2014-01-15T13:43:32-06:00 2013-02-28 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2012-03-01 941485533 CHANNING HOUSE CHAN 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 RHONDA BEKKEDAHL 6503270950 2014-01-14 1 RENIE M BURBANK P00159653 4159561500 2012 2015-11-30 17:44:51Z MELVIN MATSUMOTO 850 WEBSTER STREET PALO ALTO CA 94301 29034776 0 X WWW.CHANNINGHOUSE.ORG X 1961 CA PROVIDES HOUSING AND HEALTH CARE SERVICES WITHIN A LIFE CARE COMMUNITY. 13 13 103 70 0 0 727269 280832 15566131 13604814 744418 711385 53570 54005 17091388 14651036 10990 40768 0 0 4844635 4855828 13984 8532 27766 6757021 7083750 11626630 11988878 5464758 2662158 109258101 116074697 87334756 90837415 21923345 25237282 THE MISSION OF CHANNING HOUSE IS TO PROVIDE A CONTINUING CARE RESIDENTIAL COMMUNITY THAT ENHANCES EACH RESIDENT'S INDEPENDENCE, WELL BEING, NEEDED CARE, AND SECURITY. 0 0 10189302 40768 13604922 PROVIDE HOUSING, ASSISTED LIVING AND SKILLED NURSING SERVICES WHICH INCLUDE: FOOD SERVICES, HOUSKEEPING, NURSING AND MEDICAL CARE. DURING FY 2013 WE SERVED AN AVERAGE OF 234 RESIDENTS WITH A TOTAL UTILIZATION OF 5,475 SERVICE DAYS OF SKILLED NURSING; 10,250 SERVICE DAYS OF ASSISTED LIVING; AND 69,624 DAYS OF RESIDENTIAL CARE SERVICES. CHANNING HOUSE HOSTED PUBLIC FUNCTIONS INCLUDING COMMUNITY MEETINGS, NEIGHBORHOOD POLLING PLACE, AND OTHER VOLUNTEER ACTIVITIES. 10189302 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 41 0 1 103 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X RHONDA BEKKEDAHL 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 RAYMOND BACCHETTI 4.00 X 0 0 0 MICHAEL D COUCH 8.00 X 0 0 0 DEXTER B DAWES 8.00 X 0 0 0 MARLENE PRENDERGAST 4.00 X 0 0 0 GLORIA HOM 4.00 X 0 0 0 ROBERT HARRINGTON 4.00 X 0 0 0 PATTY IRISH 4.00 X 0 0 0 ED MILLER 4.00 X 0 0 0 JOHN NORTHWAY 4.00 X 0 0 0 ROBERT M ROSENZWEIG 4.00 X 0 0 0 JOHN SCHNIEDWIND 4.00 X 0 0 0 J ROBERT TAYLOR 4.00 X 0 0 0 DAVID G THORNTON 4.00 X 0 0 0 CARL BRAGINSKY 40.00 X 130373 0 20293 MELVIN MATSUMOTO 40.00 X 26831 0 0 ARACELI ANTONIO 40.00 X 134259 0 26306 JULIE JONES 40.00 X 126851 0 24652 STEPHANIE STEPHENS 40.00 X 106491 0 18784 JOY NAVA 40.00 X 102831 0 11039 627636 0 101074 5 0 1 0 NIBBI BROTHERS ASSOCIATES 180 HUBBELL STREET SAN FRANCISCO CA 94107 CONSTRUCTION CONTRACTORS 6144395 SODEXO INC DEPT 880328 LOS ANGELES CA 90088 FOOD SERVICE 2552966 MEDWEST - JOHN GASTON 627 HILLCREST WAY EMERALD HILLS CA 94062 PROJECT MANAGER - HEALTH CENTER 385670 HARDISON KOMATSU IVELICH & TUCKER 538 NINTH STREET 240 OAKLAND CA 94607 ARCHITECT 383370 PARAGON MECHANICAL PO BOX 58 SANTA CLARA CA 95052 CONSTRUCTION CONTRACTOR 245432 7 280832 280832 MONTHLY CARE FEES 623000 9460601 9460601 RESIDENT ENTRANCE FEES 623000 3714333 3714333 SPECIAL SERVICES 623000 411790 411790 PROCESSING FEES 623000 18090 18090 13604814 1250213 1250213 53886 0 53886 53886 53886 13822106 14343106 17828 -521000 -17828 -538828 -538828 22914 22806 108 108 TOTAL K-1 INCOME 900099 11 11 11 14651036 13604922 0 765282 X 40768 40768 189089 169855 19234 3267182 2705183 561999 183180 110079 73101 907009 726229 180780 309368 246289 63079 52653 52653 51135 51135 8532 8532 2576873 2529259 47614 58796 58796 363117 55689 307428 79380 40449 38931 783026 767637 15389 13722 13722 12173 5769 6404 2840 2840 2147798 2147798 418477 290393 128084 MAINT./HOUSEKEEPING 298047 298047 AMORTIZATION OF DEBT 156585 156585 MEDICAL EXPENSES 69128 69128 11988878 10189302 1771810 27766 21657 268320 1364578 740038 3667 34839 0 365485 3390 3390 169264 184805 91309513 23342419 56695670 67967094 47019621 42698504 92108 61305 3888146 3750917 109258101 116074697 2768898 3525946 21504337 24864723 62969413 62383769 92108 62977 87334756 90837415 X 21186586 24503281 736759 734001 21923345 25237282 109258101 116074697 X 2662158 663240 -11461 X X 0 1 X 1 0 X 109587 308680 206524 727269 280832 1632892 11898621 12952616 12002924 15566131 13604814 66025106 24094 20462 23357 22759 22914 113586 12032302 13281758 12232805 16316159 13908560 67771584 5000 5000 5000 5000 20000 1249709 2272707 3098212 3528792 3347631 13497051 1254709 2277707 3103212 3533792 3347631 13517051 54254533 770284 550842 709420 1271142 1304110 4605798 770284 550842 709420 1271142 1304110 4605798 12802586 13832600 12942225 17587301 15212670 72377382 0.74960 0.76490 0.06360 0.06220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 138437 832847 2775 974059 133000 175 5262 138437 128932 4068 133000 122548 6384 128932 116307 6241 122548 1.00000 0 0 873166 873166 52054505 19571878 32482627 7305248 3770541 3534707 31076594 31076594 67967094 LIABILITY FOR GIFT ANNUITIES 62977 62977 X 15302815 663240 -25210 638030 14664785 -13749 -13749 14651036 11988878 0 11988878 0 11988878 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENHANCE THE WELL-BEING OF RESIDENTS. PROVIDE ON-GOING SUPPORT FOR THE CHARITABLE NEEDS OF RESIDENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: CHANNING HOUSE HAS BEEN GRANTED TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. CHANNING HOUSE ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION ("ASC") 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON MARCH 1, 2008. THEY HAD NO UNRECOGNIZED TAX BENEFITS WHICH WOULD REQUIRE AN ADJUSTMENT TO THE MARCH 1, 2012 BEGINNING BALANCE OF NET ASSETS AND HAD NO UNRECOGNIZED TAX BENEFITS AT FEBRUARY 28, 2013. CHANNING HOUSE FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2006 FOR ITS FEDERAL AND 2005 FOR ITS STATE TAX FILINGS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN MINIMUM PENSION LIABLITY -23,538. CHANGE IN VALUE SPLIT INTEREST AGREEMENTS -1,672. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT IN LIMITED PARTNERSHIPS -13,749. 1 SCHOLARSHIP 1 500 RESIDENT ASSISTANCE 3 40268 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: EMPLOYEE SCHOLARSHIP: THE SCHOLARSHIP PROGRAM HAS BEEN ESTABLISHED TO HELP EMPLOYEES OF CHANNING HOUSE STRIVE FOR IMPROVEMENT IN SKILLS AND PROFESSIONAL KNOWLEDGE AS IT RELATES TO QUALITY CARE FOR OUR RESIDENTS. BASED ON FIVE STIPULATIONS, MANAGEMENT REVIEWS THE APPLICATIONS SUBMITTED BY THE EMPLOYEE AND AWARDS FUNDS BASED ON MANAGEMENT DISCRETION AND AVAILABILITY OF FUNDS. AWARDING OF SCHOLARSHIPS IS BASED ON LENGTH OF SERVICE AT CHANNING HOUSE AND EDUCATIONAL GOALS OF THE EMPLOYEE. EDUCATION OR SKILLS OBTAINED FROM THE SCHOLARSHIP FUND MUST EITHER ADVANCE CURRENT SKILLS USED AT CHANNING HOUSE OR ACQUIRE NEW SKILLS TO BE USED IN THE FIELD OF LONG-TERM CARE AND/OR THE APPLICANT'S POSITION. APPLICANT MUST APPLY USING OUR STANDARD PACKAGE; REIMBURSEMENT AND COMPLETION OF CLASSES MONITORED BY APPLICANTS' MANAGER/SUPERVISOR AND HR DEPARTMENT. ALL APPLICATIONS ARE ALSO REVIEWED BY EXECUTIVE DIRECTOR. RESIDENCE ASSISTANCE: IF A RESIDENT BECOMES UNABLE TO AFFORD HIS/HER MONTHLY CARE FEES, HE/SHE MAY REQUEST FINANCIAL ASSISTANCE FROM CHANNING HOUSE. THE RESIDENT COMPLETES AN APPLICATION FOR ASSISTANCE AND MEETS WITH THE ADMINISTRATOR TO REVIEW HIS/HER FINANCIAL RESOURCES. THE ADMINISTRATOR AND EXECUTIVE DIRECTOR REVIW AND APPROVE ANY APPLICATIONS FOR ASSISTANCE. X X 0 0 0 0 0 0 0 0 0 CARL BRAGINSKY 130373 0 0 0 0 0 12972 0 7321 0 150666 0 0 0 ARACELI ANTONIO 134259 0 0 0 0 0 14024 0 12282 0 160565 0 0 0 JULIE JONES 126851 0 0 0 0 0 12440 0 12212 0 151503 0 0 0 A ABAG FINANCE AUTHORITY FOR NONPROFIT CORPORATIONS INSURED REVENUE BONDS 941485533 0037CQP80 2010-07-08 64066348 NEW HEALTH CENTER CONSTRUCTION & REMODEL 14 UNITS IN EXISTING BUILDING 1 0 0 A 17471427 64066348 4208211 4564688 1031002 3782180 9523081 5304895 27703945 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 IT IS CHANNING HOUSE'S POLICY THAT THE AUDIT COMMITTEE REVIEW A DRAFT OF IRS FORM 990 ON BEHALF OF THE BOARD OF TRUSTEES WITHIN 60 DAYS PRIOR TO BEING FILED WITH THE IRS. THE DRAFT AS REVIEWED BY THE AUDIT COMMITTEE WILL BE MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF TRUSTEES AT LEAST 30 DAYS PRIOR TO ITS BEING FILED WITH THE IRS. PROCESS INCLUDES RECORDING WHO CONDUCTED THE REVIEW, WHEN IT WAS CONDUCTED, AND THE EXTENT (DETAIL OR SUMMARY) THE FORM WAS REVIEWED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, POLICY IS REVIEWED WITH BOARD MEMBERS AND KEY STAFF MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION GOES THROUGH AN ANNUAL REVIEW BY THE PERSONNEL COMMITTEE. THE PERSONNEL COMMITTEE IS RESPONSIBLE FOR THE PERFORMANCE APPRAISAL OF THE EXECUTIVE DIRECTOR. THE PERFORMANCE APPRAISAL IS NORMALLY ON AN ANNUAL BASIS, WITH THE PERIOD UNDER REVIEW BASED ON THE CHANNING HOUSE FISCAL YEAR. THE COMMITTEE IN ITS EVALUATION MAY SOLICIT INPUT FROM OTHER TRUSTEES, RESIDENTS AND STAFF OF CHANNING HOUSE. THE SALARY AND BENEFITS OF THE EXECUTIVE DIRECTOR ARE ALSO REVIEWED ON AN ANNUAL BASIS. THE PERSONNEL COMMITTEE SUBMITS ANY RECOMMENDED CHANGES TO THE EXECUTIVE DIRECTOR'S SALARY/BENEFITS TO THE BOARD OF TRUSTEES FOR APPROVAL. SUCH RECOMMENDATION WILL BE SUBMITTED FOR REVIEW AND APPROVAL TO THE BOARD AT THE REGULARLY SCHEDULED MEETING PRIOR TO THE EXECUTIVE DIRECTOR'S HIRE DATE ANNIVERSARY. ANY ACTION TAKEN BY THE BOARD ON PERSONNEL COMMITTEE RECOMMENDATIONS WILL BE RECORDED IN THE BOARD MINUTES. COMPENSATION ADJUSTMENTS FOR THE EXECUTIVE DIRECTOR WILL BE ESTABLISHED IN CONJUNCTION WITH A REVIEW OF COMPENSATION STUDIES AVAILABLE FROM BOTH NATIONAL AND STATEWIDE SOURCES, AS WELL AS OTHER SOURCES AS AVAILABLE (SUCH AS FROM A CONSULTANT). THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR ANNUAL EVALUATIONS AND IMPLEMENTING ANY SALARY ADJUSTMENTS FOR OTHER KEY MANAGEMENT STAFF. THESE EVALUATIONS MUST BE DONE IN CONJUNCTION WITH THE HIRE DATE ANNIVERSARIES FOR THE FOLLOWING: ADMINISTRATOR, DIRECTOR OF FINANCE, FACILITIES DIRECTOR, DIRECTOR OF HEALTH SERVICES AND HOUSEKEEPING DIRECTOR. COMPENSATIONS ADJUSTMENTS FOR KEY MANAGEMENT STAFF WILL BE BASED ON BUDGETED AMOUNTS AVAILABLE, AS WELL AS STATEWIDE COMPENSATION STUDIES. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE POSTED TO THE CORPORATE WEBSITE & RESIDENT LIBRARY; ATTACHED TO NEW RESIDENT CONTRACTS; AND AVAILABLE ON REQUEST FROM BUSINESS OFFICE. ALL BOARD MINUTES AND CHANGES TO BYLAWS ARE POSTED IN CHANNING HOUSE RESIDENT LIBRARY. COPIES OF MEETING MINUTES ARE AVAILABLE FOR A PRIOR THREE YEAR PERIOD. CONFLICT OF INTEREST POLICY IS AVAILABLE ON REQUEST FROM THE BUSINESS OFFICE. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 2,529,259. MANAGEMENT AND GENERAL EXPENSES 47,614. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,576,873. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF CHARITABLE GIFT ANNUITIES -1,672. BOOK/TAX DIFFERENCE INVESTMENT IN LP 13,749. CHANGE IN MINIMUM PENSION LIABILITY -23,538. AUDIT COMMITTEE AND OVERSIGHT 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR.