Mendota Lutheran Home Bk 20-02769: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- Mendota Lutheran Home Bk 20-02769 (EIN 36-2212706)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-04-21
- IRS object ID
- 201311119349300201
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-21T16:20:06-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jeremy Brune CPA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2508 Riverwalk Drive | AddressLine1 |
| City | Plainfield | City |
| State | IL | State |
| ZIP Code | 60586 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362212706 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mendota Lutheran Home | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MEND | NameControl |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Sixth Street | AddressLine1 |
| City | Mendota | City |
| State | IL | State |
| ZIP Code | 613421796 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jon Ragsdale | Name |
| Title | Administrator | Title |
| Phone | 8155397439 | Phone |
| Date Signed | 2013-04-30 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeremy M Brune CPA | Name |
| PTIN | P01425038 | PTIN |
| Phone | 7798753979 | Phone |
| Date Prepared | 2013-04-21 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7843949 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mlh500.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1953 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | To establish, maintain, and operate a nursing home as well as a home for the aged. Mendota Lutheran Home is affiliated with the Evangelical Lutheran Church in North America, a non-profit organization. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 235 | TotalNbrEmployees |
| Total Nbr Volunteers | 24 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 126838 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 799506 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 7109174 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 7011660 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 15081 | InvestmentIncomePriorYear |
| Investment Income Current Year | 32783 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7251093 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7843949 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4784597 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4851960 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2888825 | OtherExpensePriorYear |
| Other Expenses Current Year | 2951889 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7673422 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7803849 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -422329 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 40100 | RevenuesLessExpensesCY |
| Total Assets BOY | 5270548 | TotalAssetsBOY |
| Total Assets EOY | 5767620 | TotalAssetsEOY |
| Total Liabilities BOY | 1077224 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1340183 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4193324 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4427437 | NetAssetsOrFundBalancesEOY |
| Mission Description | To establish, maintain, and operate a nursing home as well as a home for the aged. Mendota Lutheran Home is affiliated with the Evangelical Lutheran Church in North America, a non-profit organization. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 7248771 | Expense |
| Revenue | 7011660 | Revenue |
| Description | Mendota Lutheran Home is licensed by the Illinois Department of Public Health to provide skilled, intermediate, and sheltered care nursing home services to elderly residents. During 2012, Mendota Lutheran Home provided these services to approximately 86 residents on a daily basis. Support to care for these residents includes investment income, public assistance, as well as donations from area churches, organizations, and individuals. | Description |
| Total Program Service Expense | 7248771 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 19 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 235 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | false | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Jon Ragsdale | NamePerson |
| Telephone Number | 8155397439 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Sixth Street | AddressLine1 |
| City | Mendota | City |
| State | IL | State |
| ZIP Code | 613421796 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Ginny Becker | ||||||
| President | 0.00 | X | X | 0 | 0 | 0 |
| Gloria Cogdal | ||||||
| Secretary | 0.00 | X | X | 0 | 0 | 0 |
| Greta Bates | ||||||
| Trustee | 0.00 | X | 0 | 0 | 0 | |
| Jeff Simonton | ||||||
| Trustee | 0.00 | X | 0 | 0 | 0 | |
| JoAnne Miller | ||||||
| Trustee | 0.00 | X | 0 | 0 | 0 | |
| John Nielsen | ||||||
| Trustee | 0.00 | X | 0 | 0 | 0 | |
| Ken Kurth | ||||||
| Trustee | 0.00 | X | 0 | 0 | 0 | |
| Rev Dale Peterson | ||||||
| Vice President | 0.00 | X | X | 0 | 0 | 0 |
| Rev Kevin Weeks | ||||||
| Trustee | 0.00 | X | 0 | 0 | 0 | |
| Rev Michael Morrell | ||||||
| 0.00 | X | 0 | 0 | 0 | ||
| Jon Ragsdale | ||||||
| Administrator | 40.00 | X | 76595 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 76595 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Aegis Therapies | |||||
| PO Box 8103 | Fort Smith | AR | 72902 | Therapy | 855072 |
| US FoodService | |||||
| 1829 Solution Center | Chicago | IL | 606771088 | Food Service | 350436 |
| Medline Industries | |||||
| Dept CH 14400 | Palatine | IL | 600554400 | Medical Supplies | 216022 |
| Ben Admin Services | |||||
| 17475 Jovanna Dr | Homewood | IL | 60430 | Consulting | 172922 |
| NHRMA Mutual | |||||
| PO Box 17062 | Urbana | IL | 618037062 | Insurance | 124978 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| All Other Contributions | 799506 | AllOtherContributions |
| Total Contributions | 799506 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Nursing Home | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 7011660 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7011660 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 7011660 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32783 | TotalRevenueColumn |
| Related Or Exempt Function Income | 32783 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7843949 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7044443 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77896 | Total |
| Management And General | 77896 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3891792 | Total |
| Program Services | 3654885 | ProgramServices |
| Management And General | 236907 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31370 | Total |
| Program Services | 28882 | ProgramServices |
| Management And General | 2488 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 560031 | Total |
| Program Services | 515620 | ProgramServices |
| Management And General | 44411 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 290871 | Total |
| Program Services | 268649 | ProgramServices |
| Management And General | 22222 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 227170 | Total |
| Program Services | 153898 | ProgramServices |
| Management And General | 73272 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32093 | Total |
| Program Services | 4056 | ProgramServices |
| Management And General | 28037 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51302 | Total |
| Program Services | 51302 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151645 | Total |
| Program Services | 138940 | ProgramServices |
| Management And General | 12705 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8314 | Total |
| Program Services | 5345 | ProgramServices |
| Management And General | 2969 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1615 | Total |
| Program Services | 1615 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16075 | Total |
| Management And General | 16075 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 259731 | Total |
| Program Services | 259731 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67612 | Total |
| Program Services | 57800 | ProgramServices |
| Management And General | 9812 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Supplies | 506116 | 489584 | 16532 |
| Ancillary Services | 1115796 | 1115796 | |
| Assessment Fees | 340913 | 340913 | |
| Bad Debt | 101298 | 101298 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72209 | Total |
| Program Services | 60457 | ProgramServices |
| Management And General | 11752 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7803849 | Total |
| Program Services | 7248771 | ProgramServices |
| Management And General | 555078 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | X | JointCosts |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 611 | BOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50943 | BOY |
| EOY | 179885 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 287485 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 946820 | BOY |
| EOY | 882557 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45803 | BOY |
| EOY | 47285 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53746 | BOY |
| EOY | 142033 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9075224 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5786075 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3047874 | BOY |
| EOY | 3289149 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1116429 | BOY |
| EOY | 934576 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8322 | BOY |
| EOY | 4650 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5270548 | BOY |
| EOY | 5767620 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 692055 | BOY |
| EOY | 855869 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 385169 | BOY |
| EOY | 344464 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 139850 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1077224 | BOY |
| EOY | 1340183 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3771141 | BOY |
| EOY | 3711737 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 293152 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 422183 | BOY |
| EOY | 422548 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4193324 | BOY |
| EOY | 4427437 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5270548 | BOY |
| EOY | 5767620 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 40100 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 194013 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Church170b1 Ai | X | Church170b1Ai |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 548828 | BeginningOfYearBalance |
| Contributions | 293982 | Contributions |
| Investment Earnings Or Losses | 14305 | InvestmentEarningsOrLosses |
| Other Expenditures | 8818 | OtherExpenditures |
| End Of Year Balance | 848297 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 535634 | BeginningOfYearBalance |
| Contributions | 7754 | Contributions |
| Investment Earnings Or Losses | 9593 | InvestmentEarningsOrLosses |
| Other Expenditures | 4153 | OtherExpenditures |
| End Of Year Balance | 548828 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.15000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.50000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.35000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 521044 | OtherCostOrOtherBasis |
| Book Value | 521044 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6205530 | OtherCostOrOtherBasis |
| Depreciation | 4124243 | Depreciation |
| Book Value | 2081287 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2348650 | OtherCostOrOtherBasis |
| Depreciation | 1661832 | Depreciation |
| Book Value | 686818 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3289149 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Interest and Dividends Receiva | Description |
| Book Value | 4650 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4650 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Accrued Interest | $1,014 |
| Assessment Tax - HFS | $114,019 |
| Settlement - Medicaid | $12,307 |
| Settlement - Medicare | $12,510 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 139850 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 8037965 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 194013 | NetUnrealizedGainsInvestments |
| Other Revenues | 3 | OtherRevenues |
| Revenue Not Rptd F990 | 194016 | RevenueNotRptdF990 |
| Revenue Subtotal | 7843949 | RevenueSubtotal |
| Total Revenue Per Form990 | 7843949 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7803849 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 7803849 | ExpensesSubtotal |
| Total Expenses Per Form990 | 7803849 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| D9 | Other revenues non included on Form 990 Part XI line 2d | The Other Revenue represents a rounding adjustment of $3 that reconciles the Audited Financial Statements to the Form 990. |
| D13 | Footnote for uncertain tax position under FIN 48 Part X | Generally Accepted Accounting Principles prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of tax positions taken or expected to be taken in tax returns. The amount recognized is measured as the largest amount of benefit that is more likely that not of being realized upon settlement. Mendota Lutheran Home has determined that it does not have any significant risks related to income tax expense and therefore no amounts were reserved for uncertain tax positions as of December 31, 2012. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| O01 | Form 990 governing body review Part VI line 11 | The Form 990 will be distributed to the Board of Directors for review and approval before submission to the Internal Revenue Service. |
| O02 | CEO executive director top management comp Part VI line 15a | The Board of Directors annually evaluates the Administrator and determines compensation adjustments based on both performance,industry standards, and budgetary constraints. |
| O03 | Other officer or key employee compensation Part VI line 15b | The Administrator evaluates all other employees of Mendota Lutheran Home and determines compensation based on performance, industry standards, and budgetary constraints. |
| O04 | Governing documents etc available to public Part VI line 19 | Mendota Lutheran Home makes governing documents, conflicts of interest statements, financial statements, and tax returns availabile to the public upon written request. |
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