2023-12-11T15:36:59-06:00 2022-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2021-10-01 237296950 ANNANDALE CARE CENTER ANNA 3202743737 500 PARK SREET EAST ANNANDALE MN 55302 ELSA NISKA ADMINSTRATOR 3202743737 2023-11-30 1 ELSA NISKA 999009999 TYLER JOHNSON P01604007 6123764500 2023-11-28 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z ELSA NISKA 500 PARK SREET EAST ANNANDALE MN 55302 7614465 0 X WWW.ANNANDALECARECENTER.ORG X 1973 MN SKILLED NURSING SERVICES AND ASSISTED LIVING SERVICES. 7 7 216 0 0 0 1373574 87857 6510447 7390024 127277 136584 -168713 0 7842585 7614465 25366 16585 0 0 4686327 6168575 0 0 0 2926799 3804601 7638492 9989761 204093 -2375296 20616189 18635507 13659976 14540827 6956213 4094680 X QUALITY CARE AND SERVICES THAT SHAPE THE FUTURE FOR THE DYNAMIC NEEDS OF THE PEOPLE IN OUR AREA. 0 0 9165821 16585 7390024 THE ORGANIZATION OPERATES A 45 BED SKILLED NURSING FACILITY, A 56 UNIT ASSISTED LIVING BUILDING (A.K.A CENTENNIAL VILLA ASSISTED LIVING), A 42 UNIT ASSISTED LIVING BUILDING (A.K.A PLEASANT VISTA ASSISTED LIVING), A 29 UNIT MEMORY CARE FACILITY AND A WELLNESS CENTER. IT NOT ONLY PROVIDES SERVICES TO THE ELDERLY POPULATION IN ANNANDALE BUT ALSO TO THOSE IN OTHER AREA COMMUNITIES WHICH HELPS THE INDIVIDUAL TO REMAIN IN THE SAME GEOGRAPHICAL AREA OF THEIR FORMER RESIDENCE. THE SKILLED NURSING FACILITY HAS AN EXCELLENT THERAPY PROGRAM THAT IS AVAILABLE TO ITS RESIDENTS WHO ARE IN NEED OF REHABILITATION SERVICES. IT ALSO HAS AN OUTPATIENT PROGRAM THAT TREATS THOSE FROM THE ANNANDALE COMMUNITY AND THE SURROUNDING AREA. IT IS BECAUSE OF ITS ONSITE THERAPY PROGRAM THAT IT HAS BECOME THE FIRST CHOICE FOR MOST WHEN THEY REQUIRE REHABILITATION SERVICES FOLLOWING A SURGERY IN ORDER TO RETURN HOME SAFELY. THE ASSISTED LIVING BUILDING SERVES AS A PLEASANT TRANSITION FOR THOSE WHO NEED ADDITIONAL HELP THAT IS NOT READILY AVAILABLE IN THEIR OWN HOME BUT ARE STILL INDEPENDENT ENOUGH THAT THEY DON'T REQUIRE THE SERVICES OF A SKILLED NURSING FACILITY. THE MEMORY LOSS UNIT IS MUCH MORE APPROPRIATE FOR THOSE WHO SUFFER FROM ALZHEIMER'S AND/OR SEVERE DEMENTIA THAN A SKILLED NURSING FACILITY. THE ENVIRONMENT IS CONTROLLED AND SETUP TO MEET EACH RESIDENT'S NEEDS RELATING TO THEIR SPECIFIC ILLNESS. THE WELLNESS CENTER HAS A THERAPY/EXERCISE SWIM POOL, EXERCISE CLASS STUDIO AND AN EXERCISE EQUIPMENT ROOM DEVELOPED TO SERVE THE WELLNESS NEEDS OF THOSE 50 YEARS OF AGE AND OLDER - BOTH WITHIN THE CAMPUS AND THE OUTSIDE COMMUNITY. THE WELLNESS CENTER WAS CLOSED FROM SPRING 2020 THROUGH FEBRURARY 2022. IT WAS RE-OPENED IN MARCH 2022.ANNANDALE CONGREGATE HOUSING MERGED INTO THE ORGANIZATION AS OF JULY 31ST, 2021. WITH THE MERGER, THE ORGANIZATION NOW ALSO OPERATES A 22 UNIT CONGREGATE HOUSING FACILITY THAT SERVES THE HOUSING NEEDS OF THE 55 AND OLDER ADULT POPULATION IN ANNANDALE AND THE SURROUNDING COMMUNITIES. RESIDENTS HAVE ACCESS TO PREPARED MEALS AND 24 HOUR EMERGENCY RESPONSE FROM THE NURSING STAFF IN THE ATTACHED SKILLED NURSING FACILITY. THEY ALSO HAVE PRIORITY IN THE EVENT THAT THEY REQUIRE A NURSING HOME STAY. 9165821 