2011-05-16T14:39:55-05:00 2010-06-30 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2009-07-01 411936717 Living Services Foundation LIVI 7632310410 900 Long Lake Road No 130 New Brighton MN 55112 Jennifer Kamstra 7632310410 2011-05-16 1 John Racek 6123764500 2009 2016-02-24 21:20:13Z Dennis Kamstra 900 LONG LAKE ROAD NEW BRIGHTON MN 55112 19295589 0 X www.lsfdn.org X 1999 MN TO PROVIDE HEALTHCARE SERVICES AND HOUSING TO THE ELDERLY. 4 0 651 0 0 0 19615 12761445 18536285 39491 19626 666210 720063 13467146 19295589 0 0 7849232 11537717 0 0 6446412 8808519 14295644 20346236 -828498 -1050647 29770519 28324855 28309071 27918241 1461448 406614 The Foundation is organized and shall be operated exclusively for charitable purposes within the meaning of Sections 170(c)(2), 501(c)(3), and 2055(a) of the Internal Revenue Code of 1986 as amended ("the Code"). Within the limitations established by the preceding sentence, the Foundation is organized and shall be operated to own, maintain, operate and conduct directly or indirectly, housing and long term care facilities for the elderly and to assist and coordinate activities of facilities for health care, social services, education and research, and to do any and all other acts and things and exercise any and all other rights and powers which may be reasonably necessary, incidental, desirable, or expedient in the accomplishment of such purposes. 0 1 17863883 18536285 HEALTHCARE SERVICES AND HOUSING TO ELDERLY IN APARTMENT, ASSISTED LIVING, AND HEALTHCARE CENTER UNITS FOR OVER 100 RESIDENTS AND OVER 2OO SENIORS. SERVICES ARE LICENSED BY VARIOUS GOVERNMENTAL AGENCIES. 17863883 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 4 0 1 651 1 0 0 0 0 0 0 0 0 0 4 0 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X JENNIFER KAMSTRA 7632310410 900 Long Lake Road Suite 130 New Brighton MN 55112 Rod Pakonen 5.00 X X 48000 0 0 PAUL SAUNDERS 5.00 X X 48000 0 0 robert SUNDBERG 5.00 X 48000 0 0 Dennis Kamstra 40.00 X 288000 0 12851 Jennifer Kamstra 40.00 X 90000 0 6044 522000 0 18895 1 0 1 0 benedictine health systems 1995 east rum river drive south cambridge MN 55008 Management Services 1393729 a'viands food and services management 1751 county road b west roseville MN 55113 food services 380512 us food services 280 grand avenue east st paul MN 55075 food services 199904 3 19615 19615 RESIDENT REVENUE 623000 18536285 18536285 18536285 19626 19626 apartments revenue 623990 327879 327879 rental revenue 623990 210082 210082 MISCEllaneous revenue 623990 148082 148082 34020 34020 720063 19295589 18536285 0 739689 522895 522895 9075629 8731289 344340 1144924 1091908 53016 794269 757490 36779 672504 672504 8354 8354 12021 12021 381957 381957 82664 82664 2503645 2310584 193061 216074 216074 289305 70403 218902 86370 86370 1530268 1459408 70860 1350170 1287650 62520 149329 142414 6915 License Surchage 600934 600934 Food 484748 484748 Uncollectible Accounts 148824 148824 RepAIRS & MAINTENANCE 29803 22203 7600 261549 261549 20346236 17863883 2482353 0 1305716 1001335 23578 37018 2523501 2570172 76822 111938 24870326 2608028 23200839 22262298 2640063 2342094 29770519 28324855 2304683 2377817 9760000 9575000 17831 18290 16178403 15896572 48154 50562 28309071 27918241 X 1457211 386949 4237 19665 1461448 406614 29770519 28324855 X 0 1 1 X 0 X 19615 19615 1283194 9309365 10977151 12761445 18536285 52867440 1283194 9309365 10977151 12761445 18555900 52887055 0 0 0 52887055 40113 2796245 39491 19626 2895475 40113 2796245 39491 19626 2895475 80173 384079 666210 720063 1850525 1283194 9429651 14157475 13467146 19295589 57633055 0.91770 0.89550 0.05020 0.07500 X Schedule A, Part II, Line 12, Explanation of Other Income: Other Income RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 684599 684599 22888646 2144791 20743855 1228251 432093 796158 68830 31144 37686 22262298 RESIDENT TRUST FUND 19072 DEFERRED FINANCING COSTS 888641 bond funds 1170331 escrow fund 14050 CERTIFICATES OF DEPOSIT - RESTRICTED 250000 2342094 Asset Retirement Obligation 50562 50562 Part IV, Line 2b: The organization holds in trust resident funds. Residents withdraw funds as needed from their resident trust account. X X X X 0 0 0 0 0 0 0 0 0 Dennis Kamstra 288000 0 0 0 0 0 0 0 0 0 288000 0 0 0 City of Spicer 204504668 84844vaj4 2006-12-28 9850000 finance acquisition 0 0 9460519 712522 194353 8453643 2007 0 1 1 1 1 0 0 0 1 0 1 0 0 0 0 0 Form 990, Part III, line 3 Changes in Program Services The organization sold a Class A license and home health business line. The organization no longer operates any home health services. Form 990, Part VI, Section A, line 2 dennis kamstra - jennifer kamstra - Family relationship Form 990, Part VI, Section A, line 3 Living Services Foundation has all their properties managed by Benedictine Health Systems. Form 990, Part VI, Section B, line 11 all members of the board receive an electronic draft and are given the opportunity to review the 990 and give approval prior to filing. 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. Form 990, Part VI, Section B, line 15 the process for determining compensation for officers is determined by a compensation survey and study that is done annually with the last review taking place in 2008. The compensation must then be approved by the board of directors. Form 990, Part VI, Section C, line 19 The organization makes available to the public their governing documents, conflict of interest policy and financial statements upon request. LIVING SERVICES FOUNDATIONMORA LLC 110 north 7th street mora MN 55051 263614974 skilled nursing facility, assisted living facility DE 6440834 7537623 living services foundation LIVING SERVICES FOUNDATIONNEW LONDON LLC 100 glen oaks drive New london MN 56273 204504668 skilled nursing facility, assisted living, independent living DE 6025520 10993658 living services foundation Living services FoundationWinsted LLC 551 4th street north winsted MN 55395 208684862 skilled nursing facility, assisted living facility DE 6805325 9668214 living services foundation lIVING SERVICES FOUNDATIONminneota LLC 900 Long Lake Road Suite 130 new Brighton MN 55112 263614760 FUNDRAISING DE living services foundation