2016-02-15T00:00:00-06:00 2015-09-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2014-10-01 930557803 CASCADE MANOR INC CASC 8887246424 65 WEST 30TH AVE EUGENE OR 974059931 BRIAN YOUNG EXECUTIVE DIRECTOR 8887246424 2016-02-15 1 TRACY S PAGLIA P00366884 2099556100 2016-02-15 2014 2016-08-17 19:52:53Z BILL VAN VACTOR 1 WEST MAIN SUITE 303 MEDFORD OR 97501 8605148 0 X WWW.RETIREMENT.ORG X 1967 OR CASCADE MANOR INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. 7 7 160 4 0 0 118423 245370 7504136 7696531 156068 140319 63884 65495 7842511 8147715 0 0 0 0 3650891 4016865 0 0 0 5548989 5830791 9199880 9847656 -1357369 -1699941 32558485 43199537 44436498 57171066 -11878013 -13971529 CASCADE MANOR INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. 0 0 7633977 0 7696531 CASCADE MANOR 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. 7633977 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 34 0 1 160 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 OR X SHERI LOYA 5418577644 1 WEST MAIN SUITE 303 MEDFORD OR 97501 X X BILL VAN VACTOR CHAIR 1.00 2.00 X X 0 0 0 JAMON KENT VICE CHAIR 1.00 X X 0 0 0 DON HIRST SECRETARY 1.00 X X 0 0 0 LAURIE BULLARD TREASURER 1.00 X X 0 0 0 JOAN LOOMIS DIRECTOR 1.00 X 0 0 0 DIANE SCHECHTER DIRECTOR 1.00 X 0 0 0 HUGH JOHNSTON RESIDENT DIRECTOR 1.00 1.00 X 0 0 0 MARTHA TIECH DIRECTOR (THRU 12/14) 1.00 1.00 X 0 0 0 BARB ALBERTY DIRECTOR (THRU 05/15) 1.00 X 0 0 0 BRIAN YOUNG EXECUTIVE DIRECTOR 40.00 X 175524 0 37371 175524 0 37371 1 0 1 0 PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 MANAGEMENT SERVICES 920007 ANKROM MOISAN ASSOC ARCHITECTS 6720 SW MACADAM SUITE 100 PORTLAND OR 97219 ARCHITECT 420174 LEE CONSTRUCTION COMPANY P O BOX 10367 EUGENE OR 97440 CONSTRUCTION 354084 CHAMBERS CONSTRUCTION 3028 JUDKINS RD 1 EUGENE OR 97403 CONSTRUCTION 315415 CONSONUS REHAB PO BOX 4800 UNIT 12 PORTLAND OR 97208 THERAPY SERVICES 208451 6 232210 13160 245370 SERVICE FEES 623000 4623415 4623415 HEALTH CENTER REVENUE 623000 2133950 2133950 ENTRANCE FEES 623000 668139 668139 HOME CARE/PRIVATE DUTY 623000 73559 73559 LEVEL OF CARE 623000 67739 67739 129729 129729 7696531 196720 196720 439 439 65495 0 65495 65495 65495 400593 457433 -56840 -56840 -56840 8147715 7696531 0 205814 225556 225556 2861541 2432562 428979 36109 27453 8656 692052 583778 108274 201607 165560 36047 531601 531601 3958 3958 57028 57028 7233 7233 326510 256584 69926 147962 2684 145278 216822 149421 67401 79940 79940 889218 889218 52301 13847 38454 21105 8411 12694 333640 333640 2010301 2010301 81839 81839 BOND FEES WRITE-OFF EXP 331500 331500 DIETARY EXPENSE 321922 321922 HEALTH CENTER EXPENSE 252061 252061 FACILITY SERVICE EXPENS 165850 104696 61154 9847656 7633977 2213679 0 3592390 2969074 519906 825082 441350 418167 36815 34264 187854 111963 50054789 18404987 21593534 31649802 5126121 5833895 1060515 1357290 32558485 43199537 995909 2995011 3312739 3222100 16244922 26674134 23882928 24279821 44436498 57171066 X -12603398 -14715573 725385 744044 -11878013 -13971529 32558485 43199537 X -1699941 -194185 -199390 X 0 1 X 1 0 X 88218 123068 118423 245370 575079 7384982 7900822 7773321 7504136 7696531 38259792 7384982 7989040 7896389 7622559 7941901 38834871 136647 94274 90728 122382 94269 538300 253652 274198 111929 322032 79452 1041263 390299 368472 202657 444414 173721 1579563 37255308 201355 242153 240347 205363 262654 1151872 201355 242153 240347 205363 262654 1151872 7586337 8231193 8136736 7827922 8204555 39986743 0.93170 0.92540 0.02880 0.02700 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9847656 9847656 642383 160596 0 0 558859 576433 609994 642383 2387669 3581504 139715 144108 152499 160596 596918 895377 1645217 1645217 33997570 16906464 17091106 2001526 1498523 503003 12410476 12410476 31649802 REFUNDABLE ENTRANCE FEES 1653931 DUE TO AFFILIATES 55645 ASSET RETIREMENT OBLIGATION 112265 ENTRANCE FEES REFUNDABLE UPON REOCCUPANCY 22457980 24279821 X PART X, LINE 2: THE CORPORATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT MORE LIKELY THAN NOT THAT THE TAX POSITION 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, 2015 AND 2014, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. 0 0 0 0 0 0 0 1 0 BRIAN YOUNG EXECUTIVE DIRECTOR 152875 0 22649 0 0 0 23576 0 13795 0 212895 0 0 0 PART I, LINE 3 COMPENSATION WAS RECOMMENDED BY PACIFIC RETIREMENT SERVICES, INC. AND APPROVED BY CASCADE MANOR, INC. BOARD AS PART OF THE ANNUAL BUDGET PROCESS. 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. A HOSPITAL FACILITIES AUTHORITY OF THE CITY OF MEDFORD OREGON 521378932 2014-10-15 33776237 SEE PART VI 0 0 0 A 33776252 56131 614835 10357420 15580000 7167866 1 0 0 1 A 0 1 1 1 0 0.00400 0.00000 0.00400 0 0 1 A 0 1 1 0 1 0 0 0 1 A 1 DIFFERENCE BETWEEN PART I, COLUMN E AND PART II, LINE 3: DIFFERENCE BETWEEN ISSUE PRICE IN PART I A(E), AND TOTAL PROCEEDS OF ISSUE IN PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART I, LINE A(F) PROCEEDS FROM THE BONDS WERE ISSUED AS A DRAW DOWN LOAN TO CURRENTLY REFUND THE ISSUER'S SERIES 2010 REFUNDING REVENUE BONDS, ISSUED ON 12/30/2010, FINANCE AND REIMBURSE CAPITAL COSTS, AND PAY COSTS OF ISSUANCE. SCHEDULE K, PART III, LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K, PART IV, LINE 2B THE REFUNDING PORTION OF THE BONDS HAS SATISFIED THE 6-MONTH EXPENDITURE EXCEPTION TO REBATE. FORM 990, PART VI, SECTION A, LINE 3 CASCADE MANOR, INC. DELEGATES MANAGEMENT TO PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE REVISED TO AMEND ARTICLE IV SECTION 2 TO REVISE THE NUMBER OF DIRECTORS ON THE BOARD FROM 9 - 15 TO 3 - 9. FORM 990, PART VI, SECTION A, LINE 6 CASCADE MANOR, INC. HAS ONE MEMBER, PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A PACIFIC RETIREMENT SERVICES, INC. HAS THE AUTHORITY TO ELECT ALL DIRECTORS FROM NOMINEES SELECTED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE BOARD ARE SUBJECT TO APPROVAL BY PACIFIC RETIREMENT SERVICES, INC., AS OUTLINED IN ARTICLE III OF THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS CURRENTLY BEING REVIEWED BY THE CFO, ASSISTANT CONTROLLER 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 ED'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 BRIAN YOUNG IS A LEASED EMPLOYEE OF PACIFIC RETIREMENT SERVICES, INC. AND PERFORMS SERVICES ON BEHALF OF CASCADE MANOR, INC. PURSUANT TO A MANAGEMENT SERVICES AGREEMENT BETWEEN CASCADE MANOR, INC. AND PACIFIC RETIREMENT SERVICES, INC. UNDER THE MANAGEMENT SERVICES AGREEMENT, HIS COMPENSATION IS REIMBURSED BY CASCADE MANOR, INC. HIS COMPENSATION IS REPORTED IN PART VII SECTION A IN ORDER TO HIGHLIGHT AMOUNTS PAID BY CASCADE MANOR, INC., NOTWITHSTANDING THAT HE IS A LEASED EMPLOYEE OF PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -62,220. CHANGE IN INTEREST IN NET ASSETS OF CASCADE MANOR FOUNDATION, INC. -137,170. PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931067253 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 11C, III-FI N/A 0 PACIFIC RETIREMENT SERVICES FOUNDATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 472352652 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 ROGUE VALLEY MANOR 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930453216 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 THE CUMBERLAND REST INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 750891470 SENIOR HOUSING TX 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931179254 SENIOR HOUSING CA 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930513697 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 CAPITOL LAKES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 391412320 SENIOR HOUSING WI 501(C)(3) LINE 9 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