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LUTHERAN HOME-HICKORY INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
LUTHERAN HOME-HICKORY INC (EIN 20-1457341)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-02-13
IRS object ID
201700449349300745
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-02-13T10:03:37-06:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201457341EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN HOME - HICKORY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLUTHBusinessNameControlTxt
Phone7046372870PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 947AddressLine1Txt
CitySALISBURYCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28145ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKIRBY NICKERSONPersonNm
Person TitleCFOPersonTitleTxt
Phone7046372870PhoneNum
Signature2017-02-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAmy BibbyPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
Preparation2017-02-10PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1TRINITY VILLAGEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTED GOINSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 947AddressLine1Txt
CitySALISBURYCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28145ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,936,816GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption9386GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LSCAROLINAS.NETWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionEMPOWERED BY CHRIST, WE WALK TOGETHER WITH ALL WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee334TotalEmployeeCnt
Total Volunteers145TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$27,442PYContributionsGrantsAmt
CY Contributions Grants$44,635CYContributionsGrantsAmt
PY Program Service Revenue$13,001,744PYProgramServiceRevenueAmt
CY Program Service Revenue$12,815,672CYProgramServiceRevenueAmt
PY Investment Income$63,191PYInvestmentIncomeAmt
CY Investment Income$33,098CYInvestmentIncomeAmt
PY Other Revenue$29,979PYOtherRevenueAmt
CY Other Revenue$26,130CYOtherRevenueAmt
PY Total Revenue$13,122,356PYTotalRevenueAmt
CY Total Revenue$12,919,535CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,476,626PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,773,879CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,306,770PYOtherExpensesAmt
CY Other Expenses$5,361,375CYOtherExpensesAmt
PY Total Expenses$12,783,396PYTotalExpensesAmt
CY Total Expenses$13,135,254CYTotalExpensesAmt
PY Revenues Less Expenses$338,960PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$215,719CYRevenuesLessExpensesAmt
Total Assets BOY$8,599,995TotalAssetsBOYAmt
Total Assets EOY$8,549,407TotalAssetsEOYAmt
Total Liabilities BOY$1,163,662TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,301,648TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,436,333NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,247,759NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$12,158,997ExpenseAmt
Revenue$12,841,802RevenueAmt
DescLUTHERAN HOME - HICKORY, INC. STRIVES TO BE A TRUE HOME FOR ITS RESIDENTS, A PLACE OF COMFORT, SECURITY AND BELONGING. STAFF EMPHASIZE BOTH QUALITY CARE AND QUALITY OF LIFE. MEANINGFUL ACTIVITIES BRING RESIDENTS, STAFF, FAMILIES AND VOLUNTEERS TOGETHER IN A SPIRIT OF FUN AND FELLOWSHIP. STAFF ARE COMMITTED TO PROVIDING COMPASSIONATE CARE AND PERSONAL ATTENTION TO RESIDENTS WHILE MEETING THE UNIQUE MEDICAL, EMOTIONAL, AND SPIRITUAL NEEDS OF EACH INDIVIDUAL. BECAUSE CHOOSING A NURSING HOME OFTEN COMES AT A DIFFICULT TIME, CHAPLAINS ARE AVAILABLE TO OFFER SUPPORT AND GUIDANCE TO FAMILIES AND RESIDENTS DURING ADMISSION AND THROUGHOUT THEIR STAY. SEE CONTINUATION ON SCHEDULE ODURING THE YEAR ENDED SEPTEMBER 30, 2016, LUTHERAN HOME - HICKORY, INC. PROVIDED 65,891 DAYS OF CARE TO 565 RESIDENTS.Desc
Total Program Service Expenses$12,158,997TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document29IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee334EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SUSAN MILLERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7046372870PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11416 S MARTIN LUTHER KING JR AVEAddressLine1Txt
CitySALISBURYCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28144ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
Ted Goins Jr
Chief Executive Officer/PRESIDENT40.001.00Yes (X)Yes (X)$0$315,659$15,076
Rev Pamela Cook
Director1.001.00Yes (X)$0$0$0
Eric Hoyle
Director1.001.00Yes (X)$0$0$0
Cary Grant
Director1.001.00Yes (X)$0$0$0
Skip Downs
Director1.001.00Yes (X)$0$0$0
Jim Huddle
Director1.001.00Yes (X)$0$0$0
Joy Fisher
Director1.001.00Yes (X)$0$0$0
Eunika Simons
Director1.001.00Yes (X)$0$0$0
Joycelyn Johnson
Director1.001.00Yes (X)$0$0$0
Mark Tonnesen
Director1.001.00Yes (X)$0$0$0
Betty Lohr
Director1.001.00Yes (X)$0$0$0
Dr Shannon Mathews
Director1.001.00Yes (X)$0$0$0
Greg Hudgins
Director1.001.00Yes (X)$0$0$0
Doug Nelson
Director1.001.00Yes (X)$0$0$0
Derek Shoemake
Director1.001.00Yes (X)$0$0$0
Rev Jennifer Krushas
Director1.001.00Yes (X)$0$0$0
J White Iddings Jr
Director1.001.00Yes (X)$0$0$0
Rosebud Reubel
Director1.001.00Yes (X)$0$0$0
Anna Pasour
Director1.001.00Yes (X)$0$0$0
Kirby Nickerson
Chief Financial Officer40.001.00Yes (X)$0$195,433$11,101
Karen Maddry
Secretary40.001.00Yes (X)$0$66,590$7,943
Kesha Smith
COO-SENIOR SERVICES40.001.00$0$187,084$8,116Yes (X)
Elizabeth Kuhn
Chief Development Officer40.001.00$0$151,692$9,790Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$916,458TotReportableCompRltdOrgAmt
Total Other Compensation$52,026TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Trinity Rehab LLC
113 SOUTH RAILROAD AVENUEDUNNNC28334THERAPY SERVICES$930,481
US Food Service Inc
800 FOOD SERVICE DRIVEFORT MILLSC29715DIETARY FOOD & SUPPLIES$532,685
Division of Medical Assistance
2022 MAIL SERVICE CENTERRALEIGHNC276992022BED ASSESSMENT$369,538
Grove Medical Inc
1089 PARK WEST BOULEVARDGREENVILLESC296116124MEDICAL SUPPLIES$186,795
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Related Organizations$10,000RelatedOrganizationsAmt
All Other Contributions$34,635AllOtherContributionsAmt
Total Contributions$44,635TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSERVICE FEE REVENUEDesc
Business623000BusinessCd
Total Revenue Column$12,815,672TotalRevenueColumnAmt
Related Or Exempt Func Income$12,815,672RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$12,815,672TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,379TotalRevenueColumnAmt
Exclusion$50,379ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$8,662SecuritiesAmt
Other$8,619OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$8,662SecuritiesAmt
Other-$8,619OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$17,281TotalRevenueColumnAmt
Exclusion-$17,281ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$26,130TotalRevenueColumnAmt
Related Or Exempt Func Income$26,130RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$26,130OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,919,535TotalRevenueColumnAmt
Related Or Exempt Func Income$12,841,802RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$33,098ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,431,313TotalAmt
Program Services$6,170,937ProgramServicesAmt
Management And General$260,376ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$20,487TotalAmt
Program Services$19,658ProgramServicesAmt
Management And General$829ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$813,550TotalAmt
Program Services$780,613ProgramServicesAmt
Management And General$32,937ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$508,529TotalAmt
Program Services$487,941ProgramServicesAmt
Management And General$20,588ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$513,817TotalAmt
Management And General$513,817ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,032TotalAmt
Management And General$5,032ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$18,480TotalAmt
Management And General$18,480ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$5,973TotalAmt
Management And General$5,973ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,113,782TotalAmt
Program Services$1,095,718ProgramServicesAmt
Management And General$18,064ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$21,096TotalAmt
Management And General$21,096ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$549,353TotalAmt
Program Services$475,098ProgramServicesAmt
Management And General$74,255ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$16,593TotalAmt
Program Services$16,593ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$871,212TotalAmt
Program Services$871,212ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,601TotalAmt
Program Services$5,185ProgramServicesAmt
Management And General$3,416ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,394TotalAmt
Management And General$1,394ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,397TotalAmt
Program Services$6,397ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$175,316TotalAmt
Program Services$175,316ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$59,707TotalAmt
Program Services$59,707ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical Supplies$963,908$963,908
Food EXPENSE$567,283$567,283
Bed Assessment$388,745$388,745
Bad Debt EXPENSE$73,921$73,921

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$765TotalAmt
Program Services$765ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$13,135,254TotalAmt
Program Services$12,158,997ProgramServicesAmt
Management And General$976,257ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$912,422BOYAmt
EOY$581,048EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,159,457BOYAmt
EOY$1,342,681EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$37,555BOYAmt
EOY$36,398EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$140BOYAmt
EOY$4,811EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,231,145LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,547,016LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$707,586BOYAmt
EOY$684,129EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,584,721BOYAmt
EOY$1,651,088EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,198,114BOYAmt
EOY$4,249,252EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$8,599,995BOYAmt
EOY$8,549,407EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$842,210BOYAmt
EOY$981,484EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$321,452BOYAmt
EOY$320,164EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,163,662BOYAmt
EOY$1,301,648EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,414,651BOYAmt
EOY$7,236,694EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,682BOYAmt
EOY$11,065EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,436,333BOYAmt
EOY$7,247,759EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,599,995BOYAmt
EOY$8,549,407EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$215,719ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$27,145NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$48,015CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$74,694CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$53,398CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,442CurrentTaxYearMinus1YearAmt
Current Tax Year$44,635CurrentTaxYearAmt
Total$248,184TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,578,742CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,285,163CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,764,806CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,001,744CurrentTaxYearMinus1YearAmt
Current Tax Year$12,815,672CurrentTaxYearAmt
Total$65,446,127TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,626,757CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,359,857CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,818,204CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,029,186CurrentTaxYearMinus1YearAmt
Current Tax Year$12,860,307CurrentTaxYearAmt
Total$65,694,311TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$65,694,311PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,543CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,796CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$45,650CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,893CurrentTaxYearMinus1YearAmt
Current Tax Year$50,379CurrentTaxYearAmt
