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WILLAMETTE VIEW MANOR INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
WILLAMETTE VIEW MANOR INC (EIN 93-0463816)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201343189349308284
Schema version
2012v2.0
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)
Timestamp2013-11-14T15:41:56-08:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Kern & Thompson LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11800 SW First Avenue Suite 410AddressLine1
CityPortlandCity
StateORState
ZIP Code97201ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930463816EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Willamette View IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWILLNameControl
Phone5036546581Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line113021 SE River RoadAddressLine1
CityPortlandCity
StateORState
ZIP Code97222ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK MEYERName
TitleDIRECTOR OF FINANCETitle
Date Signed2013-11-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWilliam K Rouse CPAName
PTINP00221194PTIN
Phone5032223338Phone
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts23583940GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWILLAMETTEVIEW.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1955YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionPROVIDES RESIDENTIAL AND NURSING CARE, WELLNESS AND THERAPY SERVICES THROUGH THE OPERATION OF CONTINUING CARE RETIREMENT COMMUNITY; AND PROVIDES IN-HOME CARE SERVICES TO RESIDENTS AND INDIVIDUALS IN THE GREATER COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees429TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year511578ContributionsGrantsPriorYear
Contributions Grants Current Year57108ContributionsGrantsCurrentYear
Program Service Revenue Prior Year22223163ProgramServiceRevenuePriorYear
Program Service Revenue CY21376150ProgramServiceRevenueCY
Investment Income Prior Year181489InvestmentIncomePriorYear
Investment Income Current Year322138InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year22916230TotalRevenuePriorYear
Total Revenue Current Year21755396TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year11044435SalariesEtcPriorYear
Salaries Etc Current Year10859369SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year10774731OtherExpensePriorYear
Other Expenses Current Year10813171OtherExpensesCurrentYear
Total Expenses Prior Year21819166TotalExpensesPriorYear
Total Expenses Current Year21672540TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1097064RevenuesLessExpensesPriorYear
Revenues Less Expenses CY82856RevenuesLessExpensesCY
Total Assets BOY58808808TotalAssetsBOY
Total Assets EOY57388607TotalAssetsEOY
Total Liabilities BOY57724152TotalLiabilitiesBOY
Total Liabilities EOY55938147TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1084656NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1450460NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDES RESIDENTIAL AND NURSING CARE, WELLNESS AND THERAPY SERVICES THROUGH THE OPERATION OF CONTINUING CARE RETIREMENT COMMUNITY; AND PROVIDES IN-HOME CARE SERVICES TO RESIDENTS AND INDIVIDUALS IN THE GREATER COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense7907528Expense
DescriptionTHE TERRACE AT WILLAMETTE VIEW OFFERS A SUPPORTIVE ENVIRONMENT AS A STATE-LICENSED RESIDENTIAL CARE FACILITY (RF). THE TERRACE PLAYS A VITAL ROLE IN THE CONTINUING CARE CONCEPT BY PROVIDING THE FIRST LEVELS OF SUPPORT TO RESIDENTS WHO FIND THEY NEED HELP WITH SOME OF THE ACTIVITIES OF DAILY LIVING (BATHING, DRESSING, GROOMING, ETC.). STAFF IS AVAILABLE TO ASSIST WITH MEDICATION MANAGEMENT, HOUSEKEEPING, PERSONAL LAUNDRY, SCHEDULED TRANSPORTATION, AND PERSONAL CARE SERVICES.THE HEALTH CENTER IS FOR RESIDENTS NEEDING THE HIGHEST LEVEL OF SERVICES. IT IS BASED ON A 'SOCIAL MODEL' AND PERSON-CENTERED CARE APPROACH, WHICH ALLOWS RN-SUPERVISED STAFF TO CARE FOR RESIDENTS IN SMALL "NEIGHBORHOODS" - STUDIO APARTMENTS SURROUND A HOME-LIKE LIVING SPACE IN EACH NEIGHBORHOOD. THERE ARE FOUR NEIGHBORHOODS: THREE ARE LICENSED ALF CARE FOR RESIDENTS NEEDING LONG-TERM ASSISTANCE AND DEPENDENT NURSING CARE, AND ONE LICENSED RCF FOR MEMORY OR ALZHEIMER'S CARE. THERE IS A SEPARATE WING FOR SHORT STAY "INFIRMARY" ADMISSIONS AND MEDICARE CERTIFIED SKILLED CARE NURSING FOR POST-HOSPITALIZATION ADMISSIONS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense6272520Expense
DescriptionWILLAMETTE VIEW, OPENED IN 1955, IS AN ENTRY FEE-BASED ACCREDITED NOT-FOR-PROFIT CCRC, CONTINUING CARE RETIREMENT COMMUNITY, OFFERING CAMPUS-STYLE LIVING TO 500 SENIORS, AGE 55 AND OLDER. WILLAMETTE VIEW IS NATIONALLY ACCREDITED BY CARF-CCAC, AND IS SITUATED ON 27 PARK-LIKE ACRES OVERLOOKING THE WILLAMETTE RIVER, JUST 8 MILES SOUTH OF DOWNTOWN PORTLAND, OREGON.WILLAMETTE VIEW IS CONSIDERED AN OPEN CAMPUS CCRC. AFTER APPROVAL OF A CONFIDENTIAL RESIDENCY APPLICATION, "APPROVED APPLICANTS" CAN ENTER ANY SERVICE OR CARE LEVEL DIRECTLY (INDEPENDENT, RCF, ALF, OR MEMORY CARE), WHEN AND IF THERE IS AN AVAILABILITY. AN ENTRY FEE IS APPLIED WHEN MOVING INTO "INDEPENDENT" LIVING.WILLAMETTE VIEW OFFERS:* FOUR TYPES OF RESIDENTIAL SERVICE LEVELS - 1)INDEPENDENT LIVING, 2)SUPPORTIVE LIVING IN THE RCF (RESIDENTIAL CARE FACILITY) SETTING, 3)LONG TERM NURSING CARE IN A LICENSED ALF (ASSISTED LIVING FACILITY) SETTING, AND 4)MEMORY CARE LICENSED AS RCF SETTING.* IN-HOME SERVICES, HEALTH AND PROFESSIONAL CARE TO RESIDENTS - MEDICAL AND NON-MEDICAL.* WELLNESS, HOSPITALITY & PERSONAL SERVICES* CLINIC SERVICES, THERAPY SERVICES, SOCIAL WORKER AND COUNSELOR SERVICES* SHORT STAY "INFIRMARY" SERVICES AND MEDICARE CERTIFIED BEDS IN A LICENSED SKILLED NURSING FACILITY (SNF).IN ADDITION, THROUGH 'WILLAMETTE VIEW HOME SERVICES', IN-HOME PRIVATE DUTY HEALTH CARE SERVICES ARE OFFERED TO INDIVIDUALS NOT LIVING ON WILLAMETTE VIEW'S CAMPUS BUT IN THEIR OWN HOMES WITHIN THE PORTLAND METROPOLITAN AREA. WVHS ALSO CONTRACTS TO PROVIDE HEALTH CARE STAFFING SERVICES TO OTHER CARE PROVIDERS, AGENCIES, AND CARE FACILITIES.Description
FieldValueIRS element (for citing)
Total Program Service Expense14180048TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109629NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees429NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARK MEYERNamePerson
Telephone Number5036546581TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line113021 SE RIVER ROADAddressLine1
CityPORTLANDCity
StateORState
ZIP Code97222ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
MIKE MIDDAL
Treasurer2.000.00X000
SONJA CONNOR
Director2.000.00X000
TERENCE CONNELL
Director2.000.00X000
CRAIG IVERSON
Director2.000.00X000
MICHAEL FRASER
Director2.000.00X000
SARAH ROSS
Director2.000.00X000
KENNETH GUSTAFSON
Director2.000.00X000
JOHN HARTSOCK
CHAIR2.000.00X000
GREG FITZGERALD
Director2.000.00X000
DR SUMATHI DEVARAJAN
Director2.000.00X000
CAMERON DICKEY
Director2.000.00X000
CRAIG VAN VALKENBURG
President & CEO40.000.00204436014561X
BRIAN THOMPSON
CFO40.000.00150000010218X
FieldValueIRS element (for citing)
Total Reportable Comp From Org354436TotalReportableCompFromOrg
Total Other Compensation24779TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1COATES KOKESBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1421 SW SIXTH AVENUEAddressLine1
CityPORTLANDCity
StateORState
ZIP Code97204ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesADVERTISINGDescriptionOfServices
Compensation215047Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions57108AllOtherContributions
Total Contributions57108TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
TO YOUR HOME FEES62161013012141301214
RESIDENTIAL FEES6239901017971710179717
PATIENT & INFIRMARY62300061385006138500
DEPARTMENTAL & OTHER INC623990793925793925
AMORT OF ENTRANCE FEES62399025874642587464

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column375330TotalRevenueColumn
Related Or Exempt Function Income375330RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue21376150TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column164259TotalRevenueColumn
Exclusion$164,259ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1986423Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1828544Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities157879Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column157879TotalRevenueColumn
Exclusion$157,879ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column21755396TotalRevenueColumn
Related Or Exempt Function Income21376150RelatedOrExemptFunctionIncome
Exclusion$322,138ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total354436Total
Program Services286101ProgramServices
Management And General68335ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8132433Total
Program Services6564453ProgramServices
Management And General1567980ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total154407Total
Program Services128882ProgramServices
Management And General25525ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1454275Total
Program Services1214465ProgramServices
Management And General239810ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total763818Total
Program Services637864ProgramServices
Management And General125954ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1589426Total
Program Services687861ProgramServices
Management And General901565ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total1075360Total
Management And General1075360ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3412675Total
Management And General3412675ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total354550Total
Program Services354550ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES51256343937973184
RESIDENT & PATIENT CARE550001550001
UTILITIES125379412516902104
FOOD COSTS14205681420568

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total644234Total
Program Services644234ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total21672540Total
Program Services14180048ProgramServices
Management And General7492492ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3929836BOY
EOY2593682EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1426554BOY
EOY1110165EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY36321BOY
EOY36322EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY285417BOY
EOY621515EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis87877005LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec41842290LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY46530908BOY
EOY46034715EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5471841BOY
EOY5939617EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1127931BOY
EOY1052591EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY58808808BOY
EOY57388607EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY663075BOY
EOY503033EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30210000BOY
EOY28920000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY26851077BOY
EOY26515114EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY57724152BOY
EOY55938147EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1084656BOY
EOY1450460EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1084656BOY
EOY1450460EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY58808808BOY
EOY57388607EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses82856ReconcilationRevenueExpenses
Reconciliation Unrealized Invest282948ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years412807CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years62546CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years146031CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year511578CurrentTaxYearMinus1Year
Current Tax Year57108CurrentTaxYear
Total1190070Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21355499CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years23053252CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22620565CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22223163CurrentTaxYearMinus1Year
Current Tax Year21376150CurrentTaxYear
Total110628629Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21768306CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years23115798CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22766596CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22734741CurrentTaxYearMinus1Year
Current Tax Year21433258CurrentTaxYear
Total111818699Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years407378CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years145711CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years481364CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year250494CurrentTaxYearMinus1Year
Current Tax Year259204CurrentTaxYear
Total1544151Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years407378CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years145711CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years481364CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year250494CurrentTaxYearMinus1Year
Current Tax Year259204CurrentTaxYear
Total1544151Total
FieldValueIRS element (for citing)
Public Support Total509110274548PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years369262CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years214830CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years391769CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year181489CurrentTaxYearMinus1Year
Current Tax Year322138CurrentTaxYear
Total1479488Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years369262CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years214830CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years391769CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year181489CurrentTaxYearMinus1Year
Current Tax Year322138CurrentTaxYear
Total1479488Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22137568CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years23330628CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23158365CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22916230CurrentTaxYearMinus1Year
Current Tax Year21755396CurrentTaxYear
Total113298187Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97330PublicSupportPercentage509
Prior Year Support Percentage0.96900PriorYearSupportPercentage
Investment Income Percentage0.01310InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01340PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1663210OtherCostOrOtherBasis
Book Value1663210BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis78100085OtherCostOrOtherBasis
Depreciation36084942Depreciation
Book Value42015143BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis422241OtherCostOrOtherBasis
Depreciation289962Depreciation
Book Value132279BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7691469OtherCostOrOtherBasis
Depreciation5467386Depreciation
Book Value2224083BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings46034715TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
WORKERS COMPENSATION ACCRUAL$107,006
REFUNDABLE ENTRANCE FEES$2,000,000
REFUNDABLE ADVANCE FEES$5,881,489
DEFERRED ENTRANCE FEES$17,467,789
APARTMENT DEPOSITS$145,768
ACCRUED SALARIES & P/R TAX$913,062
FieldValueIRS element (for citing)
Total Of Amounts26515114TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt22026184TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments282948NetUnrealizedGainsInvestments
Other Revenues-12160OtherRevenues
Revenue Not Rptd F990270788RevenueNotRptdF990
Revenue Subtotal21755396RevenueSubtotal
Total Revenue Per Form99021755396TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt21761260TotExpensesEtcAuditedFinclStmt
Other Expenses Included88720OtherExpensesIncluded
Expenses Not Rptd F99088720ExpensesNotRptdF990
Expenses Subtotal21672540ExpensesSubtotal
Total Expenses Per Form99021672540TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPart XII, Line 2dIdentifier
Return ReferencePart XII, Line 2d: Other expenses and losses per audited F/SReturnReference
ExplanationHILLSIDE SENIOR CENTER $88720Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
CRAIG VAN VALKENBURG
President & CEO20443614561218997
BRIAN THOMPSON
CFO15000010218160218

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1OR FACILITIES AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN936001787IssuerEIN
Date Issued2010-11-01DateIssued
Issue Price33772320IssuePrice
Description Of PurposeREFINANCING & NORTH ENTRANCEDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired1920000AmountRetired
Total Proceeds30840000TotalProceeds
Current RefundingtrueCurrentRefunding
Advance RefundingtrueAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
Hedge Identified In Books And RecdstrueHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1WELLS FARGOBusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge5.0000TermOfHedge
Superintegrated HedgetrueSuperintegratedHedge
Hedge TerminatedfalseHedgeTerminated
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqs

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSupplemental InformationIdentifier
Return ReferencePart VIReturnReference
ExplanationPART II LINE 3 - SERIES B BONDS TO BE PAID PURSUANT TO A REQUEST FOR ADVANCE CAN BE REQUESTED BEGINNING 11/01/2012.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableFINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesEXECUTIVE COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE EMPLOYMENT CONTRACT. THE BOARD OF DIRECTORS ALSO APPROVES SALARY RANGES FOR OTHER EMPLOYEES OF THE ORGANIZATION.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsBOARD OF DIRECTORS SIGN THE CONFLICT OF INTEREST POLICY EVERY YEAR
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessFINANCE COMMITTEE, DIRECTOR OF FINANCE, CFO AND PRESIDENT REVIEW BEFORE FORM 990 IS FILED.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HILLSIDE SENIOR SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line113021 SE RIVER ROAD SUITE 1000AddressLine1
CityPORTLANDCity
StateORState
ZIP Code97222ZIPCode
FieldValueIRS element (for citing)
EIN200176561EIN
Primary ActivitiesOPERATION OF ELDER CARE FACILITYPrimaryActivities
Legal Domicile StateORLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status509(A)(2)PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1HILLSIDE SENIOR SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypedTransactionType
Amount Involved612001AmountInvolved
Method Of Amt DeterminationCASHMethodOfAmtDetermination