2020-10-27T11:22:56-07:00 2019-12-31 990 2019-01-01 420868449 EVANGELICAL RETIREMENT HOMES INC EVAN 9528555000 7171 Ohms Lane Edina MN 55439 Kathy Youngquist Chief Financial Officer 9528555000 2020-10-27 50.209.15.97 2019 2021-01-29 14:40:06Z Valley View Village Robert Dahl 7171 Ohms Lane Edina MN 55439 8909864 0 X www.cassialife.org X 1962 IA To provide nursing home care and senior housing for the elderly. This includes programs and services specifically designed to meet residents' primary needs for housing, healthcare, nourishment and financial security. 4 4 227 61 0 0 48332 255000 8344827 8623112 4 33 30946 31719 8424109 8909864 0 0 0 0 4714102 5153153 0 0 68121 4320704 3845892 9034806 8999045 -610697 -89181 17798168 17712122 18488600 18384274 -690432 -672152 See Part I, Line 1 0 0 7288423 0 7467929 Evangelical Retirement Homes, Inc. was organized for the purpose of providing nursing home care for the elderly. The nursing home has 79 beds and is located in Des Moines, Iowa. During 2019 total resident days were 26,841 (93.1% occupancy). Utilization by payor source was as follows: 39.5% Medicaid, 6.4% Medicare, 52.5% Private Pay and 1.6% HMO. 746701 0 1155183 Evangelical Retirement Homes, Inc. operates two types of independent living facilities for the elderly. The Manor Apartments is a detached independent living building with 30 units. Occupancy during 2019 was 93.1%. There are also 57 Cottages for independent living residents. Occupancy for the Cottages during 2019 was 94.5%. 0 0 0 8035124 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 227 1 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Kathy L Youngquist 9528555000 7171 Ohms Lane Edina MN 55439 Robert Dahl President/CEO 1.23 18.77 X 0 739877 127818 Kathy Youngquist Chief Financial Officer 1.23 18.77 X 0 374518 106354 Ronald Sanford Chief Operating Officer (Jan-Mar) 2.46 37.54 X 0 319965 36713 Angela Brown Chief Human Resource Officer 1.23 18.77 X 0 224420 72587 Paul Mungai Certified Nursing Assistant 90.89 0 X 124516 0 6197 Stephanie Proper Administrator 40.77 0 X 100628 0 19643 Enome Massango L.P.N. 64.19 0 X 114593 0 0 Kevin Bergman Director (Jan-Apr) 0 0.12 X 0 0 0 Stann Leff Director and Vice Chairperson 0.15 0.16 X X 0 0 0 Pat Nuss Director (Jan-Apr) and Secretary/Treasurer (Jan-Apr) 0 0.18 X X 0 0 0 Jerry Nye Director (June-Dec) 0.15 0 X 0 0 0 Roland Peterson Director and Chairperson 0.15 0.08 X X 0 0 0 Dr Guy Tangedahl Director and Secretary/Treasurer (June-Dec) 0.15 0.27 X X 0 0 0 Matthew Kern Chief Operating Officer (Apr - Dec) 0.92 14.08 X 0 0 0 Sharon Wilson Chief Clinical and Compliance Officer 1.23 18.77 X 0 0 0 Kathy Kopp Chief Strategic Officer 1.23 18.77 X 0 0 0 339737 1658780 369312 3 0 1 0 Pro Rehab 7171 Ohms Lane Edina MN 55439 Therapy Services 607516 A&E Care Services 7171 Ohms Lane Edina MN 55439 Home Office Services 205000 2 X 0 0 0 255000 0 0 0 255000 Nursing Home Revenue 623000 7467929 7467929 0 0 Senior Housing Revenue 623000 1155183 1155183 0 0 0 0 0 0 8623112 33 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 Beauty Shop Revenue 812900 25225 0 0 25225 Guest Room Rental Revenue 900002 5900 0 0 5900 Miscellaneous Income 900099 594 0 0 594 0 0 0 0 31719 8909864 8623112 0 31752 4364627 4232746 