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LUTHERAN HOME-HICKORY INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
LUTHERAN HOME-HICKORY INC (EIN 20-1457341)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-02-13
IRS object ID
201520449349302147
Schema version
2013v4.0
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)
Return2015-02-13T15:48:56-06:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN561743537PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LANGDON & COMPANY LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1223 US HIGHWAY 70 EAST SUITE 100AddressLine1
CityGARNERCity
StateNCState
ZIP Code275294051ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201457341EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN HOME - HICKORY INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlLUTHBusinessNameControlTxt
Phone7046372870PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 947AddressLine1
CitySALISBURYCity
StateNCState
ZIP Code281450947ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKIRBY NICKERSONPersonNm
Person TitleTREASURERPersonTitleTxt
Phone7046372870PhoneNum
Signature2015-02-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANTHONY T PANDISCIAPreparerPersonNm
PTINP00187421PTIN
Phone9196621001PhoneNum
Preparation2015-02-13PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTED GOINSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 947AddressLine1
CitySALISBURYCity
StateNCState
ZIP Code281450947ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$12,863,854GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LSCAROLINAS.NETWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionLUTHERAN HOME - HICKORY, INC. PROVIDES LONG-TERM AND SHORT-TERM SKILLED NURSING, ASSISTED LIVING, SPECIAL CARE FOR PEOPLE WITH DEMENTIA, AND REHABILITATION SERVICES TO FRAIL OLDER ADULTS AND OTHERS IN A RESIDENTIAL SETTING IN SUPPORT OF THE LUTHERAN SERVICES FOR THE AGING, INC. (LSA). ITS MISSION STATEMENT IS "EMPOWERED BY CHRIST, WE WALK TOGETHER WITH ALL WE SERVE". MANY OF THE THOSE SERVED BY LSA HAVE BEEN SERVICE ORIENTED AND PHILANTHROPICALLY INCLINED THROUGHOUT THEIR LIVES AND CONTINUE TO SEEK OPPORTUNITIES FOR COMMUNITY SERVICE IN THEIR OLDER YEARS. 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, FUNDRAISING 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 SAMActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee335TotalEmployeeCnt
Total Volunteers107TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$74,694PYContributionsGrantsAmt
CY Contributions Grants$53,398CYContributionsGrantsAmt
PY Program Service Revenue$13,268,504PYProgramServiceRevenueAmt
CY Program Service Revenue$12,704,941CYProgramServiceRevenueAmt
PY Investment Income$20,841PYInvestmentIncomeAmt
CY Investment Income$45,650CYInvestmentIncomeAmt
PY Other Revenue$16,659PYOtherRevenueAmt
CY Other Revenue$59,865CYOtherRevenueAmt
PY Total Revenue$13,380,698PYTotalRevenueAmt
CY Total Revenue$12,863,854CYTotalRevenueAmt
PY Grants And Similar Paid$18,547PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$16,164CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,247,346PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,384,754CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,421,362PYOtherExpensesAmt
CY Other Expenses$5,096,934CYOtherExpensesAmt
PY Total Expenses$12,687,255PYTotalExpensesAmt
CY Total Expenses$12,497,852CYTotalExpensesAmt
PY Revenues Less Expenses$693,443PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$366,002CYRevenuesLessExpensesAmt
Total Assets BOY$7,933,170TotalAssetsBOYAmt
Total Assets EOY$8,258,867TotalAssetsEOYAmt
Total Liabilities BOY$1,135,583TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,101,754TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,797,587NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,157,113NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionLUTHERAN HOME - HICKORY, INC. PROVIDES LONG-TERM AND SHORT-TERM SKILLED NURSING, ASSISTED LIVING, SPECIAL CARE FOR PEOPLE WITH DEMENTIA, AND REHABILITATION SERVICES TO FRAIL OLDER ADULTS AND OTHERS IN A RESIDENTIAL SETTING IN SUPPORT OF THE LUTHERAN SERVICES FOR THE AGING, INC. (LSA). ITS MISSION STATEMENT IS "EMPOWERED BY CHRIST, WE WALK TOGETHER WITH ALL WE SERVE". MANY OF THE THOSE SERVED BY LSA HAVE BEEN SERVICE ORIENTED AND PHILANTHROPICALLY INCLINED THROUGHOUT THEIR LIVES AND CONTINUE TO SEEK OPPORTUNITIES FOR COMMUNITY SERVICE IN THEIR OLDER YEARS. 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, FUNDRAISING 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 SAMMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$12,050,300ExpenseAmt
Grant$16,164GrantAmt
Revenue$12,704,941RevenueAmt
DescLUTHERAN HOME - HICKORY, INC. OFFERS SHORT-TERM REHABILITATION, LONG-TERM CARE, AND ASSISTED LIVING SERVICES TO PEOPLE OF ALL FAITHS AND ECONOMIC STATUS. THE ORGANIZATION ALSO PROVIDES SKILLED NURSING AND ASSISTED LIVING CARE FOR THE OFTEN DIFFICULT-TO-PLACE ALZHEIMER'S RESIDENTS. LUTHERAN 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. CHAPLAINS ARE AVAILABLE TO OFFER SUPPORT AND GUIDANCE TO FAMILIES AND RESIDENTS DURING ADMISSION AND THROUGHOUT THEIR STAY. DURING THE YEAR ENDED SEPTEMBER 30, 2014, LUTHERAN HOME - HICKORY, INC. PROVIDED 60,716 DAYS OF CARE TO 534 RESIDENTS.Desc
Total Program Service Expenses$12,050,300TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document27IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee335EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSUSAN MILLERPersonNm
Phone7046372870PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11416 S MARTIN LUTHER KING JR AVEAddressLine1
CitySALISBURYCity
StateNCState
ZIP Code28144ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
TED GOINS JR
PRESIDENT40.001.00Yes (X)Yes (X)$0$274,066$5,496
REV PAMELA COOK
DIRECTOR1.001.00Yes (X)$0$0$0
ERIC HOYLE
DIRECTOR1.001.00Yes (X)$0$0$0
JERRY BRAMLEY
DIRECTOR1.001.00Yes (X)$0$0$0
DONALD BUMGARNER
DIRECTOR1.001.00Yes (X)$0$0$0
JIM HUDDLE
DIRECTOR1.001.00Yes (X)$0$0$0
REV JEFFREY SHEALY
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
LORETTA MEYERS
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
STEPHEN STANFIELD-SWITZER
DIRECTOR1.001.00Yes (X)$0$0$0
KATRINA WEIRICK
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
KIRBY NICKERSON
TREASURER/CF40.001.00Yes (X)$0$170,532$4,920
KESHA SMITH
CHIEF OPER.40.001.00Yes (X)$0$157,313$5,496
ELIZABETH KUHN
DIRECTOR R&D40.001.00Yes (X)$0$132,699$7,723
MYRA GRIFFIE
CHIEF OPER.40.001.00Yes (X)$0$120,320$5,496
KAREN MADDRY
SECRETARY40.001.00Yes (X)$0$59,139$6,351
MARCHETA CAMPBELL
ADMINISTRATO40.00Yes (X)$57,856$0$3,122
AMBER MCINTOSH
ADMINISTRATO40.00$45,090$0$1,585Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$102,946TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$914,069TotReportableCompRltdOrgAmt
Total Other Compensation$40,189TotalOtherCompensationAmt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TRINITY REHAB LLCBusinessNameLine1

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11416 S MARTIN LUTHER KING JR AVEAddressLine1
CitySALISBURYCity
StateNCState
ZIP Code28144ZIPCode
FieldValueIRS element (for citing)
ServicesTHERAPY SRVCSServicesDesc
Compensation$1,085,744CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$16,164RelatedOrganizationsAmt
All Other Contributions$37,234AllOtherContributionsAmt
Noncash Contributions$12,621NoncashContributionsAmt
Total Contributions$53,398TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSERVICE FEE REVENUESDesc
Total Revenue Column$12,704,941TotalRevenueColumnAmt
Related Or Exempt Func Income$12,704,941RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$12,704,941TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$45,650TotalRevenueColumnAmt
Exclusion$45,650ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Total Revenue Column$59,865TotalRevenueColumnAmt
Related Or Exempt Func Income$59,865RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$59,865OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,863,854TotalRevenueColumnAmt
Related Or Exempt Func Income$12,764,806RelatedOrExemptFuncIncomeAmt
Exclusion$45,650ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$16,164TotalAmt
Program Services$16,164ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$91,988TotalAmt
Program Services$88,208ProgramServicesAmt
Management And General$3,780ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,044,959TotalAmt
Program Services$5,782,057ProgramServicesAmt
Management And General$262,902ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$774,028TotalAmt
Program Services$774,028ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$473,779TotalAmt
Program Services$473,779ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$510,592TotalAmt
Program Services$510,592ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,073TotalAmt
Management And General$2,073ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$22,120TotalAmt
Management And General$22,120ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,445TotalAmt
Program Services$101ProgramServicesAmt
Management And General$8,344ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$18,691TotalAmt
Program Services$1,000ProgramServicesAmt
Management And General$17,691ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$600,000TotalAmt
Program Services$600,000ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$15,936TotalAmt
Program Services$13,264ProgramServicesAmt
Management And General$2,672ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,619TotalAmt
Program Services$6,232ProgramServicesAmt
Management And General$387ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$8,025TotalAmt
Program Services$8,025ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$173,239TotalAmt
Program Services$173,239ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$72,917TotalAmt
Program Services$6,869ProgramServicesAmt
Management And General$66,048ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
ANCILLARY EXPENSES$1,224,277$1,224,277
PHARMACY DRUGS$732,754$732,754
FOOD$499,771$499,771
BED ASSESSMENT$331,918$331,918

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$869,557TotalAmt
Program Services$808,022ProgramServicesAmt
Management And General$61,535ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,497,852TotalAmt
Program Services$12,050,300ProgramServicesAmt
Management And General$447,552ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,716,115BOYAmt
EOY$690,484EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,162,316BOYAmt
EOY$1,120,142EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$36,930BOYAmt
EOY$38,367EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$140BOYAmt
EOY$140EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,626,390LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,968,265LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$696,855BOYAmt
EOY$658,125EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$543,523BOYAmt
EOY$1,587,418EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,777,291BOYAmt
EOY$4,164,191EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,933,170BOYAmt
EOY$8,258,867EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$928,498BOYAmt
EOY$828,393EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$207,085BOYAmt
EOY$273,361EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,135,583BOYAmt
EOY$1,101,754EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,782,882BOYAmt
EOY$7,135,431EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,705BOYAmt
EOY$21,682EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,797,587BOYAmt
EOY$7,157,113EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,933,170BOYAmt
EOY$8,258,867EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$366,002ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$6,476NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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$87,078CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$57,604CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,015CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$74,694CurrentTaxYearMinus1YearAmt
Current Tax Year$53,398CurrentTaxYearAmt
Total$320,789TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,733,044CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,872,788CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,578,742CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,285,163CurrentTaxYearMinus1YearAmt
Current Tax Year$12,764,806CurrentTaxYearAmt
Total$64,234,543TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,820,122CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,930,392CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,626,757CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,359,857CurrentTaxYearMinus1YearAmt
Current Tax Year$12,818,204CurrentTaxYearAmt
Total$64,555,332TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$64,555,332PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,618CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,633CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,543CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,796CurrentTaxYearMinus1YearAmt
Current Tax Year$45,650CurrentTaxYearAmt
Total$110,240TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,618CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,633CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,543CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,796CurrentTaxYearMinus1YearAmt
Current Tax Year$45,650CurrentTaxYearAmt
Total$110,240TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,840,740CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,949,025CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,632,300CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,379,653CurrentTaxYearMinus1YearAmt
Current Tax Year$12,863,854CurrentTaxYearAmt
Total$64,665,572TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99830PublicSupportCY509Pct
Public Support PY5090.99870PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
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$542,822BeginningYearBalanceAmt
Contributions$5,686ContributionsAmt
Investment Earnings Or Losses$30,803InvestmentEarningsOrLossesAmt
End Year Balance$579,311EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$152,624BeginningYearBalanceAmt
Investment Earnings Or Losses$351,435InvestmentEarningsOrLossesAmt
End Year Balance$504,059EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$51,624BeginningYearBalanceAmt
Contributions$101,000ContributionsAmt
End Year Balance$152,624EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$51,624BeginningYearBalanceAmt
End Year Balance$51,624EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,864OtherCostOrOtherBasisAmt
Depreciation$7,824DepreciationAmt
Book Value$11,040BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,431,497OtherCostOrOtherBasisAmt
Depreciation$1,793,745DepreciationAmt
Book Value$637,752BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$176,029OtherCostOrOtherBasisAmt
Depreciation$166,696DepreciationAmt
Book Value$9,333BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$658,125TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY$4,023,727
OTHER ASSETS$138,125
CIP$2,339
DUE FROM AFFILIATE
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,164,191TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$12,857,378TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$6,476NetUnrealizedGainsInvstAmt
Revenue Not Reported-$6,476RevenueNotReportedAmt
Revenue Subtotal$12,863,854RevenueSubtotalAmt
Total Revenue Per Form990$12,863,854TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,497,852TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$12,497,852ExpensesSubtotalAmt
Total Expenses Per Form990$12,497,852TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART V, LINE 4THE ORGANIZATION'S ENDOWMENT CONSISTS OF DONOR-RESTRICTED INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. INCOME FROM THE ENDOWMENTS ARE USED BUT NOT LIMITED TO FUTURE EXPANSION, EQUIPMENT PURCHASES AND FUTURE PROGRAM SERVICE NEEDS.
SCHEDULE D, PAGE 3, PART XSUBSTANTIALLY ALL AFFILIATES OF LSA AND LFS ARE ORGANIZED AS NORTH CAROLINA NOT-FOR-PROFIT 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, 2014 OR 2013. TAX YEARS SUBSEQUENT TO 2009 REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS.
SCHEDULE D, PAGE 4, PART XIIIPART V - ENDOWMENT FUNDS AMOUNTS REPORTED AS THE CURRENT YEAR END OF YEAR BALANCE AMONG THE CONTROL GROUP ACCURATELY TIE BACK TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDesc
RHYNE SCHOLARSHIP3$15,000FMV
HOLLAR SCHOLARSHIP1$1,164FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION MAINTAINS CONTACT RECORDS ON RESIDENT GRANT RECIPIENTS AS WELL AS CONSISTENTLY FOLLOWS UP WITH INDIVIDUALS TO ENSURE THEY ARE MEETING THE ORGANIZATION'S REQUIREMENTS AND REMAIN ELIGIBLE FOR THE GRANT. PART III, LINE 1 - ADDITIONAL INFORMATION ALTHOUGH REPORTED IN AGGREGATE FOR PURPOSES OF TRANSPARENCY, NO SINGLE GRANT MADE IN THE CURRENT YEAR WAS VALUED AT AN AMOUNT GREATER THAN 5,000.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
TED GOINS JR
PRESIDENT$274,066$5,496$279,562
KIRBY NICKERSON
TREASURER/CFO$170,532$4,920$175,452
KESHA SMITH
CHIEF OPER. OFFICER$157,313$5,496$162,809
AMBER MCINTOSH
ADMINISTRATOR$45,090$355$1,230$46,675

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONLUTHERAN HOME - HICKORY, INC. PROVIDES LONG-TERM AND SHORT-TERM SKILLED NURSING, ASSISTED LIVING, SPECIAL CARE FOR PEOPLE WITH DEMENTIA, AND REHABILITATION SERVICES TO FRAIL OLDER ADULTS AND OTHERS IN A RESIDENTIAL SETTING IN SUPPORT OF THE LUTHERAN SERVICES FOR THE AGING, INC. (LSA). ITS MISSION STATEMENT IS "EMPOWERED BY CHRIST, WE WALK TOGETHER WITH ALL WE SERVE". MANY OF THE THOSE SERVED BY LSA HAVE BEEN SERVICE ORIENTED AND PHILANTHROPICALLY INCLINED THROUGHOUT THEIR LIVES AND CONTINUE TO SEEK OPPORTUNITIES FOR COMMUNITY SERVICE IN THEIR OLDER YEARS. 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, FUNDRAISING 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 LUTHERAN 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, BAKE SALES, AND CRAFT SALES. THEY HAVE HOSTED BREAKFASTS FOR FIRE, POLICE, AND EMERGENCY SERVICE PERSONNEL, COLLECTED SCHOOL SUPPLIES FOR KIDS, AND ADOPTED NEEDY FAMILIES AT CHRISTMAS. THEY HAVE LOGGED IN HUNDREDS OF HOURS IN PROJECTS FOR LOCAL SCHOOLS AND HOSPITALS, THE ARC, THE ALZHEIMER'S ASSOCIATION, MADD (MOTHERS AGAINST DRUNK DRIVING), MEAL-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, LIVINGSTONE, AND LENOIR-RHYNE COLLEGES; CATAWBA VALLEY, GASTON, ROWAN-CABARRUS, STANLY, CALDWELL AND FORSYTH COMMUNITY COLLEGES; APPALACHIAN STATE, WINSTON-SALEM STATE, AND DUKE UNIVERSITIES; THE UNIVERSITY OF NORTH CAROLINA, AND HOOD THEOLOGICAL SEMINARY. THESE COLLABORATIVE EFFORTS ENHANCE COOPERATION, 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. RESOURCES ARE AVAILABLE TO THE COMMUNITY ADDRESSING A BROAD RANGE OF AGING ISSUES SUCH AS HEALTHY AGING, NURSING HOME CARE, ADULT DAY CARE, ALZHEIMER'S DISEASE, MEDICAID AND MEDICARE, AND HEALTHCARE DIRECTIVES.
FORM 990, PAGE 2, PART III, LINE 4AOF EACH INDIVIDUAL. CHAPLAINS ARE AVAILABLE TO OFFER SUPPORT AND GUIDANCE TO FAMILIES AND RESIDENTS DURING ADMISSION AND THROUGHOUT THEIR STAY. DURING THE YEAR ENDED SEPTEMBER 30, 2014, LUTHERAN HOME - HICKORY, INC. PROVIDED 60,716 DAYS OF CARE TO 534 RESIDENTS.
FORM 990, PART VIWHISTLEBLOWER 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, PAGE 6, PART VI, 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, PAGE 6, PART VI, LINE 11BTHE FORM 990 IS REVIEWED BY THE CHIEF FINANCE OFFICER AND MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR REVIEW AND COMMENT. ANY MATTERS ARE RAISED TO THE OUTSIDE ACCOUNTANTS FOR COLLABORATION AND ULTIMATE RESOLUTION.
FORM 990, PAGE 6, PART VI, 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, PAGE 6, PART VI, 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 PRESIDENT WHICH IS PAID BY THE MANAGING ORGANIZATION OF THE CONTROL GROUP.
FORM 990, PAGE 6, PART VI, LINE 15BALL COMPENSATION LIMITS ARE COMPARED TO STATE AND NATIONAL RANGES BASED ON FACILITY SIZE AND EXPERIENCE OF STAFF. THE 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, PAGE 6, PART VI, LINE 19FORMS 990 ARE POSTED ON GUIDESTAR AND AVAILABLE UPON REQUEST AT THE LSA OFFICE LOCATED IN SALISBURY, NC.
FORM 990, PART VIIAMBER MCINTOSH SERVED AS ADMINISTRATOR UNTIL MARCH 2013 AND HER 2013 W-2 INCOME IS PROPERLY REPORTED ON PART VII. AMBER MCINTOSH DID NOT RECEIVE ANY FISCAL YEAR COMPENSATION. MARCHETA CAMPBELL TOOK THE POSITION OF ADMINISTRATOR IN MARCH 2013. PART VII, SECTION A - COLUMN (B) HOURS FOR RELATED ORGANIZATIONS BOARD MEMBERS AND OFFICERS DEVOTE TIME TO ALL ENTITIES WITHIN THE CONTROL GROUP.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)

Business Name Line2DisregardedEntityName/BusinessNameLine2Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ABUNDANT LIVING ADULT DAY SERVICES
INCPO BOX 947SALISBURYNC28145561884652ADULT DAYNC501C39LSA INCYes (true)
LFS REAL PROPERTIES INC
PO BOX 2369SALISBURYNC28145581820383REAL ESTATNC501C2LFSYes (true)
LSA ELMS AT TANGLEWOOD INC
PO BOX 947SALISBURYNC28145263735637ASSIST LVGNC501C39LSA INCYes (true)
LSA ELMS PROPERTY INC
PO BOX 947SALISBURYNC28145263739962LEASINGNC501C39LSA INCYes (true)
LSA MANAGEMENT INC
PO BOX 947SALISBURYNC28145201457236MANAGEMENTNC501C39LSA INCYes (true)
LSA PHARMACY INC
PO BOX 947SALISBURYNC28145201457251PHARMACYNC501C39LSA INCYes (true)
LUTHERAN FAMILY SERVICES IN THE
CAROLINASPO BOX 2369SALISBURYNC28145561286323COMM. SVCNC501C311BLSA INCYes (true)
LUTHERAN HOME - ALBEMARLE INC
PO BOX 947SALISBURYNC28145201457298NURSINGNC501C39LSA INCYes (true)
LUTHERAN HOME - FORSYTH COUNTY INC
PO BOX 947SALISBURYNC28145263328029NURSINGNC501C39LSA INCYes (true)
LUTHERAN HOME - HICKORY WEST INC
PO BOX 947SALISBURYNC28145201457410NURSINGNC501C39LSA INCYes (true)
LUTHERAN HOME - WILMINGTON INC
PO BOX 947SALISBURYNC28145260158686NURSINGNC501C39LSA INCYes (true)
LUTHERAN HOME - WINSTON-SALEM INC
