2021-11-15T14:46:11-06:00 2020-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-01-01 800015864 Legacy Senior Services LEGA 7635375700 14416 Spring Lake Road Minnetonka MN 55345 Eric Lunde President 7635375700 2021-11-11 1 Eric Lunde 999009999 Deb Nelson CPA P01264758 6122536500 2021-11-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Waukesha Springs Health & Rehab Center Eric Lunde 14416 Spring Lake Road Minnetonka MN 55345 24625122 0 X N/A X 2001 MN To operate skilled nursing facilities and senior housing communities. 4 4 536 5 11003 6381 15886 2219101 22729994 22403048 4839 2973 -419562 0 22331157 24625122 4890 6486 0 0 12049976 12705964 0 0 0 11261916 12641586 23316782 25354036 -985625 -728914 19290175 22110267 17383755 20932761 1906420 1177506 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 0 21365031 6486 22403048 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 59 during 2020. 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 73 during 2020.-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 77 during 2020.-LSS of Marycrest, LLC, a 138 unit assisted living facility located in Denver, Colorado. LSS of Marycrest, LLC had an average daily census of 130 during 2020.All of the skilled nursing facilities are Medicare and Medicaid certified. 21365031 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 61 0 1 536 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 4400 Baker Road Ste 100 Minneapolis MN 55343 Tenzin Kunsang Registered Nurse 40.00 X 141278 0 5322 Deborah McTighe Registered Nurse 40.00 X 127265 0 4826 Annette Kienitz Registered Nurse 40.00 X 111299 0 19257 Barbara Forman Director of Therapy Services 40.00 X 104448 0 17003 Eric Lunde President/Treasurer 8.00 X X 12000 0 0 Roger Green Secretary 1.00 X X 4800 0 0 Robert Beck Director 1.00 X 4800 0 0 Joel Jensen Director 1.00 X 4800 0 0 Mar'que Anderson Administrator-LSS of Madison 40.00 X 0 0 0 James Laine Administrator-LSS of Frazee 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 Mike Syltie Administrator-LSS of Madison 40.00 X 0 0 0 James Flaherty Administrator-LSS of Frazee 40.00 X 0 0 0 510690 0 46408 4 0 0 0 Triumph Business Capital 7451 Wiles Road Suite 107 Coral Springs FL 33067 Staffing 272754 Big Stone Therapies 500 Cross Street Big Stone City SD 57216 Therapy 219581 2 2174595 44506 2219101 Resident Service Revenue 623000 22147282 22147282 Miscellaneous Revenue 900099 255766 244763 11003 22403048 2973 2973 24625122 22392045 11003 2973 X 6486 6486 26400 26400 10503999 9339148 1164851 19783 17627 2156 1333885 1188548 145337 821897 732344 89553 1148034 1148034 56201 56201 87702 87702 3779989 3211622 568367 72086 72086 750010 692619 57391 259662 259662 1133469 1118165 15304 5459 5459 20394 4463 15931 1100764 1066192 34572 834778 820329 14449 374360 352936 21424 Bad Debt Expense 956572 956572 Medical Supplies 737871 737871 Food 546440 546440 MN DHS Surcharge/WI Pro 491564 491564 286231 82105 204126 25354036 21365031 3989005 0 601747 4076211 17222 17429 2298947 2895762 65458 96137 22242333 7434922 15499673 14807411 807128 217317 19290175 22110267 4987262 4321651 2137776 1843479 190244 217434 10068473 11426504 2195300 0 928393 17383755 20932761 X 1906420 1177506 1906420 1177506 19290175 22110267 -728914 0 X 0 1 X 1 0 X 31419 42499 18495 15886 2219101 2327400 42405957 31993508 22075078 22729994 22392045 141596582 42437376 32036007 22093573 22745880 24611146 143923982 0 0 0 143923982 50573 11548 4846 7389 2973 77329 50573 11548 4846 7389 2973 77329 23718 32328 7236 18049 7381 88712 -6586 2258162 866561 -425000 2693137 42505081 34338045 22972216 22346318 24621500 146783160 0.98050 0.98160 0.00050 0.00050 X Schedule A, Part III, Line 12, Explanation of Other Income: Gain/Loss on Sale of Subsidiary - 2016 Amount: $ -6,586. 2017 Amount: $ 2,258,162. 2018 Amount: $ 876,046. 2019 Amount: $ -425,000. Extraordinary Gain/Loss - 2018 Amount: $ -9,485. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 2501883 2501883 17641731 5794007 11847724 2098719 1640915 457804 14807411 Third-Party Payor Advance Payments 804430 Refundable Advances 123963 928393 X 24625122 0 24625122 0 24625122 25354036 0 25354036 0 25354036 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. 1 Tuition Reimbursement 15 6486 Part I, Line 2: The funds are paid directly to the educational institution. No additional monitoring is done. A City of Frazee MN 416005174 2007-08-01 4850000 Health care facility acquisition in Frazee, MN 0 0 0 A 2993024 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 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: Mar'que Anderson, LSS of Madison, LLC $58,857 Mike Syltie, LSS of Madison, LLC $76,387 Patrick Krejci, LSS of Frazee LLC $64,673 James Laine, LSS of Frazee, LLC $4,050 James Flaherty, LSS of Frazee, LLC $7,549 Pam Wright, LSS of Marycrest, LLC $92,348 Dylan Hanson LSS of Traverse, LLC $81,469 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 3,211,622. Management and general expenses 568,367. Fundraising expenses 0. Total expenses 3,779,989. LSS of Madison LLC 110 Belmont Road Madison WI 53714 201209404 Nursing Home WI 9318838 9309413 Legacy Senior Services LSS of Frazee LLC 219 W Maple Avenue Frazee MN 56544 208729268 Nursing Home & Assisted Living MN 5591054 4532772 Legacy Senior Services LSS of Marycrest 2850 Columbine Road Denver CO 80221 262181659 Assisted Living CO 4849647 6807951 Legacy Senior Services Legacy Senior Services dba Traverse Care Center 303 7th Street South Wheaton MN 56296 800015864 Nursing Home & Independent Living MN 4658414 1560856 Legacy Senior Services LSS of Wadena LLC 201 Shady Lane Drive Wadena MN 56482 454632615 Nursing Home & Independent Living MN 105754 15609 Legacy Senior Services