2024-08-14T16:24:35-05:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-10-01 412017315 ALLINA HEALTH RESTORATIVE SUITES FKA PHS WEST HEALTH INC ALLI 6122625000 2925 CHICAGO AVE S MINNEAPOLIS MN 55407 EMILY DOWNING MD PRESIDENT 6122625000 2024-08-13 1 0 MATTHEW WOCKEN P01598291 6123764500 2024-08-12 2022 2024-08-08 14:25:15Z X X EMILY DOWNING MD 2925 CHICAGO AVE MINNEAPOLIS MN 55407 23273253 0 X HTTPS://WWW.ALLINAHEALTH.ORG/ X 2001 MN PROVIDES CARE PLANS TO HELP PATIENTS TRANSITION FROM HOSPITAL STAYS BACK TO THEIR OWN HOME. 4 0 141 3 0 0 3984 13443828 8815859 9520466 -85605 -5996 289961 314955 9024199 23273253 3325 0 0 0 6288356 6421356 0 0 0 4046282 4116951 10337963 10538307 -1313764 12734946 15509739 16203479 13095581 1054375 2414158 15149104 WE SERVE OUR COMMUNITIES BY PROVIDING EXCEPTIONAL CARE, AS WE PREVENT ILLNESS, RESTORE HEALTH AND PROVIDE COMFORT TO ALL WHO ENTRUST US WITH THEIR CARE. WE WILL PUT THE PATIENT FIRST, MAKE A DIFFERENCE IN PEOPLE'S LIVES BY PROVIDING EXCEPTIONAL CARE AND SERVICE. 0 0 9646119 0 9520466 THE 50 BED FACILITY PROVIDES CARE AND TREATMENT PLANS TO HELP PATIENTS TRANSITION FROM HOSPITAL STAYS BACK TO THEIR OWN HOME. 9646119 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 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 0 0 0 1 0 0 0 1 8 0 1 141 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X MARY DEHMER 9528555088 7171 OHMS LANE EDINA MN 55439 EMILY DOWNING MD PRESIDENT 1.00 39.00 X X 0 562786 117435 COLLEEN HOLTON TREASURER 1.00 39.00 X X 0 575359 112627 HELEN STRIKE SECRETARY 1.00 39.00 X X 0 509205 27246 DANIEL LINDH BOARD CHAIR/CEO - THRU 11/22 1.00 39.00 X X 0 836839 25618 MARK MEYER SEC/TREAS/CFO - THRU 11/22 1.00 39.00 X X 0 449215 29663 DUANE LARSON VP OPERATIONS -BOARD MEMBER - THRU NOV 2022 1.00 39.00 X 0 329917 21874 CLARISSA COX DIRECTOR 40.00 0.00 X 0 331497 33062 JONATHAN FLETCHER VP DEVELOPMENT - 11/22 1.00 39.00 X 0 358151 25188 TERESA LARSON SVP EMPLOYEE EXPERIENCE - THRU NOV 2022 1.00 39.00 X 0 153546 10011 SHARON KERN CLINICAL ADMIN - THRU 11/22 1.00 39.00 X 106572 0 7715 SIRAJ MOHAMMED RN - THRU 11/22 40.00 0.00 X 132984 0 12486 GEOFFREY NGENO RN - THRU 11/22 40.00 0.00 X 108701 0 11889 KAYLA WAGNER CAMPUS ADMIN - THRU 11/22 40.00 0.00 X 103957 0 19575 JOELY WERTZ REHAB PROGRAM MGR - THRU 11/22 40.00 0.00 X 0 102927 3781 452214 4209442 458170 8 0 1 0 PHS MANAGEMENT 2845 N HAMLINE AVE ROSEVILLE MN 55113 MANAGEMENT FEES 223611 HEALTH CARE SERVICES GROUP 3220 TILLMAN DRIVE BENSALEM PA 19020 HOUSEKEEPING SERVICES 180041 2 13230915 212913 13443828 RESIDENT SERVICES 623000 9520466 9520466 9520466 -5996 -5996 CULINARY INCOME 722513 276543 276543 MISCELLANEOUS 900099 38412 38412 314955 23273253 9520466 0 308959 X 5436663 5179376 257287 84795 80782 4013 511861 487637 24224 388037 369673 18364 329785 329785 38 38 1250 1250 1263942 1198890 65052 20002 20002 46330 1776 44554 70329 6156 64173 319056 319056 20643 7234 13409 19400 3250 16150 60164 60164 703005 703005 23155 23155 MEDICAL SUPPLIES 639511 639511 FOOD 288935 288935 MA SURCHARGE 140750 140750 BLDG MAINT 134091 130866 3225 36565 5903 30662 10538307 9646119 892188 0 440952 3082957 954377 2072327 9875 1894 10760201 345679 9997717 10414522 1236221 228592 3259344 0 14440 15509739 16203479 677735 821578 11752738 665108 0 232797 13095581 1054375 X 2414158 15149104 2414158 15149104 15509739 16203479 12734946 0 X 0 1 X 1 0 X 494159 314671 3984 212913 1025727 9918615 9585835 9892126 8815859 9520466 47732901 9918615 10079994 10206797 8819843 9733379 48758628 0 0 0 48758628 44993 34708 41570 -85605 -5996 29670 44993 34708 41570 -85605 -5996 29670 386561 233189 239558 289961 314955 1464224 10350169 10347891 10487925 9024199 10042338 50252522 0.97030 0.00060 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2018 AMOUNT: $ 386,561. 2019 AMOUNT: $ 233,189. 2020 AMOUNT: $ 239,558. 2021 AMOUNT: $ 289,961. 2022 AMOUNT: $ 314,955. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10100000 286041 9813959 660201 59638 600563 10414522 DUE TO CASSIA 232797 232797 X PART X, LINE 2: THE SYSTEM HAS BEEN DETERMINED TO QUALIFY AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SYSTEM HAS ALSO BEEN DETERMINED TO BE EXEMPT FROM FEDERAL AND STATE INCOME TAX ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AND MINNESOTA STATUTE SECTION 290.05, SUBDIVISION 2. CERTAIN OF THE SYSTEM'S SUBSIDIARIES AND AFFILIATES QUALIFY AS TAX-EXEMPT ORGANIZATIONS, WHILE OTHERS ARE TAXABLE. THE SYSTEM AND ITS SUBSIDIARIES PAID TAXES OF $2,590 AND $1,921 IN 2023 AND 2022, RESPECTIVELY. AS OF DECEMBER 31, 2023 AND 2022, THE TAXABLE SUBSIDIARIES OF THE SYSTEM'S CONTINUING OPERATIONS HAD A GROSS DEFERRED TAX ASSET OF $48,485 AND $45,916, RESPECTIVELY, RESULTING FROM NET OPERATING LOSS CARRYFORWARDS, EMPLOYEE COMPENSATION AND BENEFITS ACCRUALS, AND DEPRECIATION, OFFSET BY VALUATION ALLOWANCES OF $29,685 AND $28,815, RESPECTIVELY. AS OF DECEMBER 31, 2023 AND 2022, THE CONTINUING OPERATIONS OF THE SYSTEM AND ITS SUBSIDIARIES HAD NET OPERATING LOSS CARRYFORWARDS OF $127,705 AND $128,287, RESPECTIVELY, FOR INCOME TAX PURPOSES, WHICH $93,148 WILL EXPIRE IN VARIOUS YEARS THROUGH 2030 AND WITH $34,557 HAVING AN INDEFINITE CARRYOVER PERIOD. THE SYSTEM HAS ANALYZED INCOME TAX POSITIONS TAKEN FOR FILING WITH THE INTERNAL REVENUE SERVICE AND ALL STATE JURISDICTIONS WHERE IT OPERATES. THE SYSTEM BELIEVES THAT INCOME TAX FILING POSITIONS WILL BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE EFFECT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2023 AND 2022, THE SYSTEM DOES NOT HAVE ANY SIGNIFICANT LIABILITIES FOR UNCERTAIN TAX BENEFITS. THE FILINGS FOR THE YEARS ENDED 2019 TO 2022 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. X 0 0 0 0 0 0 0 0 0 DANIEL LINDH BOARD CHAIR/CEO - THRU 11/22 0 836839 0 0 0 0 0 0 0 25618 0 862457 0 0 COLLEEN HOLTON TREASURER 0 414795 0 153618 0 6946 0 78462 0 34165 0 687986 0 0 EMILY DOWNING MD PRESIDENT 0 430062 0 107965 0 24759 0 84594 0 32841 0 680221 0 0 HELEN STRIKE SECRETARY 0 304562 0 84725 0 119918 0 16775 0 10471 0 536451 0 0 MARK MEYER SEC/TREAS/CFO - THRU 11/22 0 449215 0 0 0 0 0 0 0 29663 0 478878 0 0 JONATHAN FLETCHER VP DEVELOPMENT - 11/22 0 358151 0 0 0 0 0 0 0 25188 0 383339 0 0 CLARISSA COX DIRECTOR 0 300178 0 26054 0 5265 0 9324 0 23738 0 364559 0 0 DUANE LARSON VP OPERATIONS -BOARD MEMBER - THRU N 0 329917 0 0 0 0 0 0 0 21874 0 351791 0 0 TERESA LARSON SVP EMPLOYEE EXPERIENCE - THRU NOV 2 0 153546 0 0 0 0 0 0 0 10011 0 163557 0 0 PART I, LINE 3 THE COMPENSATION IS DETERMINED BY THE RELATED ORGANIZATION AND THE ORGANIZATION USES A)COMPENSATION COMMITTEE B)INDEPENDENT COMPENSATION CONSULTANTS C)COMPENSATION SURVEY OR STUDY AND D)APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE COMPENSATION. FORM 990, PART VI, SECTION A, LINE 3 CASSIA (AUG & SEPT 2023) - DAY TO DAY OPERATIONS OF ALLINA HEALTH RESTORATIVE SUITES INC $83,333 , PREVIOUS PHS MANAGEMENT LLC $246,452 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE ORGANIZATION ARE EMPLOYEES OF ALLINA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A ALLINA HEALTH SYSTEM APPOINTS THE MEMBERS. THE BOARD SHALL HAVE NOT LESS THEN 3 AND NO MORE THAN SEVEN MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS MAKE THE FOLLOWING GOVERNANCE DECISIONS; APPROVAL OF MINUTES, ANNUAL BUDGET AND FINANCIALS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S 990 IS PROVIDED TO VOTING MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE IRS. OFFICERS AND MANAGEMENT OF THE ORGANIZATION HAVE BEEN INVOLVED IN THE PREPARATION OF THE 990 AND HAVE REVIEWED THE 990 THROUGHOUT THE PROCESS. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL WRITTEN DISCLOSURES ARE RECEIVED FROM MEMBERS AND EVALUATED BY MANAGEMENT. IF THE RESULT IS CONFLICT THEN NECESSARY STEPS ARE TAKEN TO RESOLVE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY THE MARKET AND INFLATION WHICH IS CONDUCTED BY HR AND REVIEWED BY THE REGIONAL DIRECTOR. THE DELIBERATION AND DECISION IS DOCUMENTED IN THE BUDGET WHICH IS THEN APPROVED BY THE BOARD. THIS PROCESS WAS COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 19 ALLINA HEALTH RESTORATIVE SUITES MAKES ITS FORM 990, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 AND FINANCIAL STATEMENTS ARE ALSO AVAILABLE FROM THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. FORM 990, PART IX, LINE 11G NURSING POOL: PROGRAM SERVICE EXPENSES 217,832. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 217,832. PT, OT & ST: PROGRAM SERVICE EXPENSES 247,985. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 247,985. OTHER SERVICES: PROGRAM SERVICE EXPENSES 733,073. MANAGEMENT AND GENERAL EXPENSES 65,052. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 798,125. ALLINA HEALTH SYSTEM PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 363261413 HEALTHCARE SERVICES MN 501(C)(3) LINE 3 N/A 0 CASTLE RIDGE CARE CENTER INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 510171801 NURSING HOME MN 501(C)(3) LINE 10 PHS 1 OPTAGE INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 271507949 CARE FOR THE ELDERLY MN 501(C)(3) LINE 10 PHS 1 GIDEON POND HOUSING CORPORATION 2845 HAMLINE AVE N ROSEVILLE MN 55113 411428336 SENIOR HOUSING MN 501(C)(3) LINE 10 PHSPHHAL 1 GIDEON POND WEST INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 411671887 SENIOR HOUSING MN 501(C)(3) LINE 10 PHSPHHAL 1 PHS MARANATHA INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 410855713 NURSING HOME MN 501(C)(3) LINE 10 PHSPHHAL 1 PHS MONTICELLO INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 411819439 SENIOR HOUSING MN 501(C)(3) LINE 10 PHS 1 PHSBEACON HILL INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 300093682 SENIOR HOUSING MN 501(C)(3) LINE 10 PHS 1 PHSCOTTAGE GROVE INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 300227875 SENIOR 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PHSPHHAL 1 FAIRVIEW FOUNDATION 2845 HAMLINE AVE N ROSEVILLE MN 55113 363632069 FUND DEVELOPMENT IL 501(C)(3) PF PHSPHF 1 PHW GERMANTOWN INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 811502691 SENIOR HOUSING WI 501(C)(3) LINE 10 PHW 1 HUTCHINSON SENIOR CARE SERVICES 2845 HAMLINE AVE N ROSEVILLE MN 55113 272357574 SENIOR HOUSING MN 501(C)(3) LINE 10 PHCC 1 PHS COUNCILL BLUFFS INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 823917566 SENIOR HOUSING MN 501(C)(3) LINE 10 PHSPHHAL 1 PHS INTERLUDE FRIDLEY LLC 2845 HAMLINE AVE N ROSEVILLE MN 55113 462904490 SENIOR HOUSING MN 501(C)(3) LINE 10 PHSPHHAL 1 PHW OCONOMOWOC INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 825492636 SENIOR HOUSING WI 501(C)(3) LINE 10 PHW 1 PHW MUSKEGO INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 843659345 SENIOR HOUSING WI 501(C)(3) LINE 10 PHW 1 PHS HIGHLAND PARK INC 2845 HAMLINE AVE N ROSEVILLE MN 55113 845153204 SENIOR HOUSING MN 501(C)(3) LINE 10 PHSPHHAL 1 BPA HEALTH LLC MAIL ROUTE 10101 2925 CHICAGO AVE MINNEAPOLIS MN 55407 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