2020-03-13T13:54:57-05:00 2019-06-30 521158459 HERTZBACH & COMPANY PA 800 RED BROOK BLVD SUITE 300 OWINGS MILLS MD 21117 990 2018-07-01 530228120 ABRAHAM AND LAURA LISNER HOME FOR AGED WOMEN ABRA 2029666667 5425 WESTERN AVENUE NW WASHINGTON DC 20015 L WARD OREM CEO 2029666667 2020-03-13 1 PATRICK V TROTTA CPA P01335925 4103633200 107.1.94.226 2020-03-13 13:21:28 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 246B0BF2B7D4770E45C422024168A6CCC93F1E2F 2018 2020-09-22 18:59:49Z LISNER-LOUISE-DICKSON-HURT HOME L WARD OREM 5425 WESTERN AVE NW WASHINGTON DC 20015 23093285 0 X WWW.LLDHOME.ORG X 1939 DC TO OPERATE A HOME FOR THE AGED IN WASHINGTON, DC, UNDER PROVISIONS OF THE WILL OF ABRAHAM LISNER. 11 11 141 45 0 0 1418739 1260520 9400663 10355976 1256468 1459076 208824 -42638 12284694 13032934 0 0 0 0 7998394 8014905 0 0 199669 5304653 5467055 13303047 13481960 -1018353 -449026 22928478 21250153 4410671 3719317 18517807 17530836 TO PROVIDE EXTRAORDINARY HEALTH AND LIFE CARE SERVICES TO LOW AND MODEST INCOME SENIORS OF THE DISTRICT OF COLUMBIA, EMPOWERING THEM TO LIVE LIFE TO THE FULLEST. 0 0 8856060 8349589 THE LISNER HOME OPERATES A SHORT-TERM REHABILITATION PROGRAM FOR LOW AND MODERATE INCOME RESIDENTS OF THE GREATER WASHINGTON, DC AREA. 1791731 2012635 THE LISNER HOME PROVIDES AFFORDABLE HOUSING ASSISTED-LIVING PROGRAMS WHICH INCLUDES MEDICAL, PSYCHOSOCIAL, NUTRITIONAL AND ANCILLARY SERVICES FOR LOW AND MODERATE INCOME RESIDENTS OF THE GREATER WASHINGTON, DC AREA. 10647791 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 14 0 1 141 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 DC X JONATHAN PLATER CFO 2029666667 5425 WESTERN AVE NW WASHINGTON DC 20015 L WARD OREM CEO 40.00 X X 169954 0 15665 MATTHEW FRUMIN PRESIDENT 1.00 X X 0 0 0 PATRICIA JOHNSON VICE PRESIDENT 1.00 X X 0 0 0 MARNIE T KAGAN TREASURER 1.00 X X 0 0 0 CHRISTINE HOBBS SECRETARY 1.00 X X 0 0 0 ROBERT COOPER DIRECTOR 1.00 X 0 0 0 TOM DILLON DIRECTOR 1.00 X 0 0 0 BARBARA INGRAHAM DIRECTOR 1.00 X 0 0 0 HAYDN RICHARDS DIRECTOR 1.00 X 0 0 0 CAROLYN NAZDIN DIRECTOR 1.00 X 0 0 0 CHRISTOPHER TAWA DIRECTOR 1.00 X 0 0 0 JONATHAN PLATER CFO/CIO 40.00 X 117671 0 13115 SUSAN HARGREAVES ADMINISTRATOR 40.00 X 160854 0 7500 PAT MIRSKY DON 40.00 X 132081 0 9516 JACQUELINE SAINT-AMOUR ADON 40.00 X 106668 0 719 687228 0 46515 5 0 1 0 ERGO SOLUTIONS LLC 9013 WIPKEY COURT BOWIE MD 20720 CONTRACT REHAB SERVICES 738221 SYSCO PO BOX 1099 JESSUP MD 20794 RAW FOOD PROVIDER 298152 THI INC 7297 LEE HIGHWAY SUITE R FALLS CHURCH VA 22042 NURSING TEMP AGENCY 223417 MEDLINE INDUSTRIES DEPT CH 14263 PALATINE IL 60055 MEDICAL SUPPLIES PROVIDER 215930 ALLIED PHARMACY 1201 SEVEN LOCKS ROAD SUITE 203 ROCKVILLE MD 20854 PHARMACY PROVIDER 156010 6 104510 10750 1145260 32210 1260520 MEDICAID AND MEDICARE 621500 8343341 8343341 RESIDENT REVENUE 621500 2012635 2012635 10355976 291655 291655 11135781 9968360 1167421 1167421 1167421 43105 104510 91991 -48886 -48886 MISCELLANEOUS INCOME 621500 6248 6248 6248 13032934 10362224 0 1410190 484760 345545 139215 6414663 5440640 967652 6371 70199 55457 13338 1404 492281 373134 117730 1417 553002 442927 102274 7801 22350 22350 101722 101722 84678 84678 977945 923812 53386 747 19905 15374 4531 385881 261524 115040 9317 30772 26704 4068 28362 2343 21888 4131 22192 22192 203183 161070 38151 3962 383264 303827 71963 7474 FOOD AND DIETARY 658430 657539 349 542 BAD DEBT 514504 514504 TAXES AND LICENSES 444178 352111 92011 56 HOUSEKEEPING AND LAUNDR 344730 344730 1244959 787469 444789 12701 13481960 10647791 2634500 199669 169364 786306 653586 611980 15750 10000 1356828 1714876 131564 105507 12825145 10592596 2319010 2232549 15465357 13629713 2491104 1821454 325915 337768 22928478 21250153 2349180 2050710 1528340 1246254 165068 159065 368083 263288 4410671 3719317 X 18485214 17493853 32593 36983 18517807 17530836 22928478 21250153 -449026 -537945 0 X 0 1 X 1 0 X 1409742 1271719 1328731 1446954 1260520 6717666 1409742 1271719 1328731 1446954 1260520 6717666 4339775 2377891 401992 431941 375390 289835 291655 1790813 4475 30442 104498 251698 6248 397361 8905840 42192991 0.26700 0.25750 X THE ORGANIZATION HAS RECEIVED OVER 25% OF ITS TOTAL SUPPORT FROM THE PUBLIC FOR EACH OF THE LAST TWO YEARS. THIS SUPPORT COMES FROM A WIDE VARIETY OF INDIVIDUALS, BUSINESSES AND OTHER CHARITIES. THE ORGANIZATION SEEKS DONATIONS FROM THE PUBLIC THROUGH ITS WEBSITE AND COMMUNAL EVENTS INCLUDING AN ANNUAL FUNDRAISING EVENT. THE GOVERNING BOARD CONSISTS OF A DIVERSE GROUP OF PROFESSIONALS AND COMMUNITY LAY LEADERS FROM A VARIETY OF BACKGROUNDS. THE ORGANIZATION'S MISSION IS TO PROVIDE HEALTH AND LIFE CARE SERVICES TO LOW AND MODEST INCOME SENIORS OF THE DISTRICT OF COLUMBIA. OVER THE PAST YEAR, THE ORGANIZATION HAS PROVIDED OVER 1.7 MILLION DOLLARS IN CHARITY CARE IN ITS ASSISTED LIVING PROGRAM. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 43512 43512 10110291 8097691 2012600 2110761 1969063 141698 560581 525842 34739 2232549 PRIVATE EQUITY 567763 F HEDGE FUNDS 1253691 F 1821454 DUE TO THIRD-PARTY PAYER 263288 263288 12512752 -537945 10450 -527495 13040247 84678 -91991 -7313 13032934 13499723 10450 91991 102441 13397282 84678 84678 13481960 PART IV, LINE 2B: THE LISNER HOME MAINTAINS CHECKING ACCOUNTS TO HOLD FUNDS ON BEHALF OF CERTAIN RESIDENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT COST OF FUNDRAISING EVENT -91,991. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT COST OF FUNDRAISING EVENT 91,991. GARDEN PARTY "NATIONAL WINE DAY" 147615 104510 43105 32210 15821 14624 5200 24136 147615 104510 43105 32210 15821 14624 5200 24136 91991 -48886 X X X X 0 1 0 0 0 0 0 0 0 L WARD OREM CEO 169954 0 0 0 0 0 9300 0 6365 0 185619 0 0 0 SUSAN HARGREAVES ADMINISTRATOR 160854 0 0 0 0 0 7500 0 0 0 168354 0 0 0 PART I, LINE 4B THE LISNER HOME HAS EMPLOYMENT AGREEMENTS WITH L. WARD OREM, CEO, SUSAN HARGREAVES, ADMINISTRATOR, AND JONATHAN PLATER, CFO/CIO, THAT ARE CONSIDERED NONQUALIFIED RETIREMENT PLANS. THESE PLANS ARE SECTION 457(F) PLANS THAT DEFER COMPENSATION UNTIL RETIREMENT OR DEATH. THERE HAS BEEN NO CHANGE IN THE VALUE OF THE PLANS FROM JUNE 30, 2018 TO JUNE 30, 2019. X VARIOUS GIFT CERTIFICATES AND ENTERTAINMENT EVENT TICKETS 71 32210 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 EXECUTIVE COMMITTEE SHALL CONSIST OF ALL OFFICERS OF THE BOARD. THE COMMITTEE SHALL MEET MONTHLY AND IS RESPONSIBLE FOR OVERSEEING THE OPERATIONS OF THE BOARD AND ACTING ON ITS BEHALF DURING ON-DEMAND ACTIVITIES THAT OCCUR BETWEEN FULL BOARD MEETINGS WITH ALL ITS ACTIVITIES REPORTED TO THE FULL BOARD FOR APPROVAL AS NEEDED. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS PREPARED BY THE ORGANIZATION'S OUTSIDE ACCOUNTANTS AND PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY FOR REVIEW BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS SIGNED BY ALL NEW BOARD MEMBERS AND REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION OF CEO IS BASED ON REVIEW OF HUMAN RESOURCE SALARY SURVEY WITH OTHER AREA NURSING HOMES. ANY INCREASE ARE DETERMINED BY A COLA AND APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUEMENTS ARE AVAILABLE UPON REQUEST. LEGACY LIFE SERVICES INC 5425 WESTERN AVENUE NW WASHINGTON DC 20015 472086684 HEALTH CARE AND SOCIAL ASSISTANCE DC 501(C)(3) LINE 7 ABRAHAM AND LAURA LISNER HOME FOR AGED WOMEN 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0