FURP.ORG / PUBLIC DATA EXPLORER

LEGACY SENIOR SERVICES: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LEGACY SENIOR SERVICES (EIN 80-0015864)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-15
IRS object ID
201322279349301327
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-15T10:10:17-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 NICOLLET MALL STE 1300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN800015864EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LEGACY SENIOR SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLEGANameControl
Phone7635375700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line114416 SPRING LAKE ROADAddressLine1
CityMINNETONKACity
StateMNState
ZIP Code55345ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameERIC LUNDEName
TitlePRESIDENTTitle
Phone7635375700Phone
Date Signed2013-08-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSARAH VOGT CPAName
PTINP00978242PTIN
Phone6122536500Phone
Date Prepared2013-08-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1WAUKESHA SPRINGS HEALTH & REHAB CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonERIC LUNDENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line114416 SPRING LAKE ROADAddressLine1
CityMINNETONKACity
StateMNState
ZIP Code55345ZIPCode
FieldValueIRS element (for citing)
Gross Receipts44921100GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE SKILLED NURSING FACILITIES AND SENIOR HOUSING COMMUNITIES THAT PROVIDE FOR THE LONG-TERM CARE OF THE AGED, INFIRMED, INJURED AND SICK.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees1272TotalNbrEmployees
Total Nbr Volunteers573TotalNbrVolunteers
Total Gross UBI114742TotalGrossUBI
Net Unrelated Business Txbl Income33191NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year91071ContributionsGrantsPriorYear
Contributions Grants Current Year905228ContributionsGrantsCurrentYear
Program Service Revenue Prior Year40793567ProgramServiceRevenuePriorYear
Program Service Revenue CY44006479ProgramServiceRevenueCY
Investment Income Prior Year1858InvestmentIncomePriorYear
Investment Income Current Year9393InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year40886496TotalRevenuePriorYear
Total Revenue Current Year44921100TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year14917GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY40987GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year24470645SalariesEtcPriorYear
Salaries Etc Current Year24906956SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year31424TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY40373TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year40373TotalFundrsngExpCurrentYear
Other Expense Prior Year16960076OtherExpensePriorYear
Other Expenses Current Year19040820OtherExpensesCurrentYear
Total Expenses Prior Year41477062TotalExpensesPriorYear
Total Expenses Current Year44029136TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-590566RevenuesLessExpensesPriorYear
Revenues Less Expenses CY891964RevenuesLessExpensesCY
Total Assets BOY18126824TotalAssetsBOY
Total Assets EOY20604252TotalAssetsEOY
Total Liabilities BOY14275921TotalLiabilitiesBOY
Total Liabilities EOY14995387TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3850903NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5608865NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionLEGACY 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.MissionDescription
Significant New Program Services1SignificantNewProgramServices
Significant Change0SignificantChange
Expense36793580Expense
Grants40987Grants
Revenue44006479Revenue
DescriptionLEGACY SENIOR SERVICES IS A MINNESOTA CORPORATION THAT OPERATES A 170 BED SKILLED NURSING FACILITY IN WAUKESHA, WISCONSIN, CALLED WAUKESHA SPRINGS HEALTH & REHABILITATION CENTER. WAUKESHA SPRINGS HEALTH & REHABILITATION CENTER HAD AN AVERAGE DAILY CENSUS OF 141 RESIDENTS DURING 2012. 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 SEVEN 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 82 DURING 2012.-LSS OF FRAZEE, LLC, A 74 BED SKILLED NURSING FACILITY AND A 19 UNIT ASSISTED 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 102 DURING 2012.-LSS OF MARYCREST, LLC, A 138 UNIT ASSISTED LIVING FACILITY LOCATED IN DENVER, COLORADO. LSS OF MARYCREST, LLC HAD AN AVERAGE DAILY CENSUS OF 136 DURING 2012.-LSS OF SHEBOYGAN, LLC, A 140 BED SKILLED NURSING FACILITY LOCATED IN SHEBOYGAN, WISCONSIN. LSS OF SHEBOYGAN, LLC HAD AN AVERAGE DAILY CENSUS OF 121 DURING 2012.-LSS OF TRAVERSE, LLC, A 50 BED SKILLED NURSING FACILITY AND A 20 UNIT INDEPENDENT LIVING FACILITY LOCATED IN WHEATON, MINNESOTA. LSS OF TRAVERSE, LLC HAD AN AVERAGE DAILY CENSUS OF 61 DURING 2012.-LSS OF WADENA, LLC, A 75 BED SKILLED NURSING FACILITY LOCATED IN WADENA, MINNESOTA. LSS OF WADENA, LLC HAD AN AVERAGE DAILY CENSUS OF 59 DURING 2012.-LSS HOME HEALTH AND HOSPICE, LLC, PROVIDES HOSPICE, HOME HEALTH AND NURSING SERVICES IN WADENA, MINNESOTA.ALL OF THE SKILLED NURSING FACILITIES ARE MEDICARE AND MEDICAID CERTIFIED.Description
Total Program Service Expense36793580TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096122NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1272NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HEALTH DIMENSIONS GROUPBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7635375700TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14400 BAKER ROAD STE 100AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55343ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
ERIC LUNDE
PRESIDENT/TREASURER6.00XX840000
ROGER GREEN
SECRETARY1.00XX360000
CHAR SAMUELSON
DIRECTOR1.00X360000
CRAIG ABBOTT
CEO HEALTH DIMENSIONS GROUP1.00X000
VIRGINIA ANDERSON
VP FINANCIAL SERVICES OF HDG4.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org15600TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEALTH DIMENSIONS CONSULTING INC
4400 BAKER ROADMINNEAPOLISMN55343MANAGEMENT FEES, ADMINISTRATION2108932
HDG-WI LLC
4400 BAKER ROADMINNEAPOLISMN55343MANAGEMENT FEES, ADMINISTRATION1279056
BSG MAINTENANCE INC
PO BOX 165NEWBURGWI53060LAUNDRY & HOUSEKEEPING SERVICES849233
AVIANDS LLC
NW 5704 PO BOX 1450MINNEAPOLISMN554855704DIETARY SERVICES528095
AEGIS THERAPIES INC
PO BOX 8103FORT SMITHAR72902THERAPY SERVICES322584
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Government Grants540000GovernmentGrants
All Other Contributions365228AllOtherContributions
Noncash Contributions272571NoncashContributions
Total Contributions905228TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
RESIDENT SERVICE REVEN6230004337737243377372
MISCELLANEOUS REVENUE900099629107514365114742
FieldValueIRS element (for citing)
Total Program Service Revenue44006479TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column9393TotalRevenueColumn
Exclusion$9,393ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column44921100TotalRevenueColumn
Related Or Exempt Function Income43891737RelatedOrExemptFunctionIncome
Unrelated Business Revenue114742UnrelatedBusinessRevenue
Exclusion$9,393ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total40987Total
Program Services40987ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total15600Total
Management And General15600ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total19997994Total
Program Services18098223ProgramServices
Management And General1899771ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total38156Total
Program Services34504ProgramServices
Management And General3652ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3020887Total
Program Services2731788ProgramServices
Management And General289099ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1834319Total
Program Services1658775ProgramServices
Management And General175544ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2318140Total
Management And General2318140ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total162730Total
Management And General162730ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total92841Total
Management And General92841ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total40373Total
Fundraising40373Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3063284Total
Program Services2682973ProgramServices
Management And General380311ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total182406Total
Program Services16964ProgramServices
Management And General165442ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1398807Total
Program Services1142543ProgramServices
Management And General256264ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total221114Total
Program Services16035ProgramServices
Management And General205079ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3432789Total
Program Services3366010ProgramServices
Management And General66779ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total50958Total
Program Services43424ProgramServices
Management And General7534ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total100964Total
Program Services27919ProgramServices
Management And General73045ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total604361Total
Program Services604361ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total830006Total
Program Services830006ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total648270Total
Program Services13331ProgramServices
Management And General634939ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES28337082833708
MN DHS SURCHARGE/WI PRO13048721304872
FOOD936969936969
BAD DEBT EXPENSE257311257311

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total601290Total
Program Services410188ProgramServices
Management And General191102ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total44029136Total
Program Services36793580ProgramServices
Management And General7195183ManagementAndGeneral
Fundraising40373Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1269652BOY
EOY1875276EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY39019BOY
EOY39200EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY51845EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4011360BOY
EOY4694003EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY19426BOY
EOY19426EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY277220BOY
EOY169350EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17329848LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3785080LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY12253702BOY
EOY13544768EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY3333BOY
EOY833EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY253112BOY
EOY209551EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY18126824BOY
EOY20604252EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4414608BOY
EOY5440389EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4310917BOY
EOY4078934EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY184665BOY
EOY191487EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4960625BOY
EOY4829471EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY405106BOY
EOY455106EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14275921BOY
EOY14995387EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1208974BOY
EOY5608865EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2641929BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3850903BOY
EOY5608865EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18126824BOY
EOY20604252EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses891964ReconcilationRevenueExpenses
