2015-02-16T15:25:08-06:00 2014-09-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192303 990 2013-10-01 930513697 HOLLADAY PARK PLAZA HOLL 8887246424 1300 NE 16TH AVE PORTLAND OR 972321467 GEORGE WHEELER EXECUTIVE DIRECTOR 8887246424 2015-02-16 1 TRACY S PAGLIA P00366884 2099556100 2013 2016-02-25 16:41:14Z DONNA MUEHLECK 1 WEST MAIN SUITE 303 MEDFORD OR 97501 20274347 0 X WWW.RETIREMENT.ORG X 1967 OR TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. 9 9 292 180 0 0 202894 125192 14481484 15525867 450662 530818 92709 106147 15227749 16288024 0 0 0 0 6092617 6344315 0 0 0 7961499 8380190 14054116 14724505 1173633 1563519 46396869 57457964 31920738 41304316 14476131 16153648 X THE MISSION OF HOLLADAY PARK PLAZA IS TO CREATE AND MAINTAIN A NON-PROFIT RETIREMENT COMMUNITY WHERE THE LIVES OF RESIDENTS ARE CONTINUALLY ENRICHED.AWARE OF THE EVER CHANGING NEEDS OF RETIREES, WE ENCOURAGE AN ACTIVE LIFESTYLE AND SPIRITUAL AND SOCIAL OPPORTUNITIES. WE ARE COMMITTED TO EXCELLENCE IN OUR INDUSTRY THROUGH THE WORK OF EXPERIENCED AND EDUCATED STAFF AND DIRECTORS, ENHANCED BY RESIDENT INVOLVEMENT.WE HONOR OUR CHRISTIAN HERITAGE AND WELCOME THE DIVERSE RELIGIOUS TRADITIONS OF OUR RESIDENTS BY MAINTAINING A POSITIVE OUTLOOK, EMBRACING NEW IDEAS TO PROVIDE PROGRAMS AND SERVICES WHICH SUPPORT OUR VISION. WE ARE DEDICATED TO PROVIDING HIGH QUALITY SERVICES INCLUDING HOUSING, NUTRITIOUS MEALS, NURSING, MAINTENANCE, AND OTHER SUPPORT TO THOSE WE SERVE. WE ARE COMMITTED TO BEING GOOD FINANCIAL STEWARDS, PROVIDING SUPPORT AND SPONSORSHIP FOR RESIDENTS WHEN APPROPRIATE, WHILE KEEPING COSTS COMMENSURATE WITH SERVICES PROVIDED. 0 0 12138188 15525867 HOLLADAY PARK PLAZA 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. 12138188 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 1 0 0 1 49 0 1 292 1 0 0 0 0 0 0 0 0 0 0 X 9 9 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 DONNA MUEHLECK CHAIR 1.00 2.00 X X 0 0 0 STEPHEN SCHNEIDER VICE CHAIR 1.00 1.00 X X 0 0 0 INGRID BRYDOLF SECRETARY 1.00 1.00 X X 0 0 0 CHRISTOPHER TIFF WOOD TREASURER 1.00 4.00 X X 0 0 0 NANCY JOHNS DIRECTOR 1.00 1.00 X 0 0 0 MARIAN HODGES DIRECTOR 1.00 1.00 X 0 0 0 JOE OPSAHL DIRECTOR 1.00 1.00 X 0 0 0 STEVEN THOMSON DIRECTOR 1.00 1.00 X 0 0 0 KERRY TYMCHUK DIRECTOR 1.00 1.00 X 0 0 0 GEORGE WHEELER EXECUTIVE DIRECTOR 40.00 X 148367 0 32248 148367 0 32248 1 0 1 0 PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 MANAGEMENT SERVICES & DEVELOPMENT FEES 1322752 CONSONUS REHAB PO BOX 4800 UNIT 12 PORTLAND OR 97208 THERAPY SERVICES 859492 TURNER CONSTRUCTION COMPANY 1200 NW NAITO PARKWAY SUITE 300 PORTLAND OR 97209 CONSTRUCTION 462753 ANKROM MOISAN ACCOC ARCHITECTS 6720 SW MACADAM SUITE 100 PORTLAND OR 97219 CONSTRUCTION 213069 GENERAL BUILDERS SUPPLY INC 510 STRANDER BLVD TUKWILA WA 98188 CONSTRUCTION 203192 9 125192 125192 SERVICE FEES 623000 6520222 6520222 HEALTH SERVICE REVENUE 623000 5735977 5735977 ENTRANCE FEES 623000 2483765 2483765 DIETARY 623000 152301 152301 LEVEL OF CARE SVCS 623000 132328 132328 501274 501274 15525867 323820 323820 42 42 126426 20279 106147 106147 106147 4173000 3966044 206956 206956 206956 16288024 15525867 0 636965 4867392 4189971 677421 196108 151826 44282 916798 738154 178644 364017 315847 48170 986502 986502 308 308 55422 55422 30797 30797 241521 148709 92812 67427 1328 66099 360215 316697 43518 77642 77642 1518564 1494869 23695 51516 6672 44844 12347 7151 5196 238325 238325 2176688 2176688 145675 66298 79377 HEALTH CENTER EXPENSE 1302173 1302173 DIETARY EXPENSE 805861 805861 FACILITY SERVICE EXPENS 229789 120356 109433 ASSET DISPOSAL 57263 57263 22155 22155 14724505 12138188 2586317 0 2004306 3646157 3402951 324962 716310 741967 58173 63079 139667 145528 61443755 21937932 27953717 39505823 11393038 11994053 728707 1036395 46396869 57457964 1120369 1823834 16193387 15978659 13875000 22547796 731982 954027 31920738 41304316 X 14302569 15956131 41642 64778 131920 132739 14476131 16153648 46396869 57457964 X 1563519 90044 23954 X 0 1 X 1 0 X 3276 10000 206541 202894 125192 547903 13349343 13527850 13255954 14481484 15525867 70140498 13352619 13537850 13462495 14684378 15651059 70688401 56048 110175 97961 264184 7912 12525 101614 72174 194225 7912 12525 157662 182349 97961 458409 70229992 349444 402147 417883 381262 450288 2001024 349444 402147 417883 381262 450288 2001024 13702063 13939997 13880378 15065640 16101347 72689425 0.96620 0.96610 0.02750 0.02610 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14724505 14724505 886225 221556 0 0 773556 815240 852706 886225 3327727 4991591 193389 203810 213177 221556 831932 1247898 2944799 2944799 38612666 17980489 20632177 5974919 3957443 2017476 13911371 13911371 39505823 REFUNDABLE DEPOSITS 719657 DUE TO AFFILIATES 131626 OTHER NONCURRENT LIABILITIES 102744 954027 X PART X, LINE 2: THE CORPORATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS 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 SETTLEMENT. THE CORPORATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2014 AND 2013, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. 0 0 0 0 0 0 0 0 0 GEORGE WHEELER EXECUTIVE DIRECTOR 148367 0 0 0 0 0 16692 0 15556 0 180615 0 0 0 PART I, LINE 3 COMPENSATION WAS RECOMMENDED BY PACIFIC RETIREMENT SERVICES, INC. AND APPROVED BY HOLLADAY PARK PLAZA BOARD AS PART OF THE ANNUAL BUDGET PROCESS. A HOSPITAL FACILITIES AUTHORITY OF MULTNOMAH COUNTY OREGON 931266280 2010-12-23 14445540 REFUND ISSUER'S SERIES 2003 BONDS 0 0 0 B HOSPITAL FACILITIES AUTHORITY OF MULTNOMAH COUNTY OREGON 931266280 2013-10-31 14067310 EXPANSION TO RETIREMENT COMMUNITY & VARIOUS RENOVATIONS TO EXISTING BUILDING 0 0 0 A 905000 14445540 280485 14165055 1 0 1 1 B 14067345 29006 281346 8637851 5119142 0 0 0 1 A 0 1 1 1 0 0.00300 0.00000 0.00300 0 0 1 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 PART I(F) THE SERIES 2003 BONDS WERE ISSUED ON DECEMBER 4, 2003. PART II, LINE 3 DIFFERENCE BETWEEN PART I(E) AND PART II, LINE 3 IS DUE TO INTEREST EARNINGS ON BOND PROCEEDS. 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. PART IV, LINE 2(C) THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION TO REBATE. NO REBATE CALCULATION HAS BEEN OR WILL BE EVER MADE, BEFORE OR AFTER THE DUE DATE OF AN 8038-T. FORM 990, PART VI, SECTION A, LINE 3 HOLLADAY PARK PLAZA DELEGATES MANAGEMENT TO PACIFIC RETIREMENT SERVICES. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE REVISED TO AMEND SECTIONS 3.2.2 AND 3.2.3 TO ESTABLISH THE THRESHOLD FOR CONTRACTS REQUIRING APPROVAL BY PRS OF $100,000. FORM 990, PART VI, SECTION A, LINE 6 HOLLADAY PARK PLAZA HAS ONE MEMBER, PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A PACIFIC RETIREMENT SERVICES, INC. HAS THE AUTHORITY TO ELECT THE ORGANIZATION'S DIRECTORS WHICH ARE NOMINATED BY THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE BOARD ARE SUBJECT TO APPROVAL BY PACIFIC RETIREMENT SERVICES, AS OUTLINED IN ARTICLE III, SECTION 3.2 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 GEORGE WHEELER IS A LEASED EMPLOYEE OF PACIFIC RETIREMENT SERVICES, INC. AND PERFORMS SERVICES ON BEHALF OF HOLLADAY PARK PLAZA PURSUANT TO A MANAGEMENT SERVICES AGREEMENT BETWEEN HOLLADAY PARK PLAZA AND PACIFIC RETIREMENT SERVICES, INC. UNDER THE MANAGEMENT SERVICES AGREEMENT, HIS COMPENSATION IS REIMBURSED BY HOLLADAY PARK PLAZA. HIS COMPENSATION IS REPORTED IN PART VII SECTION A IN ORDER TO HIGHLIGHT AMOUNTS PAID BY HOLLADAY PARK PLAZA, NOTWITHSTANDING THAT HE IS A LEASED EMPLOYEE OF PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN HOLLADAY PARK PLAZA FOUNDATION 23,954. PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 931067253 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 11C, III-FI N/A 0 ROGUE VALLEY MANOR 1 WEST MAIN 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 SUITE 303 MEDFORD OR 97501 750891470 SENIOR HOUSING TX 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 CASCADE MANOR INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 930557803 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 1 WEST MAIN SUITE 303 MEDFORD OR 97501 931179254 SENIOR HOUSING CA 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA ENDOWMENT FUND 1 WEST MAIN SUITE 303 MEDFORD OR 97501 930776291 ASSISTANCE TRUST OR 501(C)(3) LINE 7 HOLLADAY PARK PLAZA 1 CAPITOL LAKES INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 391412320 SENIOR HOUSING WI 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 MIRABELLA 1 WEST MAIN SUITE 303 MEDFORD OR 97501 342030255 SENIOR HOUSING WA 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 MIRABELLA AT SOUTH WATERFRONT 1 WEST MAIN SUITE 303 MEDFORD OR 97501 711016384 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 COMMUNITY VOLUNTEER NETWORK 1 WEST MAIN SUITE 303 MEDFORD OR 97501 930892261 COMM SRVCS OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM EAGLE POINT HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943191447 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM KLAMATH FALLS HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943196455 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM MEDFORD II HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943212537 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM LIVELY OAKS HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943194409 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM REEDSPORT HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943212538 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM YREKA HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943212540 SENIOR HOUSING CA 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM EUGENE HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943247154 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM BEND II HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 943260016 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM MANSFIELD HOUSING CORPORATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 900292647 SENIOR HOUSING TX 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 PACIFIC RETIREMENT SERVICES FOUNDATION INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 472352652 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA FOUNDATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 264529118 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 HOLLADAY PARK PLAZA 1 CREST PARK 1 WEST MAIN SUITE 303 MEDFORD OR 97501 931169683 HOTEL OR N/A C 0 PRS MANAGEMENT INC 1 WEST MAIN SUITE 303 MEDFORD OR 97501 931328250 MANAGEMENT COMPANY OR N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 HOLLADAY PARK PLAZA ENDOWMENT Q 125192 CASH