2014-04-02T15:42:16-05:00 2013-06-30 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2012-07-01 200215979 LUTHERAN ASSISTED LIVING AT MIDDLETOWN INC LUTH 8603477144 628 CONGDON STREET WEST MIDDLETOWN CT 06457 LISA COHEN 7742433900 2014-03-12 1 BARBARA MORRISON P00173340 6179848100 2014-03-12 2012 2015-11-30 17:44:51Z ANGELA BOVILL 14 EAST WORCESTER STREET SUITE 300 WORCESTER MA 01604 1006427 0 6011 X WWW.LSSNE.ORG X 2003 CT ELDERLY ASSISTED LIVING. 8 7 0 7 0 0 0 0 983973 1003371 105 116 4674 2940 988752 1006427 0 0 0 0 165984 157418 0 0 0 952259 983145 1118243 1140563 -129491 -134136 6951956 6696235 7085346 6963761 -133390 -267526 WE ARE CALLED TO STRENGTHEN COMMUNITIES BY EMPOWERING PEOPLE TO RESPOND TO LIFE'S CHALLENGES. 0 0 1043206 1006311 THE ORGANIZATION OPERATES A 45 UNIT ASSISTED HOUSING FACILITY FOR THE ELDERLY. 1043206 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 1 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CT X X LISA COHEN 7742433900 14 EAST WORCESTER STREET SUITE 300 WORCESTER MA 01604 JEFF KINNEY 0.30 4.20 X 0 0 0 GAIL BUCHER 0.30 4.20 X 0 0 0 DR DON SWEET 0.30 4.20 X 0 0 0 KAREN GAYLIN 0.30 4.20 X 0 0 0 REV CARL ANTON 0.30 4.20 X 0 0 0 GARTH GREIMANN 0.30 4.20 X 0 0 0 WILLAM SWANSON 0.30 4.20 X 0 0 0 ANGELA BOVILL 2.40 37.60 X X 0 235000 10539 LISA COHEN 2.40 37.60 X 0 158000 0 WILLIAM AMES 2.40 37.60 X 0 130563 12250 NICHOLAS RUSSO 2.40 37.60 X 0 125000 4315 ALANA GEARY 2.40 37.60 X 0 67500 10539 JEAN M JACKSON 2.40 37.60 X 0 163846 0 HEATHER FELTMAN 2.40 37.60 X 0 250000 5000 TODD GAERTNER 2.40 37.60 X 0 104000 12250 STACIE LABOSSIERE 2.40 37.60 X 0 101241 0 ASIT GANATRA 2.40 37.60 X 0 100281 12250 DAVID P FORSBERG 2.40 37.60 X 0 152789 0 0 1588220 67143 0 1 1 0 0 PROGRAM SERVICE REV. 623000 1003371 1003371 1003371 116 116 MISCELLANEOUS REVENUE 623000 2940 2940 2940 1006427 1006311 0 116 128827 128809 18 19628 19628 8963 8963 83272 83272 225 225 13842 13842 6506 6506 248 248 5825 5825 2333 2333 139051 139051 2072 2072 243203 243203 180346 180346 23774 23774 MEALS CONTRACT 231788 231788 MAINTENANCE EXPENSES 34824 34824 MISCELLANEOUS EXPENSE 15836 15836 1140563 1043206 97357 0 59339 56334 5425 3761 20356 25588 7426292 1467550 6131399 5958742 735437 651810 6951956 6696235 44608 42637 1770 2289 6565102 6534338 473866 384497 7085346 6963761 X -133390 -267526 -133390 -267526 6951956 6696235 -134136 0 X 0 1 X 1 0 X 894425 935831 1029662 983972 1003371 4847261 894425 935831 1029662 983972 1003371 4847261 0 0 0 4847261 2500 630 454 105 116 3805 2500 630 454 105 116 3805 12540 5220 679 4674 2940 26053 909465 941681 1030795 988751 1006427 4877119 0.99390 0.99010 0.00080 0.00350 X 7318276 1443367 5874909 106346 22513 83833 1670 1670 0 5958742 REPLACEMENT RESERVE 174008 TENANT SECURITY DEPOSITS 35644 GROUND LEASE AQUISITIONS COSTS, NET 79157 ESCROW DEPOSITS 30288 DEFERRED GROUND LEASE EXPENSE, NET 268606 LOAN ACQUISITION COSTS, NET 64107 651810 TENANT SECURITY DEPOSITS 33905 DUE TO RELATED PARTIES 50592 ACCRUED GROUND LEASE EXPENSE 300000 384497 X 1006427 0 1006427 0 1006427 1140563 0 1140563 0 1140563 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION FILES AS A TAX EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ENTITY'S 2010 THROUGH 2013 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. 1 0 0 0 0 0 0 0 0 ANGELA BOVILL 0 195000 0 0 0 40000 0 0 0 10539 0 245539 0 0 LISA COHEN 0 158000 0 0 0 0 0 0 0 0 0 158000 0 0 JEAN M JACKSON 0 153846 0 10000 0 0 0 0 0 0 0 163846 0 0 HEATHER FELTMAN 0 105769 0 0 0 144231 0 5000 0 0 0 255000 0 0 DAVID P FORSBERG 0 152789 0 0 0 0 0 0 0 0 0 152789 0 0 PART I, LINE 4A HEATHER FELTMAN, FORMER PRESIDENT & CEO, RECEIVED A SEVERANCE PAYMENT OF $144,231. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE COPORATE MEMBER OF THE ORGANIZATION IS LUTHERAN SOCIAL SERVICES OF NEW ENGLAND, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS GOVERNING BOARD ELECTS ALL THE MEMBERS OF THIS ORGANIZATIONS GOVERNING BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE TRANSACTIONS SUBJECT TO MEMBER APPROVAL ARE ACQUISITIONS OF DEBT, SALE OF ASSETS, ANNUAL BUDGET,MERGERS AND BYLAW REVISIONS. FORM 990, PART VI, SECTION B, LINE 11 FINANCE MANAGEMENT WILL REVIEW THE 990 WHEN IT IS COMPLETED. THE AUDIT COMMITTEE OF THE LSS BOARD WILL PROVIDE SECONDARY REVIEW AND APPROVAL PRIOR TO SUBMISSION TO THE IRS. THE DOCUMENTS ARE POSTED TO THE BOARD INTRANET FOR REVIEW BY THE LSS FINANCE COMMITTEE AS WELL AS ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY TO DISCLOSE ANY CONFLICTS. CONFLICTS ARE REVIEWED BY THE CEO AND THE GOVERNANCE COMMITTEE. BOARD MEMBERS WITH CONFLICTS ARE RESTRICTED ON VOTING ON ANY ACTIONS RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. RELATED ORGANIZATIONS FILE UNDER GROUP EXEMPTION 6011 - DISCLOSURE NOT REQ CT 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 0 0 0