Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4800 WEST 57TH STREET BOX 5038
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SIOUX FALLS, SD571175038
D Employer identification number

45-0228055
E Telephone number

G Gross receipts $ 1,333,439,615
F Name and address of principal officer:
DAVID HORAZDOVSKY
4800 WEST 57TH STREET BOX 5038
SIOUX FALLS,SD571175038
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.GOOD-SAM.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1922
M State of legal domicile: ND
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO SHARE GOD'S LOVE IN WORD AND DEED BY PROVIDING SHELTER AND SUPPORTIVE SERVICES TO OTHERS IN NEED.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 9
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 27,549
6 Total number of volunteers (estimate if necessary) ............. 6 1,127
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,227,734
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -887,354
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 19,107,739 16,176,540
9 Program service revenue (Part VIII, line 2g) ......... 945,673,734 951,359,389
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,289,662 -3,556,977
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 12,706,632 15,626,038
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 979,777,767 979,604,990
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 28,646,285 7,967,745
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 573,413,646 582,739,242
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 98,791 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet3,329,345    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 377,362,169 405,647,249
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 979,520,891 996,354,236
19 Revenue less expenses. Subtract line 18 from line 12....... 256,876 -16,749,246
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,646,887,969 1,596,273,747
21 Total liabilities (Part X, line 26)............. 887,791,517 841,786,329
22 Net assets or fund balances. Subtract line 21 from line 20..... 759,096,452 754,487,418
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO SHARE GOD'S LOVE IN WORD AND DEED BY PROVIDING SHELTER AND SUPPORTIVE SERVICES TO OLDER PERSONS AND OTHERS IN NEED, BELIEVING THAT "IN CHRIST'S LOVE, EVERYONE IS SOMEONE."(CONTINUED ON SCHEDULE O)
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 608,202,482 including grants of $ 7,967,745 ) (Revenue $ 721,595,914 )
SKILLED NURSING SERVICES - REHABILITATION/SKILLED NURSING SERVICES HAVE BEEN AT THE CORE OF THE SOCIETY'S SERVICES OVER ITS 92-YEAR HISTORY. THE SOCIETY APPROACHES CARE FOR THOSE WE SERVE IN A "HOLISTIC" MANNER. IN THAT REGARD, CARE FOR THE SPIRITUAL, EMOTIONAL AND SOCIAL DIMENSIONS OF OUR SKILLED NURSING RESIDENTS IS AS IMPORTANT AS THE PHYSICAL CARE THAT IS PROVIDED TO SOCIETY RESIDENTS EVERY HOUR OF EVERY DAY.SERVICES PROVIDED IN SOCIETY SKILLED NURSING FACILITIES INCLUDE COMPREHENSIVE PROFESSIONAL NURSING CARE; REHABILITATION SERVICES; AS WELL AS A HIGH QUALITY OF RELATED SERVICES SUCH AS DIETARY, RECREATIONAL AND OTHER ACTIVITIES; MEDICATION ADMINISTRATION; AND OTHER SERVICES THAT MEET THE HOLISTIC NEEDS OF THOSE THE SOCIETY IS CALLED TO SERVE.THE SOCIETY IS THE LARGEST NOT-FOR-PROFIT PROVIDER OF REHABILITATION/SKILLED NURSING SERVICES - AND THE NINTH LARGEST OVERALL - IN THE UNITED STATES. BUT SIZE IS NOT THE SOCIETY'S OBJECTIVE. INSTEAD, SEEKING TO MEET THE NEEDS OF "OLDER PERSONS AND OTHERS IN NEED" TO IMPROVE THEIR WELL-BEING - AS THEY DEFINE IT - REMAINS PARAMOUNT. STATISTICALLY, THE SOCIETY PROVIDED A TOTAL OF 3,486,255 SKILLED NURSING HOME DAYS OF CARE AND SERVICE IN 2014. THE SOCIETY CONTINUES TO REINVEST MUCH OF ITS REVENUE TO BUILD AND REVITALIZE ITS FACILITIES ON CAMPUSES THROUGHOUT THE COUNTRY.
4b (Code:   ) (Expenses $ 55,470,638 including grants of $ 0 ) (Revenue $ 65,812,599 )
ASSISTED LIVING SERVICES - ASSISTED LIVING SERVICES RESPOND TO THE SOCIETY'S RESIDENTS' NEEDS EACH DAY IN A "HOME-LIKE" ENVIRONMENT. IN 2014, THE SOCIETY PROVIDED 724,452 RESIDENT DAYS IN ASSISTED LIVING LOCATIONS. THIS IMPORTANT LEVEL OF CARE PROVIDES A VITAL, INTERMEDIATE LEVEL OF CARE FOR INDIVIDUALS WHO ARE NEITHER ABLE TO LIVE INDEPENDENTLY NOR ARE IN NEED OF SKILLED NURSING SERVICES.THE LIST OF SERVICES PROVIDED IN SOCIETY ASSISTED LIVING FACILITIES HIGHLIGHTS AN ENVIRONMENT THAT PROVIDES FOR THE HOLISTIC CARE OF ITS RESIDENTS. SERVICES INCLUDE THREE NUTRITIOUS MEALS A DAY, HOUSEKEEPING, LAUNDRY SERVICE, 24-HOUR STAFFING (IN ADDITION TO EMERGENCY CALL SYSTEMS), SCHEDULED TRANSPORTATION, AND MEDICATION ASSISTANCE. COORDINATED SPIRITUAL AND SOCIAL PROGRAMS ARE OFFERED FOR THE TOTAL WELL-BEING OF THE RESIDENTS.
4c (Code:   ) (Expenses $ 76,962,933 including grants of $ 0 ) (Revenue $ 91,311,922 )
HOUSING WITH SERVICES - ALSO REFERRED TO AS INDEPENDENT OR SENIOR HOUSING, HOUSING WITH SERVICES HAS BEEN A GROWING PART OF THE SOCIETY'S MINISTRY FOR MANY YEARS. WITH 10,000 PEOPLE RETIRING EACH AND EVERY DAY IN THE UNITED STATES - AND WITH EVER-INCREASING NUMBERS OCCURRING IN FUTURE YEARS - THE PROVISION OF SENIOR LIVING/HOUSING WILL TAKE ON INCREASING IMPORTANCE IN YEARS TO COME. THE SOCIETY RECOGNIZES THIS GROWTH AND HAS MADE EXPANSION OF SENIOR LIVING SERVICES AND LOCATIONS A MAJOR PART OF ITS CORPORATE STRATEGIC PLANNING.IN 2014, THE SOCIETY RECORDED 1,847,309 SENIOR LIVING DAYS OF SERVICE TO RESIDENTS THROUGHOUT THE COUNTRY. CAMPUSES FEATURE ATTRACTIVE GROUNDS; A VARIETY OF COMMON SPACE AND MULTI-PURPOSE ROOMS FOR RESIDENT AND FAMILY INTERACTION AND COMMUNITY GATHERINGS; LIBRARIES AND READING ROOMS; LARGE COMMON KITCHENS; CABLE TV AND PHONE SERVICE; AND THE AVAILABILITY OF COMPUTER/INTERNET SERVICES TO ALLOW AND ENCOURAGE ELECTRONIC CONNECTIVITY WITH FAMILY AND FRIENDS. FURTHER, VARIOUS SENIOR LEARNING OPPORTUNITIES ARE PROVIDED ON SENIOR LIVING CAMPUSES IN ADDITION TO THE SPIRITUAL AND SOCIAL PROGRAMS OFFERED IN REHABILITATION/SKILLED NURSING SERVICES AND ASSISTED LIVING.
(Code:   ) (Expenses $ 63,648,909 including grants of $ 0 ) (Revenue $ 75,515,628 )
ACROSS MANY OF ITS SETTINGS, THE SOCIETY HAS MADE A SIGNIFICANT INVESTMENT AND COMMITMENT TO THE USE OF TECHNOLOGY IN THE VARIOUS LEVELS OF CARE THAT IT PROVIDES IN ITS SUITE OF SERVICES. MOST NOTABLY, A SENSOR TECHNOLOGY PROGRAM - CALLED LIVINGWELL@HOME - IS BEING ROLLED OUT THROUGHOUT THE SOCIETY'S LOCATIONS, INCLUDING IN THOUSANDS OF ITS CARE AND LIVING SPACES NATIONWIDE. THIS PROGRAM LEVERAGES TECHNOLOGY TO UNOBTRUSIVELY MONITOR RESIDENTS' DAILY LIVING BEHAVIORS AND ACTIVITIES, THUS ALLOWING THEM TO EXTEND AND EVEN CONTROL THEIR INDEPENDENCE WHILE GIVING COMFORT TO FAMILY MEMBERS WHO MAY NOT LIVE CLOSE BY.HOME HEALTH SERVICES - THE SOCIETY SERVED APPROXIMATELY 11,155 CLIENTS IN 2014 THROUGH HOME HEALTH SERVICES. HOME HEALTH SERVICES PROVIDE A RANGE OF OPTIONS INCLUDING VISITS BY PROFESSIONAL NURSES TO MEET MEDICAL CARE REQUIREMENTS TO HOMEMAKER VISITS THAT PROVIDE HOUSEKEEPING SERVICES. GENERALLY, THE HOME HEALTH SERVICES ARE PROVIDED TO SENIORS LIVING IN HOUSING OPERATED BY THE SOCIETY. RESIDENTS IN ASSISTED LIVING AND SENIOR LIVING SETTINGS MAY HAVE TEMPORARY NEED TO ACCESS THE SERVICES OF THE SOCIETY'S HOME HEALTH AGENCIES. THESE RESIDENTS MAY BE RECOVERING FROM SURGERY OR HAVE AN ILLNESS THAT TEMPORARILY PREVENTS THEM FROM PERFORMING A DAILY LIVING TASK.
4d Other program services (Describe in Schedule O.)
(Expenses $ 63,648,909 including grants of $ 0 ) (Revenue $ 75,515,628 )
4e Total program service expensesMediumBullet804,284,962
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) .... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
Yes
 
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M............. Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
2,632
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
27,549
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
No
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AL , AK , AR , CA , CO , CT , DC , FL , GA , IL , KS , KY , ME , MD , MI , MN , MS , NH , NJ , NM , NY , ND , OH , OK , PA , RI , TN , UT , VA , WA , WI , WV , HI , NC
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletG GRANT TRIBBLE CFO & TREASURER

4800 W 57TH ST
SIOUX FALLS,SD57108 (605) 362-3100
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) DAVID J HORAZDOVSKY........................................................................
PRESIDENT & CEO
 54.60
.......................1.40 		X   X       728,886 0 15,094
(2) NEIL GULSVIG........................................................................
CHAIRPERSON
 3.30
.......................1.40 		X   X       0 0 0
(3) REV JOHN F HOLT........................................................................
FIRST VICE CHAIRPERSON
 3.30
.......................0.70 		X   X       0 0 0
(4) CHRISTOPHER T JOHNSON........................................................................
MEMBER-EXECUTIVE COMMITTEE
 3.30
.......................0.70 		X           0 0 0
(5) JOHN RACEK........................................................................
MEMBER-EXECUTIVE COMMITTEE
 3.30
.......................0.70 		X           0 0 0
(6) DENNIS STENE........................................................................
MEMBER-EXECUTIVE COMMITTEE
 3.30
.......................0.70 		X           0 0 0
(7) CONNIE MARCH-CURTIS........................................................................
MEMBER-EXECUTIVE COMMITTEE
 3.30
.......................0.70 		X           0 0 0
(8) ELWIN BROWN........................................................................
MEMBER-EXECUTIVE COMMITTEE
 3.30
.......................0.70 		X           0 0 0
(9) KARI BERIT RAMLO GUSTAFSON........................................................................
FORMER DIRECTOR
 3.30
.......................0.70 		X           0 0 0
(10) DR GWEN WAGSTROM HALAAS........................................................................
DIRECTOR
 3.30
.......................0.70 		X           0 0 0
(11) DR LIANE M CONNELLY........................................................................
DIRECTOR
 3.30
.......................0.70 		X           0 0 0
(12) H THEODORE GRINDAL........................................................................
DIRECTOR
 3.30
.......................0.70 		X           0 0 0
(13) CARLA TROUT........................................................................
DIRECTOR
 50.00
.......................0.10 		X           110,548 0 28,185
(14) SHARON ST MARY........................................................................
DIRECTOR
 50.00
.......................0.10 		X           151,836 0 14,952
(15) GUY MATSON........................................................................
DIRECTOR
 50.00
.......................0.10 		X           104,899 0 34,012
(16) MICHAEL DEUTH........................................................................
DIRECTOR
 50.00
.......................0.10 		X           116,212 0 34,792
(17) MICHELLE JUFFER........................................................................
DIRECTOR
 50.00
.......................0.10 		X           74,451 0 29,190
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) TERESA HILDEBRANDT........................................................................
DIRECTOR
 50.00
.......................0.10 		X           104,425 0 31,305
(19) PHILIP SAMUELSON........................................................................
DIRECTOR
 50.00
.......................0.10 		X           105,757 0 7,388
(20) CINDY MOEGENBURG........................................................................
EXECUTIVE VICE PRESIDENT
 55.00
.......................1.00 		    X       71,694 0 1,049
(21) RAYE NAE NYLANDER........................................................................
EXECUTIVE VICE PRESIDENT,TREASURER
 54.40
.......................0.70 		    X       337,025 0 15,094
(22) JOSEPH HERDINA........................................................................
ASSISTANT TREASURER
 55.00
.......................1.00 		    X       206,651 0 26,508
(23) SYLVIA GAUSE........................................................................
SECRETARY
 40.00
.......................1.00 		    X       66,014 0 17,165
(24) MISTY HAM-QUICK........................................................................
ASSISTANT SECRETARY
 45.00
.......................0.70 		    X       37,543 0 20,473
(25) TOM SYVERSON........................................................................
EXECUTIVE VICE PRESIDENT
 55.00
.......................1.00 		    X       303,773 0 26,508
(26) DEAN MERTZ........................................................................
VICE PRESIDENT
 55.00
.......................   		      X     322,277 0 15,094
(27) LINDA STUDER........................................................................
VICE PRESIDENT
 55.00
.......................   		      X     178,238 0 26,508
(28) SUSAN RAPER........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		      X     184,290 0 26,311
(29) TED BECKER........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		      X     243,299 0 15,551
(30) DAN FOSNESS........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		      X     175,298 0 17,461
(31) JAMES DROPPERS........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		      X     168,202 0 19,850
(32) DAN HAMES........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		      X     167,194 0 26,508
(33) RANDY FITZGERALD........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		      X     185,998 0 12,733
(34) PAT KELLY........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		        X   178,914 0 9,007
(35) RUSTAN WILLIAMS........................................................................
VICE PRESIDENT
 55.00
.......................   		        X   319,180 0 26,484
(36) THOMAS KAPUSTA........................................................................
VICE PRESIDENT
 55.00
.......................   		        X   297,355 0 14,436
(37) VICTORIA WALKER........................................................................
CHIEF MEDICAL OFFICER
 55.00
.......................   		        X   233,364 0 24,992
(38) MICHAEL HINSON........................................................................
REGIONAL VICE PRESIDENT
 55.00
.......................   		        X   174,158 0 14,952
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,347,481 0 551,602
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet78
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
AEGIS THERAPIES INC

PO BOX 8103
FT SMITH,AR72902 		CONTRACT THERAPY SERVICES 22,641,464
GUSTAFSON BUILDERS

PO BOX 1376
RAPID CITY,SD57709 		GENERAL CONTRACTOR - INCLUDES MATERIALS 7,939,583
BENSON-ORTH ASSOCIATES INC

15600 37TH AVENUE NORTH SUITE 100
PLYMOUTH,MN55446 		GENERAL CONTRACTOR - INCLUDES MATERIALS 5,592,396
BRESTER CONSTRUCTION INC

