REBECCA RESIDENCE: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
REBECCA RESIDENCE (EIN 25-0974311)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-06-07
IRS object ID
201111759349300206
Schema version
2009v1.2
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)
Timestamp2011-06-07T13:52:28-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN250974311EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1REBECCA RESIDENCEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlREBENameControl
Phone7244440600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13746 Cedar Ridge RoadAddressLine1
CityAllison ParkCity
StatePAState
ZIP Code15101ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePaul BrandName
TitleCFOTitle
Phone7243521571Phone
Date Signed2011-05-04DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnXAmendedReturn

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Concordia at Rebecca ResidenceBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonKeith FrndakNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1134 Marwood RoadAddressLine1
CityCabotCity
StatePAState
ZIP Code16023ZIPCode
FieldValueIRS element (for citing)
Gross Receipts22137160GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitehttp://www.concordialm.org/rebecca.htmlWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1871YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionRebecca Residence provides high-quality assisted living, skilled nursing, and rehab/therapy services to those individuals entrusted to our care.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees194TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year49870ContributionsGrantsPriorYear
Contributions Grants Current Year17542ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8863471ProgramServiceRevenuePriorYear
Program Service Revenue CY9076847ProgramServiceRevenueCY
Investment Income Prior Year-1195823InvestmentIncomePriorYear
Investment Income Current Year839224InvestmentIncomeCurrentYear
Other Revenue Prior Year9986OtherRevenuePriorYear
Other Revenue Current Year54647OtherRevenueCurrentYear
Total Revenue Prior Year7727504TotalRevenuePriorYear
Total Revenue Current Year9988260TotalRevenueCurrentYear
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 Year4666058SalariesEtcPriorYear
Salaries Etc Current Year4765539SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year11515TotalFundrsngExpCurrentYear
Other Expense Prior Year3342366OtherExpensePriorYear
Other Expenses Current Year3188591OtherExpensesCurrentYear
Total Expenses Prior Year8008424TotalExpensesPriorYear
Total Expenses Current Year7954130TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-280920RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2034130RevenuesLessExpensesCY
Total Assets BOY25008573TotalAssetsBOY
Total Assets EOY27653162TotalAssetsEOY
Total Liabilities BOY5955410TotalLiabilitiesBOY
Total Liabilities EOY5941078TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY19053163NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY21712084NetAssetsOrFundBalancesEOY
Mission DescriptionRebecca Residence provides high-quality assisted living, skilled nursing, and rehab/therapy services to those individuals entrusted to our care.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6838723Expense
Revenue9076847Revenue
DescriptionRebecca Residence provides high-quality assisted living, skilled nursing, and rehab/therapy services to individuals entrusted to our care. The facility is licensed for 65 assisted living beds and 60 skilled nursing beds. All beds are located in either private or almost-private rooms. During the fiscal year ended June 30, 2010, 465 residents were served by the facility. 42 residents received rehabilitation services that enabled them to be transferred from skilled nursing to assisted living at Rebecca Residence. Another 27 were transferred to other assisted living facilities after receiving their rehabilitation services. 231 residents were able to be discharged back to their home in the community. During the 6/30/10 fiscal year, the facility averaged 56.9 residents per day in assisted living and 52.0 residents per day in skilled nursing, translating to a total of 39,722 days of care provided in the facility. Residents of assisted living are cared for by licensed practical nurses (LPNs) and nursing assistants. In addition to LPNs and nursing assistants, residents in skilled nursing are also cared for by registered nurses. Care plans are developed by inter-disciplinary teams in both assisted living and skilled nursing that outline the care that is to be provided to the residents. It is the goal of the facility to serve residents in the least restrictive environment - assisted living as opposed to skilled nursing and discharged home as opposed to serving residents in the facility. Residents receive assistance with activities of daily living which includes eating, bathing, toileting, transferring and medication assistance. Residents in both assisted living and skilled nursing receive housekeeping and laundry. The facility employs its own therapy staff that provides services to residents, enabling them to get back to their highest possible level of functionality. Therapy services provided include physical, occupational and speech therapy. A robust activities program is provided to create a stimulating environment. Examples of activities programs provided to the residents include, but are not limited to, musical entertainment, daily exercise classes, current events updates, Bible studies, church services, holiday parties, summer picnics and day trips outside of the facility.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense203911Expense
Revenue0Revenue
DescriptionThe facility provided 2,601 subsidized days of care during the year to residents who were unable to pay for the full cost of their care due to lack of resources. This averages 7.13 residents per day and totaled $203,911 worth of subsidies. This is funded partly by donations from the Rebecca Residence Foundation and individuals in the community.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense7042634TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art1CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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 Bonds0TaxExemptBonds
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 Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees194NumberOfEmployees
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
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBetty KendallNamePerson
Telephone Number7244441520TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13746 Cedar Ridge RoadAddressLine1
CityAllison ParkCity
StatePAState
ZIP Code15101ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
David Alsing
Board Member1X000
Brian Hortert
Board Member1X01252457185
Charlene Kline
Board Member1X01274597303
Ruth Redenbaugh
Board Member1X000
Larry Talmadge
Board Member1X01127216568
Beatrice Lynch
Board Member1X000
Glenda Larson
Board Member1X000
Missy Unkovic
Board Member1X000
Keith Frndak
President and Chairman of the Board4X034065536938X
Paul Brand
Treasurer2X017003127440X
Kimberly Young
Secretary2X01031976176X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs979308TotalReportableCompFrmRltdOrgs
Total Other Compensation91610TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Concordia Lutheran Health and Human CareBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1134 Marwood RoadAddressLine1
CityCabotCity
StatePAState
ZIP Code16023ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesManagement ServicesDescriptionOfServices
Compensation142241Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations5088RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions12454AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions17542TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionSkilled Nursing and Assisted LivingDescription
Business Code623000BusinessCode
Total Revenue Column9076847TotalRevenueColumn
Related Or Exempt Function Income9076847RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue9076847TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column242991TotalRevenueColumn
Related Or Exempt Function Income242991RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities12745133Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities12148900Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities596233Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column596233TotalRevenueColumn
Related Or Exempt Function Income596233RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMiscellaneous IncomeDescription
Business Code623000BusinessCode
Total Revenue Column54647TotalRevenueColumn
Related Or Exempt Function Income54647RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue54647TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9988260TotalRevenueColumn
Related Or Exempt Function Income9970718RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3826765Total
Program Services3482840ProgramServices
Management And General343925ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total169132Total
Program Services152280ProgramServices
Management And General16852ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total450423Total
Program Services399873ProgramServices
Management And General50550ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total319219Total
Program Services291076ProgramServices
Management And General28143ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total141348Total
Management And General141348ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8103Total
Management And General8103ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total22260Total
Management And General22260ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total52404Total
Management And General52404ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total238706Total
Program Services190434ProgramServices
Management And General48272ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total43639Total
Management And General33597ManagementAndGeneral
Fundraising10042Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total34422Total
Program Services13964ProgramServices
Management And General19561ManagementAndGeneral
Fundraising897Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total400934Total
Program Services400934ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total5280Total
Management And General4704ManagementAndGeneral
Fundraising576Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6739Total
Program Services6408ProgramServices
Management And General331ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total83655Total
Program Services83655ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total679837Total
Program Services679837ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total4819Total
Program Services4819ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Pharmacy58213858213800
Medical Supplies & Expenses20115520115500
Small Equipment445753557090050
Foodservice Expenses32547932547900
Miscellaneous Expenses3130981921721209260

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7954130Total
Program Services7042634ProgramServices
Management And General899981ManagementAndGeneral
Fundraising11515Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY747199BOY
EOY786747EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1135746BOY
EOY1079549EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6074BOY
EOY6271EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17810835LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10648303LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7609222BOY
EOY7162532EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY15079732BOY
EOY18187463EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY430600BOY
EOY430600EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY25008573BOY
EOY27653162EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY258587BOY
EOY317667EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5696823BOY
EOY5623411EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5955410BOY
EOY5941078EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12857513BOY
EOY15146206EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1597636BOY
EOY1650220EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4598014BOY
EOY4915658EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19053163BOY
EOY21712084EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY25008573BOY
EOY27653162EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
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 Years50CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1841CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1315CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2518CurrentTaxYearMinus1Year
Current Tax Year49870CurrentTaxYear
Total55594Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6846465CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7112049CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7744708CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8350305CurrentTaxYearMinus1Year
Current Tax Year8949794CurrentTaxYear
Total39003321Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6846515CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7113890CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7746023CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8352823CurrentTaxYearMinus1Year
Current Tax Year8999664CurrentTaxYear
Total39058915Total
FieldValueIRS element (for citing)
Public Support Total50939058915PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years107144CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years166645CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years330637CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year260095CurrentTaxYearMinus1Year
Current Tax Year198824CurrentTaxYear
Total1063345Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years107144CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years166645CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years330637CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year260095CurrentTaxYearMinus1Year
Current Tax Year198824CurrentTaxYear
Total1063345Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years214288CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years333290CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years661274CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year520190CurrentTaxYearMinus1Year
Current Tax Year397648CurrentTaxYear
Total2126690Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years36636CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years57148CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10556CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19836CurrentTaxYearMinus1Year
Current Tax Year9986CurrentTaxYear
Total134162Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7097439CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7504328CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8417853CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8892849CurrentTaxYearMinus1Year
Current Tax Year9407298CurrentTaxYear
Total41319767Total
FieldValueIRS element (for citing)
Public Support Percentage5090.94528PublicSupportPercentage509
Prior Year Support Percentage0.9714PriorYearSupportPercentage
Investment Income Percentage0.05147InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.0251PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationMiscellaneous related incomeGeneralExplanation

