CASSIA SERVICES: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CASSIA SERVICES (EIN 41-1806946)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-14
- IRS object ID
- 202012279349300506
- Schema version
- 2018v3.2
- 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 L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-14T08:38:21-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411806946 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A&E CARE SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | A&EC | BusinessNameControlTxt |
| Phone | 9528555000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7171 OHMS LANE | AddressLine1Txt |
| City | EDINA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55439 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATHY YOUNGQUIST | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9528555000 | PhoneNum |
| Signature | 2020-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MATT WOCKEN | PreparerPersonNm |
| PTIN | P01598291 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Preparation | 2020-08-11 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 66.188.188.148 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-11 | IPDt |
| IP Tm | 17:46:28 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 80E1F4C36FD5403AFF9C3193509FEE9CEC8C2CF0 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 8DF0D5A1DBF8E44DE93554FEEDBEEE801640FE4C | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT DAHL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7171 OHMS LANE | AddressLine1Txt |
| City | EDINA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55439 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,097,223 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CASSIALIFE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MANAGEMENT SERVICES TO AUGUSTANA CARE AND ELIM CARE AND THEIR AFFILIATES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 20 | VotingMembersIndependentCnt |
| Total Employee | 106 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $1,124,909 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,600,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,342,595 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,409,954 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$835 | PYInvestmentIncomeAmt |
| CY Investment Income | $54,526 | CYInvestmentIncomeAmt |
| PY Other Revenue | $399,254 | PYOtherRevenueAmt |
| CY Other Revenue | $3,707,636 | CYOtherRevenueAmt |
| PY Total Revenue | $17,741,014 | PYTotalRevenueAmt |
| CY Total Revenue | $20,772,116 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,247 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,405 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,633,932 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,276,078 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,015,488 | PYOtherExpensesAmt |
| CY Other Expenses | $2,840,717 | CYOtherExpensesAmt |
| PY Total Expenses | $14,652,667 | PYTotalExpensesAmt |
| CY Total Expenses | $18,123,200 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,088,347 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,648,916 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,998,633 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,254,600 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,121,220 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,728,271 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$122,587 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,526,329 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SERVE GOD BY FOSTERING FULLNESS OF LIFE FOR OLDER ADULTS AND OTHER PEOPLE IN NEED THROUGH THE PROVISION OF HEALTH CARE, HOUSING AND OTHER SERVICES IN A CHRISTIAN TRADITION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,457,284 | ExpenseAmt |
| Grant | $6,405 | GrantAmt |
| Revenue | $14,285,280 | RevenueAmt |
| Desc | MANAGEMENT SERVICES: A&E CARE SERVICES PROVIDES MANAGEMENT AND SUPPORT TO AUGUSTANA CARE AND ELIM CARE AND THEIR AFFILIATES AND UNRELATED MANAGED COMPANIES. THESE SERVICES INCLUDE OPERATIONAL OVERSIGHT, HUMAN RESOURCES, FINANCIAL ACCOUNTING, INFORMATION TECHNOLOGY, CLINICAL AND DIETARY CONSULTATION, FUNDRAISING, NEW BUSINESS DEVELOPMENT, LONG RANGE STRATEGIC PLANNING, AND MARKETING AND PROMOTION FOR ALL AUGUSTANA CARE AND ELIM CARE AFFILIATED ENTITIES. DURING FISCAL YEAR 2019, THESE AFFILIATED ENTITIES SERVED MORE THAN 21,500 OLDER ADULTS AND OTHERS IN NEED THROUGH LONG-TERM AND TRANSITIONAL HEALTH CARE, THERAPY SERVICES, SENIOR HOUSING, ADULT DAY PROGRAMS, AND OTHER COMMUNITY-BASED SERVICES IN MINNESOTA, COLORADO, IOWA, AND NORTH DAKOTA. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,665,916 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,083,092 | RevenueAmt |
| Desc | PHARMACY SERVICES: A&E PHARMACY, A NONPROFIT LIMITED LIABILITY COMPANY, WAS FORMED IN FY 2018 TO PROVIDE PHARMACY AND CONSULTING SERVICES TO AUGUSTANA CARE AND ELIM CARE'S RELATED NURSING FACILITIES, ASSISTED LIVING FACILITIES, MEMORY CARE FACILITIES, AND HOME AND COMMUNITY-BASED PROGRAMS. THE PHARMACY ALSO PROVIDES SERVICES TO UNRELATED MANAGED COMPANIES. DURING FISCAL YEAR 2019, THE PHARMACY SERVED PATIENTS IN 16 RELATED FACILITIES AND 2 UNRELATED MANAGED FACILITIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $18,123,200 | 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 | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 106 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 20 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | KATHY YOUNGQUIST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9528555000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7171 OHMS LANE | AddressLine1Txt |
| City | EDINA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55439 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY TUCKER | |||||||||
| PRESIDENT/CEO (THROUGH JUNE 2019) | 7.65 | 32.35 | Yes (X) | $708,792 | $0 | $131,561 | |||
| CRAIG KITTELSON | |||||||||
| FORMER VP/CFO (THROUGH JUNE 2018) | 0.00 | 0.00 | $522,500 | $0 | $53,130 | Yes (X) | |||
| ROBERT DAHL | |||||||||
| PRESIDENT/CEO | 3.83 | 16.17 | Yes (X) | $0 | $434,351 | $116,681 | |||
| KATHY YOUNGQUIST | |||||||||
| CFO | 3.83 | 16.17 | Yes (X) | $0 | $292,527 | $90,730 | |||
| KATHY KOPP | |||||||||
| CHIEF STRATEGY OFFICER | 0.00 | 40.00 | Yes (X) | $288,340 | $0 | $79,995 | |||
| MICHAEL JOHNSON | |||||||||
| VP OF HR (THROUGH DEC 2018) | 7.65 | 32.35 | $304,815 | $0 | $51,334 | Yes (X) | |||
| MATTHEW KERN | |||||||||
| COO | 4.78 | 20.22 | Yes (X) | $291,488 | $0 | $26,049 | |||
| ANGELA BROWN | |||||||||
| CHRO | 3.83 | 16.17 | Yes (X) | $0 | $166,647 | $60,005 | |||
| CUI LI | |||||||||
| VP OF FINANCE | 7.65 | 32.35 | $193,343 | $0 | $9,144 | Yes (X) | |||
| GERALD PIZINGER | |||||||||
| REGIONAL DIRECTOR (THROUGH DEC 2018) | 0.00 | 40.00 | $176,865 | $0 | $22,457 | Yes (X) | |||
| SHARON WILSON | |||||||||
| CHIEF CLINICAL & COMPLIANCE OFFICER | 3.83 | 16.17 | Yes (X) | $180,085 | $0 | $12,689 | |||
| DAVID SAEMROW | |||||||||
| VP OF MARKETING | 3.83 | 16.17 | $167,277 | $0 | $10,344 | Yes (X) | |||
| SHAWN JOHNSON | |||||||||
| DIRECTOR OF IT (THROUGH OCT 2018) | 7.65 | 32.35 | $157,572 | $0 | $18,840 | Yes (X) | |||
| REV DR GARY WILKERSON | |||||||||
| CHAIR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| NIKKI DANIELS | |||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CHIP PARKS | |||||||||
| SECRETARY | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| PAUL ANDERSON | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| KEVIN BERGMAN | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| DICK BJERKAAS | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| ERIK RICK ELLINGSON | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| BRIAN FARONE | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| DUANE HETLAND | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| TIMOTHY KUCK | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| LARRY KULA | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| STANN LEFF | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| MARSHALL MACKAY | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| PAT NUSS | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| JERRY NYE | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| SCOTT RAMSDALE | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| GUY TANGEDAHL | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| MICHELENE VERLAUTZ | |||||||||
