2024-08-08T12:21:51-05:00 2023-12-31 410746749 CLIFTONLARSONALLENLLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2023-01-01 860906621 NORTHERN ARIZONA SENIOR LIVING COMMUNITY LLC NORT 9523618000 1107 HAZELTINE BLVD 200 CHASKA MN 55318 CLINT KNACKE CO-CHIEF EXECUTIVE OFFICER 9523618000 2024-07-19 1 0 DANIEL DEYLE P01742059 6123764500 2024-07-19 2023 2024-08-08 14:25:15Z THE PEAKS THOMAS A EGAN 1107 HAZELTINE BLVD 200 CHASKA MN 55318 13235417 0 X WWW.THEPEAKS.ORG X 1997 MN THE CORPORATION WAS FORMED TO DEVELOP AND OPERATE A SENIOR LIVING AND MENTORING FACILITY. 4 4 283 220 0 0 23000 95006 12316087 12722089 -26916 -69866 50382 50955 12362553 12798184 2635 3400 0 0 6949529 7572107 0 0 0 6418553 7013951 13370717 14589458 -1008164 -1791274 19129783 16778630 23699762 23139883 -4569979 -6361253 X TO DEVELOP AND OPERATE A SENIOR LIVING AND MENTORING FACILITY. 0 0 10434890 3400 12722089 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. 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 AND NORTHERN ARIZONA HEALTHCARE. FOR THE FISCAL YEAR ENDED DECEMBER 31, 2023, 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 15 MEDICAID PATIENTS IN OUR SKILLED NURSING FACILITY ON A DAILY BASIS. IN OUR LODGE WE AVERAGED 14 RESIDENTS ON A DAILY BASIS DISCOUNTING ELIGIBLE RESIDENT'S CARE BY $338,554 DURING 2023. WE HAVE A PARTNERSHIP WITH THE MUSEUM OF NORTHERN ARIZONA (MNA), WHICH SUPPORTS AN ART COLLECTION WITHIN THE PEAKS AND TWO MUSEUM DOCENT PROGRAMS. WE BELIEVE THIS ART ENRICHES THE LIVES OF OUR RESIDENTS AND THE COMMUNITY AS A WHOLE. THE PEAKS FUNDED: $400 TO AMERICAN CANCER SOCIETY; $1,000 TO SOROPTIMIST INTERNATIONAL OF THE ARIZONA; $500 TO COCONINO COMMUNITY COLLEGE FOUNDATION; AND $1,500 IN OTHER DONATIONS TO ORGANIZATIONS CONSISTENT WITH OUR PHILOSOPHY OF INTERGENERATIONAL CARE. NAU NURSING STUDENTS IN THE BACCALAUREATE 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. 10434890 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 71 0 1 283 1 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 JENNIE A CLARKE MANAGER 1.00 0.00 X 0 0 0 LISA D DAVISON MANAGER 1.00 0.00 X 0 0 0 WENDY HARDEN MANAGER 1.00 0.00 X 0 0 0 JACOB LANSBURG MANAGER 1.00 0.00 X 0 0 0 CHRIS BAVASI CO-CHIEF EXECUTIVE OFFICER 1.00 0.00 X 0 0 0 THOMAS A EGAN CO-CHIEF EXECUTIVE OFFICER 1.00 0.00 X 0 0 0 MAY GRACE SUSON MDS COORDINATOR RN 40.00 0.00 X 117306 0 18720 117306 0 18720 1 0 0 0 THE GOODMAN GROUP LLC 1107 HAZELTINE BLVD 200 CHASKA MN 55318 MANAGEMENT AND ACCOUNTING SERVICES, INFO 867153 RELIANT REHABILITATION HOLDINGS INC 5800 GRANITE PARKWAY SUITE 1000 PLANO TX 75024 THERAPY 549894 MARVEL MEDICAL STAFFING 9394 W DODGE RD 300 OMAHA NE 68114 CONTRACTED NURSING 381724 PHARMERICA CORPORATION OF AMERICA 805 N WHITTINGTON PKWY LOUISVILLE KY 40222 PHARMACY 187146 ADVANTIS MEDICAL STAFFING 13155 NOEL RD SUITE 300 DALLAS TX 75240 CONTRACTED NURSING 137989 5 72006 23000 95006 RESIDENT SERVICES 623990 9928999 9928999 ANCILLARY SERVICES 623990 2793090 2793090 12722089 38174 38174 329193 437233 -108040 -108040 -108040 MISCELLANOUS REVENUE 900099 50955 50955 50955 12798184 12722089 0 -18911 3400 3400 6501992 5646120 855872 60778 52778 8000 573085 497649 75436 436252 378827 57425 694844 694844 33363 33363 231120 231120 1192604 797944 394660 151119 151119 104856 104856 164680 164680 391883 391883 159344 38415 120929 616368 414958 201410 936267 630323 305944 471228 317245 153983 DIETARY FOOD 568168 568168 OTHER EXPENSES 496490 103872 392618 SUPPLIES 489923 380646 109277 DRUGS 212662 212662 99032 99032 14589458 10434890 4154568 0 886447 210079 1430292 417227 1076984 1215650 60388 51162 210335 250940 32049962 18521578 14096431 13528384 1368906 1105188 19129783 16778630 905715 967604 246837 171304 12474 9293 22534736 21991682 23699762 23139883 X -4569979 -6361253 -4569979 -6361253 19129783 16778630 -1791274 0 X X 0 1 X 1 0 X 25000 3083824 2002338 23000 95006 5229168 15098468 12179954 12861048 12316087 12722089 65177646 15123468 15263778 14863386 12339087 12817095 70406814 0 0 0 70406814 3676 10358 550 7409 38174 60167 3676 10358 550 7409 38174 60167 101345 71131 50382 50955 273813 15127144 15375481 14935067 12396878 12906224 70740794 0.99530 0.99650 0.00090 0.00040 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2020 AMOUNT: $ 101,345. 2021 AMOUNT: $ 71,131. 2022 AMOUNT: $ 50,382. 2023 AMOUNT: $ 50,955. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 660000 660000 23836346 12578357 11257989 4862226 3569590 1292636 2691390 2373631 317759 13528384 REPLACEMENT RESERVE ACCOUNT 183186 TENANT/PATIENT FUNDS HELD IN TRUST 9393 RESIDUAL RECEIPTS RESERVE 798371 TAX AND INSURANCE ESCROW 114238 1105188 X 12902824 -3400 -3400 12906224 -108040 -108040 12798184 14694098 108040 108040 14586058 3400 3400 14589458 PART IV, LINE 2B: RESIDENT FUND TOTALING $9,293 PART X, LINE 2: THE PROJECT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE STATUTES; ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE PROJECT FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE PROJECT FILES INFORMATION RETURNS AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEAR SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHARITABLE EXPENSE -3,400. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY -108,040. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY 108,040. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHARITABLE EXPENSE 3,400. 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.