2024-11-15T16:03:25-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 20 E THOMAS RD STE 2300 PHOENIX AZ 85012 990 2023-01-01 860712529 LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE INC LIFE 7194875386 11555 WEST PEORIA AVENUE YOUNGTOWN AZ 85363 NATHAN MERRILL CFO 7194815481 2024-11-14 1 1 JEFF PARKER P00970069 6022662248 2024-11-14 2023 2024-10-15 13:58:12Z X NATHAN MERRILL 15475 GLENEAGLE DRIVE COLORADO SPRINGS CO 80921 7500 0 X WWWW.LIFESTREAMLIVING.COM X 1992 AZ MINIMAL ACTIVITY IN CALENDAR YEAR 2023 DUE TO CLOSURE. X 10 10 0 0 0 0 0 0 1870 0 -8596 0 0 7500 -6726 7500 0 0 0 0 0 0 0 0 0 22677 15583 22677 15583 -29403 -8083 11233337 0 5069 0 11228268 0 X OUR MISSION IS TO SERVE SENIORS BY ENRICHING THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL HEALTH IN A CLOSE-KNIT COMMUNITY. 0 1 0 0 0 THE ENTITY WAS A PROVIDER OF SENIOR LIVING HOUSING AND SERVICES. THE ASSETS WERE SOLD IN 2021. IN 2023, THERE WAS MINIMAL ACTIVITY DUE TO THE SALE AND CLOSURE OF THE ENTITY. 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X NATHAN MERRILL 7194815481 15475 GLENEAGLE DRIVE COLORADO SPRINGS CO 80921 RICK SUMMERS BOARD MEMBER / COO 1.00 49.00 X X 0 241509 13033 DANA RASIC BOARD CHAIR/CEO 1.00 53.00 X X 0 364389 15902 DAN VAGLE BOARD MEMBER 0.10 11.90 X X 0 61000 0 NATHAN MERRILL TREASURER / CFO 1.00 49.00 X X 0 249361 20032 AUSTIN HARBACH ASSISTANT SECRETARY 0.10 47.90 X X 0 115312 10479 TOM WORKMAN ASSISTANT SECRETARY 0.10 5.40 X X 0 0 0 DALE TURNER BOARD MEMBER 0.10 11.90 X 0 61000 0 DON MORGAN BOARD MEMBER 0.10 11.90 X 0 61000 0 JENNY KENNEDY BOARD MEMBER 0.10 46.90 X X 0 10453 0 LARRY SMITH BOARD MEMBER 0.10 11.90 X 0 30500 0 0 1194524 59446 0 0 1 0 0 OTHER RESIDENT SERVICE 812900 7500 7500 7500 7500 7500 0 0 15583 15583 15583 0 15583 0 0 5069 0 0 0 0 0 0 0 0 0 0 0 0 0 11228268 0 11233337 0 5069 5069 0 X 11228268 0 11228268 0 11233337 0 X -8083 -11220185 X X 0 1 X 1 0 X 18615 22784 21067 0 0 62466 4058616 4580632 2956155 1870 0 11597273 4077231 4603416 2977222 1870 11659739 2100 1600 1231 4931 0 2100 1600 1231 4931 11654808 2762 1614 2518 465 0 7359 2762 1614 2518 465 7359 11539 3815 51 15405 4091532 4608845 2979791 2335 11682503 0.99760 0.99690 0.00060 0.00060 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUES - 2019 AMOUNT: $ -686. 2020 AMOUNT: $ 115. BEAUTY/BARBER SERVICES - 2019 AMOUNT: $ 6,393. 2020 AMOUNT: $ 1,596. EMPLOYEE/GUEST MEALS - 2019 AMOUNT: $ 5,756. 2020 AMOUNT: $ 1,814. OTHER RESIDENT SERVICES - 2019 AMOUNT: $ 76. 2020 AMOUNT: $ 290. 2021 AMOUNT: $ 51. 0 1 X 0 X PART IV, LINE 2B: THE ORGANIZATION MAINTAINS ESCROW ACCOUNTS ON BEHALF OF ITS RESIDENTS. PART X, LINE 2: THE ORGANIZATION APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022. 1 1 PART I, LINE 2: EFFECTIVE DECEMBER 1, 2023, THE BOARD OF DIRECTORS UNANIMOUSLY APPROVED THE DISSOLUTION OF LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE, INC. AND TRANSFER REMAINING ASSETS TO LIFESTREAM. 