STRATEGY STUDIO / PUBLIC DATA EXPLORER

EVANGELICAL RETIREMENT HOMES INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
EVANGELICAL RETIREMENT HOMES INC (EIN 42-0868449)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-08
IRS object ID
202313149349300731
Schema version
2022v5.0
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)
Return2023-11-08T12:42:21-07:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420868449EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EVANGELICAL RETIREMENT HOMES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEVANBusinessNameControlTxt
Phone9528555000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17171 OHMS LANEAddressLine1Txt
CityEDINACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKathy YoungquistPersonNm
Person TitleChief Financial OfficerPersonTitleTxt
Phone9528555000PhoneNum
Signature2023-11-08SignatureDt
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer1TrustedCustomerCd
OOB Security Verification11OOBSecurityVerificationCd
Last Submission Rqr OOB1LastSubmissionRqrOOBCd
Authentication Assurance LevelAAL2AuthenticationAssuranceLevelCd
Profile Password ChangeYes (X)ProfilePasswordChangeInd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1VALLEY VIEW VILLAGEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerROBERT DAHLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line17171 OHMS LANEAddressLine1Txt
CityEDINACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,682,363GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CASSIALIFE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1962FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH CARE, HOUSING, AND COMMUNITY SERVICES FOR THE ELDERLY.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee207TotalEmployeeCnt
Total Volunteers38TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,639,232PYContributionsGrantsAmt
CY Contributions Grants$1,601,589CYContributionsGrantsAmt
PY Program Service Revenue$8,507,588PYProgramServiceRevenueAmt
CY Program Service Revenue$9,048,624CYProgramServiceRevenueAmt
PY Investment Income$167PYInvestmentIncomeAmt
CY Investment Income$2,073CYInvestmentIncomeAmt
PY Other Revenue$19,727PYOtherRevenueAmt
CY Other Revenue$30,077CYOtherRevenueAmt
PY Total Revenue$10,166,714PYTotalRevenueAmt
CY Total Revenue$10,682,363CYTotalRevenueAmt
PY Grants And Similar Paid$100PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$422CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,797,358PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,869,833CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,536,282PYOtherExpensesAmt
CY Other Expenses$5,535,925CYOtherExpensesAmt
PY Total Expenses$9,333,740PYTotalExpensesAmt
CY Total Expenses$10,406,180CYTotalExpensesAmt
PY Revenues Less Expenses$832,974PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$276,183CYRevenuesLessExpensesAmt
Total Assets BOY$16,494,150TotalAssetsBOYAmt
Total Assets EOY$16,594,910TotalAssetsEOYAmt
Total Liabilities BOY$15,830,413TotalLiabilitiesBOYAmt
Total Liabilities EOY$15,575,234TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$663,737NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,019,676NetAssetsOrFundBalancesEOYAmt
MissionTO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS IN THE SPIRIT OF CHRIST'S LOVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,223,598ExpenseAmt
Grant$422GrantAmt
Revenue$7,822,552RevenueAmt
DescEVANGELICAL RETIREMENT HOMES, INC. WAS ORGANIZED FOR THE PURPOSE OF PROVIDING NURSING HOME CARE FOR THE ELDERLY. IT HAS 79 BEDS AND IS LOCATED IN DES MOINES, IOWA.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$936,950ExpenseAmt
Grant$0GrantAmt
Revenue$1,226,072RevenueAmt
DescEVANGELICAL RETIREMENT HOMES, INC. OPERATES TWO TYPES OF INDEPENDENT LIVING FACILITIES FOR THE ELDERLY. THE MANOR APARTMENTS IS A DETACHED INDEPENDENT LIVING BUILDING WITH 30 UNITS. THERE ARE ALSO 58 COTTAGES FOR INDEPENDENT LIVING RESIDENTS.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$9,160,548TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document14IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee207EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKATHY L YOUNGQUISTPersonNm
Phone9528555000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17171 OHMS LANEAddressLine1Txt
CityEDINACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ROBERT DAHL
PRESIDENT/CEO0.9639.04Yes (X)$0$602,456$87,428
KATHY YOUNGQUIST
CHIEF FINANCIAL OFFICER0.9639.04Yes (X)$0$462,088$70,621
KATHY KOPP
CHIEF STRATEGIC OFFICER0.9639.04Yes (X)$0$320,482$76,596
MATTHEW KERN
CHIEF OPERATING OFFICER0.9639.04Yes (X)$0$317,298$72,793
SHARON WILSON
CHIEF CLINICAL AND COMPLIANCE OFFICER0.9639.04Yes (X)$0$245,326$42,846
ANGELA BROWN
CHIEF HUMAN RESOURCE OFFICER0.9639.04Yes (X)$0$234,321$44,974
PAUL MUNGAI
CERTIFIED NURSING ASSISTANT102.810$168,733$0$7,375Yes (X)
STEPHANIE PROPER
ADMINISTRATOR400$111,090$0$25,908Yes (X)
STANN LEFF
CHAIRPERSON & DIRECTOR0.250.25Yes (X)$0$0$0Yes (X)
PAT NUSS
VICE CHAIRPERSON & DIRECTOR0.250.25Yes (X)$0$0$0Yes (X)
PAUL ANDERSON
SECRETARY/TREASURER AND DIRECTOR0.250.25Yes (X)$0$0$0Yes (X)
DOCTOR GUY TANGEDAHL
DIRECTOR0.250.25$0$0$0Yes (X)
NIKKI WEBER DANIELS
DIRECTOR0.250.25$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$279,823TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,181,971TotReportableCompRltdOrgAmt
Total Other Compensation$428,541TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GRAPE TREE MEDICAL STAFFING LLC
PO BOX 5340SIOUX FALLSSD57117NURSING POOL SERVICES$823,670
PRO REHAB
7171 OHMS LANEEDINAMN55439THERAPY SERVICES$483,572
CASSIA SERVICES
7171 OHMS LANEEDINAMN55439MANAGEMENT SERVICES$365,176
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$1,570,055RelatedOrganizationsAmt
Government Grants$31,534GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$1,601,589TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
NURSING HOME REVENUE623110$7,822,552$7,822,552$0$0
SENIOR HOUSING REVENUE623312$1,226,072$1,226,072$0$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$9,048,624TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$73TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$73ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$2,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$2,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,000TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,000ExclusionAmt
FieldValueIRS element (for citing)
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
BEAUTY SHOP REVENUE812112$19,878$0$0$19,878
TRANSPORTATION REVENUE485991$10,021$0$0$10,021
MISCELLANEOUS REVENUE900099$178$0$0$178

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$30,077OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,682,363TotalRevenueColumnAmt
Related Or Exempt Func Income$9,048,624RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$32,150ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$422TotalAmt
Program Services$422ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,098,057TotalAmt
Program Services$3,788,959ProgramServicesAmt
Management And General$309,098ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$29,304TotalAmt
Program Services$27,094ProgramServicesAmt
Management And General$2,210ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$401,230TotalAmt
Program Services$370,967ProgramServicesAmt
Management And General$30,263ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$341,242TotalAmt
Program Services$315,504ProgramServicesAmt
Management And General$25,738ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$365,176TotalAmt
Management And General$365,176ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,037TotalAmt
Management And General$1,037ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$7,620TotalAmt
Management And General$7,620ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,928,326TotalAmt
Program Services$1,886,277ProgramServicesAmt
Management And General$42,049ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$79,857TotalAmt
Management And General$79,857ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$38,171TotalAmt
Management And General$38,171ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$65,971TotalAmt
Program Services$10,751ProgramServicesAmt
Management And General$55,220ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$578,163TotalAmt
Program Services$578,163ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,516TotalAmt
Management And General$8,516ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,086TotalAmt
Management And General$3,086ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$426,178TotalAmt
Program Services$426,178ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$722,730TotalAmt
Program Services$722,730ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$125,275TotalAmt
Program Services$125,275ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES AND ANCILLARY EXPENSES$528,919$515,373$13,546$0
BAD DEBT EXPENSE$246,796$0$246,796$0
FOOD$222,806$222,806$0$0
BUILDING & EQUIPMENT REPAIRS$112,697$112,697$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$74,601TotalAmt
Program Services$57,352ProgramServicesAmt
Management And General$17,249ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,406,180TotalAmt
Program Services$9,160,548ProgramServicesAmt
Management And General$1,245,632ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$327,030BOYAmt
EOY$956,506EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$929,221BOYAmt
EOY$816,772EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$31,442BOYAmt
EOY$8,000EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$25,464,287LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,084,359LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,937,279BOYAmt
EOY$14,379,928EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$269,178BOYAmt
EOY$433,704EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,494,150BOYAmt
EOY$16,594,910EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$593,535BOYAmt
EOY$795,422EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$149,509BOYAmt
EOY$190,948EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$100,375BOYAmt
EOY$98,913EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$14,219,126BOYAmt
EOY$13,610,364EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$767,868BOYAmt
EOY$879,587EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,830,413BOYAmt
EOY$15,575,234EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$481,719BOYAmt
EOY$873,910EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$182,018BOYAmt
EOY$145,766EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$663,737BOYAmt
EOY$1,019,676EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,494,150BOYAmt
EOY$16,594,910EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$276,183ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$0NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$7,310PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$72,446OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$48,332CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$255,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$473,049CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,639,232CurrentTaxYearMinus1YearAmt
Current Tax Year$1,601,589CurrentTaxYearAmt
Total$4,017,202TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,344,827CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,623,112CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,725,232CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,507,588CurrentTaxYearMinus1YearAmt
Current Tax Year$9,048,624CurrentTaxYearAmt
Total$43,249,383TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,393,159CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,878,112CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,198,281CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,146,820CurrentTaxYearMinus1YearAmt
Current Tax Year$10,650,213CurrentTaxYearAmt
Total$47,266,585TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$296,230CurrentTaxYearMinus1YearAmt
Total$296,230TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$296,230CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$296,230TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$46,970,355PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$33CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$292CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$167CurrentTaxYearMinus1YearAmt
Current Tax Year$73CurrentTaxYearAmt
Total$569TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$33CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$292CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$167CurrentTaxYearMinus1YearAmt
Current Tax Year$73CurrentTaxYearAmt
Total$569TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30,946CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$31,719CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,480CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,727CurrentTaxYearMinus1YearAmt
Current Tax Year$30,077CurrentTaxYearAmt
Total$119,949TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,424,109CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,909,864CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,206,053CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,166,714CurrentTaxYearMinus1YearAmt
Current Tax Year$10,680,363CurrentTaxYearAmt
Total$47,387,103TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99121PublicSupportCY509Pct
Public Support PY5090.99075PublicSupportPY509Pct
Investment Income CY0.00001InvestmentIncomeCYPct
Investment Income PY0.00001InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12FormAndLineReferenceDesc
ExplanationOTHER INCOME INCLUDES: BEAUTY SHOP REVENUE (2018-$26,446 2019-$25,225 2020-$5,051 2021-$8,878 2022-$19,878), GUEST ROOM RENTAL REVENUE (2018-$4,500 2019-$5,900 2020-$1,740 2021-$2,344), TRANSPORTATION REVENUE (2021-$8,505 2022-$10,021) AND MISCELLANEOUS REVENUE (2019-$594 2020-$689 2022-$178)ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$137,454OtherCostOrOtherBasisAmt
Book Value$137,454BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$21,031,665OtherCostOrOtherBasisAmt
Depreciation$7,957,187DepreciationAmt
Book Value$13,074,478BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$3,753,402OtherCostOrOtherBasisAmt
Depreciation$2,744,768DepreciationAmt
Book Value$1,008,634BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$541,766OtherCostOrOtherBasisAmt
Depreciation$382,404DepreciationAmt
Book Value$159,362BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$14,379,928TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ACCRUED INTEREST PAYABLE$27,400
DUE TO AFFILIATES$640,256
ASSET RETIREMENT OBLIGATION$211,931
FieldValueIRS element (for citing)
Total Liability$879,587TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part IV, Line 2bTHE ORGANIZATION HOLDS, IN TRUST, FUNDS ADVANCED BY RESIDENTS TO BE USED AT EACH RESIDENT'S DISCRETION. THE FUNDS ARE MAINTAINED IN A SEPARATE INTEREST-BEARING SAVINGS ACCOUNT AND THE ORGANIZATION HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THESE FUNDS. SECURITY DEPOSITS ARE REQUIRED FOR THE ORGANIZATION'S TENANTS AND INCLUDE RESERVED APARTMENTS IF AMOUNTS ARE PAID BEFORE THE TENANT ACTUALLY MOVES IN.
Schedule D, Part X, Line 2ELIM CARE, INC. AND ITS AFFILIATES HAVE BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATION THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. ELIM CARE, INC. AND ITS AFFILIATES' INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION REPORTS ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES AND FILES ALL PROPER RETURNS RELATED TO THESE ACTIVITIES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT DAHL
PRESIDENT/CEO$0$546,533$0$49,716$0$6,207$0$67,622$0$19,807$0$689,885$0$49,716
KATHY YOUNGQUIST
CHIEF FINANCIAL OFFICER$0$327,536$0$0$0$134,552$0$45,601$0$25,020$0$532,709$0$131,952
MATTHEW KERN
CHIEF OPERATING OFFICER$0$313,032$0$0$0$4,266$0$44,525$0$28,268$0$390,091$0$0
KATHY KOPP
CHIEF STRATEGIC OFFICER$0$257,664$0$0$0$62,818$0$50,298$0$26,298$0$397,078$0$59,672
SHARON WILSON
CHIEF CLINICAL AND COMPLIANCE OFFICER$0$212,660$0$19,955$0$12,711$0$30,259$0$12,588$0$288,173$0$19,955
ANGELA BROWN
CHIEF HUMAN RESOURCE OFFICER$0$214,699$0$0$0$19,622$0$20,586$0$24,388$0$279,295$0$18,282
PAUL MUNGAI
CERTIFIED NURSING ASSISTANT$157,631$0$2,450$0$8,652$0$0$0$7,375$0$176,108$0$0$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1aCASSIA AND ITS AFFILIATES PROVIDE VEHICLE BENEFITS FOR SOME OF ITS OFFICERS AND KEY EMPLOYEES. THE EMPLOYEE IS RESPONSIBLE FOR TRACKING BUSINESS VERSUS PERSONAL USE OF THE VEHICLE. THE PERSONAL USAGE OF THE VEHICLES IS TREATED AS TAXABLE COMPENSATION BY CASSIA AND ITS AFFILIATES.
Schedule J, Part I, Line 3THE CORPORATION RELIED ON THE PARENT ORGANIZATION, CASSIA, TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO. CASSIA USES THE FOLLOWING PRACTICES: INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY AND RECOMMENDATIONS FROM THE CASSIA COMPENSATION COMMITTEE TO THE CASSIA BOARD.
Schedule J, Part I, Line 4THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PROVIDED BY CASSIA SERVICES: KATHY KOPP, CSO - $13,263 KATHY YOUNGQUIST, CFO - $33,401 MATTHEW KERN, COO - $32,325 ANGELA BROWN, CHRO - $11,030
Schedule J, Part I, Line 6OFFICERS OF CASSIA SERVICES AND KEY EMPLOYEES OF CASSIA AND ITS AFFILIATES ARE ELIGIBLE TO ACCRUE INCENTIVE BONUSES EACH YEAR THAT ARE CONTINGENT ON PERFORMANCE METRICS AND FINANCIAL GOALS OF THE ORGANIZATION.
Schedule J, Part IIALL OFFICERS' COMPENSATION WAS PAID BY CASSIA SERVICES, THE MANAGEMENT SERVICES COMPANY.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CITY OF PLEASANT HILL IOWA
A4260357892014-12-10$1,580,000REFINANCE OLD DEBT & CONSTRUCTION OF NURSING HOME00Yes (1)
CITY OF BONDURANT IOWA
B4260042872014-12-10$2,800,000CONSTRUCTION OF NURSING HOME000
CITY OF CARLISLE IOWA
C4260043182014-12-10$9,000,000CONSTRUCTION OF NURSING HOME000
CITY OF BONDURANT IOWA
D4260042872014-11-18$4,400,000DEMOLISH OLD AND CONSTRUCT NEW NURSING HOME000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$296,341$0$1,580,000$0$2,720$0$125,904$0$0$435,673$0$02016Yes (1)0Yes (1)Yes (1)
B$525,159$0$2,800,000$0$5,018$0$56,000$0$0$2,738,982$0$0201600Yes (1)Yes (1)
C$1,692,627$0$9,000,000$0$152,705$0$180,000$0$0$8,667,295$0$0201600Yes (1)Yes (1)
D$1,446,028$0$4,400,000$0$213,311$0$88,000$0$0$4,098,689$0$0201600Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A000000000Yes (1)
B000000000Yes (1)
C000000000Yes (1)
D000000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)0Yes (1)Yes (1)000Yes (1)
B0Yes (1)0Yes (1)Yes (1)000Yes (1)
C0Yes (1)0Yes (1)Yes (1)000Yes (1)
D0Yes (1)0Yes (1)Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule K, Part II, Line 3-12/10/2014 1,580,000 CITY OF PLEASANT HILL IOWALOAN PROCEEDS ARE SPLIT BETWEEN EVANGELICAL RETIREMENT HOMES, INC. AND VILLAGE ASSISTED LIVING, INC. (A RELATED ORGANIZATION). THE BREAKDOWN IS AS FOLLOWS: EVANGELICAL RETIREMENT HOMES, INC.-$1,580,000 AND VILLAGE ASSISTED LIVING, INC.-$5,100,000. THE TOTAL COMBINED PROCEEDS ARE $6,680,000.
Schedule K, Part IV, Line 2c-12/10/2014 1,580,000 CITY OF PLEASANT HILL IOWATHERE WERE NO INVESTMENT EARNINGS ON ANY BOND PROCEEDS.
Schedule K, Part IV, Line 2c-12/10/2014 2,800,000 CITY OF BONDURANT IOWATHERE WERE NO INVESTMENT EARNINGS ON ANY BOND PROCEEDS.
Schedule K, Part IV, Line 2c-12/10/2014 9,000,000 CITY OF CARLISLE IOWATHERE WERE NO INVESTMENT EARNINGS ON ANY BOND PROCEEDS.
Schedule K, Part IV, Line 2c-11/18/2014 4,400,000 CITY OF BONDURANT IOWATHERE WERE NO INVESTMENT EARNINGS ON ANY BOND PROCEEDS.

Schedule K IRS990ScheduleK

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Line 3A RELATED ORGANIZATION, CASSIA SERVICES, MANAGES ITS OWN AFFILIATES, CASSIA, ELIM CARE, INC., AUGUSTANA CARE AND ALL ELIM/AUGUSTANA AFFILIATES. SERVICES PROVIDED INCLUDE FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, PHILANTHROPY AND NEW BUSINESS DEVELOPMENT.
Form 990, Part VI, Section A, Line 6THE SOLE MEMBER OF THE ORGANIZATION IS ELIM CARE, INC. THE SOLE MEMBER OF ELIM CARE, INC. IS CASSIA.
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, ELIM CARE, INC. AT THE ANNUAL MEETING.
Form 990, Part VI, Section A, Line 7bELIM CARE, INC. IS THE SOLE MEMBER OF THE CORPORATION. BOARD MEMBERS OF THE CORPORATION ARE APPOINTED BY THE SOLE MEMBER. DECISIONS OF THE CORPORATION ARE SUBJECT TO APPROVAL BY THE SOLE MEMBER. CERTAIN ACTIONS ARE FURTHER SUBJECT TO APPROVAL BY THE CASSIA BOARD, WHICH IS THE PARENT ORGANIZATION.
Form 990, Part VI, Section B, Line 11bTHE FORM 990 AND ALL RELATED SCHEDULES WERE PREPARED BY INTERNAL FINANCE STAFF AND REVIEWED BY THE ORGANIZATION'S CFO. THE FORM 990 WAS MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS PRIOR TO BEING FILED WITH THE IRS.
Form 990, Part VI, Section B, Line 12cTHE ORGANIZATION ANNUALLY REQUESTS A CONFLICT OF INTEREST DISCLOSURE FROM EACH BOARD MEMBER, KEY EMPLOYEE AND OFFICER. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND KEY EMPLOYEES. ALL COVERED INDIVIDUALS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND TO DISCLOSE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST TO THE APPROPRIATE LEVEL OF MANAGEMENT OR TO THE BOARD OF DIRECTORS AS OUTLINED IN THE POLICY, BASED ON THE INDIVIDUAL'S POSITION WITHIN THE ORGANIZATION. CONFLICTS ARE DETERMINED AT THE APPROPRIATE LEVEL OF MANAGEMENT OR BY THE BOARD OF DIRECTORS. INDIVIDUALS WITH ACTUAL OR POTENTIAL CONFLICTS WILL ABSTAIN FROM DISCUSSING OR VOTING ON ANY MATTERS RELATING TO THE CONFLICT. ALL PROCEEDINGS RELATING TO ACTUAL OR POTENTIAL CONFLICTS ARE NOTED IN THE MEETING MINUTES.
Form 990, Part VI, Section B, Line 15THE BOARD OF DIRECTORS ROUTINELY RETAINS THE SERVICES OF A COMPENSATION CONSULTANT TO REVIEW THE CURRENT WAGE AND BENEFIT LEVELS OF SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE USES THIS INFORMATION TO MAKE A RECOMMENDATION TO THE BOARD OF DIRECTORS.
Form 990, Part VI, Section C, Line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part IX, Line 11gOTHER SERVICES INCLUDE: THERAPY SERVICES $482,242 - NURSING POOL $1,029,732 - NURSING CONSULTANTS $173,008 - DIETICIAN CONSULTING $15,132 - LAUNDRY SERVICES $20,733 - MAINTENANCE CONTRACTED SERVICES $165,430 - ADMINISTRATIVE CONSULTING $42,049
Form 990, Part XI, Line 9OTHER CHANGES IN NET ASSETS WERE AS FOLLOWS: $72,448 NET RESTRICTED CONTRIBUTIONS TRANSFERRED FROM CASSIA (A RELATED ORGANIZATION) AND ($2) ROUNDING.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (33 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CASSIA
7171 OHMS LANEEDINAMN55439831758728PARENT CO/FUND RAISINGMN501(C)(3)7N/A0
CASSIA SERVICES
7171 OHMS LANEEDINAMN55439411806946MANAGEMENT SERVICESMN501(C)(3)120CASSIA
ELIM CARE INC
7171 OHMS LANEEDINAMN55439411694818HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100CASSIA
AUGUSTANA CARE
7171 OHMS LANEEDINAMN55439411728753HEALTH CARE FACILITIES/SERVICESMN501(C)(3)70CASSIA
PIONEER HOUSE ASSISTED LIVING INC
7171 OHMS LANEEDINAMN55439411927112HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
NEW HARMONY CARE CENTER INC
7171 OHMS LANEEDINAMN55439411821882HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
COUNTRY MEADOWS OF MILACA INC
7171 OHMS LANEEDINAMN55439201723948HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
LAKE RIDGE CARE CENTER OF BUFFALO INC
7171 OHMS LANEEDINAMN55439200507069HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
PARK TERRACE ASSISTED LIVING INC
7171 OHMS LANEEDINAMN55439204063752HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
VILLAGE ASSISTED LIVING INC
7171 OHMS LANEEDINAMN55439262086933HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
BAPTIST HOME INC
7171 OHMS LANEEDINAMN55439450232943HEALTH CARE FACILITIES/SERVICESND501(C)(3)100ELIM CARE INC
THE BAPTIST APARTMENTS INC
7171 OHMS LANEEDINAMN55439450359794HEALTH CARE FACILITIES/SERVICESND501(C)(3)PF0ELIM CARE INC
ELIM SHORES INC
7171 OHMS LANEEDINAMN55439411625095HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
CORNERSTONE ASSISTED LIVING OF PLYMOUTH INC
7171 OHMS LANEEDINAMN55439412013927HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
HAVEN HOMES INC
7171 OHMS LANEEDINAMN55439416045816HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
ELIM SENIOR HOUSING INC
7171 OHMS LANEEDINAMN55439810754064HEALTH CARE FACILITIES/SERVICESFL501(C)(3)100ELIM CARE INC
NEWTON VILLAGE INC
7171 OHMS LANEEDINAMN55439200044030HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
ELIM HOMES INC
7171 OHMS LANEEDINAMN55439411539761HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE INC
REDEEMER RESIDENCE INC
7171 OHMS LANEEDINAMN55439410711597HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM HOMES INC
PARK VIEW CARE CENTER
7171 OHMS LANEEDINAMN55439410855707HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM HOMES INC
THE PARK LANE APARTMENTS INC
7171 OHMS LANEEDINAMN55439410972384LOW INCOME HOUSINGMN501(C)(3)100ELIM CARE INC
ELIM CHILDREN'S CENTER INC
7171 OHMS LANEEDINAMN55439411974507CHILD DAYCAREMN501(C)(3)100ELIM CARE INC
ELIM CARE FOUNDATION
7171 OHMS LANEEDINAMN55439411694817CHARITABLE FOUNDATIONMN501(C)(3)120ELIM CARE INC
COMMUNITY HEALTH FOUNDATION OF WRIGHT COUNTY
7171 OHMS LANEEDINAMN55439363546789CHARITABLE FOUNDATIONMN501(C)(3)PF0ELIM CARE INC
APPLE VALLEY VILLA APARTMENTS
7171 OHMS LANEEDINAMN55439311608691HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100AUGUSTANA CARE
AUGUSTANA CARE FOUNDATION
7171 OHMS LANEEDINAMN55439411360678CHARITABLE FOUNDATIONMN501(C)(3)120AUGUSTANA CARE
AUGUSTANA CHAPEL VIEW HOMES INC
7171 OHMS LANEEDINAMN55439410693953HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100AUGUSTANA CARE
AUGUSTANA COMMUNITY PARTNERS
7171 OHMS LANEEDINAMN55439411783680HOME HEALTH CARE SERVICESMN501(C)(3)100AUGUSTANA CARE
AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY
7171 OHMS LANEEDINAMN55439311608696HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100AUGUSTANA CARE
AUGUSTANA HOME OF HASTINGS
7171 OHMS LANEEDINAMN55439311572624HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100AUGUSTANA CARE
AUGUSTANA APARTMENTS OF HASTINGS
7171 OHMS LANEEDINAMN55439311608701HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100AUGUSTANA CARE
BROOKSIDE SENIOR LIVING
7171 OHMS LANEEDINAMN55439410871848HEALTH CARE FACILITIES/SERVICESMN501(C)(3)10N/A0
OPEN CIRCLE ADULT DAY CENTER
7171 OHMS LANEEDINAMN55439411424801ADULT DAYCAREMN501(C)(3)100AUGUSTANA CARE

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
ELIM PREFERRED SERVICES INC
7171 OHMS LANEEDINAMN55439411681856MEDICAL SALESMNELIM CARE INCC00
PREFERRED SENIOR SERVICES INC
7171 OHMS LANEEDINAMN55439411942480MANAGEMENT SERVICESMNELIM CARE INCC00
AUGUSTANA SENIOR DEVELOPMENT INC
7171 OHMS LANEEDINAMN55439264136110CONSULTINGMNAUGUSTANA CAREC00
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (1)AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd