AUGUSTANA CARE: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
AUGUSTANA CARE (EIN 41-1728753)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-06-25
IRS object ID
201841769349300229
Schema version
2016v3.0
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)
Return2018-06-25T10:34:49-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411728753EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA CAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAUGUBusinessNameControlTxt
Phone6122385225PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55404ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCRAIG KITTELSONPersonNm
Person TitleVP - FINANCE/CFOPersonTitleTxt
Phone6122385225PhoneNum
Signature2018-06-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEMILY SCHEEVELPreparerPersonNm
PTINP01814921PTIN
Phone6123764500PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTIM TUCKERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55404ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$43,587,054GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.AUGUSTANACARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTHCARE, HOUSING AND COMMMUNITY SERVICES FOR THE ELDERLY.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee1350TotalEmployeeCnt
Total Volunteers300TotalVolunteersCnt
Total Gross UBI$3,213,202TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$8,593NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,486,509PYContributionsGrantsAmt
CY Contributions Grants$2,236,409CYContributionsGrantsAmt
PY Program Service Revenue$36,565,652PYProgramServiceRevenueAmt
CY Program Service Revenue$40,446,524CYProgramServiceRevenueAmt
PY Investment Income$188,248PYInvestmentIncomeAmt
CY Investment Income$173,872CYInvestmentIncomeAmt
PY Other Revenue$450,956PYOtherRevenueAmt
CY Other Revenue$347,821CYOtherRevenueAmt
PY Total Revenue$42,691,365PYTotalRevenueAmt
CY Total Revenue$43,204,626CYTotalRevenueAmt
PY Grants And Similar Paid$1,325,798PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,282,862CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$24,039,822PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$27,113,724CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$462,999CYTotalFundraisingExpenseAmt
PY Other Expenses$15,249,676PYOtherExpensesAmt
CY Other Expenses$17,713,330CYOtherExpensesAmt
PY Total Expenses$40,615,296PYTotalExpensesAmt
CY Total Expenses$46,109,916CYTotalExpensesAmt
PY Revenues Less Expenses$2,076,069PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,905,290CYRevenuesLessExpensesAmt
Total Assets BOY$94,999,886TotalAssetsBOYAmt
Total Assets EOY$93,193,431TotalAssetsEOYAmt
Total Liabilities BOY$79,561,178TotalLiabilitiesBOYAmt
Total Liabilities EOY$80,790,400TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,438,708NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,403,031NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$25,747,759ExpenseAmt
Grant$4,617GrantAmt
Revenue$26,323,298RevenueAmt
DescTHE 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, CASTLE PEAK SENIOR CARE IN EAGLE, CO, AUGUSTANA OAKVIEW CARE IN MOOSE LAKE, MN 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 DELIVERING STRENGTH-BASED CARE FOR INDIVIDUALS WITH MEMORY LOSS IN SMALLER, HOME-LIKE RESIDENCES WHERE ONE'S DIGNITY, PRIVACY, SAFETY AND QUALITY OF LIFE CAN BE PRESERVED. IN TOTAL, THESE ASSISTED LIVING COMMUNITIES SERVED MORE THAN 626 PEOPLE DURING THE FISCAL YEAR.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$10,080,950ExpenseAmt
Grant$403,491GrantAmt
Revenue$10,831,867RevenueAmt
DescTHE ABOVE TOTAL INCLUDES OPERATING EXPENSES FOR AUGUSTANA MERCY HEALTH CARE CENTER OF MOOSE LAKE AND AUGUSTANA LAKESIDE HEALTH CARE CENTER OF DASSEL. DURING THE FISCAL YEAR, THESE TWO RURAL SKILLED NURSING FACILITIES PROVIDED LONG-TERM, TRANSITIONAL AND MEMORY CARE TO 570 PEOPLE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$4,161,068ExpenseAmt
Grant$874,754GrantAmt
Revenue$3,291,359RevenueAmt
DescAS A LONG-TIME PROVIDER OF HEALTH CARE, HOUSING AND COMMUNITY-BASED SERVICES, AUGUSTANA CARE APPLIES ITS EXPERIENCE AND IN-DEPTH KNOWLEDGE OF THE FIELD TO PROVIDE MANAGEMENT SERVICES TO OTHER ORGANIZATIONS. THE EXPENSES LISTED ABOVE ARE FOR SENIOR DEVELOPMENT II, A BUSINESS UNIT OF AUGUSTANA CARE THROUGH WHICH THESE SERVICES ARE PROVIDED TO UNRELATED NOT-FOR-PROFIT HOUSING COMMUNITIES IN MINNESOTA. THESE COMMUNITIES INCLUDE EASTWOOD SENIOR LIVING IN MORA, AUGUSTANA APARTMENTS AND CARDINAL HOMES IN FERGUS FALLS, ST. PAUL APARTMENTS, THE PINES AT RICHFIELD, AND SIGNE BURKHARDT MANOR, THOMAS FEENEY MANOR, AND HERITAGE PARK, ALL LOCATED IN MINNEAPOLIS. SERVICES INCLUDE CONSULTING, MARKETING, LEADERSHIP DEVELOPMENT, INFORMATION SYSTEMS SUPPORT, HOUSING DEVELOPMENT AND EMPLOYEE RELATIONS. ALTOGETHER, THESE MANAGED FACILITIES SERVED 467 DURING THE FISCAL YEAR.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$39,989,777TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
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 ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
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 ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee1350EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
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 Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
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

FieldValueIRS element (for citing)
PersonCRAIG KITTELSON - AUGUSTANA CARE SEPersonNm
Phone6122385205PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55404ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
REV DR GARY WILKERSON
CHAIR1.008.00Yes (X)Yes (X)$0$0$0
MARSHALL MACKAY
VICE CHAIR1.008.00Yes (X)Yes (X)$0$0$0
CHARLES PARKS JR
SECRETARY1.008.00Yes (X)Yes (X)$0$0$0
ERIK RICK ELLINGSON
TREASURER1.009.00Yes (X)Yes (X)$0$0$0
MICHELENE VERLAUTZ
DIRECTOR1.000.00Yes (X)$0$0$0
BRUCE CRAWFORD
DIRECTOR1.000.00Yes (X)$0$0$0
LARRY KULA
DIRECTOR1.000.00Yes (X)$0$0$0
PR DAN SIEDELMANN
DIRECTOR1.000.00Yes (X)$0$0$0
JIM EHLEN
DIRECTOR1.008.00Yes (X)$0$0$0
SCOTT RAMSDALE
DIRECTOR1.008.00Yes (X)$0$0$0
TOM TURNER
DIRECTOR1.000.00Yes (X)$0$0$0
NIC PUZAK
DIRECTOR1.000.00Yes (X)$0$0$0
BERNIE CABLE-PROKOP
DIRECTOR1.000.00Yes (X)$0$0$0
ALLEN OLSON
DIRECTOR1.000.00Yes (X)$0$0$0
DUANE HETLAND
DIRECTOR1.000.00Yes (X)$0$0$0
JERRY NYE
DIRECTOR1.000.00Yes (X)$0$0$0
TIM TUCKER
PRESIDENT/CEO4.5040.50Yes (X)$0$456,247$82,238
CRAIG KITTELSON
VP - FINANCE/CFO4.5040.50Yes (X)$0$305,364$78,325
TIM MIDDENDORF
VP - OPERATIONS/COO4.5040.50Yes (X)$0$241,483$31,776
MATTHEW KERN
VP - OPERATIONS/COO4.5040.50Yes (X)$0$0$0
KATHERINE KOPP
VP - NEW BUSINESS DEVELOPMENT4.5040.50$0$267,196$57,980Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,270,290TotReportableCompRltdOrgAmt
Total Other Compensation$250,319TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA CARE SERVICESBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55404ZIPCd
FieldValueIRS element (for citing)
ServicesMANAGEMENT SERVICESServicesDesc
Compensation$1,455,730CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Fundraising$87,091FundraisingAmt
Related Organizations$1,557,648RelatedOrganizationsAmt
Government Grants$256,629GovernmentGrantsAmt
All Other Contributions$335,041AllOtherContributionsAmt
Noncash Contributions$6,545NoncashContributionsAmt
Total Contributions$2,236,409TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
ASSISTED LIVING623000$26,323,298$26,323,298
NURSING623000$10,831,867$10,831,867
PAYROLL541200$2,637,032$2,637,032
CONSULTING541610$654,327$654,327
FieldValueIRS element (for citing)
Total Program Service Revenue$40,446,524TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$191,199TotalRevenueColumnAmt
Exclusion$191,199ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$283,094RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$307,536RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$24,442RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$24,442TotalRevenueColumnAmt
Unrelated Business Revenue-$78,157UnrelatedBusinessRevenueAmt
Exclusion$53,715ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$17,327SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$17,327SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$17,327TotalRevenueColumnAmt
Exclusion-$17,327ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$51,857FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$87,091ContriRptFundraisingEventAmt
Fundraising Direct Expenses$57,565FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$5,708TotalRevenueColumnAmt
Exclusion-$5,708ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$5,189GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,189TotalRevenueColumnAmt
Exclusion$5,189ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
DIETARY INCOME722210$117,866$117,866
CABLE TV INCOME515100$55,919$55,919
HOUSEKEEPING INCOME812900$44,817$44,817

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$154,180TotalRevenueColumnAmt
Exclusion$154,180ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$372,782OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,204,626TotalRevenueColumnAmt
Related Or Exempt Func Income$37,155,165RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$3,213,202UnrelatedBusinessRevenueAmt
Exclusion$599,850ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,241,571TotalAmt
Program Services$1,241,571ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$41,291TotalAmt
Program Services$41,291ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$23,071,675TotalAmt
Program Services$20,939,933ProgramServicesAmt
Management And General$1,778,671ManagementAndGeneralAmt
Fundraising$353,071FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$142,614TotalAmt
Program Services$117,853ProgramServicesAmt
Management And General$24,761ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,390,812TotalAmt
Program Services$2,176,317ProgramServicesAmt
Management And General$214,495ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,508,623TotalAmt
Program Services$1,391,185ProgramServicesAmt
Management And General$117,438ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,645,226TotalAmt
Program Services$142,180ProgramServicesAmt
Management And General$1,503,046ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$79,763TotalAmt
Management And General$79,763ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$88,480TotalAmt
Management And General$88,480ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,453,280TotalAmt
Program Services$1,048,136ProgramServicesAmt
Management And General$362,670ManagementAndGeneralAmt
Fundraising$42,474FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$231,228TotalAmt
Management And General$231,138ManagementAndGeneralAmt
Fundraising$90FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$844,343TotalAmt
Program Services$443,429ProgramServicesAmt
Management And General$369,922ManagementAndGeneralAmt
Fundraising$30,992FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$156TotalAmt
Management And General$156ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,875,708TotalAmt
Program Services$1,875,708ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$511,580TotalAmt
Program Services$424,304ProgramServicesAmt
Management And General$83,578ManagementAndGeneralAmt
Fundraising$3,698FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$96,503TotalAmt
Program Services$60,762ProgramServicesAmt
Management And General$33,320ManagementAndGeneralAmt
Fundraising$2,421FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,838,005TotalAmt
Program Services$2,838,005ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,673,668TotalAmt
Program Services$3,673,668ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$343,656TotalAmt
Program Services$21,307ProgramServicesAmt
Management And General$322,349ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
NURSING SUPPLIES$1,780,804$1,780,575$229
DIETARY EXPENSES$1,268,665$1,268,665
LICENSES, PERMITS, FEES$484,570$370,307$112,421$1,842
BAD DEBT EXPENSE$205,519$199,466$6,053

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$292,176TotalAmt
Program Services$134,581ProgramServicesAmt
Management And General$135,237ManagementAndGeneralAmt
Fundraising$22,358FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$46,109,916TotalAmt
Program Services$39,989,777ProgramServicesAmt
Management And General$5,657,140ManagementAndGeneralAmt
Fundraising$462,999FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,738,863BOYAmt
EOY$3,382,023EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,101,302BOYAmt
EOY$687,794EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,065,386BOYAmt
EOY$2,234,935EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$372,302BOYAmt
EOY$335,279EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$100,045,283LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$21,779,026LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$80,668,698BOYAmt
EOY$78,266,257EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,993,818BOYAmt
EOY$1,969,310EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,059,517BOYAmt
EOY$6,317,833EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$94,999,886BOYAmt
EOY$93,193,431EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,682,178BOYAmt
EOY$3,074,367EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,432,309BOYAmt
EOY$32,546,118EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$359,217BOYAmt
EOY$315,358EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$39,169,796BOYAmt
EOY$42,244,819EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,917,678BOYAmt
EOY$2,609,738EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$79,561,178BOYAmt
EOY$80,790,400EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,875,837BOYAmt
EOY$11,512,086EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,414,621BOYAmt
EOY$737,495EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$148,250BOYAmt
EOY$153,450EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,438,708BOYAmt
EOY$12,403,031EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$94,999,886BOYAmt
EOY$93,193,431EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$2,905,290ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$50,631NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$79,756OtherChangesInNetAssetsAmt
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 CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,732,392CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,024,078CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,846,409CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,486,509CurrentTaxYearMinus1YearAmt
Current Tax Year$2,207,536CurrentTaxYearAmt
Total$20,296,924TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,732,392CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,024,078CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,846,409CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,486,509CurrentTaxYearMinus1YearAmt
Current Tax Year$2,207,536CurrentTaxYearAmt
Total$20,296,924TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$20,296,924PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$481,657CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$448,003CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$732,232CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$385,033CurrentTaxYearMinus1YearAmt
Current Tax Year$400,118CurrentTaxYearAmt
Total$2,447,043TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$138,637CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$83,140CurrentTaxYearMinus3YearsAmt
Current Tax Year$8,593CurrentTaxYearAmt
Total$230,370TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$272,317CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$300,443CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$462,693CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$421,051CurrentTaxYearMinus1YearAmt
Current Tax Year$429,828CurrentTaxYearAmt
Total$1,886,332TotalAmt
FieldValueIRS element (for citing)
Total Support$24,860,669TotalSupportAmt
Gross Receipts Rltd Activities$166,818,878GrossReceiptsRltdActivitiesAmt
Public Support CY1700.81640PublicSupportCY170Pct
Public Support PY1700.81070PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME - 2012 AMOUNT: $ 3,619. 2013 AMOUNT: $ 10,879. 2014 AMOUNT: $ 11,303. 2015 AMOUNT: $ 14,957. 2016 AMOUNT: $ 43,497. DIETARY INCOME - 2012 AMOUNT: $ 75,674. 2013 AMOUNT: $ 96,028. 2014 AMOUNT: $ 114,922. 2015 AMOUNT: $ 118,919. 2016 AMOUNT: $ 117,866. HOUSEKEEPING INCOME - 2012 AMOUNT: $ 77,234. 2013 AMOUNT: $ 75,037. 2014 AMOUNT: $ 69,604. 2015 AMOUNT: $ 67,209. 2016 AMOUNT: $ 44,817. VENDING INCOME - 2012 AMOUNT: $ 562. 2013 AMOUNT: $ 544. 2014 AMOUNT: $ 628. 2015 AMOUNT: $ 896. 2016 AMOUNT: $ 708. LAUNDRY INCOME - CABLE TV INCOME - 2012 AMOUNT: $ 25,206. 2013 AMOUNT: $ 37,534. 2014 AMOUNT: $ 50,047. 2015 AMOUNT: $ 48,559. 2016 AMOUNT: $ 55,919. EMERGENCY PULL CORD INCOME - 2012 AMOUNT: $ 38,544. 2013 AMOUNT: $ 39,369. 2014 AMOUNT: $ 39,612. 2015 AMOUNT: $ 39,612. 2016 AMOUNT: $ 39,612. MAINTENANCE INCOME - 2012 AMOUNT: $ 9,376. 2013 AMOUNT: $ 9,687. 2014 AMOUNT: $ 23,216. 2015 AMOUNT: $ 30,368. 2016 AMOUNT: $ 38,494. PENDANT ALARM INCOME - 2012 AMOUNT: $ 4,052. 2013 AMOUNT: $ 4,680. 2014 AMOUNT: $ 4,856. 2015 AMOUNT: $ 2,396. 2016 AMOUNT: $ 4,481. TELEPHONE INCOME - 2012 AMOUNT: $ 23,316. 2013 AMOUNT: $ 23,272. 2014 AMOUNT: $ 25,948. 2015 AMOUNT: $ 28,192. 2016 AMOUNT: $ 25,840. ANNUITY CONVERSION INCOME - 2012 AMOUNT: $ 14,734. 2014 AMOUNT: $ 1,606. 2015 AMOUNT: $ 1,575. 2016 AMOUNT: $ 1,548. FUNDRAISING EVENT INCOME - 2014 AMOUNT: $ 115,330. 2015 AMOUNT: $ 63,339. 2016 AMOUNT: $ 51,857. GIFT SHOP INCOME - 2013 AMOUNT: $ 3,413. 2014 AMOUNT: $ 5,621. 2015 AMOUNT: $ 5,029. 2016 AMOUNT: $ 5,189.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$148,250BeginningYearBalanceAmt
Contributions$200ContributionsAmt
End Year Balance$148,450EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$148,150BeginningYearBalanceAmt
Contributions$100ContributionsAmt
End Year Balance$148,250EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$147,950BeginningYearBalanceAmt
Contributions$200ContributionsAmt
End Year Balance$148,150EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$147,850BeginningYearBalanceAmt
Contributions$100ContributionsAmt
End Year Balance$147,950EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$147,835BeginningYearBalanceAmt
Contributions$15ContributionsAmt
End Year Balance$147,850EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,623,927OtherCostOrOtherBasisAmt
Book Value$12,623,927BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$79,086,778OtherCostOrOtherBasisAmt
Depreciation$16,438,713DepreciationAmt
Book Value$62,648,065BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,226,142OtherCostOrOtherBasisAmt
Depreciation$5,340,313DepreciationAmt
Book Value$2,885,829BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$108,436OtherCostOrOtherBasisAmt
Book Value$108,436BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$78,266,257TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$1,750,565
RESIDENT TRUST FUNDS$27,380
FUNDS HELD IN ESCROW$201,296
BOND FUNDS$4,048,545
TENANT SECURITY DEPOSITS$290,047
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,317,833TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DUE TO AFFILIATES$33,786
ASSET RETIREMENT OBLIGATION$50,684
NON-COMPETE AGREEMENT$450,002
NOTES PAYABLE TO AFFILIATES$2,075,266
FieldValueIRS element (for citing)
Total Liability$2,609,738TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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. AUGUSTANA CARE AND ITS AFFILIATES 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.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMENTEvent1Nm
Gross Receipts Event1$101,779GrossReceiptsEvent1Amt
Charitable Contri Event1$64,763CharitableContriEvent1Amt
Gross Revenue Event1$37,016GrossRevenueEvent1Amt
Non Cash Prizes Event1$16,983NonCashPrizesEvent1Amt
Rent Facility Costs Event1$7,805RentFacilityCostsEvent1Amt
Food And Beverage Event1$8,922FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$3,306OtherDirectExpensesEvent1Amt
Event2HOLIDAY TREE FESTIVALEvent2Nm
Gross Receipts Event2$22,270GrossReceiptsEvent2Amt
Charitable Contri Event2$12,996CharitableContriEvent2Amt
Gross Revenue Event2$9,274GrossRevenueEvent2Amt
Non Cash Prizes Event2$6,438NonCashPrizesEvent2Amt
Food And Beverage Event2$2,583FoodAndBeverageEvent2Amt
Entertainment Event2$250EntertainmentEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$14,899GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$9,332CharitableContriOtherEventsAmt
Gross Revenue Other Events$5,567GrossRevenueOtherEventsAmt
Non Cash Prizes Other Events$6,492NonCashPrizesOtherEventsAmt
Food And Beverage Other Events$2,534FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events$2,249OthDirectExpnssOtherEventsAmt
Gross Receipts Total$138,948GrossReceiptsTotalAmt
Charitable Contributions Tot$87,091CharitableContributionsTotAmt
Gross Revenue Total Events$51,857GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$29,913NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$7,805RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$14,039FoodAndBeverageTotalEventsAmt
Entertainment Total Events$250EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$5,555OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$57,562DirectExpenseSummaryEventsAmt
Net Income Summary-$5,705NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
AUGUSTANA CARE SERVICES
1007 EAST 14TH STREETMINNEAPOLISMN55404411806946501(C)(3)$871,135ELIMINATE INTERCOMPANY PAYABLE
BROOKSIDE SENIOR LIVING
804 BENSON ROADMONTEVIDEOMN56265410871848501(C)(3)$370,436ELIMINATE INTERCOMPANY PAYABLE
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient10RecipientCnt
Cash Grant$24,009CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationAUGUSTANA 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TIM TUCKER
PRESIDENT/CEO$0$348,112$0$78,000$0$30,135$0$51,852$0$30,386$0$538,485$0$0
CRAIG KITTELSON
VP - FINANCE/CFO$0$236,914$0$34,524$0$33,926$0$47,594$0$30,731$0$383,689$0$0
TIM MIDDENDORF
VP - OPERATIONS/COO$0$224,000$0$0$0$17,483$0$26,321$0$5,455$0$273,259$0$0
KATHERINE KOPP
VP - NEW BUSINESS DEVELOPMENT$0$213,039$0$31,392$0$22,765$0$28,759$0$29,221$0$325,176$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3FOR THE PURPOSE OF DETERMINING COMPENSATION, AUGUSTANA CARE RELIED ON A RELATED ORGANIZATION, AUGUSTANA CARE SERVICES, TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO. AUGUSTANA 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 4BTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PROVIDED BY AUGUSTANA CARE SERVICES, A RELATED ORGANIZATION: TIM TUCKER, PRESIDENT AND CEO - $26,569 CRAIG KITTELSON, VICE PRESIDENT OF FINANCE AND CFO - $22,311 TIM MIDDENDORF, VICE PRESIDENT OF OPERATIONS AND COO - $7,000 KATHERINE KOPP, VICE PRESIDENT OF NEW BUSINESS DEVELOPMENT - $4,000

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingIndCUSIPCUSIPNum
CITY OF DASSEL MN
A4108517012010-09-15$1,400,000FACILITY DEVELOPMENT000
DAKOTA COUNTY COMMUNITY DEVELOPMENT AGENCY
B4112533022015-03-25$5,060,000REFINANCE SERIES 2007 BOND00023409VDV9
CITY OF DASSEL MN
C4108517012007-08-21$1,500,000ACQUIRE FACILITY000
COLORADO HEALTH FACILITIES AUTHORITY
D8407329322011-03-31$875,000TO REFINANCE SERIES 2011 BONDS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmtOther Spent ProceedsOtherSpentProceedsAmt
A$322,588$1,400,000$28,000$1,372,000201100Yes (1)Yes (1)
B$450,000$5,060,000$101,2002015Yes (1)0Yes (1)Yes (1)$325,000$4,958,800
C$619,100$1,500,000$30,000$1,470,000200700Yes (1)Yes (1)
D$875,000$875,000201100Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A000000Yes (1)
B000000Yes (1)
C000000Yes (1)
D000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A00Yes (1)0Yes (1)000Yes (1)
B0Yes (1)00Yes (1)000Yes (1)
C00Yes (1)0Yes (1)000Yes (1)
D00Yes (1)00000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CITY OF VICTORIA MN
A41099725792627TAT32014-07-31$22,110,000TO REFINANCE SERIES 2009 BONDS000
CARLTON COUNTY MN
B416005767142887BB32015-03-02$5,805,000FACILITY DEVELOPMENT000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndBond DefeasedBondDefeasedAmtCapital ExpendituresCapitalExpendituresAmtUnspentUnspentAmt
A$1,625,002$22,110,000$1,075,979$4,442,200$22,254,7682014Yes (1)0Yes (1)Yes (1)
B$375,000$5,805,000$191,680$116,100201700Yes (1)Yes (1)$5,705,000$5,416,876$80,387

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A000000Yes (1)
B000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)000000Yes (1)
B0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Schedule M IRS990ScheduleM

Books And Publications BooksAndPublicationsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$5,775NoncashContributionsRptF990Amt

Food Inventory FoodInventoryGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution217ContributionCnt
Noncash Contributions Rpt F990$20,211NoncashContributionsRptF990Amt

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescGIFT CARDSDesc
Contribution31ContributionCnt
Noncash Contributions Rpt F990$2,887NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
OVERALL MISSION FOR AUGUSTANA ENTITIESAUGUSTANA 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. BECAUSE ELDERS ARE VITAL TO OUR COMMUNITIES, PROVIDING SERVICES TO HELP THEM CONTINUE LIVING LIFE TO THE FULLEST ALSO GIVES US IN THE GREATER COMMUNITY ALL THE BENEFIT OF THEIR WISDOM AND EXPERIENCE. WE OFFER A FULL SPECTRUM OF SERVICES. IN OUR 2017 FISCAL YEAR, MORE THAN 13,000 PEOPLE WERE SERVED IN COMMUNITIES IN MINNESOTA AND COLORADO. OUR FIVE HEALTH CARE CENTERS PROVIDED TRANSITIONAL, LONG-TERM AND MEMORY CARE AND REHABILITATION SERVICES TO MORE THAN 3,879 PEOPLE. AUGUSTANA CARE ALSO PROVIDES A VARIETY OF HOUSING COMMUNITIES THAT SERVE OLDER ADULTS WITH COMFORTABLE LIVING AND CARE OPTIONS, INCLUDING INDEPENDENT LIVING, HOUSING WITH SERVICES, AND ASSISTED LIVING AND MEMORY CARE. IN FISCAL YEAR 2017, A TOTAL OF 1,574 ELDERS BENEFITED FROM THESE SERVICES. ADDITIONALLY, WE 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 6,181 INDIVIDUALS WERE SERVED THROUGH THESE PROGRAMS IN FISCAL YEAR 2017. FINALLY, MANAGEMENT CONSULTING SERVICES WERE PROVIDED TO SEVEN OTHER ORGANIZATIONS THAT SERVE OLDER ADULTS.
FORM 990, PART III, LINE 2AUGUSTANA CARE BUILT A HEALTH CARE CENTER AND 22 ASSISTED LIVING APARTMENTS IN A NEIGHBORHOOD IN THE TOWN OF EAGLE. THIS ENTITY IS KNOWN AS CASTLE PEAK SENIOR CARE COMMUNITY, AND IT BEGAN WELCOMING RESIDENTS IN FALL 2016. CASTLE PEAK'S PRIMARY SERVICES INCLUDE ASSISTED LIVING AND TRANSITIONAL, LONG-TERM AND MEMORY CARE FOR ELDERS AND OTHERS WHO NEED THESE SERVICES. 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.
FORM 990, PART VI, SECTION A, LINE 3THE 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.
FORM 990, PART VI, SECTION A, LINE 6THE 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 7ATHE 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 7BAMENDMENTS 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 11BTHE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED IN DETAIL BY THE ORGANIZATION'S VICE PRESIDENT OF FINANCE/CFO. THE FORM 990 WAS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS BY THE VICE PRESIDENT OF FINANCE/CFO PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CTHE 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 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:LOSS ON EXTINGUISHMENT OF DEBT -79,756.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
REPLACEMENT RESERVES LLC
1007 EAST 14TH STREETMINNEAPOLISMN55404752990222HOME HEALTH SERVICESMN$0$0AUGUSTANA CARE
AUGUSTANA DASSEL LAKESIDE COMMUNITY HOME LLC
439 WILLIAM AVENUE EASTDASSELMN55325208916091NURSING/ASSISTED LIVING FACILITYMN$5,771,110$5,494,287AUGUSTANA CARE
AUGUSTANA SENIOR DEVELOPMENT II LLC
1007 EAST 14TH STREETMINNEAPOLISMN55404481293891CONSULTINGMN$3,373,028$157,611AUGUSTANA CARE
AUGUSTANA MERCY CARE CENTER LLC
710 S KENWOOD AVENUEMOOSE LAKEMN55767271466676NURSING/ASSISTED LIVING FACILITYMN$6,792,852$6,683,242AUGUSTANA CARE
AUGUSTANA LAND DEVELOPMENT LLC
14650 GARRENTT AVENUEAPPLE VALLEYMN55124271456660LAND DEVELOPMENTMN$0$2,218,284AUGUSTANA CARE
AUGUSTANA ELK RUN LLC
1425 10TH AVENUE SOUTHMINNEAPOLISMN55404273219747ASSISTED LIVINGMN$1,979,481$6,431,348AUGUSTANA CARE
AUGUSTANA EMERALD CARE LLC
451 EAST TRAVELERS TRAILBURNSVILLEMN55337271279704MEMORY CAREMN$9,535,188$21,760,693AUGUSTANA CARE
AUGUSTANA REGENT AT BURNSVILLE
14500 REGENT LANEBURNSVILLEMN55306208915982ASSISTED LIVINGMN$7,062,223$19,159,477AUGUSTANA CARE
AUGUSTANA PROPERTIES LLC
1425 10TH AVENUE SOUTHMINNEAPOLISMN55404462166624RENTAL PROPERTIESMN$520,194$2,369,596AUGUSTANA CARE
CASTLE PEAK SENIOR CARE LLC
1425 10TH AVENUE SOUTHMINNEAPOLISMN55404460904337NURSING/ASSISTED LIVING FACILITYMN$2,243,324$23,358,968AUGUSTANA CARE
AUGUSTANA OAKVIEW CARE LLC
300 TALBOT DRIVEMOOSE LAKEMN55767472292912HOUSING WITH SERVICESMN$1,404,286$4,012,350AUGUSTANA CARE

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
APPLE VALLEY VILLA APARTMENTS
1007 EAST 14TH STREETMINNEAPOLISMN55404311608691HEALTH CARE FACILITIES/SERVICESMN501(C)(3)LINE 10AUGUSTANA CAREYes (1)
AUGUSTANA APARTMENTS OF HASTINGS
1007 EAST 14TH STREETMINNEAPOLISMN55404311608701HEALTH CARE FACILITIES/SERVICESMN501(C)(3)LINE 10AUGUSTANA CAREYes (1)
AUGUSTANA CARE FOUNDATION
1007 EAST 14TH STREETMINNEAPOLISMN55404411360678CHARITABLE FOUNDATIONMN501(C)(3)LINE 12A, IAUGUSTANA CAREYes (1)
AUGUSTANA CARE SERVICES
1007 EAST 14TH STREETMINNEAPOLISMN55404411806946MANAGEMENT SERVICESMN501(C)(3)LINE 12A, IAUGUSTANA CAREYes (1)
AUGUSTANA CHAPEL VIEW HOMES INC
1007 EAST 14TH STREETMINNEAPOLISMN55404410693953HEALTH CARE FACILITIES/SERVICESMN501(C)(3)LINE 10AUGUSTANA CAREYes (1)
AUGUSTANA COMMUNITY PARTNERS
1007 EAST 14TH STREETMINNEAPOLISMN55404411783680HOME HEALTH CARE SERVICESMN501(C)(3)LINE 10AUGUSTANA CAREYes (1)
AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY
1007 EAST 14TH STREETMINNEAPOLISMN55404311608696HEALTH CARE FACILITIES/SERVICESMN501(C)(3)LINE 10AUGUSTANA CAREYes (1)
AUGUSTANA HOME OF HASTINGS
1007 EAST 14TH STREETMINNEAPOLISMN55404311572624HEALTH CARE FACILITIES/SERVICESMN501(C)(3)LINE 10AUGUSTANA CAREYes (1)
OPEN CIRCLE ADULT DAY CENTER
1007 EAST 14TH STREETMINNEAPOLISMN55404411424801HEALTH CARE FACILITIES/SERVICESMN501(C)(3)LINE 10AUGUSTANA CAREYes (1)
BROOKSIDE SENIOR LIVING
804 BENSON ROADMONTEVIDEOMN56265410871848HEALTH CARE FACILITIES/SERVICESMN501(C)(3)LINE 10MONTEVIDEO AREA MEMBERS & AUGUSTANA CAREYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA SENIOR DEVELOPMENT INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55404ZIPCd
FieldValueIRS element (for citing)
EIN264136110EIN
Primary ActivitiesCONSULTINGPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA CAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$233,628ShareOfTotalIncomeAmt
Share Of EOY Assets$310,144ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
AUGUSTANA CARE SERVICES
B$871,135CASH
AUGUSTANA CARE SERVICES
C$775,979CASH
APPLE VALLEY VILLA
C$700,000CASH
AUGUSTANA CARE FOUNDATION
C$81,669CASH
BROOKSIDE SENIOR LIVING
B$370,436CASH
AUGUSTANA CARE SERVICES
L$1,455,730% OF REVENUE

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