2020-10-27T11:54:39-07:00 2019-12-31 990 2019-01-01 411539761 ELIM HOMES INC ELIM 9528555000 7171 Ohms Lane Edina MN 554392142 Kathy Youngquist CFO 9528555000 2020-09-30 50.209.15.97 2019 2021-01-29 14:40:06Z Robert M Dahl 7171 Ohms Lane Edina MN 55439 53965522 0 X www.cassialife.org X 1985 MN Provide nursing home care and housing for the elderly. This includes programs and services specifically designed to meet the residents' primary needs for housing, healthcare (including in-house therapy) and nourishment. 4 4 1012 213 0 0 0 0 42909481 43543755 886791 1260080 4046194 5302893 47842466 50106728 34450 1250530 0 0 36516862 38605159 0 0 0 8823996 9386976 45375308 49242665 2467158 864063 34223119 34995545 16080995 15544998 18142124 19450547 X See Part I, Line 1 0 0 26741119 705725 30803265 Elim Homes Inc. provides skilled long-term care services to the elderly, handicapped and other having specialized needs. The organization owns and operates four long-term care facilities in Princeton, MN (105 beds), Milaca, MN (70 beds), and Fargo, ND (120 beds). Utilization by payor source was as follows for 2019: 62.5% Medicaid, 23.8% Private, 8.8% Medicare and 4.8% HMO. 11531071 544805 11245094 Elim Homes, Inc. operates a therapy division (Progressive Rehabilitation Options) that provides physical, occupational and speech therapy to related organizations and other organizations located in Minnesota, North Dakota and Iowa. 935569 0 1248027 Elim Homes, Inc. operates an assisted living facility (Caley House) located in Princeton, MN. The facility has 30 units and occupancy was 97.02% in 2018. 330119 0 247369 Other program services includes an Adult Day Care program in Princeton, MN 330119 0 247369 39537878 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 83 0 1 1012 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 554392142 Robert M Dahl President/CEO 6.47 13.53 X 739877 0 127818 Kathy L Youngquist CFO 6.47 13.53 X 374518 0 106354 Jeffrey Dagen V.P. Therapy Service 40 0 X 351936 0 80115 Ronald Sanford COO January-March 12.94 27.06 X 319965 0 36713 Angela Brown Chief Human Resource Officer 6.47 13.53 X 224420 0 72587 Sheri Ruehle Regional Director of Operations 12.94 27.06 X 179634 0 61394 Jeffrey Wipf VP of Information Technology 6.47 13.53 X 172764 0 38735 Jeffrey King VP of Finance 12.94 27.06 X 152794 0 33030 Andrew Centanni VP of Building Design & Development 12.94 27.06 X 150433 0 32848 Renee Muhonen Administrator 32 8.00 X 150231 0 9207 Pat Nuss Treasurer/Secretary and Director 0 0.18 X X 0 0 0 Stann Leff Vice Chairperson/Director 0.15 0.16 X X 0 0 0 Kevin Bergman Director 0 0.12 X 0 0 0 Dr Guy Tangedahl Director 0.15 0.27 X 0 0 0 Roland Peterson Director and Chairperson 0.15 0.08 X X 0 0 0 Jerry Nye Director 0.15 0 X 0 0 0 Matthew Kern COO April-December 4.85 10.15 X 0 0 0 Sharon Wilson Chief Clinical and Compliance Officer 6.47 13.53 X 0 0 0 Kathy Kopp Chief Strategic Officer 6.47 13.53 X 0 0 0 2816572 0 598801 30 0 1 0 Columbus 3001 Broadway St NE Suite 320 Minneapolis MN 55413 Consulting 124834 A & E Care Services 7171 Ohms Lane Edina MN 55439 Management Services 2026201 2 0 Nursing Home Services 623000 30803265 30803265 0 0 Therapy Services 621300 11245094 11245094 0 0 Assisted Living Services 623000 