2012-05-15T10:05:34-05:00 2011-06-30 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2010-07-01 362192824 LUTHERAN HOME FOR THE AGED INC LUTH 8473687342 800 W OAKTON STREET ARLINGTON HEIGHTS IL 600044602 CARL MOELLENKAMP 8473687342 2012-05-11 1 ROBERT J NOWAK CPA MST 6305738600 2010 2016-02-24 21:20:13Z CARL MOELLENKAMP 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 43863822 0 X WWW.LUTHERANLIFECOMMUNITIES.ORG X 1892 IL SEE SCHEDULE O FOR ORGANIZATION MISSION STATEMENT. EMPOWERING VIBRANT GRACE FILLED LIVING ACROSS ALL GENERATIONS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FINANCIAL FUNDS. 4 3 975 297 0 0 378692 704351 36249510 39477439 233453 315838 2148274 2178493 39009929 42676121 0 0 0 0 21150571 22576294 0 0 52650 13466058 14933747 34616629 37510041 4393300 5166080 49245817 48355133 43517249 37970793 5728568 10384340 EMPOWERING VIBRANT GRACE FILLED LIVING ACROSS ALL GENERATIONS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FINANCIAL FUNDS. 0 0 32184511 40508291 DEVELOPMENT AND OPERATION OF 392 SKILLED NURSING UNITS FOR SENIORS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FUNDS. 32184511 1 1 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 98 0 1 975 1 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X CARL MOELLENKAMP CFO 8473687342 3150 SALT CREEK LANE ARLINTON HEIGHTS IL 60005 ROGER W PAULSBERG 37.50 X X 414665 0 12410 REV DAVID G ABRAHAMSON 2.00 X X 0 0 0 PAULA K PARKS 2.00 X X 0 0 0 MARILYN HERMANN 2.00 X 0 0 0 CARL MOELLENKAMP 37.50 X 258183 0 14464 JAMES HOLBROOK 37.50 X 240403 0 11473 YVONNE RENEE WATTS 37.50 X 257863 0 9748 CARL BENDORF 37.50 X 180396 0 10398 MARIE CARLSON-KYLLO 37.50 X 193050 0 9456 RICHARD DEROCHE 37.50 X 149856 0 6194 ANNAMARIE SEBASTIAN 37.50 X 148161 0 6841 PHILIP HEMMER 37.50 X 139414 0 9068 1981991 0 90052 24 0 1 0 ACHIEVE ACCREDITATION 145 S YORK STREET ELMHURST IL 60126 CONSULTING 186803 CHUHAK & TECSON PC 30 S WACKER DRIVE CHICAGO IL 60606 LEGAL 129954 KPMG LLP PO BOX 120001 DALLAS TX 75312 AUDIT SERVICES 126000 LANER MUCHIN 515 NORTH STATE STREET STE 2800 CHICAGO IL 60610 CONSULTING 113684 4 704351 704351 HEALTH CARE SERVICES 623000 39477439 39477439 39477439 378461 378461 1147641 1147641 1147641 1147641 1125078 1187701 -62623 -62623 -62623 CAFETERIA INCOME 623000 383621 383621 BEAUTY SHOP 623000 212454 212454 PURCHASE DISCOUNTS 623000 123983 123983 310794 310794 1030852 42676121 40508291 0 1463479 1219209 1219209 17655056 17614556 40500 328063 328063 2070329 2070329 1303637 1291487 12150 80341 80341 35000 35000 2873872 2873872 158363 158363 3059217 3059217 95026 95026 1574616 1574616 88676 88676 19309 19309 1528546 1528546 2739325 2739325 72539 72539 FOOD & DIETARY SUPPLIES 1995643 1995643 GROUND MAINTENANCE & EQ 571642 571642 MEDICAL SUPPLIES 264601 264601 RESIDENT SERVICES 163899 163899 BUILDING REPAIRS 148087 148087 -534955 -4400746 3865791 37510041 32184511 5272880 52650 1396818 1791767 1028519 404835 4682034 5034080 793341 382527 121175 111293 663478 359543 68988387 40988557 29077720 27999830 2940858 2749062 8541874 9522196 49245817 48355133 3434246 4229688 24456604 23918930 2860000 3453000 12766399 6369175 43517249 37970793 X 5728568 10384340 5728568 10384340 49245817 48355133 X 5166080 -510308 X X 0 1 1 X 0 X 50251 120331 5387 378692 704351 1259012 31044759 33729409 35281735 36249510 39477439 175782852 31095010 33849740 35287122 36628202 40181790 177041864 0 0 0 177041864 1921660 1804530 1344819 1365272 1463479 7899760 1921660 1804530 1344819 1365272 1463479 7899760 812576 895001 985604 1016455 1030853 4740489 33829246 36549271 37617545 39009929 42676122 189682113 0.93340 0.92990 0.04160 0.04460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20225 20225 49928632 25110260 24818372 18472912 15332314 3140598 566618 545983 20635 27999830 LONG TERM INVESTMENTS 2749062 F 2749062 AGENCY FUNDS 50311 CUSTODIAL FUNDS 108722 DEFERRED FINANCING COSTS 465826 ASSETS HELD BY TRUSTEE UNDER BOND INDENTURE 626615 RESIDENT DEPOSITS 1348524 DUE FROM AFFILIATES 6922198 9522196 RESIDENT ASSETS 108722 RESERVE FOR FUNERAL EXPENSES 12800 AGENCY FUNDS 50311 REFUNDABLE DEPOSITS 1335724 PAYABLES UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS 26577 DUE TO AFFILIATES 4077480 INTEREST RATE SWAP AGREEMENT 757561 6369175 X X X X 0 0 0 0 0 0 0 0 0 ROGER W PAULSBERG 348242 0 30000 0 36423 0 10327 0 2083 0 427075 0 370462 0 CARL MOELLENKAMP 213313 0 23794 0 21076 0 6986 0 7478 0 272647 0 203467 0 JAMES HOLBROOK 203322 0 13750 0 23331 0 7170 0 4303 0 251876 0 222289 0 YVONNE RENEE WATTS 222129 0 10668 0 25066 0 7656 0 2092 0 267611 0 241900 0 CARL BENDORF 155710 0 3706 0 20980 0 5722 0 4676 0 190794 0 180050 0 MARIE CARLSON-KYLLO 166050 0 5000 0 22000 0 6001 0 3455 0 202506 0 170939 0 RICHARD DEROCHE 130124 0 5308 0 14424 0 2812 0 3382 0 156050 0 163587 0 ANNAMARIE SEBASTIAN 123735 0 6007 0 18419 0 4476 0 2365 0 155002 0 144632 0 ILLINOIS FINANCE AUTHORITY 861091967 45200PXL6 2003-11-13 14350000 REVENUE REFUNDING BOND 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PENNY PAULSBERG SPOUSE OF ROGER PAULSBERG, CHAIRMAN 131804 PENNY IS AN EMPLOYEE OF THE ORGANIZATION. 0 FORM 990, PART VI, SECTION A, LINE 6 LUTHERAN HOME AND SERVICES FOR THE AGED, INC. IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD IS APPOINTED BY THE SOLE CORPORATE MEMBER, LUTHERAN HOME AND SERVICES FOR THE AGED, INC. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE SOLE CORPORATE MEMBER, LUTHERAN HOME AND SERVICES FOR THE AGED, INC. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION REVIEWS THE TAX RETURN WITH THE AUDIT COMMITTEE OF LUTHERAN LIFE COMMUNITIES (WHICH IS THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) WHICH WAS APPOINTED BY THE BOARD OF LUTHERAN HOME FOR THE AGED, INC. TO REPORT TO THE BOARD OF LUTHERAN LIFE COMMUNITIES WHICH PROVIDES FINAL APPROVAL OF THE TAX RETURNS OF ALL OF ITS SUBSIDIARIES AND AFFILIATES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS TO DISCLOSE TO THE BOARD OF DIRECTORS WHEN A CONFLICT MAY EXIST. THE POLICY AND COMPLIANCE WITH THIS POLICY IS REVIEWED ANNUALLY BY THE AUDIT COMMITTEE OF LUTHERAN LIFE COMMUNITIES (WHICH IS THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED WITH THE HELP OF AN INDEPENDENT COMPENSATION CONSULTANT AND THE COMPENSATION COMMITTEE OF LUTHERAN LIFE COMMUNITIES (WHICH IS THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) ULTIMATE APPROVAL FOR THE COMPENSATION AMOUNT FOR THE CEO RESTS WITH THE BOARD OF LUTHERAN LIFE COMMUNITIES. THE LUTHERAN LIFE COMMUNITIES BOARD PROVIDES COUNSEL TO THE CEO FOR THE COMPENSATION OF ANY OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE TAX RETURN, FINANCIAL STATEMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 595,147. CHANGE IN FAIR VALUE OF DERIVATIVE INVESTMENTS 129,268. NET ASSETS TRANSFERRED TO AFFILIATES -1,234,723. TOTAL TO FORM 990, PART XI, LINE 5: -510,308. FORM 990, PART XI, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. LUTHERAN HOME AND SERVICES FOR THE AGED INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 363375902 HOUSING AND SERVICES FOR SENIORS IL 501(C)(3) 509(A)(2) N/A 0 LUTHERAN COMMUNITY SERVICES FOR THE AGED INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 363365609 IMPROVE QUALITY OF LIFE FOR SENIORS IL 501(C)(3) 509(A)(2) N/A 0 LUTHERAN FOUNDATION FOR THE AGED INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 363365615 SUPPORTS THE WORK PROVIDED IN THE LUTHERAN HOME AND SERVICES SYSTEM IL 501(C)(3) 170(B)(1)(A)(VI) N/A 0 LUTHER OAKS INC 601 LUTZ ROAD BLOOMINGTON IL 61704 202117469 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) N/A 0 WITTENBERG LUTHERAN VILLAGE INC 1200 E LUTHER DRIVE CROWN POINT IN 46307 351299499 LONG-TERM HEALTH CARE FACILITY IN 501(C)(3) 509(A)(2) N/A 0 WITTENBERG LUTHERAN VILLAGE ENDOWMENT CORPORATION 1200 E LUTHER DRIVE CROWN POINT IN 46307 351472245 LONG-TERM HEALTH CARE FACILITY IN 501(C)(3) 509(A)(2) N/A 0 LUTHERAN LIFE COMMUNITIES 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 203426654 DEVELOP NEW SERVICES FOR SENIORS AND MANAGE SENIOR LIVING FACILITIES IL 501(C)(3) 509(A)(1) N/A 0 PLEASANT VIEW LUTHERAN HOME INC 505 COLLEGE AVENUE OTTAWA IL 61350 362167830 NURSING AND HEALTHCARE FACILITY IL 501(C)(3) 509(A)(2) N/A 0 LUTHERAN LIFE COMMUNITIES FOUNDATION 3831 NORTH MOZART AVENUE CHICAGO IL 60618 363861882 SUPPORTS THE RESIDENTS AND OPERATIONS OF EACH LUTHERAN LIFE COMMUNITY IL 501(C)(3) 509(A)(1) N/A 0 ST PAUL'S HOUSE AND HEALTH CARE CENTER 3831 NORTH MOZART AVENUE CHICAGO IL 60618 362167897 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) N/A 0 VERISPRING INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 208549333 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) N/A 0 ARLINGTON OF NAPLES 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 262019353 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) N/A 0 LUTHERAN MANAGEMENT SERVICES INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 203773781 CARE FOR SENIORS IL N/A C 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 1 0 0 LUTHERAN LIFE COMMUNITIES J 25398 WITTENBERG LUTHERAN VILLAGE INC P 263336 ST PAUL'S HOUSE AND HEALTH CARE CENTER P 166394 PLEASANT VIEW LUTHER HOME INC P 184882 LUTHER OAKS INC P 66890 LUTHERAN LIFE COMMUNITIES E 11871 LUTHERAN LIFE COMMUNITIES FOUNDATION E 4065608 LUTHERAN HOME AND SERVICES FOR THE AGED INC D 2047676 WITTENBERG LUTHERAN VILLAGE INC D 1036780 PLEASANT VIEW LUTHER HOME INC D 1690626 ST PAUL'S HOUSE AND HEALTH CARE CENTER D 545957 LUTHER OAKS INC D 1016011 THE ARLINGTON OF NAPLES D 1217569 WITTENBERG LUTHERAN ENDOWMENT CORPORATION D 267579