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

Held Works Of Art Amts HeldWorksOfArtAmts

FieldValueIRS element (for citing)
Revenues Included0RevenuesIncluded
Assets In Part X430600AssetsInPartX
FieldValueIRS element (for citing)
Collect Used For PreservationXCollectUsedForPreservation
Solicited Assets For Sale0SolicitedAssetsForSale

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1061103OtherCostOrOtherBasis
Book Value1061103BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis13098721OtherCostOrOtherBasis
Depreciation7565814Depreciation
Book Value5532907BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis624243OtherCostOrOtherBasis
Depreciation468154Depreciation
Book Value156089BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1941937OtherCostOrOtherBasis
Depreciation1703308Depreciation
Book Value238629BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1084831OtherCostOrOtherBasis
Depreciation911027Depreciation
Book Value173804BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7162532TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionCollectionsDescription
Book Value430600BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets430600TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Note Payable to Affiliate$5,529,215
Accounts Payable to Related Organization$94,196
FieldValueIRS element (for citing)
Total Of Amounts5623411TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P03_S00_L01Schedule D, Part III, Line 1Collections - The Organization's collection is comprised of artifacts of historical significance, works of art and antiques. The collections were acquired through purchases and contributions since the Organization's inception and are recognized as assets on the balance sheets. Items purchased are recorded at cost and contributed items are recorded at their appraised fair market value. Purchases of collection items are recorded as decreases in unrestricted assets in the year in which the items are acquired, or as temporarily or permanently restricted net assets if the assets used to purchase the items are restricted by donors. Proceeds from deaccessions or insurance recoveries are reflected as increases in the appropriate net asset classes. The collections are classified as non-depreciable property since their value is expected to appreciate.
SchD_P03_S00_L04Schedule D, Part III, Line 4Rebecca Residence's works of art vary among paintings, vases and other items of historical significance. These items reflect the history of the organization and serve as a marketing tool to prospective residents and their families.
SchD_P10_S00_L00Schedule D, Part XIncome Tax Status- The Organization is a not-for-profit corporation and is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. In 2008, the Organization applied the guidance in FASB Staff Position FAS 126-1, Applicability of Certain Disclosure and Interim Reporting Requirements for Obligors for Conduit Debt Securities, (FSP 126-1). FSP 126-1 amended certain accounting literature to include conduit debt obligors in the definition of a public entity enterprise. As a result, the Organization adopted FASB Interpretation No. 48, Accounting for Uncertainty in Income Taxes-an Interpretation of FASB Statement No. 109 (FIN 48) effective July 1, 2007. FIN 48 clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements 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. FIN 48 also provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, and disclosure. Management has reviewed the impact of FIN 48 on these financial statements and has determined that there are no material uncertain tax positions or unrecognized tax benefits and there is no material impact on the financial position, results of operations and changes in net assets, or cash flows. The Organization's evaluation was performed for the tax years 2007 through 2009, which are the years that remain subject to federal and state examinations as of June 30, 2010.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 (2 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
Keith Frndak
031915500021500050728017460040884300
Paul Brand
015353100016500024980017460021247100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSchJ_P01_S00_L04Identifier
Return ReferenceSchedule J, Part I, Line 4ReturnReference
ExplanationAll of the following individuals had a contribution to a 457 non-qualified retirement plan during the calendar year 2009. The amounts received under the 457 plan are included under Reportable Compensation from Related Organizations. Keith Frndak; Paul Brand; Brian Hortert; Charlene Kline; Larry Talmadge; Kimberly Young.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P00_S00_L0BForm 990, Header, Line BIn the original filing, in Part IX Statement of Functional Expenses, Fundraising expenses were not recorded in comlumn (D). Because fundraising in the primary exempt purpose of this organization it was our understanding that these expenses should not be recorded in column (D). After a conversation with our tax professionals about this subject we realized that we were mistaken and this amended return now segregates fundraising expenses from all other expenses.
F990_P03_S00_L04aForm 990, Part III, Line 4aCommunity Benefits Provided by the Organization - In addition to the program services provided to residents of the facility, Rebecca Residence also provides general community benefits. Examples include, but are not limited to, hosting Seniors for Safe Driving educational course, providing space in the facility for use by outside church and community groups for their functions and donating various gift baskets for fundraisers for non-related charitable organizations.
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6Concordia Lutheran Health and Human Care is the sole member of Rebecca Residence.
F990_P06_S0A_L07aForm 990, Part VI, Section A, Line 7aConcordia Lutheran Health and Human Care is the sole member of Rebecca Residence and elects nine of the twelve members of the board of directors of Rebecca Residence.
F990_P06_S0A_L07bForm 990, Part VI, Section A, Line 7bConcordia Lutheran Health and Human Care, being the sole member of Rebecca Residence, holds certain reserve powers over the board of directors of Rebecca Residence.
F990_P06_S0B_L11Form 990, Part VI, Section B, Line 11A copy of the Form 990 is provided to the board of directors prior to submitting the Form 990 with the Internal Revenue Service. An opportunity is given to the board of directors to provide comments and/or feedback on the contents of the Form 990. Management considers all comments and feedback and makes changes to the Form 990 as appropriate.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cMembers of the board of directors are periodically reminded of their responsibility to report any potential conflict of interest. The board's conflict of interest policy is completed by each board member on an annual basis. Any potential conflict of interest that is disclosed is discussed and handled on an individual basis as appropriate.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15The administrator and director of nursing salaries are reviewed on an annual basis, most recently in January 2010. The organization participates in various state and national industry-specific salary surveys. Results of the surveys are used to measure the salaries and benefits of key employees.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Concordia Lutheran Ministries publishes an annual report that summarizes the financial operations of the organization and its affiliates which is mailed to all of its constituents and is avaivable to the public upon request. The Form 990 is available through the GuideStar website and the Form 990 would be presented to any individual who requests, in writing, a copy of the form.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1Address Line2AddressUS/AddressLine2
Concordia Lutheran Ministries
134 Marwood RoadCabotPA16023205138278Oversees all activities of affiliated organizations.PA501(c)(3)509(a)(3)N/A
Concordia Lutheran Health and Human Care
134 Marwood RoadCabotPA16023250969458Skilled Nursing, Assisted Living, Independent Living, ChildcarePA501(c)(3)509(a)(3)Concordia Lutheran Ministries
Rebecca Residence Foundation
3746 Cedar Ridge RoadAllison ParkPA15101412127319Manage investment assets of Rebecca ResidencePA501(c)(3)509(a)(3)N/A
Good Samaritan Hospice of Pittsburgh
3500 Brooktree RoadWexfordPA15090251318793In-Home and In-Patient end of life care.PA501(c)(3)509(a)(3)Concordia Lutheran Health and Human CareSuite 320

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Providence Pharmacy ServicesBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1615 North Pike RoadAddressLine1
CityCabotCity
StatePAState
ZIP Code16023ZIPCode
FieldValueIRS element (for citing)
EIN223885810EIN
Primary ActivityInstitutional PharmacyPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Concordia Providence LLCBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRelatedPredominantIncomeType
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
Code V$0CodeVAmount
General Or Managing Partner0GeneralOrManagingPartner
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 Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Concordia Lutheran Health and Human Care
l142241
Rebecca Residence Foundation
c445378
Concordia Lutheran Health and Human Care
o532837
Concordia Lutheran Ministries
p228288

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationForm 8868 was previously filed and approved by the IRS.Explanation

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