2024-08-12T09:46:52-05:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2022-10-01 260615372 WAYZATA BAY SENIOR HOUSING INC WAYZ 6516316120 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 MARK MEYER CFO 6516316120 2024-08-07 1 0 JUSTIN HARTERT P02236744 5074467100 2024-08-06 2022 2024-08-08 14:25:15Z DANIEL LINDH 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 23734790 0 X WWW.PRESHOMES.ORG X 2007 MN TO HONOR GOD BY ENRICHING THE LIVES AND TOUCHING THE HEARTS OF OLDER ADULTS. 3 0 0 253 -86113 0 541874 75794 20299448 21680343 0 322656 36440 -106243 20877762 21972550 18088 9597 0 0 7545671 8351782 0 0 0 13873901 14477017 21437660 22838396 -559898 -865846 157420069 155220264 139856099 138522140 17563970 16698124 THE MISSION OF WAYZATA BAY SENIOR HOUSING, INC., IS TO HONOR GOD BY ENRICHING THE LIVES AND TOUCHING THE HEARTS OF OLDER ADULTS. 0 0 19795754 9597 21680343 WAYZATA BAY SENIOR HOUSING, INC.IS LOCATED IN WAYZATA, MN AND CONSISTS OF 30 SKILLED NURSING BEDS, 17 APARTMENT MEMORY CARE SPECIFIC ASSISTED LIVING, 48 TRADITIONAL ASSISTED LIVING APARTMENTS, AND 221 INDEPENDENT SENIOR APARTMENTS AND 26 ALL AGE APARTMENTS. 19795754 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 0 0 0 MN X HEIDI PETERSON 6516316162 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 DANIEL LINDH CEO 1.00 39.00 X X 0 836839 25618 MARK MEYER CFO 1.00 39.00 X X 0 449215 29663 DUANE LARSON SVP OPERATIONS (THRU 12.31.22) 1.00 39.00 X X 0 329917 21874 MARK PEDERSON SVP OPERATIONS (AS OF 1.1.23) 1.00 39.00 X X 0 189597 22932 JONATHAN FLETCHER VP DEVELOPMENT 1.00 39.00 X 0 358151 25188 TERESA LARSON SVP HUMAN RESOURCES 1.00 39.00 X 0 153546 10011 JODI DEVICK NEAL CAMPUS ADMINISTRATOR 40.00 0.00 X 158509 0 13533 158509 2317265 148819 1 0 1 0 PHS MANAGEMENT LLC 2845 HAMLINE AVENUE NORTH ROSEVILLE MN 55113 MANAGEMENT SERVICES 1047414 PROMENADE OF WAYZATA 5353 WAYZATA BOULEVARD SUITE 650 MINNEAPOLIS MN 55416 MASTER ASSOCIATION 480493 ASSOCIATED MECHANICAL PO BOX 237 SHAKOPEE MN 55379 MAINTENANCE/REPAIR SERVICES 151037 MEDIACOM PO BOX 5744 CAROL STREAM IL 60197 CABLE/INTERNET SERVICES 148739 HAMERNICK DECORATING CENTER 1381 NORTH RICE ST ST PAUL MN 55117 CONTRACTED SERVICES 139754 6 74994 800 75794 RESIDENT SERVICES 623990 21562768 21562768 OTHER RESIDENT SERVICES 900099 117575 117575 21680343 321656 321656 1304044 1656361 -352317 -352317 -86113 -266204 92108 91108 1000 1000 1000 18912 14771 4141 4141 CULINARY REVENUE 900099 152007 152007 MISCELLANEOUS INCOME 900099 89926 89926 241933 21972550 21680343 -86113 302526 9597 9597 6852050 6063518 788532 141893 126623 15270 854480 750305 104175 503359 449188 54171 1047414 1047414 25038 25038 15384 15384 704717 695569 9148 36755 8327 28428 411981 263304 148677 196528 196528 1155189 994907 160282 18325 18325 3818 3818 3959183 3959183 4597122 4597122 315461 315461 BUILDING CONTRACTS/MAIN 827344 827344 FOOD 724766 724766 MISCELLANEOUS EXPENSES 221292 87158 134134 NURSING 132250 132250 84450 84450 22838396 19795754 3042642 0 11986482 14307457 269680 292317 34542 36280 178621706 48214340 135491807 130407366 1026198 987354 8611360 9189490 157420069 155220264 1696929 2968932 77019194 73567099 40055200 41645950 15246939 13850271 5837837 6489888 139856099 138522140 X 17563970 16698124 17563970 16698124 157420069 155220264 -865846 0 X X 0 1 X 1 0 X 2101050 177389 1661856 541874 75794 4557963 19442980 19711251 18942838 20299448 21680343 100076860 318155 144784 149663 176249 170919 959770 21862185 20033424 20754357 21017571 21927056 105594593 0 0 0 105594593 1829101 638661 755832 623560 1001175 4848329 -166434 36796 55483 0 -74155 1662667 638661 792628 679043 1001175 4774174 -3171078 137356 163959 156707 89926 -2623130 20353774 20809441 21710944 21853321 23018157 107745637 0.98000 0.97620 0.04430 0.04790 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME LOSS ON REFINANCING RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 26942717 26942717 131407405 35340754 96066651 10178758 4022900 6155858 10070950 8850686 1220264 21876 21876 130407366 BOND FUNDS 7664686 REPLACEMENT RESERVE 1357302 INTERCOMPANY RECEIVABLES 167502 9189490 DUE TO AFFILIATES 6489888 6489888 X PART IV, LINE 2B: ENTRANCE DEPOSITS WERE USED TO FINANCE THE CONSTRUCTION COSTS OF THE FACILITY. REFUNDABLE DEPOSITS WILL BE RETURNED TO A TENANT WITHIN 120 DAYS AFTER THEY VACATE THE UNIT. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE SECTIONS OF THE STATE STATUTES; CONSEQUENTLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. HOWEVER, THERE ARE IMMATERIAL AMOUNTS OF UNRELATED BUSINESS INCOME IN CERTAIN AFFILIATES THAT ARE TAXABLE. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INFORMATION RETURNS AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. 1 SCHOLARSHIPS 3 9597 N/A N/A PART I, LINE 2: INDIVIDUAL SCHOLARSHIP RECIPIENTS MUST BE EMPLOYED BY PHS FOR AT LEAST SIX MONTHS, WORK AN AVERAGE OF 10 HOURS A WEEK, MAINTAIN AN EXCELLENT WORK RECORD, PROVIDE PROOF OF ACCEPTANCE OR ENROLLMENT IN A DEGREED PROGRAM, RECEIVE THE ENDORSEMENT OF THEIR MANAGER, CAMPUS ADMINISTRATOR, AND BE SELECTED BY HUMAN RESOURCES. 0 0 0 0 0 0 0 0 0 DANIEL LINDH CEO 0 813148 0 0 0 23691 0 14750 0 10868 0 862457 0 0 MARK MEYER CFO 0 425562 0 0 0 23653 0 14750 0 14913 0 478878 0 0 JONATHAN FLETCHER VP DEVELOPMENT 0 351146 0 0 0 7005 0 12702 0 12486 0 383339 0 0 DUANE LARSON SVP OPERATIONS (THRU 12.31.22) 0 308632 0 0 0 21285 0 14750 0 7124 0 351791 0 0 MARK PEDERSON SVP OPERATIONS (AS OF 1.1.23) 0 188833 0 0 0 764 0 8019 0 14913 0 212529 0 0 JODI DEVICK NEAL CAMPUS ADMINISTRATOR 158229 0 0 0 280 0 7708 0 5825 0 172042 0 0 0 TERESA LARSON SVP HUMAN RESOURCES 0 145510 0 0 0 8036 0 7695 0 2316 0 163557 0 0 PART I, LINE 1B THE CEO'S COMPENSATION IS DETERMINED BY PRESBYTERIAN HOMES AND SERVICES, A RELATED ORGANIZATION. PRESBYTERIAN HOMES AND SERVICES USES THE FOLLOWING TO DETERMINE THE CEO'S COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE 4. COMPENSATION SURVEY OR STUDY A CITY OF WAYZATA MN 416005630 946829AT5 2019-08-01 76273811 CONSTRUCTION - REFINANCE OF PREVIOUS 1 0 0 A 2145000 76273811 4338100 1009199 70957812 2019 1 0 1 1 A 1 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 3 PHS MANAGEMENT, LLC PROVIDES MANAGEMENT SERVICES FOR WAYZATA BAY SENIOR HOUSING, INC. PHS MANAGEMENT, LLC PROVIDES FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, STAFFING FOR FUND DEVELOPMENT, AND NEW BUSINESS DEVELOPMENT. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF WAYZATA BAY SENIOR HOUSING, INC. IS PRESBYTERIAN HOMES AND SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION ELECT THE MEMBERS OF THE GOVERNING BODY, BUT NOT IF THE PERSONS ON THE GOVERNING BODY ARE THE ORGANIZATION'S ONLY MEMBER OR THEIR DELEGATES. FORM 990, PART VI, SECTION A, LINE 8B THE BOARD OF DIRECTORS MAY BY RESOLUTION ORGANIZE ITSELF INTO COMMITTEES. THE BOARD OF DIRECTORS MAY BY RESOLUTION APPOINT COMMITTEES, OF DEFINITE OR INDEFINITE DURATION, FOR SPECIFIC TASKS OR OTHERWISE. THERE WERE NO COMMITTEES CREATED WITH THIS AUTHORITY DURING THE YEAR ENDED SEPTEMBER 30, 2023. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PROVIDED TO VOTING MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE IRS. OFFICERS AND MANAGEMENT OF THE ORGANIZATION HAVE BEEN INVOLVED IN THE PREPARATION OF THE FORM 990 AND HAVE REVIEWED IT THROUGHOUT THE PROCESS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION OBTAINS ANNUALLY WRITTEN DISCLOSURES FROM GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. MANAGEMENT AND OFFICERS REVIEW THESE DISCLOSURES AND EVALUATE WHETHER THE INTEREST COULD RESULT IN A CONFLICT AND THEN TAKE THE NECESSARY STEPS TO REMEDIATE ANY SUCH CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS FOR SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. 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