2025-11-14T15:48:30-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2024-01-01 391819072 AMERICAN LUTHERAN COMMUNITY SERVICES INC AMER 7158323003 915 ELM STREET MENOMONIE WI 54751 AMY DUHR CEO 7158323003 2025-11-13 1 0 JUSTIN HARTERT P02236744 5074467100 2025-11-13 2024 2025-03-06 01:10:19Z AUTUMN VILLAGE AMY DUHR 915 ELM STREET MENOMONIE WI 54751 1534885 0 X WWW.AMERICANLUTHERANHOMES.COM X 1995 WI PROVIDE HOUSING AND ASSISTED LIVING SERVICES FOR ELDERLY AND PERMANENTLY DISABLED PERSONS. 8 8 41 10 0 0 10000 64 1540435 1481368 20055 41152 35896 12301 1606386 1534885 0 1300000 0 0 737825 711091 0 0 0 737624 609536 1475449 2620627 130937 -1085742 3322537 2024534 1236797 1024536 2085740 999998 TO PROVIDE SENIORS WITH PERSONALIZED ASSISTANCE IN A COMFORTABLE ENVIRONMENT THAT ENHANCES INDEPENDENCE, PRIVACY, AND DIGNITY. 0 0 2380608 1300000 1481368 AUTUMN VILLAGE OPERATES A RESIDENTIAL CARE FACILITY IN MENOMONIE, WISCONSIN WHICH BLENDS SENIOR INDEPENDENT LIVING APARTMENTS WITH SUPPORTIVE SERVICES. AUTUMN VILLAGE IS A 40-BED SENIOR APARTMENT COMPLEX AND PROVIDED 10,553 DAYS OF RESIDENT CARE IN 2024. THE GOAL OF AUTUMN VILLAGE IS TO OFFER RESIDENTS SECURITY, PRIVACY, SOCIAL OPPORTUNITIES, AND MORE. 2380608 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 41 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X GRACE LUTHERAN FOUNDATION 7158323003 PO BOX 287 EAU CLAIRE WI 54702 X LINDA LARSON PRESIDENT (THRU 5/24) 1.00 1.00 X X 0 0 0 ANITA REID PRESIDENT 1.00 1.00 X X 0 0 0 BARB VADNAIS SECRETARY 1.00 1.00 X X 0 0 0 DAVID LARSON VICE PRESIDENT 1.00 1.00 X X 0 0 0 RITA LEE TREASURER 1.00 1.00 X 0 0 0 KRIS JENSON DIRECTOR 1.00 1.00 X 0 0 0 JOANNE ERICKSON DIRECTOR 1.00 1.00 X 0 0 0 STEPHANY GROSSBIER DIRECTOR 1.00 1.00 X 0 0 0 AMY DUHR CEO 1.00 1.00 X 0 0 0 JAMIE LARSON COO 1.00 1.00 X 0 0 0 0 0 0 0 0 0 0 0 64 64 ASSISTED LIVING CARE 623000 1481368 1481368 1481368 41152 41152 DIRECT CARE WORKFORCE 900099 11611 11611 TRANSPORTATION INCOME 900099 690 690 12301 1534885 1481368 0 53453 1300000 1300000 621600 581668 39932 2399 2084 315 39632 34431 5201 47460 41232 6228 72344 72344 2637 2637 10760 10760 242367 183688 58679 189 189 1446 1446 21313 21313 71031 71031 1122 547 575 2180 2180 19766 19766 104353 104353 14563 14563 REPAIRS AND MAINTENANCE 23598 23598 MEDICAL SUPPLIES 18171 16680 1491 DUES AND SUBSCRIPTIONS 2511 2511 TAXES AND LICENSES 851 851 334 84 250 2620627 2380608 240019 0 1807367 495522 33302 73430 3004 6476 3629964 2648263 1029392 981701 449472 467405 3322537 2024534 86736 79809 24176 0 68226 42957 647002 544202 410657 357568 1236797 1024536 X 2085740 999998 2085740 999998 3322537 2024534 -1085742 0 X X 0 1 X 1 0 X 10754 138821 10000 64 159639 1420462 1205369 1260751 1540435 1481368 6908385 1431216 1344190 1260751 1550435 1481432 7068024 0 796440 911407 1707847 796440 911407 1707847 5360177 76 41 141 20055 41152 61465 2975 2975 76 41 3116 20055 41152 64440 35896 12301 48197 1431292 1344231 1263867 1606386 1534885 7180661 0.74650 0.87770 0.00900 0.00420 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2023 AMOUNT: $ 11,043. 2024 AMOUNT: $ 0. DIRECT CARE WORKFORCE - 2023 AMOUNT: $ 24,191. 2024 AMOUNT: $ 11,611. TRANSPORTATION INCOME - 2023 AMOUNT: $ 662. 2024 AMOUNT: $ 690. 0 1 X 40000 40000 3065651 2240542 825109 33751 10088 23663 490562 397633 92929 981701 SECURITY DEPOSITS 42957 ASSETS HELD BY AMERICAN LUTHERAN HOMES, INC 424448 467405 DUE TO AFFILIATES 357568 357568 PART IV, LINE 2B: THE ORGANIZATION HOLDS, IN TRUST, SECURITY DEPOSITS ADVANCED BY THE RESIDENTS OF THE APARTMENTS AND CONSIDERS THESE ASSETS LIMITED AS TO USE. SECURITY DEPOSITS ARE REFUNDABLE UPON VACANCY. 0 AMERICAN LUTHERAN HOMES INC 915 EAST ELM STREET MENOMONIE WI 54751 390806814 501(C)(3) 1300000 0 TO ASSIST IN SUPPORTING THE OAKS 1 0 FORM 990, PART VI, SECTION A, LINE 3 AUTUMN VILLAGE HAS ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION, INC. (GRACE), A NON-PROFIT, RELIGIOUS BASED SENIOR HEALTHCARE SERVICES ORGANIZATION BASED IN EAU CLAIRE, WISCONSIN. UNDER THIS AGREEMENT, GRACE PROVIDES GENERAL ADMINISTRATIVE, CONSULTING, ACCOUNTING, HUMAN RESOURCES, AND FACILITY MANAGEMENT SERVICES TO AUTUMN VILLAGE. UNDER THE MANAGEMENT AGREEMENT, GRACE IS ALSO RESPONSIBLE FOR THE SELECTION AND REVIEW OF THE ADMINISTRATOR OF AUTUMN VILLAGE. INCLUDED IN THE FEES PAID TO GRACE LUTHERAN IS THE COMPENSATION FOR AMY DUHR, CEO AND JAMIE LARSON, COO. THE COMPENSATION AMOUNT PAID FOR SERVICES PROVIDED TO AUTUMN VILLAGE INCLUDE: AMY DUHR: BASE COMPENSATION $11,487 DEFERRED COMPENSATION $476 NONTAXABLE BENEFITS $443 JAMIE LARSON: BASE COMPENSSATION $7,295 DEFERRED COMPENSATION $319 NONTAXABLE BENEFITS $1,075 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF AUTUMN VILLAGE ARE THE PASTORS AND CONGREGATIONS THAT BELONG TO THE AMERICAN LUTHERAN CHURCH AND SPONSOR THE ACTIVITES OF AUTUMN VILLAGE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD MEMBERS ARE ELECTED BY THE CONGREGATIONS OF THE SPONSORING CHURCHES AND AT A MINIMUM MUST INCLUDE THE PASTOR OF ONE OF THESE CONGREGATIONS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE CHANGE IN THE STRUCTURE OF THE AMERICAN LUTHERAN HOMES ORGANIZATION OR GOVERNING DOCUMENTS MUST BE APPROVED BY THE AMERICAN LUTHERAN HOMES SPONSORING CONGREGATIONS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WAS PROVIDED TO THE GOVERNING BODY AND MANAGEMENT FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY REVIEWS UPDATED CONFLICT OF INTEREST STATEMENTS FROM MEMBERS OF THE BOARD OF DIRECTORS. ANY NOTED CONFLICTS ARE DISCUSSED, AND DURING THE YEAR, IF CONFLICTS ARE NOTED DURING VOTES, THOSE CONFLICTING MEMBERS ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 AUTUMN VILLAGE'S EXECUTIVE LEVEL EMPLOYEES AND KEY EMPLOYEES ARE PROVIDED UNDER THE MANAGEMENT SERVICES AGREEMENT WITH GRACE LUTHERAN FOUNDATION (A NOT-FOR PROFIT ORGANIZATION WHICH SPECIALIZES IN SKILLED NURSING, LONG-TERM CARE, AND HOUSING SERVICES FOR ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY). THE CONTRACT IS A TEN-YEAR TERM THAT WAS EFFECTIVE JANUARY 1, 2020. THE BOARD OF DIRECTORS OF AUTUMN VILLAGE REVIEWS THE CONTRACT TERMS TO ENSURE THAT QUALITY SERVICES ARE BEING ACHIEVED AT THE LOWEST POSSIBLE COST FOR THE PROGRAMS BEING PROVIDED. THE BOARD ALSO CONSULTS WITH OTHER WISCONSIN NURSING HOME ASSOCIATION MEMBERS TO ENSURE THAT THE AMOUNTS BEING PAID ARE CONSISTENT FOR ADMINISTRATIVE SERVICES PAID THROUGHOUT THE REGION. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 AUTUMN VILLAGE MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AMERICAN LUTHERAN HOMES INC 915 EAST ELM STREET MENOMONIE WI 54751 390806814 SKILLED NURSING FACILITY WI 501(C)(3) LINE 10 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0