2012-08-14T15:18:22-05:00 2011-12-31 390758449 WIPFLI LLP 215 EAST FIRST STREET SUITE 200 DIXON IL 61021 990 2011-01-01 362212706 MENDOTA LUTHERAN HOME MEND 8155397439 500 SIXTH STREET MENDOTA IL 613421796 JON RAGSDALE 8155397439 2012-08-15 1 JEFFERY L JOHNSON CPA P01251758 8152843331 2012-08-14 2011 2016-02-24 21:20:13Z JON RAGSDALE 500 SIXTH STREET MENDOTA IL 613421796 7422463 0 X N/A X 1953 IL TO ESTABLISH, MAINTAIN AND OPERATE A NURSING HOME AND HOME FOR THE AGED. MENDOTA LUTHERAN HOME IS AFFILIATED WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA, A NONPROFIT ORGANIZATION. 9 9 0 0 0 0 77806 126838 6780955 7109174 34230 15081 0 0 6892991 7251093 0 0 0 0 4382552 4784597 0 0 0 2731011 2888825 7113563 7673422 -220572 -422329 5246952 5270548 691028 1077224 4555924 4193324 X THE MENDOTA LUTHERAN HOME CORPORATION WAS AND IS ESTABLISHED TO CARRY OUT A CHRISTIAN MINISTRY OF PROVIDING CARE FOR AGING MEN AND WOMEN. THE NON-PROFIT CORPORATION WAS ESTABLISHED AND IS MAINTAINED ON THE BIBLICAL PREMISE THAT EVERY INDIVIDUAL REGARDLESS OF AGE IS ALSO A CREATED AND REDEEMED PERSON OF GOD. IN KEEPING WITH THE PREMISE, EACH PERSON SERVED SHALL RECEIVE THE HIGHEST POSSIBLE REGARD, RESPECT, COMPASSION, LOVE, AND SHALL BE CARED FOR AS JESUS CHRIST HIMSELF HAS MODELED AND COMMANDED. 0 0 MENDOTA LUTHERAN HOME IS A LICENSED NURSING FACILITY FOR ELDERLY RESIDENTS. IT PROVIDES INTERMEDIATE AND SHELTERED CARE FOR RESIDENTS OF WHICH SOME CANNOT AFFORD TO PAY DIRECTLY FOR THEIR CARE AND RECEIVE ASSISTANCE THROUGH DONATIONS, INVESTMENT INCOME, AND PUBLIC ASSISTANCE. AREA CHURCHES, ORGANIZATIONS, AND INDIVIDUALS DONATE TIME AND FINANCES FOR THE AID AND COMFORT OF THE HOME'S RESIDENTS. 7088435 7124255 7088435 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 1 1 0 X JON RAGSDALE 8155397439 500 SIXTH STREET MENDOTA IL 613421796 REV KEVIN WEEKS 0.00 X 0 0 0 MR KEN KURTH 0.00 X 0 0 0 MR STANLEY HOELZER 0.00 X 0 0 0 MRS BERNICE MENNE 0.00 X 0 0 0 MS GLORIA COGDAL 0.00 X 0 0 0 MRS GINNY BECKER 0.00 X 0 0 0 REV DALE PETERSON 0.00 X 0 0 0 MR JAMES HAMACHER 0.00 X 0 0 0 MRS DARLENE ROSE 0.00 X 0 0 0 MR JON RAGSDALE 40.00 X 73280 0 0 73280 0 0 0 0 0 0 AEGIS THERAPIES PO BOX 8103 FORT SMITH IL 72906 THERAPIES 627834 US FOODSERVICE 1829 SOLUTIONS CENTER CHICAGO IL 606671008 FOOD SERVICE 282374 MEDLINE INDUSTRIES DEPT CH 14400 PATATINE IL 600554400 MEDICAL SUPPLIES 199708 MID AMERICAN ENERGY PO BOX 8020 DAVENPORT IA 528088020 UTILITY 103913 BENEFIT ADMINISTRATIVE SERVICES 17475 JOVANNA DRIVE HOMEWOOD IL 60430 CONSULTING 103748 5 126838 126838 NURSING HOME REVENUE 623000 7109174 7109174 7109174 32173 32173 154278 171370 -17092 -17092 -17092 7251093 7124255 0 0 4112133 3808171 303962 369600 369600 302864 281840 21024 86988 54189 32799 21423 21423 19300 19300 25163 2300 22863 15898 15898 40100 40100 313580 305432 8148 3602 3602 13500 10352 3148 2458 2458 223407 223407 171735 171735 ANCILLARY EXPENSES 1107255 1107255 FOOD COSTS 276928 276928 NURSING PROFESSIONAL FE 238111 238111 SUPPLIES 156935 117847 39088 172442 61868 110574 7673422 7088435 584987 0 483 611 508644 50943 584290 946820 45188 45803 44094 53746 8574218 5526344 2979795 3047874 1075788 1116429 8670 8322 5246952 5270548 555079 692055 135949 385169 691028 1077224 X 4015944 3644496 127381 126645 412599 422183 4555924 4193324 5246952 5270548 X -422329 59729 X X 0 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 521044 521044 6030203 3989142 2041061 2012410 1532870 479540 10561 4332 6229 3047874 CURRENT PORTION OF LONG-TERM LIABILITIES 123020 LONG-TERM LIABILITIES 260228 DEFERRED REVENUE 1511 OTHER LIABILITIES 410 385169 7251093 7673422 -422329 59729 59729 -362600 7310822 59729 59729 7251093 0 7251093 0 0 0 0 0 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: GAAP 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 THAN NOT OF BEING REALIZED UPON SETTLEMENT. THE 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, 2011 AND 2010. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE REVIEWED BY THE ADMINISTRATOR AND BOARD PRESIDENT BEFORE SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS EVALUATES AND DETERMINES COMPENSATION AT THE END OF CONTRACT. FORM 990, PART VI, SECTION C, LINE 19 THE HOME MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 59,729. AUDIT OVERSIGHT DESCRIPTION FORM 990, PART XII FINANCIAL STATEMENTS AND REPORTING LINE 2C WITHIN THE BOARD OF DIRECTORS THERE IS A FINANCE COMMITTEE WHICH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS IS UNCHANGED FROM LAST YEAR.