2024-07-29T11:15:16-05:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2022-10-01 410695462 SHOLOM HOME EAST INC SHOL 6516466311 740 KAY AVENUE ST PAUL MN 55102 DAVID BERRYMAN CFO 6516466311 2024-07-24 1 0 JUSTIN HARTERT P02236744 5074467100 2024-07-15 2022 2024-08-08 14:25:15Z JIM NEWBROUGH 740 KAY AVENUE ST PAUL MN 55102 22316422 0 X WWW.SHOLOM.COM X 1906 MN NURSING HOME FOR THE ELDERLY. 19 19 308 90 50949 0 1475061 938454 17889407 19910384 107745 253035 247795 290813 19720008 21392686 12039 4421 0 0 11175232 11846028 0 0 0 9815474 10831132 21002745 22681581 -1282737 -1288895 51768196 52610091 22956682 23000821 28811514 29609270 SHOLOM IS A NOT-FOR-PROFIT ORGANIZATION PROVIDING A BROAD CONTINUUM OF RESIDENTIAL, SOCIAL SERVICE, AND HEALTH CARE SERVICES PRIMARILY FOR OLDER ADULTS AND WITHIN A JEWISH ENVIRONMENT. 0 0 18142128 4421 19910384 SHOLOM HOME EAST, INC. IS A NOT-FOR-PROFIT ORGANIZATION INCORPORATED UNDER LAWS OF THE STATE OF MINNESOTA AND IS COMPRISED OF TWO OPERATING DIVISIONS: CHAPMAN NURSING HOME AND BENTSON ASSISTED LIVING. CHAPMAN NURSING HOME AND BENTSON ASSISTED LIVING ARE COLLECTIVELY THE ROSSY AND RICHARD SHALLER FAMILY SHOLOM EAST CAMPUS (SHALLER CAMPUS). THE SHALLER CAMPUS IS LOCATED IN SAINT PAUL, MINNESOTA AND PROVIDES HOUSING AND RELATED SERVICES TO SENIORS. BENTSON ASSISTED LIVING IS A 66-UNIT ASSISTED LIVING/MEMORY SUPPORT FACILITY AND CHAPMAN NURSING HOME IS A 118-BED SKILLED NURSING FACILITY. 18142128 1 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 1 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 0 1 0 0 0 1 34 0 1 308 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 19 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X DAVID BERRYMAN 9529356311 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 SCOTT SEILER PRESIDENT 1.00 1.00 X X 0 0 0 NEIL BORENSTEIN IMMEDIATE PAST PRESIDENT 1.00 0.00 X X 0 0 0 BOB MEICHES VICE PRESIDENT 1.00 0.00 X X 0 0 0 DAVID NIRENSTEIN TREASURER 1.00 0.00 X X 0 0 0 LAYNE ROSEN SECRETARY 1.00 0.00 X X 0 0 0 LISA EDSTROM DIRECTOR 1.00 0.00 X 0 0 0 KIM WOLSON DIRECTOR 1.00 0.00 X 0 0 0 DOUG WEISSMAN DIRECTOR 1.00 1.00 X 0 0 0 RENEE LAMPERT DIRECTOR 1.00 0.00 X 0 0 0 JEREMY PIEROTTI DIRECTOR 1.00 0.00 X 0 0 0 JERRY RUDICK DIRECTOR 1.00 1.00 X 0 0 0 SHERYL RUTZICK DIRECTOR 1.00 2.00 X 0 0 0 MICHAEL SAXON DIRECTOR 1.00 1.00 X 0 0 0 PAUL SCHANFIELD DIRECTOR 1.00 0.00 X 0 0 0 CHUCK SELCER DIRECTOR 1.00 1.00 X 0 0 0 LINDA STEIN DIRECTOR 1.00 0.00 X 0 0 0 JON STONE DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL BLUM DIRECTOR 1.00 1.00 X 0 0 0 JON GORDON DIRECTOR 1.00 2.00 X 0 0 0 BARB KLICK CEO 5.00 35.00 X 0 336897 10255 DAVID BERRYMAN CFO 5.00 35.00 X 0 214723 12892 ANN THOLE COO 5.00 35.00 X 0 210638 3574 ABBEY LAWAL LPN 40.00 0.00 X 175577 0 7784 MELROSE KARGBO-DAVIES LPN 40.00 0.00 X 170288 0 7358 RUTH AKALE LPN 40.00 0.00 X 162031 0 4717 DAMARIS KAMANDA RN 40.00 0.00 X 153130 0 2324 DENIS OGONCHO RN 40.00 0.00 X 151777 0 10 812803 762258 48914 13 0 1 0 SHOLOM COMMUNITY ALLIANCE 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 MANAGEMENT SERVICES 720509 1 655862 282592 938454 RESIDENT REVENUE 623000 19910384 19910384 19910384 246567 246567 17448 0 17448 17448 17448 925000 918532 6468 6468 6468 19840 5204 14636 14636 MEAL REVENUES 722320 149242 20934 128308 MISCELLANEOUS REVENUE 900099 52572 52572 VITALITY CENTER 713940 30015 30015 26900 26900 258729 21392686 19910384 50949 492899 X 4421 4421 10247059 9429680 817379 41005 38295 2710 788598 731813 56785 769366 725899 43467 938967 938967 18527 18527 3725 3725 42342 42342 3594736 3334566 260170 22888 20160 2728 206204 120753 85451 1979145 2587 1976558 25093 2931 22162 223 223 520 520 1779464 1779464 FOOD EXPENSES 844294 844294 MEDICAL SUPPLIES 601431 601431 SURCHARGES & ASSESSMENT 334875 334875 REPAIRS & MAINTENANCE 165797 13527 152270 272901 156912 115989 22681581 18142128 4539453 0 5938388 5051664 94999 94000 1707502 2059970 24354 20865 20387 22312 52398285 22604384 30955495 29793901 9896744 11833934 224000 224000 2906327 3509445 51768196 52610091 1584015 1698505 65493 400303 21679363 21244383 91210 103091 -463399 -445461 22956682 23000821 X 18812501 17685989 9999013 11923281 28811514 29609270 51768196 52610091 X -1288895 2086651 X 0 1 X 1 0 X 740516 1810470 3537784 1475061 938454 8502285 20330174 18802980 16437776 17889407 19910384 93370721 21070690 20613450 19975560 19364468 20848838 101873006 0 0 0 101873006 98736 111960 128957 125193 264015 728861 98736 111960 128957 125193 264015 728861 198329 198329 547931 300968 172768 249967 278569 1550203 21915686 21026378 20277285 19739628 21391422 104350399 0.97630 0.97360 0.00700 0.00520 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME MEAL REVENUES DAY CARE REVENUES BEAUTY SHOP REVENUES GIFT SHOP GROSS RECEIPTS VITALITY CENTER LATE CHARGE INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1536800 1536800 44247325 16720396 27526929 6552287 5883988 668299 61873 61873 29793901 INVESTMENT IN FOUNDATION 11833934 F 11833934 RESIDENT TRUST AND SECURITY DEPOSITS 107605 FUNDS HELD UNDER DEBT AGREEMENTS 1662103 DUE FROM AFFILIATES 1725224 RESTRICTED CASH 14513 3509445 X 21493993 97390 97390 21396603 -3917 -3917 21392686 22686785 5204 5204 22681581 0 22681581 PART IV, LINE 2B: TENANTS MAKE SECURITY DEPOSITS WHEN THEY MOVE IN TO THE FACILITY. THE MONEY IS MAINTAINED IN A SEPARATE BANK ACCOUNT. DEPOSITS, WITH INTEREST, LESS ANY COST OF REPAIRS, ARE RETURNED TO TENANTS OR THEIR ESTATES WHEN THE TENANT LEAVES THE FACILITY. THE ORGANIZATION HOLDS SMALL AMOUNTS IN TRUST ON BEHALF OF RESIDENTS OF THE FACILITY. RESIDENTS MAY MAKE DEPOSITS AND WITHDRAWALS AT ANY TIME. THE FUNDS ARE HELD IN A SEPARATE BANK ACCOUNT. PART X, LINE 2: THE CORPORATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 97,390. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 1,287. COST OF GOODS SOLD -5,204. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 5,204. 0 SCHOLARSHIPS 4 4421 N/A N/A PART I, LINE 2: SCHOLARSHIP FUNDS ARE AVAILABLE TO REIMBURSE LONG-TERM CARE EMPLOYEES FOR TRAINING THAT WILL ENABLE THEM TO ADVANCE IN THE FIELD OF LONG-TERM CARE. TO BE ELIGIBLE FOR THESE SCHOLARSHIPS, EMPLOYEES ARE REQUIRED TO WORK AN AVERAGE OF 20 HOURS/WEEK. AWARDS ARE BASED ON ADDITIONAL CRITERIA, INCLUDING THE AVAILABILITY OF FUNDS. 0 0 0 0 0 0 0 0 0 BARB KLICK CEO 0 336897 0 0 0 0 0 0 0 10255 0 347152 0 0 DAVID BERRYMAN CFO 0 214723 0 0 0 0 0 3221 0 9671 0 227615 0 0 ANN THOLE COO 0 210638 0 0 0 0 0 3159 0 415 0 214212 0 0 ABBEY LAWAL LPN 175577 0 0 0 0 0 2633 0 5151 0 183361 0 0 0 MELROSE KARGBO-DAVIES LPN 170288 0 0 0 0 0 2554 0 4804 0 177646 0 0 0 RUTH AKALE LPN 162031 0 0 0 0 0 0 0 4717 0 166748 0 0 0 DAMARIS KAMANDA RN 153130 0 0 0 0 0 2296 0 28 0 155454 0 0 0 DENIS OGONCHO RN 151777 0 0 0 0 0 0 0 10 0 151787 0 0 0 PART I, LINE 3 THE CEO'S COMPENSATION IS DETERMINED BY SHOLOM COMMUNITY ALLIANCE, THE SOLE MEMBER OF SHOLOM HOME EAST. THE FOLLOWING WERE USED BY SHOLOM COMMUNITY ALLIANCE IN DETERMINING THE CEO'S COMPENSATION: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. WRITTEN EMPLOYMENT CONTRACT 4. COMPENSATION SURVEY OR STUDY 5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A HOUSING AND REDEVELOPMENT AUTHORITY OF THE CITY OF ST PAUL 511440935 792893HJ1 2018-07-25 22930112 RETIRE THE 2007 HOUSING AND REDEVELOPMENT AUTHORITY OF ST. PAUL BONDS 0 0 0 A 1660000 22810000 330745 22599367 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 1 0 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 3 THE TOTAL PROCEEDS FROM BOND INCLUDED ON SCHEDULE K, PART II, LINE 3 ISSUED BY SHOLOM HOME EAST ARE LESS THAN THE ISSUE PRICE LISTED ON SCHEDULE K, PART I, COLUMN E BECAUSE THEY WERE ISSUED AT A PREMIUM. FORM 990, PART VI, SECTION A, LINE 1A THE BUDGET AND FINANCE COMMITTEE HAS BEEN DELEGATED THE AUTHORITY TO APPROVE THE 990 TAX RETURN ON BEHALF OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 SHOLOM COMMUNITY ALLIANCE CORPORATE CHARGES A MANAGEMENT FEE TO ALL OF THE AFFILIATED ENTITIES FOR ADMINISTRATIVE AND GENERAL SERVICES. THE MANAGEMENT FEES ON THE AFFILIATED ENTITIES ARE REVENUE TO SHOLOM COMMUNITY ALLIANCE. THESE TRANSACTIONS ARE ELIMINATED IN THE CONSOLIDATED FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION A, LINE 6 SHOLOM COMMUNITY ALLIANCE IS THE SOLE MEMBER OF SHOLOM HOME EAST, INC. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS ARE ELECTED AT THE ANNUAL MEETING OF THE SOLE MEMBER, SHOLOM COMMUNITY ALLIANCE. THE BOARD MEMBERS OF SHOLOM COMMUNITY ALLIANCE HAVE ELECTED THEMSELVES TO BE THE BOARD OF DIRECTORS OF SHOLOM HOME EAST. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS REQUIRE THE APPROVAL OF THE BOARD OF DIRECTORS OF SHOLOM COMMUNITY ALLIANCE. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 TAX RETURN WAS REVIEWED IN DETAIL BY MANAGEMENT, REVIEWED AND APPROVED BY A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, AND PROVIDED TO THE FULL BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND EMPLOYEES SIGN FOR RECEIPT OF POLICY WHICH COVERS ALL EMPLOYEES AND OFFICERS. COMPLIANCE IS MONITORED VIA VARIOUS MEANS INCLUDING FINANCIAL AUDIT, BOARD MINUTES, AND INVESTIGATION OF COMPLAINTS. ANY POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED AT THE TIME OF KNOWLEDGE OF THE POTENTIAL CONFLICT TO THE PRESIDENT OF THE BOARD OF DIRECTORS, OR, IF APPROPRIATE, THE CHAIR OF THE COMMITTEE EVALUATING THE PARTICULAR MATTER AND THE CEO. THE PRESIDENT OF THE BOARD OF DIRECTORS OR ANY DESIGNEE WILL EVALUATE THE APPROPRIATENESS OF THE BOARD MEMBER TO BE INVOLVED IN ANY DISCUSSIONS AND/OR VOTING ON THE POTENTIAL CONFLICT OF INTEREST ISSUE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT OPEN TO PUBLIC INSPECTION. FORM 990, PART IX, LINE 11G CONSULTING & CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 3,334,566. MANAGEMENT AND GENERAL EXPENSES 260,170. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,594,736. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF AFFILIATE 1,937,190. TRANSFER FROM AFFILIATE 149,461. SHOLOM COMMUNITY ALLIANCE 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 411837022 SUPPORT RELATED ENTITIES IN ELDERLY NURSING HOME, HOUSING AND COMMUNITY SERV MN 501(C)(3) LINE 12B, II N/A 0 SHOLOM HOME WEST INC 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 363570759 NURSING HOME FOR THE ELDERLY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 0 COMMUNITY HOUSING & SERVICE CORP 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 410982770 PROVIDE HOUSING FOR THE ELDERLY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 0 KNOLLWOOD COMMUNITY HOUSING CORP 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 411518579 LOW INCOME HOUSING MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE AND COMMUNITY HOUSING SERVICE CORP 0 MENORAH PLAZA HOUSING CORP 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 363512438 LOW INCOME HOUSING MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE AND COMMUNITY HOUSING SERVICE CORP 0 SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 010628051 PROVIDE HOME HEALTH CARE AND HOSPICE SERVICES TO THE COMMUNITY. MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 0 SHOLOM ST PAUL 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 300256100 INACTIVE SHELL COMPANY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 0 SHOLOM ST PAUL SENIOR HOUSING INC 760 PERLMAN STREET ST PAUL MN 55102 204844785 LOW INCOME HOUSING MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 0 SHOLOM FOUNDATION 3610 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 363411361 SUPPORT AFFILIATES THROUGH FUNDRAISING MN 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0