ANNANDALE CARE CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ANNANDALE CARE CENTER (EIN 23-7296950)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-05-05
- IRS object ID
- 202201259349301675
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-05T12:33:22-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1730 Burnt Boat Loop Ste 100 | AddressLine1Txt |
| City | Bismarck | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 585030886 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237296950 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Annandale Care Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANNA | BusinessNameControlTxt |
| Phone | 3202743737 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Park Street East | AddressLine1Txt |
| City | Annandale | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55302 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Richard Feeney | PersonNm |
| Person Title | Administrator | PersonTitleTxt |
| Phone | 3202743737 | PhoneNum |
| Signature | 2022-05-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Richard | PersonFirstNm |
| Person Last | Feeney | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Lisa Chaffee CPA | PreparerPersonNm |
| PTIN | P00193453 | PTIN |
| Phone | 7012551091 | PhoneNum |
| Preparation | 2022-05-02 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Richard Feeney | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Park Street East | AddressLine1Txt |
| City | Annandale | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55302 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,842,585 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.annandalecarecenter.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | Skilled nursing services and assisted living services | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 244 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $45,417 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,373,574 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,796,999 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,510,447 | CYProgramServiceRevenueAmt |
| PY Investment Income | $210,654 | PYInvestmentIncomeAmt |
| CY Investment Income | $127,277 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | -$168,713 | CYOtherRevenueAmt |
| PY Total Revenue | $8,053,070 | PYTotalRevenueAmt |
| CY Total Revenue | $7,842,585 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $23,149 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $25,366 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,790,922 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,686,327 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,991,691 | PYOtherExpensesAmt |
| CY Other Expenses | $2,926,799 | CYOtherExpensesAmt |
| PY Total Expenses | $7,805,762 | PYTotalExpensesAmt |
| CY Total Expenses | $7,638,492 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $247,308 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $204,093 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,348,461 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,616,189 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,718,366 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,659,976 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,630,095 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,956,213 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Annandale Congregate Housing, a related organization, 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. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,902,068 | ExpenseAmt |
| Grant | $25,366 | GrantAmt |
| Revenue | $6,341,734 | RevenueAmt |
| Desc | The Organization operates a 60 bed skilled nursing facility, a 26 unit assisted living building (a.k.a. Centennial Villa Assisted Living), a 30 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 the fiscal year end due to COVID. It will be opening again in 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. | Desc |
| Total Program Service Expenses | $6,902,068 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 244 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | 0 | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Richard Feeney | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3202743737 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Park Street East | AddressLine1Txt |
| City | Annandale | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55302 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| Debra Reitmeier | |||||||
| Administrator/President | 40.00 | 3.00 | Yes (X) | $152,047 | $0 | $15,287 | |
| Mark Miller | |||||||
| Chairman | 0.10 | 0.20 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Linda Dircks | |||||||
| Vice Chairman | 0.10 | 0.10 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Kathy Gruys | |||||||
| Secretary/Treasurer | 0.10 | 0.10 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Roger Millner | |||||||
| Director | 0.10 | 0.10 | $0 | $0 | $0 | Yes (X) | |
| Jack Driste | |||||||
| Director | 0.10 | 0.10 | $0 | $0 | $0 | Yes (X) | |
| Ed Schomoroh | |||||||
| Director | 0.10 | 0.20 | $0 | $0 | $0 | Yes (X) | |
| Shelley Jonas | |||||||
| City Liason | 0.10 | 0.20 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $152,047 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $15,287 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RehabVisions | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11623 Arbor St Ste 201 | AddressLine1Txt |
| City | Omaha | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68144 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Contracted Therapy | ServicesDesc |
| Compensation | $324,880 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,370,750 | GovernmentGrantsAmt |
| All Other Contributions | $2,824 | AllOtherContributionsAmt |
| Total Contributions | $1,373,574 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Resident Service Reven | 623000 | $6,378,199 | $6,378,199 |
| Other Revenue | 900099 | $129,670 | $129,670 |
| Wellness Center | 713940 | $2,578 | $2,578 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,510,447 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $126,777 | TotalRevenueColumnAmt |
| Exclusion | $126,777 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $500 | TotalRevenueColumnAmt |
| Exclusion | $500 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Debt refinance loss | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | -$168,713 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$168,713 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$168,713 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,842,585 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,341,734 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $127,277 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,366 | TotalAmt |
| Program Services | $25,366 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,061 | TotalAmt |
| Management And General | $185,061 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,727,494 | TotalAmt |
| Program Services | $3,648,173 | ProgramServicesAmt |
| Management And General | $79,321 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $521,696 | TotalAmt |
| Program Services | $507,242 | ProgramServicesAmt |
| Management And General | $14,454 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $252,076 | TotalAmt |
| Program Services | $237,553 | ProgramServicesAmt |
| Management And General | $14,523 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,088 | TotalAmt |
| Program Services | $10,164 | ProgramServicesAmt |
| Management And General | $2,924 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,700 | TotalAmt |
| Program Services | $925 | ProgramServicesAmt |
| Management And General | $29,775 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135 | TotalAmt |
| Management And General | $135 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,011 | TotalAmt |
| Program Services | $496,699 | ProgramServicesAmt |
| Management And General | $4,312 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,602 | TotalAmt |
| Program Services | $8,044 | ProgramServicesAmt |
| Management And General | $19,558 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,516 | TotalAmt |
| Program Services | $95,283 | ProgramServicesAmt |
| Management And General | $50,233 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,961 | TotalAmt |
| Program Services | $12,961 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,879 | TotalAmt |
| Program Services | $375,879 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,552 | TotalAmt |
| Program Services | $2,160 | ProgramServicesAmt |
| Management And General | $392 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,331 | TotalAmt |
| Program Services | $1,752 | ProgramServicesAmt |
| Management And General | $2,579 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,738 | TotalAmt |
| Program Services | $242,299 | ProgramServicesAmt |
| Management And General | $11,439 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,302 | TotalAmt |
| Program Services | $363,395 | ProgramServicesAmt |
| Management And General | $17,907 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,050 | TotalAmt |
| Program Services | $24,408 | ProgramServicesAmt |
| Management And General | $38,642 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Meals/Food | $537,644 | $537,163 | $481 |
| Medical Supplies | $264,233 | $264,233 | |
| DHS Surcharge | $182,975 | $182,975 | |
| Bad Debt Expense | $28,490 | $28,490 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,592 | TotalAmt |
| Program Services | $48,369 | ProgramServicesAmt |
| Management And General | $53,223 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,638,492 | TotalAmt |
| Program Services | $6,902,068 | ProgramServicesAmt |
| Management And General | $736,424 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,943,939 | BOYAmt |
| EOY | $946,282 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $532,693 | BOYAmt |
| EOY | $536,806 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,831 | BOYAmt |
| EOY | $29,984 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,862,755 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,335,589 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,150,303 | BOYAmt |
| EOY | $14,527,166 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,698,695 | BOYAmt |
| EOY | $4,575,951 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,348,461 | BOYAmt |
| EOY | $20,616,189 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,645,538 | BOYAmt |
| EOY | $1,648,372 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $406,725 | BOYAmt |
| EOY | $4,910 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,637,689 | BOYAmt |
| EOY | $11,969,594 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,414 | BOYAmt |
| EOY | $37,100 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,718,366 | BOYAmt |
| EOY | $13,659,976 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,630,095 | BOYAmt |
| EOY | $6,956,213 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,630,095 | BOYAmt |
| EOY | $6,956,213 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,348,461 | BOYAmt |
| EOY | $20,616,189 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $204,093 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $151,866 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,970,159 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,055 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,652 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,445 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,417 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,373,574 | CurrentTaxYearAmt |
| Total | $1,434,143 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,334,961 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,215,762 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,630,269 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,796,999 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,510,447 | CurrentTaxYearAmt |
| Total | $38,488,438 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,342,016 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,218,414 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,635,714 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,842,416 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,884,021 | CurrentTaxYearAmt |
| Total | $39,922,581 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $276,266 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $191,479 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $332,529 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $776,327 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $839,565 | CurrentTaxYearAmt |
| Total | $2,416,166 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $276,266 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $191,479 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $332,529 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $776,327 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $839,565 | CurrentTaxYearAmt |
| Total | $2,416,166 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $37,506,415 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $181,762 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $207,640 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $230,693 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $210,654 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $126,777 | CurrentTaxYearAmt |
| Total | $957,526 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $181,762 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $207,640 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $230,693 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $210,654 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $126,777 | CurrentTaxYearAmt |
| Total | $957,526 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,523,778 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,426,054 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,866,407 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,053,070 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,010,798 | CurrentTaxYearAmt |
| Total | $40,880,107 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.91750 | PublicSupportCY509Pct |
| Public Support PY509 | 0.93470 | PublicSupportPY509Pct |
| Investment Income CY | 0.02340 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02520 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $403,739 | OtherCostOrOtherBasisAmt |
| Book Value | $403,739 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,201,790 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,522,207 | DepreciationAmt |
| Book Value | $3,679,583 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,670,803 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,343,779 | DepreciationAmt |
| Book Value | $327,024 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,586,423 | OtherCostOrOtherBasisAmt |
| Depreciation | $469,603 | DepreciationAmt |
| Book Value | $10,116,820 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,527,166 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,993,951 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $151,866 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $151,866 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,842,085 | RevenueSubtotalAmt |
| Other Revenues Not Included | $500 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $500 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,842,585 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,637,992 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$500 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$500 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,638,492 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $7,638,492 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | Annandale Care Center acts as custodian for funds of its residents and tenants. |
| Part X, Line 2: | The Care Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does 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. |
| Part XI, Line 4b - Other Adjustments: | Realized Gain/Loss on Investment 500. |
| Part XII, Line 2d - Other Adjustments: | Realized Gain/Loss on Investment -500. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Employee Scholarships- Education | GrantTypeTxt |
| Recipient | 8 | RecipientCnt |
| Cash Grant | $25,366 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Debra Reitmeier | PersonNm |
| Title | Administrator/President | TitleTxt |
| Base Compensation Filing Org | $152,047 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $15,287 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $167,334 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| City of Annandale MN | ||||||||
| A | 416004935 | 000000000 | 2020-10-15 | $5,763,326 | To refund bonds issued 9/25/2015 | 0 | 0 | 0 |
| City of Howard Lake MN | ||||||||
| B | 416005249 | 000000000 | 2020-10-15 | $8,500,000 | To construct 42-unit assisted living and independent living building | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capitalized InterestCapitalizedInterestAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $114,768 | $5,763,326 | $5,763,326 | Yes (1) | 0 | Yes (1) | Yes (1) | ||||
| B | $1,903,347 | $8,500,000 | 0 | 0 | Yes (1) | Yes (1) | $200,000 | $50,001 | $8,249,999 | 2021 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | Annandale Congregate Housing, a related organization, 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. |
| Form 990, Part VI, Section A, line 1 | The President does not have voting rights. |
| Form 990, Part VI, Section A, line 2 | Roger Millner and Shelley Jonas have a family relationship. |
| Form 990, Part VI, Section A, line 4 | During the year, Articles of Merger were filed. Annandale Congregate Housing, a related organization, merged into Annandale Care Center as of 7/31/2021. |
| 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 | A draft copy of the Form 990 will be mailed out to members of the Board prior to the filing date. Also, the Administrator/President will review a draft copy of the Form 990 before it is filed. |
| 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 | Each year, the Corporation finds out what the increase in rates will be. The increase in rates is allocated proportionately across the board to all employees. The budget is also determined by the increase in rates and the Board of Directors approves the budget. |
| 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. |
| Form 990, Part XI, line 9: | Merger and transfer in of Annandale Congregate Housing Net Assets 1,970,159. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 0 | Annandale Health and Community Services | |
| Annandale Congregate Housing | |||||||||||
| 500 Park Street East | Annandale | MN | 55302 | 363566531 | Independent Living | MN | 501(c)(3) | Line 12a, I | 0 | Annandale Health and Community Services | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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