2013-08-07T13:38:19-05:00 2012-12-31 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2012-01-01 390845016 LUTHERAN HOMES OF OCONOMOWOC INC LUTH 2625678341 PO BOX 208 OCONOMOWOC WI 53066 JOAN BIRR 2625678341 2013-07-25 1 JAY ADKISSON CPA P01360892 4144319300 2013-07-25 2012 2016-02-24 21:20:13Z JOAN BIRR PO BOX 208 OCONOMOWOC WI 53066 19198016 0 X WWW.LHO.ORG X 1939 WI REFLECTING CHRIST'S LOVE WE PROVIDE HOMES AND RESOURCES FOR SENIORS AS A CONTINUING CARE RETIREMENT COMMUNITY AND PROVIDER OF COMMUNITY BASED SERVICES. 13 13 413 300 109099 -29487 207406 679755 17217423 17333927 128910 153339 114494 109099 17668233 18276120 0 0 0 0 10373625 10510084 0 0 0 6144788 6100805 16518413 16610889 1149820 1665231 42607069 42664989 18955838 17244567 23651231 25420422 X REFLECTING CHRIST'S LOVE WE PROVIDE HOMES AND RESOURCES FOR SENIORS AS A CONTINUING CARE RETIREMENT COMMUNITY AND PROVIDER OF COMMUNITY BASED SERVICES. 0 0 10507754 12187065 NURSING HOME CARE: OPERATION OF A SKILLED NURSING FACILITY AND REHABILITATION CENTER. PROVIDED 40,802 DAYS OF SKILLED NURSING SERVICES AND REHABILITATION. MAJORITY OF MEDICARE CLIENTS REHAB AND RETURN HOME TO THE COMMUNITY. 2054052 2803202 PROVIDE ASSISTED LIVING HOUSING AND SERVICES TO INDIVIDUALS ON AN A LA CARTE BASIS IN ORDER TO PRESERVE INDEPENDENCE AND CONSERVE THE RESIDENTS ASSETS. 1180069 1541135 PROVIDE INDEPENDENT LIVING ACCOMMODATIONS FOR SENIORS THROUGH 94 UNITS ACROSS A FULL RANGE OF APARTMENT SIZES AND COSTS. 855282 802525 PROVIDE COMMUNITY OUTREACH PROGRAMS THROUGH OUR LIFE ENRICHMENT CENTER.PROVIDE IN HOME ASSISTANCE FOR CLIENTS WHO WISH TO REMAIN IN THEIR HOMES. PROVIDE HOUSING AND SERVICES TO INDIVIDUALS WITHIN A CBRF LICENSE FOR MEMORY IMPAIRED. 855282 802525 14597157 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 71 0 1 413 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X JOAN BIRR 2625606969 1305 W WISCONSIN AVE OCONOMOWOC WI 53066 RONALD SOWINSKI 2.00 2.00 X X 0 0 0 THOMAS LANGER 2.00 2.00 X X 0 0 0 BARBARA HIRSCH 2.00 2.00 X X 0 0 0 SHARON MANKE 2.00 2.00 X X 0 0 0 W DAVID PERRY 2.00 2.00 X X 0 0 0 WILLIAM LAMM 2.00 2.00 X 0 0 0 ISOLA MILLETT 2.00 2.00 X 0 0 0 GREG JAMES 2.00 2.00 X 0 0 0 MARY JO O'MALLEY 2.00 2.00 X 0 0 0 PATRICIA PORTER 2.00 2.00 X 0 0 0 ATTY JEFF EK 2.00 2.00 X 0 0 0 MALCOM DORN 2.00 2.00 X 0 0 0 TIM THIELE 40.00 X 187230 0 20507 JOAN BIRR 40.00 X 131830 0 20507 LORNA GARTZKE 40.00 X 135683 0 20507 DALE DAHLKE 40.00 X 101810 0 20507 556553 0 82028 4 0 1 0 HEALTHREACH REHAB 17280 NORTH AVE BROOKFIELD WI 53045 REHAB SERVICES 690427 REOSCHEN'S OMNICARE PHARMACY 5185 S 9TH ST MILWAUKEE WI 53221 PHARMACY SERVICES 247616 BAND BOX PO BOX 299 TOMAH WI 54660 LAUNDRY SERVICES 177366 3 679755 679755 SKILLED NURSING FACILI 623000 12708755 12708755 ASSISTED LIVING FACILITY 623000 2803036 2803036 INDEPENDENT APTS 623000 1541301 1541301 ADULT DAY CENTER 623000 167287 167287 LIFE ENRICHMENT CENTER 623000 77812 77812 35736 35736 17333927 92371 92371 982514 350 921896 0 60618 350 60968 60968 CAFE REVENUE 900099 109099 109099 109099 18276120 17333927 109099 153339 454743 454743 7763182 6844282 918900 262270 262270 1439829 1439829 590060 590060 33314 33314 12088 12088 31577 31577 45204 504 44700 632002 482197 149805 34125 34125 568338 538376 29962 1431 1431 437819 437819 1690827 1690827 109878 109878 MEDICAL EXPENSES 944237 944237 FOOD 520843 520843 STATE BED TAX 244800 244800 CAFE EXPENSE 138586 138586 655736 462527 193209 16610889 14597157 2013732 0 5329071 5864523 1039 0 701298 676339 101028 70594 49568378 17287880 32950418 32280498 3440904 3709804 83311 63231 42607069 42664989 1295240 1383386 10744000 8800000 6916598 7061181 18955838 17244567 X 23650192 25420422 1039 0 23651231 25420422 42607069 42664989 X 1665231 143893 -39933 X 0 1 X 1 0 X 204909 268893 199452 207406 679755 1560415 17350395 16955398 17356715 17238003 17333927 86234438 17555304 17224291 17556167 17445409 18013682 87794853 0 0 0 87794853 295734 124751 104464 137666 92371 754986 295734 124751 104464 137666 92371 754986 17851038 17349042 17660631 17583075 18106053 88549839 0.99150 0.98580 0.00850 0.01420 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3463142 3463142 38133861 13613216 24520645 6303021 3674664 2628357 1668354 1668354 32280498 REFUNDABLE ENTRANCE FEES 5631074 FAIR MARKET VALUE - SWAP 1161463 MISC PAYABLES 40644 RESERVATION FEES 228000 7061181 X 18485628 209508 209508 18276120 0 18276120 16618595 7706 7706 16610889 0 16610889 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION AND THE FOUNDATION ARE TAX-EXEMPT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOME AND FOUNDATION ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT, UNRELATED BUSINESS INCOME IN ACCORDANCE WITH CODE REGULATIONS. ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THE ORGANIZATION HAS ANY MATERIAL UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2012 AND 2011. FEDERAL TAX RETURNS FOR TAX YEARS 2009 AND BEYOND, REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION REVENUE 209,508. PART XII, LINE 2D - OTHER ADJUSTMENTS: FOUNDATION EXPENSES 7,706. X X 0 0 0 0 0 0 0 0 0 TIM THIELE 187230 0 0 0 0 0 0 0 20507 0 207737 0 0 0 JOAN BIRR 131830 0 0 0 0 0 0 0 20507 0 152337 0 0 0 LORNA GARTZKE 135683 0 0 0 0 0 0 0 20507 0 156190 0 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2004-08-01 12000000 BUILD A 150 BED SNF 0 0 0 A 3200000 12000000 12000000 2005 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 1 1 US BANK 10.000000000000 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 4 ESTABLISHMENT OF EXECUTIVE COMMITTEE AS FOLLOWS: THE EXECUTIVE COMMITTEE (EC) OF THE BOARD WILL CONSIST OF ALL THE OFFICERS, I.E., PRESIDENT, VICE PRESIDENT, SECRETARY, TREASURER, AND PAST PRESIDENT. THE PRESIDENT OF THE BOARD SHALL SERVE AS CHAIR OF THE EC. WHEN APPROPRIATE, THE EXECUTIVE DIRECTOR (ED) SHALL SIT WITH THE EXECUTIVE COMMITTEE AS A NON-VOTING MEMBER. THE CHAIR OF THE EC IS NORMALLY RESPONSIBLE FOR CALLING ALL MEETINGS OF THE COMMITTEE. THE DUTIES OF THIS COMMITTEE SHALL BE AS FOLLOWS: A) CONDUCT THE BUSINESS OF THE BOARD IN URGENT CIRCUMSTANCES WHEN THE BOARD IS NOT IN SESSION. THE BOARD AT ITS NEXT MEETING MUST RATIFY ANY SUCH ACTION. B) INTERVIEW AND RECOMMEND A COMPETENT AND EXPERIENCED EXECUTIVE DIRECTOR/CEO WHO SHALL BE ITS DIRECT AND EXECUTIVE REPRESENTATIVE IN THE MANAGEMENT OF THE CORPORATION. THE CEO SHALL BE GIVEN THE NECESSARY AUTHORITY AND BE HELD RESPONSIBLE FOR THE ADMINISTRATION OF THE CORPORATION AND ALL ITS ACTIVITIES AND DEPARTMENTS, SUBJECT ONLY TO THE POWERS RESERVED TO THE CORPORATE MEMBERS OR TO THE BOARD OF DIRECTORS. THE CEO SHALL HAVE AUTHORITY TO SIGN, EXECUTE AND ACKNOWLEDGE, ON BEHALF OF THE CORPORATION, ALL DEEDS, MORTGAGES BONDS, CONTRACTS, LEASES, REPORTS AND ALL OTHER DOCUMENTS OR INSTRUMENTS NECESSARY OR PROPER TO BE EXECUTED IN THE COURSE OF THE CORPORATION'S ORDINARY BUSINESS, OR WHICH SHALL BE AUTHORIZED BY RESOLUTION OF THE BOARD OF DIRECTORS. THE EXECUTIVE DIRECTOR/CEO SHALL BE RESPONSIBLE TO THE PRESIDENT AND THE BOARD OF DIRECTORS OF THE CORPORATION. C) PERFORM AN ANNUAL EVALUATION OF THE PERFORMANCE OF THE ED AND REPORT TO THE BOARD THAT THIS HAS OCCURRED. THE EC SHALL ALSO SET THE COMPENSATION AND BENEFITS OF THE ED. D) ANNUALLY EVALUATE THE PERFORMANCE AND ATTENDANCE OF THE BOARD OF DIRECTORS AND REPORT IT TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE NOT LESS THAN 50, NOR MORE THAN 150 MEMBERS, ELECTED BY THE MEMBERS OF THE CORPORATION OR BY THE BOARD OF DIRECTORS. AT LEAST TWO-THIRDS OF THIS MEMBERSHIP SHALL BE OF THE LUTHERAN FAITH WITH THE BALANCE TO BE ELECTED FROM THE COMMUNITY AT LARGE. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBERS SHALL DETERMINE AT THE ANNUAL MEETING, BY A MAJORITY VOTE, THE NUMBER OF DIRECTORS TO BE ELECTED TO THE BOARD OF DIRECTORS AND SHALL THEN ELECT THE NUMBER NECESSARY. FORM 990, PART VI, SECTION A, LINE 7B EACH MEMBER MAY HAVE ONE VOTE AT MEETINGS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR REVIEWS THE 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C LUTHERAN HOMES OF OCONOMOWOC REQUESTS THAT ALL MEMBERS OF THE BOARD OF DIRECTORS, CORPORATE MEMBERS, AND CORPORATE STAFF COMPLETE THE "ANNUAL STATEMENT OF CONFLICT". THIS IS REQUESTED IN THE FALL OF EACH YEAR. IN THIS STATEMENT, ACKNOWLEDGEMENT OF ANY POTENTIAL CONFLICT IS TO BE IDENTIFIED. IN ADDITION, AS AN AGENDA ITEM ON ALL BOARD AND COMMITTEE MEETINGS IS ACKNOWLEDGEMENT OF ANY POTENTIAL CONFLICT OF INTEREST. DURING DISCUSSION OF THE AGENDA ITEM WHEREIN THERE IS A CONFLICT BY ONE OR MORE OF THE MEMBERS, THE BODY SHALL BEFORE HAND DECIDE AT WHAT LEVEL OF PRESENCE, DISCUSSION, AND DECISION MAKING THE MEMBER SHALL BE ALLOWED TO PARTICIPATE. FINALLY, REGULAR RECORDS ARE MAINTAINED OF ALL INSTANCES OF CONFLICT AND REVIEWED ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE EXECUTIVE DIRECTOR'S PERFORMANCE AND COMPARES COMPENSATION LEVEL WITH COMPENSATION OF SIMILAR ORGANIZATIONS OF SIMILAR SIZE. THE EXECUTIVE DIRECTOR EVALUATES THE PERFORMANCE OF KEY EMPLOYEES IN THE SAME MANNER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: FAIR MARKET VALUE OF SWAP -39,933. LUTHERAN HOMES OF OCONOMOWOC CHARITABLE FOUNDATION PO BOX 208 OCONOMOWOC WI 53066 391889721 SUPPORT LHO WI 501(C)(3) LINE 11A, I LUTHERAN HOMES OF OCONOMOWOC INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0