AUGUSTANA MOUNT OLIVET HOSPICE CARE LLC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: AUGUSTANA MOUNT OLIVET HOSPICE CARE LLC (EIN 46-4564958)
Tax period: 2018-10-01 to 2019-09-30
Filed: 2020-08-11
IRS object ID: 202032249349300713
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 G
Schedule I
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-08-11T11:45:17-05:00	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	464564958	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AUGUSTANA MOUNT OLIVET HOSPICE CARE LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	AUGU	BusinessNameControlTxt
Phone	9528555000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1015 4TH AVENUE NORTH	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55405	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SARAH VAN WINKLE	PersonNm
Person Title	PRESIDENT/CEO	PersonTitleTxt
Phone	9528555000	PhoneNum
Signature	2020-08-10	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	2020-08-07	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	67.137.57.251	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-08-10	IPDt
IP Tm	08:08:29	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

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	GRACE HOSPICE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	SARAH VAN WINKLE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1015 4TH AVENUE NORTH	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55405	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$10,771,995	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.GRACEHOSPICECARING.ORG	WebsiteAddressTxt
Type Of Organization Other	Yes (X)	TypeOfOrganizationOtherInd
Other Organization Dsc	LLC	OtherOrganizationDsc
Formation	2014	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	PROVIDE HOSPICE SERVICES TO THE ELDERLY.	ActivityOrMissionDesc
Voting Members Governing Body	6	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	93	TotalEmployeeCnt
Total Volunteers	69	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$75,979	PYContributionsGrantsAmt
CY Contributions Grants	$95,381	CYContributionsGrantsAmt
PY Program Service Revenue	$8,530,622	PYProgramServiceRevenueAmt
CY Program Service Revenue	$10,661,798	CYProgramServiceRevenueAmt
PY Investment Income	$9	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	-$7,341	PYOtherRevenueAmt
CY Other Revenue	-$17,302	CYOtherRevenueAmt
PY Total Revenue	$8,599,269	PYTotalRevenueAmt
CY Total Revenue	$10,739,877	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$400,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,292,208	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$5,023,204	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$4,049,260	PYOtherExpensesAmt
CY Other Expenses	$4,622,817	CYOtherExpensesAmt
PY Total Expenses	$8,341,468	PYTotalExpensesAmt
CY Total Expenses	$10,046,021	CYTotalExpensesAmt
PY Revenues Less Expenses	$257,801	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$693,856	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,699,845	TotalAssetsBOYAmt
Total Assets EOY	$2,406,503	TotalAssetsEOYAmt
Total Liabilities BOY	$709,057	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$721,859	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$990,788	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,684,644	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	OUR MISSION IS TO SERVE GOD BY RECOGNIZING THAT EVERY PERSON DESERVES TO LIVE OUT HIS OR HER LIFE WITH RESPECT AND DIGNITY, FREE OF PAIN, AND IN AN ENVIRONMENT THAT PROMOTES QUALITY OF LIFE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$8,358,973	ExpenseAmt
Grant	$400,000	GrantAmt
Revenue	$10,661,798	RevenueAmt
Desc	AUGUSTANA MOUNT OLIVET HOSPICE, LLC ("THE LLC") IS A JOINT VENTURE BETWEEN AUGUSTANA CARE (EIN: 41-1728753) AND MOUNT OLIVET CAREVIEW HOME (EIN: 41-0802697). AUGUSTANA CARE AND MOUNT OLIVET CAREVIEW HOME ARE THE ONLY MEMBERS OF THE LLC. BOTH MEMBERS ARE MINNESOTA NONPROFIT CORPORATIONS AND TAX EXEMPT PUBLIC CHARITIES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AUGUSTANA CARE IS A PUBLIC CHARITY UNDER SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI). MOUNT OLIVET CAREVIEW HOME IS A PUBLIC CHARITY UNDER SECTION 509 (A)(2).HOSPICE CARE:THE LLC PROVIDES END-OF-LIFE CARE TO PATIENTS, IN THEIR HOME, THAT ARE CERTIFIED AS BEING TERMINALLY ILL WITH LESS THAN SIX MONTHS OF LIFE. THE PURPOSES OF THE LLC INCLUDE:(A) TO PROVIDE END-OF-LIFE SERVICES THAT SUPPORTS EACH INDIVIDUAL'S PHYSICAL, SPIRITUAL, CULTURAL AND EMOTIONAL NEEDS TO ENHANCE THEIR QUALITY OF LIFE;(B) TO SUPPORT AND HELP PATIENTS AND FAMILIES THROUGH THEIR END OF LIFE JOURNEY UTILIZING A TEAM APPROACH OF: MEDICAL DIRECTOR, NURSES, SOCIAL WORKERS, CHAPLAINS, HOME HEALTH AIDES, MUSIC THERAPISTS, MASSAGE THERAPISTS, GRIEF COUNSELORS, MEDICATIONS RELATED TO TERMINAL DIAGNOSIS, DURABLE MEDICAL EQUIPMENT, 24/7 ON-CALL SUPPORT AND VOLUNTEERS;(C) TO PROVIDE 13 MONTHS OF BEREAVEMENT SERVICES;(D) TO ACCEPT ALL WHO ARE ELIGIBLE TO HOSPICE SERVICES REGARDLESS OF ABILITY TO PAY;(E) A FAITH-BASED ORGANIZATION BRINGING HOSPICE CARE TO PATIENTS AND FAMILIES THAT BEST FITS THEIR NEEDS; AND(F) OTHER PROGRAMS AS MAY FROM TIME TO TIME THAT IS APPROPRIATE TO THE ACCOMPLISHMENT OF THIS COMPANY'S CHARITABLE PURPOSE.IN FISCAL YEAR 2019, WE PROVIDED HOSPICE SERVICES TO 573 HOSPICE PATIENTS AND FAMILIES.	Desc
Total Program Service Expenses	$8,358,973	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	0	ReportOtherAssetsInd
Report Other Liabilities	0	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	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	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	0	DisregardedEntityInd
Related Entity	0	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	15	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	93	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
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	6	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	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	0	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 - A&E CARE SERVICES	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9528555000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7171 OHMS LN	AddressLine1Txt
City	EDINA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55439	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
SARAH VAN WINKLE
PRESIDENT/CEO	45.00	0.00	Yes (X)	$174,243	$0	$6,098
STACY LYSEN
DIRECTOR OF NURSING	45.00	0.00		$131,042	$0	$21,753	Yes (X)
BERNIE CABLE-PROKOP
CHAIR	2.00	0.00	Yes (X)	$0	$0	$0		Yes (X)
TIMOTHY HOKANSON
VICE CHAIR	2.00	0.00	Yes (X)	$0	$0	$0		Yes (X)
SHARON WILSON
SECRETARY	2.00	0.00	Yes (X)	$0	$0	$0		Yes (X)
EILEEN CARTWRIGHT
DIRECTOR	2.00	0.00		$0	$0	$0		Yes (X)
MATTHEW KERN
DIRECTOR	2.00	0.00		$0	$0	$0		Yes (X)
DAVID LOSE
DIRECTOR	2.00	0.00		$0	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$305,285	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$27,851	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
HOSPICE PHARMACY SOLUTIONS
PO BOX 161583	ATLANTA	GA	30321	PHARMACY BENEFIT MANAGER	$528,692
A&E CARE SERVICES
7171 OHMS LANE	EDINA	MN	55439	MANAGEMENT SERVICES	$429,246
INTERNAL MEDICINE & GERIATRIC ASSOC
21490 FAIRVIEW ST	EXCELSIOR	MN	55331	MEDICAL DIRECTOR	$153,361

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	3	CntrctRcvdGreaterThan100KCnt
Fundraising	$70,393	FundraisingAmt
All Other Contributions	$24,988	AllOtherContributionsAmt
Total Contributions	$95,381	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	HOSPICE CARE	Desc
Business	624100	BusinessCd
Total Revenue Column	$10,661,798	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,661,798	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$10,661,798	TotalProgramServiceRevenueAmt
Fundraising Gross Income	$14,816	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$70,393	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$32,118	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$17,302	TotalRevenueColumnAmt
Exclusion	-$17,302	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,739,877	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,661,798	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$17,302	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$400,000	TotalAmt
Program Services	$400,000	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$209,971	TotalAmt
Management And General	$209,971	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,963,806	TotalAmt
Program Services	$3,516,717	ProgramServicesAmt
Management And General	$447,089	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$57,260	TotalAmt
Program Services	$47,102	ProgramServicesAmt
Management And General	$10,158	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$471,277	TotalAmt
Program Services	$387,672	ProgramServicesAmt
Management And General	$83,605	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$320,890	TotalAmt
Program Services	$263,964	ProgramServicesAmt
Management And General	$56,926	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$429,246	TotalAmt
Management And General	$429,246	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$924	TotalAmt
Management And General	$924	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$21,535	TotalAmt
Management And General	$21,535	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,006,331	TotalAmt
