2017-04-18T00:00:00-05:00 2016-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 221 W PHILADELPHIA ST STE 200 YORK PA 17401 990 2015-07-01 521127007 CARROLL LUTHERAN VILLAGE INC CARR 4108480090 300 ST LUKE CIRCLE WESTMINSTER MD 21158 GEARY K MILLIKEN PRESIDENT/CEO 4108480090 2017-04-20 1 KERRI N BOGDA P00760402 7178467000 2015 2021-01-29 14:40:06Z GEARY K MILLIKEN 300 ST LUKE CIRCLE WESTMINSTER MD 21158 32358595 0 X WWW.CARROLLLUTHERANVILLAGE.ORG X 1981 MD TO PROVIDE NURSING CARE TO THE ELDERLY. 15 15 612 455 8120 1555 617588 593129 27360788 27728898 1678633 1525069 625557 643598 30282566 30490694 31390 36441 0 0 14122505 14731572 0 0 269651 16857132 16326465 31011027 31094478 -728461 -603784 100110520 99947963 86762364 88577194 13348156 11370769 X CARROLL LUTHERAN VILLAGE IS A CONTINUING CARE RETIREMENT COMMUNITY DEDICATED TO THE MINISTRY OF CARING IN A CHRISTIAN ATMOSPHERE FOSTERING QUALITY LIFE AND SERVICES FOR THE WHOLE PERSON. 0 0 13124941 36441 13488353 HEALTH CARE AND ASSISTED LIVING - THE VILLAGE PROVIDES QUALITY, SKILLED NURSING CARE IN A COMFORTABLE ENVIRONMENT TO ALL RESIDENTS, INCLUDING THOSE WHO HAVE OUTLIVED THEIR ASSETS OR WHOSE ANNUAL INCOME IS INSUFFICIENT TO MEET EXPENSES. EARNINGS FROM A RESTRICTED ENDOWMENT ARE USED TO SUBSIDIZE RESIDENTS AS NEEDS ARE DEMONSTRATED. THE VILLAGE PARTICIPATES IN MEDICARE AND MEDICAID PROGRAMS, ACCEPTING REIMBURSEMENT FOR CARE THAT DOES NOT FULLY COVER COSTS. THE VILLAGE HEALTH CARE CENTER HAD 34,669 HEALTHCARE CENSUS DAYS, WHICH IS 92.3% OCCUPANCY, AND 16,774 ASSISTED LIVING CENSUS DAYS, WHICH IS 89.91% OCCUPANCY. 13509883 0 13883954 RESIDENTIAL LIVING - THE VILLAGE OFFERS THE AGING ADULT EASY AND AFFORDABLE ACCESS TO QUALITY SERVICES ON A PROPERLY AND BEAUTIFULLY MAINTAINED CAMPUS WHERE QUALITY OF LIFE AND A SPIRIT OF COMMUNITY ARE EMPHASIZED. RESIDENTS MAY SELECT ACCOMMODATIONS FROM A WIDE RANGE OF UNIT SIZES WITH ENTRANCE FEES FOR THE MAJORITY OF UNITS BELOW THE U.S. MEDIAN HOME PRICE. HEALTH, WELLNESS, AND FITNESS PROGRAMMING IS INCLUDED IN MONTHLY FEES. RESIDENTS ARE ENCOURAGED TO ENGAGE IN ALL ASPECTS OF WELLNESS. RESIDENCES ARE SAFE AND SECURE AND EQUIPPED WITH ACCESS TO SKILLED HEALTH PROFESSIONALS THROUGH AN EMERGENCY CALL SYSTEM. THE VILLAGE RESIDENTIAL LIVING PROGRAM HAD 178,497 CENSUS DAYS DURING THE YEAR, WHICH IS 93.92% OCCUPANCY. 