2020-11-05T13:10:18-06:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2019-01-01 910506306 WASHINGTON CARE SERVICES WASH 2067252800 2821 SOUTH WALDEN STREET SEATTLE WA 98144 DANIEL J FALLON GOVERNOR 2067252800 2020-11-04 1 KURT BENNION CPA P01469618 4252506100 2020-11-04 67.137.57.251 2020-11-04 10:56:19 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2EFE7395B36462363DC3F040B8FE6F147F29F868 2019 2021-01-29 14:40:06Z DANIEL J FALLON 2821 SOUTH WALDEN STREET SEATTLE WA 98144 12815896 0 X WWW.WACENTER.ORG X 2004 WA TO MEET THE AGING & HEALTHCARE- RELATED NEEDS OF OUR MULTI-CULTURAL COMMUNITY WITH DIGNITY & RESPECT 1 1 215 22 0 0 16975 22218 13832514 12793223 365 0 18995 455 13868849 12815896 0 0 0 0 8630362 8586533 0 0 0 6042428 6303092 14672790 14889625 -803941 -2073729 4497601 4251818 3942229 5770175 555372 -1518357 WASHINGTON CARE SERVICES EXISTS TO MEET THE AGING AND HEALTHCARE-RELATED NEEDS OF OUR MULTI-CULTURAL COMMUNITY WITH DIGNITY AND RESPECT - WITHOUT REGARD TO ECONOMIC CIRCUMSTANCES. 0 0 13020552 0 12717286 WASHINGTON CARE SERVICES IS LICENSED TO SERVE 165 RESIDENTS BY PROVIDING COMPREHENSIVE LONG-TERM CARE AND SHORT-TERM REHABILITATION SERVICES BY SKILLED AND PROFESSIONAL STAFF. DURING 2019, WASHINGTON CARE SERVICES PROVIDED 47,648 BED DAYS OF SKILLED NURSING SERVICES INCLUDING PHARMACY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND PHYSICAL THERAPY. 13020552 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 32 0 215 1 0 0 0 0 0 0 0 0 0 0 0 0 X 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X ENGELMANN ACCOUNTING SERVICES LLC 2538567761 5715 MASTERS LANE SE E204 LACEY WA 98513 ORETIS MOORE MDS COORDINATOR & INTERIM DNS 40.00 0.00 X 133796 0 14844 CASH CARLOS CEO & ADMINISTRATOR (THRU AUG 2019) 50.00 1.00 X 116889 0 15158 EUGENIO DACAYANAN LPN & CHRONIC CARE MANAGER 40.00 0.00 X 108850 0 11411 WALE FOLARIN LPN & CHRONIC CARE MANAGER 40.00 0.00 X 112344 0 5785 BINIAM A GEBREMEDHIN LPN & CHRONIC CARE MANAGER 40.00 0.00 X 106900 0 7990 MARSHA SMITH LPN & CHRONIC CARE MANAGER 40.00 0.00 X 109035 0 3120 ESTHER DENSMORE ADMINISTRATOR 40.00 0.00 X 22084 0 217 SHEILA HOLMES PRESIDENT (THROUGH JULY 2019) 1.00 1.00 X X 0 0 0 FRANK KLINGBEIL VICE-PRESIDENT (THROUGH JULY 2019) 1.00 1.00 X X 0 0 0 DAPHNE SCHNEIDER SECRETARY (THROUGH JULY 2019) 1.00 1.00 X X 0 0 0 GLENN GREGORY TREASURER (THROUGH JULY 2019) 1.00 1.00 X X 0 0 0 KENNY CHAN DIRECTOR (THROUGH JULY 2019) 1.00 1.00 X 0 0 0 GINNY KENYON DIRECTOR (THROUGH JULY 2019) 1.00 1.00 X 0 0 0 DAN FALLON GOVERNOR 8.00 8.00 X X 0 0 0 709898 0 58525 8 0 0 0 HEALTHCARE SERVICES GROUP INC PO BOX 829677 PHILADELPHIA PA 19182 STAFFING SERVICES 554409 INFINITY REHAB 25117 SW PARKWAY SUITE D WILSONVILLE OR 97070 THERAPY SERVICES 535349 MCCALLEN & SONS INC 9133 112TH AVE NE KIRKLAND WA 98033 RECEIVERSHIP 195000 SYMMETRY HEALTHCARE MANAGEMENT LLC 33115 FINN SETTLEMENT RD ARLINGTON WA 98223 MANAGEMENT SERVICES 124597 4 22218 22218 NURSING FACILITY 623000 12605317 12605317 CAPITATION REVENUE 623000 187906 187906 12793223 MISCELLANEOUS INCOME 900099 455 455 455 12815896 12793223 0 455 X 132047 132047 7383522 6851903 531619 54430 45890 8540 310512 274572 35940 706022 653720 52302 319957 319957 20000 20000 52752 52752 2031963 1689650 342313 9283 9283 182067 94376 87691 1451303 1430830 20473 125283 125283 179922 112674 67248 145064 116537 28527 MEDICAL SUPPLIES 772033 772033 DIETARY SUPPLIES 392150 392150 BAD DEBTS 389820 389820 DUES & LICENSES 128629 107102 21527 102866 89295 13571 14889625 13020552 1869073 0 657425 377749 1359643 1290319 137844 104397 1843761 1099861 532918 743900 1787394 1720146 22377 15307 4497601 4251818 2621197 3555875 16797 15307 333680 303265 970555 970555 0 925173 3942229 5770175 X 555372 -1518357 555372 -1518357 4497601 4251818 -2073729 0 X 0 0 0 X 1587 12966 16975 22218 53746 13468640 13147754 13860716 13767787 12717286 66962183 13470227 13147754 13873682 13784762 12739504 67015929 0 0 0 67015929 219 365 584 219 365 584 152207 101490 83722 76392 413811 13470227 13299961 13975391 13868849 12815896 67430324 0.99390 0.99390 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER RESIDENT SERVICES MISCELLANEOUS INCOME FUNDRAISING EVENTS RAFFLES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 678031 150236 527795 1165730 949625 216105 743900 DUE TO RELATED ORGANIZATION 925173 925173 PART IV, LINE 2B: THE ORGANIZATION HOLDS RESIDENT FUNDS IN TRUST IN A SEPARATE INTEREST-BEARING BANK ACCOUNT. TO ACCESS THEIR FUNDS, RESIDENTS MAKE A REQUEST AT THE FRONT DESK. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT DUTIES TO MCCALLEN & SONS, INC., A COURT-APPOINTED RECEIVER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE COURT-APPOINTED RECEIVER PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO THE BOARD MEMBERS AND OFFICERS. ALL POTENTIAL CONFLICTS OF INTEREST ARE COMMUNICATED WITH THE BOARD OF DIRECTORS. BY MAJORITY VOTE, THE BOARD DETERMINES WHETHER A CONFLICT EXISTS AND, IF A CONFLICT EXISTS, THE APPROPRIATE RESPONSE. UPON JOINING THE ORGANIZATION AND EACH YEAR THEREAFTER, THE BOARD MEMBERS AND OFFICERS COMPLETE CONFLICT OF INTEREST STATEMENTS THAT ARE COLLECTED AND MAINTAINED BY THE CEO & ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR & CEO'S COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. COMPARABILITY DATA IS USED AND THE PROCESS AND OUTCOME ARE DOCUMENTED. THE PROCESS LAST OCCURRED IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASE SERVICES - CORPORATION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 342,313. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 342,313. PURCHASE SERVICES - DIRECT CARE: PROGRAM SERVICE EXPENSES 128,716. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 128,716. PURCHASE SERVICES - SUPPLEMENTARY: PROGRAM SERVICE EXPENSES 738,846. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 738,846. PURCHASE SERVICES - REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 57,765. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,765. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 764,323. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 764,323. SOUTHEAST CARE CENTER FACILITIES 5224 WILSON AVENUE S SUITE 102 SEATTLE WA 98118 912143943 PROVIDE HEALTH CARE FACILITIES TO A DISADVANTAGED COMMUNITY WA 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0