CAPITOL LAKES INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CAPITOL LAKES INC (EIN 39-1412320)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-07-09
- IRS object ID
- 201121909349300202
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-07-09T15:16:16-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391412320 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPITOL LAKES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CAPI | NameControl |
| Phone | 5418577854 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 MIRA MAR AVENUE | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97405 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN MCLEMORE | Name |
| Title | PRESIDENT | Title |
| Phone | 5418577854 | Phone |
| Date Signed | 2011-07-11 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRIAN MCLEMORE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 MIRA MAR AVE | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17769311 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.RETIREMENT.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | CAPITOL LAKES INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 3 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 272 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 5047 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17070710 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17553930 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 146017 | InvestmentIncomePriorYear |
| Investment Income Current Year | 118720 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17221774 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17672650 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8776650 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8362630 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13543552 | OtherExpensePriorYear |
| Other Expenses Current Year | 14198175 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22320202 | TotalExpensesPriorYear |
| Total Expenses Current Year | 22560805 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -5098428 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -4888155 | RevenuesLessExpensesCY |
| Total Assets BOY | 73887170 | TotalAssetsBOY |
| Total Assets EOY | 72909793 | TotalAssetsEOY |
| Total Liabilities BOY | 84470194 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 90869226 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -10583024 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -17959433 | NetAssetsOrFundBalancesEOY |
| Mission Description | CAPITOL LAKES INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8054831 | Expense |
| Revenue | 2470497 | Revenue |
| Description | HEALTH CARE CENTER HAS BEEN ESTABLISHED TO CARE FOR THE NEEDS OF ALL RESIDENTS OF CAPITOL LAKES | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1930091 | Expense |
| Revenue | 302788 | Revenue |
| Description | A FOOD PROGRAM HAS BEEN ESTABLISHED TO PROVIDE QUALITY AND NUTRITIONAL MEALS FOR ALL RESIDENTS OF CAPITOL LAKES | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2199968 | Expense |
| Revenue | 4061 | Revenue |
| Description | RESIDENTIAL COMMUNAL CARE FOR THE OVER 250 RESIDENTS OF CAPITOL LAKES | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 12184890 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 22 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 272 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Nbr Voting Governing Body Members | 3 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPITOL LAKES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5418577854 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 MIRA MAR AVE | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97504 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| William Bagley | ||||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| Len Merryman | ||||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| Larry Boeck | ||||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| ANTHONY SABATINI | ||||||||
| EXECUTIVE ADMINISRTAOR | 40.00 | 155008 | 0 | 21108 | X | |||
| LINDA LANE | ||||||||
| HEALTH CENTER ADIMINISTO | 40.00 | 132386 | 0 | 0 | X | |||
| KATHY GROTH | ||||||||
| RESIDENT SERVICDES DIREC | 40.00 | 102705 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 390099 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 21108 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Consonus Rehab | |||||
| 4560 SE International Way | Milwaukee | OR | 97222 | THERAPY | 1477678 |
| McGann Construction Inc | |||||
| 3622 Lexington Ave | MADISON | WI | 53714 | CONSTRUCTION | 831375 |
| Sysco Foods of Baraboo LLC | |||||
| PO Box 90 | BARABOO | WI | 53913 | FOOD SUPPLIES | 689724 |
| Mallatt Homecare Pharmacy | |||||
| 3250 Kingsley Way | Madison | WI | 53713 | PHARMACY SUPPLIES | 423971 |
| Physicians Plus Insurance Corp | |||||
| PO Box 630693 | Cincinatti | OH | 452630693 | MEDICAL SUPPLIES | 139284 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| HEALTH CENTER REVENUE | 531110 | 9442445 | 9442445 |
| SERVICES FEES | 531110 | 6288229 | 6288229 |
| ENTRANCE FEES | 531110 | 1081691 | 1081691 |
| OTHER REVENUE | 531110 | 741565 | 741565 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17553930 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 215381 | TotalRevenueColumn |
| Exclusion | $215,381 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 96661 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -96661 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -96661 | TotalRevenueColumn |
| Related Or Exempt Function Income | -96661 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17672650 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17457269 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $215,381 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6538442 | Total |
| Program Services | 5738946 | ProgramServices |
| Management And General | 799496 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 219177 | Total |
| Program Services | 191540 | ProgramServices |
| Management And General | 27637 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1123545 | Total |
| Program Services | 962052 | ProgramServices |
| Management And General | 161493 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 481466 | Total |
| Program Services | 424102 | ProgramServices |
| Management And General | 57364 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 996280 | Total |
| Management And General | 996280 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51089 | Total |
| Management And General | 51089 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186216 | Total |
| Management And General | 186216 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 323973 | Total |
| Management And General | 323973 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31776 | Total |
| Program Services | 20291 | ProgramServices |
| Management And General | 11485 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207954 | Total |
| Program Services | 2206 | ProgramServices |
| Management And General | 205748 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5260 | Total |
| Program Services | 5260 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29772 | Total |
| Program Services | 10790 | ProgramServices |
| Management And General | 18982 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3790882 | Total |
| Management And General | 3790882 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3026659 | Total |
| Management And General | 3026659 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONTRACT SERVICES | 1905579 | 1701019 | 204560 |
| OTHER HEALTH SERVICE EX | 812653 | 812653 | |
| UTILITIES | 774627 | 774627 | |
| OTHER DIETARY EXPENSES | 730875 | 730875 | |
| BAD DEBT | 281052 | 281052 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1043528 | Total |
| Program Services | 529477 | ProgramServices |
| Management And General | 514051 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22560805 | Total |
| Program Services | 12184890 | ProgramServices |
| Management And General | 10375915 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2995266 | BOY |
| EOY | 1384138 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2465241 | BOY |
| EOY | 1871111 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26375 | BOY |
| EOY | 24673 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 164758 | BOY |
| EOY | 335491 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 54340314 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7237559 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48132248 | BOY |
| EOY | 47102755 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5268358 | BOY |
| EOY | 8427200 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14834924 | BOY |
| EOY | 13764425 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73887170 | BOY |
| EOY | 72909793 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3328592 | BOY |
| EOY | 3502137 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16899818 | BOY |
| EOY | 19238150 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58470000 | BOY |
| EOY | 58470000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5771784 | BOY |
| EOY | 9658939 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84470194 | BOY |
| EOY | 90869226 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -10956632 | BOY |
| EOY | -18362470 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 297281 | BOY |
| EOY | 326710 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76327 | BOY |
| EOY | 76327 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -10583024 | BOY |
| EOY | -17959433 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73887170 | BOY |
| EOY | 72909793 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3191 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8940 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5858 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5047 | CurrentTaxYearMinus1Year |
| Total | 23036 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 16218699 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 16441247 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7767598 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17070710 | CurrentTaxYearMinus1Year |
| Current Tax Year | 16812365 | CurrentTaxYear |
| Total | 74310619 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 16221890 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 16450187 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7773456 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17075757 | CurrentTaxYearMinus1Year |
| Current Tax Year | 16812365 | CurrentTaxYear |
| Total | 74333655 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 74333655 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 362609 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 428073 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 244758 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 197403 | CurrentTaxYearMinus1Year |
| Current Tax Year | 215381 | CurrentTaxYear |
| Total | 1448224 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 362609 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 428073 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 244758 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 197403 | CurrentTaxYearMinus1Year |
