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CUMBERLAND REST HOME TRINITY TERRACE: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CUMBERLAND REST HOME TRINITY TERRACE (EIN 75-0891470)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-04-30
IRS object ID
201121209349300802
Schema version
2009v1.4
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)
Timestamp2011-04-30T13:40:31-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN750891470EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE CUMBERLAND REST INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCUMBNameControl
Phone5418577854Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 MIRA MAR AVEAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97504ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRIAN MCLEMOREName
TitlePRESIDENTTitle
Phone5418577854Phone
Date Signed2011-05-06DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRIAN MCLEMORENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11200 mira mar aveAddressLine1
CitymedfordCity
StateORState
ZIP Code97504ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17209991GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteRETIREMENT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1990YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionTHE PRIMARY EXEMPT PURPOSE OF THE CUMBERLAND REST IS TO PROVIDE COMPREHENSIVE CARE AND HOUSING FOR RETIRED INDIVIDUALSActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees198TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2016ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14372299ProgramServiceRevenuePriorYear
Program Service Revenue CY16572145ProgramServiceRevenueCY
Investment Income Prior Year226262InvestmentIncomePriorYear
Investment Income Current Year335610InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14600577TotalRevenuePriorYear
Total Revenue Current Year16907755TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5519373SalariesEtcPriorYear
Salaries Etc Current Year5626363SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year14379919OtherExpensePriorYear
Other Expenses Current Year12021400OtherExpensesCurrentYear
Total Expenses Prior Year19899292TotalExpensesPriorYear
Total Expenses Current Year17647763TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-5298715RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-740008RevenuesLessExpensesCY
Total Assets BOY87741358TotalAssetsBOY
Total Assets EOY95337346TotalAssetsEOY
Total Liabilities BOY92434954TotalLiabilitiesBOY
Total Liabilities EOY95850841TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-4693596NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-513495NetAssetsOrFundBalancesEOY
Mission DescriptionTHE PRIMARY EXEMPT PURPOSE OF THE CUMBERLAND REST IS TO PROVIDE COMPREHENSIVE CARE AND HOUSING FOR RETIRED INDIVIDUALSMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3437704Expense
Revenue3558206Revenue
DescriptionHEALTH CARE CENTER HAS BEEN ESTABLISHED TO CARE FOR THE NEEDS OF ALL RESIDENTS OF TRINITY TERRACEDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2083358Expense
Revenue246626Revenue
DescriptionA FOOD SERVICE PROGRAM HAD BEEN ESTABLISHED TO PROVIDE QUALITY AND NUTRITIONAL MEALS FOR ALL RESIDENTS OF TRINITY TERRACEDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3079367Expense
Revenue20113Revenue
DescriptionRESIDENTIAL COMMUNAL CARE FOR ALL RESIDENTS OF TRINITY TERRACE. THIS INCLUDES PLANNED RECREATIONAL AND OTHER ACTIVITIESDescription
FieldValueIRS element (for citing)
Total Program Service Expense8600429TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109681NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees198NumberOfEmployees
Employment Tax Returns Filed0EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledTXStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1TRINITY TERRACEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5418577854TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 MIRA MAR AVEAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97504ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
ALLAN BARR
PAST CHAIR1.00XX000
GRETCHEN SMITH
SECRETARY1.00XX000
MICHAEL HYATT
treASURER1.00XX000
Rev Karl Travis
DIRECTOR1.00X000
JIM AUSTIN
DIRECTOR1.00X000
LARRY ANFIN
DIRECTOR1.00X000
HARRY KNIGHT
DIRECTOR1.00X000
DONALD MILLS
DIRECTOR1.00X000
JIM WHITToN
VICE CHAIR1.00XX000
DOUG WILSON
CHAIR1.00XX000
FREDDY JONES
DIRECTOR1.00X000
CARLELA VOGEL
DIRECTOR1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Lone Star Classic Construction
3750 Kelly RoadALEDOTX76008reNOVATIONS1392952
SYSCO FOOD SERVICES
PO BOX 560700LEWISVILLETX97056FOOD SUPPLIER440947
HBCC Funding LLC 02-1
PO BOX 4500PORTLANDOR97208PHYSICAL THERAPY324842
V TECH MECHANICAL
PO BOX 737LILLIANTX76061RENOVATIONS176046
Glenview Prof Pharmacy II
7640 Glenveiw DriveFORT WORTHTX76118RENOVATIONS116780
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MONTHLY SERVICE FEES53111095638199563819
HEALTH CENTER REVENUE53111035582063558206
ENTRANCE FEES53111030685573068557
OTHER REVENUE531110381563381563
FieldValueIRS element (for citing)
Total Program Service Revenue16572145TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column637846TotalRevenueColumn
Exclusion$637,846ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities302236Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-302236Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-302236TotalRevenueColumn
Related Or Exempt Function Income-302236RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16907755TotalRevenueColumn
Related Or Exempt Function Income16269909RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$637,846ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4429454Total
Program Services3762172ProgramServices
Management And General667282ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total107755Total
Program Services83325ProgramServices
Management And General24430ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total734441Total
Program Services618611ProgramServices
Management And General115830ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total354713Total
Program Services302603ProgramServices
Management And General52110ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1090397Total
Management And General1090397ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total26310Total
Management And General26310ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total167914Total
Management And General167914ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total235643Total
Management And General235643ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total17216Total
Program Services4572ProgramServices
Management And General12644ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total40937Total
Program Services1116ProgramServices
Management And General39821ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total433528Total
Program Services432947ProgramServices
Management And General581ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total31491Total
Program Services7531ProgramServices
Management And General23960ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2562800Total
Management And General2562800ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3514621Total
Management And General3514621ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UTILITIES11758051175805
CONTRACT SERVICES798024687659110365
OTHER DIETARY EXPENSE759263759263
OTHER HEALTH EXPENSE385549385549
INSURANCE265014265014

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total516888Total
Program Services379276ProgramServices
Management And General137612ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17647763Total
Program Services8600429ProgramServices
Management And General9047334ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3938626BOY
EOY2823215EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY16154288BOY
EOY23964956EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY380182BOY
EOY389479EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY42068BOY
EOY39730EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY170133BOY
EOY143474EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis87935797LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec29780315LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY59977928BOY
EOY58155482EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3477047BOY
EOY987844EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3601086BOY
EOY8833166EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY87741358BOY
EOY95337346EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1088505BOY
EOY1841857EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY36659774BOY
EOY40542532EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY50000000BOY
EOY47610000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4686675BOY
EOY5856452EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY92434954BOY
EOY95850841EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-7883988BOY
EOY-9014530EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1383123BOY
EOY4850179EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1807269BOY
EOY3650856EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-4693596BOY
EOY-513495EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY87741358BOY
EOY95337346EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4328CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1960CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3270CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2016CurrentTaxYearMinus1Year
Total11574Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11822548CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11957794CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23205876CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15034337CurrentTaxYearMinus1Year
Current Tax Year16571501CurrentTaxYear
Total78592056Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11826876CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11959754CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23209146CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15036353CurrentTaxYearMinus1Year
Current Tax Year16571501CurrentTaxYear
Total78603630Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50978603630PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years78768CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years442322CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years593179CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year254467CurrentTaxYearMinus1Year
Current Tax Year489216CurrentTaxYear
Total1857952Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years78768CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years442322CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years593179CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year254467CurrentTaxYearMinus1Year
Current Tax Year489216CurrentTaxYear
Total1857952Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1762264CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1285113CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1913924CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year-662041CurrentTaxYearMinus1Year
Current Tax Year298994CurrentTaxYear
Total4598254Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13667908CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13687189CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years25716249CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14628779CurrentTaxYearMinus1Year
Current Tax Year17359711CurrentTaxYear
Total85059836Total
FieldValueIRS element (for citing)
Public Support Percentage5090.92410PublicSupportPercentage509
Prior Year Support Percentage0.91440PriorYearSupportPercentage
Investment Income Percentage0.02180InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01850PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis87935797OtherCostOrOtherBasis
Depreciation29780315Depreciation
Book Value58155482BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings58155482TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
ASSETS RESTRICTED UNDER BOND INDENTURE AGREEMENT7479863
BOND ISSUE COST, NET1169623
OTHER NONCURRENT ASSETS163600
INTEREST IN NET ASSETS OF TRINITY TERRACE FOUNDATION20080
FieldValueIRS element (for citing)
Total Book Value Other Assets8833166TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE DEPOSITS$437,670
SWAP AGREEMENT$5,353,194
DUE TO FROM AFFILIATES$65,588
FieldValueIRS element (for citing)
Total Of Amounts5856452TotalOfAmounts
Total Revenue16907755TotalRevenue
Total Expenses17647763TotalExpenses
Excess Or Deficit For Year-740008ExcessOrDeficitForYear
Prior Period Adjustments3437476PriorPeriodAdjustments
Other$1,482,633OtherAmount
Total Adjustments4920109TotalAdjustments
Excess Or Deficit Per FS4180101ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt17209991TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal17209991RevenueSubtotal
Other Revenues Not Included-302236OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-302236RevenueNotRptdOnFinStmt
Total Revenue Per Form99016907755TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt17949999TotExpensesEtcAuditedFinclStmt
Other Expenses Included302236OtherExpensesIncluded
Expenses Not Rptd F990302236ExpensesNotRptdF990
Expenses Subtotal17647763ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99017647763TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 8 - Other Adjustments:UNREALIZED GAIN ON INVESTMENT SECURITIES: 647556. SWAP AGREEMENT LOSS: -1478501. UNREALIZED GAIN ON ASSETS HELD IN TRUST: 52322. CHANGE IN TEMPORARILY RESTRICITED ASSTS: 17976. CHANGE IN TINTEREST IN TRINITY TERRACE FAOUNDATION: 20080. CHANGE IN FMV OF SPLIT INTEREST TRUST: 2223200.
DISPOSAL OF ASSETS

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1TARRANT COUNTY HEALTH FACILITES DEVELOPMENT CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN751881060IssuerEIN
CUSIP Number87638LCJ3CUSIPNumber
Date Issued2006-12-07DateIssued
Issue Price55000000IssuePrice
Description Of PurposeFINANCE CONSTRUCTION OF NEW BUILDINGDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds55000000TotalProceeds
Issuance Costs From Proceeds1490560IssuanceCostsFromProceeds
Capital Expenditures53509440CapitalExpenditures
Year Of Subst Completion2009YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged0BondCounselRoutinelyEngaged
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 2THE EXECUATIVE ADMINSITRATOR, MIKE MORRIS, IS RELATED BY MARRIAGE TO TOM BECKER, PACIFIC RETIREMENT SERVICES PRESIDENT
Form 990, Part VI, Section A, line 3TRINITY TERRACE BOARD DELEGATES DAY TO DAY MANAGEMENT TO PACIFIC RETIREMENT SERVICES
Form 990, Part VI, Section A, line 7aPACIFIC RETIREMENT SERVCES CAN APPOINT BOARD MEMBERS TO THE TRINITY TERRACE BOARD
Form 990, Part VI, Section A, line 7bSOME DECISIONS OF THE BOARD ARE SUBJECT TO APPROVAL BY PACIFIC RETIREMENT SERVICES
Form 990, Part VI, Section B, line 11THE FORM 990 IS CURRENTLY BEING REVEIWED BY CONTROLLER AND THE BOARD OF DIRECTORS
Form 990, Part VI, Section B, line 12cCORPORATE COUNSEL ISSUES POLICY ANNUALLY TO KEY EMPLOYEES AND BOARD MEMBERS
ORGANIZATION'S BOARD REVEIWS AND APPROVES ANNUAL BUDGET
Form 990, Part VI, Section C, line 18ALL REQUESTS GO THROUGH THE CORPORATE COUNSEL
Form 990, Part VI, Section C, line 19ALL REQUESTS GO THROUGH THE CORPORATE COUNSEL
FORM 990 PART XI LINE 2CPACIFIC RETIREMENT SERVICE'S AUDIT COMMITTEE SELECTS AUDITORS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (50 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Pacific Retirement Services
1200 Mira Mar AveMedfordOR97504Supporting OrgOR501(c)(3)13Pacific Retirement Services
PRS
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
RVM
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Trinity
1200 Mira Mar AveMedfordOR97504Senior HousingTX501(c)(3)9Pacific Retirement Services
Cascade Manor
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
URCAD
1200 Mira Mar AveMedfordOR97504Senior HousingCA501(c)(3)9Pacific Retirement Services
Holladay Park Plaza
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Capitol Lakes
1200 Mira Mar AveMedfordOR97504Senior HousingWI501(c)(3)9Pacific Retirement Services
RVM Foundation
1200 Mira Mar AveMedfordOR97504Public FoundationOR501(c)(3)9Pacific Retirement Services
URCAD Foundation
1200 Mira Mar AveMedfordOR97504Public FoundationCA501(c)(3)9Pacific Retirement Services
Trinity Terrace Foundation
1200 Mira Mar AveMedfordOR97504Public FoundationTX501(c)(3)9Pacific Retirement Services
HPP Foundation
1200 Mira Mar AveMedfordOR97504Public FoundationOR501(c)(3)9Pacific Retirement Services
Mirabella Washington Foundation
1200 Mira Mar AveMedfordOR97504Public FoundationWA501(c)(3)9Pacific Retirement Services
Cascade Manor Foundation Inc
1200 Mira Mar AveMedfordOR97504Public FoundationOR501(c)(3)9Pacific Retirement Services
Capitol Lakes Foundation
1200 Mira Mar AveMedfordOR97504Public FoundationOR501(c)(3)9Pacific Retirement Services
Mira Bella
1200 Mira Mar AveMedfordOR97504Senior HousingWA501(c)(3)9Pacific Retirement Services
Mira Bella South Waterfront
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Mira Bella San Francisco Bay
1200 Mira Mar AveMedfordOR97504Senior HousingCA501(c)(3)9Pacific Retirement Services
FGP RVM Comm SvcsAP
1200 Mira Mar AveMedfordOR97504Community ServicesOR501(c)(3)9Pacific Retirement Services
RSVP
1200 Mira Mar AveMedfordOR97504Community ServicesOR501(c)(3)9Pacific Retirement Services
Ross Knotts
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Don Lewis
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Foothill
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Oak Grove
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Valley ViewMyrtle Creek
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Pilot Butte
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Royal Loto
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Klamath View
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Larson Creek
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Lively OaksGlenridge Terrace
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Timber RidgeRVM Reedsport Housing Co
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Sierra Vista
1200 Mira Mar AveMedfordOR97504Senior HousingCA501(c)(3)9Pacific Retirement Services
Kingsley Court
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Silverstone
1200 Mira Mar AveMedfordOR97504Senior HousingTX501(c)(3)9Pacific Retirement Services
Pilot Butte II
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Fairview Fort Worth II Housing Corp
1200 Mira Mar AveMedfordOR97504Senior HousingTX501(c)(3)9Pacific Retirement Services
Quail Ridge
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Meadow Creek RVM Roseburg II
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Foothill II
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Shasta Point
1200 Mira Mar AveMedfordOR97504Senior HousingCA501(c)(3)9Pacific Retirement Services
Valley View II RVM Myrtle Creek II (Plaza)
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Columbia TerraceRVM Portland
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Woodland Heights
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Central Point
1200 Mira Mar AveMedfordOR97504Senior HousingOR501(c)(3)9Pacific Retirement Services
Magnolia Heights
1200 Mira Mar AveMedfordOR97504Senior HousingTX501(c)(3)9Pacific Retirement Services
Middleton Glen Inc
1200 Mira Mar AveMedfordOR97504Senior HousingWI501(c)(3)9Pacific Retirement Services
Senior Housing of Middleton Inc
1200 Mira Mar AveMedfordOR97504Senior HousingWI501(c)(3)9Pacific Retirement Services
PRS School of Aging Services Inc
1200 Mira Mar AveMedfordOR97504SchoolOR501(c)(3)9Pacific Retirement Services
Corbinton Retirement
1200 Mira Mar AveMedfordOR97504Senior HousingNC501(c)(3)9Pacific Retirement Services
Mirabella Marin
1200 Mira Mar AveMedfordOR97504Senior HousingCA501(c)(3)9Pacific Retirement Services

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityPercentage OwnershipPercentageOwnership
Crest Park
1200 Mira Mar AveMedfordOR97504931169683HotelORPacific Retirement ServicesC1.00000
RS INC
1200 Mira Mar AveMedfordOR97504931328250Management CoORPacific Retirement ServicesC1.00000
Centennial Inc
1200 Mira Mar AveMedfordOR97504510554651Golf CourseORPacific Retirement ServicesC1.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
PACIFIC RETIREMENT SEERVICES
L1243348
PACIFIC RETIREMENT SEERVICES
O63658