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WILLAMETTE VIEW MANOR INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
WILLAMETTE VIEW MANOR INC (EIN 93-0463816)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-24
IRS object ID
201242989349300049
Schema version
2011v1.2
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)
Timestamp2012-10-24T15:37:01-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Date2011-01-01TaxPeriodBeginDate

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 Signed2012-10-21DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWilliam K Rouse CPAName
Phone5032223338Phone
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCRAIG VAN VALKENBURGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line112705 SE RIVER ROADAddressLine1
CityPORTLANDCity
StateORState
ZIP Code97222ZIPCode
FieldValueIRS element (for citing)
Gross Receipts22916230GrossReceipts
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 Employees447TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year146031ContributionsGrantsPriorYear
Contributions Grants Current Year511578ContributionsGrantsCurrentYear
Program Service Revenue Prior Year22620565ProgramServiceRevenuePriorYear
Program Service Revenue CY22223163ProgramServiceRevenueCY
Investment Income Prior Year391769InvestmentIncomePriorYear
Investment Income Current Year181489InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year23158365TotalRevenuePriorYear
Total Revenue Current Year22916230TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year11280584SalariesEtcPriorYear
Salaries Etc Current Year11044435SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year10969914OtherExpensePriorYear
Other Expenses Current Year10774731OtherExpensesCurrentYear
Total Expenses Prior Year22250498TotalExpensesPriorYear
Total Expenses Current Year21819166TotalExpensesCurrentYear
Revenues Less Expenses Prior Year907867RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1097064RevenuesLessExpensesCY
Total Assets BOY59820431TotalAssetsBOY
Total Assets EOY58808808TotalAssetsEOY
Total Liabilities BOY59768501TotalLiabilitiesBOY
Total Liabilities EOY57724152TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY51930NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1084656NetAssetsOrFundBalancesEOY
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
Expense7858238Expense
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)
Expense7025557Expense
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 'TO YOUR HOME FROM WILLAMETTE VIEW', 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. TYH ALSO CONTRACTS TO PROVIDE HEALTH CARE STAFFING SERVICES TO OTHER CARE PROVIDERS, AGENCIES, AND CARE FACILITIES.Description
FieldValueIRS element (for citing)
Total Program Service Expense14883795TotalProgramServiceExpense
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 With109630NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees447NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
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
Form720 FiledfalseForm720Filed
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
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 WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
MIKE MIDDAL
Treasurer2.00X000
SONJA CONNOR
Chairman2.00X000
TERENCE CONNELL
Director2.00X000
CRAIG IVERSON
Director2.00X000
MICHAEL FRASER
Director2.00X000
SARAH ROSS
Director2.00X000
KENNETH GUSTAFSON
Director2.00X000
JOHN HARTSOCK
VICE CHAIRMAN2.00X000
KYLE BERTELSEN
Director2.00X000
DR SUMATHI DEVARAJAN
Director2.00X000
CAMERON DICKEY
Director2.00X000
CRAIG VAN VALKENBURG
President & CEO40.0019450000X
BRIAN THOMPSON
CFO40.006826200X
FieldValueIRS element (for citing)
Total Reportable Comp From Org262762TotalReportableCompFromOrg
Number Individuals GT100 K1NumberIndividualsGT100K
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 Line1HUTCHINS ADVERTISING DBA REED HUTCHINSBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 8482AddressLine1
CityPORTLANDCity
StateORState
ZIP Code97207ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesADVERTISINGDescriptionOfServices
Compensation355262Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions511578AllOtherContributions
Total Contributions511578TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
TO YOUR HOME FEES62161016483831648383
RESIDENTIAL FEES6239901002763010027630
PATIENT & INFIRMARY62300061664846166484
DEPARTMENTAL & OTHER INC62399010179511017951
AMORT OF ENTRANCE FEES62399030002843000284

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column362431TotalRevenueColumn
Related Or Exempt Function Income362431RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue22223163TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column181489TotalRevenueColumn
Exclusion$181,489ExclusionAmount

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

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 Column22916230TotalRevenueColumn
Related Or Exempt Function Income22223163RelatedOrExemptFunctionIncome
Exclusion$181,489ExclusionAmount

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)
Total262762Total
Program Services222126ProgramServices
Management And General40636ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8387597Total
Program Services7090458ProgramServices
Management And General1297139ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total262318Total
Program Services233227ProgramServices
Management And General29091ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1453923Total
Program Services1292657ProgramServices
Management And General161266ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total677835Total
Program Services602663ProgramServices
Management And General75172ManagementAndGeneral

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)
Total1507780Total
Program Services658900ProgramServices
Management And General848880ManagementAndGeneral

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)
Total1138634Total
Management And General1138634ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3302897Total
Management And General3302897ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total361270Total
Program Services361270ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UTILITIES12874691287469
SUPPLIES57841054000438406
RESIDENT & PATIENT CARE525420525420
PROPERTY TAXES380682380682
FOOD COSTS14279941427994

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total264175Total
Program Services260925ProgramServices
Management And General3250ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total21819166Total
Program Services14883795ProgramServices
Management And General6935371ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3826761BOY
EOY3929836EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1698168BOY
EOY1426554EOY

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)
BOY36322BOY
EOY36321EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY301159BOY
EOY285417EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis85824681LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec39293773LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY47507281BOY
EOY46530908EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5398034BOY
EOY5471841EOY

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)
BOY1052706BOY
EOY1127931EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY59820431BOY
EOY58808808EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1199109BOY
EOY663075EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30840000BOY
EOY30210000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY27729392BOY
EOY26851077EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY59768501BOY
EOY57724152EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY51930BOY
EOY1084656EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY51930BOY
EOY1084656EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59820431BOY
EOY58808808EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1097064ReconcilationRevenueExpenses
Reconcilation Other Changes-64338ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years274812CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years412807CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years62546CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year146031CurrentTaxYearMinus1Year
Current Tax Year511578CurrentTaxYear
Total1407774Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years20987177CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21355499CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23053252CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22620565CurrentTaxYearMinus1Year
Current Tax Year22155833CurrentTaxYear
Total110172326Total

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 Years21261989CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21768306CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23115798CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22766596CurrentTaxYearMinus1Year
Current Tax Year22667411CurrentTaxYear
Total111580100Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years705880CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years407378CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years145711CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year481364CurrentTaxYearMinus1Year
Current Tax Year250494CurrentTaxYear
Total1990827Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years705880CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years407378CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years145711CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year481364CurrentTaxYearMinus1Year
Current Tax Year250494CurrentTaxYear
Total1990827Total
FieldValueIRS element (for citing)
Public Support Total509109589273PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years358806CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years369262CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years214830CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year391769CurrentTaxYearMinus1Year
Current Tax Year184489CurrentTaxYear
Total1519156Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years358806CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years369262CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years214830CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year391769CurrentTaxYearMinus1Year
Current Tax Year184489CurrentTaxYear
Total1519156Total

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 Years21620795CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22137568CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23330628CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23158365CurrentTaxYearMinus1Year
Current Tax Year22851900CurrentTaxYear
Total113099256Total
FieldValueIRS element (for citing)
Public Support Percentage5090.96900PublicSupportPercentage509
Prior Year Support Percentage0.96600PriorYearSupportPercentage
Investment Income Percentage0.01340InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01530PriorYrInvestIncomePercentage
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 Basis1241350OtherCostOrOtherBasis
Book Value1241350BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis76920115OtherCostOrOtherBasis
Depreciation33855452Depreciation
Book Value43064663BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis415845OtherCostOrOtherBasis
Depreciation264280Depreciation
Book Value151565BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7247371OtherCostOrOtherBasis
Depreciation5174041Depreciation
Book Value2073330BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings46530908TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
WORKERS COMPENSATION ACCRUAL$128,801
REFUNDABLE ENTRANCE FEES$1,000,000
REFUNDABLE ADVANCE FEES$7,271,571
DEFERRED ENTRANCE FEES$17,222,205
APARTMENT DEPOSITS$135,295
ACCRUED SALARIES & P/R TAX$1,093,205
FieldValueIRS element (for citing)
Total Of Amounts26851077TotalOfAmounts
Total Revenue22916230TotalRevenue
Total Expenses21819166TotalExpenses
Excess Or Deficit For Year1097064ExcessOrDeficitForYear
Net Unrealized GL On Investments-64330NetUnrealizedGLOnInvestments
Prior Period Adjustments-8PriorPeriodAdjustments
Total Adjustments-64338TotalAdjustments
Excess Or Deficit Per FS1032726ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt22698686TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-64330NetUnrealizedGainsInvestments
Other Revenues-153214OtherRevenues
Revenue Not Rptd F990-217544RevenueNotRptdF990
Revenue Subtotal22916230RevenueSubtotal
Total Revenue Per Form99022916230TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt21941920TotExpensesEtcAuditedFinclStmt
Other Expenses Included122754OtherExpensesIncluded
Expenses Not Rptd F990122754ExpensesNotRptdF990
Expenses Subtotal21819166ExpensesSubtotal
Total Expenses Per Form99021819166TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XIII, Line 2dPart XIII, Line 2d: Other expenses and losses per audited F/SHILLSIDE SENIOR CENTER $122754
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesLOSS ON DEBT EXTINGUISHMENT $ -0

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

FieldValueIRS element (for citing)
Name PersonCRAIG VAN VALKENBURGNamePerson
Base Compensation Filing Org194500BaseCompensationFilingOrg
Total Compensation Filing Org194500TotalCompensationFilingOrg

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

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)
Amount Retired630000AmountRetired
Total Proceeds30840000TotalProceeds
Current RefundingtrueCurrentRefunding
Advance RefundingtrueAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
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)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
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
Exception To RebatefalseExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

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 11Form 990, Part VI, Line 11: Form 990 Review ProcessFINANCE COMMITTEE, DIRECTOR OF FINANCE 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
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 Involved643000AmountInvolved
Method Of Amt DeterminationCASHMethodOfAmtDetermination