2015-02-13T15:48:56-06:00 2014-09-30 561743537 LANGDON & COMPANY LLP 223 US HIGHWAY 70 EAST SUITE 100 GARNER NC 275294051 990 2013-10-01 561500308 LUTHERAN RETIREMENT CENTER - WILMINGTON INC LUTH 7046372870 PO BOX 947 SALISBURY NC 281450947 KIRBY NICKERSON TREASURER 7046372870 2015-02-12 true ANTHONY T PANDISCIA P00187421 9196621001 2015-02-13 2013 2016-02-25 16:41:14Z TED GOINS PO BOX 947 SALISBURY NC 281450947 0 false X WWW.LSCAROLINAS.NET X 1985 NC LUTHERAN RETIREMENT CENTER - WILMINGTON, INC. WILL BE DEVELOPED TO PROVIDE QUALITY COMPASSIONATE SERVICES IN SUPPORT OF THE LUTHERAN SERVICES FOR THE AGING, INC. (LSA), A MINISTRY OF THE NORTH CAROLINA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. THE ORGANIZATION STRIVES TO EXPRESS GOD'S LOVE IN CHRIST TO THOSE WE SERVE BY: PROVIDING MULTIPLE SERVICES FOR SENIORS INCLUDING NURSING CARE, ADULT DAY CARE, AND RETIREMENT LIVING; MINISTERING TO THEIR NEEDS IN TRADITIONAL AND INNOVATIVE WAYS; AND DEMONSTRATING RESPONSIBLE STEWARDSHIP. 19 19 0 0 0 0 0 1 0 1 0 0 0 0 0 0 8375 26686 8375 26686 -8374 -26686 557867 557866 1564727 1591412 -1006860 -1033546 X LUTHERAN RETIREMENT CENTER - WILMINGTON, INC. WILL BE DEVELOPED TO PROVIDE QUALITY COMPASSIONATE SERVICES IN SUPPORT OF THE LUTHERAN SERVICES FOR THE AGING, INC. (LSA), A MINISTRY OF THE NORTH CAROLINA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. THE ORGANIZATION STRIVES TO EXPRESS GOD'S LOVE IN CHRIST TO THOSE WE SERVE BY: PROVIDING MULTIPLE SERVICES FOR SENIORS INCLUDING NURSING CARE, ADULT DAY CARE, AND RETIREMENT LIVING; MINISTERING TO THEIR NEEDS IN TRADITIONAL AND INNOVATIVE WAYS; AND DEMONSTRATING RESPONSIBLE STEWARDSHIP. false false 15510 LUTHERAN RETIREMENT CENTER - WILMINGTON, INC. WILL PROVIDE RETIREMENT LIVING SERVICES TO THE AGING POPULATION IN THE WILMINGTON AREA. THE CORPORATION IS AN AFFILIATE OF LUTHERAN SERVICES FOR THE AGING, INC. WHICH IS A SOCIAL MINISTRY OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. WHILE INITIALLY PLANNED FOR CONSTRUCTION, THE PROPERTY IS NOW HELD FOR INVESTMENT PENDING FUTURE EXPANSION PLANS. 15510 true false false false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 0 0 0 false false false false false false false false false false X 19 19 false true false false false false false true true false false true true true true true true true true false X X SUSAN MILLER 7046372870 1416 S MARTIN LUTHER KING JR AVE SALISBURY NC 28144 X TED GOINS JR PRESIDENT 40.00 1.00 X X 0 274066 5496 REV PAMELA COOK DIRECTOR 1.00 1.00 X 0 0 0 ERIC HOYLE DIRECTOR 1.00 1.00 X 0 0 0 JERRY BRAMLEY DIRECTOR 1.00 1.00 X 0 0 0 DONALD BUMGARNER DIRECTOR 1.00 1.00 X 0 0 0 JIM HUDDLE DIRECTOR 1.00 1.00 X 0 0 0 REV JEFFREY SHEALY DIRECTOR 1.00 1.00 X 0 0 0 JOY FISHER DIRECTOR 1.00 1.00 X 0 0 0 EUNIKA SIMONS DIRECTOR 1.00 1.00 X 0 0 0 JOYCELYN JOHNSON DIRECTOR 1.00 1.00 X 0 0 0 MARK TONNESEN DIRECTOR 1.00 1.00 X 0 0 0 BETTY LOHR DIRECTOR 1.00 1.00 X 0 0 0 DR SHANNON MATHEWS DIRECTOR 1.00 1.00 X 0 0 0 LORETTA MEYERS DIRECTOR 1.00 1.00 X 0 0 0 DOUG NELSON DIRECTOR 1.00 1.00 X 0 0 0 DEREK SHOEMAKE DIRECTOR 1.00 1.00 X 0 0 0 STEPHEN STANDFIELD-SWITZER DIRECTOR 1.00 1.00 X 0 0 0 KATRINA WEIRICK DIRECTOR 1.00 1.00 X 0 0 0 J WHITE IDDINGS JR DIRECTOR 1.00 1.00 X 0 0 0 ROSEBUD REUBEL DIRECTOR 1.00 1.00 X 0 0 0 KIRBY NICKERSON TREASURER/CF 40.00 1.00 X 0 170532 4920 KESHA SMITH CHIEF OPER. 40.00 1.00 X 0 157313 5496 ELIZABETH KUHN DIRECTOR R&D 40.00 1.00 X 0 132699 7723 MYRA GRIFFIE CHIEF OPER. 40.00 1.00 X 0 120320 5496 KAREN MADDRY SECRETARY 40.00 1.00 X 0 59139 6351 914069 35482 false true false TRINITY REHAB LLC 1416 S MARTIN LUTHER KING JR AVE SALISBURY NC 28144 REHAB SERVICES 858286 1 0 5315 5315 118 118 CONTRACTED SERVICES 12063 10016 2047 TAXES, SALES, REAL & PROP 9129 9129 REPAIRS & MAINTENANCE 61 61 26686 15510 11176 0 1 557866 557866 557866 557867 557866 112056 102809 1452671 1488603 1564727 1591412 X -1006860 -1033546 -1006860 -1033546 557867 557866 -26686 X false true X true false X 1 1 2 1 1 2 2 1 1 2 1.00000 1.00000 0.00000 X SUPPLEMENTAL INFORMATION THE ORGANIZATION IS STILL PURSUING THE STEPS NECESSARY TO CONDUCT OPERATIONS IN ACCORDANCE WITH THEIR MISSION STATEMENT, PROVIDING RETIREMENT LIVING SERVICES TO THE AGING POPULATION IN THE WILMINGTON, NC AREA. ONE DOLLAR HAS BEEN INCLUDED IN PART III FOR THE PURPOSE OF ADMINISTRATIVE COMPLETENESS OF SCHEDULE A. 557866 557866 557866 INTERCOMPANY 1488603 1488603 X 26686 26686 26686 SCHEDULE D, PAGE 3, PART X SUBSTANTIALLY 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. false false false false false false false false false TED GOINS JR PRESIDENT 274066 5496 279562 KIRBY NICKERSON TREASURER/CFO 170532 4920 175452 KESHA SMITH CHIEF OPER. OFFICER 157313 5496 162809 FORM 990 - ORGANIZATION'S MISSION LUTHERAN RETIREMENT CENTER - WILMINGTON, INC. WILL BE DEVELOPED TO PROVIDE QUALITY COMPASSIONATE SERVICES IN SUPPORT OF THE LUTHERAN SERVICES FOR THE AGING, INC. (LSA), A MINISTRY OF THE NORTH CAROLINA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA. THE ORGANIZATION STRIVES TO EXPRESS GOD'S LOVE IN CHRIST TO THOSE WE SERVE BY: PROVIDING MULTIPLE SERVICES FOR SENIORS INCLUDING NURSING CARE, ADULT DAY CARE, AND RETIREMENT LIVING; MINISTERING TO THEIR NEEDS IN TRADITIONAL AND INNOVATIVE WAYS; AND DEMONSTRATING RESPONSIBLE STEWARDSHIP. FORM 990, PART VI WHISTLEBLOWER 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 3 LSA 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 11B THE 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 12C BOARD 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 15A ALL 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 15B ALL 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 19 FORMS 990 ARE POSTED ON GUIDESTAR AND AVAILABLE UPON REQUEST AT THE LSA OFFICE LOCATED IN SALISBURY, NC. FORM 990, PART VII PART VII, SECTION A - COLUMN (B) HOURS FOR RELATED ORGANIZATIONS BOARD MEMBERS AND OFFICERS DEVOTE TIME TO ALL ENTITIES WITHIN THE CONTROL GROUP. ABUNDANT LIVING ADULT DAY SERVICES INC PO BOX 947 SALISBURY NC 28145 561884652 ADULT DAY NC 501C3 9 LSA INC true LFS REAL PROPERTIES INC PO BOX 2369 SALISBURY NC 28145 581820383 REAL ESTAT NC 501C2 LFS true LSA ELMS AT TANGLEWOOD INC PO BOX 947 SALISBURY NC 28145 263735637 ASSIST LVG NC 501C3 9 LSA INC true LSA ELMS PROPERTY INC PO BOX 947 SALISBURY NC 28145 263739962 LEASING NC 501C3 9 LSA INC true LSA MANAGEMENT INC PO BOX 947 SALISBURY NC 28145 201457236 MANAGEMENT NC 501C3 9 LSA INC true LSA PHARMACY INC PO BOX 947 SALISBURY NC 28145 201457251 PHARMACY NC 501C3 9 LSA INC true LUTHERAN FAMILY SERVICES IN THE CAROLINAS PO BOX 2369 SALISBURY NC 28145 561286323 COMM. SVC NC 501C3 11B LSA INC true LUTHERAN HOME - ALBEMARLE INC PO BOX 947 SALISBURY NC 28145 201457298 NURSING NC 501C3 9 LSA INC true LUTHERAN HOME - FORSYTH COUNTY INC PO BOX 947 SALISBURY NC 28145 263328029 NURSING NC 501C3 9 LSA INC true LUTHERAN HOME - HICKORY WEST INC PO BOX 947 SALISBURY NC 28145 201457410 NURSING NC 501C3 9 LSA INC true LUTHERAN HOME - HICKORY INC PO BOX 947 SALISBURY NC 28145 201457341 NURSING NC 501C3 9 LSA INC true LUTHERAN HOME - WILMINGTON INC PO BOX 947 SALISBURY NC 28145 260158686 NURSING NC 501C3 9 LSA INC true LUTHERAN HOME - WINSTON-SALEM INC PO BOX 947 SALISBURY NC 28145 561500212 NURSING NC 501C3 9 LSA INC true LUTHERAN HOME ALBEMARLE PROPERTY INC PO BOX 947 SALISBURY NC 28145 201457273 LEASING NC 501C3 9 LSA INC true LUTHERAN HOME AT TRINITY OAKS PROPERTY INC PO BOX 947 SALISBURY NC 28145 201457796 LEASING NC 501C3 9 LSA INC true LUTHERAN HOME AT TRINITY OAKS INC PO BOX 947 SALISBURY NC 28145 201457824 NURSING NC 501C3 9 LSA INC true LUTHERAN HOME FORSYTH COUNTY PROPERTY INC PO BOX 947 SALISBURY NC 28145 461188488 LEASING NC 501C3 9 LSA INC true LUTHERAN HOME HICKORY PROPERTY INC PO BOX 947 SALISBURY NC 28145 201457319 LEASING NC 501C3 9 LSA INC true LUTHERAN HOME HICKORY WEST PROPERTY INC PO BOX 947 SALISBURY NC 28145 205304712 LEASING NC 501C3 9 LSA INC true LUTHERAN HOME WILMINGTON PROPERTY INC PO BOX 947 SALISBURY NC 28145 260158745 LEASING NC 501C3 9 LSA INC true LUTHERAN HOME WINSTON-SALEM PROPERTY INC PO BOX 947 SALISBURY NC 28145 205304794 LEASING NC 501C3 9 LSA INC true LUTHERAN RETIREMENT CENTER - SALISBURY INC PO BOX 947 SALISBURY NC 28145 561540214 ASSIST LVG NC 501C3 9 LSA INC true LUTHERAN RETIREMENT CENTER AT LUTHERIDGE INC PO BOX 947 SALISBURY NC 28145 581823983 ASSIST LVG NC 501C3 9 LSA INC true LUTHERAN SERVICES FOR THE AGING FOUNDATION INC PO BOX 947 SALISBURY NC 28145 561681723 FOUNDATION NC 501C3 9 LSA INC true LUTHERAN SERVICES FOR THE AGING INC (LSA INC) PO BOX 947 SALISBURY NC 28145 560752160 PARENT ORG NC 501C3 9 N/A false LUTHERAN SERVICES PROPERTY INC PO BOX 947 SALISBURY NC 28145 203895886 LEASING NC 501C3 9 LSA INC true LSA THERAPY INC PO BOX 947 SALISBURY NC 28145 461886488 THERAPY NC 501C3 9 LSA INC true TRINITY AT HOME INC PO BOX 947 SALISBURY NC 28145 464838098 NURSING NC 501C3 9 LSA INC true MOUNTAIN RIDGE GROUP HOME INC PO BOX 2369 SALISBURY NC 28145 581782084 GROUP HOME NC 501C3 7 LFS true WHITTECAR HOME INC PO BOX 2369 SALISBURY NC 28145 581940152 GROUP HOME NC 501C3 7 LFS true PACE AT HOME INC 1915 FAIRGROVE CHURCH ROAD NEWTON NC 28658 273462373 CARE SVC NC 501C3 3 N/A false false false false false true false false false false false false false false false false false false false false CONTROL GROUP INTERCOMPANY RECPAY E 426930 FMV LSA MANAGEMENT INC E 1057906 FMV LUTHERAN HOME WILMINGTON PROPERTY INC E 3766 FMV SCHEDULE R "CONTROL GROUP INTERCOMPANY REC/PAY" CONSISTS OF SHORT-TERM INTERCOMPANY ALLOCATIONS BETWEEN THE ENTITIES WITHIN THE CONTROLLED GROUP.