2018-11-15T15:03:07-06:00 2017-12-31 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2017-01-01 383081979 LUTHERAN HOME CARE AGENCY INC LUTH 9896523470 4100 PIER NORTH BLVD NO STE A FLINT MI 48504 AMY E STORMS CFO 9896523470 2018-11-14 1 TINA PETERS P00904574 2483522500 2018-11-14 67.59.56.31 2018-11-14 15:34:48 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B1509E34FCCAF061B5BA8ED59B5AAADFB727D68E 2017 2019-02-21 02:37:17Z WELLSPRING LUTHERAN SERVICES DAVID M GEHM 4100 PIER NORTH BLVD NO STE A FLINT MI 48504 3151746 0 X WWW.WELLSPRINGLUTHERAN.COM X 1992 MI MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 8 8 51 40 0 0 0 120759 3403313 3028531 1520 1714 12141 742 3416974 3151746 0 0 0 0 1582273 1630587 0 0 0 1892678 1619448 3474951 3250035 -57977 -98289 1067939 1048394 1231722 1406236 -163783 -357842 MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 0 0 2139953 3029022 THE LUTHERAN HOME CARE AGENCY FULFILLED ITS TAX-EXEMPT PURPOSE THROUGH THE PROVISION OF NURSING, REHAB (PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPY), SOCIAL SERVICES, SPIRITUAL AND OTHER SUPPORTIVE PROGRAMS TO FRAIL ELDERLY, DISABLED PERSONS, AND TERMINALLY ILL INDIVIDUALS. IN ADDITION, THE LHCA PROVIDES ADDITIONAL SERVICES TO THE COMMUNITY AT LARGE THROUGH EDUCATION, GRIEF SUPPORT, FLU SHOT CLINICS, AND VARIOUS WELLNESS PROGRAMS. OVERALL, THE LHCA PROVIDED A TOTAL OF 18,726 VISITS WHICH INCLUDED SERVICES SUCH AS NURSING CARE; SPEECH, PHYSICAL, AND OCCUPATIONAL THERAPIES; MEDICAL, SOCIAL, AND PERSONAL SERVICES; AND HOSPICE SERVICES TO 854 INDIVIDUALS. 2139953 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 10 0 1 51 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MI X ERIC MUSUM 9896523470 4100 PIER NORTH BLVD STE A FLINT MI 48504 RITCH CUSHWAY CHAIRMAN 0.20 0.80 X X 0 0 0 PETE BENDER TREASURER/SECRETARY 0.20 0.80 X X 0 0 0 REV DON NEUENDORF DIRECTOR - THRU 5/23/17 0.20 0.80 X 0 0 0 DARRELL ZOLTON DIRECTOR 0.20 0.80 X 0 0 0 PAUL NYQUIST DIRECTOR 0.20 0.80 X 0 0 0 CARL SCHOENOW DIRECTOR 0.20 0.80 X 0 0 0 AMY BENKO DIRECTOR 0.20 0.80 X 0 0 0 DAVID M GEHM PRESIDENT & CEO 0.00 40.00 X 0 269261 14151 ALBERT D KAUL VP HUMAN RESOURCES, CPO 0.22 39.78 X 0 132304 11024 AMY STORMS SR. VP FINANCE AND CFO 0.08 39.92 X 0 166163 12233 ERIC R MUSUM VP, CAA AND CTO 0.00 40.00 X 0 115973 10256 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 1.08 38.92 X 0 174080 6793 0 857781 54457 0 0 1 0 SELECT REHABILITATION PO BOX 80905 CHICAGO IL 60680 OCCUPATIONAL/PHYSICAL/SPEECH THERAPY 498805 LUTHERAN HOMES OF MICHIGAN 4100 PIER NORTH BLVD SUITE A FLINT MI 48504 HOSPICE CARE 278032 LUTHERAN HOME CARE PERSONAL ASSISTANCE 4100 PIER NORTH BLVD SUITE A FLINT MI 48504 RENT 120000 3 120759 30 120759 HOME CARE SERVICES 621610 3028531 3028531 3028531 1714 1714 FURNISHED SERVICES 990009 491 491 MISCELLANEOUS 990009 251 251 742 3151746 3029022 0 1965 X 1407322 1002601 404721 20924 9987 10937 101780 52213 49567 100561 74386 26175 278032 278032 107 107 621127 609991 11136 3148 1662 1486 51020 3716 47304 78607 78607 141198 212 140986 85808 79192 6616 6797 2853 3944 865 692 173 33504 33504 DRUGS AND SUPPLIES 212104 212104 RENTAL EQUIPMENT 45726 45726 LICENSES AND FEES 14706 835 13871 FOUNDATION EXPENSES 10068 10068 36631 33715 2916 3250035 2139953 1110082 0 483165 521924 245374 287722 10972 6956 484164 483660 1370 504 327058 231288 1067939 1048394 149363 134383 1082359 1271853 1231722 1406236 X -490841 -589130 327058 231288 -163783 -357842 1067939 1048394 X -98289 -95770 X X 0 1 X 1 0 X 24019 21858 0 0 120759 166636 3721914 4031886 3551829 3403313 3028531 17737473 23958 3889 9000 9854 491 47192 3769891 4057633 3560829 3413167 3149781 17951301 24019 21858 120759 166636 0 24019 21858 120759 166636 17784665 1443 1273 1193 1520 1714 7143 1443 1273 1193 1520 1714 7143 19940 758 4487 2287 251 27723 3791274 4059664 3566509 3416974 3151746 17986167 0.98880 0.98600 0.00040 0.00040 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS 0 0 0 0 0 0 0 0 1 107 107 0 PART II-B, LINE 1: MEMBERSHIP FEE ALLOCATED TO LOBBYING. 484164 483660 504 504 ASSETS LIMITED AS-TO-USE 231288 231288 DUE TO AFFILIATES 1271853 1271853 0 0 0 0 0 0 0 0 0 DAVID M GEHM PRESIDENT & CEO 0 269261 0 0 0 0 0 7285 0 6866 0 283412 0 0 AMY STORMS SR. VP FINANCE AND CFO 0 166163 0 0 0 0 0 5468 0 6765 0 178396 0 0 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 0 174080 0 0 0 0 0 0 0 6793 0 180873 0 0 PART I, LINE 3 THE PROCESS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO IS UNDERTAKEN BY LUTHERAN HOMES OF MICHIGAN, INC., A RELATED ORGANIZATION. THE PROCESS INCLUDES USE OF A COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS LUTHERAN HOMES OF MICHIGAN, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, LUTHERAN HOMES OF MICHIGAN, INC., HAS THE AUTHORITY TO APPOINT/ELECT INDIVIDUALS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES OF THE FORM 990 WERE SENT TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS' INPUTS AND COMMENTS WERE SOLICITED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE COLLECTED IN THE BEGINNING OF EACH NEW BOARD YEAR. THE FORMS ARE REVIEWED BY THE CEO. IF A CONFLICT EXISTS, THE CEO REVIEWS WITH THE BOARD CHAIR AND DETERMINES THE APPROPRIATE ACTION, WHICH IS TYPICALLY TO REMOVE THE INDIVIDUAL FROM THE POSITION OF CONFLICT FOR THE SPECIFIC TRANSACTION/PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE CORPORATE OFFICE OF WELLSPRING LUTHERAN SERVICES BY CONTACTING THE CHIEF FINANCIAL OFFICER. FORM 990, PART IX, LINE 11G INPATIENT CARE: PROGRAM SERVICE EXPENSES 486,594. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 486,594. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 50,863. MANAGEMENT AND GENERAL EXPENSES 11,136. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,999. OTHER: PROGRAM SERVICE EXPENSES 72,534. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,534. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATION -95,770. FORM 990, PART XII, LINE 2C: THERE WERE NO CHANGES TO THE AUDIT OVERSIGHT PROCEDURES FROM THE PREVIOUS YEAR. LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 381358410 NURSING CARE MI 501(C)(3) LINE 10 N/A 0 LUTHERAN HOMES OF MICHIGAN FOUNDATION 4100 PIER NORTH BLVD STE A FLINT MI 48504 261630687 DONATE FUNDS MI 501(C)(3) LINE 12A LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE PERSONAL ASSISTANCE 4100 PIER NORTH BLVD STE A FLINT MI 48504 272138954 HOME CARE MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 382236926 RETIREMENT COMMUNITY MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 PROJECT COMPASSION HEALTH 4100 PIER NORTH BLVD STE A FLINT MI 48504 382395647 SKILLED NURSING FACILITY MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 ALPENA VILLAGE 4100 PIER NORTH BLVD STE A FLINT MI 48504 320090735 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI N/A GIBRALTAR 26200 LAHSER RD STE 300 SOUTHFIELD MI 48034 301829767 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A MONROE ELDERLY LDHALP 5309 TRANSPORTATION BLVD CLEVELAND OH 44125 383609893 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A ALPENA PINES LDHALP 9710 JUNCTION ROAD FRANKENMUTH MI 48434 260236982 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A LHM HOUSING SERVICES INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 383609879 HOUSING SERVICES MI N/A C 0 GIBRALTER MANOR DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 202240778 HOUSING SERVICES MI N/A C 0 ALPENA PINES DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 260237019 HOUSING SERVICES MI N/A C 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 LUTHERAN HOME CARE PERSONAL ASSISTANCE K 120000 ACTUAL AMOUNT LUTHERAN HOMES OF MICHIGAN P 278032 ACTUAL COST LUTHERAN HOMES OF MICHIGAN L 95761 ACTUAL AMOUNT LUTHERAN HOMES OF MICHIGAN FOUNDATION C 120759 ACTUAL AMOUNT