2020-09-16T13:13:50-07:00 2019-12-31 990 2019-01-01 810754064 ELIM SENIOR HOUSING INC ELIM 9528555000 7171 Ohms Lane Edina MN 55439 Kathy Youngquist CFO 9528555009 2020-09-15 50.209.15.97 2019 2021-01-29 14:40:06Z Robert Dahl 7171 Ohms Lane Edina MN 55439 1580560 0 X www.cassialife.org X 2015 FL ELIM SENIOR HOUSING, INC. OWNS AND OPERATES A 155-UNIT SENIOR APARTMENT BUILDING. 5 5 102 12 0 0 0 2500 1580560 0 0 2500 1580560 0 0 192210 1591425 0 0 789868 5405232 982078 6996657 -979578 -5416097 56532731 49274516 54840451 52788298 1692280 -3513782 See Part I, Line 1 0 0 5751643 0 1580560 ELIM SENIOR HOUSING, INC. OWNS AND OPERATES A 155-UNIT SENIOR APARTMENT BUILDING. THE CAMPUS CONSISTS OF ASSISTED LIVING AND MEMORY CARE UNITS AS WELL AS A TOWN CENTER. 0 0 0 5751643 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 1 102 1 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Kathy Youngquist 9528555000 7171 Ohms Lane Edina MN 55439 Robert Dahl President/CEO 0.22 19.78 X 0 739877 127818 Kathy Youngquist Chief Financial Officer 0.22 19.78 X 0 374518 106354 Ronald Sanford Chief Operating Officer 0.45 39.55 X 0 319965 36713 Angela Brown VP of Human Resources 0.22 19.78 X 0 224420 72587 Richard Bjerkass Secretary/Treasurer 0.04 0.32 X X 0 0 0 Dr Thomas Cairns Vice Chair 0.04 0.15 X X 0 0 0 Nikki Daniels Director 0.04 0.11 X 0 0 0 Stann Leff Director 0.04 0.28 X 0 0 0 Patrick Nuss Chair 0.04 0.12 X X 0 0 0 0 1658780 343472 0 0 1 0 Varsity Marketing LLC 532 North Front Street Suite 200 Wormleysburg PA 17043 Marketing Services 136168 Edward Construction 85 SW 52nd Ave Ocala FL 34474 Construction Services 1983374 Henricksen 1101 West Thorndale Ave Itasa IL 60413 Furniture & Equipment 399464 3 0 Assisted Living Revenue 623000 1580560 1580560 0 0 0 0 0 0 1580560 0 0 0 0 0 1580560 1580560 0 0 1383198 1093976 289222 608 481 127 110311 87245 23066 97308 76961 20347 63222 63222 31323 31323 294726 294726 19078 19078 25869 25869 186491 175301 11190 60419 60419 2694648 2532969 161679 1300256 1222241 78015 146216 137443 8773 Food 116397 116397 0 Supplies 95881 95438 443 Purchased Services 219247 149765 69482 Miscellaneous 151459 63426 88033 6996657 5751643 1245014 0 58999 165884 10238 4600 66475 42499690 1300256 1786424 41199434 54682708 7832485 56532731 49274516 15358 1604059 51116802 51184239 3708291 54840451 52788298 X 1692280 -3522337 0 8555 1692280 -3513782 56532731 49274516 X -5416097 186535 0 0 0 23500 X 0 1 X 1 0 X 0 0 2500 1580560 1583060 0 0 0 2500 1580560 1583060 0 0 0 0 0 0 0 0 0 0 0 0 1583060 81856 0 0 81856 0 0 81856 0 0 81856 0 0 81856 2500 1580560 1664916 X 1786424 0 1786424 38621127 0 1066345 37554782 0 0 0 0 1993632 0 220918 1772714 98507 0 12993 85514 41199434 Funds Held by Trustee 7784943 Due from Affiliates 47542 7832485 1782040 186535 0 0 14945 201480 1580560 0 0 0 1580560 6996657 0 0 0 0 0 6996657 0 0 0 6996657 Schedule D, Part XI, Line 2d Net Assets Released from Restrictions - Operations - $14,945 X 1 1 X X X X 0 1 0 0 0 1 1 0 0 Robert Dahl President/CEO 0 437567 0 287186 0 15124 0 111553 0 16265 0 867695 0 235726 Kathy Youngquist Chief Financial Officer 0 302671 0 61757 0 10090 0 84392 0 21962 0 480872 0 59933 Ronald Sanford Chief Operating Officer 0 230739 0 86966 0 2260 0 31909 0 4804 0 356678 0 57023 Angela Brown VP of Human Resources 0 183057 0 33333 0 8030 0 52759 0 19828 0 297007 0 33333 Schedule J, Part I, Line 1a A set percentage is paid to help cover the taxes on personal auto usage. This amount is treated as a taxable benefit. Schedule J, Part I, Line 4 Certain officers and key employees of the organization participate in a 457(f) Deferred Compensation Plan. For 2019 the amount of deferred compensation was as follows: Robert Dahl - $54,463 Kathy Youngquist - $52,086 Angela Brown - $30,867 Schedule J, Part I, Line 6 The officers of the organization and Angela Brown accrued incentive bonuses at 12/31/19 that were contingent on the combined net income of the organization and all related organizations. A Capital Trust Agency 593591394 140542AG6 2017-08-29 53050000 To finance construction of a new senior living campus 0 0 0 A 0 0 53050000 3704212 0 0 870967 0 0 37397227 11077594 0 0 0 1 1 A 0 0 0 0 0 0 0 0 1 A 0 1 0 1 1 0 0 0 1 A 1 Schedule K, Part IV, Line 2c-08/29/2017 53,050,000 Capital Trust Agency AGENCY - 5 YEAR ANNIVERSARY HAS NOT OCCURRED YET. Form 990, Part VI, Section A, Line 6 Elim Care, Inc. is the sole member of Elim Senior Housing, Inc. Board members of Elim Senior Housing, Inc. are approved by the Elim Care, Inc. board. Directors of Elim Senior Housing are subject to apporoval by the Elim Care, Inc. board. Form 990, Part VI, Section A, Line 7a Elim Care, Inc. is the sole member of Elim Senior Housing, Inc. Board members of Elim Senior Housing, Inc. are approved by the Elim Care, Inc. board. Directors of Elim Seniors Housing, Inc. are subject to approval by the Elim Care, Inc. board. Form 990, Part VI, Section A, Line 7b Elim Care, Inc. is the sole member of Elim Senior Housing, Inc. Board members of Elim Senior Housing, Inc. are approved by the Elim Care, Inc. board. Directors of Elim Seniors Housing, Inc. 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 VP of Finance. The Chief Financial Officer reviewed the return prior to signing. The return is placed on a portal for Board Member to review prior to signing. 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 the situations that may have risen 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 wages and benefit levels of similar positions in similar organizations. The compensation committee uses this information to make a recommendation to the board of directors. Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policy and financial statements are generally not made available to the public. Form 990, Part XI, Line 9 Other Changes in Net Assets: Restricted Contributions Receivable: $23,500 Elim Care Inc 7171 Ohms Lane Edina MN 55439 411694818 Parent Co/Fund Raising MN 501(c)(3) 7 N/A 0 Elim Homes Inc 7171 Ohms Lane Edina MN 55439 411539761 NsgHome/SrHsg/Therapy MN 501(c)(3) 10 N/A 0 Pioneer House Assisted Living Inc 7171 Ohms Lane Edina MN 55439 411927112 Senior Housing MN 501(c)(3) 10 N/A 0 Park View Care Center 7171 Ohms Lane Edina MN 55439 410855707 Nursing Home MN 501(c)(3) 10 N/A 0 The Park Lane Apartments Inc 7171 Ohms Lane Edina MN 55439 410972384 Low Income Housing MN 501(c)(3) 10 N/A 0 Elim Children's Center 7171 Ohms Lane Edina MN 55439 411974507 Child Daycare MN 501(c)(3) 10 N/A 0 Redeemer Residence Inc 7171 Ohms Lane Edina MN 55439 410711597 Nursing Home MN 501(c)(3) 10 N/A 0 Country Meadows of Milaca Inc 7171 Ohms Lane Edina MN 55439 201723948 Senior Housing MN 501(c)(3) 10 N/A 0 Lake Ride Care Center of Buffalo Inc 7171 Ohms Lane Edina MN 55439 200507069 Nsg Home/Senior Hsg MN 501(c)(3) 10 N/A 0 Park Terrace Assisted Living Inc 7171 Ohms Lane Edina MN 55439 204063752 Senior Housing MN 501(c)(3) 10 N/A 0 Evangelical Retirement Homes Inc 7171 Ohms Lane Edina MN 55439 420868449 Nsg Home/Senior Hsg IA 501(c)(3) 10 N/A 0 Village Assisted Living Inc 7171 Ohms Lane Edina MN 55439 262086933 Senior Housing MN 501(c)(3) 10 N/A 0 Community Health Foundation of Wright County 7171 Ohms Lane Edina MN 55439 363546789 Fund Raising MN 501(c)(3) 7 N/A 0 Baptist Home Inc 7171 Ohms Lane Edina MN 55439 450232943 Nursing Home ND 501(c)(3) 10 N/A 0 New Harmony Care Center Inc 7171 Ohms Lane Edina MN 55430 411821882 Nursing Home MN 501(c)(3) 10 N/A 0 Elim Care Foundation 7171 Ohms Lane Edina MN 55439 411694817 Long Term Investing MN 501(c)(3) 12 N/A 0 Elim Shores Inc 7171 Ohms Lane Edina MN 55439 411625095 Senior Housing MN 501(c)(3) 10 N/A 0 Cornerstone Assisted Living of Plymouth 7171 Ohms Lane Edina MN 55439 412013927 Senior Housing MN 501(c)(3) 10 N/A 0 Newton Village Inc 7171 Ohms Lane Edina MN 55439 200044030 Nsg Home/Senior Hsg MN 501(c)(3) 10 N/A 0 Haven Homes Inc 7171 Ohms Lane Edina MN 55439 416045816 Nsg Home/Senior Hsg MN 501(c)(3) 10 N/A 0 Baptist Apartments Inc 7171 Ohms Lane Edina MN 55439 450359794 Senior Housing ND 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 N/A 0 Elim Preferred Services Inc 7171 Ohms Lane Edina MN 55439 411681856 Medical Sales MN N/A C 0 0 0 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 0 0 0 0 0 1 0 0 0 0 0 1