CASSIA SERVICES: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CASSIA SERVICES (EIN 41-1806946)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-05-16
IRS object ID
201101369349302380
Schema version
2009v1.7
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)
Timestamp2011-05-16T11:29:32-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411806946EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AUGUSTANA CARE SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlAUGUNameControl
Phone6122385225Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameCRAIG KITTELSONName
TitleVP - FINANCE/CFOTitle
Phone6122385225Phone
Date Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGordon J VetschName
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11007 EAST FOURTEENTH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7779372GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.AUGUSTANACARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1995YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE MANAGEMENT SERVICES TO AUGUSTANA CARE CORPORATION AND AFFILIATES.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees56TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI82604TotalGrossUBI
Net Unrelated Business Txbl Income37532NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1500000ContributionsGrantsPriorYear
Contributions Grants Current Year1950000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5222443ProgramServiceRevenuePriorYear
Program Service Revenue CY5745099ProgramServiceRevenueCY
Investment Income Prior Year119InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year46082OtherRevenuePriorYear
Other Revenue Current Year84273OtherRevenueCurrentYear
Total Revenue Prior Year6768644TotalRevenuePriorYear
Total Revenue Current Year7779372TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1737084GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1015203GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4191857SalariesEtcPriorYear
Salaries Etc Current Year4701716SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year868657OtherExpensePriorYear
Other Expenses Current Year957347OtherExpensesCurrentYear
Total Expenses Prior Year6797598TotalExpensesPriorYear
Total Expenses Current Year6674266TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-28954RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1105106RevenuesLessExpensesCY
Total Assets BOY2124912TotalAssetsBOY
Total Assets EOY2525140TotalAssetsEOY
Total Liabilities BOY4125536TotalLiabilitiesBOY
Total Liabilities EOY3420658TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-2000624NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-895518NetAssetsOrFundBalancesEOY
Mission DescriptionTO ASSIST IN CARRYING OUT THE CHARITABLE PURPOSES OF AUGUSTANA CARE CORPORATION AND AFFILIATES BY PROVIDING MANAGEMENT SERVICES TO THE RELATED ORGANIZATIONS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6674266Expense
Grants1015203Grants
Revenue5745099Revenue
DescriptionHousing. Augustana Care owns and manages a variety of older adult living communities in Minnesota. Each of the campuses has comfortable living and care options for older adults. Housing options include apartments for independent living, housing with services, and assisted living. In 2010, 1,617 older adults resided in housing either owned or managed by Augustana Care. Expenses shown are for the Augustana Care Services portion of expenses related to management of the housing communities.Description

Activity2 Activity2

FieldValueIRS element (for citing)
DescriptionHealth Care. Augustana Cares health care facilities in Minneapolis, Apple Valley, Hastings, Hopkins, Moose Lake and Dassel provide transitional care, long-term care, dementia care, and rehabilitation serves. In fiscal year 2010, 3,545 people received compassionate care at these facilities. The expense total reflects Augustana Care Servicess portion of expenses related to management of the health care centers.Description

Activity3 Activity3

FieldValueIRS element (for citing)
DescriptionAugustana Care offers a range of community-based support services to enhance the quality of life for older adults who continue to live in their own homes. More than 986 people received these community-based services during the last fiscal year. The total reflects the Augustana Care Services portion of expenses related to management of these community-based services.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionAugustana Cares mission is to foster fullness of life for older adults and others in need through the provision of healthcare, housing and other services. Augustana Care helps people stay connected to the things that bring meaning to their lives as they age so they can continue sharing and adding to their personal stories. We offer a full spectrum of services for older adults and serve more than 6,000 people each year. Augustana Care Services provides management services for the organizations affiliated entities that deliver housing, healthcare and community-based services.Description
FieldValueIRS element (for citing)
Total Program Service Expense6674266TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096179NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees56NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CRAIG KITTELSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6122385205TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
PR GARY WILKERSON
CHAIR1.00XX000
MARSHALL MACKAY
VICE CHAIR1.00XX000
PR ELIZABETH BEISSEL
VICE CHAIR1.00XX000
CHARLES PARKS JR
SECRETARY1.00XX000
ERIC RICK EILLINGSON
TREASURER1.00XX000
DEAN SCHUMANN
SECRETARY/TREASURER1.00XX000
DAVID JEBENS
DIRECTOR1.00X000
DON JACOBSON
DIRECTOR1.00X000
JIM EHLEN
DIRECTOR1.00X000
KURT GALENTI
DIRECTOR1.00X000
SCOTT RAMSDALE
DIRECTOR1.00X000
TIM TUCKER
PRESIDENT/CEO4.50X316400062817
CRAIG KITTELSON
VP - FINANCE/CFO4.50X251192059945
TIM MIDDENDORF
VP - OPERATIONS/COO4.50X196561043531
KATHERINE KOPP
VP - SENIOR DEVELOPMENT4.50215248033372X
MICHAEL JOHNSON
VP & DIRECTOR OF HR4.50138411050520X
BRIDGET GIBSON
CONTROLLER4.50132082028242X
KAY GUDMESTAD
VP - FUND DEVELOPMENT4.50109925027006X
SHARON WILSON
CORPORATE COMPLIANCE OFFICER4.50119280012575X
SHAWN JOHNSON
IT DIRECTOR4.50107345023860X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1586444TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation341868TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LARSONALLEN LLP
220 SOUTH 6TH STREETMINNEAPOLISMN55404AUDITING AND CONSULTING SERVICES294034
DART CHART SYSTEMS LLC
3825 GREEN TREE ROADMILWAUKEEWI53209MEDICAL RECORD CHARTING262584
VOIT KLEGON & RODE LLC
2550 UNIVERSITY AVE WST PAULMN55114LEGAL SERVICES152948
REINHART FOOD SERVICES
13400 COMMERCE BLVDROGERSMN55374FOOD SUPPLY114454
LUTHERAN SERVICES IN AMERICA
700 LIGHT STREETBALTIMOREMD21230CONSULTING SERVICES104397
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K
Related Organizations1950000RelatedOrganizations
Total Contributions1950000TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
CENTRAL OFFICE FEE5610005669888564738822500
INFO. TECH CONSULTING541519728321510757725
NURSING CONSULTING54190023792379
FieldValueIRS element (for citing)
Total Program Service Revenue5745099TotalProgramServiceRevenue

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column84273TotalRevenueColumn
Exclusion$84,273ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue84273TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7779372TotalRevenueColumn
Related Or Exempt Function Income5662495RelatedOrExemptFunctionIncome
Unrelated Business Revenue82604UnrelatedBusinessRevenue
Exclusion$84,273ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1002722Total
Program Services1002722ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total12481Total
Program Services12481ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1195609Total
Program Services1195609ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2893686Total
Program Services2893686ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total110115Total
Program Services110115ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total261125Total
Program Services261125ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total241181Total
Program Services241181ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total13779Total
Program Services13779ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total13036Total
Program Services13036ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total112318Total
Program Services112318ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total189447Total
Program Services189447ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total251414Total
Program Services251414ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total130786Total
Program Services130786ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total23714Total
Program Services23714ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total19264Total
Program Services19264ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total161892Total
Program Services161892ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total2400Total
Program Services2400ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
INCOME TAXES1470914709
DUES AND SUBSCRIPTIONS1104411044
RECRUITING/RETENTION92199219
DIETARY EXPENSES21932193
LICENSES, PERMITS, FEES19391939

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total193Total
Program Services193ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6674266Total
Program Services6674266ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1176999BOY
EOY1227836EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY40393BOY
EOY144417EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY68408BOY
EOY73926EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1357350LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec923625LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY411959BOY
EOY433725EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY427153BOY
EOY645236EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2124912BOY
EOY2525140EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2266820BOY
EOY2265564EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1858716BOY
EOY1155094EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4125536BOY
EOY3420658EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2000624BOY
EOY-895518EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-2000624BOY
EOY-895518EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2124912BOY
EOY2525140EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (9 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocAmountAmount
APPLE VALLEY VILLA APTS
31160869191$195,401
APTS OF HASTINGS
31160870191$65,963
AUGUSTANA CARE
41172875391$1,617,902
AUGUSTANA CARE FOUND
41136067811 - TYPE 11$462,615
CHAPEL VIEW HOMES
41069395391$2,252,502
COMMUNITY PARTNERS
41178368091$391,770
HCC OF APPLE VALLEY
31160869691$1,145,673
HOME OF HASTINGS
31157262491$429,672
OPEN CIRCLE
41142480191$49,415
FieldValueIRS element (for citing)
Total Number Of Supported Orgs9TotalNumberOfSupportedOrgs
Sum Of Amounts6610913SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10666OtherCostOrOtherBasis
Depreciation5101Depreciation
Book Value5565BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1346684OtherCostOrOtherBasis
Depreciation918524Depreciation
Book Value428160BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings433725TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RECEIVABLE FROM COLLATERALIZED ASSIGNMENT505188
DUE FROM AFFILIATES140048
FieldValueIRS element (for citing)
Total Book Value Other Assets645236TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDEFERRED COMPENSATION LIABILITYDescription
Amount$1,155,094Amount
FieldValueIRS element (for citing)
Total Of Amounts1155094TotalOfAmounts

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AUGUSTANA CARE
1007 EAST 14TH STREETMINNEAPOLISMN55404411728753501(C)(3)552722GENERAL OPERATING SUPPORT
AUGUSTANA CARE FOUNDATION
1007 EAST 14TH STREETMINNEAPOLISMN55404411360678501(C)(3)450000GENERAL OPERATING SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPSTypeOfGrant
Number Of Recipients3NumberOfRecipients
Amount Of Cash Grant12481AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: AUGUSTANA CARE SERVICES MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS IN THE FORM OF FORGIVENESS OF INTERCOMPANY RECEIVABLES RELATED TO DAILY OPERATIONS. AUGUSTANA CARE SERVICES AND THE RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITOR THE USE OF THE FUNDS. RECIPIENTS OF SCHOLARSHIPS RECEIVED FROM THE ORGANIZATION 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 FROM THE EDUCATIONAL INSTITUTION, AND A DETAILED VERIFICATION OF THE COSTS OF BOOKS; (3) THE RECIPIENT WILL COMPLETE THE TRAINING FOR WHICH A SCHOLARSHIP PAYMENT WAS GRANTED WITH PROOF OF A FINAL GRADE OF 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 ACCOMMODATE ANY NECESSARY CHANGES IN WORK HOURS; AND (5) UPON COMPLETION OF TRAINING FOR WHICH A SCHOLARSHIP PAYMENT IS MADE, THE RECIPIENT WILL WORK FOR THE ORGANIZATION FOR TWO YEARS WITH A MINIMUM OF 2,000 HOURS OR WILL REIMBURSE THE ORGANIZATION A PRO-RATED AMOUNT OF THE SCHOLARSHIP PAYMENT RECEIVED DURING, WHICH WILL BE DEDUCTED FROM THE RECIPIENT'S FINAL PAYCHECK.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TIM TUCKER
2470160425930267910380490247680379217000
CRAIG KITTELSON
1850110345070316740295980303470311137000
TIM MIDDENDORF
167002021877076820216100219210240092000
KATHERINE KOPP
1719940285450147090196970136750248620000
MICHAEL JOHNSON
109405019040099660204960300240188931000
BRIDGET GIBSON
11908201300000082620199800160324000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4aReturnReference
ExplanationPART I, LINE 4B: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: 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 - $12,500 KATHERINE KOPP, VICE PRESIDENT OF SENIOR DEVELOPMENT - $9,500 MICHAEL JOHNSON, VICE PRESIDENT & EXECUTIVE DIRECTOR OF HR - $12,500Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonKATY KITTELSONNamePerson
FieldValueIRS element (for citing)
RelationshipFAMILY MEMBER OF AN OFFICERRelationship
Amount Of Transaction10181AmountOfTransaction
Description Of TransactionCOMPENSATION PAID FOR EMPLOYMENT OF AUGUSTANA CARE SERVICES.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 4Changes were made to all governing documents of all legal entities in the organization. Changes included: 1.) Updates for consistency among entities 2.) Updates for changes in state law and ELCA affiliation standards 3.) Updates for improving governance focus on strategic direction and robust leadership 4.) Updates for consistency with third party financing requirements No changes in fundamental inter-entity control relationships or tax exemption considerations were made.
Form 990, Part VI, Section A, line 6THE SOLE MEMBER OF THE ORGANIZATION IS AUGUSTANA CARE.
Form 990, Part VI, Section A, line 7aTHE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED BY A MAJORITY VOTE FROM THE BOARD OF DIRECTORS OF THE SOLE MEMBER, AUGUSTANA CARE, AT THE ANNUAL MEETING.
Form 990, Part VI, Section A, line 7bTHE FOLLOWING ACTIONS REQUIRE AFFIRMATIVE APPROVAL FROM THE SOLE MEMBER OF THE ORGANIZATION, AUGUSTANA CARE: (A) AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THIS CORPORATION; (B) CAPITAL BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, AND ALL MAJOR EXPENDITURES BEFORE FUNDS ARE EXPENDED THEREFOR; (C) OPERATING BUDGETS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, BEFORE AUTHORIZED EXPENDITURES MAY BE MADE THEREFROM; (D) STRATEGIC PLANS OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSIHPS, AND OTHER LEGAL ENTITIES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION; (E) THE INCURRING OF ANY LONG TERM DEBT OF THIS CORPORATION AND ALL CORPORATIONS, PARTNERSHIPS, AND OTHER LEGAL ENTITES DIRECTLY OR INDIRECTLY CONTROLLED BY THIS CORPORATION, OTHER THAN INTRA-SYSTEM OR REFINANCING DEBT; (F) HUMAN RESOURCES AND BENEFITS POLICIES OF THIS CORPORATION; (G) MAJOR RISK CONTRACTING AGREEMENTS, WHICH FOR THESE PURPOSES MEANS ANY CONTRACT WHICH DEALS WITH CAPITATION OR SIMILAR RISK BEARING CONCEPT; (H) MERGER, CONSOLIDATION, OR TOTAL OR PARTIAL DISSOLUTION INVOLVING THIS CORPORATION; (I) GOVERNANCE AND ACTION OF THE TYPE SET FORTH IN SUBPARAGRAPH (A) AND SUBPARAGRAPHS (F) THROUGH (H) ABOVE AS PROPOSED BY THE BOARD OF DIRECTORS OF ANY CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITES DIRECTLY CONTROLLED BY THIS CORPORATION AS A MEMBER, SHAREHOLDER OR OTHERWISE, TO THE EXTENT THAT THE GOVERNING DOCUMENTS OF SUCH CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITIES GIVE THIS CORPORATION OR THE BOARD A RIGHT OF APPROVAL OVER SUCH GOVERNANCE ACTION.
Form 990, Part VI, Section B, line 11THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED IN DETAIL BY THE ORGANIZATION'S VP - FINANCE/CFO. THE FORM 990 WAS THEN PRESENTED TO THE FULL BOARD BY THE VP - FINANCE/CFO PRIOR TO BEING FILED WITH THE IRS.
Form 990, Part VI, Section B, line 12cTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND EMPLOYEES. ALL COVERED INDIVIDUALS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT. ALL COVERED INDIVIDUALS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST TO THE APPROPRIATE LEVEL OF MANAGEMENT OR TO THE BOARD OF DIRECTORS AS OUTLINED IN THE POLICY, BASED ON THE INDIVIDUAL'S POSITION WITHIN THE ORGANIZATION. CONFLICTS ARE DETERMINED AT THE APPROPRIATE LEVEL OF MANAGEMENT OR BY THE BOARD OF DIRECTORS. INDIVIDUALS WITH ACTUAL OR POTENTIAL CONFLICTS WILL ABSTAIN FROM DISCUSSING OR VOTING ON ANY MATTERS RELATING TO THE CONFLICT. ALL PROCEEDINGS RELATING TO ACTUAL OR POTENTIAL CONFLICTS WILL BE NOTED IN THE MEETING MINUTES.
Form 990, Part VI, Section B, line 15THE COMPENSATION OF THE PRESIDENT/CEO AND ALL OTHER SENIOR STAFF IS ESTABLISHED BY THE AUGUSTANA CARE SERVICES BOARD OF DIRECTORS BASED ON APPROPRIATE COMPARABILITY DATA PROVIDED BY A PROFESSIONAL COMPENSATION CONSULTANT. THE COMPENSATION STUDY WAS LAST PERFORMED IN 2008 AND AUGUSTANA RECEIVES UPDATES EACH YEAR SINCE THEN AS THE ORGANIZATION HAS BEEN IN A WAGE FREEZE. FOR ALL OFFICERS AND KEY EMPLOYEES, THE PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2010.
Form 990, Part VI, Section C, line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, LINE 1ATIM TUCKER, CRAIG KITTELSON, TIM MIDDENDORF, KATHERINE KOPP, KAY GUDMESTAD, SHARON WILSON, MICHAEL JOHNSON, BRIDGET GIBSON, AND SHAWN JOHNSON EACH SERVE AUGUSTANA CARE SERVICES AND ITS RELATED ORGANIZATIONS. EACH INDIVIDUAL SPEND APPROXIMATELY 4.5 HOURS PER WEEK WORKING FOR EACH OF THE RELATED ORGANIZATIONS, FOR A TOTAL OF 45 HOURS PER WEEK.EXPLANATION FOR HOURS WORKED

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
APPLE VALLEY VILLA APARTMENTS
1007 EAST 14TH STREETMINNEAPOLISMN55404311608691HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9N/A
AUGUSTANA APARTMENTS OF HASTINGS
1007 EAST 14TH STREETMINNEAPOLISMN55404311608701HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9N/A
AUGUSTANA CARE
1007 EAST 14TH STREETMINNEAPOLISMN55404411728753HEALTH CARE FACILITIES/SERVICESMN501(C)(3)7N/A
AUGUSTANA CARE FOUNDATION
1007 EAST 14TH STREETMINNEAPOLISMN55404411360678CHARITABLE FOUNDATIONMN501(C)(3)11 - TYPE 1N/A
AUGUSTANA CHAPEL VIEW HOMES INC
1007 EAST 14TH STREETMINNEAPOLISMN55404410693953HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9N/A
AUGUSTANA COMMUNITY PARTNERS
1007 EAST 14TH STREETMINNEAPOLISMN55404411783680HOME HEALTH CARE SERVICESMN501(C)(3)9N/A
AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY
1007 EAST 14TH STREETMINNEAPOLISMN55404311608696HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9N/A
AUGUSTANA HOME OF HASTINGS
1007 EAST 14TH STREETMINNEAPOLISMN55404311572624HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9N/A
OPEN CIRCLE ADULT DAY CENTER
1007 EAST 14TH STREETMINNEAPOLISMN55404411424801HEALTH CARE FACILITIES/SERVICESMN501(C)(3)9N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

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

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11007 EAST 14TH STREETAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55404ZIPCode
FieldValueIRS element (for citing)
EIN481293891EIN
Primary ActivityCONSULTINGPrimaryActivity
Legal Domicile StateMNLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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