ANNANDALE CARE CENTER: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
ANNANDALE CARE CENTER (EIN 23-7296950)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-05-13
IRS object ID
201921339349306807
Schema version
2017v2.3
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 ReturnHeader

FieldValueIRS element (for citing)
Return2019-05-13T16:14:42-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14310 17TH AVE S PO BOX 2545AddressLine1Txt
CityFARGOCityNm
State AbbreviationNDStateAbbreviationCd
ZIP581082545ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237296950EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Annandale Care CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlANNABusinessNameControlTxt
Phone3202743737PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 Park Street EastAddressLine1Txt
CityAnnandaleCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55302ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDebra ReitmeierPersonNm
Person TitleAdministrator/PresidentPersonTitleTxt
Phone3202743737PhoneNum
Signature2019-04-22SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLisa Chaffee CPAPreparerPersonNm
PTINP00193453PTIN
Phone7012398500PhoneNum
Preparation2019-04-22PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.247.44.78IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-04-22IPDt
IP Tm13:34:23IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id66CC91E6B7F11C4783FFFA5645E675327CB67316AtSubmissionCreationDeviceId
At Submission Filing Device Id3F1B4C4A1C1F32CA3CD03C05270CE62742EA9E6EAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDebra ReitmeierPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 Park Street EastAddressLine1Txt
CityAnnandaleCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55302ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,426,054GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.annandalecarecenter.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1973FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionSkilled nursing services and assisted living servicesActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee209TotalEmployeeCnt
Total Volunteers61TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$7,055PYContributionsGrantsAmt
CY Contributions Grants$2,652CYContributionsGrantsAmt
PY Program Service Revenue$8,334,961PYProgramServiceRevenueAmt
CY Program Service Revenue$8,215,762CYProgramServiceRevenueAmt
PY Investment Income$181,762PYInvestmentIncomeAmt
CY Investment Income$207,640CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$8,523,778PYTotalRevenueAmt
CY Total Revenue$8,426,054CYTotalRevenueAmt
PY Grants And Similar Paid$25,550PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$26,566CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,385,657PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,830,484CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,175,259PYOtherExpensesAmt
CY Other Expenses$3,269,845CYOtherExpensesAmt
PY Total Expenses$7,586,466PYTotalExpensesAmt
CY Total Expenses$8,126,895CYTotalExpensesAmt
PY Revenues Less Expenses$937,312PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$299,159CYRevenuesLessExpensesAmt
Total Assets BOY$12,053,700TotalAssetsBOYAmt
Total Assets EOY$11,897,172TotalAssetsEOYAmt
Total Liabilities BOY$7,546,773TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,162,205TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,506,927NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,734,967NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionQuality care and services that shape the future for the dynamic needs of the people in our area.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,420,186ExpenseAmt
Grant$26,566GrantAmt
Revenue$8,215,762RevenueAmt
DescThe Organization operates a 60 bed skilled nursing facility, a 26 unit assisted living building (a.k.a. Centennial Villa Assisted Living), a 29 unit memory care facility and a wellness center. It not only provides services to the elderly population in Annandale but also to those in other area communities which helps the individual to remain in the same geographical area of their former residence. The skilled nursing facility has an excellent therapy program that is available to its residents who are in need of rehabilitation services. It also has an outpatient program that treats those from the Annandale community and the surrounding area. It is because of its onsite therapy program that it has become the first choice for most when they require rehabilitation services following a surgery in order to return home safely. The assisted living building serves as a pleasant transition for those who need additional help that is not readily available in their own home but are still independent enough that they don't require the services of a skilled nursing facility. The memory loss unit is much more appropriate for those who suffer from Alzheimer's and/or severe dementia than a skilled nursing facility. The environment is controlled and setup to meet each resident's needs relating to their specific illness. The wellness center has a therapy/exercise swim pool, exercise class studio and an exercise equipment room developed to serve the wellness needs of those 50 years of age and older - both within the campus and the outside community.Desc
Total Program Service Expenses$7,420,186TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee209EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Debra ReitmeierBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3202742579PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 Park Street EastAddressLine1Txt
CityAnnandaleCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55302ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Mark Miller
Chairman0.100.30Yes (X)Yes (X)$0$0$0
Kathy Gruys
Secretary/Treasurer0.100.20Yes (X)Yes (X)$0$0$0
Roger Millner
Vice Chair0.100.20Yes (X)Yes (X)$0$0$0
Jack Driste
Director0.100.20Yes (X)$0$0$0
Ed Schomoroh
Director0.100.30Yes (X)$0$0$0
Linda Dircks
Director0.100.20Yes (X)$0$0$0
Shelley Jonas
City Liason0.100.30Yes (X)$0$0$0
Debra Reitmeier
Administrator/President40.002.00Yes (X)$132,873$0$16,348
FieldValueIRS element (for citing)
Total Reportable Comp From Org$132,873TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$16,348TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RehabVisionsBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line111623 Arbor St Ste 201AddressLine1Txt
CityOmahaCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68144ZIPCd
FieldValueIRS element (for citing)
ServicesContracted TherapyServicesDesc
Compensation$643,455CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$2,652AllOtherContributionsAmt
Total Contributions$2,652TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Resident Service Reven623000$7,977,966$7,977,966
Other Revenue900099$127,469$127,469
Wellness Center713940$108,396$108,396

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,931TotalRevenueColumnAmt
Related Or Exempt Func Income$1,931RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$8,215,762TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$207,640TotalRevenueColumnAmt
Exclusion$207,640ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,426,054TotalRevenueColumnAmt
Related Or Exempt Func Income$8,215,762RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$207,640ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$26,566TotalAmt
Program Services$26,566ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$151,336TotalAmt
Management And General$151,336ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,857,712TotalAmt
Program Services$3,549,689ProgramServicesAmt
Management And General$308,023ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$501,182TotalAmt
Program Services$460,107ProgramServicesAmt
Management And General$41,075ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$320,254TotalAmt
Program Services$284,720ProgramServicesAmt
Management And General$35,534ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$28,180TotalAmt
Management And General$28,180ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$742,502TotalAmt
Program Services$739,815ProgramServicesAmt
Management And General$2,687ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$28,693TotalAmt
Program Services$1,514ProgramServicesAmt
Management And General$27,179ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$151,724TotalAmt
Program Services$101,849ProgramServicesAmt
Management And General$49,875ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$37,380TotalAmt
Management And General$37,380ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$404,222TotalAmt
Program Services$404,222ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,493TotalAmt
Program Services$3,331ProgramServicesAmt
Management And General$3,162ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$8,581TotalAmt
Program Services$7,724ProgramServicesAmt
Management And General$857ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$217,511TotalAmt
Program Services$217,511ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$474,588TotalAmt
Program Services$474,588ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$56,825TotalAmt
Program Services$55,886ProgramServicesAmt
Management And General$939ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Meals/Food$566,118$566,118
Medical Supplies$246,760$246,760
DHS Surcharge$168,900$168,900
Bad Debt Expense$79,272$79,272

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$52,096TotalAmt
Program Services$31,614ProgramServicesAmt
Management And General$20,482ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,126,895TotalAmt
Program Services$7,420,186ProgramServicesAmt
Management And General$706,709ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,273,068BOYAmt
EOY$881,126EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$734,897BOYAmt
EOY$825,164EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$30,670BOYAmt
EOY$28,198EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,668,591LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,303,097LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,452,144BOYAmt
EOY$5,365,494EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,562,921BOYAmt
EOY$4,797,190EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$12,053,700BOYAmt
EOY$11,897,172EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$484,392BOYAmt
EOY$548,287EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,026,293BOYAmt
EOY$6,579,704EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$36,088BOYAmt
EOY$34,214EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,546,773BOYAmt
EOY$7,162,205EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,506,927BOYAmt
EOY$4,734,967EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,506,927BOYAmt
EOY$4,734,967EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,053,700BOYAmt
EOY$11,897,172EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$299,159ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$71,119NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,505CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,047CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,805CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,055CurrentTaxYearMinus1YearAmt
Current Tax Year$2,652CurrentTaxYearAmt
Total$25,064TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,446,654CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,640,177CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,570,889CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,334,961CurrentTaxYearMinus1YearAmt
Current Tax Year$8,215,762CurrentTaxYearAmt
Total$39,208,443TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,456,159CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,643,224CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,573,694CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,342,016CurrentTaxYearMinus1YearAmt
Current Tax Year$8,218,414CurrentTaxYearAmt
Total$39,233,507TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$101,024CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$51,715CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$53,284CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$276,266CurrentTaxYearMinus1YearAmt
Current Tax Year$191,479CurrentTaxYearAmt
Total$673,768TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$101,024CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$51,715CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$53,284CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$276,266CurrentTaxYearMinus1YearAmt
Current Tax Year$191,479CurrentTaxYearAmt
Total$673,768TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$38,559,739PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$153,121CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$182,474CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$194,326CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$181,762CurrentTaxYearMinus1YearAmt
Current Tax Year$207,640CurrentTaxYearAmt
Total$919,323TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$153,121CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$182,474CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$194,326CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$181,762CurrentTaxYearMinus1YearAmt
Current Tax Year$207,640CurrentTaxYearAmt
Total$919,323TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,609,280CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,825,698CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,768,020CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,523,778CurrentTaxYearMinus1YearAmt
Current Tax Year$8,426,054CurrentTaxYearAmt
Total$40,152,830TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.96030PublicSupportCY509Pct
Public Support PY5090.96560PublicSupportPY509Pct
Investment Income CY0.02290InvestmentIncomeCYPct
Investment Income PY0.02040InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$403,739OtherCostOrOtherBasisAmt
Book Value$403,739BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,239,517OtherCostOrOtherBasisAmt
Depreciation$5,878,605DepreciationAmt
Book Value$4,360,912BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,469,338OtherCostOrOtherBasisAmt
Depreciation$1,043,609DepreciationAmt
Book Value$425,729BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$555,997OtherCostOrOtherBasisAmt
Depreciation$380,883DepreciationAmt
Book Value$175,114BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,365,494TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$8,354,935TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$71,119NetUnrealizedGainsInvstAmt
Revenue Not Reported-$71,119RevenueNotReportedAmt
Revenue Subtotal$8,426,054RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$8,426,054TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,126,895TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$8,126,895ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,126,895TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:Annandale Care Center acts as custodian for funds of its residents and tenants.
Part X, Line 2:The Organization, Care Center, and Congregate are organized as Minnesota nonprofit corporations and have been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Organization, Care Center, and Congregate are annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Organization, Care Center, and Congregate are subject to income tax on net income that is derived from business activities that are unrelated to their exempt purposes. The Organization, Care Center, and Congregate have determined they are not subject to unrelated business income tax and have not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Organization, Care Center, and Congregate believe that they have appropriate support for any tax positions taken affecting their annual filing requirements, and as such, do not have any uncertain tax positions that are material to the consolidated financial statements. The Organization, Care Center, and Congregate will recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeEmployee Scholarships- EducationGrantTypeTxt
Recipient16RecipientCnt
Cash Grant$26,566CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationScholarships are awarded to employees who work an average of 20 hours a week or more and who are enrolled in a program of study related to long term care. Recipients are selected by a committee on a quarterly basis. Funds are disbursed upon receiving a copy of the recipient's tuition/fees statement and/or receipts for purchases of required textbooks. The guidelines for this program are in accordance with those set forth by the MN Department of Human Services' Nursing Facility Scholarship Program.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1City of Annandale MNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN416004935BondIssuerEIN
Bond Issued2015-09-25BondIssuedDt
Issue Price$8,090,000IssuePriceAmt
PurposeTo refund bonds issued 11/2/07PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,307,143RetiredAmt
Total Proceeds$8,090,000TotalProceedsAmt
Issuance Costs From Proceeds$161,800IssuanceCostsFromProceedsAmt
Capital Expenditures$3,699CapitalExpendituresAmt
Other Spent Proceeds$7,924,501OtherSpentProceedsAmt
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1The President does not have voting rights.
Form 990, Part VI, Section A, line 7aThe Board of Directors is elected annually by the Board of Directors of Annandale Health and Community Services.
Form 990, Part VI, Section A, line 7bThe following must be approved by the Board of Directors of Annandale Health and Community Services: ** Budget - Changes in budget of over $10,000 - Expenditures of over $10,000 - Sales of assets of over $10,000 - Changes to the bylaws The following must be approved by the President of the Annandale Health and Community Service Board: - Changes in the budget of over $5,000 but less than $10,000 - Expenditures of over $5,000 but less than $10,000 - Sales of assets of over $5,000 but less than $10,000
Form 990, Part VI, Section A, line 8bThere are no committees that can act on behalf of the Board. Committees must come back to the full Board to make a final decision.
Form 990, Part VI, Section B, line 11bA draft copy of the Form 990 will be mailed out to members of the Board prior to the filing date. Also, the Administrator/President will review a draft copy of the Form 990 before it is filed.
Form 990, Part VI, Section B, line 12cThere is no annual form or disclosure that is used to uncover conflicts of interest; however, individuals are required to disclose conflicts of interest based on an "honor-system." Anyone who can influence the actions of the Corporation is covered by the policy. This includes Board Members, key employees, officers, and employees. The Board reviews and determines when and if a conflict exists. If a conflict exists, Board Members are not allowed to vote on the issue in conflict. All conflicts of interest are documented in the Board Meeting minutes.
Form 990, Part VI, Section B, line 15Each year, the Corporation finds out what the increase in rates will be. The increase in rates is allocated proportionately across the board to all employees. The budget is also determined by the increase in rates and the Board of Directors approves the budget.
Form 990, Part VI, Section C, line 19The Organization makes it governing documents and conflict of interest policy available upon request. The financial statements are not made publicly available.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Annandale Health and Community Services
500 Park Street EastAnnandaleMN55302411820760OversightMN501(c)(3)Line 7N/A0
Heartland Transit
500 Park Street EastAnnandaleMN55302411820763Inactive CorporationMN501(c)(3)Line 70Annandale Health and Community Services
Annandale Congregate Housing
500 Park Street EastAnnandaleMN55302363566531Independent LivingMN501(c)(3)Line 12a, I0Annandale Health and Community Services
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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