2021-08-05T11:14:38-05:00 2020-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2019-10-01 411272572 CHOSEN VALLEY CARE CENTER INC CHOS 5078674220 1102 LIBERTY STREET SE CHATFIELD MN 55923 GARY BREN BOARD PRESIDENT 5078674220 2021-07-16 1 TYLER SWENSON P01663661 6123764500 2021-07-16 2019 2022-09-23 18:48:47Z GARY BREN 1102 LIBERTY STREET SE CHATFIELD MN 55923 7527898 0 X WWW.CHOSENVALLEYSENIORLIVING.COM X 1976 MN CHOSEN VALLEY CARE CENTER, INC. PROVIDES HOUSING AND NURSING CARE TO THE ELDERLY AND DISABLED. 10 10 200 10 0 0 660 20572 7679582 7567962 13269 9977 11410 -70613 7704921 7527898 0 0 0 0 5120551 5370573 0 0 0 2145014 2312107 7265565 7682680 439356 -154782 8775508 22116339 2782895 16278508 5992613 5837831 X THE CHOSEN VALLEY CARE CENTER AND APARTMENTS EXISTS TO EXPAND AND ENRICH THE LIVES OF OUR RESIDENTS THROUGH CHOICES IN RESIDENTIAL OPTIONS AND SUPPORTIVE SERVICES. THE ORGANIZATION CONSISTS OF A 78 BED SKILLED NURSING HOME, A 20 UNIT ASSISTED LIVING APARTMENT BUILDING AND A 15 UNIT INDEPENDENT LIVING APARTMENT BUILDING. 0 0 6543731 0 7567962 CHOSEN VALLEY CARE CENTER, INC. (THE CARE CENTER) IS A NONPROFIT CORPORATION WHICH OWNS AND OPERATES A 78-BED LICENSED NURSING FACILITY, A 15-UNIT RETIREMENT APARTMENT RESIDENCE, AND A 20-UNIT ASSISTED LIVING FACILITY LOCATED IN CHATFIELD, MINNESOTA. 6543731 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 37 0 1 200 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 0 1 0 0 0 0 1 1 1 1 1 1 0 0 MN X EMILY NICHOLS 5078674220 1102 LIBERTY ST SE CHATFIELD MN 55923 CRAIG BACKEN ADMINISTRATOR 40.00 X X 92423 0 2818 GARY BREN PRESIDENT 0.50 X X 0 0 0 MIKE THIEKE VICE PRESIDENT 0.50 X X 0 0 0 DAN HOLLERMANN TREASURER 0.50 X X 0 0 0 ANGIE BICKNESE SECRETARY 0.50 X X 0 0 0 MARY L ALLEN DIRECTOR 0.50 X 0 0 0 SHERYL BENNETT DIRECTOR 0.50 X 0 0 0 PAM HOLTE DIRECTOR 0.50 X 0 0 0 MIKE MULLEN DIRECTOR 0.50 X 0 0 0 MARY PATTEN DIRECTOR 0.50 X 0 0 0 MAUREEN RUSKELL DIRECTOR 0.50 X 0 0 0 92423 0 2818 0 0 0 0 AEGIS THERAPIES INC PO BOX 936653 ATLANTA GA 311936653 THERAPY SERVICES 289622 1 17410 3162 20572 MEDICARE/MEDICAID PAYM 623000 3828640 3828640 RESIDENT REVENUE 623000 3120598 3120598 ASSISTED LIVING REVENU 623000 618724 618724 7567962 9977 9977 MISCELLANEOUS INCOME 900099 12381 12381 MEAL REVENUE 623000 6290 6290 LOSS ON REFINANCING 900099 -89284 -89284 -70613 7527898 7567962 0 -60636 94754 94754 4270873 3842815 428058 62105 37463 24642 608238 366905 241333 334603 201841 132762 6303 6303 107181 102664 4517 4089 2720 1369 576058 529922 46136 191041 189429 1612 6406 2388 4018 25199 23479 1720 99282 75367 23915 300484 300484 54622 7586 47036 THERAPY EXPENSE 283629 283629 FOOD COSTS 253873 253873 LICENSES & PERMITS 228468 227142 1326 MISCELLANEOUS EXPENSE 113152 87733 25419 62320 8291 54029 7682680 6543731 1138949 0 3926744 3985862 778073 896209 429354 584202 62061 56782 15913888 6386861 3519714 9527027 59562 7066257 8775508 22116339 604242 2176967 2112619 14041634 66034 59907 2782895 16278508 X 5992613 5837831 5992613 5837831 8775508 22116339 -154782 0 X X 0 1 X 1 0 X 1745 5721 11451 660 20572 40149 6797956 7267678 7516108 7679582 7567962 36829286 6799701 7273399 7527559 7680242 7588534 36869435 0 0 0 36869435 4080 7045 8196 13269 9977 42567 4080 7045 8196 13269 9977 42567 20176 19507 18479 11410 -70613 -1041 6823957 7299951 7554234 7704921 7527898 36910961 0.99890 0.99650 0.00120 0.00100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 24078 24078 6887915 4874770 2013145 632835 242050 390785 1481813 1270041 211772 6887247 6887247 9527027 DAMAGE DEPOSIT 56075 BOND FUNDS 7010182 7066257 X 7527898 0 7527898 0 7527898 7682680 0 7682680 0 7682680 PART IV, LINE 2B: RESIDENT TRUST FUNDS AND RESIDENT SECURTITY DEPOSITS. PART X, LINE 2: THE CARE CENTER HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE CARE CENTER FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE CARE CENTER AS A RESULT OF THIS STANDARD. THE CARE CENTER FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE INTERNAL REVENUE SERVICE. A CITY OF CHATFIELD 416005045 2019-10-23 13916722 CONSTRUCTION/EXPANSION, REFUND PRIOR NOTE, FUND A DEBT SERVICE RESERVE FUND 0 0 0 A 125000 13916722 808200 917614 2190383 267000 9733525 1 0 0 0 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS COMPRISED OF NATURAL PERSONS OF LEGAL AGE WHO RESIDE IN THE CHATFIELD, MINNESOTA, SCHOOL DISTRICT AND HAVE RESIDED THEREIN CONTINUOUSLY FOR (1) YEAR PRECEDING THEIR QUALIFICATIONS FOR MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A AT THE ANNUAL MEETING OF THE BOARD OF DIRECTORS, THE MEMBERS SHALL ELECT, BY MAJORITY VOTE, THE DIRECTOR'S WHO ARE TO SERVE ON THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SHALL ELECT THE OFFICERS OF THE CORPORATION IN THE MANNER HEREIN AFTER PROVIDED. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD PRESIDENT WILL REVIEW AND PROVIDE THEIR SIGNATURE ON THE DOCUMENT AFTER COMPLETION BEFORE BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER AND KEY PERSONNEL ARE PROVIDED A CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICT OF INTEREST IS REPORTED ON THIS DOCUMENT. ANY POTENTIAL CONFLICT OF INTERESTS ARE REVIEWED AND FINAL DETERMINATIONS ARE MADE BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR'S SALARY IS DETERMINED BY REVIEW, DISCUSSION, AND APPROVAL OF THE BOARD OF DIRECTORS. THIS IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENT AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.