| Current Tax Year | 215381 | CurrentTaxYear |
| Total | 1448224 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 509394 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 758683 | CurrentTaxYearMinus3Years |
| Current Tax Year | 741565 | CurrentTaxYear |
| Total | 2009642 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 17093893 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 17636943 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8018214 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17273160 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17769311 | CurrentTaxYear |
| Total | 77791521 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.95550 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.96030 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.01860 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01860 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 54340314 | OtherCostOrOtherBasis |
| Depreciation | 7237559 | Depreciation |
| Book Value | 47102755 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 47102755 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SHORT TERM INVESTMENT | Description |
| Book Value | 8427200 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 8427200 | TotalOfBookValueSecurities |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| RESTRICTED CASH | 390834 |
| ASSETS RESTRICTED UNDER BOND INDUENTURE AGREEMENT | 11970846 |
| BOND ISSUE COSTs (NET) | 1357912 |
| INTEREST IN NET ASSETS OF CAPITOL LAKES FOUNDATION | 26242 |
| DUE FROM AFFILIATES | 18591 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 13764425 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| REFUNDABLE DEPOSITS | $159,261 |
| DUE TO AFFILIATES | $2,917,836 |
| SWAP AGREEMENTS | $6,285,283 |
| OTHER CURRENT LIABILITIES | $36,477 |
| ASSET RETIREMENT OBLIGATION | $260,082 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 9658939 | TotalOfAmounts |
| Total Revenue | 17672650 | TotalRevenue |
| Total Expenses | 22560805 | TotalExpenses |
| Excess Or Deficit For Year | -4888155 | ExcessOrDeficitForYear |
| Other | -$2,488,253 | OtherAmount |
| Total Adjustments | -2488253 | TotalAdjustments |
| Excess Or Deficit Per FS | -7376408 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 17769311 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 17769311 | RevenueSubtotal |
| Other Revenues Not Included | -96661 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -96661 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17672650 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 22657466 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 96661 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 96661 | ExpensesNotRptdF990 |
| Expenses Subtotal | 22560805 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 22560805 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | SWAP LOSS: -2730150. CHANGE IN NET ASSETS OF CAPITOL LAKES FOUNDATION: 26242. NON OPERATING REVENUE: 21526. UNREALIZED GAIN ON INVESTMENT: 194129. |
| DISPOSAL OF ASSETSS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANTHONY SABATINI | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Base Compensation Filing Org | 155008 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 21108 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 176116 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||
| 391337855 | 97710VEZ7 | 2002-04-02 | 8000000 | SERIES - 2002 | 0 | 0 |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||
| 391337855 | 97710V7V4 | 2008-04-01 | 15210000 | SERIES - 2008A | 0 | 0 |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||
| 391337855 | 97710V7W2 | 2008-04-01 | 29380000 | SERIES - 2008B | 0 | 0 |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||
| 391337855 | 97710V7X0 | 2008-04-01 | 6985000 | SERIES - 2008C | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount In Reserve FundAmountInReserveFund | Amount DefeasedAmountDefeased | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|
| 8000000 | 241948 | 7758052 | 2008 | 1 | 0 | 1 | 0 | |||
| 15210000 | 550394 | 13512493 | 2010 | 0 | 0 | 0 | 0 | 1147113 | ||
| 29380000 | 1064998 | 15188972 | 1 | 0 | 0 | 0 | 1980325 | 3707534 | 7888171 | |
| 6985000 | 329461 | 6229069 | 2010 | 0 | 0 | 0 | 0 | 426470 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | LARRY BOECK USES WILLIAM BAGLEY AS HIS ACCOUNTANT WILLIAM BAGLEY AND LEN MERRYMAN OWN PROPERTY TOGETHER |
| Form 990, Part VI, Section A, line 3 | CAPITOL LAKES DELEGATES DAY TO DAY MANAGEMENT TO PACIFIC RETIREMENT SERVICES |
| Form 990, Part VI, Section A, line 7a | PACIFIC RETIREMENT SERVICES CAN APPOINT BOARD MEMBERS |
| Form 990, Part VI, Section A, line 7b | SOME DECISIONS OF THE BOARD ARE SUBJECT TO APPROVAL BY PACIFIC RETIREMENT SERVICES |
| Form 990, Part VI, Section B, line 11 | THE FORM 990 IS CURRENTLY BEING REVEIWED BY CONTROLLER AND THE BOARD OF DIRECTORS |
| Form 990, Part VI, Section B, line 12c | CORPORATE 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 18 | ALL REQUESTS GO THROUGH THE CORPORATE COUNSEL |
| Form 990, Part VI, Section C, line 19 | ALL REQUESTS GO THROUGH THE CORPORATE COUNSEL |
| FORM 990, PART XI, LINE 2C | PACIFIC RETIREMENT SERVICE'S AUDIT COMMITTEE SELECTS AUDITORS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (50 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|
| Pacific Retirement Services | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Supporting Org | OR | 501(c)(3) | 13 | Pacific Retirement Services |
| PRS | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| RVM | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Trinity | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | TX | 501(c)(3) | 9 | Pacific Retirement Services |
| Cascade Manor | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| URCAD | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | CA | 501(c)(3) | 9 | Pacific Retirement Services |
| Holladay Park Plaza | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Capitol Lakes | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | WI | 501(c)(3) | 9 | Pacific Retirement Services |
| RVM Foundation | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Public Foundation | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| URCAD Foundation | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Public Foundation | CA | 501(c)(3) | 9 | Pacific Retirement Services |
| Trinity Terrace Foundation | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Public Foundation | TX | 501(c)(3) | 9 | Pacific Retirement Services |
| HPP Foundation | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Public Foundation | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Mirabella Washington Foundation | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Public Foundation | WA | 501(c)(3) | 9 | Pacific Retirement Services |
| Cascade Manor Foundation Inc | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Public Foundation | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Capitol Lakes Foundation | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Public Foundation | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Mira Bella | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | WA | 501(c)(3) | 9 | Pacific Retirement Services |
| Mira Bella South Waterfront | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Mira Bella San Francisco Bay | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | CA | 501(c)(3) | 9 | Pacific Retirement Services |
| FGP RVM Comm SvcsAP | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Community Services | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| RSVP | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Community Services | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Ross Knotts | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Don Lewis | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Foothill | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Oak Grove | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Valley ViewMyrtle Creek | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Pilot Butte | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Royal Loto | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Klamath View | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Larson Creek | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Lively OaksGlenridge Terrace | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Timber RidgeRVM Reedsport Housing Co | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Sierra Vista | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | CA | 501(c)(3) | 9 | Pacific Retirement Services |
| Kingsley Court | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Silverstone | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | TX | 501(c)(3) | 9 | Pacific Retirement Services |
| Pilot Butte II | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Fairview Fort Worth II Housing Corp | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | TX | 501(c)(3) | 9 | Pacific Retirement Services |
| Quail Ridge | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Meadow Creek RVM Roseburg II | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Foothill II | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Shasta Point | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | CA | 501(c)(3) | 9 | Pacific Retirement Services |
| Valley View II RVM Myrtle Creek II (Plaza) | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Columbia TerraceRVM Portland | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Woodland Heights | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Central Point | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Magnolia Heights | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | TX | 501(c)(3) | 9 | Pacific Retirement Services |
| Middleton Glen Inc | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | WI | 501(c)(3) | 9 | Pacific Retirement Services |
| Senior Housing of Middleton Inc | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | WI | 501(c)(3) | 9 | Pacific Retirement Services |
| PRS School of Aging Services Inc | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | School | OR | 501(c)(3) | 9 | Pacific Retirement Services |
| Corbinton Retirement | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | NC | 501(c)(3) | 9 | Pacific Retirement Services |
| Mirabella Marin | ||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | Senior Housing | CA | 501(c)(3) | 9 | Pacific Retirement Services |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|
| Crest Park | |||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | 931169683 | Hotel | OR | Pacific Retirement Services | C | 1.00000 |
| RS INC | |||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | 931328250 | Management Co | OR | Pacific Retirement Services | C | 1.00000 |
| Centennial Inc | |||||||||
| 1200 Mira Mar Ave | Medford | OR | 97504 | 510554651 | Golf Course | OR | Pacific Retirement Services | C | 1.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| MIDDLETON GLEN | |
| K | 34556 |
| PACIFIC RETIREMENT SERVICES | |
| O | 13316 |
| OTHER AFFILIATES | |
| O | 2758 |
| PACIFIC RETIREMENT SERVICES | |
| L | 1386386 |