St. John’s United

What it reported doing in 2024

St. John's Operations - St. John's Lutheran Ministries, Inc. is a ministry to the world given by 25 local Lutheran (ELCA) ownership congregations who are committed to caring for people regardless of religious preference, race/national origin, gender/age/marital status, diagnosis/disability, or financial status. St. John's began as a HUD facility (115 beds) in 1963 and has grown into one of the largest providers of senior housing and long-term care services in the State of Montana. We offer a full continuum of care providing low-income housing, assisted living, skilled nursing, and independent living, as well as childcare, rehabilitation/home health, child adoption services and many other support services to enhance the lives of those we serve. (Continued on Schedule O)Overall, we served 947 seniors on our campus in 2024 as well as 1,355 seniors in outlying communities. The below are examples of that support. Program Service Accomplishments: Skilled Nursing Services - We operate a 36 bed transitional rehab unit as well as 52 skilled nursing beds located in four individual cottages. During 2024, St. John's nursing division cared for 455 residents providing 29,335 patient days of care. St. John's has proven to be an innovative leader in nursing home care through the implementation of programs such as Eden Alternative, Comfort Care Vigil Ministry, and the Green House cottage model with an open door to other service providers from around the country to tour our facilities and exchange information and service delivery ideas. Two principals have contributed to the success of the cottage model of care, 1) the creation of a home environment serving a small group of elders and, 2) the role of the Elder Sharaths ("servant" in Hebrew) in the cottage and the extensive training/education given them to prepare them for this new role. The organization, operations and delivery of care within this recent paradigm are radically different from those of the traditional nursing home. Dementia Care and Assisted Living Cottages - Located next to the nursing facility are two individual cottages (24 beds) which specialize in assisted living dementia care as well as two additional high-acuity assisted living cottages (29 beds). In 2024, the cottages provided 15,579 days of care to 63 individuals. Retirement Services In 2021, residents living in our former HUD retirement facility were relocated to our new 56-unit low-income housing tax credit project or to other facilities on campus. The completion of the tax credit project provided a rejuvenated independent living space for our elders, while still giving them access to our activities program, pastoral care program, and nursing amenities if needed. We served 64 residents in our new facility in 2024.Other Facilities - The Crossings, a St. John's facility located in Laurel, Montana, includes a 12 unit assisted living dementia care cottage, 14 assisted living apartments, 24 independent living apartments and 5 townhomes. The Crossings served 69 individuals with 18,791 days of care provided in 2024. The Willows, a St. John's facility located in Red Lodge, MT has two connected assisted living cottages (24 beds total). The Willows facility was closed in August 2023.Medicaid Residents - St. John's provides services to all people in need including Medicaid residents. The cost of such care is much greater than the related reimbursement. In 2024, St. John's continued as one of the largest providers of Medicaid long-term care services in Yellowstone County, Montana providing 12,008 days of care to Medicaid residents. The gap between our cost to provide care to Medicaid recipients and the reimbursement we received in the nursing facility during 2024 is an estimated $2,470,000.Home & Community Based Services/Rural Outreach - Through our rehabilitation department, we served 48 patients. These patients were located at a hospital a distance of 50 miles from Billings. In addition, we contracted with our joint venture, Hom

Financial Efficiency

• Mission deployment rate: 92.6%; rating input score 93
• Program expense ratio: 91.3%; rating input score 91
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 62nd percentile among comparable filings
• Pay-setting controls: 3 of 6 controls in place; rating input score 50
  • Compensation committee: Pass
  • Independent consultant: Pass
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: 100%; rating input score 100; 72nd percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 100%; rating input score 100; 66th percentile among comparable filings
• Governance controls: 8 of 9 controls in place; rating input score 89
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -6.4%; rating input score 14; 14th percentile among comparable filings
• Total-asset coverage ratio: 1.74; rating input score 57; 57th percentile among comparable filings
• Liabilities to assets ratio: 0.89; rating input score 11; 11th percentile among comparable filings
• Officer compensation ratio: 4.2%; rating input score 58; 58th percentile among comparable filings

Growth

• Program expense growth: 0.5% per year; rating input score 100; 12th percentile among comparable filings
• Revenue growth: 1.1% per year; rating input score 100; 12th percentile among comparable filings
• Asset growth: -0.4% per year; rating input score 0; 9th percentile among comparable filings