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ObjectId: 201900469349302220 - Submission: 2019-02-15
TIN: 23-7426300
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
Attach to Form 990.
Go to
www.irs.gov/Form990
for the latest information.
OMB No. 1545-0047
20
17
Open to Public Inspection
Name of the organization
LEGACY HEALTH
Employer identification number
23-7426300
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.
Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a)
Donor advised funds
(b)
Funds and other accounts
1
Total number at end of year
.........
2
Aggregate value of contributions to (during year)
3
Aggregate value of grants from (during year)
4
Aggregate value at end of year
........
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control?
............
Yes
No
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit?
...................................
Yes
No
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education)
Preservation of an historically important land area
Protection of natural habitat
Preservation of a certified historic structure
Preservation of open space
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a
Total number of conservation easements
......................
2a
b
Total acreage restricted by conservation easements
....................
2b
c
Number of conservation easements on a certified historic structure included in (a)
.....
2c
d
Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register
...
2d
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year
4
Number of states where property subject to conservation easement is located
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds?
............
Yes
No
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
$
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)?
.............................
Yes
No
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1
.........................
$
(ii)
Assets included in Form 990, Part X
...............................
$
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1
..........................
$
b
Assets included in Form 990, Part X
...............................
$
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2017
Page 2
Schedule D (Form 990) 2017
Page
2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets
(continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
Public exhibition
d
Loan or exchange programs
b
Scholarly research
e
Other
c
Preservation for future generations
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?
...
Yes
No
Part IV
Escrow and Custodial Arrangements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X?
....................................
Yes
No
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c
Beginning balance
.............................
1c
d
Additions during the year
............................
1d
e
Distributions during the year
..........................
1e
f
Ending balance
................................
1f
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
...
Yes
No
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII
....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)
Current year
(b)
Prior year
(c)
Two years back
(d)
Three years back
(e)
Four years back
1a
Beginning of year balance
....
7,583,703
25,584,578
b
Contributions
...
4,093,389
11,233,870
24,414,838
c
Net investment earnings, gains, and losses
-73
73
d
Grants or scholarships
...
e
Other expenditures for facilities
and programs
...
8,008,969
29,234,673
-1,169,667
f
Administrative expenses
....
g
End of year balance
......
3,668,123
7,583,702
25,584,578
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment
100.000 %
b
Permanent endowment
c
Temporarily restricted endowment
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:
Yes
No
(i)
unrelated organizations
.................
3a(i)
No
(ii)
related organizations
.................
3a(ii)
Yes
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R?
.........
3b
Yes
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property
(a)
Cost or other basis
(investment)
(b)
Cost or other basis (other)
(c)
Accumulated depreciation
(d)
Book value
1a
Land
.....
3,637,059
3,637,059
b
Buildings
....
199,561,045
124,683,836
74,877,209
c
Leasehold improvements
2,612,050
1,281,928
1,330,122
d
Equipment
....
275,963,724
236,940,782
39,022,942
e
Other
.....
4,623,331
4,623,331
Total.
Add lines 1a through 1e.
(Column (d) must equal Form 990, Part X, column (B), line 10(c).)
..
123,490,663
Schedule D (Form 990) 2017
Page 3
Schedule D (Form 990) 2017
Page
3
Part VII
InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b.
See Form 990, Part X, line 12.
(a)
Description of security or category
(including name of security)
(b)
Book value
(c)
Method of valuation:
Cost or end-of-year market value
(1)
Financial derivatives
.........
8,008,363
F
(2)
Closely-held equity interests
........
(3)
Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total.
(Column (b) must equal Form 990, Part X, col. (B) line 12.)
152,329,748
Part VIII
InvestmentsProgram Related.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c.
See Form 990, Part X, line 13.
(a)
Description of investment
(b)
Book value
(c)
Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total.
(Column (b) must equal Form 990, Part X, col.(B) line 13.)
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d.
See Form 990, Part X, line 15.
(a)
Description
(b)
Book value
(1)
DEFERRED FINANCING COSTS
26,676,651
(2)
I/C AFFILIATE - INVESTMENT POOL
171,956,105
(3)
LAND & BUILDING HELD FOR DEVELOPMENT
12,686,842
(4)
LEGACY REAL ESTATE ASSETS
600,363
(5)
LONG TERM INTERCOMPANY RECEIVABLE
2,894,051
(6)
LONG TERM INVESTMENT HELD FOR CAPITAL
3,438,844
(6)
(7)
(8)
(9)
Total.
(Column (b) must equal Form 990, Part X, col.(B) line 15.)
...........
368,266,027
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f.
See Form 990, Part X, line 25.
1.
(a)
Description of liability
(b)
Book value
(1) Federal income taxes
I/C AFFILIATE - INVESTMENT POOL
592,705,058
NONCURRENT BENEFITS LIABILITY
28,747,823
NONCURRENT PENSION LIABILITY
8,044,584
NONCURRENT WORKERS' COMP LIABILITY
266,205
RESERVE FOR PROFESSIONAL LIABILITY COSTS
47,563,154
(6)
(7)
(8)
(9)
Total.
(Column (b) must equal Form 990, Part X, col.(B) line 25.)
677,326,824
2.
Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2017
Page 4
Schedule D (Form 990) 2017
Page
4
Part XI
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1
Total revenue, gains, and other support per audited financial statements
.......
1
266,371,000
2
Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a
Net unrealized gains (losses) on investments
....
2a
b
Donated services and use of facilities
.........
2b
c
Recoveries of prior year grants
...........
2c
d
Other (Describe in Part XIII.)
............
2d
e
Add lines
2a
through
2d
.....................
2e
3
Subtract line
2e
from line
1
..................
3
266,371,000
4
Amounts included on Form 990, Part VIII, line 12, but not on line
1
:
a
Investment expenses not included on Form 990, Part VIII, line 7b
.
4a
b
Other (Describe in Part XIII.)
...........
4b
1,030,320
c
Add lines
4a
and
4b
....................
4c
1,030,320
5
Total revenue. Add lines
3
and
4c.
(This must equal Form 990, Part I, line 12.)
......
5
267,401,320
Part XII
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1
Total expenses and losses per audited financial statements
...........
1
254,414,000
2
Amounts included on line 1 but not on Form 990, Part IX, line 25:
a
Donated services and use of facilities
.........
2a
b
Prior year adjustments
............
2b
c
Other losses
................
2c
d
Other (Describe in Part XIII.)
............
2d
e
Add lines
2a
through
2d
....................
2e
3
Subtract line
2e
from line
1
...................
3
254,414,000
4
Amounts included on Form 990, Part IX, line 25, but not on line
1:
a
Investment expenses not included on Form 990, Part VIII, line 7b
..
4a
b
Other (Describe in Part XIII.)
............
4b
1,030,201
c
Add lines
4a
and
4b
.....................
4c
1,030,201
5
Total expenses. Add lines
3
and
4c.
(This must equal Form 990, Part I, line 18.)
......
5
255,444,201
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference
Explanation
Part V, Line 4: Intended uses of the endowment fund.
Endowment funds disclosed in Part V are used to improve the healthcare of the community as designated by the donors. Legacy Health Foundation (LHF) maintains all charitable gifts including endowment funds for the benefit of Legacy and it's programs. Income from permanently restricted net assets is accounted for in accordance with the donors' instructions.Legacy follows the guidance in the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in determining the net asset classification of all donor-restricted endowment funds. In accordance with UPMIFA and board policy, assets classified as permanent endowments in accordance with donor intent are only utilized for current period expenditures to the extent that earnings on the endowment exceed the original fair value of the donation. To the extent earnings on endowment funds exceed identified expenditures on which to apply those earnings, the earnings are classified as temporarily restricted net assets. Legacy has adopted investment and spending policies for endowment assets to provide a predictable stream of funding to programs supported by its endowment and to maintain the value of the endowment assets. Asset allocation is reviewed quarterly with respect to: i) Legacy's tolerance for risk based on its financial condition and need for cash from investments to support operations; ii) expected asset class return, risk and correlation characteristics; iii) changes in accounting guidance or tax law and iv) changes in bond covenants or other restrictions.Legacy's spending practices are intended to comply with donor's wishes and meet all applicable laws and regulations. Spending must be for a purpose that is consistent with the documented intent of the donor, and may not exceed the amounts annually determined by Legacy. Factors that are considered in addressing the annual spending allocation are: i) market value of the fund relative to the principal of the gift and ii) the level of spending in prior years.From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires Legacy to retain as a fund of perpetual duration. Deficiencies of this nature are reported as a reduction to unrestricted net assets and are excluded from the performance indicator.
Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S
FOUNDATION CONTRIBUTION $7656869 FOUNDATION SALARY EXPENSE $2964313 COMMUNITY FUND $464872 OTHER RECLASS OF REV/EXP FOR TAX PURPOSE $-10069983 GAIN/LOSS OF SALE OF ASSETS $14249
Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S
FOUNDATION CONTRIBUTION $7656869 FOUNDATION SALARY EXPENSE $2964313 COMMUNITY FUNDS $464872 OTHER RECLASS OF REV/EXP FOR TAX PURPOSE $-10055853
Schedule D (Form 990) 2017
Additional Data
Software ID:
17005038
Software Version:
2017v2.2