2023-11-06T11:04:05-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-01-01 411310487 LYNGBLOMSTEN CARE CENTER INC LYNG 6516462941 1415 ALMOND AVENUE ST PAUL MN 55108 TODD FLIFLET CFO 6516462941 2023-11-03 1 TODD FLIFLET 999009999 1 MACKENZIE MCNAUGHTON P02025805 6123764500 2023-11-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JEFF HEINECKE 1415 ALMOND AVENUE ST PAUL MN 55108 37169505 0 9386 X WWW.LYNGBLOMSTEN.ORG X 1976 MN INFLUENCED BY CHRIST, LYNGBLOMSTEN PROVIDES A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS IN ORDER TO PRESERVE AND ENHANCE THEIR QUALITY OF LIFE. 11 10 498 311 0 0 6128167 76409 27626153 32664693 303969 2883996 124862 187895 34183151 35812993 5046165 2993703 0 0 20287966 23596432 0 0 0 7419795 7848059 32753926 34438194 1429225 1374799 20607717 22707793 10581005 11495005 10026712 11212788 X INFLUENCED BY CHRIST, LYNGBLOMSTEN PROVIDES A MINISTRY OF COMPASSIONATE CARE AND INNOVATIVE SERVICES TO OLDER ADULTS IN ORDER TO PRESERVE AND ENHANCE THEIR QUALITY OF LIFE. 0 1 31263858 2993703 32664693 THE LYNGBLOMSTEN CARE CENTER, A 225-BED SKILLED NURSING FACILITY, PROVIDES BOTH SHORT-TERM REHABILITATION AND LONG-TERM HEALTHCARE, INCLUDING SPECIALIZED CARE FOR ALZHEIMER'S DISEASE AND OTHER DEMENTIAS, PARKINSON'S DISEASE, AND PALLIATIVE CARE. IN 2022, 664 PERSONS RECEIVED CARE. CHAPLAINS, VOLUNTEERS, AND PROFESSIONAL STAFF ENSURE RESIDENTS RECEIVE QUALITY HEALTHCARE IN A DIGNIFIED MANNER. ALTHOUGH HEALTH ISSUES PREVENT THESE OLDER ADULTS FROM LIVING IN THEIR OWN HOMES, LYNGBLOMSTEN PROMOTES PERSON-CENTERED CARE, GIVING OLDER ADULTS AS MANY CHOICES AND COMFORTS OF HOME AS POSSIBLE. RESIDENTS ARE ABLE TO PARTICIPATE IN A VARIETY OF ACTIVITIES (INCLUDING THE ARTS) AND SOCIAL EVENTS TO ENHANCE THEIR QUALITY OF LIFE, WHICH ARE COORDINATED BY CARE CENTER STAFF AND LYNGBLOMSTEN'S LIFELONG LEARNING AND THE ARTS DEPARTMENT. LYNGBLOMSTEN CARE CENTER, INC., IS AFFILIATED WITH LYNGBLOMSTEN AND THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. 31263858 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 27 0 1 498 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X TODD FLIFLET 6516325311 1415 ALMOND AVENUE ST PAUL MN 55108 JEFF HEINECKE PRESIDENT & CEO 32.50 7.50 X X 274983 0 48438 KIM DONAT CHAIR 1.00 4.00 X X 0 0 0 DEBRA GEORGE VICE CHAIR 1.00 4.00 X X 0 0 0 REV MARTIN ERICSON SECRETARY 1.00 4.00 X X 0 0 0 DR MARK KNUDSON TREASURER 1.00 4.00 X X 0 0 0 DAVID CHRISTIANSON MAY 22 TREASURER 1.00 4.00 X X 0 0 0 REV IVY HUSTON DIRECTOR 1.00 2.00 X 0 0 0 AMY KORZENOWSKI DIRECTOR 1.00 2.00 X 0 0 0 GRETCHEN LABELLE MAY 22 DIRECTOR 1.00 2.00 X 0 0 0 DR MICHAEL LOVETT DIRECTOR 1.00 2.00 X 0 0 0 PAULETTE OLSON DIRECTOR 1.00 2.00 X 0 0 0 JOHN PECK MAY 22 DIRECTOR 1.00 2.00 X 0 0 0 PETER POLGA DIRECTOR 1.00 2.00 X 0 0 0 ELAINE PRICKEL DECEMBER 22 DIRECTOR 1.00 2.00 X 0 0 0 DIANA ROCKSTAD DIRECTOR 1.00 2.00 X 0 0 0 MICHAEL SANTORO MAY 22 DIRECTOR 1.00 2.00 X 0 0 0 TRUPTI STORLIE MAY 22 DIRECTOR 1.00 2.00 X 0 0 0 BRADLEY J JACOBSON CFO 35.00 5.00 X 166739 0 50367 GEORGE MANINSA LPN 65.00 0.00 X 150984 0 19323 MICHAEL MARANGS LPN 77.00 0.00 X 150710 0 17898 EUNICE MURITHI RN 55.00 