Mendota Lutheran Home Bk 20-02769: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- Mendota Lutheran Home Bk 20-02769 (EIN 36-2212706)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-09-22
- IRS object ID
- 201702659349300335
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-09-22T14:08:26-04:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jeremy Brune & Associates LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2508 Riverwalk Drive | AddressLine1Txt |
| City | Plainfield | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60586 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362212706 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mendota Lutheran Home | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEND | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Sixth Street | AddressLine1Txt |
| City | Mendota | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 613421796 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michelle Urnikis | PersonNm |
| Person Title | Administrator | PersonTitleTxt |
| Phone | 8155397439 | PhoneNum |
| Signature | 2017-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeremy M Brune CPA | PreparerPersonNm |
| PTIN | P01425038 | PTIN |
| Phone | 7798753979 | PhoneNum |
| Preparation | 2017-09-22 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 73.246.1.51 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-09-22 | IPDt |
| IP Tm | 14:10:20 | IPTm |
| Federal Original Submission Id | 1541522017265qc0upjl | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-09-22 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 5B4DBC4FDDE87F7BF068E23A574855F1470BCECF | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 5B4DBC4FDDE87F7BF068E23A574855F1470BCECF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,927,735 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.mlh500.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | To establish, maintain, and operate a nursing home as well as a home for the aged. Mendota Lutheran Home is affiliated with the Evangelical Lutheran Church in America, a non-profit organization. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 196 | TotalEmployeeCnt |
| Total Volunteers | 24 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $366,054 | PYContributionsGrantsAmt |
| CY Contributions Grants | $119,662 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,544,724 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,647,418 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,777 | PYInvestmentIncomeAmt |
| CY Investment Income | $33,303 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $6,924,555 | PYTotalRevenueAmt |
| CY Total Revenue | $5,800,383 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,381,031 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,269,709 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,573,354 | PYOtherExpensesAmt |
| CY Other Expenses | $2,330,389 | CYOtherExpensesAmt |
| PY Total Expenses | $6,954,385 | PYTotalExpensesAmt |
| CY Total Expenses | $6,600,098 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$29,830 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$799,715 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,787,568 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,187,613 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,366,169 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,454,828 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,421,399 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,732,785 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To establish, maintain, and operate a nursing home as well as a home for the aged. Mendota Lutheran Home is affiliated with the Evangelical Lutheran Church in America, a non-profit organization. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $6,014,138 | ExpenseAmt |
| Desc | Mendota Lutheran Home is licensed by the Illinois Department of Public Health to provide skilled, intermediate, and sheltered care nursing home services to elderly residents. During 2016, Mendota Lutheran Home provided these services to approximately 68.06 residents on a daily basis. Support to care for these residents includes investment income, public assistance, as well as donations from area churches, organizations, and individuals. | Desc |
| Total Program Service Expenses | $6,014,138 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 196 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michelle Urnikis | PersonNm |
| Phone | 8155397439 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Sixth Street | AddressLine1Txt |
| City | Mendota | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 613421796 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Greta Bates | ||||||||
| President | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Pr Tammy Anderson | ||||||||
| Vice President | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John Nielsen | ||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Dave Jones | ||||||||
| Secretary | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ed Bock | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Pr Anne Hoflen | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Lambert Leonard | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Lorraine Loomis | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Tim Munson | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Michelle Urnikis | ||||||||
| Administrator | 40.00 | 0.00 | $60,930 | $0 | $3,320 | Yes (X) | ||
| Jon Ragsdale | ||||||||
| Administrator 010116 - 02221 | 40.00 | 0.00 | $13,790 | $0 | $939 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $74,720 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $4,259 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Aegis Therapies | |||||
| PO Box 8103 | Fort Smith | AR | 72902 | Therapy | $537,498 |
| US FoodService | |||||
| 1829 Solution Center | Chicago | IL | 606771088 | Food Service | $216,103 |
| Medline Industries | |||||
| Dept CH 14400 | Palatine | IL | 600554400 | Medical Supplies | $149,211 |
| Omnicare Inc | |||||
| PO Box 78000 | Detroit | MI | 48278 | Prescriptions | $103,066 |
| Professional Healthcare Staffing | |||||
