Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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.") . | 66,456 | 167,383 | 61,755 | 76,849 | 53,380 | 425,823 |
| 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...... | 19,503,983 | 20,662,314 | 20,374,434 | 20,974,796 | 20,684,942 | 102,200,469 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 19,570,439 | 20,829,697 | 20,436,189 | 21,051,645 | 20,738,322 | 102,626,292 |
| 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.) | 102,626,292 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 19,570,439 | 20,829,697 | 20,436,189 | 21,051,645 | 20,738,322 | 102,626,292 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 82,921 | 85,211 | 126,143 | 60,875 | 63,106 | 418,256 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 82,921 | 85,211 | 126,143 | 60,875 | 63,106 | 418,256 |
| 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.) .. | 144,413 | 115,379 | 162,327 | 304,010 | 216,346 | 942,475 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 19,797,773 | 21,030,287 | 20,724,659 | 21,416,530 | 21,017,774 | 103,987,023 |
| 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) | |||||
| 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 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 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) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE IS MADE UP OF BOARD OFFICERS AND AT-LARGE MEMBERS. ALL OF THE COMMITTEE MEMBERS ARE ON THE GOVERNING BODY. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE FULL BOARD, EXCEPT FOR THE FOLLOWING ACTIONS: 1) TO ELECT OR APPOINT ANY TRUSTEE, OR REMOVE ANY OFFICER OR TRUSTEE; 2) TO AMEND OR REPEAL ANY RESOLUTION PREVIOUSLY ADOPTED BY THE BOARD; OR 3) TO MAKE, ALTER OR REPEAL THE CERTIFICATE OF INCORPORATION OR ANY BY-LAW OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | LUTHERAN SOCIAL MINISTRIES OF NEW JERSEY, INC. IS THE SOLE MEMBER OF LUTHERAN HOME AT MOORESTOWN. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS OF THE BOARD OF TRUSTEES ARE APPOINTED BY THE MEMBER, LUTHERAN SOCIAL MINISTRIES OF NEW JERSEY, INC. THE MEMBER HAS THE RIGHT TO APPROVE TRUSTEES NOMINATED BY THE NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBER, LUTHERAN SOCIAL MINISTRIES OF NEW JERSEY, INC., IN ADDITION TO STATUTORILY RESERVED RIGHTS OF APPROVAL, HAS CERTAIN RESERVED RIGHTS OF APPROVAL SET FORTH IN THE CORPORATION'S BYLAWS, INCLUDING THE RIGHT TO: APPOINT AND REMOVE TRUSTEES, THE CHAIRPERSON AND INDEPENDENT AUDITORS; ADOPT AND AMEND THE CERTIFICATE OF INCORPORATION AND BY-LAWS; APPROVE FUNDAMENTAL CHANGES SUCH AS MERGERS, SALE OF SUBSTANTIALLY ALL ASSETS, AND DISSOLUTION; APPROVE BUDGETS, MAJOR POLICIES AND LONG-TERM PLANS; AND APPROVE THE SALE OF PROPERTY, INCURRENCE OF DEBT AND MAJOR GIFTS. THE MEMBER VOTES THROUGH THE ACTION OF ITS BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE PREPARED FORM 990 WAS PROVIDED TO EACH MEMBER OF THE BOARD OF TRUSTEES. MEMBERS WERE REQUESTED TO SEND QUESTIONS, IF ANY, TO MANAGEMENT. THOSE QUESTIONS THAT WERE ADDRESSED TO MANAGEMENT WERE CONSIDERED AND RESOLVED TO THE SATISFACTION OF EACH BOARD MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 12C | PURSUANT TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, THE BOARD OF TRUSTEES AND SENIOR MANAGEMENT DISCLOSE ACTUAL AND POTENTIAL CONFLICTS ON AN ANNUAL BASIS AND AS THEY ARISE DURING THE YEAR, USING A FORM DISTRIBUTED TO THEM. THESE DISCLOSURES ARE REVIEWED BY THE ORGANIZATION'S COMPLIANCE OFFICER. IN ADDITION, STAFF ARE TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AS THEY ARISE DURING THE YEAR TO THEIR VICE PRESIDENT/EXECUTIVE DIRECTOR, WHO REVIEWS THE DISCLOSURE WITH THE PRESIDENT AND CEO AND COMPLIANCE OFFICER. THE PRESIDENT AND CEO WORKS WITH TRUSTEES AND SENIOR MANAGEMENT TO RESOLVE ANY CONFLICTS THAT ARISE OR, WHERE APPROPRIATE, REFERS THE MATTER TO THE BOARD OF TRUSTEES. THE VICE PRESIDENT/EXECUTIVE DIRECTOR WORKS WITH STAFF TO RESOLVE CONFLICTS OF INTEREST IF THEY ARISE. A CONFLICT OF INTEREST MAY BE RESOLVED IN A NUMBER OF WAYS DEPENDING ON THE CIRCUMSTANCES. FOR EXAMPLE, STAFF MAY BE ASKED TO CHANGE THEIR JOB DUTIES, AN OFFICER MAY HAVE TO WITHDRAW FROM AN EXTERNAL AND CONFLICTING ACTIVITY, OR A TRUSTEE MAY HAVE TO BE EXCUSED FROM A BOARD MEETING WHERE A MATTER INVOLVING THE TRUSTEE IS DISCUSSED AND RESOLVED. |
| FORM 990, PART VI, SECTION B, LINE 15 | SOME OF LUTHERAN HOME AT MOORESTOWN'S SENIOR MANAGEMENT ARE EMPLOYED BY LUTHERAN SOCIAL MINISTRIES OF NEW JERSEY, INC., A TAX-EXEMPT RELATED ORGANIZATION. FOLLOWING IS THE METHOD USED TO DETERMINE COMPENSATION FOR THOSE SENIOR MANAGEMENT EMPLOYEES. THE BOARD OF TRUSTEES DEVELOPED A PLAN FOR SENIOR MANAGEMENT COMPENSATION THAT MAINTAINS COMPENSATION AT MARKET LEVELS, REWARDS EXCEPTIONAL PERFORMANCE, AND ENCOURAGES LONGEVITY. THE STRUCTURE OF THE PLAN WAS DEVELOPED AND APPROVED BY THE BOARD OF TRUSTEES. THE PLAN INCLUDED AN ASSESSMENT OF COMPARABLE MARKET DATA. THE DELIBERATIONS OF THE BOARD OF TRUSTEES WERE DOCUMENTED AND HAVE BEEN MAINTAINED IN THE FORM OF WRITTEN MINUTES. SALARY SURVEY DATA WAS USED TO DETERMINE COMPENSATION RANGES FOR THE SENIOR MANAGEMENT TEAM ("SMT"), INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND GENERAL COUNSEL. THE GOAL IS TO MAINTAIN THE SMT AT MARKET COMPENSATION FOR COMPARABLE POSITIONS AS DEFINED IN THE EXECUTIVE COMPENSATION REVIEW OF THE MARKET FOR COMPARABLE POSITIONS. THE BOARD APPROVES THE PLAN AND DEVELOPS A CEO BASE SALARY AND INCENTIVE COMPENSATION RECOMMENDATION EACH YEAR AT ITS FALL MEETING TO BE APPROVED BY THE BOARD OF TRUSTEES. THE BOARD WILL REVIEW THE SALARY AND INCENTIVES THAT THE CEO DEVELOPS FOR THE SMT. |
| FORM 990, PART VI, SECTION C, LINE 19 | INTERESTED PARTIES MAY OBTAIN A COPY OF THE BYLAWS, ARTICLES OF INCORPORATION, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AT THE CORPORATE OFFICE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | AGENCY FEES: PROGRAM SERVICE EXPENSES 114,084. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 114,084. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 54,175. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,175. CONTRACTED SERVICES - CHAPLAIN: PROGRAM SERVICE EXPENSES 6,208. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,208. CONTRACTED SERVICES - HOUSEKEEPING: PROGRAM SERVICE EXPENSES 880,987. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 880,987. CONTRACTED SERVICES - MAINTENANCE: PROGRAM SERVICE EXPENSES 262,211. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 262,211. CONTRACTED SERVICES - DINING SERVICES: PROGRAM SERVICE EXPENSES 1,455,882. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,455,882. CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 151,196. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 151,196. CONTRACTED SERVICES - RECRUITING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 36,184. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,184. CONTRACTED SERVICES - DATA PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 35,347. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,347. |
| FORM 990, PART XI, LINE 9: | CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENTS 34,901. VALUATION GAIN, BENEFICIAL INTEREST IN PERPETUAL TRUSTS 915. |
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