2023-11-13T08:05:05-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2022-01-01 382395647 PROJECT COMPASSION HEALTH PROJ 9896523470 2825 WIENEKE RD SAGINAW MI 48603 TIMOTHY KALBFLEISCH SVP AND CFO 9896523470 2023-11-09 1 TIMOTHY KALBFLEISCH 999009999 0 TINA PETERS P00904574 2483757100 2023-11-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z WELLSPRING LUTHERAN SERVICES DAVID M GEHM 2825 WIENEKE RD SAGINAW MI 48603 7522023 0 X WWW.WELLSPRINGLUTHERAN.COM X 1982 MI MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 6 6 111 2 0 0 2038559 173154 6521774 7165435 -4813 -1054 45194 181880 8600714 7519415 0 0 0 0 3969455 3622923 0 0 0 3312355 4017222 7281810 7640145 1318904 -120730 7020409 7771271 4645212 5337983 2375197 2433288 MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 0 0 6480905 7347315 SKILLED NURSING CARE PROVIDED 17,267 DAYS OF CARE AND 5,323 DAYS OF REHABILITATION, ROOM AND BOARD, NURSING CARE AND RELIGIOUS SERVICES FOR RESIDENTS. 6480905 1 1 0 1 0 0 0 0 1 0 1 0 0 1 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 1 0 0 1 14 0 1 111 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MI X JODIE LAWMASTER 9892393004 2825 WIENEKE RD SAGINAW MI 48603 RITCH CUSHWAY CHAIRMAN 0.20 0.80 X X 0 0 0 PETE BENDER TREASURER/SECRETARY 0.20 0.80 X X 0 0 0 DARRELL ZOLTON DIRECTOR - PART YEAR 0.20 0.80 X 0 0 0 PAUL NYQUIST DIRECTOR 0.20 0.80 X 0 0 0 CARL SCHOENOW DIRECTOR 0.20 0.80 X 0 0 0 AMY BENKO DIRECTOR 0.20 0.80 X 0 0 0 KAREN STORCK DIRECTOR 0.20 0.80 X 0 0 0 DAVID M GEHM PRESIDENT & CEO 0.00 40.00 X 0 237364 9115 TIMOTHY KALBFLEISCH SR. VP FINANCE AND CFO 0.08 39.92 X 0 201120 3014 ALBERT D KAUL VP OF FOUNDATION, CDO 0.00 40.00 X 0 145579 8148 ERIC R MUSUM VP, CAA AND CTO 0.00 40.00 X 0 152288 9147 0 736351 29424 0 0 1 0 UNIDINE CORPORATION PO BOX 102289 ATLANTA GA 30368 CATERING SERVICE 689876 THERAPY MANAGEMENT INC 851 PENNIMAN AVE PLYMOUTH MI 48170 THERAPY SERVICES 512492 2 1548 171606 173154 ROOM/CARE/SKILLED NURS 623000 7165435 7165435 7165435 1554 1554 2608 -2608 -2608 -2608 INSURANCE PROCEEDS 524298 152612 152612 MISCELLANEOUS INCOME 561000 29268 29268 181880 7519415 7347315 0 -1054 X 3108087 2894125 213962 5400 4320 1080 279912 206884 73028 229524 213975 15549 175094 175094 26323 26323 477 477 1739800 1645249 94551 5066 4477 589 39864 489 39375 33379 33379 231641 212924 18717 61 61 8426 6684 1742 71150 71150 283627 226902 56725 145200 145200 MMQAA PROVIDER TAX 474227 474227 DRUGS/MEDICAL SUPPLIES 378897 378897 BAD DEBT EXPENSE 84705 84705 EQUIPMENT AND RENTAL 73150 50298 22852 246135 5538 240597 7640145 6480905 1159240 0 237314 478376 2294925 2448945 36954 24855 5600731 1505651 4288623 4095080 162593 724015 7020409 7771271 417928 667021 3541129 3443385 686155 1227577 4645212 5337983 X 2266650 2323858 108547 109430 2375197 2433288 7020409 7771271 X -120730 178821 X 0 1 X 1 0 X 6220 38355 1133986 2038559 173154 3390274 7547223 6715672 6198267 6521774 7165435 34148371 7553443 6754027 7332253 8560333 7338589 37538645 6220 38355 5000 500 1548 51623 0 6220 38355 5000 500 1548 51623 37487022 17 127 19 -5 1554 1712 17 127 19 -5 1554 1712 49818 35340 228309 45194 181880 540541 7603278 6789494 7560581 8605522 7522023 38080898 0.98440 0.98810 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 477 477 0 PART II-B, LINE 1: MEMBERSHIP FEE ALLOCATED TO LOBBYING. 1 2911 11984 13219 1677 0 536231 536231 4639975 1292431 3347544 390343 196890 193453 34182 16330 17852 4095080 DUE FROM AFFILIATES 11431 DEPOSITS 12394 CHAPEL FUND ASSETS 109430 INTEREST RATE SWAP MARK TO MARKET 209707 RIGHT OF USE LEASE ASSET NET OF AMORTIZATION 381053 724015 DUE TO AFFILIATES 843097 LEASE LIABILITY 384480 1227577 PART IV, LINE 1B: PROJECT COMPASSION HEALTH IS REQUIRED TO MAINTAIN RESIDENT TRUST FUNDS AT ITS NURSING HOME. 0 0 0 0 0 0 0 0 0 DAVID M GEHM PRESIDENT & CEO 0 237364 0 0 0 0 0 1940 0 7175 0 246479 0 0 TIMOTHY KALBFLEISCH SR. VP FINANCE AND CFO 0 201120 0 0 0 0 0 1538 0 1476 0 204134 0 0 ERIC R MUSUM VP, CAA AND CTO 0 152288 0 0 0 0 0 1256 0 7891 0 161435 0 0 ALBERT D KAUL VP OF FOUNDATION, CDO 0 145579 0 0 0 0 0 1248 0 6900 0 153727 0 0 PART I, LINE 3 THE PROCESS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, CEO, AND CFO IS UNDERTAKEN BY LUTHERAN HOMES OF MICHIGAN, INC., A RELATED ORGANIZATION. THE PROCESS INCLUDES USE OF A COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS LUTHERAN HOMES OF MICHIGAN, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, LUTHERAN HOMES OF MICHIGAN, INC., HAS THE AUTHORITY TO APPOINT/ELECT INDIVIDUALS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES OF THE FORM 990 WERE SENT TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS' INPUTS AND COMMENTS WERE SOLICITED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE COLLECTED IN THE BEGINNING OF EACH NEW BOARD YEAR. THE FORMS ARE REVIEWED BY THE CEO. IF A CONFLICT EXISTS, THE CEO REVIEWS WITH THE BOARD CHAIR AND DETERMINES THE APPROPRIATE ACTION, WHICH IS TYPICALLY TO REMOVE THE INDIVIDUAL FROM THE POSITION OF CONFLICT FOR THE SPECIFIC TRANSACTION/PROCESS. 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 REQUEST AT THE CORPORATE OFFICE OF WELLSPRING LUTHERAN SERVICES BY CONTACTING THE CHIEF FINANCIAL OFFICER. FORM 990, PART IX, LINE 11G CONTRACTED THERAPY SERVICES: PROGRAM SERVICE EXPENSES 532,659. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 532,659. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,005,867. MANAGEMENT AND GENERAL EXPENSES 94,551. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,100,418. LAB TESTS: PROGRAM SERVICE EXPENSES 22,201. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,201. OTHER: PROGRAM SERVICE EXPENSES 84,522. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,522. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATION 883. CHANGE IN VALUE OF INTEREST RATE SWAP 177,938. FORM 990, PAGE 1 SECTION C: PROJECT COMPASSION HEALTH IS ALSO D/B/A LIVONIA WOODS NURSING AND REHABILITATION. LUTHERAN HOMES OF MICHIGAN INC 2825 WIENEKE RD SAGINAW MI 48603 381358410 NURSING CARE MI 501(C)(3) LINE 10 N/A 0 LUTHERAN HOMES OF MICHIGAN FOUNDATION 2825 WIENEKE RD SAGINAW MI 48603 261630687 DONATE FUNDS MI 501(C)(3) LINE 12A LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE PERSONAL ASSISTANCE 2825 WIENEKE RD SAGINAW MI 48603 272138954 HOME CARE MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC 2825 WIENEKE RD SAGINAW MI 48603 382236926 RETIREMENT COMMUNITY MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE AGENCY INC 2825 WIENEKE RD SAGINAW MI 48603 383081979 HOME CARE MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 ALPENA VILLAGE 2825 WIENEKE RD SAGINAW MI 48603 320090735 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI N/A 0 1 GIBRALTER LDHALP 26200 LAHSER RD STE 300 SOUTHFIELD MI 48034 301829767 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A 0 0 MONROE ELDERLY LDHALP 5309 TRANSPORTATION BLVD CLEVELAND OH 44125 383609893 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A 0 0 ALPENA PINES LDHALP 9710 JUNCTION ROAD FRANKENMUTH MI 48434 260236982 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A 0 0 TRANSITIONAL CARE COMMUNITY LLC 2825 WIENEKE RD SAGINAW MI 48603 872544936 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI N/A 0 1 LHM HOUSING SERVICES INC 2825 WIENEKE RD SAGINAW MI 48603 383609879 HOUSING SERVICES MI N/A C 0 GIBRALTER MANOR DEVELOPMENT INC 2825 WIENEKE RD SAGINAW MI 48603 202240778 HOUSING SERVICES MI N/A C 0 ALPENA PINES DEVELOPMENT INC 2825 WIENEKE RD SAGINAW MI 48603 260237019 HOUSING SERVICES MI N/A C 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 1 0 LUTHERAN HOMES OF MICHIGAN INC P 175094 ACTUAL AMOUNT