GABRIELS VILLA INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
GABRIELS VILLA INC (EIN 39-1857036)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-10-30
IRS object ID
201303039349301265
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-10-30T14:52:47-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391857036EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GABRIEL'S VILLA INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGABRNameControl
Phone9202354653Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54902ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHERESA M BERTRAMName
TitlePRESIDENT & CEOTitle
Phone9202325228Phone
Date Signed2013-10-23DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCORY RUTLEDGEName
PTINP01329381PTIN
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHERESA M BERTRAMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54902ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1791753GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number9386GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.LUTHERANHOMES.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionPROVIDE ASSISTED LIVING TO AGING PERSONS.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees43TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year10273ContributionsGrantsPriorYear
Contributions Grants Current Year1037ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1670852ProgramServiceRevenuePriorYear
Program Service Revenue CY1647989ProgramServiceRevenueCY
Investment Income Prior Year6410InvestmentIncomePriorYear
Investment Income Current Year137815InvestmentIncomeCurrentYear
Other Revenue Prior Year5458OtherRevenuePriorYear
Other Revenue Current Year4912OtherRevenueCurrentYear
Total Revenue Prior Year1692993TotalRevenuePriorYear
Total Revenue Current Year1791753TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year952611SalariesEtcPriorYear
Salaries Etc Current Year949355SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year592519OtherExpensePriorYear
Other Expenses Current Year533771OtherExpensesCurrentYear
Total Expenses Prior Year1545130TotalExpensesPriorYear
Total Expenses Current Year1483126TotalExpensesCurrentYear
Revenues Less Expenses Prior Year147863RevenuesLessExpensesPriorYear
Revenues Less Expenses CY308627RevenuesLessExpensesCY
Total Assets BOY2546980TotalAssetsBOY
Total Assets EOY2657444TotalAssetsEOY
Total Liabilities BOY1388928TotalLiabilitiesBOY
Total Liabilities EOY1190765TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1158052NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1466679NetAssetsOrFundBalancesEOY
Mission DescriptionGABRIEL'S VILLA IS PART OF A FAMILY OF HEALTHCARE AND RESIDENTIAL SERVICE ORGANIZATIONS COMMITTED TO PROVIDING QUALITY CARE AND LIFE ENRICHING OPPORTUNITIES TO THE AGING AND THOSE IN NEED IN A CARING, CHRISTIAN ENVIRONMENT.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1060603Expense
Grants0Grants
Revenue1647989Revenue
DescriptionGABRIEL'S VILLA, INC. PROVIDES SUPERVISED CARE TO AGING PERSONS IN OSHKOSH, WI. THE ENTITY HAS 40 ASSISTED LIVING UNITS AT ITS FACILITY.Description
Total Program Service Expense1060603TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees43NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Other Explain In Sch OXOtherExplainInSchO

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KIM MAKIBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9202325238TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1225 NORTH EAGLE STREETAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54902ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
LOIS JAENKE
CHAIR0.201.40XX000
JIM STAPEL
VICE CHAIR0.201.40XX000
DR JAN EDELSTEIN
SECRETARY0.201.40XX000
KAREN FREDRICK
BOARD MEMBER0.201.40X000
MARK BEECHER
BOARD MEMBER0.201.40X000
KATHLEEN BELLAIRE
BOARD MEMBER0.201.40X000
THOMAS DUNHAM
BOARD MEMBER0.201.40X000
WAYNE MUELLER
BOARD MEMBER0.201.40X000
DR ROGER HEROLD
BOARD MEMBER0.201.40X000
REV RICK HOPKINS
BOARD MEMBER0.201.40X000
REV KAREN JEWEL
BOARD MEMBER0.201.40X000
GEORGE KONTOS
BOARD MEMBER0.201.40X000
JANE KUHN
BOARD MEMBER0.201.40X000
DR SUZANNE MARNOCHA
BOARD MEMBER0.201.40X000
REVEREND KEMP JONES
SECRETARY (FORMER)0.201.40XX000
DR RICHARD AMES
BOARD MEMBER (FORMER)0.201.40X000
STEVE LAUTENSCHLAGER
BOARD MEMBER (FORMER)0.201.40X000
JULIE VANDENBERG
CORPORATE SECRETARY4.5036.00X0676799147
CRAIG UBBELOHDE
PRESIDENT & CEO THRU FEB 20124.5036.00X0806017554
RICHARD KERN
CFO THRU MARCH 20124.5036.00X0531684307
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs201448TotalReportableCompFrmRltdOrgs
Total Other Compensation21008TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1B KOTTKE CONSTRUCTION LLCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1581 4TH STREETAddressLine1
CityFOND DU LACCity
StateWIState
ZIP Code54935ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesCONSTRUCTION SERVICESDescriptionOfServices
Compensation131954Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations1037RelatedOrganizations
Total Contributions1037TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
TENANT REVENUE53111014860221486022
SERVICE REVENUE621610161967161967
FieldValueIRS element (for citing)
Total Program Service Revenue1647989TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5861TotalRevenueColumn
Exclusion$5,861ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other131954Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other131954Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column131954TotalRevenueColumn
Exclusion$131,954ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
BEAUTY SHOP REVENUE9000991681$1,681
ASSESSMENT REVENUE9000991200$1,200
MEAL REVENUE900099730$730

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1301TotalRevenueColumn
Exclusion$1,301ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4912TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1791753TotalRevenueColumn
Related Or Exempt Function Income1647989RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$142,727ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total814701Total
Program Services650085ProgramServices
Management And General164616ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total23661Total
Program Services18880ProgramServices
Management And General4781ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total60344Total
Program Services48151ProgramServices
Management And General12193ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total50649Total
Program Services40415ProgramServices
Management And General10234ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total18696Total
Management And General18696ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total895Total
Management And General895ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total14393Total
Management And General14393ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total16489Total
Program Services11229ProgramServices
Management And General5260ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total10950Total
Management And General10950ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total110735Total
Program Services88601ProgramServices
Management And General22134ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1474Total
Management And General1474ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total105426Total
Program Services104894ProgramServices
Management And General532ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total3386Total
Program Services261ProgramServices
Management And General3125ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total63575Total
Program Services63575ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total153240Total
Management And General153240ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total30660Total
Program Services30660ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
FINES AND PENALTIES24002400
MICELLANEOUS EXPENSES10591059
MAINTENANCE SUPPLIES393393

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1483126Total
Program Services1060603ProgramServices
Management And General422523ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY330132BOY
EOY142930EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY535336BOY
EOY539191EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY32272BOY
EOY37255EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY52BOY
EOY7853EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3940181LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2265812LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1607007BOY
EOY1674369EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY4000BOY
EOY4000EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY33838BOY
EOY27867EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4343BOY
EOY223979EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2546980BOY
EOY2657444EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY116303BOY
EOY98473EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY103826BOY
EOY107356EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY1156726BOY
EOY982100EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY12073BOY
EOY2836EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1388928BOY
EOY1190765EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1154052BOY
EOY1462679EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4000BOY
EOY4000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1158052BOY
EOY1466679EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2546980BOY
EOY2657444EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses308627ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1418CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7996CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11232CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10273CurrentTaxYearMinus1Year
Current Tax Year1037CurrentTaxYear
Total31956Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1536402CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1572964CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1632361CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1670852CurrentTaxYearMinus1Year
Current Tax Year1647989CurrentTaxYear
Total8060568Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1537820CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1580960CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1643593CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1681125CurrentTaxYearMinus1Year
Current Tax Year1649026CurrentTaxYear
Total8092524Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years906895CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years935587CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years986311CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1010585CurrentTaxYearMinus1Year
Current Tax Year983965CurrentTaxYear
Total4823343Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years906895CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years935587CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years986311CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1010585CurrentTaxYearMinus1Year
Current Tax Year983965CurrentTaxYear
Total4823343Total
FieldValueIRS element (for citing)
Public Support Total5093269181PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22052CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8194CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8057CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6410CurrentTaxYearMinus1Year
Current Tax Year5861CurrentTaxYear
Total50574Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22052CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8194CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8057CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6410CurrentTaxYearMinus1Year
Current Tax Year5861CurrentTaxYear
Total50574Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13896CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4289CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4888CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5458CurrentTaxYearMinus1Year
Current Tax Year4912CurrentTaxYear
Total33443Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1573768CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1593443CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1656538CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1692993CurrentTaxYearMinus1Year
Current Tax Year1659799CurrentTaxYear
Total8176541Total
FieldValueIRS element (for citing)
Public Support Percentage5090.39980PublicSupportPercentage509
Prior Year Support Percentage0.39970PriorYearSupportPercentage
Investment Income Percentage0.00620InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00990PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: ALA CARTE SERVICES BEAUTY SHOP REVENUE ASSESSMENT FEES LAUNDRY COIN MISCELLANEOUS INCOMEGeneralExplanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FS0IncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis83333OtherCostOrOtherBasis
Book Value83333BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2944504OtherCostOrOtherBasis
Depreciation1645773Depreciation
Book Value1298731BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis69351OtherCostOrOtherBasis
Depreciation54247Depreciation
Book Value15104BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis842377OtherCostOrOtherBasis
Depreciation565792Depreciation
Book Value276585BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis616OtherCostOrOtherBasis
Book Value616BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1674369TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM AFFILIATEDescription
Book Value223979BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets223979TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$2,836Amount
FieldValueIRS element (for citing)
Total Of Amounts2836TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE ORGANIZATION IS EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ENTITY IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE INFORMATIONAL RETURNS FOR THE YEARS 2008 TO 2011 ARE OPEN TO EXAMINATION BY THOSE AUTHORITIES.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS PLUS TWO OTHER MEMBERS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE AGENDA FOR THE BOARD AND VOTING MEMBERSHIP MEETINGS. THIS COMMITTEE SHALL KEEP ITSELF INFORMED OF THE ENTIRE OPERATION OF THE CORPORATION AND ITS SUBSIDIARY CORPORATIONS, AND SHALL EXECUTE SUCH ACTIONS AS MAY BE ASSIGNED TO IT BY THE BOARD. THE COMMITTEE SHALL ALSO CONCERN ITSELF WITH MATTERS NOT ASSIGNED TO OTHER COMMITTEES.
FORM 990, PART VI, SECTION A, LINE 3GABRIEL'S VILLA'S EXECUTIVE MANAGEMENT IS PROVIDED BY LUTHERAN HOMES OF OSHKOSH, THE SOLE MEMBER AND CONTROLLING ORGANIZATION OF GABRIEL'S VILLA. DAY-TO-DAY, ON-SITE MANAGEMENT IS PROVIDED BY AN ADMINISTRATOR EMPLOYED BY GABRIEL'S VILLA.
FORM 990, PART VI, SECTION A, LINE 6LUTHERAN HOMES OF OSHKOSH, INC., IS THE SOLE MEMBER OF GABRIEL'S VILLA, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE DIRECTORS OF GABRIEL'S VILLA, INC. ARE ELECTED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER, LUTHERAN HOMES OF OSHKOSH, INC.
FORM 990, PART VI, SECTION A, LINE 7BMAJOR STANDARD OPERATING PROCEDURES, MAJOR POLICIES, AND PROGRAMS OF GABRIEL'S VILLA, INC. ARE SUBMITTED TO THE BOARD OF DIRECTORS OF THE SOLE MEMBER, LUTHERAN HOMES OF OSHKOSH, INC., FOR APPROVAL AND IMPLEMENTATION. AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS REQUIRE THE APPROVAL OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, LUTHERAN HOMES OF OSHKOSH, INC.
FORM 990, PART VI, SECTION B, LINE 11BEFORE IT WAS FILED, THE FORM 990 WAS REVIEWED BY THE CEO, THEN DISTRIBUTED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST FORM TO EACH MEMBER OF THE BOARD OF DIRECTORS AND VARIOUS COMMITTEE MEMBERS THAT REQUIRES EACH TO IDENTIFY POTENTIAL CONFLICTS OR OTHER RELATED PARTY INTERESTS. THE REPORTS ARE REVIEWED BY THE SECRETARY AND CEO AND ANY CONFLICTS ARE BROUGHT TO THE BOARD'S ATTENTION. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST IS REQUIRED TO DISCLOSE THE MATERIAL FACTS BEFORE THE BOARD DISCUSSES THE ISSUE. A MEMBER OF THE BOARD WHO HAS A CONFLICT OF INTEREST MAY NOT VOTE ON ANY SUCH ISSUE BEFORE THE BOARD. ANY QUESTION OF WHETHER THERE IS A CONFLICT IS RESOLVED BY THE BOARD OF DIRECTORS. IF THE BOARD OF DIRECTORS DETERMINES THAT A DIRECTOR HAS COMMITTED A SUBSTANTIAL VIOLATION OF THE CONFLICT OF INTEREST POLICY, THE INDIVIDUAL IS REMOVED FROM THE OFFICE OF DIRECTOR. IN ADDITION, ALL MANAGEMENT EMPLOYEES ARE INFORMED OF THE ORGANIZATION'S POLICY REGARDING RELATED PARTY TRANSACTIONS AND CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND IS ALSO AVAILABLE AT WWW.GUIDESTAR.ORG. THE ORGANIZATION'S FORM 1023 IS ALSO AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
LUTHERAN HOMES OF OSHKOSH INC
225 NORTH EAGLE STREETOSHKOSHWI54902391032234MANAGMENT SERVICESWI501(C)(3)LINE 9N/A0
BETHEL HOME INC
225 NORTH EAGLE STREETOSHKOSHWI54902391209707SKILLED NURSING FACILITYWI501(C)(3)LINE 90LUTHERAN HOMES OF OSHKOSH INC
CARMEL RESIDENCE INC
225 NORTH EAGLE STREETOSHKOSHWI54902391448325SENIOR HOUSINGWI501(C)(3)LINE 90LUTHERAN HOMES OF OSHKOSH INC
SIMEANNA APARTMENTS INC
225 NORTH EAGLE STREETOSHKOSHWI54902237148097SENIOR HOUSINGWI501(C)(3)LINE 90LUTHERAN HOMES OF OSHKOSH INC
SIMEANNA SOUTH INC
225 NORTH EAGLE STREETOSHKOSHWI54902391238670SENIOR HOUSINGWI501(C)(3)LINE 90LUTHERAN HOMES OF OSHKOSH INC
SIMEANNA III INC
225 NORTH EAGLE STREETOSHKOSHWI54902391270056SENIOR HOUSINGWI501(C)(3)LINE 90LUTHERAN HOMES OF OSHKOSH INC
BETHEL FOUNDATION OF OSHKOSH INC
225 NORTH EAGLE STREETOSHKOSHWI54902010938793FUNDRAISINGWI501(C)(3)LINE 11A, I0LUTHERAN HOMES OF OSHKOSH INC
EDEN REHABILIATION SUITES AND GREENHOUSE HOMES INC
3151 EDEN COURTOSHKOSHWI54902900506872SKILLED NURSING FACILITYWI501(C)(3)LINE 90LUTHERAN HOMES OF OSHKOSH INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.