2021-11-09T14:58:27-06:00 2020-12-31 390859910 BAKER TILLY US LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2020-01-01 231857015 DIAKON LUTHERAN SOCIAL MINISTRIES DIAK 6106821262 1 S HOME AVE TOPTON PA 19562 JARROD LEO SENIOR VP/CFO 6106821262 2021-11-09 1 JARROD LEO 999009999 JEFFREY J PETRELL CPA P00138808 4126356270 2021-11-09 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z SCOTT HABECKER 1 S HOME AVE TOPTON PA 19562 266724523 0 9386 X WWW.DIAKON.ORG X 1876 PA THE ORGANIZATION IS A PROVIDER OF SENIOR LIVING SERVICES AND ACCOMMODATIONS IN PENNSYLVANIA AND MARYLAND AND MANAGES THE STATEWIDE ADOPTION NETWORK FOR THE COMMONWEALTH OF PENNSYLVANIA. 10 10 2438 100 81263 0 4644152 10308686 220671627 209300047 7301947 8538094 1430100 1884893 234047826 230031720 414010 388457 0 0 68709263 66174577 86069 0 994684 160989107 155629460 230198449 222192494 3849377 7839226 414508131 391505362 390524008 359541181 23984123 31964181 X IN RESPONSE TO GOD'S LOVE IN JESUS CHRIST, DIAKON LUTHERAN SOCIAL MINISTRIES WILL DEMONSTRATE GOD'S COMMAND TO LOVE THE NEIGHBOR THROUGH ACTS OF SERVICE. 0 0 129058871 1000 132580655 SENIOR LIVING SERVICESMOST OF DLSM'S SENIOR LIVING COMMUNITIES OFFER A CONTINUUM OF SERVICES FOR OLDER ADULTS INCLUDING RESIDENTIAL ACCOMMODATIONS, PERSONAL CARE SERVICES, AND SKILLED NURSING AND REHABILITATIVE CARE.SENIOR LIVING SERVICES IN PENNSYLVANIA PROVIDED $16,385,041, IN UNCOMPENSATED CARE DURING 2020, DIVIDED BETWEEN COSTS IN EXCESS OF MEDICAL ASSISTANCE REIMBURSEMENT AND CARE FOR PEOPLE WHO HAVE EXHAUSTED THEIR FINANCIAL RESOURCES. 2352689 966769 HUD HOUSINGDLSM OFFERS AFFORDABLE, EQUAL OPPORTUNITY SENIOR HOUSING ACCOMMODATIONS. IN 2020 DLSM PROVIDED 83,710 DAYS OF ACCOMMODATION, FOR AN OCCUPANCY RATE OF 97.59%. 70354436 71111889 STATEWIDE ADOPTION NETWORKPENNSYLVANIA'S STATEWIDE ADOPTION AND PERMANENCY NETWORK (SWAN) IS BOTH A BROAD-BASED COOPERATIVE EFFORT AND A CENTRALIZED INFORMATION AND FACILITATION SERVICE FUNDED AND OVERSEEN BY THE PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES AND MANAGED UNDER CONTRACT BY DIAKON LUTHERAN SOCIAL MINISTRIES.THE SWAN PROGRAM SERVES CHILDREN AND YOUTHS IN THE CUSTODY OF COUNTY CHILDREN AND YOUTH AGENCIES. SWAN MANAGES REFERRALS FROM COUNTY CHILDREN AND YOUTH AGENCIES, CONTRACTS WITH PRIVATE AGENCIES THAT WORK WITH COUNTIES TO PROVIDE DIRECT SERVICES TO CHILDREN AND FAMILIES, PROVIDES CONSULTATION AND TRAINING FOR COUNTY AGENCIES AND PRIVATE PROVIDERS, DEVELOPS CONFERENCES AND REGIONAL MEETINGS, AND MANAGES SUPPORT SERVICES TO ENHANCE THE EFFECTIVENESS OF THE CHILD-PLACEMENT NETWORK. 293261 387457 6438991 OTHER PROGRAMS 293261 387457 6438991 202059257 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 261 0 2438 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MD PA X JARROD LEO 7177950364 1022 N UNION STREET MIDDLETOWN PA 17057 X REV CHAD HEBRINK CHAIR 1.00 X X 0 0 0 REV DR DON MAIN VICE CHAIR 1.00 1.00 X X 0 0 0 MICHAEL LEHMAN TREASURER 1.00 X X 0 0 0 DR JENNIFER SCHLEGEL SECRETARY 1.00 X X 0 0 0 BARBARA FEEGE BOARD MEMBER 1.00 X 0 0 0 DR JENNIFER GOLDSTEIN BOARD MEMBER 1.00 X 0 0 0 NELS HENDRICKSON BOARD MEMBER 1.00 X 0 0 0 DOUG HOUGH BOARD MEMBER 1.00 X 0 0 0 SUSAN SCHELLENBERG BOARD MEMBER 1.00 1.00 X 0 0 0 CAROL TAYLOR BOARD MEMBER 1.00 X 0 0 0 MARK T PILE PRESIDENT/CEO 20.00 17.50 X 528947 0 203050 SCOTT HABECKER EXEC VP/CHIEF OP & FINANCIAL OFFICER 27.50 10.00 X 408278 0 164996 MARY ELLEN DICKEY SENIOR VP, ADVANCEMENT 16.50 21.00 X 195954 0 32546 SHARI E VANDERGAST SENIOR VP, OPERATIONS 11.25 26.25 X 380269 0 58340 JARROD E LEO SENIOR VP, FINANCIAL PLANNING OPS 30.00 7.50 X 230830 0 36004 JENNIFER D RAUTZHAN VICE PRESIDENT, HUMAN RESOURCES 34.00 3.50 X 187989 0 21703 FIDELIS OJEVWE MEDICAL DIRECTOR 1.00 39.00 X 225644 0 4410 DILLARD F ELMORE SVP/CORPORATE MEDICAL DIRECTOR 16.00 24.00 X 272042 0 22784 DAVID BAKER SVP/FACILITIES & IT 27.00 10.50 X 198723 0 41593 CYNTHIA BONNEY VP SALES AND MARKETING 36.50 1.00 X 184222 0 12656 2812898 0 598082 47 0 1 0 FAMILY DESIGN RESOURCES INC 471 JPL WICK DRIVE HARRISBURG PA 17111 SWAN PROGRAM SERVICE 46592998 MORRISON MANAGEMENT SPECIALIST PO BOX 102289 ATLANTA GA 30368 CULINARY/HOUSEKEEPING 22178890 GENESIS ELDERCARE PO BOX 821322 PHILADELPHIA PA 19182 REHAB SERVICES 6710618 PRELUDE SERVICES 5095 RITTER ROAD SUITE 112 MECHANICSBURG PA 17055 IT SUPPORT 4566966 WARFEL CONSTRUCTION COMPANY 1110 ENTERPRISE ROAD EAST PETERSBURG PA 17520 CONSTRUCTION 2719217 61 1056700 7327820 1924166 10308686 SENIOR LIVING SERVICES 623000 132390097 132390097 STATEWIDE ADOPTION AND PERMANENCY 900099 71111889 71111889 OTHER PROGRAM SERVICES 900099 4849780 4849780 HOUSING URBAN DEVELOPMENT 900099 948281 948281 209300047 6235529 6235529 3 3 19549282 19446083 18288084 18404719 1261198 1041364 2302562 2302562 TRUST INCOME 900099 1328774 1328774 OTHER REVENUE 900099 528588 447325 81263 VENDING REVENUE 900099 22158 22158 5373 5373 1884893 230031720 211098304 81263 8543467 388457 388457 2202076 1983583 218493 52132557 45535598 6216504 380455 427993 339497 84106 4390 7717479 6674961 963171 79347 3694472 3133225 523868 37379 194334 194334 691754 4288 687466 66172 66172 51000 51000 54754 54754 10848550 9699103 1148821 626 785854 547177 236537 2140 10924051 10320268 482615 121168 4663874 272358 4363935 27581 11318035 10887478 430557 607613 431589 162343 13681 42997 2912 38437 1648 8200750 8114604 86146 16659434 15572539 1086895 1491632 993592 491868 6172 SWAN CONTRACTED SERVICE 64108539 64108539 CULINARY SERVICE 15090106 15090106 HOUSEKEEPING SERVICES 4795818 4756233 39585 PA NH ASSESSMENT FEE 1766884 1766884 3267309 3159343 57362 50604 222192494 202059257 19138553 994684 262182 2131965 1339598 2700176 900482 544115 18408130 16507904 2191657 2655184 355609474 205197333 185421715 150412141 151658575 164474763 54325792 52079114 414508131 391505362 20921656 24113852 64567927 58126759 215233134 190292236 15346019 8988657 74455272 78019677 390524008 359541181 X -25109374 -21503476 49093497 53467657 23984123 31964181 414508131 391505362 X 7839226 7042477 -6901645 X X 0 1 X 1 1 1 X 4683750 2796484 2848087 4644152 10308686 25281159 205802264 209547856 216980675 220671627 209300047 1062302469 210486014 212344340 219828762 225315779 219608733 1087583628 0 0 0 1087583628 5228830 5872877 6225428 5398596 6235532 28961263 5228830 5872877 6225428 5398596 6235532 28961263 1593266 1613963 1881419 1430100 1884893 8403641 217308110 219831180 227935609 232144475 227729158 1124948532 0.96680 0.96540 0.02570 0.02710 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: TRUST INCOME - 2016 AMOUNT: $ 1,142,539. 2017 AMOUNT: $ 1,295,250. 2018 AMOUNT: $ 1,064,627. 2019 AMOUNT: $ 868,513. 2020 AMOUNT: $ 1,328,774. OTHER REVENUE - 2016 AMOUNT: $ 427,442. 2017 AMOUNT: $ 296,836. 2018 AMOUNT: $ 283,792. 2019 AMOUNT: $ 245,500. 2020 AMOUNT: $ 528,588. VENDING REVENUE - 2016 AMOUNT: $ 23,285. 2017 AMOUNT: $ 21,877. 2018 AMOUNT: $ 22,771. 2019 AMOUNT: $ 24,672. 2020 AMOUNT: $ 22,158. GAIN ON INSURANCE PROCEEDS - 2018 AMOUNT: $ 510,229. 2019 AMOUNT: $ 291,415. 2020 AMOUNT: $ 5,373. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 1 0 1 52325 0 0 52325 0 PART II-B, LINE 1: IN 2020, DIAKON LUTHERAN SOCIAL MINISTRIES ENGAGED J.M. ULIANA & ASSOCIATES, LLC TO CONDUCT LOBBYING ACTIVITIES RELATED TO STATE LEGISLATION AFFECTING LONG-TERM CARE AND HEALTH AND SOCIAL SERVICE PROGRAMS. PAYMENTS TO J.M. ULIANA & ASSOCIATES, LLC, AND AMOUNTS PAID TO DIAKON LUTHERAN SOCIAL MINISTRIES' STAFF RELATED TO LOBBYING TOTALED $52,325. SCHEDULE C, PART II-B, 1D AND 1E AMOUNTS PAID FOR MAILINGS AND PUBLICATIONS WERE NOMINAL. SCHEDULE C, PART II-B, 1G LETTERS, EMAILS, PHONE CALLS ARE MADE TO LEGISLATORS WHEN DLSM NEEDS TO CONTACT LEGISLATORS TO SPEAK ON SUPPORT OF ANY BUDGET ITEMS OR SENATE BILLS TO BE PASSED RELATED TO LONG-TERM CARE AND HEALTH AND SOCIAL SERVICE PROGRAMS. HANDOUTS ARE CREATED BY OUR COMMUNICATIONS DEPARTMENT FOR LOBBYING VISITS THAT THE DLSM STAFF ATTEND. 18332293 787593 2472001 651738 20940149 15765734 269040 3043133 745614 18332293 17683059 310740 -903397 1324668 15765734 21244446 234619 3996820 7792826 17683059 19982346 408588 1334591 481079 21244446 0.58000 0.42000 0 1 1 8860689 8860689 280993441 166036650 114956791 20513 -622925 643438 39825941 26480133 13345808 25908890 13303475 12605415 150412141 FUNDS HELD IN TRUST BY OTHERS 30614393 ESTIMATED THIRD PARTY SETTLEMENT 699866 INVESTMENT IN JOINT VENTURES 1137733 OTHER ASSETS 276285 LEASE RECEIVABLE 12178207 DUE FROM AFFILIATES 3892371 FINANCE LEASE RIGHT OF USE ASSETS 924167 OPERATING LEASE RIGHT OF USE ASSETS 2090968 INVESTMENT IN RISK RENTENTION GROUP 265124 52079114 ESTIMATED THIRD PARTY SETTLEMENT 3449033 MINIMUM PENSION LIABILITY 46661192 RESIDENT DEPOSITS 591566 OTHER LONG TERM LIABILITIES 957438 REFUNDABLE ENTRANCE FEE LIABILITY 22163445 INTEREST RATE SWAP AGREEMENT 1079138 FINANCE LEASE RIGHT OF USE LIABILITY 917225 OPERATING LEASE RIGHT OF USE LIABILITY 2200640 78019677 X PART V, LINE 4: THE INTENDED USES OF THE ORGANIZATION'S ENDOWMNENT FUNDS ARE 1) BENEVOLENT CARE, 2) EXPANSION OF PROGRAMS, AND 3) TO SUPPORT CURRENT PROGRAMS AND ACTIVITIES. PART X, LINE 2: DIAKON AND ITS CONTROLLED AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND HAVE BEEN RECOGNIZED AS TAX EXEMPT UNDER 501(A) OF THE CODE. THE CORPORATION USES A THRESHOLD OF MORE LIKELY THAN NOT FOR RECOGNITION AND DERECOGNITION OF THE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE CORPORATION DOES NOT BELIEVE THAT THERE ARE ANY UNRECOGNIZED TAX BENEFITS OR LIABILITIES THAT SHOULD BE RECORDED. 1 DIAKON CHILD FAMILY AND COMMUNITY MINISTRIES 1 S HOME AVE TOPTON PA 19562 465390969 501(C)(3) 386957 CONTRIBUTION FOR MORTGAGE INTEREST EXPENSE AND BUILDING RELATED COSTS FOR OLD MAIN 1 PART I, LINE 2: DIAKON LUTHERAN SOCIAL MINISTRIES' GRANT REVIEW PROCESS INCLUDES ANNUAL VISITS AND REVIEW OF GRANTEE BUDGETS. DLSM DOES NOT PROVIDE A SIGNIFICANT NUMBER OF GRANTS AND, THEREFORE, DOES NOT REQUIRE DETAILED MONITORING OF THE USE OF GRANT FUNDS. X X X X X 0 1 0 0 0 0 0 1 0 MARK T PILE PRESIDENT/CEO 502470 0 26477 0 0 0 176881 0 26169 0 731997 0 0 0 SCOTT HABECKER EXEC VP/CHIEF OP & FINANCIAL OFFICER 391188 0 17090 0 0 0 137546 0 27450 0 573274 0 0 0 MARY ELLEN DICKEY SENIOR VP, ADVANCEMENT 190714 0 4092 0 1148 0 2028 0 30518 0 228500 0 0 0 SHARI E VANDERGAST SENIOR VP, OPERATIONS 344739 0 35530 0 0 0 42411 0 15929 0 438609 0 0 0 JARROD E LEO SENIOR VP, FINANCIAL PLANNING OPS 224661 0 6169 0 0 0 26163 0 9841 0 266834 0 0 0 JENNIFER D RAUTZHAN VICE PRESIDENT, HUMAN RESOURCES 184134 0 3855 0 0 0 2888 0 18815 0 209692 0 0 0 FIDELIS OJEVWE MEDICAL DIRECTOR 225634 0 10 0 0 0 3375 0 1035 0 230054 0 0 0 DILLARD F ELMORE SVP/CORPORATE MEDICAL DIRECTOR 251232 0 20810 0 0 0 4042 0 18742 0 294826 0 0 0 DAVID BAKER SVP/FACILITIES & IT 193633 0 5090 0 0 0 23000 0 18593 0 240316 0 0 0 CYNTHIA BONNEY VP SALES AND MARKETING 175033 0 9140 0 49 0 2672 0 9984 0 196878 0 0 0 PART I, LINE 3 SEE SCHEDULE O IN REFERENCE TO PART VI, SECTION B, LINE 15 FOR A DETAILED DESCRIPTION OF THE ORGANIZATION'S EXECUTIVE COMPENSATION POLICY. PART I, LINE 4B DLSM HAS A 457(F) SUPPLEMENTAL NONQUALIFIED BENEFIT PLAN TO RECOGNIZE CERTAIN EMPLOYEES FOR THEIR SIGNIFICANT CONTRIBUTIONS AND IN CONSIDERATION OF EXPECTED CONTRIBUTION TO THE GROWTH OF DLSM, ITS AFFILIATES AND SUBSIDIARIES IN THE FUTURE. THE ANNUAL ACCRUALS AND INTEREST EARNINGS FOR THE 457(F) SUPPLEMENTAL NONQUALIFIED BENEFIT PLAN IS REPORTED IN PART VII, SECTION A, COLUMN F AND SCHEDULE J, PART II, COLUMN C AND IS LISTED BELOW: SCOTT D. HABECKER $134,980 MARK T. PILE $171,655 SHARI E. VANDERGAST $37,100 JARROD E. LEO $22,750 DAVID BAKER $20,000 AS A CONDITION FOR PARTICIPATING IN THE 457(F) SUPPLEMENTAL NON QUALIFIED BENEFIT PLAN, THE INDIVIDUAL MUST BE EMPLOYED AT THE VESTING DATE AND HAVE AGREED TO CERTAIN RESTRICTIVE COVENANTS. PART I, LINE 7 THE COMPENSATION COMMITTEE OF THE DIAKON BOARD REVIEWS THE PERFORMANCE OF THE CEO ON AN ANNUAL BASIS. DURING THE FIRST QUARTER OF 2020 THE CHAIR OF THE COMPENSATION COMMITTEE PROVIDED A SUMMARY OF THE CEO'S PERFORMANCE FOR 2019 AND INDICATED THE BOARD APPROVED FOR MARK PILE, CEO/PRESIDENT, A PAYMENT IN RECOGNITION OF HIS PERFORMANCE. THE EMPLOYMENT AGREEMENT FOR THE CHIEF OPERATING AND FINANCIAL OFFICER INCLUDES A PROVISION FOR AN ANNUAL INCENTIVE COMPENSATION IN AN AMOUNT UP TO 25% OF HIS BASE COMPENSATION, BASED UPON ACHIEVEMENT OF MUTUALLY ESTABLISHED ANNUAL GOALS AND OBJECTIVES AND A REVIEW OF THE CFO'S ACCOMPLISHMENTS FOR THE PRIOR CALENDAR YEAR. THE CEO/PRESIDENT CONDUCTS AN ANNUAL REVIEW AT THE BEGINNING OF EACH YEAR FOR THE PRIOR YEAR (ANNUAL BASIS) AND DETERMINES THE AMOUNT UP TO 25% FOR PAYMENT. THE CORPORATION HAS A BROADER BASED ANNUAL INCENTIVE COMPENSATION PLAN FOR KEY EMPLOYEES AND OTHER MEMBERS OF LEADERSHIP. THE CEO AND CFO CONDUCT AN ANNUAL REVIEW AT THE BEGINNING OF EACH YEAR FOR THE PRIOR YEAR TO DETERMINE IF AN INCENTIVE PAYMENT WILL BE MADE BASED ON FINANCIAL AND QUALITATIVE FACTORS. ALL INCENTIVES ARE FIRST CONTINGENT UPON THE ORGANIZATION'S ACHIEVEMENT OF SUFFICIENT CASH FLOWS TO FUND THE INCENTIVES. EACH INDIVIDUAL'S INCENTIVE PAYMENT IS DETERMINED BASED ON ACHIEVEMENT OF MUTUALLY ESTABLISHED ANNUAL GOALS AND OBJECTIVES. A CUMBERLAND COUNTY MUNICIPAL AUTHORITY 236003119 230614HL6 2015-06-04 156104916 SEE PART VI 0 0 0 B CUMBERLAND COUNTY MUNICIPAL AUTHORITY 236003119 230614KN8 2016-06-29 38783300 SEE PART VI 0 0 0 C WERNERSVILLE MUNICIPAL AUTHORITY 2018-10-18 8326000 SEE PART VI 0 0 0 D CUMBERLAND COUNTY MUNICIPAL AUTHORITY 236003119 230614NF2 2019-01-31 20807180 SEE PART VI 0 0 0 A 14330000 15920000 156104916 154470085 1634830 2015 0 1 1 1 B 7905000 1345000 38783300 646607 6228127 3523566 2016 1 0 1 1 C 831000 8326000 8160134 206314 2018 1 0 1 1 D 1350000 20810180 417118 2019 1 0 1 1 A 0 1 0 0 0.00170 0.00110 0.00280 0 0 1 B 0 1 0 0 0.00150 0.00110 0.00260 0 0 1 C 0 1 0 0 0.00100 0.00080 0.00180 0 0 1 D 0 1 0 0 0.00100 0.00080 0.00180 0 0 1 A 0 0 0 1 0 0 0 1 1 B 0 0 0 1 0 0 0 1 1 C 0 0 0 1 1 1 BRANCH BANKING AND TRUST CO 11.750000000000 0 0 0 1 1 D 0 0 0 1 0 0 0 1 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CUMBERLAND COUNTY MUNICIPAL AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2018 ISSUER NAME: CUMBERLAND COUNTY MUNICIPAL AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/01/2018 PART I COLUMN F BOND A: DESCRIPTION OF PURPOSE - THE 2015 BONDS WERE ISSUED BY THE CUMBERLAND COUNTY MUNICIPAL AUTHORITY TO PROVIDE FUNDS TO UNDERTAKE A PROJECT CONSISTING OF, (1) THE ADVANCE REFUNDING OF THE AUTHORITY'S REVENUE BONDS SERIES A OF 2007, (2) THE ADVANCE REFUNDING OF A PORTION OF THE AUTHORITY'S REVENUE BONDS, SERIES OF 2009, AND (3) THE PAYMENT OF THE COSTS AND EXPENSES OF THE ISSUING OF THER SERIES OF 2015 BONDS. ISSUE PRICE $156,104,916 NO ARBITRAGE LIABILITY EXISTED FOR THE 2015 BONDS AS OF THE JUNE 4, 2020 INSTALLMENT COMPUTATION. THE NEXT COMPUTATION IS JUNE 4, 2025. BOND B: DESCRIPTION OF PURPOSE - THE 2016 BONDS WERE ISSUED BY THE CUMBERLAND COUNTY MUNICIPAL AUTHORITY TO FINANCE A PROJECT FOR THE BENEFIT OF DLSM COMPRISED OF, AMONG OTHER THINGS, (1) REFUNDING THE AUTHORITY'S VARIABLE RATE DEMAND BONDS SERIES B OF 2014, (2) THE ACQUISITION, CONSTRUCTION, RENOVATION, AND IMPROVEMENT OF VARIOUS CAPITAL IMPROVEMENTS, (3) PAYMENT OF A PORTION OF THE COSTS RELATED TO TERMINATING AN INTEREST RATE SWAP AGREEMENT, AND (4) THE PAYMENT OF COSTS AND EXPENSES OF THE ISSUING OF THE SERIES 2016 BONDS. ISSUE PRICE $38,783,300 NO ARBITRAGE LIABILITY EXISTED FOR THE 2016 BONDS AS OF THE JUNE 1, 2021 INSTALLMENT COMPUTATION. THE NEXT COMPUTATION DATE IS JUNE 1, 2026. BOND C: DESCRIPTION OF PURPOSE - THE 2018 BONDS WERE ISSUED BY THE WERNERSVILLE MUNICIPAL AUTHORITY TO FINANCE A PROJECT FOR THE BENEFIT OF THE DLSM COMPRISED OF, AMONG OTHER THINGS, (1) THE CURRENT REFUNDING OF A PORTION OF THE CUMBERLAND COUNTY MUNICIPAL AUTHORITY'S REVENUE BONDS, SERIES OF 2009 (DIAKON LUTHERAN SOCIAL MINISTRIES PROJECT)(THE "REFUNDED 2009 BONDS"); AND (2) THE PAYMENT OF THE COSTS AND EXPENSES INCIDENT TO THE ISSUANCE OF THE 2018 BOND. ISSUE PRICE $8,326,000 NO ARBITRAGE LIABILITY EXISTED FOR THE 2018 BONDS AS OF THE OCTOBER 1, 2019 INSTALLMENT COMPUTATION. THE NEXT COMPUTATION DATE IS OCTOBER 18, 2023. BOND D: DESCRIPTION OF PURPOSE - THE 2019 A BONDS WERE ISSUED THROUGH THE CUMBERLAND COUNTY AUTHORITY TO FINANCE A PROJECT FOR THE BENEFIT OF DLSM COMPRISED OF, AMONG OTHER THINGS (1) THE CURRENT REFUNDING OF THE ISSUER'S REVENUE NOTE, SERIES A OF 2014 (DIAKON LUTHERAN SOCIAL MINISTRIES PROJECT), AND (2) THE PAYMENT AND EXPENSES INCIDENT TO THE ISSUANCE OF THE 2019 A BONDS. ISSUE PRICE $20,887,180 NO ARBITRAGE LIABILITY EXISTED FOR THE 2019 A BONDS AS OF THE JULY 31, 2019 INSTALLMENT COMPUTATION. THE NEXT COMPUTATION DATE IS JANUARY 31, 2024. BOND E: DESCRIPTION OF PURPOSE - THE 2019 B BONDS WERE ISSUED THROUGH THE COUNTY COMMISIONER'S OF WASHINGTON COUNTY TO FINANCE A PROJECT FOR THE BENEFIT OF DLSM COMPRISED OF, AMONG OTHER THINGS, (1) THE CURRENT REFUNDING OF THE ISSUER'S REVENUE NOTE, SERIES C OF 2014 (DIAKON LUTHERAN SOCIAL MINISTRIES PROJECT), AND (2) THE PAYMENT AND EXPENSES INCIDENT TO THE ISSUANCE OF THE 2019 B BONDS. ISSUE PRICE $16,001,701 NO ARBITRAGE LIABILITY EXISTED FOR THE 2019 B BONDS AS OF THE JULY 31, 2019 INSTALLMENT COMPUTATION. THE NEXT COMPUTATION DATE IS JANUARY 31, 2024. A COUNTY COMMISIONERS OF WASHINGTON COUNTY 937752AD5 2019-01-31 16001701 SEE PART VI 0 0 0 A 685000 16001701 304801 2019 1 0 1 1 A 0 1 0 0 0.00100 0.00080 0.00180 0 0 1 A 0 0 0 1 0 0 0 1 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF DLSM IS DIAKON, A PENNSYLVANIA NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A A MAJORITY OF THE MEMBERS OF THE GOVERNING BODY (THE DLSM BOARD OF DIRECTORS) ARE ELECTED BY A MAJORITY VOTE OF THE BISHOPS OF THE FOLLOWING SYNODS OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA: NORTHEASTERN PENNSYLVANIA SYNOD, SOUTHEASTERN PENNSYLVANIA SYNOD, DELAWARE-MARYLAND SYNOD, UPPER SUSQUEHANNA SYNOD, AND LOWER SUSQUEHANNA SYNOD. THE REMAINING MEMBERS OF THE BOARD ARE ELECTED BY THE BOARD FROM A SLATE OF CANDIDATES PRESENTED BY THE BOARD DEVELOPMENT COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF DLSM IS DIAKON, A PENNSYLVANIA NON-PROFIT CORPORATION. DIAKON HAS THE APPROVAL RIGHTS, SPECIFIED IN BOTH THE DLSM AND DIAKON BY-LAWS, OVER CERTAIN TYPES OF ACTIONS BY DLSM'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B DIAKON LUTHERAN SOCIAL MINISTRIES HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE RETURN IS THEN FINALIZED AND THE BOARD IS PROVIDED A COPY OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE COMPLIANCE OFFICER OF THE ORGANIZATION REVIEWS DLSM'S CONFLICT OF INTEREST STATEMENT AND CERTIFICATION FORMS WITH THE BOARD ON A REGULAR BASIS. ALL BOARD MEMBERS AND ALL OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CERTIFICATION FORM AND DISCLOSE POSSIBLE OR ACTUAL CONFLICTS OF INTEREST. THE COMPLETED FORMS ARE REVIEWED BY THE COMPLIANCE OFFICER AND BY THE ORGANIZATION'S OUTSIDE AUDITOR ON A REGULAR BASIS. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION PHILOSOPHY A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS OF THE SOLE MEMBER, WHICH INCLUDES DIRECTORS FROM DLSM (COMPENSATION COMMITTEE), UTILIZES EXTERNAL CONSULTANTS TO ASSIST WITH THE DEVELOPMENT, ADMINISTRATION, AND DETERMINATION OF COMPENSATION, WELFARE, BENEFIT, PENSION AND OTHER PLANS, WHICH TAKE INTO ACCOUNT APPROPRIATE INDUSTRY BENCHMARKS AND THE COMPENSATION POLICIES FOLLOWED BY ORGANIZATIONS SIMILARLY SITUATED TO DLSM. THE BOARD COMPENSATION COMMITTEE HAS ADOPTED A WRITTEN "CHARTER," WHICH SETS FORTH THE PURPOSE, MEMBERSHIP AND RESPONSIBILITIES OF THE COMMITTEE. IN ADDITION, IT CONDUCTS ITS ACTIVITIES IN COMPLIANCE WITH DLSM'S "EXCESS BENEFITS TRANSACTION" POLICY, WHICH REQUIRES REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. DLSM AND ITS PARENT ORGANIZATION DIAKON'S EXECUTIVE COMPENSATION PROGRAM CONSISTS OF A BASE SALARY WHICH REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABILITIES, EXPERIENCE AND SUCCESS THROUGH MEETING MISSION, FINANCIAL, OPERATIONAL, AND QUALITY OBJECTIVES. INFORMATION ABOUT EXECUTIVE COMPENSATION ISSUES AND DECISIONS IS REPORTED TO THE FULL BOARD OF DIRECTORS AT REGULAR MEETINGS. EMPLOYEE BENEFITS DLSM PROVIDES ALL EMPLOYEES, INCLUDING EXECUTIVES, WITH A COMPREHENSIVE BENEFIT PLAN THAT INCLUDES HEALTH INSURANCE, DENTAL INSURANCE, LIFE AND DISABILITY INSURANCE, AND A DEFINED CONTRIBUTION RETIREMENT PLAN. THE DLSM DEFINED BENEFIT RETIREMENT PLAN ACCRUALS WERE FROZEN AS OF 12/31/11. FORM 990, PART VI, SECTION C, LINE 19 DLSM MAKES ITS GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS) AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. A STATEMENT OF FINANCIAL POSITION IS PUBLISHED IN THE ORGANIZATION'S ANNUAL REPORT. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND ANNUAL REPORT ARE ALSO AVAILABLE ON THE DLSM WEBSITE AT DIAKON.ORG, AS WELL AS UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A COLUMN B REFLECTS THE AVERAGE HOURS PER WEEK PER EMPLOYEE FOR DLSM AND RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 9: EQUITY IN LOSSES OF JOINT VENTURE -32,430. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS -6,751,087. NET ASSETS RELEASED FROM RESTRICTIONS - CAPITAL 202,755. LOSS FROM EARLY EXTINGUISHMENT OF DEBT -2,677,128. DECREASE IN FAIR VALUE OF SWAP AGREEMENT -359,779. WITH DONOR RESTRICTIONS: CONTRIBUTIONS AND BEQUESTS 1,005,223. INVESTMENT INCOME, NET OF EXPENSES 813,866. NET ASSETS RELEASED FROM RESTRICTIONS - OPERATIONS -970,348. NET ASSETS RELEASED FROM RESTRICTIONS - CAPITAL -202,755. CHANGE IN BENEFICIAL INTEREST IN TRUST 109,339. INCREASE IN FAIR VALUE OF FUNDS HELD IN TRUST BY OTHERS 1,960,699. FORM 990, PART XII, LINE 2C: DIAKON, THE SOLE MEMBER OF DIAKON LUTHERAN SOCIAL MINISTRIES, HAS AN ANNUAL AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS FOR DIAKON AND CONTROLLED AFFILIATES PERFORMED BY AN INDEPENDENT ACCOUNTING FIRM. THE AUDIT COMMITTEE OF THE DIAKON BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. FORM 990, PART XII, LINE 3B: DIAKON ALSO HAS AN ANNUAL AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 PERFORMED BY AN INDEPENDENT ACCOUNTING FIRM FOR THE CONSOLIDATED GROUP. DIAKON LUTHERWOOD SENIOR HOUSING LLC 1 S HOME AVE TOPTON PA 19562 260649129 HUD HOUSING PA 1282775 2819963 DLSM DIAKON-SWAN LLC 1 S HOME AVE TOPTON PA 19562 473819776 ADOPTION AND PERMANENCY NETWORK PA 71111889 6780241 DLSM DIAKON FROSTBURG SENIOR HOUSING LLC 1 S HOME AVE TOPTON PA 19562 812007592 HUD HOUSING MD 975982 2912137 DLSM DIAKON 1 S HOME AVE TOPTON PA 19562 233014613 SUB OVERSIGHT PA 501(C)(3) LINE 12B, II N/A 0 DIAKON LUTHERAN FUND 1 S HOME AVE TOPTON PA 19562 231365978 FUND PROGRAMS PA 501(C)(3) LINE 12B, II DIAKON 0 DLSH AT LUTHER MEADOWS 1 S HOME AVE TOPTON PA 19562 232837747 HUD HOUSING PA 501(C)(3) LINE 10 DLSM 1 DLSH AT HEILMAN HOUSE 1 S HOME AVE TOPTON PA 19562 232463233 HUD HOUSING PA 501(C)(3) LINE 10 DLSM 1 DIAKON CHILD FAMILY & COMMUNITY MINISTRIES 1 S HOME AVE TOPTON PA 19562 465390969 SOCIAL SERVICES PA 501(C)(3) LINE 10 DIAKON 0 0 1 1 0 0 0 0 0 0 1 1 1 0 1 1 0 1 0 0 DIAKON LUTHERAN SR HOUSING AT LUTHER MEADOWS O 98164 BOOK VALUE DIAKON LUTHERAN SR HOUSING AT HEILMAN HOUSE O 98164 BOOK VALUE