346983 0 356591 ADDITIONAL SUPPORT SERVICES - ALL LEVELS OF CARE ARE SUPPORTED BY ON CAMPUS ACCESS TO MEDICAL CARE, THERAPY SERVICES, NUTRITIONAL FOOD SERVICE, HOME HEALTH SERVICES, DIVERSE RELIGIOUS SERVICES, TRANSPORTATION, HOUSEKEEPING AND LAUNDRY SERVICES. ORGANIZATIONAL GOVERNANCE IS ACCOMPLISHED THROUGH A PROCESS THAT ENCOURAGES RESIDENT PARTICIPATION. CARROLL LUTHERAN VILLAGE IS DEDICATED NOT ONLY TO ITS RESIDENTS, BUT ALSO TO ITS STAFF, THE HEALTH PROFESSIONS, AND THE COMMUNITY AT LARGE. RESIDENTS CONDUCT AN ANNUAL APPEAL TO RAISE FUNDS FOR STAFF SCHOLARSHIPS. SUNDAY CHAPEL OFFERINGS ARE OFTEN DESIGNATED TO PROVIDE FINANCIAL SUPPORT WHERE IT IS CRITICALLY NEEDED. A COMPASSIONATE RESPONSE FUND EXISTS AND IS ADMINISTERED WITHIN THE GOVERNANCE STRUCTURE. THE VILLAGE OFFERS SUPPORT TO OTHER NON-PROFIT ORGANIZATIONS BY ENCOURAGING STAFF AND RESIDENTS TO ACT IN ADVISORY OR BOARD ROLES. LOCAL COLLEGES ARE SUPPORTED FINANCIALLY, SPECIFICALLY TO ENHANCE PROGRAMS THAT TRAIN AND DEVELOP SKILLED HEALTHCARE PROFESSIONALS. THE LOCAL HOSPITAL IS SUPPORTED FINANCIALLY AS WE ARE ENGAGED IN A GROWING, MUTUALLY BENEFICIAL PARTNERSHIP TO PROVIDE QUALITY HEALTHCARE SERVICES AND INFORMATION TO RESIDENTS OF CARROLL LUTHERAN VILLAGE AND TO MEMBERS OF THE GREATER COMMUNITY IN NEED OF HEALTHY AGING SUPPORT.INTERNALLY, THE VILLAGE OFFERS TRAINING PROGRAMS FOR ASPIRING NURSING HOME AND ASSISTED LIVING ADMINISTRATORS THAT ARE APPROVED BY THE STATE. MEETING SPACE ON THE CAMPUS IS OFFERED FOR USE BY NON-PROFIT COMMUNITY GROUPS. BLOOD DRIVES CONDUCTED BY THE RED CROSS ARE FREQUENTLY HELD ON CAMPUS. SPACE IS PROVIDED FOR CLINICAL TRAINING BY LOCAL COLLEGES AND TECH SCHOOLS.CARROLL LUTHERAN VILLAGE IS NATIONALLY ACCREDITED BY THE COMMISSION ON ACCREDITATION FOR REHABILITATION FACILITIES - CONTINUING CARE ACCREDITATION COMMISSION (CARF-CCAC), AN INDEPENDENT, NONPROFIT ACCREDITING BODY FOR HEALTH AND HUMAN SERVICES ORGANIZATIONS. CARF-CCAC ACCREDITATION IS AN ASSURANCE THAT AN ORGANIZATION PROVIDES SERVICE EXCELLENCE, RISK MANAGEMENT, VALUE AND ACCOUNTABILITY. DURING THE RIGOROUS REVIEW PROCESS, EVALUATORS LOOK FOR COMPLIANCE IN MORE THAN 1,000 QUALITY STANDARDS IN RESIDENT LIFE, HEALTH AND WELLNESS; FINANCIAL RESOURCES AND DISCLOSURE; AND GOVERNANCE AND ADMINISTRATION. NATIONWIDE ONLY 15% OF CONTINUING CARE RETIREMENT COMMUNITIES HAVE RECEIVED CARF-CCAC ACCREDITATION, MAKING CARROLL LUTHERAN VILLAGE AMONG THE ELITE AGING SERVICES PROVIDERS WITHIN THE IMMEDIATE COMMUNITY, THE REGION AND THE NATION. THE VILLAGE PROVIDED DIRECT BENEVOLENT CARE TO RESIDENTS WHO MEET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE VILLAGE PROVIDED CHARITY CARE UNDER THIS POLICY AT A COST OF APPROXIMATELY $2,394,000 DURING 2016, BASED ON DIRECT AND ALLOCABLE COSTS OF CARE. ADDITIONALLY, THE VILLAGE PROVIDED DIRECT FINANCIAL ASSISTANCE UNDER ITS RESIDENT ASSISTANCE POLICY OF $665,294 DURING 2016. 26981807 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 73 0 1 612 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 15 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X STEVEN D POWELL - VP OF FINANCE 4108480090 300 ST LUKE CIRCLE WESTMINSTER MD 21158 DAVID S BOLLINGER CHAIRPERSON 2.00 X X 0 0 0 MARLENE K TITUS VICE CHAIR 2.00 X X 0 0 0 WANDA K LYNN TREASURER 2.00 X X 0 0 0 KAY L BETZ SECRETARY 2.00 X X 0 0 0 EDWARD D LEISTER BOARD (TERM EXP. 9/15) 2.00 X 0 0 0 DAVID BOND BOARD 2.00 X 0 0 0 REV ROBIN SIMPSON-LITTON BOARD 2.00 X 0 0 0 RONALD FAIRCHILD BOARD 2.00 X 0 0 0 SANDRA L FERGUSON BOARD 2.00 X 0 0 0 CAROL E PLUNKERT BOARD 2.00 X 0 0 0 ROBERTA DILLOW BOARD 2.00 X 0 0 0 DONNA KENT BOARD 2.00 X 0 0 0 REV KEVIN C CLEMENTSON BOARD 2.00 X 0 0 0 LOUNA PRIMM BOARD 2.00 X 0 0 0 ALICE DAUM-COEN BOARD 2.00 X 0 0 0 ARTHUR S WISNER BOARD 2.00 X 0 0 0 GEARY K MILLIKEN PRESIDENT/CEO 28.00 18.00 X 295397 0 45698 STEVE POWELL VP FINANCE 28.00 12.00 X 155730 0 7518 ROY CHIAVACCI VP ENVIRO & ADMIN 20.00 20.00 X 174269 0 9682 SUZANNE DYER-GEAR VP OF HUMAN RESOURCES 40.00 X 111789 0 8051 JANET BUCHANAN VP OF PHILANTHROPY 40.00 X 113139 0 25817 850324 0 96766 5 0 1 0 SODEXO INC PO BOX 536922 ATLANTA GA 303536922 CONTRACTED SERVICES 2063173 CHESAPEAKE MEDICAL STAFFING LLC 2401 YORK RD TIMONIUM MD 21093 AGENCY NURSING SVCS 212780 KUSTOM LAWN MAINTENANCE INC 4186 MIDDLEBURG RD UNION BRIDGE MD 21791 LANDSCAPING SERVICES 210041 SYMTECH SOLUTIONS 27 STEAMWHISTLE DRIVE IVYLAND PA 18974 REPAIR SERVICES 168557 ADVANCED ANSWERS ON DEMAND BIN 18 PO BOX 9201 MINNEAPOLIS MN 554809201 SOFTWARE SERVICES 153726 9 140942 452187 4320 593129 RESIDENT SERVICE REVENUE 623000 27728898 27728898 27728898 1101605 1101605 147 147 172237 6305 20160 0 152077 6305 158382 158382 2221866 1798549 423317 423317 423317 9864 140942 34427 -24563 -24563 20286 14765 5521 5521 ADMINISTRATIVE FEES 623000 240000 240000 COFFEE SHOP 623000 99065 99065 ANCILLARY RESIDENT SERVICES 623000 58382 8120 50262 106811 106811 504258 30490694 27728898 8120 2160547 36441 36441 522209 522209 11612962 10283764 1163354 165844 299516 270204 24954 4358 1418355 1067914 314396 36045 878530 742391 123452 12687 69731 32025 37706 40578 12411 28167 42321 42321 540 540 65211 65211 2627831 2160594 467237 136304 22799 113505 2703328 2624690 57643 20995 71379 69079 2300 5094411 4960950 132113 1348 93511 78814 8191 6506 25636 5667 17247 2722 3708196 3223084 477468 7644 480912 446300 34612 MEDICAL EXPENSES 634606 634606 BAD DEBTS 147798 147798 CONTINUING EDUCATION 112480 51777 60703 DUES & LICENSES 100487 41620 53448 5419 171205 137958 29464 3783 31094478 26981807 3843020 269651 1050 1050 1993829 2830944 6610 1945241 1730318 88647 168353 214217 243112 111775 115945 123720803 63111786 62201202 60609017 22665480 22715266 3746868 3459995 1283793 1228606 5858418 6838747 100110520 99947963 2990631 3446088 33464216 34716838 49607918 49632389 699599 781879 86762364 88577194 X 6107302 3808966 250101 264183 6990753 7297620 13348156 11370769 100110520 99947963 -603784 -1373603 0 X 0 1 X 1 0 X 964378 636977 1184920 617588 593129 3996992 25292911 25954400 27234518 27360788 27728898 133571515 482569 473443 628348 485659 243954 2313973 26739858 27064820 29047786 28464035 28565981 139882480 0 0 0 139882480 500482 580309 677406 872635 1280294 3911126 500482 580309 677406 872635 1280294 3911126 36184 50387 32785 42447 290454 452257 27276524 27695516 29757977 29379117 30136729 144245863 0.96980 0.97080 0.02710 0.02210 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 3,428. 2015 AMOUNT: $ 1,774. WORKERS COMP REIMB - 2011 AMOUNT: $ 11,063. 2012 AMOUNT: $ 23,342. 2013 AMOUNT: $ 5,280. 2015 AMOUNT: $ 680. NON-CHARITABLE FUNDRAISING RECEIPTS - 2011 AMOUNT: $ 17,280. 2012 AMOUNT: $ 16,840. 2013 AMOUNT: $ 9,246. 2014 AMOUNT: $ 17,712. 2015 AMOUNT: $ 9,864. GROSS RECEIPTS OF INVENTORY - 2011 AMOUNT: $ 7,841. 2012 AMOUNT: $ 10,205. 2013 AMOUNT: $ 18,259. 2014 AMOUNT: $ 21,307. 2015 AMOUNT: $ 20,286. APPLICATION FEES - 2015 AMOUNT: $ 17,850. ADMINISTRATIVE FEES - 2015 AMOUNT: $ 240,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 540 540 0 PART II-B, LINE 1: CARROLL LUTHERAN VILLAGE PAYS DUES TO LEADING AGE. A PORTION OF THE DUES PAID TO THIS ORGANIZATION IS ALLOCABLE TO LOBBYING EXPENSES. THE TOTAL AMOUNT OF DUES PAID BY CARROLL LUTHERAN VILLAGE THAT IS ALLOCABLE TO LOBBYING IS $540. 9003101 371752 811570 716226 9470197 8127961 441529 1261840 828229 9003101 6585712 1076018 1293757 827526 8127961 5834215 524211 941088 713802 6585712 5308174 1158773 1007 633739 5834215 0.20150 0.77060 0.02790 0 0 1067705 1067705 111024963 53049890 57975073 11545608 10061896 1483712 82527 82527 60609017 DUE FROM AFFILIATES 3003330 NOTE RECEIVABLE FROM AFFILIATE 3835417 6838747 RESIDENT FUND PAYABLE 781879 781879 X 29121232 -1373603 -65211 -1438814 30560046 -69352 -69352 30490694 31098619 69352 69352 31029267 65211 65211 31094478 PART V, LINE 4: THE VILLAGE RECOGNIZES THAT FUNDS THAT ARE DONOR DESIGNATED FOR ENDOWMENT ARE TO BE PERPETUATED. EARNINGS FROM ENDOWMENT FUNDS ARE TRANSFERRED TO A BOARD DESIGNATED, TEMPORARILY RESTRICTED FUND THAT CAN BE USED FOR RESIDENT ASSISTANCE AND SCHOLARSHIPS ACCORDING TO A SPENDING ALLOWANCE DEFINED IN THE BOARD'S INVESTMENT POLICY. UNREALIZED LOSSES ON THE INVESTMENT PORTFOLIO ARE NOT ALLOCATED TO ENDOWMENT FUNDS. PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2016 AND 2015. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT FEES -65,211. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -34,427. RENTAL EXPENSES -20,160. COST OF GOODS SOLD -14,765. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 34,427. RENTAL EXPENSES 20,160. COST OF GOODS SOLD 14,765. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES 65,211. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 2137533 0 0 0 0 0 0 2137533 0 2137533 1 0 0 0 0 0 GOLF TOURNAMENT 150806 140942 9864 4000 3950 9316 9401 7760 150806 140942 9864 4000 3950 9316 9401 7760 34427 -24563 1 SCHOLARSHIPS 19 36441 PART I, LINE 2: EMPLOYEES ARE ELIGIBLE FOR A VARIETY OF SCHOLARSHIPS AND TUITION ASSISTANCE BASED UPON CRITERIA ESTABLISHED BY THE ORGANIZATION. INTERESTED EMPLOYEES MUST MEET ALL CRITERIA AND APPLY BASED ON THEIR ELIGIBILITY. THE VICE PRESIDENT OF HUMAN RESOURCES ADMINISTERS ALL SCHOLARSHIP PROGRAMS. A SCHOLARSHIP COMMITTEE HAS BEEN ESTABLISHED THAT REVIEWS AND APPROVES SCHOLARSHIP AWARDS. THE COMMITTEE INCLUDES STAFF MEMBERS FROM THE PHILANTHROPY AND HUMAN RESOURCES DEPARTMENTS. THE VICE PRESIDENTS OF PHILANTHROPY AND HUMAN RESOURCES SERVE AS DESIGNEES FOR THE PRESIDENT/CEO REGARDING SCHOLARSHIP AWARD DECISIONS. ALL FUNDS ARE REMITTED TO THE EDUCATIONAL INSTITUTION DIRECTLY AND STUDENTS ARE EXPECTED TO MAINTAIN CERTAIN STANDARDS WHILE PARTICIPATING IN A SCHOLARSHIP PROGRAM. X X X X X 0 0 0 0 0 0 0 0 0 GEARY K MILLIKEN PRESIDENT/CEO 288821 0 0 0 6576 0 11568 0 34130 0 341095 0 0 0 STEVE POWELL VP FINANCE 154341 0 0 0 1389 0 3083 0 4435 0 163248 0 0 0 ROY CHIAVACCI VP ENVIRO & ADMIN 167073 0 0 0 7196 0 6498 0 3184 0 183951 0 0 0 A THE MAYOR AND COMMON COUNCIL OF WESTMINSTER 526000811 960735AH1 2014-07-09 44281008 CURRENT REFUNDING OF PRIOR YEAR BOND ISSUE AND CAPITAL IMPROVEMENTS 0 0 0 B THE MAYOR AND COMMON COUNCIL OF WESTMINSTER 526000811 960735AJ7 2014-07-09 4663992 CURRENT REFUNDING 0 0 0 A 44948685 2953860 898973 2931654 34235262 2017 1 0 0 1 B 4734908 311122 94698 4155114 173974 2017 1 0 0 