2021-11-15T16:55:16-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2020-01-01 390981434 UNITED LUTHERAN PROGRAM FOR THE AGING INC UNIT 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 ARTHUR KEUP CFO 4144646396 2021-11-15 1 ARTHUR KEUP 999009999 KIMBERLY ANDERSON P00188889 6086628600 2021-11-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z STEPHANIE CHEDID 4545 NORTH 92ND STREET WAUWATOSA WI 53225 32564045 0 X WWW.LUTHERMANOR.ORG X 1957 WI TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS BY LEADING THE WAY IN ABUNDANT LIVING FOR ALL WHO TRUST US TO CARE. 7 6 599 70 0 0 1485268 5589397 27070157 23970054 743918 621562 766602 288557 30065945 30469570 0 0 0 0 16856589 16999205 0 0 72100 13948568 13222021 30805157 30221226 -739212 248344 43479299 46394633 22988069 25131980 20491230 21262653 X TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS AND BY LEADING THE WAY IN ABUNDANT LIVING FOR ALL WHO TRUST US TO CARE. 0 1 11975552 12429522 LUTHER MANOR HEALTH CARE CENTER PROVIDES SKILLED NURSING CARE AND SERVICES FOR FRAIL ELDERLY. WITHIN THE HEALTH CARE CENTER IS A DEDICATED 34 UNIT REHABILITATION CENTER. THE HEALTH CARE CENTER ALSO INCLUDES "SPECIAL CARE" SERVICES FOR PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA. THE FACILITY IS LICENSED FOR PARTICIPATION IN BOTH MEDICARE AND MEDICAID. 5009913 5199829 THE LUTHER MANOR TERRACE (LMT) PROVIDES ENGAGING AND SUPPORTIVE INDEPENDENT LIVING HOUSING AND SERVICES FOR OLDER ADULTS. APARTMENT RESIDENTS OFTEN CHOOSE THE LMT IN ORDER TO BECOME PART OF A LIFE PLAN COMMUNITY SETTING. THE LMT SERVICES AND AMENITIES INCLUDE LIFE ENRICHMENT OPPORTUNITIES, TRANSPORTATION SERVICES, DINING PROGRAM, SPIRITUAL WELLNESS, FITNESS, HEALTH, ENTERTAINMENT AND CULTURAL PROGRAMS. THE LMT ALSO PROVIDES PERSONAL CARE SERVICES TO RESIDENTS THROUGH THE "RESIDENTIAL CARE APARTMENT COMPLEX" RCAC PROGRAM, WHICH HELPS RESIDENTS MAINTAIN INDEPENDENT LIVING. 3974719 4125392 THE COURTYARDS AT LUTHER MANOR PROVIDES SUPPORTIVE (ASSISTED) LIVING SERVICES FOR FRAIL ELDERLY WHO RESIDE IN LUTHER MANOR'S LICENSED "COMMUNITY BASED RESIDENTIAL FACILITY (CBRF)". THE COURTYARDS PROGRAM ALSO INCLUDES "SPECIAL CARE" SERVICES FOR PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA. 2134400 2215311 LUTHER MANOR AT RIVER OAKS IS A 16-UNIT ASSISTED LIVING CENTER LOCATED IN MEQUON, WI. RIVER OAKS OFFERS SUPPORTIVE, ASSISTED LIVING AND 24-HOUR CARE SERVICES IN A WARM, HOME-LIKE SETTING. UNIQUE TO RIVER OAKS IS THE ABILITY TO FORM RELATIONSHIPS WITH STAFF WHICH ISN'T ALWAYS POSSIBLE IN A LARGER SETTING. LUTHER MANOR HOSPICE PROVIDES PATIENTS AND THEIR LOVED ONES THE OPPORTUNITY TO MAKE DECISIONS ABOUT END-OF-LIFE CARE, WHILE BEING SUPPORTED BY A DEDICATED, COMPASSIONATE STAFF OF PHYSICIANS, NURSES, CHAPLAINS, SOCIAL WORKERS AND COUNSELORS. HOSPICE IS NOT A PLACE, NOR IS IT A RESIGNATION OF HOPE. IT IS NOT INTENTED TO HASTEN OR POSTPONE DEATH, BUT TO ENCOURAGE QUALITY IN LIFE, PRESERVE DIGNITY IN DYING AND OFFER SUPPORT IN GRIEF. 2134400 2215311 23094584 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 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 61 0 599 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X ARTHUR KEUP CFO 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 RAYMOND ZASTROW DIRECTOR 0.50 X 0 0 0 KAREN GIBBS SECRETARY 1.00 X X 0 0 0 STEPHANIE CHEDID PRESIDENT & CEO 45.00 5.00 X X 540354 0 89076 KRISTINE IWINSKI VICE CHAIR & TREASURER 1.00 X X 0 0 0 KEITH FRALEIGH CHAIR 1.00 X X 0 0 0 ANDREW VEDDER DIRECTOR 0.50 X 0 0 0 ELIZABETH STRACHOTA-BENZ DIRECTOR 0.50 X 0 0 0 ARTHUR KEUP CFO 45.00 5.00 X 159124 0 9429 JULIE JOLITZ CHIEF CLINICAL OFFICER 50.00 X 154853 0 4413 PATRICK HANSEN CHIEF EXPERIENCE OFFICER 50.00 X 177178 0 5070 HERMINIA DEGUZMAN NURSE 56.20 X 140447 0 6025 PETER KWASNIAK NURSE 44.20 X 105143 0 5559 NILDA CINTRON-CORTEZ CHIEF HR OFFICER 50.00 X 136687 0 1515 1413786 0 121087 7 0 1 0 SODEXO INC AND AFFILIATES PO BOX 360170 PITTSBURG PA 15251 DINING SERVICES 1761066 SYMBRIA REHAB INC 28100 TORCH PARKWAY SUITE 600 WARRENVILLE IL 60555 THERAPY SERVICES 865914 FAVORITE HEALTHCARE STAFFING INC PO BOX 26225 OVERLAND PARK KS 66225 TEMPORARY STAFFING 358870 TOP TECHS TEMPS 150 N SUNNY SLOPE RD SUITE 215 BROOKFIELD WI 53005 TEMPORARY STAFFING 272262 ANGELL MARKETING LLC 5353 N 16TH STREET 300 PHOENIX AZ 85016 MASTER PLANNING 264734 35 1279846 4309551 5589397 RESIDENT SERVICES 623000 23415461 23415461 FOUNDERS FEES 623990 554593 554593 23970054 475550 475550 2239122 1365 2094475 0 144647 1365 146012 146012 OTHER INCOME 900099 233893 233893 INSURANCE PROCEEDS 900099 23336 23336 HOUSEKEEPING 900099 22707 22707 8621 8621 288557 30469570 23970054 0 910119 797983 16855 741896 39232 13865710 10695680 3151680 18350 41675 39558 2117 1284287 941544 340042 2701 1009550 751229 254380 3941 97601 97601 1173182 797119 376063 306878 51707 247427 7744 53150 7029 46121 420625 138015 282610 1334999 1254559 80440 5041 3005 2022 14 37988 15717 22271 358022 358022 2567798 2452022 115776 341525 341525 ALL OTHER EXPENSES 2458473 1338640 1119833 DINING FOOD AND SUPPLIE 1703585 1703585 ANCILLARIES 854211 854211 SUPPLIES 815122 662116 152888 118 693821 672446 21375 30221226 23094584 7054542 72100 1229620 4980976 205689 71536 2778588 2820227 65555 96486 250877 214196 94678766 75747120 19885777 18931646 18980783 19124435 82410 155131 43479299 46394633 2898109 2633056 3458500 1541251 10139613 9215311 61733 62663 1250000 0 8638614 8221199 22988069 25131980 X 20464606 21201591 26624 61062 20491230 21262653 43479299 46394633 248344 523079 0 X 0 1 X 1 0 X 1134276 1348161 1327002 1485268 5589397 10884104 32975304 30302614 28957454 27070157 23970054 143275583 34109580 31650775 30284456 28555425 29559451 154159687 0 0 0 154159687 650746 665134 706295 634289 475550 3132014 650746 665134 706295 634289 475550 3132014 224464 259586 251652 766602 288557 1790861 34984790 32575495 31242403 29956316 30323558 159082562 0.96910 0.96990 0.01970 0.01980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 336498 336498 63755456 52941470 10813986 2534552 1896806 637746 28052260 20908844 7143416 18931646 FOUNDERS FEES 8221199 8221199 X 30992649 523079 523079 30469570 0 30469570 30221226 0 30221226 0 30221226 PART IV, LINE 2B: RESIDENT FUNDS ARE HELD BY THE ORGANIZATION WHICH RESIDENTS CAN ACCESS IF IN NEED OF ANY AMOUNT OF MONEY IN WHICH THE RESIDENT HAS ENTRUSTED THE ORGANIZATION. THESE FUNDS ARE OFTEN USED FOR MINOR PURCHASES. THIS ASSET IS IN CORRELATION WITH A LIABILITY FOR THE SAME AMOUNT. PART X, LINE 2: THE CORPORATION FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE CORPORATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION, WHICH ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. X X X X X X 0 1 0 0 0 0 0 1 1 1 STEPHANIE CHEDID PRESIDENT & CEO 253241 0 50000 0 237113 0 73186 0 15890 0 629430 0 0 0 PATRICK HANSEN CHIEF EXPERIENCE OFFICER 159428 0 17750 0 0 0 2483 0 2587 0 182248 0 0 0 ARTHUR KEUP CFO 141874 0 17250 0 0 0 2270 0 7159 0 168553 0 0 0 JULIE JOLITZ CHIEF CLINICAL OFFICER 137853 0 17000 0 0 0 2144 0 2269 0 159266 0 0 0 PART I, LINE 4B THE CEO IS ELIGIBLE FOR A 457(F) DEFERRED COMPENSATION ARRANGEMENT UNDER HER EMPLOYMENT AGREEMENT. CONTRIBUTIONS ANNUALLY PAYABLE AFTER 5 YEARS SUBJECT TO VESTING REQUIREMENTS. IN 2020 THE 457(F) DEFERRED COMPENSATION PLAN PAID OUT $237,113 TO THE CEO. PART I, LINE 7 THE CEO, CFO, CHRO, CXO AND CCO ARE ELIGIBLE FOR DISCRETIONARY BONUS PAYMENTS. PART I, LINE 8 DEFERRED COMPENSATION PLAN FOR CEO. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-29 21170000 REFUNDING OF 2009 BONDS AND FUNDING CAPITAL PROJECTS 0 0 0 A 11915000 21170000 2270000 18900000 2012 1 0 1 1 A 0 0 1 1 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART III, LINE 3 CLOSED OUR ADULT DAY CARE PROGRAM IN MARCH 2020 DUE TO COVID-19 RESTRICTIONS AND DETERMINED THAT IT WOULD NOT BE REOPENED. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPRISED OF THE OFFICERS OF THE BOARD AND IS CHAIRED BY THE CHAIR OF THE BOARD. THEY ARE GIVEN AUTHORITY BY THE BOARD TO PERFORM SPECIFIC FUNCTIONS, INCLUDING THE ANNUAL REVIEW OF THE CEO. WHEN THE FULL BOARD CAN NOT MEET, IN AN EMERGENCY SITUATION, THEY ARE AUTHORIZED TO EXERCISE ALL POWER OF THE BOARD EXCEPT ACTIONS RELATED TO ELECTION OF OFFICER OR FILLING VACANCIES. FORM 990, PART VI, SECTION A, LINE 3 UNITED LUTHERAN PROGRAM FOR THE AGING, INC. HAS A CONTRACT WITH SODEXO TO MANAGE OUR DINING SERVICES. SODEXO DIRECTLY EMPLOYS MANAGEMENT EMPLOYEES, PURCHASES ALL FOOD, AND SUPERVISES LUTHER MANOR'S DINING SERVICE STAFF. FORM 990, PART VI, SECTION B, LINE 11B THE MEMBERS OF THE BOARD OF DIRECTORS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. HAVE THE OPPORTUNITY TO REVIEW THE FORM 990 PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS ANNUALLY REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY, DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD AND ON AN INTERIM BASIS AS CONFLICTS ARISE AS OUTLINED IN THE POLICY. THE BOARD WILL REVIEW THE CONFLICT AND DETEMINE THE APPROPRIATE ACTION. DEPENDING ON THE TYPE OF CONFLICT, DIRECTORS AND OFFICERS WITH CONFLICTS MAY BE ALLOWED TO REMAIN ON THE BOARD, BUT WOULD BE EXPECTED TO REFRAIN FROM DISCUSSIONS OR VOTING ON MATTERS WHERE A POTENTIAL CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE COMPENSATION CONSULTANT IS ENGAGED TO REVIEW NON-PROFIT COMPENSATION OF LIKE ORGANIZATIONS AND INDUSTRY COMPENSATION SURVEYS. BASED ON THIS DATA, COMPENSATION RECOMMENDATIONS ARE MADE TO THE EXECUTIVE COMMITTEE OF THE BOARD OF THE ULPA AND APPROVED BY THIS COMMITTEE. THE REVIEW WAS PERFORMED BY CARLSON DETTMANN CONSULTING USING DATA FROM THE 2020 GUIDESTAR NONPROFIT COMPENSATION REPORT, THE 2020 LEADING AGE CEMO SURVEY AND RELEVANT DATA FROM FORM 990 FOR COMPARABLE ORGANIZATIONS. THE INFORMATION WAS DOCUMENTED BY THE EXECUTIVE COMMITTEE OF THE ULPA BOARD OF DIRECTORS IN A REBUTTABLE PRESUMPTION CHECKLIST. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST AND ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION WILL CONSIDER REQUESTS AND MAKE THE DOCUMENTS AVAILABLE BASED ON FACTS AND CIRCUMSTANCES OF THE REQUEST. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. SOME YEAR-END FINANCIAL INFORMATION IS PROVIDED IN LUTHER MANOR'S ANNUAL IMPACT REPORT. LUTHER MANOR FOUNDATION 4545 NORTH 92ND STREET MILWAUKEE WI 53225 391499823 PROGRAM GRANT TO UNITED LUTHERAN PROGRAM FOR THE AGING, INC. WI 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 1