Form990
Click to see list of attachments
Department of the TreasuryInternal 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)
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OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2019 , and ending 06-30-2020
BCheck if applicable:
CName of organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
134 Marwood Road
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Cabot, PA160232215
D Employer identification number

25-0969458
E Telephone number

G Gross receipts $ 59,687,471
F Name and address of principal officer:
Keith Frndak CEO
134 Marwood Road
Cabot,PA16023
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.concordialm.org
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: 1881
M State of legal domicile: PA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Concordia Lutheran Health and Human Care provides faith based, high quality skilled nursing, short term rehab, personal care, adult day care services, retirement living, and child care services. We serve those with limited funds to the best of our ability.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 2
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 999
6 Total number of volunteers (estimate if necessary) ............. 6 324
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 285,012 1,238,185
9 Program service revenue (Part VIII, line 2g) ......... 46,289,308 47,306,730
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,305,824 1,064,855
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 4,546,424 6,667,207
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 52,426,568 56,276,977
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 9,822,163 5,692,989
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) 30,795,829 33,565,586
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet26,155    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 10,167,120 8,988,293
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 50,785,112 48,246,868
19 Revenue less expenses. Subtract line 18 from line 12....... 1,641,456 8,030,109
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 83,570,845 91,154,417
21 Total liabilities (Part X, line 26)............. 48,399,908 48,876,242
22 Net assets or fund balances. Subtract line 21 from line 20..... 35,170,937 42,278,175
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
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Signature of officer Date
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Type or print name and title
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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 (2019)
Form 990 (2019)
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: Concordia Lutheran Health and Human Care is a 501(c)(3) charitable organization and a continuing care retirement community that provides skilled nursing, personal care, independent living, inpatient and outpatient rehab and both adult day and child care services. We strive to provide the highest quality of caregiving services in a Christian environment and to serve those with limited funds to the best of our ability.
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 $ 20,439,885 including grants of $ 0 ) (Revenue $ 20,723,443 )
In the year ended June 30, 2020, the skilled nursing and rehab division had average occupancy levels of 97.2 percent and provided 50,336 bed days of service for 142 beds. 45.5 percent of the patients entrusted to our care had an inability to pay and were served through the Pennsylvania Medical Assistance program. Skilled nursing offers a comprehensive range of outstanding, professional healthcare services in a clean, homelike environment with an engaging activities program. Concordia's outpatient rehabilitation program, serves residents of the continuing care retirement community and also reaches out to the general population in the community continues to grow. Increased community referrals compounded by our ever-growing reputation as a premier rehabilitation provider in the region, has us tremendously optimistic for years to come. To serve our inpatient rehabilitation patients, we are emphasizing treatment focused on short term rehab. Most can return to their home in two to three weeks. Harmony Physical Rehabilitation, our 25 bed short-term rehabilitation facility located in Monroeville, PA had average occupancy levels of 86.3 percent and provided 7,899 bed days of service. This facility promotes a faith-based environment of healing and comfort. Rehabilitation services are conducted in a quiet, peaceful environment to enhance the overall experience. Also, Concordia provides internship opportunities to local college students in the inpatient and outpatient therapy departments in Cabot, PA. Finally, Concordia employees, community churches, and area businesses participated in an Adopt-A-Resident program. Through this program, Christmas gifts were provided to skilled nursing residents to fulfill their Christmas wishes. Concordia donates 6500 square feet of space in their Middlesex office building to the Lighthouse Foundation to house the expansion of their food pantry operation as well as provide the non-profit with office space.
4b (Code:   ) (Expenses $ 17,166,282 including grants of $ 0 ) (Revenue $ 19,418,977 )
With 405 personal care beds in Concordia Lutheran Health and Human Care spread over four unique buildings of operation, we are one of the largest senior care providers in Pennsylvania. On average we serve 360 personal care residents per day providing 131,357 days of service during the year. We are committed to serving those regardless of their ability to pay. In fiscal year 2020 Concordia provided nearly $1,200,000 in benevolent care with 48 residents per day receiving charity care. It is our goal to enable residents to stay in personal care for as long as they can before moving on to skilled nursing by offering 24 hour nursing support through six levels of care. While the focus is on our participants, we do not neglect the needs of the caregivers. Specialists on specific issues are available for consultation and support groups periodically meet such as support groups in house for stroke victim and Alzheimer caregivers. These meetings offer worry-free support for the caregiver both through educational information provided at the meeting and confidence in knowing their loved one is being taken care of while they attend the meetings. The Adult Day Care program serves 17 clients and provides a safe, secure environment. We provide a variety of therapies for individuals with Alzheimer's type diseases and offer a free trial day to all those considering regular use of the Adult Day Services at Concordia. Volunteers and fellow residents offer companionship every day while the activities department organizes trips and events, as well as classes for the residents. Concordia employees, community churches, and area businesses participated in an Adopt-A-Resident program. Through this program, Christmas gifts were provided to Concordia Community personal care and skilled nursing residents to fulfill their Christmas wishes. Chaplains hold regularly scheduled worship services and Bible classes. The Ridgewood facility held a food drive to assist the Plum Boro Food Bank, and welcomes volunteers from Plum High School to meet community services graduation requirements as well as hands on training to special needs students. At the Ridgewood and Orchard Campuses, community festivals were hosted at each of the facilities for family, friends, residents, and community members.
4c (Code:   ) (Expenses $ 5,527,509 including grants of $ 0 ) (Revenue $ 6,767,289 )
The organization's independent living services offer very reasonable entrance fees and monthly fees and allowed the organization to operate at 97.2 percent occupancy in its apartments in fiscal year 2020. Over 400 individuals have chosen the 327 Haven Apartments as their homes. The waiting list reflects the fine reputation we have established among the senior community and our success in meeting the needs of our residents. According to our annual survey, resident satisfaction is very high. Monthly fees include routine maintenance service, transportation to local shopping centers and grocery stores, various activities programs, help with medical forms and income taxes, individual local trips for medical appointments (on a limited basis), and a medical alert system. Beginning with the pandemic "shelter in place" mandates, the independent living activities staff provided grocery service for all Haven residents to ensure they did not need to leave the safety of their apartments. Independent living also hosted several musical events as well as other entertainment acts, which were opened to the public, with a combined total attendance of 555. Concordia's LifeLong Learning Institute (a senior college concept) is open to seniors in the community. During this year, there were 64 educational courses offered between the spring and fall sessions. In that, Concordia had 1,090 registrations and attendances by senior citizen community members and residents of retirement living. Fifty-four of the 64 courses were offered complimentarily and the remaining classes had a nominal fee. Classes included, but were not limited to, iPad classes, yoga classes, history classes, Tips for Senior Health and Wellness, Audubon, and cooking classes. Speaking events are offered in local communities on topics such as exercise, nutrition, fall prevention, Alzheimer education, planning for long-term care, and how to transition to a retirement community. The Cabot Campus Haven retirement living dining room was used by both the Butler County and AK Strong Chambers of Commerce free of charge to hold the Meet -N- Move Networking lunch multiple times throughout the year.
(Code:   ) (Expenses $ 375,133 including grants of $ 0 ) (Revenue $ 397,021 )
Concordia's Child Day Care center has been in operation since 1987 and cares for approximately 33 children each day, five days a week, in their all-day and before and after school programs. Concordia recognizes that child care can be expensive, therefore a discount is offered to all employees who use this service. Concordia's child care program also serves the community.
4d Other program services (Describe in Schedule O.)
(Expenses $ 375,133 including grants of $ 0 ) (Revenue $ 397,021 )
4e Total program service expensesMediumBullet43,508,809
Form 990 (2019)
Form 990 (2019)
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 I.............
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 II.........
4
 
