2013-08-14T20:16:41-05:00 2012-09-30 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2011-10-01 910666887 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST PRES 2068262111 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 EILEEN CHRISTENSON 2068262111 2013-08-14 1 SARA ELIZABETH J HYRE P00235495 4254544919 2013-08-14 2011 2016-02-24 21:20:13Z GREG ROBINSON 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 53733158 0 X WWW.PRCN.NET X 1956 WA A FAITH-BASED ORGANIZATION SUPPORTING COMMUNITIES AND SERVICES THAT CELEBRATE AND ENRICH LIVES. 16 16 540 19 18520 -10395 206906 0 31966512 38712554 659907 571987 652729 393311 33486054 39677852 3000 0 0 0 15346289 16928007 0 0 0 28730858 30101235 44080147 47029242 -10594093 -7351390 264766167 258689786 281339525 286648792 -16573358 -27959006 X A FAITH-BASED ORGANIZATION SUPPORTING COMMUNITIES AND SERVICES THAT CELEBRATE AND ENRICH LIVES. 0 0 41531509 38653989 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST (PRCN) IS A PREMIER NOT-FOR-PROFIT ORGANIZATION COMPRISED OF THREE UNIQUE RESIDENTIAL COMMUNITIES PROVIDING SERVICES FOR A DIVERSE POPULATION OF OLDER ADULTS IN THE PACIFIC NORTHWEST. FOR OVER FIVE DECADES, PARK SHORE AND EXETER HOUSE HAVE BEEN MEETING THE NEEDS OF SENIORS THROUGH OUR HEALTH, WELLNESS AND LIFE ENRICHMENT PROGRAMS. IN THE FALL OF 2012, PRCN CELEBRATED THIS MILESTONE ANNIVERSARY WITH OUR RESIDENTS AND TEAM MEMBERS. IN OCTOBER OF 2009, WE OPENED OUR NEWEST RETIREMENT COMMUNITY IN DOWNTOWN SEATTLE, SKYLINE AT FIRST HILL, AND COMMEMORATED THEIR THREE YEAR ANNIVERSARY IN OCTOBER 2012. SKYLINE HAS BEEN A TREMENDOUS SUCCESS STORY. TO ACHIEVE OUR OCCUPANCY GOALS WITHIN A 36 MONTH PERIOD HAS BEEN UNPRECEDENTED IN THIS MARKETPLACE. SEE SCHEDULE O. WITH THE ECONOMIC DOWNTURN AND HOUSING MARKET CHALLENGED, MANY COMMUNITIES HAVE NOT BEEN AS SUCCESSFUL. WE ATTRIBUTE THIS TO OUR LOW TEAM MEMBER TURNOVER, OUR COHESIVE BOARD OF DIRECTORS AND THE GUIDANCE AND DIRECTION OF STRONG LEADERSHIP. THROUGH OUR CONTINUOUS CARE RETIREMENT COMMUNITIES WE PROVIDE A CONTINUUM OF CARE: INDEPENDENT LIVING, ASSISTED LIVING, MEMORY SUPPORT, AND SKILLED NURSING CATERING TO RESIDENTS AND THEIR INDIVIDUAL NEEDS. AS A FAITH BASED ORGANIZATION, WE ARE GUIDED BY OUR MISSION AND VISION TO SUPPORT COMMUNITIES AND SERVICES THAT CELEBRATE AND ENRICH LIVES. 41531509 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 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 1 1 1 0 0 0 1 142 0 1 540 1 1 1 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X JD SMITH 2068262111 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 X BONNIE BRIAN-CALDWELL 0.30 X 0 0 0 KAY BROWELEIT 10.00 X X 0 0 0 CAROLE CONGER 0.50 X 0 0 0 JOHN ESHELMAN 5.00 X 0 0 0 RICHARD MATTHEWS 5.00 X 0 0 0 TOM VASILATOS 2.00 X 0 0 0 JAMES MELHORN 3.00 X 0 0 0 ROB MITCHELL 8.00 X 0 0 0 GREG ROBINSON 5.00 X X 0 0 0 DOUG SETO 3.00 X 0 0 0 DOUG DIEKEMA MD MPH 2.00 X 0 0 0 PAULA FITZGERALD BOOS 6.00 X 0 0 0 GARY HOULAHAN 5.00 X X 0 0 0 JAMES RAND PHD 5.00 X 0 0 0 PAUL COLLINS THRU 512 2.00 X 0 0 0 HEATHER JAMES THRU 512 2.00 X 0 0 0 TOM JOHNSTON 3.00 X 0 0 0 LUCILLE KELLEY THRU 1111 1.00 X 0 0 0 REV SCOTT LUMSDEN 1.00 X 0 0 0 TAMERYN CAMPBELL 65.00 X 232630 0 13744 EILEEN CHRISTENSON 39.00 X 16923 0 0 ROB LIEBREICH 40.00 X 66935 0 14544 RON BERGSTROM 40.00 X 8500 0 0 MARK LINDEN 40.00 X 95787 0 29702 LELA FISHE 1.00 X 0 0 0 MICHELLE MERLINO THRU 312 1.00 X 48501 