2024-05-14T10:50:35-05:00 2023-06-30 470625816 LUTZ AND COMPANY PC 3320 JAMES ROAD SUITE 100 GRAND ISLAND NE 68803 990 2022-07-01 470378984 BLUE VALLEY LUTHERAN HOMES SOCIETY INC BLUE 4027683900 220 WEST PARK AVENUE HEBRON NE 683700166 SCOTT FANGMEIER CFO 4027683900 2024-05-09 1 SCOTT FANGMEIER 999009999 0 STEVEN K PLACKE P00078534 3083827850 2024-05-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SCOTT FANGMEIER 220 WEST PARK AVENUE HEBRON NE 683700166 6490600 0 X WWW.BVLH.ORG X 1961 NE BLUE VALLEY LUTHERAN HOMES SOCIETY, INC IS A MINISTRY ORGANIZATION DEDICATED TO SERVING THE NEEDS OF THE ELDERLY AND THE PHYSICALLY AND MENTALLY CHALLENGED WITH DIGNITY AND RESPECT THROUGH CHRISTIAN LOVE AND COMPASSION. 9 9 136 12 0 0 1273826 1859504 4645841 4540352 127387 17509 87089 73235 6134143 6490600 0 0 0 0 3359859 3374302 0 0 29356 2611180 2509422 5971039 5883724 163104 606876 5962998 6747469 4901543 4964464 1061455 1783005 TO ENRICH THE LIVES OF THOSE WE SERVE THROUGH CHRISTIAN LOVE WITH COMPASSION, RESPECT, AND INTEGRITY. 0 0 3897901 3301592 THE BLUE VALLEY NURSING HOME HAS 64 BEDS IN OPERATION AND PROVIDES LONG TERM NURSING CARE. THE NURSING HOME ALSO PROVIDED SKILLED NURSING CARE WITH SHORT TERM REHABILITATION PROGRAMS INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. IN ADDITION, SPIRITUAL COUNSELING, SOCIAL WORKS, COORDINATED ACTIVITIES AND CONTINUAL HEALTH CARE PLANNING ARE PROVIDED AT NO ADDITIONAL COST TO THE PATIENT.ADULT DAY CARE IS PROVIDED TO PROVIDE OPPORTUNITIES FOR AGED INDIVIDUALS TO BE SOCIALLY AND PHYSICALLY ACTIVE IN A SAFE AND WELCOMING ENVIRONMENT. SOCIAL ACTIVITIES, MEALS AND SOME HEALTH CARE SERVICES ARE PROVIDED. 1279240 1238760 COURTYARD TERRACE IS AN ASSISTED LIVING FACILITY WITH 55 LICENSED BEDS. OUR GOAL IS TO PROVIDE OUR RESIDENTS WITH AN IMPROVED QUALITY OF LIFE WHILE MAINTAINING THEIR INDEPENDENCE.A 24-HOUR PENDANT CALL SERVICE ALLOWS RESIDENTS TO REQUEST ASSISTANCE WITH BATHING, DRESSING,AND MEDICATION. RESIDENTS HAVE THE OPPORTUNITY TO SELECT THEIR MEALS FROM OPTIONS PROVIDED DAILY. CLEANING SERVICES AND TRANSPORTATION FOR DOCTOR APPOINTMENTS ARE PROVIDED.COURTYARD TERRACE PROVIDES NUMEROUS SOCIAL ACTIVITIES FOR RESIDENTS. THERE ARE OUTINGS, OPPORTUNITIES FOR GARDENING, A MEDIA CENTER, ICE CREAM PARLOR AND GAMES. 5177141 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 19 0 1 136 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SCOTT FANGMEIER CFO 4027683900 220 WEST PARK AVENUE HEBRON NE 68370 CAROL KRUEGER PRESIDENT 1.00 X X 0 0 0 STEVE BENSON VICE PRESIDENT 1.00 X X 0 0 0 JANA TIETJEN SECRETARY 1.00 X X 0 0 0 KEVIN COTTAM DIRECTOR 1.00 X 0 0 0 TODD HEINRICHS DIRECTOR 1.00 X 0 0 0 RANDY HERGOTT DIRECTOR 1.00 X 0 0 0 KERREY MILLER DIRECTOR 1.00 X 0 0 0 SONNY MANLEY DIRECTOR 1.00 X 0 0 0 PASTOR JEFF FRIESEN DIRECTOR 1.00 X 0 0 0 DOUG CHOS CEO / ADMINISTRATOR 40.00 X 86189 0 6974 LORI WITTLER CFO (THRU 3/9/24) 40.00 X 79500 0 254 SCOTT FANGMEIER CFO (AS OF 3/9/24) 40.00 X 0 0 0 165689 0 7228 0 0 0 0 24 HOUR NURSE LLC 318 DAINGERFIELD STREET PITTSBURG TX 75686 STAFFING 182631 1 1713058 146446 1859504 NURSING HOME - MEDICAI 531110 2744193 2744193 NURSING HOME - PRIVATE 531110 1650532 1650532 NURSING HOME - MEDICAR 531110 145627 145627 4540352 17509 17509 4200 0 4200 4200 4200 LAUNDRY SERVICE 812900 44375 44375 OTHER OPERATING REVENU 812900 24660 24660 69035 6490600 4540352 0 90744 X 172917 172917 2714887 2616104 98783 273361 256179 17182 213137 191330 21807 292 292 43847 43847 4320 4320 169559 169559 9763 9525 238 178161 178161 501761 501761 213766 213766 POOL NURSING 366698 366698 FOOD 281902 281902 CONTRACT SERVICES 222236 148820 73416 SUPPLIES 180013 166534 13479 337104 76802 230946 29356 5883724 5177141 677227 29356 541414 251532 696694 2042007 8874 0 44555 30202 13110281 9083654 4311152 4026627 156041 176451 204268 220650 5962998 6747469 548362 1196213 52935 45908 4083763 3518340 178249 176749 38234 27254 4901543 4964464 X 888454 1514425 173001 268580 1061455 1783005 5962998 6747469 X 606876 7479 107195 0 X X 0 1 X 1 0 X 112220 902556 1116106 1273826 1859504 5264212 6140745 5525863 5329302 4645841 4540352 26182103 6252965 6428419 6445408 5919667 6399856 31446315 2785 2830 2116 3183 285 11199 0 2785 2830 2116 3183 285 11199 31435116 14693 7013 5893 22212 21709 71520 14693 7013 5893 22212 21709 71520 66295 60064 58058 82889 69035 336341 6333953 6495496 6509359 6024768 6490600 31854176 0.98680 0.98770 0.00220 0.00190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 350975 350975 10860066 9083654 1776412 1899240 1899240 4026627 CAPITAL LEASE OBLIGATION 7004 RESIDENT DEPOSITS 20250 27254 X 6319918 7479 7479 6312439 178161 178161 6490600 5705563 0 5705563 178161 178161 5883724 PART IV, LINE 2B: BLUE VALLEY LUTHERAN HOMES SOCIETY HOLDS CASH ACCOUNTS FOR THEIR RESIDENTS. THE RESIDENTS USE THESE PERSONAL FUNDS FOR PURCHASING PERSONAL ITEMS. PART X, LINE 2: THE HOME IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, HAS MADE NO PROVISION FOR FEDERAL INCOME TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS. ACTIVITIES NOT DIRECTLY RELATED TO ITS TAX-EXEMPT PURPOSE ARE SUBJECT TO INCOME TAXES. THERE WAS NO UNRELATED BUSINESS INCOME DURING THE YEARS ENDED JUNE 30, 2023 AND 2022 (RESTATED). THE HOME BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE JUNE 30, 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE 178,161. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE 178,161. FORM 990, PART VI, SECTION B, LINE 11B BVLH CONTRACTS WITH A PUBLIC ACCOUNTING FIRM FOR THE PREPARATION OF THE FORM 990. THE DIRECTOR OF ACCOUNTING WILL REVIEW THE FORM 990 PRIOR TO FILING. A COPY OF THE COMPLETED RETURN WILL BE PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING, AND THE BOARD WILL REVIEW THE FORM 990 AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C 1. DUTY TO DISCLOSE IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST - AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT, 2. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS AND AFTER THE DISCUSSION WITH THE INTERESTED PERSON - THE DIRECTOR OR COMMITTEE MEMBER SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. 3, PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: A, AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. B, THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C, AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN, WITH REASONABLE EFFORTS, A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D, IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTERES'R, FOR ITS OWN BEHALF, AND WHETHER I'R IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. 4. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: A. IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBERS OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. B. IF, AFTER HEARING THE MEMBER'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, IF THE GOVERNING BOARD OR COMMIT'L'EE DETERMINES THE MEMBER HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE THE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 ALL BVLH BOARD MEMBERS SHALL SERVE WITHOUT COMPENSATION. THE PRESIDENT/CEO OF BVLH SHALL BE RESPONSIBLE FOR ESTABLISHING WAGES, SALARIES, BENEFITS AND RAISES FOR ALL EMPLOYEES, SUBJECT TO BOARD APPROVAL. THE EXECUTIVE COMMITTEE AT LTC MIDWEST, LLC SHALL ANNUALLY DETERMINE THE SALARY, BENEFITS AND SEVERANCE PACKAGE FOR THE PRESIDENT/CEO OF BVLH. THE PRESIDENT'S COMPENSATION MUST MEET THE FAIR MARKET VALUE TEST, AND COMPARABILITY TEST FOR SIMILAR POSITIONS IN NOT-FOR-PROFIT ORGANIZATIONS. THE PRESIDENT'S COMPENSATION SHALL BE EVALUATED ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 BVLH DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 24E CONSULTING SERVICES - ERC: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 155,177. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 155,177. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 64,060. MANAGEMENT AND GENERAL EXPENSES 9,900. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,960. DUES & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 180. MANAGEMENT AND GENERAL EXPENSES 41,499. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,679. FUNDRAISING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 29,356. TOTAL EXPENSES 29,356. TELEPHONE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 24,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,370. PHARMACY: PROGRAM SERVICE EXPENSES 7,349. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,349. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 3,333. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,333. VEHICLE: PROGRAM SERVICE EXPENSES 1,318. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,318. LINENS: PROGRAM SERVICE EXPENSES 562. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 562. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OF BVLH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XI, LINE 8: THE FINANCIAL STATEMENTS HAD A PRIOR PERIOD ADJUSTMENT REALTED TO THE LAND SALE IN THE PRIOR YEAR. BLUE VALLEY LUTHERAN HOMES SOCIETY FOUNDATION 220 PARK AVENUE HEBRON NE 68370 470822479 SUPPORT BLUE VALLEY LUTHERAN HOMES NE 501(C)(3) LINE 12A, I BLUE VALLEY LUTHERAN HOMES 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0