131881 0 11799 11442 357 0 428979 416017 12962 0 347748 337240 10508 0 345168 0 345168 0 6648 0 6648 0 8357 0 8357 0 760607 754510 6097 0 65796 0 65796 0 31033 0 31033 0 29899 0 29899 0 383288 368328 14960 0 7449 0 7449 0 23604 0 23604 0 485211 466274 18937 0 795900 764837 31063 0 55224 24254 30970 0 Supplies and Ancillary Expenses 507191 418378 20692 68121 Maintenance Contracts/Purchased Services 154793 148752 6041 0 Building and Equipment Repairs 114781 110301 4480 0 Bad Debts 73336 0 73336 0 -2393 -17955 15562 0 8999045 8035124 895800 68121 146813 476690 33340 0 0 0 544632 696843 0 0 0 50000 45300 25237675 8931814 16845125 16305861 0 0 0 0 178258 187428 17798168 17712122 486942 484551 0 212734 174835 0 0 0 15924148 15375019 0 1864776 2349869 18488600 18384274 X -801422 -737349 110990 65197 -690432 -672152 17798168 17712122 X -89181 0 0 0 -431 107892 X 0 1 X 1 0 X 42534 48801 48592 48332 255000 443259 5621976 5688803 7931192 8344827 8623112 36209910 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5664510 5737604 7979784 8393159 8878112 36653169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36653169 13 85 133 4 33 268 0 0 0 0 0 0 13 85 133 4 33 268 0 0 0 0 0 0 18399 16740 26648 30946 35719 128452 5682922 5754429 8006565 8424109 8913864 36781889 0.99650 0.99654 0.00001 0.00001 X Schedule A, Part III, Line 12 Beauty Shop Income (2015-$18,399 2016-$16,740 2017-$23,298 2018-$26,446 2019-$25,225), Guest Room Revenue (2017-$3,350 2018-$4,500 2019-$5,900) and Miscellaneous Revenue (2019-$594) RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 137454 137454 0 20913676 6447397 14466279 0 0 0 0 0 3644779 2162644 1482135 0 541766 321773 219993 16305861 0 Accrued Interest Payable 31300 Resident Trust Payable 2864 Deposits Payable 106753 Asset Retirement Obligation 211930 Due to Affiliates 1997022 2349869 X 1 1 X X X X 0 1 0 0 0 1 1 0 0 Robert Dahl President/CEO 0 437567 0 287186 0 15124 0 111553 0 16265 0 867695 0 235726 Ronald Sanford Chief Operating Officer (Jan-Mar) 0 230739 0 86966 0 2260 0 31909 0 4804 0 356678 0 57023 Kathy Youngquist Chief Financial Officer 0 302671 0 61757 0 10090 0 84392 0 21962 0 480872 0 59933 Angela Brown Chief Human Resource Officer 0 183057 0 33333 0 8030 0 52759 0 19828 0 297007 0 33333 Schedule J, Part I, Line 1a A set percentage is paid to help cover the taxes on personal auto usage. This amount is treated as a taxable benefit. Schedule J, Part I, Line 4 Certain Officers of the organization participate in a 457(f) Deferred Compensation Plan. For 2019 the amount of deferred compensation was as follows: Robert Dahl-$54,463 Kathy Youngquist-$52,086 Angela Brown-$30,867 Schedule J, Part I, Line 6 Certain Officers of the organization accrued incentive bonuses at 12/31/19 that were contingent on performance and financial goals of the organization and all related organizations. A City of Pleasant Hill Iowa 426035789 2014-12-10 1580000 Refinance Old Debt & Construction of Nursing Home 0 0 1 B City of Bondurant Iowa 426004287 2014-12-10 2800000 Construction of Nursing Home 0 0 0 C City of Carlisle Iowa 426004318 2014-12-10 9000000 Construction of Nursing Home 0 0 0 D City of Bondurant Iowa 426004287 2014-11-18 4400000 Demolish Old and Construct New Nursing Home 0 0 0 A 1015703 0 1580000 0 2720 0 125904 0 0 435673 0 0 2016 1 0 1 1 B 0 0 2800000 0 5018 0 56000 0 0 2738982 0 0 2016 0 0 1 1 C 0 0 9000000 0 152705 0 180000 0 0 8667295 0 0 2016 0 0 1 1 D 0 0 4400000 0 213311 0 88000 0 0 4098689 0 0 2016 0 0 1 1 A 0 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 0 1 C 0 0 0 0 0 0 0 0 0 1 D 0 0 0 0 0 0 0 0 0 1 A 0 1 0 1 1 0 0 0 1 B 0 1 0 1 1 0 0 0 1 C 0 1 0 1 1 0 0 0 1 D 0 1 0 1 1 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part II, Line 3-12/10/2014 1,580,000 City of Pleasant Hill Iowa Loan proceeds are split between Evangelical Retirement Homes, Inc. and Village Assisted Living, Inc. (a related organization). The breakdown is as follows: Evangelical Retirement Homes, Inc.-$1,580,000 and Village Assisted Living, Inc.-$5,100,000. The total combined proceeds are $6,680,000. Schedule K, Part IV, Line 2c-12/10/2014 1,580,000 City of Pleasant Hill Iowa There were no investment earnings on any bond proceeds. Schedule K, Part IV, Line 2c-12/10/2014 2,800,000 City of Bondurant Iowa There were no investment earnings on any bond proceeds. Schedule K, Part IV, Line 2c-12/10/2014 9,000,000 City of Carlisle Iowa There were no investment earnings on any bond proceeds. Schedule K, Part IV, Line 2c-11/18/2014 4,400,000 City of Bondurant Iowa There were no investment earnings on any bond proceeds. Form 990, Part VI, Section A, Line 3 The purpose of A&E Care Services is to manage Elim Care, Inc. and its related organizations and Augustana Care and its related organizations. Services provided include financial accounting, operational oversight, human resources, information technology, clinical nursing consultation, corporate compliance, coordinated advertising and marketing, philanthropy and new business development. The following individuals were compensated in 2019 by A&E Care Services for providing management services to Elim Care, Inc. an its related organizations: Matthew Kern-$0, Sharon Wilson-$120,252 and Kathy Kopp-$0. Form 990, Part VI, Section A, Line 6 Elim Care, Inc. is the sole member of Evangelical Retirement Homes, Inc. Form 990, Part VI, Section A, Line 7a Board Members of Evangelical Retirement Homes, Inc. are approved by the Elim Care, Inc. board (parent company). Form 990, Part VI, Section A, Line 7b Decisions of the Evangelical Retirement Homes, Inc. board are subject to approval by the Elim Care, Inc. board (parent company). Form 990, Part VI, Section B, Line 11b The Form 990 Tax Return and all related schedules were prepared by the Director of Accounting. The Chief Financial Officer reviewed prior to signing. The return is placed on a portal for Board Members to review prior to filing. Form 990, Part VI, Section B, Line 12c The organization annually requests a conflict of interest disclosure from each Board Member and Officer. Also, questionnaires are sent out to get updates on new situations that may have arisen during the year. Form 990, Part VI, Section B, Line 15 The Board of Directors routinely retains the services of a compensation consultant to review the current wage and benefit levels of similar positions in similar organizations. The compensation committee uses this information to make a recommendation to the Board of Directors. Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policy and financial statements are generally not made available to the public. Form 990, Part VIII, Line 1f Donations are recorded as revenue on Elim Care, Inc. (a related organization). Form 990, Part XI, Line 9 Other Changes in Net Assets were as follows: $82,293 Net Contributions transferred from Elim Care, Inc. (a related organization), ($19,500) Net Assets Released from Restriction, $45,100 Change in Accounting Principal and ($1) rounding. Elim Care Inc 7171 Ohms Lane Edina MN 55439 411694818 Parent Company/Fund Raising MN 501(c)(3) 7 N/A 0 Elim Homes Inc 7171 Ohms Lane Edina MN 55439 411539761 Nursing Home/Senior Housing/Therapy MN 501(c)(3) 10 N/A 0 Pioneer House Assisted Living Inc 7171 Ohms Lane Edina MN 55439 411927112 Senior Housing MN 501(c)(3) 10 N/A 0 Park View Care Center Inc 7171 Ohms Lane Edina MN 55439 410855707 Nursing Home MN 501(c)(3) 10 N/A 0 The Park Lane Apartments Inc 7171 Ohms Lane Edina MN 55439 410972384 Low Income Housing MN 501(c)(3) 9 N/A 0 Elim Children's Center Inc 7171 Ohms Lane Edina MN 55439 411974507 Child Daycare MN 501(c)(3) 10 N/A 0 New Harmony Care Center Inc 7171 Ohms Lane Edina MN 55439 411821882 Nursing Home MN 501(c)(3) 10 N/A 0 Country Meadows of Milaca Inc 7171 Ohms Lane Edina MN 55439 201723948 Senior Housing MN 501(c)(3) 10 N/A 0 Lake Ridge Care Center of Buffalo Inc 7171 Ohms Lane Edina MN 55439 200507069 Nursing Home/Senior Housing MN 501(c)(3) 10 N/A 0 Park Terrace Assisted Living Inc 7171 Ohms Lane Edina MN 55439 204063752 Senior Housing MN 501(c)(3) 10 N/A 0 Redeemer Residence Inc 7171 Ohms Lane Edina MN 55439 410711597 Nursing Home MN 501(c)(3) 10 N/A 0 Village Assisted Living Inc 7171 Ohms Lane Edina MN 55439 262086933 Senior Housing MN 501(c)(3) 10 N/A 0 Community Health Foundation of Wright County 7171 Ohms Lane Edina MN 55439 363546789 Fund Raising MN 501(c)(3) PF N/A 0 Baptist Home Inc 7171 Ohms Lane Edina MN 55439 450232943 Nursing Home ND 501(c)(3) 10 N/A 0 The Baptist Apartments Inc 7171 Ohms Lane Edina MN 55439 450359794 Senior Housing ND 501(c)(3) PF N/A 0 Elim Care Foundation 7171 Ohms Lane Edina MN 55439 411694817 Long Term Investing MN 501(c)(3) 12 N/A 0 Elim Shores Inc 7171 Ohms Lane Edina MN 55439 411625095 Senior Housing MN 501(c)(3) 10 N/A 0 Cornerstone Assisted Living of Plymouth Inc 7171 Ohms Lane Edina MN 55439 412013927 Senior Housing MN 501(c)(3) 10 N/A 0 Newton Village Inc 7171 Ohms Lane Edina MN 55439 200044030 Nursing Home/Senior Housing MN 501(c)(3) 10 N/A 0 Haven Homes Inc 7171 Ohms Lane Edina MN 55439 416045816 Nursing Home/Senior Housing MN 501(c)(3) 10 N/A 0 Elim Senior Housing Inc 7171 Ohms Lane Edina MN 55439 810754064 Senior Housing FL 501(c)(3) 10 N/A 0 A&E Care Services Inc 7171 Ohms Lane Edina MN 55439 411806946 Management Services MN 501(c)(3) 12 N/A 0 Elim Preferred Services Inc 3500 Holly Lane Suite 30 Plymouth MN 55447 411681856 Medical Sales MN N/A C 0 0 Preferred Senior Services Inc 7485 Office Ridge Circle Eden Prairie MN 55344 411942480 Management Services MN N/A C 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 1 0 1 0 1 Schedule R, Part V, Line 2 All related tax-exempt organizations are described in Section 501(c)(3).