2017-07-28T09:50:29-05:00 2016-12-31 411690382 Malloy Montague Karnowski Radosevich 5353 Wayzata Blvd Ste 410 Minneapolis MN 55416 990 2016-01-01 860906621 Northern Arizona Senior Living Community LLC NORT 9523618000 1107 Hazeltine Blvd No 200 Chaska MN 55318 Randall Benson Authorized Signatory 9523618000 2017-05-04 1 Thomas A Karnowski P00148364 9525450424 50.241.48.137 2017-05-04 09:31:28 CD P E40D10625611E6C2C29A40A9D4B65BB9BD0CEAA0 72B179353DD9FFC32DC70291472B128039FE5711 2016 2021-01-29 14:40:06Z The Peaks Randall Benson 1107 Hazeltine Blvd No 200 Chaska MN 55318 14079688 0 X www.thepeaks.org X 1997 MN The Corporation was formed to develop and operate a senior living and mentoring facility. 6 6 285 87 0 0 10100 1126 13435166 14068583 12536 -335105 0 0 13457802 13734604 0 0 0 0 5291381 5507890 0 0 0 8913965 7823995 14205346 13331885 -747544 402719 24128991 23995265 26569544 26099848 -2440553 -2104583 X To develop and operate a senior living and mentoring facility. 0 0 11321916 14068583 Northern Arizona Senior Living Community, LLC dba The Peaks, a Senior Living Facility (The Peaks) located in Flagstaff, Arizona, is a comprehensive senior living and healthcare campus consisting of 58 skilled nursing beds, 96 assisted living units, and 39 bungalows. The Peaks, Flagstaff, Arizona, is unique in its community involvement in that it shares strong ties with the Museum of Northern Arizona, and Flagstaff Medical Center. The Peaks provides its residents, as well as children in the area, with fully developed intergenerational activities benefiting older adults and children alike. Two of The Peaks residents and The Lodge executive director are docents of the museum, providing education on local history, and discoveries of the Colorado Plateau to area schools, associations, the public and Peaks residents. The Peaks provides independent, assisted living, progressive memory care, rehabilitation, long-term care, and skilled nursing, with the opportunity for residents to "age in place." Residents are encouraged to remain in their apartment homes receiving assistance with activities of daily living through personalized levels of care. The community was developed through a nonprofit partnership between Intergenerational Living and Health Care, the Museum of Northern Arizona and Northern Arizona Healthcare. For the fiscal year ended December 31, 2016, The Peaks participated in various charitable initiatives such as the provision of discounted care through participation in the Arizona State Medicaid program and Indian Health Services. We average 17 Medicaid patients in our skilled nursing facility on a daily basis. In our lodge, and bungalows we averaged 14 residents on a daily basis discounting eligible resident's care by $492,398 during 2016. We have a partnership with the Museum of Northern Arizona (MNA), which supports an art collection within The Peaks and three museum docent programs. The Peaks has come to an agreement with the Museum of Northern Arizona to issue memberships to all Peaks' residents. We believe this art enriches the lives of our residents and the community as a whole. Each month we support the museum with an $825 monthly fee. (Value $9,900). We currently have a $7,500 endowment at Northern Arizona University within the Behavioral and Social Science Department for scholarships to students who plan careers that would support seniors. In addition, an endowment in the amount of $15,000 was established with The Northern Arizona University's (NAU) Foundation to be used for scholarships for degree advancement for registered nurses who aspire to earn a bachelors degree in nursing. NAU nursing students in the baccalaureate and masters programs serve a portion of their internship in The Peaks' healthcare center. Future Certified Nursing Assistants from Coconino Community College shadow Lodge caregivers to fulfil program graduation requirements. 11321916 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 66 0 1 285 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AZ X The Goodman Group LLC 9523618000 1107 Hazeltine Blvd Chaska MN 55318 X Lisa Brugh Manager 1.00 X 0 0 0 Florence Spyrow Manager 1.00 X 0 0 0 Mark Wilson Manager 1.00 X 0 0 0 Joseph Guertin Manager 1.00 X 0 0 0 Christopher Bavasi Co-Chief Executive Officer 1.00 X X 0 0 0 Thomas Egan Co-Chief Executive Officer 1.00 X X 0 0 0 0 0 0 0 0 0 0 Synertx 7540 North 19th Avenue Suite 200 Phoenix AZ 85021 Therapy 1174683 The Goodman Group LLC 1107 Hazeltine Blvd 200 Chaska MN 55318 Management and Accounting Services, info 866166 John B Goodman Limited Partnership 1107 Hazeltine Blvd 200 Chaska MN 55318 Construction Management & Development 794095 Pharmerica Corporation of America PO Box 409251 Atlanta GA 30384 Pharmacy 529204 4 1126 1126 Resident Services 623990 8801648 8801648 Ancillary Services 623990 5166654 5166654 Other operating revenue 623990 100281 100281 14068583 3910 3910 6069 345084 -339015 -339015 -339015 13734604 14068583 0 -335105 X 5049918 4679376 370542 69470 69470 388502 360669 27833 772855 772855 30693 30693 309690 309690 1532042 1532042 81038 79304 1734 1219970 1010702 209268 340622 340622 101590 26654 74936 864089 864089 962490 962490 605781 499751 106030 Dietary food 593455 593455 Other expenses 230010 230010 Equipment rental and ma 91849 91849 Amortization 42693 42693 45128 8210 36918 13331885 11321916 2009969 0 1736919 2124510 125375 358581 1025899 1139245 56349 52327 287752 197110 29345039 12386924 17217102 16958115 3679595 3165377 24128991 23995265 626215 851140 137047 154820 25727677 25016561 78605 77327 26569544 26099848 X -2440553 -2104583 -2440553 -2104583 24128991 23995265 X 402719 -66749 X X 0 1 X 1 0 X 700 288 10100 1226 12314 12798046 13557538 13613353 13435166 14068583 67472686 12798046 13558238 13613641 13445266 14069809 67485000 0 0 0 67485000 351732 67834 12842 16484 3910 452802 351732 67834 12842 16484 3910 452802 13149778 13626072 13626483 13461750 14073719 67937802 0.99330 0.98790 0.00670 0.01210 X 660000 660000 22088098 8206104 13881994 4076876 2330999 1745877 2520065 1849821 670244 16958115 Tax and insurance escrow 83098 Replacement reserve account 883970 Tenant/patient funds held in trust 6707 Debt service reserve escrow 1335000 Capitalized Interest - net of accumulated amortization 856602 3165377 Accrued Interest 70720 Tenant/patient funds held in trust 6607 77327 X 14072493 0 14072493 -337889 -337889 13734604 13669774 0 13669774 -337889 -337889 13331885 Part X, Line 2: The Company is exempt from taxation as a nonprofit organization in accordance with 501(c)(3) of the Internal Revenue Code. The Company adopted the recognition requirements for uncertain income tax positions as required by Financial Accounting Standards Board Accounting Standards Codification (FASB ASC) 740-10 (formerly known as FASB Interpretation No. 48, Accounting for Uncertainty in Income Taxes), with no cumulative effect adjustment required. Income tax benefits are recognized for income tax positions taken or expected to be taken in a tax return, only when it is determined that the income tax position will more-likely-than-not be sustained upon examination by taxing authorities. The Company has analyzed tax positions taken for filing with the Internal Revenue Service and the state jurisdiction where it operates. The Company believes that income tax filing positions will be sustained upon examination and does not anticipate any adjustments that would result in a material adverse effect on the Company's financial condition, results of operations, or cash flows. Accordingly, the Company has not recorded any reserves or related accruals for interest and penalties for uncertain income tax positions at December 31, 2015. The Company is subject to routine audits by taxing jurisdictions; however, there are currently no audits in progress for any open tax periods. Part XI, Line 4b - Other Adjustments: Charitable contribution revenue netted with expense 1,126. Loss on disposal of property -339,015. Part XII, Line 4b - Other Adjustments: Charitable contribution revenue netted with expense 1,126. Charitable contribution revenue netted with expense -339,015. Form 990, Part VI, Section B, line 11b The Form 990 is prepared by an independent certified public accounting firm. It is then reviewed by the controller and CPAs of the management company. The Form 990 is given to each Board member in advance of a scheduled meeting of the Board for their review. There is discussion of the Form 990 at the Board meeting with the preparers and the management company's representative prior to Board approval of the Form 990. Form 990, Part VI, Section B, line 12c Each member of the governing board annually completes a disclosure of conflict of interest questionnaire. Form 990, Part VI, Section B, line 15 Compensation is based on experience and market salary surveys, and is reviewed annually. Form 990, Part VI, Section C, line 19 The organization makes it governing documents, conflict of interest policy, and financial statements available to the public upon written request. Form 990, Part IX, line 11g General medical services : Program service expenses 61,080. Management and general expenses 0. Fundraising expenses 0. Total expenses 61,080. Nursing and therapy : Program service expenses 1,220,761. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,220,761. Dining, laundry, and housekeeping : Program service expenses 77,489. Management and general expenses 0. Fundraising expenses 0. Total expenses 77,489. Other : Program service expenses 172,712. Management and general expenses 0. Fundraising expenses 0. Total expenses 172,712. Form 990, Part XI, line 9: Capital transfer -66,749. FORM 990, PART XII, LINE 2C: The financial statements are prepared by an independent accounting firm. The statements are reviewed and approved by the board before being issued. This process was the same as last year. RELATED ORGANIZATION COMPENSATION: Made an effort to obtain information on compensation, if any were paid from a related organization. No other compensation or transactions were noted other than those listed on Form 990, Part VII, Line 1a. Form 990 Part XII, Line 2(b) and Schedule D, Parts XI, XII and XIII The Organization had an audit for the year ended December 31, 2015, however due to HUD specifications the Organization was allowed to be subject to an audit for an extended period from October 20, 2015 through December 31, 2016. There is no specific audit for the calendar year ending December 31, 2016. The Organization is reporting on Schedule D Part XI, XII and XIII the adjusted calendar year numbers for the year ended December 31, 2016.