2025-09-30T13:41:25-05:00 2024-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-01-01 410977369 LUTHER HAVEN LUTH 3202696517 1109 EAST HIGHWAY 7 MONTEVIDEO MN 56265 JUSTIN HUGHES ADMINISTRATOR 3202696517 2025-09-30 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-09-29 2024 2025-03-06 01:10:19Z JUSTIN HUGHES 1109 EAST HIGHWAY 7 MONTEVIDEO MN 56265 9843377 0 X WWW.LUTHERHAVEN-MN.ORG X 1971 MN PROVIDE SERVICES TO THE ELDERLY AND DISABLED IN THE MONTEVIDEO AND THE SOUTHWEST AREA OF MINNESOTA. WE CARE FOR THE TOTAL PERSON AND PROVIDE LONG TERM CARE AND SHORT REHAB SERVICES. 11 11 168 39 0 0 2077578 273282 9268565 9505474 21760 59021 2615 3996 11370518 9841773 15955 14981 0 0 5459887 6089644 0 0 0 3710829 3799757 9186671 9904382 2183847 -62609 8129655 8122381 664603 483934 7465052 7638447 X LUTHER HAVEN WAS ESTABLISHED AND ORGANIZED TO CARE FOR THE ELDERLY AND DISABLED IN MONTEVIDEO AND IN THE SOUTHWEST MINNESOTA DISTRICT OF THE ELCA. ITS PURPOSE IS TO SERVE THE ELDERLY AND DISABLED AND TO PROMOTE THEIR PHYSICAL, SOCIAL, EMOTIONAL, AND SPIRITUAL NEEDS IN A CHRISTIAN ATMOSPHERE. NO PERSON BECAUSE OF RACE, COLOR, CREED, RELIGION, NATIONAL ORIGIN, SEX, MARITAL STATUS, STATUS WITH REGARD TO MEDICAL ASSISTANCE, DISABILITY, SEXUAL ORIENTATION, MEMBERSHIP OR ACTIVITY IN A LOCAL COMMISSION OR VETERAN STATUS SHALL BE BARRED ADMISSION FROM LUTHER HAVEN. 0 0 8087973 14981 8520571 CARE CENTER:NURSING DEPARTMENT WITH A BUDGET OF 3.8 MILLION IS OUR LARGEST DEPARTMENT. IT EMPLOYS APPROXIMATELY 65 EMPLOYEES. WE PROVIDE LONG AND SHORT STAY CARE AND A FULL LINE OF REHAB SERVICES TO PROMOTE MAXIMUM RESIDENT HEALTH AND RETURN TO COMMUNITY. WE ARE LICENSED FOR 70 BEDS. ALSO, ON THE CAMPUS IS COPPER GLEN, ASSISTED LIVING AND THE MONTEVIDEO-CHIPPEWA COUNTY HOSPITAL AND MEDICAL CENTER. ALL BUILDINGS ARE CONNECTED, AND CERTAIN SERVICES ARE SHARED FOR COST SHARING AND COST SAVINGS. WE ARE CERTIFIED WITH MEDICARE AND MEDICAID AND LICENSED WITH THE MINNESOTA DEPARTMENT OF HEALTH. 918580 0 984903 COPPER GLEN:COPPER GLEN IS A LICENSED CLASS F ASSISTED LIVING FACILITY. COPPER GLEN IS DESIGNED AS AN APARTMENT STYLE COMPLEX WITH SERVICES AVAILABLE TO ASSIST THE TENANTS TO AGE IN A HOME ENVIRONMENT. PROGRAM SERVICES ARE INTENDED TO BRIDGE THE GAP BETWEEN INDEPENDENT LIVING AND THE CARE CENTER. SERVICES PROVIDED INCLUDE MEALS, BATHING, HOUSEKEEPING, MAINTENANCE, LAUNDRY, AND REGISTERED NURSE SUPERVISION STAFFING. ALSO PROVIDED ARE ALA CARTE SERVICES, CENTRAL STORAGE OF MEDICATIONS, MEDICATION ADMINISTRATION AND MANAGEMENT. VOLUNTEERS AND A LOCAL PASTORAL ORGANIZATION PROVIDE WORSHIP SERVICES. 9006553 1 1 0 0 0 0 0 0 1 0 1 0 0 0 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 0 0 0 0 0 1 43 0 168 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X ANN NORDSTROM 3202696517 1109 EAST HIGHWAY 7 MONTEVIDEO MN 56265 KALIN EVENSON CHAIR (THRU 04/2024) 1.00 X X 0 0 0 KATHY TAMMEN CHAIR 1.00 X X 0 0 0 CHUCK VIEN VICE-CHAIR (THRU 04/2024) 1.00 X X 0 0 0 DIANE SACHARIASON SECRETARY 1.00 X X 0 0 0 SHELLY BEDNAR DIRECTOR 1.00 X 0 0 0 PAUL DEZEEUW DIRECTOR 1.00 X 0 0 0 MARIE ECKBERG DIRECTOR 1.00 X 0 0 0 JEROME FRAGODT DIRECTOR (THRU 04/2024) 1.00 X 0 0 0 JASON KURTZBEIN DIRECTOR 1.00 X 0 0 0 KIMBERLY KVAM DIRECTOR 1.00 X 0 0 0 DIANE LANDMARK DIRECTOR 1.00 X 0 0 0 BRETT OPDAHL DIRECTOR (THRU 04/2024) 1.00 X 0 0 0 GARY RILEY DIRECTOR (THRU 12/2024) 1.00 X 0 0 0 KELLY SNELL DIRECTOR 1.00 X 0 0 0 SUE WINTER DIRECTOR 1.00 X 0 0 0 ANN NORDSTROM FINANCE DIRECTOR 40.00 X 93295 0 23088 JUSTIN HUGHES ADMINISTRATOR 40.00 X 78133 0 9144 TIM BYRNE ADMINISTRATOR (THRU 02/2024) 40.00 X 22074 0 1524 REBECCA HUGHES NURSE MANAGER 40.00 X 102584 0 2988 ALYCIA PLOCHER NURSE MANAGER 40.00 X 101303 0 19894 397389 0 56638 2 0 0 0 BIG STONE THERAPIES INC 500 CROSS STREET BIG STONE CITY SD 57216 PT/OT/ST THERAPY SERVICES 403398 ALL TEMPORARIES MIDWEST 4200 CENTRAL AVE NE COLUMBIA HEIGHTS MN 55421 STAFFING AGENCY 271439 NURZEE INC 7845 BROOKLYN BLVD SUITE 210 BROOKLYN PARK MN 55445 STAFFING AGENCY 266217 GRAPETREE MEDICAL STAFFING LLC PO BOX 5340 SIOUX FALLS SD 57117 STAFFING AGENCY 180600 DYNAMIC STAFFING SOLUTIONS LLC 3300 COUNTY RD 10 SUITE 320R BROOKLYN CENTER MN 55429 STAFFING AGENCY 151557 5 265679 7603 273282 RESIDENT ROOM AND BOAR 623000 7733042 7733042 THERAPY 623000 1007085 1007085 OTHER SERVICES 623000 469145 469145 SHARED SERVICES 623000 212646 212646 PHARMACY SERVICES 623000 83556 83556 9505474 60625 60625 1604 -1604 -1604 -1604 GUEST MEALS 900099 3996 3996 3996 9841773 9505474 0 63017 X 14981 14981 227258 227258 4767537 4547455 220082 45496 44270 1226 668416 640102 28314 380937 348688 32249 19057 19057 7379 7379 34414 34414 1769905 1758585 11320 360 360 60014 29447 30567 28480 28480 174236 174236 3134 2409 725 358 358 248333 211305 37028 111894 111894 SUPPLIES 745732 745732 REPAIRS AND MAINTENANCE 230623 188206 42417 SURCHARGE 197050 197050 BAD DEBT EXPENSE 103729 103729 65059 65059 9904382 9006553 897829 0 1312314 864285 672613 727640 1067660 1019085 43580 43581 57715 47593 11029999 7759266 3023938 3270733 1939575 2137204 12260 12260 8129655 8122381 636069 458476 10885 4917 17649 20541 664603 483934 X 7444149 7617073 20903 21374 7465052 7638447 8129655 8122381 -62609 236004 0 X 0 1 X 1 0 X 595429 212130 954799 2077578 273282 4113218 9261050 7361513 8181826 9268565 9505474 43578428 395 48 269 2615 3996 7323 9856874 7573691 9136894 11348758 9782752 47698969 0 0 0 47698969 13695 15976 7977 29434 60625 127707 13695 15976 7977 29434 60625 127707 9870569 7589667 9144871 11378192 9843377 47826676 0.99730 0.99680 0.00270 0.00170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 43917 43917 8107400 6388280 1719120 1594888 1370986 223902 1283794 1283794 3270733 SECURITY DEPOSIT 20541 20541 10077777 236004 236004 9841773 0 9841773 9904382 0 9904382 0 9904382 PART IV, LINE 2B: THE ORGANIZATION IS THE TRUSTEE OF RESIDENT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION AND DISTRIBUTION OF THESE FUNDS FOR RESIDENTS OF THE SKILLED NURSING FACILITY. SECURITY DEPOSITS ADVANCED BY TENANTS OF COPPER GLEN ARE ALSO HELD IN TRUST BY THE ORGANIZATION. THE ORGANIZATION RECORDS THE AMOUNT ADVANCED BY THE RESIDENTS AND TENANTS AS LIABILITIES IN THE ACCOMPANYING BALANCE SHEETS. 1 SCHOLARSHIPS 7 14981 PART I, LINE 2: LUTHER HAVEN HAS A NURSING FACILITY SCHOLARSHIP FUND. EMPLOYEES MUST MEET CERTAIN ELIGIBILITY REQUIREMENTS. SCHOLARSHIP PARTICIPANTS MUST PERSONALLY TURN IN ALL ALLOWABLE EXPENSES. SCHOLARSHIP APPLICATIONS AND REIMBURSEMENTS ARE PROCESSED BY ACCOUNTING AFTER BEING APPROVED BY THE DEPARTMENT MANAGER, ADMINISTRATOR OR HUMAN RESOURCES. ACCOUNTING VERIFIES AND TRACKS YEARLY PAYMENTS FOR REPORT PURPOSES. PAYMENTS ARE MADE DIRECTLY TO THE EMPLOYEE. THE APPLICANT MUST COMPLETE THE SCHOLARSHIP REIMBURSEMENT FORM BY ATTACHING AN ITEMIZED DETAILED BILLING OF THE ALLOWABLE EXPENSES WITH RECEIPTS SHOWING THEIR PAYMENT IN FULL. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF LUTHER HAVEN CONSISTS OF CONGREGATIONS OF CHRISTIAN CHURCHES WHICH HAVE APPLIED FOR SUCH MEMBERSHIP AND HAVE BEEN APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE ADMINISTRATOR AND FINANCE DIRECTOR BEFORE PROVIDING A COPY TO OUR BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE RESPONSIBILITY OF EVERY BOARD MEMBER TO STATE IF THEY FEEL THEY HAVE A CONFLICT OF INTEREST ON A VOTING MATTER. UNDER ANY TRANSACTION BETWEEN THE CORPORATION AND BOARD MEMBER, FULL DISCLOSURE MUST BE MADE TO THE BOARD OF DIRECTORS OR COMMITTEE BEFORE APPROVAL. THAT BOARD MEMBER OR COMMITTEE MEMBER SHALL NOT VOTE, AND THE MEETING MINUTES SHOULD REFLECT THE BOARD MEMBER OR COMMITTEE MEMBER ABSTAINED FROM VOTING. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY AND UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES TWO SALARY SURVEYS, ONE FROM AGING SERVICES OF MINNESOTA AND ANOTHER FROM MEDISOTA, A NON-PROFIT GROUP. THE COMPENSATION AND BENEFIT SURVEY IS FOR HEALTH CARE FACILITIES IN THE SOUTHWEST REGION OF MINNESOTA. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 11G NURSING: PROGRAM SERVICE EXPENSES 1,187,498. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,187,498. SPEECH THERAPY: PROGRAM SERVICE EXPENSES 37,568. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,568. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 180,945. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,945. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 198,063. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 198,063. DIETARY: PROGRAM SERVICE EXPENSES 36,444. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,444. OTHER SERVICES: PROGRAM SERVICE EXPENSES 118,067. MANAGEMENT AND GENERAL EXPENSES 11,320. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 129,387.