2014-09-29T11:23:48-05:00 2013-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2013-01-01 390981434 UNITED LUTHERAN PROGRAM FOR THE AGING INC UNIT 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 ELIZABETH DIEHL CFO 4144643880 2014-09-29 1 CORY RUTLEDGE P01329381 6123764500 2013 2015-11-30 17:44:51Z DAVID BEINLICH 4545 NORTH 92ND STREET WAUWATOSA WI 53225 46792303 0 X WWW.LUTHERMANOR.ORG X 1957 WI TO PROVIDE EXCELLENT HOUSING, CARE, AND SERVICES TO OLDER ADULTS. 15 15 805 534 0 0 784613 857369 35180425 34193107 1241698 1341344 121744 110797 37328480 36502617 0 0 0 0 22492468 21891044 0 0 83987 14955026 14154068 37447494 36045112 -119014 457505 57389482 54775419 34854705 32670141 22534777 22105278 X TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS THROUGH EXCELLENT HOUSING, CARE & SERVICES. 0 0 17909496 0 18883098 LUTHER MANOR HEALTH CARE CENTER PROVIDES SKILLED NURSING CARE AND SERVICE FOR FRAIL ELDERLY. WITHIN THE HEALTH CARE CENTER IS A DEDICATED 31 UNIT REHABILITATION CENTER. THE FACILITY IS LICENSED FOR PARTICIPATION IN BOTH MEDICARE AND MEDICAID. 6831060 0 7202412 THE LUTHER MANOR TERRACE (LMT) PROVIDES SAFE AND SUPPORTIVE INDEPENDENT LIVING HOUSING AND SERVICES FOR OLDER ADULTS. APARTMENT RESIDENTS OFTEN CHOOSE THE LMT IN ORDER TO BECOME PART OF A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) SETTING. THE LMT SERVICES AND AMENITIES INCLUDE LIFE ENRICHMENT OPPORTUNITIES, TRANSPORTATION SERVICES, DINING PROGRAM, SPIRITUAL WELLNESS, FITNESS, HEALTH, ENTERTAINMENT AND CULTURAL PROGRAMS. THE LMT ALSO PROVIDES PERSONAL CARE SERVICES TO RESIDENTS THROUGH THE "RESIDENTIAL CARE APARTMENT COMPLEX (RCAC)" PROGRAM, WHICH HELPS RESIDENTS MAINTAIN INDEPENDENT LIVING. 5222205 0 5506096 THE COURTYARDS AT LUTHER MANOR PROVIDES SUPPORTIVE (ASSISTED) LIVING SERVICES FOR FRAIL ELDERLY WHO RESIDE IN LUTHER MANOR'S LICENSED "COMMUNITY BASED RESIDENTIAL FACILITY (CBRF)" KNOWN AS THE COURTYARD AT LUTHER MANOR. THE COURTYARDS PROGRAM ALSO INCLUDES "MEMORY CARE" SERVICES FOR PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA. 2467369 0 2601501 UNITED LUTHERAN PROGRAM FOR THE AGING, INC. OFFERS ADDITIONAL SERVICES INCLUDING: LUTHER MANOR ADULT DAY CENTER; LUTHER MANOR RIVER OAKS - A 16-UNIT ASSISTED LIVING FACILITY LOCATED IN MEQUON, WISCONSIN; AN ADULT DAY CENTER IN GRAFTON, WISCONSIN; AND HOSPICE SERVICES. 2467369 2601501 32430130 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 40 0 805 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X ELIZABETH DIEHL CFO 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 DALE KIRCHNER CHAIR 1.00 0.00 X X 0 0 0 DEE RAMSEL CHAIR (THROUGH MAY 2013) 1.00 0.00 X X 0 0 0 WILLIAM PICKERING IMMEDIATE PAST CHAIR 1.00 0.50 X X 0 0 0 LARRY NINES TREASURER 1.00 0.00 X X 0 0 0 JOHN SILSETH TREASURER (THROUGH MAY 2013) 1.00 0.50 X X 0 0 0 GEORGE ROTH SECRETARY 1.00 0.00 X X 0 0 0 MARILYN LANGE SECRETARY (THROUGH MAY 2013) 1.00 0.00 X X 0 0 0 DAVID ANDERSON DIRECTOR 0.50 0.00 X 0 0 0 KATHLEEN CZARNIAK DIRECTOR 0.50 0.00 X 0 0 0 DR NANCY HERRELL DIRECTOR 0.50 0.00 X 0 0 0 JAMES HOFFMAN DIRECTOR 0.50 0.00 X 0 0 0 STEVE KNOWLES DIRECTOR 0.50 0.00 X 0 0 0 PASTOR MEREDITH BEDKER MUSAUS DIRECTOR (THROUGH MAY 2013) 0.50 0.00 X 0 0 0 MARK SABIN DIRECTOR 0.50 0.00 X 0 0 0 NANCY SCHRAP DIRECTOR 0.50 0.00 X 0 0 0 WILLIAM SCHULTZ DIRECTOR 0.50 0.50 X 0 0 0 RONALD SONNTAG DIRECTOR 0.50 0.00 X 0 0 0 TERRY WUSSOW DIRECTOR 0.50 0.00 X 0 0 0 REVEREND DAVID KELLER PRESIDENT/CEO 34.00 6.00 X 142099 0 107293 DAVID BEINLICH VICE PRESIDENT 34.00 6.00 X 125417 0 11890 ELIZABETH DIEHL ASST TREASURER/CFO 37.00 3.00 X 129609 0 6161 DAVID SMITH PHARMACIST DIRECTOR 40.00 0.00 X 120195 0 18957 JAMES STRONG PHARMACIST 40.00 0.00 X 108722 0 10839 LARRY SWANKE PHARMACIST 40.00 0.00 X 108682 0 11879 734724 0 167019 6 0 1 0 SODEXO 4880 PAYSHPERE CIRCLE CHICAGO IL 60674 FOOD SERVICE 2310267 HEALTHREACH REHABILITATION 17280 W NORTH AVENUE BROOKFIELD WI 53045 THERAPY SERVICES 1156342 PRODUCTIVE BUILDERS PO BOX 821 MENOMONEE FALLS WI 53052 CONSTRUCTION SERVICES 908585 JOHNSON CONTROLS PO BOX 905240 CHARLOTTE NC 28290 HVAC SERVICES 287949 4 680188 177181 857369 RESIDENT SERVICES 623000 33280265 33280265 FOUNDERS FEES 623990 912842 912842 34193107 1215998 1215998 10275262 31683 10158460 23139 116802 8544 125346 125346 130273 108087 22186 22186 CAFETERIA INCOME 900099 48161 48161 OTHER INCOME 900099 30265 30265 HOUSEKEEPING 900099 10185 10185 88611 36502617 34193107 0 1452141 522470 522470 17030609 15566008 1406141 58460 623836 390611 233225 2459985 1809420 642366 8199 1254144 1119203 130877 4064 95326 95326 32800 32800 480423 462523 17900 253098 237461 4932 10705 664887 376225 286447 2215 187719 60539 127180 2146054 2146054 66841 65480 1207 154 44598 43635 963 513783 513783 2679549 2679549 174076 174076 DINING FOOD & SUPPLIES 2208093 2208093 PHARMACEUTICALS 1872211 1872211 ANCILLARIES 1149792 1149792 MEDICAL SUPPLIES 954948 944440 10508 0 629870 611027 18653 190 36045112 32430130 3530995 83987 1970584 1560621 17885 12835 2511670 2266568 211234 219007 461791 462073 84283172 58326049 26536406 25957123 22486323 22680624 2578963 919741 178431 141168 436195 555659 57389482 54775419 3773595 3701618 100043 21170000 20040000 88364 59043 9722703 8869480 34854705 32670141 X 22355939 21975755 178838 129523 22534777 22105278 57389482 54775419 457505 -887004 0 X 0 1 X 1 0 X 144397 1221565 937797 784613 857369 3945741 36148138 35605203 36276909 35180425 34193107 177403782 36292535 36826768 37214706 35965038 35050476 181349523 0 0 0 181349523 938142 906875 960799 1062625 1215998 5084439 938142 906875 960799 1062625 1215998 5084439 211100 309563 217241 235261 218884 1192049 37441777 38043206 38392746 37262924 36485358 187626011 0.96650 0.97120 0.02710 0.02570 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: CAFETERIA INCOME COMMISSARY INCOME HOUSEKEEPING INCOME MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 336497 336497 61754456 42164188 19590268 20134188 14390172 5744016 2058031 1771689 286342 25957123 FOUNDERS FEES 8869480 8869480 X 36530900 74590 74590 36456310 46307 46307 36502617 36045112 0 36045112 0 36045112 PART IV, LINE 2B: RESIDENT FUNDS ARE HELD BY THE ORGANIZATION WHICH RESIDENTS CAN ACCESS IF IN NEED OF ANY AMOUNT OF MONEY IN WHICH THE RESIDENT HAS ENTRUSTED THE ORGANIZATION. THESE FUNDS ARE OFTEN USED FOR MINOR PURCHASES. THIS ASSET IS IN CORRELATION WITH A LIABILITY FOR THE SAME AMOUNT. PART X, LINE 2: THE CORPORATION IS A NONPROFIT CORPORATION EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE CORPORATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE CORPORATION FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE CORPORATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION, WHICH ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE INFORMATION RETURNS FOR THE YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 74,590. PART XI, LINE 4B - OTHER ADJUSTMENTS: TEMPORARY RESTRICTED CONTRIBUTIONS 46,307. X X X 1 1 X X X X 0 0 0 0 0 0 0 0 0 REVEREND DAVID KELLER PRESIDENT/CEO 133762 0 4000 0 4337 0 41865 0 65428 0 249392 0 0 0 PART I, LINE 1A REVEREND DAVID KELLER RECEIVED A HOUSING ALLOWANCE OF $45,600, WHICH WERE NOT INCLUDED IN HIS TAXABLE COMPENSATION. THE ORGANIZATION PAID SOCIAL CLUB DUES OF $1,473 ON HIS BEHALF FOR 2013, WHICH WERE FOR CORPORATE USE ONLY AND WHICH WERE NOT INCLUDED IN HIS TAXABLE COMPENSATION. HE RECEIVED GROSS-UP PAYMENTS OF $9,554 FOR THE EMPLOYER PORTION OF FICA TAXES, WHICH WERE INCLUDED IN HIS TAXABLE COMPENSATION. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-29 21170000 REFUNDING OF 2009 BONDS AND FUNDING CAPITAL PROJECTS 0 0 0 A 1130000 21170000 13245000 2270000 18900000 2012 1 0 0 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS AND TWO ADDITIONAL MEMBERS OF THE BOARD. THE EXECUTIVE COMMITTEE PERFORMS SUCH FUNCTIONS AS THE BOARD FROM TIME TO TIME MAY SPECIFY. IN ADDITION, IN ORDER TO DEAL WITH AN EMERGENCY SITUATION WHEN A MEETING OF THE BOARD CANNOT CONVENIENTLY BE HELD, THE EXECUTIVE COMMITTEE IS AUTHORIZED TO EXERCISE ALL POWERS OF THE BOARD IN THE MANAGEMENT OF THE AFFAIRS OF THE ORGANIZATION, EXCEPT ACTIONS IN RESPECT TO THE ELECTION OF OFFICERS OR THE FILLING OF VACANCIES IN THE BOARD OR THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 UNITED LUTHERAN PROGRAM FOR THE AGING, INC. HAS TWO CLASSES OF MEMBERS: CONGREGATIONAL MEMBERS AND AFFILIATE MEMBERS. CONGREGATIONAL MEMBERS CONSIST OF CONGREGATIONS OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA THAT FROM TIME TO TIME ARE INVITED AND ELECT TO BECOME CONGREGATIONAL MEMBERS. AFFILIATE MEMBERS CONSIST OF ALL CORPORATIONS, CONGREGATIONS, ASSOCIATIONS, AND INDIVIDUALS COMMITTED TO THE PURPOSES OF THE ORGANIZATION WHO FROM TIME TO TIME ARE INVITED AND ELECT TO BECOME AFFILIATE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A EACH CONGREGATIONAL MEMBER IS ENTITLED TO VOTING RIGHTS AND THE MEMBERS ARE RESPONSIBLE FOR ELECTING ALL MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS MAY BE AMENDED OR REPEALED AND NEW BYLAWS MAY BE ADOPTED EITHER BY A MAJORITY VOTE OF THE CONGREGATIONAL MEMBERS OR BY A TWO-THIRDS MAJORITY VOTE OF THE BOARD OF DIRECTORS. NO BYLAW ADOPTED BY THE CONGREGATIONAL MEMBERS SHALL BE AMENDED OR REPEALED BY THE DIRECTORS UNLESS THE BYLAWS ADOPTED BY THE CONGREGATIONAL MEMBERS SHALL HAVE CONFERRED SUCH AUTHORITY UPON THE DIRECTORS. ANY BYLAW ADOPTED BY THE BOARD OF DIRECTORS SHALL BE SUBJECT TO AMENDMENT OR REPEAL BY THE CONGREGATIONAL MEMBERS AS WELL AS BY THE DIRECTORS. ANY AMENDMENT OR REPEAL OF THE BYLAWS THAT RELATES TO THE CORPORATION'S AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA SHALL BE SUBMITTED TO THE DIVISION FOR CHURCH IN SOCIETY OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA FOR ITS OPINION AS TO WHETHER SUCH AFFILIATION MAY BE AFFECTED BY SUCH AMENDMENT OR APPEAL. AMENDMENTS TO THE ARTICLES OF INCORPORATION MAY BE MADE AT ANY SPECIAL MEETING DULY CALLED FOR THAT PURPOSE OR AT ANY ANNUAL MEETING, PROVIDED THAT A STATEMENT OF THE PROPOSED AMENDMENT IS INCLUDED IN THE NOTICE OF THE MEETING. AN AMENDMENT SHALL BE ADOPTED UPON RECEIVING AT LEAST TWO-THIRDS OF THE VOTES ENTITLED TO BE CAST BY CONGREGATIONAL MEMBERS PRESENT OR REPRESENTED BY PROXY AT SUCH MEETING. FORM 990, PART VI, SECTION B, LINE 11 THE MEMBERS OF THE BOARD OF DIRECTORS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. ARE PRESENTED WITH A COPY OF THE FORM 990 PRIOR TO THE 990 BEING FILED WITH THE IRS, AT WHICH TIME THEY ARE ABLE TO REVIEW AND APPROVE THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. ADDITIONALLY, THE POLICY IS REVIEWED ANNUALLY BY THE BOARD. AT BOARD MEETINGS, BOARD MEMBERS REFRAIN FROM VOTING ON MATTERS IN WHICH THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE UNITED LUTHERAN PROGRAM FOR THE AGING, INC. PRESIDENT AND OTHER CERTAIN OFFICERS OF THE ORGANIZATION WAS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS THROUGH THE USE OF COMPENSATION STUDIES IN 2012. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST AND ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION WILL CONSIDER REQUESTS AND MAKE THE DOCUMENTS AVAILABLE BASED ON FACTS AND CIRCUMSTANCES OF THE REQUEST. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. LUTHER MANOR FOUNDATION 4545 NORTH 92ND STREET MILWAUKEE WI 53225 391499823 PROGRAM GRANT TO UNITED LUTHERAN PROGRAM FOR THE AGING, INC. WI 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 1