2017-01-16T00:00:00-06:00 2016-02-29 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2015-03-01 941485533 Channing House CHAN 6503270950 850 Webster Street Palo Alto CA 94301 RHONDA BEKKEDAHL DIR. FINANCE 6503270950 2017-01-17 1 P00159653 4159561500 2017-01-15 2015 2021-01-29 14:40:06Z MELVIN MATSUMOTO 850 Webster Street Palo Alto CA 94301 49029195 0 X www.channinghouse.org X 1961 CA PROVIDES HOUSING AND HEALTH CARE SERVICES WITHIN A LIFE CARE COMMUNITY. 15 15 103 70 0 0 195099 483399 15415224 16260240 316472 775052 67373 44760 15994168 17563451 32982 9971 0 0 5228347 5629383 247 0 26933 9131785 13287425 14393361 18926779 1600807 -1363328 121902045 124985168 92132846 98438324 29769199 26546844 The mission of Channing House is to provide a continuing care residential community that enhances each resident's independence, well being, needed care, and security. 0 0 15840673 9971 16260240 Provide housing, assisted living and skilled nursing services which include food services, housekeeping, and nursing care. During FY2016 we served an average of 230 residents with a total of 6,175 service days of skilled nursing; 7,848 service days of assisted living; and 62,354 days of residential care services. Channing House is a neighborhood polling location, hosts various community meetings including educational sessions on End of Life planning (ELIPSIS program), and partners in emergency preparedness programs. We provide the use of our swimming pool to a local not-for-profit that serves developmentally disabled children. Our community also tutors children from disadvantaged neighborhoods, and supports many other organizations with thousands of hours of volunteer time. 15840673 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 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 35 0 1 103 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X RHONDA BEKKEDAHL 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 David Thornton Chairman 8.00 X X 0 0 0 Marlene Prendergast Vice Chairman 8.00 X X 0 0 0 Jean McCown Secretary 8.00 X X 0 0 0 John Schniedwind Treasurer 8.00 X X 0 0 0 Raymond Bacchetti Board Member 4.00 X 0 0 0 John Boggs MD Board Member 4.00 X 0 0 0 HELENE BUTLER Board Member 4.00 X 0 0 0 Andy Coe Board Member 4.00 X 0 0 0 Michael Couch Board Member 4.00 X 0 0 0 Dexter Dawes Board Member 4.00 X 0 0 0 David Golden board Member 4.00 X 0 0 0 Robert Harrington Board Member 4.00 X 0 0 0 Gloria Hom Board Member 4.00 X 0 0 0 Pat Irish Board Member 4.00 X 0 0 0 Ed Miller Board Member 4.00 X 0 0 0 Stephen Reller Thru 12016 Board Member 4.00 X 0 0 0 Melvin Matsumoto Executive Director 40.00 X 256152 0 26390 ARACELI ANTONIO Director of Health Services 40.00 X 136627 0 24378 Julia Jones Administrator 40.00 X 146035 0 27888 Rhonda Bekkedahl Director of Finance/IT 40.00 X 137743 0 14207 Joy Nava Registered Nurse 40.00 X 112907 0 12868 789464 0 105731 6 0 1 0 Vance Brown Inc 3197 Park Blvd Palo Alto CA 94306 Construction Contractors 3203608 Nibbi Brothers Associates 180 Hubbell St San Francisco CA 94107 Construction Contractors 633241 Provinet Solutions 18601 N Creek Drive Tinley Park IL 60477 IT Consultant 115560 Hardison Komatsu Ivelich & Tucker 538 Ninth St 240 oakland CA 94607 Architect 106628 8 483399 483399 MONTHLY CARE FEES 623000 10933655 10933655 RESIDENT ENTRANCE Fees 623000 5039941 5039941 SPECIAL SERVICES 623000 268144 268144 PROCESSING FEES 623000 18500 18500 16260240 562254 562254 4793 4793 44760 0 44760 44760 44760 28416186 3199032 28079508 3327705 336678 -128673 208005 208005 58531 58531 0 17563451 16260240 0 819812 X 9971 9971 285958 259025 26933 3720965 2925898 795067 319218 218722 100496 953497 651105 302392 349745 275557 74188 748689 748689 69283 69283 2881882 2743707 138175 43488 6790 36698 371225 131430 239795 144496 72248 72248 937794 889271 48523 27733 11784 15949 30324 11194 19130 3494328 3494328 3395047 3395047 456239 316724 139515 maint./housekeeping 432703 432703 amortization of debt 156585 156585 Medical expenses 97609 97609 18926779 15840673 3059173 26933 426596 3412354 830425 975214 55080 12555 119504 0 2625 2625 225055 234332 117535708 27672649 81627631 89863059 35098778 27116647 39891 29150 3476460 3339232 121902045 124985168 3046408 4860620 27058079 32073962 61152481 60491837 830425 975214 45453 36691 92132846 98438324 X 28892137 25525484 877062 1021360 29769199 26546844 121902045 124985168 X -1363328 -1462944 -396083 X 0 1 X 1 0 X 727269 280832 72368 195099 483399 1758967 15566131 13604814 14243171 15415224 16260240 75089580 22759 22914 22235 20126 58531 146565 16316159 13908560 14337774 15630449 16802170 76995112 5000 2500 10000 17500 3528792 3499758 3121718 3117776 4753499 18021543 3533792 3499758 3121718 3120276 4763499 18039043 58956069 1271142 1304110 629754 578776 611807 4395589 1271142 1304110 629754 578776 611807 4395589 17587301 15212670 14967528 16209225 17413977 81390701 0.72440 0.72860 0.05400 0.05840 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 1000 0 0 1 1000 0 0 2000 0 Part II-B, Line 1: Letters to legislators and/or their staffs regarding legislation related to long-term care, licensing agencies, and other related topics. 1 830425 221306 76517 975214 1 X 1167420 375040 136079 33429 1645110 1061075 66793 64450 24898 1167420 974059 75004 21661 9649 1061075 138437 832847 2775 974059 133000 175 5262 138437 1.00000 0 0 937969 937969 102430067 25585374 76844693 2645435 2087275 558160 11522237 11522237 89863059 LIABILITY FOR GIFT ANNUITIES 36691 36691 X 15833097 -1462944 -396083 -1859027 17692124 -128673 -128673 17563451 19055452 128673 128673 18926779 0 18926779 Part IV, Line 1b: The organization holds an escrow account for 10% entrance fee deposits for certain residents who are reserving apartments. Part IV, Line 2b: Escrow funds which were established pursuant to the trust agreement executed in connection with the issuance of the Series 2010 Revenue Bonds. Part V, Line 4: Enhance the well-being of residents. Provide on-going support for the charitable needs of residents. Part X, Line 2: CHANNING HOUSE HAS BEEN GRANTED TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. CHANNING HOUSE ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION ("ASC") 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON MARCH 1, 2008. THEY HAD NO UNRECOGNIZED TAX BENEFITS WHICH WOULD REQUIRE AN ADJUSTMENT TO THE MARCH 1, 2015 BEGINNING BALANCE OF NET ASSETS AND HAD NO UNRECOGNIZED TAX BENEFITS AT FEBRUARY 28, 2016. CHANNING HOUSE FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2007 FOR ITS FEDERAL AND 2006 FOR ITS STATE TAX FILINGS. Part XI, Line 2d - Other Adjustments: Change in minimum pension liablity -394,104. change in value split interest agreements -1,979. Part XI, Line 4b - Other Adjustments: Reclassification of loss on disposition of assets to Statement of Revenue -128,673. Part XII, Line 2d - Other Adjustments: reclassification of loss on disposal of assets to Statement of revenue 128,673. 1 RESIDENT ASSISTANCE 1 9471 EDUCATIONAL Scholarship 1 500 Part I, Line 2: Residence Assistance: If a resident becomes unable to afford his/her monthly care fees, he/she may request financial assistance from Channing House. The resident completes an application for assistance and meets with the Administrator to review his/her financial resources. The Administrator and Executive Director review and approve any applications for assistance. Educational Scholarship: Employees who wish to continue their education may apply for scholarship funding. The employee completes an application for scholarship. That application is reviewed by the employee's manager and the HR