2023-11-01T10:18:57-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2022-01-01 431147326 THE COLE COUNTY LUTHERAN HOME ASSOCIATION COLE 3149689313 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 CHAD SNEED CFO 3149689313 2023-10-23 1 CHAD SNEED 999009999 0 AMBER ROGNAN-HAMILTON P01251012 3149254300 2023-10-23 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X LSS AT HEISINGER BLUFFS ADAM MARLES 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 36311080 0 X WWW.LSSLIVING.ORG/COMMUNITIES/HEISINGER-BLUFFS X 1971 MO FAITH BASED ORGANIZATION WHICH PROVIDES A NETWORK OF SUPPORTIVE SERVICES FOR OLDER ADULTS. SEE BELOW FOR SUMMARY OF LSS CONSOLIDATED OPERATIONS. X 12 11 332 26 0 0 1109660 2542592 9645887 8078154 37481 9082027 90242 106998 10883270 19809771 0 0 0 0 6182801 4721178 0 0 0 4984711 4106599 11167512 8827777 -284242 10981994 13931659 0 24913653 0 -10981994 0 X TO ADDRESS AND MEET THE NEEDS OF AGED PERSONS, INCLUDING HOUSING, HEALTHCARE, AND FINANCIAL SECURITY. 0 1 7350735 0 8078154 OPERATION OF A LIFE PLAN COMMUNITY THAT OFFERS A CONTINUUM OF CARE THAT INCLUDES 65 INDEPENDENT LIVING APARTMENTS AND 46 ASSISTED LIVING UNITS, 20 ASSISTED LIVING MEMORY CARE UNITS AND 52 SKILLED NURSING BEDS, WHICH INCLUDE 20 MEDICAID CERTIFIED BEDS.BENEVOLENT CARE ASSISTANCE IS ALSO PROVIDED, WHICH INCLUDES MEDICAID CONTRACTUAL ALLOWANCES. TOTAL BENEVOLENT CARE ASSISTANCE PROVIDED WAS $745,384 , OF WHICH $745,384 IS OFFSETTING PROGRAM SERVICE REVENUE.THE ORGANIZATION'S RESIDENTIAL FACILITIES AND PROGRAMS ARE SPECIFICALLY DESIGNED TO MEET AND MAINTAIN ITS AGED RESIDENTS PHYSICAL AND EMOTIONAL WELL-BEING, AS WELL AS MEET THEIR RECREATIONAL, SOCIAL, AND RELIGIOUS NEEDS.THE ORGANIZATION PROVIDES CARE TO RESIDENTS AND CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE. KEY ELEMENTS USED TO DETERMINE ELIGIBILITY INCLUDE VERIFICATION OF FINANCIAL NEED AND PROPER DISCLOSURE UPON ADMISSION. LUTHERAN SENIOR SERVICES ALSO PROVIDES CARE TO RESIDENTS UNDER THE MEDICAID PROGRAM FOR WHICH THE COSTS TO PROVIDE SUCH CARE EXCEEDS REIMBURSEMENT. THE ORGANIZATION FUNDS THIS DIFFERENCE THROUGH ITS OPERATIONS. 7350735 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 332 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X CHAD SNEED 3149689313 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 BRIAN C WITTLE BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID T TURNER BOARD MEMBER 1.00 0.00 X 0 0 0 JANELLE F SCHULTE BOARD MEMBER 1.00 0.00 X 0 0 0 RANDY M MORROW TREASURER 1.00 0.00 X X 0 0 0 JIM L MARBERRY SECRETARY 1.00 0.00 X X 0 0 0 JOHN C KOLB BOARD MEMBER 1.00 0.00 X 0 0 0 JOSHUA KETELSEN BOARD MEMBER 1.00 0.00 X 0 0 0 ADAM MARLES PRESIDENT/CEO 1.00 39.00 X X 0 435108 30824 GARY L KESPOHL VICE CHAIR 1.00 0.00 X X 0 0 0 MARVIN HEIDBREDER BOARD MEMBER 1.00 0.00 X 0 0 0 JAMES L HARMS BOARD MEMBER 1.00 0.00 X 0 0 0 NORMAN R GEPHARDT BOARD MEMBER 1.00 0.00 X 0 0 0 CHAD SNEED CHIEF FINANCIAL OFFICER 1.00 39.00 X 0 309920 34816 MARYANNE WALLACE EX DIR OF MARKETING & COMMUNICATION 1.00 39.00 X 0 122072 22473 BECKY ZIMMER EX DIR OF PLANNED GIVING 1.00 39.00 X 0 129731 4794 JOSH KING VP OF INFORMATION TECHNOLOGY 1.00 39.00 X 0 174296 32909 BRIAN REINHOLD VP OF RISK/SAFETY/COMPLIANCE 1.00 39.00 X 0 167582 33711 BEN CAFFEY EX DIR OF REVENUE ENHANCEMENT 1.00 39.00 X 0 152876 17279 LISA WILLIAMS SR VP OF WORKFORCE EXCELLENCE 1.00 39.00 X 0 215296 8785 COLLEEN BOTTENS VP HCBS 1.00 39.00 X 0 180124 29494 BETH RUSERT CHIEF EXPERIENCE OFFICER 1.00 39.00 X 0 71522 654 LISA NORWINE CHIEF ADVANCEMENT OFFICER 1.00 39.00 X 0 295896 29156 GARRY ANDERSON CHIEF OPERATING OFFICER 1.00 39.00 X 0 331178 28172 VALERIE COOPER VP, LIFE PLAN COMMUNITIES 1.00 39.00 X 0 196349 29657 ASHLEY DREWEL ED AND CC ADMINISTRATOR 40.00 0.00 X 0 115594 6892 AMY THOMAS CONTROLLER 1.00 39.00 X 0 153900 7284 MARY HEMPHILL RN 1.00 39.00 X 0 164184 12538 TODD YOUNG NETWORK DIRECTOR 1.00 39.00 X 0 152144 6116 RACHEL LITTLE DIR OF CLINICAL COMPLIANCE 1.00 39.00 X 0 156008 9649 DENIS THIEN DIR OF BENEFITS & COMPENSATION 1.00 39.00 X 0 137815 13269 0 3661595 358472 0 0 1 0 LUTHERAN SENIOR SERVICES 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 MANAGEMENT FEES 470844 FALTER CONSTRUCTION LLC 403 BEAR ST W SYRACUSE NY 13204 CONSTRUCTION 202942 GRAPETREE MEDICAL STAFFING 2501 BOJI BEND DR SUITE 100 MILFORD IA 51351 THERAPY SERVICES 129327 MAINLINE FIRE PROTECTION 5224 BUSINESS RT-50 W JEFFERSON CITY MO 65109 FIRE PROTECTION INSTALLATION 127084 4 2360251 54305 128036 2542592 RESIDENT SERVICE FEES 623000 7606991 7606991 AMORTIZATION OF ENTRANCE FEES 623000 471163 471163 8078154 16204 16204 25567132 16501309 9065823 9065823 9065823 MISCELLANEOUS 623000 54499 54499 BARBER AND BEAUTY 623000 20607 20607 MEALS 623000 19458 19458 12434 12434 106998 19809771 8078154 0 9189025 131765 131765 3825293 3662391 162902 21092 19521 1571 454943 392626 62317 288085 266632 21453 470844 470844 21 21 8095 8095 832770 740513 92257 18517 18517 501427 282039 219388 28213 21622 6591 412475 316121 96354 25849 19716 6133 341 67 274 499233 499233 583228 446986 136242 130205 99789 30416 FOOD 530629 529148 1481 ADMIN ADJ 46425 46425 MEDICAL RECORDS EXPENSE 8433 6463 1970 MISCELLANEOUS 4629 4629 5265 1443 3822 8827777 7350735 1477042 0 118093 0 1244823 0 0 325873 0 0 0 0 34632 0 60328 0 0 0 12147910 0 0 0 0 0 0 13931659 0 360121 0 393088 0 16331110 0 7829334 0 24913653 0 X -10981994 0 -10981994 0 13931659 0 X 10981994 0 X X 0 1 X 1 1 1 X 176029 148618 712963 1109660 182341 2329611 8814763 9549925 9736076 9645887 8078154 45824805 177 110 90242 52499 143028 8990792 9698720 10449149 10845789 8312994 48297444 0 0 0 48297444 22897 34063 42274 34935 16204 150373 22897 34063 42274 34935 16204 150373 116903 144143 73519 54499 389064 9130592 9876926 10564942 10880724 8383697 48836881 0.98900 0.98780 0.00310 0.00300 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER - 2018 AMOUNT: $ 3,424. 2022 AMOUNT: $ 54,499. BARBER AND BEAUTY - 2018 AMOUNT: $ 54,378. 2019 AMOUNT: $ 72,330. 2020 AMOUNT: $ 37,733. MEALS - 2018 AMOUNT: $ 41,551. 2019 AMOUNT: $ 41,675. 2020 AMOUNT: $ 16,252. GUEST ROOMS - 2018 AMOUNT: $ 2,880. 2019 AMOUNT: $ 1,700. 2020 AMOUNT: $ 300. GARAGE - 2018 AMOUNT: $ 13,417. 2019 AMOUNT: $ 15,693. 2020 AMOUNT: $ 15,607. CHAPEL REVENUE - 2018 AMOUNT: $ 1,253. MAINTENANCE - 2019 AMOUNT: $ 12,708. 2020 AMOUNT: $ 3,627. HOUSEKEEPING - 2019 AMOUNT: $ 12. TRANSPORTATION - 2019 AMOUNT: $ 25. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. 0 1 0 0 0 0 0 0 0 ADAM MARLES PRESIDENT/CEO 0 429459 0 5409 0 240 0 20000 0 10824 0 465932 0 0 GARRY ANDERSON CHIEF OPERATING OFFICER 0 300936 0 28841 0 1401 0 22836 0 5336 0 359350 0 0 CHAD SNEED CHIEF FINANCIAL OFFICER 0 288731 0 20637 0 552 0 22948 0 11868 0 344736 0 0 LISA NORWINE CHIEF ADVANCEMENT OFFICER 0 275995 0 18951 0 950 0 22379 0 6777 0 325052 0 0 VALERIE COOPER VP, LIFE PLAN COMMUNITIES 0 195945 0 0 0 404 0 21960 0 7697 0 226006 0 0 LISA WILLIAMS SR VP OF WORKFORCE EXCELLENCE 0 198344 0 15658 0 1294 0 2058 0 6727 0 224081 0 0 COLLEEN BOTTENS VP HCBS 0 179764 0 0 0 360 0 21800 0 7694 0 209618 0 0 JOSH KING VP OF INFORMATION TECHNOLOGY 0 174162 0 0 0 134 0 20869 0 12040 0 207205 0 0 BRIAN REINHOLD VP OF RISK/SAFETY/COMPLIANCE 0 167448 0 0 0 134 0 21672 0 12039 0 201293 0 0 MARY HEMPHILL RN 0 155723 0 8417 0 44 0 3349 0 9189 0 176722 0 0 BEN CAFFEY EX DIR OF REVENUE ENHANCEMENT 0 152754 0 0 0 122 0 11541 0 5738 0 170155 0 0 RACHEL LITTLE DIR OF CLINICAL COMPLIANCE 0 155817 0 0 0 191 0 9342 0 307 0 165657 0 0 AMY THOMAS CONTROLLER 0 153387 0 0 0 513 0 1546 0 5738 0 161184 0 0 TODD YOUNG NETWORK DIRECTOR 0 151954 0 0 0 190 0 1552 0 4564 0 158260 0 0 DENIS THIEN DIR OF BENEFITS & COMPENSATION 0 137703 0 0 0 112 0 1468 0 11801 0 151084 0 0 PART I, LINE 3 THE PARENT ORGANIZATION, LUTHERAN SENIOR SERVICES, USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. PART I, LINE 4B DEPOSITS MADE INTO ACCOUNTS BY ORGANIZATION: GARRY ANDERSON - SEC 457(B) PLAN - $20,000 LISA NORWINE - SEC 457(B) PLAN - $20,000 CHAD SNEED - SEC 457(B) PLAN - $20,000 BRIAN REINHOLD - SEC 457(B) PLAN - $20,000 JOSH KING - SEC 457(B) PLAN - $20,000 VALERIE COOPER - SEC 457(B) PLAN - $20,000 COLLEEN BOTTENS - SEC 457(B) PLAN - $20,000 ADAM MARLES SEC 457(B) PLAN - $20,000 BEN CAFFEY SEC 457(B) PLAN - $10,000 MARYANNE WALLACE SEC 457(B) PLAN - $10,000 GARRY ANDERSON - SEC 457(F) PLAN - $28,841 LISA NORWINE - SEC 457(F) PLAN - $18,951 CHAD SNEED SEC 457(F) PLAN - $20,637 LISA WILLIAMS SEC 457(F) PLAN - $15,658 ADAM MARLES SEC 457(F) PLAN - $5,409 SEC 457(F) PLAN CONTRIBUTIONS ARE REPORTED IN THE BONUS/INCENTIVE COMPENSATION COLUMN OF SCH J. PAYMENTS RECEIVED FROM PLAN: LISA WILLIAMS - SEC 457(B) PLAN - $40,024 FURNITURES, FIXTURES, & EQUIPMENT 2022-12-31 6385750 APPRAISAL HB PROPERTY HOLDCO LLC 1002 W MAIN STREET JEFFERSON CITY MO 65109 LLC GOODWILL 2022-12-31 8940050 APPRAISAL HB PROPERTY HOLDCO LLC 1002 W MAIN STREET JEFFERSON CITY MO 65109 LLC LAND & IMPROVEMENTS 2022-12-31 10217200 APPRAISAL HB PROPERTY HOLDCO LLC 1002 W MAIN STREET JEFFERSON CITY MO 65109 LLC CLOSING COST EXPENSES 2022-12-31 221400 APPRAISAL HB PROPERTY HOLDCO LLC 1002 W MAIN STREET JEFFERSON CITY MO 65109 LLC 0 1 0 0 1 1 1 1 1 1 PART I, LINE 6C: THIS ORGANIZATION WAS ALLOCATED A PORTION OF TAX-EXEMPT BOND LIABILITIES BY THE PARENT ORGANIZATION, LUTHERAN SENIOR SERVICES. WHEN THIS FACILITY WAS SOLD, NO BONDS WERE DEFEASED NOR DISCHARGED HOWEVER, THE SALES PROCEEDS WENT INTO AN ESCROW ACCOUNT HELD BY THE TRUSTEE AND CAN ONLY BE USED FOR CAPITAL EXPENDITURES. FORM 990, PART I, LINE 1 LUTHERAN SENIOR SERVICES IS A LARGE COMPLEX ORGANIZATION THAT IS COMPRISED OF 18 SEPARATE LEGAL ENTITIES, EACH OF WHICH FILES ITS OWN TAX RETURN. DUE TO THE REQUIREMENTS FOR COMPLETING THESE 990'S (WHICH ARE FILED BY 15 OF THE 18 LSS ENTITIES), SOME OF THE INFORMATION CONTAINED WITHIN THE FORM, SUCH AS REVENUE AND EXPENSES, IS RELATED ONLY TO THAT PARTICULAR ENTITY. HOWEVER, SOME OF THE INFORMATION, SUCH AS EXECUTIVE COMPENSATION, RELATES TO THE ENTIRE ORGANIZATION. TO HELP MAKE THIS INFORMATION MORE MEANINGFUL, THE FOLLOWING PARAGRAPH PROVIDES A SUMMARY OF THE OVERALL OPERATIONS OF LSS. LUTHERAN SENIOR SERVICES IS A NOT FOR PROFIT ORGANIZATION OWNED BY 104 LUTHERAN CHURCHES AND WAS INITIALLY FOUNDED IN 1858. LUTHERAN SENIOR SERVICES OPERATES TEN SENIOR LIVING COMMUNITIES SERVING OVER 3,000 OLDER ADULTS, EIGHT AFFORDABLE HOUSING COMMUNITIES SERVING OVER 570 OLDER ADULTS AND A VARIETY OF IN HOME SERVICES PROGRAMS SERVING OVER 5,000 OLDER ADULTS. IN 2022, LSS HAD TOTAL OPERATING INCOME OF APPROXIMATELY $224,000,000, PROVIDED APPROXIMATELY $11,707,000 IN BENEVOLENT CARE, HAD NEARLY 35,500 VOLUNTEER HOURS AND EMPLOYED 16 CHAPLAINS. FORM 990, PART III, LINE 3 FACILITY WAS SOLD ON 10/6/2022. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATIONS, AND BUDGETING TO LUTHERAN SENIOR SERVICES, THE PARENT COMPANY. FORM 990, PART VI, SECTION A, LINE 4 FACILITY WAS SOLD IN 2022 AND COLE COUNTY WAS MERGED WITH LUTHERAN SENIOR SERVICES AS OF DECEMBER 31, 2022. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ASSOCIATION IS LUTHERAN SENIOR SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BOARD MEMBERS ARE ELECTED BY THE SOLE MEMBER, LUTHERAN SENIOR SERVICES. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN POWERS ARE RESERVED TO THE MEMBER. SAID RESERVED POWERS ARE: (A) TO ESTABLISH AND CHANGE THE PHILOSOPHY OF THE ASSOCIATION; (B) TO APPOINT THE BOARD OF DIRECTORS AND TO REMOVE THE APPOINTED DIRECTORS WITH OR WITHOUT CAUSE; (C) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE ASSOCIATION AS PROVIDED THEREIN; (D) TO APPROVE AMENDMENTS TO THE BYLAWS OF THE ASSOCIATION; (E) TO APPROVE THE MERGER, CONSOLIDATION, FILING FOR BANKRUPTCY OR DISSOLUTION OF THE ASSOCIATION; (F) TO APPROVE THE SALE, CONVEYANCE, ASSIGNMENT, TRANSFER, ALIENATION, PLEDGE, ENCUMBRANCE, MORTGAGE OR LEASE OF REAL OR PERSONAL PROPERTY OR ANY INTEREST THEREIN OF THE ASSOCIATION IN ACCORDANCE WITH WRITTEN POLICIES APPROVED BY THE MEMBER FROM TIME TO TIME. FORM 990, PART VI, SECTION B, LINE 11B REVIEW AND APPROVAL OF THE FORM 990 HAS BEEN DELEGATED TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF THE PARENT ORGANIZATION, LUTHERAN SENIOR SERVICES, PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES WILL DISCLOSE A CONFLICT OF INTEREST ON THE "CONFLICT OF INTEREST FORM" IN THE FOLLOWING SITUATIONS AND IN OTHER CIRCUMSTANCES WHICH HE/SHE THINKS MIGHT CAUSE A CONFLICT BETWEEN HIS/HER PERSONAL INTERESTS AND HIS/HER FIDUCIARY DUTY: FINANCIAL INTERESTS, INSIDE INFORMATION, CONFLICTING INTEREST OTHER THAN FINANCIAL, GIFTS AND FAVORS. THE FOLLOWING LSS EMPLOYEES ARE REQUIRED TO SIGN A "CONFLICT OF INTEREST FORM" ANNUALLY: PRESIDENT, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER/TREASURER, VICE PRESIDENT OF CONSTRUCTION AND IT, VICE PRESIDENT OF HUMAN RESOURCES, ALL DIRECTORS, ADMINISTRATORS AND ASSISTANT ADMINISTRATORS. THE CORPORATE COMPLIANCE OFFICER FOLLOWS UP WITH ANY CONFLICTS OF INTERESTS AND DOCUMENTS THE RESOLUTIONS OF THE CONFLICTS. THESE FORMS ARE KEPT BY THE CORPORATE COMPLIANCE OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION DID NOT COMPENSATE ANY OFFICERS, DIRECTORS OR KEY EMPLOYEES. THE COMPENSATION PROCESS USED BY THE PARENT ORGANIZATION, LUTHERAN SENIOR SERVICES, IS AS FOLLOWS: THE BOARD OF DIRECTORS ESTABLISHED A SEPARATE COMPENSATION COMMITTEE CHARGED WITH PERFORMING AN ANNUAL PERFORMANCE REVIEW OF THE CEO AND REVIEWING THE CEO'S COMPENSATION PACKAGE. THE COMPENSATION COMMITTEE ENGAGED A THIRD-PARTY GLOBAL HUMAN CAPITAL CONSULTING FIRM TO: (1) DEVELOP AN ANNUAL CEO PERFORMANCE REVIEW PROCESS, INCLUDING A NEW EVALUATION FORM, AND (2) DEVELOP A COMPENSATION PACKAGE BASED ON ITS KNOWLEDGE OF SIMILARLY SIZED NON-PROFIT ORGANIZATIONS IN ORDER TO ENSURE THAT THE COMPENSATION PAID TO THE CEO IS REASONABLE. ALL MEMBERS OF THE BOARD COMPLETE AN ANNUAL EVALUATION, WHICH THE COMPENSATION COMMITTEE SUMMARIZES AND REVIEWS. THE COMPENSATION COMMITTEE THEN MAKES A RECOMMENDATION TO THE FULL BOARD OF DIRECTORS FOR ANY COMPENSATION ADJUSTMENTS. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH NOT A REQUIREMENT, THE ORGANIZATION PROVIDES PHOTOCOPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND OTHER DOCUMENTS TO ALL WHO REQUEST ONE OR MORE OF THE ITEMS. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. THIS PROCESS IS CONSISTENT WITH THE PRIOR YEARS. FORM 990, PART XI, LINE 9 THIS IS THE ORGANIZATION'S FINAL RETURN SINCE THE FACILITY SOLD AND THE ENTITY WILL BE MERGING WITH ITS PARENT ENTITY, LUTHERAN SENIOR SERVICES. FORM 990, PART V, LINE 2A AND FORM 990, PART IX, PAGE 10, LINES 7, 9, & 10 THE ORGANIZATION'S PAYROLL IS PROCESSED WITH LUTHERAN SENIOR SERVICES, THE PARENT COMPANY. FORMS W-3 AND W-2 WERE NOT ISSUED BY LUTHERAN SENIOR SERVICES ENDOWMENT FUND AS OF DECEMBER 31, 2022. THE ORGANIZATION DID PAY THE SALARIES, EMPLOYMENT TAXES, AND EMPLOYEE BENEFITS FOR THE ORGANIZATION'S EMPLOYEES. LUTHERAN SENIOR SERVICES ENDOWMENT FUND HAD 9 FULL TIME EMPLOYEES DEDICATED TO ITS OPERATIONS ON DECEMBER 31, 2022. FORM 990, PART X, PAGE 11, LINE 20 & SCHEDULE K THE PARENT COMPANY, LUTHERAN SENIOR SERVICES, HAS ALLOCATED A PORTION OF THE TAX EXEMPT BONDS THAT WERE ISSUED TO THE PARENT COMPANY TO THIS ORGANIZATION. THE DETAILS OF THE TAX EXEMPT BONDS ISSUED TO LUTHERAN SENIOR SERVICES ARE CONTAINED ON THE SCHEDULE K THAT IS FILED WITH THE FORM 990 FOR THE PARENT COMPANY (FEIN 43-0654862). THERE IS NO SCHEDULE K FOR THIS TAX RETURN. THIS TREATMENT IS CONSISTENT WITH PRIOR YEARS. FORM 990, PART V, LINE 1A THE ORGANIZATIONS 1099S ARE PROCESSED WITH THE PARENT COMPANY, LUTHERAN SENIOR SERVICES. 1099S ARE NOT ISSUED BY THE COLE COUNTY LUTHERAN HOME ASSOCIATION AS THE PARENT COMPANY PAYS ALL VENDORS THROUGH ONE NUMBER FOR EACH VENDOR AND THE VENDOR IS PAID FOR ANY INVOICE OWED BY ANY OF THE RELATED ENTITIES. AS A RESULT, THERE IS NO WAY FOR THE ORGANIZATION TO BREAK OUT THE NUMBER OF 1099S ISSUED BY THE PARENT COMPANY ON BEHALF OF THE ORGANIZATION. LUTHERAN SENIOR SERVICES 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 430654862 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0