2013-10-10T22:55:58-05:00 2012-12-31 951720829 MARTIN WERBELOW LLP 300 N LAKE AVE SUITE 930 PASADENA CA 911014106 990 2012-01-01 951643384 SOLHEIM LUTHERAN HOME SOLH 3232577518 2236 MERTON AVE LOS ANGELES CA 90041 JAMES GRAUNKE 3232577518 2013-09-25 1 MICHAEL TAO P00967606 6265771440 2012 2016-03-07 17:11:31Z JAMES GRAUNKE 2236 MERTON AVENUE LOS ANGELES CA 90041 13601923 0 9386 X SOLHEIMLUTHERAN.ORG X 1954 CA PROVIDE A HOME, HEALTH CARE, AND SECURITY FOR THE OLDER ADULTS WHO HAVE CHOSEN SOLHEIM AS THEIR HOME. 15 15 214 179 0 0 203437 315374 11016018 11776706 143755 186681 -63437 -38699 11299773 12240062 0 0 0 0 7848268 7838685 0 0 144692 3196501 3607378 11044769 11446063 255004 793999 11659909 11861809 7151126 6550249 4508783 5311560 X THE MINISTRY OF SOLHEIM LUTHERAN HOME IS TO PROVIDE ABUNDANT LIFE FOR OLDER ADULTS IN A CARING FAITH BASED COMMUNITY FILLED WITH LOVE, PEACE, DIGNITY, AND SECURITY. 0 0 9678651 11776706 SOLHEIM LUTHERAN HOME PROVIDES RESIDENTIAL, ASSISTED LIVING, MEMORY CARE AND SKILLED NURSING CARE FOR OLDER ADULTS OF ALL FAITHS. FOR AN EXPANDED DESCRIPTION OF SOLHEIM LUTHERAN HOME'S SERVICES AND ACTIVITIES, PLEASE SEE SCHEDULE O. 9678651 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 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 1 32 0 1 214 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X ANTONIO DAVILA 3232577518 2236 MERTON AVENUE LOS ANGELES CA 90041 AUDREY BAHR 3.00 X 0 0 0 ANNETTE BRENDE RN MBA 2.00 X 0 0 0 RETA FLOYD MD 0.50 X 0 0 0 ADAM D SISSON CPA 2.00 X 0 0 0 DR JILL M BRINK 1.00 X 0 0 0 SUE CLAUSS 3.00 X 0 0 0 PAUL EGGE 1.00 X 0 0 0 ANNMARIE FLAHERTY CPA 2.00 X 0 0 0 TRACY KING 1.00 X 0 0 0 WILLIAM L KRANTZ 1.00 X 0 0 0 KENNETH MARTIN 1.00 X 0 0 0 JOEL F MILLER 1.00 X 0 0 0 REV KATHLEEN RICHTER 1.00 X 0 0 0 MASA SUZUKI 1.00 X 0 0 0 JAMES TRANQUADA 3.00 X 0 0 0 JAMES W GRAUNKE 50.00 X 59711 0 2510 ANTONIO DAVILA 40.00 X 101060 0 6240 SHERRY WAIT 40.00 X 102827 0 7780 NORMA HEATON 50.00 X 81607 0 3912 345205 0 20442 2 0 0 0 REGENCY THERAPY SERVICES 2275 HUNTINGTON DRIVE SAN MARINO CA 91108 REHABILITATION SERVICES 215702 1 315374 315374 RESIDENT SERVICE FEES 623000 9833017 9833017 MEDICARE/MEDICAL 623000 1943689 1943689 11776706 107564 107564 23140 61839 -38699 -38699 -38699 1377839 1300 1300022 0 77817 1300 79117 79117 12240062 11776706 0 147982 255040 84012 171028 5194621 4525011 598585 71025 454678 411995 39826 2857 1456937 1332830 124107 477409 401770 70206 5433 61559 61559 53043 53043 16094 16094 73044 40263 32781 78644 54460 24184 487064 408420 68185 10459 74978 74848 130 566214 540543 25671 23072 13380 7067 2625 173 173 114829 114829 603454 577533 25921 245382 232429 12953 ANCILLARY EXPENSES 557426 557426 FOOD SERVICES 393114 393114 OTHER EXPENSES 204693 45096 156787 2810 PURCHASED SERVICES 54595 29599 24996 11446063 9678651 1622720 144692 149840 240005 139725 759344 590513 708259 149927 133531 16219052 9984491 6488370 6234561 3684542 2789221 515012 456992 481876 11659909 11861809 669365 717397 2500130 2385562 3255000 2755000 726631 692290 7151126 6550249 X 4492165 5300599 8621 2364 7997 8597 4508783 5311560 11659909 11861809 793999 8778 0 X X 0 1 X 1 0 X 534626 136132 192676 203437 315374 1382245 9357223 9076468 11179046 11016018 11776706 52405461 9891849 9212600 11371722 11219455 12092080 53787706 0 49882 49882 49882 49882 53737824 118268 120713 201461 179604 209221 829267 118268 120713 201461 179604 209221 829267 10010117 9333313 11573183 11399059 12301301 54616973 0.98390 0.98590 0.01520 0.01410 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 494542 999 25279 520820 449166 20067 25309 494542 394150 7500 47516 449166 300760 500 92890 394150 427642 -126882 300760 0.98350 0.01650 0 0 1754892 1754892 11503253 7540222 3963031 2960907 2444269 516638 6234561 X 12075945 8778 8778 12067167 172895 172895 12240062 11446063 0 11446063 0 11446063 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: IN 2002, THE BOARD OF DIRECTORS COMBINED THE PREVIOUSLY DESIGNATED CHARITY CARE RESERVE WITH THE ENDOWMENT FUND TO CREATE THE BOARD DESIGNATED FUND FOR BENEVOLENT ENDOWMENT. THIS FUND WAS DESIGNATED BY THE BOARD OF DIRECTORS FOR THE PURPOSE OF SUPPORTING CHARITABLE CARE TO RESIDENTS. AS REQUIRED BY U.S. GAAP, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. SOLHEIM ALSO HAS A DONOR RESTRICTED ENDOWMENT FUND, WHICH IS CLASSIFIED AS PERMANENTLY RESTRICTED. THE DONOR REQUIRES THE HISTORICAL DOLLAR AMOUNT OF A DONOR RESTRICTED ENDOWMENT FUND TO BE PRESERVED. IN THE ABSENCE OF DONOR RESTRICTIONS, THE NET APPRECIATION ON THIS DONOR RESTRICTED ENDOWMENT FUND IS SPENDABLE. THE RESTRICTION STIPULATES THAT FUNDS ARE TO BE USED FOR NURSES' EDUCATION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: SOLHEIM CONSIDERS MANY FACTORS WHEN EVALUATING AND ESTIMATING ITS TAX POSITIONS AND TAX BENEFITS, WHICH MAY REQUIRE PERIODIC ADJUSTMENTS AND WHICH MAY NOT ACCURATELY ANTICIPATE ACTUAL OUTCOMES. SOLHEIM EVALUATES ITS UNCERTAIN TAX POSITIONS USING THE PROVISIONS IN CONFORMITY WITH U.S. GAAP. THESE STANDARDS REQUIRE MANAGEMENT TO PERFORM AN EVALUATION OF ALL INCOME TAX POSITIONS TAKEN, OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING SOLHEIM'S INCOME TAX RETURNS. MANAGEMENT BELIEVES THE INCOME TAX POSITIONS TAKEN MORE LIKELY THAN NOT WILL BE SUSTAINED UNDER EXAMINATION BY THE APPLICABLE TAX AUTHORITIES. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF SOLHEIM AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME. SINCE TAX MATTERS ARE SUBJECT TO SOME DEGREE OF UNCERTAINTY, THERE CAN BE NO ASSURANCE THAT SOLHEIM'S TAX RETURNS WILL NOT BE CHALLENGED BY THE TAXING AUTHORITIES AND THAT SOLHEIM WILL NOT BE SUBJECT TO ADDITIONAL TAX, PENALTIES, AND INTEREST AS A RESULT OF SUCH CHALLENGE. GENERALLY, SOLHEIM'S TAX RETURNS REMAIN OPEN FOR THREE YEARS FOR FEDERAL INCOME TAX EXAMINATION AND FOUR YEARS FOR STATE INCOME TAX EXAMINATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: BEQUEST FROM JOHN R. MANKEN TRUST A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY (CHFFA) 946001347 13033FUY4 2004-12-02 6415000 TO REFUND 1994 CERTIFICATES OF PARTICIPATION 0 0 0 A 9230000 6415000 617573 5960796 128300 2005 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4A SOLHEIM LUTHERAN HOME IS A SINGLE SITE NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY IN THE EAGLE ROCK NEIGHBORHOOD OF THE CITY OF LOS ANGELES, CALIFORNIA. FOUNDED 90 YEARS AGO, SOLHEIM PROVIDES 24-HOUR HIGH QUALITY RESIDENTIAL AND ASSISTED LIVING SERVICES, MEMORY CARE AND SKILLED NURSING CARE TO OLDER ADULTS OF ALL FAITHS. WE OFFER OUR RESIDENTS A FULL, VIBRANT SENIOR LIVING EXPERIENCE. WE PLACE SPECIAL EMPHASIS ON WELLNESS ACTIVITIES AND COMMUNITY ACCESS FOR OUR RESIDENTS. WE HAVE A WELLNESS CENTER AND FULL-TIME WELLNESS COORDINATOR SO THAT OUR RESIDENTS ARE ABLE TO STAY PHYSICALLY AND MENTALLY HEALTHY. IN 2012 SOLHEIM OPENED A REHABILITATION CENTER TO PROVIDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AND MORE TO ENABLE OLDER ADULTS TO REGAIN MOBILITY AND CONTROL OF THEIR LIVES IN A SAFE AN SUPPORTIVE ENVIRONMENT. TWO WHEELCHAIR ACCESSIBLE VANS AND A 30 PASSENGER WHEELCHAIR ACCESSIBLE BUS ENABLE RESIDENTS TO GO ON OUTINGS REGARDLESS OF THEIR MOBILITY. SOLHEIM PROVIDED SERVICES FOR AN AVERAGE POPULATION OF 161 RESIDENTS IN 2012. WITH DEDICATED STAFF THAT HAS AN AVERAGE LENGTH OF EMPLOYMENT GREATER THAN NINE YEARS, SOLHEIM ASPIRES TO PARTNER WITH EACH RESIDENT AND HIS/HER FAMILY TO PROVIDE INDIVIDUALIZED SERVICE AND A TRUE FEELING OF COMMUNITY. DUE TO THE EXISTENCE OF THE BOARD DESIGNATED BENEVOLENT FUND AND CONTRIBUTIONS RECEIVED, SOLHEIM WAS ABLE TO PROVIDE $162,725 WORTH OF UNCOMPENSATED CARE TO RESIDENTS WHO WERE UNABLE TO PAY STANDARD FEES. SOLHEIM IS A TEACHING SITE FOR HEALTH CARE STUDENTS WHO SPENT OVER 2,800 CLINICAL HOURS ON THE PREMISES IN 2012. THE STUDENTS ARE GUIDED BY SOLHEIM'S RESIDENTS AND STAFF TO LEARN THE BEST APPROACHES TO WORKING WITH A SENIOR POPULATION. OUR THRIVING VOLUNTEER PROGRAM ATTRACTS STUDENTS, FAMILY MEMBERS, COMMUNITY MEMBERS AND CONGREGATION MEMBERS WHO ADD TO THE QUALITY OF LIFE. SOLHEIM IS THE FISCAL AGENT FOR LUTHERAN HEALTH MINISTRIES OF THE FOOTHILLS, A LOCAL NOT-FOR-PROFIT ORGANIZATION, TO PROVIDE PARISH NURSE AND PASTORAL VISITATION SERVICES, ALONG WITH HEALTH PROMOTION ACTIVITIES, TO THE SURROUNDING COMMUNITIES. SOLHEIM WELCOMES COMMUNITY GROUPS ON CAMPUS, INCLUDING THE EAGLE ROCK CHAMBER OF COMMERCE AND CHURCH FELLOWSHIP GROUPS. SOLHEIM ALSO SERVES AS A POLLING PLACE FOR VARIOUS ELECTIONS. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION CONSIST OF EACH CURRENTLY FUNCTIONING CONGREGATION OF THE SOUTHWEST CALIFORNIA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA "ELCA" THAT ELECTS TO BE CONSIDERED A CONSTITUENT CONGREGATION OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A EACH MEMBER CONGREGATION IS INVITED ANNUALLY TO SELECT TWO PERSONS AS VOTING DELEGATES TO THE ANNUAL MEETING OF THE MEMBERS. THE DELEGATES AT THE ANNUAL MEETING SELECT THE DIRECTORS OF THE BOARD, EXCEPT FOR THE POSITION HELD BY THE BISHOP OF THE SOUTHWEST CALIFORNIA SYNOD OF THE ELCA OR HIS/HER DESIGNEE. THE MEMBERS ALSO HAVE THE RIGHT TO REMOVE A DIRECTOR OF THE BOARD WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B IF A BOARD VACANCY HAS BEEN FILLED BY THE BOARD DURING THE YEAR THEN THAT DECISION MUST BE RATIFIED BY THE MEMBERS AT THE NEXT ANNUAL MEETING OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE REVIEW OF THE ENTIRE FORM 990 PRIOR TO ITS FILING WAS PERFORMED BY THE EXECUTIVE DIRECTOR, THE CHIEF FINANCIAL OFFICER, AND THE MEMBERS OF THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE GOVERNING BODY ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. NEW BOARD MEMBERS SIGN THIS STATEMENT IN THE MONTH OF THEIR ELECTION OR APPOINTMENT. IF A CONFLICT ARISES FROM A NEW ACTIVITY OR OTHER INTEREST, THE BOARD MEMBER SHALL PROMPTLY DISCLOSE THE SAME IN WRITING TO THE PRESIDENT OF THE BOARD. ANY BOARD MEMBER WHO HAS A CONFLICT OF INTEREST WILL REFRAIN FROM VOTING ON ISSUES RELATED TO THAT INTEREST. THE PRESIDENT OF THE BOARD AND EXECUTIVE DIRECTOR ARE RESPONSIBLE FOR MONITORING THE CONFLICT OF INTEREST POLICY. ALL EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT AS PART OF THE EMPLOYEE HANDBOOK UPON HIRE. SOLHEIM MAINTAINS A WRITTEN FORMAL POLICY FOR DOCUMENT RETENTION AND DESTRUCTION AS WELL. FORM 990, PART VI, SECTION B, LINE 15 MEMBERS OF THE EXECUTIVE COMMITTEE OF THE BOARD ARE RESPONSIBLE FOR REVIEWING AND APPROVING THE COMPENSATION OF THE EXECUTIVE DIRECTOR BASED ON AN ANNUAL WRITTEN EVALUATION AND COMPENSATION TABLES PUBLISHED BY AGING SERVICES OF CALIFORNIA AND LEADING AGE (FORMERLY AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (AAHSA)). BOTH ENTITIES CONDUCT SALARY SURVEYS ANNUALLY WHICH ARE SPECIFIC TO NOT-FOR-PROFIT RETIREMENT COMMUNITIES AND REPORTED BY GEOGRAPHIC REGION AND COMPARABLE POSITION. THE EXECUTIVE DIRECTOR REVIEWS THE APPROPRIATENESS OF THE COMPENSATION OF THE CHIEF FINANCIAL OFFICER USING THE SAME SALARY SURVEYS. THESE SALARY SURVEYS ARE ALSO USED TO DETERMINE THE APPROPRIATENESS OF WAGES AND SALARIES PAID. THE POLICIES AND PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS A DETAILED SALARY SCHEDULE FOR ALL POSITIONS AS PART OF THE ANNUAL BUDGET PROCESS. FORM 990, PART VI, SECTION C, LINE 19 SOLHEIM MAKES THE FOLLOWING DOCUMENTS AVAILABLE TO THE PUBLIC BY PROVIDING COPIES UPON REQUEST OR MAKING THEM AVAILABLE FOR INSPECTION AT THE CORPORATE OFFICE; IRS FORM 990, AUDITED FINANCIAL STATEMENTS, ANNUAL REPORT, IRS TAX EXEMPTION DETERMINATION LETTER, AND CONFLICT OF INTEREST POLICY. THE IRS FORM 990 IS ALSO AVAILABLE AT WWW.GUIDESTAR.ORG. AUDITED FINANCIAL STATEMENTS ARE AN ATTACHMENT TO EACH NEW CONTINUING CARE CONTRACT. SUMMARIZED FINANCIAL STATEMENTS ARE PRESENTED TO THE RESIDENTS OF SOLHEIM ON A QUARTERLY BASIS DURING A TOWN MEETING, ARE INCLUDED IN THE ANNUAL REPORT, AND ARE PUBLISHED ANNUALLY IN THE SOUTHWEST CALIFORNIA SYNOD ELCA, BULLETIN OF REPORTS. FORM 990 PART XII LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBLITY FOR THE OVERSIGHT OF THE AUDIT AND FOR THE SELECTION OF AN INDEPENDENT ACCOUNTING FIRM. THERE ARE NO CHANGES TO THESE PROCESSES FROM THE PRIOR YEAR.