2016-08-15T13:07:16-05:00 2015-12-31 390758449 Wipfli LLP 3703 Oakwood Hills Pkwy Eau Claire WI 54701 990 2015-01-01 390806814 American Lutheran Homes Inc AMER 7158323003 915 East Elm Street Menomonie WI 54751 Mike Christensen CEO 7158323003 2016-08-15 1 PAUL M TRACZEK CPA P01368830 7158323407 2016-08-08 2015 2016-12-15 16:53:06Z MIKE CHRISTENSEN 3410 Sky Park Blvd Eau Claire WI 54701 8557504 0 X www.americanlutheranhomes.com X 1961 WI PROVIDE SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED IN THE SURROUNDING AREAS UNDER OUR FAITH BASED SENIOR CARE PROGRAMS. 9 9 289 120 49773 -26812 37540 21789 8066188 8472127 396 2590 55989 57273 8160113 8553779 0 0 0 0 4425162 4769353 0 0 0 3515685 3869459 7940847 8638812 219266 -85033 8439525 9826850 4973810 6062054 3465715 3764796 X IN RESPONSE TO THE GREAT COMMISSION OF OUR LORD, WE ENDEAVOR TO SHARE GOD'S LOVE IN WORD AND DEED. WE ATTEMPT TO PROVIDE A CHRISTIAN ATMOSPHERE WHICH, COMBINED WITH SUPPORTIVE SERVICES, ENHANCES THE LIVES OF ALL THOSE WHO ARE CONNECTED WITH IT. IN OUR MINISTRY, WE ENCOURAGE BOTH THOSE WE SERVE AND OUR EMPLOYEES TO RECOGNIZE THEIR INFINITE WORTH AND TO GROW TO REACH THEIR HIGHEST POTENTIAL AS GOD'S CHILDREN. IN FURTHERANCE OF THIS PURPOSE, WE DESIRE TO ESTABLISH QUALITY CARE IN A CHRISTIAN ATMOSPHERE BY: PROVIDING THE HIGHEST POSSIBLE QUALITY OF PHYSICAL, MENTAL AND SPIRITUAL CARE FOR THOSE ENTRUSTED TO US; BROADENING THE INTEREST AND ACTIVITIES OF THOSE IN OUR CARE THROUGH PROGRAMS AND VOLUNTEER ASSISTANCE; INVOLVING OUR CORPORATE CONGREGATIONS; AND ASSUMING A POSITION OF LEADERSHIP IN THE FIELD OF GERIATRICS BY EXTENDING OUR MINISTRY BEYOND NURSING HOME FACILITIES THROUGH THE CREATION OF PROGRAMS TO SERVE THE NEEDS OF THE ELDERLY IN OUR COMMUNITIES. 0 0 3261317 3790634 THE PRIMARY ACTIVITY OF THE ORGANIZATION IS TO PROVIDE SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED OF THE SURROUNDING AREA. THE ORGANIZATION SERVES THE MENOMONIE, WISCONSIN AREA COMMUNITY BY OPERATING A 50-BED SKILLED NURSING FACILITY. THE MENOMONIE NURSING FACILITY PROVIDED 14,779 RESIDENT DAYS OF CARE IN 2015. THE FACILITY OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND FOR LONG-TERM CARE RESIDENTS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY CARE, WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, SPEECH THERAPY, AND OCCUPATIONAL THERAPY. 4463829 4681493 THE PRIMARY ACTIVITY OF THE ORGANIZATION IS TO PROVIDE SKILLED AND INTERMEDIATE NURSING CARE FOR THE AGED AND DISABLED OF THE SURROUNDING AREA. THE ORGANIZATION SERVES THE MONDOVI, WISCONSIN COMMUNITY BY OPERATING A 50-BED SKILLED NURSING FACILITY and 24-unit Community based residential facility (CBRF). THE MONDOVI FACILITY PROVIDED 15,730 DAYS OF RESIDENT CARE IN 2015. THE FACILITY OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY CARE, WOUND CARE, BARIATRIC CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, SPEECH THERAPY, AND OCCUPATIONAL THERAPY. THE MONDOVI FACILITY ALSO OFFERS OUTPATIENT THERAPY PROGRAMS TO PROVIDE EXTENDED THERAPY SERVICES TO AREA COMMUNITY MEMBERS IN NEED OF PHYSICAL REHABILITATION PROGRAMS ON AN OUTPATIENT BASIS AND TO RESIDENTS WHO DISCHARGE FROM THE FACILITY BUT REQUIRE ONGOING THERAPY ON AN OUTPATIENT BASIS. THE MAJORITY OF THE LONG-TERM CARE RESIDENTS AT THE MONDOVI PROGRAM ARE ALSO MEDICAID PROGRAM BENEFICIARIES. 7725146 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 41 0 1 289 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 1 0 X MIKE CHRISTENSEN 7158323003 3410 SKY PARK BLVD EAU CLAIRE WI 54701 X X Kris Jenson VIce presiDENT 1.00 X X 0 0 0 Barb Piper TREASURER 1.00 X X 0 0 0 Kathy Pospishil Board member 1.00 X 0 0 0 David Larson president 1.00 X X 0 0 0 Mark Forster SECRETARY 1.00 X X 0 0 0 LARRY KUESTER BOARD MEMBER 1.00 X 0 0 0 ARDYTH BRENNER BOARD MEMBER 1.00 X 0 0 0 MARY SEGERSTROM BOARD MEMBER 1.00 X 0 0 0 SHARON MILLER BOARD member 1.00 X 0 0 0 MIKE CHRISTENSEN CEO 10.00 X 0 0 0 RANDY BESTUL COO 10.00 X 0 0 0 0 0 0 0 0 0 0 REHAB CARE GROUP INC 680 SOUTH FOURTH ST LOUISVILLE KY 40202 THERAPY SERVICES 364251 GRACE LUTHERAN FOUNDATION INC 3410 SKY PARK BLVD EAU CLAIRE WI 54701 MANaGEMENT SERVICES 253913 MIDWEST PHYSICAL THERAPY 1731 17TH AVE BLOOMER WI 54724 THERAPY SERVICES 242693 3 21789 21789 RESIDENT REVENUE 623000 8026979 8026979 SENIOR MEALS PROGRAMS 624200 378423 378423 RESIDENT TRANSPORTATIO 624100 37732 37732 OTHER RESIDENT REVENUE 623000 28993 28993 8472127 1790 1790 800 0 800 800 800 11225 3725 7500 7500 LAUNDRY 812300 49773 49773 49773 8553779 8472127 49773 10090 4091185 3905789 185396 46377 44275 2102 329746 314803 14943 302045 288358 13687 253913 253913 10418 10418 35650 35650 762130 743255 18875 100646 100646 61321 14339 46982 103318 103318 434888 434888 43720 41742 1978 543879 543879 67578 67578 Supplies 549849 525440 24409 Food and dietary expens 506614 506614 State Nursing Home Asse 204000 204000 EQUIPMENT RENTAL AND MA 76500 76500 115035 81264 33771 8638812 7725146 913666 0 483295 844867 803819 1220953 939948 858820 45821 57525 19877 63656 12470710 5854522 5803131 6616188 343634 164841 8439525 9826850 965425 626405 4008385 5435649 4973810 6062054 X 3465715 3764796 3465715 3764796 8439525 9826850 X -85033 384114 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 1381 1381 0 Part II-B, Line 1: AMERICAN LUTHERAN HOMES, INC. PAYS ANNUAL ASSOCIATION DUES TO LEADINGAGE WISCONSIN. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATION MATERIALS AND STAFFING TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL INDUSTRY ENVIRONMENT. 46513 46513 8335123 2960527 5374596 3745730 2668738 1076992 343344 225257 118087 6616188 8553779 0 8553779 0 8553779 8638812 0 8638812 0 8638812 Form 990, Part VI, Section A, line 6 THE MEMBERS OF THE ORGANIZATION ARE THE PASTORS AND CONGREGATIONS THAT BELONG TO THE AMERICAN LUTHERAN CHURCH AND SPONSOR THE ACTIVITIES OF THE AMERICAN LUTHERAN HOMES, Inc. Form 990, Part VI, Section A, line 7a THE BOARD MEMBERS ARE ELECTED BY THE CONGREGATIONS OF THE SPONSORING CHURCHES AND AT A MINIMUM MUST INCLUDE THE PASTOR OF ONE OF THESE CONGREGATIONS. Form 990, Part VI, Section A, line 7b DECISIONS ON THE CHANGES IN THE STRUCTURE OF THE AMERICAN LUTHERAN HOMES ORGANIZATION OR GOVERNING DOCUMENTS MUST BE APPROVED BY THE AMERICAN LUTHERAN CHURCH. Form 990, Part VI, Section B, line 11 A COPY OF FORM 990 WAS PROVIDED TO THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY prior to THE SUBMISSION OF THE RETURN. The FORM 990 WAS also REVIEWED BY Management PRIOR TO SUBMISSION. Form 990, Part VI, Section B, line 12c THE ORGANIZATION ANNUALLY REVIEWS UPDATED CONFLICT OF INTEREST STATEMENTS FROM MEMBERS OF THE BOARD OF DIRECTORS. ANY NOTED CONFLICTS ARE DISCUSSED, AND DURING THE YEAR, IF CONFLICTS ARE NOTED DURING VOTES, THOSE CONFLICTING MEMBERS ABSTAIN FROM VOTING. Form 990, Part VI, Section B, line 15 AMERICAN LUTHERAN HOME, Inc.'S EXECUTIVE LEVEL EMPLOYEES AND KEY EMPLOYEES ARE PROVIDED UNDER THE MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION, Inc. (A NOT-FOR PROFIT ORGANIZATION WHICH SPECIALIZES IN SKILLED NURSING, LONG-TERM CARE, AND HOUSING SERVICES FOR ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY). THE CONTRACT TERMS ARE RENEWED EVERY FIVE YEARS. THE BOARD OF DIRECTORS OF AMERICAN LUTHERAN HOMES, Inc. REVIEWS THE CONTRACT TERMS TO ENSURE THAT QUALITY SERVICES ARE BEING ACHIEVED AT THE LOWEST POSSIBLE COST FOR THE PROGRAMS BEING PROVIDED. THE BOARD ALSO CONSULTS WITH OTHER WISCONSIN NURSING HOME ASSOCIATION MEMBERS TO ENSURE THAT THE AMOUNTS BEING PAID ARE CONSISTENT FOR ADMINISTRATIVE SERVICES OF THOSE PAID THROUGHOUT THE REGION. Form 990, Part VI, Section C, line 19 AMERICAN LUTHERAN HOMES, Inc. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION. Form 990, Part VII, Section A: EXPLANATION FOR HOURS WORKED BY OFFICERS: MIKE CHRISTENSEN AND RANDY BESTUL ARE EMPLOYED BY THE MANAGEMENT SERVICES ORGANIZATION, GRACE LUTHERAN FOUNDATION, INC., AND AS SUCH A PART OF THEIR DUTIES IS TO PROVIDE MANAGEMENT AND OVERSIGHT TO ALL OF THE HEALTHCARE AND HOUSING SERVICES OF GRACE LUTHERAN FOUNDATION, INC., CHIPPEWA VALLEY ECUMENICAL HOUSING, AMERICAN LUTHERAN HOMES, INC., AMERICAN LUTHERAN COMMUNITY SERVICES, INC., AND GALLOWAY HOMES, INC., WHICH ARE ALL NON-PROFIT RELIGIOUS BASED ORGANIZATIONS THAT PROVIDE CARE AND HOUSING TO THOSE IN NEED. PART VII OF THE FORM 990 INCLUDES AN APPROXIMATE AMOUNT OF TIME DEVOTED EACH WEEK TO THE AMERICAN LUTHERAN HOMES, INC. ORGANIZATIONS, HOWEVER, THESE INDIVIDUALS OFTEN WORK WELL IN EXCESS OF THE AMOUNT OF HOURS LISTED IN ORDER TO SUPPORT AND FURTHER THE MISSION OF THE ORGANIZATIONS NOTED. EXPLANATION FOR HOURS WORKED BY BOARD MEMBERS: ALL MEMBERS OF AMERICAN LUTHERAN HOMES, INC.'S BOARD OF DIRECTORS SERVE ON THE BOARD OF AMERICAN LUTHERAN COMMUNITY SERVICES, INC. AND GALLOWAY HOMES, INC. MATTERS INVOLVING THESE ENTITIES ARE RESOLVED DURING REGULARLY SCHEDULED MEETINGS OF AMERICAN LUTHERAN HOME, INC.'S BOARD. Form 990, Part XI, line 9: Transfer to Galloway Homes, Inc. 384,115. Rounding -1. PAGE 12, PART XI, LINE 2C, Selection of independent accountant: THE BOARD OF DIRECTORS OF AMERICAN LUTHERAN HOMES, Inc. REVIEWS THE AUDITED FINANCIAL STATEMENTS ANNUALLY AND IS RESPONSIBLE FOR THE OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE BOARD ALSO TAKES TIME DURING THE PRESENTATION OF THE ANNUAL FINANCIAL STATEMENTS TO MEET WITH THE INDEPENDENT AUDITORS WITHOUT MANAGEMENT'S PRESENCE TO BE ABLE TO ASK QUESTIONS OF THE INDEPENDENT ACCOUNTANTS WITHOUT MANAGEMENT INVOLVEMENT. THERE WAS NO CHANGE TO THESE PROCEDURES IN 2015. Part VI, Line 3, Management Services Agreement: AMERICAN LUTHERAN HOMES, Inc. HAS ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION, INC. (GRACE), A NON-PROFIT, RELIGIOUS BASED SENIOR HEALTHCARE SERVICES ORGANIZATION BASED IN EAU CLAIRE, WISCONSIN. UNDER THIS AGREEMENT, GRACE PROVIDES GENERAL ADMINISTRATIVE, CONSULTING, ACCOUNTING, HUMAN RESOURCES, AND FACILITY MANAGEMENT SERVICES TO AMERICAN LUTHERAN HOMES. UNDER THE MANAGEMENT AGREEMENT, GRACE IS ALSO RESPONSIBLE FOR THE SELECTION AND REVIEW OF THE ADMINISTRATORS OF AMERICAN LUTHERAN HOMES, Inc. GALLOWAY HOMES INC 915 ELM STREET MENOMONIE WI 54751 391385391 LOW INCOME HOUSING PROJECT FOR THE ELDERLY AND DISABLED WI 501(c)(4) AMERICAN LUTHERAN CHURCH 0 AMERICAN LUTHERAN COMMUNITY SERVICES INC 915 ELM STREET MENOMONIE WI 54751 391819072 ASSISTED LIVING FACILITY WI 501(c)(3) Line 11b, II AMERICAN LUTHERAN CHURCH 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0