Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Lutheran Social Services of Michigan
Employer identification number
38-1360553
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
7,114,815
8,920,108
8,956,473
10,801,464
17,941,143
53,734,003
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
7,114,815
8,920,108
8,956,473
10,801,464
17,941,143
53,734,003
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
3,496,789
6
Public Support. Subtract line 5 from line 4.
50,237,214
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
7,114,815
8,920,108
8,956,473
10,801,464
17,941,143
53,734,003
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,007,591
307,489
241,744
338,563
431,166
2,326,553
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
56,060,556
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
282,892,770
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
89.612 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
93.883 %
16a
33 1/3% support test—2011.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2010.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2010.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Lutheran Social Services of Michigan
Employer identification number
38-1360553
Identifier
Return Reference
Explanation
RELATED PARTY DISCLOSURE - SUBSIDIARIES AND AFFILIATES
SCHEDULE R
THE LSSM FOUNDATION IS A WHOLLY-OWNED, NOT-FOR-PROFIT SUBSIDIARY OF LSSM. DONORS CONTRIBUTE PERMANENTLY RESTRICTED NET ASSETS TO THE FOUNDATION THROUGH THE ENDOWMENT FUNDS. H-LINE, INC., A WHOLLY-OWNED, NOT-FOR-PROFIT LLC OF LSSM, IS A SERVING MINISTRY FOR THE FEDERAL BUREAU OF PRISONS FOR NONVIOLENT CRIMINAL WOMEN. H-LINE ALSO PROVIDES SERVICES FOR WOMEN WITHOUT FOOD OR SHELTER OR WHO ARE OTHERWISE IN NEED. LAKEVIEW CADILLAC HOLDINGS, LLC (LCH) WAS FORMED BY LSSM TO OWN THE ASSETS OF LAKEVIEW LUTHERAN MANOR. IN AUGUST 2011, LSSM TRANSFERRED AT BOOK VALUE THE PROPERTY TO LCH, WHO SUBSEQUENTLY ENTERED INTO A $7,628,700 HUD INSURED MORTGAGE AGREEMENT TO RENOVATE THE FACILITY. AT DECEMBER 31, 2011, LCH HAD BORROWED $3,310,975 ON THE CONSTRUCTION LOAN. LSSM CONTINUES TO DO BUSINESS AS LAKEVIEW LUTHERAN MANOR AND LEASES THE ASSETS FROM LCH. IN SEPTEMBER 2011, LSSM PURCHASED THE ASSETS AND FRANCHISE RIGHTS OF A HOME CARE ASSISTANCE COMPANY. LSSM REPORTS THIS ACTIVITY AS LUTHERAN IN-HOME CARE IN ITS FINANCIAL STATEMENTS. THE ASSETS ACQUIRED AND LIABILITIES ASSUMED AS A RESULT OF THE ACQUISITION ARE INCLUDED IN LSSM'S CONSOLIDATED BALANCE SHEETS AS OF THE ACQUISITION DATE. THE PURCHASE PRICE WAS ALLOCATED TO THE TANGIBLE AND IDENTIFIABLE INTANGIBLE ASSETS ACQUIRED AND LIABILITIES ASSUMED BASED ON THEIR ESTIMATED FAIR VALUES ON THE ACQUISITION DATE. DANISH VILLAGE GP, LLC IS