ST LUKE LUTHERAN HOME FOR THE AGING: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ST LUKE LUTHERAN HOME FOR THE AGING (EIN 34-0777664)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-07
IRS object ID
201303119349300020
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)
Timestamp2013-11-07T08:45:11-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN341411715EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DA BAGNOLA & COMPANY INCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14800 MUNSON STREET NWAddressLine1
CityNORTH CANTONCity
StateOHState
ZIP Code44718ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN340777664EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST LUKE LUTHERAN HOME FOR THE AGINGBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTLUNameControl
Phone3304992486Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1220 APPLEGROVE STREET NEAddressLine1
CityNORTH CANTONCity
StateOHState
ZIP Code447201610ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRONALD DERRY CFOName
TitleCFOTitle
Phone3304992486Phone
Date Signed2013-11-07DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
PTINP01205115PTIN
Phone3304992486Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRONALD E DERRYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1220 APPLEGROVE STREET NEAddressLine1
CityNORTH CANTONCity
StateOHState
ZIP Code447201610ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14824112GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number9386GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STLUKELUTHERANCOMMUNITY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1954YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionST LUKE LUTHERAN HOME PROVIDES FAITH BASED SERVICES TO ENRICH THE LIVES OF OLDER ADULTS. LONG TERM NURSING CARE FOR THE AGING.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees408TotalNbrEmployees
Total Nbr Volunteers72TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year20188ContributionsGrantsPriorYear
Contributions Grants Current Year24312ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15219639ProgramServiceRevenuePriorYear
Program Service Revenue CY14791906ProgramServiceRevenueCY
Investment Income Prior Year9741InvestmentIncomePriorYear
Investment Income Current Year7894InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year15249568TotalRevenuePriorYear
Total Revenue Current Year14824112TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year350000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY155164GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9170768SalariesEtcPriorYear
Salaries Etc Current Year8741491SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4725397OtherExpensePriorYear
Other Expenses Current Year5012404OtherExpensesCurrentYear
Total Expenses Prior Year14246165TotalExpensesPriorYear
Total Expenses Current Year13909059TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1003403RevenuesLessExpensesPriorYear
Revenues Less Expenses CY915053RevenuesLessExpensesCY
Total Assets BOY15716533TotalAssetsBOY
Total Assets EOY16595376TotalAssetsEOY
Total Liabilities BOY9842628TotalLiabilitiesBOY
Total Liabilities EOY9806418TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5873905NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6788958NetAssetsOrFundBalancesEOY
Mission DescriptionST LUKE LUTHERAN HOME PROVIDES FAITH BASED SERVICES TO ENRICH THE LIVES OF OLDER ADULTS. LONG TERM NURSING CARE FOR THE AGING.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense13909059Expense
Revenue14791906Revenue
DescriptionPROGRAM SERVICE - LONG TERM CARE FOR THE AGINGDescription
Total Program Service Expense13909059TotalProgramServiceExpense
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 Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 With109634NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees408NumberOfEmployees
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
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
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 CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RONALD E DERRYBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3304998341TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1220 APPLEGROVE STREET NEAddressLine1
CityNORTH CANTONCity
StateOHState
ZIP Code44720ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorKey EmployeeKeyEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
JOHN SPIELER
EXECUTIVE DIRECTOR40.00XX22177208914
ANDREW MCNULTY
PRESIDENT0.00X000X
CAROL BROWER
VICE PRESIDENT0.00X000X
DIANE DIEHL
SECRETARY/TREASURER0.00X000X
JIM THIESE
VICE CHAIR0.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org221772TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation8914TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
THERAPY PARTNERS OF OHIO
16600 SPRAGUE RD STE 365MIDDLEBURG HEIGHTSOH44130PURCHASED SERVICE-THERAPY518231
PREMIER THERAPY
701 SHARON ROADBEAVERPA15009PURCHASED SERVICE-THERAPY515255
MCKESSON MEDICAL SUPPLY INC
PO BOX 630693CINCINNATIOH45274SUPPLIES - MEDICAL245548
OMNICARE INC
PO BOX 715268COLUMBUSOH43271SUPPLIES - MEDICAL192823
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
All Other Contributions24312AllOtherContributions
Total Contributions24312TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYMENTS94849619484961
RESIDENT SERVICE REVENUE53069455306945
FieldValueIRS element (for citing)
Total Program Service Revenue14791906TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7894TotalRevenueColumn
Exclusion$7,894ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14824112TotalRevenueColumn
Related Or Exempt Function Income14791906RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$7,894ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total155164Total
Program Services155164ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total221772Total
Program Services221772ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7024357Total
Program Services7024357ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total90836Total
Program Services90836ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total869595Total
Program Services869595ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total534931Total
Program Services534931ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total26766Total
Program Services26766ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total43000Total
Program Services43000ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total107206Total
Program Services107206ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total11327Total
Program Services11327ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total166003Total
Program Services166003ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total64204Total
Program Services64204ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total550474Total
Program Services550474ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total21650Total
Program Services21650ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1304Total
Program Services1304ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total230505Total
Program Services230505ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total497988Total
Program Services497988ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total142195Total
Program Services142195ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PURCHASED SERVICE - THE10641631064163
BED FRANCHISE FEE857956857956
SUPPLIES - MEDICAL498415498415
FOOD COSTS497324497324

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total231924Total
Program Services231924ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13909059Total
Program Services13909059ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1580BOY
EOY1580EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5680141BOY
EOY5744589EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2730224BOY
EOY3927929EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY88957BOY
EOY91269EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY122645BOY
EOY115812EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis15467567LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10468073LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5360478BOY
EOY4999494EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1706298BOY
EOY1706860EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY26210BOY
EOY7843EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY15716533BOY
EOY16595376EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY500677BOY
EOY598849EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY8370052BOY
EOY8166270EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY971899BOY
EOY1041299EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9842628BOY
EOY9806418EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5873905BOY
EOY6788958EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5873905BOY
EOY6788958EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15716533BOY
EOY16595376EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses915053ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
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 Years34490CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38528CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18679CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20188CurrentTaxYearMinus1Year
Current Tax Year24312CurrentTaxYear
Total136197Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15678734CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15876640CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16051304CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15219639CurrentTaxYearMinus1Year
Current Tax Year14791906CurrentTaxYear
Total77618223Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15713224CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15915168CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16069983CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15239827CurrentTaxYearMinus1Year
Current Tax Year14816218CurrentTaxYear
Total77754420Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50977754420PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years47993CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7999CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8032CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9741CurrentTaxYearMinus1Year
Current Tax Year7894CurrentTaxYear
Total81659Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years47993CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7999CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8032CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9741CurrentTaxYearMinus1Year
Current Tax Year7894CurrentTaxYear
Total81659Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15761217CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15923167CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16078015CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15249568CurrentTaxYearMinus1Year
Current Tax Year14824112CurrentTaxYear
Total77836079Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99900PublicSupportPercentage509
Prior Year Support Percentage0.99820PriorYearSupportPercentage
Investment Income Percentage0.00100InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00180PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis18616InvestmentCostOrOtherBasis
Book Value18616BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis11165916InvestmentCostOrOtherBasis
Depreciation7020934Depreciation
Book Value4144982BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis4246606InvestmentCostOrOtherBasis
Depreciation3447139Depreciation
Book Value799467BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis36429InvestmentCostOrOtherBasis
Book Value36429BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4999494TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
ACCRUED & WITHHELD TAXES$123,699
ACCRUED VACATION$332,257
ACCRUED PAYROLL$340,398
GOVERNMENT MANDATED FEES$217,609
OTHER$27,336
FieldValueIRS element (for citing)
Total Of Amounts1041299TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt14880433TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities56321DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F99056321RevenueNotRptdF990
Revenue Subtotal14824112RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99014824112TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13965380TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities56321DonatedServicesUseOfFacilities
Expenses Not Rptd F99056321ExpensesNotRptdF990
Expenses Subtotal13909059ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013909059TotalExpensesPerForm990

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
ST LUKE FOUNDATION
220 APPLEGROVE STREET NENORTH CANTONOH44720341407996501(C)(3)150000LONG-TERM CARE
SLLC-MINERVA
220 APPLEGROVE STREET NENORTH CANTONOH44720263108193501(C)(3)5164LONG-TERM CARE
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: TO ASSIST ST. LUKE FOUNDATION IN MAKING DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) AND PROVIDE SUPPORT TO LONG-TERM CARE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonJOHN SPIELERNamePerson
TitleEXECUTIVE DIRECTORTitle
Base Compensation Filing Org220343BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org1429OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org3409DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org5505NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org230686TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF NORTH CANTON OHIOBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN346002037IssuerEIN
Date Issued2012-08-22DateIssued
Issue Price8278150IssuePrice
Description Of PurposeHEALTHCARE FACILITIES REVENUE BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds8278150TotalProceeds
Refunding Escrow8188798RefundingEscrow
Issuance Costs From Proceeds89352IssuanceCostsFromProceeds
Year Of Subst Completion2012YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF THE RETURN IS PROVIDED FIRST TO MANAGEMENT AND THEN TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12CANNUAL CONFLICT OF INTEREST STATEMENTS ARE COMPLETED AND SIGNED BY EACH DIRECTOR, OFFICER, AND KEY EMPLOYEE. ALL KNOWN POTENTIAL CONFLICTS ARE LISTED AND SHARED WITH THE BOARD OF DIRECTORS. SHOULD A DECISION COME TO THE BOARD INVOLVING ONE OF THE STATED CONFLICTS, THE INDIVIDUAL WILL FOLLOW THE WRITTEN CONFLICT OF INTEREST POLICY AND DISCLOSE HIS OR HER CONFLICT, PROVIDE ANY INFORMATION DESIRED BY THE BOARD, AND RECUSE HIM OR HERSELF FROM THE MEETING FOR THE DELIBERATIONS AND THE VOTE ON THE MATTER INVOLVING THE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15A SURVEY IS CONDUCTED OF REGIONAL LONG-TERM CARE POSITIONS. SALARIES ARE BASED ON COMPARATIVE POSITIONS.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
THE WATERFORD AT ST LUKE
201 HOLL ROADNORTH CANTONOH44720341719940INDEPENDENT LIVINGOH501(C)(3)9N/A0
ST LUKE FOUNDATION
220 APPLEGROVE STREET NENORTH CANTONOH44720341407996LONG-TERM CAREOH501(C)(3)9N/A0
ST LUKE LUTHERAN COMMUNITY
220 APPLEGROVE STREET NENORTH CANTONOH44720030483120LONG-TERM CAREOH501(C)(3)9N/A0
ST LUKE LUTHERAN COMMUNITY - BELDEN VILLAGE
220 APPLEGROVE STREET NENORTH CANTONOH44720200970588LONG-TERM CAREOH501(C)(3)9N/A0
ST LUKE LUTHERAN COMMUNITY - MASSILLON
220 APPLEGROVE STREET NENORTH CANTONOH44720030483116LONG-TERM CAREOH501(C)(3)9N/A0
ST LUKE LUTHERAN COMMUNITY - PORTAGE LAKES
220 APPLEGROVE STREET NENORTH CANTONOH44720030483122LONG-TERM CAREOH501(C)(3)9N/A0
ST LUKE LUTHERAN COMMUNITY - MINERVA
220 APPLEGROVE STREET NENORTH CANTONOH44720263108193LONG-TERM CAREOH501(C)(3)9N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
ST LUKE FOUNDATION
B150000
ST LUKE LUTHERAN COMMUNITY - MINERVA
B5164

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