SKAALEN NURSING AND REHABILITATION CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: SKAALEN NURSING AND REHABILITATION CENTER INC (EIN 39-1104331)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-14
IRS object ID: 201333189349301143
Schema version: 2012v2.3
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-14T08:39:19-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JT AND ASSOCIATES LLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	700 PILGRIM PARKWAY SUITE 200	AddressLine1
City	ELM GROVE	City
State	WI	State
ZIP Code	53122	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	391104331	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SKAALEN NURSING AND REHABILITATION	BusinessNameLine1
Business Name Line2	CENTER INC	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	SKAA	NameControl
Phone	6088735651	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NORTH MORRIS STREET	AddressLine1
City	STOUGHTON	City
State	WI	State
ZIP Code	53589	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	KRIS KRENTZ	Name
Title	PRESIDENT/CEO	Title
Phone	6088735651	Phone
Date Signed	2013-11-12	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	MARK JANKE	Name
Phone	2627899945	Phone
Date Prepared	2013-11-12	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	KRIS KRENTZ	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	400 N MORRIS ST	AddressLine1
City	STOUGHTON	City
State	WI	State
ZIP Code	53589	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	10788057	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.SKAALEN.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1900	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE NURSING, PATIENT CARE AND REHABILITATION SERVICES TO ALL INDIVIDUALS REGARDLESS OF SOURCE OF PAYMENT, AND ABILITY TO PAY FROM THEIR OWN FUNDS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	341	TotalNbrEmployees
Total Nbr Volunteers	120	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	243618	ContributionsGrantsPriorYear
Contributions Grants Current Year	303756	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	11171798	ProgramServiceRevenuePriorYear
Program Service Revenue CY	10145859	ProgramServiceRevenueCY
Investment Income Prior Year	40924	InvestmentIncomePriorYear
Investment Income Current Year	54286	InvestmentIncomeCurrentYear
Other Revenue Prior Year	-102234	OtherRevenuePriorYear
Other Revenue Current Year	284156	OtherRevenueCurrentYear
Total Revenue Prior Year	11354106	TotalRevenuePriorYear
Total Revenue Current Year	10788057	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	8362280	SalariesEtcPriorYear
Salaries Etc Current Year	8148881	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	3117953	OtherExpensePriorYear
Other Expenses Current Year	3137315	OtherExpensesCurrentYear
Total Expenses Prior Year	11480233	TotalExpensesPriorYear
Total Expenses Current Year	11286196	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-126127	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-498139	RevenuesLessExpensesCY
Total Assets BOY	11185089	TotalAssetsBOY
Total Assets EOY	10217224	TotalAssetsEOY
Total Liabilities BOY	3956978	TotalLiabilitiesBOY
Total Liabilities EOY	3487252	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	7228111	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	6729972	NetAssetsOrFundBalancesEOY
Mission Description	TO PROVIDE NURSING, PATIENT CARE AND REHABILITATION SERVICES TO ALL INDIVIDUALS REGARDLESS OF SOURCE OF PAYMENT, AND ABILITY TO PAY FROM THEIR OWN FUNDS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	7870880	Expense
Revenue	6534969	Revenue
Description	SKILLED NURSING FACILITY (SNF)- SKAALEN OWNS AND OPERATES A 110 BED NURSING HOME LOCATED IN STOUGHTON, WISCONSIN. THE SNF OFFERS SPECIALIZED RESTORATIVE REHABILITATION FOR SHORT TERM STAYS, NURSING CARE FOR LONG-TERM STAYS, AND END STAGE HOSPICE CARE. A SUBSTANTIAL PORTION OF ITS CARE IS PROVIDED TO RESIDENTS ON MEDICAID WHICH DOES NOT PROVIDE ADEQUATE REIMBURSEMENT TO COVER THE COSTS OF CARE AND HOUSING.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	1094333	Expense
Revenue	1451079	Revenue
Description	ANCILLARY SERVICES RELATING TO SNF - ANCILLARY SERVICES ARE PROVIDED TO THE RESIDENTS OF THE SNF SUCH AS PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. OTHER ANCILLARY SERVICES INCLUDE THE DRUGS AND MEDICAL SUPPLIES AS WELL AS ACTIVITY AND REHABILITATION PROGRAMS.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	1628269	Expense
Revenue	2159811	Revenue
Description	COMMUNITY BASED RESIDENTIAL FACILITY (CBRF) AND RESIDENTIAL APARTMENTS. SKAALEN OWNS AND OPERATES A 57 BED CBRF AND 8 APARTMENT UNITS FOR THE ELDERLY. THE CBRF FACILITIES ARE DESIGNED TO PROVIDE CARE TO THE ELDERLY IN A HOME-LIKE SETTING. RESIDENTS RECEIVE MEALS, MEDICAL MANAGEMENT, HOUSEKEEPING, AND OTHER DAILY LIVING SERVICES BASED ON THEIR NEEDS.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	10593482	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	15	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	341	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	WI	StatesWhereCopyOfReturnIsFiled
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	SKAALEN NURSING AND REHABILITATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6088735651	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	400 NORTH MORRIS STREET	AddressLine1
City	STOUGHTON	City
State	WI	State
ZIP Code	53589	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
HOMER HOWARD
DIRECTOR	1.00	X	0	0	0
FRED INGERSOLL
PRESIDENT	1.00	X	0	0	0
LOIS DYBEVIK
DIRECTOR	1.00	X	0	0	0
AUGUST HOHL
DIRECTOR	1.00	X	0	0	0
JOHN HEFTE
DIRECTOR	1.00	X	0	0	0
FERN BINGER
TREASURER	1.00	X	0	0	0
REV JERRY PRIBBENOW
DIRECTOR	1.00	X	0	0	0
REV CLYDE CROSS
VICE PRESIDE	1.00	X	0	0	0
ALAN SORENSON
SECRETARY	1.00	X	0	0	0
MARK BENSON
EXEC DIR	30.00		154056	0	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	154056	TotalReportableCompFromOrg
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Related Organizations	95000	RelatedOrganizations
All Other Contributions	208756	AllOtherContributions
Total Contributions	303756	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PROGRAM SERVICES	Description
Total Revenue Column	10145859	TotalRevenueColumn
Related Or Exempt Function Income	10145859	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	10145859	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	54286	TotalRevenueColumn
Related Or Exempt Function Income	54286	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	INVESTMENT UNREALIZED GAINS	Description
Total Revenue Column	284156	TotalRevenueColumn
Related Or Exempt Function Income	284156	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	284156	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	10788057	TotalRevenueColumn
Related Or Exempt Function Income	10484301	RelatedOrExemptFunctionIncome

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	6444418	Total
Program Services	5907983	ProgramServices
Management And General	536435	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	293198	Total
Program Services	293198	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	868266	Total
Program Services	868266	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	542999	Total
Program Services	542999	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	12153	Total
Management And General	12153	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	16950	Total
Management And General	16950	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	62606	Total
Program Services	62606	ProgramServices

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	108882	Total
Program Services	108882	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	215133	Total
Program Services	215133	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	7105	Total
Program Services	7105	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	85739	Total
Program Services	85739	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	622798	Total
Program Services	622798	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	104446	Total
Program Services	104446	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
DIETARY	448650	448650
NURSING	347058	347058
MAINTENANCE	309876	309876
ANCILLARY EXPENSES	238466	238466

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	557453	Total
Program Services	430277	ProgramServices
Management And General	127176	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	11286196	Total
Program Services	10593482	ProgramServices
Management And General	692714	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	702066	BOY
EOY	292158	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2775835	BOY
EOY	2644483	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	973499	BOY
EOY	724542	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	106350	BOY
EOY	104437	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	19711057	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	13305630	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	6526827	BOY
EOY	6405427	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	100512	BOY
EOY	46177	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	11185089	BOY
EOY	10217224	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	854441	BOY
EOY	843268	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	739076	BOY
EOY	732140	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	1900000	BOY
EOY	1900000	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	463461	BOY
EOY	11844	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	3956978	BOY
EOY	3487252	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	6142063	BOY
EOY	5676852	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1045227	BOY
EOY	1008857	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	40821	BOY
EOY	44263	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	7228111	BOY
EOY	6729972	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	11185089	BOY
EOY	10217224	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-498139	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Church170b1 Ai	X	Church170b1Ai

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1836596	BeginningOfYearBalance
Contributions	68710	Contributions
Investment Earnings Or Losses	268308	InvestmentEarningsOrLosses
Other Expenditures	81135	OtherExpenditures
End Of Year Balance	2092479	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1894701	BeginningOfYearBalance
Contributions	54751	Contributions
Investment Earnings Or Losses	-58105	InvestmentEarningsOrLosses
Other Expenditures	54751	OtherExpenditures
End Of Year Balance	1836596	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1930237	BeginningOfYearBalance
Contributions	259773	Contributions
Investment Earnings Or Losses	202021	InvestmentEarningsOrLosses
Other Expenditures	497330	OtherExpenditures
End Of Year Balance	1894701	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1485659	BeginningOfYearBalance
Contributions	110563	Contributions
Investment Earnings Or Losses	334015	InvestmentEarningsOrLosses
End Of Year Balance	1930237	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1705646	BeginningOfYearBalance
Contributions	425210	Contributions
Investment Earnings Or Losses	-601721	InvestmentEarningsOrLosses
Other Expenditures	43476	OtherExpenditures
End Of Year Balance	1485659	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.53000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.02000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.45000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	true	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	748215	OtherCostOrOtherBasis
Book Value	748215	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	14868142	OtherCostOrOtherBasis
Depreciation	9816648	Depreciation
Book Value	5051494	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4094700	OtherCostOrOtherBasis
Depreciation	3488982	Depreciation
Book Value	605718	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	6405427	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
RESIDENT TRUST ACCOUNT	$11,844
EMPLOYEE DEFERRED COMPENSATION

Field	Value	IRS element (for citing)
Total Of Amounts	11844	TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt	10788057	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	10788057	RevenueSubtotal
Total Revenue Per Form990	10788057	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	11286196	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	11286196	ExpensesSubtotal
Total Expenses Per Form990	11286196	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	INTENDED USES FOR ENDOWMENT FUNDS	Identifier
Return Reference	SCHEDULE D, PAGE 2, PART V, LINE 4	ReturnReference
Explanation	INCOME FROM THE PERMANENTLY RESTRICTED ENDOWMENT FUND IS NOT RESTRICTED. ENDOWMENT FUNDS RELATED TO QUASI RESTRICTED FUNDS ARE GENERALLY TO BE USED FOR BENEVOLENT CARE. THE VAST MAJORITY OF ENDOWMENT FUNDS THAT ARE TEMPORARILY RESTRICTED ARE ALSO TO BE USED FOR BENEVOLENT CARE. THE REMAINDER OF THE TEMPORARILY RESTRICTRED ENDOWMENT FUNDS ARE TO BE USED FOR PROGRAMS RELATING TO PROFESSIONAL DEVELOPMENT, RECOGNITION, RECRUITMENT, AND RETENTION OF NURSING STAFF.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Field	Value	IRS element (for citing)
Name Person	MARK BENSON	NamePerson
Title	EXEC DIR	Title
Base Compensation Filing Org	154056	BaseCompensationFilingOrg
Total Compensation Filing Org	154056	TotalCompensationFilingOrg

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
CLASSES OF MEMBERS OR STOCKHOLDERS	FORM 990, PAGE 6, PART VI, LINE 6	MEMBERS OF THE CORPORATION ARE 33 LUTHERAN CHURCHES AND 1 METHODIST CHURCH IN AND AROUND THE STOUGHTON AREA.
ELECTION OF MEMBERS AND THEIR RIGHTS	FORM 990, PAGE 6, PART VI, LINE 7A	EACH CHURCH SENDS ONE PASTOR AND 2-8 DELEGATES BASED ON SIZE OF CHURCH TO THE ANNUAL MEETING HELD IN MARCH EACH YEAR. THE PASTORS AND DELEGATES ELECT THE NINE PERSON BOARD OF DIRECTORS AT THE ANNUAL MEETING. EACH DIRECTOR IS LIMITED TO TWO THREE YEAR TERMS. TERMS ARE STAGGERED SO ONE-THIRD OF THE BOARD ARE ELECTED OR RE-ELECTED EACH YEAR.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS	FORM 990, PAGE 6, PART VI, LINE 7B	THE ACTIONS OF THE BOARD ARE SUMMARIZED AND REPORTED TO THE MEMBERS OF THE ANNUAL MEETING EACH YEAR. THE MEMBERSHIP RATIFIES THE ACTIONS THROUGH A RESOLUTION WHICH IS VOTED ON EACH YEAR.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 IS REVIEWED BY THE CEO AND BOARD CHAIRMAN BEFORE IT IS FILED. COPIES ARE AVAILABLE TO ANY BOARD MEMBER UPON REQUEST.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. IF A CONFLICT IS DISCLOSED, THEY ARE PROHIBITED FROM DISCUSSION AND VOTING ON THE MATTER BY BOARD BYLAWS AND THE CEO'S EMPLOYMENT CONTRACT.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE ENTIRE BOARD CONDUCTS A PERFORMANCE REVIEW OF THE CEO IN JANUARY OF EACH YEAR AT A REGULAR BOARD MEETING. SALARY AND BENEFIT INFORMATION FROM AAHSA AND LEADING AGE ANNUAL SURVEYS ARE USED TO DETERMINE AN APPROPRIATE SALARY AND BENEFIT RANGE FOR THE CEO. THE BOARD APPROVES ANY CHANGES TO THE CEO SALARY AND BENEFIT PACKAGE. A WRITTEN LETTER OF SUCH CHANGES IS PROVIDED BY THE BOARD CHAIR TO THE CEO AND HUMAN RESOURCE DIRECTOR. IN ADDITION,THE YEARLY WRITTEN GOALS AND OBJECTIVES SET FOR THE CEO ARE REVIEWED AND A NEW SET OF GOALS AND OBJECTIVES FOR THE CURRENT YEAR ARE DISCUSSSED AND APPROVED.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	A SPREAD SHEET LISTING THE CURRENT SALARY AND BENEFITS OF ALL DEPARTMENT HEADS AND MANAGERS IS PROVIDED TO THE BOARD FOR THEIR REVIEW AND APPROVAL ANNUALLY IN JANUARY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	ANNUAL REPORT, GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.