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 216 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 1 0 0 0 MN X ELSA NISKA 3204160225 500 PARK ST E ANNANDALE MN 55302 MARK MILLER CHAIRMAN 0.10 0.20 X X 0 0 0 LINDA DIRCKS VICE CHAIRMAN 0.10 0.20 X X 0 0 0 ANGELA MANUEL SECRETARY/TREASURER 0.10 0.20 X X 0 0 0 ROGER MILLNER DIRECTOR 0.10 0.20 X 0 0 0 JACK DRISTE DIRECTOR 0.10 0.20 X 0 0 0 ED SKOMOROH DIRECTOR 0.10 0.20 X 0 0 0 JAMES GRUNDY CITY LIASON 0.10 0.20 X 0 0 0 DEBRA REITMEIR ADMINISTRATOR/PRESIDENT 40.00 3.00 X 0 0 0 RICHARD FEENEY ADMINISTRATOR/PRESIDENT 40.00 0.00 X 138000 0 0 138000 0 0 1 0 0 0 REHABVISIONS 11623 ARBOR STREET OMAHA NE 68144 THERAPY SERVICES 325833 1 74694 13163 87857 RESIDENT SERVICE REVEN 623000 7168193 7168193 OTHER SERVICE REVENUE 900099 178782 178782 WELLNESS CENTER 713940 43049 43049 7390024 136584 136584 7614465 7390024 0 136584 16585 16585 138000 138000 5107372 4744634 362738 549960 549960 373243 373243 18980 7707 11273 43712 10200 33512 670270 636294 33976 22707 12311 10396 67045 67045 13631 13631 495494 495494 4337 3296 1041 8504 3291 5213 432182 432182 824719 824719 99449 59435 40014 MEALS/FOOD 592353 592353 MEDICAL SUPPLIES 185441 185441 BAD DEBT EXPENSE 177989 177989 DHS SURCHARGE 147788 147788 9989761 9165821 823940 0 946282 323940 536806 973746 29984 72357 25316755 10149395 14527166 15167360 4575951 2098104 20616189 18635507 1648372 738576 4910 0 11969594 13725724 37100 76527 13659976 14540827 X 6956213 4094680 6956213 4094680 20616189 18635507 -2375296 -486237 0 X 0 1 X 1 0 X 2652 5445 45417 1373574 87857 1514945 8215762 7630269 7796999 6510447 7390024 37543501 8218414 7635714 7842416 7884021 7477881 39058446 0 191479 332529 776327 839565 2288309 4428209 191479 332529 776327 839565 2288309 4428209 34630237 207640 230693 210654 126777 136584 912348 207640 230693 210654 126777 136584 912348 8426054 7866407 8053070 8010798 7614465 39970794 0.86640 0.91750 0.02280 0.02340 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 403739 403739 22498930 8228429 14270501 1834729 1425763 408966 579357 495203 84154 15167360 X PART IV, LINE 2B: ANNANDALE CARE CENTER ACTS AS CUSTODIAN FOR FUNDS OF ITS RESIDENTS AND TENANTS. PART X, LINE 2: THE CARE CENTER IS ORGANIZED AS MINNESOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE CARE CENTER IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE CARE CENTER IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO THEIR EXEMPT PURPOSES. THE CARE CENTER HAS DETERMINED THEY ARE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAVE NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE CARE CENTER BELIEVES THAT THEY HAVE APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS, AND AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE CARE CENTER WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. 1 EMPLOYEE SCHOLARSHIPS- EDUCATION 7 16585 PART I, LINE 2: SCHOLARSHIPS ARE AWARDED TO EMPLOYEES WHO WORK AN AVERAGE OF 20 HOURS A WEEK OR MORE AND WHO ARE ENROLLED IN A PROGRAM OF STUDY RELATED TO LONG TERM CARE. RECIPIENTS ARE SELECTED BY A COMMITTEE ON A QUARTERLY BASIS. FUNDS ARE DISBURSED UPON RECEIVING A COPY OF THE RECIPIENT'S TUITION/FEES STATEMENT AND/OR RECEIPTS FOR PURCHASES OF REQUIRED TEXTBOOKS. THE GUIDELINES FOR THIS PROGRAM ARE IN ACCORDANCE WITH THOSE SET FORTH BY THE MN DEPARTMENT OF HUMAN SERVICES' NURSING FACILITY SCHOLARSHIP PROGRAM. A CITY OF ANNANDALE MN 416004935 2020-10-15 5763326 TO REFUND BONDS ISSUED 9/25/2015 0 0 0 B CITY OF HOWARD LAKE MN 416005249 2020-10-15 8500000 TO CONSTRUCT 42-UNIT ASSISTED LIVING AND INDEPENDENT LIVING BUILDING 0 0 0 A 360961 5763326 5763326 1 0 1 1 B 411687 8500000 200000 50001 8249999 2021 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 1 0 0 0 1 B 0 0 0 0 1 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 1A THE PRESIDENT DOES NOT HAVE VOTING RIGHTS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS ELECTED ANNUALLY BY THE BOARD OF DIRECTORS OF ANNANDALE HEALTH AND COMMUNITY SERVICES. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING MUST BE APPROVED BY THE BOARD OF DIRECTORS OF ANNANDALE HEALTH AND COMMUNITY SERVICES: - BUDGET - CHANGES IN BUDGET OF OVER $10,000 - EXPENDITURES OF OVER $10,000 - SALES OF ASSETS OF OVER $10,000 - CHANGES TO THE BYLAWS THE FOLLOWING MUST BE APPROVED BY THE PRESIDENT OF THE ANNANDALE HEALTH AND COMMUNITY SERVICE BOARD: - CHANGES IN THE BUDGET OF OVER $5,000 BUT LESS THAN $10,000 - EXPENDITURES OF OVER $5,000 BUT LESS THAN $10,000 - SALES OF ASSETS OF OVER $5,000 BUT LESS THAN $10,000 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT CAN ACT ON BEHALF OF THE BOARD. COMMITTEES MUST COME BACK TO THE FULL BOARD TO MAKE A FINAL DECISION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE REVIEWED BY THE ADMINISTRATOR, CONTROLLER AND THE BOARD PRIOR TO FINALIZING. FORM 990, PART VI, SECTION B, LINE 12C THERE IS NO ANNUAL FORM OR DISCLOSURE THAT IS USED TO UNCOVER CONFLICTS OF INTEREST; HOWEVER, INDIVIDUALS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST BASED ON AN "HONOR-SYSTEM." ANYONE WHO CAN INFLUENCE THE ACTIONS OF THE CORPORATION IS COVERED BY THE POLICY. THIS INCLUDES BOARD MEMBERS, KEY EMPLOYEES, OFFICERS, AND EMPLOYEES. THE BOARD REVIEWS AND DETERMINES WHEN AND IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, BOARD MEMBERS ARE NOT ALLOWED TO VOTE ON THE ISSUE IN CONFLICT. ALL CONFLICTS OF INTEREST ARE DOCUMENTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 ALL SALARIES ARE COMPARED TO THE INDUSTRY AVERAGES AND WEIGHTED WITH EXPERIENCE AND EDUCATION PRIOR TO A DECISION BEING MADE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE NOT MADE PUBLICLY AVAILABLE. ANNANDALE HEALTH AND COMMUNITY SERVICES 500 PARK STREET EAST ANNANDALE MN 55302 411820760 OVERSIGHT MN 501(C)(3) LINE 7 N/A 0 HEARTLAND TRANSIT 500 PARK STREET EAST ANNANDALE MN 55302 411820763 INACTIVE CORPORATION MN 501(C)(3) LINE 7 ANNANDALE HEALTH AND COMMUNITY SERVICES 0 ANNANDALE CONGREGATE HOUSING 500 PARK STREET EAST ANNANDALE MN 55302 363566531 INDEPENDENT LIVING MN 501(C)(3) LINE 12A, I ANNANDALE HEALTH AND COMMUNITY SERVICES 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1