PO BOX 947SALISBURYNC28145561500212NURSINGNC501C39LSA INCYes (true)
LUTHERAN HOME ALBEMARLE PROPERTY
INCPO BOX 947SALISBURYNC28145201457273LEASINGNC501C39LSA INCYes (true)
LUTHERAN HOME AT TRINITY OAKS
PROPERTY INCPO BOX 947SALISBURYNC28145201457796LEASINGNC501C39LSA INCYes (true)
LUTHERAN HOME AT TRINITY OAKS INC
PO BOX 947SALISBURYNC28145201457824NURSINGNC501C39LSA INCYes (true)
LUTHERAN HOME FORSYTH COUNTY
PROPERTY INCPO BOX 947SALISBURYNC28145461188488LEASINGNC501C39LSA INCYes (true)
LUTHERAN HOME HICKORY PROPERTY
INCPO BOX 947SALISBURYNC28145201457319LEASINGNC501C39LSA INCYes (true)
LUTHERAN HOME HICKORY WEST PROPERTY
INCPO BOX 947SALISBURYNC28145205304712LEASINGNC501C39LSA INCYes (true)
LUTHERAN HOME WILMINGTON PROPERTY
INCPO BOX 947SALISBURYNC28145260158745LEASINGNC501C39LSA INCYes (true)
LUTHERAN HOME WINSTON-SALEM
PROPERTY INCPO BOX 947SALISBURYNC28145205304794LEASINGNC501C39LSA INCYes (true)
LUTHERAN RETIREMENT CENTER -
SALISBURY INCPO BOX 947SALISBURYNC28145561540214ASSIST LVGNC501C39LSA INCYes (true)
LUTHERAN RETIREMENT CENTER -
WILMINGTON INCPO BOX 947SALISBURYNC28145561500308INDEP. LVGNC501C39LSA INCYes (true)
LUTHERAN RETIREMENT CENTER AT
LUTHERIDGE INCPO BOX 947SALISBURYNC28145581823983ASSIST LVGNC501C39LSA INCYes (true)
LUTHERAN SERVICES FOR THE AGING
FOUNDATION INCPO BOX 947SALISBURYNC28145561681723FOUNDATIONNC501C39LSA INCYes (true)
LUTHERAN SERVICES FOR THE AGING
INC (LSA INC)PO BOX 947SALISBURYNC28145560752160PARENT ORGNC501C39falseN/A
LUTHERAN SERVICES PROPERTY INC
PO BOX 947SALISBURYNC28145203895886LEASINGNC501C39LSA INCYes (true)
LSA THERAPY INC
PO BOX 947SALISBURYNC28145461886488THERAPYNC501C39LSA INCYes (true)
TRINITY AT HOME INC
PO BOX 947SALISBURYNC28145464838098NURSINGNC501C39LSA INCYes (true)
MOUNTAIN RIDGE GROUP HOME INC
PO BOX 2369SALISBURYNC28145581782084GROUP HOMENC501C37LFSYes (true)
WHITTECAR HOME INC
PO BOX 2369SALISBURYNC28145581940152GROUP HOMENC501C37LFSYes (true)
PACE AT HOME INC
1915 FAIRGROVE CHURCH ROADNEWTONNC28658273462373CARE SVCNC501C33falseN/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (true)AssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (12 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxtBusiness Name Line2OtherOrganizationName/BusinessNameLine2
LSA FOUNDATION
B$8,025FMV
LUTHERAN SERVICES FOR THE AGING
C$15,000FMVINC
LSA FOUNDATION
C$1,164FMV
LSA MANAGEMENT INC
D$1,376,466FMV
CONTROL GROUP INTERCOMPANY RECPAY
D$203,982FMV
LUTHERAN HOME - WILMINGTON INC
D$1,000,000FMV
LUTHERAN HOME - FORSYTH COUNTY
D$500,000FMV
LUTHERAN RETIREMENT CENTER -
D$943,278FMVSALISBURY INC
LSA PHARMACY INC
H$732,754FMV
LUTHERAN HOME HICKORY PROPERTY INC
K$600,000FMV
LSA MANAGEMENT INC
M$510,592FMV
LSA PHARMACY INC
M$21,964FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE RFormAndLineReferenceDesc
Explanation"CONTROL GROUP INTERCOMPANY REC/PAY" CONSISTS OF SHORT-TERM INTERCOMPANY ALLOCATIONS BETWEEN THE ENTITIES WITHIN THE CONTROLLED GROUP.ExplanationTxt