CAPITOL LAKES INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CAPITOL LAKES INC (EIN 39-1412320)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-12
- IRS object ID
- 202242249349302514
- Schema version
- 2020v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-12T15:28:05-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391412320 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPITOL LAKES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CAPI | BusinessNameControlTxt |
| Phone | 8887246424 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 WEST MAIN STREET | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53703 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIM CONROY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8887246424 | PhoneNum |
| Signature | 2022-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TIM | PersonFirstNm |
| Person Last | CONROY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2022-08-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUE CENTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 WEST MAIN SUITE 303 | AddressLine1Txt |
| City | MEDFORD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,062,246 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RETIREMENT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 396 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $258,965 | PYContributionsGrantsAmt |
| CY Contributions Grants | $234,440 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,500,974 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,732,097 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$14,438 | PYInvestmentIncomeAmt |
| CY Investment Income | $71,805 | CYInvestmentIncomeAmt |
| PY Other Revenue | $16,173 | PYOtherRevenueAmt |
| CY Other Revenue | $16,658 | CYOtherRevenueAmt |
| PY Total Revenue | $21,761,674 | PYTotalRevenueAmt |
| CY Total Revenue | $22,055,000 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,679,407 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,384,875 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,312,726 | PYOtherExpensesAmt |
| CY Other Expenses | $11,518,904 | CYOtherExpensesAmt |
| PY Total Expenses | $22,992,133 | PYTotalExpensesAmt |
| CY Total Expenses | $22,903,779 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,230,459 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$848,779 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $42,403,310 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,454,270 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $100,100,442 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $101,839,342 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$57,697,132 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$58,385,072 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CAPITOL LAKES IS A VIBRANT CONTINUING CARE RETIREMENT COMMUNITY COMMITTED TO THE ENRICHMENT OF RESIDENTS' LIVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,519,653 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $21,732,097 | RevenueAmt |
| Desc | CAPITOL LAKES 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 | $18,519,653 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 396 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOSH BLACKSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5418577205 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 WEST MAIN SUITE 303 | AddressLine1Txt |
| City | MEDFORD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|---|
| TIM CONROY | |||||||||
| EXECUTIVE DIRECTOR | 40.00 | 1.00 | Yes (X) | $246,382 | $0 | $50,148 | |||
| KRISTIN VATER | |||||||||
| HEALTH CENTER ADMINISTRATOR | 40.00 | 1.00 | $146,224 | $0 | $29,963 | Yes (X) | |||
| DAYLE TESSNER | |||||||||
| DIRECTOR OF NURSING | 40.00 | 0.00 | $125,952 | $0 | $16,725 | Yes (X) | |||
| STEVEN MELLSTROM | |||||||||
| HR DIRECTOR | 40.00 | 0.00 | $113,214 | $0 | $29,338 | Yes (X) | |||
| SUE CENTER | |||||||||
| CHAIR | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| CLAY NORRBOM | |||||||||
| VICE CHAIR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| SALLY DREW | |||||||||
| SECRETARY/TREASURER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| STEVE JOHANNSEN | |||||||||
| DIRECTOR | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| HARRY PETERSON | |||||||||
| DIRECTOR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| PETE TAYLOR | |||||||||
| RESIDENT DIRECTOR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| KARIL WALTHER | |||||||||
| DIRECTOR (LEFT DURING FISCAL YEAR) | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $631,772 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $126,174 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PACIFIC RETIREMENT SERVICES INC | |||||
| 1 WEST MAIN SUITE 303 | MEDFORD | OR | 97501 | MANAGEMENT SERVICES | $1,392,073 |
| CONSONUS REHAB | |||||
| PO BOX 4800 UNIT 12 | PORTLAND | OR | 97208 | THERAPY SERVICES | $1,047,100 |
| MCGANN CONSTRUCTION INC | |||||
| 3622 LEXINGTON AVENUE | MADISON | WI | 53714 | CONSTRUCTION SERVICES | $1,001,900 |
| LAPIS ADVISERS LP | |||||
| 265 MAGNOLIA AVE 100 | LARKSPUR | CA | 94939 | INVESTMENT SERVICES | $793,148 |
| HOMETOWN LONG-TERM CARE PHARMACY LLC | |||||
| 1571 IVORY DRIVE | SUN PRAIRIE | WI | 53590 | PHARMACY SERVICES | $496,141 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $66,000 | RelatedOrganizationsAmt |
| All Other Contributions | $168,440 | AllOtherContributionsAmt |
| Total Contributions | $234,440 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| SERVICE FEES | 623000 | $10,491,233 | $10,491,233 |
| HEALTH CENTER | 623000 | $7,992,398 | $7,992,398 |
| ENTRANCE FEES | 623000 | $1,588,318 | $1,588,318 |
| HOME CARE | 623000 | $391,505 | $391,505 |
| DIETARY | 623000 | $110,390 | $110,390 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,158,253 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,158,253 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,732,097 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,986 | TotalRevenueColumnAmt |
| Exclusion | $55,986 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,658 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,658 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,658 | TotalRevenueColumnAmt |
| Exclusion | $16,658 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,065 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $7,246 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,065 | SecuritiesAmt |
| Other | -$7,246 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,819 | TotalRevenueColumnAmt |
| Exclusion | $15,819 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,055,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,732,097 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $88,463 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $272,463 | TotalAmt |
| Management And General | $272,463 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,727,162 | TotalAmt |
| Program Services | $7,812,883 | ProgramServicesAmt |
| Management And General | $914,279 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $406,957 | TotalAmt |
| Program Services | $347,941 | ProgramServicesAmt |
| Management And General | $59,016 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,329,175 | TotalAmt |
| Program Services | $1,183,168 | ProgramServicesAmt |
| Management And General | $146,007 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $649,118 | TotalAmt |
| Program Services | $573,616 | ProgramServicesAmt |
| Management And General | $75,502 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,525,022 | TotalAmt |
| Management And General | $1,525,022 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,176 | TotalAmt |
| Management And General | $4,176 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,000 | TotalAmt |
| Management And General | $25,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,140 | TotalAmt |
| Management And General | $4,140 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $956,053 | TotalAmt |
| Program Services | $567,000 | ProgramServicesAmt |
| Management And General | $389,053 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $324,143 | TotalAmt |
| Management And General | $324,143 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,168,680 | TotalAmt |
| Program Services | $1,003,444 | ProgramServicesAmt |
| Management And General | $165,236 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,469 | TotalAmt |
| Management And General | $204,469 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,371,956 | TotalAmt |
| Program Services | $1,371,220 | ProgramServicesAmt |
| Management And General | $736 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,499 | TotalAmt |
| Program Services | $1,796 | ProgramServicesAmt |
| Management And General | $31,703 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,231 | TotalAmt |
| Program Services | $29,921 | ProgramServicesAmt |
| Management And General | $49,310 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,263 | TotalAmt |
| Program Services | $32,263 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,562,015 | TotalAmt |
| Program Services | $2,562,015 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,294 | TotalAmt |
| Program Services | $205,294 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| HEALTH CENTER EXPENSE | $1,768,353 | $1,768,353 | |
| OTHER DIETARY EXPENSE | $830,047 | $830,047 | |
| OTHER FACILITY SERVICE | $265,033 | $71,162 | $193,871 |
| PROGRAM FUND EXPENSES | $159,530 | $159,530 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,903,779 | TotalAmt |
| Program Services | $18,519,653 | ProgramServicesAmt |
| Management And General | $4,384,126 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,721,637 | BOYAmt |
| EOY | $5,175,147 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,343,049 | BOYAmt |
| EOY | $1,677,292 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,408 | BOYAmt |
| EOY | $112,619 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,314 | BOYAmt |
| EOY | $380,767 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $70,488,532 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,977,748 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,588,965 | BOYAmt |
| EOY | $32,510,784 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,598,453 | BOYAmt |
| EOY | $2,764,650 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $872,484 | BOYAmt |
| EOY | $833,011 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,403,310 | BOYAmt |
| EOY | $43,454,270 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,351,784 | BOYAmt |
| EOY | $2,350,862 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,557,973 | BOYAmt |
| EOY | $9,547,129 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $693,571 | BOYAmt |
| EOY | $637,132 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,554,683 | BOYAmt |