Total$172,261TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,543CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,796CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$45,650CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,893CurrentTaxYearMinus1YearAmt
Current Tax Year$50,379CurrentTaxYearAmt
Total$172,261TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$29,979CurrentTaxYearMinus1YearAmt
Current Tax Year$26,130CurrentTaxYearAmt
Total$56,109TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,632,300CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,379,653CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,863,854CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,110,058CurrentTaxYearMinus1YearAmt
Current Tax Year$12,936,816CurrentTaxYearAmt
Total$65,922,681TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99650PublicSupportCY509Pct
Public Support PY5090.99740PublicSupportPY509Pct
Investment Income CY0.00260InvestmentIncomeCYPct
Investment Income PY0.00210InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$559,927BeginningYearBalanceAmt
Contributions$3,486ContributionsAmt
Investment Earnings Or Losses$43,233InvestmentEarningsOrLossesAmt
End Year Balance$606,646EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$579,311BeginningYearBalanceAmt
Investment Earnings Or Losses-$19,384InvestmentEarningsOrLossesAmt
End Year Balance$559,927EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$542,822BeginningYearBalanceAmt
Contributions$5,686ContributionsAmt
Investment Earnings Or Losses$30,803InvestmentEarningsOrLossesAmt
End Year Balance$579,311EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$504,059BeginningYearBalanceAmt
Investment Earnings Or Losses$38,763InvestmentEarningsOrLossesAmt
End Year Balance$542,822EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$152,624BeginningYearBalanceAmt
Investment Earnings Or Losses$351,435InvestmentEarningsOrLossesAmt
End Year Balance$504,059EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,525OtherCostOrOtherBasisAmt
Depreciation$14,231DepreciationAmt
Book Value$6,294BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,185,157OtherCostOrOtherBasisAmt
Depreciation$1,515,130DepreciationAmt
Book Value$670,027BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,463OtherCostOrOtherBasisAmt
Depreciation$17,655DepreciationAmt
Book Value$7,808BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$684,129TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY RECEIVABLES$4,153,627
JOINT VENTURE IN ADULT LIFE PROGRAM$95,625
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,249,252TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationSUBSTANTIALLY ALL AFFILIATES OF LSA AND LFS ARE ORGANIZED AS NORTH CAROLINA NONPROFIT ORGANIZATIONS AND ARE EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) UNDER A GROUP EXEMPTION OF THE ELCA. LFS REAL PROPERTIES, INC. IS EXEMPT UNDER IRC SECTION 501(C)(2). THE ORGANIZATIONS RECORD A LIABILITY FOR ANY TAX POSITION TAKEN THAT IS BENEFICIAL TO THE ORGANIZATIONS, INCLUDING ANY RELATED INTEREST AND PENALTIES, WHEN IT IS MORE LIKELY THAN NOT THE POSITION OF MANAGEMENT WITH RESPECT TO A TRANSACTION OR CLASS OF TRANSACTIONS WILL BE OVERTURNED BY A TAXING AUTHORITY UPON EXAMINATION. MANAGEMENT BELIEVES THERE ARE NO SUCH POSITIONS AS OF SEPTEMBER 30, 2016.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Ted Goins Jr
Chief Executive Officer/PRESIDENT$0$315,659$0$0$0$0$0$6,059$0$9,017$0$330,735$0$0
Kirby Nickerson
Chief Financial Officer$0$195,433$0$0$0$0$0$5,369$0$5,732$0$206,534$0$0
Kesha Smith
COO-SENIOR SERVICES$0$187,084$0$0$0$0$0$2,393$0$5,723$0$195,200$0$0
Elizabeth Kuhn
Chief Development Officer$0$151,692$0$0$0$0$0$4,149$0$5,641$0$161,482$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONLUTHERAN SERVICES FOR THE AGING, INC. (LSA) AND ITS AFFILIATED ORGANIZATIONS ARE MINISTRIES OF THE NORTH CAROLINA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. THE LSA MISSION STATEMENT IS, "EMPOWERED BY CHRIST, WE WALK TOGETHER WITH ALL WE SERVE." LSA OPERATES NURSING HOMES, RETIREMENT COMMUNITIES, ASSISTED LIVING RESIDENCES, AND ADULT DAY SERVICES IN ADDITION TO PROVIDING CARE MANAGEMENT, HOME CARE, AND INFORMATION AND REFERRAL SERVICES IN NORTH CAROLINA. LSA PROVIDES A MINISTRY OF CHRISTIAN CARE TO OLDER ADULTS AND ADULTS WITH DISABILITIES REGARDLESS OF FAITH, RACE, DISABILITY, OR ECONOMIC STATUS. LSA IS MADE UP OF COMPASSIONATE PEOPLE WITH LOVING SPIRITS AND GENEROUS HEARTS. RESIDENTS, STAFF, CLIENTS, PARTICIPANTS, FAMILIES, AND VOLUNTEERS ALL STRIVE TO BE OF SERVICE TO GOD AND THE COMMUNITY. MANY OF THE SENIORS SERVED BY LSA HAVE BEEN SERVICE ORIENTED AND PHILANTHROPICALLY INCLINED THROUGHOUT THEIR LIVES AND CONTINUE TO SEEK OPPORTUNITIES FOR COMMUNITY SERVICE. FOR THE YOUNG-ELDERS OF THE RETIREMENT COMMUNITIES THOSE OPPORTUNITIES ARE ABUNDANT. RESIDENTS THERE LOG IN HUNDREDS OF VOLUNTEER HOURS FOR LOCAL CHURCHES, HABITAT FOR HUMANITY, THE ALZHEIMER' S ASSOCIATION, THE STATE VETERANS HOSPITAL, FUND RAISING FOR CANCER RESEARCH, LITERACY COUNCILS, LOCAL HOSPITALS, FOOD PANTRIES, HOMELESS SHELTERS, THE UNITED WAY, AND MENTORING PROJECTS FOR LOCAL ELEMENTARY SCHOOLS. THEY HAVE PACKED BOXES FOR SAMARITAN'S PURSE, GATHERED COATS FOR KIDS AND COLLECTED CANNED GOODS FOR FOOD PANTRIES. THEY HAVE SEWN, KNITTED, CROCHETED, AND QUILTED COUNTLESS ITEMS FOR CAUSES THROUGHOUT THE STATE AND BEYOND. THE MORE FRAIL ELDERS OF THE LSA NURSING HOMES AND ADULT DAY SERVICES MAY BE LESS VISIBLE, BUT ARE EQUALLY COMMITTED TO COMMUNITY SERVICE. SUPPORTED BY STAFF AND VOLUNTEERS, THEY HAVE HELD BLOOD DRIVES, THEY HAVE HOSTED BREAKFASTS FOR FIRE, POLICE, AND EMERGENCY SERVICE PERSONNEL, COLLECTED SCHOOL SUPPLIES FOR KIDS, AND ADOPTED NEEDY FAMILIES AT CHRISTMAS. THEY, TOO, HAVE LOGGED IN HUNDREDS OF HOURS IN PRO JECTS FOR LOCAL SCHOOLS AND HOSPITALS, THE ARC, THE ALZHEIMER'S ASSOCIATION, MEALS-ON-WHEELS, THE HUMANE SOCIETY, THE AMERICAN RED CROSS, THE UNITED WAY, AND MORE. LSA ALSO SERVES ITS COMMUNITIES BY WORKING COLLABORATIVELY WITH COLLEGES AND UNIVERSITIES THROUGHOUT NORTH CAROLINA INCLUDING CATAWBA AND LIVINGSTONE COLLEGES; CATAWBA VALLEY, GASTON, ROWAN-CABARRUS, STANLY, CALDWELL AND FORSYTH COMMUNITY COLLEGES; APPALACHIAN STATE, WINSTON-SALEM STATE, LENOIR-RHYNE AND DUKE UNIVERSITIES; AND THE UNIVERSITY OF NORTH CAROLINA AND HOOD THEOLOGICAL SEMINARY. THESE COLLABORATIVE EFFORTS FOSTER GROWTH AND COOPERATION, AND ULTIMATELY IMPROVE THE QUALITY OF LIFE FOR THE INSTITUTIONS AND THE COMMUNITIES. LSA ALSO ENCOURAGES COMMUNITY MEMBERS TO SEEK VOLUNTEER, EDUCATIONAL, AND SPIRITUAL OPPORTUNITIES THROUGH ITS MINISTRIES. THE MINISTRIES OF LSA ARE ACTIVE, BUSY PLACES WHERE MULTIPLE GENERATIONS MEET IN A SPIRIT OF FUN, FELLOWSHIP AND COOPERATION. COMMUNITY EDUCATION OPPORTUNITIES ARE ALWAYS AVAILABLE ON TOPICS SUCH AS ADULT DAY CARE, ALZHEIMER' S DISEASE, MEDICAID, MEDICARE, HEALTHCARE DIRECTIVES AND MORE.
Form 990, Part VI, Section A, line 3LSA MANAGEMENT, INC. PROVIDES ADMINISTRATIVE SUPPORT, MANAGEMENT, ACCOUNTING, INFORMATION TECHNOLOGY, AND RESOURCE DEVELOPMENT SERVICES TO LUTHERAN SERVICES FOR THE AGING AND ITS AFFILIATES. SEE SCHEDULE R, PART V.
Form 990, Part VI, Section B, line 11THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER, BEFORE MADE AVAILABLE TO THE BOARD OF DIRECTORS VIA A WEBSITE PORTAL. THE BOARD OF DIRECTORS REVIEW AND COMMENT ON THE FORM 990. ANY MATTERS ARE RAISED TO THE OUTSIDE ACCOUNTANTS FOR COLLABORATION AND ULTIMATE RESOLUTION.
Form 990, Part VI, Section B, line 12cBOARD MEMBERS RECEIVE A BOARD MANUAL AS PART OF ORIENTATION WHEN THEY JOIN THE BOARD WHICH INCLUDES THE CORPORATE COMPLIANCE POLICY AND BYLAWS. BOTH THE POLICY AND THE BYLAWS ADDRESS CONFLICT OF INTEREST. THEREAFTER, ANNUALLY, THE BOARD OF DIRECTORS RECEIVE CORPORATE COMPLIANCE TRAINING AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE.
Form 990, Part VI, Section B, line 15aALL COMPENSATION LIMITS ARE COMPARED TO STATE AND NATIONAL RANGES BASED ON FACILITY SIZE AND EXPERIENCE OF STAFF. THE BOARD OF DIRECTORS APPROVE THE COMPENSATION OF THE CEO/PRESIDENT WHICH IS PAID BY THE MANAGING ORGANIZATION OF THE CONTROL GROUP. ALL COMPENSATION LIMITS ARE COMPARED TO STATE AND NATIONAL RANGES BASED ON FACILITY SIZE AND EXPERIENCE OF STAFF. THE CEO/PRESIDENT APPROVES THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. OFFICERS OF THE CONTROLLED GROUP ARE PAID BY THE MANAGING ORGANIZATION AND CERTAIN ORGANIZATIONS WITHIN THE CONTROL GROUP ALSO COMPENSATE KEY EMPLOYEES DIRECTLY.
Form 990, Part VI, Section C, line 18FORM 990 ARE POSTED ON GUIDESTAR AND AVAILABLE UPON REQUEST AT THE LSA OFFICE LOCATED IN SALISBURY, NC.
Form 990, Part VI, Section C, line 19THE ORGANIZATION ONLY MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
FORM 990, PART VI - ADDITIONAL INFORMATIONWHISTLEBLOWER POLICY LUTHERAN SERVICES FOR THE AGING, INC. & AFFILIATES ARE COMMITTED TO THEIR ROLE IN PREVENTING HEALTH CARE FRAUD AND ABUSE AND COMPLYING WITH APPLICABLE STATE AND FEDERAL LAWS RELATED TO HEALTH CARE FRAUD AND ABUSE. THE CIVIL FALSE CLAIMS ACT PROVIDES FOR PROTECTION FOR EMPLOYEES FROM RETALIATION. ANY EMPLOYEE WHO IS DISCHARGED, DEMOTED, SUSPENDED, THREATENED, HARASSED, OR DISCRIMINATED AGAINST IN TERMS AND CONDITIONS OF EMPLOYMENT BECAUSE OF LAWFUL ACTS CONDUCTED IN FURTHERANCE OF AN ACTION UNDER THE FCA MAY BRING AN ACTION IN FEDERAL DISTRICT COURT SEEKING REINSTATEMENT, TWO TIMES THE AMOUNT OF BACK PAY PLUS INTEREST, AND OTHER ENUMERATED COSTS, DAMAGES, AND FEES. DOCUMENTATION RETENTION AND DESTRUCTION POLICY EACH ENTITY WITHIN THE LUTHERAN SERVICES FOR THE AGING, INC. & AFFILIATES GROUP WILL ENSURE THAT RECORDS ARE RETAINED FOR THE REQUIRED TIME PERIODS ESTABLISHED BY STATE LAWS, FEDERAL REGULATIONS, AND PAYOR REQUIREMENTS TO MEET THE NEEDS OF LEGITIMATE USERS. AT THE END OF THE RETENTION PERIOD, EACH ENTITY WILL ENSURE THAT DESTRUCTION OF RECORDS IS PERFORMED ACCORDING TO SPECIFIC PROCEDURE AND AUTHORIZATION WITH APPROPRIATE SUPERVISION OF DESTRUCTION. THE PROPER METHOD OF DESTRUCTION FOR ANY PAPER RECORD IS BY SHREDDING OR INCINERATION ONLY. PRIOR TO THE DESTRUCTION OF ANY FACILITY RECORDS, WHETHER ORIGINAL OR COMPUTER MEDIA, A CHECK WILL BE MADE TO ENSURE THE RETENTION PERIOD HAS EXPIRED AS DEFINED BY STATE LAWS AND FACILITY POLICIES. ANY RECORDS IN OPEN INVESTIGATION, AUDIT, OR LITIGATION WILL NOT BE DESTROYED. FOR FACILITIES USING ELECTRONIC MEDICAL RECORDS, RECORDS WILL BE STORED IN THE SYSTEM INDEFINITELY AND THE DESTRUCTION PROCESS WILL NOT APPLY.
FORM 990, PART VII - ADDITIONAL INFORMATIONPART VII, SECTION A - COLUMN (B) HOURS FOR RELATED ORGANIZATIONS BOARD MEMBERS AND OFFICERS DEVOTE TIME TO ALL ENTITIES WITHIN THE CONTROL GROUP.
