2025-11-13T14:31:26-07:00 2025-06-30 990 2024-07-01 311558826 4000 VALLEY SQUARE INC DBA WOODSIDE VILL WHEATLAND TERR 4000 7017877912 2900 14th Ave S Grand Forks ND 58201 Garth Rydland President/CEO 7017877905 2025-11-13 1 2024 2025-03-06 01:10:19Z Valley Senior Living on 42nd Woodside Village Wheatland Terrace Country Estates Garth Rydland 2900 14th Ave S Grand Forks ND 58201 26857299 0 X www.valleyseniorliving.org X 1997 ND Operation of Woodside Village a 138 Bed Skilled Nursing Facility, Operation of Wheatland Terrace a 59 Unit Assisted Living Facility and Operation of Country Estates a 60 Unit Independent Living Facility 9 8 0 52 0 0 510450 237711 25302378 25992560 445819 483777 148624 143251 26407271 26857299 0 0 0 0 15697137 16677785 0 0 0 8381090 8936392 24078227 25614177 2329044 1243122 36706114 33728089 25335080 24304885 11371034 9423204 4000 Valley Square (DBA: Valley Senior Living on 42nd) provides compassionate care and service from a Christian perspective to enhance the quality of life for those we serve. 0 0 18451075 20913697 Woodside Village is a 138 bed skilled nursing facility, including 28 Memory Care beds. FYE 6/30/2025 Woodside Village served on the average 135 residents with an annual average occupancy of 97.7%. Woodside Village serves the Medicare, Medicaid and Private Pay population 2681530 0 3619819 Wheatland Terrace a 59 unit assisted living facility. FYE 6/30/2025 Wheatland Terrace served on the average 55 residents with an annual average occupancy of 93.2%. 1134512 0 1457948 Country Estates a 60 unit independent living facility. FYE 6/30/2025 Country Estates served on the average 58 residents with an annual average occupancy of 97%. 0 0 0 22267117 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 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 X 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 X Lorilee A Bott 7017877912 2900 14th Ave S Grand Forks ND 58201 Garth Rydland President/CEO 0 40 X X X X 0 286652 23427 Gina Roller Valley Senior Living on 42nd Administrator 40 0 X X 195249 0 17683 Lorilee A Bott CFO 0 40 X X 0 180588 20436 Adam Edwards Chief Human Resource Officer 0 40 X X 0 172396 23925 Jessica Baumgarten Director of Nursing Valley Senior Living on Columbia 0 40 X X 0 169024 18280 Jennifer Schultz Director of Nursing Woodside Village 40 0 X X 145002 0 16747 Angela Goulet Tufte Manor Administrator and Director PCS 0 40 X X 0 128895 20700 LeeAnn Novak LPN Float 40 0 X 137256 0 10254 Angie Praska Assistant Director of Nursing Woodside Village 40 0 X X 122967 0 7945 Marissa Kazmierczak RN 40 0 X 109375 0 19482 Kari Gerszewski RN Care Coordinator 40 0 X 103388 0 10984 Margaret Reed Chairperson 0 0 X X 0 0 0 David Molmen Vice Chair 0 0 X X 0 0 0 Dwight Thompson Treasurer 0 0 X X 0 0 0 Patrick Moore Director 0 0 X 0 0 0 Michael Brown Director 0 0 X 0 0 0 Scott Berge Director 0 0 X 0 0 0 Carol Svendson Director 0 0 X 0 0 0 Tom Colenso Director 0 0 X 0 0 0 813237 937555 189863 6 0 1 0 0 0 0 0 34562 203149 0 0 237711 Skilled Nursing DBA: Woodside Village 623110 20913697 20887380 0 26317 Assisted Living DBA: Wheatland Terrace 623110 3619819 3566881 0 52938 Senior Independent Living DBA: Country Estates 623000 1457948 1365557 0 92391 1096 0 0 1096 25992560 483777 483777 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Interest in Net Assets VSL Foundation 623110 28984 28984 0 0 114267 114267 0 0 143251 26857299 26446846 0 172742 13355173 12885728 469445 0 590394 570972 19422 0 1686953 1630986 55967 0 1045265 893137 152128 0 4972 0 4972 0 1898 0 1898 0 466 0 466 0 86658 0 86658 0 339960 0 339960 0 568542 568542 0 0 21615 16278 5337 0 43293 35146 8147 0 1265341 1265341 0 0 0 0 0 0 1796784 1796784 0 0 245637 245637 0 0 Food 896765 896765 0 0 Direct Departmental Supplies 829957 827301 2656 0 Contracted Services/Management Fees 2467149 579775 1887374 0 Employee Expense 78959 0 78959 0 288396 54725 233671 0 25614177 22267117 3347060 0 7548988 5344214 1265921 1289009 161333 119438 126543 8890 12140 48645230 32715899 16212219 15929331 11550658 10865519 36706114 33728089 1133583 1685926 23610000 22675000 141165 123012 450332 -179053 25335080 24304885 X 11154289 9177475 216745 245729 11371034 9423204 36706114 33728089 X 1243122 0 0 0 0 -3190952 X 0 1 X 1 0 X 51027 36141 34475 49960 34562 206165 18514522 21299891 23593582 25302378 25992560 114702933 18565549 21336032 23628057 25352338 26027122 114909098 114909098 1240 16046 147498 445819 483777 1094380 1240 16046 147498 445819 483777 1094380 18566789 21352078 23775555 25798157 26510899 116003478 0.99057 0.99415 0.00943 0.00585 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1108000 1108000 0 38479246 26575987 11903259 0 3578969 2722603 856366 0 4395398 3417309 978089 0 1083617 0 1083617 15929331 Assets Whose Use is Limited 6282751 Receivable from Valley Senior Living 3944463 Investment in Long Term Care Bed Licenses 316383 Interest in Valley Senior Living Foundaiton Net Assets 245729 Resident Trust Funds and Security Deposits 39546 Tuition Grant Receivable 36647 10865519 0 Unamortized Bond Issue Costs, Premium and Discount -218599 Resident Trust Funds and Security Deposits 39546 -179053 X X X X 0 0 1 0 0 0 0 0 0 Garth Rydland President/CEO 0 270457 0 16195 0 0 0 17480 0 5947 0 310079 0 0 Gina Roller Valley Senior Living on 42nd Administrator 187249 0 8000 0 0 0 11951 0 5732 0 212932 0 0 0 Lorilee A Bott CFO 0 180588 0 0 0 0 0 11726 0 8710 0 201024 0 0 Adam Edwards Chief Human Resource Officer 0 163958 0 8438 0 0 0 11279 0 12646 0 196321 0 0 Jessica Baumgarten Director of Nursing Valley Senior Living on Columbia 0 162824 0 6200 0 0 0 18280 0 7718 0 195022 0 0 Schedule J, Part I, Line 4 Valley Senior Living, a related organization, participates in a 457B plan. A City of Grand Forks 456002085 38549PAP7 2016-12-28 19102322 Refunded 2006 Series 0 0 1 B City of Grand Forks 456002085 38549PBG6 2017-05-04 9950080 To finance building and renovation project 0 0 1 A 5870000 0 19102322 1565000 0 0 397734 0 0 0 0 0 2016 1 0 1 1 B 360000 0 9950080 999043 0 0 181785 0 0 8755114 0 0 2017 0 0 1 1 A 0 0 0 0 1 0 0 B 0 0 0 0 1 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 Form 990, Part V, Line 1a 4000 Valley Square's accounts payable is processed by Valley Senior Living, a related party. All 1099's are reflected on Valley Senior Living's Form 1096. There is not a Form 1096 for 4000 Valley Square expenditures. Valley Senior Living's EIN is 45-0448164. Form 990, Part V, Line 2a Valley Senior Living, a related organization, processes the payroll for 4000 Valley Square's employees. W2s and W3 are filed under EIN 45-0448164. Form 990, Part VI, Section A, Line 9 Margaret Reed, 297 Circle Hills Dr, Grand Forks, ND 58201; Dave Molmen, 665 Desiree Dr, Grand Forks, ND 58201; Dwight Thompson, 541 Aviamar Cir, Grand Forks, ND 58201; Carol Svendson, 2123 12th Ave NW, East Grand Forks, MN 56721; Michael Brown, 601 Desiree Dr, Grand Forks, ND 58201; Patrick Moore, 611 Terrace Dr, Grand Forks, ND 58201; Scott Berge, 2301 S 36th st, Grand Forks, ND 58201; Tom Colenso, 2118 10th Ave N, Grand Forks, ND 58203. Form 990, Part VI, Section B, Line 11b The CFO with the assistance of the President/CEO prepares the Form 990. A draft of the Form 990 and all applicable schedules are sent to the Board of Directors for review prior to the filing deadline. The CFO explains any changes, specifically reviews Part VI with the Board of Directors, inquires if the board member or any of their family members have had business transaction with or were employees of 4000 Valley Square during the year, and answers any questions. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is stated in Article 8 of the bylaws and is reviewed during board orientation. Annually board members receive and sign the policy. Form 990, Part VI, Section B, Line 15 The President/CEO of Valley Senior Living's (a related party) compensation is determined as follows: The compensation committee reviews the ND Long Term Care Association's state compensation survey each year to assess hows Valley Senior Living CEO's base salary compares with facilities of similar size and function. The survey provides a guage when it considers a change in base compensation. The committee then reviews the organization's performance and strategic plan goals to develop an incentive compensation plan in addition to base salary. Compensation for executive management team includes a performance appraisal completed by the President/CEO or their direct supervisor. Employees are eligible for annual inflationary increases to their base salary. The percentage is based upon the approved annual budget or other board approved changes. The ND Long Term Care Association salary survyes, along with local market comparisons, are reviewed and adjustments are made to base salaries if the survey demonstrates underpayment compred to like sized operations. Form 990, Part VI, Section C, Line 19 4000 Valley Square Inc'd governing documents, conflict of interest policy, and financial statements are available upon request. Requests should be made to the CFO of Valley Senior Living, located at Valley Senior Living on Columbia, 2900 14th Ave S, Grand Forks, ND between the hours of 8:30-4:30 Monday through Friday. Form 990, Part XI, Line 9 Transfer to Valley Senior Living (Related Party) Valley Senior Living 2900 14th Ave S Grand Forks ND 58201 450448164 Provides mgt, nursing, chaplaincy and support serv ND 501 (c) 3 Line 1, Type 1 N/A Valley Senior Living Foundation 2900 14th Ave S Grand Forks ND 58201 450392710 Seek & accept gifts to support serv of LTC facil(s) ND 501 (c) 3 Line 7 N/A Valley Homes and Services 2900 14th Ave S Grand Forks ND 58201 450229071 Operates Skilled Nursing & Basic Care Fac ND 501 (c) 3 Line 9 N/A Cherrywood Village 2900 14th Ave S Grand Forks ND 58201 454276187 Low Income Sr Apts (in Development phase) ND 501 (c) 3 Line 9 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 Valley Senior Living p 1870017 Direct cost or allocated. Valley Senior Living r 3190952 Transfer to related organization as allowed per Master Trust Indenture. Valley Senior Living Foundation c 34562 Actual Contribution.