AUGUSTANA CARE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- AUGUSTANA CARE (EIN 41-1728753)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201342269349302554
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule K
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-14T12:58:37-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411728753 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUGUSTANA CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | AUGU | NameControl |
| Phone | 6122385225 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55404 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CRAIG KITTELSON | Name |
| Title | VP - FINANCE/CFO | Title |
| Phone | 6122385225 | Phone |
| Date Signed | 2013-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFF VRIEZE | Name |
| PTIN | P01273590 | PTIN |
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TIM TUCKER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55404 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 30208680 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.AUGUSTANACARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1991 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTHCARE, HOUSING AND COMMMUNITY SERVICES FOR THE ELDERLY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 19 | NbrIndependentVotingMembers |
| Total Nbr Employees | 910 | TotalNbrEmployees |
| Total Nbr Volunteers | 268 | TotalNbrVolunteers |
| Total Gross UBI | 834001 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1280 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1393259 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1100175 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 23186981 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 28254703 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 182521 | InvestmentIncomePriorYear |
| Investment Income Current Year | 329536 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 372810 | OtherRevenuePriorYear |
| Other Revenue Current Year | 477477 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 25135571 | TotalRevenuePriorYear |
| Total Revenue Current Year | 30161891 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 707250 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 260835 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 12502720 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 15667302 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 381522 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10543907 | OtherExpensePriorYear |
| Other Expenses Current Year | 14413212 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 23753877 | TotalExpensesPriorYear |
| Total Expenses Current Year | 30341349 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1381694 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -179458 | RevenuesLessExpensesCY |
| Total Assets BOY | 49351886 | TotalAssetsBOY |
| Total Assets EOY | 71375665 | TotalAssetsEOY |
| Total Liabilities BOY | 38834550 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 62759414 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 10517336 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8616251 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16156450 | Expense |
| Grants | 260835 | Grants |
| Revenue | 18480074 | Revenue |
| Description | EXPENSES ABOVE ARE RELATED TO DIRECT COSTS ASSOCIATED WITH ASSISTED LIVING FOR AUGUSTANA ELK RUN ASSISTED LIVING IN EVERGREEN, CO, AUGUSTANA REGENT IN BURNSVILLE, MN AND AUGUSTANA RESIDENTIAL CARE. ALSO INCLUDED ARE EXPENSES FOR EMERALD CREST, A SPECIALIZED ASSISTED LIVING PROGRAM FOR ADULTS WITH MEMORY LOSS AT FOUR SITES IN THE SUBURBAN MINNEAPOLIS AREA. AUGUSTANA EMERALD CREST EMPLOYS A MODEL OF DELIVERING STRENGTH-BASED CARE FOR INDIVIDUALS WITH MEMORY CHALLENGES IN SMALLER, HOME-LIKE RESIDENCES WHERE ONE'S DIGNITY, PRIVACY, SAFETY AND QUALITY OF LIFE CAN BE PRESERVED. COMBINED, THESE ASSISTED LIVING COMMUNITIES SERVED 479 PEOPLE DURING THE FISCAL YEAR. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 7816463 | Expense |
| Grants | 0 | Grants |
| Revenue | 8940628 | Revenue |
| Description | THE ABOVE TOTAL INCLUDES OPERATING EXPENSES FOR MERCY HEALTH CARE CENTER OF MOOSE LAKE AND AUGUSTANA LAKESIDE HEALTH CARE CENTER OF DASSEL. DURING THE FISCAL YEAR, THESE TWO RURAL FACILITIES PROVIDED LONG-TERM CARE, TRANSITIONAL CARE AND MEMORY CARE TO 564 PEOPLE. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 717806 | Expense |
| Grants | 0 | Grants |
| Revenue | 834001 | Revenue |
| Description | AS A LONGTIME PROVIDER OF SENIOR SERVICES, AUGUSTANA CARE USES THIS EXPERIENCE AND IN-DEPTH KNOWLEDGE OF THE SENIOR CARE MARKET TO PROVIDE MANAGEMENT SERVICES TO OTHER ORGANIZATIONS. EXPENSES ABOVE ARE FOR SENIOR DEVELOPMENT II, A BUSINESS UNIT OF AUGUSTANA CARE OFFERING THESE MANAGEMENT SERVICES FOR UNRELATED NOT-FOR-PROFIT HOUSING COMMUNITIES IN MINNESOTA. THESE INCLUDE BROOKSIDE MANOR IN MONTEVIDEO, EASTWOOD SENIOR LIVING IN MORA, AUGUSTANA APARTMENTS AND CARDINAL HOMES IN FERGUS FALLS, AND ST. PAUL APARTMENTS IN MINNEAPOLIS. SERVICES INCLUDE CONSULTING, MARKETING, LEADERSHIP DEVELOPMENT, INFORMATION SYSTEMS SUPPORT, HOUSING DEVELOPMENT AND EMPLOYEE RELATIONS. ALTOGETHER, THESE MANAGED FACILITIES SERVED 293 PEOPLE DURING THE FISCAL YEAR. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 24690719 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 910 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 19 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CRAIG KITTELSON - AUGUSTANA CARE SE | NamePerson |
| Telephone Number | 6122385205 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55404 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|
| REV DR GARY WILKERSON | |||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| MARSHALL MACKAY | |||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| CHARLES PARKS JR | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| ERIC RICK ELLINGSON | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| MICHELENE VERLAUTZ | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| BRUCE CRAWFORD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| LARRY KULA | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| PR DAN SIEDELMANN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JIM EHLEN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| SCOTT RAMSDALE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TOM TURNER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| STEVE SJOBLAD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| BILL SOULES | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| PR ELIZABETH BEISSEL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| NIC PUZAK | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| BERNIE CABLE-PROKOP | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ALLEN OLSON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DUANE HETLAND | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| PATRICK IRVINE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TIM TUCKER | |||||||
| PRESIDENT/CEO | 4.50 | X | 0 | 319547 | 54491 | ||
| CRAIG KITTELSON | |||||||
| VP - FINANCE/CFO | 4.50 | X | 0 | 253836 | 50711 | ||
| TIM MIDDENDORF | |||||||
| VP - OPERATIONS/COO | 4.50 | X | 0 | 205906 | 38163 | ||
| KATHERINE KOPP | |||||||
| VP - NEW BUSINESS DEVELOPMENT | 4.50 | 0 | 221780 | 40457 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1001069 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 183822 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUGUSTANA CARE SERVICES | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55404 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | MANAGEMENT SERVICES | DescriptionOfServices |
| Compensation | 1807094 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Fundraising Events | 35201 | FundraisingEvents |
| Related Organizations | 752680 | RelatedOrganizations |
| All Other Contributions | 312294 | AllOtherContributions |
| Noncash Contributions | 8036 | NoncashContributions |
| Total Contributions | 1100175 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| ASSISTED LIVING | 623000 | 18480074 | 18480074 | |
| NURSING | 623000 | 8940628 | 8940628 | |
| PAYROLL | 541200 | 566196 | 566196 | |
| CONSULTING | 541610 | 267805 | 267805 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 28254703 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 332650 | TotalRevenueColumn |
| Exclusion | $332,650 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 210252 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 210252 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 210252 | TotalRevenueColumn |
| Exclusion | $210,252 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3615 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 6729 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -3114 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -3114 | TotalRevenueColumn |
| Exclusion | -$3,114 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 95243 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 35201 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 40060 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55183 | TotalRevenueColumn |
| Exclusion | $55,183 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | -1646 | GrossSalesOfInventory |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1646 | TotalRevenueColumn |
| Exclusion | -$1,646 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| HOUSEKEEPING INCOME | 900099 | 66789 | $66,789 |
| DIETARY INCOME | 722210 | 49600 | $49,600 |
| EMERGENCY PULL CORD IN | 900099 | 38100 | $38,100 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 59199 | TotalRevenueColumn |
| Exclusion | $59,199 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 213688 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30161891 | TotalRevenueColumn |
| Related Or Exempt Function Income | 27420702 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 834001 | UnrelatedBusinessRevenue |
| Exclusion | $807,013 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245000 | Total |
| Program Services | 245000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15835 | Total |
| Program Services | 15835 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13268436 | Total |
| Program Services | 12284620 | ProgramServices |
| Management And General | 983816 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129024 | Total |
| Program Services | 73949 | ProgramServices |
| Management And General | 55075 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1305388 | Total |
| Program Services | 1058648 | ProgramServices |
| Management And General | 246740 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 964454 | Total |
| Program Services | 849158 | ProgramServices |
| Management And General | 115296 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1807094 | Total |
| Management And General | 1475241 | ManagementAndGeneral |
| Fundraising | 331853 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26969 | Total |
| Management And General | 26969 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52269 | Total |
| Management And General | 52269 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1284981 | Total |
| Program Services | 1054285 | ProgramServices |
| Management And General | 230273 | ManagementAndGeneral |
| Fundraising | 423 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 332758 | Total |
| Management And General | 318123 | ManagementAndGeneral |
| Fundraising | 14635 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 706268 | Total |
| Program Services | 541940 | ProgramServices |
| Management And General | 136084 | ManagementAndGeneral |
| Fundraising | 28244 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12648 | Total |
| Management And General | 12648 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1269298 | Total |
| Program Services | 1224542 | ProgramServices |
| Management And General | 44756 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 287281 | Total |
| Program Services | 99999 | ProgramServices |
| Management And General | 187282 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37363 | Total |
| Program Services | 11584 | ProgramServices |
| Management And General | 24199 | ManagementAndGeneral |
| Fundraising | 1580 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2754346 | Total |
| Program Services | 2754346 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2019347 | Total |
| Program Services | 2019347 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 251367 | Total |
| Management And General | 251367 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| NURSING SUPPLIES | 1170787 | 1170787 | ||
| DIETARY EXPENSES | 702735 | 702735 | ||
| LOSS ON EXTINGUISHMENT | 559008 | 559008 | ||
| LICENSES, PERMITS, FEES | 416118 | 406057 | 8794 | 1267 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 722575 | Total |
| Program Services | 177887 | ProgramServices |
| Management And General | 541168 | ManagementAndGeneral |
| Fundraising | 3520 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30341349 | Total |
| Program Services | 24690719 | ProgramServices |
| Management And General | 5269108 | ManagementAndGeneral |
| Fundraising | 381522 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2823653 | BOY |
| EOY | 3290211 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 250000 | BOY |
| EOY | 262494 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71078 | BOY |
| EOY | 83576 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1544263 | BOY |
| EOY | 2240889 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 154963 | BOY |
| EOY | 221081 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 65897934 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7959817 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38682574 | BOY |
| EOY | 57938117 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1595664 | BOY |
| EOY | 1597201 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1051939 | BOY |
| EOY | 1466593 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3177752 | BOY |
| EOY | 4275503 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49351886 | BOY |
| EOY | 71375665 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1559503 | BOY |
| EOY | 2166337 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26049196 | BOY |
| EOY | 30220163 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 153482 | BOY |
| EOY | 316624 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8599027 | BOY |
| EOY | 27836900 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2473342 | BOY |
| EOY | 2219390 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38834550 | BOY |
| EOY | 62759414 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10162820 | BOY |
| EOY | 8205195 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 208218 | BOY |
| EOY | 263221 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146298 | BOY |
| EOY | 147835 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10517336 | BOY |
| EOY | 8616251 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49351886 | BOY |
| EOY | 71375665 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -179458 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1721627 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 278227 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1620606 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5447400 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1393259 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1100175 | CurrentTaxYear |
| Total | 9839667 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 278227 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1620606 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5447400 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1393259 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1100175 | CurrentTaxYear |
| Total | 9839667 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 9839667 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 41789 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 113464 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 227245 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 381497 | CurrentTaxYearMinus1Year |
| Current Tax Year | 542902 | CurrentTaxYear |
| Total | 1306897 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 95175 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 56425 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 87916 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 126149 | CurrentTaxYearMinus1Year |
| Current Tax Year | 213688 | CurrentTaxYear |
| Total | 579353 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 11725917 | TotalSupport |
| Gross Receipts From Admissions Etc | 72274207 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.83910 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.90870 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME FROM TENANTS DIETARY INCOME FROM TENANTS HOUSEKEEPING INCOME FROM TENANTS VENDING INCOME FROM TENANTS LAUNDRY INCOME FROM TENANTS CABLE TV INCOME FROM TENANTS EMERGENCY PULL CORD INCOME FROM TENANTS MAINTENANCE INCOME PENDANT ALARM INCOME TELEPHONE INCOME | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 146298 | BeginningOfYearBalance |
| Contributions | 1537 | Contributions |
| Investment Earnings Or Losses | 9348 | InvestmentEarningsOrLosses |
| Other Expenditures | 9348 | OtherExpenditures |
| End Of Year Balance | 147835 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 145493 | BeginningOfYearBalance |
| Contributions | 815 | Contributions |
| Investment Earnings Or Losses | 8122 | InvestmentEarningsOrLosses |
| Other Expenditures | 8122 | OtherExpenditures |
| End Of Year Balance | 146298 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 110831 | BeginningOfYearBalance |
| Contributions | 34662 | Contributions |
| Investment Earnings Or Losses | 5839 | InvestmentEarningsOrLosses |
| Other Expenditures | 5839 | OtherExpenditures |
| End Of Year Balance | 145493 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 74163 | BeginningOfYearBalance |
| Contributions | 36668 | Contributions |
| Investment Earnings Or Losses | 3933 | InvestmentEarningsOrLosses |
| Other Expenditures | 3933 | OtherExpenditures |
| End Of Year Balance | 110831 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10535729 | OtherCostOrOtherBasis |
| Book Value | 10535729 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50924113 | OtherCostOrOtherBasis |
| Depreciation | 7339973 | Depreciation |
| Book Value | 43584140 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4431964 | OtherCostOrOtherBasis |
| Depreciation | 619844 | Depreciation |
| Book Value | 3812120 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6128 | OtherCostOrOtherBasis |
| Book Value | 6128 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 57938117 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATES | 440977 |
| RESIDENT TRUST FUNDS | 20951 |
| FUNDS HELD IN ESCROW | 257148 |
| BOND FUNDS | 3266026 |
| TENANT SECURITY DEPOSIT | 290401 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4275503 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATES | $544,761 |
| ASSET RETIREMENT OBLIGATION | $39,713 |
| NON-COMPETE AGREEMENT | $550,000 |
| NOTE PAYABLE TO AFFILIATE | $1,084,916 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2219390 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION HOLDS, IN TRUST, FUNDS ADVANCED BY RESIDENTS TO BE USED AT EACH RESIDENT'S DISCRETION. THE FUNDS ARE MAINTAINED IN A SEPARATE INTEREST-BEARING SAVINGS ACCOUNT AND THE ORGANIZATION HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. SECURITY DEPOSITS ARE REQUIRED FOR THE ORGANIZATION'S TENANTS AND INCLUDE RESERVED APARTMENTS IF AMOUNTS ARE PAID BEFORE THE TENANT ACTUALLY MOVES IN. | |
| PART V, LINE 4: | THE PRINCIPAL WILL BE INVESTED AND KEPT INTACT FOR PERPETUITY TO PROVIDE AN ADDITIONAL SOURCE OF INCOME. THE INCOME GENERATED WILL BE USED TO SUPPORT THE FUND DESIGNATED PROGRAM. THE ORGANIZATION'S ENDOWMENT IS HELD AND ADMINISTERED BY AUGUSTANA CARE FOUNDATION. SEE SCHEDULE R FOR ADDITIONAL DETAILS. | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: |
| PART X: | 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. THE TAX RETURNS FOR THE FISCAL YEARS 2009 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 70130 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 13934 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 56196 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 141 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 9320 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 4861 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 4128 | OtherDirectExpensesEvent1 |
| Name Of Event2 | WILD GAME DINNER | NameOfEvent2 |
| Gross Receipts Event2 | 39955 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 15325 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 24630 | GrossRevenueEvent2 |
| Food And Beverage Event2 | 12118 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 225 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 1895 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 2 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 20359 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 5942 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 14417 | GrossRevenueOtherEvents |
| Food And Beverage Other Events | 3613 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 615 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 3144 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 130444 | GrossReceiptsTotal |
| Charitable Contributions Total | 35201 | CharitableContributionsTotal |
| Gross Revenue Total Events | 95243 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 141 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 9320 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 20592 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 840 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 9167 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 40060 | DirectExpenseSummaryEvents |
| Net Income Summary | 55183 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| AUGUSTANA HOME OF HASTINGS | |||||||
| 930 WEST 16TH STREET | HASTING | MN | 55404 | 311572624 | 501(C)(3) | 115000 | GENERAL OPERATING SUPPORTING |
| AUGUSTANA CARE FOUNDATION | |||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411360678 | 501(C)(3) | 130000 | TRANSFER OF EXCESS CASH TO AUGUSTANA CARE FOUNDATION. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIP | TypeOfGrant |
| Number Of Recipients | 5 | NumberOfRecipients |
| Amount Of Cash Grant | 5707 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: AUGUSTANA CARE MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. AUGUSTANA CARE AND THE RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITOR THE USE OF THE FUNDS. RECIPIENTS OF SCHOLARSHIPS FROM THE ARGANIZATION AGREE TO THE FOLLOWING TERMS UPON ACCEPTANCE: (1) THE ORGANIZATION WILL DETERMINE THE AMOUNT OF THE SCHOLARSHIP; (2) TUITION AND ASSOCIATED COSTS WILL BE PAID UP TO A STATED AMOUNT UPON PRESENTATION BY THE RECIPIENT OF A BILLING STATEMENT AND A DETAILED VERIFICATION OF THE COST OF BOOKS (3) THE RECIPIENT WILL COMPLETE THE TRAINING FOR WHICH A SCHOLARSHIP PAYMENT WAS GRANTED WITH PROOF OF A FINAL GRADE OF A C OR BETTER, OR RECIPIENT WILL REIMBURSE THE ORGANIZATION FOR THE COST OF THE COURSE; (4) THE RECIPIENT WILL CONTINUE EMPLOYMENT WITH THE ORGANIZATION WHILE COMPLETING COURSEWORK, WITH BOTH PARTIES MAKING EVERY EFFORT TO ACCOMODATE ANY NECESSARY CHANGES IN WORK HOURSE; AND (5) UPON COMPLETION TRAINING FOR WHICH SCHOLARSHIP WAS GRANTED, THE RECIPIENT WILL WORK FOR THE ORGANIZATION AT LEAST TWO YEARS AND A MINIMUM OF 2,000 HOURS OR WILL REIMBURSE THE ORGANIZATION A PRORATED AMOUNT OF EACH SCHOLARSHIP PAYMENT RECEIVED DURING THE PREVIOUS ONE YEAR PERIOD, WHICH WILL BE DEDUCTED FOR THEIR LAST PAYCHECK. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIM TUCKER | |||||||||||||
| 0 | 247516 | 0 | 44415 | 0 | 27616 | 0 | 31283 | 0 | 23208 | 0 | 374038 | 0 | 0 |
| CRAIG KITTELSON | |||||||||||||
| 0 | 187311 | 0 | 33897 | 0 | 32628 | 0 | 23724 | 0 | 26987 | 0 | 304547 | 0 | 0 |
| TIM MIDDENDORF | |||||||||||||
| 0 | 165401 | 0 | 30123 | 0 | 10382 | 0 | 16202 | 0 | 21961 | 0 | 244069 | 0 | 0 |
| KATHERINE KOPP | |||||||||||||
| 0 | 170993 | 0 | 35721 | 0 | 15066 | 0 | 15305 | 0 | 25152 | 0 | 262237 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 - $22,708 CRAIG KITTELSON, VICE PRESIDENT OF FINANCE AND CFO - $15,958 TIM MIDDENDORF, VICE PRESIDENT OF OPERATIONS AND COO - $11,000 KATHERINE KOPP, VICE PRESIDENT OF SENIOR DEVELOPMENT - $8,000 | |
| PART III | PART I, LINE 3: FOR THE PURPOSE OF DETERMINING COMPENSATION, AUGUSTANA CARE RELIED ON A RELATED ORGANIZATION, AUGUSTANA CARE SERVICES, TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO. AUGUSTANA CARE SERVICES USED THE FOLLOWING PRACTICES TO ESTABLISH COMPENSATION FOR THE PRESIDENT/CEO: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing | CUSIP NumberCUSIPNumber |
|---|---|---|---|---|---|---|---|
| CITY OF DASSEL MN | |||||||
| 410851701 | 2010-09-15 | 1400000 | FACILITY DEVELOPMENT | 0 | 0 | 0 | |
| CITY OF VICTORIA MN | |||||||
| 410997257 | 2009-12-31 | 19125503 | FINANCE ACQUISITION OF EMERALD CARE | 0 | 0 | 0 | 92627TAIO |
| CITY OF VICTORIA MN | |||||||
| 410997257 | 2009-12-31 | 4500000 | FINANCE ACQUISITION OF EMERALD CARE | 0 | 0 | 0 | |
| DAKOTA COUNTY COMMUNITY DEVELOPMENT AGENCY | |||||||
| 411253302 | 2007-07-12 | 5176617 | ACQUIRE FACILITY | 0 | 0 | 0 | 23409VDN7 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount In Reserve FundAmountInReserveFund |
|---|---|---|---|---|---|---|---|---|---|
| 48750 | 1400000 | 28000 | 1372000 | 2011 | 0 | 0 | 1 | 1 | |
| 515503 | 19125503 | 382510 | 17322287 | 2010 | 0 | 0 | 1 | 1 | 1420706 |
| 141837 | 4500000 | 4500000 | 2010 | 0 | 0 | 1 | 1 | ||
| 91617 | 5176617 | 103532 | 4714285 | 2007 | 0 | 0 | 1 | 1 | 358800 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 1 | 0 | 0 | 0 | 0 |
| 1 | 1 | 0 | 0 | 0 | 0 |
| 1 | 1 | 0 | 0 | 0 | 0 |
| 1 | 1 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K, PART V | Identifier |
| Return Reference | PROCEDURES TO UNDERTAKE CORRECTIVE ACTION | ReturnReference |
| Explanation | AUGUSTANA CARE DOES NOT HAVE A WRITTEN POLICY IN PLACE AS OF FISCAL YEAR ENDED SEPTEMBER 30, 2012 BUT IS WORKING TO HAVE ONE IN PLACE BY FISCAL YEAR ENDING SEPTEMBER 30, 2013. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|
| CITY OF DASSEL MN | ||||||
| 410851701 | 2007-08-21 | 1500000 | ACQUIRE FACILITY | 0 | 0 | 0 |
| COLORADO HEALTH FACILITIES AUTHORITY | ||||||
| 840732932 | 2011-03-21 | 2167000 | ACQUIRE FACILITY | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 261775 | 1500000 | 30000 | 1470000 | 2007 | 0 | 0 | 1 | 1 |
| 2167000 | 2167000 | 2011 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 1 | 0 | 0 | 0 | 0 |
| 1 | 1 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SCOTT RAMSDALE | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SCOTT RAMSDALE IS PRESIDENT OF ANCHOR BANK | Relationship |
| Amount Of Transaction | 77171 | AmountOfTransaction |
| Description Of Transaction | APPLE VALLEY LAND DEVELOPMENT, A WHOLLY OWNED SUBSIDIARY OF AUGUSTANA CARE, HAS A LOAN WITH ANCHOR BANK. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION MISSION STATEMENT | OVERALL MISSION FOR 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, 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 6,000 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 3,500 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 SERVICES | FORM 990, PART III, LINE 2 | EFFECTIVE JANUARY 25, 2012 AUGUSTANA CARE BECAME THE SOLE MEMBER OF AUGUSTANA REGENT AT BURNSVILLE, LLC. BECAUSE OF THIS CHANGE IN MEMBERSHIP THE NET ASSETS WERE TRANSFERRED FROM AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY. |
| FORM 990, PART VI, SECTION A, LINE 3 | AUGUSTANA CARE SERVICES PROVIDES MANAGEMENT SERVICES FOR AUGUSTANA CARE AND ITS RELATED ORGANIZATIONS. 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 4 | DURING FEBRUARY 2012 AUGUSTANA CARE UPDATED THEIR BYLAWS TO CHANGE THE NUMBER OF VOTING BOARD MEMBERS TO 20 FROM 15. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION'S MEMBERSHIP CONSISTS OF LUTHERAN CONGREGATIONS OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA), AND OTHER CONGREGATIONS, AS ARE FROM TIME TO TIME ELECTED BY THE MEMBERS. AT ALL TIMES, A MAJORITY OF MEMBER CONGREGATIONS SHALL BE LUTHERAN CONGREGATIONS. THERE SHALL BE AT LEAST ONE MEMBER CONGREGATION OF THE ELCA AT ALL TIMES. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS THROUGH THEIR VOTING DELEGATES ELECT THE DIRECTORS AFTER CONSIDERATION OF THE SLATE OF NOMINEES SUBMITTED BY THE NOMINATING AND BOARD DEVELOPMENT COMMITTEE. | |
| FORM 990, PART VI, SECTION A, LINE 7B | AMENDMENTS TO THE ORGANIZATION'S GOVERNING DOCUMENTS MUST BE APPROVED BY AN AFFIRMATIVE VOTE OF A MAJORITY OF THE TOTAL NUMBER OF DIRECTORS HOLDING OFFICE AND BY THE AFFIRMATIVE VOTE OF A MAJORITY OF VOTING DELEGATES OF THE MEMBER CONGREGATIONS PRESENT AND VOTING AT WHICH A QUORUM OF MEMBERS IS PRESENT AND VOTING. ANY AMENDMENT WHICH RELATES TO THE REQUIREMENTS FOR AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA ARE SUBMITTED TO THE ELCA PROGRAM UNIT FOR CHURCH IN SOCIETY FOR APPROVAL. | |
| 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 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 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. 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 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. | |
| EXPLANATION FOR HOURS WORKED | FORM 990, PART VII, LINE 1A | TIM TUCKER, CRAIG KITTELSON, TIM MIDDENDORF, AND KATHERINE KOPP EACH SERVE AUGUSTANA CARE AND ITS RELATED ORGANIZATIONS. EACH INDIVIDUAL SPENDS APPROXIMATELY 4.5 HOURS PER WEEK WORKING FOR EACH OF THE RELATED ORGANIZATIONS, FOR A TOTAL OF 45 HOURS PER WEEK. REV. DR. GARY WILKERSON, CHARLES PARKS, JR., MARSHALL MACKAY, ERIC (RICK) ELLINGSON, JIM EHLEN, SCOTT RAMSDALE, AND PR. ELIZABETH BEISSEL EACH SERVE ON THE BOARD OF AUGUSTANA CARE AND ITS RELATED ORGANIZATIONS, WITH THE EXCEPTION OF AUGUSTANA CARE FOUNDATION. EACH INDIVIDUAL SPENDS APPROXIMATELY 1 HOUR PER WEEK WORKING FOR EACH OF THE RELATED ORGANIZATIONS, FOR A TOTAL OF 8 HOURS. |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 25,654. SENIOR DEVELOPMENT, INC EQUITY 3,051. TRANSFER OF REGENT TO AUGUSTANA CARE -1,750,332. TOTAL TO FORM 990, PART XI, LINE 5: -1,721,627. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| REPLACEMENT RESERVES LLC | |||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 752990222 | HOME HEALTH SERVICES | MN | 0 | 0 | AUGUSTANA CARE |
| AUGUSTANA DASSEL LAKESIDE COMMUNITY HOME LLC | |||||||||
| 439 WILLIAM AVENUE EAST | DASSEL | MN | 55325 | 208916091 | NURSING/ASSISTED LIVING FACILITY | MN | 4530190 | 6321049 | AUGUSTANA CARE |
| AUGUSTANA SENIOR DEVELOPMENT II LLC | |||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 481293891 | CONSULTING | MN | 834001 | 185728 | AUGUSTANA CARE |
| AUGUSTANA MERCY CARE CENTER LLC | |||||||||
| 710 S KENWOOD AVENUE | MOOSE LAKE | MN | 55767 | 271466676 | NURSING/ASSISTED LIVING FACILITY | MN | 5713511 | 4737482 | AUGUSTANA CARE |
| AUGUSTANA LAND DEVELOPMENT LLC | |||||||||
| 14650 GARRENTT AVENUE | APPLE VALLEY | MN | 55124 | 271456660 | LAND DEVELOPMENT | MN | 0 | 2204397 | AUGUSTANA CARE |
| AUGUSTANA ELK RUN LLC | |||||||||
| 1425 10TH AVENUE SOUTH | MINNEAPOLIS | MN | 55404 | 273219747 | ASSISTED LIVING | MN | 2174850 | 7425855 | AUGUSTANA CARE |
| AUGUSTANA EMERALD CARE LLC | |||||||||
| 451 EAST TRAVELERS TRAIL | BURNSVILLE | MN | 55337 | 271279704 | MEMORY CARE | MN | 9841811 | 26317938 | AUGUSTANA CARE |
| AUGUSTANA REGENT AT BURNSVILLE | |||||||||
| 14500 REGENT LANE | BURNSVILLE | MN | 55306 | 208915982 | ASSISTED LIVING | MN | 4181122 | 22939865 | AUGUSTANA CARE |
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| APPLE VALLEY VILLA APARTMENTS | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 311608691 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 1 |
| AUGUSTANA APARTMENTS OF HASTINGS | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 311608701 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 1 |
| AUGUSTANA CARE FOUNDATION | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411360678 | CHARITABLE FOUNDATION | MN | 501(C)(3) | 11 - TYPE I | AUGUSTANA CARE | 1 |
| AUGUSTANA CARE SERVICES | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411806946 | MANAGEMENT SERVICES | MN | 501(C)(3) | 11 - TYPE I | AUGUSTANA CARE | 1 |
| AUGUSTANA CHAPEL VIEW HOMES INC | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 410693953 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 1 |
| AUGUSTANA COMMUNITY PARTNERS | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411783680 | HOME HEALTH CARE SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 1 |
| 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 | 1 |
| AUGUSTANA HOME OF HASTINGS | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 311572624 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 1 |
| OPEN CIRCLE ADULT DAY CENTER | ||||||||||
| 1007 EAST 14TH STREET | MINNEAPOLIS | MN | 55404 | 411424801 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 9 | AUGUSTANA CARE | 1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUGUSTANA SENIOR DEVELOPMENT INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1007 EAST 14TH STREET | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55404 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264136110 | EIN |
| Primary Activity | CONSULTING | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUGUSTANA CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| AUGUSTANA CARE SERVICES | ||
| C | 745226 | CASH |
| AUGUSTANA CARE FOUNDATION | ||
| B | 130000 | CASH |
| AUGUSTANA CARE SERVICES | ||
| L | 1807094 | % OF REVENUE |
| AUGUSTANA HOME OF HASTINGS | ||
| B | 115000 | CASH |
Comments