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ELDER CARE ALLIANCE OF SAN MATEO: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ELDER CARE ALLIANCE OF SAN MATEO (EIN 94-0831870)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-01
IRS object ID
201200619349302750
Schema version
2010v3.4
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)
Timestamp2012-03-01T14:56:34-06:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN940831870EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SALEM LUTHERAN HOME ASSOCIATION OF THE BAYBusinessNameLine1
Business Name Line2CITIESBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSALENameControl
Phone5107692700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11301 MARINA VILLAGE PARKWAYAddressLine1
CityALAMEDACity
StateCAState
ZIP Code94501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJANICE WASHBURNName
TitleCHIEF FINANCIAL OFFICERTitle
Date Signed2012-01-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJESSE JANTZENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11301 MARINA VILLAGE PKWY 210AddressLine1
CityALAMEDACity
StateCAState
ZIP Code94501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12053051GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SALEMLUTHERANHOME.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1924YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionSALEM LUTHERAN HOME ASSOCIATION SERVES AND ENRICHES THE LIVES OF OLDER ADULTS BY PROVIDING HOUSING AND SERVICES AT ITS CARE CENTER, AND ITS ASSISTED LIVING, MEMORY CARE, AND INDEPENDENT LIVING UNITS.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees175TotalNbrEmployees
Total Nbr Volunteers45TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year382092ContributionsGrantsPriorYear
Contributions Grants Current Year276740ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10798997ProgramServiceRevenuePriorYear
Program Service Revenue CY11546182ProgramServiceRevenueCY
Investment Income Prior Year114842InvestmentIncomePriorYear
Investment Income Current Year98101InvestmentIncomeCurrentYear
Other Revenue Prior Year7348OtherRevenuePriorYear
Other Revenue Current Year112681OtherRevenueCurrentYear
Total Revenue Prior Year11303279TotalRevenuePriorYear
Total Revenue Current Year12033704TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY5670GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6305766SalariesEtcPriorYear
Salaries Etc Current Year6396774SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year103395TotalFundrsngExpCurrentYear
Other Expense Prior Year4868556OtherExpensePriorYear
Other Expenses Current Year5457144OtherExpensesCurrentYear
Total Expenses Prior Year11174322TotalExpensesPriorYear
Total Expenses Current Year11859588TotalExpensesCurrentYear
Revenues Less Expenses Prior Year128957RevenuesLessExpensesPriorYear
Revenues Less Expenses CY174116RevenuesLessExpensesCY
Total Assets BOY15027149TotalAssetsBOY
Total Assets EOY15267994TotalAssetsEOY
Total Liabilities BOY6915515TotalLiabilitiesBOY
Total Liabilities EOY6495264TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8111634NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8772730NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionA NONPROFIT ORGANIZATION COMMITTED TO SERVING AND ENRICHING THE PHYSICAL, EMOTIONAL, AND SPIRITUAL WELL-BEING OF OLDER ADULTS THROUGH A PROFESSIONAL, FAITH-CENTERED CARE COMMUNITY AND SERVICES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense6203346Expense
Revenue5824376Revenue
DescriptionSALEM'S CARE CENTER IS LICENSED FOR 48 SKILLED NURSING RESIDENTS. THE CARE CENTER PROVIDES SKILLED NURSING CARE TO 48 OLDER ADULT RESIDENTS IN AN AVERAGE MONTH, FOR AN ANNUAL TOTAL OF 16,450 RESIDENT DAYS. 65% OF RESIDENTS ARE PRIVATE PAY, WHILE 19% HAVE MEDI-CAL, 15% HAVE MEDICARE AND 1% HAVE OTHER INSURANCE COVERAGE.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1573983Expense
Revenue2252521Revenue
DescriptionSALEM'S ASSISTED LIVING UNIT PROVIDES HOUSING FOR UP TO 61 OLDER ADULT RESIDENTS THAT REQUIRE SOME ASSISTANCE WITH MEDICATION OR DAILY ACTIVITIES. THIS YEAR WE PROVIDED ASSISTED LIVING HOUSING FOR 56 RESIDENTS EACH MONTH ON AVERAGE, EXCLUDING SECOND PERSONS IN EACH UNIT, FOR AN ANNUAL TOTAL OF 32,197 RESIDENT DAYS. ASSISTED LIVING RESIDENTS ARE OFFERED FOUR LEVELS OF CARE IN ADDITION TO THE BASE LEVEL OF CARE SO THAT THEIR INDIVIDUAL NEEDS CAN BE MET. THERE ARE MANY ACTIVITIES PROVIDED FOR OUR ASSISTED LIVING RESIDENTS, INCLUDING SOME THAT REFLECT OUR FAITH-BASED MISSION.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1296221Expense
Revenue2046375Revenue
DescriptionSALEM'S TERRACE MEMORY CARE UNIT PROVIDES HOUSING FOR 30 OLDER ADULT RESIDENTS WHO HAVE DEMENTIA OR MEMORY LOSS. THIS YEAR WE PROVIDED MEMORY CARE HOUSING FOR 29 RESIDENTS EACH MONTH ON AVERAGE FOR A TOTAL OF 10,134 RESIDENT DAYS. THE TERRACE HAS MANY DAILY ACTIVITIES DESIGNED FOR DEMENTIA OR MEMORY LOSS RESIDENTS.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp185174TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt5670TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev1422910TotalOfOtherProgramServiceRev
Total Program Service Expense9258724TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
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 ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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 With109654NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees175NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
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 CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJANICE WASHBURNNamePerson
Telephone Number5107692727TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11301 MARINA VILLAGE PARKWAY SUITEAddressLine1
CityALAMEDACity
StateCAState
ZIP Code94501ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
REVEREND RONALD M RENTNER
CHAIR2.0XX000
PATRICIA CONOLLY MD
DIRECTOR2.0X000
FRED WENTKER
SECRETARY2.0XX000
ROBERT JOHNSON
VICE CHAIR2.0XX000
JIM METCALFE
DIRECTOR THRU 09/102.0X000
CHARLES RUTHROFF
DIRECTOR2.0X000
CHRISTINE WHELAN
DIRECTOR THRU 11/102.0X000
REVEREND PAMELA GRIFFITH POND
DIRECTOR2.0X000
LINDA ORRICK
DIRECTOR2.0X000
SISTER KATHLEEN KEARNEY
DIRECTOR2.0X000
JOAN RYAN
DIRECTOR2.0X000
MICHAEL TELLEEN
DIRECTOR2.0X000
JESSE JANTZEN
CHIEF EXECUTIVE OFFICER40.0X000
JANICE WASHBURN
CHIEF FINANCIAL OFFICER40.0X000
REBECCA KURLAND
ASSISTANT SECRETARY THRU 09/103.0X1910346390
ADRIENE IVERSON
ASSISTANT SECRETARY BEG 11/1040.0X051213563
FieldValueIRS element (for citing)
Total Reportable Comp From Org1910TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs85852TotalReportableCompFrmRltdOrgs
Total Other Compensation563TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHABCARE GROUP INC
PO BOX 50353ST LOUISMO63150SKILLED NURSING415586
LIFE CARE SERVICES
SEE SCHEDULE O.154398
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Fundraising Events24557FundraisingEvents
All Other Contributions252183AllOtherContributions
Total Contributions276740TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE62300058507685850768
RESIDENT SERVICES62300056934195693419
OTHER PROGRAM SERVICE REVENUE62300019951995
FieldValueIRS element (for citing)
Total Program Service Revenue11546182TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column98324TotalRevenueColumn
Exclusion$98,324ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real6600Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real6600Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column6600TotalRevenueColumn
Exclusion$6,600ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other223Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-223Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-223TotalRevenueColumn
Exclusion-$223ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events7900GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events24557CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses19124FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-11224TotalRevenueColumn
Exclusion-$11,224ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionGAIN FROM INVESTMENT POOLSDescription
Business Code900099BusinessCode
Total Revenue Column117305TotalRevenueColumn
Exclusion$117,305ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue117305TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12033704TotalRevenueColumn
Related Or Exempt Function Income11546182RelatedOrExemptFunctionIncome
Exclusion$210,782ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total5670Total
Program Services5670ProgramServices

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)
Total1910Total
Management And General1910ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5166597Total
Program Services4676776ProgramServices
Management And General417055ManagementAndGeneral
Fundraising72766Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total127605Total
Program Services117600ProgramServices
Management And General9295ManagementAndGeneral
Fundraising710Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total698173Total
Program Services632149ProgramServices
Management And General61239ManagementAndGeneral
Fundraising4785Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total402489Total
Program Services354023ProgramServices
Management And General43353ManagementAndGeneral
Fundraising5113Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total883750Total
Management And General883750ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total44383Total
Management And General44383ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total46376Total
Management And General46376ManagementAndGeneral

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)
Total14776Total
Management And General14776ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total958904Total
Program Services700737ProgramServices
Management And General258167ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total141101Total
Management And General121080ManagementAndGeneral
Fundraising20021Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total900808Total
Program Services743869ProgramServices
Management And General156939ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1394Total
Management And General1394ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total520181Total
Program Services481371ProgramServices
Management And General38810ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total33105Total
Program Services21174ProgramServices
Management And General11931ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total25306Total
Program Services2316ProgramServices
Management And General22990ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total302346Total
Program Services237512ProgramServices
Management And General64834ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total831643Total
Program Services653308ProgramServices
Management And General178335ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total91114Total
Program Services71576ProgramServices
Management And General19538ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES & DRUGS265527265527
REPAIRS & MAINTENANCE23134921149419855
LICENSES, DUES & SUBSCRIPTIONS551691943335736
EMPLOYEE EXPENSES51084544045644
BAD DEBT4789547895

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total10933Total
Program Services10854ProgramServices
Management And General79ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11859588Total
Program Services9258724ProgramServices
Management And General2497469ManagementAndGeneral
Fundraising103395Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY82634BOY
EOY192428EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY194978BOY
EOY699953EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1332900BOY
EOY875882EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY5556EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY78907BOY
EOY58046EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis24489715LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec15229200LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9819974BOY
EOY9260515EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3517756BOY
EOY4175614EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY15027149BOY
EOY15267994EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY674900BOY
EOY715391EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY822524BOY
EOY718933EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY2059BOY
EOY1523EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4981906BOY
EOY4666906EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY434126BOY
EOY392511EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6915515BOY
EOY6495264EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6551366BOY
EOY6942747EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY259871BOY
EOY529586EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1300397BOY
EOY1300397EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8111634BOY
EOY8772730EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15027149BOY
EOY15267994EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses174116ReconcilationRevenueExpenses
Reconcilation Other Changes486980ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 Years176366CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years210194CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1159682CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year382092CurrentTaxYearMinus1Year
Current Tax Year276740CurrentTaxYear
Total2205074Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10030372CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9923946CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10697602CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10798997CurrentTaxYearMinus1Year
Current Tax Year11546182CurrentTaxYear
Total52997099Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10206738CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10134140CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11857284CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11181089CurrentTaxYearMinus1Year
Current Tax Year11822922CurrentTaxYear
Total55202173Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years63832CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years71018CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years85534CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year165831CurrentTaxYearMinus1Year
Current Tax Year36767CurrentTaxYear
Total422982Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years63832CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years71018CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years85534CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year165831CurrentTaxYearMinus1Year
Current Tax Year36767CurrentTaxYear
Total422982Total
FieldValueIRS element (for citing)
Public Support Total50954779191PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years99240CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years174676CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years80780CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year94263CurrentTaxYearMinus1Year
Current Tax Year104924CurrentTaxYear
Total553883Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years99240CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years174676CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years80780CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year94263CurrentTaxYearMinus1Year
Current Tax Year104924CurrentTaxYear
Total553883Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10305978CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10308816CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11938064CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11275352CurrentTaxYearMinus1Year
Current Tax Year11927846CurrentTaxYear
Total55756056Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98248PublicSupportPercentage509
Prior Year Support Percentage0.98129PriorYearSupportPercentage
Investment Income Percentage0.00993InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01015PriorYrInvestIncomePercentage
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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER LOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-B, LINE 1IReturnReference
ExplanationTHE ORGANIZATION IS A MEMBER OF SEVERAL ORGANIZATIONS WHOSE PURPOSE IS TO DIRECT, DEVELOP, OR AFFECT PUBLIC POLICY AND LEGISLATION WITH REGARD TO HEALTHCARE ISSUES. THE AMOUNT SPENT ON DUES ALLOCABLE TO LOBBYING ACTIVITIES IS NOT SPECIFICALLY KNOWN; HOWEVER, SUCH AMOUNTS ARE INSUBSTANTIAL.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1857561BeginningOfYearBalance
Investment Earnings Or Losses425572InvestmentEarningsOrLosses
End Of Year Balance2283133EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1667030BeginningOfYearBalance
Investment Earnings Or Losses190531InvestmentEarningsOrLosses
End Of Year Balance1857561EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1942767BeginningOfYearBalance
Investment Earnings Or Losses-275737InvestmentEarningsOrLosses
End Of Year Balance1667030EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.33210BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.66790PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis191734OtherCostOrOtherBasis
Book Value191734BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17948435OtherCostOrOtherBasis
Depreciation10718795Depreciation
Book Value7229640BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3132779OtherCostOrOtherBasis
Depreciation1752125Depreciation
Book Value1380654BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2565531OtherCostOrOtherBasis
Depreciation2317331Depreciation
Book Value248200BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis651236OtherCostOrOtherBasis
Depreciation440949Depreciation
Book Value210287BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9260515TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ASSET RETIREMENT OBLIGATION$365,555
DUE TO RELATED PARTIES$26,956
FieldValueIRS element (for citing)
Total Of Amounts392511TotalOfAmounts
Total Revenue12033704TotalRevenue
Total Expenses11859588TotalExpenses
Excess Or Deficit For Year174116ExcessOrDeficitForYear
Net Unrealized GL On Investments486980NetUnrealizedGLOnInvestments
Total Adjustments486980TotalAdjustments
Excess Or Deficit Per FS661096ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12525255TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments486980NetUnrealizedGainsInvestments
Revenue Not Rptd F990486980RevenueNotRptdF990
Revenue Subtotal12038275RevenueSubtotal
Investment Expenses Not Included14776InvestmentExpensesNotIncluded
Other Revenues Not Included-19347OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-4571RevenueNotRptdOnFinStmt
Total Revenue Per Form99012033704TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt11864159TotExpensesEtcAuditedFinclStmt
Other Expenses Included19347OtherExpensesIncluded
Expenses Not Rptd F99019347ExpensesNotRptdF990
Expenses Subtotal11844812ExpensesSubtotal
Investment Expenses Not Included214776InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt14776ExpensesNotRptdOnFinStmt
Total Expenses Per Form99011859588TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2ECA-CORPORATE AND ITS SUBORDINATE ORGANIZATIONS ARE EACH EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE LAWS OF THE STATE IN WHICH THEY OPERATE. HOWEVER, ECA IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. EFFECTIVE IN FISCAL YEAR ENDED JUNE 30, 2010, ECA BEGAN TO DETERMINE WHETHER ANY UNCERTAIN TAX POSITIONS EXISTED IN ACCORDANCE WITH ASC TOPIC 740. UNDER ECA'S POLICY, IF AN UNCERTAIN TAX POSITION IS IDENTIFIED, ECA FIRST EVALUATES THE TAX POSITION FOR RECOGNITION BY DETERMINING IF THE WEIGHT OF AVAILABLE EVIDENCE INDICATED THAT IT IS MORE-LIKELY-THAN-NOT THAT THE POSITION WOULD BE SUSTAINED UPON AUDIT, INCLUDING RESOLUTION OF RELATED APPEALS OR LITIGATIONS PROCESSES, IF ANY. ECA THEN MEASURES THE TAX BENEFIT OR LIABILITY AS THE LARGEST AMOUNT THAT IS MORE THAN 50% LIKELY TO BE REALIZED OR INCURRED UPON SETTLEMENT. COMPLIANCE WITH THIS GUIDANCE HAD NO EFFECT ON ECA'S CONSOLIDATED FINANCIAL STATEMENTS.
OTHER REVENUE INCLUDED ON FORM 990 NOT ON AUDITED FINANCIAL STATEMENTSSCHEDULE D, PART XII, LINE 4B(19,124) SPECIAL EVENTS EXPENSE ( 223) LOSS ON SALE OF ASSETS RECLASSED FROM EXPENSES ------- (19,347)
OTHER EXPENSE INCLUDED ON AUDITED FINANCIAL STATEMENTS NOT ON FORM 990SCHEDULE D, PART XIII, LINE 2D19,124 SPECIAL EVENTS EXPENSE 223 LOSS ON SALE OF ASSETS RECLASSED TO REVENUE -------- 19,347
ESCROW ACCOUNT LIABILITYSCHEDULE D, PART IV, LINE 2BTHE ORGANIZATION HAS A SMALL SEPARATE TRUST BANK ACCOUNT AND CASH BOX HELD FOR RESIDENTS.
ENDOWMENT PURPOSESCHEDULE D, PART V, LINE 4THERE ARE THREE ENDOWMENT FUNDS, ALL OF WHICH REQUIRE THE INCOME TO BE USED FOR CHARITABLE CARE OF RESIDENTS.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SALEM SALUTESNameOfEvent1
Gross Receipts Event132457GrossReceiptsEvent1
Charitable Contributions Event124557CharitableContributionsEvent1
Gross Revenue Event17900GrossRevenueEvent1
Food And Beverage Event111719FoodAndBeverageEvent1
Entertainment Event1400EntertainmentEvent1
Other Direct Expenses Event17005OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total32457GrossReceiptsTotal
Charitable Contributions Total24557CharitableContributionsTotal
Gross Revenue Total Events7900GrossRevenueTotalEvents
Food And Beverage Total Events11719FoodAndBeverageTotalEvents
Entertainment Total Events400EntertainmentTotalEvents
Other Direct Expenses Total Events7005OtherDirectExpensesTotalEvents
Direct Expense Summary Events19124DirectExpenseSummaryEvents
Net Income Summary-11224NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierMONITORING USE OF GRANT FUNDSIdentifier
Return ReferenceSCHEDULE I, PART 1, LINE 2ReturnReference
ExplanationTHE ORGANIZATION GIVES CHARITABLE CONTRIBUTIONS TO VARIOUS ORGANIZATIONS DEPENDING ON THE NATURE OF THE REQUEST AND WHETHER IT RELATES TO THEIR CHARITABLE, FAITH-BASED MISISON. THE ORGANIZATION KEEPS RECORDS OF THESE DONATIONS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4DOTHER PROGRAM SERVICES INCLUDE INDEPENDENT LIVING, WHICH CONSISTS OF 35 APARTMENT-STYLE UNITS AND 4 COTTAGES. ADDITIONALLY, CHARITABLE CONTRIBUTIONS WERE GIVEN TO VARIOUS ORGANIZATIONS. SEE SCHEDULE I FOR FURTHER DETAIL.
DELEGATION OF MANAGEMENT DUTIESFORM 990, PART VI, SECTION A, LINE 3SALEM HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE, A NON-PROFIT PUBLIC BENEFIT CORPORATION THAT IS THE SOLE CORPORATE MEMBER OF SALEM, TO PROVIDE MANAGEMENT SERVICES INCLUDING, BUT NOT LIMITED TO, MARKETING, HUMAN RESOURCES, ACCOUNTING, INFORMATION TECHNOLOGY SERVICES, CLINICAL OVERSIGHT AND INSURANCE. SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS OF THE ORGANIZATION WERE AMENDED ON SEPTEMBER 28, 2010 TO REMOVE THE CEO AS AN EX-OFFICIO VOTING MEMBER OF THE BOARD OF DIRECTORS AND TO PROVIDE FOR A NON-VOTING RESIDENT REPRESENTATIVE TO THE BOARD.
MEMBERSFORM 990, PART VI, SECTION A, LINES 6, 7A, & 7BTHE ORGANIZATION'S SOLE CORPORATE MEMBER IS ELDER CARE ALLIANCE. APPOINTMENT OF DIRECTORS: (A) THE BOARD OF DIRECTORS OF THE CORPORATION SHALL INCLUDE NO GREATER THAN THIRTEEN (13) INDIVIDUALS APPOINTED IN ACCORDANCE WITH THE FOLLOWING: (I) FIVE (5) INDIVIDUALS APPOINTED BY THE FACILITY AND PROGRAM SPONSOR, THE SIERRA PACIFIC SYNOD OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA; (II) FIVE (5) INDIVIDUALS APPOINTED BY THE CO-SPONSOR OF THE CORPORATE MEMBER, THE BURLINGAME REGIONAL COMMUNITY OF THE SISTERS OF MERCY OF THE AMERICAS, WEST MIDWEST COMMUNITY, INC., A DIVISION OF THE SISTERS OF MERCY OF THE AMERICAS, A RELIGIOUS INSTITUTE AND PUBLIC JURIDIC PERSON OF THE ROMAN CATHOLIC CHURCH; (III)A MAXIMUM OF TWO (2) INDIVIDUALS JOINTLY APPOINTED BY THE FACILITY AND PROGRAM SPONSOR AND BY THE CO-SPONSOR OF THE CORPORATE MEMBER; AND (IV) ONE (1) INDIVIDUAL NOMINATED BY THE RESIDENT COUNCIL OF SALEM LUTHERAN HOME, THE CONTINUING CARE RETIREMENT COMMUNITY OWNED AND OPERATED BY THE CORPORATION (THE "CCRC") AND APPOINTED BY THE APPOINTEES NAMED PURSUANT TO SUBPARAGRAPHS (I), (II) AND (III) ABOVE, WHICH NOMINEE MUST BE A RESIDENT OF THE CCRC AND WHO WILL NOT HAVE VOTING RIGHTS BUT SHALL HAVE THE SAME FIDUCIARY DUTIES, INCLUDING THE DUTIES OF LOYALTY, CARE AND CONFIDENTIALITY, TO THE CORPORATION IN THEIR ROLE OF RESIDENT REPRESENTATIVE. NOMINATION OF DIRECTORS: (A) SPONSOR AND CO-SPONSOR APPOINTEES. THE BOARD DEVELOPMENT COMMITTEE OF THE CORPORATE MEMBER SHALL IDENTIFY AND EVALUATE QUALIFIED INDIVIDUALS TO SERVE AS DIRECTORS OF THE CORPORATION AND SHALL RECOMMEND THEM TO THE FACILITY AND PROGRAM SPONSOR AND THE CO-SPONSOR OF THE CORPORATE MEMBER FOR APPOINTMENT OF THE SPONSOR AND CO-SPONSOR APPOINTEES. (B) RESIDENT REPRESENTATIVE. THE RESIDENT REPRESENTATIVE SHALL BE NOMINATED BY THE RESIDENT COUNCIL OF THE CCRC IN ANY MANNER DETERMINED BY THE RESIDENT COUNCIL THAT IS REASONABLY CALCULATED TO ENCOURAGE RESIDENT INVOLVEMENT IN SELECTING AND/OR SERVING AS THE RESIDENT REPRESENTATIVE, SO LONG AS THE RESIDENT COUNCIL CONVENES A MEETING FOR SUCH PURPOSE UPON NO LESS THAN THIRTY (30) DAYS' NOTICE. NOTICE OF THE MEETING SHALL BE POSTED IN A CONSPICUOUS PLACE WITHIN THE CCRC AND SHALL STATE THAT THE PURPOSE OF THE MEETING IS TO NOMINATE A RESIDENT TO THE BOARD OF THE CORPORATION. THE FOLLOWING ACTIONS REGARDING SALEM LUTHERAN HOME ("SALEM") SHALL NOT BE IMPLEMENTED WITHOUT THE SPECIFIC APPROVAL OF ELDER CARE ALLIANCE'S CORPORATE MEMBER, SIERRA PACIFIC SYNOD: (A) THE SALE, PURCHASE LEASE OR ENCUMBRANCE OF THE REAL PROPERTY OF SALEM; (B) ANY INCREMENT OR ADDITIONS TO THE CAPITAL DEBT LIMITATION OF SALEM OR ANY OTHER NEGOTIATION, MODIFICATION OR OTHER CHANGE IN THE EXISTING CAPITAL DEBT OF SALEM; (C) ANY ACTION SEEKING BANKRUPTCY OR OTHER DEBTOR PROTECTION FOR SALEM; AND (D) ANY OTHER MATTERS WHICH MAY BE REQUIRED BY CIVIL LAW TO BE SUBMITTED TO THE SIERRA PACIFIC SYNOD, OR WHICH THE BOARD OF DIRECTORS MAY REQUEST BE SUBMITTED.
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. ELDER CARE ALLIANCE, SALEM'S SOLE CORPORATE MEMBER AND MANAGEMENT COMPANY, HAS AN AUDIT COMMITTEE ON ITS BOARD OF DIRECTORS THAT REVIEWS THE FORM 990 BEFORE FILING. ALSO, THE EXECUTIVE DIRECTOR, CEO, AND CFO ALL REVIEW THE FORM 990 BEFORE FILING. THE FINAL FORM 990 IS THEN PROVIDED BY E-MAIL TO ALL MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING.
CONFLICT OF INTEREST POLICY COMPLIANCEFORM 990, PART VI, SECTION B, LINE 12CANNUALLY, THE ASSISTANT SECRETARY OF ELDER CARE ALLIANCE REQUESTS UPDATED CONFLICT OF INTEREST DISCLOSURE FORMS FROM THE BOARD OF DIRECTORS, OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED AUTHORITY. THE ASSISTANT SECRETARY PREPARES A TABLE SUMMARIZING THE DISCLOSURES MADE AND PRESENTS THE TABLE TO THE BOARD OF DIRECTORS FOR THEIR INFORMATION. IF AN APPARENT CONFLICT OF INTEREST IS IDENTIFIED, THE MATTER IS REFERRED TO A COMMITTEE OF THE BOARD FOR REVIEW AND ACTION, IF DEEMED NECESSARY, SUCH AS REQUIRING AN INTERESTED DIRECTOR TO RECUSE HIMSELF OR HERSELF FROM A VOTE ON THE MATTER, OR TERMINATING A BUSINESS RELATIONSHIP ENTERED INTO IN VIOLATION OF THE POLICY.
COMPENSATION DETERMINATIONFORM 990, PART VI, SECTION B, LINES 15A & 15BSALEM HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE. INCLUDED IN THE SERVICES PROVIDED UNDER THIS MANAGEMENT CONTRACT ARE THE SERVICES OF THE CEO, CFO, AND EXECUTIVE DIRECTOR. THE COMPENSATION REVIEW OF THE EXECUTIVE DIRECTORS AND KEY EMPLOYEES WAS DONE IN FY 2011 BY THE FINANCE COMMITTEE OF ELDER CARE ALLIANCE AS PART OF THE BUDGET REVIEW PROCESS. THE COMPENSATION FOR THE CEO AND CFO WAS REVIEWED AGAINST COMPARABLES PROVIDED BY THE VICE PRESIDENT OF HUMAN RESOURCES OF LIFE CARE SERVICES, ELDER CARE ALLIANCE'S MANAGEMENT COMPANY.
GOVERNING DOCUMENT AVAILABILITYFORM 990, PART VI, SECTION C, LINE 19BECAUSE SALEM IS A CONTINUING CARE RETIREMENT COMMUNITY, AN ANNUAL REPORT MUST BE FILED WITH THE STATE OF CALIFORNIA CONTAINING THE ORGANIZATION'S FINANCIAL STATEMENTS. THERE IS A NON-VOTING MEMBER OF THE BOARD OF DIRECTORS THAT REPRESENTS THE SALEM RESIDENTS WHO HAS ACCESS TO ALL GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE CONFLICT OF INTEREST POLICY FOR SALEM. ALL REQUESTS MUST BE IN WRITING TO ELDER CARE ALLIANCE, SALEM'S MANAGEMENT COMPANY, AND WILL BE PROVIDED VIA EMAIL, US MAIL, OR BY FAX IF SO REQUESTED. INDEPENDENT CONTRACTORS FORM 990, PART VII, SECTION B, LINE 1(B) ELDER CARE ALLIANCE, A RELATED ORGANIZATION, IS CONTRACTED WITH LIFE CARE SERVICES TO PROVIDE MANAGEMENT SERVICES, INCLUDING THE COMPENSATION OF THE CEO, CFO, AND EXECUTIVE DIRECTOR OF SALEM. THE AMOUNT PAID TO LIFE CARE SERVICES REPRESENTS THE REIMBURSED COST OF COMPENSATION AND BENEFITS FOR THE EXECUTIVE DIRECTOR.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5486,980 NET UNREALIZED GAINS ON INVESTMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ELDER CARE ALLIANCE
1301 MARINA VILLAGE PKWY 210ALAMEDACA94501943260975MANAGEMENTCA501(C)(3)11 B IINA
MERCY RETIREMENT AND CARE CENTER
1301 MARINA VILLAGE PKWY 210ALAMEDACA94501941156579ELDERLY CARECA501(C)(3)9NA
ELDER CARE ALLIANCE OF CAMARILLO
1301 MARINA VILLAGE PKWY 210ALAMEDACA94501943351613ELDERLY CARECA501(C)(3)9NA
ELDER CARE ALLIANCE OF SAN FRANCISCO
1301 MARINA VILLAGE PKWY 210ALAMEDACA94501943351615ELDERLY CARECA501(C)(3)9NA
ELDER CARE ALLIANCE OF UNION CITY
1301 MARINA VILLAGE PKWY 210ALAMEDACA94501943377985ELDERLY CARECA501(C)(3)9NA
ELDER CARE ALLIANCE OF SAN RAFAEL
1301 MARINA VILLAGE PKWY 210ALAMEDACA94501760730971ELDERLY CARECA501(C)(3)9NA
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 OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
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 OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg