2012-08-10T09:51:38-05:00 2011-12-31 411690382 Malloy Montague Karnowski Radosevich 5353 Wayzata Blvd Ste 410 Minneapolis MN 55416 990 2011-01-01 860906621 Northern Arizona Senior Living Community LLC NORT 9523618000 1107 Hazeltine Blvd No 200 Chaska MN 55318 Dan R Peterka 9523618000 2012-07-26 1 Thomas M Montague P00089901 9525450424 2012-07-26 2011 2016-02-24 21:20:13Z Dan R Peterka 1107 Hazeltine Blvd No 200 Chaska MN 55318 13561686 0 X www.thepeaks.org X 1997 MN The Corporation was formed to develop and operate a senior living and mentoring facility. 6 6 226 7 0 0 0 0 12310797 13195855 304373 356778 0 0 12615170 13552633 0 0 0 0 4233349 4660606 0 0 0 8334597 8660343 12567946 13320949 47224 231684 35289607 35149518 38277602 37905829 -2987995 -2756311 X To develop and operate a senior living and mentoring facility. 0 0 11688874 13186802 The 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. 11688874 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 52 0 1 226 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 AZ X The Goodman Group LLC 9523618000 1107 Hazeltine Blvd Chaska MN 55318 X Lisa Brugh 1.00 X 0 0 0 Denise Gustafson 1.00 X 0 0 0 Christopher Bavasi 1.00 X 0 0 0 Mark Wilson 1.00 X 0 0 0 Robert Breunig 1.00 X 0 0 0 Dan R Peterka 1.00 X 0 0 0 Roger S Schuler 1.00 X 0 0 0 0 0 0 0 0 0 0 The Goodman Group LLC 1107 Hazeltine Blvd 200 Chaska MN 55318 Management and Accounting Services, info 1526620 Synertx 7540 North 19th Avenue Suite 200 Phoenix AZ 85021 Therapy 900248 John B Goodman Limited Partnership 1107 Hazeltine Blvd 200 Chaska MN 55318 Construction Management & Development 141090 3 Resident Services 623000 9086118 9086118 Ancillary Services 623000 4031850 4031850 Other operating revenu 623000 77887 77887 13195855 365831 365831 9053 -9053 -9053 -9053 13552633 13186802 0 365831 4272676 3939051 333625 51537 51537 336393 306440 29953 826531 826531 13989 13989 150204 150204 47403 47403 1053046 1053046 292729 292729 61631 306 61325 2168601 2168601 951183 951183 543798 330119 213679 Contracted Services 1959867 1959867 Dietary Food 451506 451506 Equipment rental & main 107041 107041 Miscellaneous 25045 25045 7769 5000 2769 13320949 11688874 1632075 0 1305384 1834696 123025 1044733 861352 47951 45281 86696 95185 27337186 8545703 19193072 18791483 13611771 13398496 35289607 35149518 857349 910220 36400000 35985000 1020253 1010609 38277602 37905829 X -2987995 -2756311 -2987995 -2756311 35289607 35149518 231684 0 X X 0 1 1 X 0 X 10975483 11616636 12429084 12239655 13186802 60447660 10975483 11616636 12429084 12239655 13186802 60447660 0 0 0 60447660 690866 1095759 375568 375515 365831 2903539 690866 1095759 375568 375515 365831 2903539 11666349 12712395 12804652 12615170 13552633 63351199 0.95420 0.95540 0.04580 0.04460 X 660000 660000 21584034 5741284 15842750 2297237 1249077 1048160 2638872 1555342 1083530 157043 157043 18791483 Accrued interest receivable 117571 Debt service reserve 2029872 Bond fund 1785130 Net amortized loan costs 1699002 Reserve for replacement 802320 Insurance escrow 97633 Advance refunding escrow 6866968 13398496 Security Deposits 12500 Patient Funds 1371 Accrued Interest 996738 1010609 13552633 13320949 231684 231684 13561686 0 13561686 -9053 -9053 13552633 13330002 0 13330002 -9053 -9053 13320949 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. The Industrial Development Authority of the City of Flagstaff Arizona 521293802 338448AG8 2007-08-01 30650000 Refinance real estate used by organization 0 0 0 The Industrial Development Authority of the City of Flagstaff Arizona 521293802 338448AD5 2003-02-27 7000000 Construction additions 1 0 0 1180000 30650000 2050428 6866968 610673 797387 20324544 2007 0 1 1 1 485000 6515000 7086053 587938 501000 225000 25000 5747115 2003 0 0 1 1 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0 Schedule K Bond proceeds exceed par value The bond proceeds of the 2003 bond exceeded the par value due to being sold at a premium Form 990, Part VI, Section A, line 6 Members Form 990, Part VI, Section A, line 7a Members can elect members of the governing body. Form 990, Part VI, Section A, line 7b Decisions of the governing body are subject to approval by members. Form 990, Part VI, Section B, line 11 The 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 12c Each member of the governing board completes a disclosure of conflict of interest questionnaire annually. Form 990, Part VI, Section B, line 15 Compensation is based on experience and market salary surveys. Form 990, Part VI, Section C, line 19 The organization makes it governing documents, conflict of interest policy and financial statements available to the public upon request. Contact Addresses for Officers, Directors, Etc Form 990, Part VII Roger 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. FORM 990, PART XII, LINE 2C: The financial statements are prepared by an independent accounting firm. The statements are reviewed and approved by the board before being issued. This process was the same as last year. RELATED ORGANIZATION COMPENSATION: Made an effot to obtain information on compensation, if any were paid from a related organization. No responses received and no transactions noted. 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 Accomplishments The community was developed through a nonprofit partnership between Intergenerational Living and Health Care, the Museum of Northern Arizona and Northern Arizona Healthcare. For the fiscal year ended December 31, 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. Refunding Escrow 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. Form 990, Schedule K, Part II, Column B, Line 3 The total proceeds received is greater than the bond issuance price as the bond was issued at a premium.