CAPITOL LAKES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CAPITOL LAKES INC (EIN 39-1412320)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-15
- IRS object ID
- 201342279349304279
- Schema version
- 2011v1.5
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-15T18:40:06-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910189318 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3121 WEST MARCH LANE SUITE 100 | AddressLine1 |
| City | STOCKTON | City |
| State | CA | State |
| ZIP Code | 952192303 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391412320 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPITOL LAKES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CAPI | NameControl |
| Phone | 8887246424 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 W MAIN ST | AddressLine1 |
| City | MADISON | City |
| State | WI | State |
| ZIP Code | 53703 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIM CONROY | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 8887246424 | Phone |
| Date Signed | 2013-08-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TRACY S PAGLIA | Name |
| PTIN | P00366884 | PTIN |
| Phone | 2099556100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LARRY BOECK | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 965 ELLENDALE DRIVE | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 25271023 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RETIREMENT.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | CAPITOL LAKES, INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 3 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 363 | TotalNbrEmployees |
| Total Nbr Volunteers | 80 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 729 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17806007 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17830608 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1003666 | InvestmentIncomePriorYear |
| Investment Income Current Year | 207506 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 24216 | OtherRevenuePriorYear |
| Other Revenue Current Year | 22531 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18834618 | TotalRevenuePriorYear |
| Total Revenue Current Year | 18060645 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8435407 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8900963 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13623003 | OtherExpensePriorYear |
| Other Expenses Current Year | 14103644 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22058410 | TotalExpensesPriorYear |
| Total Expenses Current Year | 23004607 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3223792 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -4943962 | RevenuesLessExpensesCY |
| Total Assets BOY | 68328224 | TotalAssetsBOY |
| Total Assets EOY | 66559409 | TotalAssetsEOY |
| Total Liabilities BOY | 90929933 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 95239180 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -22601709 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -28679771 | NetAssetsOrFundBalancesEOY |
| Mission Description | CAPITOL LAKES IS A VIBRANT CONTINUING CARE RETIREMENT COMMUNITY COMMITTED TO THE ENRICHMENT OF RESIDENTS' LIVES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 19840914 | Expense |
| Grants | 0 | Grants |
| Revenue | 17830608 | Revenue |
| Description | CAPITOL LAKES 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. | Description |
| Total Program Service Expense | 19840914 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 25 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 363 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 3 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHERI DRESSLER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5418577644 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 965 ELLENDALE DRIVE | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (5 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| LEN MERRYMAN THROUGH 5112 | |||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| LARRY BOECK | |||||||
| CHAIR | 1.00 | X | X | 0 | 1000 | 0 | |
| PAULA BONNER | |||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| BRIAN PURTELL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TIM CONROY | |||||||
| EXECUTIVE DIRECTOR | 40.00 | 116123 | 0 | 13635 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 116123 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1000 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 13635 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CONSONUS REHAB | |||||
| UNIT 12 P O BOX 4800 | PORTLAND | OR | 97208 | THERAPY | 1307341 |
| MCGANN CONSTRUCTION | |||||
| 3622 LEXINGTON AVE | MADISON | WI | 53714 | CONSTRUCTION | 1005109 |
| PACIFIC RETIREMENT SERVICES | |||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | MANAGEMENT SERVICES | 744823 |
| PHYSICIAN'S PLUS INSURANCE | |||||
| PO BOX 3057 | MILWAUKEE | WI | 53201 | MEDICAL SERVICES | 709413 |
| METLIFE | |||||
| PO BOX 120945 DEPT 0945 | DALLAS | TX | 75312 | EMPLOYEE BENEFITS | 200408 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| HEALTH SERVICE REVENUE | 623000 | 9332569 | 9332569 |
| SERVICE FEES | 623000 | 6443424 | 6443424 |
| ENTRANCE FEES | 623000 | 1269600 | 1269600 |
| RELATED RENTAL | 623000 | 285404 | 285404 |
| DINING REVENUE | 623000 | 271883 | 271883 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 227728 | TotalRevenueColumn |
| Related Or Exempt Function Income | 227728 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17830608 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 218001 | TotalRevenueColumn |
| Exclusion | $218,001 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 22531 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 22531 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22531 | TotalRevenueColumn |
| Exclusion | $22,531 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7199883 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7210378 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -10495 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -10495 | TotalRevenueColumn |
| Exclusion | -$10,495 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18060645 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17830608 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $230,037 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7073466 | Total |
| Program Services | 6213567 | ProgramServices |
| Management And General | 859899 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 233611 | Total |
| Program Services | 189425 | ProgramServices |
| Management And General | 44186 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1071884 | Total |
| Program Services | 904694 | ProgramServices |
| Management And General | 167190 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 522002 | Total |
| Program Services | 458698 | ProgramServices |
| Management And General | 63304 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1030182 | Total |
| Management And General | 1030182 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208 | Total |
| Management And General | 208 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53706 | Total |
| Management And General | 53706 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22811 | Total |
| Management And General | 22811 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 565190 | Total |
| Program Services | 297793 | ProgramServices |
| Management And General | 267397 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262042 | Total |
| Management And General | 262042 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 665901 | Total |
| Program Services | 572483 | ProgramServices |
| Management And General | 93418 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64941 | Total |
| Management And General | 64941 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1116115 | Total |
| Program Services | 1113557 | ProgramServices |
| Management And General | 2558 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74139 | Total |
| Program Services | 15403 | ProgramServices |
| Management And General | 58736 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18232 | Total |
| Program Services | 13436 | ProgramServices |
| Management And General | 4796 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3710919 | Total |
| Program Services | 3710919 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2994848 | Total |
| Program Services | 2994848 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151317 | Total |
| Program Services | 96950 | ProgramServices |
| Management And General | 54367 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| HEALTH CENTER EXPENSE | 2403799 | 2403799 | |
| DIETARY EXPENSE | 792682 | 792682 | |
| FACILITY SERVICE EXPENS | 137592 | 62660 | 74932 |
| ASSET DISPOSAL | 38647 | 38647 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 373 | Total |
| Management And General | 373 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23004607 | Total |
| Program Services | 19840914 | ProgramServices |
| Management And General | 3163693 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2565862 | BOY |
| EOY | 3999164 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10041300 | BOY |
| EOY | 8313499 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1414312 | BOY |
| EOY | 2213705 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28208 | BOY |
| EOY | 42449 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 335837 | BOY |
| EOY | 338923 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 58059401 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12797949 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45065679 | BOY |
| EOY | 45261452 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7638168 | BOY |
| EOY | 5011585 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1238858 | BOY |
| EOY | 1378632 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68328224 | BOY |
| EOY | 66559409 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2967704 | BOY |
| EOY | 3255945 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20995815 | BOY |
| EOY | 24569967 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50485000 | BOY |
| EOY | 49610000 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6275000 | BOY |
| EOY | 6120000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10206414 | BOY |
| EOY | 11683268 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 90929933 | BOY |
| EOY | 95239180 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -23021040 | BOY |
| EOY | -29014202 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 343004 | BOY |
| EOY | 334431 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76327 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -22601709 | BOY |
| EOY | -28679771 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68328224 | BOY |
| EOY | 66559409 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -4943962 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1134100 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5858 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5047 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus1 Year | 729 | CurrentTaxYearMinus1Year |
| Total | 11634 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7767598 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 17070710 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 17553930 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17806007 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17830608 | CurrentTaxYear |
| Total | 78028853 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7773456 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 17075757 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 17553930 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17806736 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17830608 | CurrentTaxYear |
| Total | 78040487 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 79883 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 92168 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 86407 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 68494 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8634 | CurrentTaxYear |
| Total | 335586 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 79883 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 92168 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 86407 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 68494 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8634 | CurrentTaxYear |
| Total | 335586 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 77704901 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 244758 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 197403 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 215381 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 222539 | CurrentTaxYearMinus1Year |
| Current Tax Year | 240532 | CurrentTaxYear |
| Total | 1120613 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 244758 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 197403 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 215381 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 222539 | CurrentTaxYearMinus1Year |
| Current Tax Year | 240532 | CurrentTaxYear |
| Total | 1120613 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 1298 | CurrentTaxYearMinus1Year |