Form 990, Part XII, Line 2c:THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ABUNDANT LIVING ADULT DAY SERVICES
PO BOX 947SALISBURYNC28145561884652ADULT DAYNC501(c)(3)Line 9LSA INC0
LFS REAL PROPERTIES INC
PO BOX 2369SALISBURYNC28145581820383REAL ESTATENC501(c)(2)LFS0
LSA ELMS AT TANGLEWOOD INC
PO BOX 947SALISBURYNC28145263735637ASSIST LVGNC501(c)(3)Line 9LSA INC0
LSA ELMS PROPERTY INC
PO BOX 947SALISBURYNC28145263739962LEASINGNC501(c)(3)Line 9LSA INC0
LSA MANAGEMENT INC
PO BOX 947SALISBURYNC28145201457236MANAGEMENTNC501(c)(3)Line 9LSA INC0
LSA PHARMACY INC
PO BOX 947SALISBURYNC28145201457251PHARMACYNC501(c)(3)Line 9LSA INC0
LUTHERAN FAMILY SERVICES IN THE CAROLINAS
PO BOX 2369SALISBURYNC28145561286323COMM SVCNC501(c)(3)Line 11a, INC SYNOD OF ECLA0
LUTHERAN HOME - FORSYTH COUNTY INC
PO BOX 947SALISBURYNC28145263328029NURSINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME - HICKORY WEST INC
PO BOX 947SALISBURYNC28145201457410NURSINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME - ALBEMARLE INC
PO BOX 947SALISBURYNC28145201457298NURSINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME - WILMINGTON INC
PO BOX 947SALISBURYNC28145260158686NURSINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME - WINSTON-SALEM INC
PO BOX 947SALISBURYNC28145561500212NURSINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME ALBEMARLE PROPERTY INC
PO BOX 947SALISBURYNC28145201457273LEASINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME AT TRINITY OAKS PROPERTY INC
PO BOX 947SALISBURYNC28145201457796LEASINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME AT TRINITY OAKS INC
PO BOX 947SALISBURYNC28145201457824NURSINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME FORSYTH COUNTY PROPERTY INC
PO BOX 947SALISBURYNC28145461188488LEASINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME HICKORY PROPERTY INC
PO BOX 947SALISBURYNC28145201457319LEASINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME HICKORY WEST PROPERTY INC
PO BOX 947SALISBURYNC28145205304712LEASINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME WILMINGTON PROPERTY INC
PO BOX 947SALISBURYNC28145260158745LEASINGNC501(c)(3)Line 9LSA INC0
LUTHERAN HOME WINSTON-SALEM PROPERTY INC
PO BOX 947SALISBURYNC28145205304794LEASINGNC501(c)(3)Line 9LSA INC0
LUTHERAN RETIREMENT CENTER - SALISBURY
PO BOX 947SALISBURYNC28145561540214ASSIST LVGNC501(c)(3)Line 9LSA INC0
LUTHERAN RETIREMENT CENTER - WILMINGTON
PO BOX 947SALISBURYNC28145561500308INDEP. LVGNC501(c)(3)Line 9LSA INC0
LUTHERAN SERVICES FOR THE AGING FOUNDATION INC
PO BOX 947SALISBURYNC28145561681723FOUNDATIONNC501(c)(3)Line 9LSA INC0
LUTHERAN SERVICES FOR THE AGING INC
PO BOX 947SALISBURYNC28145560752160PARENT ORGNC501(c)(3)Line 9NC SYNOD OF ECLA0
LUTHERAN SERVICES PROPERTY INC
PO BOX 947SALISBURYNC28145203895886LEASINGNC501(c)(3)Line 9LSA INC0
LSA THERAPY INC
PO BOX 947SALISBURYNC28145461886488THERAPYNC501(c)(3)Line 9LSA INC0
TRINITY AT HOME INC
PO BOX 947SALISBURYNC28145464838098NURSINGNC501(c)(3)Line 9LSA INC0
MOUNTAIN RIDGE GROUP HOME INC
PO BOX 2369SALISBURYNC28145581782084GROUP HOMENC501(c)(3)Line 7LFS0
WHITTECAR HOME INC
PO BOX 2369SALISBURYNC28145581940152GROUP HOMENC501(c)(3)Line 7LFS0
LUTHERAN RETIREMENT CENTER - LUTHERIDGE
PO BOX 947SALISBURYNC28145581823983ASSIST LVGNC501(c)(3)Line 9LSA INC0
TRINITY GUARDIAN SERVICES INC
PO BOX 947SALISBURYNC28145474406015INACTIVENC501(c)(3)Line 9LSA INC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (1)AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd