2024-10-07T15:43:51-07:00 2023-12-31 990 2023-01-01 411927112 PIONEER HOUSE ASSISTED LIVING INC PION 9528555000 7171 OHMS LANE EDINA MN 55439 KATHY YOUNGQUIST CFO 9528555000 2024-11-15 1 2023 2024-10-15 13:58:12Z ROBERT M DAHL 7171 OHMS LANE EDINA MN 55439 2694802 0 X www.cassialife.org X 1999 MN TO PROVIDE HEALTHCARE, HOUSING, AND COMMUNITY SERVICES FOR THE ELDERLY. 5 5 40 15 0 0 180000 0 2209353 2348816 58310 75893 14403 33338 2462066 2458047 0 0 0 0 1369129 1137249 0 0 0 1000889 1150559 2370018 2287808 92048 170239 4880789 4951699 1938044 1683455 2942745 3268244 TO FOSTER FULLNESS OF LIFE FOR OLDER ADULTS IN THE SPIRIT OF CHRIST'S LOVE. 0 0 2036398 0 2352154 PIONEER HOUSE ASSISTED LIVING, INC. WAS ORGANIZED FOR THE PURPOSE OF OPERATING AN ASSISTED LIVING FACILITY FOR THE ELDERLY. IT IS LOCATED IN FARGO, ND AND HAS 48 ASSISTED LIVING UNITS. 30000 0 30000 PIONEER HOUSE RENTS ITS CHAPEL SPACE TO THE ATTACHED NURSING HOME, WHICH IS OWNED BY ELIM HOMES, INC. (A RELATED ORGANIZATION) 0 0 0 2066398 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 40 1 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X KATHY L YOUNGQUIST 9528555000 7171 OHMS EDINA MN 55439 ROBERT DAHL PRESIDENT/CEO 0.23 39.77 X 0 619856 108350 MATTHEW KERN CHIEF OPERATING OFFICER 0.23 39.77 X 0 332576 109481 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0.23 39.77 X 0 337157 79279 KATHY KOPP CHIEF STRATEGIC OFFICER 0.23 39.77 X 0 280591 88142 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0.23 39.77 X 0 245658 68177 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0.23 39.77 X 0 260482 48520 ANNETTE NYGAARD DIRECTOR OF HEALTH SERVICES 40 0 X 102904 0 20858 NIKKI WEBER DANIELS CHAIRPERSON AND DIRECTOR 0.25 0.25 X X 0 0 0 PAT NUSS VICE CHAIRPERSON AND DIRECTOR 0.25 0.25 X X 0 0 0 PAUL ANDERSON SECRETARY/TREASURER AND DIRECTOR 0.25 0.25 X X 0 0 0 MICHAEL ADERINKOMI DIRECTOR 0.25 0.25 X 0 0 0 LORES VLAMINCK DIRECTOR 0.25 0.25 X 0 0 0 STANN LEFF CHAIRPERSON AND DIRECTOR (THRU MARCH) 0.25 0.25 X X 0 0 0 DOCTOR GUY TANGEDAHL DIRECTOR (THRU JUNE) 0.25 0.25 X 0 0 0 102904 2076320 522807 1 0 1 0 0 0 ASSISTED/INDEPENDENT LIVING REVENUE 623311 2318816 2318816 0 0 RENTAL REVENUE RELATED PARTY 531120 30000 30000 0 0 0 0 0 0 2348816 40131 0 0 40131 0 0 0 0 0 0 0 0 0 0 272517 0 236755 0 35762 0 35762 0 0 35762 BEAUTY SHOP REVENUE 812112 12817 12817 0 0 HOUSEKEEPING REVENUE 561720 8256 8256 0 0 CABLE TV REVENUE 517000 4851 4851 0 0 7414 7414 0 0 33338 2458047 2382154 0 75893 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 939287 890679 48608 0 21372 20266 1106 0 107428 101869 5559 0 69162 65583 3579 0 95358 0 95358 0 137 0 137 0 1333 0 1333 0 0 0 0 0 0 0 14612 0 14612 0 415276 409033 6243 0 17104 0 17104 0 11578 1360 10218 0 21709 0 21709 0 0 0 0 0 201478 201478 0 0 2442 369 2073 0 0 0 0 0 2150 1714 436 0 48201 48201 0 0 0 0 0 0 205228 205228 0 0 21210 21210 0 0 FOOD 55912 55912 0 0 SUPPLIES 49640 49284 356 0 BACKGROUND CHECKS & DRUG TESTING 1645 0 1645 0 LICENSES 617 0 617 0 -15071 -5788 -9283 0 2287808 2066398 221410 0 240736 249054 103627 316605 64208 91665 5400 6100 6208846 4082070 2265097 2126776 1710017 1708087 491704 453412 4880789 4951699 111149 81249 1735520 1490319 63797 67257 27578 44630 1938044 1683455 X 2942745 3268244 0 0 2942745 3268244 4880789 4951699 X 170239 150398 0 0 0 4862 X 0 1 X 1 1 1 X 200000 580536 652772 180000 0 1613308 1519028 1985120 1995347 2179343 2318816 9997654 1719028 2565656 2648119 2359343 2318816 11610962 550992 250330 137132 452137 763703 2154294 550992 250330 137132 452137 763703 2154294 9456668 128210 174470 135926 88320 105893 632819 128210 174470 135926 88320 105893 632819 17090 210074 15819 14403 33338 290724 1864328 2950200 2799864 2462066 2458047 12534505 0.75445 0.68292 0.05049 0.05291 X Schedule A, Part III, Line 12 BEAUTY SHOP INCOME 2019-$17,090, 2020-$11,764, 2021-$15,819, 2022-$14,403, 2023-$12,817; INSURANCE PROCEEDS 2020-$198,400;HOUSEKEEPING REVENUE 2023-$8,256;TELEPHONE AND CABLE REVENUE 2023-$4,851;MISCELLANEOUS 2023-$7,414 0 1 X 0 14370 14370 0 5496995 3472852 2024143 0 0 0 0 0 631694 548338 83356 0 65787 60880 4907 2126776 DUE FROM AFFILIATES 193547 CIP - BUILDING 99416 REPAIR AND REPLACEMENT FUND 76282 SECURITY DEPOSITS 70867 INTEREST RECEIVABLE 9300 MISCELLANEOUS RECEIVABLE 4000 453412 DUE TO AFFILIATE 41430 ACCRUED INTEREST PAYABLE 3200 44630 X Schedule D, Part IV, Line 2b SECURITY DEPOSITS ARE REQUIRED FOR THE ORGANIZATION'S TENANTS AND INCLUDE RESERVED APARTMENTS IF AMOUNTS ARE PAID BEFORE THE TENANT ACTUALLY MOVES IN. Schedule D, Part X, Line 2 ELIM CARE, INC. 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. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATION 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. ELIM CARE, INC. 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 1 1 X X X X 0 1 0 0 0 1 1 0 0 ROBERT DAHL PRESIDENT/CEO 0 561902 0 55422 0 2533 0 90159 0 18191 0 728207 0 55422 MATTHEW KERN CHIEF OPERATING OFFICER 0 330095 0 0 0 2481 0 84010 0 25471 0 442057 0 0 KATHY YOUNGQUIST CHIEF FINANCIAL OFFICER 0 335007 0 0 0 2150 0 59632 0 19647 0 416436 0 0 KATHY KOPP CHIEF STRATEGIC OFFICER 0 265237 0 13324 0 2030 0 62423 0 25719 0 368733 0 13324 ANGELA BROWN CHIEF HUMAN RESOURCE OFFICER 0 222662 0 0 0 22996 0 41651 0 26526 0 313835 0 17327 SHARON WILSON CHIEF CLINICAL AND COMPLIANCE OFFICER 0 226573 0 21773 0 12137 0 40176 0 8344 0 309003 0 21773 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 USAGE OF THE VEHICLES IS TREATED AS 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 RECOMMENDATIONS 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 YOUNGQUIST, CFO - $34,402 MATTHEW KERN, COO - $33,941 ANGELA BROWN, CHRO - $23,310 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. A CASS COUNTY 456002205 2014-09-09 3597900 REFINANCE EXISTING LOAN 0 0 0 A 2061974 0 3597900 0 0 0 0 0 0 0 0 0 2014 1 0 1 1 A 0 0 0 0 0 0 0 0 0 1 A 0 1 0 1 1 0 0 0 1 A 1 Schedule K, Part IV, Line 2c-09/09/2014 3,597,900 CASS COUNTY THERE WERE NO INVESTMENT EARNINGS ON ANY BOND PROCEEDS. 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 AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part IX, Line 11g DIETARY PURCHASED SERVICES $362,448; OTHER SERVICES $52,828 Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS WAS AS FOLLOW: $4,865 NET RESTRICTED CONTRIBUTIONS TRANSFERRED FROM CASSIA (A RELATED ORGANIZATION); ROUNDING $-3 CASSIA 7171 OHMS LANE EDINA MN 55439 831758728 PARENT CO/FUND RAISING MN 501(C)(3) 12 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 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 HOMES INC 0 PARK VIEW CARE CENTER 7171 OHMS LANE EDINA MN 55439 410855707 HEALTH CARE FACILITIES/SERVICES MN 501(C)(3) 10 ELIM HOMES 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 ELIM CARE FOUNDATION 7171 OHMS LANE EDINA MN 55439 411694817 CHARITABLE FOUNDATION MN 501(C)(3) 12 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 INC 7171 OHMS LANE EDINA MN 55439 411681856 MEDICAL SALES MN ELIM CARE INC C 0 0 PREFERRED SENIOR SERVICES INC 7171 OHMS LANE EDINA MN 55439 411942480 MANAGEMENT SERVICES MN ELIM CARE INC C 0 0 AUGUSTANA SENIOR DEVELOPMENT INC 7171 OHMS LANE EDINA MN 55439 264136110 CONSULTING MN AUGUSTANA CARE C 0 0 0 0 0 0 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1