THE WHOLLY-OWNED GENERAL PARTNER OF DANISH VILLAGE LDHA, WHICH PROVIDES HOUSING FOR ELDERLY AND HANDICAPPED INDIVIDUALS IN ROCHESTER HILLS, MICHIGAN. THIS PARTNERSHIP WAS FORMED IN 2006 AND, IN 2007, PURCHASED AN ESTABLISHED HOUSING FACILITY FROM LUTHERAN HOUSING CORPORATION, AN AFFILIATE OF LSSM, FOR $7,140,000. DURING 2007, THE PARTNERSHIP REHABILITATED THIS HOUSING FACILITY. HOPE DEVELOPMENT SOLUTIONS, LLC, A WHOLLY-OWNED LLC OF LSSM, WAS FORMED IN 2006 TO PROVIDE MANAGEMENT SERVICES FOR THE REHABILITATION OF THE DANISH VILLAGE HOUSING FACILITY. MAPLE CREEK SENIOR LIVING, LLC IS A WHOLLY OWNED LLC OF LSSM THAT PROVIDES INDEPENDENT LIVING COMMUNITIES FOR SENIORS AT LSSM'S MAPLE CREEK CONTINUING CARE RETIREMENT COMMUNITY IN GRAND RAPIDS, MICHIGAN. THESE COMMUNITIES CONSIST OF APARTMENTS AND CONDOMINIUM-STYLE UNITS. ENTRY FEES ARE MAINTAINED IN SEPARATE ACCOUNTS AND ARE REPORTED AS FUNDS HELD IN TRUST. FIFTY PERCENT (50%) OF THE ENTRANCE FEE IS FULLY REFUNDABLE TO THE RESIDENT, WHILE MAPLE CREEK SENIOR LIVING, LLC CAN EARN UP TO THE REMAINING 50% DEPENDING ON THE ACTUAL LENGTH OF OCCUPANCY. THE REFUNDABLE PORTION OF THE ENTRANCE FEE IS REMITTED WHEN AN INDIVIDUAL TERMINATES THEIR RESIDENCY IN THE COMMUNITY. ENTRANCE FEES ARE AMORTIZED AND RECOGNIZED AS REVENUE BASED ON AN ESTIMATE OF THE AVERAGE LENGTH OF OCCUPANCY FOR ALL RESIDENTS. AT DECEMBER 31, 2011, ENTRY FEE DEPOSITS TOTALED $2,473,913 AND WERE PARTIALLY OFFSET BY A LIABILITY OF $2,212,891. LSSM IS ONE OF TWO MEMBERS OF LUTHERAN ADOPTION SERVICES (LAS), A NOT-FOR-PROFIT CORPORATION. LSSM USES THE EQUITY METHOD TO RECORD ITS 50% EQUITY INTEREST IN LAS. LSSM'S 2011 EQUITY INTEREST IN LAS WAS ($231,575).
FORM 990 REVIEW PROCESS
PART VI, SECTION B, LINE 11A
PRIOR TO SUBMISSION TO THE IRS, THE FORM IS PROVIDED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW.
CONFLICT OF INTEREST POLICY
PART VI, SECTION B, LINE 12C
THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE WRITTEN CONFLICT OF INTEREST POLICY BY MONITORING CONTRACTS, INVOICES, AND PERSONNEL, AND BY REQUESTING INFORMATION AT ALL BOARD MEETINGS.
PROCESS FOR DETERMINING COMPENSATION
PART VI, SECTION B, LINE 15
CEO COMPENSATION: THE EXECUTIVE COMMITTEE DETERMINES CEO COMPENSATION USING COMPARATIVE DATA COMPILED BY INTERNAL AND EXTERNAL HUMAN RESOURCE DIVISION SOURCES, ALONG WITH SPECIFIC GOAL ACHIEVEMENTS. OTHER TOP COMPENSATION: AT DIRECTION OF THE HUMAN RESOURCES DEPARTMENT, COMPARABLE DATA AND BUDGETARY GUIDELINES ARE USED TO DETERMINE COMPENSATION.
AVAILABILITY OF DOCUMENTS TO THE PUBLIC
PART VI, SECTION C, LINE 19
THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST. JERRY BENJAMIN HAS PUBLIC INSPECTION COPIES AVAILABLE AT 8131 EAST JEFFERSON, DETROIT, MI 48214.
