SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Living Services Foundation
 
Employer identification number

41-1936717
Return Reference Explanation
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.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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