2023-11-09T09:03:50-07:00 2022-12-31 990 2022-01-01 810754064 ELIM SENIOR HOUSING INC ELIM 9528555000 7171 Ohms Lane Edina MN 55439 Kathy Youngquist CFO 9528555009 2023-11-08 1 1 11 1 AAL2 X 2022 2023-04-26 12:10:37Z TRINITY SPRINGS ROBERT DAHL 7171 OHMS LANE EDINA MN 55439 9188090 0 X www.cassialife.org X 2015 FL TO PROVIDE HEALTH CARE, HOUSING, AND COMMUNITY SERVICES FOR THE ELDERLY. 5 5 183 22 0 0 626477 0 5572366 8881987 103544 110521 103285 195582 6405672 9188090 0 0 0 0 3076062 4126880 0 0 0 6887926 7299789 9963988 11426669 -3558316 -2238579 44315672 42479305 55615421 55000345 -11299749 -12521040 TO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS IN THE SPIRIT OF CHRIST'S LOVE. 0 0 5104808 0 9188090 ELIM SENIOR HOUSING, INC. WAS ORGANIZED FOR THE PURPOSE OF OPERATING AN ASSISTED LIVING FACILITY FOR THE ELDERLY. IT IS LOCATED IN OXFORD, FLORIDA AND HAS 160 UNITS. 0 0 0 5104808 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 14 0 183 1 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X KATHY YOUNGQUIST 9528555000 7171 Ohms Lane Edina MN 55439 ROBERT DAHL PRESIDENT/CEO 0.48 39.52 X 0 602456 87428 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0.48 39.52 X 0 462088 70621 KATHY KOPP CHIEF STRATEGIC OFFICER 0.48 39.52 X 0 320482 76596 MATTHEW KERN CHIEF OPERATING OFFICER 0.48 39.52 X 0 317298 72793 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0.48 39.52 X 0 245326 42846 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0.48 39.52 X 0 234321 44974 TRACY GAWLER EXECUTIVE DIRECTOR 40 0 X 121875 0 15562 STANN LEFF CHAIRPERSON & DIRECTOR 0.25 0.25 X X 0 0 0 PAT NUSS VICE CHAIRPERSON & DIRECTOR 0.25 0.25 X X 0 0 0 PAUL ANDERSON SECRETARY/TREASURER AND DIRECTOR 0.25 0.25 X X 0 0 0 DR GUY TANGEDAHL DIRECTOR 0.25 0.25 X 0 0 0 NIKKI WEBER DANIELS DIRECTOR 0.25 0.25 X 0 0 0 121875 2181971 410820 1 0 1 0 STAFF AMERICA 814 E SILVER SPRINGS BLVD SUITE E OCALA FL 34470 POOLED NURSING 263889 CASSIA SERVICES 7171 OHMS LANE EDINA MN 55439 MANAGEMENT SERVICES 182246 YOUR KEY TO SENIOR LIVING OPTIONS LLC 3351 HANANWOOD TERRACE THE VILLAGES FL 32163 MARKETING CONSULTING 125698 3 0 ASSISTED LIVING REVENUE 623311 8881987 8881987 0 0 0 0 0 0 8881987 110521 0 0 110521 0 0 0 0 0 0 0 0 23595 0 0 0 23595 0 23595 23595 0 0 0 0 COMMUNITY FEE REVENUE 900099 138650 138650 0 0 33337 33337 0 0 171987 9188090 9077569 0 110521 3451202 2955201 496001 22848 19564 3284 392457 336054 56403 260373 222953 37420 182246 182246 4814 4814 15640 15640 19804 19804 701384 522415 178969 52834 52834 52479 2343 50136 49115 49115 369859 320261 49598 8991 8991 444 444 3025671 3025671 0 1636722 1636722 359633 359633 SUPPLIES 261918 244357 17561 0 FOOD 428557 428557 0 0 BAD DEBT 20526 0 20526 0 109152 53103 56049 11426669 5104808 6321861 0 347183 72206 53394 103794 40634 1675 42756331 6071924 38226096 36684407 5648365 5617223 44315672 42479305 1512606 1570550 51319113 50786550 2783702 2643245 55615421 55000345 X -11301599 -12526994 1850 5954 -11299749 -12521040 44315672 42479305 X -2238579 -489776 0 0 0 1507064 X 0 1 X 1 1 1 X 0 32325 626477 0 658802 2500 1580560 5107524 5572366 8881987 21144937 2500 1580560 5139849 6198843 8881987 21803739 0 0 0 0 0 0 0 1143005 933848 298188 0 2375041 0 1143005 933848 298188 0 2375041 19428698 0 0 147840 114434 134116 396390 0 0 147840 114434 134116 396390 56252 92395 171986 320633 2500 1580560 5343941 6405672 9188089 22520762 0.86270 0 0.01760 0 X Schedule A, Part III, Line 12 OTHER INCOME INCLUDES: COMMUNITY FEE REVENUE: 2022 $138,650, 2021 $80,525, 2020 $39,000; STORAGE SPACE: 2022 $5,732, 2021 $4,124; PET REVENUE: 2022 $3,500, $2021 $4,500; MAINTENANCE REVENUE: 2022 $13,044, 2021 $1,496, 2020 $3,022; OTHER MISCELLANEOUS REVENUE: 2022 $11,061, 2021 $1,750, 2020 $5,058 0 1786424 1786424 0 38822128 4980688 33841440 0 0 0 0 0 2049272 1004363 1044909 0 98507 86873 11634 36684407 FUNDS HELD BY TRUSTEE 5608549 DUE FROM AFFILIATES 8674 5617223 DUE TO AFFILIATES 2643245 2643245 X 8624763 -489776 0 0 0 -489776 9114539 0 73551 73551 9188090 11331094 0 0 0 34750 34750 11296344 19804 110521 130325 11426669 Schedule D, Part X, Line 2 ELIM 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 D, Part XI, Line 4b BOND RESERVE INTEREST INCOME: $110,521 NET ASSETS RELEASED FROM RESTRICTION: -$2,220 MEALS REVENUE: -$34,750 Schedule D, Part XII, Line 2d MEALS REVENUE: $34,750 Schedule D, Part XII, Line 4b BOND RESERVE INTEREST INCOME:$110,521 X 1 1 X X X X 0 1 0 0 0 0 0 0 0 ROBERT DAHL PRESIDENT/CEO 0 546533 0 49716 0 6207 0 67622 0 19807 0 689885 0 49716 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0 327536 0 0 0 134552 0 45601 0 25020 0 532709 0 131952 MATTHEW KERN CHIEF OPERATING OFFICER 0 313032 0 0 0 4266 0 44525 0 28268 0 390091 0 0 KATHY KOPP CHIEF STRATEGIC OFFICER 0 257664 0 0 0 62818 0 50298 0 26298 0 397078 0 59672 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0 212660 0 19955 0 12711 0 30259 0 12588 0 288173 0 19955 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0 214699 0 0 0 19622 0 20586 0 24388 0 279295 0 18282 Schedule J, Part I, Line 1a CASSIA 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 3 THE 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 4 THE 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 6 OFFICERS 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 II ALL OFFICERS' COMPENSATION WAS PAID BY CASSIA SERVICES, THE MANAGEMENT SERVICES COMPANY. A CAPITAL TRUST AGENCY 593591394 140542AG6 2017-08-29 53050000 To finance construction of a new senior living campus 0 0 0 A 600000 0 53050000 3704212 0 0 870967 0 0 37397227 11077594 0 2020 0 0 1 1 A 0 0 0 0 0 0 0 0 1 A 0 1 0 1 1 0 0 0 1 Schedule K, Part IV, Line 2c-08/29/2017 53,050,000 CAPITAL TRUST AGENCY ARBITRAGE CALCULATION WAS PERFORMED ON 8/29/22. NO AMOUNT DUE. Form 990, Part VI, Section A, Line 3 A 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 6 THE 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 7a THE 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 7b ELIM 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 11b THE 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 12c THE 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 15 THE 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 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS WERE AS FOLLOWS: TRANSFERRED FROM RELATED PARTIES: $1,507,064. CASSIA 7171 OHMS LANE EDINA MN 55439 831758728 PARENT CO/FUND RAISING MN 501(C)(3) 7 N/A 0 CASSIA SERVICES 7171 OHMS LANE EDINA MN 55439 411806946 MANAGEMENT SERVICES MN 501(C)(3) 12 CASSIA 0 ELIM CARE INC 7171 OHMS LANE EDINA MN 55439 411694818 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 CASSIA 0 AUGUSTANA CARE 7171 OHMS LANE EDINA MN 55439 411728753 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 7 CASSIA 0 PIONEER HOUSE ASSISTED LIVING INC 7171 OHMS LANE EDINA MN 55439 411927112 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 NEW HARMONY CARE CENTER INC 7171 OHMS LANE EDINA MN 55439 411821882 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 COUNTRY MEADOWS OF MILACA INC 7171 OHMS LANE EDINA MN 55439 201723948 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 LAKE RIDGE CARE CENTER OF BUFFALO INC 7171 OHMS LANE EDINA MN 55439 200507069 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 PARK TERRACE ASSISTED LIVING INC 7171 OHMS LANE EDINA MN 55439 204063752 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 EVANGELICAL RETIREMENT HOMES INC 7171 OHMS LANE EDINA MN 55439 420868449 HEALTH CARE FACILITIES/SERVICES IA 501(C)(3) 10 ELIM CARE INC 0 VILLAGE ASSISTED LIVING INC 7171 OHMS LANE EDINA MN 55439 262086933 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 BAPTIST HOME INC 7171 OHMS LANE EDINA MN 55439 450232943 HEALTH CARE FACILITIES/SERVICES ND 501(C)(3) 10 ELIM CARE INC 0 THE BAPTIST APARTMENTS INC 7171 OHMS LANE EDINA MN 55439 450359794 HEALTH CARE FACILITIES/SERVICES ND 501(C)(3) PF ELIM CARE INC 0 ELIM SHORES INC 7171 OHMS LANE EDINA MN 55439 411625095 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 CORNERSTONE ASSISTED LIVING OF PLYMOUTH INC 7171 OHMS LANE EDINA MN 55439 412013927 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 HAVEN HOMES INC 7171 OHMS LANE EDINA MN 55439 416045816 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 NEWTON VILLAGE INC 7171 OHMS LANE EDINA MN 55439 200044030 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 ELIM HOMES INC 7171 OHMS LANE EDINA MN 55439 411539761 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 REDEEMER RESIDENCE INC 7171 OHMS LANE EDINA MN 55439 410711597 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM HOMES INC 0 PARK VIEW CARE CENTER 7171 OHMS LANE EDINA MN 55439 410855707 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM HOMES INC 0 THE PARK LANE APARTMENTS INC 7171 OHMS LANE EDINA MN 55439 410972384 LOW INCOME HOUSING MN 501(C)(3) 10 ELIM CARE INC 0 ELIM CHILDREN'S CENTER INC 7171 OHMS LANE EDINA MN 55439 411974507 CHILD DAYCARE MN 501(C)(3) 10 ELIM CARE INC 0 ELIM CARE FOUNDATION 7171 OHMS LANE EDINA MN 55439 411694817 CHARITABLE FOUNDATION MN 501(C)(3) 12 ELIM CARE INC 0 COMMUNITY HEALTH FOUNDATION OF WRIGHT COUNTY 7171 OHMS LANE EDINA MN 55439 363546789 CHARITABLE FOUNDATION MN 501(C)(3) PF ELIM CARE INC 0 APPLE VALLEY VILLA APARTMENTS 7171 OHMS LANE EDINA MN 55439 311608691 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA CARE FOUNDATION 7171 OHMS LANE EDINA MN 55439 411360678 CHARITABLE FOUNDATION MN 501(C)(3) 12 AUGUSTANA CARE 0 AUGUSTANA CHAPEL VIEW HOMES INC 7171 OHMS LANE EDINA MN 55439 410693953 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA COMMUNITY PARTNERS 7171 OHMS LANE EDINA MN 55439 411783680 HOME HEALTH CARE SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY 7171 OHMS LANE EDINA MN 55439 311608696 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA HOME OF HASTINGS 7171 OHMS LANE EDINA MN 55439 311572624 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA APARTMENTS OF HASTINGS 7171 OHMS LANE EDINA MN 55439 311608701 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 BROOKSIDE SENIOR LIVING 7171 OHMS LANE EDINA MN 55439 410871848 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 N/A 0 OPEN CIRCLE ADULT DAY CENTER 7171 OHMS LANE EDINA MN 55439 411424801 ADULT DAYCARE MN 501(C)(3) 10 AUGUSTANA CARE 0 ELIM PREFERRED SERVICES 7171 OHMS LANE EDINA MN 55439 411681856 MEDICAL SALES MN ELIM CARE INC C 0 0 PREFERRED SENIOR SERVICES INC 7171 OHMS LANE EDINA MN 55439 411942480 MANAGEMENT SERVICES MN ELIM CARE INC C 0 0 AUGUSTANA SENIOR DEVELOPMENT 7171 OHMS LANE EDINA MN 55439 264136110 CONSULTING MN AUGUSTANA CARE C 0 0 0 0 1 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 1