2019-05-10T09:30:43-05:00 2018-06-30 521158459 HERTZBACH & COMPANY PA 800 RED BROOK BLVD SUITE 300 OWINGS MILLS MD 21117 990 2017-07-01 530228120 ABRAHAM AND LAURA LISNER HOME FOR AGED WOMEN ABRA 2029666667 5425 WESTERN AVENUE NW WASHINGTON DC 20015 L WARD OREM CEO 2029666667 2019-04-24 1 PATRICK V TROTTA CPA P01335925 4103633200 107.1.94.226 2019-04-24 15:34:43 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 246B0BF2B7D4770E45C422024168A6CCC93F1E2F 2017 2019-02-21 02:37:17Z LISNER-LOUISE-DICKSON-HURT HOME L WARD OREM 5425 WESTERN AVE NW WASHINGTON DC 20015 21563037 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. 10 10 153 45 0 0 1328731 1418739 7416400 9400663 1160563 1256468 47735 208824 9953429 12284694 0 0 0 0 7097195 7998394 0 0 173166 5113842 5304653 12211037 13303047 -2257608 -1018353 24127637 22928478 4652611 4410671 19475026 18517807 TO PROVIDE HEALTH AND LIFE CARE SERVICES TO INDIGENT AND MODEST INCOME SENIORS OF THE DISTRICT OF COLUMBIA. 0 0 9655834 9652361 THE LISNER HOME PROVIDES AFFORDABLE HOUSING PROGRAMS AND INCLUDES MEDICAL, PSYCHOSOCIAL, NUTRITIONAL AND ANCILLARY SERVICES. THE HOME ALSO PROVIDES SKILLED PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY TO ALL RESIDENTS AS WELL AS A SHORT-TERM REHABILITATION PROGRAM TO RESIDENTS OF THE GREATER WASHINGTON, DC AREA. 9655834 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 15 0 1 153 1 0 0 0 0 0 1 1 0 0 0 0 X 10 10 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 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 L WARD OREM CEO 40.00 X 151369 0 15665 JONATHAN PLATER CFO/CIO 40.00 X 120872 0 13115 SUSAN HARGREAVES ADMINISTRATOR 40.00 X 132218 0 7500 PAT MIRSKY DON 40.00 X 108863 0 9516 513322 0 45796 4 0 1 0 ERGO SOLUTIONS LLC 9013 WIPKEY COURT BOWIE MD 20720 CONTRACT REHAB SERVICES 872438 THI INC 7297 LEE HIGHWAY SUIRE R FALLS CHURCH VA 22042 NURSING TEMP AGENCY 267833 SYSCO PO BOX 1099 JESSUP MD 20794 RAW FOOD PROVIDER 260347 MEDLINE INDUSTRIES DEPT CH 14263 PALATINE IL 60055 MEDICAL SUPPLIES PROVIDER 179738 EMS INC 245 MAIN STREET SUITE 204 CHESTER NJ 07930 PLANT OPERATIONS PROVIDER 114261 6 82903 9200 1326636 32903 1418739 MEDICAID AND MEDICARE 621500 7316355 7316355 RESIDENT REVENUE 621500 2084308 2084308 9400663 289835 289835 10173887 9207254 966633 966633 966633 28215 82903 71089 -42874 -42874 MISCELLANEOUS INCOME 621500 251698 251698 251698 12284694 9652361 0 1213594 X 323299 193064 130235 6215696 5050431 1165265 65295 50170 13831 1294 884876 704673 163842 16361 509228 391291 107854 10083 12191 12191 102394 102394 96229 96229 1431586 1407824 21728 2034 3863 3863 63338 338 63000 1788 1788 455846 354268 97663 3915 80273 40367 39906 850 825 25 20235 20235 215018 178465 34403 2150 225534 3523 222011 PROVIDER TAX 427976 427976 SUPPLIES 427366 394533 32501 332 FOOD AND DIETARY 381024 381024 REPAIRS AND MAINTENANCE 364891 204289 156790 3812 994251 489950 503139 1162 13303047 9655834 3474047 173166 18752 169364 883213 653586 15750 1169457 1356828 32940 131564 12709330 10390320 2391056 2319010 16726325 15465357 2521921 2491104 383973 325915 24127637 22928478 1251250 2349180 1899999 1528340 169901 165068 1331461 368083 4652611 4410671 X 19403433 18485214 71593 32593 19475026 18517807 24127637 22928478 -1018353 61134 0 X 0 1 X 1 0 X 1266405 1409742 1271719 1328731 1446954 6723551 1266405 1409742 1271719 1328731 1446954 6723551 4409926 2313625 367821 401992 431941 375390 289835 1866979 4617 4475 30442 104498 251698 395730 8986260 39599435 0.25750 0.41020 X 0 1 X 43512 43512 10041989 7943891 2098098 2075727 1946770 128957 548102 499659 48443 2319010 PRIVATE EQUITY 940732 F HEDGE FUNDS 1550372 F 2491104 DUE TO THIRD-PARTY PAYER 368083 368083 12416917 61134 61134 12355783 -71089 -71089 12284694 13374136 71089 71089 13303047 0 13303047 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 -71,089. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT COST OF FUNDRAISING EVENT 71,089. GARDEN PARTY "NATIONAL WINE DAY" 111118 82903 28215 11773 12208 1478 5050 40580 111118 82903 28215 11773 12208 1478 5050 40580 71089 -42874 X X X X 0 1 0 0 0 0 0 0 0 L WARD OREM CEO 151369 0 0 0 0 0 9300 0 6365 0 167034 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, 2017 TO JUNE 30, 2018. X VARIOUS GIFT CERTIFICATES AND ENTERTAINMENT EVENT TICKETS 89 27903 FMV X GRAPHIC DESIGN AND MEDIA SUPPORT 1 5000 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. FORM 990, PART IX, LINE 11G TEMPORARY SERVICES: PROGRAM SERVICE EXPENSES 252,686. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 252,686. CONSULTING: PROGRAM SERVICE EXPENSES 46,265. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,265. PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY: PROGRAM SERVICE EXPENSES 869,072. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 869,072. DIETICIAN: PROGRAM SERVICE EXPENSES 54,652. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,652. TRASH REMOVAL & PEST CONTROL: PROGRAM SERVICE EXPENSES 70,546. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 70,546. MEDICAL WASTE EXPENSES: PROGRAM SERVICE EXPENSES 10,133. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,133. VOLUNTEER EXPENSES: PROGRAM SERVICE EXPENSES 814. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 814. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 19,827. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,827. POM CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 83,829. MANAGEMENT AND GENERAL EXPENSES 21,728. FUNDRAISING EXPENSES 2,034. TOTAL EXPENSES 107,591. 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