2019-11-13T10:13:46-06:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2018-01-01 390981434 UNITED LUTHERAN PROGRAM FOR THE AGING INC UNIT 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 ARTHUR KEUP CFO 4144646396 2019-11-06 1 KIMBERLY ANDERSON P00188889 6086628600 2019-11-06 67.137.57.251 2019-11-06 11:22:53 CS P D96076016A1D85786C0DD27C05D232F375DC2AFE 08598E5CD8BEAEC8C407760E8BF8A64CD65A21BD 2018 2020-03-31 21:24:44Z STEPHANIE CHEDID 4545 NORTH 92ND STREET WAUWATOSA WI 53225 36736756 0 X WWW.LUTHERMANOR.ORG X 1957 WI TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS BY LEADING THE WAY IN ABUNDANT LIVING FOR ALL WHO TRUST US TO CARE. 7 6 717 373 0 0 1348161 1327002 30177042 28836186 884834 785393 287616 292410 32697653 31240991 0 0 0 0 17748160 17696326 0 0 44801 14798934 14950169 32547094 32646495 150559 -1405504 49319525 45047443 26765203 25010302 22554322 20037141 X TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS AND BY LEADING THE WAY IN ABUNDANT LIVING FOR ALL WHO TRUST US TO CARE. 0 0 14149128 15798508 LUTHER MANOR HEALTH CARE CENTER PROVIDES SKILLED NURSING CARE AND SERVICES FOR FRAIL ELDERLY. WITHIN THE HEALTH CARE CENTER IS A DEDICATED 34 UNIT REHABILITATION CENTER. THE HEALTH CARE CENTER ALSO INCLUDES "SPECIAL CARE" SERVICES FOR PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA. THE FACILITY IS LICENSED FOR PARTICIPATION IN BOTH MEDICARE AND MEDICAID. 5258151 5871099 THE LUTHER MANOR TERRACE (LMT) PROVIDES ENGAGING AND SUPPORTIVE INDEPENDENT LIVING HOUSING AND SERVICES FOR OLDER ADULTS. APARTMENT RESIDENTS OFTEN CHOOSE THE LMT IN ORDER TO BECOME PART OF A LIFE PLAN COMMUNITY SETTING. THE LMT SERVICES AND AMENITIES INCLUDE LIFE ENRICHMENT OPPORTUNITIES, TRANSPORTATION SERVICES, DINING PROGRAM, SPIRITUAL WELLNESS, FITNESS, HEALTH, ENTERTAINMENT AND CULTURAL PROGRAMS. THE LMT ALSO PROVIDES PERSONAL CARE SERVICES TO RESIDENTS THROUGH THE "RESIDENTIAL CARE APARTMENT COMPLEX" RCAC PROGRAM, WHICH HELPS RESIDENTS MAINTAIN INDEPENDENT LIVING. 4764037 5319386 THE COURTYARDS AT LUTHER MANOR PROVIDES SUPPORTIVE (ASSISTED) LIVING SERVICES FOR FRAIL ELDERLY WHO RESIDE IN LUTHER MANOR'S LICENSED "COMMUNITY BASED RESIDENTIAL FACILITY (CBRF)". THE COURTYARDS PROGRAM ALSO INCLUDES "SPECIAL CARE" SERVICES FOR PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA. 1654344 1847193 LUTHER MANOR ADULT DAY CARE CENTERS IN WAUWATOSA AND GRAFTON, WI; LUTHER MANOR RIVER OAKS - A 16 UNIT ASSISTED LIVING FACILITY LOCATED IN MEQUON, WI; AND HOSPICE SERVICES PROVIDED BY LUTHER MANOR HOSPICE. 1654344 1847193 25825660 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 71 0 1 717 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X ARTHUR KEUP CFO 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 RAYMOND ZASTROW DIRECTOR 0.50 X 0 0 0 STEPHEN KNOWLES SECRETARY 1.00 X X 0 0 0 KAREN GIBBS DIRECTOR 0.50 X 0 0 0 STEPHANIE CHEDID CEO 45.00 5.00 X X 275253 0 74116 KRISTINE IWINSKI TREASURER 1.00 X X 0 0 0 TIMOTHY SCHOEWE CHAIRMAN 1.00 X X 0 0 0 KEITH FRALEIGH VICE CHAIR 0.50 X X 0 0 0 ARTHUR KEUP CFO 45.00 5.00 X 130338 0 6895 CASSANDRA MCAFFE-HALE NURSE 63.80 X 147328 0 0 ROBYN LEFLORE NURSE 68.90 X 143367 0 13908 JULIE JOLITZ CHIEF CLINICAL OFFICER 50.00 X 136064 0 10508 LAUREN MALENSEK CHIEF HUMAN RESOURCE OFFIC 50.00 X 128508 0 1928 PATRICK HANSEN CHIEF EXPERIENCE OFFICER 50.00 X 149175 0 24555 1110033 0 131910 7 0 1 0 SODEXO INC AND AFFILIATES PO BOX 360170 PITTSBURG PA 15251 DINING SERVICES 1931435 SYMBRIA REHAB INC 28100 TORCH PARKWAY SUITE 600 WARRENVILLE IL 60555 THERAPY SERVICES 1045399 STU'S FLOORING PO BOX 210857 MILWAUKEE WI 53221 FLOORING INSTALLATION 638756 TOP TECHS TEMPS 150 N SUNNY SLOPE RD STE 215 BROOKFIELD WI 53005 TEMPORARY NURSING STAFFING 475768 TNN 7026 W NORTH AVE STE 2W CHICAGO IL 60707 TEMPORARY NURSING STAFFING 442932 5 1000000 327002 1327002 RESIDENT SERVICES 623000 28178378 28178378 FOUNDERS FEES 623990 657808 657808 28836186 706295 706295 5494353 5412538 2717 81815 -2717 79098 79098 121268 80510 40758 40758 OTHER INCOME 900099 218008 218008 HOUSEKEEPING 900099 25276 25276 CAFETERIA INCOME 900099 8368 8368 251652 31240991 28836186 0 1077803 486602 13723 437942 34937 14362063 10880387 3481288 388 62584 41953 20631 1664431 1294355 368560 1516 1120646 860417 257766 2463 173047 173047 968038 668286 299752 246310 17131 224158 5021 125923 10723 115200 284314 80085 204229 1465365 1396559 68806 35720 2478 33089 153 103672 14069 89603 400060 400060 2460695 2354317 106378 245301 245301 ALL OTHER EXPENSES 3213124 3213124 DINING FOOD AND SUPPLIE 1929055 1929055 ANCILLARIES 1809926 1150444 659482 SUPPLIES 1162387 925961 236103 323 327232 327232 32646495 25825660 6776034 44801 966558 817668 118978 170459 2638753 2158690 52806 62078 303521 336247 91140114 70697154 20911590 20442960 23887338 20888868 439981 170473 49319525 45047443 2728167 2830570 14823457 13398651 48712 58608 9164867 8722473 26765203 25010302 X 22522304 19966031 32018 71110 22554322 20037141 49319525 45047443 -1405504 -1111677 0 X 0 1 X 1 0 X 1118841 1667778 1134276 1348161 1327002 6596058 34190953 33555744 32975304 30302614 28957454 159982069 35309794 35223522 34109580 31650775 30284456 166578127 0 0 0 166578127 827057 599108 650746 665134 706295 3448340 827057 599108 650746 665134 706295 3448340 203704 202357 224464 259586 251652 1141763 36340555 36024987 34984790 32575495 31242403 171168230 0.97320 0.96850 0.02010 0.02240 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 336498 336498 63468298 50206169 13262129 24977539 18741579 6235960 2357779 1749406 608373 20442960 FOUNDERS FEES 8722473 8722473 X 31240991 0 31240991 0 31240991 32646495 0 32646495 0 32646495 PART IV, LINE 2B: RESIDENT FUNDS ARE HELD BY THE ORGANIZATION WHICH RESIDENTS CAN ACCESS IF IN NEED OF ANY AMOUNT OF MONEY IN WHICH THE RESIDENT HAS ENTRUSTED THE ORGANIZATION. THESE FUNDS ARE OFTEN USED FOR MINOR PURCHASES. THIS ASSET IS IN CORRELATION WITH A LIABILITY FOR THE SAME AMOUNT. PART X, LINE 2: THE CORPORATION FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE CORPORATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION, WHICH ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. X 0 1 X X X X X X 0 1 0 0 0 0 0 1 1 1 STEPHANIE CHEDID CEO 225253 0 50000 0 0 0 52170 0 21946 0 349369 0 0 0 ROBYN LEFLORE NURSE 142255 0 0 0 1112 0 2225 0 11683 0 157275 0 0 0 PATRICK HANSEN CHIEF EXPERIENCE OFFICER 139175 0 10000 0 0 0 0 0 24555 0 173730 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDES A MEMBERSHIP TO THE WISCONSIN CLUB UNDER STEPHANIE CHEDID'S NAME. THE MEMBERSHIP IS REQUIRED TO HAVE USE OF THE MEETING ROOMS FOR BUSINESS PURPOSES. PART I, LINE 1B THE BOARD HAS APPROVED REIMBURSMENT OF DUES TO A SOCIAL CLUB WHICH IS USED FOR BUSINESS PURPOSES. PART I, LINE 4B THE CEO IS ELIGIBLE FOR A 457(F) DEFERRED COMPENSATION ARRANGEMENT UNDER HER EMPLOYMENT AGREEMENT. CONTRIBUTIONS ANNUALLY PAYABLE OVER 5 YEARS SUBJECT TO VESTING REQUIREMENTS. PART I, LINE 7 THE CEO, CFO, CHRO, CXO AND CCO ARE ELIGIBLE FOR DISCRETIONARY BONUS PAYMENTS. PART I, LINE 8 DEFERRED COMPENSATION PLAN FOR CEO. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-29 21170000 REFUNDING OF 2009 BONDS AND FUNDING CAPITAL PROJECTS 0 0 0 A 7705000 21170000 2270000 18900000 2012 1 0 1 1 A 0 0 1 1 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPRISED OF THE OFFICERS OF THE BOARD AND IS CHAIRED BY THE CHAIR OF THE BOARD. THEY ARE GIVEN AUTHORITY BY THE BOARD TO PERFORM SPECIFIC FUNCTIONS, INCLUDING THE ANNUAL REVIEW OF THE CEO. WHEN THE FULL BOARD CAN NOT MEET, IN AN EMERGENCY SITUATION, THEY ARE AUTHORIZED TO EXERCISE ALL POWER OF THE BOARD EXCEPT ACTIONS RELATED TO ELECTION OF OFFICER OR FILLING VACANCIES. FORM 990, PART VI, SECTION A, LINE 3 UNITED LUTHERAN PROGRAM FOR THE AGING, INC. HAS A CONTRACT WITH SODEXO TO MANAGE OUR DINING SERVICES. SODEXO DIRECTLY EMPLOYS MANAGEMENT EMPLOYEES, PURCHASES ALL FOOD, AND SUPERVISES LUTHER MANOR'S DINING SERVICE STAFF. FORM 990, PART VI, SECTION B, LINE 11B THE MEMBERS OF THE BOARD OF DIRECTORS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. HAVE THE OPPORTUNITY TO REVIEW THE FORM 990 PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS ANNUALLY REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY, DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD AND ON AN INTERIM BASIS AS CONFLICTS ARISE AS OUTLINED IN THE POLICY. THE BOARD WILL REVIEW THE CONFLICT AND DETEMINE THE APPROPRIATE ACTION. DEPENDING ON THE TYPE OF CONFLICT, DIRECTORS AND OFFICERS WITH CONFLICTS MAY BE ALLOWED TO REMAIN ON THE BOARD, BUT WOULD BE EXPECTED TO REFRAIN FROM DISCUSSIONS OR VOTING ON MATTERS WHERE A POTENTIAL CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE COMPENSATION CONSULTANT IS ENGAGED TO REVIEW NON-PROFIT COMPENSATION OF LIKE ORGANIZATIONS AND INDUSTRY COMPENSATION SURVEYS. BASED ON THIS DATA, COMPENSATION RECOMMENDATIONS ARE MADE TO THE EXECUTIVE COMMITTEE OF THE BOARD OF THE ULPA AND APPROVED BY THIS COMMITTEE. THE REVIEW WAS PERFORMED BY CARLSON DETTMANN CONSULTING USING DATA FROM THE 2018 GUIDESTAR NONPROFIT COMPENSATION REPORT, THE 2018 LEADING AGE CEMO SURVEY AND RELEVANT DATA FROM FORM 990 FOR COMPARABLE ORGANIZATIONS. THE INFORMATION WAS DOCUMENTED BY THE EXECUTIVE COMMITTEE OF THE ULPA BOARD OF DIRECTORS IN A REBUTTABLE PRESUMPTION CHECKLIST. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST AND ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION WILL CONSIDER REQUESTS AND MAKE THE DOCUMENTS AVAILABLE BASED ON FACTS AND CIRCUMSTANCES OF THE REQUEST. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. SOME YEAR-END FINANCIAL INFORMATION IS PROVIDED IN LUTHER MANOR'S ANNUAL IMPACT REPORT. LUTHER MANOR FOUNDATION 4545 NORTH 92ND STREET MILWAUKEE WI 53225 391499823 PROGRAM GRANT TO UNITED LUTHERAN PROGRAM FOR THE AGING, INC. WI 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 1