2020-08-14T08:37:45-05:00 2019-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2018-10-01 411728753 AUGUSTANA CARE AUGU 9528555000 7171 OHMS LANE EDINA MN 55439 KATHY YOUNGQUIST CFO 9528555000 2020-08-13 1 MATT WOCKEN P01598291 6123764500 2020-08-12 66.188.188.148 2020-08-13 07:14:22 CD P 80E1F4C36FD5403AFF9C3193509FEE9CEC8C2CF0 8DF0D5A1DBF8E44DE93554FEEDBEEE801640FE4C 2018 2020-09-23 17:36:50Z ROBERT DAHL 7171 OHMS LANE EDINA MN 55439 55970115 0 X WWW.CASSIALIFE.ORG X 1991 MN TO PROVIDE HEALTHCARE, HOUSING AND COMMMUNITY SERVICES FOR THE ELDERLY. 11 11 1310 331 7480470 0 5981364 2071138 47771784 52589532 172476 70781 345210 827655 54270834 55559106 721630 831616 0 0 32236154 34401741 0 18375 300625 19223858 19826903 52181642 55078635 2089192 480471 98499391 99759149 87877316 88024874 10622075 11734275 X TO SERVE GOD BY FOSTERING FULLNESS OF LIFE FOR OLDER ADULTS AND OTHER PEOPLE IN NEED THROUGH THE PROVISION OF HEALTH CARE, HOUSING AND OTHER SERVICES IN A CHRISTIAN TRADITION. 0 0 23362821 3000 27951130 THE EXPENSES LISTED ABOVE ARE RELATED TO DIRECT COSTS ASSOCIATED WITH THE PROVISION OF ASSISTED LIVING SERVICES AT AUGUSTANA ELK RUN ASSISTED LIVING IN EVERGREEN, CO, AUGUSTANA REGENT IN BURNSVILLE, MN, AUGUSTANA OAKVIEW CARE IN MOOSE LAKE, MN, CASTLE PEAK SENIOR LIVING OF EAGLE, CO, AND THROUGH AUGUSTANA RESIDENTIAL CARE. EXPENSES FOR EMERALD CREST ASSISTED LIVING AND MEMORY CARE, A SPECIALIZED PROGRAM FOR ADULTS WITH MEMORY LOSS AT FOUR SITES IN THE SUBURBAN MINNEAPOLIS AREA ARE ALSO INCLUDED. EMERALD CREST EMPLOYS A MODEL OF STRENGTH-BASED CARE FOR INDIVIDUALS WITH MEMORY LOSS IN SMALLER, HOME-LIKE RESIDENCES WHERE ONE'S DIGNITY, PRIVACY, SAFETY AND QUALITY OF LIFE ARE PRIORITIZED. IN TOTAL, THESE ASSISTED LIVING COMMUNITIES SERVED MORE THAN 586 PEOPLE DURING THE PAST FISCAL YEAR. 15388256 6865 17099684 THE ABOVE TOTAL INCLUDES OPERATING EXPENSES FOR AUGUSTANA MERCY HEALTH CARE CENTER OF MOOSE LAKE, MN, AUGUSTANA LAKESIDE HEALTH CARE CENTER OF DASSEL, MN, AND CASTLE PEAK SENIOR CARE IN EAGLE, CO. DURING THE PAST FISCAL YEAR, THESE THREE RURAL SKILLED NURSING COMMUNITIES PROVIDED REHABILITATION, SKILLED NURSING AND MEMORY CARE TO 516 PEOPLE. 7564469 821751 7516814 AS A LONG-TIME PROVIDER OF HEALTH CARE, HOUSING, AND COMMUNITY-BASED SERVICES, AUGUSTANA CARE APPLIES ITS EXPERIENCE AND IN-DEPTH KNOWLEDGE OF THE HEALTH CARE FIELD TO PROVIDE MANAGEMENT SERVICES FOR OTHER ORGANIZATIONS. AUGUSTANA CASH MANAGEMENT COMPANY, LLC, MANAGES THE CASH INFLOWS AND OUTFLOWS FOR THE AUGUSTANA CARE SUBSIDIARIES. THE EXPENSES LISTED ABOVE ARE FOR AUGUSTANA SENIOR DEVELOPMENT II, LLC, A BUSINESS UNIT OF AUGUSTANA CARE THROUGH WHICH MANAGEMENT SERVICES ARE PROVIDED TO UNRELATED NOT-FOR-PROFIT AND FOR-PROFIT COMMUNITIES IN MINNESOTA. THE NOT-FOR-PROFIT COMMUNITIES INCLUDE AUGUSTANA APARTMENTS AND CARDINAL HOMES IN FERGUS FALLS, AND ST. PAUL'S HOME APARTMENTS, SIGNE BURCKHARDT MANOR, THOMAS FEENEY MANOR, AND HERITAGE PARK ALL LOCATED IN MINNEAPOLIS. THE FOR-PROFIT ASSISTED LIVING COMMUNITIES INCLUDE THE PINES IN RICHFIELD, THE ROSEMOUNT IN ROSEMOUNT, AND RIVER BEND ASSISTED LIVING IN ROCHESTER. SERVICES INCLUDE CONSULTING, MARKETING, LEADERSHIP DEVELOPMENT, INFORMATION SYSTEMS SUPPORT, HOUSING DEVELOPMENT, AND EMPLOYEE RELATIONS. ALTOGETHER, THESE MANAGED FACILITIES SERVED 594 PEOPLE DURING THE PAST FISCAL YEAR. 349274 0 0 AUGUSTANA CARE'S FORM 990 ALSO INCLUDES FINANCIAL INFORMATION ABOUT A WHOLLY-OWNED SUBSIDIARY OF AUGUSTANA CARE CALLED AUGUSTANA PROPERTIES, LLC. THIS ENTITY OVERSEES EVERYTHING RELATED TO A NUMBER OF RENTAL PROPERTIES THAT HOUSE EMPLOYEES AND MEMBERS OF THE COMMUNITY AT LARGE. 349274 0 0 46664820 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 248 0 1310 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X KATHY YOUNGQUIST - AE CARE SERVICE 9528555000 7171 OHMS LANE EDINA MN 55439 TIMOTHY TUCKER PRESIDENT/CEO (THROUGH JUNE 2019) 10.14 29.86 X 0 708792 131561 CRAIG KITTELSON FORMER VP/CFO (THROUGH JUNE 2018) 0.00 0.00 X 0 522500 53130 KATHY KOPP CHIEF STRATEGY OFFICER 24.00 16.00 X 0 288340 79995 MATTHEW KERN COO 6.34 18.66 X 0 291488 26049 SHARON WILSON CHIEF CLINICAL & COMPLIANCE OFFICER 5.07 14.93 X 0 180085 12689 TARA ADKINS ADMINISTRATOR (THRU MARCH 2019) 45.00 0.00 X 103687 0 23261 BRIANNE WOLTERS ADMINISTRATOR 45.00 0.00 X 100486 0 17291 RENEE MICALETTI DIRECTOR OF NURSING 45.00 0.00 X 107133 0 9108 ROBERT DAHL PRESIDENT/CEO 5.07 14.93 X 0 0 0 KATHY YOUNGQUIST CFO 5.07 14.93 X 0 0 0 ANGELA BROWN CHRO 5.07 14.93 X 0 0 0 REV DR GARY WILKERSON CHAIR 1.00 9.00 X X 0 0 0 MARSHALL MACKAY VICE CHAIR 1.00 9.00 X X 0 0 0 ERIK RICK ELLINGSON TREASURER 1.00 9.00 X X 0 0 0 CHIP PARKS SECRETARY 1.00 9.00 X X 0 0 0 BRUCE CRAWFORD DIRECTOR 1.00 8.00 X 0 0 0 JIM EHLEN DIRECTOR (THROUGH DEC 2018) 1.00 8.00 X 0 0 0 DUANE HETLAND DIRECTOR 1.00 9.00 X 0 0 0 TIMOTHY KUCK DIRECTOR 1.00 9.00 X 0 0 0 LARRY KULA DIRECTOR 1.00 9.00 X 0 0 0 JERRY NYE DIRECTOR 1.00 9.00 X 0 0 0 SCOTT RAMSDALE DIRECTOR 1.00 9.00 X 0 0 0 MICHELENE VERLAUTZ DIRECTOR 1.00 9.00 X 0 0 0 311306 1991205 353084 3 1 1 0 NETWORK THERAPY SERVICES 8120 PENN AVE S STE 227 BLOOMINGTON MN 55431 THERAPY SERVICES (PT, OT, ST) 6453002 A&E CARE SERVICES 7171 OHMS LANE EDINA MN 55439 MANAGEMENT SERVICES 2472363 BAUER DESIGN BUILD LLC 14030 21ST AVE N PLYMOUTH MN 55447 CONSTRUCTION 931169 CLIFTONLARSONALLEN LLP PO BOX 776376 CHICAGO IL 60677 AUDIT/CONSULTING SERVICES 446208 NETWORK SERVICE 29060 NETWORK PLACE CHICAGO IL 60673 NETWORK SERVICES 388490 20 92727 1800000 178411 2071138 ASSISTED LIVING 623000 27951130 27951130 NURSING 623000 17099684 17099684 PAYROLL 541200 6438087 6438087 CONSULTING 541610 1100631 1100631 52589532 70781 70781 275798 376768 -100970 -100970 -58248 -42722 25873 92727 34241 -8368 -8368 1796 0 1796 1796 GAIN ON INVESTMENT IN BUSINESS VE 900003 546929 546929 DIETARY INCOME 722210 112323 112323 CABLE TV INCOME 515100 76195 76195 199750 199750 935197 55559106 45050814 7480470 956684 811000 811000 20616 20616 29750512 26638924 2840100 271488 159624 136500 23124 2809221 2409713 399508 1682384 1544470 137914 2459366 139049 2320317 35358 35358 106804 106804 18375 18375 2177268 1728621 447298 1349 255094 253765 1329 652392 290226 357778 4388 1815 1815 1922774 1922774 677940 539817 136105 2018 167227 123732 42356 1139 2605277 2605277 3429852 3429852 426296 17228 409068 NURSING SUPPLIES 2022303 2022285 18 DIETARY EXPENSES 1509912 1509912 LICENSES, PERMITS, FEES 462671 378310 83822 539 ACTIVITIES EXPENSE 362031 362031 552523 34483 518040 55078635 46664820 8113190 300625 8839641 10434009 69855 144083 4421562 4150035 786250 937946 319877 102582250 28632626 75827863 73949624 1603116 1603116 495394 842323 6304014 7529832 98499391 99759149 9925957 7402956 31548895 30519657 368461 371864 41310881 39551424 4723122 10178973 87877316 88024874 X 10124729 11236929 343596 343596 153750 153750 10622075 11734275 98499391 99759149 X 480471 631730 X X 0 1 X 1 0 X 2846409 5486509 2207536 5981364 2071138 18592956 2846409 5486509 2207536 5981364 2071138 18592956 18592956 732232 385033 400118 470588 301507 2289478 8593 8593 462693 421051 429828 432275 962866 2708713 23599740 192473518 0.78780 0.83730 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2014 AMOUNT: $ 11,303. 2015 AMOUNT: $ 14,957. 2016 AMOUNT: $ 43,497. 2017 AMOUNT: $ 40,449. 2018 AMOUNT: $ 11,384. DIETARY INCOME - 2014 AMOUNT: $ 114,922. 2015 AMOUNT: $ 118,919. 2016 AMOUNT: $ 117,866. 2017 AMOUNT: $ 112,423. 2018 AMOUNT: $ 112,323. HOUSEKEEPING INCOME - 2014 AMOUNT: $ 69,604. 2015 AMOUNT: $ 67,209. 2016 AMOUNT: $ 44,817. 2017 AMOUNT: $ 55,152. 2018 AMOUNT: $ 58,663. VENDING INCOME - 2014 AMOUNT: $ 628. 2015 AMOUNT: $ 896. 2016 AMOUNT: $ 708. 2017 AMOUNT: $ 637. 2018 AMOUNT: $ 489. CABLE TV INCOME - 2014 AMOUNT: $ 50,047. 2015 AMOUNT: $ 48,559. 2016 AMOUNT: $ 55,919. 2017 AMOUNT: $ 65,188. 2018 AMOUNT: $ 76,195. EMERGENCY PULL CORD INCOME - 2014 AMOUNT: $ 39,612. 2015 AMOUNT: $ 39,612. 2016 AMOUNT: $ 39,612. 2017 AMOUNT: $ 39,612. 2018 AMOUNT: $ 40,503. MAINTENANCE INCOME - 2014 AMOUNT: $ 23,216. 2015 AMOUNT: $ 30,368. 2016 AMOUNT: $ 38,494. 2017 AMOUNT: $ 61,474. 2018 AMOUNT: $ 58,876. PENDANT ALARM INCOME - 2014 AMOUNT: $ 4,856. 2015 AMOUNT: $ 2,396. 2016 AMOUNT: $ 4,481. 2017 AMOUNT: $ 5,196. 2018 AMOUNT: $ 7,018. TELEPHONE INCOME - 2014 AMOUNT: $ 25,948. 2015 AMOUNT: $ 28,192. 2016 AMOUNT: $ 25,840. 2017 AMOUNT: $ 22,895. 2018 AMOUNT: $ 22,817. ANNUITY CONVERSION INCOME - 2014 AMOUNT: $ 1,606. 2015 AMOUNT: $ 1,575. 2016 AMOUNT: $ 1,548. 2017 AMOUNT: $ 1,524. 2018 AMOUNT: $ 0. FUNDRAISING EVENT INCOME - 2014 AMOUNT: $ 115,330. 2015 AMOUNT: $ 63,339. 2016 AMOUNT: $ 51,857. 2017 AMOUNT: $ 24,710. 2018 AMOUNT: $ 25,873. GIFT SHOP INCOME - 2014 AMOUNT: $ 5,621. 2015 AMOUNT: $ 5,029. 2016 AMOUNT: $ 5,189. 2017 AMOUNT: $ 3,015. 2018 AMOUNT: $ 1,796. GAIN ON INVESTMENT IN BUSINESS VENTURE - 2014 AMOUNT: $ 0. 2015 AMOUNT: $ 0. 2016 AMOUNT: $ 0. 2017 AMOUNT: $ 0. 2018 AMOUNT: $ 546,929. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 148750 148750 148450 300 148750 148250 200 148450 148150 100 148250 147950 200 148150 0.00000 1.00000 0.00000 0 1 1 12774581 12774581 80682390 22167722 58514668 9007755 6464904 2542851 117524 117524 73949624 DUE FROM AFFILIATES 2879246 RESIDENT TRUST FUNDS 141250 FUNDS HELD IN ESCROW 426778 BOND FUNDS 3782011 TENANT SECURITY DEPOSITS 300547 7529832 DUE TO AFFILIATES 6724667 ASSET RETIREMENT OBLIGATION 53219 NON-COMPETE AGREEMENT 50002 NOTES PAYABLE TO AFFILIATES 2404012 DEFERRED COMPENSATION LIABILITY 947073 10178973 X 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. SECURITY DEPOSITS ARE REQUIRED FOR THE ORGANIZATION'S TENANTS AND INCLUDE RESERVED APARTMENTS IF AMOUNTS ARE PAID BEFORE THE TENANT ACTUALLY MOVES IN. PART V, LINE 4: THE 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 FUND DESIGNATED PROGRAM. THE ORGANIZATION'S ENDOWMENT IS HELD AND ADMINISTERED BY AUGUSTANA CARE FOUNDATION. SEE SCHEDULE R FOR ADDITIONAL DETAILS. PART X, LINE 2: AUGUSTANA CARE 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 EVALUATING 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. AUGUSTANA CARE 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. X X X X X X X 1 JULIE STROUD 1767 JULIET AVE SAINT PAUL MN 551052124 GRANT WRITER 0 162667 8875 153792 PAT REIS 19 S 1ST ST APT B2108 MINNEAPOLIS MN 554011834 GOLF TOURNAMENT 0 78603 9500 69103 241270 18375 222895 MN CO GOLF TOURNAMENT 74485 61835 12650 552 8865 6399 11359 HOLIDAY TREE FESTIVAL 21209 11834 9375 3823 1006 1 12677 9377 3300 872 1365 108371 83046 25325 552 8865 11094 13730 34241 -8916 1 A&E CARE SERVICES 7171 OHMS LANE EDINA MN 55439 411806946 501(C)(3) 800000 PURCHASE OF NEW HOME OFFICE BUILDING. 1 0 SCHOLARSHIPS 9 10865 0 N/A N/A PART I, LINE 2: RECIPIENTS OF SCHOLARSHIPS FROM THE ORGANIZATION AGREE TO THE FOLLOWING TERMS UPON ACCEPTANCE: (1) THE ORGANIZATION WILL DETERMINE THE AMOUNT OF THE SCHOLARSHIP; (2) TUITION AND ASSOCIATED COSTS WILL BE PAID UP TO A STATED AMOUNT UPON PRESENTATION BY THE RECIPIENT OF A BILLING STATEMENT AND A DETAILED VERIFICATION OF THE COST OF BOOKS; (3) THE RECIPIENT WILL COMPLETE THE TRAINING FOR WHICH A SCHOLARSHIP PAYMENT WAS GRANTED WITH PROOF OF A FINAL GRADE OF C OR BETTER, OR RECIPIENT WILL REIMBURSE THE ORGANIZATION FOR THE COST OF THE COURSE; (4) THE RECIPIENT WILL CONTINUE EMPLOYMENT WITH THE ORGANIZATION WHILE COMPLETING COURSEWORK, WITH BOTH PARTIES MAKING EVERY EFFORT TO ACCOMODATE ANY NECESSARY CHANGES IN WORK HOURS; AND (5) UPON COMPLETION TRAINING FOR WHICH SCHOLARSHIP WAS GRANTED, THE RECIPIENT WILL WORK FOR THE ORGANIZATION AT LEAST TWO YEARS AND A MINIMUM OF 2,000 HOURS OR WILL REIMBURSE THE ORGANIZATION A PRORATED AMOUNT OF EACH SCHOLARSHIP PAYMENT RECEIVED DURING THE PREVIOUS ONE YEAR PERIOD, WHICH WILL BE DEDUCTED FOR THEIR LAST PAYCHECK. AUGUSTANA CARE MAKES INTERCOMPANY TRANSFERS TO RELATED ORGANIZATIONS. AUGUSTANA CARE AND THE RELATED ORGANIZATIONS ARE UNDER COMMON MANAGEMENT WHO REGULARLY MONITOR THE USE OF FUNDS. THE TRANSFER WAS MADE TO A&E CARE SERVICES, A 501(C)(3) ORGANIZATION, TO ASSIST WITH THE PURCHASE OF A NEW HOME OFFICE BUILDING. NO FOLLOW-UP OR OVERSIGHT WAS CONDUCTED REGARDING THE SPECIFIC USE OF TRANSFERRED FUNDS. 1 1 0 0 0 0 0 0 0 TIMOTHY TUCKER PRESIDENT/CEO (THROUGH JUNE 2019) 0 475147 0 0 0 233645 0 111869 0 19692 0 840353 0 0 CRAIG KITTELSON FORMER VP/CFO (THROUGH JUNE 2018) 0 246836 0 84981 0 190683 0 27888 0 25242 0 575630 0 0 KATHY KOPP CHIEF STRATEGY OFFICER 0 228951 0 36108 0 23281 0 30533 0 49462 0 368335 0 0 MATTHEW KERN COO 0 252354 0 39112 0 22 0 4971 0 21078 0 317537 0 0 SHARON WILSON CHIEF CLINICAL & COMPLIANCE OFFICER 0 153948 0 23715 0 2422 0 6271 0 6418 0 192774 0 0 PART I, LINE 3 FOR THE PURPOSE OF DETERMINING COMPENSATION, AUGUSTANA CARE RELIED ON A RELATED ORGANIZATION, A&E CARE SERVICES, TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO. A&E CARE SERVICES USED THE FOLLOWING PRACTICES TO ESTABLISH COMPENSATION FOR THE PRESIDENT/CEO: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B CRAIG KITTELSON STEPPED DOWN AS THE CFO OF AUGUSTANA CARE AND AFFILIATES ON JUNE 30, 2018. HE STAYED ON PAYROLL AS A CONSULTANT THROUGH SEPTEMBER 30, 2018. THERE WAS A $50,000 SEVERANCE PAID TO CRAIG IN NOVEMBER 2018. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PROVIDED BY A&E CARE SERVICES, A RELATED ORGANIZATION: TIM TUCKER, PRESIDENT AND CEO - $270,824 CRAIG KITTELSON, FORMER VICE PRESIDENT OF FINANCE AND CFO - $22,248 KATHERINE KOPP, CHIEF STRATEGY OFFICER - $2,500 A CITY OF DASSEL MN 410851701 2010-09-15 1400000 FACILITY DEVELOPMENT 0 0 0 B DAKOTA COUNTY COMMUNITY DEVELOPMENT AGENCY 411253302 23409VDV9 2015-03-25 5060000 REFINANCE SERIES 2007 BOND 0 0 0 C CITY OF DASSEL MN 410851701 2007-08-21 1500000 ACQUIRE FACILITY 0 0 0 D COLORADO HEALTH FACILITIES AUTHORITY 840732932 2011-03-31 875000 TO REFINANCE SERIES 2011 BONDS 0 0 0 A 450434 1400000 28000 1372000 2011 0 0 1 1 B 845000 5060000 325000 101200 4958800 2015 1 0 1 1 C 794540 1500000 30000 1470000 2007 0 0 1 1 D 875000 875000 2011 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF VICTORIA, MN DATE THE REBATE COMPUTATION WAS PERFORMED: 08/20/2018 A CITY OF VICTORIA MN 410997257 92627TAT3 2014-07-31 22110000 TO REFINANCE SERIES 2009 BONDS 0 0 0 B CARLTON COUNTY MN 416005767 142887BB3 2015-03-02 5805000 FACILITY DEVELOPMENT 0 0 0 A 2780000 22110000 1075979 442200 21667800 2014 1 0 1 1 B 690000 5805000 191680 116100 5497263 2017 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 OVERALL MISSION FOR AUGUSTANA ENTITIES AUGUSTANA CARE AND ITS SUBSIDIARIES' MISSION IS TO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS AND OTHERS IN NEED THROUGH THE PROVISION OF HEALTHCARE, HOUSING AND OTHER SERVICES IN A CHRISTIAN TRADITION. OUR GOAL IS TO HELP RESIDENTS LIVE THE LIVES THAT MOST INSPIRE THEM. THE PRINCIPLES THAT GUIDE OUR WORK INCLUDE VALUING OLDER GENERATIONS' TALENTS AND EXPERIENCE; WORKING TO PROVIDE THE CARE RESIDENTS NEED, WHEN AND WHERE THEY NEED IT; WORKING TO CONNECT RESIDENTS TO THE PEOPLE AND THINGS THAT MEAN THE MOST TO THEM; AND SUPPORTING RESIDENTS AND FAMILIES WITH SPIRITUAL CARE THAT SPEAKS TO WHO THEY ARE. WE OFFER A BROAD RANGE OF SERVICES TO ANTICIPATE AND ADDRESS THE NEEDS OF OLDER ADULTS. IN OUR 2019 FISCAL YEAR, MORE THAN 17,100 PEOPLE WERE SERVED IN MINNESOTA AND COLORADO. OUR SEVEN HEALTH CARE CENTERS PROVIDED TRANSITIONAL CARE, LONG-TERM AND MEMORY CARE, AND REHABILITATION SERVICES TO MORE THAN 3,000 PEOPLE. AUGUSTANA CARE ALSO PROVIDES VARIOUS HOUSING COMMUNITIES TO SERVE OLDER ADULTS WITH COMFORTABLE LIVING AND CARE OPTIONS, INCLUDING INDEPENDENT LIVING, HOUSING WITH SERVICES, ASSISTED LIVING, AND MEMORY CARE. IN FISCAL YEAR 2019, A TOTAL OF 1,742 RESIDENTS BENEFITED FROM THESE SERVICES. WE ALSO OFFER A RANGE OF COMMUNITY-BASED SERVICES, SUCH AS ADULT DAY PROGRAMS, HOSPICE, AND THERAPY SERVICES, TO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS WHO CONTINUE TO LIVE IN THEIR OWN HOMES. MORE THAN 12,342 INDIVIDUALS WERE SERVED THROUGH THESE PROGRAMS IN FISCAL YEAR 2019. FINALLY, MANAGEMENT CONSULTING SERVICES WERE PROVIDED TO NINE OTHER ORGANIZATIONS THAT SERVED 594 OLDER ADULTS IN FISCAL YEAR 2019. FORM 990, PART VI, SECTION A, LINE 3 THE PURPOSE OF A&E CARE SERVICES IS TO MANAGE AUGUSTANA CARE AND ITS RELATED ORGANIZATIONS, AND ELIM CARE AND ITS RELATED ORGANIZATIONS. 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 ORGANIZATION'S MEMBERSHIP CONSISTS OF LUTHERAN CONGREGATIONS OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA), AND OTHER CONGREGATIONS, AS ARE FROM TIME TO TIME ELECTED BY THE MEMBERS. AT ALL TIMES, A MAJORITY OF THE MEMBER CONGREGATIONS ARE LUTHERAN AND AT LEAST ONE MEMBER CONGREGATION MUST BE A PART OF THE ELCA AT ALL TIMES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF AUGUSTANA CARE, THROUGH THEIR VOTING DELEGATES, ELECT THE ORGANIZATION'S DIRECTORS AFTER CONSIDERATION OF THE SLATE OF NOMINEES SUBMITTED BY THE NOMINATING AND BOARD DEVELOPMENT COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE ORGANIZATION'S GOVERNING DOCUMENTS MUST BE APPROVED BY AN AFFIRMATIVE VOTE OF A MAJORITY OF THE TOTAL NUMBER OF DIRECTORS HOLDING OFFICE AND BY THE AFFIRMATIVE VOTE OF A MAJORITY OF VOTING DELEGATES OF THE MEMBER CONGREGATIONS PRESENT AND VOTING AT WHICH A QUORUM OF MEMBERS IS PRESENT AND VOTING. ANY AMENDMENT WHICH RELATES TO THE REQUIREMENTS FOR AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (ELCA) IS SUBMITTED TO THE ELCA PROGRAM UNIT FOR CHURCH IN SOCIETY FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO. THE FORM 990 WAS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS BY THE CFO PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C 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 C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPAL 631,730. FORM 990, PART XII, LINE 2C THE PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. 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