2015-11-11T10:18:41-06:00 2014-12-31 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2014-01-01 201034873 ELDER HOUSING LLC ELDE 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 2016-04-25 22:37:26Z X X THE MANORS DAVID M GEHM 4100 PIER NORTH BLVD NO STE A FLINT MI 48504 8357814 0 X WWW.WELLSPRINGLUTHERAN.COM X 2004 MI MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 6 6 0 34 0 0 2281 3072 8206831 8227070 -4077 1211 169082 126461 8374117 8357814 0 0 0 0 3552554 3175109 0 0 0 4424690 5063433 7977244 8238542 396873 119272 14572534 0 16978544 0 -2406010 0 X MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 0 1 4811303 8227864 ELDER HOUSING (DBA THE MANORS) PROVIDES SAFE, SECURE HOUSING TO SENIORS WITH ADDITIONAL LINKAGES TO THE COMMUNITY THROUGH OUTINGS AND EXCURSIONS, WELLNESS PROGRAMS, LIFE ENRICHMENT ACTIVITIES, MULTIPLE SPIRITUAL SUPPORT PROGRAMS, AND MEANINGFUL EDUCATIONAL OPPORTUNITIES. THIS WAS PROVIDED TO SENIORS ON THE MANORS CAMPUS WITH AN AVERAGE OCCUPANCY OF 99 APARTMENTS FOR INDEPENDENT SENIORS, 138 APARTMENTS WITH SOME SERVICES PROVIDED TO SENIORS, AND 40 ROOMS FOR SENIORS WHO SUFFER MEMORY LOSS. AS OF 12/31/14, THE ORGANIZATION WAS DISSOLVED AND THE NET ASSETS WERE TRANSFERRED TO LUTHERAN HOMES OF MICHIGAN, INC. 4811303 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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 1 0 0 1 1 1 0 0 1 21 0 1 0 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 0 0 0 0 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 1.40 38.60 X 0 199926 29733 ALBERT KAUL VP HUMAN RESOURCES, CPO 5.60 34.40 X 0 93049 15194 AMY STORMS VP FINANCE AND CFO 4.00 36.00 X 0 117875 11585 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 20.80 19.20 X 0 151997 4189 ERIC MUSUM VP, CAA AND CTO 0.00 40.00 X 0 91124 9984 0 653971 70685 0 0 1 0 UNIDINE CORPORATION PO BOX 60479 CHARLOTTE NC 28260 FOOD SERVICE 1545897 1 3072 3072 ROOM & MEDICAL CARE 623000 8109274 8109274 OTHER RESIDENT RENTAL 623000 117796 117796 8227070 1211 1211 794 0 794 794 794 OTHER INCOME 900099 125182 125182 GUEST MEALS 900099 485 485 125667 8357814 8227864 0 126878 X 2628936 2201082 427854 20048 15302 4746 273656 163430 110226 252469 165137 87332 766441 766441 139 139 48 48 1609833 1554829 55004 4810 4810 56844 56844 24682 24682 863939 558184 305755 13286 833 12453 9936 7535 2401 441285 441285 926192 926192 63869 63869 SUPPLIES 96683 96683 EQUIP, VEHICLE REPAIRS 81221 31941 49280 PROPERTY TAXES 14202 14202 PRE-EMPLOYMENT 10277 10007 270 79746 6340 73406 8238542 4811303 3427239 0 680367 0 0 0 51164 0 0 0 309 0 11715 0 23803 0 0 13666847 0 0 0 0 0 138329 0 14572534 0 294177 12455718 4228649 0 16978544 0 X -2418037 0 12027 0 -2406010 0 14572534 0 X 119272 2286738 X X 0 1 X 1 0 X 7206 4366 3596 2281 3072 20521 7880990 7420031 5877124 8211595 8227864 37617604 60947 49855 36625 53521 485 201433 7949143 7474252 5917345 8267397 8231421 37839558 7206 4366 3596 2281 3072 20521 0 7206 4366 3596 2281 3072 20521 37819037 1943 1211 3154 1943 1211 3154 15973 15182 62864 110797 125182 329998 7965116 7489434 5980209 8380137 8357814 38172710 0.99070 0.99350 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME 0 0 0 0 0 0 0 0 1 48 48 0 PART II-B, LINE 1: MEMBERSHIP FEE ALLOCATED TO LOBBYING. 0 X 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 CONSOLIDATED 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. 0 0 0 0 0 0 0 0 0 DAVID M GEHM PRESIDENT & CEO 0 199926 0 0 0 0 0 17500 0 12233 0 229659 0 0 MICHAEL LOGAN SR. VP/COO SENIOR SERVICES 0 151997 0 0 0 0 0 0 0 4189 0 156186 0 0 PART I, LINE 3 THE 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. CASH 2014-12-31 5402603 ACTUAL COST 381358410 LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 485041487 501C3 INVENTORY 2014-12-31 25757 BOOK VALUE 381358410 LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 485041487 501C3 PREPAID EXPENSES 2014-12-31 49001 BOOK VALUE 381358410 LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 485041487 501C3 FIXED ASSETS 2014-12-31 12863934 BOOK VALUE 381358410 LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 485041487 501C3 DEPOSITS 2014-12-31 103534 BOOK VALUE 381358410 LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 485041487 501C3 1 1 0 0 1 0 0 1 0 PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: THE BOARD OF DIRECTORS OF ELDER HOUSING LLC ARE ALSO THE BOARD OF DIRECTORS OF LUTHERAN HOMES OF MICHIGAN, INC (THE SOLE MEMBER OF ELDER HOUSING LLC). THESE INDIVIDUALS ARE: ANTHONY GOLDEN, PETE BENDER, RITCH CUSHWAY, REV. DON NEUNDORF, DARRELL ZOLTON, SCOTT ZIMMER, DEBORAH DUTCHER, RANDY HARRIS, MARY JO KRICK AND PAUL NYQUIST. IN ADDITION, DAVID GEHM, PRESIDENT & CEO IS ON THE BOARD OF DIRECTORS OF ELDER HOUSING LLC AND LUTHERAN HOMES OF MICHIGAN, INC. AND IS AN EMPLOYEE OF LUTHERAN HOMES OF MICHIGAN, INC. PART I, LINE I: AT THE TIME OF DISSOLUTION, ELDER HOUSING, LLC. ALSO HELD $20,689,498 IN LIABILITIES RESULTING IN A NET ASSET TRANSFER AT DECEMBER 31, 2014 OF $(2,244,669) TO LUTHERAN HOMES OF MICHIGAN, INC. THE LIABILITIES WERE NOT DISCHARGED OR PAID OFF BUT WERE INSTEAD TRANSFERRED TO LUTHERAN HOMES OF MICHIGAN, INC. WHO WILL BE RESPONSIBLE FOR PAYMENTS. FORM 990, PART I, ITEM C DBA: SHATTUCK MANOR DBA: MEADOWVIEW MANOR DBA: MCBRITE MANOR FORM 990, PART III, LINE 3 THE ORGANIZATION WAS DISSOLVED AND THE NET ASSETS TRANSFERRED TO LUTHERAN HOMES OF MICHIGAN, INC AS OF 12/31/14 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS LUTHERAN HOMES OF MICHIGAN, INC. FORM 990, PART VI, SECTION A, LINE 7A THE 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 B, LINE 11 PRIOR 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 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 15 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 IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,554,829. MANAGEMENT AND GENERAL EXPENSES 55,004. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,609,833. FORM 990, PART XI, LINE 9: NET ASSETS TRANSFERRED TO LUTHERAN HOMES OF MICHIGAN, INC. 2,244,669. INTEREST RATE SWAP ADJUSTMENT 42,069. FORM 990, PART XII, LINE 2C: THERE WERE NO CHANGES TO THE AUDIT OVERSIGHT PROCEDURES FROM THE PREVIOUS YEAR. LUTHERAN HOMES OF MICHIGAN INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 381358410 NURSING CARE MI 501(C)(3) LINE 9 N/A 0 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 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 N/A 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 N/A C 0 GIBRALTER MANOR DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 202240778 HOUSING SERVICES MI N/A C 0 ALPENA PINES DEVELOPMENT INC 4100 PIER NORTH BLVD STE A FLINT MI 48504 260237019 HOUSING SERVICES MI N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 LUTHERAN HOMES OF MICHIGAN INC R 18542543 BOOK VALUE OF ASSETS TRANSFERRED