| PO Box 594 | Pontiac | IL | 61764 | Staffing | $104,680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $119,662 | AllOtherContributionsAmt |
| Total Contributions | $119,662 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Nursing Home | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $5,647,418 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,647,418 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,647,418 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,509 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,509 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $132,146 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $127,352 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,794 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,794 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,794 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,800,383 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,680,721 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,919 | TotalAmt |
| Management And General | $75,919 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,458,294 | TotalAmt |
| Program Services | $3,229,973 | ProgramServicesAmt |
| Management And General | $228,321 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,199 | TotalAmt |
| Program Services | $29,427 | ProgramServicesAmt |
| Management And General | $2,772 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447,925 | TotalAmt |
| Program Services | $409,366 | ProgramServicesAmt |
| Management And General | $38,559 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,372 | TotalAmt |
| Program Services | $233,300 | ProgramServicesAmt |
| Management And General | $22,072 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,107 | TotalAmt |
| Program Services | $119,488 | ProgramServicesAmt |
| Management And General | $50,619 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,702 | TotalAmt |
| Program Services | $3,651 | ProgramServicesAmt |
| Management And General | $23,051 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,257 | TotalAmt |
| Program Services | $121,731 | ProgramServicesAmt |
| Management And General | $13,526 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,502 | TotalAmt |
| Program Services | $130,131 | ProgramServicesAmt |
| Management And General | $11,371 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,078 | TotalAmt |
| Program Services | $1,915 | ProgramServicesAmt |
| Management And General | $1,163 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,237 | TotalAmt |
| Program Services | $3,237 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,087 | TotalAmt |
| Management And General | $32,087 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,718 | TotalAmt |
| Program Services | $238,246 | ProgramServicesAmt |
| Management And General | $26,472 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,745 | TotalAmt |
| Program Services | $52,867 | ProgramServicesAmt |
| Management And General | $15,878 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $411,979 | $396,060 | $15,919 |
| Ancillary Services | $731,136 | $731,136 | |
| Assessment Fees | $188,475 | $188,475 | |
| Bad Debt | $60,190 | $60,190 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,176 | TotalAmt |
| Program Services | $64,945 | ProgramServicesAmt |
| Management And General | $28,231 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,600,098 | TotalAmt |
| Program Services | $6,014,138 | ProgramServicesAmt |
| Management And General | $585,960 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $85,408 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $748,148 | BOYAmt |
| EOY | $602,026 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,183 | BOYAmt |
| EOY | $39,395 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,722 | BOYAmt |
| EOY | $97,183 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,796,927 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,163,358 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,833,260 | BOYAmt |
| EOY | $2,633,569 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,050,255 | BOYAmt |
| EOY | $1,730,032 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,787,568 | BOYAmt |
| EOY | $5,187,613 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $647,951 | BOYAmt |
| EOY | $547,148 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $645,050 | BOYAmt |
| EOY | $851,341 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,168 | BOYAmt |
| EOY | $56,339 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,366,169 | BOYAmt |
| EOY | $1,454,828 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,820,087 | BOYAmt |
| EOY | $2,368,139 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,958 | BOYAmt |
| EOY | $11,294 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,297,354 | BOYAmt |
| EOY | $1,353,352 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,421,399 | BOYAmt |
| EOY | $3,732,785 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,787,568 | BOYAmt |
| EOY | $5,187,613 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$799,715 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $111,101 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Church | Yes (X) | ChurchInd |
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 | $1,742,286 | BeginningYearBalanceAmt |
| Contributions | $11,171 | ContributionsAmt |
| Investment Earnings Or Losses | $125,607 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $506,703 | OtherExpendituresAmt |
| Administrative Expenses | $7,715 | AdministrativeExpensesAmt |
| End Year Balance | $1,364,646 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,471,879 | BeginningYearBalanceAmt |
| Contributions | $303,958 | ContributionsAmt |
| Investment Earnings Or Losses | -$990 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $32,572 | OtherExpendituresAmt |
| Administrative Expenses | -$11 | AdministrativeExpensesAmt |
| End Year Balance | $1,742,286 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,434,773 | BeginningYearBalanceAmt |
| Contributions | $10,027 | ContributionsAmt |
| Investment Earnings Or Losses | $107,457 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $64,742 | OtherExpendituresAmt |
| Administrative Expenses | $15,636 | AdministrativeExpensesAmt |
| End Year Balance | $1,471,879 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,664,383 | BeginningYearBalanceAmt |
| Contributions | $33,954 | ContributionsAmt |
| Investment Earnings Or Losses | $291,764 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $543,130 | OtherExpendituresAmt |
| Administrative Expenses | $12,198 | AdministrativeExpensesAmt |
| End Year Balance | $1,434,773 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,693,743 | BeginningYearBalanceAmt |
| Contributions | $308,838 | ContributionsAmt |
| Investment Earnings Or Losses | $271,776 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $592,068 | OtherExpendituresAmt |
| Administrative Expenses | $17,906 | AdministrativeExpensesAmt |
| End Year Balance | $1,664,383 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.99000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.01000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $564,941 | OtherCostOrOtherBasisAmt |
| Book Value | $564,941 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,079,530 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,450,458 | DepreciationAmt |
| Book Value | $1,629,072 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,152,456 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,712,900 | DepreciationAmt |
| Book Value | $439,556 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,633,569 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (8 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Interest and Dividends Receivable | $8,021 |
| Investments | $283,263 |
| Beneficial Interest - Inv pool | $42,847 |
| Settlement - Medicare | $14,347 |
| Other Assets | $27 |
| Assets Whose use is Limited | $359,482 |
| Investment - Insurance Company | $21,552 |
| Beneficial Intrest - Perp Trust | $1,000,493 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,730,032 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Interest | $744 |
| Assessment Tax - HFS | $55,595 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $56,339 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,911,484 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $111,101 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $111,101 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,800,383 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,800,383 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,600,098 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $6,600,098 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $6,600,098 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Endowment funds intended uses (Part V, line 4) | The unrestricted board designated fund has an account balance of $0 at December 31, 2016. These funds were originally set aside by the Board of Directors to be utilized by Mendota Lutheran Home to provide educational scholarships to its employees. These funds were released by the Board of Directors during 2016 to be utilized for operating purposes.A more detailed explanation of the unrestricted board designated fund can be found in Note (11) of the audited financial statements of Mendota Lutheran Home. Temporarily restricted contributions represent various donations made to Mendota Lutheran Home during 2016 that were directed by the donors to be utilized for specific purposes or carry time restrictions for usage. The temporarily restricted balance at December 31, 2016 was $11,294. The restrictions on this balance is designated for the following uses: nursing and activity programs, equipment, scholarship funds, and time restrictions for receipt.A more detailed explanation of temporarily restricted contributions can be found in Note (12) of the audited financial statements of Mendota Lutheran Home. The permanently restricted endowment fund has an account balance of $1,364,646 at December 31, 2016. The permanently restricted endowment fund is derived from three bequests that have specific intended uses. The primary uses of the interest and investment income income derived from these funds is specified to be utilized for on-going operations of the facility with a portion directed to provide service funds to the employees of the organization.A more detailed explanation of the unrestricted board designated fund can be found in Note (13) of the audited financial statements of Mendota Lutheran Home. |
| Footnote for uncertain tax position under FIN 48 (Part X) | Generally Accepted Accounting Principles prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of tax positions taken or expected to be taken in tax returns. The amount recognized is measured as the largest amount of benefit that is more likely that not of being realized upon settlement. Mendota Lutheran Home has determined that it does not have any significant risks related to income tax expense and therefore no amounts were reserved for uncertain tax positions as of December 31, 2016. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | The Form 990 will be distributed to the Board of Directors for review and approval before submission to the Internal Revenue Service. |
| CEO executive director top management comp Part VI line 15a | The Board of Directors annually evaluates the Administrator and determines compensation adjustments based on both performance,industry standards, and budgetary constraints. |
| Other officer or key employee compensation Part VI line 15b | The Administrator evaluates all other employees of Mendota Lutheran Home and determines compensation based on performance, industry standards, and budgetary constraints. |
| Governing documents etc available to public Part VI line 19 | Mendota Lutheran Home makes governing documents, conflicts of interest statements, financial statements, and tax returns availabile to the public upon written request. |
| General explanation attachment | Certain reclassifications were made in regards to the presentation of prior year financial statement groupings (2015) to be consistent with the financial statement groupings for 2016. These reclassifications had no effect on reported results of operations or net assets for the year ending December 31, 2015.These reclassifications were incorporated into the completion of the prior year amounts reported within the 2016 Form 990. |
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