2015-02-13T15:20:41-06:00 2014-09-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192303 990 2013-10-01 930557803 CASCADE MANOR INC CASC 8887246424 65 WEST 30TH AVE EUGENE OR 974059931 BRIAN YOUNG EXECUTIVE DIRECTOR 8887246424 2015-02-12 1 TRACY S PAGLIA P00366884 2099556100 2013 2016-02-25 16:41:14Z BILL VAN VACTOR 1 WEST MAIN SUITE 303 MEDFORD OR 97501 10646151 0 X WWW.RETIREMENT.ORG X 1967 OR CASCADE MANOR INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. 8 8 148 6 0 0 123068 118423 7773321 7504136 331220 156068 84588 63884 8312197 7842511 0 0 0 0 3435025 3650891 0 0 0 5093635 5548989 8528660 9199880 -216463 -1357369 30818758 32558485 33727257 44436498 -2908499 -11878013 CASCADE MANOR INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. 0 0 7373324 7504136 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. 7373324 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 29 0 1 148 1 0 0 0 0 0 0 0 0 0 0 X 8 8 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 ROBERT BURKE PAST CHAIR (THRU 02/14) 1.00 X X 0 0 0 JAMON KENT VICE CHAIR 1.00 X X 0 0 0 MARTHA TIECH DIRECTOR 1.00 1.00 X 0 0 0 BILL VAN VACTOR CHAIR 1.00 3.00 X X 0 0 0 DON HIRST SECRETARY 1.00 X X 0 0 0 JOAN LOOMIS DIRECTOR 1.00 X 0 0 0 LAURIE BULLARD TREASURER 1.00 X X 0 0 0 BARB ALBERTY DIRECTOR 1.00 X 0 0 0 DIANE SCHECHTER DIRECTOR 1.00 X 0 0 0 BRIAN YOUNG EXECUTIVE DIRECTOR 40.00 X 155862 0 31585 155862 0 31585 1 0 1 0 LEE CONSTRUCTION COMPANY P O BOX 10367 EUGENE OR 97440 CONSTRUCTION 866127 PACIFIC RETIREMENT SERVICES 1 WEST MAIN SUITE 303 MEDFORD OR 97501 MANAGEMENT SERVICES 509322 ANKROM MOISAN ASSOC ARCHITECTS 6720 SW MACADAM SUITE 100 PORTLAND OR 97219 ARCHITECT 119480 CONSONUS REHAB PO BOX 4800 UNIT 12 PORTLAND OR 97208 THERAPY SERVICES 113184 4 118423 118423 SERVICE FEES 623000 4601830 4601830 HEALTH CENTER REVENUE 623000 2064412 2064412 ENTRANCE FEES 623000 533630 533630 HOME CARE/PRIVATE DUTY 623000 102113 102113 LEVEL OF CARE 623000 74367 74367 127784 127784 7504136 133047 133047 72316 8432 63884 63884 63884 2818229 2795208 23021 23021 23021 7842511 7504136 0 219952 201458 201458 2667976 2291509 376467 36624 21094 15530 579315 502848 76467 165518 137252 28266 593166 593166 12278 12278 55422 55422 5573 5573 274259 208078 66181 160554 6955 153599 188719 135640 53079 56272 56272 787046 787046 32116 8987 23129 16441 3037 13404 568446 568446 1952497 1952497 77759 40268 37491 DIETARY EXPENSE 321656 321656 HEALTH CENTER EXPENSE 246545 246545 FACILITY SERVICE EXPENS 158538 108165 50373 ASSET DISPOSAL 33301 33301 8401 8401 9199880 7373324 1826556 0 1771034 3592390 524779 519906 262894 441350 49542 36815 181834 187854 38134819 16541285 21791532 21593534 4898996 5126121 1338147 1060515 30818758 32558485 1971932 995909 14738829 3312739 16020000 16244922 996496 23882928 33727257 44436498 X -3357273 -12603398 448774 725385 -2908499 -11878013 30818758 32558485 X -1357369 71757 -7683902 X 0 1 X 1 0 X 47452 88218 123068 118423 377161 7029226 7384982 7900822 7773321 7504136 37592487 7076678 7384982 7989040 7896389 7622559 37969648 161592 136647 94274 90728 122382 605623 287573 253652 274198 111929 322032 1249384 449165 390299 368472 202657 444414 1855007 36114641 165158 201355 242153 240347 205363 1054376 165158 201355 242153 240347 205363 1054376 7241836 7586337 8231193 8136736 7827922 39024024 0.92540 0.92700 0.02700 0.02540 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 9199880 9199880 609994 152499 0 0 549980 558859 576433 609994 2295266 3442899 137495 139715 144108 152499 573817 860726 1645217 1645217 33770712 15211486 18559226 1800519 1329799 470720 918371 918371 21593534 REFUNDABLE ENTRANCE FEES 1424311 DUE TO AFFILIATES 105128 ASSET RETIREMENT OBLIGATION 119745 INTEREST RATE SWAP AGREEMENT 196964 ENTRANCE FEES REFUNDABLE UPON REOCCUPANCY 22036780 23882928 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, 2014 AND 2013, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. 0 0 0 0 0 0 0 0 0 BRIAN YOUNG EXECUTIVE DIRECTOR 138098 0 17764 0 0 0 15759 0 15826 0 187447 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. A HOSPITAL FACILITIES AUTHORITY OF THE CITY OF MEDFORD OREGON 521378932 584283EJ0 2010-12-30 16822838 REFUND ISSUER'S SERIES 2006 VARIABLE RATE DEMAND REVENUE BONDS 0 0 0 A 1195000 16822838 16822838 2010 1 0 1 1 A 0 1 1 1 0 0.00600 0.00000 0.00600 0 0 1 A 0 0 1 0 1 1 WELLS FARGO BANK NA 4.920000000000 0 0 0 0 1 A 1 SCHEDULE K, PART I, LINE A(F) THE BONDS REFUND THE ISSUER'S SERIES 2006 VARIABLE RATE DEMAND REVENUE BONDS, ISSUED ON 07/13/06. 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 2C THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION TO REBATE. NO REBATE CALCULATION HAS BEEN OR WILL EVER BE MADE, BEFORE OR AFTER THE DUE DATE OF AN 8038-T. 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 (1) AUTHORIZE THE INCLUSION OF ONE RESIDENT TO THE BOARD OF DIRECTORS AS SET FORTH IN ARTICLE IV SECTION 3(B); (2) AMEND ARTICLE III SECTION 2(C) AND DELETE ARTICLE IV SECTION 3(B) REGARDING THE REQUIREMENT FOR DIRECTORS FROM SPECIFIED CHURCHES; (3) AMEND THE DUTIES OF THE SECRETARY AND TREASURER AS SET FORTH IN ARTICLE V SECTIONS 3 AND 4; AND (4) AMEND ARTICLE III SECTION 2(J) TO ESTABLISH THE THRESHOLD FOR CONTRACTS REQUIRING APPROVAL BY PRS OF $100,000. THE ARTICLES WERE REVISED TO BE CONSISTENT WITH THE REVISED BYLAWS AND DELETE ARTICLE IV SECTION 3(B) REGARDING THE REQUIREMENT FOR DIRECTORS FROM SPECIFIED CHURCHES. 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, 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 167,996. CHANGE IN INTEREST IN NET ASSETS OF CASCADE MANOR FOUNDATION, INC. -253,679. ADOPTION OF ASU 2012-01 FOR REFUNDABLE ADVANCE FEES -7,598,219. 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 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 1 WEST MAIN 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 SUITE 303 MEDFORD OR 97501 391412320 SENIOR HOUSING WI 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 CASCADE MANOR FOUNDATION 1 WEST MAIN SUITE 303 MEDFORD OR 97501 931330100 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 CASCADE MANOR INC 1 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 CREST PARK INC 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 MGMT COMPANY OR N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 CASCADE MANOR FOUNDATION INC C 118423 CASH