2013-10-07T10:05:34-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2012-01-01 390981434 UNITED LUTHERAN PROGRAM FOR THE AGING INC UNIT 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 ELIZABETH DIEHL 4144643880 2013-09-24 1 CORY RUTLEDGE P01329381 6123764500 2012 2016-02-24 21:20:13Z DAVID J KELLER 4545 NORTH 92ND STREET WAUWATOSA WI 53225 49001335 0 X WWW.LUTHERMANOR.ORG X 1957 WI TO PROVIDE EXCELLENT HOUSING, CARE, AND SERVICES TO OLDER ADULTS. 17 17 847 534 0 0 937797 784613 36276909 35180425 1047172 1241698 111711 121744 38373589 37328480 0 0 0 0 22494239 22492468 0 0 69583 14539264 14955026 37033503 37447494 1340086 -119014 55665516 57389482 33607396 34854705 22058120 22534777 X TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS THROUGH EXCELLENT HOUSING, CARE & SERVICES. 0 0 19242081 0 19940095 LUTHER MANOR HEALTH CARE CENTER PROVIDES SKILLED NURSING CARE AND SERVICE FOR FRAIL ELDERLY. WITHIN THE HEALTH CARE CENTER IS A DEDICATED 27 UNIT REHABILITATION CENTER. THE FACILITY IS LICENSED FOR PARTICIPATION IN BOTH MEDICARE AND MEDICAID. 6885029 0 7134786 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. 5418041 0 5614582 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. 2403764 0 2490961 UNITED LUTHERAN PROGRAM FOR THE AGING, INC. OFFERS ADDITIONAL SERVICES INCLUDING: LUTHER MANOR ADULT DAY CENTER SERVING UP TO 62 PARTICIPANTS PER DAY; LUTHER MANOR RIVER OAKS - A 16-UNIT ASSISTED LIVING FACILITY LOCATED IN MEQUON, WISCONSIN; AN ADULT DAY CENTER IN GRAFTON, WISCONSIN; AND HOSPICE SERVICES. 2403764 0 2490961 33948915 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 0 847 1 0 0 0 0 0 0 0 0 0 0 X 17 17 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 DEE RAMSEL 1.00 0.00 X X 0 0 0 JOHN SILSETH 1.00 0.50 X X 0 0 0 MARILYN LANGE 1.00 0.00 X X 0 0 0 GEORGE ROTH 1.00 0.00 X X 0 0 0 DALE KIRCHNER 0.50 0.00 X X 0 0 0 WILLIAM PICKERING 0.50 0.50 X X 0 0 0 DAVID ANDERSON 0.50 0.00 X 0 0 0 REVEREND HARVEY BERG 0.50 0.00 X 0 0 0 KATHLEEN CZARNIAK 0.50 0.00 X X 0 0 0 NANCY HERRELL 0.50 0.00 X 0 0 0 JAMES HOFFMAN 0.50 0.00 X 0 0 0 PASTOR MERIDITH BEDKER MUSAUS 0.50 0.00 X 0 0 0 LARRY NINES 0.50 0.00 X 0 0 0 MARTIN PANNING 0.50 0.00 X 0 0 0 MARK SABIN 0.50 0.00 X 0 0 0 NANCY SCHRAP 0.50 0.00 X 0 0 0 WILLIAM SCHULTZ 0.50 0.50 X 0 0 0 RONALD SONNTAG 0.50 0.00 X 0 0 0 TERRY WUSSOW 0.50 0.00 X 0 0 0 REVEREND DAVID KELLER 34.00 6.00 X 130484 0 114483 DAVID BEINLICH 40.00 0.00 X 120842 0 13020 NANCY PINTER 37.00 3.00 X 92916 0 26778 ELIZABETH DIEHL 37.00 3.00 X 48081 0 1982 DAVID SMITH 40.00 0.00 X 122187 0 7527 LARRY SWANKE 40.00 0.00 X 108567 0 20053 JAMES STRONG 40.00 0.00 X 110194 0 21345 PETER KWASNIAK 40.00 0.00 X 103220 0 12474 LUANNE SCHMIDT 40.00 0.00 X 102768 0 12331 939259 0 229993 8 0 1 0 SODEXO PO BOX 536922 ATLANTA GA 30353 FOOD SERVICE 2329120 HEALTHREACH REHABILITATION 17280 W NORTH AVENUE BROOKFIELD WI 53045 THERAPY SERVICES 962854 PRODUCTIVE BUILDERS PO BOX 821 MENOMONEE FALLS WI 53052 CONSTRUCTION SERVICES 455200 JOHNSON CONTROLS PO BOX 905240 CHARLOTTE NC 28290 HVAC SERVICES 116729 JENS CONSTRUCTION N26W23314 PAUL RD PEWAUKEE WI 53072 CONSTRUCTION SERVICES 105726 5 612844 171769 784613 RESIDENT SERVICES 623000 34345637 34345637 FOUNDERS FEES 623990 834788 834788 35180425 1062625 1062625 11837878 14050 11664374 8481 173504 5569 179073 179073 CAFETERIA INCOME 900099 51191 51191 HOUSEKEEPING 900099 23337 23337 COMMISSARY INCOME 900099 18347 18347 28869 28869 121744 37328480 35180425 0 1363442 548586 548586 17367362 15932083 1390404 44875 671397 468035 203362 2620829 2011009 600041 9779 1284294 1151458 129674 3162 93179 93179 32800 32800 680784 667711 13073 350534 341597 8937 784260 463989 317643 2628 131810 53137 78673 1978429 1978429 76645 74537 2045 63 59929 58522 1407 768328 768328 3270129 3270129 181215 181215 DINING FOOD & SUPPLIES 2237098 2237098 PHARMACEUTICALS 1822443 1822443 ANCILLARIES 1060101 1060101 MEDICAL SUPPLIES 923296 905615 17681 504046 503479 428 139 37447494 33948915 3428996 69583 2628904 1970584 17849 17885 3119229 2511670 214627 211234 210500 461791 82247170 55710764 27156646 26536406 20773706 22486323 640806 2578963 903249 614626 55665516 57389482 3895339 3773595 289233 100043 19938947 21170000 83054 88364 9400823 9722703 33607396 34854705 X 21672508 22355939 385612 178838 22058120 22534777 55665516 57389482 -119014 595671 0 X 0 1 X 1 0 X 884378 144397 1221565 937797 784613 3972750 35045153 36148138 36289613 36276909 35180425 178940238 35929531 36292535 37511178 37214706 35965038 182912988 0 0 0 182912988 973898 937149 906875 960799 1062625 4841346 973898 937149 906875 960799 1062625 4841346 127036 111256 104182 111711 121744 575929 37030465 37340940 38522235 38287216 37149407 188330263 0.97120 0.97110 0.02570 0.02590 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER OPERATING INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 336497 336497 61745402 40421121 21324281 17610416 13591480 4018936 2554855 1698163 856692 26536406 FOUNDERS FEES 9722703 9722703 X 37329679 57780 57780 37271899 56581 56581 37328480 36946259 -5569 -5569 36951828 495666 495666 37447494 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 2009 TO 2011 ARE OPEN TO EXAMINATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 57,780. PART XI, LINE 4B - OTHER ADJUSTMENTS: GAIN ON DISPOSAL OF ASSET 5,569. TEMPORARY RESTRICTED CONTRIBUTIONS 51,012. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON DISPOSAL OF ASSET -5,569. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON REFINANCING 495,666. X X X 1 1 X X X X 0 0 0 0 0 0 0 0 0 REVEREND DAVID KELLER 123196 0 4000 0 3288 0 42565 0 71918 0 244967 0 0 0 PART I, LINE 1A REVEREND DAVID KELLER RECEIVES A HOUSING ALLOWANCE OF $45,600 WHICH IS INCLUDED IN NON-TAXABLE BENEFITS. ALSO INCLUDED IS GROSS-UP PAYMENTS OF $9,554 FOR THE EMPLOYER PORTION OF FICA TAXES. THE ORGANIZATION ALSO PAID SOCIAL CLUB DUES OF $1,395 ON HIS BEHALF FOR 2012 WHICH ARE FOR CORPORATE USE ONLY. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-29 15515000 ADVANCED REFUNDING OF 2009 BONDS AND TO FUND CAPITAL PROJECTS 0 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-29 5655000 ADVANCED REFUNDING OF 2009 BONDS 0 0 0 A 15515000 13245000 2270000 0 1 0 1 B 5655000 5655000 2012 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 1 0 0 0 0 A 0 B 0 SCHEDULE K, PART III, LINE 9 THE ORGANIZATION DID NOT HAVE WRITTEN PROCEDURES IN PLACE BY DECEMBER 31, 2012 TO ENSURE THAT ALL NONQUALIFIED BONDS ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2, HOWEVER, A WRITTEN POLICY WAS ESTABLISHED BY THE ORGANIZATION PRIOR TO FILING THE FORM 990 WITH THE IRS. SCHEDULE K, PART IV, LINE 7 THE ORGANIZATION DID NOT HAVE WRITTEN PROCEDURES IN PLACE BY DECEMBER 31, 2012 TO MONITOR THE REQUIREMENTS OF SECTION 148, HOWEVER, A WRITTEN POLICY WAS ESTABLISHED BY THE ORGANIZATION PRIOR TO FILING THE FORM 990 WITH THE IRS. SCHEDULE K, PART V THE ORGANIZATION DID NOT HAVE WRITTEN PROCEDURES IN PLACE BY DECEMBER 31, 2012 TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM, HOWEVER, A WRITTEN POLICY WAS ESTABLISHED BY THE ORGANIZATION PRIOR TO FILING THE FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS SHALL APPOINT FROM AMONG ITS MEMBERS AN EXECUTIVE COMMITTEE OF NOT LESS THAN FIVE MEMBERS. THE CHAIR OF THE BOARD OF DIRECTORS SHALL BE A MEMBER EX OFFICIO OF THE EXECUTIVE COMMITTEE AND SHALL SERVE ITS CHAIR. THE EXECUTIVE COMMITTEE SHALL PERFORM SUCH FUNCTIONS AS THE BOARD OF DIRECTORS FROM TIME TO TIME MAY SPECIFY. IN ADDITION, IN ORDER TO DEAL WITH AN EMERGENCY SITUATION WHEN A MEETING OF THE BOARD OF DIRECTORS CANNOT CONVENIENTLY BE HELD, THE EXECUTIVE COMMITTEE IS AUTHORIZED TO EXERCISE ALL POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION EXCEPT ACTION IN RESPECT TO THE ELECTION OF OFFICERS OR THE FILLING OF VACANCIES IN THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 THE UNITED LUTHERAN PROGRAM FOR THE AGING, INC. CORPORATION HAS TWO CLASSES OF MEMBERS: CONGREGATIONAL MEMBERS AND AFFILIATE MEMBERS. CONGREGATIONAL MEMBERS CONSIST OF CONGREGATIONS OF THE EVANGICAL LUTHERAN CHURCH OF AMERICA THAT FROM TIME TO TIME ARE INVITED AND ELECT TO BECOME CONGREGATIONAL MEMBERS. AFFILIATE MEMBERS OF THE CORPORATION CONSIST OF ALL CORPORATIONS, CONGREGATIONS, ASSOCIATIONS, AND INDIVIDUALS 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 THE CONFLICT OF INTEREST POLICY 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 0 1 1 1 0 1 0 1