2017-10-02T14:07:46-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2016-01-01 390981434 UNITED LUTHERAN PROGRAM FOR THE AGING INC UNIT 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 ELIZABETH DIEHL CFO 4144643880 2017-09-25 1 KIMBERLY ANDERSON CPA P00188889 6086628600 2017-09-25 67.137.57.251 2017-09-25 09:34:30 CD P 3E979F80BB8F399C9CB7D5D916B34B85DDD844F4 B7BE9990AD15340D9C3328E0F5C306E36A6AD06F 2016 2021-01-29 14:40:06Z STEPHANIE CHEDID 4545 NORTH 92ND STREET WAUWATOSA WI 53225 42763134 0 X WWW.LUTHERMANOR.ORG X 1957 WI TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS. 10 9 788 479 0 0 1667778 1134276 33428121 32859737 749971 716535 226577 235454 36072447 34946002 0 0 0 0 20360154 20243375 0 0 62021 15436696 16066269 35796850 36309644 275597 -1363642 52823487 49335684 29974057 27478549 22849430 21857135 X TO SHARE GOD'S LOVE BY ENRICHING THE LIVES OF OLDER ADULTS. 0 0 17038830 17492545 LUTHER MANOR HEALTH CARE CENTER PROVIDES SKILLED NURSING CARE AND SERVICES FOR FRAIL ELDERLY. WITHIN THE HEALTH CARE CENTER IS A DEDICATED 34 UNIT REHABILITATION CENTER. THE HEALTH CARE CENTER ALSO INCLUDES "SPECIAL CARE" SERVICES FOR PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA. THE FACILITY IS LICENSED FOR PARTICIPATION IN BOTH MEDICARE AND MEDICAID. 7150704 7341115 THE LUTHER MANOR TERRACE (LMT) PROVIDES SAFE AND SUPPORTIVE INDEPENDENT LIVING HOUSING AND SERVICES FOR OLDER ADULTS. APARTMENT RESIDENTS OFTEN CHOOSE THE LMT IN ORDER TO BECOME PART OF A LIFE PLAN COMMUNITY SETTING. THE LMT SERVICES AND AMENITIES INCLUDE LIFE ENRICHMENT OPPORTUNITIES, TRANSPORTATION SERVICES, DINING PROGRAM, SPIRITUAL WELLNESS, FITNESS, HEALTH, ENTERTAINMENT AND CULTURAL PROGRAMS. THE LMT ALSO PROVIDES PERSONAL CARE SERVICES TO RESIDENTS THROUGH THE "RESIDENTIAL CARE APARTMENT COMPLEX" RCAC PROGRAM, WHICH HELPS RESIDENTS MAINTAIN INDEPENDENT LIVING. 5594868 5743850 THE COURTYARDS AT LUTHER MANOR PROVIDES SUPPORTIVE (ASSISTED) LIVING SERVICES FOR FRAIL ELDERLY WHO RESIDE IN LUTHER MANOR'S LICENSED "COMMUNITY BASED RESIDENTIAL FACILITY (CBRF)". THE COURTYARDS PROGRAM ALSO INCLUDES "SPECIAL CARE" SERVICES FOR PERSONS WITH ALZHEIMER'S DISEASE AND OTHER FORMS OF DEMENTIA. 2223032 2282227 LUTHER MANOR ADULT DAY CARE CENTERS IN WAUWATOSA AND GRAFTON, WI; LUTHER MANOR RIVER OAKS - A 16 UNIT ASSISTED LIVING FACILITY LOCATED IN MEQUON, WI; AND HOSPICE SERVICES PROVIDED BY LUTHER MANOR HOSPICE. 2223032 2282227 32007434 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 50 0 1 788 1 0 0 0 0 0 0 0 0 0 0 X 10 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X ELIZABETH DIEHL CFO 4144643880 4545 NORTH 92ND STREET WAUWATOSA WI 53225 KATHLEEN CZARNIAK SECRETARY 1.00 X X 0 0 0 JAMES HOFFMAN VICE CHAIR 1.00 X X 0 0 0 STEPHEN KNOWLES DIRECTOR 0.50 X X 0 0 0 ELAINE SCHMEDA DIRECTOR 0.50 X 0 0 0 REV D WILLIAM KNAPP CHAIRMAN 1.00 X X 0 0 0 TIMOTHY SCHOEWE TREASURER 1.00 X X 0 0 0 STEPHANIE CHEDID CEO 45.00 5.00 X X 254410 0 76962 GREGORY FREAM DIRECTOR 0.50 X 0 0 0 KRISTINE IWINSKI DIRECTOR 0.50 X 0 0 0 MAY YER THAO DIRECTOR 0.50 X 0 0 0 ELIZABETH DIEHL CFO 45.00 5.00 X 139938 0 9165 DAVID SMITH DIRECTOR OF PHARMACY 40.00 X 132963 0 3097 LARRY SWANKE PHARMACIST 40.00 X 113706 0 16948 LAUREN MALENSEK CHRO 50.00 X 135558 0 0 MELANIE VARIN CMO 50.00 X 107917 0 20778 SABINA BISTA NURSE 53.00 X 110070 0 0 994562 0 126950 7 0 1 0 SODEXO 4880 PAYSHPERE CIRCLE CHICAGO IL 60674 FOOD SERVICE 2096526 HEALTHREACH REHABILITATION 17280 W NORTH AVENUE STE 104 BROOKFIELD WI 53045 REHAB THERAPY 1240511 TOP TECHS TEMPS 150 N SUNNY SLOPE RD STE 215 BROOKFIELD WI 53005 TEMPORARY NURSING STAFFING 487427 JOHNSON CONTROLS PO BOX 730068 DALLAS TX 75373 HVAC MAINTENANCE 223847 CLEARPATH CONNECTIONS 1251 E WISCONSIN AVE STE B PEWAUKEE WI 53072 IT CONSULTANT/CABLING 203444 7 1030000 104276 1134276 RESIDENT SERVICES 623000 32198570 32198570 FOUNDERS FEES 623990 661167 661167 32859737 650746 650746 7776357 1987 7711058 1497 65299 490 65789 65789 115567 104577 10990 10990 OTHER INCOME 900099 163589 163589 CAFETERIA INCOME 900099 35695 35695 HOUSEKEEPING 900099 25180 25180 224464 34946002 32859737 0 951989 458097 14910 432428 10759 15911312 14213553 1659424 38335 94264 76140 18124 2524516 1999003 525166 347 1255186 1118630 133350 3206 417154 417154 839052 799089 39963 162601 151129 3094 8378 103723 17721 86002 235998 61306 174692 1418460 1356537 61923 44726 25495 18934 297 57540 50296 7244 437673 437673 2610339 2610339 197042 197042 DINING FOOD AND SUPPLIE 2803871 2803871 ANCILLARIES 1741750 1741750 ALL OTHER EXPENSES 1709186 1193955 515231 PHARMACEUTICALS 1498791 1498791 1788363 1640204 147460 699 36309644 32007434 4240189 62021 2090520 1405940 18799 68799 2290405 2635651 206530 172539 307631 294213 87794204 65981879 23380094 21812325 23889944 22475434 90325 549239 470783 52823487 49335684 2872518 2562603 17610000 16208940 76535 55582 9415004 8651424 29974057 27478549 X 22730686 21729534 118744 127601 22849430 21857135 52823487 49335684 -1363642 371347 0 X X 0 1 X 1 0 X 784613 857369 1118841 1667778 1134276 5562877 35180425 34193107 34065374 33428121 32859737 169726764 35965038 35050476 35184215 35095899 33994013 175289641 0 0 0 175289641 1062625 1215998 827057 599108 650746 4355534 1062625 1215998 827057 599108 650746 4355534 235261 218884 329283 329980 340031 1453439 37262924 36485358 36340555 36024987 34984790 181098614 0.96790 0.96750 0.02410 0.02530 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 336497 336497 62711941 42448685 20263256 22574083 21916071 658012 2171683 1617123 554560 21812325 FOUNDERS FEES 8651424 8651424 X 34930136 20300 20300 34909836 36166 36166 34946002 36309644 0 36309644 0 36309644 PART IV, LINE 2B: RESIDENT FUNDS ARE HELD BY THE ORGANIZATION WHICH RESIDENTS CAN ACCESS IF IN NEED OF ANY AMOUNT OF MONEY IN WHICH THE RESIDENT HAS ENTRUSTED THE ORGANIZATION. THESE FUNDS ARE OFTEN USED FOR MINOR PURCHASES. THIS ASSET IS IN CORRELATION WITH A LIABILITY FOR THE SAME AMOUNT. PART X, LINE 2: THE CORPORATION IS A NONPROFIT CORPORATION EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE CORPORATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE CORPORATION FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE CORPORATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION, WHICH ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 20,300. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 36,166. X 0 1 X X X X X X 0 1 0 0 0 0 0 1 1 1 STEPHANIE CHEDID CEO 219410 0 35000 0 0 0 53965 0 22997 0 331372 0 0 0 PART I, LINE 1B THE BOARD HAS APPROVED REIMBURSMENT OF DUES TO A SOCIAL CLUB WHICH IS USED FOR BUSINESS PURPOSES. PART I, LINE 4B STEPHANIE CHEDID, CEO, IS ELIGIBLE FOR A 457(F) DEFERRED COMPENSATION ARRANGEMENT UNDER HER EMPLOYMENT AGREEMENT. CONTRIBUTIONS ARE $50,000 ANNUALLY PAYABLE OVER 5 YEARS SUBJECT TO VESTING REQUIREMENTS. PART I, LINE 7 THE CEO, CFO, CHRO, CCO AND CMO ARE ELIGIBLE FOR DISCRETIONARY BONUS PAYMENTS. PART I, LINE 8 DEFERRED COMPENSATION PLAN FOR CEO. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-29 21170000 REFUNDING OF 2009 BONDS AND FUNDING CAPITAL PROJECTS 0 0 0 A 4880000 21170000 2270000 18900000 2012 1 0 1 1 A 0 0 1 1 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPRISED OF NOT LESS THAN FIVE MEMBERS OF THE BOARD AND IS CHAIRED BY THE CHAIR OF THE BOARD. THEY ARE GIVEN AUTHORITY BY THE BOARD TO PERFORM SPECIFIC FUNCTIONS, INCLUDING THE ANNUAL REVIEW OF THE CEO. WHEN THE FULL BOARD CAN NOT MEET, IN AN EMERGENCY SITUATION, THEY ARE AUTHORIZED TO EXERCISE ALL POWER OF THE BOARD EXCEPT ACTIONS RELATED TO ELECTION OF OFFICER OR FILLING VACANCIES. FORM 990, PART VI, SECTION A, LINE 3 UNITED LUTEHRAN PROGRAM FOR THE AGING, INC. HAS A CONTRACT WITH SODEXO TO MANAGE OUR DINING SERVICES. SODEXO DIRECTLY EMPLOYS 8 MANAGEMENT EMPLOYEES, PURCHASES ALL FOOD, AND SUPERVISES THEIR DINING SERVICE STAFF. FORM 990, PART VI, SECTION A, LINE 6 UNITED LUTHERAN PROGRAM FOR THE AGING, INC. HAS TWO CLASSES OF MEMBERS: CONGREGATIONAL MEMBERS AND AFFILIATE MEMBERS. CONGREGATIONAL MEMBERS CONSIST OF CONGREGATIONS OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA THAT FROM TIME TO TIME ARE INVITED AND ELECT TO BECOME CONGREGATIONAL MEMBERS. AFFILIATE MEMBERS CONSIST OF ALL CORPORATIONS, CONGREGATIONS, ASSOCIATIONS, AND INDIVIDUALS COMMITTED TO THE PURPOSES OF THE ORGANIZATION WHO FROM TIME TO TIME ARE INVITED AND ELECTED TO BECOME AFFILIATE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A EACH CONGREGATIONAL MEMBER IS ENTITLED TO VOTING RIGHTS AND THE MEMBERS ARE RESPONSIBLE FOR ELECTING ALL MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B CONGREGATION MEMBERS RATIFY THE ACTIONS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE MEMBERS OF THE BOARD OF DIRECTORS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. HAVE THE OPPORTUNITY TO REVIEW THE FORM 990 PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS ANNUALLY REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY, DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD AND ON AN INTERIM BASIS AS CONFLICTS ARISE AS OUTLINED IN THE POLICY. THE BOARD WILL REVIEW THE CONFLICT AND DETEMINE THE APPROPRIATE ACTION. DEPENDING ON THE TYPE OF CONFLICT, DIRECTORS AND OFFICERS WITH CONFLICTS MAY BE ALLOWED TO REMAIN ON THE BOARD, BUT WOULD BE EXPECTED TO REFRAIN FROM DISCUSSIONS OR VOTING ON MATTERS WHERE A POTENTIAL CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE COMPENSATION CONSULTANT IS ENGAGED TO REVIEW NON-PROFIT COMPENSATION OF LIKE ORGANIZATIONS AND INDUSTRY COMPENSATION SURVEYS. BASED ON THIS DATA, COMPENSATION RECOMMENDATIONS ARE MADE TO THE EXECUTIVE COMMITTEE OF THE BOARD OF THE ULPA AND APPROVED BY THIS COMMITTEE. THE REVIEW WAS PERFORMED BY CARSON DETTMANN USING DATA FROM THE 2016 GUIDESTAR NONPROFIT COMPENSATION REPORT AND THE 2016 LEADINGAGE CEMO SURVEY SURVEY. THE INFORMATION WAS DOCUMENTED BY THE EXECUTIVE COMMITTEE OF THE ULPA BOARD OF DIRECTORS IN A REBUTTABLE PRESUMPTION CHECKLIST. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST AND ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS OF UNITED LUTHERAN PROGRAM FOR THE AGING, INC. ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION WILL CONSIDER REQUESTS AND MAKE THE DOCUMENTS AVAILABLE BASED ON FACTS AND CIRCUMSTANCES OF THE REQUEST. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. PART XII, LINE 2C AN AUDIT COMMITEE WAS FORMED IN 2016 TO SELECT THE INDEPENDENT ACCOUNTANT AND OVERSEE THE AUDIT PROCESS. PRIOR TO THIS, THE SELECTION AND OVERSIGHT WERE PERFORMED BY THE FINANCIE COMMITEE. LUTHER MANOR FOUNDATION 4545 NORTH 92ND STREET MILWAUKEE WI 53225 391499823 PROGRAM GRANT TO UNITED LUTHERAN PROGRAM FOR THE AGING, INC. WI 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 1 LUTHER MANOR FOUNDATION C 1030000 BOOK LUTHER MANOR FOUNDATION Q 129006 BOOK