0 0 0 0 0 0 0 0 0 RICK SUMMERS BOARD MEMBER / COO 0 235594 0 5915 0 0 0 4819 0 8214 0 254542 0 0 DANA RASIC BOARD CHAIR/CEO 0 340497 0 23892 0 0 0 6600 0 9302 0 380291 0 0 NATHAN MERRILL TREASURER / CFO 0 236579 0 12782 0 0 0 5051 0 14981 0 269393 0 0 RELATED PARTY RECEIVABLE 2023-12-31 11220185 BOOK VALUE 237458267 LIFESTREAM COMPLETE SENIOR LIVING INC 11555 WEST PEORIA AVENUE YOUNGTOWN AZ 85363 501(C)(3) 0 0 0 0 1 1 1 1 0 SCHEDULE N, PART I ON OCTOBER 15, 2021, THE ORGANIZATION CEASED OPERATIONS AT SUN RIDGE AND SOLD ASSETS TO AN UNRELATED PARTY. EFFECTIVE DECEMBER 1, 2023, THE BOARD OF DIRECTORS UNANIMOUSLY APPROVED THE DISSOLUTION OF LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE, INC. AND TRANSFER REMAINING ASSETS TO LIFESTREAM. THE DISSOLUTION WAS FORMALLY APPROVED BY THE ARIZONA CORPORATE COMMISSION ON DECEMBER 11, 2023. FORM 990, PART III, LINE 3 EFFECTIVE DECEMBER 1, 2023, THE BOARD OF DIRECTORS UNANIMOUSLY APPROVED THE DISSOLUTION OF LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE, INC. AND TRANSFER REMAINING ASSETS TO LIFESTREAM. FORM 990, PART VI, SECTION A, LINE 2 DALE TURNER AND DAN VAGLE HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 LIFESTREAM HAS A MANAGEMENT AGREEMENT WITH BETHESDA FOUNDATION D.B.A. BETHESDA SENIOR LIVING COMMUNITIES IN WHICH BETHESDA PROVIDES GENERAL OPERATIONAL SUPPORT AND COUNSEL. IN RETURN, LIFESTREAM COMPENSATES BETHESDA WITH A MANAGEMENT FEE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS LIFESTREAM COMPLETE SENIOR LIVING, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER ELECTS THE BOARD OF DIRECTORS OF LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE, INC. FORM 990, PART VI, SECTION B, LINE 11B TAX RETURNS ARE PROVIDED TO THE BOARD MEMBERS PRIOR TO THE FILING OF THE RETURN. BOARD MEMBERS ARE AFFORDED THE OPPORTUNITY TO PROPOSE APPROPRIATE CHANGES TO THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND FORMS ARE DISTRIBUTED AND DISCUSSED AT THE ANNUAL MEETING OF THE BOARD. EACH BOARD DIRECTOR, COMMITTEE MEMBER AND OFFICER WITH BOARD DELEGATED POWERS WHETHER THEY BE DIRECT OR INDIRECT MUST READ AND SIGN INDICATING TO HAVE READ AND UNDERSTOOD THE CONFLICT POLICY AND AGREE TO COMPLY. EACH PERSON, ACCORDING TO THE POLICY, HAS THE DUTY TO DISCLOSE ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST BY DISCLOSING THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. THE MINUTES OF THE BOARD AND ALL COMMITTEE WITH BOARD-DELEGATED POWERS SHALL CONTAIN - THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH. 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: TRANSFER OF ASSETS TO AFFILIATE -11,220,185. FORM 990, PAGE 12, PART XII, LINE 2C THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. LIFESTREAM COMPLETE SENIOR LIVING INC 11555 WEST PEORIA AVENUE YOUNGTOWN AZ 85363 237458267 SKILLED NURSING AZ 501(C)(3) LINE 10 BETHESDA SENIOR LIVING COMMUNITIES 0 LIFESTREAM COMPLETE SENIOR LIVING AT NORTHEAST PHOENIX INC 11555 WEST PEORIA AVENUE YOUNGTOWN AZ 85363 860682800 SENIOR HOUSING AZ 501(C)(3) LINE 10 LIFESTREAM COMPLETE SENIOR LIVING INC 0 LIFESTREAM COMPLETE SENIOR LIVING AT THUNDERBIRD INC 11555 WEST PEORIA AVENUE YOUNGTOWN AZ 85363 860739097 SENIOR HOUSING AZ 501(C)(3) LINE 10 LIFESTREAM COMPLETE SENIOR LIVING INC 0 BETHESDA SENIOR LIVING COMMUNITIES 15475 GLENEAGLE DRIVE COLORADO SPRINGS CO 80921 470497753 DEVELOPMENT AND OPERATIONS CO 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0