2022-11-15T10:05:08-06:00 2021-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2021-01-01 800015864 Legacy Senior Services LEGA 7635375700 14416 Spring Lake Road Minnetonka MN 55345 Eric Lunde President 7635375700 2022-11-14 1 Eric Lunde 999009999 Deb Nelson CPA P01264758 6122536500 2022-11-11 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Waukesha Springs Health & Rehab Center Eric Lunde 14416 Spring Lake Road Minnetonka MN 55345 24431986 0 X N/A X 2001 MN To operate skilled nursing facilities and senior housing communities. 4 4 480 101 11234 3532 2219101 3012982 22403048 21309761 2973 2961 0 106282 24625122 24431986 6486 14769 0 0 12705964 12007236 0 0 0 12641586 11721689 25354036 23743694 -728914 688292 22110267 13981648 20932761 12115850 1177506 1865798 X Legacy Senior Services' mission is to create communities of dignity, passion, and respect for adults and to partner with other not for profit organizations across the country. Through its efforts, Legacy Senior Services seeks to provide broad continuums of care to promote health, mind, and spirit of those we serve. 0 1 19898396 14769 21298527 Legacy Senior Services is a Minnesota corporation that operated a 49 bed skilled nursing facility and a 20 unit independent living facility located in Wheaton, Minnesota called Traverse Care Center. Traverse Care Center had an average daily census of 53 during 2021. Legacy Senior Services is organized to own and operate facilities with the intent of housing elderly and other vulnerable persons and meeting their healthcare, residential, physical and social needs. Legacy Senior Services is the sole member of four other limited liability companies which operate as skilled nursing, assisted living, and/or independent living facilities as follows: -LSS of Madison, LLC, a 90 bed skilled nursing facility located in Madison, Wisconsin. LSS of Madison, LLC had an average daily census of 74 during 2021.-LSS of Frazee, LLC, a 74 bed skilled nursing facility, a 19 unit assisted living facility, and an 8 unit independent living facility located in Frazee, Minnesota and a 15 unit assisted living facility located in Vergas, Minnesota. LSS of Frazee, LLC had an average daily census of 41 during 2021.-LSS of Marycrest, LLC, a 138 unit assisted living facility located in Denver, Colorado. LSS of Marycrest, LLC had an average daily census of 127 during 2021.All of the skilled nursing facilities are Medicare and Medicaid certified. 19898396 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 86 0 1 480 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 MN CO X Health Dimensions Group 7635375700 12900 Whitewater Drive Suite 201 Minneapolis MN 55343 Eric Lunde President/Treasurer 5.00 X X 12000 0 0 Roger Green Secretary 5.00 X X 4800 0 0 Robert Beck Director 5.00 X 4800 0 0 Joel Jensen Director 5.00 X 4800 0 0 Noah Brickner Administrator-LSS of Madison 40.00 X 0 0 0 Pam Wright Administrator-LSS of Marycrest 40.00 X 0 0 0 Dylan Hanson Administrator-LSS of Traverse 40.00 X 0 0 0 Jason Williams Administrator-LSS of Madison 40.00 X 0 0 0 Patrick Krejci Adminstrator-LSS of Frazee LLC 40.00 X 0 0 0 Samantha Stocke Administrator-LSS of Marycrest 40.00 X 0 0 0 Tenzin Kunsang Registered Nurse 40.00 X 121232 0 6021 Deborah McTighe RN Manager/Interim DON 40.00 X 151693 0 5906 Chad Wissler Registered Nurse 40.00 X 106320 0 12698 Danette M Peyer Registered Nurse 40.00 X 106714 0 0 Paul Obino Registered Nurse 40.00 X 175550 0 5732 687909 0 30357 6 0 1 0 Big Stone Therapies 500 Cross Street Big Stone City SD 57216 Therapy 298071 1 2985532 27450 3012982 Resident Service Revenue 623000 21170740 21170740 Miscellaneous Revenue 900099 139021 127787 11234 21309761 2961 2961 Sale of Subsidiary 900099 106282 106282 106282 24431986 21298527 11234 109243 X 14769 14769 26400 26400 9970942 8891640 1079302 36246 32363 3883 1182244 1055586 126658 791404 706618 84786 1200477 1200477 49021 49021 60306 60306 2940951 2451059 489892 106714 106714 577849 527599 50250 284044 284044 1307110 1289151 17959 3398 3398 13343 5790 7553 948588 930716 17872 812996 798669 14327 569969 537234 32735 Medical Supplies 817020 817020 Food 730175 730175 MN DHS Surcharge/WI Pro 497813 497813 Bad Debt Expense 449659 449659 352256 162535 189721 23743694 19898396 3845298 0 4076211 3342807 17429 17535 2895762 2184281 96137 162240 15261747 7170364 14807411 8091383 217317 183402 22110267 13981648 4321651 2738914 1843479 1530757 217434 189487 11426504 7397533 2195300 928393 259159 20932761 12115850 X 1177506 1865798 1177506 1865798 22110267 13981648 688292 0 X 0 1 X 1 0 X 42499 18495 15886 2219101 3012982 5308963 31993508 22075078 22729994 22392045 21309761 120500386 32036007 22093573 22745880 24611146 24322743 125809349 0 0 0 125809349 11548 4846 7389 2973 2961 29717 11548 4846 7389 2973 2961 29717 32328 7236 18049 7381 3571 68565 2258162 866561 -425000 106282 2806005 34338045 22972216 22346318 24621500 24435557 128713636 0.97740 0.98050 0.00020 0.00050 X Schedule A, Part III, Line 12, Explanation of Other Income: Gain/Loss on Sale of Subsidiary - 2017 Amount: $ 2,258,162. 2018 Amount: $ 876,046. 2019 Amount: $ -425,000. 2021 Amount: $ 106,282. Extraordinary Gain/Loss - 2018 Amount: $ -9,485. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1819570 1819570 11682191 5766264 5915927 1759986 1404100 355886 8091383 Third-Party Payor Advance Payments 259159 259159 X 15617944 0 15617944 8814042 8814042 24431986 14692167 0 14692167 9051527 9051527 23743694 Part IV, Line 2b: The organization acts as custodian for the funds of the residents of the nursing facilities and holds tenant security deposits for tenants of the assisted living facilities. Part X, Line 2: The organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 4b - Other Adjustments: Revenue from Discontinued Operations 8,707,760. Gain on Sale of Subsidiary 106,282. Part XII, Line 4b - Other Adjustments: Expenses from Discontinued Operations 9,051,527. 1 Tuition Reimbursement 15 14769 Part I, Line 2: The funds are paid directly to the educational institution. No additional monitoring is done. X 0 0 0 0 0 0 0 0 0 Paul Obino Registered Nurse 170550 0 5000 0 0 0 0 0 5815 0 181365 0 0 0 Deborah McTighe RN Manager/Interim DON 140926 0 10767 0 0 0 0 0 5922 0 157615 0 0 0 A City of Frazee MN 416005174 2007-08-01 4850000 Health care facility acquisition in Frazee, MN 0 0 0 A 3307783 4882400 133384 4749016 2008 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 1 0 0 0 0 A 0 Date Rebate Computation Performed Issuer Name: City of Frazee, MN Date the Rebate Computation was Performed: 09/11/2012 Schedule K Supplental Information The amount reported as bonds retired for the privately placed tax-exempt revenue notes is the original issue price less the outstanding principal balance of the underlying bank loan as of the end of the Schedule K reporting period. Schedule K, Part II, Lines 3 and 10: These amounts include interest earned during the construction period. Schedule K, Part III, Line 9: The organization does not have a formal board adopted policy, but the organization does ensure post-issuance compliance through their management practices and procedures. Form 990, Part III, line 3 LSS of Madison, LLC was sold December 31, 2021. Form 990, Part VI, Section A, line 3 Legacy Senior Services has a management agreement with Health Dimensions Consulting, Inc. (dba Health Dimensions Group) and HDG-WI, LLC to provide management services to Legacy Senior Services and the following wholly owned single-member LLC's: LSS of Madison, LLC; LSS of Frazee, LLC; LSS of Traverse, LLC, and LSS of Marycrest, LLC. The following individuals provided services as administrators of the facilities that included day to day management of functional operations, management of facility personnel, and execution of policies governing facility operations: Noah Brickner, LSS of Madison, LLC $58,877 Jason Williams, LSS of Madison, LLC $120,000 Patrick Krejci, LSS of Frazee LLC $112,473 Pam Wright, LSS of Marycrest, LLC $82,611 Samantha Stocke, LSS of Marycrest, LLC $60,954 Dylan Hanson LSS of Traverse, LLC $79,876 Form 990, Part VI, Section A, line 8b The organization has no committees. The full board handles all meetings. Form 990, Part VI, Section B, line 11b The 990 is reviewed by the Director of Accounting of the management company prior to filing. The 990 is also provided to the Legacy Senior Services board for review and approval prior to filing. Form 990, Part VI, Section B, line 12c The policy covers all board directors and officers of the organization. Individuals are required to disclose any actual or possible conflicts of interest to the board of directors considering the proposed transaction or arrangement. The board of directors determines whether or not a conflict exists. If the individual with a conflict is a board member, the remaining board members determine whether a conflict exists. If an individual has a conflict of interest, they must leave the meeting while the transaction or agreement is discussed and voted upon. Form 990, Part VI, Section B, line 15 The administrators' compensation is determined by an unrelated management company, Health Dimensions Group. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy and financial statements are available upon request. Form 990, Part IX, line 11g Other Fees: Program service expenses 2,451,059. Management and general expenses 489,892. Fundraising expenses 0. Total expenses 2,940,951. LSS of Madison LLC 110 Belmont Road Madison WI 53714 201209404 Nursing Home WI 8707760 0 Legacy Senior Services LSS of Frazee LLC 219 W Maple Avenue Frazee MN 56544 208729268 Nursing Home & Assisted Living MN 5728396 3874764 Legacy Senior Services LSS of Marycrest 2850 Columbine Road Denver CO 80221 262181659 Assisted Living CO 5026145 6187896 Legacy Senior Services Legacy Senior Services dba Traverse Care Center 303 7th Street South Wheaton MN 56296 800015864 Nursing Home & Independent Living MN 4809222 1352600 Legacy Senior Services