Program Services	$3,006,331	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$39,072	TotalAmt
Management And General	$39,072	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$142,716	TotalAmt
Program Services	$18,050	ProgramServicesAmt
Management And General	$124,666	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$83,173	TotalAmt
Management And General	$83,173	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$42,828	TotalAmt
Program Services	$293	ProgramServicesAmt
Management And General	$42,535	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$144,409	TotalAmt
Program Services	$120,848	ProgramServicesAmt
Management And General	$23,561	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$21,469	TotalAmt
Program Services	$12,286	ProgramServicesAmt
Management And General	$9,183	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,566	TotalAmt
Management And General	$1,566	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$41,646	TotalAmt
Management And General	$41,646	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$20,552	TotalAmt
Management And General	$20,552	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
NURSING EQUIPMENT	$485,291	$485,291
NURSING SUPPLIES	$98,697	$98,697
RECRUITMENT AND RETENTI	$16,171		$16,171
DUES AND SUBSCRIPTIONS	$14,609	$349	$14,260

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,582	TotalAmt
Program Services	$1,373	ProgramServicesAmt
Management And General	$11,209	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$10,046,021	TotalAmt
Program Services	$8,358,973	ProgramServicesAmt
Management And General	$1,687,048	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$591,493	BOYAmt
EOY	$1,117,234	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$954,340	BOYAmt
EOY	$1,106,025	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$49,912	BOYAmt
EOY	$74,543	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$236,445	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$151,014	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$104,100	BOYAmt
EOY	$85,431	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$23,270	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,699,845	BOYAmt
EOY	$2,406,503	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$642,158	BOYAmt
EOY	$681,149	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$66,899	BOYAmt
EOY	$40,710	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$709,057	BOYAmt
EOY	$721,859	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$990,788	BOYAmt
EOY	$1,684,644	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$990,788	BOYAmt
EOY	$1,684,644	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,699,845	BOYAmt
EOY	$2,406,503	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$693,856	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)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$309,203	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$110,578	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$18,409	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$75,979	CurrentTaxYearMinus1YearAmt
Current Tax Year	$95,381	CurrentTaxYearAmt
Total	$609,550	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,557,734	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$3,980,994	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,866,280	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$8,530,622	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,661,798	CurrentTaxYearAmt
Total	$31,597,428	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,866,937	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,091,572	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,884,689	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$8,606,601	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,757,179	CurrentTaxYearAmt
Total	$32,206,978	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$300,000	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$100,000	CurrentTaxYearMinus3YearsAmt
Total	$400,000	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$300,000	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$100,000	CurrentTaxYearMinus3YearsAmt
Total	$400,000	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$31,806,978	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	$9	CurrentTaxYearMinus1YearAmt
Total	$9	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	$9	CurrentTaxYearMinus1YearAmt
Total	$9	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	$30,365	CurrentTaxYearMinus1YearAmt
Current Tax Year	$14,816	CurrentTaxYearAmt
Total	$45,181	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,866,937	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,091,572	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,884,689	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$8,636,975	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,771,995	CurrentTaxYearAmt
Total	$32,252,168	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.98620	PublicSupportCY509Pct
Public Support PY509	0.95790	PublicSupportPY509Pct
Investment Income CY	0.00000	InvestmentIncomeCYPct
Investment Income PY	0.00000	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:	FormAndLineReferenceDesc
Explanation	MISCELLANEOUS INCOME - 2014 AMOUNT: $ 0. 2015 AMOUNT: $ 0. 2016 AMOUNT: $ 0. 2017 AMOUNT: $ 24,440. 2018 AMOUNT: $ 0. FUNDRAISING EVENT REVENUES - 2014 AMOUNT: $ 0. 2015 AMOUNT: $ 0. 2016 AMOUNT: $ 0. 2017 AMOUNT: $ 5,925. 2018 AMOUNT: $ 14,816.	ExplanationTxt

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

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$129,510	OtherCostOrOtherBasisAmt
Depreciation	$90,657	DepreciationAmt
Book Value	$38,853	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$106,935	OtherCostOrOtherBasisAmt
Depreciation	$60,357	DepreciationAmt
Book Value	$46,578	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$85,431	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$13,897,518	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	$3,157,641	OtherRevenueAmt
Revenue Not Reported	$3,157,641	RevenueNotReportedAmt
Revenue Subtotal	$10,739,877	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$10,739,877	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$12,544,898	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$2,498,877	OtherExpensesIncludedAmt
Expenses Not Reported	$2,498,877	ExpensesNotReportedAmt
Expenses Subtotal	$10,046,021	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$10,046,021	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART X, LINE 2:	AS A LIMITED LIABILITY COMPANY, THE COMPANY IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES AND ITS INCOME IS ALLOCATED TO AND REPORTED IN THE TAX RETURNS OF ITS MEMBERS, WHICH ARE BOTH NON-PROFIT CORPORATIONS. 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 MEMBERS' INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	SHORT PERIOD REVENUES INCLUDED IN SEPARATE FORM 990 3,157,641.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	SHORT PERIOD EXPENSES INCLUDED IN SEPARATE FORM 990 2,498,877.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GALA EVENT	Event1Nm
Gross Receipts Event1	$85,209	GrossReceiptsEvent1Amt
Charitable Contri Event1	$70,393	CharitableContriEvent1Amt
Gross Revenue Event1	$14,816	GrossRevenueEvent1Amt
Rent Facility Costs Event1	$1,065	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$11,009	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$20,044	OtherDirectExpensesEvent1Amt
Gross Receipts Total	$85,209	GrossReceiptsTotalAmt
Charitable Contributions Tot	$70,393	CharitableContributionsTotAmt
Gross Revenue Total Events	$14,816	GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events	$1,065	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$11,009	FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events	$20,044	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$32,118	DirectExpenseSummaryEventsAmt
Net Income Summary	-$17,302	NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt
AUGUSTANA CARE
7171 OHMS LANE	EDINA	MN	55439	411728753	501(C)(3)	$200,000	$0	N/A	N/A	GENERAL ASSISTANCE
MOUNT OLIVET CAREVIEW HOME
5517 LYNDALE AVENUE SOUTH	MINNEAPOLIS	MN	55419	410802697	501(C)(3)	$200,000	$0	N/A	N/A	GENERAL ASSISTANCE

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE TRANSFERS WERE MADE TO THE MEMBERS, WHO ARE BOTH 501 (C)(3) ORGANIZATIONS, AND WERE USED FOR GENERAL OPERATING SUPPORT. NO FOLLOW-UP OR OVERSIGHT WAS CONDUCTED REGARDING THE SPECIFIC USE OF TRANSFERRED FUNDS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	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	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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
SARAH VAN WINKLE
PRESIDENT/CEO	$174,218	$0	$0	$0	$25	$0	$6,098	$0	$0	$0	$180,341	$0	$0	$0
STACY LYSEN
DIRECTOR OF NURSING	$121,042	$0	$10,000	$0	$0	$0	$4,830	$0	$16,923	$0	$152,795	$0	$0	$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	1. BERNADINE CABLE-PROKOP AND SHARON WILSON - BUSINESS RELATIONSHIP 2. EILEEN CARTWRIGHT AND TIMOTHY HOKANSON - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 3	A&E CARE SERVICES PROVIDES THE FOLLOWING SERVICES TO AUGUSTANA MOUNT OLIVET HOSPICE CARE, LLC: FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, PHILANTHROPY AND NEW BUSINESS DEVELOPMENT.
