2013-08-13T08:40:04-05:00 2012-12-31 232932984 PARENTEBEARD LLC 1869 CHARTER LANE STE 301 LANCASTER PA 17601 990 2012-01-01 530196624 NATIONAL LUTHERAN HOME AND VILLAGE AT ROCKVILLE NATI 3014249560 9701 VEIRS DRIVE ROCKVILLE MD 20850 LAWRENCE R BRADSHAW 3014249560 2013-08-02 1 MICHAEL S FREY P00327329 7173935696 2012 2016-02-25 16:41:14Z THE VILLAGE AT ROCKVILLE LAWRENCE R BRADSHAW 2301 RESEARCH BLVD ROCKVILLE MD 20850 29625394 0 X WWW.THEVILLAGEATROCKVILLE.ORG X 1890 DC OPERATION OF SKILLED NURSING FACILITY AND RESIDENTIAL LIVING COMMUNITY. 8 7 396 183 0 0 1148511 2053853 25461348 23201207 1508047 2005007 243709 214647 28361615 27474714 0 0 0 0 17087394 16196061 0 0 0 11045101 11602235 28132495 27798296 229120 -323582 73830230 87209324 11543008 22310665 62287222 64898659 X TO FULFILL ITS CHRISTIAN MINISTRY NATIONAL LUTHERAN HOME AND VILLAGE AT ROCKVILLE PROVIDES AN ARRAY OF OPTIONS FOR SENIORS INCLUDING RESIDENTIAL LIVING, ALONG WITH HOME AND HEALTH CARE SERVICES WHICH ARE DESIGNED TO MEET INDIVIDUAL NEEDS. 0 0 23199514 0 23201207 SKILLED NURSING FACILITY - PROVIDES RESIDENCY AND MEDICAL CARE TO THOSE IN THE SENIOR COMMUNITY IN A 219-BED FACILITY(IN THE PROCESS OF BEING RECONFIGURED FROM A 300-BED FACILITY) FOR WHICH THERE WERE 69,224 CENSUS DAYS IN 2012.INDEPENDENT LIVING COMMUNITY - PROVIDES RESIDENCY TO THOSE IN THE SENIOR COMMUNITY IN A 141 UNIT FACILTIY(RECONFIGURED FROM THE ORIGINAL 144 UNITS) FOR WHICH THERE WERE 57,814 CENSUS DAYS IN 2012. THE ORGANIZATION EXTENDS CHARITY CARE AND OTHER SUPPORT TO RESIDENTS, WHO MEET CERTAIN CRITERIA UNDER ITS BENEVOLENT CARE POLICY AND ARE UNABLE TO PAY FOR SERVICES, AT ALL LEVELS OF CARE AS NEEDED AND WHEN APPROPRIATE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE BENEVOLENT CARE, THEY ARE NOT REPORTED AS RESIDENT SERVICE REVENUES.THE ORGANIZATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF BENEVOLENT CARE IT PROVIDES. THE ESTIMATED COSTS OF PROVIDING BENEVOLENT CARE IS BASED UPON THE DIRECT AND INDIRECT COSTS IDENTIFIED WITH THE SPECIFIC BENEVOLENT CARE PROVIDED. THE COST OF BENEVOLENT CARE PROVIDED AMOUNTED TO APPROXIMATELY $4,800,000 IN 2012 AND $4,200,000 IN 2011, RESPECTIVELY, RELATED TO THE MEDICAID PROGRAM. 23199514 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 67 0 1 396 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X X MICHAEL J BRADY CHIEF FINANCIAL OFFICER 3013542714 2301 RESEARCH BLVD ROCKVILLE MD 20850 MRS CLAUDIA HARRINGTON 1.00 1.00 X X 0 0 0 THE REV ALAN TRAHER 1.00 1.00 X X 0 0 0 MR DANIEL M BRINGMAN 1.00 X X 0 0 0 MR LAWRENCE R BRADSHAW 12.00 28.00 X X 0 259051 19219 THE REV RODNEY RONNEBERG 1.00 X X 0 0 0 MRS FAITH BAUERSFELD 1.00 1.00 X 0 0 0 MR WALLY ROSSMILLER 1.00 X 0 0 0 MRS MARJORIE BRUFFY 1.00 X 0 0 0 MR FRANK E MCGOVERN 40.00 X 169825 0 32093 MR MICHAEL BRADY 14.00 26.00 X 0 119628 17170 MS GINA MARIE D'ANGELO 40.00 X 106114 0 15899 HYANG SOON LEE 40.00 X 122077 0 20870 XIAOGIU HU 40.00 X 121525 0 18245 MRS CAMILLE A FORBES-SCOTT 40.00 X 116095 0 20617 635636 378679 144113 5 0 1 0 SHOCKEY CONSTRUCTION 1057 MARTINSBURG PIKE WINCHESTER VA 22603 CONSTRUCTION 7128735 WHITING-TURNER CONTRACTING COMPANY 200 CEDAR ST CAMBRIDGE MD 21613 CONSTRUCTION CONTRACTOR 1794668 FLAGSHIP 513 SOUTH CLEWELL STREET BETHLEHEM PA 18015 MOBILITY ASSISTANCE DEVICES 1524735 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 303536922 FOOD SERVICES 795166 PARTNERS IN PLANNING 5252 CHEROKEE AVE STE 103 ALEXANDRIA VA 22312 DESIGN CONSULTANTS 384642 11 2053853 2053853 RESIDENT INCOME 623000 23201207 23201207 23201207 1491229 1491229 3176 0 3176 3176 3176 1937220 727238 862574 1288106 1074646 -560868 513778 513778 CAFETERIA INCOME 623000 136396 136396 HAIR CARE 623000 67005 67005 RESIDENT TRIPS 623000 7752 7752 318 318 211471 27474714 23201207 0 2219654 201918 201918 12954033 11953326 1000707 389117 382175 6942 1397311 1149540 247771 1253682 877618 376064 1531700 1531700 57286 57286 398 398 117131 117131 2763919 2518795 245124 162024 162024 1702961 1475630 227331 10500 10500 1335268 1243193 92075 28383 17511 10872 2201989 2201989 MEDICAL SUPPLIES 866088 866088 BAD DEBTS 384745 384745 DUES AND SUBSRIPTIONS 109198 54350 54848 ANNUITY EXPENSES 86223 86223 244422 74554 169868 27798296 23199514 4598782 0 200 200 1397212 1912672 1600623 1441873 409500 274500 97517 110198 298549 199001 63279797 24668940 28330243 38610857 41595773 40740256 2918715 83482 83482 17131 917570 73830230 87209324 3921234 3074939 7452283 8706906 10135000 169491 393820 11543008 22310665 X 60642203 63104529 289940 375790 1355079 1418340 62287222 64898659 73830230 87209324 X -323582 2836016 99003 X X 0 1 X 1 0 X 1225978 1124921 981467 1148511 2053853 6534730 25098407 27206131 27997079 25467013 23201207 128969837 287180 234078 203401 724659 26324385 28331052 29265726 26849602 25458461 136229226 3931 2432 6363 682001 682001 3931 684433 688364 135540862 2666977 3619585 3233811 1444643 1494405 12459421 2666977 3619585 3233811 1444643 1494405 12459421 -73911 226474 3970 1214 8070 165817 28917451 32177111 32503507 28295459 26960936 148854464 0.91060 0.89180 0.08370 0.10700 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2008 AMOUNT: $ -73,911. 2009 AMOUNT: $ 226,474. 2010 AMOUNT: $ 3,970. 2011 AMOUNT: $ 1,214. 2012 AMOUNT: $ 318. RESIDENT TRIPS - 2012 AMOUNT: $ 7,752. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 398 398 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: NATIONAL LUTHERAN HOME AND VILLAGE AT ROCKVILLE PAYS DUES TO LIFESPAN. A PORTION OF THE DUES PAID TO THIS ORGANIZATION IS ALLOCABLE TO LOBBYING EXPENSES. THE TOTAL AMOUNT OF DUES PAID THAT ARE ALLOCABLE TO LOBBYING IS $398. 8210054 8210054 31292361 19617673 11674688 7143099 5051267 2091832 16634283 16634283 38610857 ANNUITIES PAYABLE 393820 393820 X 30853470 2836016 99003 2935019 27918451 117131 -560868 -443737 27474714 28242033 560868 560868 27681165 117131 117131 27798296 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION FOLLOWS THE PROVISIONS OF GENERALLY ACCEPTED ACCOUNTING STANDARDS THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS, INCLUDING NOT-FOR-PROFIT CORPORATIONS, AND PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE STANDARDS ALSO PROVIDE GUIDANCE ON DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THIS STANDARD DOES NOT HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS. THE ORGANIZATIONS'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2011, 2010, AND 2009 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF TRUSTS 99,003. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OR DISPOSAL OF ASSETS -560,868. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OR DISPOSAL OF ASSETS 560,868. X X X X X 1 0 0 0 0 0 0 0 0 MR LAWRENCE R BRADSHAW 0 259051 0 0 0 0 0 15649 0 3570 0 278270 0 0 MR FRANK E MCGOVERN 156180 0 0 0 13645 0 10643 0 21450 0 201918 0 0 0 PART I, LINE 4A THE EXECUTIVE DIRECTOR SEPARATED FROM THE ORGANIZATION IN NOVEMBER AND RECEIVED SEVERANCE PAY FOR THE MONTH OF DECEMBER. A THE MAYOR AND COUNCIL OF ROCKVILLE 526001573 774223AA9 2012-02-28 10135000 RENOVATIONS TO EXISTING FACILITIES 0 0 0 A 10135000 376672 202700 9555628 2013 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 3 NATIONAL LUTHERAN HOME FOR THE AGED, INC. (EIN 26-2222476), THE PARENT ENTITY, PROVIDES FINANCIAL AND MANAGEMENT FUNCTIONS FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SINGLE CLASS OF CONSTITUENT MEMBERS WHICH SHALL CONSIST OF THOSE DULY ELECTED MEMBERS OF THE BOARD OF TRUSTEES OF NATIONAL LUTHERAN HOME FOR THE AGED, INC., THE PARENT ORGANIZATION TO THE FILING ENTITY. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S BOARD HAS ROTATING 3 YEAR TERMS WITH THE POSSIBILITY OF 2 CONSECUTIVE TERMS BEING SERVED. THEN A BREAK OF ONE YEAR MUST OCCUR BEFORE AN INDIVIDUAL SERVES AS A BOARD MEMBER AGAIN. THE ONLY EXCEPTION TO THESE RULES ARE THE BISHOP'S DESIGNEES FROM EACH OF THE CHURCH SYNODS TO WHICH THE ORGANIZATION BELONGS. IF THE BISHOP CHOOSES NOT TO SERVE ON THE BOARD, THEN HE CAN ASSIGN AN INDIVIDUAL TO HIS/HER SEAT AS LONG AS HE/SHE IS BISHOP. FORM 990, PART VI, SECTION A, LINE 7B APPROVAL OF THE FOLLOWING MATTERS IS RESERVED EXCLUSIVELY TO THE MEMBERSHIP. HE/SHE OR THEY MAY: A) APPROVE THE ROLE AND/OR MISSION STATEMENT, IF ANY. B) APPROVE OPERATING AND CAPITAL BUDGETS C) APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. D) APPROVE ALL CONTRACTS IN EXCESS OF $1,000,000 E) APPROVE THE INCURRENCE OF DEBT IN EXCESS OF $1,000,000 F) APPROVE AND RECOMMEND THE FORMATION OF LEGAL ENTITIES, THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS, DIVESTITURES, DISSOLUTIONS, CLOSURES, MERGERS, CONSOLIDATIONS, OR CHANGES IN CORPORATE MEMBERSHIP G) LIQUIDATION, DISSOLUTION, WINDING UP OR ABANDONMENT OF THE CORPORATION H) APPROVAL OF STRATEGIC PLANS I) SELECTION OF THE AUDITOR FOR THE CORPORATION FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE, ALONG WITH APPROPRIATE STAFF, PERFORMS AN INITIAL REVIEW OF THE FORM 990. UPON APPROVAL, THE FORM 990 IS MADE AVAILABLE TO EACH BOARD MEMBER FOR REVIEW PRIOR TO TRANSMISSION OF THE RETURN TO THE IRS. THE BOARD OF THE PARENT, NATIONAL LUTHERAN HOME FOR THE AGED, INC., WILL RECEIVE A COPY OF THE RETURN PRIOR TO THE IRS FILING AS WELL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT EACH YEAR. IF A CONFLICT IS IDENTIFIED, IT IS 1) IDENTIFIED AND DISCUSSED WITH THE BOARD AND 2) REVIEWED AND DOCUMENTED BY MANAGEMENT. IF AN ACTUAL OR POTENTIAL CONFLICT IS IDENTIFIED, THE BOARD MEMBER, OFFICER, OR EMPLOYEE WILL RECUSE HIM OR HERSELF FROM ANY CONVERSATIONS, DECISIONS, OR OTHER ACTIVITIES AND DISCUSSIONS INVOLVING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD DETERMINES THE COMPENSATION FOR THE CEO THROUGH THE COMBINED USE OF SEVERAL METHODS. THE NLCS EXECUTIVE COMMITTEE SERVES AS A COMPENSATION COMMITTEE WHICH OVERSEES THE PROCESS. COMPENSATION SURVEYS ARE PERFORMED BY AN OUTSIDE HR CONSULTING FIRM, PRM, USING LOCAL MARKET DATA AND WRITTEN EMPLOYMENT CONTRACTS ARE DRAWN. THE CEO, EXECUTIVE DIRECTOR, AND DIRECTOR OF HUMAN RESOURCES USE SALARY SURVEYS TO DETERMINE THE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES TO ENSURE THEY ARE WITHIN THE LOCAL MARKET RANGE. THE SERVICES THE INDIVIDUAL PROVIDES TO THE ORGANIZATION AND THE TENURE OF THE OFFICER ARE ALSO FACTORS CONSIDERED IN SALARY DETERMINATIONS. ONCE THE EXECUTIVE COMMITTEE GIVES ITS APPROVAL, ITS DECISIONS ARE NOTED AT THE BOARD LEVEL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUEMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF TRUSTS 99,003. AUDIT OVERSIGHT: FORM 990, PART XII, LINE 2C THE ROLE OF THE AUDIT COMMITTEE, WHICH CONSISTS OF THE FINANCE COMMITTEE, IS TO SELECT THE AUDITOR. THE AUDITORS ALSO PRESENT THEIR AUDIT FINDINGS TO THE AUDIT COMMITTEE IN A FORMAT WHICH ENCOURAGES DIALOGUE AND QUESTIONS WITH THE AUDITORS. THE VILLAGE AT ORCHARD RIDGE INC 2301 RESEARCH BLVD ROCKVILLE MD 20850 263445374 PROSPECTIVE CONTINUING CARE RETIREMENT COMMUNITY VA 501(C)(3) LINE 9 NATIONAL LUTHERAN HOME FOR THE AGED INC 0 NATIONAL LUTHERAN HOME FOR THE AGED INC 2301 RESEARCH BLVD ROCKVILLE MD 20850 262222476 CORPORATE OVERSIGHT MD 501(C)(3) LINE 11B, II N/A 0 THE LEGACY AT NORTH AUGUSTA INC 2301 RESEARCH BLVD ROCKVILLE MD 20850 452857307 CONTINUING CARE RETIREMENT COMMUNITY VA 501(C)(3) LINE 9 NATIONAL LUTHERAN HOME FOR THE AGED INC 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1