1248027 1248027 0 0 Adult Daycare Services 624100 247369 247369 0 0 0 0 0 0 43543755 159709 0 0 159709 0 0 0 0 0 0 0 0 1496 0 0 0 1496 0 1496 0 0 1496 3047237 1911928 2520125 1338669 527112 573259 1100371 0 0 1100371 Management Fee 541610 5301167 0 0 5301167 Miscellaneous Revenue 900099 230 0 0 230 0 0 0 0 5301397 50106728 43543755 0 6562973 1250530 1250530 0 0 0 0 0 0 2352519 0 2352519 0 94821 94821 0 0 29439373 25556794 3882579 0 910349 732340 178009 0 3613964 2907293 706671 0 2194133 1765094 429039 0 0 0 0 0 77567 0 77567 0 42326 0 42326 0 0 0 0 0 0 0 41630 0 41630 0 253482 159855 93627 0 216655 0 216655 0 632877 343974 288903 0 346658 0 346658 0 0 0 0 0 667321 633954 33367 0 278361 0 278361 0 0 0 0 0 199430 0 199430 0 395296 375531 19765 0 0 0 0 0 1707507 1622132 85375 0 118371 0 118371 0 Supplies 2141756 2124001 17755 0 Food 598230 598230 0 0 Maintenance Contracts & Purchased Services 554295 526580 27715 0 License Surcharge 520775 520775 0 0 594439 325974 268465 0 49242665 39537878 9704787 0 5171307 4623785 1135044 1239780 0 0 4798305 5204574 0 0 0 0 448751 304817 0 0 204262 898304 39589800 27739046 13941989 11850754 4575552 4274936 0 0 0 0 0 0 3947909 6598595 34223119 34995545 6359779 6290049 0 0 0 0 8681527 7798883 0 0 0 0 0 0 0 0 1039689 1456066 16080995 15544998 X 17922595 19017960 219529 432587 18142124 19450547 34223119 34995545 X 864063 156941 0 0 0 287419 X 0 1 X 1 0 X 40347189 43774169 41140475 42909481 43543755 211715069 40347189 43774169 41140475 42909481 43543755 211715069 0 0 0 0 0 0 211715069 210378 206543 154341 173459 161205 905926 210378 206543 154341 173459 161205 905926 3144845 3465393 3479844 4032202 5301397 19423681 43702412 47446105 44774660 47115142 49006357 232044676 0.91239 0.92088 0.00390 0.00416 X Schedule A, Part III, Line 12 Management Fee (2015-2019 respectively) $3,137,372, $3,463,089, $3,473,827, $4,025,104 and $5,301,167; Sale of Miscellaneous Minor Equipment (2015-2019 respectively) $7,473, $2,304, $6,017, $7,098 and $230 0 306359 306359 0 27340569 18165311 9175258 0 496200 294556 201644 0 10669078 8701360 1967718 0 777594 577819 199775 11850754 Due from Affiliates 5637152 Resident Trust Funds 58240 Interest Receivable 26000 Inventory 44739 Security Deposits 17400 Deferred Development 15064 Investment in Business Venture 800000 6598595 Deferred Compensation Payable 468196 Due to Affiliates 740891 Asset Retirement Obligations 171339 Resident Trust Fund Payable 58240 Security Deposits Payable 17400 1456066 1 Guardian Angels of Elk River Inc 400 Evans Ave NW Elk River MN 55330 411459252 503(c)3 10000 0 N/A N/A To support the social ministry of providing quality care to seniors. Newton Village Inc 7171 Ohms Lane Edina MN 55439 200044030 501(c)3 450000 0 N/A N/A Transfer to affiliate. Evangelical Retirement Homes (dba Valley View Village) 7171 Ohms Lane Edina MN 55439 420868449 501(c)3 255000 0 N/A N/A Transfer to affiliate. Park Lane Apartments Inc 7171 Ohms Lane Edina MN 55439 410972384 501(c)3 15000 0 N/A N/A Transfer to affiliate. Community Health Foundation 7171 Ohms Lane Edina MN 55439 363546789 501(c)3 5668 0 N/A N/A Transfer to affiliate. Elim Care Foundation 7171 Ohms Lane Edina MN 55439 411694817 501(c)3 500000 0 N/A N/A Transfer to affiliate. 6 0 Schedule I, Part I, Line 2 Due to the relatively low amounts of grants given to entities outside of the organization, the organization does not generally monitor the use of those grant funds. Grants given to related organizations are monitored through the accounting records. X 1 1 X X X X 0 1 0 0 0 1 1 0 0 Robert M Dahl President/CEO 437567 0 287186 0 15124 0 111553 0 16265 0 867695 0 235726 0 Kathy L Youngquist CFO 302671 0 61757 0 10090 0 84392 0 21962 0 480872 0 59933 0 Ronald Sanford COO January-March 230739 0 86966 0 2260 0 31909 0 4804 0 356678 0 57023 0 Angela Brown Chief Human Resource Officer 183057 0 33333 0 8030 0 52759 0 19828 0 297007 0 33333 0 Jeffrey Dagen V.P. Therapy Service 263963 0 59148 0 28825 0 66205 0 13910 0 432051 0 53839 0 Sheri Ruehle Regional Director of Operations 144488 0 16432 0 18714 0 41236 0 20158 0 241028 0 5035 0 Jeffrey Wipf VP of Information Technology 165881 0 5543 0 1340 0 16955 0 21780 0 211499 0 5543 0 Jeffrey King VP of Finance 150384 0 1985 0 425 0 14500 0 18530 0 185824 0 1985 0 Andrew Centanni VP of Building Design & Development 131940 0 15525 0 2968 0 14073 0 18775 0 183281 0 15525 0 Renee Muhonen Administrator 146563 0 0 0 3668 0 6117 0 3090 0 159438 0 0 0 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, a key employee, and a highest paid employee 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, Jeffrey Dagen $26,710, and Sheri Ruehle $28,989. Schedule J, Part I, Line 6 Robert Dahl, Kathy Youngquist, Angela Brown, Sheri Ruehle, Jeffrey Wipf, Jeffrey King and Andrew Centanni 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 Princeton 416005471 000000000 2003-05-13 9000000 Moratorium Construction projects 0 0 0 B Cass County 456002205 000000000 2010-12-16 6300000 Facility Renovations and refinancing of old debt 0 0 0 C City of Milaca 416005370 000000000 2011-04-28 1116522 Refinancing of 1996 issue 0 0 0 A 0 0 9000000 0 0 0 180000 0 0 8820000 0 0 2004 0 0 1 1 B 666977 0 6300000 0 0 0 126800 0 0 5507023 0 0 2012 1 0 1 1 C 1116522 0 1116522 0 0 0 0 0 0 0 0 0 2011 1 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 A 0 0 1 1 1 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 1 1 1 0 0 0 1 A 1 B 1 C 1 Schedule K, Part IV, Line 2c-05/13/2003 9,000,000 City of Princeton There were no investment earnings on any bond proceeds. No further calculations required. Schedule K, Part IV, Line 2c-12/16/2010 6,300,000 Cass County Rebate calculation done on 5/8/14. No rebate payable. No further calculations required. Schedule K, Part IV, Line 2c-04/28/2011 1,116,522 City of Milaca No calculation required. Shaun Seaburg Grandson-in-law of board member 94821 Wages 0 Form 990, Part III, Line 4d The organization operates an adult daycare program located in Princeton, MN. 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. and 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 Elim Homes, Inc. Form 990, Part VI, Section A, Line 7a Board members of Elim Homes, Inc. are approved by the Elim Care, Inc. board. Form 990, Part VI, Section A, Line 7b Decisions of Elim Homes, Inc. board are subject to approval by the Elim Care, Inc. board. Form 990, Part VI, Section B, Line 11b The Form 990 Tax Return and all related schedules were prepared by the Director of Finance. The Chief