2013-01-14T18:34:49-06:00 2012-02-29 910189318 MOSS ADAMS LLP 805 SW BROADWAY 1200 PORTLAND OR 97205 990 2011-03-01 930613108 FRIENDSHIP HEALTH CENTER FRIE 5032311411 3320 SE HOLGATE BLVD PORTLAND OR 97202 SEPTEMBER FRAY 5032311411 2013-01-10 1 WENDY CAMPOS P00448102 5032421447 2011 2016-02-25 16:41:14Z SEPTEMBER FRAY 3320 SE HOLGATE BLVD PORTLAND OR 97202 9256244 0 X WWW.HOLGATECENTER.ORG X 1972 OR HEALTH CARE SERVICES - SKILLED NURSING FACILITY 11 11 283 26 0 0 7580 225 9032409 9080506 99535 26998 76425 148515 9215949 9256244 0 0 0 0 5205412 5462213 0 0 0 4121358 4202411 9326770 9664624 -110821 -408380 8450922 7969738 6836777 6763973 1614145 1205765 HEALTH CARE SERVICES - SKILLED NURSING FACILITY 0 0 8270245 9229021 HEALTH CARE SERVICES - CARE FOR THE ELDERLY AVERAGE FTE CENSUS 84 BEDS OF 100-BED FACILITY 8270245 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 14 0 1 283 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 OR X SEPTEMBER FRAY 5032311411 3320 SE HOLGATE BLVD PORTLAND OR 97202 X DIANE GOETZ 1.00 X X 0 0 0 EV SMITH 1.00 X X 0 0 0 JOAN COMPTON 1.00 X 0 0 0 BERNIECE HUNTLEY 1.00 X 0 0 0 GARY CLARK 1.00 X X 0 0 0 PATRICIA OLSON 1.00 X X 0 0 0 BABE BOGEART 1.00 X 0 0 0 WILLIAM HAWES 1.00 X 0 0 0 JOYCE LYNN 1.00 X 0 0 0 DAN MATHEWS 1.00 X 0 0 0 JERRY BROADDUS 1.00 X 0 0 0 SEPTEMBER FRAY 25.00 X 146599 0 10966 JUSTIN SPEER 25.00 X 64010 0 10521 DAVID MCMANAWAY 25.00 X 97315 0 20866 307924 0 42353 1 0 1 0 CONSONUS REHAB PO BOX 4800 PORTLAND OR 97208 REHAB PROVIDER 711292 DEPARTMENT OF HUMAN SERVICES 500 SUMMER STREET NE E-08 SALEM OR 97301 SERVICES 502476 AFCO DEPT LA 21315 PASADENA CA 91185 SERVICES 276245 3 225 225 PATIENT REVENUE 623000 9080506 9080506 9080506 26998 26998 MISCELLANEOUS INCOME 623000 148515 148515 148515 9256244 9229021 0 26998 367586 367586 4221140 4102104 119036 45448 45448 828039 778546 49493 31042 31042 87457 87457 1211578 1205157 6421 14325 1296 13029 148026 10821 137205 73072 73072 261055 261055 34721 6753 27968 355680 355680 286590 286590 353275 353275 PROVIDER TAX EXPENSE 490936 490936 NURSING SUPPLIES 387585 387585 DIETARY EXPENSE 185798 185798 PHARMACY EXPENSE 124620 124620 156651 75709 80942 9664624 8270245 1394379 0 119362 140469 0 20000 990359 1006985 13977 54773 10441299 5313671 5261511 5127628 2065713 1619883 8450922 7969738 1476570 1528524 4681244 4813993 116456 678963 305000 6836777 6763973 X 1614144 1205765 1614144 1205765 8450922 7969738 X -408380 1 X 0 1 1 X 0 X 50383 50490 27145 7580 225 135823 8912856 8565761 9257341 9032409 9080506 44848873 8963239 8616251 9284486 9039989 9080731 44984696 0 24238 24238 24238 24238 44960458 60174 48407 26579 99535 26998 261693 60174 48407 26579 99535 26998 261693 15610 76425 148515 240550 9023413 8664658 9326675 9215949 9256244 45486939 0.98840 0.99200 0.00580 0.00600 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: PART III LINE 12 CONSISTS OF MISCELLANEOUS INCOME RELATED TO THE EXEMPT PURPOSE OF THE ORGANIZATION. 7642078 3534194 4107884 534403 338951 195452 2173142 1417828 755314 91676 22698 68978 5127628 ESTIMATED PROFESSIONAL LIABILITY RECOVERIES 305000 ASSETS WHOSE USE IS LIMITED, INTENDED FOR LONG TERM 1117117 BOND ISSUANCE COST 500508 ASSETS WHOSE USE IS LIMITED, CURRENT PORTION 553469 INTERCOMPANY RECEIVABLES, NET -856211 1619883 ESTIMATED PROFESSIONAL LIABILITY CLAIMS 305000 305000 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE AFFILIATED COMPANIES ARE NON-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. IN ADDITION, THE AFFILIATED COMPANIES QUALIFY FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER 170(B)(1)(A) AND HAVE BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). THE AFFILIATED COMPANIES FOLLOWS FASB ASC 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE AFFILIATED COMPANIES RECOGNIZE 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. THERE WERE NO UNRECOGNIZED TAX BENEFITS AT FEBRUARY 29, 2012 AND FEBRUARY 28, 2011. THE AFFILIATED COMPANIES RECOGNIZE INTEREST ACCRUED AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AS AN ADMINISTRATIVE EXPENSE. DURING THE YEARS ENDED FEBRUARY 29, 2012 AND FEBRUARY 28, 2011, THE AFFILIATED COMPANIES RECOGNIZED NO INTEREST AND PENALTIES. THE AFFILIATED COMPANIES FILES AN EXEMPT ORGANIZATION INCOME TAX RETURN IN THE U.S. FEDERAL JURISDICTION, AND IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2008 FOR ITS FEDERAL AND STATE FILINGS. X X 0 0 0 0 0 0 0 0 0 SEPTEMBER FRAY 146599 0 0 0 0 0 0 0 10966 0 157565 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION'S BOARD DOES NOT UTILIZE COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11 A COMPLETE COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS WITH A Q&A REVIEW PROCESS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED AT LEAST ANNUALLY AT THE QUALITY ASSURANCE MEETING. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS REVIEWED BY A BOARD APPOINTED COMMITTEE AND FINAL APPROVAL PROVIDED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 ANNUAL FINANCIAL STATEMENTS ARE MADE AVAILABLE ON WEBSITE EMMA. AVERAGE HOURS PER WEEK FROM RELATED ORGANIZATIONS FORM 990, PART VII 1- SEPTEMBER FRAY, EXECUTIVE DIRECTOR ODD FELLOWS HOME OF OREGON - 10 HOURS KENILWORTH PARK PLAZA - 5 HOURS 2- JUSTIN SPEER, CFO ODD FELLOWS HOME OF OREGON - 10 HOURS KENILWORTH PARK PLAZA - 5 HOURS 3- DAVID MCMANAWAY, DNS ODD FELLOWS HOME OF OREGON - 10 HOURS KENILWORTH PARK PLAZA - 5 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: 1. ODD FELLOWS HOME OF OREGON 3102 SE HOLGATE BLVD PORTLAND OR 97202 930391597 RESIDENTIAL CARE OR 501(C)3 LINE 9 N/A 0 IOOF GRAND LODGE 3202 SE HOLGATE BLVD PORTLAND OR 97202 930195535 BENEVOLENT ORGANIZATION OR 501(C)8 N/A 0 KENILWORTH PARK PLAZA 3314 SE HOLGATE BLVD PORTLAND OR 97202 930740167 LOW INCOME/SUBSIDIZED (HUD) HOUSING FOR THE ELDERLY OR 501(C)3 LINE 9 N/A 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 IOOF GRAND LODGE J 12000 FAIR MARKET VALUE KENILWORTH PARK PLAZA K 60000 FAIR MARKET VALUE ODD FELLOWS HOME OF OREGON P 174909 ACTUAL PAYMENTS KENILWORTH PARK PLAZA O 115824 ACTUAL PAYMENTS