2021-11-01T07:55:40-07:00 2020-12-31 990 2020-01-01 262086933 VILLAGE ASSISTED LIVING INC VILL 9528555000 7171 OHMS LANE EDINA MN 55439 Kathy Youngquist Chief Financial Officer 9528555000 2021-11-01 0 11 1 AAL2 X 2020 2022-09-23 18:48:47Z VALLEY VIEW VILLAGE ASSISTED LIVING ROBERT DAHL 7171 OHMS LANE EDINA MN 55439 2768620 0 X WWW.CASSIALIFE.ORG X 2008 MN TO PROVIDE HEALTH CARE, HOUSING, AND COMMUNITY SERVICES FOR THE ELDERLY. 3 3 55 3 0 0 0 197887 2421163 2045041 36659 75484 18291 5003 2476113 2323415 0 0 0 0 1132455 1123247 0 0 0 1321706 1307741 2454161 2430988 21952 -107573 6333425 6215652 4495334 4372730 1838091 1842922 TO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS IN THE SPIRIT OF CHRIST'S LOVE. 0 0 2121088 2045041 VILLAGE ASSISTED LIVING, INC. WAS ORGANIZED FOR THE PURPOSE OF OPERATING AN ASSISTED LIVING FACILITY FOR THE ELDERLY. IT HAS 54 UNITS, IS LOCATED IN DES MOINES, IOWA AND IS ATTACHED TO THE NURSING HOME AT EVENGELICAL RETIREMENT HOMES, INC. (A RELATED ORGANIZATION). DURING 2020 TOTAL RESIDENT DAYS WERE 15409 (78.8% OCCUPANCY). 0 0 0 2121088 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 1 55 1 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X KATHY L YOUNGQUIST 9528555000 7171 OHMS LANE EDINA MN 55439 ROBERT DAHL PRESIDENT/CEO 0.25 39.75 X 0 520872 73644 KATHY KOPP CHIEF STRATEGIC OFFICER 0.25 39.75 X 0 447607 93161 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0.25 39.75 X 0 391408 48892 MATTHEW KERN CHIEF OPERATING OFFICER 0.25 39.75 X 0 322194 60097 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0.25 39.75 X 0 228372 37090 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0.25 39.75 X 0 211131 39181 RICHARD BJERKAAS DIRECTOR AND SECRETARY/TREASURER 0.25 2.25 X X 0 0 0 DOCTOR THOMAS CAIRNS DIRECTOR AND VICE CHAIRPERSON 0.25 2 X X 0 0 0 JOHN SUNDMAN DIRECTOR AND CHAIRPERSON 0.25 1.75 X X 0 0 0 0 2121584 352065 0 0 1 0 CASSIA SERVICES 7171 OHMS LANE EDINA MN 55439 MANAGEMENT SERVICES 111309 1 0 0 0 0 197887 0 0 197887 ASSISTED LIVING REVENUE 623000 2045041 2045041 0 0 0 0 0 0 2045041 26505 0 0 26505 0 0 0 0 0 0 0 0 0 0 494184 0 445205 0 48979 0 48979 0 0 48979 0 BEAUTY SHOP REVENUE 812900 5003 0 0 5003 0 0 0 0 5003 2323415 2045041 0 80487 935098 817731 117367 5346 4675 671 117425 102687 14738 65378 57172 8206 89717 89717 9856 9856 1275 1275 0 9983 9983 17450 16656 794 15521 15521 11729 11729 13842 13842 246132 246132 694 694 4520 4520 128266 128266 274474 274474 24530 24530 DIETARY/FOOD ALLOCATION 338051 338051 0 0 SUPPLIES 50704 50704 0 0 MAINTENANCE CONTRACTS/PURCHASED SERVICES 40055 40055 0 0 BUILDING & EQUIPMENT REPAIRS 19048 19048 0 0 11894 907 10987 2430988 2121088 309900 0 488818 438230 105357 161538 25886 34520 15700 12651 6525501 2652426 4110363 3873075 1038554 1133753 548747 561885 6333425 6215652 113839 111327 32500 4289395 4137567 92100 91336 4495334 4372730 X 1829451 1832862 8640 10060 1838091 1842922 6333425 6215652 X -107573 110985 0 0 0 1419 X X 0 1 X 1 0 X 197887 197887 2382816 2373686 2481902 2421163 2045041 11704608 2382816 2373686 2481902 2421163 2242928 11902495 715963 804338 970682 957223 1034400 4482606 715963 804338 970682 957223 1034400 4482606 7419889 25441 31102 26249 36659 75484 194935 25441 31102 26249 36659 75484 194935 21181 19642 20021 18291 5003 84138 2429438 2424430 2528172 2476113 2323415 12181568 0.60911 0.6394 0.01600 0.0115 X Schedule A, Part III, Line 12 OTHER INCOME INCLUDE: $5,003 BEAUTY SHOP REVENUE. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 0 0 0 0 5974196 2212210 3761986 0 0 0 0 0 478051 381846 96205 0 73254 58370 14884 3873075 DUE FROM AFFILIATES 522100 SECURITY DEPOSITS CASH 33285 INTEREST RECEIVABLE 6500 561885 ACCRUED INTEREST PAYABLE 7600 DUE TO AFFILIATES 83736 91336 X Schedule D, Part IV, Line 2b SECURITY DEPOSITS ARE REQUIRED FOR THE ORGANIZATION'S TENANTS AND INCLUDE RESERVED APARTMENTS IF AMOUNTS ARE PAID BEFORE THE TENANT ACTUALLY MOVES IN. Schedule D, Part X, Line 2 THE CORPORATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501 (C) (3) AND APPLICABLE STATE CODES. THE CORPORATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES AND FILES ALL PROPER RETURNS RELATED TO THESE ACTIVITIES. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 ROBERT DAHL PRESIDENT/CEO 0 452956 0 47554 0 20362 0 57237 0 16407 0 594516 0 147021 KATHY KOPP CHIEF STRATEGIC OFFICER 0 243050 0 16581 0 187976 0 58917 0 34244 0 540768 0 182581 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0 311454 0 50389 0 29565 0 51642 0 23447 0 466497 0 21108 MATTHEW KERN CHIEF OPERATING OFFICER 0 295044 0 19208 0 7942 0 37484 0 22613 0 382291 0 0 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0 189303 0 28674 0 10395 0 32464 0 20663 0 281499 0 12788 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0 187957 0 12683 0 10491 0 27521 0 11660 0 250312 0 0 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 - $48,475 KATHY YOUNGQUIST, CFO - $40,242 MATTHEW KERN, COO - $26,084 ANGELA BROWN, CHRO - $24,172 Schedule J, Part I, Line 6 OFFICERS OF CASSIA SERVICES AND KEY EMPLOYEES OF CASSIA AND ITS AFFILIATES ARE ELIGIBLE TO ACCRUE INCENTIVE BONUSES EACH YEAR THAT ARE CONTINGENT ON PERFORMANCE METRICS AND FINANCIAL GOALS OF THE ORGANIZATION. Schedule J, Part II ALL OFFICERS' COMPENSATION WAS PAID BY CASSIA SERVICES, THE MANAGEMENT SERVICES COMPANY. A CITY OF PLEASANT HILL IOWA 426035789 2014-12-10 5100000 REFINANCE EXISTING DEBT 0 0 1 A 901328 0 5100000 0 0 0 7696 0 0 0 0 0 2014 1 0 1 1 A 0 0 0 0 0 0 0 0 0 1 A 0 1 0 1 1 0 0 0 1 A 1 Schedule K, Part II, Line 3-12/10/2014 5,100,000 CITY OF PLEASANT HILL IOWA LOAN PROCEEDS ARE SPLIT BETWEEN VILLAGE ASSISTED LIVING, INC. AND EVANGELICAL RETIREMENT HOMES, INC. (A RELATED ORGANIZATION). THE BREAKDOWN IS AS FOLLOWS: VILLAGE ASSISTED LIVING, INC.-$5,100,000 AND EVANGELICAL RETIREMENT HOMES, INC.-$1,580,000. THE TOTAL COMBINED PROCEEDS ARE $6,680,000. Schedule K, Part IV, Line 2c-12/10/2014 5,100,000 CITY OF PLEASANT HILL IOWA THERE WERE NO INVESTMENT EARNINGS ON ANY BOND PROCEEDS. Form 990, Part VI, Section A, Line 3 A RELATED ORGANIZATION, CASSIA SERVICES, MANAGES ITS OWN AFFILIATES, ELIM CARE, INC., AUGUSTANA CARE AND ALL ELIM/AUGUSTANA AFFILIATES. SERVICES PROVIDED INCLUDE FINANCIAL ACCOUNTING, OPERATIONAL OVERSIGHT, HUMAN RESOURCES, INFORMATION TECHNOLOGY, CLINICAL NURSING CONSULTATION, CORPORATE COMPLIANCE, COORDINATED ADVERTISING AND MARKETING, PHILANTHROPY AND NEW BUSINESS DEVELOPMENT. Form 990, Part VI, Section A, Line 6 THE SOLE MEMBER OF THE ORGANIZATION IS ELIM CARE, INC. THE SOLE MEMBER OF ELIM CARE, INC. IS CASSIA. Form 990, Part VI, Section A, Line 7a THE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED BY A MAJORITY VOTE FROM THE BOARD OF DIRECTORS OF THE SOLE MEMBER, ELIM CARE, INC, AT THE ANNUAL MEETING. Form 990, Part VI, Section A, Line 7b ELIM CARE, INC IS THE SOLE MEMBER OF THE CORPORATION. BOARD MEMBERS OF THE CORPORATION ARE APPOINTED BY THE SOLE MEMBER. DECISIONS OF THE CORPORATION ARE SUBJECT TO APPROVAL BY THE SOLE MEMBER. CERTAIN ACTIONS ARE FURTHER SUBJECT TO APPROVAL BY THE CASSIA BOARD, WHICH IS THE PARENT ORGANIZATION. Form 990, Part VI, Section B, Line 11b THE FORM 990 AND ALL RELATED SCHEDULES WERE PREPARED BY THE DIRECTOR OF ACCOUNTING 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 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 SERVIES 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 TEH BOARD OF DIRECTORS. Form 990, Part VI, Section C, Line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS WERE AS FOLLOWS: $1,420 NET RESTRICTED CONTRIBUTIONS TRANSFERRED FROM CASSIA (A RELATED ORGANIZATION) AND ($1) ROUNDING. Form 990, Part XII, Line 2c OVERSIGHT OF THE AUDIT PROCESS CHANGED IN 2020 AND IS NOW HANDLED BY THE FINANCE COMMITTEE FOR CASSIA AND ITS AFFILIATES. CASSIA 7171 OHMS LANE EDINA MN 55439 831758728 PARENT CO/FUND RAISING MN 501(C)(3) 7 N/A 0 CASSIA SERVICES 7171 OHMS LANE EDINA MN 55439 411806946 MANAGEMENT SERVICES MN 501(C)(3) 12 CASSIA 0 ELIM CARE INC 7171 OHMS LANE EDINA MN 55439 411694818 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 7 CASSIA 0 AUGUSTANA CARE 7171 OHMS LANE EDINA MN 55439 411728753 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 7 CASSIA 0 PIONEER HOUSE ASSISTED LIVING INC 7171 OHMS LANE EDINA MN 55439 411927112 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 NEW HARMONY CARE CENTER INC 7171 OHMS LANE EDINA MN 55439 411821882 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 COUNTRY MEADOWS OF MILACA INC 7171 OHMS LANE EDINA MN 55439 201723948 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 LAKE RIDGE CARE CENTER OF BUFFALO INC 7171 OHMS LANE EDINA MN 55439 200507069 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 PARK TERRACE ASSISTED LIVING INC 7171 OHMS LANE EDINA MN 55439 204063752 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 EVANGELICAL RETIREMENT HOMES INC 7171 OHMS LANE EDINA MN 55439 420868449 HEALTH CARE FACILITIES/SERVICES IA 501(C)(3) 10 ELIM CARE INC 0 BAPTIST HOME INC 7171 OHMS LANE EDINA MN 55439 450232943 HEALTH CARE FACILITIES/SERVICES ND 501(C)(3) 10 ELIM CARE INC 0 THE BAPTIST APARTMENTS INC 7171 OHMS LANE EDINA MN 55439 450359794 HEALTH CARE FACILITIES/SERVICES ND 501(C)(3) PF ELIM CARE INC 0 ELIM SHORES INC 7171 OHMS LANE EDINA MN 55439 411625095 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 CORNERSTONE ASSISTED LIVING OF PLYMOUTH INC 7171 OHMS LANE EDINA MN 55439 412013927 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 HAVEN HOMES INC 7171 OHMS LANE EDINA MN 55439 416045816 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 ELIM SENIOR HOUSING INC 7171 OHMS LANE EDINA MN 55439 810754064 HEALTH CARE FACILITIES/SERVICES FL 501(C)(3) 10 ELIM CARE INC 0 NEWTON VILLAGE INC 7171 OHMS LANE EDINA MN 55439 200044030 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 ELIM HOMES INC 7171 OHMS LANE EDINA MN 55439 411539761 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE INC 0 REDEEMER RESIDENCE INC 7171 OHMS LANE EDINA MN 55439 410711597 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM HOMES INC 0 PARK VIEW CARE CENTER 7171 OHMS LANE EDINA MN 55439 410855707 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM HOMES INC 0 THE PARK LANE APARTMENTS INC 7171 OHMS LANE EDINA MN 55439 410972384 LOW INCOME HOUSING MN 501(C)(3) 10 ELIM CARE INC 0 ELIM CHILDREN'S CENTER INC 7171 OHMS LANE EDINA MN 55439 411974507 CHILD DAYCARE MN 501(C)(3) 10 ELIM CARE INC 0 ELIM CARE FOUNDATION 7171 OHMS LANE EDINA MN 55439 411694817 CHARITABLE FOUNDATION MN 501(C)(3) 12 ELIM CARE INC 0 COMMUNITY HEALTH FOUNDATION OF WRIGHT COUNTY 7171 OHMS LANE EDINA MN 55439 363546789 CHARITABLE FOUNDATION MN 501(C)(3) PF ELIM CARE INC 0 APPLE VALLEY VILLA APARTMENTS 7171 OHMS LANE EDINA MN 55439 311608691 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA CARE FOUNDATION 7171 OHMS LANE EDINA MN 55439 411360678 CHARITABLE FOUNDATION MN 501(C)(3) 12 AUGUSTANA CARE 0 AUGUSTANA CHAPEL VIEW HOMES INC 7171 OHMS LANE EDINA MN 55439 410693953 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA COMMUNITY PARTNERS 7171 OHMS LANE EDINA MN 55439 411783680 HOME HEALTH CARE SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY 7171 OHMS LANE EDINA MN 55439 311608696 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA HOME OF HASTINGS 7171 OHMS LANE EDINA MN 55439 311572624 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 AUGUSTANA APARTMENTS OF HASTINGS 7171 OHMS LANE EDINA MN 55439 311608701 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 AUGUSTANA CARE 0 BROOKSIDE SENIOR LIVING 7171 OHMS LANE EDINA MN 55439 410871848 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 N/A 0 OPEN CIRCLE ADULT DAY CENTER 7171 OHMS LANE EDINA MN 55439 411424801 ADULT DAYCARE MN 501(C)(3) 10 AUGUSTANA CARE 0 ELIM PREFERRED SERVICES INC 7171 OHMS LANE EDINA MN 55439 411681856 MEDICAL SALES MN ELIM CARE INC C 0 0 0 0 PREFERRED SENIOR SERVICES INC 7171 OHMS LANE EDINA MN 55439 411942480 MANAGEMENT SERVICES MN ELIM CARE INC C 0 0 0 0 AUGUSTANA SENIOR DEVELOPMENT INC 7171 OHMS LANE EDINA MN 55439 264136110 CONSULTING MN AUGUSTANA CARE C 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 1 1 0 0 1