Ebenezer Lakes Assisted Living

“Ebenezer Lakes Assisted Living is managed by Ebenezer Society employees.”

“Ebenezer Society, a Minnesota Nonprofit Organization, is the sole member of Ebenezer Lakes Assisted Living.”

“The chair of the corporation shall be elected from and by the board of directors. The board of directors shall elect members to director positions and fill vacancies in elected director positions. The board of directors of this corporation shall elect members from the nominees made from the boards of each of the constituent organizations as listed in the bylaws of this corporation."”

“The following actions must be approved by Ebenezer Society, the sole member: (A) All amendments to the articles of incorporation and bylaws; (B) All capital budgets of the organization and all other entities directly or indirectly controlled by this organization, and all major capital expenditures before funds are expended therefore; (C) All operating budgets of this organization and all other entities directly or indirectly controlled by this organization, before authorized expenditures may be made therefrom; (D) Strategic plans of this organization and all other entities directly or indirectly controlled by this organization; (E) The incurring of any long term debt of this organization and all other entities directly or indirectly controlled by this organization, other than intra-system of refinancing debt; (F) All human resources and benefit policies;(G) Any major risk contracting agreements, which for these purposes means any contract that deals with capitation or a similar risk bearing concept; (H) Any merger, consolidation, or total or partial dissolution; (I) The number of directors; and (J) Any governance and action of the type set forth in subparagraphs (A) and (F) through (I) above as proposed by the board of directors of any entity directly controlled by this organization to the extent that the governing documents of such entity give this organization or the board a right to approval over such governance action.”

“The Tax Department conducts a detailed review of the completed return. The return is also reviewed by the President and CFO. The Form 990 is subsequently presented to the Board of Directors. Upon approval from the Board of Directors, the Form 990 is filed.”

“Managers, Directors and senior management are required to annually complete a Duty of Loyalty and Conflict of Interest Statement in compliance with Fairview's system Conflict of Interest Policy. Disclosures are reviewed by the compliance department. Any conflicts of interest by board members are brought to the board for review.”

“The determination of executive compensation of the organization is processed by the Fairview System Human Resources Committee and includes a review of comparability data, review by independent experts and contemporaneous substantiation of the deliberation and decision process.”

“The determination of executive compensation of the organization is processed by the Fairview System Human Resources Committee and includes a review of comparability data, review by independent experts and contemporaneous substantiation of the deliberation and decision process.”

“This organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request and inspection of the documents is available at the corporate finance department.”

“Form 1099's were filed by a related organization Ebenezer Society, a 501(c)(3) non-profit, tax-exempt organizations. Ebenezer Society reports the five highest compensated independent contractors for the system.”

“All cash disbursements are centralized through a related organization, Ebenezer Society. Therefore the related organization, Ebenezer Society, makes the payment and files the related Form 1099's and Form 1096 instead of this organization.”

“Ebenezer Lakes Assisted Living leases employees from a related organization, Ebenezer Society, a 501(c)(3) tax-exempt, non-profit organization. Therefore, Ebenezer Society files the appropriate W-3 and related W-2 tax forms for these individuals instead of Ebenezer Lakes Assisted Living. The leased employee compensation on the Ebenezer Lakes Assisted Living Form 990 Part VII and Schedule J is reported as compensation paid by related organization, Ebenezer Society.”

“Fairview health services, a related 501(c)3 tax-exempt organization, files and remits all related section 4960 excise tax on form 4720 for the system.”

“Rounding - 4; Total - 4;”