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS OF THE ORGANIZATION ARE AUGUSTANA CARE AND MOUNT OLIVET CAREVIEW HOME, BOTH MINNESOTA NON PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL CODE AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND AFFILIATED WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. THE INCUMBENT CHIEF EXECUTIVE OFFICER OF EACH MEMBER SHALL BE THE MEMBER DELEGATE OF EACH MEMBER ENTITLED TO VOTE ON BEHALF OF THE VOTING INTERESTS OF EACH MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF GOVENORS SHALL CONSIST OF AT LEAST SIX GOVERNORS, THREE OF WHOM SHALL BE APPOINTED BY THE MEMBER DELEGATE OF AUGUSTANA CARE AND THREE OF WHOM SHALL BE APPOINTED BY THE MEMBER DELEGATE OF MOUNT OLIVET CAREVIEW HOME.
FORM 990, PART VI, SECTION A, LINE 7B	THE ARTICLES OF ORGANIZATION AND THE BYLAWS OF THIS ORGANIZATION MAY BE AMENDED OR RESTATED ONLY BY THE UNANIMOUS APPROVAL OF THE MEMBERS. ANY PROPOSED AMENDMENTS RELATING TO THE AFFILIATION REQUIREMENTS OF THE ELCA SHALL BE SUBMITTED TO THE ELCA FOR COMMENT PRIOR TO THEIR EFFECTIVE DATE.
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 CEO. THE FORM 990 WAS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS BY THE CEO PRIOR TO BEING FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	INFORMATION REGARDING THE HOSPICE'S POLICY ON CONFLICTS OF INTEREST IS PROVIDED DURING ORIENTATION OF NEW STAFF, VOLUNTEERS AND BOARD MEMBERS. MEMBERS OF THE BOARD OF DIRECTORS AND HOSPICE STAFF SUBMIT A FORM TO DISCLOSE PERSONAL OR FINANCIAL INTERESTS THAT COULD POTENTIALLY INTERFERE WITH THEIR DUTIES AND RESPONSIBILITIES TO GRACE HOSPICE. DISCLOSURE FORMS ARE SUBMITTED AT THE TIME OF HIRE OR BOARD APPOINTMENT, ANNUALLY, AND WHENEVER A POTENTIAL CONFLICT ARISES. FAILURE TO DISCLOSE EXISTING OR POTENTIAL CONFLICTS OF INTEREST IS GROUNDS FOR TERMINATION OF EMPLOYMENT OR BOARD APPOINTMENT. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE BOARD OF DIRECTORS AND/OR BY THE HOSPICE ADMINISTRATOR TO DETERMINE APPROPRIATE ACTION.
FORM 990, PART VI, SECTION B, LINE 15A	THE COMPENSATION FOR SARAH VAN WINKLE, PRESIDENT/CEO, IS SET BY TWO REPRESENTATIVES OF THE PARTNERING AGENCIES: BOB DAHL, CEO OF AUGUSTANA CARE, AND TIM HOKANSON, ADMINISTRATOR OF MOUNT OLIVET CARE VIEW HOME. THEY SET SARAH'S COMPENSATION BY REVIEWING SALARY SURVEYS SPECIFIC TO HOSPICE AGENCIES. ADDITIONALLY, THEY REVIEW FINANCIAL OUTCOMES, GROWTH OUTCOMES, QUALITY INDICATORS, AND STAFF RETENTION. THIS PROCESS 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 IX, LINE 11G	OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 3,006,331. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,006,331.
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.