2014-05-14T09:53:44-05:00 2013-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2012-10-01 410693843 BETHESDA BETH 3202359532 901 SE WILLMAR AVENUE WILLMAR MN 56201 MICHELLE HAEFNER 3202359532 2014-05-08 1 CORY RUTLEDGE P01329381 6123764500 2012 2015-11-30 17:44:51Z MICHELLE HAEFNER 901 SE WILLMAR AVENUE WILLMAR MN 56201 17144716 0 X WWW.BETHESDAWILLMAR.COM X 1897 MN TO PROVIDE HOUSING AND NURSING SERVICES TO THE ELDERLY AND DISABLED. 12 12 630 70 0 0 371081 64813 15921642 16675490 70913 93008 -129966 311405 16233670 17144716 0 0 0 0 10092764 10048813 0 0 0 6308197 6725827 16400961 16774640 -167291 370076 19382796 19106806 13820125 13154191 5562671 5952615 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 13836335 0 14939343 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, 2013, BETHESDA HAD 84,369 RESIDENT DAYS AND 92% OCCUPANCY. 778181 0 1065710 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 83 PATIENTS EACH MONTH AND ADULT DAY SERVICES SERVED 31 CLIENTS A MONTH FOR THE YEAR ENDED SEPTEMBER 30, 2013. 494339 0 521946 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, 2013, PARK VIEW VILLAGE HAD 5,750 RESIDENT DAYS AND 85% OCCUPANCY. 215862 0 148491 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. 215862 148491 15324717 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 24 0 630 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 ALANA ZIEHL 3202145603 901 SE WILLMAR AVENUE WILLMAR MN 56201 LARRY KNUTSON 0.10 0.40 X X 0 0 0 CAROLE VENNERSTROM 0.10 0.40 X X 0 0 0 KAREN SCHUELER 0.10 0.40 X X 0 0 0 MONA DOERING 0.10 0.40 X X 0 0 0 RICHARD FALK 0.10 0.40 X 0 0 0 MARLIN HENJUM 0.10 0.40 X 0 0 0 CARLA LAGERSTEDT 0.10 0.40 X 0 0 0 RICHARD LARSON 0.10 0.40 X 0 0 0 KAROL MARKFELDER 0.10 0.40 X 0 0 0 TED OLSON 0.10 0.40 X 0 0 0 VIVIAN OLSEN 0.10 0.40 X 0 0 0 RAY POAGE 0.10 0.40 X 0 0 0 ANN AMUNDSON 0.10 0.40 X 0 0 0 JODI FONKERT 0.10 0.40 X 0 0 0 DEAN JOHNSON 0.10 0.40 X X 0 0 0 DIANE RASMUSSEN 0.10 0.40 X 0 0 0 DOUG DEWANE 8.00 32.00 X 181352 0 13387 ALANA ZIEHL 8.00 32.00 X 70048 0 6990 MICHELLE HAEFNER 8.00 32.00 X 139101 0 13044 390501 0 33421 2 0 1 0 A'VIANDS 1751 W COUNTY ROAD B ROSEVILLE MN 55113 NUTRITION SERVICES 1150100 PRO REHAB 200 LEWIS AVE S STE 210 WATERTOWN MN 55388 THERAPY 771141 2 13444 51369 64813 RESIDENT SERVICES 623000 16675490 16675490 16675490 36435 36435 75315 0 75315 75315 75315 47123 9450 0 0 47123 9450 56573 56573 OTHER INCOME 900099 118928 118928 MEALS 623000 117162 117162 236090 17144716 16675490 0 404413 385905 22994 362911 8128929 7803176 325753 134938 124387 10551 806204 766069 40135 592837 546484 46353 30617 30617 301118 301118 7016 7016 1079398 1076695 2703 54111 51916 2195 378159 258085 120074 562375 507769 54606 18060 18060 70038 70038 326450 313208 13242 1090049 1045831 44218 125567 120473 5094 LICENSES & SURCHARGES 754162 751889 2273 FOOD 737626 737626 MEDICAL SUPPLIES 696361 696361 REPAIRS & MAINTENANCE 198088 190053 8035 296632 293641 2991 16774640 15324717 1449923 0 1494921 1589571 10000 1407470 1585551 144077 166936 26394206 12919173 14211729 13475033 1393431 1484770 342800 342800 388368 452145 19382796 19106806 1287178 1261767 11851138 11249148 20143 19451 661666 623825 13820125 13154191 X 5562671 5952615 5562671 5952615 19382796 19106806 370076 19868 0 X 0 1 X 1 0 X 173627 196535 184480 371081 64813 990536 16761291 16109933 16158660 15921642 16675490 81627016 16934918 16306468 16343140 16292723 16740303 82617552 0 0 0 82617552 84116 47902 89046 145168 111750 477982 84116 47902 89046 145168 111750 477982 -203589 236090 32501 17019034 16354370 16432186 16234302 17088143 83128035 0.99390 0.99700 0.00570 0.00540 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 900555 900555 21136876 9881580 11255296 4356775 3037593 1319182 13475033 NOTE PAYABLE - RELATED PARTY 623825 623825 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 ON UNRELATED BUSINESS INCOME OR EXCISE TAXES. THE TAX FILINGS FOR THE YEARS 2010 - 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL OR STATE AUTHORITIES. X X X 0 0 0 0 0 0 0 0 0 DOUG DEWANE 181352 0 0 0 0 0 5441 0 7946 0 194739 0 0 0 MICHELLE HAEFNER 139101 0 0 0 0 0 4173 0 8871 0 152145 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 399004 2008000 1967989 40011 2008 1 0 0 1 B 359848 10000000 9947500 52500 2012 1 0 0 0 A 0 0 0 0 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 0 B 0 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 DELEGTE 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 INTERIM CEO AND DIRECTOR OF ACCOUNTING WILL REVIEW THE FORM 990. THE FINAL FORM 990 WILL BE EMAILED TO THE BOARD MEMBERS PRIOR TO A BOARD MEETING WHERE AT THIS TIME THE BOARD WILL HAVE 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 INTERIM 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 INTERIM 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 BETHESDA FOUNDATION OF WILLMAR C 13444 CASH SUNRISE VILLAGE O 312383 COST OF SALARIES PAID SUNRISE VILLAGE E 623825 OUTSTANDING BALANCE 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.