2022-11-01T10:03:40-07:00 2021-12-31 911537851 PAULSEN MEGAARD & CO PS 22232 17th Ave SE Suite 310 Bothell WA 98021 990 2021-01-01 910570840 COLUMBIA LUTHERAN MINISTRIES COLU 2066327400 4700 PHINNEY AVE N SEATTLE WA 981036374 DAVID HEYER PRESIDENT/ADMINISTRATOR 2066327400 2022-05-10 true DAVID HEYER XXX-XX-XXXX Susan L Paulsen CPA P00443486 4254893416 2022-11-01 3 AAL1 IAL1 FAL1 2021 2022-09-23 18:48:47Z COLUMBIA LUTHERAN HOME DAVID HEYER 4700 PHINNEY AVE N SEATTLE WA 981036399 18053613 false X www.columbialutheranhome.org X 1963 WA Columbia Lutheran Home has practiced compassionate care since 1920. Offering short term rehabilitation and long term elder care we are guided by a holistic approach: our mission is to "provide care for the whole person- body, mind and spirit." Delivering the highest standard of care with dignity and respect is essential to our mission. 8 8 209 0 0 0 1025805 4577806 11576359 9628731 407306 990463 0 13009470 15197000 0 0 8750473 8170071 0 3642 5194126 4512757 13944599 12682828 -935129 2514172 23225094 23787297 2931946 876426 20293148 22910871 Columbia Lutheran Home has practiced compassionate care since 1920. Offering short term rehabilitation and long term elder care we are guided by a holistic approach: our mission is to "provide care for the whole person body, mind and spirit." Delivering the highest standard of care with dignity and respect is essential to our mission. false false 11754303 0 9628731 Columbia Lutheran Home has practiced compassionate care since 1920. Offering short term rehabilitation and long term elder care we are guided by a holistic approach: our mission is to "provide care for the whole person - body, mind and spirit." Delivering the highest standard of care with dignity and respect is essential to our mission. We welcome everyone regardless of religion, orientation or ability to pay. Nearly 25,000 patient days are provided annually with at least half paid by Medicaid. 11754303 true true false false false false false false false false true false false false true false true false false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 22 0 true 209 true false false false false false false false false false false X 8 8 false false false false false false false true true false false true true true true true true true true false WA X CINDY SEARS 2066327400 4700 PHINNEY AVENUE N SEATTLE WA 981036399 HABIB HARIRI RN 105.00 X 326848 0 12210 DAVID HEYER PRESIDENT/ADMINISTRATOR 40.00 X 192867 0 48253 ROZINA KETSELA RN 64.00 X 152064 0 6083 ALICIA JANCOLA RN 44.00 X 143451 0 2934 SHALLUM LEGASPI LPN 59.00 X 136785 0 5471 ADJIJATU AYILARA RN 50.00 X 134850 0 5416 CINDY SEARS DIRECTOR OF FINANCE/TREASURER 35.00 X 91850 0 3674 CAROLINE ALABACH BOARD MEMBER 1.00 X 0 0 0 KEITH MAHLER CHAIRPERSON 1.00 X 0 0 0 STEPHANIE HILLMAN BOARD MEMBER 1.00 X 0 0 0 ED MASON BOARD MEMBER 1.00 X 0 0 0 JENNY RORABACK CARSON MD BOARD MEMBER 1.00 X 0 0 0 BARBARA GRAHAM BOARD MEMBER 1.00 X 0 0 0 DOUG STENSBY BOARD MEMBER 1.00 X 0 0 0 CHARLOTTE MCGINNESS BOARD MEMBER 1.00 X 0 0 0 DEBORAH RAMSEY BOARD MEMBER 1.00 X 0 0 0 SABINE VON PREYSS-FRIEDMAN MD BOARD MEMBER 1.00 X 0 0 0 JANET SMITH BOARD MEMBER 1.00 X 0 0 0 1178715 0 84041 12 false true false PREMERE REHAB LLC M/S 24 PO BOX 5700 PORTLAND OR 97228 THERAPY SERVICES 454661 WG CLARK CONSTRUCTION CO 1945 YALE PLACE EAST SEATTLE WA 98102 GENERAL CONTRACTOR 399567 SODEXO PO BOX 360170 PITTSBURGH PA 15251 DIETARY/FOOD SERV. MANAGEMENT 592194 3 4558945 18861 4577806 NURSING CARE 623000 9628731 0 0 9628731 253746 0 253746 3593330 2856613 736717 736717 0 0 736717 15197000 9628731 0 990463 336644 0 336644 0 6606574 6473360 131186 2028 173373 171208 2165 0 457028 441766 15262 0 596452 566479 29973 0 10174 0 10174 0 56612 0 56612 0 51516 0 51516 0 1067697 925277 142420 0 29795 29627 168 0 179987 118321 61666 0 1181 1181 0 0 345119 338078 6592 449 1274 0 1274 0 3291 2014 1277 0 873138 855326 16677 1135 65323 65323 0 0 SAFETY NET ASSESSMENTS 483460 483460 0 0 NURSING SUPPLIES 325603 325603 0 0 ANCILLARIES 302869 302869 0 0 FOOD 298366 298366 0 0 417352 356045 61277 30 12682828 11754303 924883 3642 654878 524134 2358839 1084640 781532 52395 48672 200878 191851 18694459 11229128 8134381 7465331 12862593 12208131 235329 208807 23225094 23787297 1284659 839057 1642800 4487 37369 2931946 876426 X 20262063 22881048 31085 29823 20293148 22910871 23225094 23787297 2514172 103551 X false true X true true true X 0 0 0 0 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 103591 103591 6387796 5157585 1230211 4334764 3445923 888841 7868308 2625620 5242688 7465331 PATIENT TRUST FUND 1643 RESIDENT COUNCIL PAYABLE 591 MEDICARE SETTLEMENT PAYABLE 35135 37369 15249035 103551 103551 15145484 51516 51516 15197000 12631312 12631312 51516 51516 12682828 X X X false false false false false false false false false HABIB HARIRI 316470 0 10378 0 0 0 12210 0 0 0 339058 0 0 0 DAVID HEYER 184867 0 8000 0 0 0 7715 0 40538 0 241120 0 0 0 ROZINA KETSELA 147782 0 4282 0 0 0 6083 0 0 0 158147 0 0 0 Pt VI, Line 11b AFTER CPA PREPARES THE FORM 990, IT IS FORWARDED TO THE TREASURER FOR REVIEW AND THEN TO THE BOARD OF DIRECTORS TO REVIEW BEFORE FILING. Pt VI, Line 12c OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE A WRITTEN CONFLICT OF INTEREST FORM UPON HIRE AND ANNUALLY. Pt VI, Line 15a HUMAN RESOURCES DIRECTOR REVIEWS SALARY SURVEY DATA, ORGANIZATIONAL BUDGET, AND AVERAGE INCREASE OF OTHER EMPLOYEE WAGES. THE HUMAN RESOURCES DIRECTOR RECOMMENDS TO THE CHAIRPERSON OF THE BOARD CHANGES TO COMPENSATION FOR THE PRESIDENT/ADMINISTRATOR BASED ON THIS REVIEW. THE BOARD OF DIRECTORS THEN CONSIDERS ALL RELEVANT FACTORS AND APPROVES ANY CHANGES TO THE PRESIDENT/ADMINISTRATOR COMPENSATION. Pt VI, Line 15b HUMAN RESOURCES DIRECTOR REVIEWS SALARY SURVEY DATA, ORGANIZATIONAL BUDGET, AND AVERAGE INCREASE OF OTHER EMPLOYEE WAGES. THE HUMAN RESOURCES DIRECTOR RECOMMENDS TO THE PRESIDENT/ADMINISTRATOR CHANGES TO COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES BASED ON THIS REVIEW. THE PRESIDENT/ADMINISTRATOR THEN CONSIDERS ALL RELEVANT FACTORS AND APPROVES ANY CHANGES TO OTHER OFFICERS AND KEY EMPLOYEES COMPENSATION. Pt VI, Line 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. LUTHERAN SERVICES IN NORTHWEST LLC 1301 N HIGHLANDS PKWY TACOMA WA 98406 912130411 ES-ADMIN & BUSINESS SUPPORT SERVICES WA NA RELATED 260 12 false 0 false 0.12500 false false false false false false false false false false false false false false false false false false false