No
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 III..
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 I.........................
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 II....
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..............
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 IV..............
9
 
No
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 V......
10
 
No
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 VII.......
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
Yes
 
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 IX............
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......................
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.........
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 IV.....
15
 
No
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...
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) ....
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............
18
 
No
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...................
19
 
No
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
 
 
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
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
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........
22
 
No
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 attachment
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 ....
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.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
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, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV..................... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
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............
33
 
No
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 ...
35b
 
No
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.............
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 VI
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
 
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
121
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
 
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
999
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
 
No
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
 
 
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
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
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
 
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
 
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
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
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
 
 
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
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
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
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
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
12
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
2
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
Yes
 
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
 
No
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
 
No
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
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A 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:
MediumBulletMichael Falbo134 Marwood Road   Cabot,PA160232215 (724) 352-1571
Form 990 (2019)
Form 990 (2019)
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.

See instructions for the order in which to list the persons above.
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) Keith Frndak-See Schedule O......................................................................
CEO/Chairman of the Board
 5
.................
45 		X   X       725,675 0 78,860
(2) Brian Hortert-See Schedule O......................................................................
Board Member/Chief Operating Officer
 10
.................
35 		X   X       286,557 0 57,130
(3) Charlene Kish-See Schedule O......................................................................
Board Member
 1
.................
44 		X           0 268,976 33,879
(4) Paul Brand-See Schedule O......................................................................
Executive Vice President/Former CFO
 20
.................
25 		    X       267,217 0 34,226
(5) Kim Young-See Schedule O......................................................................
Former CFO/Former Treasurer
 0
.................
0 		          X 269,999 0 23,049
(6) Martin Trettel-See Schedule O......................................................................
Board Member
 0
.................
45 		          X 0 243,398 44,220
(7) Cristen Fiffik......................................................................
General Council
 20
.................
25 		      X     186,573 0 12,127
(8) Michael Falbo-See Schedule O......................................................................
Secretary/Treasurer
 25
.................
20 		X   X       148,835 0 32,276
(9) Kay Frndak-Suder-See Schedule O......................................................................
Board Member
 1
.................
44 		X           0 155,358 21,348
(10) Dave Drane......................................................................
Director of Maintenance
 26
.................
19 		        X   139,136 0 22,425
(11) Mike Kaufman-See Schedule O......................................................................
Board Member
 1
.................
44 		X           0 131,660 23,573
(12) Lisa Brooks-See Schedule O......................................................................
Board Member
 1
.................
44 		X           0 117,737 34,617
(13) Tammy Young-See Schedule O......................................................................
Board Member
 1
.................
44 		X           0 138,937 9,327
(14) Melissa Sullivan-See Schedule O......................................................................
Board Member
 1
.................
44 		X           0 128,910 16,758
(15) Natalie McKay......................................................................
Administrator
 42
.................
3 		        X   131,863 0 8,571
(16) Brian Llewellyn......................................................................
Director of Human Resources
 44
.................
1 		        X   128,106 0 8,694
(17) Karen McCarrier......................................................................
Corporate Compliance Officer
 20
.................
25 		        X   119,586 0 14,779
Form 990 (2019)
Form 990 (2019)
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) Michele Capurso-See Schedule O........................................................................
Board Member
 1
.......................44 		X           0 115,748 14,655
(19) Hope Rouda........................................................................
Personal Care Administrator
 41
.......................4 		        X   119,030 0 8,267
(20) Misty Ingram-See Schedule O........................................................................
Board Member
 1
.......................44 		X           0 101,682 6,975
(21) Karen McCreary-See Schedule O........................................................................
Board Member
 0
.......................0 		          X 0 92,471 10,294
(22) Fred Heintz Jr........................................................................
Board Member
 1
.......................1 		X           0 0 0
(23) Paul Hoffman........................................................................
Board Member
 1
.......................1 		X           0 0 0
(24) James Limbaugh........................................................................
Board Member
 1
.......................2 		X           0 0 0
(25) Daniel Spittel........................................................................
Board Member
 1
.......................0 		X           0 0 0










1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 2,522,577 1,494,877 516,050
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet19
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
Yes
 
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
Top Choice Roofing Service LLC

3519 Hadley Road
Hadley,PA16130 		Roofing Services 176,703
Abraham Shetler,
98 Gordon Road
Sandy Lake,PA16145 		Roofing Services 155,490
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet2
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a 0
b Membership dues..1b 0
c Fundraising events..1c 0
d Related organizations1d 288,105
e Government grants (contributions)1e 918,602
f All other contributions, gifts, grants, and similar amounts not included above1f 31,478
g Noncash contributions included in lines 1a - 1f:$ 1g 0
h Total. Add lines 1a-1f.......MediumBullet 1,238,185
Program Service RevenueAmt Business Code
2a Skilled Nursing and Rehab 623000 20,723,443 20,723,443 0 0
b Personal Care 623000 20,607,125 20,607,125 0 0
c Senior Independent Living 623000 6,774,894 6,774,894 0 0
d Child Day Care Services 624110 397,021 397,021 0 0
e Benevolent Care 623000 -1,195,753 -1,195,753 0 0
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f .....MediumBullet 47,306,730
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 390,379 390,379 0 0
4 Income from investment of tax-exempt bond proceedsMediumBullet 0 0 0 0
5 Royalties...........MediumBullet 0 0 0 0
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss) 0 0 6c
d Net rental income or (loss).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 0 4,084,970 7a
b Less: cost or other basis and sales expenses 0 3,410,494 7b
c Gain or (loss) 0 674,476 7c
d Net gain or (loss).........MediumBullet 674,476 674,476 0 0
8a Gross income from fundraising events (not including $ 0of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a Investments in Affiliates 623000 5,599,855 5,599,855 0 0
b Space Rental-Affiliated Organizations 623000 796,752 796,752 0 0
c            
d All other revenue .... 270,600 270,600 0 0
e Total. Add lines 11a–11d ...... MediumBullet 6,667,207
12 Total revenue. See instructions.....MediumBullet 56,276,977 55,038,792 0 0
Form 990 (2019)
Form 990 (2019)
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 .... 5,692,989 5,692,989
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 1,829,476   1,829,476  
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........ 25,425,933 21,510,627 3,915,306  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,341,404 1,077,886 263,518  
9 Other employee benefits ....... 2,932,901 2,508,027 424,874  
10 Payroll taxes ........... 2,035,872 1,657,035 378,837  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 8,321   8,321  
c Accounting ........... 30,012   30,012  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 32,278   32,278  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 423,221 276,070 120,996 26,155
12 Advertising and promotion .... 160,461 72,353 88,108  
13 Office expenses ....... 153,628 52,717 100,911  
14 Information technology ...... 57,758 10,081 47,677  
15 Royalties ..        
16 Occupancy ........... 1,552,770 1,546,651 6,119  
17 Travel ............ 9,519 1,554 7,965  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 12,091 2,113 9,978  
20 Interest ........... 533,039 533,039    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 3,304,910 3,230,469 74,441  
23 Insurance ... 273,683 269,776 3,907  
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 Food Service Costs 2,289,462 2,289,328 134  
b EMR, Pharmacy and Medical Supplies 2,685,688 2,672,711 12,977  
c Maintenance Costs 307,219 300,246 6,973  
d Expenses Allocated to Affiliates -4,083,203 -1,131,482 -2,951,721  
e All other expenses 1,237,436 936,619 300,817  
25 Total functional expenses. Add lines 1 through 24e 48,246,868 43,508,809 4,711,904 26,155
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 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 2,159,859 1 5,892,254
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 4,179,233 4 3,950,433
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 961,438 9 2,512,973
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 97,220,751
b Less: accumulated depreciation 10b 60,903,061 38,182,817 10c 36,317,690
11 Investments—publicly traded securities . 13,566,870 11 16,660,516
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .. 24,520,628 13 25,820,551
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ...........   15  
16 Total assets. Add lines 1 through 15 (must equal line 33)... 83,570,845 16 91,154,417
Liabilities 17 Accounts payable and accrued expenses ..... 3,596,855 17 4,569,583
18 Grants payable ...   18  
19 Deferred revenue ......... 5,040,232 19 5,425,207
20 Tax-exempt bond liabilities ......... 31,263,871 20 29,966,493
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
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 8,498,950 25 8,914,959
26 Total liabilities. Add lines 17 through 25.. 48,399,908 26 48,876,242
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 35,158,177 27 42,188,601
28 Net assets with donor restrictions ........... 12,760 28 89,574
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 35,170,937 32 42,278,175
33 Total liabilities and net assets/fund balances ........ 83,570,845 33 91,154,417
Form 990 (2019)
Form 990 (2019)
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
56,276,977
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
48,246,868
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
8,030,109
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
35,170,937
5
Net unrealized gains (losses) on investments ...............
5
-999,685
6
Donated services and use of facilities .................
6
0
7
Investment expenses .....................
7
0
8
Prior period adjustments .....................
8
0
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
76,814
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
42,278,175
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
 
No
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
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID: 19009572
Software Version: v1.00
Form 990, Special Condition Description:
Special Condition Description
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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number

25-0969458
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
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- 10 above (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 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 failed 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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 254,937 320,302 272,033 258,011 1,238,185 2,343,468
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 43,617,338 46,519,966 46,765,860 47,729,011 48,502,483 233,134,658
3 Gross receipts from activities that are not an unrelated trade or business under section 513 ..... 0 0 0 0 0 0
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... 0 0 0 0 0 0
5 The value of services or facilities furnished by a governmental unit to the organization without charge 0 0 0 0 0 0
6 Total. Add lines 1 through 5 43,872,275 46,840,268 47,037,893 47,987,022 49,740,668 235,478,126
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.) 235,478,126
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
9 Amounts from line 6... 43,872,275 46,840,268 47,037,893 47,987,022 49,740,668 235,478,126
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 189,536 894,323 1,023,983 1,228,577 1,384,899 4,721,318
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 189,536 894,323 1,023,983 1,228,577 1,384,899 4,721,318
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.) .. 3,184,814 5,430,494 5,184,270 3,595,922 5,668,677 23,064,177
13 Total support. (Add lines 9, 10c, 11, and 12.).. 47,246,625 53,165,085 53,246,146 52,811,521 56,794,244 263,263,621
14
Section C. Computation of Public Support Percentage
15
15
89.446 %
16
16
90.372 %
Section D. Computation of Investment Income Percentage
17
17
1.793 %
18
18
1.395 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
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 I of Schedule L (Form 990 or 990-EZ).
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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
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
 
 
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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
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 2019 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-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2020. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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 $5,599,855-Investment in Affiliates, $68,822-Miscellaneous Income
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 19009572
Software Version: v1.00
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number

25-0969458
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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
  		Employer identification number
25-0969458
Part I
Contributors
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
  		Employer identification number

25-0969458
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
  		Employer identification number

25-0969458
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) (2019)

Additional Data


Software ID: 19009572
Software Version: v1.00
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number

25-0969458
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB 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 FASB 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 on 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 FASB ASC 958 relating to these items:
a
Revenue included on 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) 2019

Schedule D (Form 990) 2019
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" on 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" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on 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)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 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" on 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 ..... 0 2,757,174 2,757,174
b Buildings .... 0 68,061,625 39,660,482 28,401,143
c Leasehold improvements 0 0 0 0
d Equipment .... 0 26,401,952 21,242,579 5,159,373
e Other ..... 0 0 0 0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 36,317,690
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on 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........    
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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' on 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
(1)Investment in Rebecca Residence 21,123,984 F
(2)Investment in Good Samaritan Hospice 2,657,214 F
(3)Investment in Providence Pharmacy Services 2,039,353 F
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 25,820,551
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 8,914,959
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) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
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  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
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  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
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  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
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  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
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
Schedule D, Part X, Line 2 The Organization is a not-for-profit corporation and is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes has been provided. The Organization adopted the standard for accounting for uncertainty in income taxes recognized in an organization's financial statements that prescribes a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has been met. The standard also provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, and disclosure. Management has determined that the adoption of the standard did not have a material effect on the consolidated financial statements. The Organization's policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses. There were no interest or penalties recognized on the consolidated statement of operations as a result of the adoption.
Schedule D (Form 990) 2019


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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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number
25-0969458
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" on 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
noncash assistance		 (h) Purpose of grant
or assistance
(1) Concordia Lutheran Ministries Foundation
134 Marwood Road
Cabot,PA16023 		20-5138266 501(c)(3) 5,550,000 0     Donation to further the mission and corporate promise of Concordia Lutheran Ministries (EIN 20-5138278) and its affiliates.
(2) Lighthouse Foundation
PO Box 366
Bakerstown,PA15007 		25-1547324 501(c)(3) 0 119,600 Market value Donated space for food bank and offices  
(3) Saxonburg Volunteer Fire Company
210 Horne Avenue
Saxonburg,PA16056 		25-0776855 501(c)(3) 34,922 0     General donations
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
3
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) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
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
Schedule I, Part I, Line 2 The organization monitors the operations of the recipient to ensure the funds are used for the appropriate purposes.
Schedule I (Form 990) 2019



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Software ID: 19009572
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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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number

25-0969458
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 on 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 on 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 on 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 on 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
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
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 on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on 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" on 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) 2019

Schedule J (Form 990) 2019
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 on 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 on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Keith Frndak-See Schedule O
CEO/Chairman of the Board 		(i)

(ii)		 573,625
-------------
0 		152,050
-------------
0 		0
-------------
0 		18,200
-------------
0 		4,910
-------------
0 		748,785
-------------
0 		0
-------------
0
2Brian Hortert-See Schedule O
Board Member/Chief Operating Officer 		(i)

(ii)		 250,183
-------------
0 		11,250
-------------
0 		25,124
-------------
0 		18,200
-------------
0 		12,913
-------------
0 		317,670
-------------
0 		0
-------------
0
3Kim Young-See Schedule O
Former CFO/Former Treasurer 		(i)

(ii)		 221,749
-------------
0 		48,250
-------------
0 		0
-------------
0 		17,630
-------------
0 		5,419
-------------
0 		293,048
-------------
0 		0
-------------
0
4Paul Brand-See Schedule O
Executive Vice President/Former CFO 		(i)

(ii)		 237,846
-------------
0 		4,050
-------------
0 		25,321
-------------
0 		17,186
-------------
0 		0
-------------
0 		284,403
-------------
0 		0
-------------
0
5Cristen Fiffik
General Council 		(i)

(ii)		 185,673
-------------
0 		900
-------------
0 		0
-------------
0 		12,127
-------------
0 		0
-------------
0 		198,700
-------------
0 		0
-------------
0
6Michael Falbo-See Schedule O
Secretary/Treasurer 		(i)

(ii)		 145,785
-------------
0 		3,050
-------------
0 		0
-------------
0 		10,176
-------------
0 		10,120
-------------
0 		169,131
-------------
0 		0
-------------
0
7Dave Drane
Director of Maintenance 		(i)

(ii)		 109,563
-------------
0 		20,150
-------------
0 		9,423
-------------
0 		9,513
-------------
0 		12,913
-------------
0 		161,562
-------------
0 		0
-------------
0
8Charlene Kish-See Schedule O
Board Member 		(i)

(ii)		 0
-------------
216,533 		0
-------------
30,000 		0
-------------
22,444 		0
-------------
12,775 		0
-------------
7,454 		0
-------------
289,206 		0
-------------
0
9Martin Trettel-See Schedule O
Board Member 		(i)

(ii)		 0
-------------
213,529 		0
-------------
8,150 		0
-------------
21,719 		0
-------------
15,966 		0
-------------
6,603 		0
-------------
265,967 		0
-------------
0
10Kay Frndak-Suder-See Schedule O
Board Member 		(i)

(ii)		 0
-------------
149,058 		0
-------------
6,300 		0
-------------
0 		0
-------------
10,124 		0
-------------
504 		0
-------------
165,986 		0
-------------
0
11Mike Kaufman-See Schedule O
Board Member 		(i)

(ii)		 0
-------------
126,760 		0
-------------
4,900 		0
-------------
0 		0
-------------
9,311 		0
-------------
14,262 		0
-------------
155,233 		0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
Schedule J, Part I, Line 3 The Executive Committee of Concordia Lutheran Ministries (Parent) (EIN 20-5138278) approves the compensation of the Chief Executive Officer (CEO) annually through his employer Concordia Lutheran Health and Human Care (CLHHC) (EIN 25-0969458). Compensation includes base compensation, bonuses, and other fringe benefits such as health insurance. The committee uses data from state and national associations for organizations of similar size to compare compensation. Executive Committee decisions for CEO compensation are communicated to the Chief Financial Officer. Compensation for key employees is determined by the CEO. Data from state and national associations is used for comparison purposes.
Schedule J, Part I, Line 4 Affiliates, Concordia Lutheran Health and Human Care (CLHHC) (EIN 25-0969458) and Concordia Community Support Services (CCSS) (EIN 47-3508524), Concordia Lutheran Ministries Pittsburgh (EIN 27-0209886), Concordia of Ohio (EIN 61-1682165), Rebecca Residence (EIN 25-0974311), and Concordia of Florida (EIN 37-1869372) participate in a non-qualified 457 deferred compensation plan for certain highly compensated employees of the Organization. The Concordia Lutheran Ministries (EIN 20-5138278) Board of Directors, and CEO approve all participants who are enrolled in the plan. In the calendar year 2019 the following participants were enrolled in the plan and contributions are deferred and fully vests in five years. After the five year vesting period the contributions will be included on their W-2 in Box 5. In the calendar year 2019 the following participants were enrolled in the plan: Michael Falbo, Cristen Fiffik, Keith Frndak, Brian Hortert, Paul Brand, Natalie McKay, Hope Rouda, William Zeckzer, Karen McCarrier, Dave Drane, Brian Llewellyn, Martin Trettel, Tammy Young, Kay Frndak-Suder, Charlene Kish, Mike Kaufman, Lisa Brooks, and Michele Capurso,.
Schedule J, Part II All board members of Concordia Lutheran Health and Human Care serve on a purely volunteer basis. Any compensation to a board member by a related organization, reported on Part VII and Schedule J, is for his/her service as an employee of that organization and not for his/her service as a board member.
Schedule J (Form 990) 2019

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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number
25-0969458
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 Butler County Industrial Dev Authority series 2004
  		25-1487895 123600AK4 05-21-2004 16,130,560 Building expansion and acquisition   X   X   X
B Butler County Industrial Dev Authority series 2008
  		25-1487895 123600AL2 10-29-2008 31,885,000 Refinancing   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 0 0    
2 Amount of bonds legally defeased .............. 0 0    
3 Total proceeds of issue .................. 16,000,000 31,885,000    
4 Gross proceeds in reserve funds ............. 0 0    
5 Capitalized interest from proceeds ............. 0 0    
6 Proceeds in refunding escrows ............... 0 0    
7 Issuance costs from proceeds ............... 232,896 207,805    
8 Credit enhancement from proceeds ............. 0 0    
9 Working capital expenditures from proceeds ............. 0 0    
10 Capital expenditures from proceeds ............. 15,767,104 31,677,195    
11 Other spent proceeds ............. 0 0    
12 Other unspent proceeds ............. 0 0    
13 Year of substantial completion ............. 2007 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........ 		  X   X        
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........ 		X   X          
16 Has the final allocation of proceeds been made? .......... X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. 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        
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X        
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
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        
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        
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 0.91 % 0 %    
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 0 % 0 %    
6 Total of lines 4 and 5 ............. 0.91 % 0 %    
7 Does the bond issue meet the private security or payment test? ... 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        
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          
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          
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......                
b Exception to rebate? ........                
c No rebate due? .........                
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          
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X        
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
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        
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? ... 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?                
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Schedule K (Form 990) 2019

Additional Data


Software ID: 19009572
Software Version: v1.00

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.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number

25-0969458
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 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 the 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) 2019
Schedule L (Form 990 or 990-EZ) 2019
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) Keith Frndak CEO Father of board member Kay Frndak-Suder 0 See Schedule L Part V for explanation   No
(2) Kay Frndak-Suder Daughter of CEO Keith Frndak 0 Board members are not compensated   No
(3) Olivia Danner Activities Assistant Daughter of COO Brian Hortert 41,124 Total reportable compensation   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L, Part IV The Concordia Lutheran Health and Human Care board, which includes the CEO's daughter (Kay Frndak-Suder) does not determine the compensation of Keith Frndak, CEO. The compensation is determined by the Concordia Lutheran Ministries (EIN 20-5138278) board of directors. Therefore, the transaction on Schedule L is zero. For total compensation of the interested person please see Schedule J.
Schedule L (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 19009572
Software Version: v1.00




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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number

25-0969458
Return Reference Explanation
Form 990, Part III Concordia Lutheran Health and Human Care is one of the 10 largest providers of senior care in the Pittsburgh region. The organization was founded in 1881 and began operations in 1882. For nearly 140 years, Concordia has been a place with a mission of caring. It is a place to feel comfortable and a place where heartfelt Christian faith and a strong sense of service to others help us make a difference every day. Concordia's financial stability has enabled us to donate over $5.5 million in fiscal year 2020 to other non-profit organizations that support many missions and ministries. Concordia's community benefit continues to support our region's community in a number of ways. Annually, Concordia holds multiple community festivals. At the Cabot Campus, the Summer Festival (attended by over 800 visitors) and the Oktoberfest (attended by 1,600 visitors) continues to provide fun-filled family days for our community. Each event included free children and family activities, music, and entertainment. Food was provided for a small fee and children under the age of 12 ate for free. The Oktoberfest also included a professional display of fireworks for the viewing pleasure of all in attendance. During the Christmas season, the Cabot Campus held a live Nativity, which included a number of employee volunteers, for the enjoyment of over 400 community members and residents. The baseball and soccer fields at the Cabot Campus are utilized each spring and summer by the athletic programs in the Saxonburg area. The use of Concordia's fields offers them additional space for practices and games enhancing the quality of the program for the children. Concordia also travels locally to participate in public health fairs at malls and convention centers with several hundred community members in attendance. Several of the area's non-profits such as Rails to Trails utilize Concordia's meeting rooms to hold their monthly or quarterly board meetings. Golden Agers, a local seniors social club, is provided a free of charge lunch and facility use annually. Concordia Lutheran Health and Human Care also sponsors numerous community organizations and schools in the area through sponsorships of community youth athletic teams, area school youth athletics, educational scholarships through school sponsored programs and youth community volunteer projects including allowing local high school band/cheer group, "the Knochettes" use of campus space and water supply for a fundraising carwash. There are also several event sponsorships for the local hospitals in the area to benefit patient care at those hospitals. Concordia offers several internships to local college students in our food service/dietetics, social services, therapy, public relations, and nursing departments. Concordia donates 6500 square feet of space in their Middlesex office building to the Lighthouse Foundation to house the expansion of their food pantry operation as well as provide the non-profit with office space. On January 31, 2020, acting HHS Secretary Alex Azar first declared a public health emergency following the World Health Organization's recognition of the novel coronavirus, COVID-19, as a pandemic. In response to this coronavirus outbreak, the state and federal governments have taken preventative or protective actions, such as imposing restrictions on travel and business operations and advising or requiring individuals to limit or forego their time outside of their homes. Daily high-level leadership meetings were established to assess and provide guidance to staff through every changing regulation surrounding the pandemic. Throughout the pandemic, education and guidance related to best practices and CDC protocol was provided by our corporate compliance team. This allowed our frontline workers to remain safe and able to provide quality care to many COVID affected patients and families. On March 31st, we initiated our first ever Employee Appreciation Daily Bonus of $25 for each eight-hour shift worked on site to all staff members who make less than $75,000 per year. The bonus program was made retroactive to begin as of Sunday, March 29th and remained in effect until Saturday, May 16th, 2020. Even with decreased census when surrounding hospitals shut down, there were no layoffs as a result of the pandemic. A call center was established to call any current or referred patients even if they were declining visits to ensure there wasn't an exasperation of symptoms to avoid rehospitalizations. The organization worked with a corporate purchasing team to ensure appropriate levels of personal protective equipment (PPE) were purchased to provide care is the safest way possible. The organization purchased $25,537 of PPE.
Form 990, Part VI, Section A, Line 2 CEO and Chairman of the Board, Keith Frndak and board member, Kay Frndak-Suder are father and daughter.
Form 990, Part VI, Section A, Line 6 Concordia Lutheran Ministries (EIN 20-5138278) is the sole member of Concordia Lutheran Health and Human Care.
Form 990, Part VI, Section A, Line 7a The sole member, Concordia Lutheran Ministries (EIN 20-5138278), assigns the board of directors.
Form 990, Part VI, Section A, Line 7b The sole member, Concordia Lutheran Ministries (EIN 20-5138278), has certain reserve powers over the organization's board of directors' decisions and actions.
Form 990, Part VI, Section B, Line 11b The Concordia Lutheran Ministries (EIN 20-5138278) board of directors maintains reserve powers on the binding decisions made by the board of directors of Concordia Lutheran Health and Human Care. Due to these reserve powers, it has been decided to present the Form 990 of this organization to the board of directors of Concordia Lutheran Ministries for review prior to submission. Additionally, any independent board member of this organization was offered an opportunity to review the Form 990 prior to submission as well.
Form 990, Part VI, Section B, Line 12c The corporate compliance officer attends at least one board meeting per year to educate the board members on the compliance policies, including the conflict of interest policy. Board members are required to disclose any potential conflicts of interest prior to discussion on a topic where a conflict may exist. The board will determine if the conflict exists and act accordingly, which may include the conflicted board member recusing himself/herself from discussion and any votes related to the matter.
Form 990, Part VI, Section B, Line 15 Concordia Lutheran Ministries has no employees. The processes listed in Line 15 are performed by affiliate organizations for those persons listed on Part VII and on Schedule J.
Form 990, Part VI, Section C, Line 18 Concordia Lutheran Health and Human Care's Form 990 is available at guidestar.org.
Form 990, Part VI, Section C, Line 19 Concordia Lutheran Ministries publishes an annual report that summarizes the financial operations of the organization and its affiliates which is mailed to all of its constituents. The annual report, governing documents, conflict of interest policies, and financial statements are available to the public upon request.
Form 990, Part VII, Section A, Line 1a All board members of Concordia Lutheran Ministries Foundation serve on a purely volunteer basis. Any compensation to a board member by a related organization, reported on Part VII and Schedule J, is for his/her service as an employee of that organization and not for his/her service as a board member. Employment compensation for board members is as follows: Keith Frndak, CEO, Concordia Lutheran Ministries and its affiliates, Kim Young, Former CFO, Concordia Lutheran Ministries and its affiliates, Michael Falbo, CFO, Concordia Lutheran Ministries and its affiliates, Brian Hortert, COO, Concordia Lutheran Ministries and its affiliates, Lisa Brooks, Executive Director, Concordia of Florida, Kay Frndak-Suder, Executive Director, Concordia Lutheran Ministries of Pittsburgh, Mike Kaufman, Executive Director, Rebecca Residence, Charlene Kish, CEO, Concordia of Ohio, Karen McCreary, Former COO Concordia Community Support Services and community based affiliates, Misty Ingram, COO Concordia Community Support Services and community based affiliates, Tammy Young, CFO, Concordia Community Support Services and community based affiliates, Melissa Sullivan, Administrator, Concordia of Monroeville, Michele Capurso, Administrator, Concordia of Florida, Paul Brand, Executive VP, Concordia Lutheran Ministries and its affiliates, and Martin Trettel, CEO, Concordia Community Support Services and community based affiliates.
Form 990, Part XI, Line 9 $76,814-Change in Temporarily Restricted Net Assets
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 19009572
Software Version: v1.00
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 Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
 
Employer identification number

25-0969458
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










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)Concordia Lutheran Ministries
134 Marwood Rd

Cabot,PA16023
20-5138278 		Manages, oversees, and carries out the purpose of the affiliated 501(c)(3) organizations PA 501(c)(3) 12 Type III N/A
 
