EDGEBROOK CARE CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- EDGEBROOK CARE CENTER INC (EIN 41-0907322)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-27
- IRS object ID
- 201743009349301139
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-10-27T14:08:17-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 EAST 10TH ST PO BOX 5125 | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571175125 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410907322 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EDGEBROOK CARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EDGE | BusinessNameControlTxt |
| Phone | 5074427121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 505 WEST TROSKY ROAD | AddressLine1Txt |
| City | EDGERTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56128 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BOB VAN ESSEN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5074427121 | PhoneNum |
| Signature | 2017-10-09 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURIE HANSON | PreparerPersonNm |
| PTIN | P00851848 | PTIN |
| Phone | 6053391999 | PhoneNum |
| Preparation | 2017-10-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 199.116.171.203 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-10-09 | IPDt |
| IP Tm | 12:51:00 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 171BAB973F07BBF56AF44147332F3B8F939E6447 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EF8011075554CB02D1779489BD3504755D118D03 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BOB VAN ESSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 505 WEST TROSKY ROAD | AddressLine1Txt |
| City | EDGERTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56128 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,025,487 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GOOD-SAM.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1966 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A LONG-TERM CARE FACILITY, ASSISTED LIVING FACILITY, AND SENIOR APARTMENT FACILITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 164 | TotalEmployeeCnt |
| Total Volunteers | 150 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $24,376 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,821 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,625,473 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,998,638 | CYProgramServiceRevenueAmt |
| PY Investment Income | $159,601 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,540 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,028 | PYOtherRevenueAmt |
| CY Other Revenue | $9,415 | CYOtherRevenueAmt |
| PY Total Revenue | $4,817,478 | PYTotalRevenueAmt |
| CY Total Revenue | $5,020,414 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,150 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,696 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,525,646 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,749,143 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,719,516 | PYOtherExpensesAmt |
| CY Other Expenses | $1,778,808 | CYOtherExpensesAmt |
| PY Total Expenses | $4,251,312 | PYTotalExpensesAmt |
| CY Total Expenses | $4,537,647 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $566,166 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $482,767 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,964,881 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,567,769 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $352,218 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $472,339 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,612,663 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,095,430 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE CARE FOR ALL THOSE WHO FOR VARIOUS REASONS MUST RELY ON OTHERS TO CARE FOR THEM. THIS CARE IS BASED ON CHRISTIAN LOVE AND CONCERN WITH AN EMPHASIS ON MEETING THE NEEDS OF THE WHOLE PERSON WHILE RESPECTING INDIVIDUAL RIGHTS AND PERSONAL DIGNITY. EVERYONE INVOLVED IN THIS CARE, INCLUDING FAMILY MEMBERS, FRIENDS, CHURCH FAMILY, VOLUNTEERS, AND STAFF, SEEK TO SHARE THIS COMMON GOAL OF REACHING OUT TO THE RESIDENTS AS AMBASSADORS OF A LOVING GOD. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,837,813 | ExpenseAmt |
| Grant | $9,696 | GrantAmt |
| Revenue | $4,953,609 | RevenueAmt |
| Desc | ROUTINE RESIDENT CARE BY OPERATION OF A 56 BED LONG-TERM CARE UNIT, A 16 BED ASSISTED LIVING FACILITY, AND A 21-UNIT SENIOR APARTMENT FACILITY; THE NUMBER OF RESIDENT DAYS DURING 2016 WAS 31,750. | Desc |
| Total Program Service Expenses | $3,837,813 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 164 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL REDINGER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5074427121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 505 WEST TROSKY ROAD | AddressLine1Txt |
| City | EDGERTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56128 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| LARRY BROUWER END JUNE 2016 | ||||||
| PRESIDENT | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BOB VAN ESSEN | ||||||
| VICE PRES/PRESIDENT | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ALLEN BRUMMEL | ||||||
| DIRECTOR/VICE PRES (BEG JULY 2016) | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MINA VANDER POL | ||||||
| TREASURER/SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARILYN SCHOOLMEESTER | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| GENE KUIPERS END JUNE 2016 | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| GARY BAKER END JUNE 2016 | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| WENDY KROSSHELL | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| LONNA VIS | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| GORDON DYK BEG JULY 2016 | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| SHELA GUNNINK BEG JULY 2016 | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| RANDY LANDHUIS BEG JULY 2016 | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL REDINGER | ||||||
| ADMINISTRATOR | 40.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN | |||||
| 4800 WEST 57TH STREET | SIOUX FALLS | SD | 57108 | MANAGEMENT FEES & BILLING SERVICES, SHAR | $269,951 |
| AEGIS THERAPIES INC | |||||
| PO BOX 8103 | FT SMITH | AR | 72902 | CONTRACT THERAPY SERVICES | $196,123 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $7,821 | AllOtherContributionsAmt |
| Total Contributions | $7,821 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| RESIDENT ROUTINE CARE | 623000 | $4,627,231 | $4,627,231 | |
| OTHER REVENUE | 623000 | $216,125 | $216,125 | |
| ANCILLARY CHARGES | 623000 | $110,253 | $110,253 | |
| MEALS - STAFF & GUEST | 624210 | $45,029 | $45,029 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,998,638 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,503 | TotalRevenueColumnAmt |
| Exclusion | $4,503 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,415 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,415 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,415 | TotalRevenueColumnAmt |
| Exclusion | $9,415 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,110 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,073 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $37 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37 | TotalRevenueColumnAmt |
| Exclusion | $37 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,020,414 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,953,609 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $58,984 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,696 | TotalAmt |
| Program Services | $9,696 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,207,652 | TotalAmt |
| Program Services | $2,041,156 | ProgramServicesAmt |
| Management And General | $166,496 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,350 | TotalAmt |
| Program Services | $27,138 | ProgramServicesAmt |
| Management And General | $5,212 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352,196 | TotalAmt |
| Program Services | $325,634 | ProgramServicesAmt |
| Management And General | $26,562 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,945 | TotalAmt |
| Program Services | $147,159 | ProgramServicesAmt |
| Management And General | $9,786 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,406 | TotalAmt |
| Management And General | $314,406 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,500 | TotalAmt |
| Management And General | $22,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $277,476 | TotalAmt |
| Program Services | $220,033 | ProgramServicesAmt |
| Management And General | $57,443 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,539 | TotalAmt |
| Program Services | $509 | ProgramServicesAmt |
| Management And General | $6,030 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,255 | TotalAmt |
| Program Services | $19,975 | ProgramServicesAmt |
| Management And General | $54,280 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16 | TotalAmt |
| Program Services | $16 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,206 | TotalAmt |
| Program Services | $220,206 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,770 | TotalAmt |
| Program Services | $5,255 | ProgramServicesAmt |
| Management And General | $2,515 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,193 | TotalAmt |
| Program Services | $258,193 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,007 | TotalAmt |
| Management And General | $7,007 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM SUPPLIES | $394,217 | $394,217 | |
| STATE BED SURCHARGE | $157,640 | $157,640 | |
| EMPLOYEE AND PUBLIC REL | $15,238 | $15,238 | |
| LICENSE AND FEES | $8,060 | $8,060 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,285 | TotalAmt |
| Program Services | $10,986 | ProgramServicesAmt |
| Management And General | $4,299 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,537,647 | TotalAmt |
| Program Services | $3,837,813 | ProgramServicesAmt |
| Management And General | $699,834 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,304 | BOYAmt |
| EOY | $1,365,654 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,919 | BOYAmt |
| EOY | $304,409 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,482 | BOYAmt |
| EOY | $15,282 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,121 | BOYAmt |
| EOY | $64,968 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,804,000 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,000,588 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,417,861 | BOYAmt |
| EOY | $3,803,412 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,194 | BOYAmt |
| EOY | $14,044 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,964,881 | BOYAmt |
| EOY | $5,567,769 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $302,578 | BOYAmt |
| EOY | $394,249 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,640 | BOYAmt |
| EOY | $64,090 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,000 | BOYAmt |
| EOY | $14,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $352,218 | BOYAmt |
| EOY | $472,339 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,605,915 | BOYAmt |
| EOY | $5,092,748 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,748 | BOYAmt |
| EOY | $2,682 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,612,663 | BOYAmt |
| EOY | $5,095,430 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,964,881 | BOYAmt |
| EOY | $5,567,769 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $482,767 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,796 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,908 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,595 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,376 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,821 | CurrentTaxYearAmt |
| Total | $68,496 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,063,091 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,115,292 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,194,504 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,590,903 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,953,609 | CurrentTaxYearAmt |
| Total | $21,917,399 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $44,436 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $53,298 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $56,945 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $34,570 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $45,029 | CurrentTaxYearAmt |
| Total | $234,278 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,113,323 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,184,498 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,266,044 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,649,849 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,006,459 | CurrentTaxYearAmt |
| Total | $22,220,173 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $526,510 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $598,123 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $794,154 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $477,302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,002,537 | CurrentTaxYearAmt |
| Total | $3,398,626 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $526,510 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $598,123 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $794,154 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $477,302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,002,537 | CurrentTaxYearAmt |
| Total | $3,398,626 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $18,821,547 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,518 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,574 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,696 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,303 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,918 | CurrentTaxYearAmt |
| Total | $52,009 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,518 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,574 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,696 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,303 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,918 | CurrentTaxYearAmt |
| Total | $52,009 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,128,841 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,190,072 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,272,740 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,660,152 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,020,377 | CurrentTaxYearAmt |
| Total | $22,272,182 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.84510 | PublicSupportCY509Pct |
| Public Support PY509 | 0.85770 | PublicSupportPY509Pct |
| Investment Income CY | 0.00230 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00250 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,030 | OtherCostOrOtherBasisAmt |
| Book Value | $7,030 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,230,993 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,172,490 | DepreciationAmt |
| Book Value | $3,058,503 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $863,246 | OtherCostOrOtherBasisAmt |
| Depreciation | $638,850 | DepreciationAmt |
| Book Value | $224,396 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $702,731 | OtherCostOrOtherBasisAmt |
| Depreciation | $189,248 | DepreciationAmt |
| Book Value | $513,483 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,803,412 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TENANT SECURITY DEPOSITS | Desc |
| Amt | $14,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,020,414 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,020,414 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,020,414 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,537,647 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,537,647 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,537,647 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | EDGEBROOK 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), THE ORGANIZATION 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 ITS EXEMPT PURPOSE. THE ORGANIZATION HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. THE ORGANIZATION 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 FINANCIAL STATEMENTS. THE ORGANIZATION 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. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 16 | RecipientCnt |
| Cash Grant | $9,696 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE SCHOLARSHIPS WERE PAID DIRECTLY TO THE UNIVERSITY BY THE ORGANIZATION. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RANDY LANDHUIS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | OWNER OF COUNTRY LUMBER | RelationshipDescriptionTxt |
| Transaction | $84,564 | TransactionAmt |
| Transaction | COUNTRY LUMBER SOLD EDGEBROOK CARE CENTER THE MATERIAL FOR THE GARAGE PROJECT. THEY WERE THE LOW BID AND RANDY LANDHUIS ABSTAINED FROM THE VOTE. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION HAS DELEGATED MANAGEMENT DUTIES TO THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, AN UNRELATED ORGANIZATION. MICHAEL REDINGER, ADMINISTRATOR, RECEIVED $68,710 IN COMPENSATION AND $14,108 IN OTHER BENEFITS FOR MANAGEMENT SERVICES PROVIDED TO EDGEBROOK CARE CENTER IN 2016. |
| FORM 990, PART VI, SECTION A, LINE 8B | AS A WHOLE THERE WERE NO COMMITTEE MEETINGS TO MAKE ANY FORMAL DECISIONS WITHOUT BRINGING RECOMMENDATIONS TO THE BOARD. THE COMMITTEES WERE USED PRIMARILY FOR GUIDANCE BY THE ADMINISTRATOR. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY AT LEAST ONE WEEK PRIOR TO THE FILING DATE AND A DETAILED REVIEW IS COMPLETED BY THE ADMINISTRATOR AND BOARD PRESIDENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND THE ADMINISTRATOR ARE COVERED BY THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT OF INTEREST IS DISCOVERED OR SUSPECTED, THAT BOARD MEMBER WILL BE ASKED TO ABSTAIN FROM VOTING ON THAT TOPIC. THEY MAY PROVIDE INFORMATION ON THE TOPIC THAT IS BEING DISCUSSED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ADMINISTRATOR FOR THE ORGANIZATION IS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH AN UNRELATED MANAGEMENT COMPANY, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. THE COMPENSATION IS REVIEWED AND DETERMINED BY THE UNRELATED MANAGEMENT COMPANY ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |