CARMEL RESIDENCE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CARMEL RESIDENCE INC (EIN 39-1448325)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-07
IRS object ID
201703119349302915
Schema version
2016v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-07T16:00:59-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18215 GREENWAY BOULEVARD SUITE 600AddressLine1Txt
CityMIDDLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53562ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391448325EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CARMEL RESIDENCE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCARMBusinessNameControlTxt
Phone9202354653PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1220 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHERESA M BERTRAMPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone9202325220PhoneNum
Signature2017-11-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIMBERLY ANDERSON CPAPreparerPersonNm
PTINP00188889PTIN
Phone6086628600PhoneNum
Preparation2017-11-02PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-02IPDt
IP Tm13:24:43IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id3E979F80BB8F399C9CB7D5D916B34B85DDD844F4AtSubmissionCreationDeviceId
At Submission Filing Device Id1C4AA1E388E3DC50B055405D9AA64341548DFCA7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHERESA M BERTRAMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$735,481GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption9386GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LUTHERANHOMES.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1988FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO PROVIDE HOUSING FOR AGING PERSONS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$30,476PYContributionsGrantsAmt
CY Contributions Grants$4,671CYContributionsGrantsAmt
PY Program Service Revenue$718,047PYProgramServiceRevenueAmt
CY Program Service Revenue$674,149CYProgramServiceRevenueAmt
PY Investment Income$8,595PYInvestmentIncomeAmt
CY Investment Income$9,221CYInvestmentIncomeAmt
PY Other Revenue$47,566PYOtherRevenueAmt
CY Other Revenue$47,440CYOtherRevenueAmt
PY Total Revenue$804,684PYTotalRevenueAmt
CY Total Revenue$735,481CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$202,249PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$197,143CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$474,397PYOtherExpensesAmt
CY Other Expenses$504,415CYOtherExpensesAmt
PY Total Expenses$676,646PYTotalExpensesAmt
CY Total Expenses$701,558CYTotalExpensesAmt
PY Revenues Less Expenses$128,038PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$33,923CYRevenuesLessExpensesAmt
Total Assets BOY$4,377,623TotalAssetsBOYAmt
Total Assets EOY$4,429,556TotalAssetsEOYAmt
Total Liabilities BOY$3,052,891TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,070,901TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,324,732NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,358,655NetAssetsOrFundBalancesEOYAmt
MissionCARMEL RESIDENCE, INC., IS PART OF A FAMILY OF HEALTHCARE AND RESIDENTIAL SERVICE ORGANIZATIONS COMMITTED TO PROVIDING QUALITY CARE AND LIFE ENRICHING OPPORTUNITIES TO THE AGING AND THOSE IN NEED IN A CARING, CHRISTIAN ENVIRONMENT.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$511,813ExpenseAmt
Revenue$674,149RevenueAmt
DescCARMEL RESIDENCE, INC., PROVIDES INDEPENDENT LIVING FACILITIES FOR AGING PERSONS. THE ENTITY HAS 75 INDEPENDENT LIVING UNITS.Desc
Total Program Service Expenses$511,813TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKIM MAKIPersonNm
Phone9202325238PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MARK BEECHER
CHAIR0.201.40Yes (X)Yes (X)$0$0$0
KATHLEEN BELLAIRE
VICE CHAIR0.201.40Yes (X)Yes (X)$0$0$0
THOMAS DUNHAM
SECRETARY0.201.40Yes (X)Yes (X)$0$0$0
KAREN JACOBSON
BOARD MEMBER0.201.40Yes (X)$0$0$0
PEG OLSON
BOARD MEMBER0.201.40Yes (X)$0$0$0
MARY MURKEN
BOARD MEMBER0.201.40Yes (X)$0$0$0
REV JAN VESETH
BOARD MEMBER0.201.40Yes (X)$0$0$0
JIM STAPEL
BOARD MEMBER0.201.40Yes (X)$0$0$0
DR SUZANNE MARNOCHA
BOARD MEMBER0.201.40Yes (X)$0$0$0
WAYNE MUELLER
BOARD MEMBER0.201.40Yes (X)$0$0$0
THERESA BERTRAM
PRESIDENT & CEO4.5036.00Yes (X)$0$251,820$0
JULIE VANDENBERG
CORPORATE SECRETARY4.5036.00Yes (X)$0$69,234$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$321,054TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$4,671RelatedOrganizationsAmt
Total Contributions$4,671TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
APARTMENT OPERATIONS623990$604,900$604,900
ENTRANCE FEE REVENUES623990$69,249$69,249
FieldValueIRS element (for citing)
Total Program Service Revenue$674,149TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,221TotalRevenueColumnAmt
Exclusion$9,221ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$41,460RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$41,460RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$41,460TotalRevenueColumnAmt
Exclusion$41,460ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
LAUNDRY REVENUE900099$4,198$4,198
BEAUTY SHOP REVENUE900099$1,165$1,165
MISCELLANEOUS900099$617$617
FieldValueIRS element (for citing)
Other Revenue Total$5,980OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$735,481TotalRevenueColumnAmt
Related Or Exempt Func Income$674,149RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$56,661ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$197,143TotalAmt
Program Services$97,543ProgramServicesAmt
Management And General$99,600ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$56,604TotalAmt
Management And General$56,604ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,648TotalAmt
Management And General$1,648ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$4,740TotalAmt
Management And General$4,740ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$32,293TotalAmt
Program Services$30,543ProgramServicesAmt
Management And General$1,750ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,859TotalAmt
Management And General$9,859ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$11,751TotalAmt
Management And General$11,751ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$920TotalAmt
Management And General$920ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$135,454TotalAmt
Program Services$135,454ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$44TotalAmt
Management And General$44ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,047TotalAmt
Program Services$1,047ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$231,582TotalAmt
Program Services$231,582ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$10,671TotalAmt
Program Services$10,671ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MISCELLANEOUS EXPENSES$4,845$4,845
RESIDENT EXPENSES$2,829$2,829
FOOD$125$125
MEDICAL SUPPLIES$3$3

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$701,558TotalAmt
Program Services$511,813ProgramServicesAmt
Management And General$189,745ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$33,583BOYAmt
EOY$55,279EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,790,981BOYAmt
EOY$1,921,820EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$441BOYAmt
EOY$252EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,957,941LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,509,700LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,548,654BOYAmt
EOY$2,448,241EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$3,964BOYAmt
EOY$3,964EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,377,623BOYAmt
EOY$4,429,556EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$27,194BOYAmt
EOY$29,393EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$524,458BOYAmt
EOY$524,470EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$2,480,796BOYAmt
EOY$2,502,076EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,443BOYAmt
EOY$14,962EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,052,891BOYAmt
EOY$3,070,901EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,320,768BOYAmt
EOY$1,354,691EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,964BOYAmt
EOY$3,964EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,324,732BOYAmt
EOY$1,358,655EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,377,623BOYAmt
EOY$4,429,556EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$33,923ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,994CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,309CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,751CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$30,476CurrentTaxYearMinus1YearAmt
Current Tax Year$4,671CurrentTaxYearAmt
Total$55,201TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$570,274CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$596,279CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$717,352CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$718,047CurrentTaxYearMinus1YearAmt
Current Tax Year$674,149CurrentTaxYearAmt
Total$3,276,101TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$576,268CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$605,588CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$722,103CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$748,523CurrentTaxYearMinus1YearAmt
Current Tax Year$678,820CurrentTaxYearAmt
Total$3,331,302TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$53,858CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$169,497CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$181,467CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$174,885CurrentTaxYearMinus1YearAmt
Current Tax Year$194,247CurrentTaxYearAmt
Total$773,954TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$53,858CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$169,497CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$181,467CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$174,885CurrentTaxYearMinus1YearAmt
Current Tax Year$194,247CurrentTaxYearAmt
Total$773,954TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$2,557,348PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$52,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$47,191CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$46,054CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,004CurrentTaxYearMinus1YearAmt
Current Tax Year$50,681CurrentTaxYearAmt
Total$246,443TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$52,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$47,191CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$46,054CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$50,004CurrentTaxYearMinus1YearAmt
Current Tax Year$50,681CurrentTaxYearAmt
Total$246,443TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,771CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,899CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,488CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,157CurrentTaxYearMinus1YearAmt
Current Tax Year$5,980CurrentTaxYearAmt
Total$38,295TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$637,552CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$661,678CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$776,645CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$804,684CurrentTaxYearMinus1YearAmt
Current Tax Year$735,481CurrentTaxYearAmt
Total$3,616,040TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.70720PublicSupportCY509Pct
Public Support PY5090.73500PublicSupportPY509Pct
Investment Income CY0.06820InvestmentIncomeCYPct
Investment Income PY0.07200InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$43,875OtherCostOrOtherBasisAmt
Book Value$43,875BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,004,557OtherCostOrOtherBasisAmt
Depreciation$3,408,941DepreciationAmt
Book Value$1,595,616BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$148,645OtherCostOrOtherBasisAmt
Depreciation$129,519DepreciationAmt
Book Value$19,126BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,760,864OtherCostOrOtherBasisAmt
Depreciation$971,240DepreciationAmt
Book Value$789,624BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,448,241TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO AFFILIATES$7,229
LEASE PAYABLE$7,733
FieldValueIRS element (for citing)
Total Liability$14,962TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:CARMEL RESIDENCE OFFERS RESIDENTS THREE ENTRANCE OPTIONS UPON RESIDENCY. THE RESIDENT(S) MAY CHOOSE TO MAKE A NON-INTEREST-BEARING ENTRANCE DEPOSIT, WHICH IS REFUNDABLE AT 90% WITHIN 90 DAYS OF TERMINATION OF OCCUPANCY TO THE RESIDENT OR THEIR PERSONAL REPRESENTATIVE. THE SECOND OPTION REQUIRES A NONREFUNDABLE DEPOSIT OF 10% OF THE ENTRANCE FEE, AND THE THIRD OPTION REQUIRES A REFUNDABLE SECURITY DEPOSIT EQUAL TO ONE MONTH'S RENT. UNTIL RECOGNIZED AS REVENUE, NON-REFUNDABLE SECURITY DEPOSITS ARE REPORTED IN FORM 990, PART X, LINE 19 AS DEFERRED REVENUE. REFUNDABLE DEPOSITS ARE REPORTED IN FORM 990, PART X, LINE 21 AS ESCROW ACCOUNTS.
PART X, LINE 2:THE ORGANIZATION'S NINE NONPROFIT CORPORATIONS ARE EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THESE ENTITIES ARE NOT PRIVATE FOUNDATIONS, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THE INCOME TAX STANDARD HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonTHERESA BERTRAMPersonNm
TitlePRESIDENT & CEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$208,136CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$40,769BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$2,915OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$251,820TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE COMPENSATION OF THE PRESIDENT & CEO IS DETERMINED BY THE ORGANIZATION'S SOLE MEMBER, LUTHERAN HOMES OF OSHKOSH, INC. THE FOLLOWING METHODS WERE USED BY LUTHERAN HOMES OF OSHKOSH, INC. TO ESTABLISH THE PRESIDENT & CEO'S COMPENSATION: 1. COMPENSATION SURVEY OR STUDY 2. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEEExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS PLUS TWO OTHER MEMBERS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE AGENDA FOR THE BOARD AND VOTING MEMBERSHIP MEETINGS. THIS COMMITTEE SHALL KEEP ITSELF INFORMED OF THE ENTIRE OPERATION OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS, AND SHALL EXECUTE SUCH ACTIONS AS MAY BE ASSIGNED TO IT BY THE BOARD. THE COMMITTEE SHALL ALSO CONCERN ITSELF WITH MATTERS NOT ASSIGNED TO OTHER COMMITTEES.
FORM 990, PART VI, SECTION A, LINE 3ALL OF CARMEL RESIDENCE, INC.'S MANAGEMENT, INCLUDING EXECUTIVE MANAGEMENT, IS PROVIDED BY LUTHERAN HOMES OF OSHKOSH, INC., THE SOLE MEMBER AND CONTROLLING ORGANIZATION OF CARMEL RESIDENCE, INC.
FORM 990, PART VI, SECTION A, LINE 6LUTHERAN HOMES OF OSHKOSH, INC., IS THE SOLE MEMBER OF CARMEL RESIDENCE, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE DIRECTORS OF CARMEL RESIDENCE, INC. ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER, LUTHERAN HOMES OF OSHKOSH, INC.
FORM 990, PART VI, SECTION A, LINE 7BMAJOR STANDARD OPERATING PROCEDURES, MAJOR POLICIES, AND PROGRAMS OF CARMEL RESIDENCE, INC. ARE SUBMITTED TO THE BOARD OF DIRECTORS OF THE SOLE MEMBER, LUTHERAN HOMES OF OSHKOSH, INC. FOR APPROVAL AND IMPLEMENTATION. AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS REQUIRE THAT APPROVAL OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, LUTHERAN HOMES OF OSHKOSH, INC.
FORM 990, PART VI, SECTION B, LINE 11BBEFORE IT WAS FILED, THE FORM 990 WAS REVIEWED BY THE CEO, THEN DISTRIBUTED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST FORM TO EACH MEMBER OF THE BOARD OF DIRECTORS AND VARIOUS COMMITTEE MEMBERS NOT ON THE BOARD THAT REQUIRES EACH TO IDENTIFY POTENTIAL CONFLICTS OR OTHER RELATED PARTY INTERESTS. THE REPORTS ARE REVIEWED BY THE SECRETARY AND CEO AND ANY CONFLICTS ARE BROUGHT TO THE BOARD'S ATTENTION. A MEMBER OF THE BOARD WHO HAS A CONFLICT OF INTEREST MAY NOT VOTE ON ANY SUCH ISSUE BEFORE THE BOARD. ANY QUESTION OF WHETHER THERE IS A CONFLICT IS RESOLVED BY THE BOARD OF DIRECTORS. IF THE BOARD OF DIRECTORS DETERMINES THAT A DIRECTOR HAS COMMITTED A SUBSTANTIAL VIOLATION OF THE CONFLICT OF INTEREST POLICY, THE INDIVIDUAL IS REMOVED FROM THE OFFICE OF DIRECTOR. IN ADDITION, ALL MANAGEMENT AND SUPERVISORY EMPLOYEES ARE INFORMED OF THE ORGANIZATION'S POLICY REGARDING RELATED PARTY TRANSACTIONS AND CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15CEO COMPENSATION IS DETERMINED BY A COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE CONSIDERS COMPARABLE DATA AND ECONOMIC CONDITIONS. THE DELIBERATIONS ARE RECORDED. OTHER OFFICER AND SENIOR MANAGEMENT SALARIES ARE DETERMINED BY THE CEO, WITHOUT CONFLICT, IN CONJUNCTION WITH HUMAN RESOURCES MANAGER AND ARE BASED ON COMPARABLE DATA, PERFORMANCE MEASURES, AND OTHER ECONOMIC CONDITIONS. THIS PROCESS LAST OCCURRED IN 2015 FOR THE CEO AND FOR ALL OTHER OFFICERS AND SENIOR MANAGEMENT.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND IS ALSO AVAILABLE AT WWW.GUIDESTAR.ORG. THE ORGANIZATION'S FORM 1023 IS ALSO AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION'S PROCESSES HAVE NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
LUTHERAN HOMES OF OSHKOSH INC
225 NORTH EAGLE STREETOSHKOSHWI54902391032234MANAGEMENT SERVICESWI501(C)(3)LINE 10N/A0
BETHEL HOME INC
225 NORTH EAGLE STREETOSHKOSHWI54902391209707SKILLED NURSING FACILITYWI501(C)(3)LINE 100LUTHERAN HOMES OF OSHKOSH INC
GABRIEL'S VILLA INC
215 NORTH WESTFIELD STREETOSHKOSHWI54902391857036SENIOR HOUSINGWI501(C)(3)LINE 100LUTHERAN HOMES OF OSHKOSH INC
SIMEANNA APARTMENTS INC
155 NORTH EAGLE STREETOSHKOSHWI54902237148097SENIOR HOUSINGWI501(C)(3)LINE 100LUTHERAN HOMES OF OSHKOSH INC
SIMEANNA SOUTH INC
145 NORTH EAGLE STREETOSHKOSHWI54902391238670SENIOR HOUSINGWI501(C)(3)LINE 100LUTHERAN HOMES OF OSHKOSH INC
SIMEANNA III INC
151 NORTH EAGLE STREETOSHKOSHWI54902391270056SENIOR HOUSINGWI501(C)(3)LINE 100LUTHERAN HOMES OF OSHKOSH INC
BETHEL FOUNDATION OF OSHKOSH INC
225 NORTH EAGLE STREETOSHKOSHWI54902010938793FUNDRAISINGWI501(C)(3)LINE 12A, I0LUTHERAN HOMES OF OSHKOSH INC
EDEN REHABILIATION SUITES AND GREENHOUSE HOMES INC
3151 EDEN COURTOSHKOSHWI54902900506872SKILLED NURSING FACILITYWI501(C)(3)LINE 100LUTHERAN HOMES OF OSHKOSH INC
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.