2024-08-07T08:35:07-05:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 20 STANWIX STREET PITTSBURGH PA 15222 990 2023-01-01 472584315 NATIONAL LUTHERAN INC NATI 3013542710 5275 WESTVIEW DRIVE 110 FREDERICK MD 21703 CYNTHIA WALTERS PRESIDENT AND CEO 3013542710 2024-08-01 1 1 JEFFREY J PETRELL P00138808 4126976400 2024-08-01 2023 2024-08-08 14:25:15Z NATIONAL LUTHERAN COMMUNITIES & SERVICES CYNTHIA WALTERS 5275 WESTVIEW DRIVE 110 FREDERICK MD 21703 8556639 0 X WWW.NATIONALLUTHERAN.ORG X 2014 MD TO SERVE AS CORPORATE OVERSIGHT FOR ITS AFFILIATED COMMUNITIES DESIGNED FOR SENIORS. 10 9 98 0 76450 40283 117679 73095 6593904 7897201 10589 9423 594698 576920 7316870 8556639 42500 0 0 0 8724670 6913368 0 0 9152 3741868 3125341 12509038 10038709 -5192168 -1482070 3642217 12287239 11508610 22386139 -7866393 -10098900 TO FULFILL ITS CHRISTIAN MINISTRY, NATIONAL LUTHERAN COMMUNITIES & SERVICES IS ORGANIZED TO PROVIDE AN ARRAY OF OPTIONS FOR SENIORS INCLUDING RESIDENTIAL LIVING AS WELL AS HOME AND COMMUNITY-BASED SERVICES WHICH ARE DESIGNED TO MEET INDIVIDUAL NEEDS. 0 0 4260903 7897201 TO SERVE AS CORPORATE OVERSIGHT WHICH INCLUDES, BUT IS NOT LIMITED TO, THE MARKETING, DEVELOPMENT, INFORMATION TECHNOLOGY, PHILANTHROPY, FINANCE, AND HUMAN RESOURCE SERVICES OF THREE CCRC COMMUNITIES AND ONE DUAL-CERTIFIED INDEPENDENT LIVING/ASSISTED LIVING FACILITY THAT PROVIDES SENIORS WITH HOUSING, MEDICAL ATTENTION, AND ANY SERVICES THAT PROMOTE GOOD EMOTIONAL AND PHYSICAL HEALTH IN A CHRISTIAN ENVIRONMENT. CURRENTLY THE ORGANIZATION IS OVERSEEING THE FUTURE DEVELOPMENT OF A CCRC TO BE LOCATED IN ANNAPOLIS, MD. 4260903 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 189 0 98 1 1 1 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X X DONNA CASNER 3013542710 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 JOHN E HANDLEY CHAIR 1.00 X X 0 0 0 DR RACHEL CARLSON VICE CHAIR 1.00 X X 0 0 0 CORNELL P ABOD TREASURER/SECRETARY 1.00 X X 0 0 0 REV SCOTT MAXWELL BOARD MEMBER 1.00 X 0 0 0 SUSAN DAILEY BOARD MEMBER 1.00 X 0 0 0 TOM WHITEFORD BOARD MEMBER 1.00 X 0 0 0 MICHAEL HELLER BOARD MEMBER 1.00 X 0 0 0 REV SANDRA SHAW BOARD MEMBER 1.00 X 0 0 0 CYNTHIA WALTERS PRESIDENT/CEO 10.00 30.00 X X 424579 0 48535 REV DEBBIE DUKES BOARD MEMBER 1.00 X 0 0 0 RICHARD MAZZA CHIEF FINANCIAL OFFICER 10.00 30.00 X 156605 0 17533 DONNA CASNER VICE PRESIDENT OF FINANCE 10.00 30.00 X 196575 0 18639 KAREN SROKA CLINICAL SERVICES DIRECTOR 40.00 X 198222 0 15409 KATHLEEN O'HALLORAN CHIEF TALENT & CULTURE OFFICER 40.00 X 206590 0 18357 CRAIG WAGONER VP OF OPERATIONS 40.00 X 183889 0 9789 LAWRENCE JORDAN III GENERAL COUNSEL 40.00 X 257036 0 21294 VICTORIA BLAKEMORE VP TALENT & CULTURE DEI 40.00 X 174890 0 9839 1798386 0 159395 27 0 1 0 FUNCTIONAL PATHWAYS OF TN LLC 10133 SHERRILL BLVD SUITE 200 KNOXVILLE TN 37932 THERAPY 2481931 INTELYCARE INC 1250 HANCOCK ST 501N QUINCY MA 02169 AGENCY NURSING 2260201 STAT NURSING LLC 5906 MAIN STREET MT JACKSON VA 22842 AGENCY NURSING 717264 NURSESPRING OF CHARLOTTESVILLE LLC 1807 EMMET STREET N 1A CHARLOTTESVILLE VA 22901 AGENCY NURSING 456436 ARCH CONSULTANTS LTD 300 KNIGHTSBRIDGE PKWY LINCOLNSHIRE IL 60069 PROJECT MANAGEMENT 437095 12 14100 58995 73095 MANAGEMENT FEES 623000 6714294 6714294 SKILLED NURSING REVENU 623000 1182907 1182907 7897201 9423 9423 DEVELOPER FEES 900099 500000 500000 CONSULTING INCOME 541610 76450 76450 OTHER INCOME 623000 470 470 576920 8556639 7897201 76450 509893 862466 862466 4966188 3211479 1754709 118101 31120 86981 338441 203789 134652 628172 269851 352662 5659 151879 151879 84943 84943 17070 17070 3437 3437 271849 271849 44179 3499 37332 3348 65207 36354 28853 1018429 153194 865235 148681 14015 134666 107858 34964 72894 484 484 24661 1629 23032 645925 2284 643641 DUES & SUBSCRIPTIONS 438442 259528 178914 REPAIRS & MAINTENANCE 17476 1755 15721 FOOD 14955 6106 8849 RECRUITMENT 11064 7341 3723 58802 23511 35146 145 10038709 4260903 5768654 9152 500 713624 9898019 104123 167347 960943 956797 258979 115015 69559 143964 899037 194323 894431 926789 3642217 12287239 3889481 3846504 7619129 18539635 11508610 22386139 X -8240497 -10423936 374104 325036 -7866393 -10098900 3642217 12287239 X -1482070 -750437 X 0 1 X 1 0 X 27205 1613231 43475 117679 73095 1874685 6884674 7531080 6585492 6593904 7897201 35492351 6911879 9144311 6628967 6711583 7970296 37367036 0 0 0 37367036 67695 76524 35856 10589 9423 200087 67695 76524 35856 10589 9423 200087 28500 67500 76450 172450 453062 954892 501672 527198 500470 2937294 7432636 10175727 7194995 7316870 8556639 40676867 0.91860 0.92660 0.00490 0.00570 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: CONSULTING REVENUE - DEVELOPER FEES - 2019 AMOUNT: $ 445,128. 2020 AMOUNT: $ 870,936. 2021 AMOUNT: $ 500,000. 2022 AMOUNT: $ 500,000. 2023 AMOUNT: $ 500,000. OTHER ANCILLARY REVENUE - OTHER INCOME - 2019 AMOUNT: $ 7,934. 2020 AMOUNT: $ 8,740. 2021 AMOUNT: $ 1,672. 2022 AMOUNT: $ 27,198. 2023 AMOUNT: $ 470. PROVIDER RELIEF FUNDS - 2020 AMOUNT: $ 75,216. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3395 3395 0 PART II-B, LINE 1: NATIONAL LUTHERAN, INC. PAYS DUES TO LUTHERAN SERVICES IN AMERICA. A PORTION OF THE DUES PAID TO THIS ORGANIZATION ARE ALLOCABLE TO LOBBYING EXPENSES. 258979 115015 143964 143964 RIGHT OF-USE ASSETS 926789 926789 LEASE LIABILITY 926789 DUE TO AFFILIATES 17612846 18539635 8605707 89732 89732 8515975 40664 40664 8556639 10038709 0 10038709 0 10038709 PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 89,732. PART XI, LINE 4B - OTHER ADJUSTMENTS: DONOR RESTRICTED CONTRIBUTIONS 40,664. X 0 0 X X X X X 0 0 0 0 0 0 0 1 0 CYNTHIA WALTERS PRESIDENT/CEO 423547 0 0 0 1032 0 14200 0 34335 0 473114 0 0 0 LAWRENCE JORDAN III GENERAL COUNSEL 256203 0 0 0 833 0 8312 0 12982 0 278330 0 0 0 KATHLEEN O'HALLORAN CHIEF TALENT & CULTURE OFFICER 205757 0 0 0 833 0 7678 0 10679 0 224947 0 0 0 DONNA CASNER VICE PRESIDENT OF FINANCE 191023 0 5000 0 552 0 8173 0 10466 0 215214 0 0 0 KAREN SROKA CLINICAL SERVICES DIRECTOR 197389 0 0 0 833 0 7007 0 8402 0 213631 0 0 0 CRAIG WAGONER VP OF OPERATIONS 182057 0 0 0 1832 0 619 0 9170 0 193678 0 0 0 VICTORIA BLAKEMORE VP TALENT & CULTURE DEI 168858 0 5000 0 1032 0 6998 0 2841 0 184729 0 0 0 RICHARD MAZZA CHIEF FINANCIAL OFFICER 156287 0 0 0 318 0 3673 0 13860 0 174138 0 0 0 PART I, LINE 1A EXECUTIVE APARTMENTS WERE PROVIDED FOR USE BY CYNTHIA WALTERS, CEO & RICHARD MAZZA, CFO. THIS WAS REPORTED AS TAXABLE COMPENSATION ON THEIR FORMS W-2. PART I, LINE 7 BONUSES ARE DETERMINED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND ARE BASED ON A VARIETY OF FACTORS SUCH AS WHETHER CAMPUS BUDGETS ARE MET, HOW EACH CAMPUS DOES ON ITS RESPECTIVE NURSING/HEALTH CARE SURVEY AND HOW EACH SENIOR LEADER DOES IN OBTAINING HIS OR HER GOALS FOR THE YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE VP OF FINANCE AND PRESIDENT PERFORM AN INITIAL REVIEW OF THE FORM 990. UPON APPROVAL, THE FORM 990 IS MADE AVAILABLE TO EACH BOARD MEMBER FOR REVIEW AND APPROVAL AT A BOARD MEETING PRIOR TO TRANSMISSION OF THE RETURN TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT EACH YEAR. IF A CONFLICT IS IDENTIFIED, IT IS 1) IDENTIFIED AND DISCUSSED WITH THE BOARD 2) REVIEWED AND DOCUMENTED BY MANAGEMENT. IF AN ACTUAL OR POTENTIAL CONFLICT IS IDENTIFIED, THE BOARD MEMBER, OFFICER, OR EMPLOYEE WILL RECUSE HIM OR HERSELF FROM ANY CONVERSATION, DECISIONS, OR OTHER ACTIVITIES AND DISCUSSIONS INVOLVING THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE CONFLICT OF INTEREST POLICY AS POTENTIAL SOURCES OF CONFLICTS WITH INTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD DETERMINES THE COMPENSATION FOR THE CEO THROUGH THE COMBINED USE OF SEVERAL METHODS. THE EXECUTIVE COMMITTEE SERVES AS A COMPENSATION COMMITTEE WHICH OVERSEES THE PROCESS. THE CEO, EXECUTIVE DIRECTOR, AND DIRECTOR OF HUMAN RESOURCES USE SALARY SURVEYS TO DETERMINE THE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES TO ENSURE THEY ARE WITHIN THE LOCAL MARKET RANGE. THE SERVICES THE INDIVIDUAL PROVIDES TO THE ORGANIZATION AND THE TENURE OF THE OFFICER ARE ALSO FACTORS CONSIDERED IN SALARY DETERMINATIONS. ONCE THE EXECUTIVE COMMITTEE GIVES ITS APPROVAL, ITS DECISIONS ARE NOTED AT THE BOARD LEVEL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AND AT NO COST. THE DOCUMENTS WILL ALSO BE MADE AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. FORM 990, PART XI, LINE 9: INHERENT CONTRIBUTIONS TO AFFILIATES -750,437. LOSS FROM DISCONTINUED OPERATIONS COMMUNITY SERVICES LLC 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 371843616 PROJECT MANAGEMENT MD 0 0 NATIONAL LUTHERAN INC MYPOTENTIAL MD 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 812686381 HEALTH CLINIC MD 655519 57983 COMMUNITY SERVICES LLC MYPOTENTIAL VA 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 474102818 HEALTH CLINIC VA 527388 47231 COMMUNITY SERVICES LLC TVOR CLINIC LLC 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 300962299 HEALTH CLINIC MD 0 0 COMMUNITY SERVICES LLC IMPACT 1890 LLC 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 301007964 GRANT PAYMENTS MD 0 0 NATIONAL LUTHERAN INC THE VILLAGE AT ORCHARD RIDGE INC 400 CLOCKTOWER RIDGE DRIVE WINCHESTER VA 22603 263445374 CONTINUING CARE RETIREMENT COMMUNITY VA 501(C)(3) LINE 10 NATIONAL LUTHERAN INC 1 THE VILLAGE AT ROCKVILLE INC 9701 VEIRS DRIVE ROCKVILLE MD 20850 530196624 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL LUTHERAN INC 1 THE LEGACY AT NORTH AUGUSTA INC 1410 A NORTH AUGUSTA STREET STAUNTON VA 24401 452857307 RESIDENTAL CARE AND ASSISTED LIVING FACILITY VA 501(C)(3) LINE 10 NATIONAL LUTHERAN INC 1 THE VILLAGE AT PROVIDENCE POINT INC 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 454024593 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL LUTHERAN INC 1 NATIONAL LUTHERAN HOME FOR THE AGED INC 5275 WESTVIEW DRIVE SUITE 110 FREDERICK MD 21703 262222476 SUPPORTING ORGANIZATION MD 501(C)(3) LINE 10 NATIONAL LUTHERAN INC 1 AUGSBURG LUTHERAN HOME OF MD INC 6811 CAMPFIELD ROAD BALTIMORE MD 21207 520696196 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 7 NATIONAL LUTHERAN INC 1 0 0 0 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 THE VILLAGE AT ROCKVILLE INC D 11404470 COST THE LEGACY AT NORTH AUGUSTA INC D 14546500 COST THE VILLAGE AT ORCHARD RIDGE INC D 11886398 COST THE VILLAGE AT ROCKVILLE INC E 6100111 COST THE VILLAGE AT ROCKVILLE INC L 2655168 COST THE VILLAGE AT ORCHARD RIDGE INC L 1834500 COST THE LEGACY AT NORTH AUGUSTA INC L 661896 COST THE VILLAGE AT ROCKVILLE INC O 72648 COST THE VILLAGE AT ORCHARD RIDGE INC O 72648 COST THE LEGACY AT NORTH AUGUSTA INC O 72648 COST AUGSBURG LUTHERAN HOME OF MD INC O 72648 COST AUGSBURG LUTHERAN HOME OF MD INC L 1410851 COST