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Nonprofiteer
← AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY

Form 990 for tax year 2023

Filed by AUGUSTANA HEALTH CARE CENTER OF APPLE VALLEY.

Totals

Total revenue
$26,199,950
Total expenses
$25,269,942
Contributions and grants received
$437,838
Grants paid
$1,565,567
Program services expenses (Part IX)
$22,306,727
Management and general expenses
$2,963,215
Fundraising expenses
$0
Program service expenses (Part III)
$22,306,727

Program services were 88.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROBERT DAHL

    PRESIDENT/CEO

    Total calculated
    $728,206
    From this org
    $0
    From related orgs
    $619,856
    Other
    $108,350
    Hours/week
    3.75 + 36.25 related

    Schedule J breakdown matched by us

    Base
    $0 + $561,902 related
    Bonus
    $0 + $55,422 related
    Other
    $0 + $2,533 related
    Deferred
    $0 + $90,159 related
    Nontaxable benefits
    $0 + $18,191 related
    Filer's total
    $0 + $728,207 related

  • MATTHEW KERN

    CHIEF OPERATING OFFICER

    Total calculated
    $442,057
    From this org
    $0
    From related orgs
    $332,576
    Other
    $109,481
    Hours/week
    3.75 + 36.25 related

    Schedule J breakdown matched by us

    Base
    $0 + $330,095 related
    Bonus
    $0
    Other
    $0 + $2,481 related
    Deferred
    $0 + $84,010 related
    Nontaxable benefits
    $0 + $25,471 related
    Filer's total
    $0 + $442,057 related

  • KATHY YOUNGQUIST

    CHIEF FINANCIAL OFFICER

    Total calculated
    $416,436
    From this org
    $0
    From related orgs
    $337,157
    Other
    $79,279
    Hours/week
    3.75 + 36.25 related

    Schedule J breakdown matched by us

    Base
    $0 + $335,007 related
    Bonus
    $0
    Other
    $0 + $2,150 related
    Deferred
    $0 + $59,632 related
    Nontaxable benefits
    $0 + $19,647 related
    Filer's total
    $0 + $416,436 related

  • KATHY KOPP

    CHIEF STRATEGIC OFFICER

    Total calculated
    $368,733
    From this org
    $0
    From related orgs
    $280,591
    Other
    $88,142
    Hours/week
    3.75 + 36.25 related

    Schedule J breakdown matched by us

    Base
    $0 + $265,237 related
    Bonus
    $0 + $13,324 related
    Other
    $0 + $2,030 related
    Deferred
    $0 + $62,423 related
    Nontaxable benefits
    $0 + $25,719 related
    Filer's total
    $0 + $368,733 related

  • ANGELA BROWN

    CHIEF HUMAN RESOURCE OFFICER

    Total calculated
    $313,835
    From this org
    $0
    From related orgs
    $245,658
    Other
    $68,177
    Hours/week
    3.75 + 36.25 related

    Schedule J breakdown matched by us

    Base
    $0 + $222,662 related
    Bonus
    $0
    Other
    $0 + $22,996 related
    Deferred
    $0 + $41,651 related
    Nontaxable benefits
    $0 + $26,526 related
    Filer's total
    $0 + $313,835 related

  • SHARON WILSON

    CHIEF CLINICAL AND COMPLIANCE OFFICER

    Total calculated
    $309,002
    From this org
    $0
    From related orgs
    $260,482
    Other
    $48,520
    Hours/week
    3.75 + 36.25 related

    Schedule J breakdown matched by us

    Base
    $0 + $226,573 related
    Bonus
    $0 + $21,773 related
    Other
    $0 + $12,137 related
    Deferred
    $0 + $40,176 related
    Nontaxable benefits
    $0 + $8,344 related
    Filer's total
    $0 + $309,003 related

  • GLEN SHAW

    ADMINISTRATOR

    Total calculated
    $210,677
    From this org
    $172,378
    From related orgs
    $0
    Other
    $38,299
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $156,504
    Bonus
    $15,000
    Other
    $874
    Deferred
    $15,647
    Nontaxable benefits
    $22,652
    Filer's total
    $210,677

  • DAVID ONDUSO

    CNA NAR

    Total calculated
    $172,556
    From this org
    $159,736
    From related orgs
    $0
    Other
    $12,820
    Hours/week
    88.36

    Schedule J breakdown matched by us

    Base
    $148,075
    Bonus
    $7,788
    Other
    $3,873
    Deferred
    $2,202
    Nontaxable benefits
    $10,617
    Filer's total
    $172,555

  • WILFRED MOSOTI

    CNA NAR

    Total calculated
    $151,020
    From this org
    $139,082
    From related orgs
    $0
    Other
    $11,938
    Hours/week
    74.26

    Schedule J breakdown matched by us

    Base
    $128,797
    Bonus
    $10,259
    Other
    $25
    Deferred
    $5,590
    Nontaxable benefits
    $6,348
    Filer's total
    $151,019

  • CYRUS SIAMBE

    RN

    Total calculated
    $132,968
    From this org
    $124,992
    From related orgs
    $0
    Other
    $7,976
    Hours/week
    43.83

  • SARAH REYNOLDS

    LPN

    Total calculated
    $131,020
    From this org
    $123,598
    From related orgs
    $0
    Other
    $7,422
    Hours/week
    55.25

  • GARY WILKERSON

    CHAIR (THROUGH MARCH)

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

  • TIMOTHY KUCK

    VICE-CHAIR (THROUGH MARCH)

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

  • ERIK ELLINGSON

    TREASURER

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

  • CHARLES PARKS

    SECRETARY

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

  • JERRY NYE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

  • SCOTT RAMSDALE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

  • MICHELENE VERLAUTZ

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Tax indemnification and gross-up payments
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

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.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2023
Filed
8 October 2024
IRS schema version
2023v5.0
Source object
202402859349300800

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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