2022-09-15T16:09:49-05:00 2021-12-31 410746749 CLIFTONLARSONALLENLLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2021-01-01 860906621 NORTHERN ARIZONA SENIOR LIVING COMMUNITY LLC NORT 9523618000 1107 HAZELTINE BLVD 200 CHASKA MN 55318 THOMAS A EGAN CO-CHIEF EXECUTIVE OFFICER 9523618000 2022-08-31 1 THOMAS EGAN 999009999 CHRISTOPHER STEINHOFF P01587351 6123764500 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z THE PEAKS THOMAS A EGAN 1107 HAZELTINE BLVD 200 CHASKA MN 55318 15074013 0 X WWW.THEPEAKS.ORG X 1997 MN THE CORPORATION WAS FORMED TO DEVELOP AND OPERATE A SENIOR LIVING AND MENTORING FACILITY. 4 4 279 225 0 0 3083824 2002338 12179954 12861048 -16389 -3369 101345 71131 15348734 14931148 2500 6935 0 0 6930681 7316214 0 0 0 8201865 6673122 15135046 13996271 213688 934877 21150074 21182635 25646766 24744450 -4496692 -3561815 X TO DEVELOP AND OPERATE A SENIOR LIVING AND MENTORING FACILITY. 0 0 10333514 6935 12861048 THE PEAKS, FLAGSTAFF, ARIZONA, IS UNIQUE IN ITS COMMUNITY INVOLVEMENT IN THAT IT SHARES STRONG TIES WITH THE MUSEUM OF NORTHERN ARIZONA, AND FLAGSTAFF MEDICAL CENTER. THE PEAKS PROVIDES ITS RESIDENTS, AS WELL AS CHILDREN IN THE AREA, WITH FULLY DEVELOPED INTERGENERATIONAL ACTIVITIES BENEFITING OLDER ADULTS AND CHILDREN ALIKE. TWO OF THE PEAKS RESIDENTS ARE DOCENTS OF THE MUSEUM, PROVIDING EDUCATION ON LOCAL HISTORY, AND DISCOVERIES OF THE COLORADO PLATEAU TO AREA SCHOOLS, ASSOCIATIONS, THE PUBLIC AND PEAKS RESIDENTS. THE PEAKS PROVIDES INDEPENDENT, ASSISTED LIVING, PROGRESSIVE MEMORY CARE, REHABILITATION, LONG-TERM CARE, AND SKILLED NURSING, WITH THE OPPORTUNITY FOR RESIDENTS TO "AGE IN PLACE." RESIDENTS ARE ENCOURAGED TO REMAIN IN THEIR APARTMENT HOMES RECEIVING ASSISTANCE WITH ACTIVITIES OF DAILY LIVING THROUGH PERSONALIZED LEVELS OF CARE. THE COMMUNITY WAS DEVELOPED THROUGH A NONPROFIT PARTNERSHIP BETWEEN INTERGENERATIONAL LIVING AND HEALTH CARE, THE MUSEUM OF NORTHERN ARIZONA AND NORTHERN ARIZONA HEALTHCARE. FOR THE FISCAL YEAR ENDED DECEMBER 31, 2021, THE PEAKS PARTICIPATED IN VARIOUS CHARITABLE INITIATIVES SUCH AS THE PROVISION OF DISCOUNTED CARE THROUGH PARTICIPATION IN THE ARIZONA STATE MEDICAID PROGRAM AND INDIAN HEALTH SERVICES. WE AVERAGE 19 MEDICAID PATIENTS IN OUR SKILLED NURSING FACILITY ON A DAILY BASIS. IN OUR LODGE WE AVERAGED 9 RESIDENTS ON A DAILY BASIS DISCOUNTING ELIGIBLE RESIDENT'S CARE BY $355,998 DURING 2021. WE HAVE A PARTNERSHIP WITH THE MUSEUM OF NORTHERN ARIZONA (MNA), WHICH SUPPORTS AN ART COLLECTION WITHIN THE PEAKS AND TWO MUSEUM DOCENT PROGRAMS. THE PEAKS HAS COME TO AN AGREEMENT WITH THE MUSEUM OF NORTHERN ARIZONA TO ISSUE MEMBERSHIPS TO ALL PEAKS' RESIDENTS. WE BELIEVE THIS ART ENRICHES THE LIVES OF OUR RESIDENTS AND THE COMMUNITY AS A WHOLE. THE PEAKS FUNDED: $3,000 TO MUSEUM OF NORTHERN ARIZONA, STAGING OF ARTIFACTS; $1,875 TO ROCK STEADY BOXING FOR FURTHER RESEARCH ON PARKINSON'S DISEASE; $1,120 TO AMERICAN CANCER SOCIETY; INCLUDING OTHER DONATIONS TO ORGANIZATIONS CONSISTENT WITH OUR PHILOSOPHY OF INTERGENERATIONAL CARE. NAU NURSING STUDENTS IN THE BACCALAUREATE AND MASTERS PROGRAMS SERVE A PORTION OF THEIR INTERNSHIP IN THE PEAKS HEALTH & REHABILITATION. FUTURE CERTIFIED NURSING ASSISTANTS FROM COCONINO COMMUNITY COLLEGE SHADOW SNF CNA'S TO FULFIL PROGRAM GRADUATION REQUIREMENTS. 10333514 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 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 0 0 0 0 1 61 0 1 279 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 1 0 AZ X THE GOODMAN GROUP LLC 9523618000 1107 HAZELTINE BLVD CHASKA MN 55318 X RUSSELL GODDARD EXECUTIVE DIRECTOR 40.00 X 125297 0 31324 MICHELE ORTIZ EXECUTIVE DIRECTOR 40.00 X 124487 0 31122 CHRIS BAVASI CO-CHIEF EXECUTIVE OFFICER 1.00 X 0 0 0 THOMAS A EGAN CO-CHIEF EXECUTIVE OFFICER 1.00 X 0 0 0 JENNIE A CLARKE MANAGER 1.00 X 0 0 0 LISA D DAVIDSON MANAGER 1.00 X 0 0 0 WENDY HARDEN MANAGER 1.00 X 0 0 0 JACOB LANSBURG MANAGER 1.00 X 0 0 0 249784 0 62446 2 0 1 0 THE GOODMAN GROUP LLC 1107 HAZELTINE BLVD 200 CHASKA MN 55318 MANAGEMENT AND ACCOUNTING SERVICES, INFO 866015 SYNERTX 7540 NORTH 19TH AVE SUITE 200 PHOENIX AZ 85021 THERAPY 733865 PHARMERICA CORPORATION OF AMERICA 805 N WHITTINGTON PKWY LOUISVILLE KY 40222 PHARMACY 380482 JOHN B GOODMAN LIMITED PARTNERSHIP 1107 HAZELTINE BLVD 200 CHASKA MN 55318 CONSTRUCTION MANAGEMENT AND DEVELOPMENT 208095 MEDLINE 1 THREE LAKES DRIVE NORTHFIELD IL 60093 MEDICAL 149427 5 1981338 21000 2002338 RESIDENT SERVICES 623990 9553405 9553405 ANCILLARY SERVICES 623990 3259745 3259745 OTHER OPERATING REVENU 623990 47898 47898 12861048 550 550 138946 142865 -3919 -3919 -3919 MISCELLANOUS REVENUE 900099 71131 71131 71131 14931148 12861048 0 67762 6935 6935 6234239 5336377 897862 96156 82308 13848 521245 446175 75070 464574 397666 66908 733399 733399 36195 36195 230521 230521 1202335 957713 244622 118607 118607 102322 102322 152105 152105 328450 328450 80426 30906 49520 645552 468250 177302 967802 680281 287521 371643 261233 110410 DIETARY FOOD 528432 528432 SUPPLIES 402482 329468 73014 OTHER EXPENSES 372718 170948 201770 DRUGS 308372 308372 91761 91761 13996271 10333514 3662757 0 1341001 2653561 1709370 1410743 933425 735143 51933 53025 196633 167729 31815642 17028674 15514938 14786968 1402774 1375466 21150074 21182635 893620 836075 1167695 830315 12695 15073 23572756 23062987 25646766 24744450 X -4496692 -3561815 -4496692 -3561815 21150074 21182635 934877 0 X X 0 1 X 1 0 X 250 350 25000 3083824 2002338 5111762 14604600 14175391 15098468 12179954 12861048 68919461 14604850 14175741 15123468 15263778 14863386 74031223 0 0 0 74031223 4115 4470 3676 10358 550 23169 4115 4470 3676 10358 550 23169 101345 71131 172476 14608965 14180211 15127144 15375481 14935067 74226868 0.99740 0.99830 0.00030 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 660000 660000 23741906 11522645 12219261 4664409 3102307 1562102 2749327 2403722 345605 14786968 REPLACEMENT RESERVE ACCOUNT 473922 TENANT/PATIENT FUNDS HELD IN TRUST 15173 OPERATING RESERVE 796550 TAX AND INSURANCE ESCROW 89821 1375466 X 14928132 -6935 -6935 14935067 -3919 -3919 14931148 13993255 3919 3919 13989336 6935 6935 13996271 PART IV, LINE 2B: RESIDENT FUND TOTALING $15,073 PART X, LINE 2: THE COMPANY IS EXEMPT FROM TAXATION AS A NONPROFIT ORGANIZATION IN ACCORDANCE WITH 501(C)(3) OF THE INTERNAL REVENUE CODE. THE COMPANY FOLLOWS THE RECOGNITION REQUIREMENTS FOR UNCERTAIN INCOME TAX POSITIONS AS REQUIRED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION 740-10 INCOME TAX BENEFITS ARE RECOGNIZED FOR INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, ONLY WHEN IT IS DETERMINED THAT THE INCOME TAX POSITION WILL MORE-LIKELY-THAN-NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. THE COMPANY HAS ANALYZED TAX POSITIONS TAKEN FOR FILING WITH THE INTERNAL REVENUE SERVICE AND THE STATE JURISDICTION WHERE IT OPERATES. THE COMPANY 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 COMPANY'S FINANCIAL CONDITION, RESULTS OF OPERATIONS OR CASH FLOWS. ACCORDINGLY, THE COMPANY HAS NOT RECORDED ANY RESERVES, OR RELATED ACCRUALS FOR INTEREST AND PENALTIES FOR UNCERTAIN INCOME TAX POSITIONS AT DECEMBER 31, 2019. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS, HOWEVER, THERE ARE CURRENTLY NO AUDITS IN PROGRESS FOR ANY TAX OPEN TAX PERIODS. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSE NETTED WITH REVENUES -6,935. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY -3,919. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY 3,919. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES NETTED WITH REVENUES 6,935. 0 0 0 0 0 0 0 0 0 RUSSELL GODDARD EXECUTIVE DIRECTOR 118357 0 6940 0 0 0 5078 0 26246 0 156621 0 0 0 MICHELE ORTIZ EXECUTIVE DIRECTOR 117447 0 7040 0 0 0 3735 0 27387 0 155609 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE GOODMAN GROUP, LLC, MANAGES THE PROJECT'S FACILITIES. MANAGEMENT FEES ARE INCURRED PURSUANT TO A MANAGEMENT AGREEMENT BASED ON 5.5% OF GROSS RECEIPTS, AS APPROVED BY HUD. THE PROJECT PAYS THE GOODMAN GROUP, LLC AN ACCOUNTING SERVICES FEE. THE ACCOUNTING FEE IS BASED UPON AN ALLOCATION OF THE COSTS OF ACCOUNTANTS, BOOKKEEPERS, PAYROLL TAXES, INSURANCE, THE COST OF DATA PROCESSING, AND OTHER ALLOCABLE COSTS. THE FEE IS CHARGED TO ALL PROJECTS MANAGED BY THE GOODMAN GROUP, LLC ON A PRO RATA ALLOCATION BASED ON NET REVENUES EARNED. THE PROJECT PAYS THE GOODMAN GROUP, LLC AN IT FEE. THE IT FEE IS BASED UPON AN ALLOCATION OF THE COSTS OF INFORMATION TECHNOLOGY AND RELATED SERVICES. THE FEE IS CHARGED TO ALL PROJECTS MANAGED BY THE GOODMAN GROUP, LLC ON A PRO RATA ALLOCATION BASED ON COMPUTER UNITS. THE GOODMAN GROUP, LLC ALSO PROVIDES LEGAL SERVICES, WHICH ARE CHARGED TO THE PROJECT ON A PER HOUR BASIS BASED ON ACTUAL COSTS INCURRED. FORM 990, PART VI, SECTION A, LINE 8B NO INDIVIDUAL COMMITTEE CREATED BY THE BOARD HAS THE BROAD AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM. IT IS THEN REVIEWED BY THE CONTROLLER AND CPAS OF THE MANAGEMENT COMPANY. THE FORM 990 IS GIVEN TO EACH BOARD MEMBER IN ADVANCE OF A SCHEDULED MEETING OF THE BOARD FOR THEIR REVIEW. THERE IS DISCUSSION OF THE FORM 990 AT THE BOARD MEETING WITH THE PREPARERS AND THE MANAGEMENT COMPANY'S REPRESENTATIVE PRIOR TO BOARD APPROVAL OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS, COMMITTEE MEMBERS AND KEY EMPLOYEES OF THE NORTHERN ARIZONA SENIOR LIVING COMMUNITY OWE SUCH ENTITIES A DUTY OF GOOD FAITH LOYALTY. THUS, PERSONS HOLDING SUCH POSITIONS MAY NOT USE THEIR POSITIONS TO PROFIT PERSONALLY OR TO ASSIST OTHERS IN PROFITING IN ANY WAY AT THE EXPENSE OF ANY OF THE NORTHERN ARIZONA SENIOR LIVING COMMUNITY. CONSEQUENTLY, RESPONSIBLE PERSONS ARE REQUIRED TO DISCLOSE ALL CONFLICTS OF INTEREST PROMPTLY AND FULLY TO THE CHAIR OF THE BOARD AND THE CO-CHIEF EXECUTIVE OFFICERS OF NORTHERN ARIZONA SENIOR LIVING COMMUNITY, WHO SHALL BRING THE MATTER TO THE ATTENTION OF THE BOARD. IF A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE PERSON WITH SUCH CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE AFFAIRS OF NORTHERN ARIZONA SENIOR LIVING COMMUNITY IN CONNECTION WITH THE SPECIFIC CONTRACT, TRANSACTION OR RELATIONSHIP THAT FORMS THE BASIS OF SUCH CONFLICT OF INTEREST, EXCEPT AS EXPRESSLY PERMITTED UNDER THIS POLICY. EACH POTENTIAL CONFLICT OF INTEREST MUST BE PRESENTED TO THE BOARD (OR A COMMITTEE DESIGNATED BY THE BOARD) FOR AUTHORIZATION, APPROVAL OR RATIFICATION. THE BOARD SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO NORTHERN ARIZONA SENIOR LIVING COMMUNITY. THE DECISION OF THE BOARD ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION, AND THEIR CONCERN MUST BE THE WELFARE OF NORTHERN ARIZONA SENIOR LIVING COMMUNITY AND THE ADVANCEMENT OF ITS PURPOSE. THE DISCLOSING PERSON SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF HIS OR HER INTEREST AND SHALL INCLUDE ANY KNOWN, RELEVANT AND MATERIAL FACTS ABOUT THE CONTRACT OR TRANSACTION, INCLUDING ALL AREAS THAT MIGHT REASONABLY BE CONSTRUED TO BE ADVERSE TO NORTHERN ARIZONA SENIOR LIVING COMMUNITY'S INTERESTS OR TO BE BENEFICIAL TO THE DISCLOSING PERSON. THE PERSON WITH THE POTENTIAL CONFLICT OF INTEREST SHALL BE EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION, EXCEPT AS EXPRESSLY REQUESTED BY THE BOARD (OR OTHER DESIGNATED COMMITTEE) AND SUCH PERSON SHALL NOT BE COUNTED IN DETERMINING ANY NECESSARY QUORUM OR APPROVAL FOR ACTION TO BE TAKEN. AFTER DISCLOSURE, TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE PERMITTED TO BE UNDERTAKEN IF A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS, IF APPLICABLE OR THE BOARD HAS DETERMINED THAT THE TERMS OF THE TRANSACTION ARE FAIR AND REASONABLE; AND THE BOARD HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION REVIEWS AND APPROVES COMPENSATION LEVELS ANNUALLY DURING BUDGET REVIEW, INCLUDING PAY LEVELS FOR KEY EMPLOYEES. TO FACILITATE THIS REVIEW, THE ORGANIZATION UTILIZES AN INDEPENDENT MANAGEMENT COMPANY TO RESEARCH AND RECOMMEND PAY LEVELS. THE MANAGEMENT COMPANY HAS OVER 50 YEARS OF EXPERIENCE IN THE SENIOR HOUSING AND PROPERTY MANAGEMENT INDUSTRY WITH NUMEROUS RESOURCES TO INDEX. KEY EMPLOYEES WOULD INCLUDE EXECUTIVE DIRECTORS AND LEADERSHIP AT THE WHOLLY OWNED ENTITIES OF THE ORGANIZATION, AS WELL AS, RECOMMENDATIONS OF PAY LEVELS FOR MEMBERS AND OFFICERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. 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 WRITTEN REQUEST. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS ARE PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE STATEMENTS ARE REVIEWED AND APPROVED BY THE BOARD BEFORE BEING ISSUED. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.