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MIRA BELLA: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
MIRA BELLA (EIN 34-2030255)
Tax period
2021-10-01 to 2022-09-30
Filed
2023-08-11
IRS object ID
202302239349300805
Schema version
2021v4.2
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)
Return2023-08-11T07:58:18-05:00ReturnTs
Tax Period End2022-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110700 NORTHUP WAY SUITE 200AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN342030255EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MIRABELLABusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMIRABusinessNameControlTxt
Phone8887246424PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1116 FAIRVIEW AVENUE NORTHAddressLine1Txt
CitySEATTLECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98109ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTRAVIS DUNCANPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone8887246424PhoneNum
Signature2023-08-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTRAVISPersonFirstNm
Person LastDUNCANPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNIONPreparerPersonNm
PTINP01469618PTIN
Phone4252506100PhoneNum
Preparation2023-08-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHRISTOPHER WOODPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 WEST MAIN SUITE 303AddressLine1Txt
CityMEDFORDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97501ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$34,354,895GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RETIREMENT.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPREHENSIVE CARE AND HOUSING FOR THE ELDERLY.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee387TotalEmployeeCnt
Total Volunteers80TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$398,553PYContributionsGrantsAmt
CY Contributions Grants$2,432,957CYContributionsGrantsAmt
PY Program Service Revenue$30,183,414PYProgramServiceRevenueAmt
CY Program Service Revenue$29,594,020CYProgramServiceRevenueAmt
PY Investment Income$539,781PYInvestmentIncomeAmt
CY Investment Income$121,832CYInvestmentIncomeAmt
PY Other Revenue$209,859PYOtherRevenueAmt
CY Other Revenue$193,503CYOtherRevenueAmt
PY Total Revenue$31,331,607PYTotalRevenueAmt
CY Total Revenue$32,342,312CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$14,843,555PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,703,406CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$18,858,707PYOtherExpensesAmt
CY Other Expenses$20,839,589CYOtherExpensesAmt
PY Total Expenses$33,702,262PYTotalExpensesAmt
CY Total Expenses$35,542,995CYTotalExpensesAmt
PY Revenues Less Expenses-$2,370,655PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,200,683CYRevenuesLessExpensesAmt
Total Assets BOY$187,904,464TotalAssetsBOYAmt
Total Assets EOY$187,281,071TotalAssetsEOYAmt
Total Liabilities BOY$312,948,086TotalLiabilitiesBOYAmt
Total Liabilities EOY$315,551,534TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$125,043,622NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$128,270,463NetAssetsOrFundBalancesEOYAmt
MissionNONEMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$29,948,449ExpenseAmt
Grant$0GrantAmt
Revenue$29,594,020RevenueAmt
DescMIRABELLA IS A CONTINUING CARE RETIREMENT COMMUNITY, DEDICATED TO ENHANCING OUR RESIDENTS' QUALITY OF LIFE IN A STIMULATING, SECURE ENVIRONMENT. WE PROVIDE HIGH-QUALITY SERVICES INCLUDING HOUSING, NUTRITIOUS MEALS, NURSING, HOUSEKEEPING, MAINTENANCE, AND OTHER SUPPORT TO THOSE WE SERVE. OUR LEVELS OF SERVICE INCLUDE INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING.Desc
Total Program Service Expenses$29,948,449TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document64IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee387EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KATRINA BYWATERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5416463300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 WEST MAIN SUITE 303AddressLine1Txt
CityMEDFORDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97501ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
TRAVIS DUNCAN
EXECUTIVE DIRECTOR40.000.00Yes (X)$245,792$0$43,235
JESAN FRAZIER
DIRECTOR NURSING SERVICES40.000.00$141,716$0$24,446Yes (X)
STEPHEN VANPELT
DIRECTOR OF DINING SERVICES40.000.00$128,505$0$27,601Yes (X)
SEMERE HAILEMARIAM
REGISTERED NURSE40.000.00$136,993$0$10,297Yes (X)
GAIL CARTER-LINDBERG
HUMAN RESOURCES DIRECTOR40.000.00$126,710$0$15,153Yes (X)
FIORI BARIAGABIR
REGISTERED NURSE40.000.00$128,424$0$11,266Yes (X)
CHRISTOPHER WOOD
CHAIR/PRESIDENT1.000.00$0$0$0Yes (X)Yes (X)
LEE BURNSIDE
VICE CHAIR1.000.00$0$0$0Yes (X)Yes (X)
OLEG ZASLAVSKY
SECRETARY1.000.00$0$0$0Yes (X)Yes (X)
RUTH BENFIELD
RESIDENT DIRECTOR1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$908,140TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$131,998TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K12IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PACIFIC RETIREMENT SERVICES INC
1 WEST MAIN SUITE 303MEDFORDOR97501MANAGEMENT SERVICES$1,986,169
JTM CONSTRUCTION INC
800 MAYNARD AVE SOUTH STE 1010SEATTLEWA98134CONSTRUCTION$859,519
CONSONUS REHAB
PO BOX 4800 UNIT 12PORTLANDOR97208THERAPY SERVICES$471,155
ISOMEDIACOM
PO BOX 58288SEATTLEWA98138TELECOM SERVICES$438,364
UNIVERSITY MECHANICAL CONTRACTORS
11611 49TH PLACE WMUKILTEOWA98275MECHANICAL ENGINEERING$211,137
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Government Grants$2,011,227GovernmentGrantsAmt
All Other Contributions$421,730AllOtherContributionsAmt
Total Contributions$2,432,957TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
SERVICE FEES623000$20,943,369$20,943,369
HEALTH CENTER623000$3,962,072$3,962,072
ENTRANCE FEES623000$2,665,272$2,665,272
HOME CARE/PRIVATE DUTY623000$1,123,602$1,123,602
GARAGE & CARPORT623000$181,451$181,451

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$718,254TotalRevenueColumnAmt
Related Or Exempt Func Income$718,254RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$29,594,020TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$228,974TotalRevenueColumnAmt
Exclusion$228,974ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$193,503RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$193,503RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$193,503TotalRevenueColumnAmt
Exclusion$193,503ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,905,441SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,986,677SecuritiesAmt
Other$25,906OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$81,236SecuritiesAmt
Other-$25,906OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$107,142TotalRevenueColumnAmt
Exclusion-$107,142ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,342,312TotalRevenueColumnAmt
Related Or Exempt Func Income$29,594,020RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$315,335ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$259,004TotalAmt
Management And General$259,004ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,503,741TotalAmt
Program Services$10,646,799ProgramServicesAmt
Management And General$856,942ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$484,022TotalAmt
Program Services$418,183ProgramServicesAmt
Management And General$65,839ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,646,062TotalAmt
Program Services$1,404,474ProgramServicesAmt
Management And General$241,588ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$810,577TotalAmt
Program Services$775,112ProgramServicesAmt
Management And General$35,465ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,232,102TotalAmt
Management And General$2,232,102ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$35,060TotalAmt
Management And General$35,060ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,750TotalAmt
Management And General$24,750ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$19,393TotalAmt
Management And General$19,393ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,953,314TotalAmt
Program Services$1,415,884ProgramServicesAmt
Management And General$537,430ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$321,185TotalAmt
Management And General$321,185ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$869,912TotalAmt
Program Services$786,482ProgramServicesAmt
Management And General$83,430ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$302,682TotalAmt
Management And General$302,682ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,129,997TotalAmt
Program Services$2,129,628ProgramServicesAmt
Management And General$369ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$127,420TotalAmt
Program Services$42,608ProgramServicesAmt
Management And General$84,812ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$40,911TotalAmt
Program Services$29,705ProgramServicesAmt
Management And General$11,206ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,895,718TotalAmt
Program Services$2,895,718ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,035,252TotalAmt
Program Services$6,035,252ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$422,075TotalAmt
Program Services$422,075ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OTHER DIETARY EXPENSE$1,755,321$1,755,321
OTHER FACILITY SERVICE$682,179$198,890$483,289
HEALTH CENTER EXPENSE$592,977$592,977
PROGRAM FUND EXPENSES$399,341$399,341

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$35,542,995TotalAmt
Program Services$29,948,449ProgramServicesAmt
Management And General$5,594,546ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,032,771BOYAmt
EOY$5,038,763EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$81,692BOYAmt
EOY$113,692EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$740,217BOYAmt
EOY$966,702EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$258,036BOYAmt
EOY$197,871EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$703,077BOYAmt
EOY$519,828EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$250,633,081LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$81,624,687LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$173,439,462BOYAmt
EOY$169,008,394EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,105,708BOYAmt
EOY$7,909,486EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$782,936EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$543,501BOYAmt
EOY$2,743,399EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$187,904,464BOYAmt
EOY$187,281,071EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,069,562BOYAmt
EOY$3,070,321EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$16,092,060BOYAmt
EOY$17,545,551EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$93,085,046BOYAmt
EOY$91,457,601EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$961,049BOYAmt
EOY$1,739,629EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$199,740,369BOYAmt
EOY$201,738,432EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$312,948,086BOYAmt
EOY$315,551,534EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$125,643,111BOYAmt
EOY-$128,901,884EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$599,489BOYAmt
EOY$631,421EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$125,043,622BOYAmt
EOY-$128,270,463EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$187,904,464BOYAmt
EOY$187,281,071EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,200,683ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$37,568NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$11,410OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$263,152CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$452,335CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$399,558CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$398,553CurrentTaxYearMinus1YearAmt
Current Tax Year$2,432,956CurrentTaxYearAmt
Total$3,946,554TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$29,475,888CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$30,620,866CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$31,101,562CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$30,183,414CurrentTaxYearMinus1YearAmt
Current Tax Year$29,594,020CurrentTaxYearAmt
Total$150,975,750TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$29,739,040CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$31,073,201CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$31,501,120CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$30,581,967CurrentTaxYearMinus1YearAmt
Current Tax Year$32,026,976CurrentTaxYearAmt
Total$154,922,304TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$154,922,304PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$583,769CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$733,012CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$665,501CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$578,757CurrentTaxYearMinus1YearAmt
Current Tax Year$422,477CurrentTaxYearAmt
Total$2,983,516TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$583,769CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$733,012CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$665,501CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$578,757CurrentTaxYearMinus1YearAmt
Current Tax Year$422,477CurrentTaxYearAmt
Total$2,983,516TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30,322,809CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$31,806,213CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,166,621CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,160,724CurrentTaxYearMinus1YearAmt
Current Tax Year$32,449,453CurrentTaxYearAmt
Total$157,905,820TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98110PublicSupportCY509Pct
Public Support PY5090.98060PublicSupportPY509Pct
Investment Income CY0.01890InvestmentIncomeCYPct
Investment Income PY0.01940InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$35,542,995FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$35,542,995FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$1,000,000FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$250,000FilingOrganizationsTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$1,000,000CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$4,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Current Year Minus2$250,000CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,194,646OtherCostOrOtherBasisAmt
Book Value$21,194,646BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$214,504,111OtherCostOrOtherBasisAmt
Depreciation$73,325,231DepreciationAmt
Book Value$141,178,880BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,443,543OtherCostOrOtherBasisAmt
Depreciation$8,299,456DepreciationAmt
Book Value$3,144,087BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,490,781OtherCostOrOtherBasisAmt
Book Value$3,490,781BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$169,008,394TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
REFUNDABLE ENTRANCE FEES$183,374,231
DUE TO AFFILIATES$18,364,201
FieldValueIRS element (for citing)
Total Liability$201,738,432TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:RESIDENT SECURITY DEPOSITS ARE HELD IN A SEPARATE BANK ACCOUNT. WHEN THE RESIDENT LEAVES THE FACILITY THE SECURITY DEPOSIT, MINUS ANY AMOUNTS RETAINED FOR REPAIRS, IS REFUNDED.
PART X, LINE 2:THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2022 AND 2021, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TRAVIS DUNCAN
EXECUTIVE DIRECTOR$208,153$0$37,639$0$0$0$31,899$0$11,336$0$289,027$0$0$0
JESAN FRAZIER
DIRECTOR NURSING SERVICES$128,476$0$13,240$0$0$0$10,227$0$14,219$0$166,162$0$0$0
STEPHEN VANPELT
DIRECTOR OF DINING SERVICES$122,582$0$5,923$0$0$0$6,843$0$20,758$0$156,106$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3COMPENSATION WAS RECOMMENDED BY PACIFIC RETIREMENT SERVICES, INC. AND APPROVED BY THE MIRABELLA BOARD AS PART OF THE ANNUAL BUDGET PROCESS.
PART I, LINE 7THE ORGANIZATION PAID BONUSES THIS YEAR. THE PROCESS FOR DETERMINING EXECUTIVE BONUSES IS DISCRETIONARY. IT IS DETERMINED BY THE VP OF OPERATIONS FOR PRS AND IT IS BASED ON THE PERFORMANCE OF THE COMMUNITY FOR THE YEAR.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WASHINGTON STATE HOUSING FINANCE COMMISSIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN911874730BondIssuerEIN
Bond Issued2021-03-29BondIssuedDt
Issue Price$20,950,000IssuePriceAmt
PurposeSEE PART VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$525,000RetiredAmt
Total Proceeds$20,950,000TotalProceedsAmt
Issuance Costs From Proceeds$355,766IssuanceCostsFromProceedsAmt
Other Spent Proceeds$20,594,234OtherSpentProceedsAmt
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease ArrangementsYes (1)AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (1)EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.01000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.01000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, COLUMN E:THE BONDS WERE ISSUED CONTEMPORANEOUSLY WITH $40,000,000 IN AGGREGATE PRINCIPAL AMOUNT OF THE OREGON FACILITIES AUTHORITY REFUNDING REVENUE BONDS (PRS PACIFIC NORTHWEST OBLIGATION GROUP PROJECTS), 2021 SERIES A (THE OREGON BONDS").
PART I, COLUMN F:THE BONDS CURRENT REFUNDED MIRABELLA 2006AR BONDS (ISSUED ON DECEMBER 27, 2012).
PART III, LINE 7:AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
PART IV, LINE 2B:THE BONDS HAVE SATISFIED THE 6-MONTH EXPENDITURE EXCEPTION TO REBATE.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3MIRABELLA'S BOARD DELEGATES MANAGEMENT DUTIES TO PACIFIC RETIREMENT SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS ONE MEMBER, PACIFIC RETIREMENT SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 7APACIFIC RETIREMENT SERVICES, INC. HAS THE RIGHT TO VOTE ON THE ELECTION OF DIRECTORS FOR THE BOARD OF MIRABELLA.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING ACTIONS ARE RESERVED TO PACIFIC RETIREMENT SERVICES, INC., THE SOLE MEMBER: (A) AMEND, RESTATE OR REPEAL THE BYLAWS, OR ADOPT NEW BYLAWS; (B) COORDINATE THE ACTIVITIES OF THE ORGANIZATION, AND ENGAGE IN THE OVERALL PLANNING, POLICY DEVELOPMENT, BUDGETING, AND RESOURCE ALLOCATION FOR THE ORGANIZATION; (C) APPOINT OUTSIDE AUDITORS FOR THE ORGANIZATION; (D) ELECT OR APPOINT THE ORGANIZATION'S DIRECTORS, INCLUDING THE RESIDENT DIRECTOR AND THE PRS REPRESENTATIVE DIRECTOR, AND FILL VACANCIES CAUSED BY THE DEATH, REMOVAL OR RESIGNATION OF A DIRECTOR; AND (E) REMOVE ANY OF THE ORGANIZATION'S DIRECTORS OR OFFICERS. THE PRIOR APPROVAL OF THE MEMBER IS REQUIRED BEFORE THE BOARD OF DIRECTORS MAY (A) APPROVE ANY MERGER OR CONSOLIDATION OF THE ORGANIZATION WITH ANOTHER ENTITY, OR ANY PARTIAL OR TOTAL LIQUIDATION OF THE ORGANIZATION'S ASSETS; (B) INCUR ANY DEBT, OR ENTER INTO ANY CONTRACT, NOT CONTEMPLATED BY THE ANNUAL BUDGET IF THE DOLLAR AMOUNT EXCEEDS THE SUM OF $100,000; (C) MAKE ANY GIFT OR GRATUITOUS TRANSFER IN EXCESS OF $15,000 IN ANY CALENDAR YEAR; (D) CREATE A TAXABLE OR TAX-EXEMPT SUBSIDIARY OR AFFILIATED ORGANIZATION; (E) ACQUIRE A CONTROLLING INTEREST IN ANOTHER ENTITY; OR (F) APPROVE ANY AMENDMENT, REPEAL, OR RESTATE OF THE ORGANIZATION'S ARTICLES OF INCORPORATION, OR ADOPT ANY NEW ARTICLES OF INCORPORATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS REVIEWED BY THE DIRECTOR OF FINANCE, CFO AND THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE ARE SENT TO ALL BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY. THERE ARE TWO POLICIES RELATED TO CONFLICTS OF INTEREST: 1) BOARD OF DIRECTORS; 2)KEY EMPLOYEES, WHICH IDENTIFY THE PURPOSE, DEFINITIONS, AND PROCEDURES. IF A CONFLICT IS SELF-IDENTIFIED BY A BOARD MEMBER OR KEY EMPLOYEE IN THE QUESTIONNAIRE AND/OR MEETING, PROCEDURES ARE FOLLOWED AND DOCUMENTED ACCORDING TO THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15AA COMPENSATION COMMITTEE OF THE PRS BOARD EXISTS TO DETERMINE COMPENSATION FOR THE EXECUTIVE DIRECTOR OF EACH COMMUNITY. THIS COMMITTEE IS COMPRISED OF THE OFFICERS OF THE PRS BOARD OF DIRECTORS. THE COMMITTEE HAS A CHARTER THAT OUTLINES ITS DUTIES AND RESPONSIBILITIES. IT ALSO HAS AGENDA ELEMENTS THAT DESCRIBE THE ACTIVITIES THAT THE COMMITTEE UNDERTAKES DURING THE YEAR. THE VP OF HUMAN RESOURCES PROVIDED SALARY STUDIES FROM THE FOLLOWING RESOURCES TO THE COMMITTEE RELATIVE TO EXECUTIVE DIRECTOR COMPENSATION: SALARY.COM, PAYSCALE.COM, 990 REVIEW (LIKE SIZE ORGANIZATIONS), CEMO (CHIEF EXECUTIVE OFFICERS OF MULTI-FACILITY ORGANIZATIONS) SALARY STUDY RESULTS, AND INDUSTRY STATE ASSOCIATION SALARY STUDY RESULTS BASED ON GEOGRAPHICAL LOCATION. THE RECOMMENDATION FOR BASE COMPENSATION AND BONUS ARE PROVIDED BY THE EXECUTIVE DIRECTOR'S DIRECT SUPERVISOR (COO OR VP OF OPERATIONS).
FORM 990, PART VI, SECTION C, LINE 19ALL REQUESTS GO THROUGH CORPORATE COUNSEL.
FORM 990, PART VII, SECTION A:NOTE THAT TRAVIS DUNCAN IS A LEASED EMPLOYEE OF PACIFIC RETIREMENT SERVICES, INC. AND PERFORMS SERVICES ON BEHALF OF MIRABELLA PURSUANT TO A MANAGEMENT SERVICES AGREEMENT BETWEEN MIRABELLA AND PACIFIC RETIREMENT SERVICES, INC. UNDER THE MANAGEMENT SERVICES AGREEMENT, HIS COMPENSATION IS REIMBURSED BY MIRABELLA. COMPENSATION HAS BEEN REPORTED IN FORM 990, PART VII, SECTION A IN ORDER TO HIGHLIGHT AMOUNTS PAID BY MIRABELLA, NOTWITHSTANDING THAT HE IS A LEASED EMPLOYEE OF PACIFIC RETIREMENT SERVICES, INC.
FORM 990, PART XI, LINE 9:CHANGES IN INTEREST IN NET ASSETS OF FOUNDATION 11,410.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (45 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
PACIFIC RETIREMENT SERVICES INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501931067253SUPPORTING ORGANIZATIONOR501(C)(3)LINE 12C, III-FIN/A0
PACIFIC RETIREMENT SERVICES FOUNDATION INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501472352652PUBLIC FOUNDATIONOR501(C)(3)LINE 70PACIFIC RETIREMENT SERVICES INC
ROGUE VALLEY MANOR
1 WEST MAIN ST SUITE 303MEDFORDOR97501930453216SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
THE CUMBERLAND REST INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501750891470SENIOR HOUSINGTX501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
CASCADE MANOR INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501930557803SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
UNIVERSITY RETIREMENT COMMUNITY AT DAVIS
1 WEST MAIN ST SUITE 303MEDFORDOR97501931179254SENIOR HOUSINGCA501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
HOLLADAY PARK PLAZA
1 WEST MAIN ST SUITE 303MEDFORDOR97501930513697SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
CAPITOL LAKES INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501391412320SENIOR HOUSINGWI501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
ROGUE VALLEY MANOR FOUNDATION INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501930712867PUBLIC FOUNDATIONOR501(C)(3)LINE 70ROGUE VALLEY MANOR
UNIVERSITY RETIREMENT COMMUNITY FOUNDATION INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501931301816PUBLIC FOUNDATIONCA501(C)(3)LINE 70UNIVERSITY RETIREMENT COMMUNITY AT DAVIS
MIRABELLA WASHINGTON FOUNDATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501450574348PUBLIC FOUNDATIONWA501(C)(3)LINE 7Yes (1)MIRABELLA
CASCADE MANOR FOUNDATION INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501931330100PUBLIC FOUNDATIONOR501(C)(3)LINE 70CASCADE MANOR INC
CAPITOL LAKES FOUNDATION INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501383781089PUBLIC FOUNDATIONOR501(C)(3)LINE 70CAPITOL LAKES INC
MIRABELLA PORTLAND FOUNDATION INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501452508860PUBLIC FOUNDATIONOR501(C)(3)LINE 70MIRABELLA AT SOUTH WATERFRONT
MIRABELLA AT SOUTH WATERFRONT
1 WEST MAIN ST SUITE 303MEDFORDOR97501711016384SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
COMMUNITY VOLUNTEER NETWORK
1 WEST MAIN ST SUITE 303MEDFORDOR97501930892261COMMUNITY SERVICESOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501930864466SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM ASHLAND HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501930942933SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM GRANTS PASS HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943136037SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM ROSEBURG HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943179782SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM MYRTLE CREEK HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943162074SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM BEND HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943163349SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM EAGLE POINT HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943191447SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM KLAMATH FALLS HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943196455SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM MEDFORD II HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943212537SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM LIVELY OAKS HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943194409SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM REEDSPORT HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943212538SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM YREKA HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943212540SENIOR HOUSINGCA501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM EUGENE HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943247154SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM FORT WORTH I HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311520436SENIOR HOUSINGTX501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM BEND II HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501943260016SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM FORT WORTH II HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311587415SENIOR HOUSINGTX501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM MEDFORD III HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311587418SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM ROSEBURG II HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311587420SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM GRANTS PASS II HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311662259SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM DAVIS HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311662208SENIOR HOUSINGCA501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM MYRTLE CREEK II HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311715321SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM PORTLAND HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501311780332SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM PORTLAND II HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501300037898SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM CENTRAL POINT HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501300315618SENIOR HOUSINGOR501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
RVM MANSFIELD HOUSING CORPORATION
1 WEST MAIN ST SUITE 303MEDFORDOR97501900292647SENIOR HOUSINGTX501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
MIDDLETON GLEN INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501911859494SENIOR HOUSINGWI501(C)(3)LINE 100CAPITOL LAKES INC
SENIOR HOUSING OF MIDDLETON INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501470825736SENIOR HOUSINGWI501(C)(3)LINE 100CAPITOL LAKES INC
MIRABELLA AT ASU INC
1 WEST MAIN ST SUITE 303MEDFORDOR97501813784956SENIOR HOUSINGAZ501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC
BAY AREA SENIOR SERVICES INC
1 BALDWIN AVENUESAN MATEOCA94401943008774SENIOR HOUSINGCA501(C)(3)LINE 100PACIFIC RETIREMENT SERVICES INC

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