0 0 JIM YAMAMOTO THRU 1211 40.00 X 91157 0 20464 THOM HOWSON THRU 112 40.00 X 119493 0 32018 SHELLEY PARKS 40.00 X 111939 0 9016 SALLY NAFZIGER 40.00 X 106729 0 16288 WESLEY BARD 40.00 X 106029 0 16794 1004623 0 152570 5 1 1 0 GREYSTONE DEVELOPMENT 222 W LAS COLINAS BLVD IRVING TX 75039 CONSULTING 238273 GOTTLIEB FISHER PLLC 1501 FOURTH AVENUE SUITE 2150 SEATTLE WA 98101 ATTORNEY 135766 CLARK NUBER PS 10900 NE 4TH ST SUITE 1700 BELLEVUE WA 98004 ACCOUNTING AND AUDITING 118424 PERKINS COIE LLP 11201 THIRD AVENUE SUITE 4900 SEATTLE WA 98101 ATTORNEY 103943 4 RESIDENCY FEES 623990 23174994 23174994 MEDICAL SERVICES 623000 8575130 8575130 ASSISTED LIVING 623990 6637768 6637768 GUEST SERVICES 900099 188631 188631 OTHER RESIDENT SRVCS 900099 133482 133482 2549 2549 38712554 404859 404859 336901 336901 102397 0 102397 102397 102397 13885533 13857721 197585 27812 -197585 -169773 -169773 GARAGE INCOME 900099 148586 130066 18520 MISCELLANEOUS 900099 56320 56320 REFUNDS 900099 51945 51945 34063 34063 290914 39677852 38653989 18520 1005343 892869 892869 13140534 11608777 1531757 164352 151438 12914 1064794 907700 157094 1665458 1382330 283128 337681 280275 57406 81057 67277 13780 127683 105977 21706 43863 43863 3522344 2923546 598798 627813 521085 106728 1119671 929327 190344 190356 157995 32361 2151229 1785520 365709 119454 99147 20307 51009 42337 8672 8322512 8322512 8768520 7891668 876852 682395 566388 116007 RAW FOOD & KITCHEN 2142991 2142991 MEDICAL & HEALTHCARE 573468 573468 EMPLOYEE EXPENSES 430898 357645 73253 DUES/PERMITS/LICENSE 379677 315132 64545 428614 398974 29640 47029242 41531509 5497733 0 2997508 6108684 6354468 2399680 5950547 12468116 460837 440375 249200083 49003460 210150317 200196623 19771910 23459906 11149985 11422553 7930595 2193849 264766167 258689786 4460991 7722981 117917850 140540216 154165000 135760000 4795684 2625595 281339525 286648792 X -16573358 -27959006 -16573358 -27959006 264766167 258689786 X -7351390 -4034258 X 0 1 1 X 0 X 13000 14701 206906 234607 16063743 16481882 22080501 31989355 38722323 125337804 209405 222694 432099 16076743 16496583 22080501 32405666 38945017 126004510 0 0 0 126004510 523801 519253 1066106 871960 844157 3825277 523801 519253 1066106 871960 844157 3825277 36468 19367 2272 56320 114427 337299 51945 389244 16600544 17052304 23165974 33617197 39897439 130333458 0.96680 0.96320 0.02930 0.03270 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: REFUNDS 1 0 0 0 0 1 1253 0 0 0 1253 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PORTION OF DUES PAID TO THE LEADING AGE ORGANIZATION THAT SUPPORTS LEGISLATION FOR AGING POPULATION IN THE UNITED STATES. 13218689 13218689 205081106 38685304 166395802 12195943 7704456 4491487 18704345 2613700 16090645 200196623 DEPOSITS 1246839 ACCRUED MARKETING FEES 1325357 CAPITAL LEASE OBLIGATIONS 53399 2625595 39677852 47029242 -7351390 347722 146980 494702 -6856688 40260271 347722 234697 582419 39677852 0 39677852 47116959 87717 87717 47029242 0 47029242 PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN NET ASSETS FROM AFFILIATE 146,980. PART XII, LINE 2D - OTHER ADJUSTMENTS: REVENUE FROM AFFILIATE 234,697. PART XIII, LINE 2D - OTHER ADJUSTMENTS: EXPENSE FROM AFFILIATE 87,717. X X X X X 0 0 0 0 0 0 0 0 0 TAMERYN CAMPBELL 232630 0 0 0 0 0 0 0 13744 0 246374 0 0 0 THOM HOWSON THRU 112 119493 0 0 0 0 0 4909 0 27109 0 151511 0 0 0 WESLEY BARD 106029 0 0 0 0 0 4271 0 12523 0 122823 0 0 0 WASHINGTON STATE HOUSING FINANCE COMMISSION- SERIES A AND C 911874730 93978LDE3 2007-02-28 204865405 CONSTRUCT A CONTINUING CARE RETIREMENT COMMUNITY 0 0 0 WASHINGTON STATE HOUSING FINANCE COMMISSION- SERIES 2012 911874730 93978LFU5 2012-03-23 7600000 REFUND BOND SERIES 2007B 0 0 0 85960405 204865405 15822834 3869728 1358952 169068115 2009 0 0 1 1 7600000 7600000 2012 1 0 1 1 0 0 1 1 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 1 SOVEREIGN BANK 5.000000000000 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART I, LINE 6: THERE WERE 19 VOLUNTEER MEMBERS ON THE BOARD OF DIRECTORS WHO SERVED AT VARIOUS TIMES OVER THE COURSE OF THE FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WAS DISTRIBUTED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. IT WAS ALSO SPECIFICALLY DISCUSSED AND APPROVED BY THE FINANCE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS OF THE BOARD OF DIRECTORS AND EMPLOYEES. ANNUALLY, A CONFLICT OF INTEREST FORM IS DISTRIBUTED TO THE BOARD OF DIRECTORS AND OFFICERS. THE PRESIDENT & CEO REVIEWS THE COMPLETED FORMS AND IDENTIFIES IF ANY CONFLICTS EXIST. ANY ACTUAL OR PERCEIVED CONFLICT OF INTEREST OF ANY GOVERNING BOARD MEMBER OR OFFICER SHALL BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD OR HIGHEST LEVEL OF MANAGEMENT (PRESIDENT & CEO) AND MADE A MATTER OF RECORD AT THE SOONEST POSSIBLE TIME. ANY GOVERNING BOARD MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST SHALL NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER, AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD USES AN INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION SURVEY TO ANNUALLY DETERMINE THE CEO AND CFO'S COMPENSATION. THE CEO IS RESPONSIBLE FOR CONDUCTING THE REVIEW OF OTHER OFFICERS' COMPENSATION (EXECUTIVE DIRECTORS). THE LAST REVIEW FOR THE CEO WAS PERFORMED IN MARCH 2013. FORM 990, PART VI, SECTION C, LINE 19 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, COLUMN (B) THE ESTIMATED AVERAGE HOURS PER WEEK DEVOTED BY THE FOLLOWING INDIVIDUALS TO RELATED ORGANIZATIONS ARE AS LISTED BONNIE BRIAN-CALDWELL DIRECTOR 0.3 HOURS KAY BROWELEIT DIRECTOR 3.0 HOURS CAROLE CONGER DIRECTOR 0.5 HOURS JOHN EHSELMAN DIRECTOR 1.0 HOUR RICHARD MATTHEWS DIRECTOR 1.0 HOUR TOM VASILATOS DIRECTOR 2.0 HOURS JAMES MELHORN DIRECTOR 0.3 HOURS ROB MITCHELL DIRECTOR 0.5 HOURS GREG ROBINSON CHAIR 1.0 HOUR DOUG DIEKEMA MD, MPH DIRECTOR 2.0 HOURS PAULA FITZGERALD BOOS DIRECTOR 1.0 HOUR GARY HOULAHAN CHAIR 5.0 HOURS JAMES RAND, PHD DIRECTOR 1.0 HOUR DOUG SETO DIRECTOR 1.0 HOUR HEATHER JAMES DIRECTOR 1.0 HOUR PAUL COLLINS DIRECTOR 1.0 HOUR TOM JOHNSTON DIRECTOR 1.0 HOUR LUCILLE KELLEY DIRECTOR 1.0 HOUR LELA FISHE SECRETARY 1.0 HOUR MICHELLE MERLINO SECRETARY 1.0 HOUR REV. SCOTT LUMSDEN EX-OFFICIO DIRECTOR 1.0 HOUR TAMERYN CAMPBELL PRESIDENT & CEO 1.0 HOUR EILEEN CHRISTENSON CFO 1.0 HOUR CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 347,722. PRIOR PERIOD ADJUSTMENT FOR DEPRECIATION -4,381,980. TOTAL TO FORM 990, PART XI, LINE 5: -4,034,258. FH LLC 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 910666887 OPERATE RETIREMENT COMMUNITY WA 22150010 222489889 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST PRESBYTERIAN RETIREMENT NORTHWEST FOUNDATION 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 911586491 BENEFIT RESIDENTS AND EMPLOYEES WA 501(C)(3) 11-TYPE 1 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0