LUTHERAN HILLSIDE VILLAGE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LUTHERAN HILLSIDE VILLAGE INC (EIN 37-0818454)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-24
IRS object ID
201202379349300005
Schema version
2011v1.2
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)
Timestamp2012-08-24T09:30:04-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Line1600 WASHINGTON AVENUE SUITE 1800AddressLine1
CityST LOUISCity
StateMOState
ZIP Code63101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370818454EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN HILLSIDE VILLAGE INCBusinessNameLine1
Business Name Line2C/O LUTHERAN SENIOR SERVICESBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlLUTHNameControl
Phone3149689313Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11150 HANLEY INDUSTRIAL COURTAddressLine1
CityST LOUISCity
StateMOState
ZIP Code63144ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePAUL OGIERName
TitleCFOTitle
Phone3149689313Phone
Date Signed2012-08-22DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameALLAN B LARSON CPAName
PTINP00028482PTIN
Phone3149254300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN KOTOVSKYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11150 HANLEY INDUSTRIAL COURTAddressLine1
CityST LOUISCity
StateMOState
ZIP Code63144ZIPCode
FieldValueIRS element (for citing)
Gross Receipts15587000GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.LSSLIVING.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1960YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionFAITH BASED ORGANIZATION WHICH PROVIDES A NETWORK OF SUPPORTIVE SERVICES FOR OLDER ADULTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers621TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year325209ContributionsGrantsPriorYear
Contributions Grants Current Year354524ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14540672ProgramServiceRevenuePriorYear
Program Service Revenue CY14207249ProgramServiceRevenueCY
Investment Income Prior Year297473InvestmentIncomePriorYear
Investment Income Current Year240627InvestmentIncomeCurrentYear
Other Revenue Prior Year389350OtherRevenuePriorYear
Other Revenue Current Year415384OtherRevenueCurrentYear
Total Revenue Prior Year15552704TotalRevenuePriorYear
Total Revenue Current Year15217784TotalRevenueCurrentYear
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 Year6528314SalariesEtcPriorYear
Salaries Etc Current Year6849201SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9087688OtherExpensePriorYear
Other Expenses Current Year9308563OtherExpensesCurrentYear
Total Expenses Prior Year15616002TotalExpensesPriorYear
Total Expenses Current Year16157764TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-63298RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-939980RevenuesLessExpensesCY
Total Assets BOY54496387TotalAssetsBOY
Total Assets EOY54905934TotalAssetsEOY
Total Liabilities BOY74030103TotalLiabilitiesBOY
Total Liabilities EOY75542517TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-19533716NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-20636583NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE PRIMARY PURPOSE OF THE EXEMPT ORGANIZATION IS TO ADDRESS AND MEET THE NEEDS OF AGED PERSONS, INCLUDING HOUSING, HEALTHCARE, AND FINANCIAL SECURITY. THE CORPORATION'S RESIDENTIAL FACILITIES AND PROGRAMS ARE SPECIFICALLY DESIGNED TO MEET AND MAINTAIN ITS AGED RESIDENTS PHYSICAL AND EMOTIONAL WELL-BEING, AS WELL AS MEET THEIR RECREATIONAL, SOCIAL, AND RELIGIOUS NEEDS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense14394443Expense
Revenue14207249Revenue
Description(1) OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY THAT OFFERS A CONTINUUM OF CARE THAT INCLUDES 126 INDEPENDENT LIVING APARTMENTS, 49 PATIO HOMES, 40 ASSISTED LIVING UNITS, 20 ASSISTED LIVING MEMORY CARE UNITS AND 85 SKILLED NURSING BEDS, WHICH INCLUDES 22 MEDICAID CERTIFIED BEDS. (2) BENEVOLENT CARE ASSISTANCE IS ALSO PROVIDED IN THE AMOUNT OF $604,018, OF WHICH $604,018 IS OFFSETTING PROGRAM SERVICE REVENUE. BENEVOLENCE CARE ASSISTANCE ALSO INCLUDES MEDICAID CONTRACTUAL ALLOWANCES.Description
Total Program Service Expense14394443TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
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 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 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
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
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 Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PAUL OGIERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3149689313TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11150 HANLEY INDUSTRIAL COURTAddressLine1
CityST LOUISCity
StateMOState
ZIP Code63144ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
MR DEAN A HEINZMANN
CHAIRPERSON1.00XX000
MR JOHN EWING
BOARD MEMBER1.00X000
REV RICHARD J HANSON
BOARD MEMBER1.00X000
REV RON MILLER
BOARD MEMBER1.00X000
MR RICHARD MOORE
BOARD MEMBER1.00X000
MR THOMAS J PILAT
BOARD MEMBER1.00X000
MR FLOYD RADEMAKER
BOARD MEMBER1.00X000
MR GARY W SETTERLUND
BOARD MEMBER1.00X000
MS DEBRA J SIPPEL
BOARD MEMBER1.00X000
MS MARILEE A TILLY
BOARD MEMBER1.00X000
MR MIKE RASO
REGIONAL VP/ ASSISTANT SECRETARY/ASSISTANT TREASUR40.00XX014870611015
MR JOHN R KOTOVSKY
PRESIDENT/CHIEF EXECUTIVE40.00X038747648749
MR PAUL OGIER
CFO40.00X027365746157
MS LINDA DETRING
CHIEF OPERATING OFFICER40.00X024783934595
MR MARK SCHOEDEL
VP OF CONSTRUCTION AND IT40.00X017919833538
MR DALE KREIENKAMP
VP OF HUMAN RESOURCES40.00X016345832987
MS CARLA BAUM
REGIONAL VICE PRESIDENT40.00X013240810382
LORRAINE NEITZER
EXECUTIVE DIRECTOR40.0001014694146X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1634211TotalReportableCompFrmRltdOrgs
Total Other Compensation221569TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLIANCE REHAB
1520 KENSINGTON ROAD STE 110OAKBROOKIL60523THERAPY & CONSULTANT569331
TECH ELECTRONICS
PO BOX 790379ST LOUISMO63139TELEPHONE EQUIPMENT, WIRING AND MAINTENA145176
WIDEMER & SONS
23460 2200 NORTH AVENUEPRINCETONIL61356CONSTRUCTION CONTRACTOR113735
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Related Organizations341916RelatedOrganizations
All Other Contributions12608AllOtherContributions
Total Contributions354524TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENT SERVICE FEES6230001382356213823562
AMORTIZATION OF ENTRAN623000383687383687
FieldValueIRS element (for citing)
Total Program Service Revenue14207249TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column178735TotalRevenueColumn
Exclusion$178,735ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities431108Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities369216Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities61892Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column61892TotalRevenueColumn
Exclusion$61,892ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MISCELLANEOUS INCOME900099268372$268,372
BEAUTY & BARBER62300071817$71,817
MEALS62300054003$54,003

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column21192TotalRevenueColumn
Exclusion$21,192ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue415384TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15217784TotalRevenueColumn
Related Or Exempt Function Income14207249RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$656,011ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5523553Total
Program Services5369560ProgramServices
Management And General153993ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total94311Total
Program Services91682ProgramServices
Management And General2629ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total822510Total
Program Services799579ProgramServices
Management And General22931ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total408827Total
Program Services397429ProgramServices
Management And General11398ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total792420Total
Management And General792420ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total210Total
Management And General210ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total11547Total
Management And General11547ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total518414Total
Program Services498857ProgramServices
Management And General19557ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total70063Total
Management And General70063ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total944709Total
Program Services591959ProgramServices
Management And General352750ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1171569Total
Program Services1127372ProgramServices
Management And General44197ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total31321Total
Program Services29771ProgramServices
Management And General1550ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1780Total
Management And General1780ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1757553Total
Program Services1691250ProgramServices
Management And General66303ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2453201Total
Program Services2360655ProgramServices
Management And General92546ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
FOOD/DIETARY748255748255
ANCILLARY EXPENSE611770611770
DESIGNATED EXPENSE7061470614
MISCELLANEOUS EXPENSE6757567575

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total57562Total
Program Services5690ProgramServices
Management And General51872ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16157764Total
Program Services14394443ProgramServices
Management And General1763321ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3867318BOY
EOY5703294EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY851812BOY
EOY769068EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY455983BOY
EOY306280EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY42204BOY
EOY40961EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY-3394BOY
EOY32529EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis69478258LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec26598932LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY44177349BOY
EOY42879326EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4786297BOY
EOY4849115EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY318818BOY
EOY325361EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY54496387BOY
EOY54905934EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY643090BOY
EOY839635EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3801129BOY
EOY4180097EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY41969730BOY
EOY41207552EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY27616154BOY
EOY29315233EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY74030103BOY
EOY75542517EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-19637211BOY
EOY-20774855EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY98495BOY
EOY133272EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5000BOY
EOY5000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-19533716BOY
EOY-20636583EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY54496387BOY
EOY54905934EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-939980ReconcilationRevenueExpenses
Reconcilation Other Changes-162887ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 Years232714CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years106096CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years170705CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year325209CurrentTaxYearMinus1Year
Current Tax Year354524CurrentTaxYear
Total1189248Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13496248CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13806876CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14281173CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14540672CurrentTaxYearMinus1Year
Current Tax Year14207249CurrentTaxYear
Total70332218Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13728962CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13912972CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14451878CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14865881CurrentTaxYearMinus1Year
Current Tax Year14561773CurrentTaxYear
Total71521466Total

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 Total50971521466PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years475097CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years314976CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years91386CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year153113CurrentTaxYearMinus1Year
Current Tax Year178735CurrentTaxYear
Total1213307Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years475097CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years314976CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years91386CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year153113CurrentTaxYearMinus1Year
Current Tax Year178735CurrentTaxYear
Total1213307Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years299786CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years474939CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years386329CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year389350CurrentTaxYearMinus1Year
Current Tax Year415384CurrentTaxYear
Total1965788Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years14503845CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14702887CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14929593CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15408344CurrentTaxYearMinus1Year
Current Tax Year15155892CurrentTaxYear
Total74700561Total
FieldValueIRS element (for citing)
Public Support Percentage5090.95740PublicSupportPercentage509
Prior Year Support Percentage0.95950PriorYearSupportPercentage
Investment Income Percentage0.01620InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01910PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis369068OtherCostOrOtherBasis
Book Value369068BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis65468026OtherCostOrOtherBasis
Depreciation23875187Depreciation
Book Value41592839BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3456788OtherCostOrOtherBasis
Depreciation2723745Depreciation
Book Value733043BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis184376OtherCostOrOtherBasis
Book Value184376BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings42879326TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
RESIDENT DEPOSITS$373,130
DUE TO RELATED ORGANIZATION$1,392,744
REFUNDABLE RESIDENCY FEES$27,549,359
FieldValueIRS element (for citing)
Total Of Amounts29315233TotalOfAmounts
Total Revenue15217784TotalRevenue
Total Expenses16157764TotalExpenses
Excess Or Deficit For Year-939980ExcessOrDeficitForYear
Net Unrealized GL On Investments-162887NetUnrealizedGLOnInvestments
Total Adjustments-162887TotalAdjustments
Excess Or Deficit Per FS-1102867ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14984287TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-162887NetUnrealizedGainsInvestments
Other Revenues-70610OtherRevenues
Revenue Not Rptd F990-233497RevenueNotRptdF990
Revenue Subtotal15217784RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99015217784TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16087154TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal16087154ExpensesSubtotal
Other Expenses Not Included70610OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt70610ExpensesNotRptdOnFinStmt
Total Expenses Per Form99016157764TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE ORGANIZATIONS QUALIFY AS TAX-EXEMPT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE ORGANIZATIONS ARE CLASSIFIED AS PUBLICLY-SUPPORTED CHARITABLE ORGANIZATIONS UNDER THE CODE AND CONTRIBUTIONS TO THE ORGANIZATIONS QUALIFY AS A CHARITABLE TAX DEDUCTION FOR THE CONTRIBUTOR. PROVIDENT GROUP IS ORGANIZED AS A TAXABLE NON-PROFIT FOR FEDERAL AND STATE INCOME TAX PURPOSES. THE ORGANIZATIONS ARE NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE TAX RETURNS FOR THE YEARS 2008 TO 2011 ARE SUBJECT TO REVIEW AND EXAMINATION BY THE IRS.
SCH D, PART XII, LINE 2D: THIS AMOUNT REPRESENTS AMOUNTS THAT ARE GROUPED WITH REVENUES FOR THE FINANCIAL STATEMENTS BUT ARE BROKEN OUT ON THE STATEMENT OF FUNCTIONAL EXPENSES FOR USE ON FORM 990.
SCH D, PART XIII, LINE 4B: THIS AMOUNT REPRESENTS AMOUNTS THAT ARE GROUPED WITH REVENUES FOR THE FINANCIAL STATEMENTS BUT ARE BROKEN OUT ON THE STATEMENT OF FUNCTIONAL EXPENSES FOR USE ON FORM 990.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
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 (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MR MIKE RASO
0148706000000011015015972100
MR JOHN R KOTOVSKY
0280754000106722020000028749043622500
MR PAUL OGIER
024174900031908020000026157031981400
MS LINDA DETRING
023014300017696020000014595028243400
MR MARK SCHOEDEL
016619800013000020000013538021273600
MR DALE KREIENKAMP
01634580000020000012987019644500

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS FINANCE AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN861091967IssuerEIN
CUSIP Number45200BE87CUSIPNumber
Date Issued2006-08-03DateIssued
Issue Price46564912IssuePrice
Description Of PurposeTO REFINANCE THE SERIES 2001A AND 2001B BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired1485000AmountRetired
Total Proceeds46564912TotalProceeds
Amount In Reserve Fund3339420AmountInReserveFund
Issuance Costs From Proceeds807882IssuanceCostsFromProceeds
Credit Enhancement141981CreditEnhancement
Working Capital Expenditures45468WorkingCapitalExpenditures
Other Spent Proceeds42230161OtherSpentProceeds
Year Of Subst Completion2007YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding1AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K, PART II, LINE 11Identifier
ExplanationTHE AMOUNT OF OTHER SPENT PROCEEDS REPRESENTS $45,459,758 OF PROCEEDS IN REFUNDING OR DEFEASANCE ESCROWS THAT ARE NO LONGER REPORTED, -218,861 WHICH REPRESENTS THE DIFFERENCE BETWEEN THE CURRENT MARKET VALUE OF THE DEBT RESERVE FUND AND THE INITIAL FUNDING AMOUNT, AND -3,010,736 FOR THE DEBT SERVICE RESERVE FUND THAT WAS NOT FUNDED WITH DEBT PROCEEDS SINCE THIS WAS A REFUNDING ISSUE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATION, AND BUDGETING TO LUTHERAN SENIOR SERVICES, THE PARENT COMPANY.
FORM 990, PART VI, SECTION A, LINE 7ATHE GOVERNING BOARD MEMBERS ARE ELECTED BY THE SOLE MEMBER, LUTHERAN SENIOR SERVICES.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 WAS NOT PROVIDED TO THE ORGANIZATION'S GOVERNING BODY PRIOR TO BEING FILED. HOWEVER, REVIEW AND APPROVAL OF THE FORM 990 WAS DELEGATED TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF THE PARENT ORGANIZATION, LUTHERAN SENIOR SERVICES, PRIOR TO BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12CALL DIRECTORS AND EMPLOYEES WILL DISCLOSE A CONFLICT OF INTEREST ON THE "CONFLICT OF INTEREST FORM" IN THE FOLLOWING SITUATIONS AND IN OTHER CIRCUMSTANCES WHICH HE/SHE THINKS MIGHT CAUSE A CONFLICT BETWEEN HIS/HER PERSONAL INTERESTS AND HIS/HER FIDUCIARY DUTY: FINANCIAL INTERESTS, INSIDE INFORMATION, CONFLICTING INTEREST OTHER THAN FINANCIAL, GIFTS AND FAVORS. THE FOLLOWING LSS EMPLOYEES ARE REQUIRED TO SIGN A "CONFLICT OF INTEREST FORM" ANNUALLY: PRESIDENT, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER/TREASURER, VICE PRESIDENT OF CONSTRUCTION AND IT, VICE PRESIDENT OF HUMAN RESOURCES, ALL DIRECTORS, ADMINISTRATORS AND ASSISTANT ADMINISTRATORS. THE CORPORATE COMPLIANCE OFFICER FOLLOWS UP WITH ANY CONFLICTS OF INTERESTS AND DOCUMENTS THE RESOLUTIONS OF THE CONFLICTS. THESE FORMS ARE KEPT BY THE CORPORATE COMPLIANCE OFFICE.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS ESTABLISHED A SEPARATE COMPENSATION COMMITTEE CHARGED WITH PERFORMING AN ANNUAL PERFORMANCE REVIEW OF THE CEO AND REVIEWING THE CEO'S COMPENSATION PACKAGE. THE COMPENSATION COMMITTEE ENGAGED A THIRD-PARTY GLOBAL HUMAN CAPITAL CONSULTING FIRM TO: (1) DEVELOP AN ANNUAL CEO PERFORMANCE REVIEW PROCESS, INCLUDING A NEW EVALUATION FORM, AND (2) DEVELOP A COMPENSATION PACKAGE BASED ON ITS KNOWLEDGE OF SIMILARLY SIZED NON-PROFIT ORGANIZATIONS IN ORDER TO ENSURE THAT THE COMPENSATION PAID TO THE CEO IS REASONABLE. ALL MEMBERS OF THE BOARD COMPLETE AN ANNUAL EVALUATION, WHICH THE COMPENSATION COMMITTEE SUMMARIZES AND REVIEWS. THE COMPENSATION COMMITTEE THEN MAKES A RECOMMENDATION TO THE FULL BOARD OF DIRECTORS FOR ANY COMPENSATION ADJUSTMENTS.
FORM 990, PART VI, SECTION C, LINE 19ALTHOUGH NOT A REQUIREMENT, THE ORGANIZATION PROVIDES PHOTOCOPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIAL STATEMENTS, AND OTHER DOCUMENTS TO ALL WHO REQUEST ONE OR MORE OF THESE ITEMS.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -162,887.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE ORGANIZATION HAS AN AUDIT COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. THIS PROCESS IS CONSISTENT WITH THE PRIOR YEARS.
FORM 990, PART V, LINE 2 AND PART IX, LINES 7, 8, 9, AND 10THE ORGANIZATION'S PAYROLL IS PROCESSED WITH LUTHERAN SENIOR SERVICES, THE PARENT COMPANY. FORMS W-3 AND W-2 WERE NOT ISSUED BY LUTHERAN HILLSIDE VILLAGE, INC. AS OF DECEMBER 31, 2011. THE ORGANIZATION DID PAY THE SALARIES, EMPLOYMENT TAXES, AND EMPLOYEE BENEFITS FOR THE ORGANIZATION'S EMPLOYEES. AS OF DECEMBER 31, 2011 THE ORGANIZATION HAD 302 FULL-TIME EMPLOYEES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
LUTHERAN SENIOR SERVICES
1150 HANLEY INDUSTRIAL COURTST LOUISMO63144430654862SENIOR LIVINGMO501(C)(3)509A2N/A0
LUTHERAN HILLSIDE VILLAGE FOUNDATION
1150 HANLEY INDUSTRIAL COURTST LOUISMO63144371371314SENIOR LIVINGIL501(C)(3)509A1N/A0
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 Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
LUTHERAN HILLSIDE VILLAGE FOUNDATION
C341916
LUTHERAN SENIOR SERVICES
L792421

Comments

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