2023-06-19T08:52:42-05:00 2022-12-31 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2022-01-01 390845016 LUTHERAN HOMES OF OCONOMOWOC INC LUTH 2625678341 PO BOX 208 OCONOMOWOC WI 53066 JOAN BIRR CFO 2625678341 2023-06-15 1 JOAN BIRR 999009999 0 SOLOMON MARDAKHAEV P01806552 6105653930 2023-06-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOAN BIRR PO BOX 208 OCONOMOWOC WI 53066 25495307 0 X WWW.SHOREHAVENLIVING.ORG X 1939 WI REFLECTING CHRIST'S LOVE, WE PROVIDE HOMES AND RESOURCES FOR SENIORS AS A CONTINUING CARE RETIREMENT COMMUNITY AND PROVIDER OF COMMUNITY BASED SERVICES. 13 13 472 250 80504 0 2625460 367643 22023287 22976657 414034 315023 182136 250221 25244917 23909544 0 0 0 0 13269068 14565170 0 0 1438 7805665 8262707 21074733 22827877 4170184 1081667 72939781 74973078 27602579 30221369 45337202 44751709 X REFLECTING CHRIST'S LOVE, WE PROVIDE HOMES AND RESOURCES FOR SENIORS AS A CONTINUING CARE RETIREMENT COMMUNITY AND PROVIDER OF COMMUNITY BASED SERVICES. 0 0 9698689 0 11788138 NURSING HOME CARE: OPERATION OF A SKILLED NURSING FACILITY AND REHABILITATION CENTER. PROVIDED 28,347 DAYS OF SKILLED NURSING SERVICES AND REHABILITATION. MAJORITY OF MEDICARE CLIENTS REHAB AND RETURN HOME TO THE COMMUNITY. 3215998 0 4625845 PROVIDE INDEPENDENT LIVING ACCOMMODATIONS FOR SENIORS THROUGH 141 UNITS ACROSS A FULL RANGE OF APARTMENT SIZES AND COSTS. 2453619 0 3198709 PROVIDE ASSISTED LIVING HOUSING AND SERVICES TO INDIVIDUALS ON AN A LA CARTE BASIS IN ORDER TO PRESERVE INDEPENDENCE AND CONSERVE THE RESIDENTS' ASSETS. 3184724 0 3363965 PROVIDE COMMUNITY OUTREACH PROGRAMS THROUGH OUR LIFE ENRICHMENT CENTER.PROVIDE IN HOME ASSISTANCE FOR CLIENTS WHO WISH TO REMAIN IN THEIR HOMES. PROVIDE HOUSING AND SERVICES TO INDIVIDUALS WITHIN A LICENSED CBRF FOR MEMORY IMPAIRED. 3184724 0 3363965 18553030 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 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 1 1 0 0 0 1 56 0 472 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X JOAN BIRR 2625606969 1305 W WISCONSIN AVENUE OCONOMOWOC WI 53066 PHIL HOLLAND CHAIR 2.00 2.00 X X 0 0 0 ATTY MARY LEE RATZEL PAST CHAIR 2.00 2.00 X X 0 0 0 NORMAN ECKSTAEDT VICE CHAIR 2.00 2.00 X X 0 0 0 BILL LENTZ TREASURER 2.00 2.00 X X 0 0 0 KAREN JENSEN SECRETARY 2.00 2.00 X X 0 0 0 ROGER MAYER DIRECTOR 2.00 2.00 X 0 0 0 JOHN BORAY DIRECTOR 2.00 2.00 X 0 0 0 KATIE MILLER DIRECTOR 2.00 2.00 X 0 0 0 JOEL LAMMERS DIRECTOR 2.00 2.00 X 0 0 0 MARY JO O'MALLEY DIRECTOR 2.00 2.00 X 0 0 0 KURT SCHRANG DIRECTOR 2.00 2.00 X 0 0 0 MARY KAY SOKOP DIRECTOR 2.00 2.00 X 0 0 0 CAROL ZEUTZIUS DIRECTOR 2.00 2.00 X 0 0 0 DALE DAHLKE CEO 38.00 2.00 X 227812 0 19792 JOAN BIRR CFO 38.00 2.00 X 191834 0 15093 BRYAN POLINSKE COO 40.00 X 141512 0 16033 EMILY KARLS ADMINISTRATOR 40.00 X 116772 0 5830 CAROLYN CLAUTER DIRECTOR OF HUMAN RESOURCES 35.00 X 121971 0 10885 799901 0 67633 5 0 1 0 PROHEALTH CARE MEDICAL ASSOCIATES INC N17 W24100 RIVERWOOD DRIVE SUITE 2 WAUKESHA WI 53188 THERAPY SERVICES 402929 HOFFMAN PLANNING DESIGN AND CONST 122E COLLEGE AVE SUITE 1G APPLETON WI 54911 CONSTRUCTION SERVICES 316008 BANDBOX CLEANERS PO BOX 299 TOMAH WI 54660 LAUNDRY SERVICES 194988 GFL ENVIRONMENTAL PO BOX 555193 DETROIT MI 482555193 GARBAGE SERVICES 124569 PARASOL ALLIANCE 557 FOREST VIEW ROAD LINDHURST IL 60046 IT SERVICES 119308 6 367643 367643 SKILLED NURSING FACILITY 623000 11788138 11788138 INDEPENDENT LIVING FACILITY 623000 4625845 4625845 ASSISTED LIVING FACILITY 623000 3198709 3198709 MEMORY CARE 623000 2011632 2011632 HILLSIDE TERRACE 623000 857285 857285 495048 495048 22976657 214976 214976 1667160 18650 1583431 2332 83729 16318 100047 100047 CAFE REVENUE 722514 250221 80504 169717 250221 23909544 22976657 80504 484740 454531 454531 11108716 9554331 1554385 300692 266740 33952 1846638 1541809 304829 854593 708259 146334 58721 9972 48749 20770 20770 557884 520005 37879 49748 2089 46221 1438 803182 609484 193698 197770 197770 890316 573805 316511 145 145 3088565 2661241 427324 198518 198518 FOOD 671011 671011 MEDICAL EXPENSES 473976 473976 CAFE EXPENSE 295132 295132 STATE BED TAX 188700 188700 768269 476331 291938 22827877 18553030 4273409 1438 14832152 19115867 4126 344946 574001 99174 97745 87269797 39146785 50112902 48123012 7546481 6900388 0 162065 72939781 74973078 1476210 1620794 1066318 1059330 4796 3904 25055255 27537341 27602579 30221369 X 45337202 44751709 45337202 44751709 72939781 74973078 1081667 -1667160 0 X 0 1 X 1 0 X 96265 46828 1033553 2625460 367643 4169749 22570128 23152019 21842360 22023287 22976657 112564451 22666393 23198847 22875913 24648747 23344300 116734200 5000 5760 5000 15760 72710 72710 5000 5760 77710 88470 116645730 134119 177796 135917 235380 214976 898188 134119 177796 135917 235380 214976 898188 141674 67612 112767 169717 491770 22800512 23518317 23079442 24996894 23728993 118124158 0.98750 0.99020 0.00760 0.00690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 5929123 5929123 65698830 30807822 34891008 15188215 8338963 6849252 453629 453629 48123012 REFUNDABLE ENTRANCE FEES 26522775 REFUNDABLE RESERVATION FEES 852500 COPIER LEASE 162066 27537341 21457387 -1667160 -784997 -2452157 23909544 0 23909544 22840963 13086 13086 22827877 0 22827877 PART IV, LINE 2B: THE ACCOUNTS THAT LUTHERAN HOMES OF OCONOMOWOC, INC. IS A CUSTODIAN FOR ARE RESIDENT TRUST FUNDS. PART XI, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION REVENUE 528,454. FOUNDATION UNREALIZED GAINS/LOSSES -1,313,451. PART XII, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION EXPENSES 13,086. X X 0 0 0 0 0 0 0 0 0 DALE DAHLKE CEO 224002 0 0 0 3810 0 11400 0 8392 0 247604 0 0 0 JOAN BIRR CFO 189854 0 0 0 1980 0 9759 0 5334 0 206927 0 0 0 BRYAN POLINSKE COO 140232 0 0 0 1280 0 7441 0 8592 0 157545 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE NOT LESS THAN 50, NOR MORE THAN 150 MEMBERS, ELECTED BY THE MEMBERS OF THE CORPORATION OR BY THE BOARD OF DIRECTORS. THE ORGANIZATION STRIVES TO HAVE A MAJORITY OF THE MEMBERSHIP BE OF THE LUTHERAN FAITH WITH THE BALANCE TO BE ELECTED FROM THE COMMUNITY AT LARGE. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBERS SHALL DETERMINE AT THE ANNUAL MEETING, BY A MAJORITY VOTE, THE NUMBER OF DIRECTORS TO BE ELECTED TO THE BOARD OF DIRECTORS AND SHALL THEN ELECT THE NUMBER NECESSARY. FORM 990, PART VI, SECTION A, LINE 7B EACH MEMBER MAY HAVE ONE VOTE AT MEETINGS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF EXECUTIVE OFFICER REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C LUTHERAN HOMES OF OCONOMOWOC REQUESTS THAT ALL MEMBERS OF THE BOARD OF DIRECTORS, CORPORATE MEMBERS, AND CORPORATE STAFF COMPLETE THE "ANNUAL STATEMENT OF CONFLICT". THIS IS REQUESTED IN THE FALL OF EACH YEAR. IN THIS STATEMENT, ACKNOWLEDGEMENT OF ANY POTENTIAL CONFLICT IS TO BE IDENTIFIED. IN ADDITION, AS AN AGENDA ITEM ON ALL BOARD AND COMMITTEE MEETINGS IS ACKNOWLEDGEMENT OF ANY POTENTIAL CONFLICT OF INTEREST. DURING DISCUSSION OF THE AGENDA ITEM WHEREIN THERE IS A CONFLICT BY ONE OR MORE OF THE MEMBERS, THE BODY SHALL BEFOREHAND DECIDE AT WHAT LEVEL OF PRESENCE, DISCUSSION, AND DECISION MAKING THE MEMBER SHALL BE ALLOWED TO PARTICIPATE. FINALLY, REGULAR RECORDS ARE MAINTAINED OF ALL INSTANCES OF CONFLICT AND REVIEWED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND COMPARES COMPENSATION LEVEL WITH COMPENSATION OF SIMILAR ORGANIZATIONS OF SIMILAR SIZE. THE CHIEF EXECUTIVE OFFICER EVALUATES THE PERFORMANCE OF KEY EMPLOYEES IN THE SAME MANNER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. LUTHERAN HOMES OF OCONOMOWOC CHARITABLE FOUNDATION INC PO BOX 208 OCONOMOWOC WI 53066 391889721 SUPPORT LUTHERAN HOMES OF OCONOMOWOC, INC. WI 501(C)(3) LINE 12B, II LUTHERAN HOMES OF OCONOMOWOC INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0