STRATEGY STUDIO / PUBLIC DATA EXPLORER

APPLE VALLEY VILLA APARTMENTS: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
APPLE VALLEY VILLA APARTMENTS (EIN 31-1608691)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-09
IRS object ID
202233139349305908
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)
Return2022-11-09T14:19:25-07:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311608691EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1APPLE VALLEY VILLA APARTMENTSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAPPLBusinessNameControlTxt
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
Signature2022-11-08SignatureDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer0TrustedCustomerCd
OOB Security Verification11OOBSecurityVerificationCd
Last Submission Rqr OOB1LastSubmissionRqrOOBCd
Authentication Assurance LevelAAL2AuthenticationAssuranceLevelCd
Profile Password ChangeYes (X)ProfilePasswordChangeInd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

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$5,207,161GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.cassialife.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH CARE, HOUSING AND COMMUNITY SERVICES FOR THE ELDERLY.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee98TotalEmployeeCnt
Total Volunteers21TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$271,349PYContributionsGrantsAmt
CY Contributions Grants$981CYContributionsGrantsAmt
PY Program Service Revenue$4,939,039PYProgramServiceRevenueAmt
CY Program Service Revenue$4,700,440CYProgramServiceRevenueAmt
PY Investment Income$1,179PYInvestmentIncomeAmt
CY Investment Income$628CYInvestmentIncomeAmt
PY Other Revenue$568,722PYOtherRevenueAmt
CY Other Revenue$505,112CYOtherRevenueAmt
PY Total Revenue$5,780,289PYTotalRevenueAmt
CY Total Revenue$5,207,161CYTotalRevenueAmt
PY Grants And Similar Paid$1,713PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,418,016PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,480,576CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,071,534PYOtherExpensesAmt
CY Other Expenses$3,184,586CYOtherExpensesAmt
PY Total Expenses$5,491,263PYTotalExpensesAmt
CY Total Expenses$5,665,162CYTotalExpensesAmt
PY Revenues Less Expenses$289,026PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$458,001CYRevenuesLessExpensesAmt
Total Assets BOY$13,062,958TotalAssetsBOYAmt
Total Assets EOY$12,354,817TotalAssetsEOYAmt
Total Liabilities BOY$13,828,359TotalLiabilitiesBOYAmt
Total Liabilities EOY$13,575,225TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$765,401NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,220,408NetAssetsOrFundBalancesEOYAmt
MissionTO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS IN THE SPIRIT OF CHRIST'S LOVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,265,382ExpenseAmt
Grant$0GrantAmt
Revenue$5,207,162RevenueAmt
DescAPPLE VALLEY VILLA APARTMENTS IS A 208-UNIT SENIOR SERVICE AND CONGREGATE HOUSING COMPLEX IN APPLE VALLEY, MINNESOTA. APPLE VALLEY VILLA APARTMENTS SERVED 263 INDIVIDUALS DURING THE PERIOD ENDED DECEMBER 31, 2021.Desc
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$4,265,382TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
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 EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
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 Bonds0TaxExemptBondsInd
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 Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee98EmployeeCnt
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 Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
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 CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KATHY YOUNGQUISTBusinessNameLine1Txt
Business Name Line2CASSIA SERVICESBusinessNameLine2Txt
FieldValueIRS element (for citing)
Phone9528555000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17171 Ohms LaneAddressLine1Txt
CityEdinaCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ROBERT DAHL
PRESIDENT/CEO0.6939.31Yes (X)$0$569,472$79,039
KATHY YOUNGQUIST
CHIEF FINANCIAL OFFICER0.6939.31Yes (X)$0$385,391$82,587
MATTHEW KERN
CHIEF OPERATING OFFICER0.6939.31Yes (X)$0$324,672$83,458
KATHY KOPP
CHIEF STRATEGIC OFFICER0.6939.31Yes (X)$0$267,750$90,300
ANGELA BROWN
CHIEF HUMAN RESOURCES OFFICER0.6939.31Yes (X)$0$236,279$60,827
SHARON WILSON
CHIEF CLINICAL AND COMPLIANCE OFFICER0.6931.31Yes (X)$0$241,179$42,698
REV DR GARY WILKERSON
CHAIR0.252.25Yes (X)$0$0$0Yes (X)
TIMOTHY KUCK
VICE CHAIR0.252.25Yes (X)$0$0$0Yes (X)
ERIK ELLINGSON
TREASURER0.252.25Yes (X)$0$0$0Yes (X)
CHIP PARKS
SECRETARY0.252.25Yes (X)$0$0$0Yes (X)
JERRY NYE
DIRECTOR0.253.5$0$0$0Yes (X)
SCOTT RAMSDALE
DIRECTOR0.252.00$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

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonCASSIA SERVICESPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line17171 OHMS LANDEAddressLine1Txt
CityEDINACityNm
State AbbreviationMNStateAbbreviationCd
ZIP55439ZIPCd
FieldValueIRS element (for citing)
ServicesMANAGEMENT SERVICESServicesDesc
Compensation$260,588CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$0GovernmentGrantsAmt
All Other Contributions$981AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$981TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSENIOR APARTMENTSDesc
Business623000BusinessCd
Total Revenue Column$4,700,440TotalRevenueColumnAmt
Related Or Exempt Func Income$4,700,440RelatedOrExemptFuncIncomeAmt
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$4,700,440TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$628TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$628ExclusionAmt

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 Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
DIETARY REVENUE623990$281,876$0$0$281,876
TELEPHONE REVENUE623990$83,229$0$0$83,229
HOUSEKEEPING REVENUE623990$70,061$0$0$70,061

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$69,946TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$69,946ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$505,112OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,207,161TotalRevenueColumnAmt
Related Or Exempt Func Income$4,700,440RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$505,740ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,011,080TotalAmt
Program Services$1,557,486ProgramServicesAmt
Management And General$453,594ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$29,713TotalAmt
Program Services$23,011ProgramServicesAmt
Management And General$6,702ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$307,856TotalAmt
Program Services$238,420ProgramServicesAmt
Management And General$69,436ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$131,927TotalAmt
Program Services$102,171ProgramServicesAmt
Management And General$29,756ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$260,588TotalAmt
Program Services$0ProgramServicesAmt
Management And General$260,588ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,548TotalAmt
Program Services$0ProgramServicesAmt
Management And General$1,548ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$22,418TotalAmt
Program Services$0ProgramServicesAmt
Management And General$22,418ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$215,876TotalAmt
Program Services$154,596ProgramServicesAmt
Management And General$61,280ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$29,515TotalAmt
Program Services$0ProgramServicesAmt
Management And General$29,515ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$107,842TotalAmt
Program Services$43,186ProgramServicesAmt
Management And General$64,656ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$17,324TotalAmt
Program Services$0ProgramServicesAmt
Management And General$17,324ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$531,996TotalAmt
Program Services$457,670ProgramServicesAmt
Management And General$74,326ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$897TotalAmt
Program Services$0ProgramServicesAmt
Management And General$897ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$8,710TotalAmt
Program Services$0ProgramServicesAmt
Management And General$8,710ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$503,583TotalAmt
Program Services$433,226ProgramServicesAmt
Management And General$70,357ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$857,475TotalAmt
Program Services$737,675ProgramServicesAmt
Management And General$119,800ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$79,282TotalAmt
Program Services$68,205ProgramServicesAmt
Management And General$11,077ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES$169,753$162,415$7,338$0
DIETARY EXPENSES$234,526$234,526$0$0
BAD DEBT EXPENSE$59,511$0$59,511$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$83,742TotalAmt
Program Services$52,795ProgramServicesAmt
Management And General$30,947ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,665,162TotalAmt
Program Services$4,265,382ProgramServicesAmt
Management And General$1,399,780ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$791,163BOYAmt
EOY$493,012EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$206,191BOYAmt
EOY$172,219EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$25,573BOYAmt
EOY$24,779EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,937,624LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,979,623LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,549,891BOYAmt
EOY$9,958,001EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,490,140BOYAmt
EOY$1,706,806EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,062,958BOYAmt
EOY$12,354,817EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$179,200BOYAmt
EOY$195,534EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$108,407BOYAmt
EOY$123,509EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$12,227,831BOYAmt
EOY$11,949,288EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$538,103BOYAmt
EOY$555,884EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$774,818BOYAmt
EOY$751,010EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,828,359BOYAmt
EOY$13,575,225EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$1,536,318BOYAmt
EOY-$1,973,544EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$770,917BOYAmt
EOY$753,136EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$765,401BOYAmt
EOY-$1,220,408EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,062,958BOYAmt
EOY$12,354,817EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$458,001ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$0NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments-$6PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$3,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
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$7,079CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$65,518CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$50,403CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$271,349CurrentTaxYearMinus1YearAmt
Current Tax Year$972CurrentTaxYearAmt
Total$395,321TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,930,933CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,996,295CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,240,518CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,939,039CurrentTaxYearMinus1YearAmt
Current Tax Year$4,770,440CurrentTaxYearAmt
Total$20,877,225TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

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

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

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

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

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

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,938,012CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,061,813CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,290,921CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,210,388CurrentTaxYearMinus1YearAmt
Current Tax Year$4,771,412CurrentTaxYearAmt
Total$21,272,546TotalAmt

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
Current Tax Year$0CurrentTaxYearAmt
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$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

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$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$21,272,546PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,054CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,772CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$523CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,291CurrentTaxYearMinus1YearAmt
Current Tax Year$628CurrentTaxYearAmt
Total$11,268TotalAmt

Post1975 UBTI Post1975UBTIGrp

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

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,054CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,772CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$523CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,291CurrentTaxYearMinus1YearAmt
Current Tax Year$628CurrentTaxYearAmt
Total$11,268TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

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

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$553,927CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$562,822CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$153,808CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$567,610CurrentTaxYearMinus1YearAmt
Current Tax Year$505,113CurrentTaxYearAmt
Total$2,343,280TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,496,993CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,627,407CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,445,252CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,780,289CurrentTaxYearMinus1YearAmt
Current Tax Year$5,277,153CurrentTaxYearAmt
Total$23,627,094TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.90035PublicSupportCY509Pct
Public Support PY5090.9018PublicSupportPY509Pct
Investment Income CY0.00048InvestmentIncomeCYPct
Investment Income PY0.0006InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule A, Part III, Line 12DIETARY INCOME FROM TENANTS: 2017-$358,774, 2018-$369,331, 2019-$97,798, 2020-$362,337, 2021-$281,876 MISCELLANOUS INCOME FROM TENANTS: 2017-$53,220, 2018-$52,731, 2019-$13,532, 2020-$45,200, 2021-$69,946 HOUSKEEPING INCOME FROM TENANTS: 2017-$77,019, 2018-$74,677, 2019-$26,266, 2020-$97,521, 2021-$70,061 TELEPHONE INCEOM FROM TENANTS: 2017-$64,914, 2018-$65,083, 2019-$16,212, 2020-$62,552, 2021-$83,229
Schedule A, Part III, Line 13(f)COLUMN C, 2019, IS FOR A SHORT PERIOD THAT BEGAN ON OCTOBER 1, 2019 AND ENDED ON SEPTEMBER 31, 2019.

Schedule D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$525BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$525EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$525BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$525EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$525BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$525EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$525BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$525EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$525BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$525EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,402,457OtherCostOrOtherBasisAmt
Book Value$1,402,457BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$14,666,107OtherCostOrOtherBasisAmt
Depreciation$6,645,345DepreciationAmt
Book Value$8,020,762BookValueAmt

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$1,710,374OtherCostOrOtherBasisAmt
Depreciation$1,334,278DepreciationAmt
Book Value$376,096BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$158,686OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$158,686BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,958,001TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
TENANT SECURITY DEPOSITS$127,917
BENEFICIAL INTEREST IN NET ASSETS OF THE FOUNDATION$525
TAX AND INSURANCE ESCROW$232,602
RESIDUAL RECEIPTS ESCROW$629,407
RESERVE FOR REPLACEMENTS$713,355
DUE FROM AFFILIATE$3,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,706,806TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$751,010Amt
FieldValueIRS element (for citing)
Total Liability$751,010TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part IV, Line 2bSECURITY 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 V, Line 4THE PRINCIPAL WILL BE INVESTED AND KEPT INTACT FOR PERPETUITY TO PROVIDE AN ADDITIONAL SOURCE OF INCOME. THE INCOME GENERATED WILL BE USED TO SUPPORT THE FUNDS DESIGNATED PROGRAM. THE ORGANIZATION'S ENDOWMENT IS HELD AND ADMINISTERED BY AUGUSTANA CARE FOUNDAITON. SEE SCHEDULE R FOR ADDITIONAL DETAILS.
Schedule D, Part X, Line 2THE CORPORATIONS 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 ACTIVITEIS.

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 RESOURCES 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 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 AUGUSTANA CARE. THE SOLE MEMBER OF AUGUSTANA CARE 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, AUGUSTANA CARE, AT THE ANNUAL MEETING.
Form 990, Part VI, Section A, Line 7bAUGUSTANA CARE 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: UNRESRICITED FUND TRANSFER $3,000

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)70CASSUA
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
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 CARE INC
PARK VIEW CARE CENTER
7171 OHMS LANEEDINAMN55439410855707HEALTH CARE FACILITIES/SERVICESMN501(C)(3)100ELIM CARE 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
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 StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
ELIM PREFERRED SERVICES INC
7171 Ohms LaneEdinaMN55439411681856MEDICAL SALESMNN/AC$0$000
PREFERRED SENIOR SERVICES INC
7171 Ohms LaneEdinaMN55439411942480MANAGEMENT SERVICESMNN/AC$0$000
AUGUSTANA SENIOR DEVELOPMENT
7171 Ohms LaneEdinaMN55439264136110CONSULTINGMNN/AC$0$000
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 Org0LoansOrGuaranteesFromOthOrgInd
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 FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationEXTENSION WAS FILED TIMELY.ExplanationTxt