No
(2)Concordia Lutheran Ministries Foundation
134 Marwood Rd

Cabot,PA16023
20-5138266 		Manages investment assets of Concordia Lutheran Ministries Foundation PA 501(c)(3) 12 Type II Concordia Lutheran Ministries
20-5138278
 
No
(3)Concordia Visiting Nurses
615 North Pike Rd

Cabot,PA16023
42-1704067 		Provides home health care services PA 501(c)(3) 10 Concordia Community Support Services
47-3508524
 
No
(4)Good Samaritan Hospice of Pittsburgh
3500 Brooktree Road
Suite 320
Wexford,PA15090
25-1818793 		Provides inpatient and outpatient hospice services PA 501(c)(3) 10 Concordia Lutheran Health and Human Care
25-0969458
Yes
 
(5)Rebecca Residence
3746 Cedar Ridge Road

Allison Park,PA15101
25-0974311 		Provides skilled nursing, personal care, independent living, and rehabilitation services PA 501(c)(3) 10 Concordia Lutheran Health and Human Care
25-0969458
Yes
 
(6)Concordia Lutheran Ministries of Pittsburgh
1300 Bower Hill Rd

Pittsburgh,PA15243
27-0209886 		Provides skilled nursing, personal care, independent living services, and rehabilitation services PA 501(c)(3) 10 Concordia Lutheran Ministries
20-5138278
 
No
(7)Concordia of Ohio
970 Sumner Parkway

Copley,OH44321
61-1682165 		Provides skilled nursing, personal care, independent living, and rehabilitation services OH 501(c)(3) 10 Concordia Lutheran Ministries
20-5138278
 
No
(8)Concordia Telecaregivers
613 North Pike Road
Suite A
Cabot,PA16023
25-1881783 		Provides free monitoring to homebound clients and private duty services PA 501(c)(3) 10 Concordia Community Support Services
47-3508524
 
No
(9)Concordia Visiting Nurses of Ohio
613 North Pike Road

Cabot,PA16023
46-3845269 		Provides home health care services OH 501(c)(3) 10 Concordia Community Support Services
47-3508524
 
No
(10)Concordia of Monroeville
4363 Northern Pike

Monroeville,PA15146
25-1475192 		Provides skilled nursing, personal care, and rehabilitation services PA 501(c)(3) 10 Concordia Lutheran Ministries of Pittsburgh
27-0209886
 
No
(11)Concordia Community Support Services
613 North Pike Road
Suite B
Cabot,PA16023
47-3508524 		Provides oversight, management, and strategic planning for home and community based services PA 501(c)(3) 12 Type II Concordia Lutheran Ministries
20-5138278
 
No
(12)Concordia Physicians Practice
134 Marwood Road

Cabot,PA16023
47-3951584 		Provides primary care physician services PA 501(c)(3) 10 Concordia Lutheran Ministries
20-5138278
 
No
(13)Cedars Home Health Care Services
4363 Northern Pike

Monroeville,PA15146
25-1875508 		Provides home health care services PA 501(c)(3) 10 Concordia Telecaregivers
25-1881783
 
No
(14)Concordia Hospice of Washington
613 North Pike Road
Suite B
Cabot,PA16023
81-2448411 		Provides inpatient and outpatient hospice services PA 501(c)(3) 10 Concordia Community Support Services
47-3508524
 
No
(15)Concordia of Florida
4100 E Fletcher Avenue

Tampa,FL33613
37-1869372 		Provides skilled nursing, personal care, independent living, and rehabilitative services FL 501(c)(3) 10 Concordia Lutheran Ministries
20-5138278
 
No
(16)Concordia Medical Equipment
615 North Pike Road

Cabot,PA16023
20-4386767 		Rental/sales of medical equipment and supplies PA 501(c)(3) 10 Concordia Lutheran Ministries
EIN 20-5138278
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) Providence Pharmacy Services

615 North Pike Road
Cabot,PA16023
22-3885810 		provides institutional pharmacy services and consulting to the limited partnership PA Concordia Providence LLC
20-5138278 		Related 1,162,744 3,328,750   No     No 75.43 %












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












Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
 
No
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
Yes
 
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
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
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 Hospice of Pittsburgh

 a-iv 130,188 Market
(2) Good Samaritan Hospice of Pittsburgh

 s 3,630,000 Cost
(3) Good Samaritan Hospice of Pittsburgh

 o 216,526 Cost
(4) Good Samaritan Hospice of Pittsburgh

 q 425,296 Cost
(5) Rebecca Residence

 o 500,987 Cost
(6) Rebecca Residence

 q 970,672 Cost
(7) Providence Pharmacy Services

 a-iv 62,400 Market
(8) Providence Pharmacy Services

 o 104,000 Cost
(9) Providence Pharmacy Services

 q 97,341 Cost
(10) Providence Pharmacy Services

 r 1,896,845 Cost
(11) Providence Pharmacy Services

 s 746,745 Cost
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


Software ID: 19009572
Software Version: v1.00






TY 2019 ReasonableCauseExplanation
Name:
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
EIN:
25-0969458
Software ID:
19009572
Software Version:
v1.00
Explanation:
Filed IRS Form 8868 for the automatic six month extension. Additional time was necessary to gather information and complete for Form 990 accurately.