2024-11-15T13:55:18-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 10401 W INNOVATION DR STE 300 WAUWATOSA WI 53226 990 2023-01-01 390806344 FOND DU LAC LUTHERAN HOME INC FOND 9209219520 1045 HILL STREET WATERTOWN WI 53098 NICOLE CHWALA CFO 9209219520 2024-11-14 1 0 KRISTEN DONLEVY P01670215 4144761880 2024-11-14 2023 2024-10-15 13:58:12Z NICOLE CHWALA 1045 HILL STREET WATERTOWN WI 53098 8715439 0 X HTTPS://WWW.ILLUMINUS.US/COMMUNITIES/LUTHERAN-HOM X 1939 WI FOND DU LAC LUTHERAN HOME, AS PART OF LUTHERAN HOMES AND HEALTH SERVICES, PROVIDES A CHRISTIAN-BASED INNOVATIVE APPROACH TO AGING THROUGH COMPREHENSIVE SERVICES, PROGRAMS, AND COMMUNITIES. 7 4 109 28 0 0 0 230 7783677 8597627 1354 4307 105350 113275 7890381 8715439 0 0 0 0 2525812 2392053 0 0 0 5196864 6619611 7722676 9011664 167705 -296225 7704204 7265223 1165861 1023105 6538343 6242118 X FOND DU LAC LUTHERAN HOME, AS PART OF LUTHERAN HOMES AND HEALTH SERVICES, PROVIDES A CHRISTIAN-BASED INNOVATIVE APPROACH TO AGING THROUGH COMPREHENSIVE SERVICES, PROGRAMS, AND COMMUNITIES. 0 0 6795434 0 8587646 LUTHERAN HOMES AND HEALTH SERVICES, INC ENCOMPASSES A VARIETY OF PROGRAMS DESIGNED TO ASSIST SENIORS IN ACTIVELY AGING. THE FOND DU LAC LUTHERAN HOME, INC, A LHHS ENTITY, PROVIDES SKILLED NURSING, SHORT-TERM REHABILITATION, AND ASSISTED LIVING IN A CHRISTIAN-BASED ENVIRONMENT FOR PEOPLE OF ALL FAITHS SHORT-TERM REHAB. THE FOND DU LAC LUTHERAN HOME IS KNOWN FOR DELIVERING HIGH-QUALITY SHORT-TERM REHABILITATION. OUR SKILLED THERAPISTS UTILIZE STATE OF THE ART METHODS AND EQUIPMENT TO PROVIDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY ON AN INPATIENT OR OUTPATIENT BASIS. THE FOND DU LAC LUTHERAN HOME HAS PROVIDED HIGH QUALITY SKILLED NURSING CARE FOR OVER SEVENTY YEARS. IT SERVES PEOPLE OF ALL FAITHS AND FINANCIAL MEANS. THE HOME'S COMFORTABLE, INVITING ATMOSPHERE AS WELL AS THE TALENTED, COMPASSIONATE AND KNOWLEDGABLE STAFF MAKES THE PROGRAM A SUCCESS. THE FOND DU LAC LUTHERAN HOME'S ASSISTED LIVING PROGRAM TARFA TERRACE PROVIDES THE FLEXIBILITY AND SUPPORT TO MEET A VARIETY OF NEEDS FOR ITS PATIENTS IN AN ENVIRONMENT THAT ENHANCES AND ENCOURAGES INDEPENDENCE. 6795434 1 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 109 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WI X NICOLE CHWALA CFO OF ILLUMINUS INC 9202610400 1045 HILL STREET WATERTOWN WI 53098 X TERRY SCHLEIF CHAIR 1.50 1.50 X X 0 0 0 JIM FETT BOARD MEMBER 0.25 0.25 X 0 0 0 MIKE KROLCZYK BOARD MEMBER 0.25 0.25 X 0 0 0 KIM SUHS VICE CHAIR 1.00 1.00 X X 0 0 0 NICOLE CHWALA CFO 1.00 2.00 X X 0 0 0 MATT MAUTHE CEO 1.00 2.00 X X 0 0 0 MICHAEL LIBBY SENIOR VP OF OPERATIONS 1.00 2.00 X X 0 0 0 0 0 0 0 0 0 0 0 230 230 NURSING HOME 623000 7128486 7128486 RESIDENTIAL FACILITY 623000 1459160 1459160 BEAUTY SHOP REVENUE 623000 9981 9981 8597627 4307 4307 CABLE TV 623000 15906 15906 TRANSPORTATION 623000 8715 8715 TELEPHONE 623000 1846 1846 86808 86808 113275 8715439 8587646 0 127563 X 2061396 1910560 150836 24930 24930 150665 149505 1160 155062 155062 849220 849220 6783 6783 47739 47739 3220681 2549244 671437 111312 24248 87064 1906 1906 136420 136420 413577 389539 24038 74683 74683 19372 19372 12002 12002 264527 264527 136575 136575 DIETARY EXPENSES 395171 395171 SUPPLIES 363809 353752 10057 BAD DEBT EXPENSE 219216 219216 DUES AND LICENSES 189780 189780 156838 156838 9011664 6795434 2216230 0 3707262 2819109 939894 1402442 58263 51151 14865095 12473672 2541896 2391423 456889 601098 7704204 7265223 914463 917373 251398 60864 0 44868 1165861 1023105 X 6538343 6242118 6538343 6242118 7704204 7265223 -296225 0 X 0 1 X 1 0 X 4287 1378346 1159605 230 2542468 7405448 6755212 7317059 7783677 8587646 37849042 7409735 8133558 8476664 7783677 8587876 40391510 0 488749 274839 3694 767282 488749 274839 3694 767282 39624228 3566 1234 419 1354 4307 10880 3566 1234 419 1354 4307 10880 25659 307960 27425 105350 123256 589650 7438960 8442752 8504508 7890381 8715439 40992040 0.96660 0.95450 0.00030 0.00020 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2019 AMOUNT: $ 25,659. 2020 AMOUNT: $ 307,960. 2021 AMOUNT: $ 27,425. 2022 AMOUNT: $ 105,350. 2023 AMOUNT: $ 123,256. 89363 89363 10961538 8973223 1988315 100337 91301 9036 3671689 3409148 262541 42168 42168 2391423 DUE FROM LUTHERAN HOMES AND HEALTH SERVICES 197928 FINANCIAL LEASE 39604 ASSESTS LIMITED AS TO USE 361007 RESIDENT FUNDS IN TRUST 2559 601098 RESIDENT FUNDS HELD IN TRUST 2559 FINANCING LEASES 42309 44868 0 0 0 0 0 0 0 0 0 PART I, LINE 3 RELATED ORGANIZATIONS USE THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR: 1. INDEPENDENT COMPENSATION CONSULTANT 2. COMPENSATION SURVEY OR STUDY 3. FORM 990 OF OTHER ORGANIZATIONS 4. APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SINGLE CLASS OF MEMBERS, AND THE SOLE MEMBER OF THAT CLASS IS LUTHERAN HOMES & HEALTH SERVICES, INC, A WISCONSIN NONSTOCK CORPORATION (THE "MEMBER"). FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE BOARD OF DIRECTORS SHALL BE APPOINTED BY THE MEMBER WITH CONSIDERATION GIVEN TO THEIR CHARACTER, CONCERN FOR THE PRINCIPLES AND PROGRAMS OF THE CORPORATION, AND THE SINGULAR CONTRIBUTIONS THEY COULD RENDER TO THE INCREASED EFFECTIVENESS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEWS THE FORM 990. THE FORM 990 IS THEN PROVIDED TO THE BOARD MEMBERS ELECTRONICALLY FOR THEIR REVIEW IN ADVANCE OF THE BOARD MEETING AND REVIEWED AS INDICATED IN THE BOARD MINUTES, BEFORE IT IS FINALIZED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY AT A REGULARLY SCHEDULED BOARD MEETING, ALL BOARD MEMBERS ARE GIVEN A 'CONFLICT OF INTEREST' STATEMENT TO SIGN. PRIOR TO THE SIGNING, EACH BOARD MEMBER IS BRIEFED ON THE PURPOSE AND INTENT OF THE FORM AND THE NEED TO LIST ANY PERSONAL CONTACTS AND/OR INTEREST THAT MAY CONFLICT WITH THEIR ABILITY TO SERVE AS BOARD MEMBERS. THOSE THAT HAVE NOT ATTENDED THE BOARD MEETING WOULD BE CONTACTED PERSONALLY WITH SIMILAR INSTRUCTIONS. ALL SIGNED DOCUMENTS ARE RETAINED. ALL BOARD MEMBERS SIGN AND COMPLETE THE FORM. MANAGEMENT FOLLOWS UP ON ANY CONFLICTS THAT ARE IDENTIFIED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,549,244. MANAGEMENT AND GENERAL EXPENSES 671,437. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,220,681. LUTHERAN HOMES AND HEALTH SERVICES INC 1045 HILL STREET WATERTOWN WI 53098 392032901 PROVIDE MANAGEMENT SERVICES TO FOND DU LAC LUTHERAN HOME, INC WI 501(C)(3) LINE 10 N/A 0 LUTHERAN HOMES AND HEALTH SERVICES FOUNDATION INC 1045 HILL STREET WATERTOWN WI 53098 391466308 FUND DEVELOPMENT WI 501(C)(3) LINE 7 LUTHERAN HOMES AND HEALTH SERVICES INC 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0