| EOY | $43,912,946 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,942,431 | BOYAmt |
| EOY | $45,391,273 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,100,442 | BOYAmt |
| EOY | $101,839,342 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$58,621,727 | BOYAmt |
| EOY | -$59,278,106 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $924,595 | BOYAmt |
| EOY | $893,034 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$57,697,132 | BOYAmt |
| EOY | -$58,385,072 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,403,310 | BOYAmt |
| EOY | $43,454,270 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$848,779 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $91,725 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $69,114 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $153,353 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $208,344 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $207,383 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $258,965 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $234,440 | CurrentTaxYearAmt |
| Total | $1,062,485 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,867,694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,870,492 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,577,973 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,500,974 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,732,097 | CurrentTaxYearAmt |
| Total | $108,549,230 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,021,047 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,078,836 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,785,356 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,759,939 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,966,537 | CurrentTaxYearAmt |
| Total | $109,611,715 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $109,611,715 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $59,231 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $64,206 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $97,996 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $73,154 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72,645 | CurrentTaxYearAmt |
| Total | $367,232 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $59,231 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $64,206 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $97,996 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $73,154 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72,645 | CurrentTaxYearAmt |
| Total | $367,232 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,080,278 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,143,042 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,883,352 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,833,093 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,039,182 | CurrentTaxYearAmt |
| Total | $109,978,947 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99670 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99580 | PublicSupportPY509Pct |
| Investment Income CY | 0.00330 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00420 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
Total Grassroots Lobbying TotalGrassrootsLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Total Direct Lobbying TotalDirectLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Other Exempt Purpose Expend OtherExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $22,903,779 | FilingOrganizationsTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $22,903,779 | FilingOrganizationsTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $1,000,000 | FilingOrganizationsTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $250,000 | FilingOrganizationsTotalAmt |
Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $1,000,000 | CurrentYearMinus3Amt |
| Current Year Minus2 | $1,000,000 | CurrentYearMinus2Amt |
| Current Year Minus1 | $1,000,000 | CurrentYearMinus1Amt |
| Current Year | $1,000,000 | CurrentYearAmt |
| Total | $4,000,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $6,000,000 | LobbyingCeilingAmt |
Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $250,000 | CurrentYearMinus3Amt |
| Current Year Minus2 | $250,000 | CurrentYearMinus2Amt |
| Current Year Minus1 | $250,000 | CurrentYearMinus1Amt |
| Current Year | $250,000 | CurrentYearAmt |
| Total | $1,000,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $1,500,000 | GrassrootsCeilingAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,537,600 | OtherCostOrOtherBasisAmt |
| Book Value | $8,537,600 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,527,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,922,817 | DepreciationAmt |
| Book Value | $22,604,483 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,248,916 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,054,931 | DepreciationAmt |
| Book Value | $1,193,985 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $174,716 | OtherCostOrOtherBasisAmt |
| Book Value | $174,716 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $32,510,784 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $4,647,267 |
| OTHER CURRENT LIABILITIES | $18,968 |
| ENTRANCE FEES REFUNDABLE UPON REOCCUPANCY | $38,587,793 |
| REFUNDABLE ADVANCE | $2,137,245 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $45,391,273 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 CORPORATION 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 CORPORATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2021 AND 2020, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIM CONROY | ||||||||||||||
