SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
LUTHERAN SENIORLIFE FOUNDATION
 
Employer identification number

25-1705233
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to 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" to 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) ST JOHN LUTHERAN CARE CENTER DBA ST JOHN SPECIALTY CARE CENTER

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
25-0969478
SKILLED NURSING AND PERSONAL CARE FACILITY SERVING MORE THAN 300 RESIDENTS PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
(2) LUTHER COURT INC

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
25-1527660
TO PROVIDE LOW INCOME HOUSING FOR THE ELDERLY PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
(3) PASSAVANT RETIREMENT AND HEALTH CENTER DBA PASSAVANT RETIREMENT COMMUNITY

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
25-0986051
PROVIDER OF RESIDENTIAL, ASSISTED LIVING AND SKILLED NURSING CARE TO ELDERS PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
(4) LAS GERIATRIC CARE SERVICES INC

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
25-1738347
PROVIDER OF MEDICAL GERIATRIC THERAPY SERVICES TO ITS EXEMPT AFFILIATES PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
(5) LUTHERAN SENIORLIFE

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
25-1527666
ORGANIZATION THAT PROMOTES THE CHARITABLE INTERESTS OF ITS EXEMPT AFFILIATES PA 501(C)(3) LINE 11A, I N/A
 
No
(6) SAMARITAN HEALTH CARE INC

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
25-1527663
TO PROVIDE HEALTH CARE SERVICES TO THE ELDERLY PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
(7) VIECARE INC

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
20-5900922
PROVIDER OF HOME AND COMMUNITY BASED HEALTHCARE TO LOW INCOME ELDERLY PA 501(C)(3) LINE 7 LUTHERAN SENIORLIFE
 
Yes
 
(8) VIECARE BEAVER LLC DBA LIFE BEAVER AND LAWRENCE COUNTIES

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
26-0363509
PROVIDER OF HOME AND COMMUNITY BASED HEALTHCARE TO LOW INCOME ELDERLY PA 501(C)(3) LINE 7 LUTHERAN SENIORLIFE
 
Yes
 
(9) VIECARE BUTLER LLC DBA LIFE BUTLER COUNTY

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
20-8512169
PROVIDER OF HOME AND COMMUNITY BASED HEALTHCARE TO LOW INCOME ELDERLY PA 501(C)(3) LINE 7 LUTHERAN SENIORLIFE
 
Yes
 
(10) MARS HOLDINGS INC

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
25-1883384
DEVELOPING ALZHEIMERS FACILITY PROVIDING ASSISTED LIVING SERVICES PA 501(C)(3) LINE 11A, I LUTHERAN SENIORLIFE
 
Yes
 
(11) BEHOME PARTNERS

1323 FREEDOM ROAD

CRANBERRY TOWNSHIP,PA16066
20-2932676
PROVIDER OF HOME HEALTH SERVICES IN SKILLED NURSING, THERAPY, & PRIVATE DUTY PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
(12) VISTING NURSES ASSOCIATION OF BUTLER COUNTY INC

154 HINDMAN ROAD

BUTLER,PA16001
23-7040715
TO OPTIMIZE HEALTH AND INDEPENDENCE, AND TO KEEP RESIDENTS OF OUR COMMUNITY PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
(13) HOSPICE SERVICES INC

154 HINDMAN ROAD

BUTLER,PA16001
25-1468529
TO PROVIDE COMPASSIONATE, QUALITY CARE FOR PEOPLE WITH LIFE-LIMITING ILLNESS PA 501(C)(3) LINE 9 LUTHERAN SENIORLIFE
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Page 2
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) TIMON PROPERTY DEVELOPMENT COMPANY

1323 FREEDOM ROAD
CRANBERRY TOWNSHIP,PA16066
20-5133658
PROVIDER OF SENIOR HOUSING PA N/A
C         No












Schedule R (Form 990) 2012
Page 3
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to 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
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2012
Page 4
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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 section 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) 2012
Page 5
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


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