2023-05-09T08:59:15-05:00 2022-06-30 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2021-07-01 831746407 MOSAIC SENIOR SERVICES INC MOSA 4028963884 4980 S 118TH ST LIND CENTER A OMAHA NE 68137 SCOTT HOFFMAN CHIEF FINANCIAL OFFICER 4028963884 2023-05-08 1 SCOTT HOFFMAN 999009999 WENDY R COOLEY CPA P01523804 4023302660 2023-05-08 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z SCOTT HOFFMAN 4980 S 118TH ST LIND CENTER A OMAHA NE 68137 14498610 0 X WWW.SOREO.COM X 2018 AZ MOSAIC SENIOR SERVICES IS PRIMARILY FUNDED THROUGH MEDICAID AND PROVIDES DIRECT CARE SERVICES TO INDIVIDUALS WITH VARYING NEEDS. SERVICES ARE INDIVIDUALIZED TO MEET THE NEEDS OF THE INDIVIDUAL, ALLOWING THEM TO REMAIN AT HOME AND TO WORK AND PARTICIPATE IN ACTIVITIES IN THEIR COMMUNITY. 5 0 0 0 0 0 196188 1080022 15304216 13300544 0 0 0 118044 15500404 14498610 0 0 0 0 987260 1565655 0 0 0 13012237 10924097 13999497 12489752 1500907 2008858 13220331 12548882 8044726 4362875 5175605 8186007 NONE 0 0 11243061 13418588 MOSAIC SENIOR SERVICES IS PRIMARILY FUNDED THROUGH MEDICAID AND PROVIDES DIRECT CARE SERVICES TO INDIVIDUALS WITH VARYING NEEDS. SERVICES ARE INDIVIDUALIZED TO MEET THE NEEDS OF THE INDIVIDUAL, ALLOWING THEM TO REMAIN AT HOME AND TO WORK AND PARTICIPATE IN ACTIVITIES IN THEIR COMMUNITY. 11243061 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 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 1 0 0 0 1 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X SCOTT HOFFMAN 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 LINDA TIMMONS PRESIDENT 0.10 39.90 X X 0 613998 6847 SCOTT HOFFMAN TREASURER 0.10 39.90 X X 0 354597 32482 MIKE LYONS SECRETARY 0.10 39.90 X X 0 259393 25895 HEATHER GUNN DIRECTOR 0.10 39.90 X 0 215813 25191 JEN ZAJICEK DIRECTOR 0.10 39.90 X 0 155356 24488 0 1599157 114903 0 0 1 0 DESERT LAB STUDIO LLC 5215 N SABINO CANYON RD TUCSON AZ 85750 COMPUTER CONSULTING 323000 1 1080022 1080022 PROGRAM SERVICE REVENUE 624100 13300096 13300096 448 448 13300544 BAD DEBT ADJUSTMENT 900099 118044 118044 118044 14498610 13418588 0 0 X 1422445 1422445 70787 70787 72423 72423 1246228 1246228 8195616 8195153 463 22858 22858 275470 275470 85680 85680 2193 2193 129019 129019 722143 722143 235587 235587 DUES, SUBSCRIPTIONS, LI 9114 9114 MISCELLANEOUS EXPENSE 189 189 12489752 11243061 1246691 0 6717 2090010 1086714 1736136 3876073 1446354 5847 81640 67572 29343 14068 8187674 7211514 33810 44953 13220331 12548882 220160 554931 7824566 3807944 8044726 4362875 X 5175605 8186007 5175605 8186007 13220331 12548882 X 2008858 1001544 X X 0 1 X 1 0 X X X 1 MOSAIC 113669999 10 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 81640 67572 14068 14068 DUE TO MOSAIC 243514 LOAN PAYABLE TO AFFILIATE 1474170 LEASE LIABILITY 44952 REFUNDABLE ADVANCES 2045308 3807944 X PART X, LINE 2: ALL CONSOLIDATED AFFILIATED ENTITIES, EXCEPT FOR MOSAIC HOUSING CORP V, INC., EASE-E MEDICAL, INC. (EASE-E), BICO AND LISS, LLC ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN MOSAIC'S TAX EXEMPT STATUS. MOSAIC HOUSING CORP V, INC. IS A FOR-PROFIT TAXABLE CORPORATION AND HAD NO MATERIAL OPERATIONS OR INCOME. EASE-E IS A FOR-PROFIT TAXABLE CORPORATION. EASE-E HAD NET INCOME DURING 2022 AND 2021. INCOME TAX REFUNDS AND DEFERRED TAX LIABILITIES ARE CONSIDERED IMMATERIAL AND ARE INCLUDED IN OTHER RECEIVABLES AND OTHER ACCRUED EXPENSES, RESPECTIVELY, ON THE CONSOLIDATED BALANCE SHEETS. BICO WAS INCORPORATED UNDER THE LAWS OF BERMUDA, WHICH DO NOT REQUIRE INCOME TAXES. LISS, LLC ELECTED TO BE TAXED UNDER THE PROVISIONS OF SUBCHAPTER S AND IS CONSIDERED A DISREGARDED ENTITY UNDER THE INTERNAL REVENUE CODE SINCE ITS SOLE MEMBER IS MOSAIC. MOSAIC WOULD BE RESPONSIBLE IF ANY FEDERAL INCOME TAXES WERE ASSESSED ON LISS, LLC'S INCOME. MOSAIC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2022 AND 2021, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE FINANCIAL STATEMENTS OTHER THAN DESCRIBED PREVIOUSLY. 0 0 0 0 0 0 0 0 0 LINDA TIMMONS PRESIDENT 0 486127 0 123724 0 4147 0 -31879 0 38726 0 620845 0 0 SCOTT HOFFMAN TREASURER 0 301014 0 52416 0 1167 0 6458 0 26024 0 387079 0 0 MIKE LYONS SECRETARY 0 222374 0 36500 0 519 0 14231 0 11664 0 285288 0 0 HEATHER GUNN DIRECTOR 0 195193 0 20000 0 620 0 7707 0 17484 0 241004 0 0 JEN ZAJICEK DIRECTOR 0 146429 0 8150 0 777 0 4064 0 20424 0 179844 0 0 SCHEDULE J, PART I, LINE 3: THE SALARIES OF LINDA TIMMONS AND SCOTT HOFFMAN ARE PAID FROM A RELATED ORGANIZATION, MOSAIC. MS. TIMMONS SERVES AS CEO OF MOSAIC. MR. HOFFMAN SERVES AS CFO OF MOSAIC. THE SALARY FOR MS. TIMMONS IS SET BY THE MOSAIC EXECUTIVE COMMITTEE AND MOSAIC BOARD OF DIRECTORS. MR. HOFFMAN'S SALARY IS SET BY THE CEO OF MOSAIC WORKING WITHIN THE SALARY RANGES ESTABLISHED BY THE EXECUTIVE COMMITTEE. MOSAIC'S BOARD AND EXECUTIVE COMMITTEE USE AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, AND A COMPENSATION SURVEY IN ESTABLISHING THE COMPENSATION OF THE PRESIDENT AND CEO OF MOSAIC AND GUIDELINES FOR OTHER KEY STAFF. SCHEDULE J, PART II, COLUMN C: MOSAIC EVALUATES THE LIABILITY RELATED TO THEIR POSTRETIREMENT BENEFITS (SALARY AND HEALTH INSURANCE CONTINUATION) THROUGH AN ACTUARIAL REVIEW. THE ADJUSTMENT IS INCLUDED IN RETIREMENT AND OTHER DEFERRED COMPENSATION. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE ONE MEMBER, MOSAIC, A NEBRASKA NON-PROFIT PUBLIC BENEFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MOSAIC BOARD OF DIRECTORS APPOINTS OR ELECTS MOSAIC SENIOR SERVICES' BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION REQUIRE APPROVAL BY A MAJORITY OF THE MOSAIC BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY MOSAIC SENIOR SERVICE'S OUTSIDE INDEPENDENT AUDIT FIRM. THE RETURN IS REVIEWED BY MOSAIC SENIOR SERVICE'S TREASURER AND THE OUTSIDE INDEPENDENT AUDIT FIRM. A COPY IS SHARED WITH THE BOARD OF DIRECTORS PRIOR TO FILING FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, EACH BOARD DIRECTOR COMPLETES A CONFLICT OF INTEREST FORM AND SUBMITS IT TO THE CHAIRPERSON OF THE MOSAIC BOARD INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE CHIEF FINANCIAL OFFICER/TREASURER FOR REPORTING ON THE FORM 990, IF APPROPRIATE. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 MOSAIC SENIOR SERVICES DOES NOT HAVE ANY EMPLOYEES, AND THEREFORE, THERE IS NOT AN ESTABLISHED PROCESS FOR DETERMINING COMPENSATION OF OFFICERS OR OTHER EMPLOYEES. THE FOLLOWING IS THE PROCEDURE USED BY MOSAIC, MOSAIC SENIOR SERVICES' SOLE MEMBER: THE BOARD OF DIRECTORS ESTABLISHED AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR: CONTRACTING WITH AN INDEPENDENT CONSULTANT TO DOCUMENT COMPARABLE COMPENSATION LEVELS PAID TO EXECUTIVES WITH SIMILAR POSITIONS AND RESPONSIBILITIES IN SIMILAR ORGANIZATIONS, HELPING THE COMMITTEE APPLY MOSAIC'S COMPENSATION PHILOSOPHY TO THE MARKET SURVEY DATA TO IDENTIFY SUPPORTABLE COMPENSATION LEVELS AND COMPENSATION RANGES, AND OPINING IN ADVANCE THAT RESULTING COMPENSATION RANGES ARE REASONABLE COMPENSATION. THE COMPENSATION CONSULTANT WILL ALSO ADVISE AND OPINE ON BENEFIT DESIGN, BENEFIT OPTIONS, AND REASONABLENESS OF BENEFIT AMOUNTS AS ELEMENTS OF COMPENSATION. THE EXECUTIVE COMMITTEE WILL ADOPT A COMPENSATION PHILOSOPHY FOR OFFICERS AND KEY EMPLOYEES GUIDED BY THE CONSULTANT'S INFORMATION AND USE THE COMPENSATION PHILOSOPHY TO APPROVE THE COMPENSATION OF THE CEO, APPROVE THE COMPENSATION RANGES FOR OTHER OFFICERS AND KEY EMPLOYEES, AND REPORT ITS ACTIONS TO THE FULL BOARD. THE CEO, WORKING WITHIN SALARY RANGES APPROVED BY THE EXECUTIVE COMMITTEE, SETS THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. MINUTES, DOCUMENTATION OF INDEPENDENT CONSULTANT COMPARABILITY DATA AND RECOMMENDATIONS ARE MAINTAINED AS PART OF THE RECORD OF THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 MOSAIC SENIOR SERVICES DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 463. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 463. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 60,569. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,569. CONTRACTED INDIVIDUAL CARE SERVICES: PROGRAM SERVICE EXPENSES 8,134,584. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,134,584. FORM 990, PART XI, LINE 9: OTHER TRANSFER OF LIABILITIES -464,328. EQUITY TRANSFER FROM MOSAIC 1,465,872. FORM 990, PART XII, LINE 2C: THE MOSAIC FINANCE AND AUDIT COMMITEE OVERSEES THE AUDIT & SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC 4980 S 118 STREET OMAHA NE 68137 113669999 SERVICES FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES NE 501(C)(3) LINE 10 N/A 0 MOSAIC FOUNDATION 4980 S 118 STREET OMAHA NE 68137 363837360 FUNDRAISING & INVESTMENT ASSET MANAGEMENT NE 501(C)(3) LINE 12A, I MOSAIC 0 OAKS OF DUNN COUNTY INC 4980 S 118 STREET OMAHA NE 68137 391913323 SENIOR LIVING SERVICES WI 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP I 4980 S 118 STREET OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP II 4980 S 118 STREET OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP IV 4980 S 118 STREET OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP VII 4980 S 118 STREET OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP VIII 4980 S 118 STREET OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP IX 4980 S 118 STREET OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP X 4980 S 118 STREET OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XI 4980 S 118 STREET OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XII 4980 S 118 STREET OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XIII 4980 S 118 STREET OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XIV - ROCKFORD 4980 S 118 STREET OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XV - COUNCIL BLUFFS 4980 S 118 STREET OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XVI - FARMINGTON 4980 S 118 STREET OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XVII - BEATRICE 4980 S 118 STREET OMAHA NE 68137 261710013 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XVIII - OSCEOLA-WAUKON 4980 S 118 STREET OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XIX - WINFIELD 4980 S 118 STREET OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XX - GARDEN CITY 4980 S 118 STREET OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XXI - MEMPHIS 4980 S 118 STREET OMAHA NE 68137 264555313 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORP XXII - LOGAN 4980 S 118 STREET OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC HOUSING CORPORATION XXIII - AUSTIN 4980 S 118 STREET OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC ILLINOIS HOUSING I 4980 S 118 STREET OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC ILLINOIS HOUSING II 4980 S 118 STREET OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC ILLINOIS HOUSING AT MACOMB I 4980 S 118 STREET OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC ILLINOIS HOUSING OF ROCKFORD I 4980 S 118 STREET OMAHA NE 68137 204841856 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 0 MOSAIC EMPLOYEE WELFARE BENEFIT PLAN 4980 S 118 STREET OMAHA NE 68137 383831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 0 MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A 0 0 EASE-E MEDICAL INC 731 SOUTH 8TH STREET CANON CITY CO 81212 470842353 SALE OF MEDICAL EQUIPMENT AND SUPPLIES NE N/A C 0 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE N/A C 0 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD N/A C 0 CHARITABLE REMAINDER TRUSTS (5) INVESTMENT MANAGEMENT NE N/A T 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1