2025-07-31T17:19:15-05:00 2024-09-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2023-10-01 010628051 SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE SHOL 9529356311 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 DAVID BERRYMAN CHIEF FINANCIAL OFFICER 9529356311 2025-07-30 1 0 JUSTIN HARTERT P02236744 5074467100 2025-07-30 2023 2025-03-06 01:10:19Z SHOLOM HOME CARE JOHNSON HOSPICE CARE JIM NEWBROUGH 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 5933062 0 X WWW.SHOLOM.COM X 2001 MN PROVIDE HOME HEALTH CARE AND HOSPICE SERVICES TO THE COMMUNITY. 17 17 84 18 0 0 3015 6245 5842050 5752155 36668 16633 9332 157016 5891065 5932049 0 0 0 0 5367936 3711523 0 0 0 744223 3730447 6112159 7441970 -221094 -1509921 1796377 1192791 503148 2071555 1293229 -878764 SHOLOM IS A NOT-FOR-PROFIT ORGANIZATION PROVIDING A BROAD CONTINUUM OF RESIDENTIAL, SOCIAL SERVICE, AND HEALTH CARE SERVICES PRIMARILY FOR OLDER ADULTS. 0 0 6548611 0 5752155 PROVIDES HOME HEALTH CARE SERVICES TO RESIDENTS OF THE VARIOUS FACILITIES OWNED AND OPERATED BY SHOLOM COMMUNITY ALLIANCE AND IN THE COMMUNITY. PROVIDES HOSPICE CARE SERVICES THROUGHOUT SHOLOM COMMUNITY ALLIANCE FACILITIES AND IN THE COMMUNITY. 6548611 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 2 0 84 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 17 1 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 PKWY ST LOUIS PARK MN 55426 SCOTT SEILER PAST PRESIDENT 1.00 0.00 X 0 0 0 DAVID NIRENSTEIN PRESIDENT 1.00 2.00 X X 0 0 0 BOB MEICHES MD VICE PRESIDENT 1.00 0.00 X X 0 0 0 LAYNE ROSEN SECRETARY 1.00 0.00 X X 0 0 0 RENEE LAMPERT TREASURER 1.00 1.00 X X 0 0 0 LISA EDSTROM DIRECTOR - THRU 1/30/24 1.00 0.00 X 0 0 0 KIM WOLSON 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 1.00 X 0 0 0 PAUL SCHANFIELD DIRECTOR 1.00 0.00 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 DOUG WEISSMAN DIRECTOR 1.00 1.00 X 0 0 0 MIKE RESIG DIRECTOR 1.00 0.00 X 0 0 0 SONIA UNGERMAN DIRECTOR 1.00 0.00 X 0 0 0 MARC SALITA DIRECTOR 1.00 0.00 X 0 0 0 LISA FURMAN DIRECTOR 1.00 1.00 X 0 0 0 BARB KLICK CEO 5.00 35.00 X 0 397536 22194 DAVID BERRYMAN CFO 5.00 35.00 X 0 254785 17686 ANN THOLE COO 5.00 35.00 X 0 249490 7894 JIM NEWBROUGH CEO 5.00 35.00 X 0 0 0 ELIZABETH ADAMS DIRECTOR OF HOMECARE SERVICES 40.00 0.00 X 107378 0 3489 107378 901811 51263 1 0 1 0 SHOLOM COMMUNITY ALLIANCE 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 MANAGEMENT SERVICES 715007 1 5990 255 6245 RESIDENT SERVICE REV. 621610 5752155 5752155 5752155 16633 16633 3874 1013 2861 2861 MISCELLANEOUS 621610 154155 154155 154155 5932049 5752155 0 173649 X 3245927 3142641 103286 40881 39578 1303 192831 186450 6381 231884 224493 7391 407855 407855 12204 12204 1000364 752582 247782 2646 2646 55468 31139 24329 36089 36089 56741 51696 5045 526 526 1401 1401 HOSPICE MA ROOM & BOARD 1633756 1633756 BAD DEBTS 173252 173252 MEDICAL SUPPLIES 164525 164525 FOOD 143621 143621 41999 4878 37121 7441970 6548611 893359 0 164850 161451 831742 13288 633341 864184 10614 16278 281920 275978 7343 5942 148487 131648 1796377 1192791 221660 265979 6904 28339 274584 1777237 503148 2071555 X 1293229 -878764 1293229 -878764 1796377 1192791 X -1509921 -662072 X 0 1 X 1 0 X 85079 1656227 256990 3015 6245 2007556 4581800 4698094 4773675 5842201 5752155 25647925 4666879 6354321 5030665 5845216 5758400 27655481 0 0 0 27655481 15065 17705 23034 36668 16633 109105 15065 17705 23034 36668 16633 109105 207558 229733 9181 158029 604501 4889502 6601759 5053699 5891065 5933062 28369087 0.97480 0.97770 0.00380 0.00380 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME GROSS SALES OF INVENTORY RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 281920 275978 5942 5942 DUE FROM AFFILIATES 1678 RIGHT-OF-USE ASSETS 129970 131648 DUE TO AFFILIATES 1647267 OPERATING LEASE LIABILITY 129970 1777237 X PART X, LINE 2: SHOLOM AND ITS AFFILIATES QUALIFY AS TAX-EXEMPT ENTITIES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE ORGANIZATIONS ARE CLASSIFIED AS PUBLICLY-SUPPORTED CHARITABLE ORGANIZATIONS UNDER EITHER SECTION 509(A)(1), 509(A)(2) OR SECTION 509(A)(3) OF THE CODE AND CONTRIBUTIONS TO THE ORGANIZATIONS QUALIFY AS A CHARITABLE TAX DEDUCTION BY THE CONTRIBUTOR. SHOLOM'S ANNUAL TAX FILINGS ARE SUBJECT TO REVIEW BY FEDERAL, STATE, AND LOCAL AUTHORITIES. SHOLOM IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. SHOLOM IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OTHER TAXES. 0 0 0 0 0 0 0 0 0 BARB KLICK CEO 0 397536 0 0 0 0 0 11937 0 10257 0 419730 0 0 DAVID BERRYMAN CFO 0 254785 0 0 0 0 0 7993 0 9693 0 272471 0 0 ANN THOLE COO 0 249490 0 0 0 0 0 7472 0 422 0 257384 0 0 PART I, LINE 3 THE CEO'S COMPENSATION IS DETERMINED BY SHOLOM COMMUNITY ALLIANCE, THE SOLE MEMBER OF SHOLOM COMMUNITY ALLIANCE HOME HEALTH CARE. 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 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 2 DAVID NIRENSTEIN AND RENEE LAMPERT - FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 3 SHOLOM COMMUNITY ALLIANCE 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 COMMUNITY ALLIANCE HOME HEALTH CARE. 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 COMMUNITY ALLIANCE HOME HEALTH CARE. 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 BY MANAGEMENT IN DETAIL, REVIEWED AND APPROVED BY A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, AND PROVIDED TO THE FULL BOARD OF DIRECTORS ELECTRONICALLY 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 PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 752,582. MANAGEMENT AND GENERAL EXPENSES 247,782. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,000,364. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATE -662,072. 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 EAST INC 3620 PHILLIPS PARKWAY ST LOUIS PARK MN 55426 410695462 NURSING HOME FOR THE ELDERLY MN 501(C)(3) LINE 10 SHOLOM COMMUNITY ALLIANCE 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 AND 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 AND SERVICE CORP 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 TO AFFILIATES THROUGH FUNDRAISING MN 501(C)(3) LINE 7 N/A 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 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0