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NEW HARMONY CARE CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
NEW HARMONY CARE CENTER INC (EIN 41-1821882)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-09
IRS object ID
202223139349301332
Schema version
2021v4.0
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)
Return2022-11-09T06:50:04-07:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411821882EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NEW HARMONY CARE CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNEWHBusinessNameControlTxt
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
Phone9522555000PhoneNum
Signature2022-11-09SignatureDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer1TrustedCustomerCd
OOB Security Verification11OOBSecurityVerificationCd
Last Submission Rqr OOB1LastSubmissionRqrOOBCd
Authentication Assurance LevelAAL2AuthenticationAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1NEW HARMONY CARE & REHAB CENTERBusinessNameLine1Txt
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$11,846,414GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CASSIALIFE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH CARE, HOUSING AND COMMUNITY SERVICES FOR THE ELDERLY.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee163TotalEmployeeCnt
Total Volunteers22TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$212,024PYContributionsGrantsAmt
CY Contributions Grants$4,256,373CYContributionsGrantsAmt
PY Program Service Revenue$8,233,975PYProgramServiceRevenueAmt
CY Program Service Revenue$7,585,752CYProgramServiceRevenueAmt
PY Investment Income$2,601PYInvestmentIncomeAmt
CY Investment Income$4,289CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$8,448,600PYTotalRevenueAmt
CY Total Revenue$11,846,414CYTotalRevenueAmt
PY Grants And Similar Paid$405,794PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,100,136PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,163,273CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,672,735PYOtherExpensesAmt
CY Other Expenses$2,858,745CYOtherExpensesAmt
PY Total Expenses$8,178,665PYTotalExpensesAmt
CY Total Expenses$8,025,018CYTotalExpensesAmt
PY Revenues Less Expenses$269,935PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,821,396CYRevenuesLessExpensesAmt
Total Assets BOY$4,509,003TotalAssetsBOYAmt
Total Assets EOY$17,674,874TotalAssetsEOYAmt
Total Liabilities BOY$2,666,194TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,829,255TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,842,809NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,845,619NetAssetsOrFundBalancesEOYAmt
MissionTO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS IN THE SPIRIT OF CHRIST'S LOVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,072,910ExpenseAmt
Grant$3,000GrantAmt
Revenue$7,585,752RevenueAmt
DescNEW HARMONY CARE CENTER, INC. WAS ORGANIZED FOR THE PURPOSE OF PROVIDING NURSING HOME CARE FOR THE ELDERLY. IT IS LOCATED IN ST. PAUL, MINNESOTA AND HAS 76 BEDS IN SERVICE. DURING 2021 NEW HARMONY HAD 22,104 RESIDENT DAYS (79.4% OCCUPANCY). UTILIZATION BY PAYOR SOURCE WAS AS FOLLOWS: 75.5% MEDICAID, 7.4% MEDICARE, 9.6% PRIVATE PAY AND 7.5% HMO.Desc
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$7,072,910TotalProgramServiceExpensesAmt
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 AssetsYes (1)ReportOtherAssetsInd
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 Document11IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee163EmployeeCnt
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 CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ROBERT DAHL
PRESIDENT/CEO0.9739.03Yes (X)$0$569,472$79,039
KATHY YOUNGQUIST
CHIEF FINANCIAL OFFICER0.9739.03Yes (X)$0$385,391$82,587
MATTHEW KERN
CHIEF OPERATING OFFICER0.9739.03Yes (X)$0$324,672$83,458
KATHY KOPP
CHIEF STRATEGIC OFFICER0.9739.03Yes (X)$0$267,750$90,300
ANGELA BROWN
CHIEF HUMAN RESOURCE OFFICER0.9739.03Yes (X)$0$236,279$60,827
SHARON WILSON
CHIEF CLINICAL AND COMPLIANCE OFFICER0.9739.03Yes (X)$0$241,179$42,698
STANN LEFF
CHAIRPERSON & DIRECTOR0.254.25Yes (X)$0$0$0Yes (X)
PAT NUSS
VICE CHAIRPERSON & DIRECTOR0.254.5Yes (X)$0$0$0Yes (X)
PAUL ANDERSON
SECRETARY/TREASURER AND DIRECTOR0.254.75Yes (X)$0$0$0Yes (X)
DOCTOR GUY TANGEDAHL
DIRECTOR0.254.75$0$0$0Yes (X)
NIKKI WEBER DANIELS
DIRECTOR0.254.5$0$0$0Yes (X)
ROLAND PETERSON
CHAIRPERSON & DIRECTOR (THRU JUNE)0.251.5$0$0$0Yes (X)
JERRY NYE
DIRECTOR (THRU JUNE)0.253.5$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,024,743TotReportableCompRltdOrgAmt
Total Other Compensation$438,909TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CBS CONSTURCTION SERVICES INC
11124 ZEALAND AVENUE NORTHCHAMPLINMN55316CONSTRUCTION GENERAL CONTRACTOR$7,535,422
CASSIA SERVICES
7171 OHMS LANEEDINAMN55439MANAGEMENT SERVIES$364,675
PRO REHAB
7171 OHMS LANEEDINAMN55439THERAPY SERVICES$356,643
POPE ARCHITECTS INC
767 NORTH EUSTIS STREETST PAULMN55114ARCHITECT SERVICES$138,536
CLIFTONLARSONALLEN LLP
220 SOUTH SIXTH STREETMINNEAPOLISMN55402ACCOUNTING FORECAST SERVICES$112,733
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$2,830,563RelatedOrganizationsAmt
Government Grants$1,425,810GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$4,256,373TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNURSING HOME REVENUEDesc
Business623000BusinessCd
Total Revenue Column$7,585,752TotalRevenueColumnAmt
Related Or Exempt Func Income$7,585,752RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

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$7,585,752TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,289TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,289ExclusionAmt

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

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt
FieldValueIRS element (for citing)
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,846,414TotalRevenueColumnAmt
Related Or Exempt Func Income$7,585,752RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,289ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$3,000TotalAmt
Program Services$3,000ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,298,905TotalAmt
Program Services$4,034,991ProgramServicesAmt
Management And General$263,914ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$105,155TotalAmt
Program Services$98,699ProgramServicesAmt
Management And General$6,456ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$434,563TotalAmt
Program Services$407,885ProgramServicesAmt
Management And General$26,678ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$324,650TotalAmt
Program Services$304,719ProgramServicesAmt
Management And General$19,931ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$364,675TotalAmt
Management And General$364,675ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,477TotalAmt
Management And General$6,477ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$8,252TotalAmt
Management And General$8,252ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$960TotalAmt
Management And General$960ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$645,457TotalAmt
Program Services$602,351ProgramServicesAmt
Management And General$43,106ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,476TotalAmt
Management And General$9,476ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$30,593TotalAmt
Program Services$1,794ProgramServicesAmt
Management And General$28,799ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$27,170TotalAmt
Program Services$7,852ProgramServicesAmt
Management And General$19,318ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$174,073TotalAmt
Program Services$166,026ProgramServicesAmt
Management And General$8,047ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,229TotalAmt
Management And General$3,229ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$13,189TotalAmt
Management And General$13,189ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$59,272TotalAmt
Program Services$56,532ProgramServicesAmt
Management And General$2,740ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$397,641TotalAmt
Program Services$379,259ProgramServicesAmt
Management And General$18,382ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$45,421TotalAmt
Program Services$43,321ProgramServicesAmt
Management And General$2,100ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES AND ANCILLARY EXPENSES$552,157$544,021$8,136$0
LICENSE SURCHARGE$213,940$213,940$0$0
FOOD$177,993$177,993$0$0
BAD DEBT EXPENSE$82,957$0$82,957$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$45,813TotalAmt
Program Services$30,527ProgramServicesAmt
Management And General$15,286ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,025,018TotalAmt
Program Services$7,072,910ProgramServicesAmt
Management And General$952,108ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,118,881BOYAmt
EOY$1,535,475EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,055,531BOYAmt
EOY$909,734EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$12,259BOYAmt
EOY$11,835EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$8,250,015LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,458,079LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,140,302BOYAmt
EOY$1,791,936EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$182,030BOYAmt
EOY$13,425,894EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,509,003BOYAmt
EOY$17,674,874EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$624,881BOYAmt
EOY$599,238EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$427,978BOYAmt
EOY$48,465EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$7,550,000EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$22,763BOYAmt
EOY$38,027EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,394,397BOYAmt
EOY$635,502EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$196,175BOYAmt
EOY$2,958,023EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,666,194BOYAmt
EOY$11,829,255EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,811,113BOYAmt
EOY$5,676,471EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,696BOYAmt
EOY$169,148EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,842,809BOYAmt
EOY$5,845,619EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,509,003BOYAmt
EOY$17,674,874EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,821,396ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$47,129NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$91,092PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$137,451OtherChangesInNetAssetsAmt
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 Minus1 Year$212,024CurrentTaxYearMinus1YearAmt
Current Tax Year$4,256,373CurrentTaxYearAmt
Total$4,468,397TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,142,728CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,930,682CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,524,983CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,233,975CurrentTaxYearMinus1YearAmt
Current Tax Year$7,585,752CurrentTaxYearAmt
Total$36,418,120TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,142,728CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,930,682CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,524,983CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,445,999CurrentTaxYearMinus1YearAmt
Current Tax Year$11,842,125CurrentTaxYearAmt
Total$40,886,517TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,174,117CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,368,692CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,611,915CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,800,471CurrentTaxYearMinus1YearAmt
Current Tax Year$3,005,618CurrentTaxYearAmt
Total$12,960,813TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,174,117CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,368,692CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,611,915CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,800,471CurrentTaxYearMinus1YearAmt
Current Tax Year$3,005,618CurrentTaxYearAmt
Total$12,960,813TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$27,925,704PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$633CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$748CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$701CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,601CurrentTaxYearMinus1YearAmt
Current Tax Year$4,289CurrentTaxYearAmt
Total$8,972TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$633CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$748CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$701CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,601CurrentTaxYearMinus1YearAmt
Current Tax Year$4,289CurrentTaxYearAmt
Total$8,972TotalAmt

Other Income509 OtherIncome509Grp

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
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,143,361CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,931,430CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,525,684CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,448,600CurrentTaxYearMinus1YearAmt
Current Tax Year$11,846,414CurrentTaxYearAmt
Total$40,895,489TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.68286PublicSupportCY509Pct
Public Support PY5090.66363PublicSupportPY509Pct
Investment Income CY0.00022InvestmentIncomeCYPct
Investment Income PY0.00014InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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$3,500OtherCostOrOtherBasisAmt
Book Value$3,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$6,533,963OtherCostOrOtherBasisAmt
Depreciation$4,945,845DepreciationAmt
Book Value$1,588,118BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,514,095OtherCostOrOtherBasisAmt
Depreciation$1,361,056DepreciationAmt
Book Value$153,039BookValueAmt

Equipment EquipmentGrp

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

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$198,457OtherCostOrOtherBasisAmt
Depreciation$151,178DepreciationAmt
Book Value$47,279BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,791,936TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$340,083
RESIDENT TRUST CASH$38,027
RESERVE FUND$567,062
INTEREST RESERVE FUND$459,760
CONSTRUCTION IN PROGRESS$12,020,962
FieldValueIRS element (for citing)
Total Book Value Other Assets$13,425,894TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED INTEREST PAYABLE$41,400
DUE TO AFFILIATES$18,823
ASSET RETIREMENT OBLIGATION$31,320
CONSTRUCTION PAYABLE$2,866,480
FieldValueIRS element (for citing)
Total Liability$2,958,023TotalLiabilityAmt
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.
Schedule D, Part X, Line 2THE CORPORATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501 (C) (3) AND APPLICABLE STATE CODES. THE CORPORATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, 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 (6 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$494,499$0$48,337$0$26,636$0$60,077$0$18,962$0$648,511$0$48,337
KATHY YOUNGQUIST
CHIEF FINANCIAL OFFICER$0$317,931$0$10,000$0$57,460$0$58,286$0$24,301$0$467,978$0$32,615
MATTHEW KERN
CHIEF OPERATING OFFICER$0$304,172$0$12,273$0$8,227$0$48,009$0$35,449$0$408,130$0$0
KATHY KOPP
CHIEF STRATEGIC OFFICER$0$250,790$0$11,059$0$5,901$0$50,739$0$39,561$0$358,050$0$0
SHARON WILSON
CHIEF CLINICAL AND COMPLIANCE OFFICER$0$195,286$0$30,867$0$15,026$0$27,967$0$14,731$0$283,877$0$19,279
ANGELA BROWN
CHIEF HUMAN RESOURCE OFFICER$0$195,671$0$10,000$0$30,608$0$37,914$0$22,913$0$297,106$0$18,838

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 - $28,701 KATHY YOUNGQUIST, CFO - $48,725 MATTHEW KERN, COO - $36,409 ANGELA BROWN, CHRO - $29,958
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
PORT AUTHORITY OF THE CITY OF SAINT PAUL
A4160055242005-03-14$4,400,000MORATORIUM CONSTRUCTION PROJECT000
CITY OF FALCON HEIGHTS MINNESOTA
B4160076442021-05-28$7,000,000CONSTRUCTION OF NEW NURSING HOME AND ASSISTED LIVING BUILDING000
CITY OF HAMPTON MINNESOTA
C4112322592021-05-28$10,000,000CONSTRUCTION OF NEW NURSING HOME AND ASSISTED LIVING BUILDING000
CITY OF LANDFALL VILLAGE MINNESOTA
D4115928212021-05-28$10,000,000CONSTRUCTION OF NEW NURSING HOME AND ASSISTED LIVING BUILDING000

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$3,286,661$0$4,400,000$0$180,257$0$0$0$0$4,219,743$0$0200600Yes (1)Yes (1)
B$0$0$7,000,000$0$0$0$100,000$0$0$0$0$6,900,000202200Yes (1)Yes (1)
C$0$0$10,000,000$0$0$0$427,614$0$0$0$0$9,572,386202200Yes (1)Yes (1)
D$0$0$10,000,000$0$0$0$100,000$0$0$0$0$9,900,000202200Yes (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 (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule K, Part IV, Line 2c-03/14/2005 4,400,000 PORT AUTHORITY OF THE CITY OF SAINT PAULTHERE WERE NO INVESTMENT EARNINGS ON ANY BOND PROCEEDS.
Schedule K, Part IV, Line 2c-05/28/2021 7,000,000 CITY OF FALCON HEIGHTS MINNESOTA5 YEAR ANNIVERSARY HAS NOT OCCURRED YET.
Schedule K, Part IV, Line 2c-05/28/2021 10,000,000 CITY OF HAMPTON MINNESOTA5 YEAR ANNIVERSARY HAS NOT OCCURRED YET.
Schedule K, Part IV, Line 2c-05/28/2021 10,000,000 CITY OF LANDFALL VILLAGE MINNESOTA5 YEAR ANNIVERSARY HAS NOT OCCURRED YET.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF LITTLE CANADA MINNESOTABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN410973960BondIssuerEIN
CUSIP537029AL4CUSIPNum
Bond Issued2021-05-28BondIssuedDt
Issue Price$7,550,000IssuePriceAmt
PurposeCONSTRUCTION OF NEW NURSING HOME AND ASSISTED LIVING BUILDINGPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$0RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$7,550,000TotalProceedsAmt
In Reserve Fund$575,000InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$151,000IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$6,824,000CapitalExpendituresAmt
Other Spent Proceeds$0OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2022SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Private Bus Concerning UBI0PrivateBusConcerningUBIPct
Total Private Business Use0TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule K, Part IV, Line 2c-05/28/2021 7,550,000 CITY OF LITTLE CANADA MINNESOTAFormAndLineReferenceDesc
Explanation5 YEAR ANNIVERSARY HAS NOT OCCURRED YET.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 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 XI, Line 9OTHER CHANGES IN NET ASSETS WERE AS FOLLOWS: $151,671 NET RESTRICTED CONTRIBUTIONS TRANSFERRED FROM CASSIA (A RELATED ORGANIZATION), ($14,219) NET ASSETS RELEASED FROM RESTRICTION AND ($1) 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)70CASSIA
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
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
EVANGELICAL RETIREMENT HOMES INC
7171 OHMS LANEEDINAMN55439420868449HEALTH CARE FACILITIES/SERVICESIA501(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 Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd