2021-11-04T15:56:01-05:00 2020-12-31 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2020-01-01 390845016 LUTHERAN HOMES OF OCONOMOWOC INC LUTH 2625678341 PO BOX 208 OCONOMOWOC WI 53066 JOAN BIRR CFO 2625678341 2021-11-03 1 JOAN BIRR 999009999 CHLOE CHIUMINATTO P01924323 4144319300 2021-11-03 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JOAN BIRR PO BOX 208 OCONOMOWOC WI 53066 23176428 0 X WWW.LHO.ORG X 1939 WI REFLECTING CHRIST'S LOVE, WE PROVIDE HOMES AND RESOURCES FOR SENIORS AS A CONTINUING CARE RETIREMENT COMMUNITY AND PROVIDER OF COMMUNITY BASED SERVICES. 13 13 504 250 54890 0 46828 1033553 23152019 21842360 661746 168534 213946 122502 24074539 23166949 0 0 0 0 13382812 13877553 0 0 12748 8112597 7666869 21495409 21544422 2579130 1622527 72197175 72676109 33678370 32032806 38518805 40643303 X REFLECTING CHRIST'S LOVE, WE PROVIDE HOMES AND RESOURCES FOR SENIORS AS A CONTINUING CARE RETIREMENT COMMUNITY AND PROVIDER OF COMMUNITY BASED SERVICES. 1 0 9759903 0 12257054 NURSING HOME CARE: OPERATION OF A SKILLED NURSING FACILITY AND REHABILITATION CENTER. PROVIDED 32,200 DAYS OF SKILLED NURSING SERVICES AND REHABILITATION. MAJORITY OF MEDICARE CLIENTS REHAB AND RETURN HOME TO THE COMMUNITY. 3004041 0 4265746 PROVIDE INDEPENDENT LIVING ACCOMMODATIONS FOR SENIORS THROUGH 141 UNITS ACROSS A FULL RANGE OF APARTMENT SIZES AND COSTS. 2185801 0 3184171 PROVIDE ASSISTED LIVING HOUSING AND SERVICES TO INDIVIDUALS ON AN A LA CARTE BASIS IN ORDER TO PRESERVE INDEPENDENCE AND CONSERVE THE RESIDENTS' ASSETS. 2181166 0 2135389 PROVIDE COMMUNITY OUTREACH PROGRAMS THROUGH OUR LIFE ENRICHMENT CENTER.PROVIDE IN HOME ASSISTANCE FOR CLIENTS WHO WISH TO REMAIN IN THEIR HOMES. PROVIDE HOUSING AND SERVICES TO INDIVIDUALS WITHIN A LICENSED CBRF FOR MEMORY IMPAIRED.SERVING THE FRAIL ELDERLY POPULATION WITH 13 BEDS UNDER CLASS C CBRF. 2181166 0 2135389 17130911 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 45 0 504 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X JOAN BIRR 2625606969 1305 W WISCONSIN AVENUE OCONOMOWOC WI 53066 DALE DAHLKE CEO 38.00 2.00 X 216365 0 17937 JOAN BIRR CFO 38.00 2.00 X 176110 0 13857 BRYAN POLINSKE COO 40.00 X 131666 0 12027 BARBARA DEHNERT DIRECTOR OF FOOD SERVICES 40.00 X 110607 0 12017 CAROLYN CLAUTER DIRECTOR OF HUMAN RESOURCES 35.00 X 108338 0 13103 ATTY MARY LEE RATZEL CHAIR 2.00 2.00 X X 0 0 0 MALCOM DORN PAST CHAIR 2.00 2.00 X X 0 0 0 EDWIN JOHNSON VICE CHAIR 2.00 2.00 X X 0 0 0 PHIL HOLLAND TREASURER 2.00 2.00 X X 0 0 0 KAREN JENSEN SECRETARY 2.00 2.00 X X 0 0 0 NORMAN ECKSTAEDT DIRECTOR 2.00 2.00 X 0 0 0 DIANE GARD DIRECTOR 2.00 2.00 X 0 0 0 JOEL LAMMERS DIRECTOR 2.00 2.00 X 0 0 0 MARY JO O'MALLEY DIRECTOR 2.00 2.00 X 0 0 0 KURT SCHRANG DIRECTOR 2.00 2.00 X 0 0 0 MARY KAY SOKOP DIRECTOR 2.00 2.00 X 0 0 0 ANDREW WAGNER DIRECTOR 2.00 2.00 X 0 0 0 CAROL ZEUTZIUS DIRECTOR 2.00 2.00 X 0 0 0 743086 0 68941 5 0 1 0 PROHEALTH CARE MEDICAL ASSOCIATES INC N17 W24100 RIVERWOOD DRIVE SUITE 2 WAUKESHA WI 53188 THERAPY SERVICES 467972 BANDBOX CLEANERS PO BOX 299 TOMAH WI 54660 LAUNDRY SERVICES 163803 PARASOL ALLIANCE 557 FOREST VIEW ROAD LINDHURST IL 60046 IT SERVICES 110204 3 977599 55954 1033553 SKILLED NURSING FACILITY 623000 12265174 12265174 INDEPENDENT LIVING FACILITY 623000 4265746 4265746 ASSISTED LIVING FACILITY 623000 3176051 3176051 MEMORY CARE 623000 1675670 1675670 HILLSIDE TERRACE 623000 177179 177179 282540 282540 21842360 135917 135917 42096 9479 32617 32617 32617 CAFE REVENUE 722514 122502 54890 67612 122502 23166949 21842360 54890 236146 424269 424269 10651965 8669459 1982506 283541 237854 45687 1715211 1357641 357570 802567 630615 171952 3277 3277 40526 40526 15138 15138 465873 430403 35470 59085 769 45568 12748 806460 651271 155189 200795 200795 759438 496273 263165 164 164 223845 223845 3156788 2717393 439395 158408 158408 FOOD 598719 598719 MEDICAL EXPENSES 532566 532566 STATE BED TAX 214200 214200 CAFE EXPENSE 183514 183514 248073 186225 61848 21544422 17130911 4400763 12748 11193554 13532293 41366 24596 468328 313060 59810 86832 87230048 35143712 54439222 52086336 5994895 6632992 72197175 72676109 1721382 1811094 1351605 1109668 7561419 3973288 7536 4851 23036428 25133905 33678370 32032806 X 38518805 40643303 38518805 40643303 72197175 72676109 1622527 501971 0 X 0 1 X 1 0 X 653467 349556 96265 46828 1033553 2179669 18300814 20252052 22570128 23152019 21842360 106117373 141674 67612 209286 18954281 20601608 22666393 23340521 22943525 108506328 15000 5000 5760 25760 0 15000 5000 5760 25760 108480568 110542 110550 134119 177796 135917 668924 110542 110550 134119 177796 135917 668924 19064823 20712158 22800512 23518317 23079442 109175252 0.99360 0.99110 0.00610 0.00600 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 5596449 5596449 65657285 27248309 38408976 15976314 7895403 8080911 52086336 REFUNDABLE ENTRANCE FEES 22135505 REFUNDABLE RESERVATION FEES 542500 PAYCHECK PROTECTION PROGRAM LOAN PAYABLE 2455900 25133905 PART IV, LINE 2B: THE ACCOUNTS THAT LUTHERAN HOMES OF OCONOMOWOC, INC. IS A CUSTODIAN FOR ARE RESIDENT TRUST FUNDS. X X 0 0 0 0 0 0 0 0 0 DALE DAHLKE CEO 212555 0 0 0 3810 0 10545 0 7392 0 234302 0 0 0 JOAN BIRR CFO 174130 0 0 0 1980 0 8625 0 5232 0 189967 0 0 0 FORM 990, PART III, LINE 2 OPENED A 13 BED CBRF IN SEPTEMBER 2020 FOR THE FRAIL ELDERLY. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE NOT LESS THAN 50, NOR MORE THAN 150 MEMBERS, ELECTED BY THE MEMBERS OF THE CORPORATION OR BY THE BOARD OF DIRECTORS. THE ORGANIZATION STRIVES TO HAVE A MAJORITY OF THE MEMBERSHIP BE OF THE LUTHERAN FAITH WITH THE BALANCE TO BE ELECTED FROM THE COMMUNITY AT LARGE. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBERS SHALL DETERMINE AT THE ANNUAL MEETING, BY A MAJORITY VOTE, THE NUMBER OF DIRECTORS TO BE ELECTED TO THE BOARD OF DIRECTORS AND SHALL THEN ELECT THE NUMBER NECESSARY. FORM 990, PART VI, SECTION A, LINE 7B EACH MEMBER MAY HAVE ONE VOTE AT MEETINGS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF EXECUTIVE OFFICER REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C LUTHERAN HOMES OF OCONOMOWOC REQUESTS THAT ALL MEMBERS OF THE BOARD OF DIRECTORS, CORPORATE MEMBERS, AND CORPORATE STAFF COMPLETE THE "ANNUAL STATEMENT OF CONFLICT". THIS IS REQUESTED IN THE FALL OF EACH YEAR. IN THIS STATEMENT, ACKNOWLEDGEMENT OF ANY POTENTIAL CONFLICT IS TO BE IDENTIFIED. IN ADDITION, AS AN AGENDA ITEM ON ALL BOARD AND COMMITTEE MEETINGS IS ACKNOWLEDGEMENT OF ANY POTENTIAL CONFLICT OF INTEREST. DURING DISCUSSION OF THE AGENDA ITEM WHEREIN THERE IS A CONFLICT BY ONE OR MORE OF THE MEMBERS, THE BODY SHALL BEFOREHAND DECIDE AT WHAT LEVEL OF PRESENCE, DISCUSSION, AND DECISION MAKING THE MEMBER SHALL BE ALLOWED TO PARTICIPATE. FINALLY, REGULAR RECORDS ARE MAINTAINED OF ALL INSTANCES OF CONFLICT AND REVIEWED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND COMPARES COMPENSATION LEVEL WITH COMPENSATION OF SIMILAR ORGANIZATIONS OF SIMILAR SIZE. THE CHIEF EXECUTIVE OFFICER EVALUATES THE PERFORMANCE OF KEY EMPLOYEES IN THE SAME MANNER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. LUTHERAN HOMES OF OCONOMOWOC CHARITABLE FOUNDATION INC PO BOX 208 OCONOMOWOC WI 53066 391889721 SUPPORT LUTHERAN HOMES OF OCONOMOWOC, INC. WI 501(C)(3) LINE 12B, II LUTHERAN HOMES OF OCONOMOWOC INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0