| DIRECTOR | 2.00 | 8.00 | $0 | $0 | $0 | Yes (X) | |||
| LORES VLAMINCK | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| BUD WESSMAN | |||||||||
| DIRECTOR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,991,077 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $893,525 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $682,959 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,600,000 | RelatedOrganizationsAmt |
| Total Contributions | $1,600,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CENTRAL OFFICE FEE | 561000 | $13,776,572 | $13,776,572 | |
| MANAGEMENT FEE | 561000 | $1,583,570 | $489,246 | $1,094,324 |
| INFO. TECH CONSULTING | 541519 | $49,812 | $19,462 | $30,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,409,954 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,661 | TotalRevenueColumnAmt |
| Exclusion | $41,661 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,523 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,523 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,523 | TotalRevenueColumnAmt |
| Exclusion | $14,523 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,606 | SecuritiesAmt |
| Other | $11,259 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,606 | SecuritiesAmt |
| Other | $11,259 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,865 | TotalRevenueColumnAmt |
| Exclusion | $12,865 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $8,408,434 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $5,325,107 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,083,327 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,083,092 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $235 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $609,786 | TotalRevenueColumnAmt |
| Exclusion | $609,786 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $609,786 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,772,116 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,368,372 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,124,909 | UnrelatedBusinessRevenueAmt |
| Exclusion | $678,835 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,405 | TotalAmt |
| Program Services | $6,405 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,469,308 | TotalAmt |
| Program Services | $1,469,308 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,561 | TotalAmt |
| Program Services | $487,561 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,154,445 | TotalAmt |
| Program Services | $11,154,445 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,370 | TotalAmt |
| Program Services | $230,370 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,045,345 | TotalAmt |
| Program Services | $1,045,345 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $889,049 | TotalAmt |
| Program Services | $889,049 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,530 | TotalAmt |
| Program Services | $64,530 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,411 | TotalAmt |
| Program Services | $46,411 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $405,602 | TotalAmt |
| Program Services | $405,602 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,951 | TotalAmt |
| Program Services | $22,951 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,630 | TotalAmt |
| Program Services | $366,630 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $568,754 | TotalAmt |
| Program Services | $568,754 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,546 | TotalAmt |
| Program Services | $360,546 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,481 | TotalAmt |
| Program Services | $79,481 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,543 | TotalAmt |
| Program Services | $82,543 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $525,496 | TotalAmt |
| Program Services | $525,496 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,429 | TotalAmt |
| Program Services | $39,429 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| INCOME TAXES | $7,680 | $7,680 |
| MEDICAL SUPPLIES | $91,263 | $91,263 |
| RECRUITMENT/RETENTION | $73,476 | $73,476 |
| LICENSES AND PERMITS | $57,098 | $57,098 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,827 | TotalAmt |
| Program Services | $48,827 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,123,200 | TotalAmt |
| Program Services | $18,123,200 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,295 | BOYAmt |
| EOY | $636,720 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $341,344 | BOYAmt |
| EOY | $845,315 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $220,588 | BOYAmt |
| EOY | $671,626 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,865 | BOYAmt |
| EOY | $213,253 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,535,726 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,148,259 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,150,535 | BOYAmt |
| EOY | $8,387,467 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $943,006 | BOYAmt |
| EOY | $3,500,219 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,998,633 | BOYAmt |
| EOY | $14,254,600 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,154,896 | BOYAmt |
| EOY | $2,463,113 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,764,184 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $572,500 | BOYAmt |
| EOY | $1,572,500 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $393,824 | BOYAmt |
| EOY | $928,474 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,121,220 | BOYAmt |
| EOY | $11,728,271 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$122,587 | BOYAmt |
| EOY | $2,526,329 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$122,587 | BOYAmt |
| EOY | $2,526,329 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,998,633 | BOYAmt |
| EOY | $14,254,600 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,648,916 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| AUGUSTANA CARE | ||||
| 411728753 | 7 | Yes (1) | $7,964,944 | $0 |
| ELIM CARE INC | ||||
| 411694818 | 7 | Yes (1) | $5,871,368 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $13,836,312 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,120,200 | OtherCostOrOtherBasisAmt |
| Book Value | $1,120,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,496,644 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,093 | DepreciationAmt |
| Book Value | $2,455,551 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,441 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,446 | DepreciationAmt |
| Book Value | $8,995 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,272,482 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,105,720 | DepreciationAmt |
| Book Value | $1,166,762 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,635,959 | OtherCostOrOtherBasisAmt |
| Book Value | $3,635,959 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,387,467 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $1,877,706 |
| BOND RESERVE FUND | $246,206 |
| BOND CONSTRUCTION FUND | $1,323,481 |
| BOND SERVICE FUND | $52,826 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,500,219 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $928,474 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $928,474 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $31,267,724 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $4,965,282 | OtherRevenueAmt |
| Revenue Not Reported | $4,965,282 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,302,442 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$5,530,326 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$5,530,326 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $20,772,116 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $23,542,281 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $5,430,277 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $5,430,277 | ExpensesNotReportedAmt |
| Expenses Subtotal | $18,112,004 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $11,196 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $11,196 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $18,123,200 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CORPORATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE PHARMACY AND CARE PROPERTIES, AS LIMITED LIABILITY COMPANIES, ARE NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES AND THEIR INCOME IS REPORTED IN THE TAX RETURN OF ITS MEMBER, WHICH IS A NONPROFIT CORPORATION. THE COMPANY FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE COMPANY'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE COMPANY IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE COMPANY REPORTS ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNREALTED BUSINESS INCOME OR EXCISE OR OTHER TAXES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SHORT PERIOD REVENUES INCLUDED IN SEPARATE FORM 990 4,965,282. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | EQUITY TRANSFER IN 1,600,000. INVESTMENT INCOME 55,335. COST OF GOODS SOLD -7,206,865. GAIN ON SALE OF FIXED ASSETS 21,204. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SHORT PERIOD EXPENSES INCLUDED IN SEPARATE FORM 990 5,430,277. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INCOME TAX EXPENSE 11,196. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIP EXPENSES | GrantTypeTxt |
| Recipient | 1 | RecipientCnt |
| Cash Grant | $6,405 | CashGrantAmt |
| Valuation Method Used | N/A | ValuationMethodUsedDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | EMPLOYEES WHO WISH TO RECEIVE SCHOLARSHIP FUNDS MUST COMPLETE AN "EDUCATIONAL SCHOLARSHIP APPLICATION". THIS APPLICATION IS REVIEWED BY THE FACILITY DIRECTOR OF HUMAN RESOURCES, THE EMPLOYEE'S DEPARTMENT HEAD, AND THE FACILITY ADMINISTRATOR. THE "EDUCATIONAL SCHOLARSHIP COMMITTEE REVIEW FORM" SHALL BE USED BY THE COMMITTEE TO ENSURE THAT CONSISTENT METHODS ARE USED IN THE DECISION-MAKING PROCESS AFFECTING SCHOLARSHIP DISTRIBUTION. MONIES DOLED OUT WILL BE PRIORITIZED BASED ON SCHOOL ATTAINMENT/DEGREES THAT ARE BENEFICIAL TO THE SUCCESS AND GROWTH OF AUGUSTANA CARE. A RESPONSE WILL BE GIVEN TO THE EMPLOYEE IN TWO WEEKS. EMPLOYEES WILL SUBMIT AN APPLICATION FOR THIS PROGRAM ON AN ANNUAL BASIS (EVERY 12 MONTHS FROM PROGRAM COMMENCEMENT). MONIES ARE AVAILABLE BASED ON THE BUDGET ON A PER LOCATION BASIS ($5K MAXIMUM) ANNUALLY (JAN DEC) TO EMPLOYEES WHO MEET ALL THE ELIGIBILITY REQUIREMENTS AS DEFINED HEREIN. ADMINISTRATORS WILL RE-EVALUATE SCHOLARSHIPS QUARTERLY WITH HR AND APPLICABLE DEPARTMENT DIRECTORS TO ASSURE ELIGIBILITY. UPON COMPLETION OF A COURSE, THE EMPLOYEE SHALL SUBMIT TO THE FACILITY'S DIRECTOR OF HUMAN RESOURCES A COURSE TRANSCRIPT REFLECTING A GRADE OF "C OR BETTER. UPON COMPLETION OF THE COURSE FOR WHICH A SCHOLARSHIP WAS AWARDED THE EMPLOYEE SHALL WORK FOR ACC FOR TWO (2) YEAR/MINIMUM @ FTE STATUS EACH YEAR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY TUCKER | ||||||||||||||
| PRESIDENT/CEO (THROUGH JUNE 2019) | $475,147 | $0 | $0 | $0 | $233,645 | $0 | $111,869 | $0 | $19,692 | $0 | $840,353 | $0 | $0 | $0 |
| CRAIG KITTELSON | ||||||||||||||
| FORMER VP/CFO (THROUGH JUNE 2018) | $246,836 | $0 | $84,981 | $0 | $190,683 | $0 | $27,888 | $0 | $25,242 | $0 | $575,630 | $0 | $0 | $0 |
| ROBERT DAHL | ||||||||||||||
| PRESIDENT/CEO | $0 | $402,996 | $0 | $26,378 | $0 | $4,977 | $0 | $98,828 | $0 | $17,853 | $0 | $551,032 | $0 | $26,378 |
| KATHY YOUNGQUIST | ||||||||||||||
| CFO | $0 | $264,899 | $0 | $19,717 | $0 | $7,911 | $0 | $68,360 | $0 | $22,370 | $0 | $383,257 | $0 | $18,562 |
| KATHY KOPP | ||||||||||||||
| CHIEF STRATEGY OFFICER | $228,951 | $0 | $36,108 | $0 | $23,281 | $0 | $30,533 | $0 | $49,462 | $0 | $368,335 | $0 | $0 | $0 |
| MICHAEL JOHNSON | ||||||||||||||
| VP OF HR (THROUGH DEC 2018) | $173,114 | $0 | $0 | $0 | $131,701 | $0 | $25,359 | $0 | $25,975 | $0 | $356,149 | $0 | $0 | $0 |
| MATTHEW KERN | ||||||||||||||
| COO | $252,354 | $0 | $39,112 | $0 | $22 | $0 | $4,971 | $0 | $21,078 | $0 | $317,537 | $0 | $0 | $0 |
| ANGELA BROWN | ||||||||||||||
| CHRO | $0 | $155,726 | $0 | $10,181 | $0 | $740 | $0 | $40,619 | $0 | $19,386 | $0 | $226,652 | $0 | $10,181 |
| CUI LI | ||||||||||||||
| VP OF FINANCE | $148,320 | $0 | $45,001 | $0 | $22 | $0 | $6,648 | $0 | $2,496 | $0 | $202,487 | $0 | $0 | $0 |
| GERALD PIZINGER | ||||||||||||||
| REGIONAL DIRECTOR (THROUGH DEC 2018) | $175,265 | $0 | $0 | $0 | $1,600 | $0 | $6,361 | $0 | $16,096 | $0 | $199,322 | $0 | $0 | $0 |
| SHARON WILSON | ||||||||||||||
| CHIEF CLINICAL & COMPLIANCE OFFICER | $153,948 | $0 | $23,715 | $0 | $2,422 | $0 | $6,271 | $0 | $6,418 | $0 | $192,774 | $0 | $0 | $0 |
| DAVID SAEMROW | ||||||||||||||
| VP OF MARKETING | $140,351 | $0 | $21,544 | $0 | $5,382 | $0 | $4,375 | $0 | $5,969 | $0 | $177,621 | $0 | $0 | $0 |
| SHAWN JOHNSON | ||||||||||||||
| DIRECTOR OF IT (THROUGH OCT 2018) | $135,673 | $0 | $21,899 | $0 | $0 | $0 | $4,901 | $0 | $13,939 | $0 | $176,412 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | AUGUSTANA CARE PROVIDES VEHICLES FOR SOME OF ITS OFFICERS AND KEY EMPLOYEES. THE EMPLOYEE IS RESPONSIBLE FOR KEEPING TRACK OF THE BUSINESS VERSUS PERSONAL USE OF THE VEHICLE, WHICH IS TURNED IN AT THE END OF EACH CALENDAR YEAR TO PAYROLL. PAYROLL THEN INCREASES THE EMPLOYEE'S W-2 TO INCLUDE THE PERSONAL USE OF THE VEHICLE AND GROSSES UP THAT AMOUNT TO COVER THE PAYROLL AND INCOME TAXES FOR THE PERSONAL USE. THIS IS DONE FOR TIM TUCKER, CRAIG KITTELSON, TIM MIDDENDORF, KATHY KOPP, MICHAEL JOHNSON AND DAVE SAEMROW. |
| PART I, LINES 4A-B | CRAIG KITTELSON STEPPED DOWN AS THE CFO OF AUGUSTANA CARE AND AFFILIATES ON JUNE 30, 2018. HE STAYED ON PAYROLL AS A CONSULTANT THROUGH SEPTEMBER 30, 2018. THERE WAS A $50,000 SEVERANCE PAID TO CRAIG IN NOVEMBER 2018. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PROVIDED BY A&E CARE SERVICES: TIM TUCKER, PRESIDENT AND CEO - $186,842 CRAIG KITTELSON, FORMER VICE PRESIDENT OF FINANCE AND CFO - $163,309 MICHAEL JOHNSON, VP OF HR - $5,500 KATHERINE KOPP, CHIEF STRATEGY OFFICER - $2,500 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PROVIDED BY ELIM CARE, INC: ROBERT DAHL, PRESIDENT & CEO - $27,669 KATHY YOUNGQUIST, CFO - $17,616 ANGELA BROWN, CHRO - $11,566 |
| PART I, LINE 6 | CERTAIN OFFICERS OF THE ORGANIZATION ACCRUED INCENTIVE BONUSES AT 12/31/18 FROM ELIM CARE THAT WERE CONTINGENT ON THE COMBINED NET INCOME OF ELIM CARE AND ITS RELATED ORGANIZATIONS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF MILACA MINNESOTA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005370 | BondIssuerEIN |
| Bond Issued | 2019-02-21 | BondIssuedDt |
| Issue Price | $7,000,000 | IssuePriceAmt |
| Purpose | PURCHASE OF NEW OFFICE BUILDING | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $7,000,000 | TotalProceedsAmt |
| In Reserve Fund | $245,000 | InReserveFundAmt |
| Issuance Costs From Proceeds | $140,000 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $6,615,000 | CapitalExpendituresAmt |
| Substantial Completion | 2019 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATY KITTELSON | PersonNm |
| Relationship With Org | FAMILY MEMBER OF A FORMER OFFICER | RelationshipWithOrgTxt |
| Cash Grant | $6,405 | CashGrantAmt |
| Type Of Assistance | SCHOLARSHIP | TypeOfAssistanceTxt |
| Assistance Purpose | SCHOLARSHIP | AssistancePurposeTxt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KATY KITTELSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER OF A FORMER OFFICER | RelationshipDescriptionTxt |
| Transaction | $63,763 | TransactionAmt |
| Transaction | EMPLOYEE COMPENSATION | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS OF THE ORGANIZATION ARE AUGUSTANA CARE AND ELIM CARE, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED BY A MAJORITY VOTE FROM THE BOARD OF DIRECTORS OF THE MEMBERS, AUGUSTANA CARE AND ELIM CARE, AT THE ANNUAL MEETING. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS REQUIRE AFFIRMATIVE APPROVAL FROM THE MEMBERS OF THE ORGANIZATION, AUGUSTANA CARE AND ELIM CARE: (A) AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THIS CORPORATION; (B) CAPITAL BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, AND ALL MAJOR EXPENDITURES BEFORE FUNDS ARE EXPENDED THEREFORE; (C) OPERATING BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, BEFORE AUTHORIZED EXPENDITURES MAY BE MADE THEREFROM; (D) STRATEGIC PLANS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION; (E) THE INCURRING OF ANY LONG TERM DEBT OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, OTHER THAN INTRA-SYSTEM OR REFINANCING DEBT; (F) HUMAN RESOURCES AND BENEFITS POLICIES OF THIS CORPORATION; (G) MAJOR RISK CONTRACTING AGREEMENTS, WHICH FOR THESE PURPOSES MEANS ANY CONTRACT WHICH DEALS WITH CAPITATION OR SIMILAR RISK BEARING CONCEPT; (H) MERGER, CONSOLIDATION, OR TOTAL OR PARTIAL DISSOLUTION INVOLVING THIS CORPORATION; AND (I) GOVERNANCE AND ACTION OF THE TYPE SET FORTH IN SUBPARAGRAPH (A) AND SUBPARAGRAPHS (F) THROUGH (H) ABOVE AS PROPOSED BY THE BOARD OF DIRECTORS OF ANY CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITIES DIRECTLY CONTROLLED BY THIS CORPORATION AS A MEMBER, SHAREHOLDER OR OTHERWISE, TO THE EXTENT THAT THE GOVERNING DOCUMENTS OF SUCH CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITIES GIVE THIS CORPORATION OR THE BOARD A RIGHT OF APPROVAL OVER SUCH GOVERNANCE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO. THE FORM 990 WAS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS BY THE CFO PRIOR TO BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND KEY EMPLOYEES. ALL COVERED INDIVIDUALS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT. ALL COVERED INDIVIDUALS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST TO THE APPROPRIATE LEVEL OF MANAGEMENT OR TO THE BOARD OF DIRECTORS AS OUTLINED IN THE POLICY BASED ON THE INDIVIDUAL'S POSITION WITHIN THE ORGANIZATION. CONFLICTS ARE DETERMINED AT THE APPROPRIATE LEVEL OF MANAGEMENT OR BY THE BOARD OF DIRECTORS. INDIVIDUALS WITH ACTUAL OR POTENTIAL CONFLICTS WILL ABSTAIN FROM DISCUSSING OR VOTING ON ANY MATTERS RELATING TO THE CONFLICT. ALL PROCEEDINGS RELATING TO ACTUAL OR POTENTIAL CONFLICTS WILL BE NOTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE PRESIDENT/CEO AND ALL OTHER SENIOR STAFF FROM AUGUSTANA CARE WAS ESTABLISHED BY THE AUGUSTANA CARE BOARD OF DIRECTORS BASED ON APPROPRIATE COMPARABILITY DATA PROVIDED BY A PROFESSIONAL COMPENSATION CONSULTANT. THE COMPENSATION STUDY WAS LAST PERFORMED IN 2018. THE COMPENSATION OF THE PRESIDENT/CEO FROM ELIM CARE, INC. WAS ESTABLISHED BY THE ELIM CARE, INC. COMPENSATION COMMITTEE BASED ON APPROPRIATE COMPARABILITY DATA PROVIDED BY A PROFESSIONAL COMPENSATION CONSULTANT. ALL OTHER SENIOR STAFF'S SALARIES WERE DETERMINED BY THE PRESIDENT/CEO. A COMPENSATION STUDY FOR ALL SENIOR STAFF WAS LAST PERFORMED IN 2018. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| A&E PHARMACY LLC | |||||||||
| 1425 10TH AVENUE S SUITE 100 | MINNEAPOLIS | MN | 55404 | 824736177 | PHARMACY SERVICES | MN | $8,410,503 | $2,065,101 | A&E CARE SERVICES |
| A&E CARE PROPERTIES LLC | |||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 832946271 | REAL ESTATE HOLDIGNS | MN | $127,495 | $9,119,631 | A&E CARE SERVICES |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (32 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| APPLE VALLEY VILLA APARTMENTS | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 311608691 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 10 | AUGUSTANA CARE | 0 | |
| AUGUSTANA APARTMENTS OF HASTINGS | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 311608701 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 10 | AUGUSTANA CARE | 0 | |
| AUGUSTANA CARE | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411728753 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 7 | 0 | N/A | |
| AUGUSTANA CARE FOUNDATION | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411360678 | CHARITABLE FOUNDATION | MN | 501(C)(3) | LINE 12A, I | AUGUSTANA CARE | 0 | |
| AUGUSTANA CHAPEL VIEW HOMES INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 410693953 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 10 | AUGUSTANA CARE | 0 | |
| AUGUSTANA COMMUNITY PARTNERS | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411783680 | HOME HEALTH CARE SERVICES | MN | 501(C)(3) | LINE 10 | AUGUSTANA CARE | 0 | |
| AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 311608696 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 10 | AUGUSTANA CARE | 0 | |
| AUGUSTANA HOME OF HASTINGS | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 311572624 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 10 | AUGUSTANA CARE | 0 | |
| OPEN CIRCLE ADULT DAY CENTER | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411424801 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 10 | AUGUSTANA CARE | 0 | |
