2015-11-11T10:18:41-06:00 2014-12-31 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2014-01-01 381358410 LUTHERAN HOMES OF MICHIGAN INC LUTH 9896523470 4100 PIER NORTH BLVD NO STE A FLINT MI 48504 AMY E STORMS CFO 9896523470 2015-11-10 1 TINA M PETERS CPA P00904574 2483522500 2014 2016-02-25 16:41:14Z X WELLSPRING LUTHERAN SERVICES DAVID M GEHM 4100 PIER NORTH BLVD NO STE A FLINT MI 48504 36684489 0 X WWW.WELLSPRINGLUTHERAN.COM X 1892 MI MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 6 6 1169 170 -9695 -9821 162512 154862 31335747 34208084 164418 94897 3186539 2048412 34849216 36506255 0 0 0 0 21221503 21776557 0 0 255514 12889299 13319923 34110802 35096480 738414 1409775 27753520 38898839 15192193 27076314 12561327 11822525 MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 0 0 26106389 34208084 SKILLED NURSING CARE UNIT AND HOME FOR THE AGED UNIT PROVIDED 115,120 DAYS OF CARE AND 20,768 DAYS OF REHABILITATION, ROOM AND BOARD, NURSING CARE AND RELIGIOUS SERVICES FOR RESIDENTS OF THREE NURSING HOMES 26106389 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 75 0 1 1169 1 1 1 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 1 1 MI X ERIC MUSUM 9896523470 4100 PIER NORTH BLVD STE A FLINT MI 48504 ANTHONY D GOLDEN CHAIR 0.20 0.80 X X 0 0 0 RITCH CUSHWAY VICE CHAIR 0.20 0.80 X X 0 0 0 PETER BENDER TREASURER 0.20 0.80 X X 0 0 0 REV DON NEUENDORF DIRECTOR 0.20 0.80 X 0 0 0 DARRELL ZOLTON DIRECTOR 0.20 0.80 X 0 0 0 PAUL NYQUIST DIRECTOR 0.20 0.80 X 0 0 0 SCOTT ZIMMER DIRECTOR - PARTIAL YEAR 0.20 0.80 X 0 0 0 DEBORAH DUTCHER DIRECTOR - PARTIAL YEAR 0.20 0.80 X 0 0 0 RANDY HARRIS DIRECTOR - PARTIAL YEAR 0.20 0.80 X 0 0 0 MARY JO KRICK SECRETARY - PARTIAL YEAR 0.20 0.80 X X 0 0 0 DAVID M GEHM PRESIDENT & CEO 33.00 7.00 X 199926 0 29733 DENNIS KRAFFT CEO, LHM ASSET MANAGEMENT 40.00 0.00 X 23034 0 4204 ALBERT KAUL VP HUMAN RESOURCES, CPO 25.60 14.40 X 93049 0 15194 MAUREEN MCGEE COO - CAMPUS BASED SERVICES 30.00 10.00 X 106863 0 26330 AMY STORMS VP FINANCE AND CFO 25.00 15.00 X 117875 0 11585 ERIC MUSUM VP, CAA AND CTO 40.00 0.00 X 91123 0 9984 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 8.60 31.40 X 151997 0 4189 TIM JOHNSTON VP, SALES AND MARKETING 40.00 0.00 X 94723 0 12337 JOHNATHAN GOLM DIRECTOR OF PROJECT DEVELOPMENT 40.00 0.00 X 113658 0 3958 992248 0 117514 5 0 1 0 SELECT REHABILITATION 550 FRONTAGE RD STE 2415 NORTHFIELD IL 60093 THERAPY 2078610 CERIDIAN 3201 34TH ST ST PETERSBURG FL 33711 PAYROLL 176521 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY 157880 PLANTE MORAN 27400 NORTHWESTERN HWY SOUTHFIELD MI 48037 ACCOUNTING 138050 ROLF GOFFMAN MARTIN LANG LLP 30100 CHAGRIN BLVD STE 350 CLEVELAND OH 44124 ATTORNEY 129738 6 154862 154862 SKILLED NURSING & HOME CARE 623000 32857602 32857602 FURNISHED SERVICES 623000 1119264 1119264 OTHER RESIDENT INCOME 623000 231218 231218 34208084 61834 61834 23248 32943 -9695 -9695 -9695 25854 152500 0 145291 25854 7209 33063 33063 EXPENSE REIMBURSEMENT 900099 1560658 1560658 497449 497449 2058107 36506255 34208084 -9695 2153004 885086 796577 88509 17483786 13325957 4044370 113459 247110 138160 102865 6085 1704096 1140579 549127 14390 1456479 988579 453849 14051 143076 143076 135025 135025 196 196 609376 265065 343870 441 303415 303288 127 261999 261599 400 219000 217236 1764 949101 776573 172528 182582 3850 167410 11322 90247 26516 59365 4366 434757 434757 817013 817013 280423 280423 PATIENT CARE 2983002 2983002 MMQAA PROVIDER TAX 2085848 2085848 DRUGS AND MEDICAL SUPPL 1692514 1692514 FOOD 849920 849920 1282429 1012813 269016 600 35096480 26106389 8734577 255514 4790772 6158064 4034193 3858675 7953583 4961643 50041 71260 192579 652219 51194993 31204699 7743536 19990294 632464 715543 2356352 2491141 27753520 38898839 2635196 2320630 11948852 23703441 608145 1052243 15192193 27076314 X 9941803 9221083 2619524 2601442 12561327 11822525 27753520 38898839 X 1409775 19282 -2167859 X X 0 1 X 1 0 X 81034 25481 679023 162512 154862 1102912 30395124 32430881 23834371 31335747 34208084 152204207 42450 23547 30842 96839 30476158 32498812 24536941 31529101 34362946 153403958 81034 25144 679023 161762 154862 1101825 0 81034 25144 679023 161762 154862 1101825 152302133 44260 43767 22799 52950 61834 225610 44260 43767 22799 52950 61834 225610 787 -9695 -8908 200718 4108839 1337379 3154910 2058108 10859954 30721136 36651418 25897119 34737748 36473193 164480614 0.92600 0.92980 0.00140 0.00120 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: CONSULTING AND OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 196 196 0 PART II-B, LINE 1: MEMBERSHIP FEE ALLOCATED TO LOBBYING. 1 3946 27660 28359 3247 0 2654989 2654989 35909046 21260500 14648546 4828302 3106023 1722279 7758997 6838176 920821 43659 43659 19990294 LOAN CLOSING COSTS 50102 CONTRIBUTIONS RECEIVABLE 2000439 DEPOSITS 236600 OTHER ASSETS 204000 2491141 OTHER AFFILIATED ORGANIZATIONS 410819 QAS 175583 RESIDENT SECURITY DEPOSITS 343350 INTEREST RATE SWAP 122491 1052243 X PART IV, LINE 1B: LUTHERAN HOMES OF MICHIGAN, INC. IS REQUIRED TO MAINTAIN RESIDENT TRUST FUNDS AT ITS NURSING HOMES. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2011. X X 0 0 0 0 0 0 0 0 0 DAVID M GEHM PRESIDENT & CEO 199926 0 0 0 0 0 17500 0 12233 0 229659 0 0 0 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 151997 0 0 0 0 0 4189 0 0 0 156186 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES WERE SENT TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS' INPUTS AND COMMENTS WERE SOLICITED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT 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 B, LINE 15A THE EXECUTIVE COMMITTEE OF THE BOARD, UNDER THE BOARD CHAIR'S LEADERSHIP, IS RESPONSIBLE FOR ANNUAL PERFORMANCE REVIEW AND COMPENSATION ADJUSTMENT OF THE CEO, WHEN APPROPRIATE. OUTSIDE SOURCES OR COMPARATIVE REVIEW ARE TAKEN INTO CONSIDERATION WHEN SETTING TOTAL COMPENSATION. THE LAST ANNUAL PERFORMANCE REVIEW OCCURRED IN 2014 AND THE LAST IN-DEPTH COMPENSATION REVIEW OCCURRED IN 2014. FORM 990, PART VI, SECTION C, LINE 19 THE 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 XI, LINE 9: INTEREST RATE SWAP ADJUSTMENT 40,221. TRANSFER OF NET ASSETS FROM ELDER HOUSING, LLC -2,244,669. RECOVERY OF BAD DEBT 36,589. FORM 990, PART XII, LINE 2C: THERE WERE NO CHANGES TO THE AUDIT OVERSIGHT PROCEDURES FROM THE PREVIOUS YEAR. LHM ASSET MANAGEMENT LLC 244 WALNUT STREET FRANKENMUTH MI 48734 200055004 ASSET MANAGEMENT MI -72068 88045 LUTHERAN HOMES OF MICHIGAN INC LUTHERAN HOME CARE AGENCY INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 383081979 HOME CARE MI 501(C)(3) LINE 9 LUTHERAN HOMES OF MICHIGAN INC 1 ELDER HOUSING LLC 4100 PIER NORTH BLVD STE A FLINT MI 48504 201034873 SENIOR HOUSING MI 501(C)(3) LINE 9 LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOMES OF MICHIGAN FOUNDATION 4100 PIER NORTH BLVD STE A FLINT MI 48504 261630687 DONATE FUNDS MI 501(C)(3) LINE 11A, I LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE PERSONAL ASSISTANCE 4100 PIER NORTH BLVD STE A FLINT MI 48504 272138954 HOME CARE MI 501(C)(3) LINE 9 LUTHERAN HOMES OF MICHIGAN INC 1 AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 382236926 RETIREMENT COMMUNITY MI 501(C)(3) LINE 9 LUTHERAN HOMES OF MICHIGAN INC 1 ALPENA VILLAGE 4100 PIER NORTH BLVD STE A FLINT MI 48504 320090735 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI LUTHERAN HOMES OF MICHIGAN INC RELATED -6072 317723 0 1 0.50000 GIBRALTAR LDHALP 26200 LAHSER RD STE 300 SOUTHFIELD MI 48034 301829767 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A MONROE ELDERLY LDHALP 5309 TRANSPORTATION BLVD CLEVELAND OH 44125 383609893 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A ALPENA PINES LDHALP 9710 JUNCTION ROAD FRANKENMUTH MI 48434 260236982 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A LHM HOUSING SERVICES INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 383609879 HOUSING SERVICES MI LUTHERAN HOMES OF MICHIGAN INC C -9 331 0.79000 1 GIBRALTAR MANOR DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 202240778 HOUSING SERVICES MI N/A C -6 224 0.50000 0 ALPENA PINES DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 260237019 HOUSING SERVICES MI N/A C -5 195 0.50000 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 LUTHERAN HOMES OF MICHIGAN FOUNDATION C 154862 CASH RECEIPTS AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC Q 125000 CASH RECEIPTS ELDER HOUSING LLC S 18542543 BOOK VALUE OF ASSETS TRANSFERRED LUTHERAN HOME CARE AGENCY INC Q 200000 CASH RECEIPTS