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Nonprofiteer
← EBENEZER LAKES SENIOR HOUSING

Form 990 for tax year 2022

Filed by EBENEZER LAKES SENIOR HOUSING.

Totals

Total revenue
$214,923
Total expenses
$361,529
Contributions and grants received
$1,500
Grants paid
$0
Program service revenue
$209,463
Investment income
$0
Other revenue
$3,960
Total assets, end of year
$2,990,746
Total liabilities, end of year
$655,634
Net assets or fund balances, end of year
$2,335,112
Program services expenses (Part IX)
$163,816
Management and general expenses
$197,713
Fundraising expenses
$0
Program service expenses (Part III)
$163,816

Program services were 45.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $1,500

  • 2a · Program service revenue: Senior Housing Revenue

    total $209,463 · related or exempt $209,463

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11a · Other revenue: Ancillary Services

    total $3,960 · related or exempt $3,960

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $3,960

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $53,796 · program services $7,735 · management and general $46,061

  • 9 · Other employee benefits

    total $6,101 · program services $948 · management and general $5,153

  • 10 · Payroll taxes

    total $4,375 · program services $550 · management and general $3,825

  • 11a · Fees: management

    total $24,330 · management and general $24,330

  • 11c · Fees: accounting

    total $8,800 · management and general $8,800

  • 11g · Fees: other

    total $14,553 · program services $13,042 · management and general $1,511 · fundraising $0

  • 13 · Office expenses

    total $7,864 · program services $3,927 · management and general $3,937

  • 16 · Occupancy

    total $111,184 · program services $110,617 · management and general $567

  • 17 · Travel

    total $44 · program services $44

  • 20 · Interest

    total $141 · management and general $141

  • 22 · Depreciation, depletion and amortization

    total $101,253 · management and general $101,253

  • 24a · Other expenses: Resident Supplies

    total $3,090 · program services $2,297 · management and general $793

  • 24b · Other expenses: Utilities, Repairs & Main

    total $24,656 · program services $24,656

  • 24c · Other expenses: License/Memberships

    total $494 · management and general $494

  • 24d · Other expenses: Affiliation/Membership

    total $848 · management and general $848

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $18,873 · end of year $17,584

  • 4 · Accounts receivable

    beginning of year $36,815 · end of year $36,206

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $818 · end of year $844

  • 10a · Land, buildings and equipment: cost or other basis

    $3,989,982

  • 10b · Land, buildings and equipment: accumulated depreciation

    $1,287,627

  • 10c · Land, buildings and equipment, net

    beginning of year $2,794,683 · end of year $2,702,355

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $219,877 · end of year $233,757

  • 17 · Accounts payable and accrued expenses

    beginning of year $573,025 · end of year $22,014

  • 19 · Deferred revenue

    beginning of year $2,531 · end of year $3,235

  • 21 · Escrow or custodial account liability

    beginning of year $13,792 · end of year $13,951

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $616,434

  • 27 · Net assets without donor restrictions

    beginning of year $59,916 · end of year -$1,714

  • 28 · Net assets with donor restrictions

    beginning of year $2,421,802 · end of year $2,336,826

Mission and programs · 2022

Mission

Ebenezer Lakes Senior Living is part of Ebenezer Society. Ebenezer Society helps older adults and others make their lives more independent, healthful, meaningful and secure. Building on our Lutheran heritage, we respond to physical, psychological, social and spiritual dimensions of the whole person. We welcome persons of diverse cultures and faith traditions. We practice responsible stewardship of humans, property, and financial resources and encourage continual learning and innovation to strive for excellence.

Activities or mission (Part I)

Housing for elderly individuals in Wyoming, Minnesota.

  • Providing affordable housing for low income elderly tenants in Wyoming, Minnesota.

    Expenses $163,816 · Revenue $213,423

As filed on the 2022 return.

Listed in Part VII

  • James Hereford

    Ex-Officio

    Total calculated
    $3,487,618
    From this org
    $0
    From related orgs
    $3,370,758
    Other
    $116,860
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,753,793 related
    Bonus
    $0 + $1,399,311 related
    Other
    $0 + $217,654 related
    Deferred
    $0 + $100,535 related
    Nontaxable benefits
    $0 + $16,325 related
    Filer's total
    $0 + $3,487,618 related

  • Jonathan Lundberg

    President

    Total calculated
    $576,819
    From this org
    $0
    From related orgs
    $543,648
    Other
    $33,171
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $363,251 related
    Bonus
    $0 + $139,389 related
    Other
    $0 + $41,008 related
    Deferred
    $0 + $18,580 related
    Nontaxable benefits
    $0 + $14,591 related
    Filer's total
    $0 + $576,819 related

  • Richard Howard

    Chair, ended 5-2022

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Scott Wordelman

    Chair

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Todd Willett

    CFO, Treasurer

    Total calculated
    $345,342
    From this org
    $0
    From related orgs
    $326,029
    Other
    $19,313
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $308,273 related
    Bonus
    $0
    Other
    $0 + $17,756 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $19,313 related
    Filer's total
    $0 + $345,342 related

  • Carl Runck

    Director

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Carolyn Jacobson

    Director

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Christina Widdess

    Director, new 5-2022

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Kenneth Ashton-Piper

    Director, New 5-2022

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Kimberly Faust

    Director

    Total calculated
    $396,690
    From this org
    $0
    From related orgs
    $359,093
    Other
    $37,597
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $318,422 related
    Bonus
    $0 + $39,244 related
    Other
    $0 + $1,427 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $19,297 related
    Filer's total
    $0 + $396,690 related

  • Robb Gruman

    Director

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Robert Walker

    Director, new 5-2022

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Susan Carlson-Weinberg

    Vice Chair

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

  • Thomas Hokr

    Secretary

    Total calculated
    $0
    Hours/week
    0.3 + 1.5 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD, JONATHAN LUNDBERG DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD $208,150 JONATHAN LUNDBERG $38,485
Schedule J, Part I, Line 7 Non-fixed payments
Fairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.
Schedule J, Part I, Line 3 Related Org to establish compensation
THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.
Schedule J, Part III Other Additional Information
The nonqualified plan is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. The contribution is unfunded. The plan complies with section 457(f) of the Code.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • Ebenezer Management Services Inc

    C Corporation · Mgmt Svcs · MN

    Directly controlled by Ebenezer Society

  • Ebenezer Development Inc

    C Corporation · Property Management · MN

    Directly controlled by Ebenezer Society

Provenance

Return type
form_990
Tax year
2022
Filed
26 October 2023
IRS schema version
2022v5.0
Source object
202302999349301710

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