2023-11-15T10:32:06-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2022-01-01 910743702 THE LUTHERAN RETIREMENT HOME OF GREATER SEATTLE LUTH 2065259666 6720 EAST GREEN LAKE WAY NORTH SEATTLE WA 98103 JACK MCKITTRICK CFO 2065259666 2023-11-14 1 JACK MCKITTRICK 999009999 1 KURT BENNION CPA P01469618 4252506100 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z THE HEARTHSTONE REGGIE MULLIS 6720 EAST GREEN LAKE WAY NORTH SEATTLE WA 98103 22935375 0 9386 X WWW.HEARTHSTONE.ORG X 1961 WA PROMOTE INDEPENDENCE, HEALTH, SECURITY, PURPOSE AND BELONGING IN LIFE FOR ADULTS AGE 62 PLUS. 11 11 244 13 0 0 1741115 92861 18084095 18849707 2015646 1311466 151807 231034 21992663 20485068 243206 331998 0 0 11006348 11431749 0 0 75512 11418523 11724097 22668077 23487844 -675414 -3002776 84207346 75646397 74942411 74297506 9264935 1348891 X SEE SCHEDULE OTHE HEARTHSTONE, A LIFE PLAN COMMUNITY, A SEATTLE LANDMARK SINCE 1966, IS WELL REGARDED FOR COMFORT, HEALTH AND SENIOR WELLNESS. OUR GOAL IS TO PROVIDE A FULL RANGE OF OPTIONS WITH 162 INDEPENDENT LIVING APARTMENTS, 36 ASSISTED LIVING APARTMENTS, 12 MEMORY CARE APARTMENTS, AND CAN ACCOMODATE 40 RESIDENTS IN OUR HEALTH CARE CENTER WITH 24-HOUR NURSING CARE. THE HEARTHSTONE ALSO PROVIDES DAILY ACTIVITIES, THREE MEALS A DAY, REHABILITATION SERVICES FOR WELLNESS TO RECOVERY, AND HOSPICE SERVICES. THE CHAPEL IS OPEN FOR WEEKLY VESPER SERVICES, MUSIC RECITALS BY LOCAL STUDENTS, AND BOARD MEETINGS FOR OTHER NOT-FOR-PROFIT BUSINESSES. THROUGH DONATIONS, THE HEARTHSTONE PROVIDES FINANCIAL ASSISTANCE TO RESIDENTS WHO HAVE OUTLIVED THEIR ASSETS WHILE LIVING INDEPENDENTLY OR IN ASSISTED LIVING. THE HEARTHSTONE'S HEALTH CARE CENTER IS ALSO AVAILABLE FOR NON-HEARTHSTONE RESIDENTS AGE 62 AND OVER NEEDING SHORT-TERM REHABILITATION SERVICES. 0 0 19989277 331998 18849707 THE HEARTHSTONE OWNS AND OPERATES A LIFE PLAN COMMUNITY ("LAKESIDE") LOCATED IN SEATTLE, WASHINGTON, THAT INCLUDES 112 INDEPENDENT LIVING APARTMENTS, A SECOND FACILITY ("COVE WEST") THAT INCLUDES 28 INDEPENDENT LIVING APARTMENTS, AND A THIRD FACILITY ("COVE EAST") WITH 22 INDEPENDENT LIVING APARTMENTS. LAKESIDE ALSO INCLUDES A 40-BED NURSING CARE FACILITY, A 36-UNIT ASSISTED LIVING AREA, AND 12 MEMORY CARE APARTMENTS. 19989277 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 67 0 244 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X PETER SCHULTZ 2065259666 6720 E GREEN LAKE WAY N SEATTLE WA 98103 REGGIE MULLIS CHIEF EXECUTIVE OFFICER 40.00 X 248074 0 64705 AIJA STAPARS CHRO (THROUGH JUNE 2022) 40.00 X 206527 0 49017 ROSIE VELASCO CHIEF HEALTH CARE OFFICER 40.00 X 181880 0 31360 JACK MCKITTRICK CHIEF FINANCIAL OFFICER 40.00 X 168286 0 10437 JEREMIAS RAMIREZ REGISTERED NURSE 40.00 X 144852 0 33287 EMILIANA CUPAT DIRECTOR OF NURSING 40.00 X 118393 0 48714 ANTHONY BAE LICENSED PRACTICAL NURSE 40.00 X 116580 0 23847 CHATHURIKA ABAYAGUNAWARDHANA ACCOUNTING MANAGER & CONTROLLER 40.00 X 109243 0 15346 NIDA MOUSER MDS COORDINATOR 40.00 X 107356 0 14518 LEE COHRS CHAIR 1.00 X X 0 0 0 CAITLIN GRANT CPA VICE CHAIR 1.00 X X 0 0 0 HARRY EDMON SECRETARY 1.00 X X 0 0 0 LAUREN BLEDSOE TRUSTEE (THROUGH SEPTEMBER 2022) 1.00 X 0 0 0 DOUG CUSTER CFP CAP TRUSTEE 1.00 X 0 0 0 KARRIN DANIELS TRUSTEE 1.00 X 0 0 0 TERI HIGBY CPA TRUSTEE 1.00 X 0 0 0 MARK JOHNSON TRUSTEE (THROUGH FEBRUARY 2022) 1.00 X 0 0 0 DR ANN MELVIN TRUSTEE 1.00 X 0 0 0 MIKE OLDEN TRUSTEE 1.00 X 0 0 0 KARI RALLO TRUSTEE 1.00 X 0 0 0 CAROL REDFIELD TRUSTEE 1.00 X 0 0 0 REV ELISE SCOTT TRUSTEE 1.00 X 0 0 0 1401191 0 291231 11 0 1 0 UNIDINE CORPORATION PO BOX 102289 ATLANTA GA 303682289 DINING MANAGEMENT 1559830 NAIVAS STAFFING AGENCY 109 S DIVISION STREET APT 636 AUBURN WA 98001 STAFFING SERVICES 738939 ACG BUILDS INC 1900 AIRPORT WAY S SUITE 102 SEATTLE WA 98134 CONSTRUCTION 424105 MACDONALD-MILLER FACILITY SOLUTIONS LLC PO BOX 509017 SAN DIEGO CA 921509017 CONSTRUCTION 368838 CONSONUS REHAB PO BOX 4800 PORTLAND OR 972084800 REHAB THERAPY 235123 10 92861 92861 RESIDENTS' MONTHLY FEES 623000 10044823 10044823 HEALTH CARE SERVICES 623000 4685828 4685828 ENTRANCE FEE AMORTIZATION 623000 4119056 4119056 18849707 546695 546695 3512 0 3512 3512 3512 3215078 2450307 764771 764771 764771 MEAL REVENUES 722210 138532 138532 MISCELLANEOUS INCOME 900099 88990 88990 227522 20485068 18849707 0 1542500 331998 331998 960286 960286 7588713 6992041 543069 53603 245031 213565 29829 1637 1885570 1690848 181760 12962 752149 626565 120781 4803 922533 922533 29699 29699 113078 113078 102039 102039 1999238 1439982 558627 629 26581 24357 2224 30281 27733 2548 1169829 1071372 97892 565 89416 81369 8047 12648 11589 1059 1434133 1324484 109105 544 3903239 3578473 324766 250287 131315 118972 FOOD 609275 557996 51279 BAD DEBTS 540834 540834 SUPPLIES 517531 473975 43556 EQUIPMENT MAINTENANCE 262282 240207 22075 -288826 -291959 2364 769 23487844 19989277 3423055 75512 1384090 701365 931850 275015 640320 539614 132828 176221 334941 187317 94500664 38194654 59120443 56306010 21662874 17460855 84207346 75646397 2182105 2317064 25614753 25981609 35054422 34582300 10685131 10216533 1406000 1200000 74942411 74297506 X 9212640 1239550 52295 109341 9264935 1348891 84207346 75646397 -3002776 -4913268 0 X X 0 1 X 1 0 X 102866 83550 569618 1741115 92861 2590010 17655599 16978145 19599023 18084095 18849707 91166569 167114 178483 120108 138105 138532 742342 17925579 17240178 20288749 19963315 19081100 94498921 0 0 0 94498921 1116597 944389 787690 1219209 550207 4618092 1116597 944389 787690 1219209 550207 4618092 32786 44639 5309 13702 88990 185426 19074962 18229206 21081748 21196226 19720297 99302439 0.95160 0.94740 0.04650 0.05110 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 359 359 0 PART II-B, LINE 1: THE HEARTHSTONE PAYS MEMBERSHIP DUES TO LEADINGAGE NATIONAL AND LEADINGAGE WASHINGTON, A PORTION OF WHICH ARE USED FOR LOBBYING. 0 1 X 8023820 8023820 73925629 28074816 45850813 12409895 10119838 2290057 141320 141320 56306010 LAND PAYABLE - REMEDIATION OBLIGATION 1200000 1200000 20304983 0 20304983 102039 78046 180085 20485068 23385805 0 23385805 102039 102039 23487844 PART IV, LINE 2B: THE ORGANIZATION HOLDS WAIT LIST DEPOSITS FOR INDIVIDUALS WHO WANT TO ACCESS FUTURE ENTRANCE TO THE FACILITY. THE DEPOSITS ARE RETURNED TO INDIVIDUALS WHO WISH TO REMOVE THEMSELVES FROM THE WAIT LIST. WHILE BEING HELD, THE FUNDS ARE INVESTED. THE ORGANIZATION HOLDS PARTIALLY REFUNDABLE ENTRANCE FEES FOR RESIDENTS LIVING IN OUR FACILITY. DEPENDING ON THE ENTRANCE FEE CONTRACT EACH RESIDENT USES, 90%, 80%, 50% OR 0% OF THEIR FEES WILL EVENTUALLY BE REFUNDED TO THE RESIDENT OR THEIR ESTATE. IN ADDITION, AN INDIVIDUAL CAN RECEIVE A PARTIAL REFUND OF THEIR ENTRANCE FEE IF THEY LEAVE THE FACILITY WITHIN FOUR YEARS OF ENTRANCE. WHILE BEING HELD, FUNDS ARE INVESTED. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS WITH DONOR RESTRICTIONS 78,046. 1 RESIDENT ASSISTANCE 6 331998 PART I, LINE 2: THE ORGANIZATION PROVIDES SERVICES TO RESIDENTS WHO HAVE EXHAUSTED THEIR FINANCIAL RESOURCES. ASSISTANCE IS PROVIDED TO HELP COVER ROOM AND BOARD, MEDICAL CARE, AND PRESCRIPTIONS. THE AMOUNT REPORTED AS GRANTS CONSTITUTES THE VALUE OF THESE SERVICES. X X X X 1 0 0 0 0 0 0 0 0 REGGIE MULLIS CHIEF EXECUTIVE OFFICER 248074 0 0 0 0 0 1743 0 62962 0 312779 0 0 0 AIJA STAPARS CHRO (THROUGH JUNE 2022) 83651 0 0 0 122876 0 6027 0 42990 0 255544 0 0 0 ROSIE VELASCO CHIEF HEALTH CARE OFFICER 181880 0 0 0 0 0 3569 0 27791 0 213240 0 0 0 JACK MCKITTRICK CHIEF FINANCIAL OFFICER 168286 0 0 0 0 0 0 0 10437 0 178723 0 0 0 JEREMIAS RAMIREZ REGISTERED NURSE 144852 0 0 0 0 0 7387 0 25900 0 178139 0 0 0 EMILIANA CUPAT DIRECTOR OF NURSING 118393 0 0 0 0 0 4252 0 44462 0 167107 0 0 0 PART I, LINE 4A IN 2022, AIJA STAPARS RECEIVED SEVERANCE PAYMENTS TOTALLING $122,876. A WASHINGTON STATE HOUSING FINANCE COMMISSION 911874730 939783WS1 2018-06-28 45700955 REFUND SERIES 2013 BONDS; DEVELOP, CONSTRUCT AND EQUIP FACILITIES 0 0 0 A 1875000 45700955 1072000 20487000 24219464 2019 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 3 THROUGH NOVEMBER 2022, THE ORGANIZATION UTILIZED UNIDINE TO PROVIDE DINING SERVICES, INCLUDING MANAGEMENT. DURING 2022, THE ORGANIZATION UTILIZED SODEXHO TO PROVIDE DINING SERVICES AND MAINTENANCE SERVICES, INCLUDING MANAGEMENT. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S MEMBERSHIP IS MADE UP OF BETWEEN EIGHT AND FIFTEEN CONGREGATIONS FROM THE NORTHWEST WASHINGTON SYNOD OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA AND THE NORTHWEST DISTRICT, LUTHERAN CHURCH - MISSOURI SYNOD (COLLECTIVELY, THE "JURISDICTIONAL UNITS"). CONGREGATIONS, AT LEAST TWO OF WHICH SHALL COME FROM EACH OF THE JURISDICTIONAL UNITS, ARE ADMITTED TO MEMBERSHIP UPON APPLICATION APPROVED BY A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ELECT ALL FULL-TERM BOARD POSITIONS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE HEARTHSTONE'S ACCOUNTING MANAGER, CFO AND THE BOARD OF TRUSTEE'S AUDIT AND FINANCE COMMITTEE. ALL OTHER BOARD MEMBERS WERE PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C KEY MANAGERS AND BOARD MEMBERS ARE REQUIRED TO SIGN STATEMENTS ANNUALLY. BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS IMMEDIATELY AS THEY ARISE. BOTH MANAGEMENT AND THE BOARD ARE SENSITIVE TO THIS ISSUE AND ARE EXPECTED TO CONTINUOUSLY MONITOR SITUATIONS FOR POSSIBLE CONFLICTS. AN INDIVIDUAL WITH A CONFLICT OF INTEREST IS ALLOWED TO ANSWER QUESTIONS BUT IS NOT PERMITTED TO VOTE ON THE MATTER. THE STATEMENTS ARE REVIEWED EACH YEAR AS PART OF CORPORATE COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION FOR 2022 WAS SET USING THE FOLLOWING PROCESS WHEN THE CEO WAS HIRED IN 2021. THE CHIEF HUMAN RESOURCES OFFICER PROVIDES A REPORT TO THE CHAIR OF THE BOARD OF TRUSTEES USING DATA FROM COMPENSATION SURVEYS, AS WELL AS THE CPI FOR THE SEATTLE AREA, TO DETERMINE AN APPROPRIATE SALARY RANGE FOR THE CEO. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS THE REPORT AND MAKES A RECOMMENDATION TO THE FULL BOARD. THE BOARD COMPARES SALARIES WITH SIMILAR ORGANIZATIONS AND MAKES THE FINAL DECISION ON CEO COMPENSATION. ANNUAL INCREASES ARE DETERMINED BY THE BOARD BASED ON ANNUAL PERFORMANCE EVALUATIONS. THE CHIEF HUMAN RESOURCES OFFICER PROVIDES A REPORT USING DATA FROM COMPENSATION SURVEYS, AS WELL AS THE CPI FOR THE SEATTLE AREA, TO DETERMINE AN APPROPRIATE SALARY RANGE FOR THE OTHER OFFICERS AND KEY EMPLOYEES. THE REPORT IS REVIEWED AND DISCUSSED BY THE ADMINISTRATOR, CFO AND CEO. THE CEO MAKES THE FINAL DECISION FOR COMPENSATION AMOUNTS. ANNUAL INCREASES ARE BASED ON ANNUAL PERFORMANCE EVALUATIONS. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE UPON REQUEST AND ON THIRD-PARTY WEBSITES SUCH AS GUIDESTAR AND PROPUBLICA. THE FORM 1023 IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S BUSINESS OFFICE. FORM 990, PART XII, LINE 2C: THE PROCESS FOR SELECTING THE FINANCIAL STATEMENT AUDITOR AND FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE YEAR.