manager. It is then presented to the executive director for approval. X X 0 0 0 0 0 0 0 0 0 Melvin Matsumoto Executive Director 256152 0 0 0 0 0 25783 0 607 0 282542 0 0 0 ARACELI ANTONIO Director of Health Services 136627 0 0 0 0 0 14334 0 10044 0 161005 0 0 0 Julia Jones Administrator 146035 0 0 0 0 0 15613 0 12275 0 173923 0 0 0 Rhonda Bekkedahl Director of Finance/IT 137743 0 0 0 0 0 13796 0 411 0 151950 0 0 0 A ABAG Finance Authority For Nonprofit Corporations Insured Revenue Bonds 941485533 0037CQP80 2010-07-08 64066348 New Health Center Construction & remodel 14 units in existing building 1 0 0 A 17471427 64066348 4202629 4564881 1031002 3782180 32564043 7439440 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 Form 990, Part VI, Section B, line 11 The Audit committee reviews a draft of IRS Form 990 on behalf of the Board of Trustees prior to filing with the IRS. The draft as reviewed by the Audit committee is made available to all members of the Board of Trustees. Process includes recording who conducted the review, when it was conducted and the extent (detail or summary) the form was reviewed. Form 990, Part VI, Section B, line 12c ANNUALLY, POLICY IS REVIEWED WITH BOARD MEMBERS AND KEY STAFF MEMBERS. Form 990, Part VI, Section B, line 15 The Personnel Committee (a Board Committee comprised of 3 Trustees) is responsible for the performance appraisal of the Executive Director. The performance appraisal is normally on an annual basis, with the period under review based on the Executive Director's date of hire. The Committee in its evaluation may solicit input from other Trustees, residents and staff of Channing House. The salary and benefits of the Executive Director are also reviewed on an annual basis. The Personnel Committee submits any recommended changes to the Executive Director's salary/benefits to the Board of Trustees for approval. Such recommendation will be submitted for review and approval to the Board at the regularly scheduled meeting prior to the Executive Director's hire date anniversary. Any action taken by the Board on Personnel Committee recommendations will be recorded in the Board minutes. Compensation adjustments for the Executive Director will be established in conjunction with a review of compensation studies available from both national and statewide sources, as well as other sources as available (such as from a consultant). The Executive Director is responsible for annual evaluations and implementing any salary adjustments for the Administrator, Director of Finance & IT, Marketing Director & Facilities Director. The Administrator conducts the annual reviews for the Director of Health Services and the Director of Environmental Services. Compensation adjustments for key Management Staff are based on budgeted amounts available, as well as statewide compensation studies. Form 990, Part VI, Section C, line 19 Audited financial statements are posted in the resident library; attached to new resident contracts; and available on request from the business office. All Board minutes and changes to bylaws are posted in the Channing House resident library. Copies of meeting minutes are available for a prior three year period. Conflict of interest policy is available on request from the business office. Form 990, Part IX, line 11g FOOD SERVICES: Program service expenses 2,645,422. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,645,422. MEDICAL SERVICES: Program service expenses 90,391. Management and general expenses 363. Fundraising expenses 0. Total expenses 90,754. ADMINISTRATIVE: Program service expenses 7,894. Management and general expenses 137,812. Fundraising expenses 0. Total expenses 145,706. Form 990, Part XI, line 9: CHANGE IN VALUE OF CHARITABLE GIFT ANNUITIES -1,979. CHANGE IN MINIMUM PENSION LIABILITY -394,104.