AUGUSTANA COMMUNITY PARTNERS: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
AUGUSTANA COMMUNITY PARTNERS (EIN 41-1783680)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-05-13
IRS object ID
201401339349304505
Schema version
2012v2.1
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)
Timestamp2014-05-13T14:59:58-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411783680EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA COMMUNITY PARTNERSBusinessNameLine1
Business Name Line2FKA AUGUSTANA HOME HEALTH CARE SERVICESBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlAUGUNameControl
Phone6122385225Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCRAIG KITTELSONName
TitleVP - FINANCE/CFOTitle
Phone6122385225Phone
Date Signed2014-05-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEFF VRIEZEName
PTINP01273590PTIN
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIM TUCKERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3642740GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.AUGUSTANACARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH CARE, HOUSING AND COMMUNITY SERVICES FOR THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees326TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI181786TotalGrossUBI
Net Unrelated Business Txbl Income-42550NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7327ContributionsGrantsPriorYear
Contributions Grants Current Year295324ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9112617ProgramServiceRevenuePriorYear
Program Service Revenue CY3336634ProgramServiceRevenueCY
Investment Income Prior Year2545InvestmentIncomePriorYear
Investment Income Current Year2111InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year8671OtherRevenueCurrentYear
Total Revenue Prior Year9122489TotalRevenuePriorYear
Total Revenue Current Year3642740TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY137440GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6328765SalariesEtcPriorYear
Salaries Etc Current Year2391972SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2616194OtherExpensePriorYear
Other Expenses Current Year1161208OtherExpensesCurrentYear
Total Expenses Prior Year8944959TotalExpensesPriorYear
Total Expenses Current Year3690620TotalExpensesCurrentYear
Revenues Less Expenses Prior Year177530RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-47880RevenuesLessExpensesCY
Total Assets BOY1340698TotalAssetsBOY
Total Assets EOY471614TotalAssetsEOY
Total Liabilities BOY1169129TotalLiabilitiesBOY
Total Liabilities EOY347925TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY171569NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY123689NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO SERVE GOD BY FOSTERING FULLNESS OF LIFE FOR OLDER ADULTS AND OTHER PEOPLE IN NEEDS THROUGH THE PROVISION OF HEALTH CARE, HOUSING AND OTHER SERVICES IN A CHRISTIAN TRADITION.MissionDescription
Significant New Program Services1SignificantNewProgramServices
Significant Change1SignificantChange
Expense640611Expense
Grants137440Grants
Revenue614577Revenue
DescriptionAUGUSTANA THERAPY SERVICES PROVIDED THERAPY SERVICES FOR ALL OF AUGUSTANA'S AFFILIATED SKILLED CARE CENTERS, WITH THE EXCEPTION OF AUGUSTANA CARE MERCY, AND PEOPLE IN COMMUNITY SETTINGS. AUGUSTANA THERAPY SERVICES PROVIDED THERAPY FOR APPROXIMATELY 355 RESIDENTS FOR THE MONTH OF OCTOBER 2012. EFFECTIVE NOVEMBER 1, 2012, THIS SEGMENT OF BUSINESS WAS TRANSFERRED OUT FROM AUGUSTANA COMMUNITY PARTNERS TO AUGUSTANA SENIOR DEVELOPMENT, INC. STATING NOVEMBER 1ST, THERAPY SERVICES FOR AUGUSTANA'S AFFILIATED SKILLED CARE CENTERS, WITH THE EXCEPTION OF AUGUSTANA CARE MERCY, ARE PROVIDED BY NETWORK THERAPY SERVICES, LLC A JOINT VENTURE BETWEEN AUGUSTANA SENIOR DEVELOPMENT, INC. AND EBENEZER.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2097425Expense
Grants0Grants
Revenue2368193Revenue
DescriptionAUGUSTANA HOME HEALTH PROVIDED HOME HEALTH CARE SERVICES FOR THE ASSISTED LIVING RESIDENTS OF HERITAGE COMMONS ON POND'S EDGE AND FEENEY MANOR, WHICH CONSISTS OF 88 UNITS OF A CITY OF MINNEAPOLIS SENIOR HOUSING PROJECT. FOR THE YEAR ENDED SEPTEMBER 30,2013, AUGUSTANA HOME HEALTH SERVED 108 RESIDENTS.AUGUSTANA SIGNE BURCKHARDT PROVIDED HOME HEALTH CARE SERVICES FOR THE ASSISTED LIVING RESIDENTS OF SIGNE BURCKHARDT MANOR, WHICH CONSISTS OF 42 UNITS OF A CITY OF MINNEAPOLIS SENIOR HOUSING PROJECT. FOR THE YEAR ENDED SEPTEMBER 30, 2013, AUGUSTANA SIGNE BURCKHARDT SERVED 30 RESIDENTS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense415825Expense
Grants0Grants
Revenue353864Revenue
DescriptionAUGUSTANA'S TABLE TALK PROGRAM SERVED APPROXIMATELY 50,710 MEALS ON WHEELS DURING THE YEAR ENDED SEPTEMBER 30, 2013.Description
FieldValueIRS element (for citing)
Total Program Service Expense3153861TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation1PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees326NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCRAIG KITTELSON - AUGUSTANA CARE SENamePerson
Telephone Number6122385205TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployee
REV DR GARY WILKERSON
CHAIR1.008.00XX000
MARSHALL MACKAY
VICE CHAIR1.008.00XX000
CHARLES PARKS JR
SECRETARY1.008.00XX000
ERIC RICK ELLINGSON
TREASURER1.009.00XX000
JIM EHLEN
DIRECTOR1.008.00X000
SCOTT RAMSDALE
DIRECTOR1.008.00X000
PR ELIZABETH BEISSEL
DIRECTOR1.008.00X000
TIM TUCKER
PRESIDENT/CEO4.5040.50X031699067832
CRAIG KITTELSON
VP - FINANCE/CFO4.5040.50X025379261363
TIM MIDDENDORF
VP - OPERATIONS/COO4.5040.50X020358528605
KATHERINE KOPP
VP - NEW BUSINESS DEVELOPMENT4.5040.50022040443005X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs994771TotalReportableCompFrmRltdOrgs
Total Other Compensation200805TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA CARE SERVICESBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesMANAGEMENT SERVICESDescriptionOfServices
Compensation164193Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations290000RelatedOrganizations
Government Grants382GovernmentGrants
All Other Contributions4942AllOtherContributions
Total Contributions295324TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
HOME HEALTH62130022046942204694
THERAPY SERVICES621300614577441302173275
CATERING REVENUE7223203538641901608511$155,193
ASSISTED LIVING623000163499163499
FieldValueIRS element (for citing)
Total Program Service Revenue3336634TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2111TotalRevenueColumn
Exclusion$2,111ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMEAL INCOMEDescription
Business Code624210BusinessCode
Total Revenue Column8671TotalRevenueColumn
Exclusion$8,671ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue8671TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3642740TotalRevenueColumn
Related Or Exempt Function Income2999655RelatedOrExemptFunctionIncome
Unrelated Business Revenue181786UnrelatedBusinessRevenue
Exclusion$165,975ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total137440Total
Program Services137440ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2095852Total
Program Services1969261ProgramServices
Management And General126591ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total14001Total
Program Services13804ProgramServices
Management And General197ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total125706Total
Program Services116031ProgramServices
Management And General9675ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total156413Total
Program Services149169ProgramServices
Management And General7244ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total164193Total
Management And General164193ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total5083Total
Management And General5083ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12364Total
Management And General12364ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total111453Total
Program Services91435ProgramServices
Management And General20018ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1075Total
Management And General1075ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total39049Total
Program Services18123ProgramServices
Management And General20926ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total27659Total
Program Services27659ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total12704Total
Program Services6163ProgramServices
Management And General6541ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2343Total
Program Services519ProgramServices
Management And General1824ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1243Total
Program Services1243ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total12908Total
Program Services12908ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total30478Total
Management And General30478ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
UNREL. BUS. TAX (UBIT)5992359923
DIETARY EXPENSES587353587353
BAD DEBT EXPENSE5922959229
NURSING SUPPLIES2222622226

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total11925Total
Program Services527ProgramServices
Management And General11398ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3690620Total
Program Services3153861ProgramServices
Management And General536759ManagementAndGeneral
Fundraising0Fundraising
FieldValueIRS element (for citing)
Joint CostsXJointCosts

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY621BOY
EOY775EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY634594BOY
EOY359493EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY65660BOY
EOY7224EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis83881LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec40729LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY180207BOY
EOY43152EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY459616BOY
EOY60970EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1340698BOY
EOY471614EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY590678BOY
EOY146360EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY578451BOY
EOY201565EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1169129BOY
EOY347925EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY170744BOY
EOY123689EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY825BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY171569BOY
EOY123689EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1340698BOY
EOY471614EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-47880ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years173788CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16176CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4049CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7327CurrentTaxYearMinus1Year
Current Tax Year295324CurrentTaxYear
Total496664Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5869418CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6284908CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6323503CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6986246CurrentTaxYearMinus1Year
Current Tax Year3154848CurrentTaxYear
Total28618923Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6043206CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6301084CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6327552CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6993573CurrentTaxYearMinus1Year
Current Tax Year3450172CurrentTaxYear
Total29115587Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50929115587PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4871CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9561CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6870CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2545CurrentTaxYearMinus1Year
Current Tax Year2111CurrentTaxYear
Total25958Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4871CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9561CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6870CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2545CurrentTaxYearMinus1Year
Current Tax Year2111CurrentTaxYear
Total25958Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years95913CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years40352CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years74618CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year220941CurrentTaxYearMinus1Year
Total431824Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years1306CurrentTaxYearMinus3Years
Current Tax Year8671CurrentTaxYear
Total9977Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6143990CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6352303CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6409040CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7217059CurrentTaxYearMinus1Year
Current Tax Year3460954CurrentTaxYear
Total29583346Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98420PublicSupportPercentage509
Prior Year Support Percentage0.98080PriorYearSupportPercentage
Investment Income Percentage0.00090InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00090PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME FROM PATIENTS - 2009 AMOUNT: $ 1,306. MEAL REVENUE - 2012 AMOUNT: $ 8,671.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3789OtherCostOrOtherBasis
Depreciation629Depreciation
Book Value3160BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis80092OtherCostOrOtherBasis
Depreciation40100Depreciation
Book Value39992BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings43152TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
HCIR INSURANCE RECIPROCAL30388
DUE FROM AFFILIATES30582
FieldValueIRS element (for citing)
Total Book Value Other Assets60970TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION LIABILITY$65,656
DUE TO AFFILIATES$135,909
FieldValueIRS element (for citing)
Total Of Amounts201565TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationAUGUSTANA 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. THE TAX RETURNS FOR THE FISCAL YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA SENIOR DEVELOPMENT INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient244136110EINOfRecipient
Amount Of Non Cash Assistance137440AmountOfNonCashAssistance
Method Of ValuationFAIR MARKET VALUEMethodOfValuation
Description Of Non Cash AssistanceFIXED ASSETSDescriptionOfNonCashAssistance
Purpose Of GrantTRANSFER OF PPE TO RELATED FOR-PROFIT THERAPY SERVICES COMPANYPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: AUGUSTANA COMMUNITY PARTNERS MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. AUGUSTANA COMMUNITY PARTNERS AND THE RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITOR THE USE OF FUNDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TIM TUCKER
PRESIDENT/CEO0248658044700023632042284025548038482200
CRAIG KITTELSON
VP - FINANCE/CFO0188047034593031152033116028247031515500
TIM MIDDENDORF
VP - OPERATIONS/COO017003202391109642015920012685023219000
KATHERINE KOPP
VP - NEW BUSINESS DEVELOPMENT0170327034640015437015013027992026340900

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 3FOR THE PURPOSE OF DETERMINING COMPENSATION, AUGUSTANA COMMUNITY PARTNERS 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 - $33,534 CRAIG KITTELSON, VICE PRESIDENT OF FINANCE AND CFO - $25,061 TIM MIDDENDORF, VICE PRESIDENT OF OPERATIONS AND COO - $10,500 KATHERINE KOPP, VICE PRESIDENT OF NEW BUSINESS DEVELOPMENT - $7,500

Schedule N IRS990ScheduleN

Disposition Table DispositionTable

FieldValueIRS element (for citing)
Description Of AssetFIXTURES, FURNITURE, COMPUTERS, AND SOFTWAREDescriptionOfAsset
Date Of Distribution2012-12-17DateOfDistribution
FMV Of Asset137440FMVOfAsset
Method Of FMV DeterminationNET BOOK VALUE AS OF TRANSFER DATEMethodOfFMVDetermination
EIN264136110EIN

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA SENIOR DEVELOPMENT INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode
FieldValueIRS element (for citing)
Director Of Successor21DirectorOfSuccessor2
Employee Of Successor20EmployeeOfSuccessor2
Owner Of Successor20OwnerOfSuccessor2
Receive Compensation20ReceiveCompensation2

Form990 Schedule N Part III Form990ScheduleNPartIII (2 entries)

ExplanationExplanation
PART II, LINE 2E: REV. DR. GARY WILKERSON, MARSHALL MACKAY, CHARLES PARKS, JR., RICK ELLINGSON, JIM EHLEN, SCOTT RAMSDALE, TIM TUCKER, CRAIG KITTELSON, TIM MIDDENDORF, AND KATHERINE KOPP
PART II, LINE 2E: ALL OF THE BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES OF AUGUSTANA COMMUNITY PARTNERS SERVE AS THE BOARD MEMBERS OF THE TRANSFEREE ORGANIZATION, AUGUSTANA SENIOR DEVELOPMENT, INC.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION MISSION STATEMENTOVERALL MISSION OF 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. BECAUSE ELDERS ARE VITAL TO OUR COMMUNITIES, WE PROVIDE SERVICES TO HELP THEM CONTINUE LIVING LIFE TO THE FULLEST, GIVING US ALL THE BENEFIT OF THEIR WISDOM AND EXPERIENCE. WE OFFER A FULL SPECTRUM OF SERVICES FOR OLDER ADULTS AND SERVE MORE THAN 10,500 PEOPLE EACH YEAR IN COMMUNITIES IN MINNESOTA AND COLORADO. OUR HEALTH CARE FACILITIES PROVIDE TRANSITIONAL CARE, LONG-TERM CARE, DEMENTIA CARE, AND REHABILITATION SERVICES TO MORE THAN 4,000 PEOPLE EACH YEAR. AUGUSTANA CARE ALSO OWNS AND MANAGES A VARIETY OF LIVING COMMUNITIES SERVING OLDER ADULTS WITH COMFORTABLE LIVING AND CARE OPTIONS, INCLUDING APARTMENTS FOR INDEPENDENT LIVING, HOUSING WITH SERVICES, AND ASSISTED LIVING AND MEMORY CARE. ADDITIONALLY, WE OFFER A RANGE OF COMMUNITY-BASED SUPPORT SERVICES SUCH AS ADULT DAY PROGRAMS TO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS WHO CONTINUE TO LIVE IN THEIR OWN HOMES, AS WELL AS MANAGEMENT CONSULTING SERVICES TO OTHER ORGANIZATIONS THAT SERVE OLDER ADULTS.
NEW PROGRAM SERVICESFORM 990, PART III, LINE 2AUGUSTANA COMMUNITY PARTNERS ADDED SIGNE BURKARDT MANOR DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2013. AUGUSTANA SIGNE BURKHARDT MANOR PROVIDES HOME HEALTH SERVICES TO THE RESIDENTS OF SIGNE BURKHARDT MANOR, A SENIOR HOUSING COMMUNITY IN MINNEAPOLIS, MINNESOTA.
CHANGES IN PROGRAM SERVICESFORM 990, PART III, LINE 3THE THERAPY SERVICES SEGMENT OF AUGUSTANA COMMUNITY PARTNERS WAS TRANSFERRED TO AUGUSTANA SENIOR DEVELOPMENT, INC. AS OF NOVEMBER 1, 2012. SUBSEQUENT TO THE TRANSFER, ALL THERAPY SERVICES PROVIDED TO AUGUSTANA'S AFFILIATED CARE CENTERS, WITH THE EXCEPTION OF AUGUSTANA CARE MERCY, WERE PROVIDED BY NETWORK THERAPY SERVICES, LLC A JOINT VENTURE CREATED BY AUGUSTANA SENIOR DEVELOPMENT, INC. AND EBENEZER.
FORM 990, PART VI, SECTION A, LINE 3AUGUSTANA CARE SERVICES PROVIDES MANAGEMENT SERVICES FOR AUGUSTANA COMMUNITY PARTNERS. AUGUSTANA CARE SERVICES PROVIDES FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, STAFFING FOR FUND DEVELOPMENT, AND NEW BUSINESS DEVELOPMENT.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE ORGANIZATION IS AUGUSTANA CARE.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED BY A MAJORITY VOTE FROM THE BOARD OF DIRECTORS OF THE SOLE MEMBER, AUGUSTANA CARE.
FORM 990, PART VI, SECTION A, LINE 7BTHE 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 ENTITES 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 11THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED IN DETAIL BY THE ORGANIZATION'S VP - FINANCE/CFO. THE FORM 990 WAS THEN PRESENTED TO THE FULL BOARD BY THE VP - FINANCE/CFO PRIOR TO BEING FILED WITH THE IRS.
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. ALL COVERED INDIVIDUALS ARE REQUIRED 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 WILL BE 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
APPLE VALLEY VILLA APARTMENTS
1007 EAST 14TH STREETMINNEAPOLISMN55404311608691HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9AUGUSTANA CARE0
AUGUSTANA APARTMENTS OF HASTINGS
1007 EAST 14TH STREETMINNEAPOLISMN55404311608701HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9AUGUSTANA CARE0
AUGUSTANA CARE
1007 EAST 14TH STREETMINNEAPOLISMN55404411728753HEALTH CARE FACILITIES/SERVICESMN501(C)(3)70N/A
AUGUSTANA CARE FOUNDATION
1007 EAST 14TH STREETMINNEAPOLISMN55404411360678CHARITABLE FOUNDATIONMN501(C)(3)11 - TYPE 1AUGUSTANA CARE0
AUGUSTANA CARE SERVICES
1007 EAST 14TH STREETMINNEAPOLISMN55404411806946MANAGEMENT SERVICESMN501(C)(3)11 - TYPE 1AUGUSTANA CARE0
AUGUSTANA CHAPEL VIEW HOMES INC
1007 EAST 14TH STREETMINNEAPOLISMN55404410693953HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9AUGUSTANA CARE0
AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY
1007 EAST 14TH STREETMINNEAPOLISMN55404311608696HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9AUGUSTANA CARE0
AUGUSTANA HOME OF HASTINGS
1007 EAST 14TH STREETMINNEAPOLISMN55404311572624HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9AUGUSTANA CARE0
OPEN CIRCLE ADULT DAY CENTER
1007 EAST 14TH STREETMINNEAPOLISMN55404411424801HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9AUGUSTANA CARE0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA SENIOR DEVELOPMENT INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode
FieldValueIRS element (for citing)
EIN264136110EIN
Primary ActivityCONSULTINGPrimaryActivity
Legal Domicile StateMNLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.