2021-05-14T10:11:28-05:00 2020-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2019-07-01 362167830 PLEASANT VIEW LUTHER HOME INC PLEA 8477543610 505 COLLEGE AVENUE OTTAWA IL 61350 JAMES BUCKMAN INTERIM CFO 8473687365 2021-05-12 1 CHRIS MANDERFIELD P01238973 6305738600 2021-05-12 2019 2022-09-23 18:48:47Z SLOAN BENTLEY 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 11969351 0 X WWW.LUTHERANLIFECOMMUNITIES.ORG X 1937 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. 3 0 223 28 0 0 84940 184421 10505088 11422527 -15754 167015 427241 -28451 11001515 11745512 0 0 0 0 5105354 5421059 0 0 0 6371117 5899346 11476471 11320405 -474956 425107 28967875 28324883 33125017 37280556 -4157142 -8955673 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 9742413 11422527 DEVELOPMENT AND OPERATION OF 34 INDEPENDENT LIVING UNITS, 41 ASSISTED LIVING UNITS, AND 90 SKILLED NURSING UNITS FOR SENIORS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FUNDS. 9742413 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 32 0 223 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X LUTHERAN LIFE MINISTRIES 8473687365 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 JESSE JANTZEN CHAIR/CEO (UNTIL 3/31/20) 2.00 35.50 X X 0 619712 11315 MICHAEL RENETZKY CHAIR/INTERIM CEO (STARTED 3/31/20) 1.00 19.00 X X 0 0 0 LORI SMITH VICE CHAIR 2.00 35.50 X X 0 331804 3731 MARIE CARLSON-KYLLO TREASURER & SECRETARY 2.00 35.50 X X 0 319820 25723 DAWN ST CLAIR DAVIS EXECUTIVE DIRECTOR 37.50 X 103859 0 16301 103859 1271336 57070 1 0 1 0 SELECT REHABILITATION PO BOX 71985 CHICAGO IL 60694 THERAPY SERVICES 729694 1 29640 154781 184421 RESIDENT SERVICE REVENUE 623000 10955877 10955877 AMORTIZATION OF ENTRANCE FEES 623000 370521 370521 ANCILLARY REVENUE 623000 96129 96129 11422527 167015 167015 193541 223839 -30298 -30298 -30298 1847 0 1847 1847 11745512 11422527 0 138564 4456956 4111838 345118 29051 25052 3999 593765 332521 261244 341287 294546 46741 450262 450262 109700 109700 43110 43110 509078 479599 29479 99585 97991 1594 376194 310116 66078 81666 81666 665285 665285 7171 5958 1213 1879 1281 598 1420346 1420346 885245 885245 243777 24921 218856 FOOD & DIETARY SUPPLIES 424158 424158 MEDICAL SUPPLIES 321532 321532 COVID-19 EXPENSE 154781 154781 BUILDING REPAIRS 78313 78313 27264 27264 11320405 9742413 1577992 0 3016045 2429171 698491 877677 40328 45308 44952 301325 39338752 17614641 22653680 21724111 2514379 2947291 28967875 28324883 1277151 1197622 22638 0 21339303 28622153 4077721 4045247 1412312 2650163 4995892 765371 33125017 37280556 X -4157142 -8955673 -4157142 -8955673 28967875 28324883 X 425107 -79010 -5144628 X X 0 1 X 1 0 X 22696 60889 60939 84940 184421 413885 10659608 10862238 10232766 10614088 11422527 53791227 10682304 10923127 10293705 10699028 11606948 54205112 0 0 0 54205112 325138 260124 380374 265546 167015 1398197 325138 260124 380374 265546 167015 1398197 11007442 11183251 10674079 10964574 11773963 55603309 0.97490 0.96240 0.02510 0.02720 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 592665 592665 35026992 15324738 19702254 3416381 2113757 1302624 302714 176146 126568 21724111 HELD BY TRUSTEE UNDER BOND INDENTURE 2947291 2947291 DUE TO AFFILIATES 372236 FAIR VALUE OF INTEREST RATE SWAP 65287 REFUNDABLE ADVANCE 327848 765371 X PART X, LINE 2: THE CORPORATION QUALIFIES AS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATION HAS ADOPTED ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE COMBINED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, THE CORPORATION MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURES. THE CORPORATION DOES NOT HAVE AN ASSET OR LIABILITY FOR UNRECOGNIZED TAX BENEFITS. X X X X 0 0 0 0 0 0 0 0 0 JESSE JANTZEN CHAIR/CEO (UNTIL 3/31/20) 0 504712 0 115000 0 0 0 3828 0 7487 0 631027 0 0 LORI SMITH VICE CHAIR 0 269993 0 61811 0 0 0 3731 0 0 0 335535 0 0 MARIE CARLSON-KYLLO TREASURER & SECRETARY 0 265047 0 54773 0 0 0 3574 0 22149 0 345543 0 0 A ILLINOIS FINANCE AUTHORITY 861091967 45204E6F0 2019-12-12 25441085 REFINANCE PREVIOUS BONDS AND FUND FUTURE CAPITAL EXPENDITURES 0 0 0 A 25441085 1617104 422332 1559241 21842408 2010 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 10 THE SERIES 2019 BONDS AS SHOWN ABOVE WERE ISSUED VIA AN OBLIGATED GROUP WHICH INCLUDES THE FOLLOWING ENTITIES: LUTHERAN HOME AND SERVICES FOR THE AGED, INC., LUTHERAN HOME FOR THE AGED, INC., LUTHER OAKS, INC., WITTENBERG LUTHERAN VILLAGE, INC., WITTENBERG LUTHERAN ENDOWMENT CORPORATION, AND PLEASANT VIEW LUTHER HOME, INC. AMOUNTS DISCLOSED ON PART II, LINE 10, WERE CALCULATED BASED ON THE PRORATED PORTION OF THE SERIES 2019 BOND ISSUANCE PRICE BENEFITING THE APPLICABLE ORGANIZATION (AS DISCLOSED WITHIN FORM 8038 FILED IN CONNECTION WITH THE SERIES 2019 BONDS). THESE AMOUNTS ARE ESTIMATES OF THE FUTURE CAPITAL EXPENDITURES TO BE INCURRED BY MEMBERS OF THE OBLIGATED GROUP. THE CUMULATIVE AMOUNT OF FUTURE CAPITAL EXPENDITURES FOR THE OBLIGATED GROUP TOTALS $10,000,000 AND HAS BEEN ALLOCATED ACROSS THE OBLIGATED GROUP CONSISTENT WITH THE ALLOCATION OF THE BOND ISSUE PRICE FROM FORM 8038. FORM 990, PART VI, SECTION A, LINE 6 LUTHERAN LIFE MINISTRIES 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 LIFE MINISTRIES. 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 LIFE MINISTRIES. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION REVIEWS THE TAX RETURN WITH THE AUDIT COMMITTEE OF ITS PARENT LUTHERAN LIFE MINISTRIES TO REPORT TO THE BOARD OF LUTHERAN LIFE MINISTRIES, WHICH PROVIDES FINAL APPROVAL OF THE TAX RETURNS OF ALL SUBSIDIARIES FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS, DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE TO THE BOARD OF DIRECTORS WHEN A CONFLICT MAY EXIST. THE POLICY AND COMPLIANCE WITH THIS POLICY ARE REVIEWED ANNUALLY BY THE AUDIT COMMITTEE OF ITS PARENT LUTHERAN LIFE MINISTRIES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED WITH THE HELP OF AN INDEPENDENT COMPENSATION CONSULTANT AND THE COMPENSATION COMMITTEE OF THE BOARD OF ITS PARENT LUTHERAN LIFE MINISTRIES. ULTIMATE APPROVAL FOR THE COMPENSATION AMOUNT FOR THE CEO RESTS WITH THE BOARD OF LUTHERAN LIFE MINISTRIES. THE BOARD PROVIDES COUNSEL TO THE CEO FOR THE COMPENSATION OF ANY OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S TAX RETURN, FINANCIAL STATEMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTR - PV 4,225. NET ASSETS TRANSFERRED TO AFFILIATE -1,640,000. CHANGE IN FAIR VALUE OF INTEREST RA -65,287. LOSS ON REFINANCE OF LONG-TERM DEBT -3,443,566. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. LUTHERAN HOME FOR THE AGED INC 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 362192824 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 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)(3) LUTHERAN LIFE MINISTRIES 0 LUTHERAN COMMUNITY SERVICES FOR THE AGED 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 363365609 IMPROVE QUALITY OF LIFE FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 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) LUTHERAN LIFE MINISTRIES 0 LUTHER OAKS 601 LUTZ ROAD BLOOMINGTON IL 61704 202117469 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 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) LUTHERAN LIFE MINISTRIES 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) LUTHERAN LIFE MINISTRIES 0 LUTHERAN LIFE MINISTRIES 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 203426654 DEVELOP NEW SERVICES FOR SENIORS AND MANAGE SENIOR LIVING FACILITIES IL 501(C)(3) 509(A)(3) N/A 0 LUTHERAN LIFE COMMUNITIES FOUNDATION 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 363861882 SUPPORTS THE RESIDENTS AND OPERATIONS OF EACH LUTHERAN LIFE COMMUNITY IL 501(C)(3) 509(A)(1) LUTHERAN LIFE MINISTRIES 0 ST PAULS HOUSE AND HEALTH CARE CENTER 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 362167897 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 LUTHERAN LIFE COMMUNITIES 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 208549333 MANAGEMENT SEVICES IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 THE ARLINGTON OF NAPLES 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 262019353 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 LUTHERAN LIFE COMMUNITIES E 190636 LUTHERAN HOME FOR THE AGED INC E 196420 LUTHERAN LIFE COMMUNITIES O 450262 LUTHERAN HOME FOR THE AGED INC P 270740 LUTHERAN LIFE COMMUNITIES R 1640000