| BROOKSIDE SENIOR LIVING | |||||||||||
| 804 BENSON ROAD | MONTEVIDEO | MN | 56265 | 410871848 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | LINE 10 | 0 | N/A | |
| ELIM CARE INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411694818 | PARENT CO/FUND RAISING | MN | 501(C)(3) | LINE 7 | 0 | N/A | |
| ELIM HOMES INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411539761 | NSGHOME/SRHSG/THERAPY | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| PIONEER HOUSE ASSISTED LIVING INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411927112 | SENIOR HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| PARK VIEW CARE CENTER | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 410855707 | NURSING HOME | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| THE PARK LANE APARTMENTS INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 410972384 | LOW INCOME HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| ELIM CHILDREN'S CENTER INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411974507 | CHILD DAYCARE | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| NEW HARMONY CARE CENTERS INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411821882 | NURSING HOME | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| COUNTRY MEADOWS OF MILACA INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 201723948 | SENIOR HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| LAKE RIDGE CARE CENTER OF BUFFALO INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 200507069 | HSG HOME/SENIOR HSG | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| PARK TERRACE ASSISTED LIVING INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 204063752 | SENIOR HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| EVANGELICAL RETIREMENT HOMES INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 420868449 | NSG HOME/SENIOR HSG | IA | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| VILLAGE ASSISTED LIVING INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 262086933 | SENIOR HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| COMMUNITY HEALTH FOUNDATION OF WRIGHT COUNTY | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 363546789 | FUND RAISING | MN | 501(C)(3) | LINE 7 | ELIM CARE INC | 0 | |
| BAPTIST HOME INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 450232943 | NURSING HOME | ND | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| THE BAPTIST APARTMENTS INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 450359794 | SENIOR HOUSING | ND | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| REDEEMER RESIDENCE INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 410711597 | NURSING HOME | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| ELIM SHORES INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411625095 | SENIOR HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| CORNERSTONE ASSISTED LIVING OF PLYMOUTH INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 412013927 | SENIOR HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| NEWTON VILLAGE INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 200044030 | NSG HOME/SENIOR HSG | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| HAVEN HOMES INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 416045816 | NSG HOME/SENIOR HSG | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| ELIM SENIOR HOUSING INC | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 810754064 | SENIOR HOUSING | MN | 501(C)(3) | LINE 10 | ELIM CARE INC | 0 | |
| ELIM CARE FOUNDATION | |||||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411694817 | CHARITABLE FOUNDATION | MN | 501(C)(3) | LINE 12A, I | ELIM CARE INC | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| AUGUSTANA SENIOR DEVELOPMENT INC | |||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 264136110 | CONSULTING | MN | N/A | C | 0 |
| ELIM PREFERRED SERVICES INC | |||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411681856 | MEDICAL SALES | MN | N/A | C | 0 |
| PREFERRED SENIOR SERVICES INC | |||||||||
| 7171 OHMS LN | EDINA | MN | 55439 | 411942480 | MANAGEMENT SERVICES | MN | N/A | C | 0 |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments