2020-08-25T08:55:18-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 1 BRONZE POINTE BELLEVILLE IL 62226 990 2019-01-01 430654862 LUTHERAN SENIOR SERVICES LUTH 3149689313 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 CHAD SNEED SENIOR VP FINANCE 3149689313 2020-08-20 1 JEFF PARKER P00970069 6182331200 2020-08-20 67.137.57.251 2020-08-20 09:31:20 CD P DBE5E9100BD705C5801F05FB9419F1388E8E9FDA FB4EFBCC3D346908292E1C741B9B22B9FBDCD958 2019 2020-11-06 18:47:13Z JOHN KOTOVSKY 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 568329364 0 X WWW.LSSLIVING.ORG X 1863 MO FAITH BASED ORGANIZATION WHICH PROVIDES A NETWORK OF SUPPORTIVE SERVICES FOR OLDER ADULTS. SEE BELOW FOR SUMMARY OF LSS CONSOLIDATED OPERATIONS. 15 15 3515 2492 0 0 3064113 3553004 165559258 173260002 2382724 2866268 1486411 1446765 172492506 181126039 29636 28037 0 0 97747258 103282081 0 0 0 83771657 88099487 181548551 191409605 -9056045 -10283566 507349922 599827596 496835999 591941753 10513923 7885843 TO PROVIDE A NETWORK OF SUPPORTIVE SERVICES THAT MEET THE NEEDS OF OLDER ADULTS AT ALL INCOME LEVELS IN ORDER TO LIVE OUT OUR MISSION OF "OLDER ADULTS LIVING LIFE TO THE FULLEST". 0 0 167048678 28037 175195829 OPERATIONS FOR FIVE LIFE PLAN COMMUNITIES THAT OFFER A CONTINUUM OF CARE THAT INCLUDES INDEPENDENT LIVING, ASSISTED LIVING, MEMORY CARE, AND SKILLED NURSING, THE MAJORITY OF WHICH ARE MEDICARE/MEDICAID CERTIFIED. IN ADDITION, OPERATIONS OF ONE ASSISTED LIVING AND ONE SKILLED NURSING FACILITY NOT ASSOCIATED WITH A CCRC. A TOTAL OF 3,275 UNITS ARE OFFERED WITH A SUSTAINED OCCUPANCY RATE EXCEEDING 92%. MORE THAN 3,300 CLIENTS ARE SERVED ANNUALLY. 7867263 A VARIETY OF HOME COMMUNITY BASED SERVICES FOR OLDER ADULTS WHO REMAIN IN THEIR OWN HOMES, INCLUDING MEDICARE CERTIFIED HOME HEALTH, PRIVATE DUTY HOME HEALTH SERVICES, HOSPICE SERVICES AND THREE PROGRAMS IN PARTNERSHIP WITH THE UNITED WAY: OUTREACH SOCIAL SERVICES, THE GOOD NEIGHBOR PROGRAM, AND VOLUNTEER MONEY MANAGEMENT. -9803090 A BENEVOLENT CARE FUND EXISTS TO PROVIDE FINANCIAL ASSISTANCE TO RESIDENTS OR CLIENTS WHO OUTLIVE THEIR ABILITY TO PAY.TOTAL BENEVOLENT CARE ASSISTANCE PROVIDED WAS $9,803,090, OF WHICH, $9,803,090 IS OFFSETTING PROGRAM SERVICE REVENUE. THERE WAS ADDITIONAL BENEVOLENT CARE ASSISTANCE PROVIDED BY OTHER ENTITIES WITHIN THE LUTHERAN SENIOR SERVICES AFFILIATED GROUP BRINGING THE TOTAL TO APPROXIMATELY $11,624,000. 167048678 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 382 0 3515 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X CHAD SNEED 3149689313 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 KATHLEEN T MUELLER CHAIRPERSON (TERM ENDED 5/19) 0.20 2.00 X X 0 0 0 JEFFREY L DUNN CHAIRPERSON 0.20 2.00 X X 0 0 0 SCOTT M HARTWIG SECRETARY (TERM ENDED 5/19) 0.20 2.00 X X 0 0 0 DR F MATTHEW KUHLMANN SECRETARY 0.20 2.00 X X 0 0 0 RICHARD J BAGY JR BOARD MEMBER (TERM ENDED 5/19) 0.20 2.00 X 0 0 0 REV ROY CHRISTELL BOARD MEMBER 0.20 2.00 X 0 0 0 DIANE R DROLLINGER BOARD MEMBER 0.20 2.00 X 0 0 0 JOHN A KOMLOS BOARD MEMBER 0.20 2.00 X 0 0 0 HARRY MUELLER BOARD MEMBER 0.20 2.00 X 0 0 0 GARY OLSON BOARD MEMBER 0.20 2.00 X 0 0 0 LISA J SOMBART BOARD MEMBER 0.20 2.00 X 0 0 0 SHERRI C STRAND BOARD MEMBER 0.20 2.00 X 0 0 0 PAUL N TICE VICE CHAIRPERSON 0.20 2.00 X X 0 0 0 DAVID ANDERSON BOARD MEMBER 0.20 2.00 X 0 0 0 JULIE BANTLE BOARD MEMBER 0.20 2.00 X 0 0 0 REV DR TRAVIS J SCHOLL BOARD MEMBER 0.20 2.00 X 0 0 0 NORMAN TOON BOARD MEMBER 0.20 2.00 X 0 0 0 DAN BROWN ASSISTANT SECRETARY 0.20 2.00 X X 0 0 0 JOHN KOTOVSKY PRESIDENT AND CEO 26.00 15.00 X 399732 0 17523 PAUL J OGIER CFO AND TREASURER 26.00 15.00 X 316744 0 16636 MARK W SCHOEDEL CHIEF DEVELOPMENT OFFICER 26.00 15.00 X 271342 0 10323 GARY ANDERSON CHIEF OPERATING OFFICER 26.00 15.00 X 296182 0 38651 LISA NORWINE CHIEF ADVANCEMENT OFFICER 26.00 15.00 X 218854 0 38586 VALERIE COOPER VP OF OPERATIONS AND EXEC DIRECTOR 26.00 15.00 X 173152 0 21226 CHAD SNEED VP OF FINANCIAL REPORTING 26.00 15.00 X 160068 0 26330 RITA VICARY VP OF MARKETING COMMUNICATIONS 26.00 15.00 X 211761 0 12318 COLLEEN BOTTENS VP SUPPORT SERVICES & EXEC DIRECTOR 26.00 15.00 X 170076 0 22065 JOSH KING VP OF INFORMATION TECHNOLOGY 26.00 15.00 X 139886 0 21251 BRIAN REINHOLD VP OF RISK MAN & CORP SAFETY 26.00 15.00 X 135899 0 21768 DREW REDMAN EXECUTIVE DIRECTOR 26.00 15.00 X 137950 0 10393 MIKE RASO EXECUTIVE DIRECTOR 26.00 15.00 X 148185 0 9674 BECKY ZIMMER ED OF PLANNED GIVING 26.00 15.00 X 116564 0 6618 JOHN TURONGIAN EXECUTIVE DIRECTOR 26.00 15.00 X 120947 0 4955 TODD YOUNG NETWORK DIRECTOR 26.00 15.00 X 133357 0 14800 LISA WILLIAMS REGIONAL DIRECTOR OF HR 26.00 15.00 X 139733 0 11267 RACHEL LITTLE DIRECTOR OF CLINICAL COMPLIANCE 26.00 15.00 X 142447 0 4555 DAVID LUETHY DIRECTOR OF PROCUREMENT 26.00 15.00 X 139830 0 6437 ERIC BOSAW DIRECTOR OF BUSINESS INTELLIGENCE 26.00 15.00 X 124383 0 10933 3697092 0 326309 72 0 1 0 BSI CONSTRUCTORS INC 6767 SOUTHWEST AVENUE ST LOUIS MO 63143 CONSTRUCTION CONTRACTOR 31337420 SYMBRIA REHAB 28100 TORCH PARKWAY WARRENVILLE IL 60555 THERAPY SERVICES 5435344 OMNICARE 100 E RIVERCENTER BLVD COVINGTON KY 41101 PHARMACY SERVICES 2708677 MEDICAL STAFFING NETWORK HEALTHCARE LLC 4 CITYPLACE DR 300 ST LOUIS MO 63141 STAFFING SERVICES 724374 MAXIM HEALTHCARE SERVICES INC 1807 PARK 270 DRIVE SUITE 200 ST LOUIS MO 63146 STAFFING SERVICES 667538 39 3553004 3553004 LIFE PLAN COMMUNITIES REVENUE 623000 153916922 153916922 MANAGEMENT FEES 623000 16330512 16330512 HOME COMMUNITY BASED SERVICES REV 623000 7867263 7867263 AMORTIZATION OF ENTRANCE FEES 623000 3848904 3848904 DEVELOPMENT FEES 623000 1099491 1099491 -9803090 -9803090 173260002 3332225 3332225 1165156 1165156 535587 184850 350737 350737 350737 385305462 15373 386951948 0 -1646486 15373 -1631113 -1631113 94700 66527 28173 28173 BARBER AND BEAUTY 623000 648871 648871 TRANSPORTATION 623000 146310 146310 GARAGE FEES 623000 101706 101706 170968 170968 1067855 181126039 173260002 0 4313033 28037 28037 2977616 2977616 82136899 70330488 11806411 968047 771677 196370 11104042 9873664 1230378 6095477 5106608 988869 11147135 10914973 232162 309723 133386 176337 205234 34308 170926 27786 27786 194324 194324 14030323 12941574 1088749 197137 110248 86889 7529513 6880784 648729 1868492 1673062 195430 5984757 5716342 268415 640120 422235 217885 41868 14130 27738 11611959 8839290 2772669 22935976 22308573 627403 1750828 1671457 79371 DIETARY 6845573 6826553 19020 PHARMACY EXPENSES 2034449 2034449 MISC 297701 105290 192411 BAD DEBT EXPENSE 189382 189382 257207 122168 135039 191409605 167048678 24360927 0 2580834 1613722 1788669 22203074 7684175 6601048 1469413 526277 355967 366281 1377158 1552391 548516892 203925759 316328036 344591133 163704965 216223397 598616 937366 460404 432603 4470485 1960000 6531200 2820304 507349922 599827596 30037383 32823548 15812324 17166064 276079328 365728177 56829 52935 174850135 176171029 496835999 591941753 X 10513923 7885843 10513923 7885843 507349922 599827596 X -10283566 11828430 -2510485 -1662459 X X 0 1 X 1 0 X 1927513 2183527 1636708 3064113 3553004 12364865 140357100 154439385 156030233 165559258 173260002 789645978 27057 31127 94700 152884 142284613 156622912 157693998 168654498 176907706 802163727 344111 330344 323294 997749 0 344111 330344 323294 997749 801165978 3287793 3566475 2790612 3294275 5032968 17972123 3287793 3566475 2790612 3294275 5032968 17972123 2474944 2807153 2521286 1296860 1067855 10168098 148047350 162996540 163005896 173245633 183008529 830303948 0.96490 0.96260 0.02160 0.02160 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MEAL INCOME - 2015 AMOUNT: $ 577,123. 2016 AMOUNT: $ 580,094. 2017 AMOUNT: $ 650,430. TRANSPORTATION - 2015 AMOUNT: $ 91,858. 2016 AMOUNT: $ 97,758. 2017 AMOUNT: $ 69,165. 2018 AMOUNT: $ 100,550. 2019 AMOUNT: $ 146,310. TELEPHONE - 2015 AMOUNT: $ 10,688. 2016 AMOUNT: $ 9,000. 2017 AMOUNT: $ 8,509. 2018 AMOUNT: $ 7,369. 2019 AMOUNT: $ 4,914. MISCELLANEOUS - 2015 AMOUNT: $ 126,698. 2016 AMOUNT: $ 554,815. 2017 AMOUNT: $ 253,590. 2018 AMOUNT: $ 35,707. 2019 AMOUNT: $ 8,793. GIFT SHOP - 2015 AMOUNT: $ 20,949. 2016 AMOUNT: $ 28,208. MAINTENANCE - 2015 AMOUNT: $ 20,383. 2016 AMOUNT: $ 30,951. 2017 AMOUNT: $ 49,696. 2018 AMOUNT: $ 64,140. 2019 AMOUNT: $ 23,775. LAUNDRY - 2015 AMOUNT: $ 821,062. 2016 AMOUNT: $ 708,055. 2017 AMOUNT: $ 725,086. 2018 AMOUNT: $ 286,684. 2019 AMOUNT: $ 1,890. HOUSEKEEPING - 2015 AMOUNT: $ 11,339. 2016 AMOUNT: $ 6,941. 2017 AMOUNT: $ 10,931. 2018 AMOUNT: $ 3,401. 2019 AMOUNT: $ 3,005. GUEST ROOM - 2015 AMOUNT: $ 78,678. 2016 AMOUNT: $ 68,260. 2017 AMOUNT: $ 81,187. 2018 AMOUNT: $ 79,848. 2019 AMOUNT: $ 76,499. GARAGE FEES - 2015 AMOUNT: $ 55,955. 2016 AMOUNT: $ 51,244. 2017 AMOUNT: $ 52,095. 2018 AMOUNT: $ 98,586. 2019 AMOUNT: $ 101,706. CHAPEL - 2015 AMOUNT: $ 24,289. 2016 AMOUNT: $ 23,779. 2017 AMOUNT: $ 19,955. 2018 AMOUNT: $ 305. BARBER AND BEAUTY - 2015 AMOUNT: $ 609,712. 2016 AMOUNT: $ 619,386. 2017 AMOUNT: $ 573,425. 2018 AMOUNT: $ 614,411. 2019 AMOUNT: $ 648,871. ACTIVITIES - 2015 AMOUNT: $ 26,210. 2016 AMOUNT: $ 28,662. 2017 AMOUNT: $ 27,217. 2018 AMOUNT: $ 5,859. 2019 AMOUNT: $ 4,847. PNC REWARDS - 2019 AMOUNT: $ 47,245. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 27786 27786 0 PART II-B, LINE 1: THE ORGANIZATION UTILIZES THE SERVICES OF A LOBBYIST TO KEEP THE ORGANIZATION ABREAST OF LEGISLATIVE ACTS PERTAINING TO THE ORGANIZATION'S INDUSTY AND OCCASIONALLY HAVE EMPLOYEES ATTEND HEARINGS TO SPEAK ABOUT INDUSTRY ISSUES. ALSO, THE ORGANIZATION PAYS MEMBERSHIP DUES TO MISSOURI HEALTH CARE ASSOCIATION, OF WHICH, A PORTION IS RELATED TO LOBBYING. 0 1 X 23540017 23540017 418039328 169230964 248808364 20516271 11901502 8614769 36735072 22793293 13941779 49686204 49686204 344591133 REFUNDABLE ADMISSION FEES 163557507 RESIDENT DEPOSITS 11021156 INTEREST RATE SWAP AGREEMENT 1592366 176171029 X PART IV, LINE 2B: RESIDENT FUNDS ARE HELD BY THE ORGANIZATION FOR THE BENEFIT OF THE RESIDENT. PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. 1 NURSING SCHOLARSHIP 7 22119 WEBSTER CHILD CARE 5 5918 PART I, LINE 2: TO QUALIFY FOR NURSING SCHOLARSHIP, AN EMPLOYEE MUST BE RECOMMENDED BY THEIR SUPERVISOR. THIS IS FORWARDED THROUGH THE CARE CENTER ADMINISTRATOR FOR APPROVAL OF THE AMOUNT OF ASSISTANCE. TO QUALIFY FOR WEBSTER CHILD CARE, AN EMPLOYEE AT LACLEDE GROVES (LG) MUST BE FULL TIME WHO HAS WORKED FOR 6 MONTHS OR MORE WITH NO DISCIPLINARY PROBLEMS ON FILE. THE EMPLOYEE WOULD THEN SUBMIT A FINANCIAL APPLICATION INCLUDING TWO EARNINGS STATEMENTS TO WEBSTER CHILD CARE (WCC). WCC REVIEWS THE APPLICATION AND ASSURES THE EMPLOYEE MEETS LG EMPLOYMENT REQUIREMENTS. IF APPROVED, AMOUNT WILL DEPEND UPON THE AMOUNT OWED FOR CHILD CARE (NUMBER OF DAYS A WEEK AND CHILD'S AGE DETERMINES COST) AND THE EMPLOYEES NEED PER THEIR FINANCIAL APPLICATION. IF APPROVED FOR ASSISTANCE, WCC DETERMINES AMOUNT UNITED WAY WILL PAY, AMOUNT GRANT FROM LSS WILL PAY AND REMAINING AMOUNT EMPLOYEE WILL PAY. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 JOHN KOTOVSKY PRESIDENT AND CEO 273009 0 27612 0 99111 0 12019 0 5504 0 417255 0 0 0 PAUL J OGIER CFO AND TREASURER 230315 0 57920 0 28509 0 11200 0 5436 0 333380 0 0 0 MARK W SCHOEDEL CHIEF DEVELOPMENT OFFICER 115773 0 17019 0 138550 0 6168 0 4155 0 281665 0 0 0 GARY ANDERSON CHIEF OPERATING OFFICER 264659 0 30000 0 1523 0 31200 0 7451 0 334833 0 0 0 LISA NORWINE CHIEF ADVANCEMENT OFFICER 203810 0 14250 0 794 0 28950 0 9636 0 257440 0 0 0 VALERIE COOPER VP OF OPERATIONS AND EXEC DIRECTOR 172930 0 0 0 222 0 14422 0 6804 0 194378 0 0 0 CHAD SNEED VP OF FINANCIAL REPORTING 159872 0 0 0 196 0 16683 0 9647 0 186398 0 0 0 RITA VICARY VP OF MARKETING COMMUNICATIONS 142049 0 59017 0 10695 0 8624 0 3694 0 224079 0 0 0 COLLEEN BOTTENS VP SUPPORT SERVICES & EXEC DIRECTOR 158152 0 11623 0 301 0 15270 0 6795 0 192141 0 0 0 JOSH KING VP OF INFORMATION TECHNOLOGY 139794 0 0 0 92 0 11454 0 9797 0 161137 0 0 0 BRIAN REINHOLD VP OF RISK MAN & CORP SAFETY 135790 0 0 0 109 0 15671 0 6097 0 157667 0 0 0 MIKE RASO EXECUTIVE DIRECTOR 134576 0 13000 0 609 0 5986 0 3688 0 157859 0 0 0 LISA WILLIAMS REGIONAL DIRECTOR OF HR 132648 0 6400 0 685 0 5805 0 5462 0 151000 0 0 0 PART I, LINE 1A JOHN R. KOTOVSKY HAS A HOUSING ALLOWANCE RELATED TO HIS PASTORAL DUTIES THAT IS INCLUDED IN HIS OTHER REPORTABLE COMPENSATION. PART I, LINE 4B DEPOSITS MADE INTO ACCOUNTS BY ORGANIZATION: GARY ANDERSON - SEC 457(B) PLAN - $20,000 LISA NORWINE - SEC 457(B) PLAN - $20,000 CHAD SNEED - SEC 457(B) PLAN - $10,000 JOSH KING - SEC 457(B) PLAN - $10,000 BRIAN REINHOLD - SEC 457(B) PLAN - $10,000 VALERIE COOPER - SEC 457(B) PLAN - $10,000 COLLEEN BOTTENS - SEC 457(B) PLAN - $10,000 JOHN KOTOVSKY - SEC 457(F) PLAN - $27,612 PAUL OGIER - SEC 457(F) PLAN - $27,920 GARY ANDERSON - SEC 457(F) PLAN - $19,546 LISA NORWINE - SEC 457(F) PLAN - $16,053 MARK SCHOEDEL - SEC 457(F) PLAN - $16,474 PAYMENTS RECEIVED FROM PLAN: PAUL OGIER - SEC 457(B) PLAN - $22,309 JOHN KOTOVSKY - SEC 457(B) PLAN - $21,668 MARK SCHOEDEL - SEC 457(B) PLAN - $98,555 RITA VICARY - SEC 457(B) PLAN - $ 10,037 PAUL OGIER - SEC 457(F) PLAN - $4,677 MARK SCHOEDEL - SEC 457(F) PLAN - $39,658 SCHEDULE J PART II LUTHERAN SENIOR SERVICES IS A LARGE COMPLEX ORGANIZATION THAT IS COMPRISED OF 18 SEPARATE LEGAL ENTITIES, EACH OF WHICH FILES ITS OWN TAX RETURN. DUE TO THE REQUIREMENTS FOR COMPLETING THESE 990'S (WHICH ARE FILED BY 15 OF THE 18 LSS ENTITIES), SOME OF THE INFORMATION CONTAINED WITHIN THE FORM, SUCH AS REVENUE AND EXPENSES, IS RELATED ONLY TO THAT PARTICULAR ENTITY. HOWEVER, SOME OF THE INFORMATION, SUCH AS EXECUTIVE COMPENSATION, RELATES TO THE ENTIRE ORGANIZATION. TO HELP MAKE THIS INFORMATION MORE MEANINGFUL, THE FOLLOWING PARAGRAPH PROVIDES A SUMMARY OF THE OVERALL OPERATIONS OF LSS. LUTHERAN SENIOR SERVICES IS A NOT FOR PROFIT ORGANIZATION OWNED BY 104 LUTHERAN CHURCHES AND WAS INITIALLY FOUNDED IN 1858. LUTHERAN SENIOR SERVICES OPERATES 10 SENIOR LIVING COMMUNITIES SERVING OVER 3,000 OLDER ADULTS, NINE AFFORDABLE HOUSING COMMUNITIES SERVING OVER 570 OLDER ADULTS AND A VARIETY OF IN HOME SERVICES PROGRAMS SERVING OVER 5,000 OLDER ADULTS. IN 2019, LSS HAD TOTAL ASSETS OF $897,311,146, PROVIDED APPROXIMATELY $11,624,000 IN BENEVOLENT CARE, HAD NEARLY 68,000 VOLUNTEER HOURS, AND EMPLOYED 16 CHAPLAINS. A HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI 431178966 60635HM55 2011-09-29 47187481 CAPITAL IMPROVEMENTS TO LUTHERAN SENIOR SERVICES 0 0 0 B HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI SERIES 2014A 431178966 60635HS26 2014-06-04 84146040 REFUNDING OF 2004 BONDS AND CAPITAL IMPROVEMENTS 0 0 0 C HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI SER 2014B 431178966 2014-06-04 50000000 REFUNDING OF 2008 BONDS 0 0 0 D HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI SERIES 2016A 431178966 60635HU56 2016-01-29 58320378 ACQUISITION OF MASON POINTE AND OTHER LSS CAPITAL PROJECTS 0 0 0 A 7550000 47452221 871285 751862 5541743 40287331 2013 0 0 1 1 B 5305000 84658512 3866287 1293330 284416 745123 54739476 23729880 2016 1 0 1 1 C 30000000 50000000 50000000 2015 1 0 1 1 D 2835000 58386615 3409829 952321 851018 1895 50625563 2545989 2017 0 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOU DATE THE REBATE COMPUTATION WAS PERFORMED: 09/29/2013 ISSUER NAME: HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI DATE THE REBATE COMPUTATION WAS PERFORMED: 06/01/2019 SCHEDULE K, ENTITY 1, PAGE 1, PART I, LINE (A), COLUMN (F) THE CAPITAL IMPROVEMENTS BENEFITTED LUTHERAN SENIOR SERVICES, HEISINGER LUTHERAN HOME, LUTHERAN RETIREMENT CENTER ASSOCIATION, AND MERIDIAN VILLAGE ASSOCIATION III. AS SUCH, A PORTION OF THE BOND DEBT LIABILITY HAS BEEN ALLOCATED TO THOSE ENTITIES ON THEIR RESPECTIVE FORMS 990, PART X, PAGE 11, LINE 20. THE PARENT ORGANIZATION HAS ELECTED TO FILE ALL APPLICABLE SCHEDULE K REPORTING ON ITS RETURN SO THERE IS NO SCHEDULE K REPORTING ON ANY RETURN EXCEPT THE PARENT ENTITY. SCHEDULE K, ENTITY 2, PAGE 1, PART I, LINE C, COLUMN F - PURPOSE TO REFUND SERIES 2000 BONDS ISSUED 12/21/2000, 2010 BONDS ISSUED 10/14/2010, PARTIALLY REFUND 2014B BONDS ISSUED 8/14/2015, 2014C BONDS ISSUED 2/5/2015 AND 2014D BONDS ISSUED 2/1/2016 SCHEDULE K, ENTITY 2, PAGE 1, PART I, LINE C, COLUMN E - ISSUE PRICE ISSUE PRICE LISTED ON 8038 PART III LINE 21 IS $151,834,192, WHICH INCLUDES $20,000,000 OF REISSUED 2014B BONDS. THESE BONDS ARE ALREADY RECORDED ON SCHEDULE K AND AS A RESULT, HAVE BEEN EXCLUDED FROM THE ISSUE PRICE OF THIS ISSUANCE. SCHEDULE K, PAGE 1, ENTITY 1, PART II, LINE 3, COLUMN A PROCEEDS DIFFERS FROM ISSUANCE PRICE DUE TO INCLUSION OF ACCUMULATED INTEREST INCOME THROUGH 12/31/19 OF $264,740. SCHEDULE K, PAGE 1, ENTITY 1, PART II, LINE 3, COLUMN B PROCEEDS DIFFERS FROM ISSUANCE PRICE DUE TO INCLUSION OF ACCUMULATED INTEREST INCOME THROUGH 12/31/19 OF $512,472. SCHEDULE K, PAGE 1, ENTITY 1, PART II, LINE 3, COLUMN D PROCEEDS DIFFERS FROM ISSUANCE PRICE DUE TO INCLUSION OF ACCUMULATED INTEREST INCOME THROUGH 12/31/19 OF $66,237. SCHEDULE K, PAGE 1, ENTITY 2, PART II, LINE 3, COLUMN A PROCEEDS DIFFERS FROM ISSUANCE PRICE DUE TO INCLUSION OF ACCUMULATED INTEREST INCOME THROUGH 12/31/19 OF $437,446. SCHEDULE K, ENTITY 1, PAGE 1, PART II, LINE 4, COLUMN (A) - RESERVE FUNDS THE TOTAL AMOUNT OF GROSS PROCEEDS IN RESERVE FUNDS AT 12/31/19 EQUALS $3,617,317. THIS AMOUNT IS REDUCED BY $96,032, WHICH REPRESENTS THE DIFFERENCE BETWEEN CURRENT MARKET VALUE OF DEBT RESERVE FUNDS AND THE INITIAL FUNDING AMOUNT AND $2,650,000, WHICH REPRESENTS AN LSS EQUITY CONTRIBUTION. SCHEDULE K, ENTITY 1, PAGE 1, PART II, LINE 4, COLUMN (B) - RESERVE FUNDS THE TOTAL AMOUNT OF GROSS PROCEEDS IN RESERVE FUNDS AT 12/31/19 EQUALS $5,669,296. THIS AMOUNT IS REDUCED BY $86,958, WHICH REPRESENTS THE DIFFERENCE BETWEEN CURRENT MARKET VALUE OF DEBT RESERVE FUNDS AND THE INITIAL FUNDING AMOUNT, $1,541,208, WHICH REPRESENTS FUNDS NOT FROM DEBT PROCEEDS SINCE IT WAS A REFUNDING ISSUE. SCHEDULE K, ENTITY 1, PAGE 1, PART II, LINE 4, COLUMN (D) - RESERVE FUNDS THE TOTAL AMOUNT OF GROSS PROCEEDS IN RESERVE FUNDS AT 12/31/19 EQUALS $3,409,829. THIS AMOUNT IS REDUCED BY $2,550,000, WHICH REPRESENTS AN LSS EQUITY CONTRIBUTION. SCHEDULE K, PAGE 1, PART I THE 2019 SERIES C BONDS WERE USED TO REFUND THE SERIES 2010, 2014C, AND 2014D BONDS, WHICH ARE NO LONGER REQUIRED TO BE DISCLOSED ON SCHEDULE K. A HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI SER 2016B&C 431178966 60635HZ85 2016-11-04 123622927 REFUNDING OF SERIES 2006, 2007A, 2007B, AND 2007C BONDS AND CAPITAL PROJECTS 0 0 0 B HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI SER 2019A 431178966 60635H2S7 2019-02-25 96498029 CAPITAL IMPROVEMENTS TO LUTHERAN SENIOR SERVICES 0 0 0 C HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF STATE OF MISSOURI SER 2019C 431178966 60635H3E7 2019-11-05 131834192 SEE SUPPLEMENTAL INFORMATION IN PART VI 0 0 0 A 9010000 124060373 782691 1941885 1561698 286004 36000000 83336653 2017 1 1 0 1 B 96498029 1527650 8904110 405000 144248 49429400 36087621 2020 0 0 0 0 C 131834192 1265448 130568744 2019 1 0 0 0 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 1 1 PNC BANK NATIONAL ASSOCIATION 6.000000000000 0 0 0 0 1 A 1 B 1 C 1 FORM 990, PAGE 1, PART I CONTINUATION LUTHERAN SENIOR SERVICES IS A LARGE COMPLEX ORGANIZATION THAT IS COMPRISED OF 18 SEPARATE LEGAL ENTITIES, EACH OF WHICH FILES ITS OWN TAX RETURN. DUE TO THE REQUIREMENTS FOR COMPLETING THESE 990'S (WHICH ARE FILED BY 15 OF THE 18 LSS ENTITIES), SOME OF THE INFORMATION CONTAINED WITHIN THE FORM, SUCH AS REVENUE AND EXPENSES, IS RELATED ONLY TO THAT PARTICULAR ENTITY. HOWEVER, SOME OF THE INFORMATION, SUCH AS EXECUTIVE COMPENSATION, RELATES TO THE ENTIRE ORGANIZATION. TO HELP MAKE THIS INFORMATION MORE MEANINGFUL, THE FOLLOWING PARAGRAPH PROVIDES A SUMMARY OF THE OVERALL OPERATIONS OF LSS. LUTHERAN SENIOR SERVICES IS A NOT FOR PROFIT ORGANIZATION OWNED BY 104 LUTHERAN CHURCHES AND WAS INITIALLY FOUNDED IN 1858. LUTHERAN SENIOR SERVICES OPERATES TEN SENIOR LIVING COMMUNITIES SERVING OVER 3,000 OLDER ADULTS, EIGHT AFFORDABLE HOUSING COMMUNITIES SERVING OVER 570 OLDER ADULTS AND A VARIETY OF IN HOME SERVICES PROGRAMS SERVING OVER 5,000 OLDER ADULTS. IN 2019, LSS HAD TOTAL OPERATING INCOME OF APPROXIMATELY $237,000,000, PROVIDED APPROXIMATELY $11,624,000 IN BENEVOLENT CARE, HAD NEARLY OVER 68,000 VOLUNTEER HOURS, AND EMPLOYED 16 CHAPLAINS. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION REVISED THEIR BYLAWS IN JANUARY 2019 TO CHANGE THE REQUIREMENT TO AT LEAST SIXTY SEVEN (67%) OF ALL VOTING DIRECTORS SHALL BE COMMUNICANT MEMBERS IN GOOD STANDING OF CONGREGATIONS WHICH ARE MEMBERS OF THE ORGANIZATION AND AT LEAST 30% OF ALL VOTING DIRECTORS SHALL BE COMMUNICANT MEMBERS IN GOOD STANDING OF MEMBER CONGREGATIONS OF THE LUTHERAN CHURCH-MISSOURI SYNOD. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION (THE "MEMBERS") SHALL BE THOSE LUTHERAN CONGREGATIONS LOCATED WITHIN A RADIUS OF APPROXIMATELY 150 MILES FROM ST. LOUIS MISSOURI, WHICH APPLY FOR AND ARE ADMITTED INTO MEMBERSHIP IN ACCORDANCE WITH THESE BYLAWS. FOR PURPOSES OF THESE BYLAWS, "LUTHERAN CONGREGATION" SHALL REFER TO A MEMBER CONGREGATION OF EITHER THE LUTHERAN CHURCH-MISSOURI SYNOD OR THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BOARD MEMBERS ARE ELECTED BY ASSOCIATED CHURCHES. FORM 990, PART VI, SECTION A, LINE 7B THE MERGER (OTHER THAN A MERGER IN WHICH THE CORPORATION IS THE SURVIVING ENTITY), DISSOLUTION, OR SALE OR DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE ASSETS, OF THE CORPORATION SHALL REQUIRE THE VOTE OF THE LESSER OF TWO-THIRDS OF THE MEMBERS OF THE CORPORATION PRESENT AT A DULY CALLED AND CONVENED MEETING OF THE MEMBERS AND A MAJORITY OF ALL OF THE MEMBERS. THE MEMBERS MAY AT ANY TIME AND FOR WHATEVER REASON OR CAUSE, AS THEY MAY DEEM BEST IN THEIR SOLE DISCRETION, REMOVE ANY VOTING DIRECTOR BY A TWO-THIRDS MAJORITY VOTE OF ALL THE MEMBERS PRESENT AT A DULY CALLED AND CONVENED MEETING OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY IS PROVIDED A COPY OF THE FORM 990 FOR REVIEW PRIOR TO FILING. APPROVAL OF THE FORM 990 IS DELEGATED TO THE AUDIT COMMITTEE OF THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES WILL DISCLOSE A CONFLICT OF INTEREST ON THE "CONFLICT OF INTEREST FORM" IN THE FOLLOWING SITUATIONS AND IN OTHER CIRCUMSTANCES WHICH HE/SHE THINKS MIGHT CAUSE A CONFLICT BETWEEN HIS/HER PERSONAL INTERESTS AND HIS/HER FIDUCIARY DUTY: FINANCIAL INTERESTS, INSIDE INFORMATION, CONFLICTING INTEREST OTHER THAN FINANCIAL, GIFTS AND FAVORS. THE FOLLOWING LSS EMPLOYEES ARE REQUIRED TO SIGN A "CONFLICT OF INTEREST FORM" ANNUALLY: PRESIDENT, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER/TREASURER, VICE PRESIDENT OF CONSTRUCTION AND IT, VICE PRESIDENT OF HUMAN RESOURCES, ALL DIRECTORS, ADMINISTRATORS AND ASSISTANT ADMINISTRATORS. THE CORPORATE COMPLIANCE OFFICER FOLLOWS UP WITH ANY CONFLICTS OF INTERESTS AND DOCUMENTS THE RESOLUTIONS OF THE CONFLICTS. THESE FORMS ARE KEPT BY THE CORPORATE COMPLIANCE OFFICE. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS ESTABLISHED A SEPARATE COMPENSATION COMMITTEE CHARGED WITH PERFORMING AN ANNUAL PERFORMANCE REVIEW OF THE CEO AND REVIEWING THE CEO'S COMPENSATION PACKAGE. THE COMPENSATION COMMITTEE ENGAGED A THIRD-PARTY GLOBAL HUMAN CAPITAL CONSULTING FIRM TO: (1) DEVELOP AN ANNUAL CEO PERFORMANCE REVIEW PROCESS, INCLUDING A NEW EVALUATION FORM, AND (2) DEVELOP A COMPENSATION PACKAGE BASED ON ITS KNOWLEDGE OF SIMILARLY SIZED NON-PROFIT ORGANIZATIONS IN ORDER TO ENSURE THAT THE COMPENSATION PAID TO THE CEO IS REASONABLE. ALL MEMBERS OF THE BOARD COMPLETE AN ANNUAL EVALUATION, WHICH THE COMPENSATION COMMITTEE SUMMARIZES AND REVIEWS. THE COMPENSATION COMMITTEE THEN MAKES A RECOMMENDATION TO THE FULL BOARD OF DIRECTORS FOR ANY COMPENSATION ADJUSTMENTS. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH NOT A REQUIREMENT, THE ORGANIZATION PROVIDES PHOTOCOPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND OTHER DOCUMENTS TO ALL WHO REQUEST ONE OR MORE OF THE ITEMS. FORM 990, PART XI, LINE 9: NET PERIODIC PENSION COST -679,234. CHANGE IN VALUE OF INTEREST RATE SWAP -1,585,997. OTHER CHANGES IN PLAN ASSETS AND BENEFIT OBLIGATIONS 602,772. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. THIS PROCESS IS CONSISTENT WITH PRIOR YEARS. FORM 990, PAGE 10, PART IX, LINE 11A THE MANAGEMENT FEE EXPENSE REPRESENTS ONLY INTERCOMPANY CHARGES THAT ARE OFFSET BY MANAGEMENT FEE REVENUES INCLUDED IN PROGRAM SERVICE REVENUES ON PAGE 9. MACKENZIE PLACE LIHTC GP LLC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 272136187 DEVELOPMENT & MANAGEMENT OF SENIOR LIVING FACILITIES MO 30 541 LUTHERAN SENIOR SERVICES DUNN ROAD MANOR LIHTC GP LLC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 474889447 DEVELOPMENT & MANAGEMENT OF SENIOR LIVING FACILITIES MO 29 626 LUTHERAN SENIOR SERVICES LUTHERAN SENIOR SERVICES ENDOWMENT FUND 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 431818832 SENIOR LIVING MO 501(C)(3) LINE 12A, I LUTHERAN SENIOR SERVICES 1 HALLS FERRY MANOR 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 431660879 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 DUNN ROAD MANOR INC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 431874215 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 ROSE HILL HOUSE INC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 431736720 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 ROSE HILL HOUSE II INC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 201889216 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 HILLTOP MANOR ASSOCIATION INC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 020667342 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 WESTFIELD MANOR ASSOCIATION 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 020568032 SENIOR LIVING IL 501(C)(3) LINE 10 N/A 0 MERIDIAN VILLAGE ASSOCIATION 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 371415588 SENIOR LIVING IL 501(C)(3) LINE 10 N/A 0 COLE COUNTY LUTHERAN HOME ASSOCIATION 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 431147326 SENIOR LIVING MO 501(C)(3) LINE 10 LUTHERAN SENIOR SERVICES 1 LUTHERAN RETIREMENT CENTER ASSOCIATION 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 371199021 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 LUTHERAN HILLSIDE VILLAGE INC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 370818454 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 LUTHERAN HILLSIDE VILLAGE FOUNDATION 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 371371314 SENIOR LIVING MO 501(C)(3) LINE 7 N/A 0 MACKENZIE PLACE 202 - II - 45-4000626 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 454000626 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 MACKENZIE PLACE 202 - 27-3777863 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 273777863 SENIOR LIVING MO 501(C)(3) LINE 10 N/A 0 PROVIDENT GROUP INC 1150 HANLEY INDUSTRIAL COURT ST LOUIS MO 63144 300134496 DEVELOPMENT & MANAGEMENT OF SENIOR LIVING FACILITIES MO LUTHERAN SENIOR SERVICES C 149438 1.00000 1 0 0 1 1 1 0 0 0 0 0 0 1 0 1 1 0 1 0 0 LUTHERAN SENIOR SERVICES ENDOWMENT FUND C 3553004 G/L DETAIL