DISREGARDED ENTITY PRIMARY ACTIVITY
SCHEDULE R, PART I
HOPE DEVELOPMENT SOLUTIONS LLC PRIMARY ACTIVITY: TO DEVELOP AFFORDABLE HOUSING SOLUTIONS
ADDITIONAL SCHEDULE R INFORMATION
SCHEDULE R, PART V, LINE 2
LSSM'S BOARD OF DIRECTORS ELECTS THE MAJORITY OF THE BOARDS OF LUTHERAN HOUSING CORPORATION (FORMERLY D/B/A DANISH VILLABE), LUTHERAN HOUSING CORPORATION OF CHEBOYGAN (D/B/A GREBE VILLAGE), LUTHERAN HOUSING CORPORATION OF LANSING (D/B/A ALISON HOUSE), LUTHERAN HOUSING CORPORATION OF ALPENA (D/B/A LUTHER COMMUNITY MANOR), LUTHERAN HOUSING CORPORATION OF ANN ARBOR (D/B/A SEQUOIA PLACE), LUTHERAN HOUSING CORPORATION - CALVARY (D/B/A GATESHEAD CROSSING), LUTHERAN HOUSING CORPORATION OF ADRIAN (D/B/A ADRIAN VILLAGE) AND LUTHERAN HOUSING CORPORATION OF MONROE (D/B/A VILLAGE PINES OF MONROE), EACH OF WHICH IS A SEPARATE TAX-EXEMPT ORGANIZATION WHOSE PURPOSE IS AFFORDABLE HOUSING SOLUTIONS. LSSM HAS RECEIVABLES FROM THESE RELATED FACILITIES AND OTHER MANAGED FACILITIES TOTALING $2,309,497 AND LSSM PROVIDES MANAGEMENT SERVICES TO THESE FACILITIES FOR WHICH IT RECOGNIZED MANAGEMENT SERVICE REVENUE OF $643,993.
JOINT VENTURE PARTICIPATION
PART VI, SECTION B, LINE 16
DANISH VILLAGE LIMITED DIVIDEND HOUSING ASSOCIATION LIMITED PARTNERSHIP (THE ASSOCIATION) WAS FORMED AS A LIMITED PARTNERSHIP IN DECEMBER 2006 FOR THE PURPOSE OF CONSTRUCTING, OWNING, OPERATING, AND MANAGING HOUSING FACILITIES IN ROCHESTER HILLS, MICHIGAN FOR ELDERLY AND HANDICAPPED INDIVIDUALS. THE PROJECT IS A 150-UNIT APARTMENT COMPLEX. THE ASSOCIATION HAS ONE GENERAL PARTNER - DANISH VILLAGE GP, LLC AND ONE LIMITED PARTNER - GL-DANISH VILLAGE ROCHESTER HILLS LLC.
POLICIES OF DISREGARDED ENTITIES
PART VI, SECTION B, LINE 12-16
ALTHOUGH THE DISREGARDED ENTITIES HAVE NOT ADOPTED ALL OF THESE GOVERNANCE POLICIES, THEY FOLLOW THE SAME POLICIES AS LSSM.
DANISH VILLAGE GP, LLC
SCHEDULE R, PART I
DANISH VILLAGE GP, LLC IS THE GENERAL PARTNER OF DANISH VILLAGE LIMITED DIVIDEND HOUSING ASSOCIATION LIMITED PARTNERSHIP (DANISH VILLAGE LDHA). WHILE ALLOCATION OF THE PROFITS AND LOSSES ARE ALLOCATED 99.99% TO THE LIMITED PARTNER AND 0.01% TO THE GENERAL PARTNER, IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) PROVISIONS REGARDING CONSOLIDATION OF SUBSIDIARIES, THE GENERAL PARTNER IS DEEMED TO CONTROL THE LIMITED PARTNERSHIP AND, THEREFORE, THE ACCOUNTS OF THE PARTNERSHIP ARE CONSOLIDATED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF LSSM. THE LIMITED PARTNER'S SHARE OF EQUITY, INCOME AND LOSS OF DANISH VILLAGE LDHA ARE REPORTED AS MINORITY INTEREST IN THE CONSOLIDATED FINANCIAL STATEMENTS. TOTAL ASSETS: $11,229,049 TOTAL LIABILITIES: $9,076,244 TOTAL NET ASSETS: $2,152,805
AFFILIATED ORGANIZATIONS INCLUDED
FORM 990, LINE H(B)
LSSM FOUNDATION 8131 E. JEFFERSON AVE. DETROIT, MI 48214 38-3201490 H-LINE INC. 8131 E. JEFFERSON AVE. DETROIT, MI 48214 38-2726270
RECONCILIATION OF NET ASSETS
990, PART XI, LINE 5
PARTNERSHIP REVENUE - 1,220,656 PARTNERSHIP EXPENSES - (1,636,239) MINORITY INTEREST IN PARTNERSHIP (INCOME) - 1,454,390 UNREALIZED LOSS ON INVESTMENTS - (280,019) NET LOSS FROM AFFILIATE'S OPERATIONS - (38,352)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.