2025-10-23T15:51:37-05:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2024-01-01 910573114 FOSS HOME & VILLAGE FOSS 2537527112 1301 N HIGHLANDS PARKWAY TACOMA WA 98406 R KEVIN MCFEELY PRESIDENT/CEO 2537527112 2025-10-17 1 1 KURT BENNION CPA P01469618 4252506100 2025-10-14 2024 2025-03-06 01:10:19Z X R KEVIN MCFEELY 1301 N HIGHLANDS PARKWAY TACOMA WA 98406 28267151 0 X N/A X 1929 WA NURSING HOME AND ASSISTED LIVING FACILITY. 6 6 329 65 0 0 1708346 293823 22956414 24515291 2691021 3387466 29241 10669 27385022 28207249 0 0 0 0 16462903 18162590 0 0 166410 10778755 12766879 27241658 30929469 143364 -2722220 11477442 9028327 5329520 5570591 6147922 3457736 X NURSING HOME AND ASSISTED LIVING FACILITY. 0 1 23865645 0 24515291 SINCE 1929 FOSS HOME AND VILLAGE PROVIDED CARE FOR THE COMMUNITY IN A NURSING HOME AND ASSISTED LIVING SETTING. FOSS SERVES A POPULATION WITH A SUBSTANTIAL NUMBER OF MEDICAID AND MEDICARE SUPPORTED RESIDENTS AND PATIENTS, WITH 70% OF ITS SERVICE REVENUE FROM MEDICAID/MEDICARE. IN ADDITION TO PROVIDING CARE, FOSS STRIVES TO BE ACTIVE IN THE COMMUNITY BY PARTNERING WITH THE UNIVERSITY OF WASHINGTON, SHORELINE COMMUNITY COLLEGE AND OTHER COLLEGES AND UNIVERSITIES. FOSS PROVIDES A LEARNING ENVIRONMENT FOR INTERNSHIPS BASED IN THE FIELDS OF DENTISTRY, PHARMACY, RESTORATIVE THERAPY, NURSING, AND NURSING ASSISTANT TRAINING. FOSS ALSO HAS AN ACTIVE VOLUNTEER PROGRAM THAT ENCOURAGES HIGH SCHOOL AND COLLEGE STUDENTS. (CONTINUED ON SCHEDULE O)IN 2024, FOSS SERVED 499 NURSING HOME CLIENTS AND 39 ASSISTED LIVING CLIENTS, WITH THE AVERAGE LENGTH OF STAY FOR SHORT-STAY RESIDENTS, DEFINED BY THOSE WHO STAYED 100 DAYS OR LESS, OF APPROXIMATELY 22 DAYS. RATES ARE SET BASED ON THE MARKET IN THE SEATTLE AREA, WHICH ARE NECESSARY TO MAKE THE ORGANIZATION VIABLE. 23865645 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 28 0 1 329 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 X R KEVIN MCFEELY 2537527112 1301 NORTH HIGHLANDS PARKWAY TACOMA WA 98406 R KEVIN MCFEELY PRESIDENT/CEO 22.50 27.50 X 0 520729 46503 DAVID HOFFMAN VICE PRESIDENT OF FINANCE 22.50 27.50 X 0 371240 31580 BANAFSHEH BAHARLOO RN NURSE 40.00 0.00 X 262037 0 12218 AYENEW AEMERO LPN NURSE 40.00 0.00 X 210299 0 10318 SOLOMON G-KIDANE LPN NURSE 40.00 0.00 X 204923 0 10318 LAURA MOLZAHN ADMINISTRATOR 40.00 0.00 X 171601 0 29385 GEBRU TEZERA LPN NURSE 40.00 0.00 X 187760 0 12517 EVELYNE ONYANGO NURSE 40.00 0.00 X 176867 0 10318 JEFFREY WEST RN CHAIR 0.50 2.00 X X 0 0 0 JULIE YARI VICE CHAIR 0.50 2.00 X X 0 0 0 KRISTEN CHICK SECRETARY 0.50 2.00 X X 0 0 0 BRIAN BRUCE BOARD MEMBER 0.50 0.00 X 0 0 0 KRIS JOHANSSEN BOARD MEMBER 0.50 0.00 X 0 0 0 BEVERLY ROACH BOARD MEMBER 0.50 2.00 X 0 0 0 1213487 891969 163157 42 0 1 0 CONSONUS REHAB 4560 SE INTERNATIONAL WAY SUITE 10 MILWAUKIE OR 97222 THERAPY SERVICES 929154 A KIND HEART INC 23005 76TH AVENUE W EDMONDS WA 98026 STAFFING AGENCY 764435 STURDY MEDICAL STAFFING LLC PO BOX 64885 UNIVERSITY PLACE WA 98464 STAFFING AGENCY 365075 OTTERSENS PHARMACEUTICAL PO BOX 33026 SEATTLE WA 98133 PHARMACY SERVICES 360597 4 293823 293823 RESIDENT FEES 623000 24515291 24515291 24515291 269 269 53660 55376 -1716 -1716 -1716 3387197 0 3387197 3387197 3387197 16075 4526 11549 11549 MISCELLANEOUS INCOME 900099 836 836 836 28207249 24515291 0 3398135 200986 200986 15427599 11891240 3453729 82630 198713 151478 46182 1053 796477 629553 162549 4375 1538815 1173036 357628 8151 113287 113287 16875 16875 2991118 2343943 641436 5739 47457 47105 352 480283 255914 162702 61667 111794 89435 22359 697983 434721 263262 1782 1782 123849 123849 3296903 3132057 164846 509882 407906 101976 MEDICAL SUPPLIES 1540122 1539794 328 0 BAD DEBT 971292 971292 0 0 FOOD 839403 839403 0 0 ALLOCATED EXPENSES 590872 0 590872 0 433977 5873 425661 2443 30929469 23865645 6897414 166410 -1130820 617277 3698119 2905071 346027 -785 94431 40398 23013800 17557684 8459435 5456116 4514 4514 5736 5736 11477442 9028327 2497489 2782631 137431 155260 5736 5736 2688864 2626964 5329520 5570591 X 6147922 3419526 0 38210 6147922 3457736 11477442 9028327 -2722220 32034 0 X 0 0 0 X 1660130 5766978 294489 1708346 293823 9723766 16588783 14477342 17502492 22956414 24515291 96040322 19589 13866 15435 17308 16075 82273 18268502 20258186 17812416 24682068 24825189 105846361 1923 1923 0 1923 1923 105844438 363425 370622 281682 201650 53929 1271308 363425 370622 281682 201650 53929 1271308 210695 131610 74571 332 836 418044 18842622 20760418 18168669 24884050 24879954 107535713 0.98430 0.97940 0.01180 0.01440 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 1 563 563 0 PART II-B, LINE 1: FOSS HOME AND VILLAGE IS A MEMBER OF LEADINGAGE WASHINGTON AND LEADINGAGE NATIONAL. BOTH ORGANIZATIONS USE A PORTION OF MEMBERSHIP DUES TO CONDUCT LOBBYING ACTIVITIES FOR THEIR MEMBERS. 0 1 X 2304775 2304775 12124765 9486400 2638365 1338894 1184909 153985 7245366 6886375 358991 5456116 PART IV, LINE 2B: THE ORGANIZATION HOLDS TRUST ACCOUNTS FOR RESIDENTS WHO REQUEST THAT WE DO SO AND FOR ANY RESIDENTS OF WHICH THE ORGANIZATION IS REPRESENTATIVE PAYEE FOR SOCIAL SECURITY PURPOSES. THE MONEY IS HELD IN AN INTEREST-BEARING CHECKING ACCOUNT. RESIDENTS CAN OBTAIN THEIR MONEY UPON REQUEST. THE ORGANIZATION HOLDS SECURITY DEPOSITS FOR ASSISTED LIVING RESIDENTS AND OTHER RENTAL TENANTS. SECURITY DEPOSITS ARE HELD IN NON-INTEREST BEARING ACCOUNTS. SECURITY DEPOSITS ARE RETURNED TO TENANTS WHEN THE LEASE IS TERMINATED, LESS ANY AMOUNTS FOR DAMAGES. 0 0 0 0 0 0 0 0 0 R KEVIN MCFEELY PRESIDENT/CEO 0 520729 0 0 0 0 0 0 0 46503 0 567232 0 0 DAVID HOFFMAN VICE PRESIDENT OF FINANCE 0 371240 0 0 0 0 0 0 0 31580 0 402820 0 0 BANAFSHEH BAHARLOO RN NURSE 262037 0 0 0 0 0 0 0 12218 0 274255 0 0 0 AYENEW AEMERO LPN NURSE 210299 0 0 0 0 0 0 0 10318 0 220617 0 0 0 SOLOMON G-KIDANE LPN NURSE 204923 0 0 0 0 0 0 0 10318 0 215241 0 0 0 LAURA MOLZAHN ADMINISTRATOR 171601 0 0 0 0 0 0 0 29385 0 200986 0 0 0 GEBRU TEZERA LPN NURSE 187760 0 0 0 0 0 0 0 12517 0 200277 0 0 0 EVELYNE ONYANGO NURSE 176867 0 0 0 0 0 0 0 10318 0 187185 0 0 0 PART I, LINE 3 THE PRESIDENT/CEO'S COMPENSATION IS SET BY THE BOARD OF DIRECTORS OF FUTURA AGE, A RELATED ORGANIZATION. FUTURA AGE USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE PRESIDENT/CEO: 1. COMPENSATION COMMITTEE 2. FORM 990 OF OTHER ORGANIZATIONS 3. COMPENSATION SURVEY OR STUDY 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART III, LINE 3 ON JANUARY 1, 2025, THE ORGANIZATION'S ASSETS AND OPERATIONS WERE SOLD AND THE ENTITY BECAME DORMANT. THE FACILITY WAS REBRANDED BY THE NEW OWNER AS "THE BROADVIEW CENTER", CONTINUING ITS SERVICES TO ITS RESIDENTS AND THE COMMUNITY. FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE BOARD. IT HAS GENERAL MANAGEMENT OVER THE FACILITIES OF FOSS, SUBJECT TO INSTRUCTIONS OF THE BOARD, AND HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS BETWEEN REGULAR BOARD MEETINGS SUBJECT TO ANY LIMITATIONS PLACED ON IT BY THE BOARD. IT FORMULATES POLICIES FOR THE ORGANIZATION'S INTERNAL MANAGEMENT SUBJECT TO APPROVAL BY THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 FUTURA AGE IS THE SOLE MEMBER OF FOSS HOME & VILLAGE. FORM 990, PART VI, SECTION A, LINE 7A FUTURA AGE, HAS THE RIGHT TO APPROVE THE NOMINATION, ELECTION AND REMOVAL OF ALL MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B FUTURA AGE, HAS THE FOLLOWING RIGHTS AS THE SOLE MEMBER: A. APPROVAL OF THE ANNUAL CAPITAL AND OPERATING BUDGETS; B. SELECTION, EMPLOYMENT AND TERMINATION OF THE CHIEF EXECUTIVE OFFICER; C. APPROVAL OF ANY SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS OUTSIDE OF THE NORMAL COURSE OF BUSINESS, OR ANY ACQUISITION OF, OR MERGER OR CONSOLIDATION; D. APPROVAL OF ANY AMENDMENT OR MODIFICATION TO THE ARTICLES OF INCORPORATION OR BYLAWS; E. APPROVAL OF THE ORGANIZATION'S PROPOSED VOLUNTARY DISSOLUTION, LIQUIDATION OR WINDING-UP; F. APPROVAL OF THE DECLARATION OF ANY EVENT OF BANKRUPTCY, INSOLVENCY OR OTHER APPLICATION FOR JUDICIAL RELIEF FROM CREDITORS; G. APPROVAL OF ANY ACTION THAT MIGHT JEOPARDIZE THE ORGANIZATION'S TAX-EXEMPT STATUS; AND H. APPROVAL OF THE CREATION OF AND ORGANIZATIONAL DOCUMENTS (AND AMENDMENTS THERETO) FOR ANY SUBSIDIARY OR AFFILIATED ENTITY, JOINT VENTURE, AFFILIATION OR SIMILAR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, A DRAFT OF THE FORM 990 WAS REVIEWED BY THE PRESIDENT/CEO OF FUTURA AGE, THEN SUBMITTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED AT THE BOARD MEETING, AND MEMBERS ARE REQUIRED TO COMPLETE AND SIGN THE FORM FOR PROPER DISCLOSURE. MEMBERS ARE DIRECTED TO NOTIFY THE BOARD DURING THE YEAR IF A CONFLICT OF INTEREST DEVELOPS. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS OF FUTURA AGE, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FUTURA AGE 1301 N HIGHLANDS PARKWAY TACOMA WA 98406 882748740 MANAGEMENT SERVICES WA 501(C)(3) LINE 12C, III-FI N/A 0 ELISEO 1301 N HIGHLANDS PARKWAY TACOMA WA 98406 910963214 LIFE PLAN COMMUNITY WA 501(C)(3) LINE 10 FUTURA AGE 0 ELISEO FOUNDATION 1301 N HIGHLANDS PARKWAY TACOMA WA 98406 943031579 FUNDRAISING WA 501(C)(3) LINE 12A, I ELISEO 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0