2021-10-21T15:23:19-05:00 2020-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2020-01-01 390806814 AMERICAN LUTHERAN HOMES INC AMER 7158323003 915 EAST ELM STREET MENOMONIE WI 54751 AMY DUHR CEO 7158323003 2021-10-17 1 AMY DUHR 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2021-10-17 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z RAYMOND WEISS 915 EAST ELM STREET MENOMONIE WI 54751 7896841 0 X WWW.AMERICANLUTHERANHOMES.COM X 1961 WI PROVIDE SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED IN THE SURROUNDING AREAS UNDER OUR FAITH BASED SENIOR CARE PROGRAMS. 9 9 224 24 0 0 8904 694638 7666803 7149523 55578 52680 17721 -48 7749006 7896793 0 0 0 0 3547741 3770930 0 0 0 4071380 3988259 7619121 7759189 129885 137604 8182905 8611620 5389986 5689072 2792919 2922548 X IN RESPONSE TO THE GREAT COMMISSION OF OUR LORD, WE ENDEAVOR TO SHARE GOD'S LOVE IN WORD AND DEED. WE ATTEMPT TO PROVIDE A CHRISTIAN ATMOSPHERE WHICH, COMBINED WITH SUPPORTIVE SERVICES, ENHANCES THE LIVES OF ALL THOSE WHO ARE CONNECTED WITH IT. IN OUR MINISTRY, WE ENCOURAGE BOTH THOSE WE SERVE AND OUR EMPLOYEES TO RECOGNIZE THEIR INFINITE WORTH AND TO GROW TO REACH THEIR HIGHEST POTENTIAL AS GOD'S CHILDREN. IN FURTHERANCE OF THIS PURPOSE, WE DESIRE TO ESTABLISH QUALITY CARE IN A CHRISTIAN ATMOSPHERE BY: PROVIDING THE HIGHEST POSSIBLE QUALITY OF PHYSICAL, MENTAL AND SPIRITUAL CARE FOR THOSE ENTRUSTED TO US; BROADENING THE INTEREST AND ACTIVITIES OF THOSE IN OUR CARE THROUGH PROGRAMS AND VOLUNTEER ASSISTANCE; INVOLVING OUR CORPORATE CONGREGATIONS; AND ASSUMING A POSITION OF LEADERSHIP IN THE FIELD OF GERIATRICS BY EXTENDING OUR MINISTRY BEYOND NURSING HOME FACILITIES THROUGH THE CREATION OF PROGRAMS TO SERVE THE NEEDS OF THE ELDERLY IN OUR COMMUNITIES. 0 0 3722727 0 4248205 THE PRIMARY ACTIVITY OF THE ORGANIZATION IS TO PROVIDE SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED OF THE SURROUNDING AREA. THE ORGANIZATION SERVES THE MONDOVI, WISCONSIN COMMUNITY BY OPERATING A 35-BED SKILLED NURSING FACILITY AND 38-UNIT COMMUNITY BASED RESIDENTIAL FACILITY (CBRF). THE MONDOVI SKILLED NURSING FACILITY PROVIDED 9,414 DAYS OF RESIDENT CARE IN 2020. THE CBRF PROVIDED 8,112 DAYS OF RESIDENT CARE IN 2020. THE FACILITY OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY CARE, WOUND CARE, BARIATRIC CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, SPEECH THERAPY, AND OCCUPATIONAL THERAPY. THE MONDOVI FACILITY ALSO OFFERS OUTPATIENT THERAPY PROGRAMS TO PROVIDE EXTENDED THERAPY SERVICES TO AREA COMMUNITY MEMBERS IN NEED OF PHYSICAL REHABILITATION PROGRAMS ON AN OUTPATIENT BASIS AND TO RESIDENTS WHO DISCHARGE FROM THE FACILITY BUT REQUIRE ONGOING THERAPY ON AN OUTPATIENT BASIS. THE MAJORITY OF THE LONG-TERM CARE RESIDENTS AT THE MONDOVI PROGRAM ARE ALSO MEDICAID PROGRAM BENEFICIARIES. 2967497 0 2901318 THE PRIMARY ACTIVITY OF THE ORGANIZATION IS TO PROVIDE SKILLED NURSING CARE FOR THE AGED AND DISABLED OF THE SURROUNDING AREA. THE ORGANIZATION SERVES THE MENOMONIE, WISCONSIN AREA COMMUNITY BY OPERATING A 37-BED SKILLED NURSING FACILITY. THE MENOMONIE NURSING FACILITY PROVIDED 9,742 RESIDENT DAYS OF CARE IN 2020. THE FACILITY OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND FOR LONG-TERM CARE RESIDENTS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY CARE, WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, SPEECH THERAPY, AND OCCUPATIONAL THERAPY. 6690224 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 26 0 224 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X KELLY LARSON 7158323003 3410 SKY PARK BLVD EAU CLAIRE WI 54701 X X RAYMOND WEISS CEO 1.50 39.00 X 0 0 0 BRYAN BESSA CHRO 1.50 39.00 X 0 0 0 ARDYTH BRENNER PRESIDENT 1.50 1.00 X X 0 0 0 KRIS JENSON VICE PRESIDENT 1.50 1.00 X X 0 0 0 KATHY POSPISHIL SECRETARY 1.50 1.00 X X 0 0 0 LINDA LARSON TREASURER 1.50 1.00 X X 0 0 0 LARRY KUESTER BOARD MEMBER 1.50 1.00 X 0 0 0 RITA LEE BOARD MEMBER 1.50 1.00 X 0 0 0 SHARON MILLER BOARD MEMBER 1.50 1.00 X 0 0 0 BARB PIPER BOARD MEMBER 1.50 1.00 X 0 0 0 BARB VADNAIS BOARD MEMBER 1.50 1.00 X 0 0 0 0 0 0 0 0 0 0 MIDWEST PHYSICAL THERAPY 1731 17TH AVE BLOOMER WI 54724 THERAPY SERVICES 389904 GRACE LUTHERAN COMMUNITIES 3410 SKY PARK BLVD EAU CLAIRE WI 54738 MANAGEMENT SERVICES 202478 SPECIALIZED MEDICAL STAFFING 13797 210TH AVE BLOOMER WI 54724 STAFFING AGENCY 185859 MEDICAL STAFFING SOLUTIONS PO BOX 101 RICE LAKE WI 54868 STAFFING AGENCY 145477 ONE STAFF MEDICAL PO BOX 3544 OMAHA NE 68103 STAFFING AGENCY 134777 5 6708 676283 11647 694638 RESIDENT REVENUE 623000 6502768 6502768 SENIOR MEALS PROGRAMS 624200 555294 555294 OTHER RESIDENT REVENUE 623000 65725 65725 RESIDENT TRANSPORTATIO 624100 25736 25736 7149523 5508 5508 47172 0 47172 47172 47172 0 6708 48 -48 -48 7896793 7149523 0 52632 X 3241475 3163390 78085 39078 37935 1143 251301 243949 7352 239076 232082 6994 202478 202478 4157 4157 36490 36490 19338 19338 1544283 1294924 249359 67630 67630 77602 75608 1994 123879 123879 201921 201921 26132 25578 554 11878 5146 6732 136355 136355 407528 407528 76708 76708 SUPPLIES 721337 700860 20477 STATE NURSING HOME ASSE 146880 146880 REPAIRS AND MAINTENANCE 58892 56858 2034 BAD DEBT EXPENSE 34245 34245 90526 73845 16681 7759189 6690224 1068965 0 2500 2500 357693 1251419 665925 475078 48005 81283 61312 20300 12941337 8283888 5028500 4657449 1678522 1710561 340448 413030 8182905 8611620 638016 532180 349362 358049 4402608 4162843 0 636000 5389986 5689072 X 2792919 2921417 1131 2792919 2922548 8182905 8611620 X 137604 -1463 -6512 X 0 1 X 1 0 X 51541 7874 5749 8904 694638 768706 7872642 6738531 7393615 7677803 7149523 36832114 46981 12821 10828 9879 0 80509 7971164 6759226 7410192 7696586 7844161 37681329 0 0 0 37681329 5492 6450 168 170 5508 17788 5492 6450 168 170 5508 17788 7976656 6765676 7410360 7696756 7849669 37699117 0.99950 0.99960 0.00050 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5100 5100 0 PART II-B, LINE 1: AMERICAN LUTHERAN HOMES, INC. PAYS ANNUAL ASSOCIATION DUES TO LEADINGAGE WISCONSIN. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATION MATERIALS AND STAFFING TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL INDUSTRY ENVIRONMENT. 0 1 X 22629 22629 8676228 4499372 4176856 4242480 3784516 457964 4657449 PPP LOAN PAYABLE 636000 636000 7868349 -1463 -1463 7869812 19338 7643 26981 7896793 7739851 0 7739851 19338 19338 7759189 PART IV, LINE 2B: AMERICAN LUTHERAN COMMUNITY SERVICES, INC. (AUTUMN VILLAGE) PREVIOUSLY TRANSFERRED $300,000 TO AMERICAN LUTHERAN HOMES, INC. THESE FUNDS WERE TRANSFERRED FOR THE PURPOSE OF ALH INVESTING THE FUNDS ON BEHALF OF AUTUMN VILLAGE. THE FUNDS ARE NOT SEGREGATED AND ARE POOLED FOR BOTH ORGANIZATION WITHIN ALH'S INVESTMENT PORTFOLIO. IT WAS AGREED THAT AUTUMN VILLAGE IS ENTITLED TO ITS APPROXIMATE SHARE OF THE INVESTMENT EARNINGS OR LOSS FROM THE POOLED INVESTMENT PROGRAM AND THE LIABILITY RELATED TO AMOUNTS HELD FOR INVESTMENT FOR AUTUMN VILLAGE IS ADJUSTED IN THE ACCOMPANYING BALANCE SHEETS BASED ON THE CHANGE IN APPROXIMATE SHARE OF THE FAIR VALUE OF ASSETS HELD FOR INVESTMENT. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS TO RESTRICTED NET ASSETS 1,131. INCREASE IN INVESTMENT HELD BY RELATED PARTY 6,512. FORM 990, PART VI, SECTION A, LINE 3 AMERICAN LUTHERAN HOMES, INC. HAS ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION, INC. (GRACE), A NON-PROFIT, RELIGIOUS BASED SENIOR HEALTHCARE SERVICES ORGANIZATION BASED IN EAU CLAIRE, WISCONSIN. UNDER THIS AGREEMENT, GRACE PROVIDES GENERAL ADMINISTRATIVE, CONSULTING, ACCOUNTING, HUMAN RESOURCES, AND FACILITY MANAGEMENT SERVICES TO AMERICAN LUTHERAN HOMES. UNDER THE MANAGEMENT AGREEMENT, GRACE IS ALSO RESPONSIBLE FOR THE SELECTION AND REVIEW OF THE ADMINISTRATORS OF AMERICAN LUTHERAN HOMES, INC. THE AMOUNT PAID FOR THESE SERVICES IS SHOWN ON THE STATEMENT OF FUNCTIONAL EXPENSES. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE ORGANIZATION ARE THE PASTORS AND CONGREGATIONS THAT BELONG TO THE AMERICAN LUTHERAN CHURCH AND SPONSOR THE ACTIVITIES OF THE AMERICAN LUTHERAN HOMES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD MEMBERS ARE ELECTED BY THE CONGREGATIONS OF THE SPONSORING CHURCHES AND AT A MINIMUM MUST INCLUDE THE PASTOR OF ONE OF THESE CONGREGATIONS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS ON THE CHANGES IN THE STRUCTURE OF THE AMERICAN LUTHERAN HOMES ORGANIZATION OR GOVERNING DOCUMENTS MUST BE APPROVED BY THE AMERICAN LUTHERAN CHURCH. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WAS PROVIDED TO THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE SUBMISSION OF THE RETURN. THE FORM 990 WAS ALSO REVIEWED BY MANAGEMENT PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY REVIEWS UPDATED CONFLICT OF INTEREST STATEMENTS FROM MEMBERS OF THE BOARD OF DIRECTORS. ANY NOTED CONFLICTS ARE DISCUSSED, AND DURING THE YEAR, IF CONFLICTS ARE NOTED DURING VOTES, THOSE CONFLICTING MEMBERS ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 AMERICAN LUTHERAN HOME, INC.'S EXECUTIVE LEVEL EMPLOYEES AND KEY EMPLOYEES ARE PROVIDED UNDER THE MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION, INC. (A NOT-FOR PROFIT ORGANIZATION WHICH SPECIALIZES IN SKILLED NURSING, LONG-TERM CARE, AND HOUSING SERVICES FOR ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY). THE CONTRACT TERMS ARE RENEWED EVERY FIVE YEARS. THE BOARD OF DIRECTORS OF AMERICAN LUTHERAN HOMES, INC. REVIEWS THE CONTRACT TERMS TO ENSURE THAT QUALITY SERVICES ARE BEING ACHIEVED AT THE LOWEST POSSIBLE COST FOR THE PROGRAMS BEING PROVIDED. THE BOARD ALSO CONSULTS WITH OTHER WISCONSIN NURSING HOME ASSOCIATION MEMBERS TO ENSURE THAT THE AMOUNTS BEING PAID ARE CONSISTENT FOR ADMINISTRATIVE SERVICES OF THOSE PAID THROUGHOUT THE REGION. FORM 990, PART VI, SECTION C, LINE 19 AMERICAN LUTHERAN HOMES, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION. FORM 990, PART VII, SECTION A: EXPLANATION FOR HOURS WORKED BY OFFICERS: RAYMOND WEISS (CEO) AND BRYAN BESSA (CHRO) ARE EMPLOYED BY THE MANAGEMENT SERVICES ORGANIZATION, GRACE LUTHERAN FOUNDATION, INC., AND AS SUCH A PART OF THEIR DUTIES IS TO PROVIDE MANAGEMENT AND OVERSIGHT TO ALL OF THE HEALTHCARE AND HOUSING SERVICES OF GRACE LUTHERAN FOUNDATION, INC., CHIPPEWA VALLEY ECUMENICAL HOUSING ASSOCIATION, AMERICAN LUTHERAN HOMES, INC., AND AMERICAN LUTHERAN COMMUNITY SERVICES, INC. (AUTUMN VILLAGE), WHICH ARE ALL NON-PROFIT RELIGIOUS BASED ORGANIZATIONS WHO PROVIDE CARE AND HOUSING TO THOSE IN NEED. THE AVERAGE AMOUNT OF TIME DEVOTED TO AUTUMN VILLAGE AS NOTED IN PART VII OF THE FORM 990 INCLUDES AN APPROXIMATE AMOUNT OF TIME DEVOTED EACH WEEK TO THE AMERICAN LUTHERAN HOMES ORGANIZATIONS WHICH INCLUDES AUTUMN VILLAGE, HOWEVER THESE INDIVIDUALS OFTEN WORK WELL IN EXCESS OF THE AMOUNT OF HOURS LISTED IN ORDER TO SUPPORT AND FURTHER THE MISSION OF THE ORGANIZATIONS AS NOTED. EXPLANATION FOR HOURS WORKED BY BOARD MEMBERS: ALL MEMBERS OF AUTUMN VILLAGE'S BOARD OF DIRECTORS SERVE ON THE BOARD OF AMERICAN LUTHERAN HOMES, INC. MATTERS INVOLVING THESE ENTITIES ARE RESOLVED DURING REGULARLY SCHEDULED MEETINGS OF AMERICAN LUTHERAN HOME, INC.'S BOARD; AS SUCH, NO ADDITIONAL TIME HAS BEEN ALLOCATED TO THE ADDITIONAL RELATED ORGANIZATION. FORM 990, PART IX, LINE 11G NURSING SERVICES: PROGRAM SERVICE EXPENSES 543,184. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 543,184. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 360,138. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 360,138. QUALITY ASSURANCE SERVICES: PROGRAM SERVICE EXPENSES 37,333. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,333. RESIDENT MEALS SERVICES: PROGRAM SERVICE EXPENSES 236,227. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 236,227. CONSULTANT SERVICES: PROGRAM SERVICE EXPENSES 31,030. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,030. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 164,705. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,705. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 87,012. MANAGEMENT AND GENERAL EXPENSES 84,654. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 171,666. FORM 990, PART XI, LINE 9: INCREASE IN INVESTMENT HELD BY RELATED PARTY -6,512. AMERICAN LUTHERAN COMMUNITY SERVICES INC 915 ELM STREET MENOMONIE WI 54751 391819072 ASSISTED LIVING FACILITY WI 501(C)(3) LINE 10 AMERICAN LUTHERAN HOME INC 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 AMERICAN LUTHERAN COMMUNITY SERVICES INC Q 272310 CASH VALUE