BAPTIST HOME INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- BAPTIST HOME INC (EIN 45-0232943)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-10
- IRS object ID
- 202243149349305519
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-10T09:39:25-07:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450232943 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAPTIST HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BAPT | BusinessNameControlTxt |
| Phone | 9528555000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7171 Ohms Lane | AddressLine1Txt |
| City | Edina | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55439 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kathy Youngquist | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Phone | 9528555000 | PhoneNum |
| Signature | 2022-11-10 | SignatureDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 1 | TrustedCustomerCd |
| OOB Security Verification | 11 | OOBSecurityVerificationCd |
| Last Submission Rqr OOB | 1 | LastSubmissionRqrOOBCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT DAHL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7171 OHMS LANE | AddressLine1Txt |
| City | EDINA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55439 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,230,367 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cassialife.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1940 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE, HOUSING, AND COMMUNITY SERVICES FOR THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 369 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $698,684 | PYContributionsGrantsAmt |
| CY Contributions Grants | $231,729 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,038,081 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,745,415 | CYProgramServiceRevenueAmt |
| PY Investment Income | $74,956 | PYInvestmentIncomeAmt |
| CY Investment Income | $175,219 | CYInvestmentIncomeAmt |
| PY Other Revenue | $66,815 | PYOtherRevenueAmt |
| CY Other Revenue | $198,005 | CYOtherRevenueAmt |
| PY Total Revenue | $17,878,536 | PYTotalRevenueAmt |
| CY Total Revenue | $18,350,368 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,258,345 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,352,645 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,898,462 | PYOtherExpensesAmt |
| CY Other Expenses | $6,964,045 | CYOtherExpensesAmt |
| PY Total Expenses | $17,156,807 | PYTotalExpensesAmt |
| CY Total Expenses | $18,316,690 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $721,729 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $33,678 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,103,941 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,839,414 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,124,940 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,664,538 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,979,001 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,174,876 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS IN THE SPIRIT OF CHRIST'S LOVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,293,924 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $17,745,415 | RevenueAmt |
| Desc | BAPTIST HOME, INC. WAS ORGANIZED FOR THE PURPOSE OF PROVIDING NURSING CARE FOR THE ELDERLY. IT HAS 140 BEDS AND IS LOCATED IN BISMARCK, ND. FOR THE YEAR ENDED DECEMBER 31, 2021, BAPTIST HOME HAD 49,356 RESIDENT DAYS (96.6% OCCUPANCY). UTILIZATION BY PAYOR SOURCES WAS AS FOLLOWS: 55.0% MEDICAID, 34.4% PRIVATE, 10.3% MEDICARE AND .3% HMO. | Desc |
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $16,293,924 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 369 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kathy L Youngquist | PersonNm |
| Phone | 9528555000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7171 Ohms Lane | AddressLine1Txt |
| City | Edina | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55439 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT DAHL | ||||||||
| PRESIDENT/CEO | 1.92 | 38.08 | Yes (X) | $0 | $569,472 | $79,039 | ||
| KATHY YOUNGQUIST | ||||||||
| CHIEF FINANCIAL OFFICER | 1.92 | 38.08 | Yes (X) | $0 | $385,391 | $82,587 | ||
| MATTHEW KERN | ||||||||
| CHIEF OPERATING OFFICER | 1.92 | 38.08 | Yes (X) | $0 | $324,672 | $83,458 | ||
| KATHY KOPP | ||||||||
| CHIEF STRATEGIC OFFICER | 1.92 | 38.08 | Yes (X) | $0 | $267,750 | $90,300 | ||
| ANGELA BROWN | ||||||||
| CHIEF HUMAN RESOURCE OFFICER | 1.92 | 38.08 | Yes (X) | $0 | $236,279 | $60,827 | ||
| SHARON WILSON | ||||||||
| CHIEF CLINICAL AND COMPLIANCE OFFICER | 1.92 | 38.08 | Yes (X) | $0 | $241,179 | $42,698 | ||
| DEANNA BERG | ||||||||
| ADMINISTRATOR | 40 | 0 | $152,625 | $0 | $36,030 | Yes (X) | ||
| TANYA MOSZER | ||||||||
| DIRECTOR OF NURSING | 40 | 0 | $110,101 | $0 | $12,694 | Yes (X) | ||
| GERALD GROSZ | ||||||||
| CHAIR | 0.25 | 0.25 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MAYSIL MALARD | ||||||||
| VICE CHAIR | 0.25 | 0.25 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DARREL GRUBB | ||||||||
| SECRETARY | 0.25 | 0.25 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PASTOR JAMES GRUBB | ||||||||
| DIRECTOR | 0.25 | 0.25 | $0 | $0 | $0 | Yes (X) | ||
| MICHALE JUST | ||||||||
| DIRECTOR | 0.25 | 0.25 | $0 | $0 | $0 | Yes (X) | ||
| KAREN SCHINDLER | ||||||||
| DIRECTOR | 0.25 | 0.25 | $0 | $0 | $0 | Yes (X) | ||
| DENNIS SOTEBEER | ||||||||
| DIRECTOR | 0.25 | 0.25 | $0 | $0 | $0 | Yes (X) | ||
| DR GUY TANGEDAHL | ||||||||
| DIRECTOR | 0.25 | 4.75 | $0 | $0 | $0 | Yes (X) | ||
| DR BRIAN WRIGHT | ||||||||
| DIRECTOR | 0.25 | 0.5 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $262,726 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,024,743 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $487,633 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| DTN STAFFING INC | ||||||
| 1200 COLLINS AVE | MANDAN | ND | 58554 | POOLED NURSING SERVICES | $796,506 | |
| CASSIA SERVICES | ||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | MANAGEMENT SERVICES | $722,564 | |
| PRO REHAB | ||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | THERAPY SERVICES | $545,206 | |
| PRIME TIME HEALTHCARE INC | ||||||
| C/O AMERICAN NATIONAL BANK | OMAHA | NE | 68103 | POOLED NURSING SERVICES | $227,742 | PO BOX 3544 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $231,729 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $231,729 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NURISNG HOME SERVICES | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $17,745,415 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,745,415 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,745,415 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $76,612 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $76,612 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $978,606 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $879,999 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $98,607 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,607 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $98,607 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| BEAUTY SHOP | 900099 | $12,926 | $12,926 | $0 | $0 |
| TELEPHONE | 900099 | $11,200 | $11,200 | $0 | $0 |
| CABLE TV | 900099 | $31,694 | $31,694 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $142,185 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $142,185 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $198,005 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,350,368 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,943,420 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $175,219 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,323,879 | TotalAmt |
| Program Services | $8,736,352 | ProgramServicesAmt |
| Management And General | $587,527 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,604 | TotalAmt |
| Program Services | $178,593 | ProgramServicesAmt |
| Management And General | $12,011 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,159,439 | TotalAmt |
| Program Services | $1,086,379 | ProgramServicesAmt |
| Management And General | $73,060 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $678,723 | TotalAmt |
| Program Services | $635,955 | ProgramServicesAmt |
| Management And General | $42,768 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,564 | TotalAmt |
| Management And General | $722,564 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$1,431 | TotalAmt |
| Management And General | -$1,431 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,461 | TotalAmt |
| Management And General | $22,461 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,450 | TotalAmt |
| Management And General | $29,450 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,932,885 | TotalAmt |
| Program Services | $1,925,248 | ProgramServicesAmt |
| Management And General | $7,637 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,649 | TotalAmt |
| Management And General | $21,649 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,418 | TotalAmt |
| Program Services | $26,803 | ProgramServicesAmt |
| Management And General | $55,615 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,926 | TotalAmt |
| Program Services | $12,553 | ProgramServicesAmt |
| Management And General | $33,373 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286,320 | TotalAmt |
| Program Services | $269,141 | ProgramServicesAmt |
| Management And General | $17,179 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,726 | TotalAmt |
| Management And General | $19,726 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,731 | TotalAmt |
| Management And General | $26,731 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $560,995 | TotalAmt |
| Program Services | $527,335 | ProgramServicesAmt |
| Management And General | $33,660 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,501,253 | TotalAmt |
| Program Services | $1,411,178 | ProgramServicesAmt |
| Management And General | $90,075 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,052 | TotalAmt |
| Program Services | $110,969 | ProgramServicesAmt |
| Management And General | $7,083 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $999,573 | $963,993 | $35,580 | $0 |
| FOOD | $323,614 | $323,614 | $0 | $0 |
| BAD DEBT | $71,531 | $0 | $71,531 | |
| OTHER MISCELLANEOUS | $200,328 | $85,811 | $114,517 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,316,690 | TotalAmt |
| Program Services | $16,293,924 | ProgramServicesAmt |
| Management And General | $2,022,766 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,572,851 | BOYAmt |
| EOY | $1,227,150 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,312,830 | BOYAmt |
| EOY | $1,435,615 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,308 | BOYAmt |
| EOY | $44,084 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,721,906 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,376,966 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,520,343 | BOYAmt |
| EOY | $16,344,940 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,318,462 | BOYAmt |
| EOY | $3,488,441 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $474,036 | BOYAmt |
| EOY | $519,297 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $864,111 | BOYAmt |
| EOY | $779,887 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,103,941 | BOYAmt |
| EOY | $23,839,414 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,023,397 | BOYAmt |
| EOY | $1,121,829 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,729 | BOYAmt |
| EOY | $86,296 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,515 | BOYAmt |
| EOY | $19,418 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,033,887 | BOYAmt |
| EOY | $16,144,964 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $806,412 | BOYAmt |
| EOY | $292,031 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,124,940 | BOYAmt |
| EOY | $17,664,538 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,618,033 | BOYAmt |
| EOY | $5,828,526 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $360,968 | BOYAmt |
| EOY | $346,350 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,979,001 | BOYAmt |
| EOY | $6,174,876 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,103,941 | BOYAmt |
| EOY | $23,839,414 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $33,678 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $129,687 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $32,510 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $698,684 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $231,729 | CurrentTaxYearAmt |
| Total | $930,413 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,458,928 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,909,814 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,158,416 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,093,095 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,802,435 | CurrentTaxYearAmt |
| Total | $82,422,688 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,458,928 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,909,814 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,158,416 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,791,779 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,034,164 | CurrentTaxYearAmt |
| Total | $83,353,101 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $83,353,101 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,004 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,144 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $62,461 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,956 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $175,219 | CurrentTaxYearAmt |
| Total | $407,784 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,004 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,144 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $62,461 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,956 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $175,219 | CurrentTaxYearAmt |
| Total | $407,784 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $37,388 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $84,432 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,741 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,801 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $140,985 | CurrentTaxYearAmt |
| Total | $281,347 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,539,320 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,048,390 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,227,618 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,876,536 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,350,368 | CurrentTaxYearAmt |
| Total | $84,042,232 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99180 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99450 | PublicSupportPY509Pct |
| Investment Income CY | 0.00485 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00330 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part III, Line 12 | FormAndLineReferenceDesc |
| Explanation | INSURANCE PROCEEDS 2021: $130,663, VENDING MACHINE/GIFT SHOP/MISC. INCOME 2021: $10,322, 2020: $11,801, 2019: $6,741, 2018: $84,432, 2017: $37,388 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $259,800 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $259,800 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $259,800 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $259,800 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $259,800 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $259,800 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $259,800 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $259,800 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $259,800 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $259,800 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $712,908 | OtherCostOrOtherBasisAmt |
| Book Value | $712,908 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $21,773,742 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,631,327 | DepreciationAmt |
| Book Value | $13,142,415 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,941,318 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,979,327 | DepreciationAmt |
| Book Value | $1,961,991 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,293,938 | OtherCostOrOtherBasisAmt |
| Depreciation | $766,312 | DepreciationAmt |
| Book Value | $527,626 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,344,940 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $36,711 |
| MC COVID-19 ADVANCED PMT PAYABLE | $95,411 |
| OTHER - MISCELLANEEOUS PAYABLE | $75,491 |
| ACCRUED INTEREST PAYABLE | $84,418 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $292,031 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part IV, Line 2b | THE 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 V, Line 4 | THE PRINCIPAL OF THE ENDOWMENT FUNDS CANNOT BE USED. |
| Schedule D, Part X, Line 2 | AND ITS AFFILIATES HAVE BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THESE 501(c)(3) ORGANIZATIONS HAVE BEEN CLASSIFIED AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS UNDER SECTION 509(A). THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATION THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp 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 |
| DEANNA BERG | ||||||||||||||
| ADMINISTRATOR | $138,240 | $0 | $11,077 | $0 | $3,309 | $0 | $6,301 | $0 | $29,729 | $0 | $188,656 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a | CASSIA AND ITS AFFILIATES PROVIDE VEHICLE BENEFITS FOR SOME OF ITS OFFICERS AND KEY EMPLOYEES. THE EMPLOYEE IS RESPONSIBLE FOR TRACKING BUSINESS VERSUS PERSONAL USE OF THE VEHICLE. THE PERSONAL USAGE OF THE VEHICLES IS TREATED AS TAXABLE COMPENSATION BY CASSIA AND ITS AFFILIATES. |
| Schedule J, Part I, Line 3 | THE CORPORATION RELIED ON THE PARENT ORGANIZATION, CASSIA, TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO. CASSIA USES THE FOLLOWING PRACTICES: INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY AND RECOMMENDATIONS FROM THE CASSIA COMPENSATION COMMITTEE TO THE CASSIA BOARD. |
| Schedule J, Part I, Line 4 | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PROVIDED BY CASSIA SERVICES: KATHY KOPP, CSO - $28,701 KATHY YOUNGQUIST, CFO - $48,725 MATTHEW KERN, COO - $36,409 ANGELA BROWN, CHRO - $29,958 |
| Schedule J, Part I, Line 6 | OFFICERS OF CASSIA SERVICES AND KEY EMPLOYEES OF CASSIA AND ITS AFFILIATES ARE ELIGIBLE TO ACCRUE INCENTIVE BONUSES EACH YEAR THAT ARE CONTINGENT ON PERFORMANCE METRICS AND FINANCIAL GOALS OF THE ORGANIZATION. |
| Schedule J, Part II | ALL OFFICERS' COMPENSATION WAS PAID BY CASSIA SERVICES, THE MANAGEMENT SERVICES COMPANY. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Burleigh County North Dakota | ||||||||
| A | 456002204 | 000000000 | 2012-07-31 | $6,000,000 | To finance construction of a new nursing facility | 0 | 0 | 0 |
| City of Wilton North Dakota | ||||||||
| B | 456002188 | 000000000 | 2016-07-01 | $10,000,000 | To pay down a portion of the 2012 bonds | 0 | 0 | 0 |
| City of Lincoln North Dakota | ||||||||
| C | 450345241 | 000000000 | 2016-07-01 | $9,000,000 | To pay down a portion of the 2012 bonds | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $4,010,000 | $0 | $6,000,000 | $490,230 | $0 | $0 | $120,000 | $0 | $0 | $5,389,770 | $0 | $0 | 2013 | 0 | 0 | Yes (1) | Yes (1) |
| B | $1,143,952 | $0 | $10,000,000 | $0 | $0 | $0 | $0 | $0 | $0 | $10,000,000 | $0 | $0 | 2013 | Yes (1) | 0 | Yes (1) | Yes (1) |
| C | $1,029,557 | $0 | $9,000,000 | $0 | $0 | $0 | $0 | $0 | $0 | $9,000,000 | $0 | $0 | 2013 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) |
| C | 0 | Yes (1) | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule K, Part IV, Line 2c-07/31/2012 6,000,000 Burleigh County North Dakota | NO AMOUNT WAS DUE. |
| Schedule K, Part IV, Line 2c-07/01/2016 10,000,000 City of Wilton North Dakota | 5 YEAR ANNIVERSARY HAS NOT OCCURED YET. |
| Schedule K, Part IV, Line 2c-07/01/2016 9,000,000 City of Lincoln North Dakota | 5 YEAR ANNIVERSARY HAS NOT YET OCCURED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 3 | A RELATED ORGANIZATION, CASSIA SERVICES, MANAGES ITS OWN AFFILIATES, CASSIA, ELIM CARE, INC., AUGUSTANA CARE AND ALL ELIM/AUGUSTANA AFFILIATES. SERVICES PROVIDED INCLUDE FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, PHILANTHROPY AND NEW BUSINESS DEVELOPMENT. |
| Form 990, Part VI, Section A, Line 6 | THE SOLE MEMBER OF THE ORGANIZATION IS ELIM CARE, INC. THE SOLE MEMBER OF ELIM CARE, INC. IS CASSIA. |
| Form 990, Part VI, Section A, Line 7a | THE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED BY A MAJORITY VOTE FROM THE BOARD OF DIRECTORS OF THE SOLE MEMBER, ELIM CARE, INC, AT THE ANNUAL MEETING. AT LEAST 41% OF THE DIRECTORS MUST BE MEMBERS OF A NORTH AMERICAN BAPTIST CONFERENCE CHURCH. |
| Form 990, Part VI, Section A, Line 7b | ELIM CARE, INC. IS THE SOLE MEMBER OF THE CORPORATION. BOARD MEMBERS OF THE CORPORATION ARE APPOINTED BY THE SOLE MEMBER. DECISIONS OF THE CORPORATION ARE SUBJECT TO APPROVAL BY THE SOLE MEMBER. CERTAIN ACTIONS ARE FURTHER SUBJECT TO APPROVAL BY THE CASSIA BOARD, WHICH IS THE PARENT ORGANIZATION. |
| Form 990, Part VI, Section B, Line 11b | THE FORM 990 AND ALL RELATED SCHEDULES WERE PREPARED BY INTERNAL FINANCE STAFF AND REVIEWED BY THE ORGANIZATION'S CFO. THE FORM 990 WAS MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS PRIOR TO BEING FILED WITH THE IRS. |
| Form 990, Part VI, Section B, Line 12c | THE ORGANIZATION ANNUALLY REQUESTS A CONFLICT OF INTEREST DISCLOSURE FROM EACH BOARD MEMBER, KEY EMPLOYEE AND OFFICER. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND KEY EMPLOYEES. ALL COVERED INDIVIDUALS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND TO DISCLOSE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST TO THE APPROPRIATE LEVEL OF MANAGEMENT OR TO THE BOARD OF DIRECTORS AS OUTLINED IN THE POLICY, BASED ON THE INDIVIDUAL'S POSITION WITHIN THE ORGANIZATION. CONFLICTS ARE DETERMINED AT THE APPROPRIATE LEVEL OF MANAGEMENT OR BY THE BOARD OF DIRECTORS. INDIVIDUALS WITH ACTUAL OR POTENTIAL CONFLICTS WILL ABSTAIN FROM DISCUSSING OR VOTING ON ANY MATTERS RELATING TO THE CONFLICT. ALL PROCEEDINGS RELATING TO ACTUAL OR POTENTIAL CONFLICTS ARE NOTED IN THE MEETING MINUTES. |
| Form 990, Part VI, Section B, Line 15 | THE BOARD OF DIRECTORS ROUTINELY RETAINS THE SERVICES OF A COMPENSATION CONSULTANT TO REVIEW THE CURRENT WAGE AND BENEFIT LEVELS OF SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE USES THIS INFORMATION TO MAKE A RECOMMENDATION TO THE BOARD OF DIRECTORS. |
| Form 990, Part VI, Section C, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part IX, Line 11g | OTHER CONTRACTED SERVICES CONSIST OF: POOLED NURSING: $1,071,303, THERAPY: $605,769, MAINTENANCE: $120,267, PHARMACY: $23,042, AND OTHER: $112,504 |
| Form 990, Part X, Line 2 | ELIM CARE, INC. AND ITS AFFILIATES HAVE BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THESE 501(c)(3) ORGANIZATIONS HAVE BEEN CLASSIFIED AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS UNDER SECTION 509(A). THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATION THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. ELIM CARE, INC. AND ITS AFFILIATES' INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION REPORTS ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES AND FILES ALL PROPER RETURNS RELATED TO THESE ACTIVITIES. |
| Form 990, Part XI, Line 9 | OTHER CHANGES IN NET ASSETS WERE AS FOLLOWS: TRANSFERS FROM AFFILIATES: $52,142, NET ASSETS RELEASED FROM RESTRICTION FOR OPERATIONS: -$19,632 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (33 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CASSIA | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 831758728 | PARENT CO/FUND RAISING | MN | 501(C)(3) | 7 | N/A | 0 | |
| CASSIA SERVICES | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411806946 | MANAGEMENT SERVICES | MN | 501(C)(3) | 12 | 0 | CASSIA | |
| ELIM CARE INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411694818 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 7 | 0 | CASSIA | |
| AUGUSTANA CARE | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411728753 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 7 | 0 | CASSIA | |
| PIONEER HOUSE ASSISTED LIVING INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411927112 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| NEW HARMONY CARE CENTER INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411821882 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| COUNTRY MEADOWS OF MILACA INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 201723948 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| LAKE RIDGE CARE CENTER OF BUFFALO INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 200507069 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| PARK TERRACE ASSISTED LIVING INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 204063752 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| EVANGELICAL RETIREMENT HOMES INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 420868449 | HEALTH CARE FACILITIES/SERVICES | IA | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| VILLAGE ASSISTED LIVING INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 262086933 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| THE BAPTIST APARTMENTS INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 450359794 | HEALTH CARE FACILITIES/SERVICES | ND | 501(C)(3) | PF | 0 | ELIM CARE INC | |
| ELIM SHORES INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411625095 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| CORNERSTONE ASSISTED LIVING OF PLYMOUTH INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 412013927 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| HAVEN HOMES INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 416045816 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| ELIM SENIOR HOUSING INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 810754064 | HEALTH CARE FACILITIES/SERVICES | FL | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| NEWTON VILLAGE INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 200044030 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| ELIM HOMES INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411539761 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| REDEEMER RESIDENCE INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 410711597 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM HOMES INC | |
| PARK VIEW CARE CENTER | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 410855707 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | ELIM HOMES INC | |
| THE PARK LANE APARTMENTS INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 410972384 | LOW INCOME HOUSING | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| ELIM CHILDREN'S CENTER INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411974507 | CHILD DAYCARE | MN | 501(C)(3) | 10 | 0 | ELIM CARE INC | |
| ELIM CARE FOUNDATION | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411694817 | CHARITABLE FOUNDATION | MN | 501(C)(3) | 12 | 0 | ELIM CARE INC | |
| COMMUNITY HEALTH FOUNDATION OF WRIGHT COUNTY | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 363546789 | CHARITABLE FOUNDATION | MN | 501(C)(3) | PF | 0 | ELIM CARE INC | |
| APPLE VALLEY VILLA APARTMENTS | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 311608691 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | AUGUSTANA CARE | |
| AUGUSTANA CARE FOUNDATION | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411360678 | CHARITABLE FOUNDATION | MN | 501(C)(3) | 12 | 0 | AUGUSTANA CARE | |
| AUGUSTANA CHAPEL VIEW HOMES INC | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 410693953 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | AUGUSTANA CARE | |
| AUGUSTANA COMMUNITY PARTNERS | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411783680 | HOME HEALTH CARE SERVICES | MN | 501(C)(3) | 10 | 0 | AUGUSTANA CARE | |
| AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 311608696 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | AUGUSTANA CARE | |
| AUGUSTANA HOME OF HASTINGS | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 311572624 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | AUGUSTANA CARE | |
| AUGUSTANA APARTMENTS OF HASTINGS | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 311608701 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | 0 | AUGUSTANA CARE | |
| BROOKSIDE SENIOR LIVING | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 410871848 | HEALTH CARE FACILITIES/SERVICES | MN | 501(C)(3) | 10 | N/A | 0 | |
| OPEN CIRCLE ADULT DAY CENTER | |||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411424801 | ADULT DAYCARE | MN | 501(C)(3) | 10 | 0 | AUGUSTANA CARE | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ELIM PREFERRED SERVICES INC | ||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411681856 | MEDICAL EQUIPMENT AND SUPPLIES | MN | ELIM CARE INC | C | 0 | 0 |
| PREFERRED SENIOR SERVICES INC | ||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 411942480 | MANAGEDMENT SERVICES | MN | ELIM CARE INC | C | 0 | 0 |
| AUGUSTANA SERNIOR DEVELOPMENT | ||||||||||
| 7171 OHMS LANE | EDINA | MN | 55439 | 264136110 | CONSULTING | MN | AUGUSTANA CARE | C | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |