2018-05-15T12:28:54-05:00 2017-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 221 W PHILADELPHIA ST STE 200 YORK PA 17401 990 2016-07-01 521127007 CARROLL LUTHERAN VILLAGE INC CARR 4108480090 300 St Luke Circle WESTMINSTER MD 21158 geary k milliken PRESIDENT/CEO 4108480090 2018-05-14 1 Kerri N Bogda P00760402 7178467000 2016 2022-09-23 18:48:47Z GEARY K MILLIKEN 300 St Luke Circle WESTMINSTER MD 21158 32952963 0 X www.CLVILLAGE.ORG X 1981 MD Resid., Assisted & Skilled care to residents over 60 and skilled rehab. svc to qualified persons. 16 16 538 373 6880 330 593129 350292 27728898 29381903 1525069 1186085 643598 760289 30490694 31678569 36441 24916 0 0 14731572 15371169 0 0 412200 16326465 16178445 31094478 31574530 -603784 104039 99947963 99342683 88577194 86925097 11370769 12417586 X CARROLL LUTHERAN VILLAGE IS A CONTINUING CARE RETIREMENT COMMUNITY DEDICATED TO THE MINISTRY OF CARING IN A CHRISTIAN ATMOSPHERE, FOSTERING QUALITY LIFE AND SERVICES FOR THE WHOLE PERSON. 0 0 13706607 24916 14635109 HEALTH CARE AND ASSISTED LIVING - The Village provides quality, skilled nursing care, long term care and assisted living in a comfortable, homelike environment to all residents, including those who have outlived their assets or whose annual income is insufficient to meet expenses. Earnings from a restricted endowment are used to subsidize residents as needs are demonstrated. The Village participates in Medicare and Medicaid programs and accepts reimbursement for care that does not fully cover costs. The Village Health Care Center hAD 35,117 HEALTHCARE census days, which represents 93.4% occupancy, AND 16,404 ASSISTED LIVING CENSUS DAYS, which represents 86.13% occupancy. 13463159 0 14375169 RESIDENTIAL LIVING - The Village offers seniors 60 years of age and older affordable access to quality services on a properly and beautifully maintained campus where quality of life and a spirit of community are emphasized. Residents may select accommodations from a wide range of unit sizes with entrance fees for the majority of units below the U.S. median home price. Health, wellness, and fitness programming is included in monthly fees. Residents are encouraged to engage in all aspects of wellness. Residences are safe and secure and equipped with access to skilled health professionals through an emergency call system. THE VILLAGE residential living program HAD 178,624 CENSUS DAYS DURING THE YEAR, which represents 94.16% occupancy. 348048 0 371625 ADDITIONAL SUPPORT SERVICES - All levels of care are supported by on campus access to medical care, therapy services, nutritional food service, home health services, diverse religious services, transportation, maintenance, housekeeping and laundry services. Organizational governance is accomplished through a process that encourages resident participation. Carroll Lutheran Village is dedicated not only to its residents, but also to its staff, the health professions, and the community at large. Residents conduct an annual appeal to raise funds for staff scholarships. Sunday chapel offerings are often designated to provide financial support where it is critically needed. A compassionate response fund exists and is administered within the governance structure. The Village offers support to other non-profit organizations by encouraging staff and residents to act in volunteer, advisory or board roles. Local colleges are supported financially, specifically to enhance programs that train and develop skilled healthcare professionals. The local hospital is supported financially as we are engaged in a growing, mutually beneficial partnership to provide quality healthcare services and information to residents of carroll lutheran village and to members of the greater community in need of healthy aging support.Internally, the Village offers training programs for aspiring nursing home and assisted living administrators who are approved by the state. Meeting space on the campus is offered for use by non-profit community groups. clinical training is provided for local colleges and tech schools.Carroll Lutheran Village is nationally accredited by the CARF International, an independent, nonprofit accrediting body for health and human services organizations. CARF accreditation is an assurance that an organization provides service excellence, risk management, value and accountability. During the rigorous review process, evaluators look for compliance in more than 1,000 quality standards in resident life, health and wellness; financial resources and disclosure; and governance and administration. Nationwide only 15% of continuing care retirement communities have received CARF accreditation, making Carroll Lutheran Village among the elite aging services providers within the immediate community, the region and the nation. The village provided direct benevolent care to residents who met certain criteria without charge or at amounts less than established rates. The Corporation provided charity care under this policy at a cost of approximately $2,707,716 during 2017, based on direct and allocable costs of care. Additionally, the village provided direct financial assistance under its resident assistance policy of $569,013 during 2017. 27517814 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 1 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 71 0 1 538 1 1 1 0 0 0 0 1 1 0 0 0 0 X 16 16 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X Steven d Powell - vp of finance 4108480090 300 ST LUKE CIRCLE WESTMINSTER MD 21158 DAVID S BOLLINGER CHAIRPERSON (TERM EXP. 9/16) 2.00 X X 0 0 0 Marlene K Titus ChairPERSON 2.00 X X 0 0 0 WANDA K LYNN Vice Chair 2.00 X X 0 0 0 KAY L BETZ SECRETARY 2.00 X X 0 0 0 DAVID BOND BOARD (TERM EXP. 9/16) 2.00 X 0 0 0 REV ROBIN SIMPSON-LITTON BOARD (TERM EXP. 9/16) 2.00 X 0 0 0 RONALD FAIRCHILD BOARD 2.00 X 0 0 0 SANDRA L FERGUSON BOARD 2.00 X 0 0 0 Carol E Plunkert board 2.00 X 0 0 0 roberta dillow bOARD 2.00 X 0 0 0 donna kent bOARD 2.00 X 0 0 0 rev kevin c clementson BOARD 2.00 X 0 0 0 Louna Primm BOARD 2.00 X 0 0 0 alice daum-coen BOARD 2.00 X 0 0 0 ARTHUR S WISNER BOARD 2.00 X 0 0 0 Richard SImmons Board 2.00 X 0 0 0 joe hikel trEASURER 2.00 X X 0 0 0 Rev Michael K Louia Board 2.00 X 0 0 0 sharon Mcclernan board 2.00 X 0 0 0 GEARY K MILLIKEN PRESIDENT/CEO 28.00 12.00 X 315843 0 39705 steve powell vp fINANCE 28.00 12.00 X 159119 0 18585 ROY CHIAVACCI VICE PRESIDENT (UNTIL DEC. 2017) 40.00 X 186694 0 7031 JOHN HENRY NHA DIR. OF HC CENTER 40.00 X 134240 0 9679 GEORGE OXX EXECUTIVE DIRECTOR 40.00 X 127026 0 9105 KAREN HODGE VP OF MKTING AND COMMUN. 40.00 X 130061 0 6898 DENISE ZIMMERMAN DIRECTOR OF NURSING 40.00 X 122941 0 11639 JANET BUCHANAN VP OF PHILANTHROPHY 40.00 X 108129 0 20075 1284053 0 122717 8 0 1 0 ABAR HOME IMPROVEMENT 384 WHITE FENCE DRIVE WESTMINSTER MD 21157 CONSTRUCTION SERVICES 754540 SODEXO INC PO BOX 370170 pittsburgh PA 152516170 Contracted Services 674897 MORGAN-KELLER INC 70 THOMAS JOHNSON DRIVE FREDERICK MD 217024306 CONSTRUCTION SERVICES 545593 MAXIM STAFFING SOLUTIONS 12558 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 NURSING SERVICES 238586 GRAVITY CONSULTING AND MANAGEMENT 157 BALTIMORE STREET CUMBERLAND MD 21502 CONSULTING SERVICES 228886 9 118230 232062 350292 Resident Service Revenue 623000 29381903 29381903 29381903 773751 773751 191072 19992 171080 171080 171080 1617260 1204926 412334 412334 412334 10500 118230 35871 -25371 -25371 20385 13605 6780 6780 Administrative Fees 623000 353391 353391 Coffee Shop 623000 110207 110207 Resident Catering 623000 49264 49264 94938 6880 88058 607800 31678569 29381903 6880 1939494 24916 24916 565742 565742 11970312 10801914 1006061 162337 326214 300363 21337 4514 1588870 1169593 382031 37246 920031 790461 117151 12419 61725 22892 38833 7291 2618 4673 37400 37400 502 502 85324 85324 2740154 2301538 438616 154357 23340 131017 2859046 2710415 85729 62902 65989 55386 10603 4555122 4454178 60387 40557 106668 93909 5509 7250 26963 7983 16893 2087 3710204 3208033 440795 61376 496501 460792 35709 Medical Expenses 732413 732413 Bad Debts 192033 192033 Books, Dues, Licenses 77568 77568 Resident Activities 45584 45584 223601 174839 37853 10909 31574530 27517814 3644516 412200 1050 1090 2830944 1002362 6610 0 1730318 1628004 168353 0 243112 202362 115945 91100 126294575 66773936 60609017 59520639 22715266 25737716 3459995 4727102 1228606 6838747 6432308 99947963 99342683 3446088 3033799 34716838 36076295 49632389 47635904 781879 179099 88577194 86925097 X 3808966 4590756 264183 319207 7297620 7507623 11370769 12417586 99947963 99342683 104039 942778 0 X 0 1 X 1 0 X 636977 1184920 617588 593129 350292 3382906 25954400 27234518 27360788 27728898 29381904 137660508 473443 628348 485659 243954 234742 2066146 27064820 29047786 28464035 28565981 29966938 143109560 0 0 0 143109560 580309 677406 872635 1280294 964823 4375467 580309 677406 872635 1280294 964823 4375467 50387 32785 42447 290454 403943 820016 27695516 29757977 29379117 30136729 31335704 148305043 0.96500 0.96980 0.02950 0.02710 X Schedule A, Part III, Line 12, Explanation of Other Income: other income - 2014 Amount: $ 3,428. 2015 Amount: $ 1,774. 2016 Amount: $ 1,297. WORKERS COMP REIMB - 2012 Amount: $ 23,342. 2013 Amount: $ 5,280. 2015 Amount: $ 680. 2016 Amount: $ 3,070. Non-Charitable Fundraising Receipts - 2012 Amount: $ 16,840. 2013 Amount: $ 9,246. 2014 Amount: $ 17,712. 2015 Amount: $ 9,864. 2016 Amount: $ 10,500. Gross Receipts of Inventory - 2012 Amount: $ 10,205. 2013 Amount: $ 18,259. 2014 Amount: $ 21,307. 2015 Amount: $ 20,286. 2016 Amount: $ 20,385. application fees - 2015 Amount: $ 17,850. 2016 Amount: $ 15,300. administrative fees - 2015 Amount: $ 240,000. 2016 Amount: $ 353,391. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 502 502 0 Part II-B, Line 1: CARROLL LUTHERAN VILLAGE PAYS DUES TO LEADING AGE. A PORTION OF THE DUES PAID TO THIS ORGANIZATION IS ALLOCABLE TO LOBBYING EXPENSES. THE TOTAL AMOUNT OF DUES PAID BY CARROLL LUTHERAN VILLAGE THAT IS ALLOCABLE TO LOBBYING IS $502. 9470197 295491 1315303 624393 10456598 9003101 371752 811570 716226 9470197 8127961 441529 1261840 828229 9003101 6585712 1076018 1293757 827526 8127961 5834215 524211 941088 713802 6585712 0.25150 0.71800 0.03050 0 0 1067705 1067705 113146080 56232465 56913615 12072680 10541471 1531209 8110 8110 59520639 Due from Affiliates 2421891 Note Receivable from Affiliate 4010417 6432308 Resident Fund Payable 179099 179099 32601619 942778 -89196 853582 31748037 -69468 -69468 31678569 31554802 69468 69468 31485334 89196 89196 31574530 Part V, Line 4: The Village recognizes that funds that are donor designated for endowment are to be perpetuated. Earnings from endowment funds are transferred to a board designated, temporarily restricted fund that can be used for resident assistance and scholarships according to a spending allowance defined in the board's investment policy. Unrealized losses on the investment portfolio are not allocated to endowment funds. Part XI, Line 2d - Other Adjustments: investment fees -85,324. Negative Revenue reclassed to expenses -3,872. Part XI, Line 4b - Other Adjustments: fundraising expenses -35,871. rental expenses -19,992. cost of goods sold -13,605. Part XII, Line 2d - Other Adjustments: fundraising expenses 35,871. rental expenses 19,992. cost of goods sold 13,605. Part XII, Line 4b - Other Adjustments: investment fees 85,324. Negative Revenue reclassed to expenses 3,872. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 investments 2365839 0 0 0 0 0 0 2365839 0 2365839 0 0 1 0 0 0 SCHEDULE F, PART IV, LINE 3 THE ORGANIZATION HAD AN INTEREST IN A FOREIGN DOMICILED CORPORATION BUT DID NOT MEET THE THRESHOLD FOR FILING FORM 5471. golf tournament 128730 118230 10500 4000 1756 9520 8730 11865 128730 118230 10500 4000 1756 9520 8730 11865 35871 -25371 1 SCHOLARSHIPS 19 24916 Part I, Line 2: EMPLOYEES ARE ELIGIBLE FOR A VARIETY OF SCHOLARSHIPS AND TUITION ASSISTANCE BASED UPON CRITERIA ESTABLISHED BY THE ORGANIZATION. INTERESTED EMPLOYEES MUST MEET ALL CRITERIA AND APPLY BASED ON THEIR ELIGIBILITY. THE VICE PRESIDENT OF HUMAN RESOURCES ADMINISTERS ALL SCHOLARSHIP PROGRAMS. A SCHOLARSHIP COMMITTEE HAS BEEN ESTABLISHED THAT REVIEWS AND APPROVES SCHOLARSHIP AWARDS. THE COMMITTEE INCLUDES STAFF MEMBERS FROM THE PHILANThROPY AND HUMAN RESOURCES DEPARTMENTS. THE VICE PRESIDENTS OF PHILANTHROPY AND HUMAN RESOURCES SERVE AS DESIGNEES FOR THE PRESIDENT/CEO REGARDING SCHOLARSHIP AWARD DECISIONS. ALL FUNDS ARE REMITTED TO THE EDUCATIONAL INSTITUTION DIRECTLY AND STUDENTS ARE EXPECTED TO MAINTAIN CERTAIN STANDARDS WHILE PARTICIPATING IN A sCHOLARSHIP PROGRAM. X X X X X 0 0 0 0 0 0 0 0 0 GEARY K MILLIKEN PRESIDENT/CEO 306325 0 0 0 9518 0 12529 0 27176 0 355548 0 0 0 steve powell vp fINANCE 155894 0 0 0 3225 0 6366 0 12219 0 177704 0 0 0 ROY CHIAVACCI VICE PRESIDENT (UNTIL DEC. 2017) 177534 0 0 0 9160 0 7031 0 0 0 193725 0 0 0 A The mayor and common council of westminster 526000811 960735AH1 2014-07-09 44281008 current refunding of prior year bond issue and capital improvements 0 0 0 B the mayor and common council of westminster 526000811 960735Aj7 2014-07-09 4663992 current refunding 0 0 0 A 44948685 3000761 898973 2931654 34235262 2017 1 0 1 1 B 765000 4734908 264220 94698 4375990 2017 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 0 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 1 NATAXIS FUNDING CORPORATION 4.300000000000 1 0 1 B 0 0 1 0 0 0 0 NATAXIS FUNDING CORPORATION 4.300000000000 1 0 1 A 1 B 1 PART I, COLUMN e: THE ISSUE PRICE REPORTED DOES NOT AGREE TO THE AMOUNTS LISTED ON PART II, LINE 3 DUE TO ORIGINAL ISSUE BOND PREMIUM. PART III, LINE 9: THE finance department IS IN THE PROCESS OF ESTABLISHING A WRITTEN PROCEDURE FOR POTENTIALLY NONQUALIFYING BOND ISSUES. POST-BOND ISSUANCE transactions are carefully monitored and the finance department BELIEVES IT IS IN FULL COMPLIANCE WITH ALL REGULATIONS. ALL PROCEDURES WILL BE DOCUMENTED AS WRITTEN POLICY FOR THE CURRENT AND FUTURE ISSUANCES. Form 990, Part VI, Section A, line 1 The Executive Committee, composed of the four board officers, can act for the board on routine business between meetings and in emergencies. Form 990, Part VI, Section A, line 3 THE ORGANIZATION OUTSOURCES MANAGEMENT OF FACILITIES AND FOOD SERVICE. Form 990, Part VI, Section A, line 6 THE CONGREGATIONS OF THE WESTMINSTER CONFERENCE OF THE DELAWARE-MARYLAND SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (THE "ELCA") CONSTITUTE THE ORIGINAL MEMBERS. CURRENT MEMBER CONGREGATIONS ARE NOTED IN THE BYLAWS. ANY OTHER DULY ORGANIZED LUTHERAN CONGREGATION OF THE DELAWARE-MARYLAND SYNOD OF THE ELCA ("SYNOD") OR ITS SUCCESSOR MAY BECOME A MEMBER CONGREGATION UPON APPROVAL BY THE CORPORATION. ANY CONGREGATION THAT IS NO LONGER AFFILIATED WITH THE SYNOD WILL IMMEDIATELY CEASE TO BE A MEMBER CONGREGATION. Form 990, Part VI, Section A, line 7a The board's governance committee serves as a nominating committee that recommends potential new board members. Nominees are presented to delegates from member churches at a meeting called specifically for the purpose of electing the board. Delegates choose trustees from the nominees presented and are also free to nominate and elect other individuals from the floor. Form 990, Part VI, Section A, line 7b THE CORPORATE CONGREGATION'S APPROVAL IS REQUIRED TO ELECT THE BOARD AND APPROVE THE INDEPENDENT AUDIT FIRM. Form 990, Part VI, Section B, line 11b The form 990 is reviewed by both the President/CEO and the VP of Finance. Once the review has been completed, the 990 is given to the entire board and reviewed at a regularly scheduled board meeting PRIOR TO THE RETURN BEING FILED WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Section B, line 12c CARROLL LUTHERAN VILLAGE HAS AN ESTABLISHED POLICY AND STANDARDS REGARDING CONFLICTS OF INTEREST. mANY BOARD AND COMMITTEE MEMBERS ARE ACTIVE AS COMMUNITY AND BUSINESS LEADERS IN cARROLL cOUNTY AND WILL AT TIMES FIND THEMSELVES IN A POSITION WHERE THERE MAY BE A DEGREE OF CONFLICT WITH THE Village's business. These conflicts are expected and the fact that they will regularly occur does not preclude such a member from serving on the board or committee. The village in fact needs the varied expertise of its board and committee volunteers and believes that THE board policy of disclosure and abstention assures that the village's business is conducted in a fair and independent manner. The Carroll Lutheran Village (CLV) COnflict of interest policy applies to officers, directors, board committee members and employees of CLV, each of whom is considered an interested person. The Conflict of Interest Policy statement is reviewed annually by the Board of Trustees. Further, In 2013 Carroll Lutheran Village began a relationship with Peace Church Compliance Program to assist with the organization's ongoing compliance efforts. Annually, an overview of CLV's Code of Integrity is shared with all vendors with whom CLV has an agreement or contractual relationship. A tri-fold pamphlet provides information about the Code of Integrity as well as personal and professional expectations of integrity and accountability. The pamphlet also shares information about the Conflict of Information Policy and how vendors can request a full copy. An entity with a CLV transaction is any individual or business organization which proposes to enter into any transaction with CLV involving: 1) The sale, purchase, lease or rental of any property or asset, 2) Employment, or rendition of services, personal or otherwise, 3) the award of any grant, contract, or subcontract, Or 4) the investment or deposit of any funds of CLV. An interested person has a financial interest in an entity if such person oR an immediate family member (including all lineal relatives and their spouses, siblings and their spouses) has an ownership interest in the entity or is an employee of or receives compensation from the entity. Compensation includes any direct or indirect remuneration or substantial gifts or favors. An interested person has a conflict of interest when that person, or an immediate family member, is or has a financial interest in an entity with a CLV transaction. Conflicts of interest can also arise in other instances. the types of activities which may create a conflict of interest include: 1) outside activities: To render directive, managerial or consultative services to any outside concern that does business with, or competes with, the services of CLV, or to render other services in competition with CLV. 2) Gifts, gratuities and entertainment: To accept gifts, entertainment or other favors from any outside concern that does or is seeking to do business with or is a competitor of CLV. 3) Inside information: To disclose or use information relating to the business of clv for the personal profit or advantage of the individual or his/her immediate family. It is the responsibility of an interested person to appropriately disclose to clv any potential conflicts of interest. Once disclosed, it is the responsibility of the ceo/president to determine if a conflict exists. The governance committee of the board of trustees may be utilized by the ceo/president, if needed, to determine a potential conflict of interest. If an interested person has failed to disclose a conflict of interest, appropriate disciplinary and/or corrective action will be taken. The conflict of interest policy statement is reviewed annually by the board of trustees and is included as a part of all agreements and/or contracts. An appropriate statement form is available and must be signed and on file for all interested persons. Form 990, Part VI, Section B, line 15 The board executive committee, including the board chairperson, participates as a compensation committee with the support of the VP of Human Resources. the committee uses a variety of surveys and compensation consultants to determine a recommended compensation amount for the President/CEO which is within fair market range for the industry. The full board reviews and approves the compensation of the President/CEO. DISCUSSIONS ARE DOCUMENTED AT COMMITTEE AND BOARD LEVELS. Form 990, Part VI, Section C, line 19 The organization makes its financial statements, form 990, and other operating documents available to the public upon request. Certain governing documents and policies are considered proprietary and are not generally disclosed. The organization is in full compliance with all regulations concerning disclosure at the federal, state and local levels. lutheran village at millers grant 300 st luke circle westminster MD 21158 320154392 retirement village MD 501(c)(3) Line 10 CARROLL LUTHERAN VILLAGE 1 CLV CATERING INC 300 ST LUKE CIRCLE westminster MD 21158 753195092 catering MD N/A C -15583 47509 0.90000 0 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 lutheran village at millers grant D 2342574 COST CLv catering D 79317 cOST CLv catering A 60000 COST lutheran village at millers grant L 353391 COST LUtheran village at millers grant O 169723 COST