2021-05-17T13:04:20-05:00 2020-06-30 410746749 CLIFTONLARSONALLEN LLP TWO INTERNATIONAL PLACE 22ND FLOOR BOSTON MA 02110 990 2019-07-01 200215979 LUTHERAN ASSISTED LIVING AT MIDDLETOWN INC LUTH 8603477144 14 EAST WORCESTER NO 300 WORCESTER MA 01604 ANGELA BOVILL PRESIDENT & CEO 8603477144 2021-05-14 1 LAURA J KENNEY P00202198 6177170831 2021-05-14 2019 2022-09-23 18:48:47Z ANGELA BOVILL 14 EAST WORCESTER NO 300 WORCESTER MA 01604 1083293 0 6011 X WWW.ASCENTRIA.ORG X 2003 CT WE ARE CALLED TO STRENGTHEN COMMUNITIES BY EMPOWERING PEOPLE TO RESPOND TO LIFE'S CHALLENGES. 14 13 0 20 0 0 0 0 1078685 1045812 7420 5891 6659 31590 1092764 1083293 0 0 0 0 171978 193225 0 0 0 1109618 1141211 1281596 1334436 -188832 -251143 5775218 5637989 6970606 7084520 -1195388 -1446531 WE ARE CALLED TO STRENGTHEN COMMUNITIES BY EMPOWERING PEOPLE TO RESPOND TO LIFE'S CHALLENGES. 0 0 1223335 1045812 LUTHERAN ASSISTED LIVING AT MIDDLETOWN WAS FORMED TO CONSTRUCT AND OPERATE A 45-UNIT MANAGED RESIDENTIAL CARE COMMUNITY IN MIDDLETOWN, CONNECTICUT FOR THE ELDERLY. THE ORGANIZATION IS OPERATED UNDER THE GUIDANCE AND REGULATIONS OF THE CONNECTUICUT HOUSING FINANCE AUTHORITY. 1223335 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 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 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CT X ANGELA BOVILL 8603477144 14 EAST WORCESTER STREET SUITE 300 WORCESTER MA 01604 ANGELA BOVILL PRESIDENT & CEO 2.40 37.60 X X 0 314682 12257 TIMOTHY JOHNSTONE EXECUTIVE VP/COO 2.40 37.60 X 0 201779 14536 NANCY MEEGAN EXECUTIVE VP, CHRO 2.40 37.60 X 0 162001 14493 JEANETTE WADE EXECUTIVE VP/CFO 2.40 37.60 X 0 161719 0 NICHOLAS RUSSO TREASURER 2.40 37.60 X 0 130812 5626 MICHAEL ALDEN VP & GM SOCIAL ENTERPRISE 2.40 37.60 X 0 123676 12127 STACIE LABOSSIERE SENIOR DIRECTOR OF FINANCE 2.40 37.60 X 0 117447 8420 ANN DANCY VP FOR NH OPERATIONS 2.40 37.60 X 0 110779 14452 PATRICK WILLIAMS VP OF QUALITY AND COMPLIAN 2.40 37.60 X 0 117964 108 PAUL HALSTEAD SENIOR DIRECTOR OF IT 2.40 37.60 X 0 105719 123 JEFFREY KINNEY EXECUTIVE VP, CERO 0.30 4.20 X 0 96312 2836 TARA BROWNE CLERK/EXECUTIVE ASSISTANT 2.40 37.60 X 0 65607 0 WILLIAM MAYO CHAIR 0.30 4.20 X X 0 0 0 THE REV ROSS GOODMAN VICE CHAIR 0.30 4.20 X X 0 0 0 KAREN GAYLIN SECRETARY 0.30 4.20 X X 0 0 0 GARTH GREIMANN FINANCIAL SECRETARY 0.30 4.20 X X 0 0 0 SCOTT HAMILTON DIRECTOR 0.30 4.20 X 0 0 0 KEITH ROBERTSON DIRECTOR 0.30 4.20 X 0 0 0 BARBARA RUHE DIRECTOR 0.30 4.20 X 0 0 0 KIMBERLY SALMON DIRECTOR 0.30 4.20 X 0 0 0 PETER SCHMIDT DIRECTOR 0.30 4.20 X 0 0 0 FREDERICK JENOURE DIRECTOR 0.30 4.20 X 0 0 0 STACEY LUSTER DIRECTOR 0.30 4.20 X 0 0 0 SHERRI PITCHER DIRECTOR 0.30 4.20 X 0 0 0 THE REV LAURA EVERETT DIRECTOR 0.30 4.20 X 0 0 0 0 1708497 84978 0 0 1 0 0 RENTAL INCOME 623000 832628 832628 MEALS INCOME 623000 213184 213184 1045812 5891 5891 MISCELLANEOUS INCOME 623000 31590 31590 31590 1083293 1045812 0 37481 156067 156067 23667 23667 13491 13491 51682 51682 592 592 43361 43361 6062 6062 18569 18569 11296 1892 9404 294046 294046 748 748 274 274 225214 225214 198270 198270 9735 9735 RESIDENT CARE COSTS 275317 275317 OTHER EXPENSES 6045 6045 1334436 1223335 111101 0 35980 43246 5278 276 16873 29443 7526008 2817607 4898200 4708401 818887 856623 5775218 5637989 67231 76619 1243 915 6263443 6216151 638689 790835 6970606 7084520 X -1195388 -1446531 -1195388 -1446531 5775218 5637989 -251143 0 X X 0 1 X 1 0 X 1031970 1009611 1006409 1078685 1045812 5172487 1031970 1009611 1006409 1078685 1045812 5172487 0 561897 531928 547935 586941 547497 2776198 561897 531928 547935 586941 547497 2776198 2396289 380 1581 4015 7420 5891 19287 380 1581 4015 7420 5891 19287 12257 50326 8408 6659 31590 109240 1044607 1061518 1018832 1092764 1083293 5301014 0.45200 0.45000 0.00360 0.00260 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2015 AMOUNT: $ 12,257. 2016 AMOUNT: $ 50,326. 2017 AMOUNT: $ 8,408. 2018 AMOUNT: $ 6,659. 2019 AMOUNT: $ 31,590. 0 1 X 7301348 2721103 4580245 97930 42896 55034 126730 53608 73122 4708401 ESCROW DEPOSITS 124789 TENANT SECURITY DEPOSITS 34523 REPLACEMENT RESERVE 351160 GROUND LEASE ACQUISITION, NET 316151 CONSTRUCTION IN PROGRESS 30000 856623 DUE TO RELATED PARTIES 461626 ACCRUED GROUND LEASE EXPENSE 300000 TENANT SECURITY DEPOSITS 29209 790835 1083293 0 1083293 0 1083293 1334436 0 1334436 0 1334436 PART IV, LINE 2B: THE ORGANIZATION HOLDS FUNDS ON BEHALF OF RESIDENTS. 0 0 0 0 0 0 0 0 0 ANGELA BOVILL PRESIDENT & CEO 0 306991 0 7691 0 0 0 0 0 12257 0 326939 0 0 TIMOTHY JOHNSTONE EXECUTIVE VP/COO 0 192858 0 8921 0 0 0 0 0 14536 0 216315 0 0 NANCY MEEGAN EXECUTIVE VP, CHRO 0 162001 0 0 0 0 0 0 0 14493 0 176494 0 0 JEANETTE WADE EXECUTIVE VP/CFO 0 161719 0 0 0 0 0 0 0 0 0 161719 0 0 PART I, LINE 3 ASCENTRIA CARE ALLIANCE, INC. (ACA) IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. THE COMPENSATION OF THE ORGANIZATION'S CEO IS DETERMINED AND PAID BY ACA. THE CEO OF ACA IS THE PRINCIPAL REPRESENTATIVE OF ASCENTRIA CARE ALLIANCE, INCLUDING ITS AFFILIATES AND SUBSIDIARIES, AND IS THE PERSON RESPONSIBLE FOR THE EFFICIENT OPERATION OF THE ACA, ITS AFFILIATES, AND ITS SUBSIDIARIES. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF ACA ANNUALLY EVALUATES THE CEO ON HIS/HER PERFORMANCE. THE CHAIR OF ACA'S BOARD OF DIRECTORS, AN UNCOMPENSATED VOLUNTEER, IS THE CHAIR OF THE EXECUTIVE COMMITTEE AND IS INDEPENDENT WITHOUT UNDUE INFLUENCE FROM THE CEO. THE EXECUTIVE COMMITTEE WILL OBTAIN RESEARCH TO MAKE A RECOMMENDATION FOR THE COMPENSATION OF THE CEO. A REVIEW OF COMPARABILITY DATA MAY INCLUDE THE FOLLOWING: COMPENSATION STUDIES BY INDEPENDENT SOURCES, WRITTEN JOB OFFERS FOR POSITIONS AT SIMILAR ORGANIZATIONS, DOCUMENTED PHONE CALLS ABOUT SIMILAR CEO POSITIONS, AND INFORMATION OBTAINED FROM THE IRS FORM 990 FILINGS OF SIMILAR ORGANIZATIONS. THE EXECUTIVE COMMITTEE WILL DOCUMENT ITS DECISIONS IN THE MINUTES OF THE MEETING. THE DOCUMENTATION OF THE CEO'S COMPENSATION INCLUDES: A DISCUSSION OF THE CEO'S RESPONSIBILITIES; ANNUAL PERFORMANCE REVIEW; DESCRIPTION OF THE COMPENSATION, BENEFITS, AND APPROVAL DATE; LIST OF COMMITTEE MEMBERS PRESENT DURING THE DISCUSSION; ACTIONS TAKEN WITH RESPECT TO ANY CONFLICTS OF INTEREST BY ANY MEMBER WITH RESPECT TO THE DECISION ON THE COMPENSATION; AND A RECORD OF THE RESULT OF THE COMPENSATION VOTE. FORM 990, PART VI, SECTION A, LINE 2 OFFICERS ANGELA BOVILL, TIMOTHY JOHNSTONE, NANCY MEEGAN, JEANETTE WADE, NICHOLAS RUSSO, JEFFREY KINNEY AND TARA BROWNE HAVE A BUSINESS RELATIONSHIP WITH ALL OF THE BOARD MEMBERS BECAUSE THESE OFFICERS ARE EMPLOYED BY A RELATED ORGANIZATION OF WHICH THE DIRECTORS ARE ALSO BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS ASCENTRIA CARE ALLIANCE, INC. (FKA LUTHERAN SOCIAL SERVICES OF NEW ENGLAND, INC.). FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF ASCENTRIA CARE ALLIANCE, INC.'S GOVERNING BOARD ELECT ALL THE MEMBERS OF THIS ORGANIZATION'S GOVERNING BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE TRANSACTIONS SUBJECT TO MEMBER APPROVAL ARE ACQUISITIONS OF DEBT, SALE OF ASSETS, ANNUAL BUDGET, MERGERS AND BYLAW REVISIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY A NATIONAL INDEPENDENT ACCOUNTING FIRM FROM INFORMATION PROVIDED BY MANAGEMENT. FINANCIAL MANAGEMENT WILL REVIEW THE FORM 990 WHEN IT IS COMPLETED. ASCENTRIA CARE ALLIANCE, INC.'S (ACA) AUDIT COMMITTEE PROVIDES SECONDARY REVIEW AND APPROVAL PRIOR TO SUBMISSION TO THE IRS. THE COMPLETE FORM 990 IS POSTED TO THE BOARD INTRANET FOR REVIEW BY THE ACA FINANCE COMMITTEE AS WELL AS ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANY DIRECTOR, OFFICER, EMPLOYEE, COMMITTEE MEMBER, OR VOLUNTEER OF ACA OR ITS SUBSIDIARIES, WHETHER BECAUSE OF HIS/HER EMPLOYMENT, BUSINESS INTERESTS, INVESTMENTS, OR OTHERWISE, WHO HAS INTERESTS THAT DO OR MAY, DIRECTLY OR INDIRECTLY, COMPETE WITH OR BE IN CONFLICT WITH THE INTERESTS OF ACA SHALL PROMPTLY DISCLOSE ALL MATERIAL FACTS OF SUCH CONFLICT OF INTEREST IN WRITING TO THE CHAIRPERSON OF THE BOARD OF DIRECTORS AND/OR TO THE PRESIDENT OF ACA. SUCH PERSON SHALL ALSO ANNOUNCE THE SAME AT ANY MEETING OR DISCUSSION IN WHICH HE/SHE IS A PARTICIPANT AND AT WHICH SUCH CONFLICT ARISES AND SHALL REFRAIN FROM ACTING THEREON. AFTER DISCLOSURE OF A FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER ACA CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN ACA'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. RELATED ORGANIZATIONS FILE UNDER GROUP EXEMPTION 6011 - DISCLOSURE NOT REQ CT 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 1 1 0 0 0 LUTHER RIDGE AT MIDDLETOWN INC P 470323 FMV LUTHER RIDGE AT MIDDLETOWN INC K 300000 FMV