2017-05-15T17:52:19-05:00 2016-06-30 910189318 MOSS ADAMS LLP 805 SW BROADWAY STE 1200 PORTLAND OR 97205 990 2015-07-01 930386852 ROBISON JEWISH HOME ROBI 5035354300 6125 SW BOUNDARY STREET PORTLAND OR 97221 BOBBIE JENKINS CFO 5035354300 2017-05-15 1 WENDY CAMPOS P00448102 5032421447 2017-05-15 2015 2021-01-29 14:40:06Z CEDAR SINAI PARK SANDRA SIMON 6125 SW BOUNDARY STREET PORTLAND OR 97221 26899669 0 X WWW.CSPARK.COM X 1920 OR TO PROVIDE RESIDENTIAL AND COMMUNITY-BASED CARE TO OUR ELDERS AND INFIRM WITH SERVICES THAT ALLOW THEM TO LIVE WITH COMFORT, INDEPENDENCE AND DIGNITY IN A MANNER AND IN AN ENVIRONMENT BASED ON JEWISH VALUES. 18 18 377 120 0 0 4881615 9870244 17502562 16763733 34187 44940 147708 177938 22566072 26856855 160099 474853 0 0 12695346 12075558 0 0 121159 7108073 6285898 19963518 18836309 2602554 8020546 34821411 50626687 9487726 8281780 25333685 42344907 TO PROVIDE RESIDENTIAL AND COMMUNITY-BASED CARE TO OUR ELDERS AND INFIRM WITH SERVICES THAT ALLOW THEM TO LIVE WITH COMFORT, INDEPENDENCE AND DIGNITY IN A MANNER AND IN AN ENVIRONMENT BASED ON JEWISH VALUES. 0 0 15743877 474853 16980165 PROVIDING A HIGH LEVEL OF NURSING CARE AND HOUSING TO PRIVATE, MEDICARE, AND WELFARE RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY. 15743877 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 48 0 1 377 1 0 0 0 0 0 0 0 0 0 0 X 18 18 1 0 0 0 1 1 0 1 1 0 0 0 1 1 0 1 0 0 0 0 OR X BOBBIE JENKINS CFO 5035354300 6125 SW BOUNDARY STREET PORTLAND OR 97221 LANCE STEINBERG PRESIDENT 2.00 X X 0 0 0 LIZ LIPPOFF PRESIDENT ELECT 2.00 X X 0 0 0 PAUL FRISCH IMMEDIATE PAST PRESIDENT 2.00 X X 0 0 0 ELSIE BRICKNER-SCHULZ FOUNDATION PRESIDENT 2.00 X X 0 0 0 IVAN GOLD VP OF PROGRAMS 2.00 X X 0 0 0 ANDREW ROSENGARTEN VP OF FINANCE 2.00 X X 0 0 0 SUSIE MARCUS SECRETARY 2.00 X X 0 0 0 RACHEL DUKE TRUSTEE 1.00 X 0 0 0 ALIX ROSENBAUM DYKE TRUSTEE 1.00 X 0 0 0 MICHAEL FEVES TRUSTEE 1.00 X 0 0 0 MICHAEL MILLENDER TRUSTEE 1.00 X 0 0 0 JEFF REINGOLD TRUSTEE 1.00 X 0 0 0 MYLEN SHENKER TRUSTEE 1.00 X 0 0 0 EDDY SHULDMAN TRUSTEE 1.00 X 0 0 0 LES SOLTESZ TRUSTEE 1.00 X 0 0 0 BEVERLY STEIN TRUSTEE 1.00 X 0 0 0 SHARON WEIL TRUSTEE 1.00 X 0 0 0 JIM WINKLER TRUSTEE 1.00 X 0 0 0 SANDRA SIMON CEO/COO AS OF 10/15/15 37.30 2.70 X 275443 0 14963 DAVID FUKS CEO UNTIL 9/15/15 40.00 X 207618 0 23513 BOBBIE JENKINS CFO 40.00 X 166309 0 0 DAVID KOHNSTAMM RSM ADMINISTRATOR 40.00 X 100428 0 15823 749798 0 54299 4 0 1 0 CONSONUS REHAB PO BOX 4800 UNIT 12 PORTLAND OR 97208 PHYSICAL AND SPEECH THERAPY 447578 REHAB SPECIALISTS 4560 SE INTERNATIONAL WAY 100 MILWAUKIE OR 97222 NURSE CONSULTING 165600 AEROTEK PROFESSIONAL SERVICES 3689 COLLECTION CTR DR CHICAGO IL 60693 TEMPORARY LABOR 148573 3 199890 468014 9202340 9870244 RESIDENT SERVICES 623000 16705607 16705607 DEVELOPER FEES 623000 58126 58126 16763733 44940 44940 4320 199890 42814 -38494 -38494 OTHER INCOME 623000 216432 216432 216432 26856855 16980165 0 6446 474853 474853 589619 589619 8784116 7808055 976061 26962 18313 8649 1838702 1624421 214281 836159 707440 128719 125993 33490 92503 64506 878 63628 62491 62491 104430 88387 16043 637758 637758 93342 15291 78051 262888 262888 1057676 972674 85002 116944 93389 23555 OTHER EXPENSES 1737182 1034254 581769 121159 FOOD COSTS 1082815 1082815 MEDICARE BED TAX 608292 608292 SUPPLIES 331581 280679 50902 18836309 15743877 2971273 121159 9227923 7454594 2373073 494782 2560562 2214459 911402 2253736 1267240 9097436 61580 44368 85959 491847 46535670 18997975 17400413 27537695 647770 1037770 285489 0 34821411 50626687 1201306 2438040 6511719 5247917 105439 3736 1669262 592087 9487726 8281780 X 17023402 36417211 8310283 5927696 25333685 42344907 34821411 50626687 8020546 -72676 9063352 0 X 0 1 X 1 0 X 1865143 2998039 2445999 4881615 9870244 22061040 16047205 17518442 18067135 17502562 16763733 85899077 17912348 20516481 20513134 22384177 26633977 107960117 360067 351222 355929 443492 379127 1889837 0 360067 351222 355929 443492 379127 1889837 106070280 103724 170245 138686 34187 44940 491782 103724 170245 138686 34187 44940 491782 151409 216432 367841 18016072 20686726 20651820 22569773 26895349 108819740 0.97470 0.97550 0.00450 0.00540 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 151,409. 2015 AMOUNT: $ 216,432. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 2325994 2325994 27389342 16328932 11060410 3417814 2529963 887851 13402520 139080 13263440 27537695 INTERCOMPANY PAYABLE 506576 DEPOSITS 85511 592087 X PART IV, LINE 2B: FUNDS HELD IN TRUST FOR RESIDENTS. PART X, LINE 2: INCOME TAXES CSP, THE FOUNDATION, KEHILLAH, JFCS AND SHC ARE TAXEXEMPT ORGANIZATIONS PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND APPLICABLE STATE LAWS. O'BRIEN, INC. IS A TAX EXEMPT ORGANIZATION PURSUANT TO IRC SECTION 501(C)(2) AND APPLICABLE STATE LAWS. HWS, CLAY TOWER, CSP-1200 AND CSP-PARK LEXINGTON ARE LIMITED LIABILITY COMPANIES, SO ALL TAXABLE INCOME/LOSS FLOWS THROUGH TO THE MEMBERS' TAX RETURNS. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS, IF ANY, 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 SETTLEMENTS. THE CORPORATION RECOGNIZES INTEREST ACCRUED AND PENALTIES RELATED TO TAX MATTERS IN ADMINISTRATIVE EXPENSES. THE CORPORATION HAD NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2016. NO INTEREST AND PENALTIES WERE ACCRUED FOR THE YEAR ENDED JUNE 30, 2016. THE CORPORATION FILES AN EXEMPT ORGANIZATION RETURN AND UNRELATED BUSINESS INCOME TAX RETURN IN THE U.S. FEDERAL JURISDICTION AND A CORPORATE TAX RETURN IN OREGON. ANNUAL BENEFIT 204210 199890 4320 500 23951 11403 6960 204210 199890 4320 500 23951 11403 6960 42814 -38494 1 HOUSING WITH SERVICES LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 465768550 N/A 75000 TO PROVIDE HEALTH AND WELLNESS SERVICES TO LOW INCOME SENIORS CEDAR SINAI PARK FOUNDATION 6125 SW BOUNDARY STREET PORTLAND OR 97221 043774565 501(C)(3) 399853 FORGIVENESS OF DEBT 1 1 PART I, LINE 2: RESTRICTED FUNDS ARE PLACED INTO ACCOUNTS AND MONITORED TO ENSURE THE MONIES ARE USED PER DONOR INTENT. OUR STAFF AND ADMINISTRATORS DETERMINE WHICH RESIDENTS ARE LOW INCOME AND QUALIFY FOR ASSISTANCE. ONCE DETERMINATION IS MADE, ASSISTANCE IS MADE AVAILABLE. X X X 0 0 0 0 0 0 0 0 0 SANDRA SIMON CEO/COO AS OF 10/15/15 275443 0 0 0 0 0 345 0 14618 0 290406 0 0 0 DAVID FUKS CEO UNTIL 9/15/15 207618 0 0 0 0 0 2035 0 21478 0 231131 0 0 0 BOBBIE JENKINS CFO 166309 0 0 0 0 0 0 0 0 0 166309 0 0 0 A HOSPITAL FACILITY AUTHORITY 930847114 179027VH7 2005-12-16 9218214 CONSTRUCTION OF ASSISTED LIVING FACILITY 0 0 0 B OREGON FACILITIES AUTHORITY 930847114 179027VH7 2016-06-28 20000000 CONSTRUCTION OF ASSISTED LIVING FACILITY 0 0 0 A 9218214 9218214 9034150 184364 2005 0 1 1 1 B 6314169 6314169 2016 0 1 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 2 ALBERT, JOANNE & JACK MENASHE HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 ANY PERSON MAY BECOME A MEMBER OF THE ROBISON JEWISH HOME BY PAYING THE DUES SET BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION WILL ELECT APPROXIMATELY ONE THIRD OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS PREPARED BY AN INDEPENDENT CPA AND IS REVIEWED WITH THE FINANCE COMMITTEE PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CLAY TOWER GP LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 020536507 TO OPERATE APARTMENT COMPLEX OR 0 749040 ROBISON JEWISH HOME CSP-1200 GP LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 454612993 TO ACQUIRE & REHABILITATE PROPERTY OR 0 100 ROBISON JEWISH HOME CSP-PARK LEXINGTON GP LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 260526202 TO ACQUIRE & REHABILITATE PROPERTY OR 0 100 ROBISON JEWISH HOME SINAI FAMILY HOME SERVICES INC 7412 SW BEAVERTON-HILLSDALE HWY 106 PORTLAND OR 97225 208504069 HOME CARE SERVICES OR 501(C)(3) LINE 11A, I ROBISON JEWISH HOME 1 CEDAR SINAI PARK FOUNDATION 6125 SW BOUNDARY STREET PORTLAND OR 97221 043774565 SUPPORTING ROBISON JEWISH HOME OR 501(C)(3) LINE 11A, I ROBISON JEWISH HOME 1 CSP KEHILLAH HOUSING 6125 SW BOUNDARY STREET PORTLAND OR 97221 454839314 AFFORDABLE HOUSING TO DISABLED ADULTS OR 501(C)(3) LINE 7 ROBISON JEWISH HOME 1 JEWISH FAMILY AND CHILD SERVICE 1221 SW YAMHILL STREET 301 PORTLAND OR 97205 930386851 SOCIAL SERVICES OR 501(C)(3) LINE 7 ROBISON JEWISH HOME 1 CEDAR SINAI PARK-CLAY TOWER APTS 6125 SW BOUNDARY STREET PORTLAND OR 97221 260536507 LOW INCOMING HOUSING OR CLAY TOWER GP LLC RELATED -53 907487 0 1 0.00010 CSP-1200 LIMITED PARTNERSHIP 6125 SW BOUNDARY STREET PORTLAND OR 97221 320371089 LOW INCOMING HOUSING OR CSP-1200 GP LLC RELATED -36 1164303 0 1 0.00010 CSP-PARK LEXINGTON LTD PARTNERSHIP 6125 SW BOUNDARY STREET PORTLAND OR 97221 900881617 LOW INCOMING HOUSING OR CSP-PARK LEXINGTON GP LLC RELATED -21 7086631 0 1 0.00010 HOUSING WITH SERVICES LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 465768550 SOCIAL SERVICES OR ROBISON JEWISH HOME RELATED -50186 140209 0 1 0.51000 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 HOUSING WITH SERVICES LLC B 75000 FAIR MARKET VALUE CEDAR SINAI PARK FOUNDATION B 399853 FAIR MARKET VALUE CEDAR SINAI PARK FOUNDATION C 468014 FAIR MARKET VALUE CSP KEHILLAH HOUSING E 501309 FAIR MARKET VALUE SINAI FAMILY HOME SERVICES INC D 78268 FAIR MARKET VALUE