2016-04-11T08:55:48-05:00 2015-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1869 CHARTER LANE STE 301 LANCASTER PA 17601 990 2015-01-01 262222476 NATIONAL LUTHERAN HOME FOR THE AGED INC NATI 3013542710 2301 RESEARCH BLVD NO 310 ROCKVILLE MD 20850 MICHAEL J BRADY CHIEF FINANCIAL OFFICER 3013542710 2016-04-10 1 KERRI N BOGDA P00760402 7173935696 2015 2016-09-27 15:27:22Z NATIONAL LUTHERAN COMMUNITIES & SERVICES LAWRENCE BRADSHAW 2301 RESEARCH BLVD NO 310 ROCKVILLE MD 20850 47177395 0 X WWW.NATIONALLUTHERAN.ORG X 2008 MD TO SERVE AS CORPORATE OVERSIGHT FOR COMMUNITIES DESIGNED FOR SENIORS. 16 15 82 2 0 0 13187 52763 4364628 5706910 7989146 4498314 0 0 12366961 10257987 221067 270043 0 0 4201196 5167520 0 0 355803 6794878 5819244 11217141 11256807 1149820 -998820 114995090 109039519 1064340 1316476 113930750 107723043 TO FULFILL ITS CHRISTIAN MINISTRY, NATIONAL LUTHERAN COMMUNITIES & SERVICES IS ORGANIZED TO PROVIDE AN ARRAY OF OPTIONS FOR SENIORS INCLUDING RESIDENTIAL LIVING AS WELL AS HOME AND COMMUNITY-BASED SERVICES WHICH ARE DESIGNED TO MEET INDIVIDUAL NEEDS. 0 0 321024 270043 5706910 TO SERVE AS CORPORATE OVERSIGHT WHICH INCLUDES, BUT IS NOT LIMITED TO, THE MARKETING, DEVELOPMENT, INFORMATION TECHNOLOGY, PHILANTHROPY, FINANCE, AND HUMAN RESOURCE SERVICES OF TWO EXPANDING CCRC COMMUNITIES AND ONE DUAL-CERTIFIED INDEPENDENT LIVING/ASSISTED LIVING FACILITY THAT PROVIDES SENIORS WITH HOUSING, MEDICAL ATTENTION, AND ANY SERVICES THAT PROMOTE GOOD EMOTIONAL AND PHYSICAL HEALTH IN A CHRISTIAN ENVIRONMENT. CURRENTLY THE ORGANIZATION IS OVERSEEING THE FUTURE DEVELOPMENT OF A CCRC COMMUNITY TO BE LOCATED IN ANNAPOLIS, MD AND A HOME CARE AGENCY IN WINCHESTER, VA. 321024 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 35 0 1 82 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X X MICHAEL J BRADY CHIEF FINANCIAL OFFICER 3013542714 2301 RESEARCH BLVD ROCKVILLE MD 20850 THE REV WILLIAM H HALL II BOARD MEMBER 1.00 1.00 X 0 0 0 THE REV MARTHA M SIMS CHAIR 1.00 1.00 X X 0 0 0 MR LAWRENCE R BRADSHAW PRESIDENT/CEO 10.00 30.00 X X 328948 0 29193 MR DALE SUMMERS BOARD MEMBER 1.00 X 0 0 0 MR SHAWN M BLOOM BOARD MEMBER 1.00 X 0 0 0 THE REV WOLLOM JENSEN BOARD MEMBER 1.00 X 0 0 0 THE REV RONALD SCHLAK BOARD MEMBER 1.00 X 0 0 0 DR TOMMIE ROBINSON JR VICE CHAIR 1.00 X X 0 0 0 THE REV JOSEPH LETTRICH BOARD MEMBER 1.00 X 0 0 0 THE REV SCOTT ICKERT SECRETARY 1.00 1.00 X X 0 0 0 MS ELIZABETH FLURY BOARD MEMBER 1.00 X 0 0 0 MS DONNA DUSS BOARD MEMBER 1.00 X 0 0 0 BARBARA WALKER CPA TREASURER 1.00 X X 0 0 0 REV DEBBIE DUKES BOARD MEMBER 1.00 X 0 0 0 MICHAEL RODGERS BOARD MEMBER 1.00 X 0 0 0 REV JOHN WERTZ JR BOARD MEMBER 1.00 1.00 X 0 0 0 MR MICHAEL BRADY ASSISTANT TREASURER/CFO 10.00 30.00 X 177089 0 38652 DANIEL C LOOK CHIEF STRATEGY OFFICER 40.00 X 213028 0 33730 MS KATHRYN E BAERWALD CHIEF PHILANTHROPY OFFICER 40.00 X 155971 0 38488 MR CAMILLE ROUSSEL CHIEF QUALITY & PERFORMANCE OFFICER 40.00 X 147488 0 34752 MS KATHLEEN O'HALLORAN CHIEF TALENT & CULTURE OFFICER 40.00 X 131623 0 14939 MELODY SCHNEIDER CHIEF MARKETING OFFICER 40.00 X 128848 0 6785 JAE SHIN DIR., INFORMATION TECHONOLOGY 40.00 X 137500 0 12710 1420495 0 209249 15 0 1 0 ASPIRE CONSULTING PARTNERS 12890 BLALOCK DR FISHERS IN 46037 CONSULTING SERVICES 642134 NORTEC 7531 LEESBURG PIKE FALLS CHURCH VA 22043 COMMUNICATION SERVICES 420643 ADP INC PO BOX 842875 BOSTON MA 022842875 PAYROLL SERVICES 344965 3 52763 52763 MANAGEMENT FEE INCOME 623000 4877881 4877881 OTHER INCOME 623000 440780 440780 RESIDENT SERVICE REVENUE 623000 388249 388249 5706910 2691494 2691494 38726228 36919408 1806820 1806820 1806820 10257987 5706910 0 4498314 X 270043 270043 820642 820642 3554229 46749 3367032 140448 117982 1433 97705 18844 389114 1345 347618 40151 285553 1454 274871 9228 97378 97378 88750 88750 542293 542293 1974940 1954172 20768 319865 277527 42338 434751 404808 29943 665724 643241 22483 266649 266649 140525 127576 12949 20505 20505 221157 221157 302072 302072 LICENSES, DUES, AND SUB 668263 649745 18518 WELLNESS PROGRAM 49775 49775 RECRUITING EXPENSES 26464 26464 CREDIT CARD FEES 133 133 11256807 321024 10579980 355803 500 500 17713 311996 58328 113843 32783 49604 413407 556607 19889716 1329269 16725471 18560447 90587833 72333401 7159055 17113121 114995090 109039519 1064340 1316476 1064340 1316476 X 113930750 107723043 113930750 107723043 114995090 109039519 -998820 -5208887 0 X 0 1 X 1 0 X X 5 THE VILLAGE AT ORCHARD RIDGE INC 263445374 9 0 0 0 NATL LUTH HOME & VILLAGE AT ROCKVILLE 530196624 9 0 0 0 THE LEGACY AT NORTH AUGUSTA 452857307 9 0 0 0 THE VILLAGE AT CRYSTAL SPRING INC 454024593 9 0 0 0 NATIONAL LUTHERAN INC 472584315 7 1 0 0 5 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE A, PART IV, SECTION A, LINE 1: THE BY-LAWS FOR NATIONAL LUTHERAN HOME FOR THE AGED, INC. (NLHA) DO NOT MENTION ITS SUBSIDIARIES BY NAME; HOWEVER, EACH SUBSIDIARY MENTIONS NLHA AS THE SOLE MEMBER OF ITS ORGANIZATION. THE DAY-TO-DAY OPERATIONS OF THE CONSOLIDATED GROUP CLEARLY INDICATES THAT NLHA IS THE SUPPORTING ORGANIZATION FOR THE ENTITIES LISTED ON PART I, LINE 11G (I). NOTE THAT A NEW ENTITY HAS BEEN CREATED, NATIONAL LUTHERAN, INC., WHICH, PER NLHA'S NEWLY AMENDED BYLAWS, HAS THE POWER TO ELECT NLHA'S BOARD OF TRUSTEES. SCHEDULE A, PART IV, SECTION A, LINE 2: A NEWLY CREATED ORGANIZATION, NATIONAL LUTHERAN, INC., HAS FILED A FORM 1023 TO OBTAIN A TAX DETERMINATION LETTER CERTIFYING IT WILL BE CONSIDERED TAX-EXEMPT. 8357151 8357151 1555831 1329269 226562 9976734 9976734 18560447 DUE FROM AFFILIATES 16609025 DEFERRED MARKETING COSTS 504096 17113121 X 4506807 -5208887 -542293 -5751180 10257987 0 10257987 10714514 0 10714514 542293 542293 11256807 PART X, LINE 2: THE ORGANIZATION FOLLOWS THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARD FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE STANDARD ALSO PROVIDES GUIDANCE ON DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THIS STANDARD DOES NOT HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS. NLCS, TVAR, TVOR AND TLNA'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2014, 2013, AND 2012 REMAIN SUBJECT TO EXAMINATION BY THE IRS. TVCS OBTAINED ITS TAX-EXEMPT STATUS DURING JUNE 2014, EFFECTIVE OCTOBER 8, 2010, AND ITS FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN FOR THE YEAR ENDED DECEMBER 31, 2014 REMAINS SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSES -542,293. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT EXPENSES 542,293. 1 CATHOLIC CHARITIES OF THE ARCHDIOCESE OF WASHINGTON 924 G STREET NW WASHINGTON DC 20001 530196524 501 (C)(3) 15000 SUPPORT FOOD INSECURITY AMONG OLDER ADULTS COLONIAL HERITAGE COMMUNITY FOUNDATION PO BOX 12 WILLIAMSBURG VA 23127 270883584 501 (C)(3) 17500 SUPPORT OF THE INNOVATIVE SENIOR CHAMPION PROGRAM COMMUNITY MINISTRIES OF ROCKVILLE 1010 GRANDIN AVENUE SUITE A1 ROCKVILLE MD 20851 520910334 501 (C)(3) 10000 HOME REPAIRS FOR LOW-INCOME SENIORS CROSSROADS COMMUNITY FOOD NETWORK INC 6930 CARROLL AVE SUITE 426 TAKOMA PARK MD 20912 364635237 501 (C)(3) 7000 PROVIDE FOOD TO LOW-INCOME SENIORS DIAKON CHILD FAMILY AND COMMUNITY MINISTRIES 1018 N UNION STREET MIDDLETOWN PA 17057 465390969 501 (C)(3) 10000 SUPPORT ADULT DAY SERVICE PROGRAMS FAMILY SERVICES INC 610 E DIAMOND AVE SUITE 100 GAITHERSBURG MD 20877 520730225 501 (C)(3) 15000 SUPPORT ADULT DAY SERVICE PROGRAMS GRACEINSIDE 2828 EMERYWOOD PARKWAY RICHMOND VA 23294 540542300 501 (C)(3) 15000 ENHANCE CHAPLAINCY SERVICES FOR PROJECT ELDER CARE JEWISH COUNCIL FOR THE AGING OF GREATER WASHINGTON 12320 PARKLAWN DRIVE ROCKVILLE MD 20852 520983740 501 (C)(3) 15000 SUPPORT ART AND MOVEMENT THERAPY AND CAREGIVER SUPPORT PROGRAMS LUTHERAN COMMUNITY SERVICES INC 2809 BAYNARD BLVD WILMINGTON DE 19802 510102403 501 (C)(3) 15000 HOME REPAIRS FOR LOW-INCOME SENIORS MENTAL HEALTH AMERICA OF FREDERICKSBURG 2217 PRINCESS ANNE 104-1 FREDERICKSBURG VA 22401 540678704 501 (C)(3) 10000 SUPPORT FRIENDLY VISITOR PROGRAM MENTAL HEALTH ASSOCIATION OF MONTGOMERY COUNTY 1000 TWINBROOK PARKWAY ROCKVILLE MD 20851 520681147 501 (C)(3) 7500 SUPPORT FRIENDLY VISITOR PROGRAM OUR SAVIOUR LUTHERAN CHURCH 6194 DUMFRIES RD WARRENTON VA 20187 541130475 501 (C)(3) 10000 SUPPORT PROGRAMS FOR SENIORS SHENANDOAH AREA AGENCY ON AGING 207 MOSBY LANE FRONT ROYAL VA 22630 541008875 501 (C)(3) 8000 SUPPORT CHRONIC DISEASE MANAGEMENT WORKSHOPS SHENANDOAH VALLEY LUTHERAN MINISTRIES BOX 132 TOMS BROOK VA 22660 271675977 501 (C)(3) 20000 SUPPORT FAITH COMMUNITY NURSING PROGRAM SHEPHERD'S CENTER OF FAIRFAX-BURKE 4019 OLLEY LANE FAIRFAX VA 22032 364597392 501 (C)(3) 10000 SUPPORT TRANSPORTATION PROGRAM FOR LOW-INCOME SENIORS ST PAUL'S LUTHERAN CHURCH 4900 CONNECTICUT AVE NW WASHINGTON DC 20008 530196496 501 (C)(3) 10000 SUPPORT SENIOR CENTER UPPER MONTGOMERY ASSISTANCE NETWORK 640 C EAST DIAMOND AVE GAITHERSBURG MD 20877 521648943 501 (C)(3) 7500 SUPPORT EMERGENCY ASSISTANCE PROGRAMS FOR SENIORS 17 PART I, LINE 2: THE ORGANIZATION SUPPORTS OTHER NON-PROFITS WITH SIMILAR MISSIONS. ALL APPLICATIONS ARE REVIEWED AND APPROVED BY THE COMMUNITY IMPACT ADVISORY COMMITTEE AND ARE REPORTED TO AND THEN APPROVED BY THE BOARD. DONEES ARE EXPECTED TO SUPPLY DOCUMENTATION TO SUBSTANTIATE THAT GRANTS HAVE BEEN USED FOR THEIR INTENDED PURPOSES. X X X X X 0 0 0 0 0 0 0 1 0 MR LAWRENCE R BRADSHAW PRESIDENT/CEO 328769 0 0 0 179 0 18625 0 10568 0 358141 0 0 0 MR MICHAEL BRADY ASSISTANT TREASURER/CFO 177068 0 0 0 21 0 8688 0 29964 0 215741 0 0 0 DANIEL C LOOK CHIEF STRATEGY OFFICER 212810 0 0 0 218 0 11849 0 21881 0 246758 0 0 0 MS KATHRYN E BAERWALD CHIEF PHILANTHROPY OFFICER 155813 0 0 0 158 0 9948 0 28540 0 194459 0 0 0 MR CAMILLE ROUSSEL CHIEF QUALITY & PERFORMANCE OFFICER 147477 0 0 0 11 0 9124 0 25628 0 182240 0 0 0 JAE SHIN DIR., INFORMATION TECHONOLOGY 137500 0 0 0 0 0 750 0 11960 0 150210 0 0 0 PART I, LINE 7 BONUSES ARE DETERMINED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND ARE BASED ON A VARIETY OF FACTORS SUCH AS WHETHER CAMPUS BUDGETS ARE MET, HOW EACH CAMPUS DOES ON ITS RESPECTIVE NURSING/HEALTH CARE SURVEY AND HOW EACH SENIOR LEADER DOES IN OBTAINING HIS OR HER GOALS FOR THE YEAR. MARTHA SIMS CHAIR MARTHA SIMS' HUSBAND IS AN EMPLOYEE OF THE VILLAGE AT ORCHARD RIDGWE 94933 MARTHA SIMS' HUSBAND IS AN EMPLOYEE OF THE VILLAGE AT ORCHARD RIDGE, A RELATED ENTITY. MARTHA SIMS DOES NOT OVERSEE HER HUSBAND NOR IS SHE INVOLVED IN ANY COMPENSATION OR OTHER HUMAN RESOURCE-RELATED DECISIONS RELATED TO HER HUSBAND. 0 FORM 990, PART VI, SECTION A, LINE 4 NATIONAL LUTHERAN HOME FOR THE AGED, INC.'S BYLAWS WERE CHANGED TO REFLECT THE ESTABLISHMENT OF NATIONAL LUTHERAN, INC., A NEW PARENT ORGANIZATION TO WHICH THE OPERATIONS OF NATIONAL LUTHERAN HOME FOR THE AGED, INC. WILL BE TRANSFERRED. FORM 990, PART VI, SECTION A, LINE 6 NATIONAL LUTHERAN INC. IS THE SOLE MEMBER OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A NATIONAL LUTHERAN, INC., THE SOLE MEMBER OF NATIONAL LUTHERAN HOME FOR THE AGED, INC., HAS THE RIGHT TO VOTE AND ELECT MEMBERS OF THE FILING ORGANIZATION'S BOARD OF TRUSTEES. THE MEMBER ALSO RESERVES THE RIGHT TO REMOVE ANY TRUSTEE WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION B, LINE 11 THE CFO AND PRESIDENT PERFORM AN INITIAL REVIEW OF THE FORM 990. UPON APPROVAL, THE FORM 990 IS MADE AVAILABLE TO EACH BOARD MEMBER FOR REVIEW AND APPROVAL AT A BOARD MEETING PRIOR TO TRANSMISSION OF THE RETURN TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT EACH YEAR. IF A CONFLICT IS IDENTIFIED, IT IS 1) IDENTIFIED AND DISCUSSED WITH THE BOARD AND 2) REVIEWED AND DOCUMENTED BY MANAGEMENT. IF AN ACTUAL OR POTENTIAL CONFLICT IS IDENTIFIED, THE BOARD MEMBER, OFFICER, OR EMPLOYEE WILL RECUSE HIM OR HERSELF FROM ANY CONVERSATIONS, DECISIONS, OR OTHER ACTIVITIES AND DISCUSSIONS INVOLVING THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE CONFLICT OF INTEREST POLICY AS POTENTIAL SOURCES OF CONFLICTS WITH INTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD DETERMINES THE COMPENSATION FOR THE CEO THROUGH THE COMBINED USE OF SEVERAL METHODS. THE EXECUTIVE COMMITTEE SERVES AS A COMPENSATION COMMITTEE WHICH OVERSEES THE PROCESS. COMPENSATION SURVEYS ARE PERFORMED BY AN OUTSIDE HR CONSULTING FIRM, PRM, USING LOCAL MARKET DATA. THE CEO, EXECUTIVE DIRECTOR, AND DIRECTOR OF HUMAN RESOURCES USE SALARY SURVEYS TO DETERMINE THE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES TO ENSURE THEY ARE WITHIN THE LOCAL MARKET RANGE. THE SERVICES THE INDIVIDUAL PROVIDES TO THE ORGANIZATION AND THE TENURE OF THE OFFICER ARE ALSO FACTORS CONSIDERED IN SALARY DETERMINATIONS. ONCE THE EXECUTIVE COMMITTEE GIVES ITS APPROVAL, ITS DECISIONS ARE NOTED AT THE BOARD LEVEL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUEMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND AT NO COST. THE DOCUMENTS WILL ALSO BE MADE AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,930,510. FUNDRAISING EXPENSES 20,768. TOTAL EXPENSES 1,951,278. MAINTENANCE AND EQUIPMENT CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 23,662. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,662. THE VILLAGE AT ORCHARD RIDGE INC 400 CLOCKTOWER RIDGE DRIVE WINCHESTER VA 22603 263445374 CONTINUING CARE RETIREMENT COMMUNITY VA 501(C)(3) 9 NATIONAL LUTHERAN HOME FOR THE AGED INC 1 THE VILLAGE AT ROCKVILLE INC 9701 VEIRS DRIVE ROCKVILLE MD 20850 530196624 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) 9 NATIONAL LUTHERAN HOME FOR THE AGED INC 1 THE LEGACY AT NORTH AUGUSTA INC 1410 A NORTH AUGUSTA STREET STAUNTON VA 24401 452857307 CONTINUING CARE RETIREMENT COMMUNITY VA 501(C)(3) 9 NATIONAL LUTHERAN HOME FOR THE AGED INC 1 THE VILLAGE AT CRYSTAL SPRING INC 2301 RESEARCH BLVD ROCKVILLE MD 20850 454024593 CONTINUING CARE RETIREMENT COMMUNITY IN DEVELOPMENT STAGES MD 501(C)(3) 9 NATIONAL LUTHERAN HOME FOR THE AGED INC 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 THE VILLAGE AT ROCKVILLE D 6268512 COST THE LEGACY AT NORTH AUGUSTA INC D 4495237 COST THE VILLAGE AT ORCHARD RIDGE D 5845275 COST THE LEGACY AT NORTH AUGUSTA INC L 543910 COST THE VILLAGE OF ORCHARD RIDGE L 1135910 COST THE VILLAGE AT ROCKVILLE L 2658106 COST THE VILLAGE AT ROCKVILLE O 107603 COST THE VILLAGE OF ORCHARD RIDGE O 107603 COST THE LEGACY AT NORTH AUGUSTA INC O 107603 COST