CEDAR LAKE VILLAGE INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: CEDAR LAKE VILLAGE INC (EIN 48-1209650)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-10-27
IRS object ID: 202023019349301607
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule K
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-10-27T12:44:36-05:00	ReturnTs
Tax Period End	2019-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450250958	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	EIDE BAILLY LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	200 E 10TH ST STE 500	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571046375	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	481209650	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CEDAR LAKE VILLAGE INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CEDA	BusinessNameControlTxt
Phone	6053331000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 5039 RTE 5218	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571175039	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ERIC VANDEN HULL	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	6053331000	PhoneNum
Signature	2020-10-23	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	LAURIE HANSON	PreparerPersonNm
PTIN	P00851848	PTIN
Phone	6053391999	PhoneNum
Preparation	2020-10-23	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	184.83.199.194	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-10-23	IPDt
IP Tm	10:25:23	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	50CCFF325394DF76E401CCE6D67578A0FB45D135	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Principal Officer	NATHAN SCHEMA	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4800 W 57TH STREET	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57117	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$24,905,261	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SANFORDHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1998	FormationYr
Legal Domicile State	KS	LegalDomicileStateCd
Activity Or Mission	HOUSING, PROGRAMS AND SERVICES FOR ELDERLY PERSONS AND OTHERS IN NEED.	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	363	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$7,251	PYContributionsGrantsAmt
CY Contributions Grants	$41,737	CYContributionsGrantsAmt
PY Program Service Revenue	$11,389,121	PYProgramServiceRevenueAmt
CY Program Service Revenue	$11,906,674	CYProgramServiceRevenueAmt
PY Investment Income	-$54,303	PYInvestmentIncomeAmt
CY Investment Income	$78,684	CYInvestmentIncomeAmt
PY Other Revenue	$69,661	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$11,411,730	PYTotalRevenueAmt
CY Total Revenue	$12,027,095	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$5,416,885	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$29,848	CYTotalFundraisingExpenseAmt
PY Other Expenses	$7,058,873	PYOtherExpensesAmt
CY Other Expenses	$12,756,075	CYOtherExpensesAmt
PY Total Expenses	$12,475,758	PYTotalExpensesAmt
CY Total Expenses	$12,756,075	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,064,028	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$728,980	CYRevenuesLessExpensesAmt
Total Assets BOY	$41,103,064	TotalAssetsBOYAmt
Total Assets EOY	$41,165,178	TotalAssetsEOYAmt
Total Liabilities BOY	$30,521,446	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$32,142,448	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$10,581,618	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$9,022,730	NetAssetsOrFundBalancesEOYAmt
Mission	IMPROVING THE WELL-BEING AND QUALITY OF LIFE FOR OLDER PERSONS AND OTHERS IN NEED THROUGH THE PROVISION OF HOUSING, PROGRAMS, AND SERVICES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$10,333,796	ExpenseAmt
Revenue	$11,906,674	RevenueAmt
Desc	PROVIDING HOUSING, PROGRAMS, AND SERVICES IN AN EFFORT TO IMPROVE THE QUALITY OF LIFE FOR OLDER PERSONS AND OTHERS IN NEED. 20,572 ASSISTED LIVING RESIDENT DAYS, 39,647 SENIOR HOUSING RESIDENT DAYS, AND 8,305 SKILLED NURSING RESIDENT DAYS IN 2019.	Desc
Total Program Service Expenses	$10,333,796	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	0	MinutesOfCommitteesInd
Officer Mailing Address	Yes (1)	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	KS	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ERIC VANDEN HULL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6053623100	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4800 W 57TH STREET	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571175038	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
THOMAS A SYVERSON
PRES UNTIL 8/19; TRUSTEE UNTIL 8/19	1.00	Yes (X)	Yes (X)	$0	$0	$0
NATHAN SCHEMA
PRESIDENT BEG. 9/19; CHAIR BEG. 9/19	1.00	Yes (X)	Yes (X)	$0	$0	$0
JAMES R HUBBARD
VICE-PRESIDENT; VICE CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOSEPH HERDINA
TREASURER UNTIL 8/19	1.00	Yes (X)	Yes (X)	$0	$0	$0
RANDY FITZGERALD
SECRETARY; TRUSTEE	1.00	Yes (X)	Yes (X)	$0	$0	$0
ERIC VANDEN HULL
TREAS. BEG 9/19; TRUSTEE BEG. 9/19	1.00	Yes (X)	Yes (X)	$0	$0	$0
J MACK BOWEN
TRUSTEE	1.00	Yes (X)		$0	$0	$0
VINCE DONOFRIO
TRUSTEE	1.00	Yes (X)		$0	$0	$0
JOANNA RANDALL
EXECUTIVE DIRECTOR	45.00		Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
THE EVANGELICAL LUTHERAN GOOD SAMARITAN
4800 W 57TH STREET	SIOUX FALLS	SD	57108	MANAGEMENT FEES & BILLING SERVICES, SHAR	$6,347,489
SUMMIT CARE INC
6830 W 121ST CT	OVERLAND PARK	KS	66209	CONTRACT THERAPY SERVICES	$616,657

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	2	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$41,737	AllOtherContributionsAmt
Total Contributions	$41,737	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ROOM REVENUE & ANCILLARY SERVICES	623000	$11,813,062	$11,813,062
MEALS, GUEST ROOMS, AND OTHER REV	623000	$93,612	$93,612

Field	Value	IRS element (for citing)
Total Program Service Revenue	$11,906,674	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$68,915	TotalRevenueColumnAmt
Exclusion	$68,915	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$12,887,935	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$12,846,015	SecuritiesAmt
Other	$32,151	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$41,920	SecuritiesAmt
Other	-$32,151	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,769	TotalRevenueColumnAmt
Exclusion	$9,769	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,027,095	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,906,674	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$78,684	ExclusionAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$651,202	TotalAmt
Management And General	$651,202	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$905,355	TotalAmt
Program Services	$867,506	ProgramServicesAmt
Management And General	$37,849	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$69,080	TotalAmt
Program Services	$68,718	ProgramServicesAmt
Management And General	$362	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,151,144	TotalAmt
Program Services	$1,097,245	ProgramServicesAmt
Management And General	$53,489	ManagementAndGeneralAmt
Fundraising	$410	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$7,536	TotalAmt
Management And General	$7,536	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$984,770	TotalAmt
Program Services	$945,272	ProgramServicesAmt
Management And General	$39,498	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$18,578	TotalAmt
Program Services	$11,175	ProgramServicesAmt
Management And General	$7,403	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$920,000	TotalAmt
Program Services	$920,000	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,791,527	TotalAmt
Program Services	$1,791,527	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$131,352	TotalAmt
Program Services	$131,352	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
CONTRACT SERVICES - PER	$5,754,584	$4,450,266	$1,274,880	$29,438
BAD DEBT	$221,003		$221,003
EMPLOYEE, PUBLIC & RESI	$63,377	$21,556	$41,821
TAXES AND LICENSES	$52,206		$52,206

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$34,361	TotalAmt
Program Services	$29,179	ProgramServicesAmt
Management And General	$5,182	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,756,075	TotalAmt
Program Services	$10,333,796	ProgramServicesAmt
Management And General	$2,392,431	ManagementAndGeneralAmt
Fundraising	$29,848	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$81,006	BOYAmt
EOY	$1,243,580	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$19,760	BOYAmt
EOY	$839,305	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$553,100	BOYAmt
EOY	$449,263	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$53,505	BOYAmt
EOY	$33,116	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$9,952	BOYAmt
EOY	$7,408	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$50,394,656	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$18,760,760	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$33,104,017	BOYAmt
EOY	$31,633,896	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$7,073,672	BOYAmt
EOY	$6,788,072	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$208,052	BOYAmt
EOY	$170,538	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$41,103,064	BOYAmt
EOY	$41,165,178	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,520,080	BOYAmt
EOY	$610,735	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$907	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$16,652,996	BOYAmt
EOY	$15,957,766	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$12,348,370	BOYAmt
EOY	$15,573,040	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$30,521,446	BOYAmt
EOY	$32,142,448	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,386,149	BOYAmt
EOY	$8,808,164	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$195,469	BOYAmt
EOY	$214,566	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$10,581,618	BOYAmt
EOY	$9,022,730	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$41,103,064	BOYAmt
EOY	$41,165,178	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$728,980	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$826,090	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$3,818	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$161,782	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$26,557	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$22,110	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$7,251	CurrentTaxYearMinus1YearAmt
Current Tax Year	$41,737	CurrentTaxYearAmt
Total	$259,437	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$10,997,283	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$11,199,969	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,178,236	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$11,389,121	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,906,674	CurrentTaxYearAmt
Total	$56,671,283	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$11,159,065	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$11,226,526	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,200,346	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$11,396,372	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,948,411	CurrentTaxYearAmt
Total	$56,930,720	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$101,200	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,000	CurrentTaxYearMinus3YearsAmt
Total	$102,200	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$101,200	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,000	CurrentTaxYearMinus3YearsAmt
Total	$102,200	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$56,828,520	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$38,862	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$70,108	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$105,639	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$154,630	CurrentTaxYearMinus1YearAmt
Current Tax Year	$68,915	CurrentTaxYearAmt
Total	$438,154	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$38,862	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$70,108	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$105,639	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$154,630	CurrentTaxYearMinus1YearAmt
Current Tax Year	$68,915	CurrentTaxYearAmt
Total	$438,154	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$11,197,927	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$11,296,634	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,305,985	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$11,551,002	CurrentTaxYearMinus1YearAmt
Current Tax Year	$12,017,326	CurrentTaxYearAmt
Total	$57,368,874	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.99060	PublicSupportCY509Pct
Public Support PY509	0.98950	PublicSupportPY509Pct
Investment Income CY	0.00760	InvestmentIncomeCYPct
Investment Income PY	0.00750	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$174,356	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$3,818	InvestmentEarningsOrLossesAmt
End Year Balance	$170,538	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$165,876	BeginningYearBalanceAmt
Investment Earnings Or Losses	$8,480	InvestmentEarningsOrLossesAmt
End Year Balance	$174,356	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$148,937	BeginningYearBalanceAmt
Investment Earnings Or Losses	$16,939	InvestmentEarningsOrLossesAmt
End Year Balance	$165,876	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$140,611	BeginningYearBalanceAmt
Investment Earnings Or Losses	$8,326	InvestmentEarningsOrLossesAmt
End Year Balance	$148,937	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$140,599	BeginningYearBalanceAmt
Investment Earnings Or Losses	$12	InvestmentEarningsOrLossesAmt
End Year Balance	$140,611	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,922,557	OtherCostOrOtherBasisAmt
Book Value	$1,922,557	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$41,923,344	OtherCostOrOtherBasisAmt
Depreciation	$15,069,335	DepreciationAmt
Book Value	$26,854,009	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,174,760	OtherCostOrOtherBasisAmt
Depreciation	$2,066,223	DepreciationAmt
Book Value	$1,108,537	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,373,995	OtherCostOrOtherBasisAmt
Depreciation	$1,625,202	DepreciationAmt
Book Value	$1,748,793	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$31,633,896	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	HOUSING ENTRY FEES	Desc
Book Value	$6,788,072	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$6,788,072	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
SPECIAL ASSESSMENTS PAYABLE	$129,347
SECURED MORTGAGES AND NOTES PAYABLE TO MEMBERS	$7,861,079
SECURITY DEPOSITS	$177,400
HOUSING ENTRY FEES AND OTHER LIABIL	$6,565,302
INTEREST RATE SWAP	$839,912

Field	Value	IRS element (for citing)
Total Liability	$15,573,040	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$11,178,090	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$826,090	NetUnrealizedGainsInvstAmt
Other Revenue	$15,136	OtherRevenueAmt
Revenue Not Reported	-$810,954	RevenueNotReportedAmt
Revenue Subtotal	$11,989,044	RevenueSubtotalAmt
Other Revenues Not Included	$38,051	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$38,051	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$12,027,095	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$12,756,075	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$12,756,075	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$12,756,075	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	EARNINGS ON THE CEDAR LAKE VILLAGE ENDOWMENT FUNDS WILL BE USED AS DIRECTED BY DONOR RESTRICTIONS OR THE BOARD'S DESIGNATION, ABSENT DONOR RESTRICTIONS.
PART X, LINE 2:	THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES WERE INCURRED. THE ORGANIZATION IS SUBJECT TO FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	NET ASSET RELEASED FROM RESTRICTION 15,136.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	CONTRIBUTIONS AND EARNINGS - TEMP RESTRISTED NET ASSETS 38,051.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CITY OF OLATHE KANSAS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	486034756	BondIssuerEIN
Bond Issued	2015-05-15	BondIssuedDt
Issue Price	$19,200,000	IssuePriceAmt
Purpose	SEE NARRATIVE	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$3,095,000	RetiredAmt
Total Proceeds	$19,200,000	TotalProceedsAmt
Issuance Costs From Proceeds	$270,367	IssuanceCostsFromProceedsAmt
Capital Expenditures	$7,509,781	CapitalExpendituresAmt
Other Spent Proceeds	$11,419,852	OtherSpentProceedsAmt
Substantial Completion	2015	SubstantialCompletionYr
Refunding Tax Exempt Bonds	Yes (1)	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	0	RefundingTaxableBondsInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (1)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	Yes (1)	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	Yes (1)	VariableRateIssueInd
Hedge Identified In Bks And Rec	Yes (1)	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	CENTER STATE BANK	BusinessNameLine1Txt
Business Name Line2	OF FLORIDA NA	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Term Of Hedge	20.600000000000	TermOfHedgePct
Superintegrated Hedge	0	SuperintegratedHedgeInd
Hedge Terminated	0	HedgeTerminatedInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K, PART I, COLUMN F, LINE A	FormAndLineReferenceDesc
Explanation	CONSTRUCT ADDITIONAL FACILITIES, PAY COSTS RELATED TO BOND ISSUANCE, REFUND OF CITY OF OLATHE, KS BOND ISSUE DATED 12/16/04, CUSIP 679390FB5, AND REFUND OF BANK OF AMERICA LINE OF CREDIT.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3	THE ORGANIZATION HAS DELEGATED MANAGEMENT DUTIES TO THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, A MEMBER OF THE ORGANIZATION. JOANNA RANDALL, THE ADMINISTRATOR FOR THE ORGANIZATION, RECEIVED COMPENSATION OF $134,018 PLUS EMPLOYER PAID BENEFITS OF $8,909 FOR SERVICES PROVIDED TO CEDAR LAKE VILLAGE, INC. DURING 2019.
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS ARE OLATHE MEDICAL CENTER, INC. AND THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY.
FORM 990, PART VI, SECTION A, LINE 7A	THE TRUSTEES ARE APPOINTED BY THE MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	THE DECISIONS OF THE GOVERNING BODY THAT ARE SUBJECT TO APPROVAL INCLUDE: ELECTION OF TRUSTEES AND OFFICERS; APPROVE ARTICLE AND BYLAW CHANGES; APPROVE OR REJECT NON-BUDGETED ACQUISITIONS, EXPENDITURES, OR DISPOSALS OF A VALUE IN EXCESS OF $100,000; DISTRIBUTIONS TO MEMBERS; APPROVE INCURRENCE OF DEBT BY CEDAR LAKE VILLAGE, INC ("CLV") IN EXCESS OF $100,000; AND APPROVE LIENS OF ANY CLV PROPERTY HAVING A VALUE IN EXCESS OF $100,000.
FORM 990, PART VI, SECTION A, LINE 8B	THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES.
FORM 990, PART VI, SECTION B, LINE 11B	AN ELECTRONIC COPY OF FORM 990 IS SENT TO EACH MEMBER OF THE BOARD PRIOR TO ITS FILING. THE ORGANIZATION'S OFFICERS AND MANAGEMENT ARE AN INTEGRAL PART OF THE PREPARATION OF THE FORM 990 AND HAVE AN ON-GOING REVIEW OF THE FORM 990 AS IT IS PREPARED.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION ASKS THAT ALL OFFICERS AND DIRECTORS COMPLY WITH THE IRS CONFLICT OF INTEREST AND DISCLOSURE CERTIFICATION. THE ORGANIZATION REQUIRES ALL OFFICERS AND DIRECTORS TO PROVIDE A SIGNED COPY TO THE CORPORATION'S MAIN OFFICE ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15A	THE ADMINISTRATOR FOR THE ORGANIZATION IS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH AN UNRELATED MANAGEMENT COMPANY, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. THE COMPENSATION IS REVIEWED AND DETERMINED BY THE UNRELATED MANAGEMENT COMPANY ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC	JAMES R. HUBBARD - 15325 S LONE ELM ROAD, OLATHE, KS 66061. RANDY FITZGERALD - 15325 S LONE ELM ROAD, OLATHE, KS 66061. J. MACK BOWEN - 15325 S LONE ELM ROAD, OLATHE, KS 66061. VINCE DONOFRIO - 15325 S LONE ELM ROAD, OLATHE, KS 66061. JOANNA RANDALL - 15325 S LONE ELM ROAD, OLATHE, KS 66061.
FORM 990, PART XI, LINE 9:	CHANGE IN TELGSS FDTN INTEREST -3,818.
FORM 990, SCHEDULE D, PART VI, LINE 1E, COLUMNS B AND C:	OTHER PROPERTY SHOWN IN THE OTHER COLUMN CONSISTS OF LAND IMPROVEMENTS OF $3,225,795 WITH RELATED ACCUMULATED DEPRECIATION OF $1,625,202 AND CONSTRUCTION AND DEVELOPMENT OF $148,200 WITH NO RELATED ACCUMULATED DEPRECIATION. DEPRECIATION WILL BE RECOGNIZED FOR THE CONSTRUCTION AND DEVELOPMENT ASSETS ONCE CONSTRUCTION HAS BEEN COMPLETED AND THE ASSETS HAVE BEEN PLACED INTO SERVICE.
FORM 990, PART V, LINES 1A AND 2A:	FORM 1099 AND W-2 PROCESSING IS COMPLETED BY THE MANAGEMENT COMPANY, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, A MEMBER OF THE ORGANIZATION. AS SUCH, PART V LINES 1A AND 2A REPORT NO 1099'S OR W-2'S FOR THE ORGANIZATION.