AUGUSTANA MOUNT OLIVET HOSPICE CARE LLC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: AUGUSTANA MOUNT OLIVET HOSPICE CARE LLC (EIN 46-4564958)
Tax period: 2017-10-01 to 2018-09-30
Filed: 2019-08-15
IRS object ID: 201922279349303022
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-08-15T15:44:55-05:00	ReturnTs
Tax Period End	2018-09-30	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 SOUTH SIXTH 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	2017-10-01	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	KATHY YOUNGQUIST	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	9528555000	PhoneNum
Signature	2019-08-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	EMILY SCHEEVEL	PreparerPersonNm
PTIN	P01814921	PTIN
Phone	6123764500	PhoneNum

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	2019-08-15	IPDt
IP Tm	10:33:36	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	FCD06153B7C3F4186BBEFC76B30654521E54D624	AtSubmissionCreationDeviceId
At Submission Filing Device Id	64D167D091931D8555FA058DC075EC7E31BCB1E3	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd

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	$8,636,975	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	LIMITED LIABILITY COMPANY	OtherOrganizationDsc
Formation	2014	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	PROVIDE HOSPICE SERVICES TO THE ELDERLY.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	67	TotalEmployeeCnt
Total Volunteers	37	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$18,409	PYContributionsGrantsAmt
CY Contributions Grants	$75,979	CYContributionsGrantsAmt
PY Program Service Revenue	$5,866,280	PYProgramServiceRevenueAmt
CY Program Service Revenue	$8,530,622	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$9	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	-$7,341	CYOtherRevenueAmt
PY Total Revenue	$5,884,689	PYTotalRevenueAmt
CY Total Revenue	$8,599,269	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$2,741,284	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$4,292,208	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$3,202,820	PYOtherExpensesAmt
CY Other Expenses	$4,049,260	CYOtherExpensesAmt
PY Total Expenses	$5,944,104	PYTotalExpensesAmt
CY Total Expenses	$8,341,468	CYTotalExpensesAmt
PY Revenues Less Expenses	-$59,415	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$257,801	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,209,114	TotalAssetsBOYAmt
Total Assets EOY	$1,699,845	TotalAssetsEOYAmt
Total Liabilities BOY	$476,127	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$709,057	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$732,987	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$990,788	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	Yes (1)	SignificantChangeInd
Expense	$6,834,453	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$8,530,622	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, WHEREVER THEY LIVE, THAT HAVE BEEN 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 2018, WE PROVIDED HOSPICE SERVICES TO 439 HOSPICE PATIENTS AND FAMILIES.HOME HEALTH SERVICES:THE LLC PROVIDED IN-HOME HEALTH CARE TO PATIENTS ELIGIBLE FOR MEDICARE HOME CARE. THE PURPOSES OF THE LLC INCLUDE:(A)TO PROVIDE SKILLED NURSING AND THERAPY SERVICES TO PATIENTS TO IMPROVE PHYSICAL FUNCTIONING AND HELP EACH INDIVIDUAL PATIENT REMAIN SAFELY IN THEIR OWN HOME;(B)TO SUPPORT AND IMPROVE FUNCTIONING IN THEIR OWN HOME THROUGH A TEAM: MEDICAL DIRECTOR, NURSING, HOME HEALTH AIDES, MEDICAL SOCIAL WORKERS, PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, SPEECH THERAPISTS AND DIETICIANS; AND(C) A FAITH-BASED ORGANIZATION BRINGING HOME CARE TO PATIENTS AND FAMILIES THAT BEST FITS THEIR NEEDSIN FISCAL YEAR 2018, WE PROVIDED HOME CARE SERVICES TO 77 PATIENTS. HOME CARE SERVICES WERE DISCONTINUED IN MARCH 2018.	Desc
Total Program Service Expenses	$6,834,453	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	0	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	10	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	67	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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	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 (10 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
BERNIE CABLE-PROKOP
CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
TIMOTHY HOKANSON
VICE CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
DAN SIEDELMANN
TREASURER (THROUGH FEB 2018)	1.00	Yes (X)	Yes (X)	$0	$0	$0
SHARON WILSON
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
EILEEN CARTWRIGHT
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
MATTHEW KERN
BOARD MEMBER (FROM JUNE 2018)	1.00	Yes (X)		$0	$0	$0
DAVID LOSE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
THOMAS MACNALLY
BOARD MEMBER (THROUGH OCT. 2017)	1.00	Yes (X)		$0	$0	$0
SARAH VAN WINKLE
PRESIDENT/CEO	45.00	Yes (X)	Yes (X)	$188,124	$0	$6,584
STACY LYSEN
DIRECTOR OF NURSING	45.00			$115,615	$0	$27,138	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$303,739	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$33,722	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

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	A&E CARE SERVICES	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

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

Field	Value	IRS element (for citing)
Services	MANAGEMENT SERVICES	ServicesDesc
Compensation	$342,336	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Fundraising	$50,510	FundraisingAmt
All Other Contributions	$25,469	AllOtherContributionsAmt
Total Contributions	$75,979	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOSPICE CARE	624100	$8,342,398	$8,342,398
HOME HEALTH	621610	$188,224	$188,224

Field	Value	IRS element (for citing)
Total Program Service Revenue	$8,530,622	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9	TotalRevenueColumnAmt
Exclusion	$9	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$5,925	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$50,510	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$37,706	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$31,781	TotalRevenueColumnAmt
Exclusion	-$31,781	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MISCELLANEOUS INCOME	Desc
Business	623000	BusinessCd
Total Revenue Column	$24,440	TotalRevenueColumnAmt
Exclusion	$24,440	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$24,440	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,599,269	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,530,622	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$7,332	ExclusionAmt

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$203,537	TotalAmt
Management And General	$203,537	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,381,958	TotalAmt
Program Services	$2,949,477	ProgramServicesAmt
Management And General	$432,481	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$41,587	TotalAmt
Program Services	$34,209	ProgramServicesAmt
Management And General	$7,378	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$403,678	TotalAmt
Program Services	$332,066	ProgramServicesAmt
Management And General	$71,612	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$261,448	TotalAmt
Program Services	$215,067	ProgramServicesAmt
Management And General	$46,381	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$342,334	TotalAmt
Management And General	$342,334	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,233	TotalAmt
Management And General	$2,233	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$23,391	TotalAmt
Management And General	$23,391	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,602,413	TotalAmt
Program Services	$2,602,413	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$7,923	TotalAmt
Management And General	$7,923	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$119,147	TotalAmt
Program Services	$11,714	ProgramServicesAmt
Management And General	$107,433	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$94,823	TotalAmt
Management And General	$94,823	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$34,779	TotalAmt
Management And General	$34,779	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$130,183	TotalAmt
Program Services	$101,793	ProgramServicesAmt
Management And General	$28,390	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$19,221	TotalAmt
Program Services	$15,618	ProgramServicesAmt
Management And General	$3,603	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,301	TotalAmt
Management And General	$2,301	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$40,918	TotalAmt
Management And General	$40,918	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$19,840	TotalAmt
Management And General	$19,840	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
NURSING EQUIPMENT	$395,683	$395,683
AMORTIZATION OF GOODWIL	$95,201	$95,201
NURSING SUPPLIES	$80,085	$80,085
BAD DEBT EXPENSE	$11,476		$11,476

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$27,309	TotalAmt
Program Services	$1,127	ProgramServicesAmt
Management And General	$26,182	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,341,468	TotalAmt
Program Services	$6,834,453	ProgramServicesAmt
Management And General	$1,507,015	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$285,204	BOYAmt
EOY	$591,493	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$652,927	BOYAmt
EOY	$954,340	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$35,714	BOYAmt
EOY	$49,912	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$213,468	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$109,368	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$140,068	BOYAmt
EOY	$104,100	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$95,201	BOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,209,114	BOYAmt
EOY	$1,699,845	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$383,773	BOYAmt
EOY	$642,158	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$92,354	BOYAmt
EOY	$66,899	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$476,127	BOYAmt
EOY	$709,057	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$732,987	BOYAmt
EOY	$990,788	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$732,987	BOYAmt
EOY	$990,788	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,209,114	BOYAmt
EOY	$1,699,845	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$257,801	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
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	$500,000	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$309,203	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$110,578	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$18,409	CurrentTaxYearMinus1YearAmt
Current Tax Year	$75,979	CurrentTaxYearAmt
Total	$1,014,169	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$110,191	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,557,734	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$3,980,994	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,866,280	CurrentTaxYearMinus1YearAmt
Current Tax Year	$8,530,622	CurrentTaxYearAmt
Total	$21,045,821	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$610,191	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,866,937	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,091,572	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,884,689	CurrentTaxYearMinus1YearAmt
Current Tax Year	$8,606,601	CurrentTaxYearAmt
Total	$22,059,990	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$500,000	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$300,000	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$100,000	CurrentTaxYearMinus2YearsAmt
Total	$900,000	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	$500,000	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$300,000	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$100,000	CurrentTaxYearMinus2YearsAmt
Total	$900,000	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$21,159,990	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

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

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

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

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year	$30,365	CurrentTaxYearAmt
Total	$30,365	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$610,191	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,866,937	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,091,572	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,884,689	CurrentTaxYearMinus1YearAmt
Current Tax Year	$8,636,975	CurrentTaxYearAmt
Total	$22,090,364	TotalAmt

Field	Value	IRS element (for citing)
First5 Years509	Yes (X)	First5Years509Ind

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 - 2017 AMOUNT: $ 24,440. FUNDRAISING EVENT REVENUES - 2017 AMOUNT: $ 5,925.	ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$129,510	OtherCostOrOtherBasisAmt
Depreciation	$64,755	DepreciationAmt
Book Value	$64,755	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$83,958	OtherCostOrOtherBasisAmt
Depreciation	$44,613	DepreciationAmt
Book Value	$39,345	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$104,100	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$8,636,975	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	$37,706	OtherRevenueAmt
Revenue Not Reported	$37,706	RevenueNotReportedAmt
Revenue Subtotal	$8,599,269	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$8,599,269	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$8,283,973	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$37,706	OtherExpensesIncludedAmt
Expenses Not Reported	$37,706	ExpensesNotReportedAmt
Expenses Subtotal	$8,246,267	ExpensesSubtotalAmt
Other Expenses Not Included	$95,201	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$95,201	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$8,341,468	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 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:	FUNDRAISING EVENT EXPENSES 37,706.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	FUNDRAISING EVENT EXPENSES 37,706.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	GOODWILL IMPAIRMENT 95,201.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GALA EVENT	Event1Nm
Gross Receipts Event1	$56,435	GrossReceiptsEvent1Amt
Charitable Contri Event1	$50,510	CharitableContriEvent1Amt
Gross Revenue Event1	$5,925	GrossRevenueEvent1Amt
Non Cash Prizes Event1	$3,000	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$1,065	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$12,000	FoodAndBeverageEvent1Amt
Entertainment Event1	$6,000	EntertainmentEvent1Amt
Other Direct Expenses Event1	$15,641	OtherDirectExpensesEvent1Amt
Gross Receipts Total	$56,435	GrossReceiptsTotalAmt
Charitable Contributions Tot	$50,510	CharitableContributionsTotAmt
Gross Revenue Total Events	$5,925	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$3,000	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$1,065	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$12,000	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$6,000	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$15,641	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$37,706	DirectExpenseSummaryEventsAmt
Net Income Summary	-$31,781	NetIncomeSummaryAmt

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

Field	Value	IRS element (for citing)
Person	SARAH VAN WINKLE	PersonNm
Title	PRESIDENT/CEO	TitleTxt
Base Compensation Filing Org	$164,011	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$24,113	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$6,584	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$0	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$194,708	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 3	HOME HEALTH SERVICES WERE DISCONTINUED IN MARCH 2018.
FORM 990, PART VI, SECTION A, LINE 2	1. BERNADINE CABLE-PROKOP AND DAN SIEDELMANN - BUSINESS RELATIONSHIP 2. BERNADINE CABLE-PROKOP AND SHARON WILSON - BUSINESS RELATIONSHIP 3. DAN SIEDELMANN AND SHARON WILSON - BUSINESS RELATIONSHIP 4. EILEEN CARTWRIGHT AND TIMOTHY HOKANSON - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 3	AUGUSTANA CARE SERVICES WAS THE MANAGEMENT COMPANY TO PROVIDE MANAGEMENT SERVICES THOURGH 12/31/17. 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, FUND DEVELOPMENT 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 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 CFO. THE FORM 990 WAS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS BY THE CFO 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 2,602,413. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,602,413.