIEW WILL BE LEAD BY BRIAN ENGLER, 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 15A THE ADMINISTRATOR'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS ANNUALLY. EVERY YEAR, THE ADMINISTRATOR 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 THEN INCORPORATED IN THE BOARD MINUTES AND ADMINISTRATOR'S ANNUAL REVIEW. THE PROCESS LAST OCCURRED AUGUST 1, 2015. 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. MINNEWASKA HOME CARE PO BOX 40 STARBUCK MN 56381 331124162 HOME CARE MN 501(C)(3) 9 N/A 1 HOLLY RIDGE MANOR 500 HOLLY RIDGE DRIVE STARBUCK MN 56381 411649721 ASSISTED LIVING MN 501(C)(3) 11 - TYPE 2 N/A 1 MINNEWASKA HOME DEVELOPMENT PO BOX 40 STARBUCK MN 56381 411504339 FUNDRAISING MN 501(C)(3) 11 - TYPE 2 N/A 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 1