2011-11-14T09:32:22-06:00 2010-12-31 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2010-01-01 420794364 CEDAR FALLS LUTHERAN HOME CEDA 3192680401 7511 UNIVERSITY AVENUE CEDAR FALLS IA 50613 DAWN BENGEN 3192680401 2011-11-11 1 6123764500 2010 2016-03-07 17:11:31Z KATHY DUKE 7511 UNIVERSITY AVENUE CEDAR FALLS IA 50613 16992072 0 X WWW.CFLH.ORG X 1958 IA ENHANCING THE LIVES OF SENIORS THROUGH A COMMITMENT TO INDIVIDUALIZED, CHRISTIAN CARE. 13 13 477 200 0 0 129142 267166 11910174 13229147 -305959 654171 0 0 11733357 14150484 0 0 0 0 7693901 7909895 0 0 0 4005129 4695815 11699030 12605710 34327 1544774 15949652 20815550 9201281 13057709 6748371 7757841 ENHANCING LIVES THROUGH A COMMITMENT TO INDIVIDUALIZED, CHRISTIAN CARE IN A HOME EMPOWERED BY GOD'S LOVE. 0 0 11765143 0 13229147 WE OFFER CHRISTIAN CARING THROUGHOUT OUR 135-BED NURSING FACILITY, 42-UNIT ASSISTED LIVING FACILITY AND 105 INDEPENDENT LIVING UNITS. WE ARE COMMITTED TO QUALITY FIRST, A PHILOSOPHY OF QUALITY AND A FRAMEWORK FOR EARNING PUBLIC TRUST IN AGING SERVICES. WE CONTINUE OUR JOURNEY TO PROMOTE RESIDENT-CENTERED, CONSUMER DRIVEN SERVICE. WE OFFER WELLNESS PROGRAMMING THAT INCLUDES MUSIC, ART AND HORTICULTURE THERAPIES. 11765143 1 1 0 0 0 1 0 1 1 1 0 0 1 1 1 0 1 0 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 0 1 0 0 0 0 0 1 17 0 477 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X X DAWN BENGEN 3192680401 7511 UNIVERSITY AVENUE CEDAR FALLS IA 50613 KATHY DUKE 3.00 X X 0 0 0 LARRY GREGORY 2.00 X X 0 0 0 BETTY BERGMAN 2.00 X X 0 0 0 ALLEN SCHNEIDER 1.00 X X 0 0 0 DENNIS ESLICK 1.00 X 0 0 0 DEON SENCHINA 1.00 X 0 0 0 ART LUPKES 1.00 X 0 0 0 RICHARD HANFT 1.00 X 0 0 0 LARRY SORENSEN 1.00 X 0 0 0 BOB NELSON 1.00 X 0 0 0 MARCIA MICHAELSEN 1.00 X 0 0 0 AMY HOYER 1.00 X 0 0 0 LARRY CLARK 1.00 X 0 0 0 MILLISA TIERNEY 40.00 X 117323 0 13614 DAWN BENGEN 40.00 X 80219 0 9189 197542 0 22803 1 0 0 0 AGILITY THERAPY PO BOX 77000 DETROIT MN 48277 THERAPY SERVICES 683095 REHAB WORKS LLC PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 126436 ARAMARK UNIFORM SERVICES 600 LINDEN AVE PO BOX 1510 WATERLOO IA 50701 LAUNDRY SERVICES 122976 3 267166 267166 NURSING FACILITY 623000 10650196 10650196 ASSISTED LIVING 623000 1180586 1180586 APARTMENT REVENUE 623000 998792 998792 ENTRANCE FEES 623000 357660 357660 MEALS & ACTIVITIES 623990 41913 41913 13229147 89625 89625 3341486 64648 2767951 73637 573535 -8989 564546 564546 14150484 13229147 0 654171 220345 50616 169729 6458640 6454681 3959 197382 197265 117 513337 513018 319 520191 519882 309 36358 36358 41097 41097 16521 16521 954985 760185 194800 392403 389868 2535 13198 1984 11214 295196 293289 1907 563969 560326 3643 141188 141188 THERAPY SERVICES 836562 836562 FOOD 522788 522788 PROGRAM SERVICES 493724 493724 MISCELLANEOUS 210097 6646 203451 LOSS ON REFINANCING OF 133567 133567 44162 23121 21041 12605710 11765143 840567 0 581241 1027971 420000 453301 106739 75168 749360 865435 103431 67146 19670089 7990815 10929731 11679274 2729437 2779261 226560 397098 103153 3470896 15949652 20815550 1011327 1541474 1059236 2921986 4530000 8202007 2314770 122028 285948 270214 9201281 13057709 X 3821800 4614012 419016 631718 2507555 2512111 6748371 7757841 15949652 20815550 X 1544774 -535304 X 0 1 1 X 0 X 397129 288845 381924 129142 267133 1464173 9887001 10294742 10741057 11910174 13229147 56062121 10284130 10583587 11122981 12039316 13496280 57526294 13167 10000 12500 9000 44667 0 13167 10000 12500 9000 44667 57481627 149870 245084 165135 87311 89625 737025 149870 245084 165135 87311 89625 737025 10434000 10828671 11288116 12126627 13585905 58263319 0.98660 0.98390 0.01260 0.01510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X X X 1 0.33 0 0 0 1 0 5.00 115 0 1 2507555 4556 2512111 2502221 5334 2507555 2471131 31090 2502221 1.00000 0 0 208962 208962 16337033 6167400 10169633 2213449 1823415 390034 910645 910645 11679274 RESIDENTS AND SECURITY DEPOSITS 11143 BOND FUNDS 3446019 INTEREST RECEIVABLE 13734 3470896 ANNUITY INTEREST PAYABLE 6818 ASSET RETIREMENT OBLIGATION 85534 FAIR VALUE OF DERIVATIVE INSTRUMENT 177862 270214 14150484 12605710 1544774 -535660 356 -535304 1009470 13229147 0 13229147 921337 921337 14150484 12470438 0 12470438 135272 135272 12605710 DESCRIPTION OF HOW ORGANIZATION REPORTS CONSERVATION EASEMENTS: PART II, LINE 9: LISTED UNDER MAINTENANCE DEPARTMENT; VERY SMALL AND DOESN'T REQUIRE MUCH MAINTENANCE. PART IV, LINE 2B: CONTRACT ARRANGEMENTS BETWEEN THE CORPORATION AND CERTAIN OF ITS RESIDENTS REQUIRE PAYMENTS UPON OCCUPANCY. THE TERMS OF THE CONTRACTS PROVIDE FOR A PARTIAL REFUND OF DEFERRED ENTRANCE FEES ON A PRO RATA BASIS IF THE RESIDENT DIES OR VOLUNTARILY VACATES THE UNIT WITHIN A SPECIFIED TIME PERIOD - IN ALL CASES TEN YEARS OR LESS. THE REFUNDS ARE PAID WITH RE-OCCUPANCY PROCEEDS FROM RESALE OF THE UNITS. THE ORGANIZATION IS THE TRUSTEE OF VARIOUS RESIDENT AND SECURITY DEPOSITS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION AND DISTRIBUTION OF THESE FUNDS FOR THE RESIDENTS. THESE FUNDS ARE ON DEPOSIT IN A SEPARATE BANK ACCOUNT, CONSISTING OF CASH AND CASH EQUIVALENTS. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INTEREST EARNED IN THE ENDOWMENT FUND IS TO BE USED TO OFFSET OPERATING EXPENSES AND KEEP RATES LOW FOR NURSING FACILITY RESIDENTS. IT ALSO WAS SET UP TO HELP MAKE UP THE LOSS INCURRED WITH TITLE XIX(MEDICAID) RESIDENTS. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN PRESENT VALUE OF ANNUITIES 356. PART XII, LINE 4B - OTHER ADJUSTMENTS: UNRESTRICTED CONTRIBUTIONS 35,527. LOSS ON DISPOSAL OF ASSETS -8,989. INVESTMENT LOSS 616,216. GAIN ON DERIVATIVE INSTRUMENT 46,944. RESTRICTED CONTRIBUTIONS 231,639. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ASSET RETIREMENT OBLIGATION EXPENSE 1,705. LOSS ON REFINANCING OF DEBT 133,567. INCOME TAXES: THE CORPORTION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE YEARS 2007 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. CITY OF EVANSDALE IOWA 426006424 299218AQ0 2010-08-12 8265000 BUILDING IMPROVEMENTS, EXPANSIONS, AND REFINANCING 2005 BONDS 0 0 0 62993 8265000 648356 4530346 164024 2858493 2011 1 0 0 1 0 0 0 0 1 0 1 1 WACHOVIA BANK 10.000000000000 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SEVEN MEMBERS WE HAVE ARE OUR SEVEN SPONSORING LUTHERAN CHURCHES. EACH MEMBER AND THE CEDAR FALLS LUTHERAN HOME RESIDENTS EACH PRESENT ONE OF ITS PASTORS TO BE A VOTING DELEGATE AT THE CORPORATION'S ANNUAL MEETING. IN ADDITION, ANY MEMBER WITH A CONGREGATION MEMBERSHIP LARGER THAN 2,00O BAPTIZED MEMBERS MAY PRESENT ONE ADDITIONAL DELEGATE FOR EACH 1,000 MEMBERS IN EXCESS OF 2,000 MEMBERS AS OF JANUARY FIRST OF THE YEAR IN WHICH THE ANNUAL MEETING IS TO BE HELD. THE CEDAR FALLS LUTHERAN HOME RESIDENTS SELECT TWO VOTING DELEGATES FROM THEIR MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION ELECT THE MEMBERS OF THE BOARD OF DIRECTORS AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7B ANY CHANGE TO THE ORGANIZATION'S NAME OR AMENDMENTS TO THE ORGANIZATIN'S BYLAWS REQUIRES THE APPROVAL OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE REVIEWED BY THE BOARD OF DIRECTORS WITH THE CFO BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AT A BOARD MEETING AND ALL BOARD MEMBERS SIGN TO INDICATE THEY UNDERSTAND THE POLICY. BOARD MEMBERS ARE TO IMMEDIATELY REPORT ANY ACTIVITY THAT COULD APPEAR TO BE A CONFLICT OF INTEREST. IF THERE IS A CONFLICT OF INTEREST, THEY ARE TO PUBLICLY DISCLOSE IT TO THE COMMITTEE AND/OR BOARD, AND REFRAIN FROM DISCUSSING OR TAKING ANY OFFICIAL ACTION THAT WOULD AFFECT THE DECISION MAKING PROCESS. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD'S PERSONNEL COMMITTEE MEETS WITH THE HUMAN RESOURCE AND FINANCE DIRECTORS TO REVIEW WAGE SURVEYS FROM THE IOWA ASSOCIATION OF HOME AND SERVICES FOR THE AGING (IAHSA) AND THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (AAHSA). THE PERSONNEL CHAIRPERSON AND THE EXECUTIVE COMMITTEE MEET TO DETERMINE THE FINAL COMPENSATION PACKAGE. THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER IS DETERMINED BY THE EXECUTIVE DIRECTOR. THE CFO REPORTS TO THE CEO AND PERFORMANCE EVALUATIONS ARE COMPLETED BY THE CEO. THE CEO MEETS WITH THE HUMAN RESOURCE DIRECTOR TO REVIEW WAGE SURVEYS FROM THE IOWA ASSOCIATION OF HOME AND SERVICES FOR THE AGING (IAHSA) AND THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (AAHSA). THE CEO MEETS WITH CFO TO DISCUSS GOALS, PERFORMANCE, AND WAGE SURVEYS. FINAL COMPENSATION IS THEN FORWARDED TO THE PAYROLL SPECIALIST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -535,660. CHANGE IN PRESENT VALUE OF ANNUITIES 356. TOTAL TO FORM 990, PART XI, LINE 5: -535,304. HOME CONNECTIONS LLC 7517 UNIVERSITY AVE CEDAR FALLS IA 50613 205472733 IN-HOME SERVICES IA 5426 1231 N/A