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CASCADE MANOR INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CASCADE MANOR INC (EIN 93-0557803)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-04-30
IRS object ID
201131209349300403
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)
EIN930557803EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CASCADE MANOR INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCASCNameControl
Phone5418577854Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 MIRA MAR AVEAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97405ZIPCode

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 Receipts7241836GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.RETIREMENT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1967YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionCASCADE MANOR INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees103TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4329ContributionsGrantsPriorYear
Contributions Grants Current Year47452ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7148768ProgramServiceRevenuePriorYear
Program Service Revenue CY7029226ProgramServiceRevenueCY
Investment Income Prior Year198808InvestmentIncomePriorYear
Investment Income Current Year165158InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year7351905TotalRevenuePriorYear
Total Revenue Current Year7241836TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2909957SalariesEtcPriorYear
Salaries Etc Current Year3073922SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4079549OtherExpensePriorYear
Other Expenses Current Year4121859OtherExpensesCurrentYear
Total Expenses Prior Year6989506TotalExpensesPriorYear
Total Expenses Current Year7195781TotalExpensesCurrentYear
Revenues Less Expenses Prior Year362399RevenuesLessExpensesPriorYear
Revenues Less Expenses CY46055RevenuesLessExpensesCY
Total Assets BOY32412856TotalAssetsBOY
Total Assets EOY31978547TotalAssetsEOY
Total Liabilities BOY34345653TotalLiabilitiesBOY
Total Liabilities EOY33612908TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1932797NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1634361NetAssetsOrFundBalancesEOY
Mission DescriptionCASCADE MANOR. INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1621488Expense
Revenue1013534Revenue
DescriptionHEALTH CARE CENTER HAS BEEN ESTABLISHED TO CARE FOR THE NEEDS OF ALL RESIDENTS OF CASCADE MANORDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense863612Expense
Revenue54112Revenue
DescriptionA FOOD SERVICE PROGRAM HAS BEEN ESTABLISHED TO PROVIDE QUALITY AND NUTRITIONAL MEALS FOR ALL RESIDENTS OF CASCADE MANORDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1260130Expense
Revenue26117Revenue
DescriptionRESIDENTIAL COMMUNAL CARE FOR THE OVER 100 RESIDENTS OF CASCADE MANOR.Description
FieldValueIRS element (for citing)
Total Program Service Expense3745230TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
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 Required1ScheduleJRequired
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 With109619NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees103NumberOfEmployees
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 Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CASCADE MANORBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5418577854TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
ROBERT BURKE
PRESIDENT1.00XX000
MICHAEL ELDON DRENNAN
VICE PRESIDENT1.00XX000
JAMON KENT
SECRETARY1.00XX000
JOHN THOMAS
DIRECTOR1.00X000
Carolyn Kranzler
DIRECTOR1.00X000
Martha Teich
DIRECTOR1.00X000
NIA FLECK
DIRECTOR1.00X000
JOHN PORTER
DIRECTOR1.00X000
Bill Van Vactor
DIRECTOR1.00X000
BRIAN YOUNG
EXEC ADMIN40.00145084032021X
FieldValueIRS element (for citing)
Total Reportable Comp From Org145084TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation32021TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CHAMBERS CONSTRUCTION
3028 JUDKINS RD 1EUGENEOR97403CONSTRUCTION1388169
PETER BEREZNIAK
615 HAYDEN BRIDGE PLSPRINGFIELDOR97477RENOVATIONS235649
SYSCO FOOD SERVICES
P O BOX 2210WILSONVILLEOR97070FOOD SUPPLIER181606
INTERIORS PLUS INC
25055 KYLE ROADMONROEOR97456CONSTRUCTION148485
EMK MECHANICAL INC
4290 W 11TH SUITE AEUGENEOR97402CONSTRUCTION114180
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions47452AllOtherContributions
Total Contributions47452TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MONTHLY SERVICE FEES53111043110544311054
ENTRANCE FEES53111013697561369756
HEALTH CARE FEES53111010135341013534
OTHER INCOME531110334882334882
FieldValueIRS element (for citing)
Total Program Service Revenue7029226TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column165158TotalRevenueColumn
Exclusion$165,158ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7241836TotalRevenueColumn
Related Or Exempt Function Income7029226RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$165,158ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2432916Total
Program Services2029867ProgramServices
Management And General403049ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total20354Total
Program Services4511ProgramServices
Management And General15843ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total428539Total
Program Services361088ProgramServices
Management And General67451ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total192113Total
Program Services162576ProgramServices
Management And General29537ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total358623Total
Management And General358623ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3005Total
Management And General3005ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total84903Total
Management And General84903ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total67657Total
Management And General67657ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total24162Total
Program Services10808ProgramServices
Management And General13354ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total77805Total
Program Services14719ProgramServices
Management And General63086ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total58775Total
Program Services58775ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total17795Total
Program Services7955ProgramServices
Management And General9840ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total293929Total
Management And General293929ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1812311Total
Management And General1812311ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UTILITIES292621292621
OTHER DIETARY EXPENSE278174278174
CONTRACT SERVICES18481513438750428
PROPERTY TAXES160144160144
OTHER HEALTH CENTER EXP123920123920

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total283220Total
Program Services105685ProgramServices
Management And General177535ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7195781Total
Program Services3745230ProgramServices
Management And General3450551ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1279BOY
EOY53EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1046833BOY
EOY838731EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY102685BOY
EOY54678EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY48406BOY
EOY47265EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY109707BOY
EOY65001EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis34951603LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10702591LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24821702BOY
EOY24249012EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5067704BOY
EOY5420114EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1214540BOY
EOY1303693EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32412856BOY
EOY31978547EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY832287BOY
EOY1082258EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY15423320BOY
EOY15186064EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY17165000BOY
EOY16865000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY925046BOY
EOY479586EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY34345653BOY
EOY33612908EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2373072BOY
EOY-2146084EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY440275BOY
EOY511723EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1932797BOY
EOY-1634361EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32412856BOY
EOY31978547EOY
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 Years432685CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years62590CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2991CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4329CurrentTaxYearMinus1Year
Current Tax Year47452CurrentTaxYear
Total550047Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5774992CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6143983CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7676019CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7148768CurrentTaxYearMinus1Year
Current Tax Year7029226CurrentTaxYear
Total33772988Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6207677CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6206573CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7679010CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7153097CurrentTaxYearMinus1Year
Current Tax Year7076678CurrentTaxYear
Total34323035Total

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 Total50934323035PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years101026CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years345831CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years266963CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year126637CurrentTaxYearMinus1Year
Current Tax Year165158CurrentTaxYear
Total1005615Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years101026CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years345831CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years266963CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year126637CurrentTaxYearMinus1Year
Current Tax Year165158CurrentTaxYear
Total1005615Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6308703CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6552404CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7945973CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7279734CurrentTaxYearMinus1Year
Current Tax Year7241836CurrentTaxYear
Total35328650Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97150PublicSupportPercentage509
Prior Year Support Percentage0.96920PriorYearSupportPercentage
Investment Income Percentage0.02850InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.03080PriorYrInvestIncomePercentage
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

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis34951603OtherCostOrOtherBasis
Depreciation10702591Depreciation
Book Value24249012BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24249012TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionS/T INVESTMENTSDescription
Book Value5420114BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities5420114TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ENTRANCE FEES$230,900
DUE TO AFFILIATES$38,217
ASSET RETIREMENT OBLIGATION$210,469
FieldValueIRS element (for citing)
Total Of Amounts479586TotalOfAmounts
Total Revenue7241836TotalRevenue
Total Expenses7195781TotalExpenses
Excess Or Deficit For Year46055ExcessOrDeficitForYear
Other$252,381OtherAmount
Total Adjustments252381TotalAdjustments
Excess Or Deficit Per FS298436ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt7241836TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal7241836RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9907241836TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt7195781TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal7195781ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9907195781TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8 - Other Adjustments:Identifier
ExplanationUNREALIZED GAIN ON INVESTMENT SECURITIES: 180933. CHANGE IN INTEREST OF NET ASSETS OF CM FOUNDATION: 71448.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BRIAN YOUNGBusinessNameLine1
FieldValueIRS element (for citing)
Base Compensation Filing Org145084BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org10913DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org21108NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org177105TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1HOSPITAL FACILITIES AUTHORITY OF THE CITY OF MEDFORDBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521378932IssuerEIN
CUSIP Number584283EJ0CUSIPNumber
Date Issued2006-07-13DateIssued
Issue Price18000000IssuePrice
Description Of PurposePAY OFF CONSTRUCTION LOAN FOR NEW GARDEN APARTMENTSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds18000000TotalProceeds
Issuance Costs From Proceeds555000IssuanceCostsFromProceeds
Capital Expenditures17445000CapitalExpenditures
Year Of Subst Completion2007YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
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 Engaged1BondCounselRoutinelyEngaged
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed1Form8038TFiled
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 (9 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 3CASCADE MANOR DELEGATES MANAGEMENT TO PACIFIC RETIREMENT SERVICES
Form 990, Part VI, Section A, line 7aPACIFIC RETIREMENT SERVCES CAN APPOINT CASCADE MANOR BOARD MEMBERS
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 REVIEWED 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 REVIEWS 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 Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
PACIFIC RETIREMENT SERVICES
L436789
PACIFIC RETIREMENT SERVICES
O40066
CASCADE MANOR FOUNDATION
R47452