STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

LUTHERAN RETIREMENT HOME INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
LUTHERAN RETIREMENT HOME INC (EIN 42-0807185)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-08-13
IRS object ID
202102259349301105
Schema version
2020v4.0
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

FieldValueIRS element (for citing)
Return2021-08-13T08:53:38-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN421377056PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WILLIAMS & COMPANY CPA PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11009 IOWA AVEAddressLine1Txt
CityONAWACityNm
State AbbreviationIAStateAbbreviationCd
ZIP51040ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420807185EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN RETIREMENT HOMEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLUTHBusinessNameControlTxt
Phone6413241712PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 9TH STREET NORTHAddressLine1Txt
CityNORTHWOODCityNm
State AbbreviationIAStateAbbreviationCd
ZIP504590108ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJERRY BRUNSVOLDPersonNm
Person TitleBOARD PRESIDENTPersonTitleTxt
Phone6413241712PhoneNum
Signature2021-05-07SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJERRYPersonFirstNm
Person LastBRUNSVOLDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID D RADKE CPAPreparerPersonNm
PTINP00112027PTIN
Phone7124232616PhoneNum
Preparation2021-07-16PreparationDt
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJERRY BRUNSVOLDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 N 9TH STAddressLine1Txt
CityNORTHWOODCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50459ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,962,687GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressNORTHWOODLRH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionLUTHERAN RETIREMENT HOME IS A CHRISTIAN BASED CONTINUUM OF SERVICE ENRICHING LIVES BY PROVIDING CARE AND COMPASSION TO OUR RESIDENTS AND OUR COMMUNITIESActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee93TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$8,429PYContributionsGrantsAmt
CY Contributions Grants$910,368CYContributionsGrantsAmt
PY Program Service Revenue$4,200,788PYProgramServiceRevenueAmt
CY Program Service Revenue$3,807,372CYProgramServiceRevenueAmt
PY Investment Income$55,870PYInvestmentIncomeAmt
CY Investment Income$51,174CYInvestmentIncomeAmt
PY Other Revenue$25,211PYOtherRevenueAmt
CY Other Revenue$21,191CYOtherRevenueAmt
PY Total Revenue$4,290,298PYTotalRevenueAmt
CY Total Revenue$4,790,105CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,867,544PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,126,949CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,571,984PYOtherExpensesAmt
CY Other Expenses$1,638,104CYOtherExpensesAmt
PY Total Expenses$4,439,528PYTotalExpensesAmt
CY Total Expenses$4,765,053CYTotalExpensesAmt
PY Revenues Less Expenses-$149,230PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$25,052CYRevenuesLessExpensesAmt
Total Assets BOY$10,129,686TotalAssetsBOYAmt
Total Assets EOY$10,185,247TotalAssetsEOYAmt
Total Liabilities BOY$2,015,098TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,934,975TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,114,588NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,250,272NetAssetsOrFundBalancesEOYAmt
MissionLUTHERAN RETIREMENT HOME IS A CHRISTIAN BASED CONTINUUM OF SERVICE ENRICHING LIVES BY PROVIDING CARE AND COMPASSION TO OUR RESIDENTS AND OUR COMMUNITIESMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$4,279,222ExpenseAmt
Revenue$3,807,372RevenueAmt
DescLUTHERAN RETIREMENT HOME PROVIDES SKILLED, INTERMEDIATE LEVELS OF CARE, AND ASSISTED LIVING FOR THE ELDERLY AND DISABLED PEOPLE IN THE NURSING HOME AND LEASE APARTMENTS TO THE ELDERLYDesc
Total Program Service Expenses$4,279,222TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee93EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN RETIREMENT HOMEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6413241712PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 9TH STREET NORTH PO BOX 108AddressLine1Txt
CityNORTHWOODCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50459ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JERRY BRUNSVOLD
BOARD PRESID1.00Yes (X)Yes (X)$0$0$0
MIKE KENNEDY
DIRECTOR1.00Yes (X)$0$0$0
LYNN DAVIS
TREASURER1.00Yes (X)Yes (X)$0$0$0
RON CHRISTIANSON
VICE PRESIDE1.00Yes (X)Yes (X)$0$0$0
DONNA MARTIN
DIRECTOR1.00Yes (X)$0$0$0
BRIAN NELSON
DIRECTOR1.00Yes (X)$0$0$0
MARGE TENOLD
DIRECTOR1.00Yes (X)$0$0$0
BARRY EUSTICE
DIRECTOR1.00Yes (X)$0$0$0
SCOTT HALBACH
ADMINISTRATO40.00Yes (X)$94,891$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$94,891TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GRAPETREE MEDICAL STAFFING
2501 BOJI BEND DR 100MILFORDIA51351TEMP NURSING$107,366
LARSON PLUMBING & HEATING
PO BOX 459ISANTIMN55040PLUMBING$101,141
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$896,929GovernmentGrantsAmt
All Other Contributions$13,439AllOtherContributionsAmt
Total Contributions$910,368TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT AND RESIDENT REVENUE623000$3,806,947$3,806,947
MEALS623000$425$425
FieldValueIRS element (for citing)
Total Program Service Revenue$3,807,372TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$77,136TotalRevenueColumnAmt
Exclusion$77,136ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$146,620SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$143,004SecuritiesAmt
Other$29,578OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,616SecuritiesAmt
Other-$29,578OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$25,962TotalRevenueColumnAmt
Related Or Exempt Func Income-$25,962RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business623000BusinessCd
Total Revenue Column$21,191TotalRevenueColumnAmt
Related Or Exempt Func Income$21,191RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$21,191OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,790,105TotalRevenueColumnAmt
Related Or Exempt Func Income$3,802,601RelatedOrExemptFuncIncomeAmt
Exclusion$77,136ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,523,369TotalAmt
Program Services$2,221,643ProgramServicesAmt
Management And General$301,726ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$33,777TotalAmt
Program Services$25,929ProgramServicesAmt
Management And General$7,848ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$384,272TotalAmt
Program Services$317,174ProgramServicesAmt
Management And General$67,098ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$185,531TotalAmt
Program Services$164,228ProgramServicesAmt
Management And General$21,303ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$37,293TotalAmt
Program Services$37,293ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$103,071TotalAmt
Program Services$103,071ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$234,961TotalAmt
Program Services$234,961ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
FOOD & DEPT SUPPLIES$437,349$414,460$22,889
OCCUPANCY$348,536$348,536
CONTRACTED & OUTSIDE$330,480$280,874$49,606
BAD DEBT EXPENSE$82,152$82,152

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$64,262TotalAmt
Program Services$48,901ProgramServicesAmt
Management And General$15,361ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,765,053TotalAmt
Program Services$4,279,222ProgramServicesAmt
Management And General$485,831ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$197,693BOYAmt
EOY$254,971EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$641,971BOYAmt
EOY$2,406,489EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$385,362BOYAmt
EOY$81,407EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$7,145BOYAmt
EOY$17,629EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,876,682LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,519,081LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,519,669BOYAmt
EOY$4,357,601EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,377,846BOYAmt
EOY$3,051,499EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$15,651EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,129,686BOYAmt
EOY$10,185,247EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$59,768BOYAmt
EOY$46,564EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,683,370BOYAmt
EOY$1,600,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$9,688BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$262,272BOYAmt
EOY$288,411EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,015,098BOYAmt
EOY$1,934,975EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,114,588BOYAmt
EOY$8,250,272EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,114,588BOYAmt
EOY$8,250,272EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,129,686BOYAmt
EOY$10,185,247EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$25,052ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$110,632NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
ChurchYes (X)ChurchInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$37,605OtherCostOrOtherBasisAmt
Book Value$37,605BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,996,194OtherCostOrOtherBasisAmt
Depreciation$4,052,803DepreciationAmt
Book Value$3,943,391BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,674,821OtherCostOrOtherBasisAmt
Depreciation$1,356,325DepreciationAmt
Book Value$318,496BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$168,062OtherCostOrOtherBasisAmt
Depreciation$109,953DepreciationAmt
Book Value$58,109BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,357,601TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED VACATION$157,794
ACCRUED SALARIES AND WAGES$88,843
ACCRUED REAL ESTATE TAXES$22,774
APARTMENT DEPOSITS$19,000
FieldValueIRS element (for citing)
Total Liability$288,411TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$4,863,444TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$110,632NetUnrealizedGainsInvstAmt
Revenue Not Reported$110,632RevenueNotReportedAmt
Revenue Subtotal$4,752,812RevenueSubtotalAmt
Investment Expenses Not Incld$37,293InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$37,293RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,790,105TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,727,760TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$4,727,760ExpensesSubtotalAmt
Investment Expenses Not Incld2$37,293InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$37,293ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$4,765,053TotalExpensesPerForm990Amt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1REVENUE BONDSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN426005048BondIssuerEIN
Bond Issued2007-07-01BondIssuedDt
Issue Price$2,800,000IssuePriceAmt
PurposeCONSTRUCTION OF ASSISTED LIVING FACILITY AND REFINANCING OF EXESTING DEBTPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,100,000RetiredAmt
Total Proceeds$2,800,000TotalProceedsAmt
Capitalized Interest$262,952CapitalizedInterestAmt
Issuance Costs From Proceeds$48,853IssuanceCostsFromProceedsAmt
Working Capital Expenditures$69,055WorkingCapitalExpendituresAmt
Capital Expenditures$2,419,140CapitalExpendituresAmt
Substantial Completion2007SubstantialCompletionYr
Refunding Tax Exempt BondsfalseRefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdfalseProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePURPOSE OF ISSUE DESCRIPTIONFormAndLineReferenceDesc
ExplanationREVENUE BONDS CONSTRUCTION OF ASSISTED LIVING FACILITY AND REFINANCING OF EXESTING DEBTExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BBOARD REVIEWS FORM 990 AT BOARD MEETING PRIOR TO FILING IT WITH THE IRS.
FORM 990, PAGE 6, PART VI, LINE 12CLUTHERAN RETIREMENT HOME MONITORS THEIR EMPLOYEES' COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ANNUAL REVIEWS AND THROUGH INVESTIGATIONS OF ANY ALLEGATIONS OF POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD OF DIRECTORS DETERMINES THE SALARY OF THE ADMINISTRATOR BY DOING AN AREA MARKET SURVEY OF OTHER NURSING HOMES IN THE AREA. THEY COMPARE SALARIES, BENEFITS AND EXPERIENCE OF THE OTHER ADMINISTRATORS AND FROM THIS SURVEY AND DISCUSSIONS THEY DETERMINE AND SET THE ADMINISTRATOR'S SALARY FOR LUTHERAN RETIREMENT HOME.
FORM 990, PAGE 6, PART VI, LINE 15BTHE BOARD OF DIRECTORS DETERMINES THE SALARY OF THE ADMINISTRATOR BY DOING AN AREA MARKET SURVEY OF OTHER NURSING HOMES IN THE AREA. THEY COMPARE SALARIES, BENEFITS AND EXPERIENCE OF THE OTHER ADMINISTRATORS AND FROM THIS SURVEY AND DISCUSSIONS THEY DETERMINE AND SET THE ADMINISTRATOR'S SALARY FOR LUTHERAN RETIREMENT HOME.
FORM 990, PAGE 6, PART VI, LINE 19LUTHERAN RETIREMENT HOME MAKES ALL OF THEIR GOVERNING DOCUMENTS, POLICIES, FINANCIAL STATEMENTS AND FORM 990 TAX RETURN AVAILABLE AT ANY TIME TO THE PUBLIC IN THE ADMINISTRATIVE OFFICES LOCATED AT 701 9TH STREET NORTH, NORTHWOOD, IA 50459