2023-11-08T11:47:45-07:00 2022-12-31 990 2022-01-01 411694817 ELIM CARE FOUNDATION ELIM 9528555000 7171 OHMS LANE EDINA MN 55439 Kathy Youngquist CFO 9528555000 2023-11-08 1 1 11 0 AAL2 X 2022 2023-04-26 12:10:37Z Robert Dahl 7171 Ohms Lane Edina MN 55374 7005816 0 X WWW.CASSIALIFE.ORG X 1986 MN TO HOLD AND INVEST NON-OPERATING INVESTMENTS OF THE ELIM CARE FAMILY OF CORPORATIONS. 4 4 0 4 3024 0 500000 6762618 0 0 105617 84989 988 11279 606605 6858886 1751105 4006935 0 0 0 0 0 0 0 384554 156226 2135659 4163161 -1529054 2695725 8740383 8773067 4985519 2863502 3754864 5909565 TO HOLD AND INVEST NON-OPERATING INVESTMENTS OF THE ELIM CARE FAMILY OF CORPORATIONS. 0 0 4006935 4006935 0 PRIMARILY RESPONSIBLE FOR THE LONG-TERM INVESTING OF FUNDS FOR THE AFFILIATED TAX-EXEMPT ORGANIZATIONS AND TO PROVIDE EQUITY FOR NEW PROJECTS. 0 0 0 4006935 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 X 4 4 0 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MN X KATHY YOUNGQUIST 9528555000 7171 OHMS LANE EDINA MN 55439 ROBERT DAHL PRESIDENT/CEO 0.25 39.75 X 0 602456 87428 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0.25 39.75 X 0 462088 76596 KATHY KOPP CHIEF STRATEGIC OFFICER 0.25 39.75 X 0 320482 76596 MATTHEW KERN CHIEF OPERATING OFFICER 0.25 39.75 X 0 317298 72793 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0.25 39.75 X 0 245326 42846 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0.25 39.75 X 0 234321 44974 ERIK ELLINGSON DIRECTOR AND CHAIR 0.25 0.25 X X 0 0 0 JOHN SOMROCK DIRECTOR AND VICE CHAIR 0.25 0.25 X X 0 0 0 PAUL ANDERSON DIRECTOR AND SECRETARY/TREASURER 0.25 0.25 X X 0 0 0 JAN LARSON DIRECTOR 0.25 0 X X 0 0 0 ROLAND PETERSON DIRECTOR 0.25 0 X 0 0 0 ROBERT PRENTISS DIRECTOR 0.25 0 X X 0 0 0 DAVID JOHNSON DIRECTOR 0.25 0.25 X 0 0 0 TIM KUCK DIRECTOR 0.05 0.25 X 0 0 0 0 2181971 401233 0 0 1 0 0 0 0 0 6762618 0 0 0 6762618 0 98343 0 0 98343 0 0 0 0 0 0 0 0 9600 0 6576 0 3024 0 3024 0 3024 0 127000 0 140354 0 -13354 0 -13354 0 0 -13354 0 Easement Revenue 900099 8255 0 0 8255 0 0 0 0 8255 6858886 0 3024 93244 4006935 4006935 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4600 0 4600 0 0 0 0 0 600 0 600 0 0 0 0 0 0 0 21597 0 21597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3916 0 3916 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4688 0 4688 0 Development Fees 4189 0 4189 0 Bank Charge 27 0 27 0 Write off Development Fees 116609 0 116609 0 4163161 4006935 156226 0 2032619 985144 938528 569874 450000 300000 48 847111 53300 793811 793811 3737961 5184464 787416 939774 8740383 8773067 0 2502 77129 0 4908390 2861000 4985519 2863502 X 3095584 5366241 659280 543324 3754864 5909565 8740383 8773067 X 2695725 -524226 0 0 0 -16798 X 0 1 X 1 0 X X 21 ELIM CARE INC 411694818 10 1 0 0 ELIM HOMES INC 411539761 10 1 6462618 0 HAVEN HOMES INC 416045816 10 1 0 0 PIONEER HOUSE ASSISTED LIVING INC 411927112 10 1 0 0 COMMUNITY HEALTH FOUNDATION OF WRIGHT COUNTY 363546789 10 1 0 0 REDEEMER RESIDENCE INC 410711597 10 1 0 0 PARK VIEW CARE CENTER 410855707 10 1 0 0 PARK LANE APARTMENTS 410972384 10 1 0 0 ELIM CHILDRENS CENTER INC 411974507 10 1 0 0 NEW HARMONY CARE CENTER 411821882 10 1 0 0 COUNTRY MEADOWS OF MILACA INC 201723948 10 1 0 0 LAKE RIDGE CARE CENTER INC 200507069 10 1 0 0 PARK TERRACE ASSISTED LIVING INC 204063752 10 1 0 0 EVANGELICAL RETIREMENT HOME INC 420868449 10 1 0 0 VILLAGE ASSISTED LIVING INC 262086933 10 1 0 0 BAPTIST HOME INC 450232943 10 1 0 0 THE BAPTIST APARTMENTS INC 450359794 10 1 0 0 ELIM SHORES INC 411625095 10 1 0 0 CORNERSTONE ASSISTED LIVING OF PLYMOUTH INC 412013927 10 1 300000 0 NEWTON VILLAGE INC 200044030 10 1 0 0 ELIM SENIOR HOUSING INC 810754064 10 1 0 0 21 6762618 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Schedule A, Part I, Line 1 THE GOVERNING DOCUMENTS STATE THAT ELIM CARE FOUNDATION WAS ORGANIZED TO SUPPORT ELIM CARE, INC. AND OTHER CORPORATIONS CONTROLLED BY ELIM CARE, INC. ALL ORGANIZATIONS SUPPORTED BY ELIM CARE FOUNDATION ARE CONTROLLED BY ELIM CARE, INC. (PARENT COMPANY). Schedule A, Part IV, Section C, Line 1 THE BOARD MEMBERS OF ELIM CARE FOUNDATION ARE APPROVED BY THE ELIM CARE, INC. BOARD (PARENT COMPANY), DECISION OF THE ELIM CARE FOUNDATION BOARD ALONG WITH THE BOARDS OF ALL ORGANIZATIONS THAT ELIM CARE FOUNDATION SUPPORTS ARE SUBJECT TO APPROVAL BY THE ELIM CARE, INC. BOARD (PARENT COMPANY). RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 659279 0 -111491 0 0 3291 544497 33968 638409 -3022 0 6785 3291 659279 585689 0 87703 0 635140 4284 33968 516852 0 92078 0 19002 4239 585689 533491 7622 -7816 0 12197 4288 516812 0 0.7 0.3 0 1 1 475146 2100 477246 369865 0 53300 316565 0 0 0 0 0 0 0 0 0 0 0 0 793811 Due From Affiliates 855958 Interest Receivable 83816 939774 0 Due to Affiliates 2861000 2861000 X Schedule D, Part V, Line 4 ENDOWMENT FUNDS WILL BE USED FOR CHAPLAINCY NEEDS, STAFF SCHOLARSHIPS AND RESIDENT NEEDS. THE FOLLOWING WERE TRANSFERRED FROM ELIM CARE, INC. (A RELATED ORGANIZATION): $7,662 DURING 2018, $31,543 DURING 2017. Schedule D, Part X, Line 2 THE CORPORATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND STATE CORPORATION 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 ACTIVITES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION REPORTS ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES AND FILES ALL PROPER RETURNS RELATED TO THESE ACTIVITIES. 1 CASSIA SERVICES 7171 OHMS LANCE EDINA MN 55374 411806946 501(C)(3) 357000 0 N/A N/A TRANSFER TO AFFILIATE CASSIA 7171 OHMS LANE EDINA MN 55439 831758728 501(C)(3) 3649935 0 N/A N/A TRANSFER TO AFFILIATE 1 0 Schedule I, Part I, Line 2 SEE SCHEDULE I, STATEMENT 1 X 1 1 X X X X 0 1 0 0 0 0 0 0 0 ROBERT DAHL PRESIDENT/CEO 0 546533 0 49716 0 6207 0 67622 0 19807 0 689885 0 49716 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0 327536 0 0 0 134552 0 45601 0 25020 0 532709 0 131952 MATTHEW KERN CHIEF OPERATING OFFICER 0 313032 0 0 0 4266 0 44525 0 28268 0 390091 0 0 KATHY KOPP CHIEF STRATEGIC OFFICER 0 257664 0 0 0 62818 0 50298 0 26298 0 397078 0 59672 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0 212660 0 19955 0 12711 0 30259 0 12588 0 288173 0 19955 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0 214699 0 0 0 19622 0 20586 0 24388 0 279295 0 18282 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 USE OF THE VEHICLES IS TREATED AS A 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 RECOMMNEDATIONS 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 - $13,263 KATHY YOUNGQUIST, CFO - $33,401 MATTHEW KERN, COO - $32,325 ANGELA BROWN, CHRO - $11,030 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. 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. 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 AVAILALBE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS WERE AS FOLLOWS: $(16,798) ENDOWMENT FUND PAYOUTS 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) 10 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 VILLAGE ASSISTED LIVING INC 7171 OHMS LANE EDINA MN 55439 262086933 HEALTH CARE FACILITIES/SERVICES MN 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 CARE INC 0 PARK VIEW CARE CENTER 7171 OHMS LANE EDINA MN 55439 410855707 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM CARE 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 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 7171 OHMS LANE EDINA MN 55439 411681856 MEDICAL SALES MN ELIM CARE INC C 0 0 PREFERRED SENIOR SERVICES 7171 OHMS LANE EDINA MN 55439 411942480 MANAGEMENT SERVICES MN ELIM CARE INC C 0 0 AUGUSTANA SENIOR DEVELOPMENT 7171 OHMS LANE EDINA MN 55439 264136110 CONSULTING MN AUGUSTANA CARE C 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1