2024-11-14T12:45:37-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2023-12-05 932878522 ECUMEN SBC INC ECUM 6517664300 3520 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 SCOTT BJERKETVEDT PRESIDENT & CEO 6517664300 2024-11-13 1 0 JUSTIN HARTERT P02236744 5074467100 2024-11-12 2023 2024-10-15 13:58:12Z X SHELLEY KENDRICK 3520 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 51177677 0 X WWW.ECUMEN.ORG X 2023 MN WE EMPOWER INDIVIDUALS AND FAMILIES TO CONFIDENTLY NAVIGATE AGING SO THAT IT IS A PURPOSEFUL JOUNEY FILLED WITH DIGNITY AND SUPPORT. 11 11 0 12 0 0 0 1350644 43914559 62474 45327677 0 0 686231 0 0 233726 919957 44407720 52848386 8440666 44407720 WE EMPOWER INDIVIDUALS AND FAMILIES TO CONFIDENTLY NAVIGATE AGING SO THAT IT IS A PURPOSEFUL JOUNEY FILLED WITH DIGNITY AND SUPPORT. 0 0 827960 0 1350644 ECUMEN SBC IS A NEW ACQUISITION IN ECUMEN, A MINNESOTA NONPROFIT CORPORATION ORGANIZED PRIMARILY TO OWN, OPERATE, MANAGE AND SUPPORT SENIOR LIVING AND HEALTH CARE COMMUNITIES. HOUSING AND SERVICES FOR SENIORS ARE PROVIDED AT ECUMEN COMMUNITIES THROUGH A CONTINUUM OF CARE, INCLUDING VARIOUS LEVELS OF RESIDENTIAL LIVING AND SKILLED NURSING AS WELL AS OTHER COMMUNITY BASED PROGRAMS AND SERVICES, INCLUDING HOME HEALTH CARE AND OUTPATIENT THERAPIES. AS OF DECEMBER 31, 2023, ECUMEN SBC SENIOR COMMUNITY INCLUDED 2 INDEPENDENT LIVING, 5 ASSISTED LIVING AND/OR MEMORY CARE, AND 2 SKILLED NURSING FACILITIES. IN 2023, ECUMEN SBC HAD AN OCCUPANCY OF 80.20%. 827960 1 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X SHELLEY KENDRICK 6517664300 3530 LEXINGTON AVE NORTH SHOREVIEW MN 55126 JOHN PETRABORG CHAIR 0.10 0.90 X X 0 0 0 PETER JACOBSON VICE CHAIR 0.10 0.90 X X 0 0 0 J MICHAEL DADY IMMEDIATE PAST CHAIR 0.10 0.90 X X 0 0 0 MARCIA KULL SECRETARY 0.10 0.90 X X 0 0 0 SUZIE CROCKETT TREASURER 0.10 0.90 X X 0 0 0 ANN BARKELEW TRUSTEE 0.10 0.90 X 0 0 0 DAN ABDUL TRUSTEE (THRU 12/7) 0.10 0.90 X 0 0 0 JAN CONLIN TRUSTEE 0.10 0.90 X 0 0 0 JAMES KNAPP TRUSTEE (THRU 12/29) 0.10 0.90 X 0 0 0 JEN AUGUSTON TRUSTEE 0.10 0.90 X 0 0 0 JOHN TRUCKENBROD TRUSTEE 0.10 0.90 X 0 0 0 INGRID RASMUSSEN TRUSTEE 0.10 0.90 X 0 0 0 NANCY THOMPSON ULVESTAD TRUSTEE 0.10 0.90 X 0 0 0 SUE MOORES TRUSTEE (THRU 12/8) 0.10 0.90 X 0 0 0 SHELLEY KENDRICK PRESIDENT/CEO 0.10 39.90 X 0 490367 49805 MELANIE SULLIVAN SR VP/CHIEF PEOPLE OFFICER 0.10 39.90 X 0 323390 16321 BRETT ANDERSON SR VP/CHIEF OPERATIONS & STRATEGY 0.10 39.90 X 0 293045 26862 SCOTT BJERKETVEDT SR VP/CFO 0.10 39.90 X 0 293673 48936 JAMES MCALPINE SR VP LEGAL AFFAIRS & CORP 0.10 39.90 X 0 241939 7653 0 1642414 149577 0 0 1 0 0 RENT REVENUE 623311 994501 994501 TENANT CHARGES 623311 200045 200045 ANCILLARY REVENUE 623311 156098 156098 1350644 394 394 49764165 5850000 43914165 43914165 43914165 MANAGEMENT AND CONSULTING FEES 900099 56589 56589 MISCELLANEOUS REVENUE 900099 5809 5809 BEAUTY SHOP 900099 76 76 62474 45327677 1350644 0 43977033 581677 523509 58168 63073 56766 6307 41481 37333 4148 113176 101858 11318 19596 17636 1960 849 764 85 48201 43381 4820 4500 4050 450 976 878 98 232 209 23 10000 9000 1000 LICENSES AND PERMITS 28560 25704 2856 RESIDENT CARE SUPPLIES 6497 5847 650 DUES & SUBSCRIPTIONS 1098 988 110 MINOR EQUIPMENT 37 33 4 4 4 919957 827960 91997 0 0 1514304 0 792082 50542000 0 0 50542000 0 52848386 0 418196 0 963435 0 4482905 0 2576130 0 8440666 X 0 44407720 0 44407720 0 52848386 44407720 0 X 0 1 X 1 0 X 0 1350644 1350644 1350644 1350644 0 0 0 1350644 394 394 394 394 62474 62474 1413512 1413512 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MANAGEMENT AND CONSULTING - 2023 AMOUNT: $ 56,589. BEAUTY SHOP - 2023 AMOUNT: $ 76. MISCELLANEOUS INCOME - 2023 AMOUNT: $ 5,809. PART III, SHORT YEAR EXPLANATION: COLUMN E REPRESENTS A SHORT YEAR COVERING PERIOD 12/05/2023 - 12/31/2023. 0 0 5210600 5210600 44409200 44409200 768000 768000 154200 154200 50542000 DUE TO RELATED PARTY 1476130 CAPITAL LEASES 1100000 2576130 X PART X, LINE 2: WITH THE EXCEPTION OF ECUMEN SERVICES, INC., A WHOLLY-OWNED SUBSIDIARY OF ECUMEN, THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE FEDERAL INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. INCOME OR LOSS FROM ACTIVITIES CONSIDERED UNRELATED TO ECUMEN'S TAX EXEMPT PURPOSE IS RECORDED IN THE ACCOUNTS OF ECUMEN SERVICES, INC. INCOME TAXES FOR ECUMEN SERVICES, INC. ARE RECORDED AT THE PREVAILING STATUTORY RATES AND ARE INCLUDED IN OPERATING EXPENSE. THERE WERE NO INCOME TAXES PAYABLE AT DECEMBER 31, 2023 OR DECEMBER 31, 2022. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. 0 0 0 0 0 0 0 0 0 SHELLEY KENDRICK PRESIDENT/CEO 0 487965 0 0 0 2402 0 15000 0 34805 0 540172 0 0 SCOTT BJERKETVEDT SR VP/CFO 0 293071 0 0 0 602 0 15077 0 33859 0 342609 0 0 MELANIE SULLIVAN SR VP/CHIEF PEOPLE OFFICER 0 321133 0 0 0 2257 0 15351 0 970 0 339711 0 0 BRETT ANDERSON SR VP/CHIEF OPERATIONS & STRATEGY 0 292725 0 0 0 320 0 13621 0 13241 0 319907 0 0 JAMES MCALPINE SR VP LEGAL AFFAIRS & CORP 0 241414 0 0 0 525 0 6750 0 903 0 249592 0 0 PART I, LINE 3 THE COMPENSATION OF THE PRESIDENT & CEO IS DETERMINED BY ECUMEN, THE SOLE MEMBER. THE FOLLOWING WERE USED BY ECUMEN TO DETERMINE THE PRESIDENT & CEO'S COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEY OR STUDY 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 3 ECUMEN SBC, INC.'S PARENT ORGANIZATION, ECUMEN, MANAGES THE RENTAL PROPERTY OF ECUMEN SBC INC. AND PERFORMS VARIOUS OTHER FUNCTIONS ON ECUMEN SBC, INC.'S BEHALF. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS ECUMEN (EIN: 41-0711588), A MINNESOTA 501(C)(3) NONPROFIT ORGANIZATION AFFILIATED WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. FORM 990, PART VI, SECTION A, LINE 7A EACH MEMBER OF THE BOARD OF DIRECTORS IS ELECTED BY THE BOARD OF TRUSTEES OF ECUMEN, THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B ECUMEN, THE SOLE MEMBER, MUST APPROVE ANY OF THE FOLLOWING: (A) ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THIS CORPORATION; (B) ALL CAPITAL BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THE CORPORATION, AND ALL MAJOR CAPITAL EXPENDITURES BEFORE FUNDS ARE EXPENDED THEREFORE (FOR THESE PURPOSES A MAJOR CAPITAL EXPENDITURE SHALL BE DEFINED BY THE SOLE MEMBER'S BYLAWS THEN IN EFFECT); (C) ALL OPERATING BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, BEFORE AUTHORIZED EXPENDITURES MAY BE MADE THEREFROM; (D) STRATEGIC PLANS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION; (E) THE INCURRING OF ANY LONG TERM DEBT OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, OTHER THAN INTRA-SYSTEM OR REFINANCING DEBT; (F) ALL HUMAN RESOURCES AND BENEFITS POLICIES OF THIS CORPORATION; (G) ANY MAJOR RISK CONTRACTING AGREEMENTS, WHICH FOR THESE PURPOSES MEANS ANY CONTRACT WHICH DEALS WITH CAPITATION OR SIMILAR RISK BEARING CONCEPT; (H) ANY MERGER, CONSOLIDATION, OR TOTAL OR PARTIAL DISSOLUTION INVOLVING THIS CORPORATION; (I) THE NUMBER OF DIRECTORS OF THIS CORPORATION; AND (J) ANY GOVERNANCE AND ACTION OF THE TYPE SET FORTH IN SUBPARAGRAPH (A) AND SUBPARAGRAPHS (F) THROUGH (I) ABOVE AS PROPOSED BY THE BOARD OF DIRECTORS OF ANY CORPORATION, PARTNERSHIP OR OTHER LEGAL ENTITIES DIRECTLY CONTROLLED BY THIS CORPORATION AS A MEMBER, SHAREHOLDER OR OTHERWISE, TO THE EXTENT THAT THE GOVERNING DOCUMENTS OF SUCH CORPORATION, PARTNERSHIP OR OTHER LEGAL ENTITIES GIVE THIS CORPORATION OR THE BOARD A RIGHT OF APPROVAL OVER SUCH GOVERNANCE ACTION. WITH RESPECT TO THE FOREGOING, THE BOARD SHALL CONSULT WITH AND COOPERATE WITH ECUMEN. FINAL DECISIONS WITH RESPECT TO THE ABOVE LISTED MATTERS SHALL BE SUBJECT TO THE APPROVAL OF ECUMEN AND ITS PERSONNEL WITH THE AUTHORITY TO ACT FOR AND ON BEHALF OF ECUMEN IN CONNECTION WITH SUCH MATTERS. AS PART OF ITS FINAL APPROVAL PROCESS, ECUMEN MAY MODIFY THE CAPITAL AND OPERATING BUDGETS AND STRATEGIC PLANS OF THIS CORPORATION AS REFERRED TO IN SUBPARAGRAPHS (B) THROUGH (D) ABOVE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CEO OF ECUMEN, THE SOLE MEMBER, THEN PRESENTED TO ECUMEN SBC, INC.'S BOARD OF DIRECTORS FOR REVIEW, THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ECUMEN - SBC, INC. UTILIZES ITS PARENT COMPANY, ECUMEN'S, CONFLICT OF INTEREST POLICY, AS IT DOES NOT HAVE A CONFLICT OF INTEREST POLICY OF ITS OWN. ECUMEN'S CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, OFFICERS, MANAGERS AND EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF ECUMEN, INCLUDING THOSE WHO MAKE PURCHASING DECISIONS OR WHO HAVE PROPRIETARY INFORMATION CONCERNING ECUMEN. THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO APPLICABLE PARTIES ANNUALLY AND A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT IS OBTAINED. THE POLICY STATES THAT IT IS THE RESPONSIBILITY OF THE APPLICABLE PARTY TO DISCLOSE A POTENTIALLY CONFLICTING TRANSACTION BEFORE IT IS CONSUMMATED AND TO CONTINUE TO SCRUTINIZE THEIR TRANSACTIONS AND DISCLOSE POTENTIAL CONFLICTS IMMEDIATELY. THE SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE MONITORED BY AN H.R. GENERALIST IN THE HOME OFFICE AND BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE VICE PRESIDENT OF HUMAN RESOURCES NOTIFIES THE CEO FOR DISCLOSURES INVOLVING EMPLOYEES, UNLESS THE EMPLOYEE IS THE CEO IN WHICH CASE THE BOARD CHAIR IS NOTIFIED. THE BOARD CHAIR NOTIFIES THE BOARD OR THE APPLICABLE COMMITTEE OF THE BOARD. DISCLOSURES INVOLVING TRUSTEES ARE MADE TO THE BOARD CHAIR, UNLESS THE BOARD CHAIR HAS A CONFLICT IN WHICH CASE THE VICE-CHAIR IS NOTIFIED. THE CONTROLS ARE SPECIFIC TO THE POTENTIAL AREA OF CONFLICT. FOR INSTANCE, IF AN EMPLOYEE PROVIDES DAILY WORK DIRECTION TO A FAMILY MEMBER, ALL SALARY-RELATED DECISIONS FOR THAT FAMILY MEMBER WOULD BE ASSIGNED TO ANOTHER (NON-RELATED) PERSON. DURING BOARD DISCUSSIONS, THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL FOR THE CONFLICTING TRANSACTION. OTHER SPECIFIC RESTRICTIONS MAY BE IMPOSED, DEPENDING ON THE CONFLICT. A COMPETITIVE BID OR COMPARABLE VALUATION MUST EXIST. THE BOARD, OR DULY CONSTITUTED COMMITTEE, HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 ALL COMPENSATION IS DETERMINED BY ECUMEN, THE SOLE MEMBER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND ECUMEN'S CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. ECUMEN 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 410711588 LOW-INCOME & SENIOR HOUSING MN 501(C)(3) LINE 10 N/A 0 ALEXANDRIA SENIOR HOUSING INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 311749430 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 AUGUSTANA LUTHERAN HOMES INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 410734237 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 BETHEL MANOR II INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411347125 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 HUBBARD COUNTY SENIOR HOUSING INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411932209 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 LAMPLIGHTER MANOR INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411772945 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 NEW RICHMOND SENIOR HOUSING INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411974837 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 ROBBINSDALE SENIOR HOUSING INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411667830 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 WHITE BEAR LAKE SENIOR HOUSING INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411824727 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 PARMLY LAKEVIEW INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 263789732 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 ST FRANCIS OF ASSISI INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411427983 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 BETHEL MANOR I INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411773022 LOW-INCOME HOUSING MN 501(C)(3) LINE 10 ECUMEN 0 ECUMEN SERVICES INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411768508 MANAGEMENT SERVICES MN N/A C 0 BRIDGE REHABILITATION SERVICES INC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411893649 INACTIVE MN N/A C 0 DIVERSIFIED BUSINESS INSURANCE 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 411843778 INSURANCE MN N/A C 0 ONETWOONE DEVELOPMENT LLC 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 473992783 DEVELOPMENT MN N/A C 0 ZVAGO COOPERATIVE AT CENTRAL VILLAGE 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 812899630 DEVELOPMENT MN N/A C 0 ZVAGO COOPERATIVE AT LAKE SUPERIOR 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 830622475 DEVELOPMENT MN N/A C 0 ZVAGO COOPERATIVE AT STILLWATER 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 831063342 DEVELOPMENT MN N/A C 0 ZVAGO COOPERATIVE AT LONG LAKE 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 845096775 DEVELOPMENT MN N/A C 0 ECUMEN DBA THE ECUMEN STORE 3530 LEXINGTON AVENUE NORTH SHOREVIEW MN 55126 410711588 SENIOR CARE SUPPLIES SERVICES MN N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0