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FOSS HOME & VILLIAGE: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
FOSS HOME & VILLIAGE (EIN 91-0573114)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-09-10
IRS object ID
201412539349300816
Schema version
2013v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2014-09-10T10:57:39-05:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13000 NORTHUP WAY SUITE 200AddressLine1
CityBELLEVUECity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN910573114EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FOSS HOME & VILLAGEBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlFOSSBusinessNameControlTxt
Phone2063641300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line113023 GREENWOOD AVE NAddressLine1
CitySEATTLECity
StateWAState
ZIP Code981337397ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID CROUCHPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone2063641300PhoneNum
Signature2014-09-03SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSTEVEN BASS CPAPreparerPersonNm
PTINP00004800PTIN
Phone4252506100PhoneNum
Preparation2014-08-22PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID CROUCHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line113023 GREENWOOD AVE NAddressLine1
CitySEATTLECity
StateWAState
ZIP Code981337397ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$19,073,837GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FOSSCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1929FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionNURSING HOME & ASSISTED LIVING FACILITYActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee369TotalEmployeeCnt
Total Volunteers155TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$276,129PYContributionsGrantsAmt
CY Contributions Grants$268,034CYContributionsGrantsAmt
PY Program Service Revenue$19,036,746PYProgramServiceRevenueAmt
CY Program Service Revenue$18,680,194CYProgramServiceRevenueAmt
PY Investment Income$80,861PYInvestmentIncomeAmt
CY Investment Income$54,009CYInvestmentIncomeAmt
PY Other Revenue$855PYOtherRevenueAmt
CY Other Revenue$7,447CYOtherRevenueAmt
PY Total Revenue$19,394,591PYTotalRevenueAmt
CY Total Revenue$19,009,684CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,901,811PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,055,923CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$150,061CYTotalFundraisingExpenseAmt
PY Other Expenses$5,356,522PYOtherExpensesAmt
CY Other Expenses$5,475,023CYOtherExpensesAmt
PY Total Expenses$18,258,333PYTotalExpensesAmt
CY Total Expenses$18,530,946CYTotalExpensesAmt
PY Revenues Less Expenses$1,136,258PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$478,738CYRevenuesLessExpensesAmt
Total Assets BOY$14,792,743TotalAssetsBOYAmt
Total Assets EOY$15,603,079TotalAssetsEOYAmt
Total Liabilities BOY$7,900,721TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,014,216TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,892,022NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,588,863NetAssetsOrFundBalancesEOYAmt
MissionNURSING HOME AND ASSISTED LIVING FACILITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,237,754ExpenseAmt
Revenue$18,680,194RevenueAmt
DescNURSING HOME AND ASSISTED LIVING CARE, INCLUDING A SUBSTANTIAL NUMBER OF MEDICARE & MEDICAID SUPPORTED RESIDENTS/PATIENTS. 52% OF REVENUE IS FROM MEDICARE/MEDICAID AND THE REMAINDER IS FROM PRIVATE PAY RESIDENTS. RATES ARE SET BASED ON MARKET RATES IN THE SEATTLE AREA, AND ARE NECESSARY TO MAKE THE ORGANIZATION VIABLE.Desc
Total Program Service Expenses$14,237,754TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document42IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee369EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PATRICIA UPDEGRAFFBusinessNameLine1
FieldValueIRS element (for citing)
Phone2063641300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line113023 GREENWOOD AVE NAddressLine1
CitySEATTLECity
StateWAState
ZIP Code981337397ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DR MARYANN JOHNSTON
CHAIRPERSON2.00Yes (X)Yes (X)$0$0$0
MR ART BATT
VICE-CHAIRPERSON2.00Yes (X)Yes (X)$0$0$0
MR CARLOS GUANGORENA
SECRETARY2.00Yes (X)Yes (X)$0$0$0
MS MARTA ACEDO
TRUSTEE2.00Yes (X)$0$0$0
MS NORMA BEERWEILER
TRUSTEE2.00Yes (X)$0$0$0
MR JOHN GIENAPP
TRUSTEE2.00Yes (X)$0$0$0
MS LARRAINE KING
TRUSTEE2.00Yes (X)$0$0$0
MS JANE JONES
TRUSTEE2.00Yes (X)$0$0$0
REV MARVIN R JONASEN
TRUSTEE2.00Yes (X)$0$0$0
MS BEV ROACH
TRUSTEE2.00Yes (X)$0$0$0
MR PAUL WOLD
TRUSTEE2.00Yes (X)$0$0$0
MS GAIL SCOTT
TRUSTEE2.00Yes (X)$0$0$0
MR DAVID CROUCH
PRESIDENT, CEO40.00Yes (X)$169,120$0$78,102
MS PAT UPDEGRAFF
TREASURER40.00Yes (X)$102,939$0$66,034
FieldValueIRS element (for citing)
Total Reportable Comp From Org$272,059TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$144,136TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeCompensationCompensationAmt
REHAB SPECIALISTS I
4560 SE INTERNATIONAL WAY STE 100MILWAUKIEOR97222$1,068,277
HAIDER REMODELING AND ROOFING
5607 244TH ST SWMOUNTLAKE TERRACEWA98043$218,294
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$268,034AllOtherContributionsAmt
Total Contributions$268,034TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRESIDENT FEESDesc
Business623000BusinessCd
Total Revenue Column$18,477,167TotalRevenueColumnAmt
Related Or Exempt Func Income$18,477,167RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$203,027TotalRevenueColumnAmt
Related Or Exempt Func Income$203,027RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$18,680,194TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$54,009TotalRevenueColumnAmt
Exclusion$54,009ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$71,600RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$64,153RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$7,447RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,447TotalRevenueColumnAmt
Exclusion$7,447ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,009,684TotalRevenueColumnAmt
Related Or Exempt Func Income$18,680,194RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$61,456ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$508,710TotalAmt
Management And General$508,710ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,427,769TotalAmt
Program Services$7,274,671ProgramServicesAmt
Management And General$2,091,419ManagementAndGeneralAmt
Fundraising$61,679FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$294,875TotalAmt
Program Services$224,395ProgramServicesAmt
Management And General$68,577ManagementAndGeneralAmt
Fundraising$1,903FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,546,462TotalAmt
Program Services$1,241,463ProgramServicesAmt
Management And General$294,473ManagementAndGeneralAmt
Fundraising$10,526FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,278,107TotalAmt
Program Services$948,506ProgramServicesAmt
Management And General$321,559ManagementAndGeneralAmt
Fundraising$8,042FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,284,657TotalAmt
Program Services$1,284,657ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$56,322TotalAmt
Program Services$965ProgramServicesAmt
Management And General$25,334ManagementAndGeneralAmt
Fundraising$30,023FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$71,134TotalAmt
Program Services$16,054ProgramServicesAmt
Management And General$52,220ManagementAndGeneralAmt
Fundraising$2,860FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$750,742TotalAmt
Program Services$527,712ProgramServicesAmt
Management And General$223,030ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$13,471TotalAmt
Program Services$10,919ProgramServicesAmt
Management And General$2,341ManagementAndGeneralAmt
Fundraising$211FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$188,154TotalAmt
Management And General$188,154ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$552,694TotalAmt
Program Services$525,059ProgramServicesAmt
Management And General$27,635ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
FOOD$776,360$776,360
SUPPLIES$711,980$711,838$142
PHARMACY$395,512$395,512
PURCHASED SERVICES$293,966$60,933$231,858$1,175

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$380,031TotalAmt
Program Services$238,710ProgramServicesAmt
Management And General$107,679ManagementAndGeneralAmt
Fundraising$33,642FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,530,946TotalAmt
Program Services$14,237,754ProgramServicesAmt
Management And General$4,143,131ManagementAndGeneralAmt
Fundraising$150,061FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,127,982BOYAmt
EOY$4,798,376EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,858,149BOYAmt
EOY$1,632,453EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$61,403BOYAmt
EOY$74,871EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$133,181BOYAmt
EOY$135,770EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,334,675LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$12,325,878LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,005,916BOYAmt
EOY$7,008,797EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$135,345BOYAmt
EOY$183,867EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,395,141BOYAmt
EOY$1,702,445EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$75,626BOYAmt
EOY$66,500EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$14,792,743BOYAmt
EOY$15,603,079EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,877,166BOYAmt
EOY$1,544,798EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$153,489BOYAmt
EOY$151,426EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,670,000BOYAmt
EOY$4,529,514EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$200,066BOYAmt
EOY$1,788,478EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,900,721BOYAmt
EOY$8,014,216EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,892,022BOYAmt
EOY$7,588,863EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,892,022BOYAmt
EOY$7,588,863EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,792,743BOYAmt
EOY$15,603,079EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$478,738ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$218,103NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$131,773CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$200,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus1 Year$276,129CurrentTaxYearMinus1YearAmt
Current Tax Year$268,034CurrentTaxYearAmt
Total$875,936TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,705,425CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,198,386CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,015,586CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,313,530CurrentTaxYearMinus1YearAmt
Current Tax Year$18,961,984CurrentTaxYearAmt
Total$93,194,911TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,193CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$57,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$58,700CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$69,700CurrentTaxYearMinus1YearAmt
Current Tax Year$71,600CurrentTaxYearAmt
Total$261,193TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,841,391CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,455,386CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,074,286CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,659,359CurrentTaxYearMinus1YearAmt
Current Tax Year$19,301,618CurrentTaxYearAmt
Total$94,332,040TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$94,332,040PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39,024CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$41,491CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,851CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$80,861CurrentTaxYearMinus1YearAmt
Current Tax Year$54,009CurrentTaxYearAmt
Total$264,236TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39,024CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$41,491CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,851CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$80,861CurrentTaxYearMinus1YearAmt
Current Tax Year$54,009CurrentTaxYearAmt
Total$264,236TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,290CurrentTaxYearMinus4YearsAmt
Total$9,290TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,889,705CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,496,877CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,123,137CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,740,220CurrentTaxYearMinus1YearAmt
Current Tax Year$19,355,627CurrentTaxYearAmt
Total$94,605,566TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99710PublicSupportCY509Pct
Public Support PY5090.99670PublicSupportPY509Pct
Investment Income CY0.00280InvestmentIncomeCYPct
Investment Income PY0.00280InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,454,155OtherCostOrOtherBasisAmt
Book Value$1,454,155BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,798,181OtherCostOrOtherBasisAmt
Depreciation$6,182,769DepreciationAmt
Book Value$4,615,412BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,087,303OtherCostOrOtherBasisAmt
Depreciation$955,421DepreciationAmt
Book Value$131,882BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,821,333OtherCostOrOtherBasisAmt
Depreciation$5,020,343DepreciationAmt
Book Value$800,990BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$173,703OtherCostOrOtherBasisAmt
Depreciation$167,345DepreciationAmt
Book Value$6,358BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,008,797TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
WELLESLEY INCOME FUND$722,177F
WELLINGTON FUND ADMIRAL$1,003,782F
VANGUARD DESIGNATED$605,514F
RECLASS OF CASH OUT OF INVESTMENTS-$629,028C
FieldValueIRS element (for citing)
Total Book Value Securities$1,702,445TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
RESIDENT TRUST ACCTS$13,012
DEFERRED COMPENSATION$1,775,466
FieldValueIRS element (for citing)
Total Liability$1,788,478TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$19,217,787TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$218,103NetUnrealizedGainsInvstAmt
Revenue Not Reported$218,103RevenueNotReportedAmt
Revenue Subtotal$18,999,684RevenueSubtotalAmt
Other Revenues Not Included$10,000OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$10,000RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$19,009,684TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$18,530,945TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$18,530,945ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$18,530,945TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS REPORT THERE ARE NO MATTERS THAT WOULD CREATE UNRELATED BUSINESS INCOME TAX OR CALL INTO QUESTION ITS EXEMPT STATUS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS RESTRICTED

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MR DAVID CROUCH
PRESIDENT, CEO$169,120$0$0$0$0$0$62,133$0$15,969$0$247,222$0$0$0
MS PAT UPDEGRAFF
TREASURER$102,939$0$0$0$0$0$50,083$0$15,951$0$168,973$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationDAVID CROUCH $57,673 PAT UPDEGRAFF $32,208ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11DRAFT TAX RETURN DISTRIBUTED AT BOARD MEETING FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY 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 15BOARD OF DIRECTORS REVIEWS DATA ON SALARY FROM SALARY SURVEY COMPILED BY HOPSITAL ASSOCIATION, REVIEWS FROM 990'S OF COMPARABLE ORGANIZAITONS.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2CTHE AUDIT COMMITTEE HAS OVERSIGHT RESPONSIBILITY FOR THE FINANCIAL STATEMENTS, AND THE SELECTION OF THE INDEPENDENT AUDITOR. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1FOSS FOUNDATIONBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line113023 GREENWOOD AVE NAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98133ZIPCode
FieldValueIRS element (for citing)
EIN911640102EIN
Primary ActivitiesFUNDRAISING ACTIVITIES TO RAISE FUNDS TO PROVIDE GRANTS TO FOSS HOME & VILLAPrimaryActivitiesTxt
Legal Domicile StateWALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 1PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1FOSS HOME & VILLAGEBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd