NORTHERN ARIZONA SENIOR LIVING COMMUNITY LLC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
NORTHERN ARIZONA SENIOR LIVING COMMUNITY LLC (EIN 86-0906621)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-10
IRS object ID
201232239349300333
Schema version
2011v1.2
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)
Timestamp2012-08-10T09:51:38-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN411690382EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Malloy Montague Karnowski RadosevichBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15353 Wayzata Blvd Ste 410AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code55416ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860906621EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northern Arizona Senior Living Community LLCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone9523618000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11107 Hazeltine Blvd No 200AddressLine1
CityChaskaCity
StateMNState
ZIP Code55318ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDan R PeterkaName
TitleManager-Co Chief Executive OfficerTitle
Phone9523618000Phone
Date Signed2012-07-26DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameThomas M MontagueName
PTINP00089901PTIN
Phone9525450424Phone
Date Prepared2012-07-26DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDan R PeterkaNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11107 Hazeltine Blvd No 200AddressLine1
CityChaskaCity
StateMNState
ZIP Code55318ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13561686GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.thepeaks.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionThe Corporation was formed to develop and operate a senior living and mentoring facility.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees226TotalNbrEmployees
Total Nbr Volunteers7TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12310797ProgramServiceRevenuePriorYear
Program Service Revenue CY13195855ProgramServiceRevenueCY
Investment Income Prior Year304373InvestmentIncomePriorYear
Investment Income Current Year356778InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year12615170TotalRevenuePriorYear
Total Revenue Current Year13552633TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4233349SalariesEtcPriorYear
Salaries Etc Current Year4660606SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8334597OtherExpensePriorYear
Other Expenses Current Year8660343OtherExpensesCurrentYear
Total Expenses Prior Year12567946TotalExpensesPriorYear
Total Expenses Current Year13320949TotalExpensesCurrentYear
Revenues Less Expenses Prior Year47224RevenuesLessExpensesPriorYear
Revenues Less Expenses CY231684RevenuesLessExpensesCY
Total Assets BOY35289607TotalAssetsBOY
Total Assets EOY35149518TotalAssetsEOY
Total Liabilities BOY38277602TotalLiabilitiesBOY
Total Liabilities EOY37905829TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-2987995NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-2756311NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo develop and operate a senior living and mentoring facility.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11688874Expense
Revenue13186802Revenue
DescriptionThe Peaks, Flagstaff, Arizona, is unlike any senior community in the county because it shares strong ties with the Museum of Northern Arizona. The Peaks also provides its residents, as well as children in the area, with unique intergenerational activities that benefit the older adults and the children alike. Two of The Peaks residents and The Lodge executive director are docents of the museum, providing education on local history, and discoveries of the Colorado Plateau to area schools, associations, the public and Peaks residents. The Peaks also provides assisted living, progressive memory care, rehabilitation, long-term care, and skilled nursing. The Peaks offers the opportunity for residents to "age in place," which encourages the resident to remain in their apartment homes receiving assistance with activities of daily living through personalized levels of care. Northern Arizona Senior Living Community, LLC is a comprehensive senior living and healthcare campus consisting of 58 skilled nursing beds, 96 assisted living units, and 39 bungalows.Description
Total Program Service Expense11688874TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
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 Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109652NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees226NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
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
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
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 Duties0DelegationOfManagementDuties
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 Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1The Goodman Group LLCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9523618000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11107 Hazeltine BlvdAddressLine1
CityChaskaCity
StateMNState
ZIP Code55318ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Lisa Brugh
Manager1.00X000
Denise Gustafson
Manager1.00X000
Christopher Bavasi
Manager1.00X000
Mark Wilson
Manager1.00X000
Robert Breunig
Non-Voting Member1.00X000
Dan R Peterka
Co-Chief Executive Officer1.00000X
Roger S Schuler
Co-Chief Executive Officer1.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
The Goodman Group LLC
1107 Hazeltine Blvd 200ChaskaMN55318Management and Accounting Services, info1526620
Synertx
7540 North 19th Avenue Suite 200PhoenixAZ85021Therapy900248
John B Goodman Limited Partnership
1107 Hazeltine Blvd 200ChaskaMN55318Construction Management & Development141090
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Resident Services62300090861189086118
Ancillary Services62300040318504031850
Other operating revenu6230007788777887
FieldValueIRS element (for citing)
Total Program Service Revenue13195855TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column365831TotalRevenueColumn
Exclusion$365,831ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other9053Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-9053Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-9053TotalRevenueColumn
Related Or Exempt Function Income-9053RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13552633TotalRevenueColumn
Related Or Exempt Function Income13186802RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$365,831ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4272676Total
Program Services3939051ProgramServices
Management And General333625ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total51537Total
Program Services51537ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total336393Total
Program Services306440ProgramServices
Management And General29953ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total826531Total
Management And General826531ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total13989Total
Management And General13989ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total150204Total
Management And General150204ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total47403Total
Program Services47403ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1053046Total
Program Services1053046ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total292729Total
Program Services292729ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total61631Total
Program Services306ProgramServices
Management And General61325ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2168601Total
Program Services2168601ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total951183Total
Program Services951183ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total543798Total
Program Services330119ProgramServices
Management And General213679ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Contracted Services19598671959867
Dietary Food451506451506
Equipment rental & main107041107041
Miscellaneous2504525045

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total7769Total
Program Services5000ProgramServices
Management And General2769ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13320949Total
Program Services11688874ProgramServices
Management And General1632075ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1305384BOY
EOY1834696EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY123025EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1044733BOY
EOY861352EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY47951BOY
EOY45281EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY86696BOY
EOY95185EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis27337186LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8545703LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19193072BOY
EOY18791483EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY13611771BOY
EOY13398496EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY35289607BOY
EOY35149518EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY857349BOY
EOY910220EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY36400000BOY
EOY35985000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1020253BOY
EOY1010609EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY38277602BOY
EOY37905829EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2987995BOY
EOY-2756311EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-2987995BOY
EOY-2756311EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY35289607BOY
EOY35149518EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses231684ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10975483CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11616636CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12429084CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12239655CurrentTaxYearMinus1Year
Current Tax Year13186802CurrentTaxYear
Total60447660Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10975483CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11616636CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12429084CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12239655CurrentTaxYearMinus1Year
Current Tax Year13186802CurrentTaxYear
Total60447660Total

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 Total50960447660PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years690866CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1095759CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years375568CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year375515CurrentTaxYearMinus1Year
Current Tax Year365831CurrentTaxYear
Total2903539Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years690866CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1095759CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years375568CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year375515CurrentTaxYearMinus1Year
Current Tax Year365831CurrentTaxYear
Total2903539Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11666349CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12712395CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12804652CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12615170CurrentTaxYearMinus1Year
Current Tax Year13552633CurrentTaxYear
Total63351199Total
FieldValueIRS element (for citing)
Public Support Percentage5090.95420PublicSupportPercentage509
Prior Year Support Percentage0.95540PriorYearSupportPercentage
Investment Income Percentage0.04580InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.04460PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis660000OtherCostOrOtherBasis
Book Value660000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis21584034OtherCostOrOtherBasis
Depreciation5741284Depreciation
Book Value15842750BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2297237OtherCostOrOtherBasis
Depreciation1249077Depreciation
Book Value1048160BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2638872OtherCostOrOtherBasis
Depreciation1555342Depreciation
Book Value1083530BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis157043OtherCostOrOtherBasis
Book Value157043BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18791483TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
Accrued interest receivable117571
Debt service reserve2029872
Bond fund1785130
Net amortized loan costs1699002
Reserve for replacement802320
Insurance escrow97633
Advance refunding escrow6866968
FieldValueIRS element (for citing)
Total Book Value Other Assets13398496TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Security Deposits$12,500
Patient Funds$1,371
Accrued Interest$996,738
FieldValueIRS element (for citing)
Total Of Amounts1010609TotalOfAmounts
Total Revenue13552633TotalRevenue
Total Expenses13320949TotalExpenses
Excess Or Deficit For Year231684ExcessOrDeficitForYear
Excess Or Deficit Per FS231684ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt13561686TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal13561686RevenueSubtotal
Other Revenues Not Included-9053OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-9053RevenueNotRptdOnFinStmt
Total Revenue Per Form99013552633TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13330002TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal13330002ExpensesSubtotal
Other Expenses Not Included-9053OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-9053ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013320949TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:The Company is exempt from federal and state income taxes under Internal Revenue Code 501(c)(3). The Company is subject to tax on income from any unrelated business. On January 1, 2010, the Company adopted the recognition requirements for uncertain income tax positions as required by the FASB ASC 740-10 (formerly known as FASB Interpretation No. 48, Accounting for Uncertainty in Income Taxes), with no cumulative effect adjustment required. Income tax benefits are recognized for income tax positions taken or expected to be taken in a tax return, only when it is determined that the income tax position will more-likely-than-not be sustained upon examination by taxing authorities. The Company has analyzed tax positions taken for filing with the Internal Revenue Service and state jurisdiction where it operates. The Company believes that income tax filing positions will be sustained upon examination and does not anticipate any adjustments that would result in a material adverse effect on the Company's financial condition, results of operations, or cash flows. Accordingly, the Company has not recorded any reserves, or related accruals for interest and penalties for uncertain income tax positions at December 31, 2011.
Part XII, Line 4b - Other Adjustments:Loss on disposal or property and equipment -9,053.
Part XIII, Line 4b - Other Adjustments:Loss on disposal or property and equipment -9,053.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
The Industrial Development Authority of the City of Flagstaff Arizona
521293802338448AG82007-08-0130650000Refinance real estate used by organization000
The Industrial Development Authority of the City of Flagstaff Arizona
521293802338448AD52003-02-277000000Construction additions100

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount Bond DefeasedAmountBondDefeasedCapitalized InterestCapitalizedInterestCapital ExpendituresCapitalExpenditures
118000030650000205042868669686106737973872032454420070111
4850007086053587938225000250002003001165150005010005747115

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
110000
110000

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSchedule KIdentifier
Return ReferenceBond proceeds exceed par valueReturnReference
ExplanationThe bond proceeds of the 2003 bond exceeded the par value due to being sold at a premiumExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6Members
Form 990, Part VI, Section A, line 7aMembers can elect members of the governing body.
Form 990, Part VI, Section A, line 7bDecisions of the governing body are subject to approval by members.
Form 990, Part VI, Section B, line 11The Form 990 is prepared by an independent certified public accounting firm. It is then reviewed by the controller of the management company who is a CPA. The Form 990 is given to each board member in advance of a scheduled meeting of the board for their review. There is a discussion of the Form 990 at the board meeting with the preparers and the management company's representative prior to board approval of the Form 990.
Form 990, Part VI, Section B, line 12cEach member of the governing board completes a disclosure of conflict of interest questionnaire annually.
Form 990, Part VI, Section B, line 15Compensation is based on experience and market salary surveys.
Form 990, Part VI, Section C, line 19The organization makes it governing documents, conflict of interest policy and financial statements available to the public upon request.
Form 990, Part VIIRoger S. Schuler - 1200 North Beaver Street, Flagstaff, AZ 86001. Lisa Brugh - 1200 N. Beaver Street, Flagstaff, AZ 86001. Denise Gustafson - 3386 Pilot Knob Road, Eagan, MN 55121. Christopher Bavasi - Flagstaff Medical Center, PO Box 891, Flagstaff, AZ 86002. Mark Wilson - 220 South 6th Street, Suite 1800, Minneapolis, MN 55402. Robert Breunig - 3101 North Fort Valley Road, Flagstaff, AZ 86001.Contact Addresses for Officers, Directors, Etc
FORM 990, PART XII, LINE 2C:The financial statements are prepared by an independent accounting firm. The statements are reviewed and approved by the board before being issued. This process was the same as last year.
Made an effot to obtain information on compensation, if any were paid from a related organization. No responses received and no transactions noted.RELATED ORGANIZATION COMPENSATION:
FORM 990, PART VI, LINE 1A:Robert Breunig is a non-voting board member and is not included in the total for voting members.
Form 990, Part III, Line 4a Program Service AccomplishmentsThe community was developed through a nonprofit partnership between Intergenerational Living and Health Care, the Museum of Northern Arizona and Northern Arizona Healthcare. For the fiscal year ended December 31, 2011, The Peaks participated in various charitable initiatives such as the provision of discounted care through participation in the Arizona state Medicaid program. We average 18 Medicaid patients in our skilled nursing facility on a daily basis and discounted their care by $271,611 during the 2011 year. In our lodge we averaged 23 residents on a daily basis and discounted their care by $25,003 during 2011. We have a partnership with the Museum of Northern Arizona (MNA) that consists of supporting an art collection within The Peaks and three museum docent programs. We believe this art enriches the lives of our residents and the community as a whole. Each month we support the museum with an $825 monthly fee. (Value $9,900). In the budget for 2012 we added an additional $5,000 to support the programming held at The Peaks by MNA. We currently have a $7,500 endowment at Northern Arizona University within the Behavioral and Social Science Department for scholarships to students who plan careers that would support seniors. The endowment minimum was recently raised to $25,000. The Peaks participated in the American Cancer Society "Climb The Mountain" event. We sponsored several of our employees to climb the 7 mile hike up the mountain north of the Peaks. We supported Flagstaff Big Brothers and Big Sisters by sponsoring two bowling teams during their fundraiser in 2011. We also supported Northland Hospice, which is a local non-profit hospice agency, by sponsoring a hole at their annual golf tournament and fund-raiser. (Value: $2,400). During the 2011 holiday season The Peaks sponsored a food drive benefitting the Northern Arizona Food Bank.
The entity has an outstanding refunding escrow that is both an asset and liability on the books. Therefore it is not included on the Schedule K.Refunding Escrow
Form 990, Schedule K, Part II, Column B, Line 3The total proceeds received is greater than the bond issuance price as the bond was issued at a premium.

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