| Total | 1298 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 8018214 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 17273160 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 17769311 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 18030573 | CurrentTaxYearMinus1Year |
| Current Tax Year | 18071140 | CurrentTaxYear |
| Total | 79162398 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.98160 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.97900 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.01420 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01680 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: NON OPERATING INCOME | GeneralExplanation |
Schedule C IRS990ScheduleC
Total Lobbying Expenditures TotalLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 0 | FilingOrganizationsTotals |
Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 23004607 | FilingOrganizationsTotals |
Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 23004607 | FilingOrganizationsTotals |
Lobbying Nontaxable LobbyingNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 1000000 | FilingOrganizationsTotals |
Grassroots Nontaxable GrassrootsNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 250000 | FilingOrganizationsTotals |
Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 0 | FilingOrganizationsTotals |
Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 0 | FilingOrganizationsTotals |
Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 1000000 | CurrentYearMinus1 |
| Current Year | 1000000 | CurrentYear |
| Total | 2000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $3,000,000 | LobbyingCeilingAmount |
Total Lobbying Expenditures2 TotalLobbyingExpenditures2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 0 | CurrentYearMinus1 |
Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 250000 | CurrentYearMinus1 |
| Current Year | 250000 | CurrentYear |
| Total | 500000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $750,000 | GrassrootsCeilingAmount |
Grassroots Lobbying Expenditures GrassrootsLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus1 | 0 | CurrentYearMinus1 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8537600 | OtherCostOrOtherBasis |
| Book Value | 8537600 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 44720858 | OtherCostOrOtherBasis |
| Depreciation | 11170508 | Depreciation |
| Book Value | 33550350 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2485754 | OtherCostOrOtherBasis |
| Depreciation | 1065374 | Depreciation |
| Book Value | 1420380 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2315189 | OtherCostOrOtherBasis |
| Depreciation | 562067 | Depreciation |
| Book Value | 1753122 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 45261452 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| REFUNDABLE DEPOSITS | $223,850 |
| DUE TO AFFILIATES | $3,204,336 |
| SWAP AGREEMENTS | $8,033,508 |
| OTHER CURRENT LIABILITIES | $49,800 |
| ASSET RETIREMENT OBLIGATION | $97,559 |
| CAPITAL LEASE | $74,215 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11683268 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE CORPORATION RECOGNIZES 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. THE CORPORATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2012 AND 2011, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN HEALTH AND EDUCATIONAL FACILITIES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 391337855 | IssuerEIN |
| CUSIP Number | 97710V7V4 | CUSIPNumber |
| Date Issued | 2008-04-01 | DateIssued |
| Issue Price | 44590000 | IssuePrice |
| Description Of Purpose | ACQUISITION, CONST, RENOVATION & IMPROVEMENT OF FACILITIES & REFUND BOND | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 1515000 | AmountRetired |
| Total Proceeds | 44872130 | TotalProceeds |
| Amount In Reserve Fund | 3189999 | AmountInReserveFund |
| Capitalized Interest | 771878 | CapitalizedInterest |
| Issuance Costs From Proceeds | 890841 | IssuanceCostsFromProceeds |
| Credit Enhancement | 724551 | CreditEnhancement |
| Capital Expenditures | 32061837 | CapitalExpenditures |
| Other Spent Proceeds | 3479412 | OtherSpentProceeds |
| Amount Unspent | 3753452 | AmountUnspent |
| Year Of Subst Completion | 2014 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 1 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 1 | MngmentCntrctBondFinancdPrprty |
| Engage Bond Counsel Contracts | 1 | EngageBondCounselContracts |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00500 | PrcntgePrvtBusinessUseByOthers |
| Total Private Business Use | 0.00500 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KBC BANK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 11.900000000000 | TermOfHedge |
| Superintegrated Hedge | 0 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 1 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THE DIFFERENCE BETWEEN ISSUE PRICE IN PART I(E) AND TOTAL PROCEEDS OF ISSUE IN PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. THE BONDS REFUNDED WERE ISSUED ON 4/25/1995 AND 8/25/1999. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | CAPITOL LAKES DELEGATES MANAGEMENT TO PACIFIC RETIREMENT SERVICES. | |
| FORM 990, PART VI, SECTION A, LINE 6 | CAPITOL LAKES, INC. HAS ONE MEMBER, PACIFIC RETIREMENT SERVICES, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | PACIFIC RETIREMENT SERVICES HAS THE RIGHT TO ELECT THE DIRECTORS OF THE BOARD OF CAPITOL LAKES INC. | |
| 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 IV SECTION 1 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. | |
| PART VII, SECTION A: | LEN MERRYMAN DEVOTES 1 HOUR PER WEEK TO EACH OF THE FOLLOWING ENTITIES: ROGUE VALLEY MANOR MIRABELLA SEATTLE MIRABELLA PORTLAND LARRY BOECK DEVOTES 1 HOUR PER WEEK TO EACH OF THE FOLLOWING ENTITIES: PACIFIC RETIREMENT SERVICES CAPITOL LAKES FOUNDATION MIRABELLA SEATTLE MIRABELLA PORTLAND TIM CONROY DEVOTES 1 HOUR PER WEEK TO EACH OF THE FOLLOWING ENTITIES: MIDDLETON GLEN, INC. SENIOR HOUSING OF MIDDLETON | HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 307,907. CHANGE IN INTEREST IN NET ASSETS OF CAPITOL LAKES FOUNDATION, INC. 267,028. CHANGE IN VALUE OF INTEREST RATE SWAP -1,186,182. TRANSFER OF EQUITY TO FOUNDATION -522,853. TOTAL TO FORM 990, PART XI, LINE 5: -1,134,100. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (48 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PACIFIC RETIREMENT SERVICES INC | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 931067253 | SUPPORTING ORGANIZATION | OR | 501(C)(3) | LINE 11C, III-FI | N/A | 0 | |
| ROGUE VALLEY MANOR | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930453216 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| THE CUMBERLAND REST INC | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 750891470 | SENIOR HOUSING | TX | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| CASCADE MANOR INC | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930557803 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| UNIVERSITY RETIREMENT COMMUNITY AT DAVIS | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 931179254 | SENIOR HOUSING | CA | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| HOLLADAY PARK PLAZA | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930513697 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| HOLLADAY PARK PLAZA ENDOWMENT FUND | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930776291 | ASSISTANCE TRUST | OR | 501(C)(3) | LINE 7 | 0 | HOLLADAY PARK PLAZA | |
| ROGUE VALLEY MANOR FOUNDATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930712867 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| UNIVERSITY RETIREMENT COMMUNITY AT DAVIS FOUNDATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 931301816 | PUBLIC FOUNDATION | CA | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| TRINITY TERRACE FOUNDATION INC | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 912162130 | PUBLIC FOUNDATION | TX | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| HOLLADAY PARK PLAZA FOUNDATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 264529118 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIRABELLA WASHINGTON FOUNDATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 450574348 | PUBLIC FOUNDATION | WA | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| CASCADE MANOR FOUNDATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 931330100 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| CAPITOL LAKES FOUNDATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 383781089 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 1 | CAPITOL LAKES INC | |
| MIRABELLA | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 342030255 | SENIOR HOUSING | WA | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIRABELLA PORTLAND FOUNDATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 452508860 | PUBLIC FOUNDATION | OR | 501(C)(3) | LINE 7 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIRABELLA AT SOUTH WATERFRONT | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 711016384 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIRABELLA SAN FRANCISCO BAY | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 200428927 | SENIOR HOUSING | CA | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM COMMUNITY SERVICES INC | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930892261 | COMM SRVCS | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930864466 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM ASHLAND HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 930942933 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM GRANTS PASS HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943136037 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM ROSEBURG HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943179782 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM MYRTLE CREEK HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943162074 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM BEND HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943163349 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM EAGLE POINT HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943191447 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM KLAMATH FALLS HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943196455 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM MEDFORD II HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943212537 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM LIVELY OAKS HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943194409 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM REEDSPORT HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943212538 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM YREKA HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943212540 | SENIOR HOUSING | CA | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM EUGENE HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943247154 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM FORT WORTH I HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311520436 | SENIOR HOUSING | TX | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM BEND II HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 943260016 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| RVM FORT WORTH II HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311587415 | SENIOR HOUSING | TX | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM MEDFORD III HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311587418 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM ROSEBURG II HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311587420 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM GRANTS PASS II HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311662259 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM DAVIS HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311662208 | SENIOR HOUSING | CA | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM MYRTLE CREEK II HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311715321 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM PORTLAND HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 311780332 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM PORTLAND II HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 300037898 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM CENTRAL POINT HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 300315618 | SENIOR HOUSING | OR | 501(C)(3) | LINE 9 | 0 | ROGUE VALLEY MANOR | |
| RVM MANSFIELD HOUSING CORPORATION | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 900292647 | SENIOR HOUSING | TX | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| CORBINTON RETIREMENT | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 262987036 | SENIOR HOUSING | NC | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIRABELLA AT MORRISON | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 271016196 | SENIOR HOUSING | NC | 501(C)(3) | LINE 9 | 0 | PACIFIC RETIREMENT SERVICES INC | |
| MIDDLETON GLEN INC | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 911859494 | SENIOR HOUSING | WI | 501(C)(3) | LINE 9 | 0 | CAPITOL LAKES INC | |
| SENIOR HOUSING OF MIDDLETON | |||||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 470825736 | SENIOR HOUSING | WI | 501(C)(3) | LINE 9 | 0 | CAPITOL LAKES INC | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| CREST PARK INC | ||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 931169683 | HOTEL | OR | N/A | C |
| RETIREMENT SERVICES INC | ||||||||
| 965 ELLENDALE DRIVE | MEDFORD | OR | 97504 | 931328250 | MANAGEMENT COMPANY | OR | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |