2021-09-10T12:16:26-07:00 2020-12-31 990 2020-01-01 390859107 AMERICAN LUTHERAN CHURCH-NORTHLAND LUTHERN SERVICES FOR THE ELDERLY AMER 7157320155 831 Pine Beach Road Marinette WI 54143 Darrell Lancour CEO 7157320155 2021-07-14 0 11 0 AAL2 X 2020 2022-09-23 18:48:47Z Luther Home Luther Manor Darrell Lancour 831 Pine Beach Road Marinette WI 54143 11067729 0 X www.northlandlutheranwi.com X 1917 WI Provides skilled nursing and rehabilitation services including physical, occupational, and speech therapy. Offers 47 units of assisted living arrangements. Community wide emergency response system. 5 5 228 5 0 0 31484 13008 10201369 9001348 59 846 63530 2052527 10296442 11067729 0 0 5873102 5321556 0 0 4359324 4648985 10232426 9970541 64016 1097188 5608180 6380649 1959768 1696135 3648412 4684514 Northland Lutheran Services for the Elderly, Inc. mission is to meet the spiritual, emotional, social needs of those being served. 0 0 7808752 7838615 Luther Home, a skilled nursing and rehabilitation facility had an average occupancy rate of 74.6% in 2020. Admitted a total of 194 individuals and discharged 190 individuals. Luther Home's Medicaid write-off in 2020 was $1,411,624. 1192483 1186675 Luther Manor provides assisted living arrangements to persons needing services, but who do not need full nursing care. Supportive services include dietary, housekeeping, laundry, medication management along with social and spiritual needs in an environment that is dedicated to quality of life. 0 0 0 9001235 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 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 1 0 0 0 1 34 0 1 228 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Northland Lutheran Retirement Community Inc 7157320155 831 Pine Beach Road Marinette WI 54143 Darrell Lancour CEO 20 20 X 78082 17273 14303 Rev David Christenson Director at Large 0.50 0 X 0 0 0 Cathy Craw Chairperson 0.50 0 X 0 0 0 Joyce Buchman Vice Chairperson 0.50 0 X 0 0 0 Donna Cramer Treasurer 0.50 0 X 0 0 0 Gail Sieglaff Secretary 0.50 0 X 0 0 0 78082 17273 14303 0 0 0 0 Greenfield Rehabilitation Agency 1939 W Capitol Drive Suite 200 Brookfield WI 53045 Rehabilitation services 659691 0 0 0 0 0 0 13008 0 13008 Net Patient Revenue 623000 8968169 8968169 0 0 Lifeline Rentals 900099 33179 33179 0 0 9001348 846 846 0 0 0 0 0 0 0 0 0 0 24000 0 0 0 24000 0 24000 24000 0 0 0 0 0 Meals, Rebates, Refunds 900099 6127 6127 0 0 2022400 2022400 0 0 2028527 11067729 11054721 0 0 X 4242033 3806701 435332 43186 38867 4319 736546 736546 299791 292844 6947 277663 277663 2242574 2242574 8038 8038 115903 115903 68931 68931 892670 892670 69254 69254 313290 313290 94569 94569 Bad Debts 129142 0 129142 0 Occupied Bed Assessment 226270 226270 0 0 General Miscellaneous 210681 210681 0 0 9970541 9001235 969306 0 118208 1235172 13790 871558 745411 40815 63308 62120 14940 11894712 7587518 4514602 4307194 877 834 5608180 6380649 898771 742674 1060997 953461 0 1959768 1696135 X 3648412 4684514 0 0 3648412 4684514 5608180 6380649 X 1097188 -86 0 0 0 -61000 X 0 1 X 1 0 X 0 34570 15683 31484 13008 94745 10518197 10347912 10727508 10201369 9001348 50796334 10518197 10382482 10743191 10232853 9014356 50891079 50891079 10 16 40 59 846 971 10 16 40 59 846 971 327426 69450 58259 63530 30127 548792 10845633 10451948 10801490 10296442 9045329 51440842 0.98931 0.9796 0.00002 0.00002 X Schedule A, Part III, Line 12 Other income represents refunds, rebates, meals, rental fees 0 34838 34838 0 8310746 4925785 3384961 0 0 0 0 0 3549128 2661733 887395 0 0 0 0 4307194 0 0 X 9045329 -43 0 0 0 -43 9045372 0 2022357 2022357 11067729 9970541 0 0 0 0 0 9970541 0 0 0 9970541 Schedule D, Part X, Line 2 The Organization qualifies as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code and is also exempt from state taxes. The Organization is subject to a tax on income from any unrelated activities. The Organization continually evaluates its tax positions, changes in tax law and new authoritative rulings for potential implications to its tax status. The Organization has not identified any income it would consider to be unrelated business income. Schedule D, Part XI, Line 4b SBA Payroll Protection Program loan forgiveness. Federal CARES Act grants. Form 990, Part VI, Section A, Line 6 The sole member of the Organization is the parent company, Northland Lutheran Retirement Community, Inc. Form 990, Part VI, Section A, Line 7a The sole member of the Organization is the parent company, Northland Lutheran Retirement Community, Inc. and all decisions made by the Organization must be approved by the sole member, including election of governing board members. Form 990, Part VI, Section A, Line 7b The sole member of the Organization is the parent company, Northland Lutheran Retirement Community, Inc. and all decisions made by the Organization must be approved by the sole member, including election of governing board members. Form 990, Part VI, Section B, Line 11b 990 forms are distributed to all governing board members at a regularly scheduled meeting prior to submission of the forms to the IRS. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is reviewed with all board members annually. Also, a survey is mailed to all board members specifically asking each member to sign a statement that discloses any possible conflict of interest situations. Form 990, Part VI, Section B, Line 15 The CEO receives an annual survey of salary/wage information from state association members. The CEO reviews the survey with the Executive Committee of the parent board, which is comprised of the officers of the board. The Executive Committee then determines the salary of the CEO. The CEO determines the salaries/wages of key personnel. Form 990, Part VI, Section C, Line 19 Organization provides its financial statements in its annual report to the congregational owners. It also makes its governing documents, conflict of interest policy and financial statements available for public inspection upon proper request. Form 990, Part IX, Line 11g Rehabilitation fees, Dietary Services Form 990, Part XI, Line 9 Transfers to affiliates. Northland Lutheran Retirement Community Inc 831 Pine Beach Road Marinette WI 54143 391637677 Management Services WI 501(c)(3) 10 N/A 0 Northland Lutheran Housing for the Elderly Inc 1025 Pine Beach Road Marinette WI 54143 391302221 Elderly housing WI 501(c)(3) 10 N/A 0 Northland Foundation Inc 831 Pine Beach Road Marinette WI 54143 391431787 Investment management WI 501(c)(3) 10 N/A 0 Northland Terrace Estates Inc 1200 Northland Terrace Lane Marinette WI 54143 391564355 Independent elderly housing WI 501(c)(3) 10 N/A 0 Edgewood Manor Inc 831 Pine Beach Road Marinette WI 54143 391483436 Group home for developmentally disabled adults WI 501(c)(3) 10 N/A 0 Northland Lutheran Home Health Services Inc 831 Pine Beach Road Marinette WI 54143 391644145 Home Health services WI 501(c)(3) 10 N/A Michigan Interfaith Housing Corp Inc 1220 9th Ave Menominee MI 49858 382292400 Elderly housing MI 501(c)(3) 10 N/A 0 Northland Affordable Living for the Elderly Inc 1520 46th Ave Menominee MI 49858 392031271 Elderly housing MI 501(c)(3) 10 N/A 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 Northland Lutheran Retirement Community Inc j 12000 Office space rental Northland Lutheran Home Health Services Inc j 12000 Office space rental Northland Lutheran Retirement Community Inc p 739944 Management and maintenance fees Northland Lutheran Retirement Community Inc r 61000 Cash flow transfers