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 0 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 A 1 B 1 PART I, COLUMN E: THE ISSUE PRICE REPORTED DOES NOT AGREE TO THE AMOUNTS LISTED ON PART II, LINE 3 DUE TO ORIGINAL ISSUE BOND PREMIUM. PART III, LINE 9: THE FINANCE DEPARTMENT IS IN THE PROCESS OF ESTABLISHING A WRITTEN PROCEDURE FOR POTENTIALLY NONQUALIFYING BOND ISSUES. POST-BOND ISSUANCE TRANSACTIONS ARE CAREFULLY MONITORED AND THE FINANCE DEPARTMENT BELIEVES IT IS IN FULL COMPLIANCE WITH ALL REGULATIONS. ALL PROCEDURES WILL BE DOCUMENTED AS WRITTEN POLICY FOR THE CURRENT AND FUTURE ISSUANCES. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE, COMPOSED OF THE FOUR BOARD OFFICERS, CAN ACT FOR THE BOARD ON ROUTINE BUSINESS BETWEEN MEETINGS AND IN EMERGENCIES. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION OUTSOURCES MANAGEMENT OF FACILITIES AND FOOD SERVICE. FORM 990, PART VI, SECTION A, LINE 6 THE CONGREGATIONS OF THE WESTMINSTER CONFERENCE OF THE DELAWARE-MARYLAND SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA (THE "ELCA") CONSTITUTE THE ORIGINAL MEMBERS. CURRENT MEMBER CONGREGATIONS ARE NOTED IN THE BYLAWS. ANY OTHER DULY ORGANIZED LUTHERAN CONGREGATION OF THE DELAWARE-MARYLAND SYNOD OF THE ELCA ("SYNOD") OR ITS SUCCESSOR MAY BECOME A MEMBER CONGREGATION UPON APPROVAL BY THE CORPORATION. ANY CONGREGATION THAT IS NO LONGER AFFILIATED WITH THE SYNOD WILL IMMEDIATELY CEASE TO BE A MEMBER CONGREGATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD'S GOVERNANCE COMMITTEE SERVES AS A NOMINATING COMMITTEE THAT RECOMMENDS POTENTIAL NEW BOARD MEMBERS. NOMINEES ARE PRESENTED TO DELEGATES FROM MEMBER CHURCHES AT A MEETING CALLED SPECIFICALLY FOR THE PURPOSE OF ELECTING THE BOARD. DELEGATES CHOOSE TRUSTEES FROM THE NOMINEES PRESENTED AND ARE ALSO FREE TO NOMINATE AND ELECT OTHER INDIVIDUALS FROM THE FLOOR. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE CONGREGATION'S APPROVAL IS REQUIRED TO ELECT THE BOARD, AMEND BY-LAWS, AND APPROVE THE INDEPENDENT AUDIT FIRM. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY BOTH THE PRESIDENT/CEO AND THE VP OF FINANCE. ONCE THE REVIEW HAS BEEN COMPLETED, THE 990 IS GIVEN TO THE ENTIRE BOARD AND REVIEWED AT A REGULARLY SCHEDULED BOARD MEETING PRIOR TO THE RETURN BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CARROLL LUTHERAN VILLAGE HAS AN ESTABLISHED POLICY AND STANDARDS REGARDING CONFLICTS OF INTEREST. MANY BOARD AND COMMITTEE MEMBERS ARE ACTIVE AS COMMUNITY AND BUSINESS LEADERS IN CARROLL COUNTY AND WILL AT TIMES FIND THEMSELVES IN A POSITION WHERE THERE MAY BE A DEGREE OF CONFLICT WITH THE VILLAGE'S BUSINESS. THESE CONFLICTS ARE EXPECTED AND THE FACT THAT THEY WILL REGULARLY OCCUR DOES NOT PRECLUDE SUCH A MEMBER FROM SERVING ON THE BOARD OR COMMITTEE. THE VILLAGE IN FACT NEEDS THE VARIED EXPERTISE OF ITS BOARD AND COMMITTEE VOLUNTEERS AND BELIEVES THAT THE BOARD POLICY OF DISCLOSURE AND ABSTENTION ASSURES THAT THE VILLAGE'S BUSINESS IS CONDUCTED IN A FAIR AND INDEPENDENT MANNER. THE CARROLL LUTHERAN VILLAGE (CLV) CONFLICT OF INTEREST POLICY APPLIES TO OFFICERS, DIRECTORS, BOARD COMMITTEE MEMBERS AND EMPLOYEES OF CLV, EACH OF WHOM IS CONSIDERED AN INTERESTED PERSON. THE CONFLICT OF INTEREST POLICY STATEMENT IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES. FURTHER, IN 2013 CARROLL LUTHERAN VILLAGE BEGAN A RELATIONSHIP WITH PEACE CHURCH COMPLIANCE PROGRAM TO ASSIST WITH THE ORGANIZATION'S ONGOING COMPLIANCE EFFORTS. ANNUALLY, AN OVERVIEW OF CLV'S CODE OF INTEGRITY IS SHARED WITH ALL VENDORS WITH WHOM CLV HAS AN AGREEMENT OR CONTRACTUAL RELATIONSHIP. THE TRI-FOLD PAMPHLET PROVIDES INFORMATION ABOUT THE CODE OF INTEGRITY AS WELL AS PERSONAL AND PROFESSIONAL EXPECTATIONS OF INTEGRITY AND ACCOUNTABILITY. THE PAMPHLET ALSO SHARES INFORMATION ABOUT THE CONFLICT OF INFORMATION POLICY AND HOW VENDORS CAN REQUEST A FULL COPY. AN ENTITY WITH A CLV TRANSACTION IS ANY INDIVIDUAL OR BUSINESS ORGANIZATION WHICH PROPOSES TO ENTER INTO ANY TRANSACTION WITH CLV INVOLVING: 1) THE SALE, PURCHASE, LEASE OR RENTAL OF ANY PROPERTY OR ASSET, 2) EMPLOYMENT, OR RENDITION OF SERVICES, PERSONAL OR OTHERWISE, 3) THE AWARD OF ANY GRANT, CONTRACT, OR SUBCONTRACT, OR 4) THE INVESTMENT OR DEPOSIT OF ANY FUNDS OF CLV. AN INTERESTED PERSON HAS A FINANCIAL INTEREST IN AN ENTITY IF SUCH PERSON OR AN IMMEDIATE FAMILY MEMBER (INCLUDING ALL LINEAL RELATIVES AND THEIR SPOUSES, SIBLINGS AND THEIR SPOUSES) HAS AN OWNERSHIP INTEREST IN THE ENTITY OR IS AN EMPLOYEE OF OR RECEIVES COMPENSATION FROM THE ENTITY. COMPENSATION INCLUDES ANY DIRECT OR INDIRECT REMUNERATION OR SUBSTANTIAL GIFTS OR FAVORS. AN INTERESTED PERSON HAS A CONFLICT OF INTEREST WHEN THAT PERSON, OR AN IMMEDIATE FAMILY MEMBER, IS OR HAS A FINANCIAL INTEREST IN AN ENTITY WITH A CLV TRANSACTION. CONFLICTS OF INTEREST CAN ALSO ARISE IN OTHER INSTANCES. THE TYPES OF ACTIVITIES WHICH MAY CREATE A CONFLICT OF INTEREST INCLUDE: 1) OUTSIDE ACTIVITIES: TO RENDER DIRECTIVE, MANAGERIAL OR CONSULTATIVE SERVICES TO ANY OUTSIDE CONCERN THAT DOES BUSINESS WITH, OR COMPETES WITH, THE SERVICES OF CLV, OR TO RENDER OTHER SERVICES IN COMPETITION WITH CLV. 2) GIFTS, GRATUITIES AND ENTERTAINMENT: TO ACCEPT GIFTS, ENTERTAINMENT OR OTHER FAVORS FROM ANY OUTSIDE CONCERN THAT DOES OR IS SEEKING TO DO BUSINESS WITH OR IS A COMPETITOR OF CLV. 3) INSIDE INFORMATION: TO DISCLOSE OR USE INFORMATION RELATING TO THE BUSINESS OF CLV FOR THE PERSONAL PROFIT OR ADVANTAGE OF THE INDIVIDUAL OR HIS/HER IMMEDIATE FAMILY. IT IS THE RESPONSIBILITY OF AN INTERESTED PERSON TO APPROPRIATELY DISCLOSE TO CLV ANY POTENTIAL CONFLICTS OF INTEREST. ONCE DISCLOSED, IT IS THE RESPONSIBILITY OF THE CEO/PRESIDENT TO DETERMINE IF A CONFLICT EXISTS. THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES MAY BE UTILIZED BY THE CEO/PRESIDENT, IF NEEDED, TO DETERMINE A POTENTIAL CONFLICT OF INTEREST. IF AN INTERESTED PERSON HAS FAILED TO DISCLOSE A CONFLICT OF INTEREST, APPROPRIATE DISCIPLINARY AND/OR CORRECTIVE ACTION WILL BE TAKEN. THE CONFLICT OF INTEREST POLICY STATEMENT IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES AND IS INCLUDED AS A PART OF ALL AGREEMENTS AND/OR CONTRACTS. AN APPROPRIATE STATEMENT FORM IS AVAILABLE AND MUST BE SIGNED AND ON FILE FOR ALL INTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD EXECUTIVE COMMITTEE, INCLUDING THE BOARD CHAIRPERSON, PARTICIPATES AS A COMPENSATION COMMITTEE WITH THE SUPPORT OF THE VP OF HUMAN RESOURCES. THE COMMITTEE USES A VARIETY OF SURVEYS AND COMPENSATION CONSULTANTS TO DETERMINE A RECOMMENDED COMPENSATION AMOUNT FOR THE PRESIDENT/CEO WHICH IS WITHIN FAIR MARKET RANGE FOR THE INDUSTRY. THE FULL BOARD REVIEWS AND APPROVES THE COMPENSATION OF THE PRESIDENT/CEO. DISCUSSIONS ARE DOCUMENTED AT COMMITTEE AND BOARD LEVELS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS, FORM 990, AND OTHER OPERATING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CERTAIN GOVERNING DOCUMENTS AND POLICIES ARE CONSIDERED PROPRIETARY AND ARE NOT GENERALLY DISCLOSED. THE ORGANIZATION IS IN FULL COMPLIANCE WITH ALL REGULATIONS CONCERNING DISCLOSURE AT THE FEDERAL, STATE AND LOCAL LEVELS. LUTHERAN VILLAGE AT MILLERS GRANT 300 ST LUKE CIRCLE WESTMINTER MD 21158 320154392 RETIREMENT VILLAGE IN THE DEVELOPMENTAL STAGE MD 501(C)(3) 9 CARROLL LUTHERAN VILLAGE 1 CLV CATERING INC 300 ST LUKE CIRCLE WESTMINSTER MD 21158 753195092 CATERING MD N/A C -14561 34942 0.90000 0 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 LUTHERAN VILLAGE AT MILLERS GRANT D 2958015 COST CLV CATERING A 60000 COST LUTHERAN VILLAGE AT MILLERS GRANT L 240000 COST LUTHERAN VILLAGE AT MILLERS GRANT O 236271 COST