2014-02-15T13:07:31-06:00 2013-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2012-07-01 272628802 IMMANUEL HOME AND COMMUNITY RESOURCES IMMA 4028292900 5858 WENNINGHOFF ROAD NO 2 OMAHA NE 68134 DAN FRIEDLUND 4028292900 2014-02-17 1 BARBARA J FAJEN P00400874 4023302660 2012 2015-11-30 17:44:51Z ERIC N GURLEY 6757 NEWPORT AVENUE SUITE 200 OMAHA NE 68152 25994139 0 X WWW.IMMANUELCOMMUNITIES.COM X 2010 NE TO PROVIDE IN-HOME, RESIDENTIAL AND COMMUNITY-BASED HEALTH CARE AND RELATED SERVICES TO THE ELDERLY. 17 16 0 0 0 0 0 25000000 680876 945658 46509 48481 39119 0 766504 25994139 36500 37000 0 0 738455 1411255 0 0 0 998638 1092036 1773593 2540291 -1007089 23453848 859035 22322049 3173219 1301338 -2314184 21020711 CHRIST-CENTERED SERVICE TO SENIORS AND EACH OTHER. 0 0 749666 723591 LIFELINE BY IMMANUEL IS AN AFFORDABLE EMERGENCY CALL SYSTEM. THE PROGRAM PROVIDES HELP AT THE PUSH OF A BUTTON GIVING INDIVIDUALS INDEPENDENCE AND SAFETY WHILE LIVING ALONE. 1594408 37000 222067 IMMANUEL HOME AND COMMUNITY RESOURSES (IHCR) IS THE SOLE MEMBER OF PACE IOWA AND PACE NEBRASKA, BOTH 501(C)(3) ORGANIZATIONS DOING BUSINESS AS IMMANUEL PATHWAYS. IHCR OVERSEES AND COORDINATES THE ACTIVITIES OF PACE IOWA. PACE NEBRASKA BEGAN OPERATIONS ON 05/01/2013, TO SERVE CLIENTS IN CASS, DODGE, DOUGLAS, SARPY, SAUNDERS AND WASHINGTON COUNTIES IN NEBRASKA. "PACE" STANDS FOR PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY. PACE PROGRAMS COORDINATE AND PROVIDE ALL NEEDED PREVENTATIVE, PRIMARY, ACUTE AND LONG-TERM CARE SERVICES SO THAT OLDER INDIVIDUALS CAN CONTINUE LIVING IN THEIR COMMUNITIES. 2344074 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 17 16 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 0 1 0 0 0 X MARY ANDERSON CONTROLLER 4028292933 5858 WENNINGHOFF ROAD SUITE 2 OMAHA NE 68134 X REV CARMALA ADERMAN 0.30 2.30 X X 0 0 0 DAVID MUSSMAN 0.30 2.30 X X 0 0 0 MIKE WILLIAMS 0.30 2.30 X X 0 0 0 REV DR DENNIS ANDERSON 0.30 2.30 X 0 0 0 REV DR DAVID DEFREESE 0.30 2.30 X 0 0 0 LAURA FENDER 0.30 2.30 X 0 0 0 TOM GARVEY 0.30 2.30 X 0 0 0 REV MARK GRORUD 0.30 2.30 X 0 0 0 RUTH HENRICHS 0.30 2.30 X 0 0 0 SUZANNE HRUZA MD 0.30 2.30 X 0 0 0 GUILLERMO BILL HUERTA MD 0.30 2.30 X 0 0 0 DAVE JACOX 0.30 2.30 X 0 0 0 ANTHONY SCIOLI 0.30 2.30 X 0 0 0 MARK WATERSTRAAT 0.30 2.30 X 0 0 0 DELIGHT WREED BYRD 0.30 2.30 X 0 0 0 BISHOP BRIAN MASS 0.30 2.30 X 0 0 0 JAMES J OLMSTED 0.30 2.30 X 0 0 0 ERIC N GURLEY 2.00 45.00 X X 0 359330 203992 DAN FRIEDLUND 2.00 45.00 X 0 162663 0 STEVE HESS 25.00 22.00 X 155994 0 20811 ROXANN ROGERS MEYER 2.00 45.00 X 0 115893 31177 TAMMY SEALER 2.00 46.00 X 0 116982 23073 MARY ANDERSON 2.00 46.00 X 0 103746 32788 CHERYL L MUNDT 35.00 12.00 X 121447 0 8806 DEBRA WIENS 2.00 45.00 X 0 108124 14721 277441 966738 335368 2 0 1 0 PHILLIPS LIFELINE PO BOX 403109 ATLANTA GA 303843109 MONITORING SERVICES 386565 1 25000000 25000000 LIFELINE EMERGENCY CALL SYSTEM 621990 723591 723591 PACE PROGRAM MGMT SERVICES 623990 207538 207538 PROGRAM SERVICE REVENUE 900099 14529 14529 945658 48481 48481 25994139 945658 0 48481 X 37000 37000 176805 26521 150284 958134 958134 16437 16437 225215 225215 34664 30879 3785 36180 36180 105 105 5863 5863 433629 433629 23133 23133 242967 242967 1091 1091 12799 12799 40150 40150 199473 199473 66281 66281 13440 13440 MEDICAL SUPPLIES 14802 14802 BAD DEBT EXPENSE 1831 1831 292 292 2540291 2344074 196217 0 19323 19343 400091 42182 48924 236066 305611 19400 24760 490907 97532 331829 393375 9929421 210235 11200524 859035 22322049 327197 417038 2846022 884300 3173219 1301338 X -2314184 21020711 -2314184 21020711 859035 22322049 23453848 -118953 0 X X 0 1 X 1 0 X 15123 1000 16123 624622 655851 719995 945658 2946126 639745 655851 719995 946658 2962249 0 0 0 2962249 182 2053 43088 48481 93804 182 2053 43088 48481 93804 639927 657904 763083 995139 3056053 X SCHEDULE A, PART IV, LIST OF UNUSUAL GRANTS: CASH DATE: 06/17/13 AMOUNT: 24999000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12042 10934 1108 476534 84267 392267 2331 2331 0 393375 RECEIVABLE FROM PACE IOWA 6992506 F RECEIVABLE FROM PACE NEBRASKA 4208018 F 11200524 SUBORDINATED NOTE PAYABLE TO IMMANUEL 884300 884300 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ALL AFFILIATED ENTITIES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND HAVE RECEIVED DETERMINATION LETTERS OR HAVE FILED APPLICATIONS TO RECEIVE DETERMINATION LETTERS THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT FOR IMMANUEL CORE FUND, LLC, WHICH IS A DISREGARDED ENTITY FOR TAX PURPOSES. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN IMMANUEL'S TAX EXEMPT STATUS. IMMANUEL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. IMMANUEL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2013, IMMANUEL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. WITH FEW EXCEPTIONS, IMMANUEL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR FISCAL YEARS ENDING BEFORE JUNE 30, 2010. 1 NEBRASKA SYNOD ELCA 4980 SOUTH 118TH STREET SUITE D OMAHA NE 68137 363514308 501(C)(3) 36000 SUPPORT FOR MISSION FIELD NEBRASKA AND ITS MINISTRIES. 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: IHCR ONLY MAKES GRANTS TO OTHER 501(C)(3) ORGANIZATIONS. THE CHARITABLE PURPOSE FOR WHICH THE FUNDS ARE GIVEN IS AGREED UPON PRIOR TO THE TRANSFER OF FUNDS. 0 1 0 0 0 0 0 0 0 ERIC N GURLEY 0 284080 0 68351 0 6899 0 173258 0 30734 0 563322 0 0 DAN FRIEDLUND 0 132198 0 30465 0 0 0 0 0 0 0 162663 0 0 STEVE HESS 127283 0 28711 0 0 0 9549 0 11262 0 176805 0 0 0 PART I, LINE 3 THE COMPENSATED OFFICERS ARE EMPLOYEES OF IMMANUEL, A RELATED ENTITY. THE BOARD'S EXECUTIVE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE TO REVIEW AND APPROVE THE TOTAL COMPENSATION FOR ERIC GURLEY, AND TO APPROVE THE BONUS PLAN AND PAYOUT OF BONUSES TO THE LEADERSHIP TEAM. THE COMPENSATION COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP SET SALARIES AND BENEFITS. WRITTEN EMPLOYMENT CONTRACTS ARE USED FOR ERIC GURLEY AND DAN FRIEDLUND. PART I, LINE 4B ERIC N. GURLEY - $157,473 IN PREMIUMS EXPENSED FOR FUNDING OF SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN. PART I, LINE 6 THE ORGANIZATION DOES NOT PAY OR ACCRUE ANY COMPENSATION BASED ON THE REVENUES OR THE NET EARNINGS OF THE ORGANIZATION OR ANY RELATED ORGANIZATION. HOWEVER, A SMALL PERCENTAGE (LESS THAN 10%) OF THE BONUSES PAID TO ERIC GURLEY, DAN FRIEDLUND AND ROXANNE ROGERS MEYER IS BASED ON AN OPERATING MARGIN CALCULATION OF IMMANUEL AND RELATED TAX-EXEMPT ORGANIZATIONS. A SMALL PERCENTAGE (LESS THAN 10%) OF THE BONUSES PAID TO STEVE HESS AND CHERYL MUNDT IS BASED ON AN OPERATING MARGIN CALCULATION OF IMMANUEL HOME AND COMMUNITY RESOURCES. A SMALL PERCENTAGE (LESS THAN 10%) OF THE BONUSES PAID TO TAMMY SEALER AND DEBRA WIENS IS BASED ON AN OPERATING MARGIN CALCULATION OF IMMANUEL RETIREMENT COMMUNITIES, A RELATED TAX-EXEMPT ORGANIZATION. FORM 990, PART V, LINE 2A: INDIVIDUALS PERFORMING SERVICES FOR IMMANUEL HOME AND COMMUNITY RESOURCES ARE EMPLOYEES OF IMMANUEL, A RELATED ENTITY. THEREFORE, IMMANUEL ISSUES THE FORM W-2 FOR THESE EMPLOYEES. BECAUSE IMMANUEL HOME AND COMMUNITY RESOURCES REIMBURSES IMMANUEL FOR THE SALARIES AND BENEFITS OF THESE EMPLOYEES, THE EXPENSES FOR THEIR SALARIES AND BENEFITS ARE REFLECTED ON THIS RETURN IN PART IX, STATEMENT OF FUNCTIONAL EXPENSES. FORM 990, PART VI, SECTION A, LINE 2 ERIC N. GURLEY IS THE PRESIDENT AND CEO OF IMMANUEL, A SUPPORTING ORGANIZATION OF IHCR. ALL COMPENSATED BOARD MEMBERS, OFFICERS AND OTHER EMPLOYEES ARE EMPLOYEES OF IMMANUEL. FORM 990, PART VI, SECTION A, LINE 4 IMMANUEL HOME AND COMMUNITY RESOURCES' ARTICLES OF INCORPORATION AND BYLAWS WERE AMENDED AS OF 12/18/12 TO INCLUDE THE FOLLOWING: 1. PURPOSES: THE ARTICLES ADDED THE FOLLOWING WORDING TO THE PURPOSE SECTION, "TO IDENTIFY UNMET HEALTH, RESIDENTIAL, SOCIAL, EDUCATIONAL AND SPIRITUAL NEEDS IN COMMUNITIES SERVED" AND "TO RECOGNIZE AND PROMOTE THE CORPORATION'S LUTHERAN HERITAGE." 2. BOARD OF DIRECTORS AND COMMITTEES OF IMMANUEL: THE BOARD OF DIRECTORS AND COMMITTEES OF IMMANUEL ARE AUTHORIZED TO EXERCISE ALL POWERS OF THE BOARD OF DIRECTORS OF IMMANUEL HOME AND COMMUNITY RESOURCES. 3. COMPENSATION: IMMANUEL, A RELATED ORGANIZATION, DETERMINES COMPENSATION OF EXECUTIVE EMPLOYEES OF IMMANUEL HOME AND COMMUNITY RESOURCES. 4. BOARD OF DIRECTORS: A MAJORITY OF THE BOARD OF DIRECTORS MUST ALSO BE MEMBERS OF THE CONGREGATIONS OF THE NEBRASKA SYNOD OF THE ELCA INCLUDING ONE MEMBER SHALL BE THE BISHOP OF THE NEBRASKA SYNOD OF THE ECLA, SERVING EX-OFFICIO, WITH VOTE. FORM 990, PART VI, SECTION A, LINE 6 IMMANUEL HOME AND COMMUNITY RESOURCES (IHCR) HAS ONE MEMBER, IMMANUEL. FORM 990, PART VI, SECTION A, LINE 7A IMMANUEL, IHCR'S SOLE MEMBER, HAS THE RIGHT TO APPOINT AND REMOVE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B IMMANUEL, IHCR'S SOLE MEMBER, MUST APPROVE ANY AMENDMENT AND INITIATE OR ADOPT AMENDMENTS TO THE ARTICLES OR BYLAWS OF IMMANUEL HOME AND COMMUNITY RESOURCES. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM WITH THE ASSISTANCE OF THE CONTROLLER. THE PREPARED FORM 990 IS REVIEWED BY THE CFO AND CONTROLLER. COPIES OF THE RETURN ARE PROVIDED TO THE BOARD AFTER THE CFO AND CONTROLLER HAVE REVIEWED THE RETURN. THE RETURN IS APPROVED BY THE CFO PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C IMMANUEL HOME AND COMMUNITY RESOURCES USES THE SAME POLICY AS IMMANUEL, A RELATED ORGANIZATION. THE POLICY STATES THAT THE BOARD OF DIRECTORS MUST SIGN THE CONFLICT OF INTEREST POLICY AND DISCLOSE ALL CONFLICTS. THE GOVERNANCE COMMITTEE SHALL DECIDE WHAT ACTIONS NEED TO BE TAKEN CONCERNING ANY CONFLICTS. THE BOARD MEMBER IS PROHIBITED FROM VOTING ON ANY BUSINESS RELATED TO ANY CONFLICT THE GOVERNANCE COMMITTEE HAS IDENTIFIED. FORM 990, PART VI, SECTION C, LINE 19 IMMANUEL HOME AND COMMUNITY RESOURCES DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. COMPENSATION FORM 990, PART VII: ALL COMPENSATION AND BENEFITS SHOWN FOR DIRECTORS ARE PAID BY IMMANUEL, THE SPONSOR ORGANIZATION, FOR SERVICES PERFORMED FOR IMMANUEL OR OTHER RELATED ENTITIES. THE COMPENSATION IS NOT PAID FOR SERVICES IN CONNECTION WITH THE POSITION OF DIRECTOR FOR IMMANUEL HOME AND COMMUNITY RESOURCES. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 47,064. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,064. LIFELINE MONITORING SERVICES: PROGRAM SERVICE EXPENSES 386,565. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 386,565. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OF IMMANUEL HOME AND COMMUNITY RESOURCES ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM PRIOR YEARS. FORM 990, PART VI, SECTION B, LINE 15: IMMANUEL HOME AND COMMUNITY RESOURCES DOES NOT HAVE A CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL OR ANY KEY EMPLOYEES THE ORGANIZATION DIRECTLY COMPENSATES. THE ORGANIZATION REIMBURSES IMMANUEL, A RELATED ORGANIZATION, FOR PORTIONS OF THE SALARIES OF IMMANUEL EMPLOYEES WHO PROVIDE NEEDED SERVICES. THEREFORE, IT IS NOT NECESSARY TO HAVE A PROCESS TO DETERMINE COMPENSATION FOR THESE POSITIONS. IMMANUEL 5858 WENNINGHOFF ROAD OMAHA NE 68134 470733774 CORPORATE SUPPORT NE 501(C)(3) LINE 11B, II N/A 0 IMMANUEL RETIREMENT COMMUNITIES 5858 WENNINGHOFF ROAD OMAHA NE 68134 470799108 ELDERLY HOUSING NE 501(C)(3) LINE 9 IMMANUEL 0 IMMANUEL COMMUNITY FOUNDATION 5858 WENNINGHOFF ROAD OMAHA NE 68134 470624928 FUNDRAISING NE 501(C)(3) LINE 11C, III-FI IMMANUEL - SEE STATEMENT 0 PACE IOWA 5858 WENNINGHOFF ROAD OMAHA NE 68134 273635343 ELDERLY SERVICES NE 501(C)(3) LINE 9 IMMANUEL HOME AND COMMUNITY RESOURCES 1 PACE NEBRASKA 5858 WENNINGHOFF ROAD OMAHA NE 68134 273635416 ELDERLY SERVICES NE 501(C)(3) LINE 9 IMMANUEL HOME AND COMMUNITY RESOURCES 1 IMMANUEL AFFORDABLE INC 5858 WENNINGHOFF ROAD OMAHA NE 68134 470831041 ELDERLY & LOW INCOME HOUSING NE 501(C)(3) LINE 9 IMMANUEL 0 IMMANUEL AFFORDABLE II INC 5858 WENNINGHOFF ROAD OMAHA NE 68134 800016829 ELDERLY & LOW INCOME HOUSING NE 501(C)(3) LINE 9 IMMANUEL 0 IMMANUEL TRINITY AFFORDABLE INC 5858 WENNINGHOFF ROAD OMAHA NE 68134 113742894 ELDERLY & LOW INCOME HOUSING NE 501(C)(3) LINE 9 IMMANUEL 0 IMMANUEL LONG TERM CARE 5858 WENNINGHOFF ROAD OMAHA NE 68134 462582783 LONG-TERM HEALTH CARE SERVICES NE 501(C)(3) LINE 9 IMMANUEL 0 IMMANUEL COMMUNITY VISION FOUNDATION 5858 WENNINGHOFF ROAD OMAHA NE 68134 462693844 SUPPORT COMMUNITY ORGANIZATIONS WHOSE MISSIONS ALIGN WITH IMMANUEL ENTITIES NE 501(C)(3) LINE 11B, II IMMANUEL 0 0 0 1 1 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0 PACE IOWA D 6992506 CASH TRASFERRED EQUALS FMV PACE NEBRASKA D 4208018 CASH TRASFERRED EQUALS FMV COLUMN (F), DIRECT CONTROLLING ENTITY SCHEDULE R, PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS IMMANUEL COMMUNITY FOUNDATION'S DIRECTORS ARE SELECTED BY THE BOARDS OF DIRECTORS OF THE THREE ORGANIZATIONS IT SUPPORTS; IMMANUEL RETIREMENT COMMUNITIES, IMMANUEL HOME AND COMMUNITY RESOURCES, AND IMMANUEL LONG TERM CARE. EACH OF THESE THREE ORGANIZATIONS IS CONTROLLED BY THEIR SOLE MEMBER, IMMANUEL.