0.00 X 170908 0 19170 TRISHA GERLEMAN ADMINISTRATOR 40.00 0.00 X 155202 0 44312 NEWTON MOMANYI RN 52.00 0.00 X 147502 0 40634 1217028 0 240142 37 0 1 0 PRO REHAB 200 LEWIS AVENUE SOUTH SUITE 210 WATERTOWN MN 55388 PHYSICAL THERAPY SERVICES 940748 MERWIN LTC PHARMACY PO BOX 856706 MINNEAPOLIS MN 554856706 PHARMACY 546684 CLIFTONLARSONALLEN 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 FINANCIAL/CONSULTING 146443 3 76409 76409 RESIDENT SERVICES 623312 32664693 32664693 32664693 138363 138363 1346510 2755635 1356512 0 -10002 2755635 2745633 2745633 BEAUTY SHOP REVENUE 900099 46510 46510 SATELLITE TV REVENUE 900099 44455 44455 TELEPHONE REVENUE 900099 19494 19494 77436 77436 187895 35812993 32664693 0 3071891 2396745 2396745 596958 596958 540528 540528 18044526 16880026 1164500 471687 434742 36945 3127611 2845679 281932 1412080 1252593 159487 56134 56134 83209 83209 1285868 1188907 96961 29744 29744 740020 497058 242962 176002 176002 1012098 908014 104084 26687 12036 14651 1746 1566 180 1498186 1344112 154074 55970 50214 5756 MEDICAL SUPPLIES 1231792 1231792 FOOD 931028 931028 LICENSE SURCHARGE 633375 633375 DUES & SUBSCRIPTIONS 41506 9038 32468 44694 49975 -5281 34438194 31263858 3174336 0 2399677 4343349 559355 549106 3528576 3403512 61945 95693 34821917 23177538 12597153 11644379 270409 0 399180 1642153 791422 1029601 20607717 22707793 2104899 2867373 361106 8267331 8027398 86876 94101 121899 145027 10581005 11495005 X 9968845 11170583 57867 42205 10026712 11212788 20607717 22707793 X 1374799 -163724 -25000 X 0 1 X 1 0 X 40255 246379 1668011 6070143 76409 8101197 25045501 25696959 25098789 27425571 32664693 135931513 25085756 25943338 26766800 33495714 32741102 144032710 0 0 0 144032710 148039 82809 50804 191760 138363 611775 148039 82809 50804 191760 138363 611775 146164 370116 516280 126325 120577 156107 124862 187895 715766 25506284 26516840 26973711 33812336 33067360 145876531 0.98740 0.98570 0.00420 0.00440 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY SHOP REVENUE SATELLITE TV REVENUE TELEPHONE REVENUE GUEST MEAL REVENUE MISCELLANEOUS REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 94767 94767 30107576 19803106 10304470 4487539 3328342 1159197 132035 46090 85945 11644379 INVESTMENT IN INSURANCE RECIPROCAL 472153 C INVESTMENT IN UNRELATED PARTY 1170000 C 1642153 ASSET RETIREMENT OBLIGATION 132212 CAPITAL LEASE OBLIGATION 12815 145027 X PART IV, LINE 2B: THE CORPORATION IS THE TRUSTEE OF VARIOUS RESIDENT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. THESE FUNDS ARE ON DEPOSIT IN SEPARATE BANK ACCOUNTS. PART X, LINE 2: THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. 1 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVENUE ST PAUL MN 55108 363371887 501(C)(3) 0 2396745 N/A N/A TO SUPPORT GENERAL OPERATIONS. 2 0 SCHOLARSHIPS 62 596958 N/A N/A PART I, LINE 2: LYNGBLOMSTEN CARE CENTER MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. ALL RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITORS THE USE OF THESE FUNDS THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS. LYNGBLOMSTEN SCHOLARSHIPS WILL BE AWARDED TO EMPLOYEES ENTERING AND/OR FURTHERING THEIR EDUCATION IN LONG TERM HEALTH CARE. THE FOLLOWING PROCEDURES MUST BE FOLLOWED IN ORDER TO RECEIVE SUCH A SCHOLARSHIP. 1. A FULLY COMPLETED APPLICATION PACKET MUST BE SUBMITTED TO HUMAN RESOURCES ON OR BEFORE PAYMENT OR THIRD PARTY BILLING FORMS WILL BE COMPLETED. 2. ALL EMPLOYEES EXCEPT THE ADMINISTRATOR ARE ELIGIBLE. 3. APPLICANT MUST BE CURRENTLY EMPLOYED BY LYNGBLOMSTEN AND HAVE COMPLETED 1040 HOURS OF SERVICE PRIOR TO APPLYING. IF EMPLOYMENT IS TERMINATED WITHIN 90 DAYS OF RECEIVING SCHOLARSHIP FUNDS, THEY MUST BE RETURNED TO LYNGBLOMSTEN. ALL FUNDS GRANTED MUST BE USED FOR STATED PURPOSE OF APPLICATION, OTHERWISE THEY MUST BE RETURNED TO LYNGBLOMSTEN. 4. APPLICANT MUST BE WORKING AN AVERAGE OF 10 HOURS PER WEEK THE 6 MONTH PERIOD PRIOR TO THE SEMESTER OR QUARTER FUNDS ARE APPLIED FOR. 5. APPLICANT MAY BE FROM ANY DEPARTMENT/PROGRAM WITHIN LYNGBLOMSTEN. 6. APPLICANT MUST BE ENROLLED IN AND/OR ACCEPTED IN AN EDUCATIONAL PROGRAM THAT WILL PREPARE THEM FOR POSITIONS COMMON TO LONG TERM CARE. 7. SCHOLARSHIPS MAY BE AWARDED FOR AMOUNTS COVERING FULL TUITION AND BOOK FEES FOR ALL APPLICANTS. 8. SCHOLARSHIPS MAY BE AWARDED MORE THAN ONCE PER YEAR, BUT A NEW APPLICATION PACKET MUST BE COMPLETED WITH EACH REQUEST FOR FUNDS. 9. AWARDED SCHOLARSHIP MONEY WILL BE SENT DIRECTLY TO THE INSTITUTION, WHEN POSSIBLE. 10. ALL SCHOLARSHIPS AWARDED BY LYNGBLOMSTEN ARE INTENDED FOR SCHOOL TUITION AND BOOKS ONLY. OTHER GRANTS AND SCHOLARSHIPS MUST BE AWARDED, PRIOR TO THE LYNGBLOMSTEN SCHOLARSHIP. IF LYNGBLOMSTEN SCHOLARSHIP DOLLARS ARE IN EXCESS, THEY MUST BE RETURNED TO LYNGBLOMSTEN IMMEDIATELY. FAILURE TO DO SO WILL RESULT IN REPAYMENT AND/OR DISCIPLINE UP TO AND INCLUDING TERMINATION. X X X X 0 0 0 0 0 0 0 0 0 JEFF HEINECKE PRESIDENT & CEO 261805 0 5116 0 8062 0 11297 0 37141 0 323421 0 0 0 BRADLEY J JACOBSON CFO 161519 0 5220 0 0 0 7112 0 43255 0 217106 0 0 0 TRISHA GERLEMAN ADMINISTRATOR 144398 0 3760 0 7044 0 6545 0 37767 0 199514 0 0 0 EUNICE MURITHI RN 147578 0 18144 0 5186 0 6864 0 12306 0 190078 0 0 0 NEWTON MOMANYI RN 126067 0 13806 0 7629 0 6110 0 34524 0 188136 0 0 0 GEORGE MANINSA LPN 130146 0 17621 0 3217 0 6107 0 13216 0 170307 0 0 0 MICHAEL MARANGS LPN 114133 0 36577 0 0 0 6061 0 11837 0 168608 0 0 0 A PORT AUTHORITY OF THE CITY OF SAINT PAUL 416005524 79307PBE7 2018-06-21 9200000 TO FUND A RENOVATION PROJECT 0 0 0 A 9381816 461590 184000 9349821 2020 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 3- TOTAL PROCEEDS OF ISSUE THE TOTAL PROCEEDS OF ISSUE REPORTED ON LINE 3 FOR THE PORT AUTORITY OF THE CITY OF SAINT PAUL BONDS INCLUDES $181,816 OF INVESTMENT EARNINGS. DAN SHAUGHNESSY BROTHER IN-LAW TO PRESIDENT/CEO 26735 COMPENSATION & BENEFITS 0 FORM 990, PART III, LINE 3 THE LYNGBLOMSTEN CARE CENTER CONTINUED TO RESPOND TO THE COVID-19 PANDEMIC, ADJUSTING ITS POLICIES RELATED TO VISITATION, TESTING, STAFFING, AND MORE AS UPDATED GUIDANCE WAS RELEASED BY FEDERAL AND STATE HEALTH AGENCIES. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS MADE UP THE CHAIR, VICE CHAIR, TREASURER, AND SECRETARY OF THE BOARD ALONG WITH PRESIDENT/CEO OF THE CORPORATION. ALL ITEMS APPROVED BY THE EXECUTIVE COMMITTEE ARE REAFFIRMED BY THE FULL BOARD AT THEIR NEXT MEETING. FORM 990, PART VI, SECTION A, LINE 6 THE BOARD OF DIRECTORS OF LYNGBLOMSTEN ARE THE MEMBERS OF LYNGBLOMSTEN CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE CONGREGATIONS SEND DELEGATES TO THE LYNGBLOMSTEN ANNUAL MEETING, WHO, AS MEMBERS OF LYNGBLOMSTEN, ELECT THE LYNGBLOMSTEN BOARD. THE BOARD OF DIRECTORS OF LYNGBLOMSTEN CARE CENTER CONSISTS SOLELY OF DULY ELECTED AND QUALIFIED MEMBERS OF THE BOARD OF DIRECTORS OF LYNGBLOMSTEN. ELECTION AS A DIRECTOR OF LYNGBLOMSTEN CONSTITUTES ELECTION AS A DIRECTOR OF LYNGBLOMSTEN CARE CENTER FOR THE SAME TERM. FORM 990, PART VI, SECTION A, LINE 7B CHANGES IN THE BYLAWS AND ARTICLES OF INCORPORATION REQUIRE MEMBERSHIP APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B THE CEO, CFO, AND CONTROLLER REVIEW THE DOCUMENT, WHICH IS EMAILED TO THE FINANCE COMMITTEE OF THE BOARD PRIOR TO THEIR MEETING FOR REVIEW AND COMMENT. THE BOARD RECEIVES THE DOCUMENT PRIOR TO THEIR BOARD MEETING BY EMAIL. PAPER COPIES ARE AVAILABLE AT THE BOARD MEETING FOR FURTHER DISCUSSION AND BOARD APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C AN UPDATED CONFLICT OF INTEREST POLICY IS SIGNED BY ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. THIS POLICY IS MONITORED BY THE CORPORATE COMPLIANCE OFFICER AND IF ANY CONFLICTS OF INTERESTS EXIST THAT INDIVIDUAL IS EXCLUDED FROM PARTICIPATION AND VOTING ON RELATED TRANSACTIONS. UPON COMPLETION OF THE CONFLICT OF INTEREST STATEMENTS, THE RESULTS/CONFLICTS ARE REPORTED TO THE EXECUTIVE COMMITTEE OF THE BOARD AND RECORDED IN THEIR MINUTES. FORM 990, PART VI, SECTION B, LINE 15A THE LYNGBLOMSTEN BOARD'S EXECUTIVE COMMITTEE REVIEWS AND SETS THE CEO'S COMPENSATION ANNUALLY AND PERFORMS A COMPENSATION STUDY PERIODICALLY, LAST COMPLETED FALL 2022. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE -25,000. LYNGBLOMSTEN APARTMENTS INC 1455 ALMOND AVE ST PAUL MN 55108 411327121 LOW INCOME SENIOR HOUSING MN 501(C)3 LINE 10 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 HERITAGE APARTMENTS INC 1440 MIDWAY PARKWAY ST PAUL MN 55108 411913420 MARKET RATE SENIOR HOUSING, ASSISTED LIVING SERVIES MN 501(C)3 LINE 10 LYNGBLOMSTEN LYNGBLOMSTEN SENIOR HOUSING INC 0 LYNGBLOMSTEN FOUNDATION 1415 ALMOND AVE ST PAUL MN 55108 363371887 FUNDRAISING FOR LYNGBLOMSTEN MN 501(C)3 LINE 7 LYNGBLOMSTEN 0 LYNGBLOMSTEN SERVICES INC 1415 ALMOND AVE ST PAUL MN 55108 411760448 SENIOR CENTER, COMMUNITY SERVICES, HOME HEALTH MN 501(C)3 LINE 10 LYNGBLOMSTEN 0 LYNGBLOMSTEN 1415 ALMOND AVE ST PAUL MN 55108 410693865 MANAGEMENT OVERSIGHT SERVICES TO ALL LYNGBLOMSTEN ORGANIZATIONS MN 501(C)3 LINE 10 N/A 0 LYNGBLOMSTEN SENIOR HOUSING INC 1415 ALMOND AVE ST PAUL MN 55108 411913422 MANAGEMENT OVERSIGHT SERVICES TO LYNGBLOMSTEN APTS & HERITAGE APTS MN 501(C)3 LINE 10 LYNGBLOMSTEN 0 EMENUCHOICE INC 1415 ALMOND AVENUE ST PAUL MN 55108 863278441 MAINTAINS, DEVELOPS, AND OFFERS WEB-BASED MEAL AND DIETARY SOFTWARE PROGRAM MN LYNGBLOMSTEN CARE CENTER INC C 0.90000 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 LYNGBLOMSTEN FOUNDATION C 76409 CASH LYNGBLOMSTEN FOUNDATION B 2396745 CASH