2023-11-13T08:45:23-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2022-01-01 272138954 LUTHERAN HOME CARE PERSONAL ASSISTANCE LUTH 9896523470 2825 WIENEKE RD SAGINAW MI 48603 TIMOTHY KALBFLEISCH SVP AND CFO 9896523470 2023-11-08 1 TIMOTHY KALBFLEISCH 999009999 0 TINA PETERS P00904574 2483757100 2023-11-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z WELLSPRING LUTHERAN SERVICES DAVID M GEHM 2825 WIENEKE RD SAGINAW MI 48603 753617 0 X WWW.WELLSPRINGLUTHERAN.COM X 2010 MI MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 6 6 38 0 0 0 0 500 558983 627288 -1867 0 149448 125829 706564 753617 0 0 0 0 662500 690062 0 0 0 195298 238871 857798 928933 -151234 -175316 1855936 1824928 2684008 2744517 -828072 -919589 MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 0 0 706497 742562 PERSONAL ASSISTANCE PROVIDED THOUSANDS OF HOURS OF PERSONAL HOME CARE SERVICES WHILE ASSISTING VARIOUS INDIVIDUAL CLIENTS. THESE SERVICES ALLOW THEM TO REMAIN IN THEIR HOMES, PROMOTE THEIR INDEPENDENCE, AND DELAY OR PREVENT TRANSITION TO A NURSING HOME OR ASSISTED LIVING ENVIRONMENT. THE LHCPA PROVIDED A TOTAL OF 8,273 VISITS TO 106 INDIVIDUALS. 706497 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 2 0 1 38 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 0 0 0 MI X JODIE LAWMASTER 9892393004 2825 WIENEKE RD SAGINAW MI 48603 RITCH CUSHWAY CHAIRMAN 0.20 0.80 X X 0 0 0 PETE BENDER TREASURER/SECRETARY 0.20 0.80 X X 0 0 0 DARRELL ZOLTON DIRECTOR - PART YEAR 0.20 0.80 X 0 0 0 PAUL NYQUIST DIRECTOR 0.20 0.80 X 0 0 0 CARL SCHOENOW DIRECTOR 0.20 0.80 X 0 0 0 AMY BENKO DIRECTOR 0.20 0.80 X 0 0 0 KAREN STORCK DIRECTOR 0.20 0.80 X 0 0 0 DAVID M GEHM PRESIDENT & CEO 0.00 40.00 X 0 237364 9115 TIMOTHY KALBFLEISCH SR. VP FINANCE AND CFO 0.08 39.92 X 0 201120 3014 ALBERT D KAUL VP OF FOUNDATION, CDO 0.00 40.00 X 0 145579 8148 ERIC R MUSUM VP, CAA AND CTO 0.00 40.00 X 0 152288 9147 0 736351 29424 0 0 1 0 0 500 500 PATIENT SERVICE REVENU 621610 627288 627288 627288 115274 0 115274 115274 115274 MISCELLANEOUS 561000 10555 10555 10555 753617 742562 0 10555 582124 518295 63829 1828 1644 184 62457 38498 23959 43653 38968 4685 14404 14404 48 48 4408 4408 17724 17724 2239 2239 11558 11558 37008 21282 15726 841 331 510 1903 1825 78 30261 30261 43452 34762 8690 11857 11857 BAD DEBT EXPENSE 32711 32711 LICENSE AND FEES 18007 112 17895 RENTAL EQUIPMENT 9526 9526 RECRUITING EXPENSE 1449 1320 129 1475 1475 928933 706497 222436 0 48377 145441 109400 64587 4327 2140 1103357 582176 564633 521181 1129199 1091579 1855936 1824928 42923 27162 582965 0 462125 1010545 1595995 1706810 2684008 2744517 X -828096 -919613 24 24 -828072 -919589 1855936 1824928 X -175316 83799 X 0 1 X 1 0 X 500 500 1000 2033215 2249520 1543217 705618 742562 7274132 2033215 2250020 1543217 705618 743062 7275132 0 226547 229829 154349 240895 288617 1140237 226547 229829 154349 240895 288617 1140237 6134895 117 7 124 117 7 124 15237 7090 2813 10555 35695 2033215 2265374 1550314 708431 753617 7310951 0.83910 0.86580 0.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS 0 0 0 0 0 0 0 0 1 48 48 0 PART II-B, LINE 1: MEMBERSHIP FEE ALLOCATED TO LOBBYING 966780 473726 493054 22734 22734 0 113843 85716 28127 521181 DEPOSITS 6700 ASSETS LIMIMITED AS-TO-USE 24 DUE FROM AFFILIATES 1004442 INTEREST RATE SWAP MARK TO MARKET 80413 1091579 DUE TO AFFILIATES 1706810 1706810 0 0 0 0 0 0 0 0 0 DAVID M GEHM PRESIDENT & CEO 0 237364 0 0 0 0 0 1940 0 7175 0 246479 0 0 TIMOTHY KALBFLEISCH SR. VP FINANCE AND CFO 0 201120 0 0 0 0 0 1538 0 1476 0 204134 0 0 ERIC R MUSUM VP, CAA AND CTO 0 152288 0 0 0 0 0 1256 0 7891 0 161435 0 0 ALBERT D KAUL VP OF FOUNDATION, CDO 0 145579 0 0 0 0 0 1248 0 6900 0 153727 0 0 PART I, LINE 3 THE PROCESS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, CEO, AND CFO IS UNDERTAKEN BY LUTHERAN HOMES OF MICHIGAN, INC., A RELATED ORGANIZATION. THE PROCESS INCLUDES USE OF A COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS LUTHERAN HOMES OF MICHIGAN, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, LUTHERAN HOMES OF MICHIGAN, INC., HAS THE AUTHORITY TO APPOINT/ELECT INDIVIDUALS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES OF THE FORM 990 WERE SENT TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS' INPUTS AND COMMENTS WERE SOLICITED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE COLLECTED IN THE BEGINNING OF EACH NEW BOARD YEAR. THE FORMS ARE REVIEWED BY THE CEO. IF A CONFLICT EXISTS, THE CEO REVIEWS WITH THE BOARD CHAIR AND DETERMINES THE APPROPRIATE ACTION, WHICH IS TYPICALLY TO REMOVE THE INDIVIDUAL FROM THE POSITION OF CONFLICT FOR THE SPECIFIC TRANSACTION/PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE CORPORATE OFFICE OF WELLSPRING LUTHERAN SERVICES BY CONTACTING THE CHIEF FINANCIAL OFFICER. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP 83,799. LUTHERAN HOMES OF MICHIGAN INC 2825 WIENEKE RD SAGINAW MI 48603 381358410 NURSING CARE MI 501(C)(3) LINE 10 N/A 0 LUTHERAN HOMES OF MICHIGAN FOUNDATION 2825 WIENEKE RD SAGINAW MI 48603 261630687 DONATE FUNDS MI 501(C)(3) LINE 12A LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE AGENCY INC 2825 WIENEKE RD SAGINAW MI 48603 383081979 HOME CARE MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY INC 2825 WIENEKE RD SAGINAW MI 48603 382236926 RETIREMENT COMMUNITY MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 PROJECT COMPASSION HEALTH 2825 WIENEKE RD SAGINAW MI 48603 382395647 SKILLED NURSING FACILITY MI 501(C)(3) LINE 10 LUTHERAN HOMES OF MICHIGAN INC 1 ALPENA VILLAGE 2825 WIENEKE RD SAGINAW MI 48603 320090735 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI N/A 0 1 GIBRALTER 26200 LAHSER RD STE 300 SOUTHFIELD MI 48034 301829767 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A 0 1 MONROE ELDERLY LDHALP 5309 TRANSPORTATION BLVD CLEVELAND OH 44125 383609893 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A 0 1 ALPENA PINES LDHALP 9710 JUNCTION ROAD FRANKENMUTH MI 48434 260236982 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI N/A 0 1 TRANSITIONAL CARE COMMUNITY LLC 2825 WIENEKE RD SAGINAW MI 48603 872544936 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI N/A 0 1 LHM HOUSING SERVICES INC 2825 WIENEKE RD SAGINAW MI 48603 383609879 HOUSING SERVICES MI N/A C 0 GIBRALTER MANOR DEVELOPMENT INC 2825 WIENEKE RD SAGINAW MI 48603 202240778 HOUSING SERVICES MI N/A C 0 ALPENA PINES DEVELOPMENT INC 2825 WIENEKE RD SAGINAW MI 48603 260237019 HOUSING SERVICES MI N/A C 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 LUTHERAN HOME CARE AGENCY INC J 114974 ACTUAL AMOUNT