1200 INFINITY COURT
LINCOLN,NE68512 		GENERAL CONTRACTOR - INCLUDES MATERIALS 5,247,612
INFINITY REHAB

25117 SW PARKWAY SUITE D
WILSONVILLE,OR97070 		CONTRACT THERAPY SERVICES 4,762,098
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet204
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a 100,171
b Membership dues....1b  
c Fundraising events....1c 129,610
d Related organizations...1d 2,584,386
e Government grants (contributions)1e 957,073
f All other contributions, gifts, grants, and
similar amounts not included above1f 		12,405,300
g Noncash contributions included in lines
1a-1f:$ 		322,827
h Total. Add lines 1a-1f.......MediumBullet 16,176,540
Program Service RevenueAmt Business Code
2a RESIDENT ROUTINE CARE 623000 856,782,746 856,782,746    
b ANCILLARY SERVICES 623000 77,025,573 77,025,573    
c SURCHARGE 623000 5,825,871 5,825,871    
d A/L ANCILLARY SERVICES 623000 3,843,110     3,843,110
e RENT 623000 2,898,123 2,898,123    
f All other program service revenue . 4,983,966     4,983,966
g Total. Add lines 2a–2f........MediumBullet 951,359,389
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 7,073,260     7,073,260
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 1,809,115 186,905
b Less: rental expenses 0 0
c Rental income or (loss) 1,809,115 186,905
d Net rental income or (loss).......MediumBullet 1,996,020 186,905   1,809,115
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 314,358,565 28,223,590
b Less: cost or other basis and sales expenses 309,907,315 43,305,077
c Gain or (loss) 4,451,250 -15,081,487
d Net gain or (loss)..........MediumBullet -10,630,237     -10,630,237
8a Gross income from fundraising events (not including
$ 129,610
of contributions reported on line 1c). See Part IV, line 18 ..
a 1,410,675
b Less: direct expenses ...b 436,672
c Net income or (loss) from fundraising events..MediumBullet 974,003   974,003
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 67,860
b Less: direct expenses ...b 53,272
c Net income or (loss) from gaming activities...MediumBullet 14,588     14,588
10a Gross sales of inventory, less
returns and allowances .
a 303,510
b Less: cost of goods sold ..b 132,289
c Net income or (loss) from sales of inventory..MediumBullet 171,221     171,221
Miscellaneous Revenue Business Code
11a EMPLOYEE & GUEST MEALS 722210 6,086,385   863,490 5,222,895
b ADMINISTRATIVE SERVICES 561000 3,956,098 2,689,769 1,266,329  
c BARBER & BEAUTY SHOP 623990 750,488     750,488
d All other revenue .... 1,677,235   97,915 1,579,320
e Total. Add lines 11a–11d ...... MediumBullet 12,470,206
12 Total revenue. See Instructions......MediumBullet 979,604,990 945,408,987 2,227,734 15,791,729
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 7,560,865 7,560,865
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 368,266 368,266
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 38,614 38,614
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 4,814,161 4,814,161    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages .... 480,609,568 390,274,728 88,350,034 1,984,806
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 9,980,414 8,121,308 1,818,258 40,848
9 Other employee benefits ....... 48,123,554 39,071,630 8,853,038 198,886
10 Payroll taxes ........... 39,211,545 31,907,397 7,143,664 160,484
11 Fees for services (non-employees):        
a Management ...... 2,647,634   2,647,634  
b Legal ......... 528,250   528,250  
c Accounting ........... 142,655   142,655  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 79,769,919 73,022,865 6,664,750 82,304
12 Advertising and promotion .... 5,196,166 114 5,184,643 11,409
13 Office expenses ....... 10,413,385 63,205 10,276,670 73,510
14 Information technology ...... 11,511,818   11,511,818  
15 Royalties ..        
16 Occupancy ........... 38,972,497 38,972,497    
17 Travel ............ 8,266,406 4,468,267 3,773,873 24,266
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 124,825   124,825  
20 Interest ........... 22,103,288 21,822,108 274,348 6,832
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 67,372,307 54,717,558 12,347,277 307,472
23 Insurance .............. 14,048,116 11,409,415 2,574,589 64,112
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 85,148,237 85,148,237    
b EQUIPMENT MAINTENANCE 18,474,887 15,601,242 2,873,588 57
c LICENSE SURCHARGE 16,950,786 16,950,786    
d UNCOLLECTIBLE EXPENSE 10,219,829   10,219,829  
e All other expenses 13,756,244 -48,301 13,430,186 374,359
25 Total functional expenses. Add lines 1 through 24e 996,354,236 804,284,962 188,739,929 3,329,345
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 17,633,086 1 11,772,939
2 Savings and temporary cash investments ......... 875,503 2 805,022
3 Pledges and grants receivable, net ........... 1,636,554 3 1,455,128
4 Accounts receivable, net ............. 84,442,907 4 83,614,875
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 7,833,859 7 8,869,842
8 Inventories for sale or use .............. 5,787,887 8 4,010,011
9 Prepaid expenses and deferred charges .......... 6,313,194 9 6,795,767
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,917,720,023
b Less: accumulated depreciation ..... 10b 973,249,869 920,853,475 10c 944,470,154
11 Investments—publicly traded securities .......... 481,534,929 11 405,866,749
12 Investments—other securities. See Part IV, line 11 ..... 4,503,441 12 4,394,302
13 Investments—program-related. See Part IV, line 11 ..... 71,606,588 13 78,078,699
14 Intangible assets ............... 4,063,283 14 3,962,454
15 Other assets. See Part IV, line 11 ........... 39,803,263 15 42,177,805
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,646,887,969 16 1,596,273,747
Liabilities 17 Accounts payable and accrued expenses ......... 92,915,623 17 102,096,478
18 Grants payable .................   18  
19 Deferred revenue ................ 4,442,080 19 4,453,226
20 Tax-exempt bond liabilities ............. 582,455,000 20 491,825,048
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 95,190,838 21 97,091,726
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 33,967,522 23 84,841,183
24 Unsecured notes and loans payable to unrelated third parties .... 12,256 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 78,808,198 25 61,478,668
26 Total liabilities. Add lines 17 through 25......... 887,791,517 26 841,786,329
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 718,000,298 27 714,322,706
28 Temporarily restricted net assets ........... 22,385,617 28 21,358,622
29 Permanently restricted net assets ........... 18,710,537 29 18,806,090
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 759,096,452 33 754,487,418
34 Total liabilities and net assets/fund balances ........ 1,646,887,969 34 1,596,273,747
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
979,604,990
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
996,354,236
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-16,749,246
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
759,096,452
5
Net unrealized gains (losses) on investments ...............
5
11,269,854
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
870,358
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
754,487,418
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
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            
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)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 10,983,028 11,021,275 16,031,754 19,112,946 16,176,540 73,325,543
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...... 911,859,071 945,148,214 934,780,394 945,993,052 952,770,064 4,690,550,795
3 Gross receipts from activities that are not an unrelated trade or business under section 513.. 86,533 88,098 189,519 366,252 371,370 1,101,772
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. 922,928,632 956,257,587 951,001,667 965,472,250 969,317,974 4,764,978,110
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...           0
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.           0
c Add lines 7a and 7b..           0
8 Public support (Subtract line 7c from line 6.) 4,764,978,110
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
9 Amounts from line 6... 922,928,632 956,257,587 951,001,667 965,472,250 969,317,974 4,764,978,110
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 9,998,217 9,182,093 8,835,266 9,381,581 9,069,280 46,466,437
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 9,998,217 9,182,093 8,835,266 9,381,581 9,069,280 46,466,437
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 VI.) .. 1,224,976 1,743,415 9,546,162 8,395,068 10,242,472 31,152,093
13 Total support. (Add lines 9, 10c, 11, and 12.).. 934,151,825 967,183,095 969,383,095 983,248,899 988,629,726 4,842,596,640
14
Section C. Computation of Public Support Percentage
15
15
98.400 %
16
16
98.510 %
Section D. Computation of Investment Income Percentage
17
17
0.960 %
18
18
1.010 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2014 		(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: ADMINISTRATIVE SERVICES - 2010 AMOUNT: $ 1,928,306. 2011 AMOUNT: $ 1,740,083. 2012 AMOUNT: $ 2,718,788. 2013 AMOUNT: $ 2,559,371. 2014 AMOUNT: $ 2,689,769. GAINLOSS ON EXTINGUISHMENT OF DEBT - 2010 AMOUNT: $ -464,800. 2011 AMOUNT: $ 3,332. 2012 AMOUNT: $ -3,236,037. 2013 AMOUNT: $ -3,249,071. 2014 AMOUNT: $ -1,354,897. INTEREST RATE SWAP ADJUSTMENT - 2010 AMOUNT: $ -238,530. OTHER REVENUE - 2012 AMOUNT: $ 10,063,411. 2013 AMOUNT: $ 9,084,768. 2014 AMOUNT: $ 8,907,600.
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
  		Employer identification number

45-0228055
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
  		Employer identification number

45-0228055
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
  		Employer identification number

45-0228055
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
35,275
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
320,373
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
0
j
Total. Add lines 1c through 1i ...............................
355,648
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: ONE STAFF MEMBER IS DEVOTED FULL TIME TO PUBLIC POLICY ISSUES, INCLUDING LOBBYING ACTIVITIES. AN OUTSIDE REPRESENTATIVE IS ALSO ENGAGED TO ASSIST WITH COORDINATING THIS ACTIVITY. SEVERAL STAFF MEMBERS AND RESIDENTS WRITE LETTERS TO ELECTED OFFICIALS WHICH PROVIDE BACKGROUND AND EXPRESS RECOMMENDED POSITIONS ON SPECIFIC ISSUES. IN ADDITION, PERIODIC CORRESPONDENCE AND PERSONAL VISITS OCCUR BETWEEN STAFF MEMBERS AND ELECTED OFFICIALS TO ADVOCATE PARTICULAR POSITIONS ON ISSUES. IT IS ESTIMATED THAT TWO PERCENT OF ONE AVERAGE STAFF MEMBERS' TIME IS DEVOTED TO THIS ACTIVITY.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 2,980,000 1,966,000 1,508,000 1,077,000 1,348,000
b Contributions ........ -1,109,000 617,000 6,000 81,000  
c Net investment earnings, gains, and losses 13,000 -3,000 14,000 -6,000 -16,000
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		-405,000 -400,000 -438,000 356,000 -255,000
f Administrative expenses ....          
g End of year balance ...... 2,289,000 2,980,000 1,966,000 1,508,000 1,077,000
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet13.900 %
b
Permanent endowment SchDMd Bullet5.500 %
c
Temporarily restricted endowment SchDMd Bullet80.600 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   60,168,876 60,168,876
b Buildings ................   1,375,417,711 708,145,586 667,272,125
c Leasehold improvements ............   94,559,548 56,481,466 38,078,082
d Equipment ................   277,869,625 208,622,817 69,246,808
e Other .................   109,704,263   109,704,263
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 944,470,154
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
REAL ESTATE TAXES & OTHER LIABILITIES 13,160,736
UNAMORTIZED BOND PREMIUM 4,171,960
ANNUITIES PAYABLE 3,108,598
PAYABLE UNDER INVESTMENT LOAN AGREEMENT 23,262,238
NON-REFUNDABLE APARTMENT ENTRANCE FEES 17,775,136




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 61,478,668
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 974,253,301
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 3,129,415
e Add lines 2a through 2d ..................... 2e 3,129,415
3 Subtract line 2e from line 1..................... 3 971,123,886
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 8,481,104
c Add lines 4a and 4b....................... 4c 8,481,104
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 979,604,990
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 990,142,278
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d -6,043,793
e Add lines 2a through 2d...................... 2e -6,043,793
3 Subtract line 2e from line 1..................... 3 996,186,071
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 168,165
c Add lines 4a and 4b....................... 4c 168,165
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 996,354,236
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART IV, LINE 2B: AS SET FORTH BY FEDERAL AND STATE REGULATIONS, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (SOCIETY) PROVIDES RESIDENT TRUST ACCOUNT (RTA) SERVICES FOR RESIDENTS. THESE RTA FUNDS ARE NOT COMMINGLED WITH SOCIETY FUNDS, ARE ACCESSIBLE FOR RESIDENTS' USE, HAVE DETAILED ACCOUNTING RECORDS MAINTAINED ON AN INDIVIDUAL RESIDENT BASIS, AND FOLLOW BOTH FEDERAL AND STATE REGULATIONS REGARDING THE HANDLING AND DOCUMENTATION OF ACTIVITY. AS RTA FUNDS ARE HELD IN TRUST FOR RESIDENTS, A RESIDENT MAY AUTHORIZE THAT THEIR RTA FUNDS BE RETURNED TO THE RESIDENT OR THEIR DESIGNEE (REPRESENTATIVE PAYEE, FINANCIAL POWER OF ATTORNEY, GUARDIAN, ETC.) AT ANY TIME. ADDITIONALLY, WHEN A RESIDENT IS DISCHARGED FROM A FACILITY, THEIR RTA FUNDS ARE RETURNED TO THE RESIDENT OR THEIR AUTHORIZED DESIGNEE. IF A RESIDENT EXPIRES WITH RTA FUNDS ON HAND, SPECIFIC STATE REGULATIONS ALONG WITH STATE AND/OR FEDERAL AGENCIES GUIDELINES ARE REVIEWED TO ENSURE THESE RTA FUNDS ARE HANDLED APPROPRIATELY.
PART V, LINE 4: THE SOCIETY'S ENDOWMENT FUNDS WILL BE USED AS DIRECTED BY THE DONOR'S RESTRICTIONS OR THE BOARD'S DESIGNATION.
PART X, LINE 2: TAX EXEMPT STATUS FOOTNOTE - THE SOCIETY'S U.S. DOMICILED ENTITIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OR ARE PASS-THROUGH ENTITIES NOT SUBJECT TO TAX. GOOD SAMARITAN SOCIETY INSURANCE, LTD. IS AN EXEMPTED COMPANY UNDER THE COMPANIES LAW OF THE CAYMAN ISLANDS. THE SOCIETY FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE SOCIETY'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE SOCIETY IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE TAX RETURNS FOR THE YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATING PURPOSES 3,297,580. OTHER EXPENSES INCLUDED IN REVENUE -168,165.
PART XI, LINE 4B - OTHER ADJUSTMENTS: INTEREST INCOME 7,683,794. REALIZED GAIN ON SECURITIES 3,840,716. REALIZED LOSS ON SALE OF PROPERTY -15,081,487. LOSS ON EXTINGUISHMENT OF DEBT -1,354,897. T/R CONTRIBUTIONS 9,008,339. CONTRIBS FOR ENDOWMENT FUNDS & TRUSTS 200,129. REVENUE FROM DISCONTINUED OPERATIONS 4,806,745. SPECIAL EVENT FUNDRAISING EXPENSES -436,673. GAMING EXPENSES -53,273. COGS - GIFT SHOP EXPENSES -132,289.
PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 436,672. GAMING EXPENSES 53,273. COGS - GIFT SHOP EXPENSES 132,289. EXPENSES FROM DISCONTINUED OPS -6,666,027.
PART XII, LINE 4B - OTHER ADJUSTMENTS: OTHER EXPENSES INCLUDED IN REVENUE 168,165.
FORM 990, PART IV, LINE 2A PART IV, LINE 2A THE SOCIETY HAS HOUSING ENTRY FEES FOR ADMITTANCE INTO HOUSING UNITS AT VARIOUS LOCATIONS. THESE CONTRACTS FOR HOUSING ENTRY FEES VARY BY LOCATION, AND TYPICALLY HAVE VARYING REFUNDABLE PORTIONS UP TO 100% OF THESE ENTRY FEES. THE REFUNDABLE PORTIONS OF THE HOUSING ENTRY FEES ARE REFUNDABLE BASED UPON TIME RESTRICTIONS AND VACANCY OF THE HOUSING UNIT. THE NONREFUNDABLE PORTION OF THE HOUSING ENTRY FEES ARE RECORDED AS DEFERRED REVENUE AND AMORTIZED INTO INCOME OVER THE LIFE EXPECTANCY OF THE RESIDENT AND FULLY RECOGNIZED WHEN THE RESIDENT VACATES ITS UNIT. THE SOCIETY RECORDS A CURRENT PORTION OF HOUSING ENTRANCE FEES THAT IS EXPECTED TO BE REFUNDED IN THE NEXT YEAR.
Schedule D (Form 990) 2014

Additional Data


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SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria
used to award the grants or assistance? ...........................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 0
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (a)(c) Region (b)(d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
SOUTH AMERICA OUR CONTRIBUTION TO THE EVANGELICAL LUTHERAN CHURCH IN COLOMBIA GOES TO SUPPORT THEIR WORK WITH ELDERS IN TWO LOCATIONS - SOACHA AND TUNJA. SPECIFICALLY, OUR CONTRIBUTION HELPS PROVIDE SHELTER, FOOD AND SOCIAL SERVICES FOR ABOUT 50 ELDERS IN SOACHA AND 30 ELDERS IN TUNJA. 38,614 WIRE TRANSFERS      
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
1
3
Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
PART I, LINE 2: REGULAR CORRESPONDENCE IS RECEIVED FROM THE GRANTEE REGARDING THE PROGRESS OF THEIR INITIATIVES.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2014
Additional Data


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SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ
filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2014
Schedule G (Form 990 or 990-EZ) 2014
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

BOWLING EVENT
(event type) 		(b) Event #2

GOLF TOURNAMENT
(event type) 		(c) Other events

151
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 84,883 59,694 1,395,708 1,540,285
2 Less: Contributions . . 81,522 48,088   129,610
3 Gross income (line 1
minus line 2) . . . 		3,361 11,606 1,395,708 1,410,675
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . . 729     729
6 Rent/facility costs . . 3,359 5,058   8,417
7 Food and beverages . 268 3,680   3,948
8 Entertainment . . .        
9 Other direct expenses . 16,330 1,319 405,929 423,578
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 436,672
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 974,003
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . . 55,827   12,033 67,860
VerticalDirectExpenses 2 Cash prizes . . . . 45,702   2,000 47,702
3 Non-cash prizes . . .     4,066 4,066
4 Rent/facility costs . . .        
5 Other direct expenses . . 1,504     1,504
6 Volunteer labor . . .
100.000 %
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow 53,272
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow 14,588
9
Enter the state(s) in which the organization conducts gaming activities: FL , MN
a
Is the organization licensed to conduct gaming activities in each of these states? ............
b
If "No," explain:
THE SOCIETY IS REGISTERED IN THE STATE OF MINNESOTA. IT IS NOT REQUIRED TO BE REGISTERED IN THE STATE OF FLORIDA SO IT HAS NOT REGISTERED IN THAT STATE.
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2014
Schedule G (Form 990 or 990-EZ) 2014
Page 3
11
Does the organization conduct gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activities conducted in:
a
The organization's facility ......................
13a
100.000 %
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
CHARLES HIATT
Address right arrow
4800 WEST 57TH STREET
SIOUX FALLS,SD57108
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $  
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
SEE PART IV FOR A LIST
Gaming manager compensation right arrow $  
Description of services provided right arrow
THE SOCIETY'S VARIOUS FACILITIES CONDUCT LIMITED CHARITABLE GAMING ACTIVITIES. EACH FACILITY'S ADMINISTRATOR OR EXECUTIVE DIRECTOR IS IN CHARGE OF THAT FACILITY'S CHARITABLE GAMING ACTIVITIES. THEY ARE:SUSAN JENSEN - ADMINISTRATOR - MAPLEWOOD, MN - $200DAREN RIFE - ADMINISTRATOR - WESTBROOK, MN - $248LUANN FOOS - EXECUTIVE DIRECTOR - KISSIMMEE, FL - $3,293NICOLE MATTSON - ADMINISTRATOR - ROBBINSDALE, MN - $140TIM SWOBODA - ADMINISTRATOR - ST. JAMES, MN - $225
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information (see instructions).
Return Reference Explanation
SCHEDULE G, PART III, LINE 6, COLUMN C PERCENT OF VOLUNTEER LABOR THE SOCIETY'S VARIOUS FACILITIES CONDUCT LIMITED CHARITABLE GAMING ACTIVITIES AND EACH USES VOLUNTEER LABOR. EACH FACILITY REPORTED A DIFFERENT AMOUNT OF VOLUNTEER LABOR FOR THEIR GAMING ACTIVITIES, THEY ARE: SPECIALTY CARE - 10% MAPLEWOOD - 100% WESTBROOK - 50%
Schedule G (Form 990 or 990-EZ) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number
45-0228055
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) WORLD MISSION PRAYER LEAGUE
232 CLIFTON AVE
MINNEAPOLIS,MN55403 		41-0786986 501(C)(3) 14,647       CONTRIBUTIONS SUPPORT THE WORK OF LAMB HOSPITAL IN BANGLADESH. SPECIFICALLY, OUR CONTRIBUTIONS SUPPORT THE "POOR FUND" WHICH IS MONEY USED FOR OPERATIONS AND MEDICINE FOR THOSE PATIENTS WHO HAVE LITTLE OR NO MONEY. THE CONTRIBUTIONS ARE ALSO USED TO SUPPORT THE WORK OF THE CHAPLAINS IN THE HOSPITAL.
(2) TEAM
PO BOX 969
WHEATON,IL601890969 		36-2169146 501(C)(3) 11,348       CONTRIBUTIONS SUPPORT THE WORK OF THE KARANDA MISSION HOSPITAL IN ZIMBABWE. SPECIFICALLY, OUR CONTRIBUTION HELPS PROVIDE MEDICAL SUPPLIES, MEDICINE, AND GENERAL HOSPITAL COSTS FOR THIS MISSION HOSPITAL WHICH IS LOCATED ABOUT 4 HOURS FROM HARARE, THE CAPITAL OF ZIMBABWE.
(3) SIOUX EMPIRE UNITED WAY
1000 N WEST AVE SUITE 120
SIOUX FALLS,SD57104 		46-0233701 501(C)(3) 8,000       CONTRIBUTION
(4) SON MINISTRIES INC
440 E ST NE
LINTON,IN47441 		45-2541252 501(C)(3) 7,500       SOCIAL ACCOUNTABILITY GRANT
(5) MILLARD BUSINESS COMMUNITY FOUNDATION
705 SOUTH 153RD CIRCLE
OMAHA,NE68154 		27-3413949 501(C)(3) 5,600       SOCIAL ACCOUNTABILITY GRANT
(6) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
4800 W 57TH ST
SIOUX FALLS,SD57117 		46-0422866 501(C)(3) 7,288,961       TO SUPPORT THE GENERAL OPERATIONS AND TRANSFER OF GIFTS TO BE HELD BY THE FOUNDATION.
(7) PROPHETSTOWN GOOD SAMARITIAN HOUSING INC
4800 W 57TH ST
SIOUX FALLS,SD57117 		46-0323943 501(C)(3) 36,700       CONTRIBUTION TO ASSIST WITH OPERATIONS.
(8) SENIOR COMPANION FUND
1000 N WEST AVE SUITE 260
SIOUX FALLS,SD57104 		46-0379180 501(C)(3) 15,640       SUPPORT GENERAL OPERATIONS.








2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
8
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) SCHOLARSHIPS 274 368,266      












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: THE SOCIETY PROVIDES GRANTS TO ORGANIZATIONS TO SUPPORT VARIOUS CAUSES EACH YEAR. GENERAL CORRESPONDENCE WITH THE RECIPIENTS OF THESE GRANTS IS USED WHEN NEEDED WHILE MONITORING THE USE OF THE GRANTED MONIES. THE SOCIETY PROVIDES SCHOLARSHIPS TO EMPLOYEES WHO ARE ENROLLED IN A QUALIFIED EDUCATION PROGRAM. THE SOCIETY PAYS THE SCHOLARSHIP DIRECTLY TO THE EDUCATIONAL INSTITUTION WHERE THE EMPLOYEE IS ENROLLED. IF AN EMPLOYEE HAS ALREADY PAID THE EXPENSES, THE SOCIETY REQUIRES RECEIPT OF PAYMENT BEFORE REIMBURSEMENT IS MADE TO THE EMPLOYEE.
Schedule I (Form 990) 2014


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1DAVID J HORAZDOVSKYPRESIDENT & CEO (i)
(ii)		 633,322
...............................
0 		0
...............................
0 		95,564
...............................
0 		0
...............................
0 		15,939
...............................
0 		744,825
...............................
0 		0
...............................
0
2SHARON ST MARYDIRECTOR (i)
(ii)		 102,708
...............................
0 		0
...............................
0 		49,128
...............................
0 		0
...............................
0 		15,798
...............................
0 		167,634
...............................
0 		0
...............................
0
3MICHAEL DEUTHDIRECTOR (i)
(ii)		 98,046
...............................
0 		0
...............................
0 		18,166
...............................
0 		8,284
...............................
0 		27,354
...............................
0 		151,850
...............................
0 		0
...............................
0
4RAYE NAE NYLANDEREXECUTIVE VICE PRESIDENT,TREASURER (i)
(ii)		 259,963
...............................
0 		0
...............................
0 		77,062
...............................
0 		0
...............................
0 		15,939
...............................
0 		352,964
...............................
0 		0
...............................
0
5JOSEPH HERDINAASSISTANT TREASURER (i)
(ii)		 158,516
...............................
0 		0
...............................
0 		48,135
...............................
0 		0
...............................
0 		27,354
...............................
0 		234,005
...............................
0 		0
...............................
0
6TOM SYVERSONEXECUTIVE VICE PRESIDENT (i)
(ii)		 240,890
...............................
0 		0
...............................
0 		62,883
...............................
0 		0
...............................
0 		27,354
...............................
0 		331,127
...............................
0 		0
...............................
0
7DEAN MERTZVICE PRESIDENT (i)
(ii)		 244,221
...............................
0 		0
...............................
0 		78,056
...............................
0 		0
...............................
0 		15,939
...............................
0 		338,216
...............................
0 		0
...............................
0
8LINDA STUDERVICE PRESIDENT (i)
(ii)		 148,337
...............................
0 		0
...............................
0 		29,901
...............................
0 		0
...............................
0 		27,354
...............................
0 		205,592
...............................
0 		0
...............................
0
9SUSAN RAPERREGIONAL VICE PRESIDENT (i)
(ii)		 158,867
...............................
0 		0
...............................
0 		25,423
...............................
0 		0
...............................
0 		27,157
...............................
0 		211,447
...............................
0 		0
...............................
0
10TED BECKERREGIONAL VICE PRESIDENT (i)
(ii)		 127,155
...............................
0 		0
...............................
0 		116,144
...............................
0 		0
...............................
0 		16,256
...............................
0 		259,555
...............................
0 		0
...............................
0
11DAN FOSNESSREGIONAL VICE PRESIDENT (i)
(ii)		 126,821
...............................
0 		0
...............................
0 		48,477
...............................
0 		0
...............................
0 		18,306
...............................
0 		193,604
...............................
0 		0
...............................
0
12JAMES DROPPERSREGIONAL VICE PRESIDENT (i)
(ii)		 123,439
...............................
0 		0
...............................
0 		44,763
...............................
0 		0
...............................
0 		20,695
...............................
0 		188,897
...............................
0 		0
...............................
0
13DAN HAMESREGIONAL VICE PRESIDENT (i)
(ii)		 114,857
...............................
0 		0
...............................
0 		52,337
...............................
0 		0
...............................
0 		27,354
...............................
0 		194,548
...............................
0 		0
...............................
0
14RANDY FITZGERALDREGIONAL VICE PRESIDENT (i)
(ii)		 135,216
...............................
0 		0
...............................
0 		50,782
...............................
0 		0
...............................
0 		13,579
...............................
0 		199,577
...............................
0 		0
...............................
0
15PAT KELLYREGIONAL VICE PRESIDENT (i)
(ii)		 105,709
...............................
0 		0
...............................
0 		73,205
...............................
0 		0
...............................
0 		9,853
...............................
0 		188,767
...............................
0 		0
...............................
0
16RUSTAN WILLIAMSVICE PRESIDENT (i)
(ii)		 245,931
...............................
0 		0
...............................
0 		73,249
...............................
0 		0
...............................
0 		27,329
...............................
0 		346,509
...............................
0 		0
...............................
0
17THOMAS KAPUSTAVICE PRESIDENT (i)
(ii)		 233,472
...............................
0 		0
...............................
0 		63,883
...............................
0 		0
...............................
0 		15,281
...............................
0 		312,636
...............................
0 		0
...............................
0
18VICTORIA WALKERCHIEF MEDICAL OFFICER (i)
(ii)		 208,442
...............................
0 		0
...............................
0 		24,922
...............................
0 		0
...............................
0 		25,837
...............................
0 		259,201
...............................
0 		0
...............................
0
19MICHAEL HINSONREGIONAL VICE PRESIDENT (i)
(ii)		 147,796
...............................
0 		0
...............................
0 		26,362
...............................
0 		0
...............................
0 		15,798
...............................
0 		189,956
...............................
0 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 4A TED BECKER LEFT THE ORGANIZATION AND RECEIVED SEVERANCE PAY OF $50,529
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number
45-0228055
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A COHFA
  		84-0752932 196474P46 08-31-2004 28,168,375 REFUNDED 1992-1993 AND 2004 BOND ISSUES   X   X X  
B COHFA
  		84-0752932 1964742TG 11-15-2005 64,472,262 REFUNDED 1995, 2003, AND 2005 BOND ISSUES   X   X X  
C COHFA
  		84-0752932 1964745B2 10-31-2006 108,145,790 REFUNDED 2000 AND 2001 BOND ISSUES   X   X X  
D COHFA
  		84-0752932 19648AFY6 12-06-2007 23,830,000 REFUNDED 2003 AND 2006 BOND ISSUES   X   X X  
COHFA
  		84-0752932 19648ANT8 12-11-2008 28,305,000 REFUNDED 2004 BOND ISSUE   X   X X  
COHFA
  		84-0752932   12-08-2011 60,000,000 REFUNDED 2011 BOND ISSUE   X   X X  
COHFA
  		84-0752932 19648AYW9 05-23-2012 175,711,853 NONREFUNDING AND REFUNDED 1997, 1998, 2000, 2009 BOND ISSUES AND 2006 TERM L   X   X X  
COHFA
  		84-0752932 19648AM44 10-02-2013 62,441,164 NONREFUNDING AND REFUNDED A PRIOR TAXABLE BOND ISSUE   X   X X  
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 4,795,000 9,120,000 17,410,000  
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 28,168,375 64,472,262 108,145,790 23,830,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 2,573,959 4,373,983 7,987,447 6,410,896
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 420,812 1,046,025 1,365,882 476,600
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 8,283,287 8,283,287 58,112,099 11,006,400
11 Other spent proceeds . . . . . . . . . . . . . .        
12 Other unspent proceeds . . . . . . . . . . . . . . 791,184   791,184 1,684,067
13 Year of substantial completion . . . . . . . . . . . . 2004 2007 2008 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X X     X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . .        
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . . X   X   X   X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . NA
  		NA
  		NA
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .   X   X   X   X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X   X     X   X
b Name of provider . . . . . . . . . MBIA INC
PRODUCTS CORP 		AIG FINANCIAL
PRODUCTS CORP 		NA
  		NA
 
