TY 2016 Form 990 Schedule O

efile Public Visual Render ObjectId: 201743189349306739 - Submission: 2017-11-14 TIN: 15-0543616

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.
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Attach to Form 990 or 990-EZ.
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Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2016

Open to Public
Inspection

Name of the organization

THE LUTHERAN HOME OF CENTRAL NEW YORK
INC

Employer identification number

15-0543616

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 4	A NEW PARENT CORPORATION, COMMUNITY WELLNESS PARTNERS, INC., WAS FORMED AND IS THE SOLE MEMBER OF LUTHERAN CARE CHARITABLE NETWORK, INC. LUTHERAN CARE CHARITABLE NETWORK CONTINUES TO BE THE SOLE MEMBER OF LUTHERAN HOME OF CENTRAL NEW YORK, INC. LUTHERAN HOME OF CENTRAL NEW YORK, INC. IS A STAND-ALONE TAX EXEMPT 501(C)(3) CORPORATION, NO LONGER UNDER THE GROUP EXEMPTION OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA.
FORM 990, PART VI, SECTION A, LINE 6	COMMUNITY WELLNESS PARTNERS, INC., FORMERLY LUTHER CARE MINISTRIES NETWORK, INC., IS THE PARENT CORPORATION AND SOLE MEMBER OF LUTHERAN CARE CHARITABLE NETWORK, INC. LUTHERAN CARE CHARITABLE NETWORK, INC. IS THE SOLE MEMBER OF THE FOLLOWING RELATED ORGANIZATIONS: KATHERINE LUTHER RESIDENTIAL HEALTHCARE AND REHABILITATION CENTER, INC., LUTHERAN HOME OF CENTRAL NEW YORK, INC., LUTHERAN HOMES MANAGEMENT SERVICES, INC. THE EXECUTIVE COMMITTEE OF LUTHERAN CARE CHARITABLE NETWORK, INC. IS THE SOLE MEMBER OF LUTHERAN HOMES FOUNDATION, INC.
FORM 990, PART VI, SECTION A, LINE 7A	COMMUNITY WELLNESS PARTNERS, INC. IS A SELF-PERPETUATING CORPORATION WHOSE DIRECTORS ARE ELECETED ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 11B	A COMPLETED COPY OF ENTIRE FORM 990 AND SUPPORTING SCHEDULES ARE GIVEN TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12C	ON A YEARLY BASIS, A CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED BY EVERY MEMBER OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION USES LEADING AGE NY COMPENSATION SURVEY REPORTS. THE SALARY COMPENSATION COMMITTEE REVIEWS THESE ALONG WITH PERFORMANCE APPRAISAL FOR APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19	NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC EXCEPT FOR THE FORM 990. ALL OTHER GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:	CHANGE IN VALUE OF EQUITY INVESTMENT -4,487.

Return Reference

Explanation

FORM 990, PART VI, SECTION A, LINE 4

A NEW PARENT CORPORATION, COMMUNITY WELLNESS PARTNERS, INC., WAS FORMED AND IS THE SOLE MEMBER OF LUTHERAN CARE CHARITABLE NETWORK, INC. LUTHERAN CARE CHARITABLE NETWORK CONTINUES TO BE THE SOLE MEMBER OF LUTHERAN HOME OF CENTRAL NEW YORK, INC. LUTHERAN HOME OF CENTRAL NEW YORK, INC. IS A STAND-ALONE TAX EXEMPT 501(C)(3) CORPORATION, NO LONGER UNDER THE GROUP EXEMPTION OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA.

FORM 990, PART VI, SECTION A, LINE 6

COMMUNITY WELLNESS PARTNERS, INC., FORMERLY LUTHER CARE MINISTRIES NETWORK, INC., IS THE PARENT CORPORATION AND SOLE MEMBER OF LUTHERAN CARE CHARITABLE NETWORK, INC. LUTHERAN CARE CHARITABLE NETWORK, INC. IS THE SOLE MEMBER OF THE FOLLOWING RELATED ORGANIZATIONS: KATHERINE LUTHER RESIDENTIAL HEALTHCARE AND REHABILITATION CENTER, INC., LUTHERAN HOME OF CENTRAL NEW YORK, INC., LUTHERAN HOMES MANAGEMENT SERVICES, INC. THE EXECUTIVE COMMITTEE OF LUTHERAN CARE CHARITABLE NETWORK, INC. IS THE SOLE MEMBER OF LUTHERAN HOMES FOUNDATION, INC.

FORM 990, PART VI, SECTION A, LINE 7A

COMMUNITY WELLNESS PARTNERS, INC. IS A SELF-PERPETUATING CORPORATION WHOSE DIRECTORS ARE ELECETED ANNUALLY.

FORM 990, PART VI, SECTION B, LINE 11B

A COMPLETED COPY OF ENTIRE FORM 990 AND SUPPORTING SCHEDULES ARE GIVEN TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION.

FORM 990, PART VI, SECTION B, LINE 12C

ON A YEARLY BASIS, A CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED BY EVERY MEMBER OF THE BOARD OF DIRECTORS.

FORM 990, PART VI, SECTION B, LINE 15

THE ORGANIZATION USES LEADING AGE NY COMPENSATION SURVEY REPORTS. THE SALARY COMPENSATION COMMITTEE REVIEWS THESE ALONG WITH PERFORMANCE APPRAISAL FOR APPROVAL.

FORM 990, PART VI, SECTION C, LINE 19

NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC EXCEPT FOR THE FORM 990. ALL OTHER GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

FORM 990, PART XI, LINE 9:

CHANGE IN VALUE OF EQUITY INVESTMENT -4,487.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2016

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