| EXECUTIVE DIRECTOR | $206,821 | $0 | $39,561 | $0 | $0 | $0 | $19,487 | $0 | $30,661 | $0 | $296,530 | $0 | $0 | $0 |
| KRISTIN VATER | ||||||||||||||
| HEALTH CENTER ADMINISTRATOR | $133,461 | $0 | $12,763 | $0 | $0 | $0 | $19,321 | $0 | $10,642 | $0 | $176,187 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION WAS DETERMINED BY PACIFIC RETIREMENT SERVICES, INC., A RELATED ORGANIZATION, THAT USED ONE OR MORE OF THE METHODS DESCRIBED ON LINE 3 TO ESTABLISH COMPENSATION. |
| PART I, LINE 7 | THE 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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | CAPITOL LAKES, INC. DELEGATES MANAGEMENT DUTIES TO PACIFIC RETIREMENT SERVICES, INC. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS ONE MEMBER, PACIFIC RETIREMENT SERVICES, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | PACIFIC RETIREMENT SERVICES, INC. HAS THE RIGHT TO ELECT THE DIRECTORS OF THE BOARD OF CAPITOL LAKES, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE AUTHORITY OF THE BOARD OF DIRECTORS TO EXERCISE THE FOLLOWING POWERS IS CONDITIONED UPON THE APPROVAL OF THE CORPORATE MEMBER: (A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE ORGANIZATION; (B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE ORGANIZATION; (C) SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL THE PROPERTY AND ASSETS OF THE ORGANIZATION; (D) THE ESTABLISHMENT, FORMATION, ACQUISITION, MERGER, CONSOLIDATION OR DISSOLUTION OF ANY SUBSIDIARY ORGANIZATION; (E) THE ADOPTION OF THE AGGREGATE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE ORGANIZATION; (F) AGGREGATE BORROWING FOR PERIODS OF ONE (1) YEAR OR LESS FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE MEMBER FROM TIME TO TIME; AND AGGREGATE BORROWING FOR PERIODS OF MORE THAN ONE (1) YEAR FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE MEMBER FROM TIME TO TIME; (G) THE PURCHASE, SALE, LEASE DISPOSITION HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, AND ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE MEMBER FROM TIME TO TIME, NOT PREVIOUSLY INCLUDED IN THE CAPITAL BUDGET; (H) THE APPOINTMENT OF AN INDEPENDENT AUDITOR; (I) GIFTS OR GRATUITOUS TRANSFERS IN EXCESS OF $5,000 IN A CALENDAR YEAR; (J) ADOPTION OR REVISION OF THE MISSION STATEMENT AND LONG RANGE PLANS; AND (K) INCUR ANY DEBT OR ENTER INTO ANY CONTRACT NOT CONTEMPLATED BY THE ANNUAL BUDGET IF THE DOLLAR AMOUNT EXCEEDS THE SUM OF $100,000. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS REVIEWED BY THE DIRECTOR OF FINANCE, CFO AND THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE 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 15A | A 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 19 | ALL REQUESTS GO THROUGH CORPORATE COUNSEL. |
| FORM 990, PART VII, SECTION A: | NOTE THAT TIM CONROY AND KRISTIN VATER ARE LEASED EMPLOYEES OF PACIFIC RETIREMENT SERVICES, INC. AND PERFORM SERVICES ON BEHALF OF CAPITOL LAKES, INC. PURSUANT TO A MANAGEMENT SERVICES AGREEMENT BETWEEN CAPITOL LAKES, INC. AND PACIFIC RETIREMENT SERVICES, INC. UNDER THE MANAGEMENT SERVICES AGREEMENT, THEIR COMPENSATION IS REIMBURSED BY CAPITOL LAKES, INC. COMPENSATION HAS BEEN REPORTED IN PART VII, SECTION A IN ORDER TO HIGHLIGHT AMOUNTS PAID BY CAPITOL LAKES, INC., NOTWITHSTANDING THAT THEY ARE LEASED EMPLOYEES OF PACIFIC RETIREMENT SERVICES, INC. |
| FORM 990, PART XI, LINE 9: | CHANGES IN INTEREST IN NET ASSETS OF FOUNDATION -39,473. NON OPERATING - MANAGEMENT FEES 108,587. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (46 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PACIFIC RETIREMENT SERVICES INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 931067253 | SUPPORTING ORGANIZATION | OR | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| PACIFIC RETIREMENT SERVICES FOUNDATION INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 472352652 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| ROGUE VALLEY MANOR | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 930453216 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| THE CUMBERLAND REST INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 750891470 | SENIOR HOUSING | TX | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| CASCADE MANOR INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 930557803 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| UNIVERSITY RETIREMENT COMMUNITY AT DAVIS | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 931179254 | SENIOR HOUSING | CA | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| HOLLADAY PARK PLAZA | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 930513697 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| ROGUE VALLEY MANOR FOUNDATION INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 930712867 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | ROGUE VALLEY MANOR | |
| UNIVERSITY RETIREMENT COMMUNITY FOUNDATION INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 931301816 | PUBLIC FOUNDATION | CA | 501(C)(3) | LINE 7 | 0 | UNIVERSITY RETIREMENT COMMUNITY AT DAVIS | |
| HOLLADAY PARK PLAZA FOUNDATION INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 264529118 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | HOLLADAY PARK PLAZA | |
| MIRABELLA WASHINGTON FOUNDATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 450574348 | PUBLIC FOUNDATION | WA | 501(C)(3) | LINE 7 | 0 | MIRABELLA | |
| CASCADE MANOR FOUNDATION INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 931330100 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | CASCADE MANOR INC | |
| CAPITOL LAKES FOUNDATION INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 383781089 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | Yes (1) | CAPITOL LAKES INC | |
| MIRABELLA | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 342030255 | SENIOR HOUSING | WA | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIRABELLA PORTLAND FOUNDATION INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 452508860 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | MIRABELLA AT SOUTH WATERFRONT | |
| MIRABELLA AT SOUTH WATERFRONT | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 711016384 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| COMMUNITY VOLUNTEER NETWORK | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 930892261 | COMMUNITY SERVICES | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 930864466 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM ASHLAND HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 930942933 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM GRANTS PASS HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943136037 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM ROSEBURG HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943179782 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM MYRTLE CREEK HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943162074 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM BEND HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943163349 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM EAGLE POINT HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943191447 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM KLAMATH FALLS HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943196455 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM MEDFORD II HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943212537 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM LIVELY OAKS HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943194409 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM REEDSPORT HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943212538 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM YREKA HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943212540 | SENIOR HOUSING | CA | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM EUGENE HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943247154 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM FORT WORTH I HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311520436 | SENIOR HOUSING | TX | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM BEND II HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 943260016 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM FORT WORTH II HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311587415 | SENIOR HOUSING | TX | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM MEDFORD III HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311587418 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM ROSEBURG II HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311587420 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM GRANTS PASS II HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311662259 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM DAVIS HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311662208 | SENIOR HOUSING | CA | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM MYRTLE CREEK II HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311715321 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM PORTLAND HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 311780332 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM PORTLAND II HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 300037898 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM CENTRAL POINT HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 300315618 | SENIOR HOUSING | OR | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM MANSFIELD HOUSING CORPORATION | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 900292647 | SENIOR HOUSING | TX | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIDDLETON GLEN INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 911859494 | SENIOR HOUSING | WI | 501(C)(3) | LINE 10 | Yes (1) | CAPITOL LAKES INC | |
| SENIOR HOUSING OF MIDDLETON INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 470825736 | SENIOR HOUSING | WI | 501(C)(3) | LINE 10 | Yes (1) | CAPITOL LAKES INC | |
| MIRABELLA AT ASU INC | |||||||||||
| 1 WEST MAIN ST SUITE 303 | MEDFORD | OR | 97501 | 813784956 | SENIOR HOUSING | AZ | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| BAY AREA SENIOR SERVICES INC | |||||||||||
| 1 BALDWIN AVE | SAN MATEO | CA | 94401 | 943008774 | SENIOR HOUSING | CA | 501(C)(3) | LINE 10 | 0 | PACIFIC RETIREMENT SERVICES INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CREST PARK INC | |||||||||
| 1 WEST MAIN SUITE 303 | MEDFORD | OR | 97501 | 931169683 | REAL ESTATE | OR | N/A | C | 0 |
| PRS MANAGEMENT | |||||||||
| 1 WEST MAIN SUITE 303 | MEDFORD | OR | 97501 | 931328250 | MANAGEMENT COMPANY | OR | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPITOL LAKES FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $66,000 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |