2023-11-14T13:43:58-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2022-01-01 381358410 LUTHERAN HOMES OF MICHIGAN INC LUTH 9896523470 2825 WIENEKE RD SAGINAW MI 48603 TIMOTHY KALBFLEISCH SVP AND CFO 9896523470 2023-11-14 1 TIMOTHY KALBFLEISCH 999009999 0 TINA PETERS P00904574 2483757100 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z WELLSPRING LUTHERAN SERVICES DAVID M GEHM 2825 WIENEKE RD SAGINAW MI 48603 46186663 0 X WWW.WELLSPRINGLUTHERAN.COM X 1892 MI MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 6 6 655 80 0 0 8195120 3699978 28467142 29362867 4741059 1206762 1080430 3806999 42483751 38076606 0 0 0 0 18615343 20093326 0 0 270378 17498557 16518152 36113900 36611478 6369851 1465128 62116968 59659370 33144595 31289945 28972373 28369425 MOTIVATED BY CHRIST'S LOVE, WE ENGAGE PEOPLE AS THEY EXPERIENCE AND EMBRACE THEIR GOD-GIVEN POTENTIAL. 0 0 29889942 29362867 SKILLED NURSING CARE UNIT AND HOME FOR THE AGED UNIT PROVIDED 78,483 DAYS OF CARE AND 11,207 DAYS OF REHABILITATION, ROOM AND BOARD, NURSING CARE AND RELIGIOUS SERVICES FOR RESIDENTS OF TWO NURSING HOMES 29889942 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 0 0 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 1 1 1 1 0 0 1 83 0 1 655 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 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 38.54 1.46 X 237364 0 9115 TIMOTHY KALBFLEISCH SR. VP FINANCE AND CFO 39.50 0.50 X 201120 0 3014 ALBERT D KAUL VP OF FOUNDATION, CDO 39.39 0.61 X 145579 0 8148 ERIC R MUSUM VP, CAA AND CTO 39.29 0.71 X 152288 0 9147 JONATHAN GOLM DIRECTOR OF PROJECT DEVELOPMENT 40.00 0.00 X 203811 0 2813 JILL HAISER VP OF MARKETING, CMO 12.50 27.50 X 156688 0 8187 VICTORIA PARRISH EXECUTIVE DIRECTOR 40.00 0.00 X 129397 0 7407 SCOTT KECK-WARREN AES TECHNOLOGY MANAGER 40.00 0.00 X 116613 0 7834 NOELLE CONZELMANN DIRECTOR OF SKILLED NURSING OPS 40.00 0.00 X 115328 0 6357 1458188 0 62022 19 0 1 0 WM BRONNER & SONS CONTRACTORS INC 393 LIST ST STE A FRANKENMUTH MI 48734 CONSTRUCTION 4306357 UNIDINE PO BOX 102289 ATLANTA GA 30368 CATERING SERVICE 3348698 THERAPY MANAGEMENT INC 851 PENNIMAN AVE PLYMOUTH MI 48170 THERAPY SERVICES 755298 PRN ON DEMAND LLC 851 PENNIMAN AVE PLYMOUTH MI 48170 STAFFING 542490 REMEDI SENIORCARE OF MICHIGAN 14700 HELM CT PLYMOUTH MI 48170 PHARMACY 443592 18 2813489 886489 6730 3699978 SKILLED NURSING & HOME CARE 623000 25027719 25027719 FURNISHED SERVICES 623000 4123860 4123860 OTHER RESIDENT INCOME 623000 211288 211288 29362867 368888 368888 17520 0 17520 17520 17520 7003412 1944519 6167973 1942084 835439 2435 837874 837874 CONSULTING INCOME 561000 2694800 2694800 MISCELLANEOUS INCOME 561000 563817 563817 MANAGEMENT FEES 561000 524492 524492 6370 6370 3789479 38076606 29362867 0 5013761 X 765775 650232 105248 10295 16691793 14251624 2216215 223954 55295 42485 11088 1722 1303576 941590 349274 12712 1276887 1100931 159248 16708 176350 176350 1824 1824 6060683 5526069 534614 388268 385648 2620 276593 55831 219736 1026 398527 74871 323656 1557763 1365489 191092 1182 78638 24165 51776 2697 113807 37226 76549 32 1380431 1380431 2029683 1623746 405937 1027837 1027837 INCOME TAX EXPENSE 129793 129793 MMQAA PROVIDER TAX 1248619 1248619 DRUGS AND MEDICAL SUPPL 1060290 1054890 5350 50 OTHER EXPENSE 330659 40492 290167 258387 85603 172784 36611478 29889942 6451158 270378 19512668 14354323 9819435 7386195 7219205 7513883 70956 80013 892852 595114 58571560 34343595 20921001 24227965 1647139 1720361 2033712 3781516 62116968 59659370 2789645 2552070 56363 2440 4198994 24467245 27660326 1632348 1075109 33144595 31289945 X 25074840 24934995 3897533 3434430 28972373 28369425 62116968 59659370 X 1465128 -3782233 1714157 X 0 1 X 1 0 X 180052 253077 7630870 8195120 3699978 19959097 41454569 33338014 27879717 28467142 29362867 160502309 41634621 33591091 35510587 36662262 33062845 180461406 166665 249671 41500 5877 2813489 3277202 0 166665 249671 41500 5877 2813489 3277202 177184204 212875 379169 464455 491955 386408 1934862 212875 379169 464455 491955 386408 1934862 327305 339978 960230 1627513 2725559 3110124 1864751 1062910 3789479 12552823 44573055 37407689 38179771 39177357 37238732 196576604 0.90130 0.92450 0.00980 0.00860 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: CONSULTING AND OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1824 1824 0 PART II-B, LINE 1: MEMBERSHIP FEE ALLOCATED TO LOBBYING. 1 5249 42659 43592 4316 0 1208644 1208644 47595073 29035473 18559600 67928 61290 6638 2904947 1923179 981768 6794968 3323653 3471315 24227965 DEPOSITS 414287 BENEFICIAL INTEREST IN WELLSPRING FOUNDATION 1591102 INTEREST RATE SWAP ASSET 1612835 RIGHT OF USE OPERATING LEASE ASSETS 163292 3781516 RESIDENT SECURITY DEPOSITS 11200 ACCRUED OTHER LIABILITIES 900617 LEASE LIABILITY 163292 1075109 PART IV, LINE 1B: LUTHERAN HOMES OF MICHIGAN, INC. IS REQUIRED TO MAINTAIN RESIDENT TRUST FUNDS AT ITS NURSING HOMES. X X 0 0 0 0 0 0 0 0 0 DAVID M GEHM PRESIDENT & CEO 237364 0 0 0 0 0 1940 0 7175 0 246479 0 0 0 JONATHAN GOLM DIRECTOR OF PROJECT DEVELOPMENT 203811 0 0 0 0 0 1682 0 1131 0 206624 0 0 0 TIMOTHY KALBFLEISCH SR. VP FINANCE AND CFO 201120 0 0 0 0 0 1538 0 1476 0 204134 0 0 0 JILL HAISER VP OF MARKETING, CMO 156688 0 0 0 0 0 1215 0 6972 0 164875 0 0 0 ERIC R MUSUM VP, CAA AND CTO 152288 0 0 0 0 0 1256 0 7891 0 161435 0 0 0 ALBERT D KAUL VP OF FOUNDATION, CDO 145579 0 0 0 0 0 1248 0 6900 0 153727 0 0 0 A MICHIGAN STRATEGIC FUND LIMITED OBLIGATION REVENUE BONDS (WELLSPRING LUTHER 521417332 2015-10-29 13524231 SEE BELOW 0 0 0 A 13524231 123618 13400613 1 0 1 1 A 0 0 0 0 1 1 0.23940 0 0 A 0 1 0 0 1 1 HUNTINGTON NATIONAL BANK 10.000000000000 0 0 0 0 1 A 0 SCHEDULE K, PART I, BOND ISSUES (F) DESCRIPTION OF PURPOSE: PROCEEDS OF THE BONDS WERE USED TO FINANCE HEALTHCARE FACILITIES AND $7,196,494 PROCEEDS WERE USED TO REFINANCE BANK LOAN WHICH HAD REFUNDED BONDS ISSUED TO FINANCE HEALTHCARE AND HOUSING FACILITIES. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990 RETURN, ELECTRONIC COPIES 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 B, LINE 15A THE EXECUTIVE COMMITTEE OF THE BOARD, UNDER THE BOARD CHAIR'S LEADERSHIP, IS RESPONSIBLE FOR ANNUAL PERFORMANCE REVIEW AND COMPENSATION ADJUSTMENT OF THE CEO, WHEN APPROPRIATE. OUTSIDE SOURCES OR COMPARATIVE REVIEW ARE TAKEN INTO CONSIDERATION WHEN SETTING TOTAL COMPENSATION. A COMPREHENSIVE PERFORMANCE EVALUATION WAS COMPLETED IN 2023; COMPENSATION WAS NOT ADJUSTED AT THAT TIME. 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 IX, LINE 11G CONTRACTED THERAPY SERVICES: PROGRAM SERVICE EXPENSES 737,030. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 737,030. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 4,584,740. MANAGEMENT AND GENERAL EXPENSES 273,244. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,857,984. OTHER: PROGRAM SERVICE EXPENSES 204,299. MANAGEMENT AND GENERAL EXPENSES 261,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 465,669. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP 2,187,260. CHANGE IN INTEREST OF NET ASSETS OF CHARITABLE FOUNDATION -463,103. PRIOR YEAR ADJUSTMENT -10,000. THE WELLSPRING CLINIC 2825 WIENEKE RD SAGINAW MI 48603 381358410 OUTPATIENT CLINIC MI -108999 -92618 LUTHERAN HOMES OF MICHIGAN INC AGING ENRICHED SERVICES LLC 2825 WIENEKE RD SAGINAW MI 48603 472636131 FOLLOW-UP COMMUNICATION SERVICES MI -105009 1572186 LUTHERAN HOMES OF MICHIGAN INC THE SPRINGS OF FRANKENMUTH LLC 2825 WIENEKE RD SAGINAW MI 48603 842433251 INDEPENDENT LIVING COMMUNITY MI -104643 1956976 LUTHERAN HOMES OF MICHIGAN INC MGK HOLDINGS LLC 2825 WIENEKE RD SAGINAW MI 48603 872269762 ASSET MANAGEMENT MI 0 1350000 LUTHERAN HOMES OF MICHIGAN INC LHM ASSET MANAGEMENT LLC 2825 WIENEKE RD SAGINAW MI 48603 200055004 ASSET MANAGEMENT MI 9571 178074 LUTHERAN HOMES OF MICHIGAN INC 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 LUTHERAN HOMES OF MICHIGAN FOUNDATION 2825 WIENEKE RD SAGINAW MI 48603 261630687 DONATE FUNDS MI 501(C)(3) LINE 12A, I LUTHERAN HOMES OF MICHIGAN INC 1 LUTHERAN HOME CARE PERSONAL ASSISTANCE 2825 WIENEKE RD SAGINAW MI 48603 272138954 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 LUTHERAN HOMES OF MICHIGAN INC RELATED -1566 163266 0 1 0.50000 GIBRALTER LDHALP 26200 LAHSER RD STE 300 SOUTHFIELD MI 48034 301829767 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI GIBRALTAR MANOR DEVELOPMENT INC RELATED -3 166 0 0 MONROE ELDERLY LDHALP 5309 TRANSPORTATION BLVD CLEVELAND OH 44125 383609893 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI LHM HOUSING SERVICES INC RELATED 97 0 0 ALPENA PINES LDHALP 9710 JUNCTION ROAD FRANKENMUTH MI 48434 260236982 PROVIDE AFFORDABLE HOUSING TO THE ELDERLY MI ALPENA PINES DEVELOPMENT INC RELATED -10 140 0 0 TRANSITIONAL CARE COMMUNITY LLC 2825 WIENEKE RD SAGINAW MI 48603 872544936 RESIDENTIAL CONTINUING CARE RETIREMENT FACILITY MI LUTHERAN HOMES OF MICHIGAN INC RELATED -675773 855536 0 1 0.50000 LHM HOUSING SERVICES INC 2825 WIENEKE RD SAGINAW MI 48603 383609879 HOUSING SERVICES MI LUTHERAN HOMES OF MICHIGAN INC C -6 121 0.79000 1 GIBRALTAR MANOR DEVELOPMENT INC 2825 WIENEKE RD SAGINAW MI 48603 202240778 HOUSING SERVICES MI N/A C -3 166 0.50000 0 ALPENA PINES DEVELOPMENT INC 2825 WIENEKE RD SAGINAW MI 48603 260237019 HOUSING SERVICES MI N/A C -10 140 0.50000 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 AUSABLE VALLEY CONTINUING CARE RETIREMENT COMMUNITY Q 107530 ACTUAL AMOUNT LUTHERAN HOME CARE AGENCY M 212583 ACTUAL AMOUNT PROJECT COMPASSION HEALTH Q 175094 ACTUAL AMOUNT LUTHERAN HOME CARE AGENCY Q 78284 ACTUAL AMOUNT LUTHERAN HOMES OF MICHIGAN FOUNDATION C 2813489 ACTUAL AMOUNT