2019-05-13T10:05:47-05:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2017-07-01 362192824 LUTHERAN HOME FOR THE AGED INC LUTH 8473687342 800 W OAKTON STREET ARLINGTON HEIGHTS IL 600044602 JESSE JANTZEN CHIEF EXECUTIVE OFFICER 8473687342 2019-05-10 1 CHRIS MANDERFIELD P01238973 6305738600 2019-05-02 67.137.57.251 2019-05-10 11:53:17 CD P 12A6B3437D91A0C23DF0ED0A84D4C146BA3FB911 B78854EE20A5AAAEA57700933C1E697C4E2B71FA 2017 2019-02-21 02:37:17Z JESSE JANTZEN 3150 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 79444082 0 X WWW.LUTHERANLIFECOMMUNITIES.ORG X 1892 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 0 788 250 0 0 400042 383595 51367834 53498139 232955 23062353 2092982 1805749 54093813 78749836 0 0 0 0 26021883 25682901 0 0 18459 26295009 27511191 52316892 53194092 1776921 25555744 129945332 139305923 106200072 103776423 23745260 35529500 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 48149462 54339293 DEVELOPMENT AND OPERATION OF 376 SKILLED NURSING UNITS AND 100 ASSISTED LIVING BEDS FOR SENIORS. PROVIDING RESIDENTIAL AND HEALTH CARE SERVICES TO SENIORS INCLUDING BENEVOLENT CARE TO THOSE WHO HAVE EXHAUSTED THEIR FUNDS. 48149462 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 1 145 0 1 788 1 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 8473687342 3150 SALT CREEK LANE ARLINTON HEIGHTS IL 60005 JESSE JANTZEN STARTED 21218 CHAIR/PRESIDENT/CEO 4.00 32.50 X X 0 0 0 SHAREEN ANDERSON VICE CHAIR & SECRETARY 2.00 35.50 X X 0 192083 21490 MARIE CARLSON-KYLLO TREAURER 2.00 35.50 X X 0 215976 19909 ROGER W PAULSBERG UNTIL 111417 CHAIR/DIRECTOR 4.00 32.50 X X 0 518982 12526 LORI S FEDYK THROUGH 2118 OFFICER/VP 2.00 35.50 X X 0 239801 10333 PAULS PARKS SECRETARY & TREASURER 2.00 X X 0 0 0 DAVID ABRAHAMSON VICE CHAIR 2.00 X X 0 0 0 MARILYN HERMANN DIRECTOR 2.00 X 0 0 0 ANDREW KAZMIERCZAK STARTED 2118 EXECUTIVE DIRECTOR 37.50 X 0 120776 7142 RICHARD W STEFFENS REGIONAL CONTROLLER 37.50 X 157616 0 28386 SARAH KURTH ADMINISTRATOR 37.50 X 154992 0 26639 LAURA K NOLDEN NURSE TEAM SUPERVISOR 37.50 X 142830 0 1413 ANGELA ZAMORA CORPORATE DIRECTOR OF CULINARY SERVICES 37.50 X 123008 0 8598 578446 1287618 136436 5 0 1 0 SYMBRIA REHAB - ILLINOIS 28100 TORCH PARKWAY SUITE 600 WARRENVILLE IL 60555 THERAPY SERVICES 4172045 1ST CHOICE SENIOR HOMECARE INC 4556 OAKTON STREET 201 SKOKIE IL 60076 HOMECARE SERVICES 893325 ALLIANCE REHAB INC 28100 TORCH PARKWAY SUITE 600 WARRENVILLE IL 60555 THERAPY SERVICES 866715 GOLDEN BRIDGE HOME CARE SERVICES INC 5901 N CICERO AVE SUITE 605 CHICAGO IL 60646 HOMECARE SERVICES 443225 CHUHAK & TECSON PC 30 S WACKER DRIVE CHICAGO IL 60606 LEGAL 438378 8 220000 163595 383595 RESIDENT SERVICE REVENUE 623000 53498139 53498139 53498139 256599 256599 964595 0 964595 964595 964595 23500000 694246 22805754 22805754 22805754 CAFETERIA INCOME 623000 585140 585140 PURCHASE DISCOUNTS 623000 62928 62928 MUSIC INCOME 623000 61052 61052 132034 132034 841154 78749836 54339293 0 24026948 21415597 20380804 1034793 94704 87724 6980 2614497 2585345 27852 1300 1558103 1485247 72856 47811 47811 55700 55700 5500 5500 5276183 5253180 23003 237803 237803 3078379 3004969 56251 17159 98908 98908 1651492 1651492 104213 102507 1706 21994 20539 1455 5262425 5262425 4358360 4358360 1192268 1192268 ALLOCATION 2499996 2499996 FOOD & DIETARY SUPPLIES 1735788 1735788 BAD DEBT 884133 884133 GROUND MAINTENANCE & EQ 471925 471925 528313 528313 53194092 48149462 5026171 18459 2538193 1290883 1996663 10512354 4778653 4474033 3252878 2814000 128111 116489 1408185 1931782 147634394 60797601 89740922 86836793 134340 134340 25967387 31195249 129945332 139305923 5647940 5247641 661219 77781 92030112 90731202 1817488 1968718 5962421 5669741 80892 81340 106200072 103776423 X 23745260 35529500 23745260 35529500 129945332 139305923 X 25555744 -13771504 X X 0 1 X 1 0 X 878795 782606 136625 400042 383595 2581663 47065891 45859896 43894970 51367834 53498139 241686730 47944686 46642502 44031595 51767876 53881734 244268393 0 0 0 244268393 2188101 1384671 4461673 1403620 23526948 32965013 2188101 1384671 4461673 1403620 23526948 32965013 1121563 958942 904108 922317 841159 4748089 51254350 48986115 49397376 54093813 78249841 281981495 0.86630 0.93770 0.11690 0.04230 X 0 1817488 1512230 305258 1 X 20225 20225 122639008 40734393 81904615 23578323 19455232 4123091 1396838 607976 788862 86836793 CSV LIFE INSURANCE 3000 ASSETS HELD BY TRUSTEE UNDER BOND INDENTURE 7628575 OTHER ASSETS 8660 DUE FROM AFFILIATES 23555014 31195249 RESERVE FOR FUNERAL EXPENSES 6400 PAYABLES UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS 61394 CAPITAL LEASE OBLIGATION 13546 81340 X PART IV, LINE 2B: ESCROW LIABILITIES REPRESENT RESIDENT DEPOSITS AND RESIDENT PERSONAL FUND LIABILITIES. PART X, LINE 2: THE CORPORATIONS QUALIFY AS NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT THE LLC FOUNDATION, WHICH IS EXEMPT FROM TAXES UNDER SECTION 509(A)(2) OF THE CODE. THE CORPORATIONS HAVE 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 CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, THE CORPORATIONS 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 CONSOLIDATED 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. AS OF JUNE 30, 2018 AND 2017, THE CORPORATIONS DO NOT HAVE AN ASSET OR LIABILITY FOR UNRECOGNIZED TAX BENEFITS. X X X X 0 0 0 0 0 0 0 0 0 SHAREEN ANDERSON VICE CHAIR & SECRETARY 0 189933 0 2150 0 0 0 1971 0 19519 0 213573 0 0 MARIE CARLSON-KYLLO TREAURER 0 204019 0 6089 0 5868 0 2169 0 17740 0 235885 0 0 ROGER W PAULSBERG UNTIL 111417 CHAIR/DIRECTOR 0 455096 0 2000 0 61886 0 2873 0 9653 0 531508 0 0 LORI S FEDYK THROUGH 2118 OFFICER/VP 0 235404 0 4397 0 0 0 1014 0 9319 0 250134 0 0 RICHARD W STEFFENS REGIONAL CONTROLLER 151965 0 5651 0 0 0 1691 0 26695 0 186002 0 0 0 SARAH KURTH ADMINISTRATOR 154992 0 0 0 0 0 1664 0 24975 0 181631 0 0 0 A ILLINOIS FINANCE AUTHORITY 861091967 45203HMT6 2012-10-30 9670000 REVENUE REFUNDING BOND 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 45203HMU3 2012-10-30 10025000 REVENUE REFUNDING BOND 0 0 0 C ILLINOIS FINANCE AUTHORITY 861091967 45203HMX7 2012-10-30 7445000 REVENUE REFUNDING BOND 0 0 0 D ILLINOIS FINANCE AUTHORITY 861091967 45203HMW9 2012-10-30 45525000 REVENUE REFUNDING BOND 0 0 0 A 3300000 9670000 2012 0 0 1 1 B 10025000 2012 0 0 1 1 C 7445000 0 0 1 1 D 45525000 2012 0 0 1 1 A 0 1 0 0 0 0 1 B 0 1 0 0 0 0 1 C 0 1 0 0 0 0 1 D 0 1 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2017 ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2017 ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2017 ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2017 ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2017 A ILLINOIS FINANCE AUTHORITY 861091967 45203HMV1 2012-10-30 23185000 REVENUE REFUNDING BOND 0 0 0 A 23185000 2012 0 0 1 1 A 0 1 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 LUTHERAN HOME AND SERVICES FOR THE AGED, INC. 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 HOME AND SERVICES FOR THE AGED, INC. 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 HOME AND SERVICES FOR THE AGED, INC. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION REVIEWS THE TAX RETURN WITH THE AUDIT COMMITTEE OF LUTHERAN LIFE MINISTRIES,(THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) 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(WHICH IS THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED WITH THE HELP OF AN INDEPENDENT COMPENSATION CONSULTANT AND THE COMPENSATION COMMITTEE OF LUTHERAN LIFE MINISTRIES (WHICH IS THE SOLE CORPORATE MEMBER OF ITS PARENT, LUTHERAN HOME AND SERVICES FOR THE AGED, INC.) ULTIMATE APPROVAL FOR THE COMPENSATION AMOUNT FOR THE CEO RESTS WITH THE BOARD OF LUTHERAN LIFE MINISTRIES. THE LUTHERAN LIFE MINISTRIES BOARD PROVIDES COUNSEL TO THE CEO FOR THE COMPENSATION OF ANY OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE TAX RETURN, FINANCIAL STATEMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTION 17,496. TRANSFER OF NET ASSETS TO LUTHERAN LIFE COMMUNITIES FOUNDATION -13,289,000. LOSS ON IMPAIRMENT OF NOTE RECEIVABLE -500,000. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR 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 INC 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 INC 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 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 203426654 DEVELOP NEW SERVICES FOR SENIORS AND MANAGE SENIOR LIVING FACILITIES IL 501(C)(3) 509(A)(3) N/A 0 PLEASANT VIEW LUTHERAN HOME INC 505 COLLEGE AVENUE OTTAWA IL 61350 362167830 NURSING AND HEALTHCARE FACILITY IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 LUTHERAN LIFE COMMUNITIES FOUNDATION 3831 NORTH MOZART AVENUE CHICAGO IL 60618 363861882 SUPPORTS THE RESIDENTS AND OPERATIONS OF EACH LUTHERAN LIFE COMMUNITY IL 501(C)(3) 509(A)(1) LUTHERAN LIFE MINISTRIES 0 ST PAUL'S HOUSE AND HEALTH CARE CENTER 3831 NORTH MOZART AVENUE CHICAGO IL 60618 362167897 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 LUTHERAN LIFE COMMUNITIES 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 208549333 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 ARLINGTON OF NAPLES 800 W OAKTON STREET ARLINGTON HEIGHTS IL 60004 262019353 HEALTH CARE AND HOUSING FOR SENIORS IL 501(C)(3) 509(A)(2) LUTHERAN LIFE MINISTRIES 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 LUTHERAN LIFE COMMUNITIES E 32808 WITTENBERG LUTHERAN VILLAGE ENDOWMENT CORPORATION D 97537 LUTHERAN LIFE COMMUNITIES FOUNDATION E 4277825 LUTHERAN HOME AND SERVICES FOR THE AGED INC D 22979606 WITTENBERG LUTHERAN VILLAGE INC D 1805787 PLEASANT VIEW LUTHER HOME INC D 736396 ST PAUL'S HOUSE AND HEALTH CARE CENTER D 381403 LUTHER OAKS INC D 582418 THE ARLINGTON OF NAPLES D 1026595 LUTHERAN LIFE COMMUNITIES D 39640 WITTENBERG LUTHERAN VILLAGE Q 41165 ST PAUL'S HOUSE AND HEALTH CARE CENTER Q 431174 PLEASANT VIEW LUTHER HOME INC Q 281884 LUTHER OAKS INC Q 156004 THE ARLINGTON OF NAPLES Q 396257 LUTHERAN LIFE COMMUNITIES R 2499996 LUTHERAN LIFE COMMUNITIES FOUNDATION R 13289000 LUTHERAN LIFE COMMUNITIES FOUNDATION S 220000