LUTHER MEMORIAL HOME: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: LUTHER MEMORIAL HOME (EIN 45-0261669)
Tax period: 2022-07-01 to 2023-06-30
Filed: 2023-12-13
IRS object ID: 202333479349300948
Schema version: 2022v5.0
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)
Return	2023-12-13T14:57:34-06:00	ReturnTs
Tax Period End	2023-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450310328	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BRADY MARTZ & ASSOCIATES PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 14296	AddressLine1Txt
City	GRAND FORKS	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	582084296	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	450261669	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LUTHER MEMORIAL HOME	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	LUTH	BusinessNameControlTxt
Phone	7017863401	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	750 MAIN ST E	AddressLine1Txt
City	MAYVILLE	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58257	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	BRITTANY NESS	PersonNm
Person Title	ADMINISTRATOR	PersonTitleTxt
Phone	7017863401	PhoneNum
Signature	2023-12-08	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	BRITTANY	PersonFirstNm
Person Last	NESS	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	NICOLE HELDSTAB	PreparerPersonNm
PTIN	P01220683	PTIN
Phone	7017754685	PhoneNum
Preparation	2023-12-08	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	BRITTANY NESS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	750 MAIN ST E	AddressLine1Txt
City	MAYVILLE	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58257	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$11,001,902	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.LUTHERMEMORIALHOME.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1957	FormationYr
Legal Domicile State	ND	LegalDomicileStateCd
Activity Or Mission	LUTHER MEMORIAL HOME SERVES AS A TANGIBLE EXPRESSION OF GOD'S LOVE BY RESPONDING TO THE NEEDS OF THE AGING, EVER MINDFUL OF THE WORTH AND DIGNITY OF THE INDIVIDUAL. WE ADDRESS OURSELVES IN BOTH TRADITIONAL AND INNOVATIVE WAYS TO MEETING THE NEEDS OF THE AGED WHO ARE BEST SERVED IN A RESIDENTIAL SETTING WITHOUT REGARD TO NATIONAL ORIGIN, RACE, COLOR, CREED, SEX, OR HANDICAP. WE SEEK TO MINISTER TO THE WHOLE PERSON, OFFERING A FULL RANGE OF PROGRESSIVE CARE, FROM RETIREMENT HOUSING THROUGH SKILLED NURSING. WE SEEK FURTHERMORE TO REPRESENT THE CONCERNS OF ALL AGING TO THE SOCIETY OF WHICH WE ARE A PART. OUR BOARD AND STAFF DEDICATE THEMSELVES TO MAKING LUTHER MEMORIAL HOME A PLACE WHERE OUR RESIDENTS WILL LIVE IN COMFORT IN A COMMUNITY THAT IS SHAPED BY CHRISTIAN CONCERN.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	210	TotalEmployeeCnt
Total Volunteers	8	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$980,782	PYContributionsGrantsAmt
CY Contributions Grants	$91,556	CYContributionsGrantsAmt
PY Program Service Revenue	$9,941,667	PYProgramServiceRevenueAmt
CY Program Service Revenue	$10,301,325	CYProgramServiceRevenueAmt
PY Investment Income	$185,593	PYInvestmentIncomeAmt
CY Investment Income	$152,226	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$11,108,042	PYTotalRevenueAmt
CY Total Revenue	$10,545,107	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$7,367,621	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$6,745,936	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$3,034,989	PYOtherExpensesAmt
CY Other Expenses	$4,310,590	CYOtherExpensesAmt
PY Total Expenses	$10,402,610	PYTotalExpensesAmt
CY Total Expenses	$11,056,526	CYTotalExpensesAmt
PY Revenues Less Expenses	$705,432	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$511,419	CYRevenuesLessExpensesAmt
Total Assets BOY	$14,348,681	TotalAssetsBOYAmt
Total Assets EOY	$13,510,228	TotalAssetsEOYAmt
Total Liabilities BOY	$2,792,135	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$2,389,143	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$11,556,546	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$11,121,085	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	LUTHER MEMORIAL HOME SERVES AS A TANGIBLE EXPRESSION OF GOD'S LOVE BY RESPONDING TO THE NEEDS OF THE AGING, EVER MINDFUL OF THE WORTH AND DIGNITY OF THE INDIVIDUAL. WE ADDRESS OURSELVES IN BOTH TRADITIONAL AND INNOVATIVE WAYS TO MEETING THE NEEDS OF THE AGED WHO ARE BEST SERVED IN A RESIDENTIAL SETTING WITHOUT REGARD TO NATIONAL ORIGIN, RACE, COLOR, CREED, SEX, OR HANDICAP. WE SEEK TO MINISTER TO THE WHOLE PERSON, OFFERING A FULL RANGE OF PROGRESSIVE CARE, FROM RETIREMENT HOUSING THROUGH SKILLED NURSING. WE SEEK FURTHERMORE TO REPRESENT THE CONCERNS OF ALL AGING TO THE SOCIETY OF WHICH WE ARE A PART. OUR BOARD AND STAFF DEDICATE THEMSELVES TO MAKING LUTHER MEMORIAL HOME A PLACE WHERE OUR RESIDENTS WILL LIVE IN COMFORT IN A COMMUNITY THAT IS SHAPED BY CHRISTIAN CONCERN.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$10,146,700	ExpenseAmt
Revenue	$10,290,286	RevenueAmt
Desc	26,501 TOTAL DAYS OF SKILLED NURSING CARE PROVIDED TO ELDERLY MEN AND WOMEN DURING FISCAL YEAR 7/1/2022 - 6/30/2023. IN ADDITION, WE PROVIDED RESIDENTIAL RENTAL SERVICES TO ELDERLY TENANTS FROM 7/1/2022 - 6/30/2023.	Desc
Total Program Service Expenses	$10,146,700	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	16	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	210	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JULIE WINGER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7017863401	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	750 MAIN ST E	AddressLine1Txt
City	MAYVILLE	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58257	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
BRENDA EIDE
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
LINDA STROMSTAD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
DEAN ERICKSON
DIRECTOR	1.00	Yes (X)		$0	$0	$0
GARY SUNDEEN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JEFF VOLTZ
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ROGER ERICKSON
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
RICHELLE MEWES
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
BRAD THYKESON
DIRECTOR	1.00	Yes (X)		$0	$0	$0
GRETA PASCHKE
DIRECTOR	1.00	Yes (X)		$0	$0	$0
TERRY THORESON
DIRECTOR	1.00	Yes (X)	Yes (X)	$0	$0	$0
BRETT ULRICH
ADMINISTRATOR	40.00		Yes (X)	$188,256	$0	$35,729
JULIE WINGER
CFO	40.00		Yes (X)	$78,079	$0	$25,341
BRITTANY NESS
ADMINISTRATOR STARTED 2023	40.00		Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$266,335	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$61,070	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
PROCARE STAFFING
300 2ND AVE NE SUITE 224	JAMESTOWN	ND	58401	CONTRACTED NURSING	$721,103
DTN STAFFING
1200 COLLINS AVE	MANDAN	ND	58554	CONTRACTED NURSING	$634,371
ROLINC STAFFING
333 WEST HAMPDEN AVE SUITE 545	ENGLEWOOD	CO	80110	CONTRACTED NURSING	$318,101
FARGO ROOFING & SIDING
4265 45TH ST S SUITE 111-12	FARGO	ND	58104	ROOFING PROJECT	$216,675
FUSION MEDICAL STAFFING LLC
PO BOX 30131	OMAHA	NE	681031231	CONTRACTED NURSING	$167,259

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Government Grants	$63,368	GovernmentGrantsAmt
All Other Contributions	$28,188	AllOtherContributionsAmt
Total Contributions	$91,556	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
RESIDENT REVENUE	623000	$10,198,836	$10,198,836
MEALS	624210	$56,086	$47,276	$8,810
OTHER INCOME	811000	$44,174	$44,174
MISCELLANEOUS INCOME	812900	$2,229		$2,229

Field	Value	IRS element (for citing)
Total Program Service Revenue	$10,301,325	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$121,398	TotalRevenueColumnAmt
Exclusion	$121,398	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$486,682	SecuritiesAmt
Other	$941	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$456,795	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$29,887	SecuritiesAmt
Other	$941	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,828	TotalRevenueColumnAmt
Exclusion	$30,828	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,545,107	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,290,286	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$163,265	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$420,383	TotalAmt
Management And General	$420,383	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$4,867,861	TotalAmt
Program Services	$4,679,423	ProgramServicesAmt
Management And General	$188,438	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$132,882	TotalAmt
Program Services	$127,738	ProgramServicesAmt
Management And General	$5,144	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$907,152	TotalAmt
Program Services	$872,036	ProgramServicesAmt
Management And General	$35,116	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$417,658	TotalAmt
Program Services	$401,490	ProgramServicesAmt
Management And General	$16,168	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$74,412	TotalAmt
Management And General	$74,412	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$15,311	TotalAmt
Management And General	$15,311	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$56,003	TotalAmt
Management And General	$56,003	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$43,740	TotalAmt
Management And General	$43,740	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$432,734	TotalAmt
Program Services	$428,321	ProgramServicesAmt
Management And General	$4,413	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$27,476	TotalAmt
Management And General	$27,476	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$32,446	TotalAmt
Program Services	$32,446	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$56,144	TotalAmt
Program Services	$56,144	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$293,637	TotalAmt
Program Services	$289,158	ProgramServicesAmt
Management And General	$4,479	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$128,397	TotalAmt
Program Services	$126,459	ProgramServicesAmt
Management And General	$1,938	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
PURCHASED SERVICES	$2,399,793	$2,399,793
SUPPLIES	$733,692	$733,692
MISCELLANEOUS	$13,471		$13,471
MEMBERSHIP DUES	$8,346		$8,346

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	-$5,012	TotalAmt
Management And General	-$5,012	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,056,526	TotalAmt
Program Services	$10,146,700	ProgramServicesAmt
Management And General	$909,826	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,675,910	BOYAmt
EOY	$423,019	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,958,804	BOYAmt
EOY	$3,007,527	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$755,836	BOYAmt
EOY	$549,060	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$118,776	BOYAmt
EOY	$112,137	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$34,635	BOYAmt
EOY	$44,316	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$12,308,890	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$9,710,849	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,422,173	BOYAmt
EOY	$2,598,041	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$905,711	BOYAmt
EOY	$974,510	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$5,476,836	BOYAmt
EOY	$5,801,618	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$14,348,681	BOYAmt
EOY	$13,510,228	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$801,354	BOYAmt
EOY	$671,439	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$28,862	BOYAmt
EOY	$8,473	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$11,272	BOYAmt
EOY	$10,062	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,950,647	BOYAmt
EOY	$1,699,169	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,792,135	BOYAmt
EOY	$2,389,143	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,556,546	BOYAmt
EOY	$11,121,085	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$11,556,546	BOYAmt
EOY	$11,121,085	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$14,348,681	BOYAmt
EOY	$13,510,228	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$511,419	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$75,958	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$70,692	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$95,784	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,055,946	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$980,782	CurrentTaxYearMinus1YearAmt
Current Tax Year	$91,556	CurrentTaxYearAmt
Total	$3,294,760	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,728,437	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$9,541,799	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$9,538,577	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$9,900,580	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,290,286	CurrentTaxYearAmt
Total	$43,999,679	TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$12,184	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$23,270	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,262	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$41,087	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,039	CurrentTaxYearAmt
Total	$98,842	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,811,313	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$9,660,853	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,605,785	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$10,922,449	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,392,881	CurrentTaxYearAmt
Total	$47,393,281	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$184,841	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$415,556	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$176,276	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$663,944	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,489,551	CurrentTaxYearAmt
Total	$2,930,168	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$184,841	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$415,556	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$176,276	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$663,944	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,489,551	CurrentTaxYearAmt
Total	$2,930,168	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$44,463,113	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$47,304	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$128,158	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$110,889	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$126,332	CurrentTaxYearMinus1YearAmt
Current Tax Year	$121,398	CurrentTaxYearAmt
Total	$534,081	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$47,304	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$128,158	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$110,889	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$126,332	CurrentTaxYearMinus1YearAmt
Current Tax Year	$121,398	CurrentTaxYearAmt
Total	$534,081	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,858,617	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$9,789,011	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,716,674	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$11,048,781	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,514,279	CurrentTaxYearAmt
Total	$47,927,362	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.92770	PublicSupportCY509Pct
Public Support PY509	0.98900	PublicSupportPY509Pct
Investment Income CY	0.01110	InvestmentIncomeCYPct
Investment Income PY	0.01100	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$21,314	OtherCostOrOtherBasisAmt
Book Value	$21,314	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,097,907	OtherCostOrOtherBasisAmt
Depreciation	$8,134,936	DepreciationAmt
Book Value	$1,962,971	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,829,086	OtherCostOrOtherBasisAmt
Depreciation	$1,432,708	DepreciationAmt
Book Value	$396,378	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$360,583	OtherCostOrOtherBasisAmt
Depreciation	$143,205	DepreciationAmt
Book Value	$217,378	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,598,041	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
ASSETS WHOSE USE LIMITED BY BOARD	$5,738,250
CONTRIBUTIONS RECEIVABLE	$63,368

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$5,801,618	TotalBookValueOtherAssetsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$10,605,752	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$75,958	NetUnrealizedGainsInvstAmt
Revenue Not Reported	$75,958	RevenueNotReportedAmt
Revenue Subtotal	$10,529,794	RevenueSubtotalAmt
Investment Expenses Not Incld	$15,311	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$2	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$15,313	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$10,545,107	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$11,041,212	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$11,041,212	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$15,311	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$3	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$15,314	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$11,056,526	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART IV, LINE 2B:

FOR THOSE RESIDENTS WHO REQUEST, THE NURSING HOME WILL MAINTAIN CASH AMOUNTS IN AN INTEREST BEARING CHECKING ACCOUNT MANAGED FOR THE BENEFIT OF THE RESIDENTS AS REQUIRED BY NDDHS REGULATIONS. THE ORGANIZATION HAS INCLUDED THE AMOUNT OF CASH AND AN OFF-SETTING PAYABLE ON THEIR BALANCE SHEET FOR THIS CUSTODIAL ACCOUNT.

PART X, LINE 2:

THE HOME'S POLICY IS TO EVALUATE THE LIKELIHOOD THAT ITS UNCERTAIN TAX POSITIONS WILL PREVAIL UPON EXAMINATION BASED ON THE EXTENT TO WHICH THOSE POSITIONS HAVE SUBSTANTIAL SUPPORT WITHIN THE INTERNAL REVENUE CODE AND REGULATIONS, REVENUE RULINGS, COURT DECISIONS AND OTHER EVIDENCE. IT IS THE OPINION OF MANAGEMENT THAT THE HOME HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION. THE FEDERAL INCOME TAX RETURNS OF THE HOME ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	BRETT ULRICH	PersonNm
Title	ADMINISTRATOR	TitleTxt
Base Compensation Filing Org	$188,256	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$5,781	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$35,948	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$229,985	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7A	DIRECTORS ARE ELECTED BY DELEGATES FROM MEMBER CONGREGATIONS. OFFICERS ARE ELECTED BY THE DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B	A DRAFT OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	NEW BOARD MEMBERS ARE INFORMED OF THE CONFLICT OF INTEREST POLICY AND ARE ASKED IF THEY HAVE ANY CONFLICTS. BOARD MEMBERS ARE INSTRUCTED TO INFORM THE BOARD OF ANY CONFLICTS THAT MAY ARISE.
FORM 990, PART VI, SECTION B, LINE 15A	COMPENSATION FOR THE ADMINISTRATOR IS DETERMINED BY THE BOARD OF DIRECTORS BASED ON REVIEWS OF ADMINISTRATIVE COMPENSATION FOR ADMINISTRATORS AT COMPARABLE FACILITIES IN THE AREA WITH SIMILAR RESPONSIBILITIES AND DUTIES. DOCUMENTATION OF THE PROCESS AND APPROVAL IS INCLUDED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND VARIOUS POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART XII, LINE 2C	THERE HAS BEEN NO CHANGE IN THE ROLE OF THE AUDIT COMMITTEE IN OVERSIGHT OF THE AUDIT PROCESS FROM THE PRIOR YEAR.