2022-11-10T14:27:48-07:00 2022-06-30 990 2021-07-01 450448164 VALLEY SENIOR LIVING VALL 7017877912 2900 14th Ave S Grand Forks ND 58201 Garth Rydland President/CEO 7017877905 2022-11-10 1 11 1 AAL2 2021 2022-09-23 18:48:47Z Valley Senior Living Garth Rydland 2900 14th Ave S Grand Forks ND 58201 3496436 0 X www.valleyseniorliving.org X 1997 ND To provide management, nursing, chaplaincy and other support services to related healthcare entities. 32 31 1286 200 0 0 5629900 128860 3047930 3367576 0 0 0 0 8677830 3496436 5629900 0 0 0 2500003 2644499 0 0 0 547927 851937 8677830 3496436 0 0 874016 804854 856586 787424 17430 17430 Valley Senior Living provides compassionate care and service from a Christian perspective to enhance the quality of life for those we serve. 0 0 3047785 0 0 Management support services including the following: Administration, Finance, IT, and Human Resources. Providing services to related organizations, who combined serve up to 523 residents and tenants on a daily basis and employs over 800 employees. 127091 0 0 Skilled Nursing Facility Support Services including Nursing-Admissions, and Medical Records for up to 334 skilled residents a day. 321560 0 0 Transportation services are provided to Valley Homes and Services and 4000 Valley Square Inc residents for medical appointments, activity outing and other transportation needs on regular basis. 0 0 0 3496436 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 1286 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 32 31 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 X Lorilee Bott 7017877912 2900 14th Ave S Grand Forks ND 58201 Garth Rydland President/CEO 40 0 X X X X 236170 0 23898 Gina Roller Valley Senior Living on 42nd Administrator 0 40 X X 0 168946 19621 Lorilee Bott CFO 40 0 X X 158376 0 26455 Jessica Baumgarten Director of Nursing Valley Senior Living on Columbia 0 40 X X 0 127423 31633 Jennifer Schultz Director of Nursing Woodside Village 0 40 X X 0 121812 22642 Angela Goulet Tufte Manor Administrator/Director of PCS 0 40 X X 0 110232 31565 LeeAnn Novak LPN Float 0 85.00 X X 0 119367 17241 Sarah Sharpe RN Care Coordinator 0 48.00 X 0 109454 25679 Barb Barta Director of Human Resources 40 0 X X 112641 0 16372 Angie Praska Assistant Director of Nursing 0 40 X 0 101469 6647 Dave Molmen Director 0 0 X 0 0 0 Margaret Reed Chair 0 0 X X 0 0 0 Peter Hoistad Treasurer 0 0 X X 0 0 0 Karen Brekke Secretary 0 0 X X 0 0 0 Susan Kuster Director 0 0 X 0 0 0 Jacky Jones Director 0 0 X 0 0 0 Marilyn Nyberg Director 0 0 X 0 0 0 Patrick Moore Director 0 0 X 0 0 0 Tara O'Hearn Director 0 0 X 0 0 0 Sue Moe Director 0 0 X 0 0 0 Wendy Waller Director 0 0 X 0 0 0 Betty Bloomquist Director 0 0 X 0 0 0 Robin Thompson Director 0 0 X 0 0 0 Ken Miller Director 0 0 X 0 0 0 Jim Lancaster Director 0 0 X 0 0 0 Linda Simmons Director 0 0 X 0 0 0 Susan Hahn Director 0 0 X 0 0 0 Sharon Bakke Director 0 0 X 0 0 0 Sara Munson Director 0 0 X 0 0 0 Marilyn Lee Director 0 0 X 0 0 0 Paulette Novak Director 0 0 X 0 0 0 Marcia Wehe Director 0 0 X 0 0 0 Michael Brown Director 0 0 X 0 0 0 Roger Stadstad Director 0 0 X 0 0 0 Loretta Prather Director 0 0 X 0 0 0 George Davis Director 0 0 X 0 0 0 Sarah Raymond Director 0 0 X 0 0 0 Kristi Adam Director 0 0 X 0 0 0 Kim Cariveau Director 0 0 X 0 0 0 John Snustad Vice Chair 0 0 X 0 0 0 507187 858703 221753 10 0 1 0 Altru Health Systems PO Box 13780 Grand Forks ND 58201 Contracted Therapies and Chaplaincy Service for Valley Homes and Services and 4000 Valley Square Inc 1208143 Industrial Contract Services PO Box 13158 Grand Forks ND 582083158 General Contractor - Construction 969274 C&R Cleaners and Laundry 1010 N 5th Street Grand Forks ND 58203 Laundry Purchased Services 347890 Networking Specialists 2397 Demers Ave Grand Forks ND 58201 IT Managed Services 396686 Tim Shea's Nursery 3515 S Washington Street Grand Forks ND 58201 Landscraping 216630 10 0 0 0 128860 0 0 0 128860 Management Fee 623110 3367576 3367576 0 0 0 0 0 0 3367576 0 0 0 0 0 0 3496436 3367576 0 0 394546 394546 0 0 1661718 1661718 0 0 109591 109591 0 0 331414 331414 0 0 147230 147230 0 0 11326 11326 0 0 43387 43387 0 0 43052 43052 0 0 37632 37632 0 0 57077 57077 0 0 5060 5060 0 0 14015 14015 0 0 83628 83628 0 0 44199 44199 0 0 Employee Expense 184790 184790 0 0 Purchased Services Admin, Chaplain, IT, HR 88509 88509 0 0 Direct Supplies, Repairs & Maintenance 66299 66299 0 0 Other Rental Administration 30310 30310 0 0 142653 142653 0 0 3496436 3496436 0 0 40324 169763 1892 3160 0 109194 58937 1282021 1138522 220729 143499 501877 429495 874016 804854 290235 404989 566351 382435 856586 787424 X 17430 17430 0 0 17430 17430 874016 804854 0 0 0 0 0 0 X 0 0 0 X X 3 Valley Senior Living Foundation 450392710 7 1 0 0 Valley Homes and Services 450229071 7 1 1963511 0 4000 Valley Square Inc 311558826 9 1 1205334 0 3 3168845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Part I, Line 1 Valley Senior Living's bylaws indicate that a part of its corporate purpose is to promote the interest of other organizations formally affiliated with it which fall within the category of 501 (c) (3) of the Code. Valley Senior Living is the sole corporate member of both Valley Homes and Services and 4000 Valley Square Inc. Schedule A, Part IV, Section A, Line 1 Supporting organizations are referred to indirectly in bylaws which start part of Valley Senior Living's corporate mission is to support organizations with which is formally affiliated. 0 0 0 0 0 0 0 0 0 0 0 0 1282021 1138522 143499 0 0 0 0 143499 457B PLAN 429495 429495 0 457 B PLAN 429480 Intercompany Due To/Due From -47045 382435 X X X X 0 1 0 0 0 0 0 0 0 Garth Rydland President/CEO 234470 0 1700 0 9439 0 14459 0 0 0 260068 0 0 Lorilee Bott CFO 150426 0 7950 0 16792 0 9663 0 0 0 184831 0 Gina Roller Valley Senior Living on 42nd Administrator 0 158749 0 10197 0 9356 0 10265 0 0 0 188567 0 Schedule J, Part I, Line 4 Valley Senior Living participates in a 457B Plan Form 990, Part VI, Section A, Line 9 John Snustad, PO Box 13318, Grand Forks, ND 58208; Patrick Moore, 611 Terrace Drive, Grand Forks, ND 58201; Maragaret Reed, 297 Circle Hills Dr, Grand Forks, ND 58201; Karen Brekke, 1413 Central Ave NW, East Grand Forks, MN 56721; Michael Brown, 601 Desiree Dr, Grand Forks, ND 58201; Marilyn Nyberg, 697 Mighty Acres Dr, Grand Forks, ND 58201; Loretta Prather, 417 S 5th St, Grand Forks, ND 58201; Sue Moe, 618 5th St SE, East Grand Forks, MN 56721; George Davis, 722 Dauman Ave N, Thief River Falls, MN 56701; Wendy Waller, 21067 420th Ave SW, East Grand Forks, MN 56721; Pete Hoistad, 118 Breezy Hills Cove, Grand Forks, ND 58201; Sarah Raymond, PO Box 326, Thompson ND, 58278-0326; Kristie Adam, 1827 7th Ave NE, Thompson, ND 58278; Tara O'Hearn, 1095 17th St NE, Grand Forks, ND 58201; Kim Cariveau, 2574 Sara Lyn Dr, Grand Forks, ND 5820; Ken Miller, 202 Thompson Ave, Fisher, MN 56723; Roger Stadstad, 2742 18th St NE, Manvel, ND 58256; Sharon Bakke, 2321 25th St NE, Mekinock, ND 58258; Robin Thompson, 1209 23 St S, Grand Forks, ND 58201; Jim Lancaster, 806 25th Ave S, Grand Forks, ND 58201; Susan Kuster, 313 7th Ave, Reynolds, ND 58275; Dave Molmenm 665 Desiree Dr, Grand Forks, ND 58201; Linda Simmons, 1015 N 39th St #J40, Grand Forks, ND 58201; Sara Munson, 543 Crescent Dr, Grand Forks, ND 58201; Marilyn Lee, 1852 1st Ave NE, Reynolds, ND 47275; Paulette Novak, 1612 N 6th St, Grand Forks, ND 58203; Marcie Wehe, 3396 69th St S, Grand Forks, ND 58202; Betty Bloomquist, 1119 Sunset Dr, Grand Forks, ND 58201; Susan Hahn, 9 Goodwin Ave, Thompson, ND 58278; Jacky Jones, PO Box 203, Oslo, MN 56744 Form 990, Part VI, Section B, Line 11b The CFO with the assistance of the President/CO prepares the Form 990. A draft of the Form 990 and all applicable schedules are sent to the Board of Directors' Executive Committee for review prior to a meeting held the second Thursday in November. The CFO explains any changes, specifically reviews Part VI and answer any questions. The Form 990 is filed after Executive Committee approval electronically. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is stated in Article 8 of the bylaws. It is reviewed with board members at Board Orientation. Board members are presented the policy and sign off annually. Form 990, Part VI, Section B, Line 15 The President/CEO's compensation is determined as follows: The compensation committee reviews the ND Long Term Care Association's state compensation survey each year and Form 990's of similar organizations to assess how Valley Senior Living's CEO's salary compares with others of similar size and function. The survey provides the committee with a gauge when it considers base compensation. The committee then reviews the organization's performance and strategic plan goals to develop an incentive compensation plan in addition to base salary. Compensation for executive management includes performance appraisal completed by the President/CEO or employee's direct supervisor. Employees are eligible for annual inflationary increase to their base salary. The percentage is based upon approved annual budget or other board approved changes. The ND Long Term Care salary surveys are reviewed and adjustments are made to the base salaries and identified positions if the survey demonstrates underpayment compared to like sized organization. Form 990, Part VI, Section C, Line 19 Valley Senior Living's governing documents, conflict of interest policy and financial statements are available upon request. Requests should be made to the CFO at Valley Senior Living's corporate office, located at Valley Senior Living on Columbia, 2900 14th Ave S., Grand Forks, ND 58201 between the hours of 8:30-4:30 Monday through Friday. Valley Homes and Services 2900 14th Ave S Grand Forks ND 58201 450229071 Skilled Nursing & Basic Care Fac ND 501 (c) 3 Line 9 N/A 0 4000 Valley Square Inc 4000 24th Ave S Grand Forks ND 58201 311558826 Sk Nursing Fac, Asst Liv, & Housing ND 501 (c) 3 Line 9 N/A 0 Valley Senior Living Foundation 2900 14th Ave S Grand Forks ND 58201 450392710 Seek and accept gifts to support LTC facilities ND 501 (c) 3 Line 7 N/A 0 Cherrywood Village 2900 14th Ave S Grand Forks ND 58201 454276187 Low Income Senior Apartments ND 501 (c) 3 Line 9 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 Valley Homes and Services q 1205334 Direct costed or allocated. 4000 Valley Square Inc q 1963511 Direct costed or allocated. Valley Senior Living Foundation c 128860 Actual contribution. Schedule R, Part V, Line 2 The amounts involved in transactions "m", "n", "o", "r" and "s" are included in transaction "q". Valley Senior Living expenses are direct costed or allocated to Valley Homes and Services and 4000 Valley Square Inc. based on allocation methodologies prescribed by the ND Department of Human Services.