Reconciliation Unrealized Invest865998ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years25985CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14754CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years38914CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year91071CurrentTaxYearMinus1Year
Current Tax Year905228CurrentTaxYear
Total1075952Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years34641309CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38965370CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years39732833CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year40765252CurrentTaxYearMinus1Year
Current Tax Year43891737CurrentTaxYear
Total197996501Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years34667294CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38980124CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years39771747CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year40856323CurrentTaxYearMinus1Year
Current Tax Year44796965CurrentTaxYear
Total199072453Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509199072453PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years30037CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8064CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9116CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1858CurrentTaxYearMinus1Year
Current Tax Year9393CurrentTaxYear
Total58468Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years30037CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8064CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9116CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1858CurrentTaxYearMinus1Year
Current Tax Year9393CurrentTaxYear
Total58468Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years34697331CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years38988188CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years39780863CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year40858181CurrentTaxYearMinus1Year
Current Tax Year44806358CurrentTaxYear
Total199130921Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99970PublicSupportPercentage509
Prior Year Support Percentage0.99950PriorYearSupportPercentage
Investment Income Percentage0.00030InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00050PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1413200OtherCostOrOtherBasis
Book Value1413200BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12315668OtherCostOrOtherBasis
Depreciation2262916Depreciation
Book Value10052752BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis737710OtherCostOrOtherBasis
Depreciation31737Depreciation
Book Value705973BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2503153OtherCostOrOtherBasis
Depreciation1463727Depreciation
Book Value1039426BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis360117OtherCostOrOtherBasis
Depreciation26700Depreciation
Book Value333417BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13544768TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
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:LEGACY SENIOR SERVICES IS ORGANIZED AS A MINNESOTA NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). EACH OF THE CONTROLLED LIMITED LIABILITY CORPORATIONS MAINTAINS EXEMPT STATUS UNDER LEGACY SENIOR SERVICES' EXEMPTION SINCE LEGACY SENIOR SERVICES IS THE SOLE MEMBER OF EACH ENTITY. THE ORGANIZATION IS REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS ANNUALLY. IN ADDITION, THE ORGANIZATION IS SUBJECT TO INCOME TAX ON ANY NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO THEIR EXEMPT PURPOSE. THE ORGANIZATION FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING 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.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

FieldValueIRS element (for citing)
Business Name Line1MULLEN COMPANY LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14825 S AMMONS ST 127AddressLine1
CityDENVERCity
StateCOState
ZIP Code80123ZIPCode
FieldValueIRS element (for citing)
ActivityGRANT WRITING AND FUND SOLICITATIONActivity
Fundraiser Control Of Funds0FundraiserControlOfFunds
Gross Receipts611277GrossReceipts
Amount Retained By Contractor40373AmountRetainedByContractor
Net To Organization570904NetToOrganization
FieldValueIRS element (for citing)
Total Gross Receipts611277TotalGrossReceipts
Total Retained By Contractors40373TotalRetainedByContractors
Total Net To Organization570904TotalNetToOrganization
Licensed StatesCOLicensedStates
Licensed StatesMNLicensedStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPSTypeOfGrant
Number Of Recipients13NumberOfRecipients
Amount Of Cash Grant39432AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE ORGANIZATION PROVIDES FUNDS UNDER SCHOLARSHIP AND TUITION ASSISTANCE PROGRAMS FOR ITS EMPLOYEES. EMPLOYEES MUST MEET CERTAIN CRITERIA TO QUALIFY. THE ORGANIZATION EITHER REIMBURSES THE EMPLOYEE FOR EDUCATIONAL EXPENSES OR PAYS THE EDUCATIONAL INSTITUTION DIRECTLY.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF FRAZEE MNBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN416005174IssuerEIN
Date Issued2007-08-01DateIssued
Issue Price4850000IssuePrice
Description Of PurposeHEALTH CARE FACILITY ACQUISITION IN FRAZEE, MNDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired771065AmountRetired
Total Proceeds4882400TotalProceeds
Issuance Costs From Proceeds133384IssuanceCostsFromProceeds
Capital Expenditures4749016CapitalExpenditures
Year Of Subst Completion2008YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due1NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action0ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI (4 entries)

IdentifierIdentifierExplanationExplanation
SCHEDULE K SUPPLENTAL INFORMATIONTHE 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.
SCHEDULE K, PART IV, LINE 2C:A REBATE CALCULATION WAS COMPLETED ON SEPTEMBER 11, 2012 SHOWING THAT NO REBATE WAS DUE FOR THE APPLICABLE COMPUTATION DATE.

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercial

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990272571NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NEW PROGRAM SERVICESFORM 990, PART III, LINE 2EFFECTIVE MAY 1, 2012, LEGACY SENIOR SERVICES BECAME THE SOLE MEMBER OF 2 NEW LLCS LSS HOME HEALTH & HOSPICE, LLC AND LSS OF WADENA, LLC. LSS OF WADENA, LLC IS A SKILLED NURSING FACILITY LOCATED IN WADENA, MN. LSS HOME HEALTH & HOSPICE, LLC IS A NEW SERVICE OFFERING FOR LEGACY. THIS LLC PROVIDES HOSPICE, HOME HEALTH AND NURSING SERVICES IN WADENA, MN.
FORM 990, PART VI, SECTION A, LINE 3LEGACY SENIOR SERVICES HAS A MANAGEMENT AGREEMENT WITH HEALTH DIMENSIONS CONSULTING, INC. (DBA HEALTH DIMENSIONS GROUP) OR 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 SHEBOYGAN, LLC; LSS OF FRAZEE, LLC; LSS OF TRAVERSE, LLC, LSS OF MARYCREST, LLC; LSS OF WADENA, LLC, AND LSS HOME HEALTH AND HOSPICE, LLC.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION HAS NO COMMITTEES. THE FULL BOARD HANDLES ALL MEETINGS.
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS REVIEWED BY THE MANAGER OF FINANCIAL SERVICES AND THE VICE PRESIDENT OF FINANCIAL SERVICES 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 12CTHE 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.
THE CEO AND VICE PRESIDENT OF FINANCIAL SERVICES ARE COMPENSATED AND EMPLOYED BY AN UNRELATED MANAGEMENT COMPANY, HEALTH DIMENSIONS GROUP.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:HEALTH DIMENSIONS GROUP (HDG), AS LEGACY SENIOR SERVICES' MANAGEMENT COMPANY, HAS RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND PREPARATION OF THE MONTHLY FINANCIAL STATEMENTS. THE LEGACY SENIOR SERVICES' BOARD PRESIDENT, HDG'S FINANCIAL SERVICES MANAGER, AND HDG'S VP OF FINANCIAL SERVICES WERE INVOLVED TOGETHER IN SELECTION OF AN INDEPENDENT ACCOUNTANT FOR AUDIT/TAX SERVICES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
LSS OF MADISON LLC
110 BELMONT ROADMADISONWI53714201209404NURSING HOMEWI70757451440694LEGACY SENIOR SERVICES
LSS OF SHEBOYGAN LLC
3014 ERIE AVENUESHEBOYGANWI53081208658381NURSING HOMEWI96100173702363LEGACY SENIOR SERVICES
LSS OF FRAZEE LLC
219 W MAPLE AVENUEFRAZEEMN56544208729268NURSING HOME & ASSISTED LIVINGMN58375285087123LEGACY SENIOR SERVICES
LSS OF MARYCREST
2850 COLUMBINE ROADDENVERCO80221262181659ASSISTED LIVINGCO37211966952412LEGACY SENIOR SERVICES
LSS OF TRAVERSE LLC
303 7TH STREET SOUTHWHEATONMN56296273274611NURSING HOME & INDEPENDENT LIVINGMN3145320362615LEGACY SENIOR SERVICES
LSS OF WADENA LLC
201 SHADY LANE DRIVEWADENAMN56482454632615NURSING HOMEMN29841691698161LEGACY SENIOR SERVICES
LSS HOME HEALTH & HOSPICE LLC
201 SHADY LANE DRIVEWADENAMN56482454700887HOME HEALTH AND HOSPICE AGENCYMN819290440691LEGACY SENIOR SERVICES