LUTHERAN HOME-HICKORY INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- LUTHERAN HOME-HICKORY INC (EIN 20-1457341)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-11
- IRS object ID
- 202202239349302600
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-11T14:50:10-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201457341 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUTHERAN HOME - HICKORY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LUTH | BusinessNameControlTxt |
| Phone | 7046372870 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 947 | AddressLine1Txt |
| City | SALISBURY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28145 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIRBY NICKERSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7046372870 | PhoneNum |
| Signature | 2022-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KIRBY | PersonFirstNm |
| Person Last | NICKERSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2022-08-10 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRINITY VILLAGE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TED GOINS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 947 | AddressLine1Txt |
| City | SALISBURY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28145 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,014,095 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 9386 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LSCAROLINAS.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | EMPOWERED BY CHRIST, WE WALK TOGETHER WITH ALL WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 363 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $458,534 | PYContributionsGrantsAmt |
| CY Contributions Grants | $527,452 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,312,146 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,368,871 | CYProgramServiceRevenueAmt |
| PY Investment Income | $84,804 | PYInvestmentIncomeAmt |
| CY Investment Income | $97,165 | CYInvestmentIncomeAmt |
| PY Other Revenue | $29,827 | PYOtherRevenueAmt |
| CY Other Revenue | $20,607 | CYOtherRevenueAmt |
| PY Total Revenue | $14,885,311 | PYTotalRevenueAmt |
| CY Total Revenue | $16,014,095 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,623,951 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,884,453 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,165,807 | PYOtherExpensesAmt |
| CY Other Expenses | $6,905,949 | CYOtherExpensesAmt |
| PY Total Expenses | $14,789,758 | PYTotalExpensesAmt |
| CY Total Expenses | $15,790,402 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $95,553 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $223,693 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,351,726 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,958,824 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,664,137 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $809,836 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,687,589 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,148,988 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,561,012 | ExpenseAmt |
| Revenue | $15,368,871 | RevenueAmt |
| Desc | LUTHERAN HOME - HICKORY, INC. STRIVES TO BE A TRUE HOME FOR ITS RESIDENTS, A PLACE OF COMFORT, SECURITY AND BELONGING. STAFF EMPHASIZE BOTH QUALITY CARE AND QUALITY OF LIFE. MEANINGFUL ACTIVITIES BRING RESIDENTS, STAFF, FAMILIES AND VOLUNTEERS TOGETHER IN A SPIRIT OF FUN AND FELLOWSHIP. STAFF ARE COMMITTED TO PROVIDING COMPASSIONATE CARE AND PERSONAL ATTENTION TO RESIDENTS WHILE MEETING THE UNIQUE MEDICAL, EMOTIONAL, AND SPIRITUAL NEEDS OF EACH INDIVIDUAL. BECAUSE CHOOSING A NURSING HOME OFTEN COMES AT A DIFFICULT TIME, CHAPLAINS ARE AVAILABLE TO OFFER SUPPORT AND GUIDANCE TO FAMILIES AND RESIDENTS DURING ADMISSION AND THROUGHOUT THEIR STAY. SEE CONTINUATION ON SCHEDULE ODURING THE YEAR ENDED SEPTEMBER 30, 2021, LUTHERAN HOME - HICKORY, INC. PROVIDED 54,357 DAYS OF CARE TO 399 RESIDENTS. | Desc |
| Total Program Service Expenses | $14,561,012 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 31 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 363 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KIRBY NICKERSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7047548228 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1416 S MARTIN LUTHER KING JR AVE | AddressLine1Txt |
| City | SALISBURY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28144 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| TED GOINS | |||||||||
| CEO/PRESIDENT | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $354,362 | $12,590 | ||
| GREGORY HUDGINS | |||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CARY M GRANT | |||||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN MADDRY | |||||||||
| SECRETARY | 1.00 | 40.00 | Yes (X) | $0 | $77,515 | $7,963 | |||
| KIRBY NICKERSON | |||||||||
| CHIEF FINANCIAL OFFICER | 1.00 | 40.00 | Yes (X) | $0 | $245,913 | $14,050 | |||
| KESHA SMITH | |||||||||
| COO - SENIOR SERVICES | 1.00 | 40.00 | $0 | $239,790 | $13,928 | Yes (X) | |||
| MARCHETA CAMPBELL | |||||||||
| TOP 5 HIGHEST PAID | 40.00 | 1.00 | $113,988 | $0 | $7,182 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $113,988 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $917,580 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $55,713 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LSA MANAGEMENT INC | |||||
| PO BOX 947 | SALISBURY | NC | 28145 | MANAGEMENT SERVICES | $2,457,755 |
| TRINITY REHAB LLC | |||||
| 113 SOUTH RAILROAD AVENUE | DUNN | NC | 28334 | THERAPY SERVICES | $1,222,873 |
| LSA PHARMACY | |||||
| PO BOX 947 | SALISBURY | NC | 28145 | PHARMACEUTICAL SERVICES | $617,313 |
| LUTHERAN HOME HICKORY PROPERTY | |||||
| PO BOX 947 | SALISBURY | NC | 28145 | ASSISTED LIVING AND CONTINUING CARE SERV | $600,000 |
| GORDON FOOD SERVICE INC | |||||
| PO BOX 88029 | CHICAGO | IL | 60680 | FOOD SERVICES | $580,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $490,617 | GovernmentGrantsAmt |
| All Other Contributions | $36,835 | AllOtherContributionsAmt |
| Total Contributions | $527,452 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SERVICE FEE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $15,368,871 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,368,871 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,368,871 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,200 | TotalRevenueColumnAmt |
| Exclusion | $46,200 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $50,965 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $50,965 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,965 | TotalRevenueColumnAmt |
| Exclusion | $50,965 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $20,607 | TotalRevenueColumnAmt |
| Exclusion | $20,607 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $20,607 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,014,095 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,368,871 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $117,772 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,348,940 | TotalAmt |
| Program Services | $7,046,780 | ProgramServicesAmt |
| Management And General | $302,160 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,812 | TotalAmt |
| Program Services | $41,052 | ProgramServicesAmt |
| Management And General | $1,760 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $897,176 | TotalAmt |
| Program Services | $860,288 | ProgramServicesAmt |
| Management And General | $36,888 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $595,525 | TotalAmt |
| Program Services | $571,039 | ProgramServicesAmt |
| Management And General | $24,486 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $754,530 | TotalAmt |
| Management And General | $754,530 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,000 | TotalAmt |
| Management And General | $17,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,221 | TotalAmt |
| Management And General | $2,221 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,333,298 | TotalAmt |
| Program Services | $1,301,175 | ProgramServicesAmt |
| Management And General | $32,123 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,959 | TotalAmt |
| Management And General | $1,959 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $485,442 | TotalAmt |
| Program Services | $430,709 | ProgramServicesAmt |
| Management And General | $54,733 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,276 | TotalAmt |
| Program Services | $19,276 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $850,925 | TotalAmt |
| Program Services | $850,925 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,105 | TotalAmt |
| Program Services | $304 | ProgramServicesAmt |
| Management And General | $801 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,340 | TotalAmt |
| Program Services | $8,611 | ProgramServicesAmt |
| Management And General | $729 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,215 | TotalAmt |
| Program Services | $4,215 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,825 | TotalAmt |
| Program Services | $123,825 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,361 | TotalAmt |
| Program Services | $110,361 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| OTHER EXPENSES | $1,100,085 | $1,100,085 |
| MEDICAL EXPENSES | $908,815 | $908,815 |
| FOOD | $520,246 | $520,246 |
| BED ASSESSMENT | $357,896 | $357,896 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,410 | TotalAmt |
| Program Services | $305,410 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,790,402 | TotalAmt |
| Program Services | $14,561,012 | ProgramServicesAmt |
| Management And General | $1,229,390 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,082,715 | BOYAmt |
| EOY | $589,646 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,372,839 | BOYAmt |
| EOY | $1,771,336 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,443 | BOYAmt |
| EOY | $82,764 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$15,855 | BOYAmt |
| EOY | -$14,649 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,611,992 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,153,055 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $490,112 | BOYAmt |
| EOY | $458,937 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,937,727 | BOYAmt |
| EOY | $2,270,349 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,348,745 | BOYAmt |
| EOY | $3,800,441 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,351,726 | BOYAmt |
| EOY | $8,958,824 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,075,348 | BOYAmt |
| EOY | $528,149 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $301,235 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $287,554 | BOYAmt |
| EOY | $281,687 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,664,137 | BOYAmt |
| EOY | $809,836 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,645,953 | BOYAmt |
| EOY | $8,113,504 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,636 | BOYAmt |
| EOY | $35,484 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,687,589 | BOYAmt |
| EOY | $8,148,988 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,351,726 | BOYAmt |
| EOY | $8,958,824 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $223,693 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $237,706 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,397 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $83,946 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $61,285 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $52,622 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $527,452 | CurrentTaxYearAmt |
| Total | $768,702 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,963,979 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,670,200 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,021,409 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,312,146 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,368,871 | CurrentTaxYearAmt |
| Total | $71,336,605 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,007,376 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,754,146 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,082,694 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,364,768 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,896,323 | CurrentTaxYearAmt |
| Total | $72,105,307 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $72,105,307 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,973 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $41,561 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $43,268 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,304 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46,200 | CurrentTaxYearAmt |
| Total | $220,306 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,973 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $41,561 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $43,268 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,304 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46,200 | CurrentTaxYearAmt |
| Total | $220,306 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,179 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,747 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,108 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,827 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,607 | CurrentTaxYearAmt |
| Total | $127,468 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,072,528 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,824,454 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,153,070 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,439,899 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,963,130 | CurrentTaxYearAmt |
| Total | $72,453,081 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99520 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99490 | PublicSupportPY509Pct |
| Investment Income CY | 0.00300 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00320 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $606,646 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $19 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $606,316 | GrantsOrScholarshipsAmt |
| Other Expenditures | $349 | OtherExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $157,587 | OtherCostOrOtherBasisAmt |
| Depreciation | $129,898 | DepreciationAmt |
| Book Value | $27,689 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,701 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,524 | DepreciationAmt |
| Book Value | $1,177 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,422,241 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,996,644 | DepreciationAmt |
| Book Value | $425,597 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,463 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,989 | DepreciationAmt |
| Book Value | $4,474 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $458,937 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTERCOMPANY RECEIVABLES | $3,811,066 |
| JOINT VENTURE IN ADULT LIFE PROGRAM | -$10,625 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,800,441 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | SUBSTANTIALLY ALL AFFILIATES OF LSA AND LFS ARE ORGANIZED AS NORTH CAROLINA NONPROFIT ORGANIZATIONS AND ARE EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) UNDER A GROUP EXEMPTION OF THE ELCA. LFS REAL PROPERTIES, INC. IS EXEMPT UNDER IRC SECTION 501(C)(2). THE ORGANIZATIONS RECORD A LIABILITY FOR ANY TAX POSITION TAKEN THAT IS BENEFICIAL TO THE ORGANIZATIONS, INCLUDING ANY RELATED INTEREST AND PENALTIES, WHEN IT IS MORE LIKELY THAN NOT THE POSITION OF MANAGEMENT WITH RESPECT TO A TRANSACTION OR CLASS OF TRANSACTIONS WILL BE OVERTURNED BY A TAXING AUTHORITY UPON EXAMINATION. MANAGEMENT BELIEVES THERE ARE NO SUCH POSITIONS AS OF SEPTEMBER 30, 2021. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TED GOINS | ||||||||||||||
| CEO/PRESIDENT | $0 | $354,062 | $0 | $300 | $0 | $0 | $0 | $7,165 | $0 | $5,425 | $0 | $366,952 | $0 | $0 |
| KIRBY NICKERSON | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $240,913 | $0 | $5,000 | $0 | $0 | $0 | $5,199 | $0 | $8,851 | $0 | $259,963 | $0 | $0 |
| KESHA SMITH | ||||||||||||||
| COO - SENIOR SERVICES | $0 | $234,590 | $0 | $5,200 | $0 | $0 | $0 | $5,077 | $0 | $8,851 | $0 | $253,718 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | LUTHERAN SERVICES FOR THE AGING, INC. (LSA) AND ITS AFFILIATED ORGANIZATIONS ARE MINISTRIES OF THE NORTH CAROLINA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. THE LSA MISSION STATEMENT IS, "EMPOWERED BY CHRIST, WE WALK TOGETHER WITH ALL WE SERVE." LSA OPERATES NURSING HOMES, RETIREMENT COMMUNITIES, ASSISTED LIVING RESIDENCES, AND ADULT DAY SERVICES IN ADDITION TO PROVIDING CARE MANAGEMENT, HOME CARE, AND INFORMATION AND REFERRAL SERVICES IN NORTH CAROLINA. LSA PROVIDES A MINISTRY OF CHRISTIAN CARE TO OLDER ADULTS AND ADULTS WITH DISABILITIES REGARDLESS OF FAITH, RACE, DISABILITY, OR ECONOMIC STATUS. LSA IS MADE UP OF COMPASSIONATE PEOPLE WITH LOVING SPIRITS AND GENEROUS HEARTS. RESIDENTS, STAFF, CLIENTS, PARTICIPANTS, FAMILIES, AND VOLUNTEERS ALL STRIVE TO BE OF SERVICE TO GOD AND THE COMMUNITY. MANY OF THE SENIORS SERVED BY LSA HAVE BEEN SERVICE ORIENTED AND PHILANTHROPICALLY INCLINED THROUGHOUT THEIR LIVES AND CONTINUE TO SEEK OPPORTUNITIES FOR COMMUNITY SERVICE. FOR THE YOUNG-ELDERS OF THE RETIREMENT COMMUNITIES THOSE OPPORTUNITIES ARE ABUNDANT. RESIDENTS THERE LOG IN HUNDREDS OF VOLUNTEER HOURS FOR LOCAL CHURCHES, HABITAT FOR HUMANITY, THE ALZHEIMER'S ASSOCIATION, THE STATE VETERANS HOSPITAL, FUND RAISING FOR CANCER RESEARCH, LITERACY COUNCILS, LOCAL HOSPITALS, FOOD PANTRIES, HOMELESS SHELTERS, THE UNITED WAY, AND MENTORING PROJECTS FOR LOCAL ELEMENTARY SCHOOLS. THEY HAVE PACKED BOXES FOR SAMARITAN'S PURSE, GATHERED COATS FOR KIDS AND COLLECTED CANNED GOODS FOR FOOD PANTRIES. THEY HAVE SEWN, KNITTED, CROCHETED, AND QUILTED COUNTLESS ITEMS FOR CAUSES THROUGHOUT THE STATE AND BEYOND. THE MORE FRAIL ELDERS OF THE LSA NURSING HOMES AND ADULT DAY SERVICES MAY BE LESS VISIBLE, BUT ARE EQUALLY COMMITTED TO COMMUNITY SERVICE. SUPPORTED BY STAFF AND VOLUNTEERS, THEY HAVE HELD BLOOD DRIVES, THEY HAVE HOSTED BREAKFASTS FOR FIRE, POLICE, AND EMERGENCY SERVICE PERSONNEL, COLLECTED SCHOOL SUPPLIES FOR KIDS, AND ADOPTED NEEDY FAMILIES AT CHRISTMAS. THEY, TOO, HAVE LOGGED IN HUNDREDS OF HOURS IN PROJECTS FOR LOCAL SCHOOLS AND HOSPITALS, THE ARC, THE ALZHEIMER'S ASSOCIATION, MEALS-ON-WHEELS, THE HUMANE SOCIETY, THE AMERICAN RED CROSS, THE UNITED WAY, AND MORE. LSA ALSO SERVES ITS COMMUNITIES BY WORKING COLLABORATIVELY WITH COLLEGES AND UNIVERSITIES THROUGHOUT NORTH CAROLINA INCLUDING CATAWBA AND LIVINGSTONE COLLEGES; CATAWBA VALLEY, GASTON, ROWAN-CABARRUS, STANLY, CALDWELL AND FORSYTH COMMUNITY COLLEGES; APPALACHIAN STATE, WINSTON-SALEM STATE, LENOIR-RHYNE AND DUKE UNIVERSITIES; AND THE UNIVERSITY OF NORTH CAROLINA AND HOOD THEOLOGICAL SEMINARY. THESE COLLABORATIVE EFFORTS FOSTER GROWTH AND COOPERATION, AND ULTIMATELY IMPROVE THE QUALITY OF LIFE FOR THE INSTITUTIONS AND THE COMMUNITIES. LSA ALSO ENCOURAGES COMMUNITY MEMBERS TO SEEK VOLUNTEER, EDUCATIONAL, AND SPIRITUAL OPPORTUNITIES THROUGH ITS MINISTRIES. THE MINISTRIES OF LSA ARE ACTIVE, BUSY PLACES WHERE MULTIPLE GENERATIONS MEET IN A SPIRIT OF FUN, FELLOWSHIP AND COOPERATION. COMMUNITY EDUCATION OPPORTUNITIES ARE ALWAYS AVAILABLE ON TOPICS SUCH AS ADULT DAY CARE, ALZHEIMER'S DISEASE, MEDICAID, MEDICARE, HEALTHCARE DIRECTIVES AND MORE. |
| FORM 990, PART VI, SECTION A, LINE 3 | LSA MANAGEMENT, INC. PROVIDES ADMINISTRATIVE SUPPORT, MANAGEMENT, ACCOUNTING, INFORMATION TECHNOLOGY, AND RESOURCE DEVELOPMENT SERVICES TO LUTHERAN SERVICES FOR THE AGING AND ITS AFFILIATES. SEE SCHEDULE R, PART V. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER, BEFORE MADE AVAILABLE TO THE BOARD OF DIRECTORS VIA A WEBSITE PORTAL. THE BOARD OF DIRECTORS REVIEW AND COMMENT ON THE FORM 990. ANY MATTERS ARE RAISED TO THE OUTSIDE ACCOUNTANTS FOR COLLABORATION AND ULTIMATE RESOLUTION. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS RECEIVE A BOARD MANUAL AS PART OF ORIENTATION WHEN THEY JOIN THE BOARD WHICH INCLUDES THE CORPORATE COMPLIANCE POLICY AND BYLAWS. BOTH THE POLICY AND THE BYLAWS ADDRESS CONFLICT OF INTEREST. THEREAFTER, ANNUALLY, THE BOARD OF DIRECTORS RECEIVE CORPORATE COMPLIANCE TRAINING AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE. |
| FORM 990, PART VI, SECTION B, LINE 15 | ALL COMPENSATION LIMITS ARE COMPARED TO STATE AND NATIONAL RANGES BASED ON FACILITY SIZE AND EXPERIENCE OF STAFF. THE BOARD OF DIRECTORS APPROVE THE COMPENSATION OF THE CEO/PRESIDENT WHICH IS PAID BY THE MANAGING ORGANIZATION OF THE CONTROL GROUP. ALL COMPENSATION LIMITS ARE COMPARED TO STATE AND NATIONAL RANGES BASED ON FACILITY SIZE AND EXPERIENCE OF STAFF. THE CEO/PRESIDENT APPROVES THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. OFFICERS OF THE CONTROLLED GROUP ARE PAID BY THE MANAGING ORGANIZATION AND CERTAIN ORGANIZATIONS WITHIN THE CONTROL GROUP ALSO COMPENSATE KEY EMPLOYEES DIRECTLY. |
| FORM 990, PART VI, SECTION C, LINE 18 | FORM 990 ARE POSTED ON GUIDESTAR AND AVAILABLE UPON REQUEST AT THE LSA OFFICE LOCATED IN SALISBURY, NC. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION ONLY MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VI - ADDITIONAL INFORMATION | WHISTLEBLOWER POLICY LUTHERAN SERVICES FOR THE AGING, INC. & AFFILIATES ARE COMMITTED TO THEIR ROLE IN PREVENTING HEALTH CARE FRAUD AND ABUSE AND COMPLYING WITH APPLICABLE STATE AND FEDERAL LAWS RELATED TO HEALTH CARE FRAUD AND ABUSE. THE CIVIL FALSE CLAIMS ACT PROVIDES FOR PROTECTION FOR EMPLOYEES FROM RETALIATION. ANY EMPLOYEE WHO IS DISCHARGED, DEMOTED, SUSPENDED, THREATENED, HARASSED, OR DISCRIMINATED AGAINST IN TERMS AND CONDITIONS OF EMPLOYMENT BECAUSE OF LAWFUL ACTS CONDUCTED IN FURTHERANCE OF AN ACTION UNDER THE FCA MAY BRING AN ACTION IN FEDERAL DISTRICT COURT SEEKING REINSTATEMENT, TWO TIMES THE AMOUNT OF BACK PAY PLUS INTEREST, AND OTHER ENUMERATED COSTS, DAMAGES, AND FEES. DOCUMENTATION RETENTION AND DESTRUCTION POLICY EACH ENTITY WITHIN THE LUTHERAN SERVICES FOR THE AGING, INC. & AFFILIATES GROUP WILL ENSURE THAT RECORDS ARE RETAINED FOR THE REQUIRED TIME PERIODS ESTABLISHED BY STATE LAWS, FEDERAL REGULATIONS, AND PAYOR REQUIREMENTS TO MEET THE NEEDS OF LEGITIMATE USERS. AT THE END OF THE RETENTION PERIOD, EACH ENTITY WILL ENSURE THAT DESTRUCTION OF RECORDS IS PERFORMED ACCORDING TO SPECIFIC PROCEDURE AND AUTHORIZATION WITH APPROPRIATE SUPERVISION OF DESTRUCTION. THE PROPER METHOD OF DESTRUCTION FOR ANY PAPER RECORD IS BY SHREDDING OR INCINERATION ONLY. PRIOR TO THE DESTRUCTION OF ANY FACILITY RECORDS, WHETHER ORIGINAL OR COMPUTER MEDIA, A CHECK WILL BE MADE TO ENSURE THE RETENTION PERIOD HAS EXPIRED AS DEFINED BY STATE LAWS AND FACILITY POLICIES. ANY RECORDS IN OPEN INVESTIGATION, AUDIT, OR LITIGATION WILL NOT BE DESTROYED. FOR FACILITIES USING ELECTRONIC MEDICAL RECORDS, RECORDS WILL BE STORED IN THE SYSTEM INDEFINITELY AND THE DESTRUCTION PROCESS WILL NOT APPLY. |
| FORM 990, PART VII - ADDITIONAL INFORMATION | PART VII, SECTION A - COLUMN (B) HOURS FOR RELATED ORGANIZATIONS BOARD MEMBERS AND OFFICERS DEVOTE TIME TO ALL ENTITIES WITHIN THE CONTROL GROUP. |
| FORM 990, PART XII, LINE 2C: | THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (35 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ABUNDANT LIVING ADULT DAY SERVICES | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 561884652 | ADULT DAY | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LFS REAL PROPERTIES INC | ||||||||||
| PO BOX 2369 | SALISBURY | NC | 28145 | 581820383 | REAL ESTATE | NC | 501(C)(2) | LFS INC | 0 | |
| LSA ELMS AT TANGLEWOOD INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 263735637 | ASSIST LVG | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LSA ELMS PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 263739962 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LSA MANAGEMENT INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457236 | MANAGEMENT | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LSA PHARMACY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457251 | PHARMACY | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN FAMILY SERVICES IN THE CAROLINAS | ||||||||||
| PO BOX 2369 | SALISBURY | NC | 28145 | 561286323 | COMM SVC | NC | 501(C)(3) | LINE 10 | NC & SC SYNOD OF ECLA | 0 |
| LUTHERAN HOME - FORSYTH COUNTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 263328029 | NURSING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME AT TRINITY OAKS INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457824 | NURSING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME - ALBEMARLE INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457298 | NURSING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME - WILMINGTON INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 260158686 | NURSING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME - WINSTON-SALEM INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 561500212 | NURSING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME ALBEMARLE PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457273 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME AT TRINITY OAKS PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457796 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME - HICKORY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457341 | NURSING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME FORSYTH COUNTY PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 461188488 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME HICKORY PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 201457319 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME HICKORY WEST PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 205304712 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME WILMINGTON PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 260158745 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN HOME WINSTON-SALEM PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 205304794 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN RETIREMENT CENTER - SALISBURY | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 561540214 | ASSIST LVG | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN RETIREMENT CENTER - WILMINGTON | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 561500308 | INDEP. LVG | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| THE FOUNDATION FOR ABUNDANT LIVING | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 561681723 | FOUNDATION | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN SERVICES FOR THE AGING INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 560752160 | PARENT ORG | NC | 501(C)(3) | LINE 10 | NC & SC SYNOD OF ECLA | 0 |
| LUTHERAN SERVICES PROPERTY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 203895886 | LEASING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LSA THERAPY INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 461886488 | THERAPY | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| TRINITY AT HOME INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 464838098 | NURSING | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| MOUNTAIN RIDGE GROUP HOME INC | ||||||||||
| PO BOX 2369 | SALISBURY | NC | 28145 | 581782084 | GROUP HOME | NC | 501(C)(3) | LINE 10 | LFS INC | 0 |
| WHITTECAR HOME INC | ||||||||||
| PO BOX 2369 | SALISBURY | NC | 28145 | 581940152 | GROUP HOME | NC | 501(C)(3) | LINE 10 | LFS INC | 0 |
| LUTHERAN RETIREMENT CENTER - LUTHERIDGE | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 581823983 | ASSIST LVG | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| TRINITY GUARDIAN SERVICES INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 474406015 | INACTIVE | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| LUTHERAN RETIREMENT CENTER - CLEMMONS INC | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 824069577 | INDEP. LVG | NC | 501(C)(3) | LINE 10 | LSA INC | 0 |
| TRINITY TEAM SERVICES | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | 852020967 | INACTIVE | NC | 501(C)(3) | LINE 12A, I | LSA INC | 0 |
| LUTHERAN RETIREMENT CENTER - HICKORY | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | INACTIVE | NC | 501(C)(3) | 0 | |||
| LUTHERAN RETIREMENT CENTER - HICKORY WEST | ||||||||||
| PO BOX 947 | SALISBURY | NC | 28145 | INACTIVE | NC | 501(C)(3) | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |