2016-08-09T13:03:58-05:00 2015-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2014-10-01 410693843 BETHESDA BETH 3202359532 901 SE WILLMAR AVENUE WILLMAR MN 56201 MICHELLE HAEFNER CEO 3202359532 2016-08-09 1 KACIE MCEWEN P01599614 6123764500 2014 2016-12-15 16:53:06Z MICHELLE HAEFNER 901 SE WILLMAR AVENUE WILLMAR MN 56201 16815340 0 X WWW.BETHESDAWILLMAR.COM X 1897 MN TO PROVIDE HOUSING AND NURSING SERVICES TO THE ELDERLY AND DISABLED. 12 12 659 73 0 0 2842404 42578 16432502 16229880 155482 45930 260431 291313 19690819 16609701 0 0 0 0 10744841 10483379 0 0 0 6609616 6559522 17354457 17042901 2336362 -433200 20873044 22838696 12656212 15079926 8216832 7758770 X WE SEEK DAILY TO EARN YOUR TRUST THROUGH EXCELLENT SERVICE BY CREATING QUALITY HEALTH, HOUSING, AND HOME BASED CHOICES PRIMARILY FOR OLDER ADULTS. 0 0 13817022 0 14435156 BETHESDA HEALTH AND HOUSING IS LOCATED IN WILLMAR, MINNESOTA. IT OPERATES EXCLUSIVELY TO PROMOTE HEALTH, RELIGIOUS, AND GENERAL SOCIAL WELFARE OF PHYSICALLY AND MENTALLY DISADVANTAGED PERSONS, PRIMARILY THE ELDERLY. SERVICES ARE PROVIDED THROUGH PLEASANT VIEW, HERITAGE CENTER, PARK VIEW VILLAGE, HOME HEALTH, AND ADULT DAY CARE SERVICES. BETHESDA PROVIDES LONG-TERM SKILLED CARE THROUGH TWO SKILLED NURSING HOMES, PLEASANT VIEW AND HERITAGE CENTER. PLEASANT VIEW IS A 123-BED LONG-TERM SKILLED NURSING HOME THAT PROVIDES A SPECIALIZED MEMORY LOSS CARE UNIT AND A SHORT-TERM REHABILITATION UNIT. HERITAGE CENTER IS A 125-BED LONG-TERM SKILLED NURSING HOME WHICH PROVIDES A SHORT-TERM REHABILITATION UNIT. FOR THE YEAR ENDED SEPTEMBER 30, 2015, BETHESDA HAD 80,782 RESIDENT DAYS AND 89% OCCUPANCY. 874122 0 1095399 HOME HEALTH SERVICES PROVIDES IN-HOME HEALTH CARE, WHILE ADULT DAY CARE SERVICES PROVIDES DAILY HEALTH CARE SUPPORT TO INDIVIDUALS WHO NEED HELP BUT REMAIN IN THE COMMUNITY. HOME HEALTH PROVIDES IN-HOME SKILLED NURSING, HOME HEALTH AIDE, HOMEMAKER SERVICES, PHYSICAL THERAPY, SPEECH THERAPY, AND OCCUPATIONAL THERAPY. THE ADULT DAY SERVICES INCLUDES HEALTH MONITORING AND EDUCATION, COMMUNITY RESOURCE EDUCATION AND LINKAGE, SOCIAL AND RECREATIONAL ACTIVITIES, CAREGIVERS RESPITE SUPPORT, TRANSPORTATION, AND MEALS. HOME HEALTH SERVED AN AVERAGE OF 85 PATIENTS EACH MONTH AND ADULT DAY SERVICES SERVED 36 CLIENTS A MONTH FOR THE YEAR ENDED SEPTEMBER 30, 2015. 522168 0 516800 PARK VIEW VILLAGE IS A 20-UNIT ASSISTED LIVING FACILITY IN OLIVIA, MN. A 24-HOUR ON-SITE STAFF OFFERS PERSONAL ASSISTANCE, MEDICATION, MONITORING, AND MEALS. FOR THE YEAR ENDED SEPTEMBER 30, 2015, PARK VIEW VILLAGE HAD 17 TENANTS A MONTH AND 85% OCCUPANCY. 262776 0 182525 CLUB BETHESDA IS A FITNESS CENTER FOR PEOPLE AGES 50 AND OLDER. THE CLUB IS OPEN TO BETHESDA'S RESIDENTS/TENANTS, AS WELL AS COMMUNITY MEMBERS. 262776 0 182525 15476088 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 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 0 0 1 1 1 0 0 1 17 0 659 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 0 0 MN X ASHLEY BORMANN 3202145603 901 SE WILLMAR AVENUE WILLMAR MN 56201 CARLA LAGERSTEDT CHAIR 0.10 0.40 X X 0 0 0 LARRY KNUTSON PAST BOARD CHAIR 0.10 0.40 X X 0 0 0 RICHARD LARSON VICE CHAIR 0.10 0.40 X X 0 0 0 KAROL MARKFELDER SECRETARY 0.10 0.40 X X 0 0 0 MARLIN HENJUM TREASURER 0.10 0.40 X X 0 0 0 PASTOR MARY HOVLAND BOARD MEMBER 0.10 0.40 X 0 0 0 VIVIAN OLSEN BOARD MEMBER 0.10 0.40 X 0 0 0 CHUCK OTT BOARD MEMBER 0.10 0.40 X 0 0 0 RAY POAGE BOARD MEMBER 0.10 0.40 X 0 0 0 STEVE RENQUIST BOARD MEMBER 0.10 0.40 X 0 0 0 NATHAN STREED BOARD MEMBER 0.10 0.40 X 0 0 0 CAROLE VENNERSTROM BOARD MEMBER 0.10 0.40 X 0 0 0 MICHELLE HAEFNER CEO 8.00 32.00 X 198986 0 8306 ALANA ZIEHL DIRECTOR OF ACCOUNTING 8.00 32.00 X 75085 0 7951 ASHLEY BORMANN ADMINISTRATOR 8.00 32.00 X 68935 0 2169 BRANDON PIETSCH ADMINISTRATOR 8.00 32.00 X 101744 0 1749 444750 0 20175 2 0 1 0 PRO REHAB 200 LEWIS AVE S STE 210 WATERTOWN MN 55388 THERAPY SERVICES 792554 A'VIANDS 1751 W COUNTY ROAD B ROSEVILLE MN 55113 NUTRITION SERVICES 641547 SYNTAX 1295 BANDANA BLVD N STE 125 ST PAUL MN 55108 COMPUTER CONSULTING SERVICES 137803 3 6398 36180 42578 RESIDENT SERVICES 623000 16227402 16227402 WELLNESS CENTER 624110 2478 2478 16229880 36688 36688 11741 0 11741 11741 11741 214881 205639 9242 9242 9242 MEALS 722210 178127 178127 OTHER INCOME 517000 101445 101445 279572 16609701 16229880 0 337243 413750 413750 8459815 8179267 280548 141967 130859 11108 802969 740142 62827 664878 612856 52022 42632 42632 133605 133605 9147 9147 1017744 951781 65963 45183 43558 1625 413372 244564 168808 145550 145550 530245 489010 41235 13126 13126 71266 71266 383541 369745 13796 880402 848734 31668 173761 167511 6250 LICENSES & SURCHARGES 764646 757642 7004 FOOD 751467 751467 MEDICAL SUPPLIES 701785 701785 REPAIRS & MAINTENANCE 228263 220452 7811 253787 253589 198 17042901 15476088 1566813 0 1744510 921033 921862 924810 183347 56604 32592939 14639570 14044036 17953369 2521979 1568369 342800 342800 1048997 1013987 65513 57724 20873044 22838696 1439950 2415855 10607657 9943978 17964 19464 0 2146085 590641 554544 12656212 15079926 X 8216832 7758770 8216832 7758770 20873044 22838696 -433200 -24862 0 X 0 1 X 1 0 X 184480 371081 64813 2842404 42578 3505356 16158660 15921642 16675490 16432502 16229880 81418174 16343140 16292723 16740303 19274906 16272458 84923530 0 0 0 84923530 89046 145168 111750 40484 48429 434877 89046 145168 111750 40484 48429 434877 -203589 236090 247405 279572 559478 16432186 16234302 17088143 19562795 16600459 85917885 0.98840 0.99170 0.00510 0.00510 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2011 AMOUNT: $ -203,589. 2012 AMOUNT: $ 118,928. 2013 AMOUNT: $ 65,543. 2014 AMOUNT: $ 101,445. MEALS - 2012 AMOUNT: $ 117,162. 2013 AMOUNT: $ 181,862. 2014 AMOUNT: $ 178,127. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 906755 906755 21141244 11027694 10113550 4696646 3611876 1084770 5848294 5848294 17953369 NOTE PAYABLE - RELATED PARTY 554544 554544 X PART IV, LINE 2B: RESIDENT TRUST FUNDS REPRESENT FUNDS HELD BY THE ORGANIZATION ON BEHALF OF THEIR RESIDENTS. SECURITY DEPOSITS ARE HELD AS COLLATERAL FOR DAMAGES TO ROOMS. PART X, LINE 2: THE CORPORATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3); ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CORPORATION'S ANNUAL TAX FILINGS ARE SUBJECT TO REVIEW BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OTHER TAXES. X X X 0 0 0 0 0 0 0 0 0 MICHELLE HAEFNER CEO 198986 0 0 0 0 0 6603 0 1703 0 207292 0 0 0 A CITY OF OLIVIA MINNESOTA 416005436 2008-04-22 2008000 ISSUED TO REFUND PRIOR ISSUANCE OF SERIES 2001 REVENUE BOND 0 0 0 B CITY OF WILLMAR MINNESOTA 400951605 2012-06-01 10000000 ISSUED TO REFUND PRIOR ISSUANCE OF SERIES 1998, 2004A, & 2009 REVENUE BONDS 0 0 0 A 572937 2008000 40011 1967989 2008 1 0 0 1 B 1491085 10000000 250764 52500 9947500 2012 1 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE WHICH CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS AND ONE ADDITIONAL BOARD MEMBER. THIS COMMITTEE ONLY ACTS IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND AT ALL TIMES IS SUBJECT TO THE CONTROL AND DIRECTION OF THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO CLASSES OF MEMBERSHIP. MEMBERSHIP CONSISTS OF CONGREGATIONS OF CHRISTIAN CHURCHES WHICH HAVE APPLIED FOR MEMBERSHIP AND ARE APPROVED BY THE BOARD OF DIRECTORS. IT ALSO CONSISTS OF INDIVIDUAL MEMBERS WHO ARE IN GOOD STANDING AT THE TIME OF THE ADOPTION OF THE BYLAWS, AND ADDITIONAL INDIVIDUAL MEMBERS WHO ARE MEMBERS AND ARE IN GOOD STANDING OF ANY CHRISTIAN CHURCH CONGREGATION. THEIR MEMBERSHIP MUST BE APPROVED BY THE BOARD OF DIRECTORS. EACH CONGREGATION SHALL BE ENTITLED TO THREE VOTING DELEGATES. CONGREGATIONS WITH MORE THAN 500 CONFIRMED MEMBERS WILL BE ENTITLED TO FOUR VOTING DELEGATES. EACH VOTING DELEGATE IS ENTITLED TO ONE VOTE AT ALL ANNUAL MEETINGS. FORM 990, PART VI, SECTION A, LINE 7A EACH DELEGATE IS ENTITLED TO ONE VOTE AT ALL ANNUAL MEETINGS ON THE ELECTION OF THE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF BETHESDA MUST BE APPROVED BY THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE CEO AND DIRECTOR OF ACCOUNTING HAVE REVIEWED THE FORM 990. THE FINAL FORM 990 WAS EMAILED TO THE BOARD MEMBERS PRIOR TO A BOARD MEETING WHERE AT THAT TIME THE BOARD GAVE THE FINAL APPROVAL OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS THE KEY EMPLOYEES AND BOARD OF DIRECTORS. THE CEO REVIEWS THE ANNUAL DISCLOSURES FOR CONFLICTS AND DETERMINES IF ONE EXISTS. IF A CONFLICT OF INTEREST EXISTS, THAT INDIVIDUAL MUST ABSTAIN FROM VOTING ON THE ITEM IN CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION OF THE CEO IS REVIEWED BY THE EXECUTIVE BOARD COMMITTEE. THEY USE AN INTERNAL SCALE WHICH IS BASED OFF OF COMPARABILITY DATA AND IS SUBSTANTIATED IN THEIR MEETING NOTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. BETHESDA TERRACE 901 SE WILLMAR AVE WILLMAR MN 56201 363355337 HOUSING FOR ELDERLY MN 501(C)(3) LINE 9 SEE PART VII 1 SUNRISE VILLAGE 901 SE WILLMAR AVE WILLMAR MN 56201 411670808 INDEPENDENT & ASSISTED LIVING MN 501(C)(3) LINE 9 SEE PART VII 1 CENTENNIAL SQUARE 1015 SE WILLMAR AVE WILLMAR MN 56201 411804213 LOW INCOME HOUSING MN 501(C)(3) LINE 9 SEE PART VII 1 BETHESDA FOUNDATION OF WILLMAR 901 SE WILLMAR AVE WILLMAR MN 56201 411457903 SUPPORT ORGANIZATION MN 501(C)(3) LINE 11B, II SEE PART VII 1 0 0 1 0 1 0 0 0 0 0 0 1 1 1 1 1 1 0 0 SUNRISE VILLAGE O 331460 COST OF SALARIES PAID SUNRISE VILLAGE E 554544 OUTSTANDING BALANCE SCHEDULE R PART II COLUMN F BETHESDA AND ITS RELATED ENTITIES LISTED IN SCHEDULE R, PART II ALL SHARE A COMMON BOARD OF DIRECTORS WHICH RELATES IN COMMON CONTROL OF EACH OF THE ENTITIES.