2018-11-15T15:06:46-06:00 2017-12-31 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2017-01-01 382395647 PROJECT COMPASSION HEALTH PROJ 9896523470 4100 PIER NORTH BLVD NO STE A FLINT MI 48504 AMY E STORMS CFO 9896523470 2018-11-14 1 TINA PETERS P00904574 2483522500 2018-11-14 67.59.56.31 2018-11-14 15:06:41 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 852ED58CBC9AA6807749D456DA873D43AD1BF2F7 2017 2019-02-21 02:37:17Z WELLSPRING LUTHERAN SERVICES DAVID M GEHM 4100 PIER NORTH BLVD NO STE A FLINT MI 48504 7478580 0 X WWW.WELLSPRINGLUTHERAN.COM X 1982 MI MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 8 8 168 3 0 0 0 11685 7425498 7423516 11 18 15069 43361 7440578 7478580 0 0 0 0 3912143 3699547 0 0 0 4297708 4100358 8209851 7799905 -769273 -321325 7264446 6580220 5879753 5510452 1384693 1069768 MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 0 0 6438820 7423516 SKILLED NURSING CARE PROVIDED 23,217 DAYS OF CARE AND 3,882 DAYS OF REHABILITATION, ROOM AND BOARD, NURSING CARE AND RELIGIOUS SERVICES FOR RESIDENTS. 6438820 1 0 0 1 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 1 0 0 1 14 0 1 168 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MI X ERIC MUSUM 9896523470 4100 PIER NORTH BLVD SUITE A FLINT MI 48504 RITCH CUSHWAY CHAIRMAN 0.20 0.80 X X 0 0 0 PETE BENDER TREASURER/SECRETARY 0.20 0.80 X X 0 0 0 REV DON NEUENDORF DIRECTOR - THRU 5/23/17 0.20 0.80 X 0 0 0 DARRELL ZOLTON DIRECTOR 0.20 0.80 X 0 0 0 PAUL NYQUIST DIRECTOR 0.20 0.80 X 0 0 0 CARL SCHOENOW DIRECTOR 0.20 0.80 X 0 0 0 AMY BENKO DIRECTOR 0.20 0.80 X 0 0 0 DAVID M GEHM PRESIDENT & CEO 0.79 39.21 X 0 269261 14151 ALBERT D KAUL VP HUMAN RESOURCES, CPO 0.39 39.61 X 0 132304 11024 MAUREEN MCGEE VP OF HEALTH SERVICES 0.17 39.83 X 0 131708 9623 AMY STORMS SR. VP FINANCE AND CFO 0.00 40.00 X 0 166163 12233 ERIC R MUSUM VP, CAA AND CTO 0.63 39.37 X 0 115973 10256 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 8.99 31.01 X 0 174080 6793 0 989489 64080 0 0 1 0 UNIDINE CORPORATION 1000 WASHINGTON ST 510 BOSTON MA 02118 CATERING SERVICE 921119 SELECT REHABILITATION 2600 COMPASS RD GLENVIEW IL 60026 THERAPY SERVICES 611353 HEALTH CARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 DIETARY/HOUSEKEEPING SERVICES 204056 OMNICARE INC 2455 PEPPERIDGE TRAIL BRIGHTON MI 48114 LONG TERM CARE PHARMACY 188390 4 1685 10000 500 11685 ROOM/CARE/SKILLED NURS 623000 7422093 7422093 OTHER RESIDENT REIMBUR 623000 1423 1423 7423516 18 18 MISCELLANEOUS INCOME 900099 31408 31408 DISCOUNTS EARNED 900099 11953 11953 43361 7478580 7423516 0 43379 X 3195661 2923988 271673 30140 22695 7445 241507 173172 68335 232239 218225 14014 639835 639835 14083 14083 532 532 1893029 1841186 51843 718 616 102 23420 23420 31602 198 31404 206585 169620 36965 1982 405 1577 6834 6028 806 120140 120140 246385 197108 49277 101714 101714 DRUGS/MEDICAL SUPPLIES 359383 359383 MMQAA PROVIDER TAX 351132 351132 EQUIPMENT AND RENTAL 44795 30037 14758 BAD DEBT EXPENSE 34233 34233 23956 -9346 33302 7799905 6438820 1361085 0 845812 858912 1291983 753206 87782 145091 5111225 368552 4957348 4742673 81521 80338 7264446 6580220 558719 446106 5321034 5064346 5879753 5510452 X 1303172 989430 81521 80338 1384693 1069768 7264446 6580220 X -321325 6400 X X 0 1 X 1 0 X 11685 11685 8477899 8080096 8409043 7425498 7423516 39816052 8477899 8080096 8409043 7425498 7435201 39827737 1685 1685 0 1685 1685 39826052 0 96 2003 11 18 2128 96 2003 11 18 2128 15069 43361 58430 8477899 8080192 8411046 7440578 7478580 39888295 0.99840 0.99960 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME 0 0 0 0 0 0 0 0 1 532 532 0 PART II-B, LINE 1: MEMBERSHIP FEE ALLOCATED TO LOBBYING. 1 2006 11617 12613 1010 0 536231 536231 4296987 274000 4022987 265239 92996 172243 12768 1556 11212 4742673 DUE TO AFFILIATES 5048079 INTEREST RATE SWAP MARK TO MARKET 16267 5064346 PART IV, LINE 1B: PROJECT COMPASSION HEALTH IS REQUIRED TO MAINTAIN RESIDENT TRUST FUNDS AT ITS NURSING HOME. 0 0 0 0 0 0 0 0 0 DAVID M GEHM PRESIDENT & CEO 0 269261 0 0 0 0 0 7285 0 6866 0 283412 0 0 AMY STORMS SR. VP FINANCE AND CFO 0 166163 0 0 0 0 0 5468 0 6765 0 178396 0 0 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 0 174080 0 0 0 0 0 0 0 6793 0 180873 0 0 PART I, LINE 3 THE PROCESS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO IS UNDERTAKEN BY LUTHERAN HOMES OF MICHIGAN, INC., A RELATED ORGANIZATION. THE PROCESS INCLUDES USE OF A COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS LUTHERAN HOMES OF MICHIGAN, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, LUTHERAN HOMES OF MICHIGAN, INC., HAS THE AUTHORITY TO APPOINT/ELECT INDIVIDUALS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES OF THE FORM 990 WERE SENT TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS' INPUTS AND COMMENTS WERE SOLICITED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE COLLECTED IN THE BEGINNING OF EACH NEW BOARD YEAR. THE FORMS ARE REVIEWED BY THE CEO. IF A CONFLICT EXISTS, THE CEO REVIEWS WITH THE BOARD CHAIR AND DETERMINES THE APPROPRIATE ACTION, WHICH IS TYPICALLY TO REMOVE THE INDIVIDUAL FROM THE POSITION OF CONFLICT FOR THE SPECIFIC TRANSACTION/PROCESS. 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 AT THE CORPORATE OFFICE OF WELLSPRING LUTHERAN SERVICES BY CONTACTING THE CHIEF FINANCIAL OFFICER. FORM 990, PART IX, LINE 11G CONTRACTED THERAPY SERVICES: PROGRAM SERVICE EXPENSES 599,207. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 599,207. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,057,273. MANAGEMENT AND GENERAL EXPENSES 51,843. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,109,116. LAB TESTS: PROGRAM SERVICE EXPENSES 35,531. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,531. OTHER: PROGRAM SERVICE EXPENSES 149,175. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 149,175. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATION 80,338. CHANGE IN VALUE OF INTEREST RATE SWAP 7,583. TRANSFER TO AFFILIATE -81,521. FORM 990, PART XII, LINE 2C: THERE WERE NO CHANGES TO THE AUDIT OVERSIGHT PROCEDURES FROM THE PREVIOUS YEAR. FORM 990, PAGE 1 SECTION C: PROJECT COMPASSION HEALTH IS ALSO D/B/A LIVONIA WOODS NURSING AND REHABILITATION. LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 381358410 NURSING CARE MI 501(C)(3) LINE 10 N/A 0 LUTHERAN HOMES OF MICHIGAN FOUNDATION 4100 PIER NORTH BLVD STE A FLINT MI 48504 261630687 DONATE FUNDS MI 501(C)(3) LINE 12A LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE PERSONAL ASSISTANCE 4100 PIER NORTH BLVD STE A FLINT MI 48504 272138954 HOME CARE MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 382236926 RETIREMENT COMMUNITY MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE AGENCY INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 383081979 HOME CARE MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 ALPENA VILLAGE 4100 PIER NORTH BLVD STE A FLINT MI 48504 320090735 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI N/A GILBRALTAR LDHALP 26200 LAHSER RD STE 300 SOUTHFIELD MI 48034 301829767 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A MONROE ELDERLY LDHALP 5309 TRANSPORTATION BLVD CLEVELAND OH 44125 383609893 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A ALPENA PINES LDHALP 9710 JUNCTION ROAD FRANKENMUTH MI 48434 260236982 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A LHM HOUSING SERVICES INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 383609879 HOUSING SERVICES MI N/A C 0 GIBRALTER MANOR DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 202240778 HOUSING SERVICES MI N/A C 0 ALPENA PINES DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 260237019 HOUSING SERVICES MI N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 LUTHERAN HOMES OF MICHIGAN INC P 639835 ACTUAL AMOUNT LUTHERAN HOMES OF MICHIGAN FOUNDATION R 81521 ACTUAL AMOUNT