c Term of GIC . . . . . . . . . . 13.000000000000 5.000000000000    
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X   X     X   X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/10/2014 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/16/2010 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/17/2011 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/11/2012 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 07/17/2013
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number
45-0228055
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A COHFA
  		84-0752932 196474P46 08-31-2004 28,168,375 REFUNDED 1992-1993 AND 2004 BOND ISSUES   X   X X  
B COHFA
  		84-0752932 1964742TG 11-15-2005 64,472,262 REFUNDED 1995, 2003, AND 2005 BOND ISSUES   X   X X  
C COHFA
  		84-0752932 1964745B2 10-31-2006 108,145,790 REFUNDED 2000 AND 2001 BOND ISSUES   X   X X  
D COHFA
  		84-0752932 19648AFY6 12-06-2007 23,830,000 REFUNDED 2003 AND 2006 BOND ISSUES   X   X X  
COHFA
  		84-0752932 19648ANT8 12-11-2008 28,305,000 REFUNDED 2004 BOND ISSUE   X   X X  
COHFA
  		84-0752932   12-08-2011 60,000,000 REFUNDED 2011 BOND ISSUE   X   X X  
COHFA
  		84-0752932 19648AYW9 05-23-2012 175,711,853 NONREFUNDING AND REFUNDED 1997, 1998, 2000, 2009 BOND ISSUES AND 2006 TERM L   X   X X  
COHFA
  		84-0752932 19648AM44 10-02-2013 62,441,164 NONREFUNDING AND REFUNDED A PRIOR TAXABLE BOND ISSUE   X   X X  
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 4,795,000 9,120,000 17,410,000  
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 28,168,375 64,472,262 108,145,790 23,830,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 2,573,959 4,373,983 7,987,447 6,410,896
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 420,812 1,046,025 1,365,882 476,600
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 8,283,287 8,283,287 58,112,099 11,006,400
11 Other spent proceeds . . . . . . . . . . . . . .        
12 Other unspent proceeds . . . . . . . . . . . . . . 791,184   791,184 1,684,067
13 Year of substantial completion . . . . . . . . . . . . 2004 2007 2008 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X X     X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . .        
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . . X   X   X   X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . NA
  		NA
  		NA
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .   X   X   X   X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X   X     X   X
b Name of provider . . . . . . . . . MBIA INC
PRODUCTS CORP 		AIG FINANCIAL
PRODUCTS CORP 		NA
  		NA
 
c Term of GIC . . . . . . . . . . 13.000000000000 5.000000000000    
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X   X     X   X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/10/2014 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/16/2010 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/17/2011 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/11/2012 ISSUER NAME: COHFA DATE THE REBATE COMPUTATION WAS PERFORMED: 07/17/2013
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) THOMAS FRASER FAMILY RELATIONSHIP - SON OF CINDY MOEGENBURG, OFFICER 55,663 COMPENSATION   No
(2) MICHAEL DROPPERS FAMILY RELATIONSHIP - SON OF JIM DROPPERS, KEY EMPLOYEE 46,688 COMPENSATION   No
(3) RYAN MERTZ FAMILY RELATIONSHIP - SON OF DEAN MERTZ, OFFICER 88,361 COMPENSATION   No
(4) HALEY SAMUELSON FAMILY RELATIONSHIP - WIFE OF PHILIP SAMUELSON, DIRECTOR 101,759 COMPENSATION   No
(5) DEBORAH HAMES FAMILY RELATIONSHIP - WIFE OF DAN HAMES, KEY EMPLOYEE 37,536 COMPENSATION   No
(6) KELLY HORAZDOVSKY FAMILY RELATIONSHIP - DAUGHTER OF DAVID HORAZDOVSKY, TELGSS PRESIDENT 58,949 COMPENSATION   No
(7) JACOB STUDER FAMILY RELATIONSHIP - SON OF LINDA STUDER, KEY EMPLOYEE 56,717 COMPENSATION   No
(8) KATHERYN STUDER FAMILY RELATIONSHIP - DAUGHTER-IN LAW OF LINDER STUDER, KEY EMPLOYEE 86,496 COMPENSATION   No
(9) BREANNA GOEMBEL FAMILY RELATIONSHIP - DAUGHTER OF LINDER STUDER, KEY EMPLOYEE 55,913 COMPENSATION   No
(10) GREG WILCOX FAMILY RELATIONSHIP - GRANDSON OF FOUNDER 198,935 COMPENSATION   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 24 8,630 FAIR MARKET VALUE
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 1,082 FAIR MARKET VALUE
5 Clothing and household
goods ....... 		X 13,893 FAIR MARKET VALUE
6 Cars and other vehicles .. X 9 107,990 FAIR MARKET VALUE
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential . X 1 21,650 FAIR MARKET VALUE
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ... X 76 5,170 FAIR MARKET VALUE
20 Drugs and medical supplies . X 4 380 FAIR MARKET VALUE
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( MISCELLANEOUS ITEMS ) X 758 164,031 FAIR MARKET VALUE
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2014)
Schedule M (Form 990) (2014)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
PART I, COLUMN (B): THE NUMBER IN COLUMN B RESPRESENTS THE NUMBER OF CONTRIBUTORS.
Schedule M (Form 990) (2014)
Additional Data


Software ID:  
Software Version:  
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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Return Reference Explanation
FORM 990, PART III, LINE 1 IN 2014, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (THE SOCIETY) CELEBRATED ITS 92ND YEAR OF EXISTENCE SINCE ITS FOUNDING IN A SMALL NORTH DAKOTA COMMUNITY. AS THE SOCIETY RAPIDLY APPROACHES A CENTURY OF SERVICE, MISSION AND MINISTRY, ITS STRATEGIC AND OPERATIONAL WORK IS FOCUSED ON THE GOOD SAMARITAN SOCIETY WAY: - GUIDED BY OUR OBLIGATION (MISSION) TO SHARE GOD'S LOVE, THE SOCIETY IS CHALLENGED TO DO NOTHING LESS THAN TO BE OUTSTANDING IN BOTH OPERATIONS AND STRATEGY. - TO SHARE GOD'S LOVE, THE SOCIETY SEEKS OUT AND FINDS OPPORTUNITIES (OUR STRATEGIC DIRECTION) TO HELP IMPROVE WELL-BEING AND LET PEOPLE LEAD THE LIVES THEY WANT TO LIVE IN THE PLACES WHERE THEY WANT TO BE. - AND THE SOCIETY IS SUCCESSFUL WHEN IT ACHIEVES ITS OUTCOME (VISION) OF CREATING ENVIRONMENTS WHERE PEOPLE FEEL LOVED, VALUED AND AT PEACE. EVERY ONE OF OUR 20,000 STAFF MEMBERS HAS TRAINED IN THE GOOD SAMARITAN SOCIETY WAY. THE CHALLENGE OF MEETING PEOPLE'S NEEDS WHERE THEY ARE COMPELS AND PROPELS THE SOCIETY TO MEET THE CHALLENGES OF THE FUTURE. ALTHOUGH THE SOCIETY'S CONSTANCY AND CONSISTENCY OF MISSION HAS STAYED TRUE, THE ENVIRONMENT SURROUNDING THE ORGANIZATION HAS CHANGED GREATLY OVER THESE PAST 92 YEARS. WE STAND AT A CRITICAL JUNCTURE IN OUR NATION'S HISTORY, AS CONDITIONS OF OUR ECONOMY, DEMOGRAPHICS, SOCIETY AND CULTURE HAVE SEEN REVOLUTIONARY CHANGE. THE SOCIETY RECOGNIZES THESE CHANGING NEEDS AND DEMANDS AND STANDS READY TO SERVE PEOPLE'S NEEDS FOR THE NEXT 100 YEARS.
FORM 990, PART V, LINE 7H GOOD SAMARITAN SOCIETY RECEIVED MULTIPLE VEHICLES DURING 2014 OF WHICH THEY FILED ONE FORM 1098-C AND NONE FOR THE OTHERS SO WE CHECKED NO TO THIS QUESTION ON THE FORM 990.
FORM 990, PART VI, SECTION A, LINE 1 THE GOVERNING BODY DELEGATED BROAD AUTHORITY TO THE EXECUTIVE COMMITTEE OF THE BOARD TO ACT ON ITS BEHALF ON MATTERS THAT NEED ATTENTION WHEN THE BOARD IS NOT IN SESSION. ALL ACTIONS OF THE EXECUTIVE COMMITTEE ARE RATIFIED AT THE NEXT SCHEDULED BOARD MEETING. THE EXECUTIVE COMMITTEE IS COMPRISED OF THE FOLLOWING BOARD MEMBERS: CHAIRPERSON, FIRST VICE CHAIRPERSON, TWO OTHER MEMBERS, AND THE PRESIDENT.
FORM 990, PART VI, SECTION A, LINE 6 THE FOLLOWING ARE ELIGIBLE VOTING MEMBERS OF THE SOCIETY BY VIRTUE OF THEIR RELATIONSHIP WITH THE SOCIETY: 1. ALL MEMBERS OF THE BOARD OF DIRECTORS OF THE SOCIETY WHO ARE MEMBERS OF A CHRISTIAN CHURCH. 2. ALL SOCIETY CORPORATE OFFICERS AND ASSISTANT OFFICERS WHO ARE MEMBERS OF A CHRISTIAN CHURCH. 3. ALL REGIONAL VICE PRESIDENTS WHO ARE MEMBERS OF A CHRISTIAN CHURCH. 4. ALL ADMINISTRATOR/EXECUTIVE DIRECTOR/EXECUTIVE MANAGER EMPLOYEES OF THE SOCIETY WHO ARE MEMBERS OF A CHRISTIAN CHURCH. 5. ALL MEMBERS OF EXECUTIVE LEADERSHIP WHO ARE MEMBERS OF A CHRISTIAN CHURCH. 6. ALL MEMBERS WHO ARE MEMBERS OF A CHRISTIAN CHURCH WHO WERE MEMBERS ON JANUARY 1, 2002, THE DAY OF THE ADOPTION OF THIS AMENDED BYLAW. HOWEVER, VOTING MEMBERSHIP FOR ALL SUCH MEMBERS UNDER THIS ARTICLE II. A. 6. SHALL CEASE, AFTER REASONABLE NOTICE, WHEN SUCH MEMBER FAILS TO VOTE AT THE ANNUAL METING OF THE SOCIETY FOR TWO CONSECUTIVE YEARS. 7. ALL MEMBERS OF THE BOARD OF DIRECTORS OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION WHO ARE MEMBERS OF A CHRISTIAN CHURCH.
FORM 990, PART VI, SECTION A, LINE 7A VOTING MEMBERS ELECT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS MUST APPROVE ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION.
FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED AND APPROVED BY THE BOARD PRIOR TO ITS FILING. THE ORGANIZATION'S OFFICERS AND MANAGEMENT ARE AN INTEGRAL PART OF THE PREPARATION OF THE FORM 990. THEREFORE, THEY WILL HAVE AN ON-GOING REVIEW OF THE INFORMATION AS IT IS PREPARED FOR THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. ALL POTENTIAL DIRECTOR CONFLICTS ARE INVESTIGATED BY THE SOCIETY'S CHIEF LEGAL OFFICER. THE CHIEF LEGAL OFFICER REPORTS HIS FINDINGS TO THE BOARD CHAIR. THE BOARD ULTIMATELY DETERMINES WHETHER OR NOT AN ACTUAL CONFLICT OF INTEREST EXISTS AND THE REMEDIAL STEPS NECESSARY BASED UPON SUCH LEGAL OPINION. THE SOCIETY HAS A CONFLICT OF INTEREST POLICY THAT COVERS SUBSTANTIALLY ALL EMPLOYEES. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS TO THE APPROPRIATE INDIVIDUAL AS INDICATED IN THE POLICY. ALL POTENTIAL CONFLICTS ARE INVESTIGATED TO DETERMINE IF A CONFLICT EXISTS. IF APPROVAL IS GIVEN TO PROCEED WITH THE ACTION, A COPY OF THE APPROVAL IS DOCUMENTED IN THE EMPLOYEE'S PERSONNEL FILE.
FORM 990, PART VI, SECTION B, LINE 15 THE SOCIETY'S CEO'S TOTAL COMPENSATION PLAN IS DETERMINED BY THE EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE (EECC) OF THE BOARD OF DIRECTORS. AS PART OF THEIR RESPONSIBILITIES, THE EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE SHALL REVIEW AND DETERMINE THE ANNUAL BASE SALARY LEVEL, EMPLOYEE AGREEMENTS IF AND WHEN APPROPRIATE, FRINGE BENEFITS, ANY COMPENSATION INCENTIVES AND SUPPLEMENTAL BENEFITS (THE "COMPENSATION") FOR THE PRESIDENT/CEO. THE COMMITTEE WILL USE BEST EFFORTS TO REVIEW AND DETERMINE THE COMPENSATION IN ACCORDANCE WITH THE IRS REBUTTABLE PRESUMPTION PROCEDURE UNDER IRC 4958. THE COMMITTEE INTENDS TO COMPLY WITH THIS PROCEDURE BY MEETING THE THREE GENERAL REQUIREMENTS LISTED BELOW: (1) THE COMPENSATION SHALL BE APPROVED IN ADVANCE BY THE COMMITTEE WITH NO COMMITTEE MEMBERS HAVING A CONFLICT OF INTEREST AS STATED UNDER IRC 4958. (2) THE DETERMINATION SHALL BE BASED UPON COMPARABLE DATA OF SIMILARLY SITUATED POSITIONS WITH DATA PREFERABLY PROVIDED BY AN OUTSIDE COMPENSATION CONSULTANT. (3) THE REVIEW AND DETERMINATION SHALL BE ADEQUATELY AND TIMELY DOCUMENTED. THE DOCUMENTATION SHALL BE IN SIMILAR FORM AND SUBSTANCE. THE EECC ALSO ENGAGES AN EXTERNAL CONSULTANT, AON-HEWITT TO HELP DETERMINE THE COMPENSATION PACKAGE FOR THE CEO. THE EXTERNAL CONSULTANT IS ENGAGED AS NEEDED BUT AT LEAST EVERY FIVE YEARS. SEE SCHEDULE J, PART 1, LINE 3 FOR ADDITIONAL DETAILS RELATED TO THE PRESIDENT/CEO POSITION. THE SOCIETY'S EMPLOYEE COMPENSATION PLAN IS REVIEWED BY THE EXECUTIVE LEADERSHIP TEAM. DURING THE REVIEW, THE COMPENSATION IS EVALUATED, UPDATED, AND RESET TO BE 100% COMPETITIVE AT THE 50TH PERCENTILE OF THE NATIONAL LABOR MARKET UTILIZING A NATIONALLY RECOGNIZED DATABASE. THE COMPENSATION PLAN INCLUDES ALL NATIONAL CAMPUS POSITIONS WITHIN THE SOCIETY, INCLUDING EXECUTIVE MANAGEMENT, KEY EMPLOYEES AND OFFICERS. THIS EMPLOYEE COMPENSATION PLAN WAS REVIEWED AND UPDATED BY AON-HEWITT AS THE OUTSIDE CONSULTANT. AON-HEWITT PROVIDED A WRITTEN REVIEW BASED UPON CURRENT MARKET CONDITIONS WHICH IS ON FILE. COMPENSATION WAS REVIEWED IN 2011 AND IMPLEMENTED IN 2012 FOR OTHER OFFICERS AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19 THE SOCIETY'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. THE SOCIETY'S FINANCIAL STATEMENTS ARE AVAILABLE THROUGH ITS EXTERNAL WEBSITE.
FORM 990, PART VI, SECTION A, LINE 1B EACH AND EVERY DAY THE SOCIETY'S TOP LOCAL LEADER POSITION AT ITS 200+ DECENTRALIZED LOCATIONS CARRYOUT THE SOCIETY'S MISSION BY ASSURING CARE AND SERVICES ARE PROVIDED TO THOSE MOST IN NEED. IN ORDER FOR THE SOCIETY'S BOARD TO STAY CONNECTED WITH ITS MISSION AND TO ASSURE ALL STRATEGIES HAVE LOCAL LEADERSHIP INPUT, THE SOCIETY'S BYLAWS REQUIRE 6 BOARD MEMBERS TO BE SELECTED FROM THE LOCAL LEADERSHIP. INDEPENDENT BOARD MEMBERS PERIODICALLY REVIEW THE BYLAWS FOR THE MAKEUP OF THE BOARD MEMBERS AND CONTINUE TO DETERMINE THAT IT IS EXTREMELY VALUABLE TO INCLUDE LOCAL LEADERSHIP BOARD REPRESENTATION TO PROVIDE THE INPUT FOR SETTING STRATEGIES FOR THE SOCIETY. THE SEVENTH NON-INDEPENDENT BOARD MEMBER IS THE CEO OF THE SOCIETY.
FORM 990, PART XI, LINE 9: T/R TRANSFERS TO FOUNDATION FROM SOCIETY 543,996. T/R INCREASE IN INTEREST IN THE T/R NET ASSETS OF FOUNDATION 432,004. P/R DECREASE IN BENEFICIAL INTEREST IN PERPETUAL TRUST -109,000. P/R TRANSFERS TO FOUNDATION FROM SOCIETY -1,308,715. P/R INCREASE IN INTEREST IN THE P/R NET ASSETS OF FOUNDATION 1,313,715. ROUNDING -1,642.
FORM 990, PAGE 1, BOX B EXPLANATION FOR AMENDED RETURN: THE TAXPAYER AMENDED FORM 990 TO PROPERLY EXCLUDE SERVICE LOCATIONS RELATED TO UNRELATED BUSINESS INCOME, RESULTING IN A DECREASE IN UBIT OF $61,714. THIS CHANGE AFFECTED FORM 990 PART I LINES 7A-B, PART III LINE 4, PART VIII LINE 11B, AND SCHEDULE A LINE 12.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
 
Employer identification number

45-0228055
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) AH GOOD SAMARITAN HOUSING LLC
4800 W 57TH ST
SIOUX FALLS,SD57108
 SENIOR HOUSING SD 0 0 TELGSS
 
(2) GOOD SAMARITAN SOCIETY HCBS LLC
4800 W 57TH ST
SIOUX FALLS,SD57108
36-4798232 		SOLE MEMBER OF HOME AND COMMUNITY BASED SERVICES & HOSPICE LLC'S SD 0 0 TELGSS
 
(3) GOOD SAMARITAN SOCIETY HCBS-CHOICE LLC
4800 W 57TH ST
SIOUX FALLS,SD57108
32-0454108 		PROVIDE HOME AND COMMUNITY BASED SERVICES SD 0 0 GOOD SAMARITAN SOCIETY HCBS LLC
 
(4) GOOD SAMARITAN SOCIETY HCBS-BJC LLC
4800 W 57TH ST
SIOUX FALLS,SD57108
38-3945118 		PROVIDE HOSPICE SERVICES SD 0 0 GOOD SAMARITAN SOCIETY HCBS LLC
 




Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) GOOD SAMARITAN SOCIETY INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0349951 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(2) BOISE GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
36-3370371 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) PF TELGSS
 
Yes
 
(3) LOVINGTON GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0392944 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(4) PROPHETSTOWN GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0323943 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(5) JASONVILLE GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0396355 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(6) OLATHE GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0396398 		PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(7) MILLARD GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0396332 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(8) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0422866 		ASSIST TELGSS IN PROVIDING SENIOR CARE MN 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(9) SIOUX FALLS GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0385187 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(10) KEARNEY GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0421846 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) PF TELGSS
 
Yes
 
(11) HASTINGS GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0434693 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(12) BROOKINGS GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0439509 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(13) GRANTS GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0439511 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(14) VALENTINE GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
91-1751139 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(15) JEFFERSONTOWN GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
91-1751137 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(16) GOLDBECK TOWERS GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
91-1751135 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(17) WISCONSIN GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0447338 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(18) GREELEY GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0456087 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(19) SOUTH DAYTONA BEACH GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-0461264 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(20) WINFIELD GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
20-1115155 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(21) INVER GROVE HEIGHTS GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
76-0789504 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(22) LEMARS GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
20-4714415 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(23) ALLIANCE GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
20-4714573 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(24) SIOUX FALLS 57 GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
20-4714647 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(25) HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
27-1212446 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(26) GOOD SAMARITAN HOLDINGS LLC
4800 W 57TH ST

SIOUX FALLS,SD57108
75-2979560 		OWNER OF GOOD SAMARITAN HERITAGE LLC SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(27) EL PASO GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
27-2876627 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(28) LEA COUNTY GOOD SAMARITAN HOUSING INC
4800 W 57TH ST

SIOUX FALLS,SD57108
45-3946645 		PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 9 TELGSS
 
Yes
 
(29) SIOUX FALLS DOWNTOWN GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
45-2473519 		GENERAL PARTNER OF LIHTC LIMITED PARTNERSHIP SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(30) PRESCOTT GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
27-5114421 		GENERAL PARTNER OF LIHTC PATNERSHIP SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(31) ADAMS COUNTY GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-1495572 		GENERAL PARTNER OF LIHTC PARTNERSHIP SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(32) INDIANOLA GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-1328052 		GENERAL PARTNER OF LIHTC PARTNERSHIP SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(33) WELD COUNTY GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-1591360 		PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(34) RAPID CITY GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-1579750 		PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
(35) LILAC WAY GOOD SAMARITAN HOUSING GP INC
4800 W 57TH ST

SIOUX FALLS,SD57108
46-5740381 		MANAGING PARTNER OF LILAC WAY GOOD SAMARITAN HOUSING, LP SD 501(C)(3) 11 - TYPE 1 TELGSS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
27-1212511 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(2) OLATHE GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
20-5297369 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(3) MILLARD GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
27-1212324 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(4) PRESCOTT GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
27-5115281 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(5) INDIANOLA GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
30-0755780 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(6) ADAMS COUNTY GOOD SAMARITAN HOUSINGS LP

4800 W 57TH ST
SIOUX FALLS,SD57108
38-3896526 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(7) RAPID CITY GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
35-2466169 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(8) SIOUX FALLS DOWNTOWN GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
32-0377442 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(9) ADA COUNTY GOOD SAMARITAN HOUSING LP

4800 W 57TH ST
SIOUX FALLS,SD57108
36-4799439 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(10) COLLISTER DRIVE GOOD SAMARITAN HOUSING LLC

4800 W 57TH ST
SIOUX FALLS,SD57108
61-1752929 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(11) RUTH STREET GOOD SAMARITAN HOUSING LLC

4800 W 57TH ST
SIOUX FALLS,SD57108
61-1748321 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
(12) TEXAS GOOD SAMARITAN HOUSING LLC

4800 W 57TH ST
SIOUX FALLS,SD57108
37-1774574 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
                  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) IDAHO SAMARITAN HOUSING INC

4800 W 57TH ST
SIOUX FALLS,SD57108
46-0424311 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
 C         No
(2) GOOD SAMARITAN SOCIETY INSURANCE LTD

PO BOX 69 GT
CJ
98-0379099 		INSURANCE CJ N/A
 C         No
(3) GOOD SAMARITAN HUMANITARIAN SERVICES INC

4800 W 57TH ST
SIOUX FALLS,SD57108
20-5533741 		MANAGEMENT SERVICES, UNBUNDLED SERVICES, UNRELATED BUSINESS ACTIVITIES SD N/A
 C         No
(4) ROSEVILLE GOOD SAMARITAN HOUSING GP INC

4800 W 57TH ST
SIOUX FALLS,SD57108
46-1579750 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
 C         No
(5) ADA COUNTY GOOD SAMARITAN HOUSING GP INC

4800 W 57TH ST
SIOUX FALLS,SD57108
47-2533379 		PROVIDE LOW-INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A
 C         No




Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) GOOD SAMARITAN SOCIETY INC

 L 123,987 FMV OF TRANSACTION
(2) GOOD SAMARITAN SOCIETY INC

 Q 765,683 FMV OF TRANSACTION
(3) BOISE GOOD SAMARITAN HOUSING INC

 Q 263,702 FMV OF TRANSACTION
(4) PROPHETSTOWN GOOD SAMARITAN HOUSING INC

 Q 58,682 FMV OF TRANSACTION
(5) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION

 B 7,288,961 FMV OF TRANSACTION
(6) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION

 C 2,584,386 FMV OF TRANSACTION
(7) SIOUX FALLS GOOD SAMARITAN HOUSING INC

 Q 83,864 FMV OF TRANSACTION
(8) BROOKINGS GOOD SAMARITAN HOUSING INC

 Q 55,688 FMV OF TRANSACTION
(9) GRANTS GOOD SAMARITAN HOUSING INC

 Q 51,316 FMV OF TRANSACTION
(10) JEFFERSONTOWN GOOD SAMARITAN HOUSING INC

 Q 90,798 FMV OF TRANSACTION
(11) GREELEY GOOD SAMARITAN HOUSING INC

 Q 102,224 FMV OF TRANSACTION
(12) SOUTH DAYTONA BEACH GOOD SAMARITAN HOUSING INC

 Q 102,734 FMV OF TRANSACTION
(13) WINFIELD GOOD SAMARITAN HOUSING INC

 Q 52,117 FMV OF TRANSACTION
(14) INVER GROVE HEIGHTS GOOD SAMARITAN HOUSING INC

 Q 97,293 FMV OF TRANSACTION
(15) SIOUX FALLS 57 GOOD SAMARITAN HOUSING INC

 Q 138,764 FMV OF TRANSACTION
(16) LEA COUNTY GOOD SAMARITAN HOUSING INC

 Q 399,827 FMV OF TRANSACTION
(17) PRESCOTT GOOD SAMARITAN HOUSING LIMITED PARTNERSHIP

 D 1,315,698 FMV OF TRANSACTION
(18) PRESCOTT GOOD SAMARITAN HOUSING LIMITED PARTNERSHIP

 L 335,200 FMV OF TRANSACTION
(19) OLATHE GOOD SAMARITAN HOUSING LP

 L 84,626 FMV OF TRANSACTION
(20) OLATHE GOOD SAMARITAN HOUSING LP

 Q 139,457 FMV OF TRANSACTION
(21) HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP

 A 72,029 FMV OF TRANSACTION
(22) HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP

 D 311,927 FMV OF TRANSACTION
(23) HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP

 Q 287,543 FMV OF TRANSACTION
(24) MILLARD GOOD SAMARITAN HOUSING LP

 D 113,180 FMV OF TRANSACTION
(25) MILLARD GOOD SAMARITAN HOUSING LP

 Q 103,266 FMV OF TRANSACTION
(26) ADAMS COUNTY GOOD SAMARITAN HOUSING LP

 D 1,496,427 FMV OF TRANSACTION
(27) ADAMS COUNTY GOOD SAMARITAN HOUSING LP

 L 265,411 FMV OF TRANSACTION
(28) ADAMS COUNTY GOOD SAMARITAN HOUSING LP

 Q 72,745 FMV OF TRANSACTION
(29) EL PASO GOOD SAMARITAN HOUSING LP

 Q 87,905 FMV OF TRANSACTION
(30) SIOUX FALLS GOOD SAMARITAN HOUSING INC

 D 1,865,511 FMV OF TRANSACTION
(31) SIOUX FALLS GOOD SAMARITAN HOUSING LP

 L 206,542 FMV OF TRANSACTION
(32) SIOUX FALLS GOOD SAMARITAN HOUSING LP

 Q 246,844 FMV OF TRANSACTION
(33) GOOD SAMARITAN SOCIETY INSURANCE LTD

 M 12,907,822 FMV OF TRANSACTION
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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