FURP.ORG / PUBLIC DATA EXPLORER

AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC (EIN 38-2236926)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201643209349308289
Schema version
2015v2.1
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)
Return2016-11-15T13:12:13-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 307AddressLine1Txt
CitySOUTHFIELDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP480370307ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN382236926EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AUSABLE VALLEY CONTINUING CAREBusinessNameLine1Txt
Business Name Line2RETIREMENT COMMUNITY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlAUSABusinessNameControlTxt
Phone9896523470PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14100 PIER NORTH BLVD NO STE AAddressLine1Txt
CityFLINTCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48504ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAMY E STORMSPersonNm
Person TitleCFOPersonTitleTxt
Phone9896523470PhoneNum
Signature2016-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLYNNE HUISMANNPreparerPersonNm
PTINP00053811PTIN
Phone2483522500PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1WELLSPRING LUTHERAN SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDAVID M GEHMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14100 PIER NORTH BLVD NO STE AAddressLine1Txt
CityFLINTCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48504ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,791,333GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WELLSPRINGLUTHERAN.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1980FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionMOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee147TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,795PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$4,495,177PYProgramServiceRevenueAmt
CY Program Service Revenue$4,736,077CYProgramServiceRevenueAmt
PY Investment Income$2PYInvestmentIncomeAmt
CY Investment Income-$1,904CYInvestmentIncomeAmt
PY Other Revenue$34,729PYOtherRevenueAmt
CY Other Revenue$55,255CYOtherRevenueAmt
PY Total Revenue$4,535,703PYTotalRevenueAmt
CY Total Revenue$4,789,428CYTotalRevenueAmt
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$2,570,707PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,481,794CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,430,152PYOtherExpensesAmt
CY Other Expenses$2,652,688CYOtherExpensesAmt
PY Total Expenses$5,000,859PYTotalExpensesAmt
CY Total Expenses$5,134,482CYTotalExpensesAmt
PY Revenues Less Expenses-$465,156PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$345,054CYRevenuesLessExpensesAmt
Total Assets BOY$3,162,219TotalAssetsBOYAmt
Total Assets EOY$2,943,231TotalAssetsEOYAmt
Total Liabilities BOY$4,706,064TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,572,336TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$1,543,845NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$2,629,105NetAssetsOrFundBalancesEOYAmt
MissionMOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,129,023ExpenseAmt
Revenue$4,736,077RevenueAmt
DescPROVIDED SKILLED NURSING CARE AND INDEPENDENT LIVING OPTIONS FOR 17,053 SENIOR DAYS.Desc
Total Program Service Expenses$4,129,023TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
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 Footnote0IncludeFIN48FootnoteInd
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 EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee147EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
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 Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ERIC MUSUMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9896523470PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14100 PIER NORTH BLVD STE AAddressLine1Txt
CityFLINTCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48504ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
ANTHONY D GOLDEN
VICE CHAIR0.251.75Yes (X)Yes (X)$0$0$0
RITCH CUSHWAY
CHAIR0.250.75Yes (X)Yes (X)$0$0$0
PETER BENDER
TREASURER0.250.75Yes (X)Yes (X)$0$0$0
REV DON NEUENDORF
DIRECTOR0.250.75Yes (X)$0$0$0
DARRELL ZOLTON
DIRECTOR0.250.75Yes (X)$0$0$0
PAUL NYQUIST
DIRECTOR0.250.75Yes (X)$0$0$0
CARL SCHOENOW
DIRECTOR0.250.75Yes (X)$0$0$0
DAVID M GEHM
PRESIDENT & CEO0.1739.83Yes (X)$0$246,795$23,015
MAUREEN MCGEE
VP, HEALTH SERVICES2.5037.50Yes (X)$0$131,948$9,283
ERIC MUSUM
VP, CAA AND CTO0.0040.00Yes (X)$0$112,230$9,020
AMY STORMS
SR VP FINANCE AND CFO0.0040.00Yes (X)$0$137,491$9,995
ALBERT KAUL
VP HUMAN RESOURCES, CPO0.0040.00Yes (X)$0$117,918$9,298
MICHAEL LOGAN
SR. VP/COO SENIOR SERVICES0.0040.00Yes (X)$0$170,148$5,693
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$916,530TotReportableCompRltdOrgAmt
Total Other Compensation$66,304TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SELECT REHABILITATION
PO BOX 809056CHICAGOIL606809056THERAPY$435,567
OMNICARE INC
900 OMNICARE CENTER 201 EAST FOURTCINCINNATIOH45202PHARMACY SERVICES$130,201
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ROOM/CARE/SKILLED NURS623990$4,723,441$4,723,441
OTHER RESIDENT REIMB623990$9,516$9,516
RESIDENT RENTAL INCOME623990$3,120$3,120
FieldValueIRS element (for citing)
Total Program Service Revenue$4,736,077TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1TotalRevenueColumnAmt
Exclusion$1ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$1,905OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$1,905OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,905TotalRevenueColumnAmt
Exclusion-$1,905ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
REBATE INCOME900099$9,292$9,292
TV CHARGES900099$8,964$8,964
MEALS - GUEST900099$419$419

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,580TotalRevenueColumnAmt
Exclusion$36,580ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$55,255OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,789,428TotalRevenueColumnAmt
Related Or Exempt Func Income$4,736,077RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$53,351ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,063,005TotalAmt
Program Services$1,902,572ProgramServicesAmt
Management And General$160,433ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$24,722TotalAmt
Program Services$20,181ProgramServicesAmt
Management And General$4,541ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$236,639TotalAmt
Program Services$172,674ProgramServicesAmt
Management And General$63,965ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$157,428TotalAmt
Program Services$145,753ProgramServicesAmt
Management And General$11,675ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$544,133TotalAmt
Management And General$544,133ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$232TotalAmt
Management And General$232ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$190TotalAmt
Management And General$190ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$564,052TotalAmt
Program Services$525,200ProgramServicesAmt
Management And General$38,852ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,261TotalAmt
Program Services$267ProgramServicesAmt
Management And General$2,994ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$31,519TotalAmt
Program Services$326ProgramServicesAmt
Management And General$31,193ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$17,248TotalAmt
Management And General$17,248ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$207,488TotalAmt
Program Services$187,094ProgramServicesAmt
Management And General$20,394ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,108TotalAmt
Program Services$1,158ProgramServicesAmt
Management And General$5,950ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$10,271TotalAmt
Program Services$8,586ProgramServicesAmt
Management And General$1,685ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$61,076TotalAmt
Program Services$61,076ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$150,328TotalAmt
Program Services$150,328ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$62,702TotalAmt
Management And General$62,702ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MMQAA PROVIDER TAX$385,287$385,287
DRUGS/MEDICAL SUPPLIES$329,857$329,857
FOOD$128,395$128,395
BAD DEBT EXPENSE$65,039$65,039

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$84,502TotalAmt
Program Services$45,230ProgramServicesAmt
Management And General$39,272ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,134,482TotalAmt
Program Services$4,129,023ProgramServicesAmt
Management And General$1,005,459ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$403,313BOYAmt
EOY$879,500EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$387,304BOYAmt
EOY$516,778EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,124BOYAmt
EOY$9,213EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$25,295BOYAmt
EOY$24,233EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,092,876LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$611,284LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,563,675BOYAmt
EOY$1,481,592EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$760,426BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,082BOYAmt
EOY$31,915EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,162,219BOYAmt
EOY$2,943,231EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$367,271BOYAmt
EOY$433,476EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,738,647BOYAmt
EOY$1,382,735EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,600,146BOYAmt
EOY$3,756,125EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,706,064BOYAmt
EOY$5,572,336EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$1,560,316BOYAmt
EOY-$2,661,020EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,471BOYAmt
EOY$31,915EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$1,543,845BOYAmt
EOY-$2,629,105EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,162,219BOYAmt
EOY$2,943,231EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$345,054ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$740,206OtherChangesInNetAssetsAmt
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 Minus3 Years$900CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus1 Year$5,795CurrentTaxYearMinus1YearAmt
Current Tax Year$15,444CurrentTaxYearAmt
Total$22,139TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,007,762CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,558,980CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,869,903CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,495,177CurrentTaxYearMinus1YearAmt
Current Tax Year$4,736,077CurrentTaxYearAmt
Total$21,667,899TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,337CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,208CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,549CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,844CurrentTaxYearMinus1YearAmt
Current Tax Year$9,383CurrentTaxYearAmt
Total$44,321TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,017,099CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,566,088CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,887,452CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,502,816CurrentTaxYearMinus1YearAmt
Current Tax Year$4,760,904CurrentTaxYearAmt
Total$21,734,359TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$184,058CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$447,724CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$107,290CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$92,868CurrentTaxYearMinus1YearAmt
Current Tax Year$23,311CurrentTaxYearAmt
Total$855,251TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$184,058CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$447,724CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$107,290CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$92,868CurrentTaxYearMinus1YearAmt
Current Tax Year$23,311CurrentTaxYearAmt
Total$855,251TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$20,879,108PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$126CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2CurrentTaxYearMinus1YearAmt
Current Tax Year$1CurrentTaxYearAmt
Total$131TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$126CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2CurrentTaxYearMinus1YearAmt
Current Tax Year$1CurrentTaxYearAmt
Total$131TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,962CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,011CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$97,144CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,885CurrentTaxYearMinus1YearAmt
Current Tax Year$45,872CurrentTaxYearAmt
Total$199,874TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,034,187CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,573,100CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,984,597CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,535,703CurrentTaxYearMinus1YearAmt
Current Tax Year$4,806,777CurrentTaxYearAmt
Total$21,934,364TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.95190PublicSupportCY509Pct
Public Support PY5090.92300PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOMEExplanationTxt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$190OtherActivitiesAmt
Total Lobbying Expenditures$190TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationMEMBERSHIP FEE ALLOCATED TO LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcYes (1)AgentTrusteeEtcInd
Beginning Balance$6,291BeginningBalanceAmt
Additions During Year$21,107AdditionsDuringYearAmt
Distributions During Year$20,764DistributionsDuringYearAmt
Ending Balance$6,634EndingBalanceAmt
Incl Escrow Custodial Acct Liab0InclEscrowCustodialAcctLiabInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$180,000OtherCostOrOtherBasisAmt
Book Value$180,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,352,239OtherCostOrOtherBasisAmt
Depreciation$241,550DepreciationAmt
Book Value$1,110,689BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$428,350OtherCostOrOtherBasisAmt
Depreciation$285,103DepreciationAmt
Book Value$143,247BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$132,287OtherCostOrOtherBasisAmt
Depreciation$84,631DepreciationAmt
Book Value$47,656BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,481,592TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO AFFILIATES$3,566,328
ACCRUED OTHER LIABILITIES$189,797
FieldValueIRS element (for citing)
Total Liability$3,756,125TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, LINE 1B:FormAndLineReferenceDesc
ExplanationAUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY, INC. IS REQUIRED TO MAINTAIN RESIDENT TRUST FUNDS AT ITS NURSING HOMES.ExplanationTxt

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 (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVID M GEHM
PRESIDENT & CEO$0$246,795$0$0$0$0$0$0$0$23,015$0$269,810$0$0
MICHAEL LOGAN
SR. VP/COO SENIOR SERVICES$0$170,148$0$0$0$0$0$0$0$5,693$0$175,841$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE PROCESS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO IS UNDERTAKEN BY LUTHERAN HOMES OF MICHIGAN, INC., A RELATED ORGANIZATION. THE PROCESS INCLUDES USE OF A COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE ORGANIZATION IS LUTHERAN HOMES OF MICHIGAN, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION'S SOLE MEMBER, LUTHERAN HOMES OF MICHIGAN, INC., HAS THE AUTHORITY TO APPOINT/ELECT INDIVIDUALS TO THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBER, LUTHERAN HOMES OF MICHIGAN, INC.
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES OF THE FORM 990 WERE SENT TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS' INPUTS AND COMMENTS WERE SOLICITED.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST FORMS ARE COLLECTED IN THE BEGINNING OF EACH NEW BOARD YEAR. THE FORMS ARE REVIEWED BY THE CEO. IF A CONFLICT EXISTS, THE CEO REVIEWS WITH THE BOARD CHAIR AND DETERMINES THE APPROPRIATE ACTION, WHICH IS TYPICALLY TO REMOVE THE INDIVIDUAL FROM THE POSITION OF CONFLICT FOR THE SPECIFIC TRANSACTION/PROCESS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE CORPORATE OFFICE OF WELLSPRING LUTHERAN SERVICES BY CONTACTING THE CHIEF FINANCIAL OFFICER.
FORM 990, PART VI, SECTION B, LINE 14:A WRITTEN DOCUMENT RETENTION AND DOCUMENT DESTRUCTION POLICY IS CURRENTLY UNDER DEVELOPMENT.
FORM 990, PART IX, LINE 11GPATIENT CARE: PROGRAM SERVICE EXPENSES 525,200. MANAGEMENT AND GENERAL EXPENSES 38,852. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 564,052.
FORM 990, PART XI, LINE 9:INTEREST RATE SWAP ADJUSTMENT -11,695. GOODWILL IMPAIRMENT -760,426. TRANSFER OF ASSETS FROM LUTHERAN HOMES OF MICHIGAN FOUNDATION 31,915.
FORM 990, PART XII, LINE 2C:THERE WERE NO CHANGES TO THE AUDIT OVERSIGHT PROCEDURES FROM THE PREVIOUS YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
LUTHERAN HOMES OF MICHIGAN INC
4100 PIER NORTH BLVD STE AFLINTMI48504381358410NURSING CAREMI501(C)(3)LINE 9N/A0
LUTHERAN HOMES OF MICHIGAN FOUNDATION
4100 PIER NORTH BLVD STE AFLINTMI48504261630687DONATE FUNDSMI501(C)(3)LINE 11A, IYes (1)LUTHERAN HOMES OF MICHIGAN INC
LUTHERAN HOME CARE PERSONAL ASSISTANCE
4100 PIER NORTH BLVD STE AFLINTMI48504272138954HOME CAREMI501(C)(3)LINE 9Yes (1)LUTHERAN HOMES OF MICHIGAN INC
LUTHERAN HOME CARE AGENCY INC
4100 PIER NORTH BLVD STE AFLINTMI48504383081979SENIOR SERVICESMI501(C)(3)LINE 9Yes (1)LUTHERAN HOMES OF MICHIGAN INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
ALPENA VILLAGE
4100 PIER NORTH BLVD STE AFLINTMI48504320090735RESIDENTIAL CONTINUING CARE RETIREMENT FACILITYMIN/A
GILBRALTAR LDHALP
26200 LAHSER RD STE 300SOUTHFIELDMI48034301829767PROVIDE AFFORDABLE HOUSING TO THE ELDERLYMIN/A
MONROE ELDERLY LDHALP
5309 TRANSPORTATION BLVDCLEVELANDOH44125383609893PROVIDE AFFORDABLE HOUSING TO THE ELDERLYMIN/A
ALPENA PINES LDHALP
9710 JUNCTION ROADFRANKENMUTHMI48434260236982PROVIDE AFFORDABLE HOUSING TO THE ELDERLYMIN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
LHM HOUSING SERVICES INC
4100 PIER NORTH BLVD STE AFLINTMI48504383609879HOUSING SERVICESMIN/AC0
GIBRALTER MANOR DEVELOPMENT INC
4100 PIER NORTH BLVD STE AFLINTMI48504202240778HOUSING SERVICESMIN/AC0
ALPENA PINES DEVELOPMENT INC
4100 PIER NORTH BLVD STE AFLINTMI48504260237019HOUSING SERVICESMIN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
LUTHERAN HOMES OF MICHIGAN FOUNDATION
S$31,915ACTUAL AMOUNT
LUTHERAN HOMES OF MICHIGAN FOUNDATION
P$16,471ACTUAL AMOUNT
LUTHERAN HOMES OF MICHIGAN INC
P$544,133ACTUAL AMOUNT