LIVING SERVICES FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- LIVING SERVICES FOUNDATION (EIN 41-1936717)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201701359349305775
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule D
- Schedule J
- Schedule K
- Schedule K
- Schedule L
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T12:23:39-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411936717 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Living Services Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LIVI | BusinessNameControlTxt |
| Phone | 7632310410 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 North Monroe Street | AddressLine1Txt |
| City | Minneota | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56264 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jennifer Gleason | PersonNm |
| Person Title | Chief Operating Officer | PersonTitleTxt |
| Phone | 7632310410 | PhoneNum |
| Signature | 2017-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Deb Nelson CPA | PreparerPersonNm |
| PTIN | P01264758 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2017-05-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | Dennis Kamstra | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 North Monroe Street | AddressLine1Txt |
| City | Minneota | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56264 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,925,186 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lsfdn.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | To support subsidiaries of Benedictine Health System. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 143 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,390,511 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,349,513 | CYProgramServiceRevenueAmt |
| PY Investment Income | $22,091 | PYInvestmentIncomeAmt |
| CY Investment Income | $575,673 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,412,602 | PYTotalRevenueAmt |
| CY Total Revenue | $7,925,186 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,067 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,478 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,089,168 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,967,296 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,926,629 | PYOtherExpensesAmt |
| CY Other Expenses | $7,103,234 | CYOtherExpensesAmt |
| PY Total Expenses | $9,016,864 | PYTotalExpensesAmt |
| CY Total Expenses | $10,074,008 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,604,262 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,148,822 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,235,798 | TotalAssetsBOYAmt |
| Total Assets EOY | $30,939,425 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $45,186,678 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $37,924,240 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$5,950,880 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$6,984,815 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The Foundation is organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of the subsidiaries of Benedictine Living Community of Winsted, Benedictine Living Community of New London, Benedictine Living Community of Mora, Benedictine Living Community of Wahpeton, and Benedictine Living Community of Byron. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $9,207,026 | ExpenseAmt |
| Grant | $3,478 | GrantAmt |
| Revenue | $7,349,513 | RevenueAmt |
| Desc | The organization owns and provides management oversight to the following wholly owned subsidiaries:Living Services Foundation/Minneota, LLC consists of a 67-bed skilled nursing facility and 33-unit assisted living facility located in Minneota, Minnesota. Living Services Foundation/New London, LLC consists of a 62-bed licensed nursing facility, 36-unit attached apartment center and a 12-unit attached assisted living building located in New London, Minnesota. Living Services Foundation/Winsted, LLC consists of a 70-bed licensed nursing facility and a 16-unit attached memory care assisted living building located in Winsted, Minnesota. Living Services Foundation/Mora, LLC consists of a 80-bed skilled nursing facility, a 35-unit assisted living facility and clinic space located in Mora, Minnesota. Living Services Foundation/Wahpeton, LLC consists of a 32-unit assisted living facility located in Wahpeton, North Dakota. This organization was sold during the fiscal year.Living Services Foundation/Byron, LLC will consist of 20 units of independent living, 16 units of assisted living, and 14 units of memory care assisted living when construction is complete in the spring of 2016. The project is located in Byron, Minnesota. This organization was sold during the fiscal year. The organization operates Living Services Foundation - Minneota, but leases the other facilities through the wholly owned subsidiaries to Benedictine Living Community of New London, Benedictine Living Community of Winsted, Benedictine Living Community of Mora, and Benedictine Living Community of Wahpeton and Benedictine Living Community of Byron, which are subsidiaries of Benedictine Health System (BHS), who operates those facilities. | Desc |
| Total Program Service Expenses | $9,207,026 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 143 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jennifer Gleason | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7632310410 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 North Monroe Street | AddressLine1Txt |
| City | Minneota | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56264 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Robert Sundberg | |||||||
| Chair | 5.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Rod Pakonen | |||||||
| Board Member | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Kevin Rymanowski | |||||||
| Board Member | 3.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| Paul Sanders | |||||||
| Board Member | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Dennis Kamstra | |||||||
| CEO | 40.00 | 0.00 | Yes (X) | Yes (X) | $240,000 | $0 | $21,800 |
| Jennifer Gleason | |||||||
| COO/Secretary/Treasurer | 40.00 | 0.00 | Yes (X) | $130,000 | $0 | $8,447 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $370,000 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $30,247 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Big Stone | |||||
| 450 Eastvold Ave | Ortonville | MN | 56278 | Therapy | $482,875 |
| A 'Viands | |||||
| 1751 County B Rd W 300 | St Paul | MN | 55113 | Food Services | $224,965 |
| Prime Health | |||||
| PO Box 3544 | Omaha | NE | 681030544 | Pool Nursing | $143,239 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Resident Service Reven | 623000 | $4,421,307 | $4,421,307 |
| Lease Revenue | 532000 | $2,868,736 | $2,868,736 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,470 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $59,470 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,349,513 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,425 | TotalRevenueColumnAmt |
| Exclusion | $38,425 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $537,248 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $537,248 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $537,248 | TotalRevenueColumnAmt |
| Exclusion | $537,248 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,925,186 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,349,513 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $575,673 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,478 | TotalAmt |
| Program Services | $3,478 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $399,299 | TotalAmt |
| Program Services | $35,321 | ProgramServicesAmt |
| Management And General | $363,978 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,209,650 | TotalAmt |
| Program Services | $2,101,406 | ProgramServicesAmt |
| Management And General | $108,244 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,274 | TotalAmt |
| Program Services | $11,808 | ProgramServicesAmt |
| Management And General | $2,466 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,239 | TotalAmt |
| Program Services | $156,448 | ProgramServicesAmt |
| Management And General | $6,791 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,834 | TotalAmt |
| Program Services | $149,587 | ProgramServicesAmt |
| Management And General | $31,247 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237,262 | TotalAmt |
| Management And General | $237,262 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,305 | TotalAmt |
| Management And General | $72,305 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,689 | TotalAmt |
| Management And General | $44,689 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,060 | TotalAmt |
| Program Services | $184,060 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,262 | TotalAmt |
| Program Services | $23,262 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,328 | TotalAmt |
| Program Services | $180,328 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529 | TotalAmt |
| Program Services | $529 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,612 | TotalAmt |
| Program Services | $179,612 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,944 | TotalAmt |
| Program Services | $25,944 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,900 | TotalAmt |
| Program Services | $40,900 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,391,312 | TotalAmt |
| Program Services | $2,391,312 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,562,229 | TotalAmt |
| Program Services | $1,562,229 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,947 | TotalAmt |
| Program Services | $68,947 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| License | $670,590 | $670,590 |
| Financing Costs | $546,386 | $546,386 |
| Food | $207,115 | $207,115 |
| DHS Surcharge | $188,605 | $188,605 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $479,159 | TotalAmt |
| Program Services | $479,159 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,074,008 | TotalAmt |
| Program Services | $9,207,026 | ProgramServicesAmt |
| Management And General | $866,982 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,928 | BOYAmt |
| EOY | $128,931 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $447,906 | BOYAmt |
| EOY | $1,719,932 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,841,895 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,306 | BOYAmt |
| EOY | $58,346 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,375,075 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,641,639 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,377,762 | BOYAmt |
| EOY | $24,733,436 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,593,301 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,674,595 | BOYAmt |
| EOY | $1,456,885 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,235,798 | BOYAmt |
| EOY | $30,939,425 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,570,568 | BOYAmt |
| EOY | $1,494,926 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,964,479 | BOYAmt |
| EOY | $35,117,078 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,101 | BOYAmt |
| EOY | $16,358 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,000 | BOYAmt |
| EOY | $245,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $282,500 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,000 | BOYAmt |
| EOY | $243,105 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,530 | BOYAmt |
| EOY | $525,273 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,186,678 | BOYAmt |
| EOY | $37,924,240 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,950,880 | BOYAmt |
| EOY | -$6,984,815 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,950,880 | BOYAmt |
| EOY | -$6,984,815 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,235,798 | BOYAmt |
| EOY | $30,939,425 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,148,822 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $22,169 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $1,092,718 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 6 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (6 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| Bendictine Living Community of Winsted | ||||
| 274219293 | 9 | Yes (1) | $1,713,766 | $0 |
| Bendictine Living Community of New London | ||||
| 274218436 | 9 | Yes (1) | $884,645 | $0 |
| Bendictine Living Community of Mora | ||||
| 274219119 | 9 | Yes (1) | $586,004 | $0 |
| Bendictine Living Community of Wahpeton | ||||
| 454274091 | 9 | Yes (1) | $351,814 | $0 |
| Benedictine Living Community of Byron | ||||
| 471538777 | 9 | Yes (1) | $0 | $0 |
| Benedictine Health System | ||||
| 411531892 | 1 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 6 | SupportedOrganizationsTotalCnt |
| Support Sum | $3,536,229 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | Yes (1) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (1) | ActivitiesEngagedOrgInvlmntInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Section D, Line 3: | Benedictine Health System's CEO appointed one of the Foundation's five Directors, Kevin Rymanowski. In addition to his service on the Foundation's Board, Mr. Rymanowski serves as the Chief Financial Officer of BHS and each of the Supported Organizations. He is actively engaged as a Board member in the Foundation's governance and participates in decisions and discussions at the Board level and with the Foundation's leadership in all aspects of the Foundation's management and use of its income and assets for the benefit of BHS and the Supported Organizations. In this manner, the Supported organizations have a significant voice in the Foundation's management and use of its income and assets. |
| Part IV, Section E, Line 2a: | The Foundation holds title to and manages properties used by the Supported Organizations in furtherance of their exempt purposes of providing senior housing and long-term care services with special concern for the underserved and those in need of such services. The Supported Organizations each use the respective properties to provide housing to seniors and offer supportive long-term care services. |
| Part IV, Section E, Line 2b: | If these facilities were not owned and managed by the Foundation, the Supported Organizations would own and manage such facilities itself because these activities are critical to the Supported Organizations' ability to carry out their own activities in furtherance of their mission and purposes. Because the Supported Organizations would otherwise conduct these same activities if they were not performed by the Foundation, the Foundation's activities represent an integral part of the activities of the Supported Organizations. |
| Part IV, Section A, Line 11: | Benedictine Health System is a Type III Functionally Integrated Supporting Organization and is also recognized within the IRS Group Ruling for Catholic organizations under IRC Section 170(b)(1)(A)(i). |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,194,322 | OtherCostOrOtherBasisAmt |
| Book Value | $1,194,322 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,042,643 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,820,325 | DepreciationAmt |
| Book Value | $22,222,318 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,861,802 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,354,775 | DepreciationAmt |
| Book Value | $507,027 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,276,308 | OtherCostOrOtherBasisAmt |
| Depreciation | $466,539 | DepreciationAmt |
| Book Value | $809,769 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $24,733,436 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Asset retirement obligation | $67,756 |
| Due To/From Parent Company | $457,517 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $525,273 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part IV, Line 2b: | FormAndLineReferenceDesc |
| Explanation | The Organization acts as custodian for the funds of the residents and holds tenant security deposits. These funds are included in cash and cash equivalents and current liabilities. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dennis Kamstra | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $240,000 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $21,800 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $261,800 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| City of Spicer | ||||||||
| A | 416005550 | 84844VAJ4 | 2006-12-28 | $9,600,000 | To purchase a nursing & assisted living facility & clinic in Spicer, MN. | 0 | 0 | 0 |
| City of Winsted | ||||||||
| B | 416005652 | 975574AQ7 | 2010-09-16 | $16,505,000 | Refinance Series 2008 notes issued in 8/29/2008 & fund new construction. | 0 | 0 | 0 |
| City of Mora | ||||||||
| C | 416005389 | 2009-04-30 | $6,258,382 | To purchase a nursing & assisted living facility in Mora, MN. | 0 | 0 | 0 | |
| City of Mora | ||||||||
| D | 416005389 | 2013-09-06 | $4,851,795 | Refinance a portion of Series 2009 notes issues in 4/30/2009. | 0 | 0 | 0 | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Other Spent ProceedsOtherSpentProceedsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $970,519 | $9,460,519 | $695,298 | $189,210 | $8,558,787 | 2007 | 0 | 0 | Yes (1) | Yes (1) | |
| B | $588,895 | $16,112,135 | $1,321,256 | $322,243 | $6,170,490 | 2011 | Yes (1) | 0 | Yes (1) | Yes (1) | $8,308,071 |
| C | $1,707,377 | $6,258,382 | $6,258,382 | 2009 | 0 | 0 | Yes (1) | Yes (1) | |||
| D | $300,790 | $4,851,795 | $97,035 | $5,059 | 2013 | Yes (1) | 0 | Yes (1) | Yes (1) | $4,749,701 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| D | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| D | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule K, Part I, Line A, Column (e): | The issue price for Bond A, Part I, Line A, Column (e) is different than the Part II, Line 3 due to the bonds being issued at a discount of $139,481. |
| Schedule K, Part I, Line B, Column (e): | The issue price for Bond B, Part I, Line B, Column (e) is different than the Part II, Line 3 due to the bonds being issued at a discount of $392,865. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Minneota | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005373 | BondIssuerEIN |
| Bond Issued | 2013-12-31 | BondIssuedDt |
| Issue Price | $4,397,409 | IssuePriceAmt |
| Purpose | To purchase a nursing & assisted living facility in Minneota, MN. | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $302,175 | RetiredAmt |
| Total Proceeds | $4,397,409 | TotalProceedsAmt |
| In Reserve Fund | $150,000 | InReserveFundAmt |
| Issuance Costs From Proceeds | $34,437 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $4,212,972 | CapitalExpendituresAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan To OrganizationLoanToOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| Robert Sundberg | |||||||
| Board Member | Capital improvements to skilled nursing facility. | Yes (X) | $120,000 | $120,000 | 0 | Yes (1) | Yes (1) |
| Paul S and Gretchen M Sanders Revocable Trust | |||||||
| Entity owned by Board Member | Capital improvements to skilled nursing facility. | Yes (X) | $125,000 | $125,000 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $245,000 | TotalBalanceDueAmt |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail (2 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| Benedictine Health System | |||||||||
| 50 unit senior housing facility in Byron, MN | 2016-03-09 | $1 | See statement | 411531892 | 1995 East Rum River Drive Sout | Cambridge | MN | 55008 | 501(c)(3) |
| Benedictine Living Community of Wahpeton | |||||||||
| 32 unit assisted living facility in Wahpeton, ND | 2016-03-09 | $463,937 | See statement | 454274091 | 1995 East Rum River Drive Sout | Cambridge | MN | 55008 | 501(c)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 0 | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | 0 | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule N, Part II, Line 1 - Byron Sale: | Living Services Foundation entered into a purchase agreement with Benedictine Health System to sell the Membership Interest in Living Services Foundation Byron, LLC. The purchase price for the Membership Interest was $1.00. In addition, Benedictine Health System assumed Living Services Foundation's obligations as guarantor, which included the following: *City of Byron, Minnesota, $8,015,000 Senior Housing Facility Revenue Note (Living Services Foundation Byron Project) Series 2014A; *City of Byron, Minnesota, $305,000 Senior Housing Facility Revenue Note (Living Services Foundation Byron Project) Series 2014A-T; and *City of Byron, Minnesota, $1,985,000 Subordinate Senior Housing Facility Revenue Bonds (Living Services Foundation Byron Project) Series 2014B |
| Schedule N, Part II, Line 1 - Wahpeton Sale: | Living Services Foundation entered into a purchase agreement with Benedictine Living Community of Wahpeton to sell the Membership Interest in Living Services Foundation Wahpeton, LLC. The purchase price for the Membership Interest was $463,937. In addition, Benedictine Living Community of Wahpeton assumed Living Services Foundation's obligations as guarantor, which included the following: *City of Wahpeton, North Dakota, Senior Loan Participation Revenue Notes (St. Catherine's Assisted Living Community Project) Series 2011A in the original principal amount of $4,285,000; and *City of Wahpeton, North Dakota, Subordinate Loan Participation Revenue Notes (St. Catherine's Assisted Living Community Project) Series 2011B in the original principal amount of $1,320,000. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 3 | Operations in Wahpeton and Byron were sold in March 2016 to Benedictine Health System, a related organization. |
| Form 990, Part VI, Section A, line 2 | Dennis Kamstra and Jennifer Gleason have a family relationship. |
| Form 990, Part VI, Section A, line 7a | Benedictine Health Systems may appoint one board member with voting rights. |
| Form 990, Part VI, Section A, line 8b | No committees are able to act on behalf of the board. |
| Form 990, Part VI, Section B, line 11 | An electronic draft of the Form 990 is distributed to the full board of directors for review and approval prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | The Conflict of Interest policy is enforced and consistently monitored. An interested person must disclose the existence of their financial interest to the board considering the proposed transaction or arrangement. The remaining board members then determine if a conflict of interest exists. Corrective action is taken by the board of directors as deemed necessary when a conflict of interest is determined to have occurred. Disclosure of a conflict of interest would prevent that person from taking part in discussions or voting on related issues. |
| Form 990, Part VI, Section B, line 15 | The process for determining compensation for the CEO and COO is determined by a compensation survey and study. The compensation is then approved by the independent members of the Board of Directors. The last review took place during the summer of 2014. |
| Form 990, Part VI, Section C, line 19 | The Organization makes the governing documents and conflict of interest policy available upon request. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| Living Services Foundation Mora LLC | |||||||||
| 110 North 7th Street | Mora | MN | 55051 | 263614974 | Leasing of skilled nursing and assisted living facility. | DE | $544,103 | $5,200,943 | Living Services Foundation |
| Living Services Foundation New London LLC | |||||||||
| 100 Glen Oaks Drive | New London | MN | 56273 | 204504668 | Leasing of skilled nursing, assisted and independent living facility. | DE | $765,299 | $7,310,533 | Living Services Foundation |
| Living Services Foundation Winsted LLC | |||||||||
| 551 4th Street North | Winsted | MN | 55395 | 208684862 | Leasing of skilled nursing and assisted living facility. | DE | $1,309,396 | $12,985,374 | Living Services Foundation |
| Living Services Foundation Minneota LLC | |||||||||
| 700 North Monroe Street | Minneota | MN | 56264 | 263614760 | Operation of skilled nursing, assisted lving, and home health agency. | DE | $4,373,759 | $3,711,529 | Living Services Foundation |
| Living Services Foundation Wahpeton LLC | |||||||||
| 711 14th Avenue North | Wahpeton | ND | 58075 | 453638196 | Leasing of assisted living facility | DE | $0 | $0 | Benedictine Health Systems (from March 2016) |
| Living Services Foundation Byron LLC | |||||||||
| 4000 Lexington Avenue Ste 201 | Shoreview | MN | 55126 | 472337717 | Operation of assisted living facility | DE | $0 | $0 | Benedictine Health Systems (from March 2016) |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Benedictine Living Community of Winsted | ||||||||||
| 1995 East Rum River Drive South | Cambridge | MN | 55008 | 274219293 | Skilled nursing care center and memory care assisted living | MN | 501(c)(3) | Line 9 | Benedictine Health Systems | 0 |
| Benedictine Living Community of New London | ||||||||||
| 1995 East Rum River Drive South | Cambridge | MN | 55008 | 274218436 | Skilled nursing care center, assisted living, and senior apartments. | MN | 501(c)(3) | Line 9 | Benedictine Health Systems | 0 |
| Benedictine Living Community of Mora | ||||||||||
| 1995 East Rum River Drive South | Cambridge | MN | 55008 | 274219119 | Skilled nursing care center and assisted living facility. | MN | 501(c)(3) | Line 9 | Benedictine Health Systems | 0 |
| Benedictine Health System | ||||||||||
| 1995 East Rum River Drive South | Cambridge | MN | 55008 | 411531892 | Health Care System | MN | 501(c)(3) | Line 11c, III-FI | 0 | |
| Benedictine Living Community of Wahpeton | ||||||||||
| 1995 East Rum River Drive South | Cambridge | MN | 55008 | 454274091 | Assisted living and basic care facility | MN | 501(c)(3) | Line 9 | Benedictine Health Systems | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part I - Disregarded Entities: | FormAndLineReferenceDesc |
| Explanation | The Wahpeton and Byron facilities were sold to Benedictine Health System in March 2016. | ExplanationTxt |