OPEN CIRCLE ADULT DAY CARE: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- OPEN CIRCLE ADULT DAY CARE (EIN 41-1424801)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-07-27
- IRS object ID
- 201702089349300545
- Schema version
- 2015v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-07-27T14:07:17-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | 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 | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411424801 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OPEN CIRCLE ADULT DAY CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OPEN | BusinessNameControlTxt |
| Phone | 6122385225 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55404 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG KITTELSON | PersonNm |
| Person Title | VP - FINANCE/CFO | PersonTitleTxt |
| Phone | 6122385225 | PhoneNum |
| Signature | 2017-07-13 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIM TUCKER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55404 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,897,523 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AUGUSTANACARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE, HOUSING AND COMMUNITY SERVICES FOR THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 49 | TotalEmployeeCnt |
| Total Volunteers | 47 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $16,932 | PYContributionsGrantsAmt |
| CY Contributions Grants | $53,756 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,835,078 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,843,720 | CYProgramServiceRevenueAmt |
| PY Investment Income | $302 | PYInvestmentIncomeAmt |
| CY Investment Income | $47 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,852,312 | PYTotalRevenueAmt |
| CY Total Revenue | $1,897,523 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $190,000 | 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 | $1,267,348 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,319,501 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $474,203 | PYOtherExpensesAmt |
| CY Other Expenses | $527,530 | CYOtherExpensesAmt |
| PY Total Expenses | $1,931,551 | PYTotalExpensesAmt |
| CY Total Expenses | $1,847,031 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$79,239 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $50,492 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $374,561 | TotalAssetsBOYAmt |
| Total Assets EOY | $395,792 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $118,350 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $89,089 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $256,211 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $306,703 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SERVE GOD BY FOSTERING FULLNESS OF LIFE FOR OLDER ADULTS AND OTHER PEOPLE IN NEED THROUGH THE PROVISION OF HEALTH CARE, HOUSING, AND OTHER SERVICES IN A CHRISTIAN TRADITION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,412,593 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,843,720 | RevenueAmt |
| Desc | ADULT DAY CARE - PROVIDED SOCIAL, THERAPEUTIC AND HEALTH RELATED SERVICES TO ELDERLY AND DISABLED ADULTS. OPEN CIRCLE ADULT DAY CENTER SERVED 278 INDIVIDUALS DURING THE YEAR ENDED SEPTEMBER 30, 2016. | Desc |
| Total Program Service Expenses | $1,412,593 | 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 | Yes (1) | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 49 | 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 | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG KITTELSON - AUGUSTANA CARE SE | PersonNm |
| Phone | 6122385205 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55404 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| REV DR GARY WILKERSON | ||||||||
| CHAIR | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARSHALL MACKAY | ||||||||
| VICE CHAIR | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CHARLES PARKS JR | ||||||||
| SECRETARY | 1.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ERIC RICK ELLINGSON | ||||||||
| TREASURER | 1.00 | 9.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JIM EHLEN | ||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT RAMSDALE | ||||||||
| DIRECTOR | 1.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| TIM TUCKER | ||||||||
| PRESIDENT/CEO | 4.50 | 40.50 | Yes (X) | $0 | $408,367 | $98,317 | ||
| CRAIG KITTELSON | ||||||||
| VP - FINANCE/CFO | 4.50 | 40.50 | Yes (X) | $0 | $312,056 | $89,780 | ||
| TIM MIDDENDORF | ||||||||
| VP - OPERATIONS/COO | 4.50 | 40.50 | Yes (X) | $0 | $276,034 | $32,305 | ||
| KATHERINE KOPP | ||||||||
| VP - NEW BUSINESS DEVELOPMENT | 4.50 | 40.50 | $0 | $272,525 | $60,575 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,268,982 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $280,977 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | 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 | AUGUSTANA CARE SERVICES | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55404 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MANAGEMENT SERVICES | ServicesDesc |
| Compensation | $113,852 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $53,756 | AllOtherContributionsAmt |
| Total Contributions | $53,756 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOUSING FACILITIES | 623000 | $1,742,161 | $1,742,161 |
| TRANSPORTATION INCOME | 480000 | $101,559 | $101,559 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,843,720 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47 | TotalRevenueColumnAmt |
| Exclusion | $47 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,897,523 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,843,720 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $47 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,088,349 | TotalAmt |
| Program Services | $876,894 | ProgramServicesAmt |
| Management And General | $211,455 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,864 | TotalAmt |
| Program Services | $10,342 | ProgramServicesAmt |
| Management And General | $4,522 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,642 | TotalAmt |
| Program Services | $120,461 | ProgramServicesAmt |
| Management And General | $21,181 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,646 | TotalAmt |
| Program Services | $59,875 | ProgramServicesAmt |
| Management And General | $14,771 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,852 | TotalAmt |
| Management And General | $113,852 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,690 | TotalAmt |
| Management And General | $4,690 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,461 | TotalAmt |
| Program Services | $38,662 | ProgramServicesAmt |
| Management And General | $7,799 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,460 | TotalAmt |
| Management And General | $1,460 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,782 | TotalAmt |
| Program Services | $20,861 | ProgramServicesAmt |
| Management And General | $23,921 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,176 | TotalAmt |
| Program Services | $56,176 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,499 | TotalAmt |
| Program Services | $77,003 | ProgramServicesAmt |
| Management And General | $1,496 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,723 | TotalAmt |
| Program Services | $2,303 | ProgramServicesAmt |
| Management And General | $4,420 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,684 | TotalAmt |
| Program Services | $24,684 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,025 | TotalAmt |
| Management And General | $13,025 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DIETARY EXPENSES | $77,172 | $77,172 | |
| PURCHASED MEALS | $37,848 | $37,848 | |
| BAD DEBT EXPENSES | $6,519 | $6,519 | |
| ACTIVITES EXPENSE | $5,091 | $5,091 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,548 | TotalAmt |
| Program Services | $5,221 | ProgramServicesAmt |
| Management And General | $5,327 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,847,031 | TotalAmt |
| Program Services | $1,412,593 | ProgramServicesAmt |
| Management And General | $434,438 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600 | BOYAmt |
| EOY | $600 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,361 | BOYAmt |
| EOY | $222,683 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,124 | BOYAmt |
| EOY | $8,153 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $770,796 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $608,860 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,888 | BOYAmt |
| EOY | $161,936 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,588 | BOYAmt |
| EOY | $2,420 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $374,561 | BOYAmt |
| EOY | $395,792 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,350 | BOYAmt |
| EOY | $89,089 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,350 | BOYAmt |
| EOY | $89,089 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $248,086 | BOYAmt |
| EOY | $299,443 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,125 | BOYAmt |
| EOY | $7,260 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,211 | BOYAmt |
| EOY | $306,703 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $374,561 | BOYAmt |
| EOY | $395,792 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $50,492 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $7,268 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,922 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,379 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,932 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,756 | CurrentTaxYearAmt |
| Total | $99,257 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,283,343 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,605,949 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,779,082 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,835,078 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,843,720 | CurrentTaxYearAmt |
| Total | $8,347,172 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,290,611 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,613,871 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,792,461 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,852,010 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,897,476 | CurrentTaxYearAmt |
| Total | $8,446,429 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $8,446,429 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,423 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $354 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $741 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $47 | CurrentTaxYearAmt |
| Total | $2,867 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,423 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $354 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $741 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $47 | CurrentTaxYearAmt |
| Total | $2,867 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,292,034 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,614,225 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,793,202 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,852,312 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,897,523 | CurrentTaxYearAmt |
| Total | $8,449,296 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99970 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99940 | PublicSupportPY509Pct |
| Investment Income CY | 0.00030 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00060 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,000 | OtherCostOrOtherBasisAmt |
| Book Value | $20,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $521,009 | OtherCostOrOtherBasisAmt |
| Depreciation | $433,532 | DepreciationAmt |
| Book Value | $87,477 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $229,787 | OtherCostOrOtherBasisAmt |
| Depreciation | $175,328 | DepreciationAmt |
| Book Value | $54,459 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $161,936 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIM TUCKER | ||||||||||||||
| PRESIDENT/CEO | $0 | $318,469 | $0 | $61,200 | $0 | $28,698 | $0 | $66,373 | $0 | $31,944 | $0 | $506,684 | $0 | $0 |
| CRAIG KITTELSON | ||||||||||||||
| VP - FINANCE/CFO | $0 | $227,810 | $0 | $50,400 | $0 | $33,846 | $0 | $57,991 | $0 | $31,789 | $0 | $401,836 | $0 | $0 |
| TIM MIDDENDORF | ||||||||||||||
| VP - OPERATIONS/COO | $0 | $220,614 | $0 | $41,800 | $0 | $13,620 | $0 | $26,850 | $0 | $5,455 | $0 | $308,339 | $0 | $0 |
| KATHERINE KOPP | ||||||||||||||
| VP - NEW BUSINESS DEVELOPMENT | $0 | $209,780 | $0 | $41,640 | $0 | $21,105 | $0 | $30,267 | $0 | $30,308 | $0 | $333,100 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | FOR THE PURPOSES OF DETERMINING COMPENSATION, OPEN CIRCLE ADULT DAY CENTER 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 4B | THE 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 - $42,557 CRAIG KITTELSON, VICE PRESIDENT OF FINANCE AND CFO - $34,194 TIM MIDDENDORF, VICE PRESIDENT OF OPERATIONS AND COO - $8,000 KATHERINE KOPP, VICE PRESIDENT OF NEW BUSINESS DEVELOPMENT - $5,000 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| OVERALL MISSION OF AUGUSTANA ENTITIES | AUGUSTANA CARE AND ITS SUBSIDIARIES' MISSION IS TO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS AND OTHERS IN NEED THROUGH THE PROVISION OF HEALTHCARE, HOUSING AND OTHER SERVICES IN A CHRISTIAN TRADITION. 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 2016 FISCAL YEAR, MORE THAN 12,200 PEOPLE WERE SERVED IN COMMUNITIES IN MINNESOTA AND COLORADO. OUR SEVEN HEALTH CARE CENTERS PROVIDED TRANSITIONAL, LONG-TERM AND MEMORY CARE AND REHABILITATION SERVICES TO MORE THAN 3,500 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 2016, A TOTAL OF 1,653 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 3,736 INDIVIDUALS WERE SERVED THROUGH THESE PROGRAMS IN FISCAL YEAR 2016. FINALLY, MANAGEMENT CONSULTING SERVICES WERE PROVIDED TO SEVEN OTHER ORGANIZATIONS THAT SERVE OLDER ADULTS. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE PURPOSE OF AUGUSTANA CARE SERVICES IS TO MANAGE AUGUSTANA CARE AND ITS RELATED ORGANIZATIONS. SERVICES PROVIDED INCLUDE FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, FUND DEVELOPMENT AND NEW BUSINESS DEVELOPMENT. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS AUGUSTANA CARE. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED BY A MAJORITY VOTE FROM THE BOARD OF DIRECTORS OF THE SOLE MEMBER, AUGUSTANA CARE, AT THE ANNUAL MEETING. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS REQUIRE AFFIRMATIVE APPROVAL FROM THE SOLE MEMBER OF THE ORGANIZATION, AUGUSTANA CARE: (A) AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THIS CORPORATION; (B) CAPITAL BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, AND ALL MAJOR EXPENDITURES BEFORE FUNDS ARE EXPENDED THEREFORE; (C) OPERATING BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, BEFORE AUTHORIZED EXPENDITURES MAY BE MADE THEREFROM; (D) STRATEGIC PLANS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSIHPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION; (E) THE INCURRING OF ANY LONG TERM DEBT OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, OTHER THAN INTRA-SYSTEM OR REFINANCING DEBT; (F) HUMAN RESOURCES AND BENEFITS POLICIES OF THIS CORPORATION; (G) MAJOR RISK CONTRACTING AGREEMENTS, WHICH FOR THESE PURPOSES MEANS ANY CONTRACT WHICH DEALS WITH CAPITATION OR SIMILAR RISK BEARING CONCEPT; (H) MERGER, CONSOLIDATION, OR TOTAL OR PARTIAL DISSOLUTION INVOLVING THIS CORPORATION; (I) GOVERNANCE AND ACTION OF THE TYPE SET FORTH IN SUBPARAGRAPH (A) AND SUBPARAGRAPHS (F) THROUGH (H) ABOVE AS PROPOSED BY THE BOARD OF DIRECTORS OF ANY CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITES DIRECTLY CONTROLLED BY THIS CORPORATION AS A MEMBER, SHAREHOLDER OR OTHERWISE, TO THE EXTENT THAT THE GOVERNING DOCUMENTS OF SUCH CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITIES GIVE THIS CORPORATION OR THE BOARD A RIGHT OF APPROVAL OVER SUCH GOVERNANCE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 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 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND KEY EMPLOYEES. ALL COVERED INDIVIDUALS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST TO THE APPROPRIATE LEVEL OF MANAGEMENT OR TO THE BOARD OF DIRECTORS AS OUTLINED IN THE POLICY BASED ON THE INDIVIDUAL'S POSITION WITHIN THE ORGANIZATION. CONFLICTS ARE DETERMINED AT THE APPROPRIATE LEVEL OF MANAGEMENT OR BY THE BOARD OF DIRECTORS. INDIVIDUALS WITH ACTUAL OR POTENTIAL CONFLICTS WILL ABSTAIN FROM DISCUSSING OR VOTING ON ANY MATTERS RELATING TO THE CONFLICT. ALL PROCEEDINGS RELATING TO ACTUAL OR POTENTIAL CONFLICTS ARE NOTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| APPLE VALLEY VILLA APARTMENTS | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 311608691 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 0 | |
| AUGUSTANA APARTMENTS OF HASTINGS | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 311608701 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 0 | |
| AUGUSTANA CARE | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411728753 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 7 | 0 | N/A | |
| AUGUSTANA CARE FOUNDATION | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411360678 | CHARITABLE FOUNDATION | MN | 501(C)(3) | 11 - TYPE 1 | AUGUSTANA CARE | 0 | |
| AUGUSTANA CARE SERVICES | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411806946 | MANAGEMENT SERVICES | MN | 501(C)(3) | 11 - TYPE 1 | AUGUSTANA CARE | 0 | |
| AUGUSTANA CHAPEL VIEW HOMES INC | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 410693953 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 0 | |
| AUGUSTANA COMMUNITY PARTNERS | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411783680 | HOME HEALTH CARE SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 0 | |
| AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 311608696 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 0 | |
| AUGUSTANA HOME OF HASTINGS | |||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 311572624 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUGUSTANA SENIOR DEVELOPMENT INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55404 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481293891 | EIN |
| Primary Activities | CONSULTING | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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