2019-08-15T15:44:30-05:00 2018-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-10-01 411728753 AUGUSTANA CARE AUGU 9528555000 7171 OHMS LANE EDINA MN 55439 KATHY YOUNGQUIST CFO 9528555000 2019-08-15 1 EMILY SCHEEVEL P01814921 6123764500 67.137.57.251 2019-08-15 09:48:54 CD P FCD06153B7C3F4186BBEFC76B30654521E54D624 64D167D091931D8555FA058DC075EC7E31BCB1E3 2017 2019-02-21 02:37:17Z X ROBERT DAHL 7171 OHMS LANE EDINA MN 55439 54656011 0 X WWW.AUGUSTANACARE.ORG X 1991 MN TO PROVIDE HEALTHCARE, HOUSING AND COMMMUNITY SERVICES FOR THE ELDERLY. 12 12 1287 387 5005892 -115947 2236409 5981364 40446524 47771784 173872 172476 347821 345210 43204626 54270834 1282862 721630 0 0 27113724 32236154 0 0 337992 17713330 19223858 46109916 52181642 -2905290 2089192 93193431 98499391 80790400 87877316 12403031 10622075 X 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. 1 0 27374033 4000 31274826 THE EXPENSES LISTED ABOVE ARE RELATED TO DIRECT COSTS ASSOCIATED WITH THE PROVISION OF ASSISTED LIVING SERVICES AT AUGUSTANA ELK RUN ASSISTED LIVING IN EVERGREEN, CO, AUGUSTANA REGENT IN BURNSVILLE, MN, AUGUSTANA OAKVIEW CARE IN MOOSE LAKE, MN, CASTLE PEAK SENIOR CARE IN EAGLE, CO, AND THROUGH AUGUSTANA RESIDENTIAL CARE. EXPENSES FOR EMERALD CREST ASSISTED LIVING AND MEMORY CARE, A SPECIALIZED PROGRAM FOR ADULTS WITH MEMORY LOSS AT FOUR SITES IN THE SUBURBAN MINNEAPOLIS AREA ARE ALSO INCLUDED. EMERALD CREST EMPLOYS A MODEL OF STRENGTH-BASED CARE FOR INDIVIDUALS WITH MEMORY LOSS IN SMALLER, HOME-LIKE RESIDENCES WHERE ONE'S DIGNITY, PRIVACY, SAFETY AND QUALITY OF LIFE ARE PRIORITIZED. IN TOTAL, THESE ASSISTED LIVING COMMUNITIES SERVED MORE THAN 552 PEOPLE DURING THE PAST FISCAL YEAR. 10344284 20849 11404674 THE ABOVE TOTAL INCLUDES OPERATING EXPENSES FOR AUGUSTANA MERCY HEALTH CARE CENTER OF MOOSE LAKE, MN, AUGUSTANA LAKESIDE HEALTH CARE CENTER OF DASSEL, MN, AND CASTLE PEAK SENIOR LIVING OF EAGLE, CO. DURING THE PAST FISCAL YEAR, THESE THREE RURAL SKILLED NURSING COMMUNITIES PROVIDED REHABILITATION, SKILLED NURSING AND MEMORY CARE TO 773 PEOPLE. 5642561 696781 5092284 AS A LONG-TIME PROVIDER OF HEALTH CARE, HOUSING, AND COMMUNITY-BASED SERVICES, AUGUSTANA CARE APPLIES ITS EXPERIENCE AND IN-DEPTH KNOWLEDGE OF THE HEALTH CARE FIELD TO PROVIDE MANAGEMENT SERVICES FOR OTHER ORGANIZATIONS. AUGUSTANA CASH MANAGEMENT COMPANY, LLC, MANAGES THE CASH INFLOWS AND OUTFLOWS FOR THE AUGUSTANA CARE SUBSIDIARIES. THE EXPENSES LISTED ABOVE ARE FOR AUGUSTANA SENIOR DEVELOPMENT II, LLC, A BUSINESS UNIT OF AUGUSTANA CARE THROUGH WHICH MANAGEMENT SERVICES ARE PROVIDED TO UNRELATED NOT-FOR-PROFIT AND FOR-PROFIT COMMUNITIES IN MINNESOTA. THE NOT-FOR-PROFIT COMMUNITIES INCLUDE AUGUSTANA APARTMENTS AND CARDINAL HOMES IN FERGUS FALLS, AND ST. PAUL'S HOME APARTMENTS, SIGNE BURCKHARDT MANOR, THOMAS FEENEY MANOR, AND HERITAGE PARK ALL LOCATED IN MINNEAPOLIS. THE FOR-PROFIT ASSISTED LIVING COMMUNITIES INCLUDE THE PINES IN RICHFIELD, THE ROSEMOUNT IN ROSEMOUNT, AND RIVER BEND ASSISTED LIVING IN ROCHESTER. SERVICES INCLUDE CONSULTING, MARKETING, LEADERSHIP DEVELOPMENT, INFORMATION SYSTEMS SUPPORT, HOUSING DEVELOPMENT, AND EMPLOYEE RELATIONS. ALTOGETHER, THESE MANAGED FACILITIES SERVED 533 PEOPLE DURING THE PAST FISCAL YEAR. 319987 0 0 AUGUSTANA CARE'S FORM 990 ALSO INCLUDES FINANCIAL INFORMATION ABOUT A WHOLLY-OWNED SUBSIDIARY OF AUGUSTANA CARE CALLED AUGUSTANA PROPERTIES, LLC. THIS ENTITY OVERSEES EVERYTHING RELATED TO A NUMBER OF RENTAL PROPERTIES THAT HOUSE EMPLOYEES AND MEMBERS OF THE COMMUNITY AT LARGE. 319987 0 0 43680865 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 240 0 1287 1 1 1 0 0 0 0 1 1 0 0 0 0 X 12 12 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X KATHY YOUNGQUIST - AE CARE SERVICE 9528555000 7171 OHMS LANE EDINA MN 55439 REV DR GARY WILKERSON CHAIR 1.00 8.00 X X 0 0 0 MARSHALL MACKAY VICE CHAIR 1.00 8.00 X X 0 0 0 CHARLES PARKS JR SECRETARY 1.00 8.00 X X 0 0 0 ERIK RICK ELLINGSON TREASURER 1.00 9.00 X X 0 0 0 BERNIE CABLE-PROKOP DIRECTOR (THROUGH APRIL 2018) 1.00 1.00 X 0 0 0 BRUCE CRAWFORD DIRECTOR 1.00 0.00 X 0 0 0 JIM EHLEN DIRECTOR 1.00 8.00 X 0 0 0 DUANE HETLAND DIRECTOR 1.00 0.00 X 0 0 0 TIMOTHY KUCK DIRECTOR 1.00 0.00 X 0 0 0 LARRY KULA DIRECTOR 1.00 0.00 X 0 0 0 JERRY NYE DIRECTOR 1.00 8.00 X 0 0 0 ALLEN OLSON DIRECTOR (THROUGH APRIL 2018) 1.00 0.00 X 0 0 0 NIC PUZAK DIRECTOR (THROUGH APRIL 2018) 1.00 0.00 X 0 0 0 SCOTT RAMSDALE DIRECTOR 1.00 8.00 X 0 0 0 PR DAN SIEDELMANN DIRECTOR (THROUGH MAY 2018) 1.00 0.00 X 0 0 0 TOM TURNER DIRECTOR (THROUGH APRIL 2018) 1.00 0.00 X 0 0 0 MICHELENE VERLAUTZ DIRECTOR 1.00 0.00 X 0 0 0 TIM TUCKER PRESIDENT/CEO 4.50 40.50 X 0 534949 345355 CRAIG KITTELSON VP - FINANCE/CFO 4.50 40.50 X 0 355306 100645 MATTHEW KERN VP - OPERATIONS/COO 4.50 40.50 X 0 116025 8017 KATHERINE KOPP VP - NEW BUSINESS DEVELOPMENT 4.50 40.50 X 0 293436 58361 TIM MIDDENDORF FORMER VP - OPERATIONS/COO 4.50 40.50 X 0 234157 57998 0 1533873 570376 0 1 1 0 NETWORK THERAPY SERVICES 8120 PENN AVE S STE 227 BLOOMINGTON MN 55431 THERAPY SERVICES (PT, OT, ST) 10579280 A&E CARE SERVICES 7171 OHMS LANE EDINA MN 55439 MANAGEMENT SERVICES 2144082 MILLER ARCHITECTS AND BUILDERS PO BOX 1228 ST CLOUD MN 56302 CONSTRUCTION OF NEW BROOKSIDE BUILDING 1067377 GRAY PLANT MOOTY MOOTY & BENNETT PA 500 IDS CENTER 80 SOUTH 8TH STREET MINNEAPOLIS MN 55402 LEGAL SERVICES 586147 CLIFTONLARSONALLEN LLP PO BOX 776376 CHICAGO MN 60677 AUDIT/CONSULTING SERVICES 371148 8 86311 5388745 285578 220730 16525 5981364 ASSISTED LIVING 623000 31274826 31274826 NURSING 623000 11404674 11404674 PAYROLL 541200 4175581 4175581 CONSULTING 541610 916703 916703 47771784 172476 172476 298112 345713 -47601 -47601 -86392 38791 24710 86311 39464 -14754 -14754 3015 0 3015 3015 DIETARY INCOME 722210 112423 112423 CABLE TV INCOME 515100 65188 65188 MAINTENANCE INCOME 811000 61474 61474 165465 165465 404550 54270834 42679500 5005892 604078 700849 700849 20781 20781 27683614 24328008 3074381 281225 157511 130200 27311 2757237 2443347 313890 1637792 1496427 141365 2339051 148633 2190418 147599 147599 104328 104328 1576389 1256716 310237 9436 261894 261609 285 845140 464436 366242 14462 55056 54471 585 1867904 1867904 609376 492736 111736 4904 156256 122251 28782 5223 2792112 2715873 76239 3354518 3354518 406932 19433 387499 NURSING SUPPLIES 2116718 2116718 DIETARY EXPENSES 1372178 1372178 LICENSES, PERMITS, FEES 466767 375314 89627 1826 BAD DEBT EXPENSE 288275 288587 -312 463365 200072 242350 20943 52181642 43680865 8162785 337992 3382023 8839641 687794 69855 2234935 4421562 335279 937946 101012078 25184215 78266257 75827863 1602816 1603116 366494 495394 6317833 6304014 93193431 98499391 3074367 9925957 32546118 31548895 315358 368461 42244819 41310881 2609738 4723122 80790400 87877316 X 11512086 10124729 737495 343596 153450 153750 12403031 10622075 93193431 98499391 X 2089192 108370 -3978518 X 0 1 X 1 0 X 7024078 2846409 5486509 2207536 5981364 23545896 7024078 2846409 5486509 2207536 5981364 23545896 23545896 448003 732232 385033 400118 470588 2435974 83140 8593 91733 300443 462693 421051 429828 432275 2046290 28119893 179230857 0.83730 0.81640 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2013 AMOUNT: $ 10,879. 2014 AMOUNT: $ 11,303. 2015 AMOUNT: $ 14,957. 2016 AMOUNT: $ 43,497. 2017 AMOUNT: $ 40,449. DIETARY INCOME - 2013 AMOUNT: $ 96,028. 2014 AMOUNT: $ 114,922. 2015 AMOUNT: $ 118,919. 2016 AMOUNT: $ 117,866. 2017 AMOUNT: $ 112,423. HOUSEKEEPING INCOME - 2013 AMOUNT: $ 75,037. 2014 AMOUNT: $ 69,604. 2015 AMOUNT: $ 67,209. 2016 AMOUNT: $ 44,817. 2017 AMOUNT: $ 55,152. VENDING INCOME - 2013 AMOUNT: $ 544. 2014 AMOUNT: $ 628. 2015 AMOUNT: $ 896. 2016 AMOUNT: $ 708. 2017 AMOUNT: $ 637. CABLE TV INCOME - 2013 AMOUNT: $ 37,534. 2014 AMOUNT: $ 50,047. 2015 AMOUNT: $ 48,559. 2016 AMOUNT: $ 55,919. 2017 AMOUNT: $ 65,188. EMERGENCY PULL CORD INCOME - 2013 AMOUNT: $ 39,369. 2014 AMOUNT: $ 39,612. 2015 AMOUNT: $ 39,612. 2016 AMOUNT: $ 39,612. 2017 AMOUNT: $ 39,612. MAINTENANCE INCOME - 2013 AMOUNT: $ 9,687. 2014 AMOUNT: $ 23,216. 2015 AMOUNT: $ 30,368. 2016 AMOUNT: $ 38,494. 2017 AMOUNT: $ 61,474. PENDANT ALARM INCOME - 2013 AMOUNT: $ 4,680. 2014 AMOUNT: $ 4,856. 2015 AMOUNT: $ 2,396. 2016 AMOUNT: $ 4,481. 2017 AMOUNT: $ 5,196. TELEPHONE INCOME - 2013 AMOUNT: $ 23,272. 2014 AMOUNT: $ 25,948. 2015 AMOUNT: $ 28,192. 2016 AMOUNT: $ 25,840. 2017 AMOUNT: $ 22,895. ANNUITY CONVERSION INCOME - 2014 AMOUNT: $ 1,606. 2015 AMOUNT: $ 1,575. 2016 AMOUNT: $ 1,548. 2017 AMOUNT: $ 1,524. FUNDRAISING EVENT INCOME - 2014 AMOUNT: $ 115,330. 2015 AMOUNT: $ 63,339. 2016 AMOUNT: $ 51,857. 2017 AMOUNT: $ 24,710. GIFT SHOP INCOME - 2013 AMOUNT: $ 3,413. 2014 AMOUNT: $ 5,621. 2015 AMOUNT: $ 5,029. 2016 AMOUNT: $ 5,189. 2017 AMOUNT: $ 3,015. 0 1 X 148450 300 148750 148250 200 148450 148150 100 148250 147950 200 148150 147850 100 147950 0.00000 1.00000 0.00000 0 1 1 12656227 12656227 79655880 19273090 60382790 8649591 5911125 2738466 50380 50380 75827863 DUE FROM AFFILIATES 1481053 RESIDENT TRUST FUNDS 29732 FUNDS HELD IN ESCROW 261883 BOND FUNDS 4230299 TENANT SECURITY DEPOSITS 301047 6304014 DUE TO AFFILIATES 2166533 ASSET RETIREMENT OBLIGATION 53219 NON-COMPETE AGREEMENT 250002 NOTES PAYABLE TO AFFILIATES 2253368 4723122 X PART IV, LINE 2B: THE ORGANIZATION HOLDS, IN TRUST, FUNDS ADVANCED BY RESIDENTS TO BE USED AT EACH RESIDENT'S DISCRETION. THE FUNDS ARE MAINTAINED IN A SEPARATE INTEREST-BEARING SAVINGS ACCOUNT AND THE ORGANIZATION HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. SECURITY DEPOSITS ARE REQUIRED FOR THE ORGANIZATION'S TENANTS AND INCLUDE RESERVED APARTMENTS IF AMOUNTS ARE PAID BEFORE THE TENANT ACTUALLY MOVES IN. PART V, LINE 4: THE PRINCIPAL WILL BE INVESTED AND KEPT INTACT FOR PERPETUITY TO PROVIDE AN ADDITIONAL SOURCE OF INCOME. THE INCOME GENERATED WILL BE USED TO SUPPORT THE FUND DESIGNATED PROGRAM. THE ORGANIZATION'S ENDOWMENT IS HELD AND ADMINISTERED BY AUGUSTANA CARE FOUNDATION. SEE SCHEDULE R FOR ADDITIONAL DETAILS. PART X, LINE 2: AUGUSTANA CARE AND ITS AFFILIATES HAVE 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. THESE 501(C)(3) ORGANIZATIONS HAVE BEEN CLASSIFIED AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS UNDER SECTION 509(A). THE ORGANIZATION 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. AUGUSTANA CARE AND ITS AFFILIATES' INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION REPORTS ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES AND FILES ALL PROPER RETURNS RELATED TO THESE ACTIVITIES. GOLF TOURNAMENT 83604 67764 15840 500 8025 8138 0 14720 HOLIDAY TREE FESTIVAL 18915 12675 6240 3717 200 249 1 8502 5872 2630 50 2875 990 111021 86311 24710 550 8025 14730 200 15959 39464 -14754 1 AUGUSTANA COMMUNITY PARTNERS 7171 OHMS LANE EDINA MN 55439 411783680 501(C)(3) 420000 GENERAL ASSISTANCE AUGUSTANA HOME OF HASTINGS 7171 OHMS LANE EDINA MN 55439 311572624 501(C)(3) 90000 GENERAL ASSISTANCE AUGUSTANA CHAPEL VIEW HOMES 7171 OHMS LANE EDINA MN 55439 410693953 501(C)(3) 150000 GENERAL ASSISTANCE AUGUSTANA MOUNT OLIVET HOSPICE 1015 4TH AVENUE NORTH MINNEAPOLIS MN 55405 464564958 501(C)(3) 6000 GENERAL ASSISTANCE 4 0 SCHOLARSHIPS 26 20781 PART I, LINE 2: AUGUSTANA CARE MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. AUGUSTANA CARE AND THE RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITOR THE USE OF THE FUNDS. RECIPIENTS OF SCHOLARSHIPS FROM THE ORGANIZATION AGREE TO THE FOLLOWING TERMS UPON ACCEPTANCE: (1) THE ORGANIZATION WILL DETERMINE THE AMOUNT OF THE SCHOLARSHIP; (2) TUITION AND ASSOCIATED COSTS WILL BE PAID UP TO A STATED AMOUNT UPON PRESENTATION BY THE RECIPIENT OF A BILLING STATEMENT AND A DETAILED VERIFICATION OF THE COST OF BOOKS; (3) THE RECIPIENT WILL COMPLETE THE TRAINING FOR WHICH A SCHOLARSHIP PAYMENT WAS GRANTED WITH PROOF OF A FINAL GRADE OF C OR BETTER, OR RECIPIENT WILL REIMBURSE THE ORGANIZATION FOR THE COST OF THE COURSE; (4) THE RECIPIENT WILL CONTINUE EMPLOYMENT WITH THE ORGANIZATION WHILE COMPLETING COURSEWORK, WITH BOTH PARTIES MAKING EVERY EFFORT TO ACCOMODATE ANY NECESSARY CHANGES IN WORK HOURS; AND (5) UPON COMPLETION TRAINING FOR WHICH SCHOLARSHIP WAS GRANTED, THE RECIPIENT WILL WORK FOR THE ORGANIZATION AT LEAST TWO YEARS AND A MINIMUM OF 2,000 HOURS OR WILL REIMBURSE THE ORGANIZATION A PRORATED AMOUNT OF EACH SCHOLARSHIP PAYMENT RECEIVED DURING THE PREVIOUS ONE YEAR PERIOD, WHICH WILL BE DEDUCTED FOR THEIR LAST PAYCHECK. 0 1 0 0 0 0 0 0 0 TIM TUCKER PRESIDENT/CEO 0 426861 0 78000 0 30088 0 314219 0 31136 0 880304 0 0 CRAIG KITTELSON VP - FINANCE/CFO 0 266405 0 55000 0 33901 0 69714 0 30931 0 455951 0 0 KATHERINE KOPP VP - NEW BUSINESS DEVELOPMENT 0 223833 0 46200 0 23403 0 28940 0 29421 0 351797 0 0 TIM MIDDENDORF FORMER VP - OPERATIONS/COO 0 185684 0 31360 0 17113 0 17634 0 40364 0 292155 0 0 PART I, LINE 3 FOR THE PURPOSE OF DETERMINING COMPENSATION, AUGUSTANA CARE RELIED ON A RELATED ORGANIZATION, A&E CARE SERVICES (FORMERLY KNOWN AS AUGUSTANA CARE SERVICES), TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO. A&E CARE SERVICES USED THE FOLLOWING PRACTICES TO ESTABLISH COMPENSATION FOR THE PRESIDENT/CEO: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PROVIDED BY A&E CARE SERVICES (FORMERLY KNOWN AS AUGUSTANA CARE SERVICES), A RELATED ORGANIZATION: TIM TUCKER, PRESIDENT AND CEO - $287,793 CRAIG KITTELSON, VICE PRESIDENT OF FINANCE AND CFO - $43,287 KATHERINE KOPP, VICE PRESIDENT OF NEW BUSINESS DEVELOPMENT - $3,000 A CITY OF DASSEL MN 410851701 2010-09-15 1400000 FACILITY DEVELOPMENT 0 0 0 B DAKOTA COUNTY COMMUNITY DEVELOPMENT AGENCY 411253302 23409VDV9 2015-03-25 5060000 REFINANCE SERIES 2007 BOND 0 0 0 C CITY OF DASSEL MN 410851701 2007-08-21 1500000 ACQUIRE FACILITY 0 0 0 D COLORADO HEALTH FACILITIES AUTHORITY 840732932 2011-03-31 875000 TO REFINANCE SERIES 2011 BONDS 0 0 0 A 385131 1400000 28000 1372000 2011 0 0 1 1 B 645000 5060000 325000 101200 4958800 2015 1 0 1 1 C 770978 1500000 30000 1470000 2007 0 0 1 1 D 875000 875000 2011 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF VICTORIA, MN DATE THE REBATE COMPUTATION WAS PERFORMED: 08/20/2018 A CITY OF VICTORIA MN 410997257 92627TAT3 2014-07-31 22110000 TO REFINANCE SERIES 2009 BONDS 0 0 0 B CARLTON COUNTY MN 416005767 142887BB3 2015-03-02 5805000 FACILITY DEVELOPMENT 0 0 0 A 2195000 22110000 1075979 442200 21667800 2014 1 0 1 1 B 530000 5805000 191680 116100 5497263 2017 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 OVERALL MISSION FOR AUGUSTANA ENTITIES AUGUSTANA CARE AND ITS SUBSIDIARIES' MISSION IS TO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS AND OTHERS IN NEED THROUGH THE PROVISION OF HEALTHCARE, HOUSING AND OTHER SERVICES IN A CHRISTIAN TRADITION. OUR GOAL IS TO HELP RESIDENTS LIVE THE LIVES THAT MOST INSPIRE THEM. THE PRINCIPLES THAT GUIDE OUR WORK INCLUDE VALUING OLDER GENERATIONS' TALENTS AND EXPERIENCE; WORKING TO PROVIDE THE CARE RESIDENTS NEED, WHEN AND WHERE THEY NEED IT; WORKING TO CONNECT RESIDENTS TO THE PEOPLE AND THINGS THAT MEAN THE MOST TO THEM; AND SUPPORTING RESIDENTS AND FAMILIES WITH SPIRITUAL CARE THAT SPEAKS TO WHO THEY ARE. WE OFFER A BROAD RANGE OF SERVICES TO ANTICIPATE AND ADDRESS THE NEEDS OF OLDER ADULTS. IN OUR 2018 FISCAL YEAR, MORE THAN 16,500 PEOPLE WERE SERVED IN MINNESOTA AND COLORADO. OUR SEVEN HEALTH CARE CENTERS PROVIDED TRANSITIONAL CARE, LONG-TERM AND MEMORY CARE, AND REHABILITATION SERVICES TO MORE THAN 3,900 PEOPLE. AUGUSTANA CARE ALSO PROVIDES VARIOUS HOUSING COMMUNITIES TO SERVE OLDER ADULTS WITH COMFORTABLE LIVING AND CARE OPTIONS, INCLUDING INDEPENDENT LIVING, HOUSING WITH SERVICES, ASSISTED LIVING, AND MEMORY CARE. IN FISCAL YEAR 2018, A TOTAL OF 1,727 RESIDENTS BENEFITED FROM THESE SERVICES. WE ALSO OFFER A RANGE OF COMMUNITY-BASED SERVICES, SUCH AS ADULT DAY PROGRAMS, HOSPICE, AND THERAPY SERVICES, TO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS WHO CONTINUE TO LIVE IN THEIR OWN HOMES. MORE THAN 11,213 INDIVIDUALS WERE SERVED THROUGH THESE PROGRAMS IN FISCAL YEAR 2018. FINALLY, MANAGEMENT CONSULTING SERVICES WERE PROVIDED TO NINE OTHER ORGANIZATIONS THAT SERVED 533 OLDER ADULTS IN FISCAL YEAR 2018. FORM 990, PART III, LINE 2 AUGUSTANA SENIOR DEVELOPMENT II, LLC BEGAN MANAGING RIVER BEND ASSISTED LIVING AT THE END OF 2017. RIVER BEND OFFERS ASSISTED LIVING AND MEMORY CARE UNITS IN ROCHESTER, MN. AUGUSTANA SENIOR DEVELOPMENT II, LLC ALSO BEGAN MANAGING SEVERAL NEW PROPERTIES THAT BEGAN CONSTRUCTION IN 2018. THESE INCLUDE PRAHA VILLAGE IN NEW PRAGUE, MN; STONEY POINT MEADOWS IN CEDAR RAPIDS, IA; PARKS' PLACE IN PLYMOUTH, MN; AND OKALEE IN MEDINA, MN. THESE PROPERTIES WILL PROVIDE A VARIETY OF CARE AND SERVICES FOR OLDER ADULTS, INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, MEMORY CARE, AND RESPITE CARE OPTIONS. FORM 990, PART VI, SECTION A, LINE 3 THE PURPOSE OF AUGUSTANA CARE SERVICES IS TO MANAGE 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. EFFECTIVE JANUARY 1, 2018 THE NAME OF THE CORPORATION WAS CHANGED TO A&E CARE SERVICES AND THE ORGANIZATIONAL DOCUMENTS WERE AMENDED TO APPOINT AUGUSTANA CARE AND ELIM CARE, INC. AS THE TWO MEMBERS OF THE CORPORATION. THE PURPOSE OF A&E CARE SERVICES REMAINS THE SAME AS THAT OF AUGUSTANA CARE SERVICES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S MEMBERSHIP CONSISTS OF LUTHERAN CONGREGATIONS OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA), AND OTHER CONGREGATIONS, AS ARE FROM TIME TO TIME ELECTED BY THE MEMBERS. AT ALL TIMES, A MAJORITY OF THE MEMBER CONGREGATIONS ARE LUTHERAN AND AT LEAST ONE MEMBER CONGREGATION MUST BE A PART OF THE ELCA AT ALL TIMES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF AUGUSTANA CARE, THROUGH THEIR VOTING DELEGATES, ELECT THE ORGANIZATION'S DIRECTORS AFTER CONSIDERATION OF THE SLATE OF NOMINEES SUBMITTED BY THE NOMINATING AND BOARD DEVELOPMENT COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ORGANIZATION'S GOVERNING DOCUMENTS MUST BE APPROVED BY AN AFFIRMATIVE VOTE OF A MAJORITY OF THE TOTAL NUMBER OF DIRECTORS HOLDING OFFICE AND BY THE AFFIRMATIVE VOTE OF A MAJORITY OF VOTING DELEGATES OF THE MEMBER CONGREGATIONS PRESENT AND VOTING AT WHICH A QUORUM OF MEMBERS IS PRESENT AND VOTING. ANY AMENDMENT WHICH RELATES TO THE REQUIREMENTS FOR AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA) IS SUBMITTED TO THE ELCA PROGRAM UNIT FOR CHURCH IN SOCIETY FOR APPROVAL. 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 INTERNAL REVENUE SERVICE. 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 AND TO DISCLOSE AN 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 ARE NOTED IN THE MEETING MINUTES. 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 XI, LINE 9: NET ASSET TRANSFER FROM CONSOLIDATION -3,978,518. REPLACEMENT RESERVES LLC 7171 OHMS LANE EDINA MN 55439 752990222 HOME HEALTH SERVICES MN 0 0 AUGUSTANA CARE AUGUSTANA DASSEL LAKESIDE COMMUNITY HOME LLC 439 WILLIAM AVENUE EAST DASSEL MN 55325 208916091 NURSING/ASSISTED LIVING FACILITY MN 6224647 5536032 AUGUSTANA CARE AUGUSTANA SENIOR DEVELOPMENT II LLC 7171 OHMS LANE EDINA MN 55439 481293891 CONSULTING MN 5092284 182569 AUGUSTANA CARE AUGUSTANA MERCY CARE CENTER LLC 710 S KENWOOD AVENUE MOOSE LAKE MN 55767 271466676 NURSING/ASSISTED LIVING FACILITY MN 7064907 6529909 AUGUSTANA CARE AUGUSTANA LAND DEVELOPMENT LLC 14650 GARRENTT AVENUE APPLE VALLEY MN 55124 271456660 LAND DEVELOPMENT MN 0 2218284 AUGUSTANA CARE AUGUSTANA ELK RUN LLC 1425 10TH AVENUE SOUTH MINNEAPOLIS MN 55404 273219747 ASSISTED LIVING MN 1835125 6162111 AUGUSTANA CARE AUGUSTANA EMERALD CARE LLC 451 EAST TRAVELERS TRAIL BURNSVILLE MN 55337 271279704 MEMORY CARE MN 11213373 21371332 AUGUSTANA CARE AUGUSTANA REGENT AT BURNSVILLE LLC 14500 REGENT LANE BURNSVILLE MN 55306 208915982 HOUSING WITH SERVICES MN 7419641 18394169 AUGUSTANA CARE AUGUSTANA PROPERTIES LLC 1425 10TH AVENUE SOUTH MINNEAPOLIS MN 55404 462166624 RENTAL PROPERTIES MN 185684 2345900 AUGUSTANA CARE CASTLE PEAK SENIOR CARE LLC 1425 10TH AVENUE SOUTH MINNEAPOLIS MN 55404 460904337 NURSING/ASSISTED LIVING FACILITY MN 5192696 22144376 AUGUSTANA CARE AUGUSTANA OAKVIEW CARE LLC 300 TALBOT DRIVE MOOSE LAKE MN 55767 472292912 HOUSING WITH SERVICES MN 1292531 3776280 AUGUSTANA CARE AUGUSTANA CASH MANAGEMENT COMPANY LLC 7171 OHMS LANE EDINA MN 55439 823725231 MANAGING CASH/ACCOUNTS PAYABLE FOR SUBSIDIARIES OF AUGUSTANA CARE MN 29656 8149662 AUGUSTANA CARE APPLE VALLEY VILLA APARTMENTS 7171 OHMS LANE EDINA MN 55439 311608691 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) LINE 10 AUGUSTANA CARE 1 AUGUSTANA APARTMENTS OF HASTINGS 7171 OHMS LANE EDINA MN 55439 311608701 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) LINE 10 AUGUSTANA CARE 1 AUGUSTANA CARE FOUNDATION 7171 OHMS LANE EDINA MN 55439 411360678 CHARITABLE FOUNDATION MN 501(C)(3) LINE 12A, I AUGUSTANA CARE 1 A&E CARE SERVICES 7171 OHMS LANE EDINA MN 55439 411806946 MANAGEMENT SERVICES MN 501(C)(3) LINE 12C, III-FI AUGUSTANA CARE AND ELIM CARE INC 0 AUGUSTANA CHAPEL VIEW HOMES INC 7171 OHMS LANE EDINA MN 55439 410693953 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) LINE 10 AUGUSTANA CARE 1 AUGUSTANA COMMUNITY PARTNERS 7171 OHMS LANE EDINA MN 55439 411783680 HOME HEALTH CARE SERVICES MN 501(C)(3) LINE 10 AUGUSTANA CARE 1 AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY 7171 OHMS LANE EDINA MN 55439 311608696 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) LINE 10 AUGUSTANA CARE 1 AUGUSTANA HOME OF HASTINGS 7171 OHMS LANE EDINA MN 55439 311572624 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) LINE 10 AUGUSTANA CARE 1 OPEN CIRCLE ADULT DAY CENTER 7171 OHMS LANE EDINA MN 55439 411424801 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) LINE 10 AUGUSTANA CARE 1 BROOKSIDE SENIOR LIVING 804 BENSON ROAD MONTEVIDEO MN 56265 410871848 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) LINE 10 N/A 0 AUGUSTANA SENIOR DEVELOPMENT INC 7171 OHMS LANE EDINA MN 55439 264136110 CONSULTING MN AUGUSTANA CARE C 265706 521541 1.00000 1 0 1 1 1 1 0 0 0 0 0 1 1 1 1 1 1 1 0 0 APPLE VALLEY VILLA APARTMENTS C 3878745 CASH AUGUSTANA CHAPEL VIEW HOMES C 680000 CASH AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY C 830000 CASH AUGUSTANA COMMUNITY PARTNERS B 420000 CASH AUGUSTANA HOME OF HASTINGS B 90000 CASH AUGUSTANA CHAPEL VIEW HOMES B 150000 CASH