Financial Officer reviewed the return 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, annual 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 benefits 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, conflicts of interest policy and financial statements are generally not made available to the public. Form 990, Part XI, Line 9 Other Changes in Net Assets were as follows: $306,311 Contributions transferred from Elim Care, Inc. (a related organization); $(18,715) Contribution Distributions; $4,008 Contributions transferred from Elim Care Foundation (a related organization); $(4,188) Contributions transferred to Pioneer House Assisted Living, Inc. (a related organization); $3 Rounding. Elim Management Services LLC 7171 Ohms Lane Edina MN 55439 461572000 Management Services MN 7331864 907783 Elim Homes Inc Park Terrace Assisted Living Inc 7171 Ohms Lane Edina MN 55439 204063752 Senior Housing MN 501c3 10 N/A 0 New Harmony Care Center 7171 Ohms Lane Edina MN 55439 411821882 Nursing Home MN 501c3 10 N/A 0 Park View Care Center 7171 Ohms Lane Edina MN 55439 410855707 Nursing Home MN 501c3 10 N/A 0 Redeemer Residence Inc 7171 Ohms Lane Edina MN 55439 410711597 Nursing Home MN 501c3 10 N/A 0 Cornerstone Assisted Living of Plymouth Inc 7171 Ohms Lane Edina MN 55439 412013927 Senior Housing MN 501c3 10 N/A 0 Park Lane Apartments Inc 7171 Ohms Lane Edina MN 55439 410972384 Low Income Housing MN 501c3 10 N/A 0 Elim Children's Center Inc 7171 Ohms Lane Edina MN 55439 411974507 Child Daycare MN 501c3 10 N/A 0 Elim Care Inc 7171 Ohms Lane Edina MN 55439 411694818 Parent Company/Fundraising MN 501c3 7 N/A 0 Lake Ridge Care Center of Buffalo Inc 7171 Ohms Lane Edina MN 55439 200507069 Nursing Home/Senior Housing MN 501c3 10 N/A 0 Evangelical Retirement Homes Inc 7171 Ohms Lane Edina MN 55439 420868449 Nursing Home/Senior Housing IA 501c3 10 N/A 0 Elim Shores Inc 7171 Ohms Lane Edina MN 55439 411625095 Senior Housing MN 501c3 10 N/A 0 Newton Village Inc 7171 Ohms Lane Edina MN 55439 200044030 Senior Housing MN 501c3 10 N/A 0 Country Meadows of Milaca Inc 7171 Ohms Lane Edina MN 55439 201723948 Senior Housing MN 501c3 10 N/A 0 Pioneer House Assisted Living Inc 7171 Ohms Lane Edina MN 55439 411927112 Senior Housing MN 501c3 10 N/A 0 Village Assisted Living Inc 7171 Ohms Lane Edina MN 55439 262086933 Senior Housing MN 501c3 10 N/A 0 Elim Care Foundation 7171 Ohms Lane Edina MN 55439 411694817 Longterm Investing MN 501c3 12 N/A 0 Community Health Foundation of Wright County 7171 Ohms Lane Edina MN 55439 363546789 Fund Raising MN 501c3 PF N/A 0 Baptist Home Inc 7171 Ohms Lane Edina MN 55439 450232943 Nursing Home ND 501c3 10 N/A 0 The Baptist Apartments Inc 7171 Ohms Lane Edina MN 55439 450359794 Senior Housing ND 501c3 PF 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 7171 Ohms Lane Edina MN 55439 411806946 Management Services MN 501(c)3 12 Not applicable 0 Elim Preferred Services Inc 7171 Ohms Lane Edina MN 55439 411681856 Medical Equipment and Supplies Sales MN N/A C 0 Preferred Senior Services Inc 7171 Ohms Lane Edina MN 55439 411942480 Management Services MN N/A C 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 1 1 1 Redeemer Residence Inc l 722505 Book Value Park View Care Center l 1140072 Book Value