2021-11-11T14:08:46-07:00 2021-06-30 990 2020-07-01 450448164 VALLEY SENIOR LIVING VALL 7017877912 2900 14th Ave S Grand Forks ND 58201 Garth Rydland President/CEO 7017877905 2021-11-11 1 11 0 AAL2 2020 2022-09-23 18:48:47Z Valley Senior Living Garth Rydland 2900 14th Ave S Grand Forks ND 58201 8677830 0 X www.valleyseniorliving.org X 1997 ND To provide management, nursing, chaplaincy and other support services to related healthcare entities. 32 31 1263 50 0 0 25373 5629900 2735769 3047930 0 0 0 0 2761142 8677830 0 5629900 0 0 2148975 2500003 0 0 0 612167 547927 2761142 8677830 0 0 6228350 874016 6210920 856586 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 2635696 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. 125106 0 0 Skilled Nursing Facility Support Services including Nursing-Admissions, and Medical Records for up to 334 skilled residents a day. 287128 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. 5629900 0 0 Valley Senior Living received SBA Paycheck Protection Program funds and loan was forgiven. Allocations were made to related organization based on eligible salaries claimed on the loan forgiveness application that are direct costed to Valley Homes and Services and 4000 Valley Square Inc. 5629900 0 0 8677830 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 25 0 1 1263 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 265237 0 25261 Lorilee Bott CFO 40 0 X 180328 0 11309 Jessica Baumgarten Director of Nursing Valley Senior Living on Columbia 40 0 X 145969 0 32430 Angela Goulet Tufte Manor Administrator/Director of PCS 40 0 X 116314 0 32267 Jennifer Schultz Director of Nursing Woodside Village 40 0 X 117658 0 30100 Gina Roller Valley Senior Living on 42nd Administrator 40 0 X 127252 0 7764 John Snustad Chair 0 0 X X 0 0 0 Charles Johnson Board Secretary 0 0 X X 0 0 0 Peter Hoistad Treasurer 0 0 X X 0 0 0 Gary Masilko Director 0 0 X 0 0 0 Roger Stadstad Director 0 0 X 0 0 0 Sharon Bakke Director 0 0 X 0 0 0 Sharon Gustafson Director 0 0 X 0 0 0 Carol Snortland Director 0 0 X 0 0 0 Duane Hanson Director 0 0 X 0 0 0 Ellis Larson Director 0 0 X 0 0 0 JoAnn Miller Director 0 0 X 0 0 0 Lisa Piche Director 0 0 X 0 0 0 Susan Kuster Director 0 0 X 0 0 0 Clark Piepkorn 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 Margaret Reed Vice Chair 0 0 X 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 Luther Frette 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 Karen Brekke Director 0 0 X 0 0 0 Dave Molmen Director 0 0 X 0 0 0 952758 0 139131 15 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 1187136 Industrial Contract Services PO Box 13158 Grand Forks ND 582083158 General Contractor - Construction 701825 C&R Cleaners and Laundry 1010 N 5th Street Grand Forks ND 58203 Laundry Purchased Services 260096 Networking Specialists 2397 Demers Ave Grand Forks ND 58201 IT Managed Services 512101 Widseth Smith Nolting PO Box 459 Crookston MN 56716 Architectural and construction management 147229 8 0 0 0 0 5629900 0 0 5629900 Management Fee 623110 3047930 3047930 0 0 0 0 0 0 3047930 0 0 0 0 0 0 8677830 3047930 0 0 5629900 5629900 0 0 445565 445565 0 0 0 0 0 0 1500878 1500878 0 0 104493 104493 0 0 316939 316939 0 0 132128 132128 0 0 6306 6306 0 0 33580 33580 0 0 31815 31815 0 0 35365 35365 0 0 39075 39075 0 0 710 710 0 0 11556 11556 0 0 92603 92603 0 0 42375 42375 0 0 Purchased Services-IT, Chaplain, Adm 107555 107555 0 0 Direct Supplies, Minor Equip, R&M 64841 64841 0 0 Employee Expense 20085 20085 0 0 Dues, Subscription 4612 4612 0 0 57449 57449 0 0 8677830 8677830 0 0 435702 40324 23992 1892 399 0 90838 109194 1275623 1054894 338814 220729 5338605 501877 6228350 874016 276090 290235 5934830 566351 6210920 856586 X 17430 17430 0 0 17430 17430 6228350 874016 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 5239738 0 4000 Valley Square Inc 311558826 9 1 3438092 0 3 8677830 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 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 organization are referred to indirectly in bylaws which state part of Valley Senior Living's corporate is to support organizations with which is formally affiliated. 0 0 0 0 0 0 0 0 0 0 0 0 1275623 1054894 220729 0 0 0 0 220729 457B Plan 501877 501877 0 457 B Plan 501862 Intercompany Due to/from 64489 566351 1 Valley Homes and Services DBA Valley Senior Living on Columbia and Tufte Manor 2900 14th Ave S Grand Forks ND 58201 450229071 501 (c) 3 3349722 0 Eligible salaries submitted on loan forgiveness application To cover salary expenses during covered period on SBA PPP Forgiveness Application 4000 Valley Square Inc 4000 24th Ave S Grand Forks ND 58201 311558826 501 (c) 3 2280180 0 Eligible salaries submitted on loan forgiveness application To cover salary expenses during covered period on SBA PPP Forgiveness Application. 2 0 Schedule I, Part I, Line 2 Valley Senior Living received SBA Paycheck Protection Funds and received notification of loan forgiveness/grant conversion. These funds were then allocated to related organizations based on direct costing of eligible salaries applied claimed on loan forgiveness application. X X X X 0 1 0 0 0 0 0 0 0 Garth Rydland President/CEO 245074 0 20163 0 9439 0 15822 0 0 0 290498 0 0 0 Lorilee Bott CFO 171128 0 9200 0 489 0 10820 0 0 0 191637 0 0 0 Gina Roller Valley Senior Living on 42nd Administrator 121592 0 5660 0 9356 0 7764 0 0 0 144372 0 0 0 Schedule J, Part I, Line 3 Compensation of President/CEO is determined by compensation committee. Base salary is evaluated by comparison to other organizations of similar size and function. Schedule J, Part I, Line 4 Valley Senior Living participates in a 457B plan. Form 990, Part VI, Section A, Line 9 Marilyn Nyberg, 697 Mighty Acres Dr, Grand Forks, ND 58201 ; Carol Snortland, 3802 Cherry St K-43, Grand Forks, ND 58201; Sue Moe,618 5th St SE, East Grand Forks, MN 56721; Wendy Waller, 21067 420th Ave SW, East Grand Forks, MN 56721 Pete Hoistad,118 Breezy Hills Cove, Grand Forks, ND 58201 Duane Hanson, 710 Goodwin Ave, Thompson, ND 58278; Tara O'Hearn, 1095 17th St NE, Grand Forks, ND 58201; Ellis Larson, 1034 10th Ave SE, East Grand Forks, MN 56721; 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 Thomspon, 1209 23 St S, Grand Forks, ND 58201; Jim Lancaster, 806 25th Ave S, Grand Forks, ND 58201; Linda Simmons, 1015 N 39th St #J40, Grand Forks, ND 58201; Sharon Gustafson, 510 Woodland Dr, Thompson, ND 58278; Susan Kuster, 313 7th Ave, Reynolds, ND 58275; Dave Molmen, 665 Desiree Dr, Grand Forks, ND 58201; JoAnn Miller, 748 Great Plains Ct, Grand Forks, ND 58201; Lisa Piche, 1307 Truesdale Dr, Manvel, ND 58256; Gary Masilko, 210 Circle Hills Dr, Grand Forks, ND 58201; 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; Bud Johnson, 3008 Legend Land, Grand Forks, ND 58201; John Snustad, PO Box 13318, Grand Forks, ND 58208; Clark Piepkorn, 3021 Olson Dr, Grand Forks, ND 58201; Patrick Moore, 611 Terrace Dr, Grand Forks, ND 58201; Margaret Reed, 297 Circle Hills Dr, Grand Forks, ND 58201 Karen Brekke, 1413 Central Ave NW, East Grand Forks, MN 56721, Luther Frette, 4002 24th Ave S #334, Grand Forks, ND 58201. Form 990, Part VI, Section B, Line 11b The CFO with the assistance of the President/CEO 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 answers 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 of identified positions if the survey demonstrates underpayment compared to like sized organizations. 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 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 Valley Homes and Services b 3349722 Transfer of SBA Paycheck Protection program forgiven loan/grant funds based on eligible salaries of employees who worked for Valley Homes and Services entities: Valley Senior Living on Columbia and Tufte Manor. Valley Homes and Services q 1890018 Actual expense-Direct costs or allocated. 4000 Valley Square Inc b 2280181 Transfer of SBA Paycheck Protection program forgiven loan/grant funds based on eligible salaries of employees who worked for 4000 Valley Square entities: Woodside Village, Wheatland Terrace, and Country Estates. 4000 Valley Square Inc q 1065524 Actual costs - Direct costs or allocated. Schedule R, Part V, Line 2 The amounts involved in transactions in "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.