2024-04-22T13:48:40-05:00 2023-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-07-01 941156579 MERCY RETIREMENT AND CARE CENTER MERC 5107692700 1301 MARINA VILLAGE PARKWAY 210 ALAMEDA CA 94501 BING ISENBERG CFO 5108582902 2024-04-17 1 BING ISENBERG 999009999 0 QI WEN LIANG P01270238 4159561500 2024-04-17 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ADRIENE IVERSON 1301 MARINA VILLAGE PARKWAY 210 ALAMEDA CA 94501 26248642 0 X WWW.ELDERCAREALLIANCE.ORG X 1872 CA MERCY RETIREMENT AND CARE CENTER SERVES & ENRICHES THE LIVES OF OLDER ADULTS BY PROVIDING HOUSING AND SERVICES IN ITS SKILLED NURSING, ASSISTED LIVING, AND MEMORY CARE NEIGHBORHOODS. 7 7 254 50 0 0 7361002 8120923 13984050 16394348 247257 130880 60049 63215 21652358 24709366 0 0 0 0 9558842 10334765 0 0 132204 13604701 17578504 23163543 27913269 -1511185 -3203903 60174692 59042185 28284691 28130510 31890001 30911675 X A NONPROFIT ORGANIZATION COMMITTED TO SERVING AND ENRICHING THE PHYSICAL, EMOTIONAL, AND SPIRITUAL WELL-BEING OF OLDER ADULTS THROUGH A PROFESSIONAL, FAITH-CENTERED CARE COMMUNITY AND SERVICES. 0 0 9984835 9548191 MERCY RETIREMENT AND CARE CENTER IS LICENSED FOR 59 SKILLED NURSING RESIDENTS. THIS YEAR, THE CARE CENTER PROVIDED SKILLED NURSING CARE TO 48.9 OLDER ADULT RESIDENTS EACH MONTH (ON AVERAGE) FOR AN ANNUAL TOTAL OF OVER 17,853 RESIDENTS DAYS. OF OUR RESIDENTS,13.52% WERE PRIVATE PAY, 57.17% HAD MEDI-CAL, 21.11% HAD MEDICARE, AND 8.2% HAD OTHER INSURANCE COVERAGE. 6973919 4338641 MERCY'S ASSISTED LIVING PROVIDES HOUSING AND SERVICES FOR UP TO 85 OLDER ADULT RESIDENTS THAT REQUIRE SOME ASSISTANCE WITH MEDICATION OR DAILY ACTIVITIES. THIS YEAR, WE PROVIDED ASSISTED LIVING HOUSING FOR 47.8 RESIDENTS EACH MONTH (ON AVERAGE), EXCLUDING SECOND PERSONS IN EACH APARTMENT, FOR AN ANNUAL TOTAL OF 17,447 RESIDENT DAYS. THE ASSISTED LIVING RESIDENTS ARE OFFERED FIVE LEVELS OF CARE IN ADDITION TO THE BASE LEVEL OF CARE SO THAT THEIR INDIVIDUAL NEEDS CAN BE MET. THERE ARE MANY ACTIVITIES PROVIDED FOR OUR ASSISTED LIVING RESIDENTS, INCLUDING MANY THAT REFLECT OUR FAITH-CENTERED MISSION. 5456125 MERCY'S BROWN BAG PROGRAM, PROVIDES FOOD DISTRIBUTION TO LOW INCOME SENIORS. FOR ALMOST 40 YEARS, MERCY BROWN BAG VOLUNTEERS HAVE FILLED AND DISTRIBUTED GROCERIES TO OVER 66 SITES THROUGHOUT ALAMEDA COUNTY. THE PROGRAM IS FUNDED BY CONTRIBUTIONS AND GRANTS. 2198849 2507516 MERCY'S MEMORY CARE NEIGHBORHOOD PROVIDES HOUSING AND SERVICES FOR UP TO 22 OLDER ADULT RESIDENTS WHO HAVE DEMENTIA OR MEMORY LOSS. THIS YEAR, WE PROVIDED MEMORY CARE HOUSING FOR 21.6 RESIDENTS EACH MONTH (ON AVERAGE) FOR A TOTAL OF 7,875 RESIDENT DAYS. THE MEMORY CARE NEIGHBORHOOD HAS MANY DAILY ACTIVITIES DESIGNED FOR DEMENTIA OR MEMORY LOSS RESIDENTS. 2198849 2507516 24613728 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 48 0 1 254 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X BING ISENBERG 5108582902 1301 MARINA VILLAGE PARKWAY SUITE ALAMEDA CA 94501 GERALDINE MCGRATH VICE CHAIR 1.00 5.00 X X 0 0 0 JOY MOORE CHAIR 1.00 5.00 X X 0 0 0 JACKIE EJUWA SECRETARY 1.00 5.00 X X 0 0 0 ERICKA RYAN DIRECTOR 1.00 1.00 X 0 0 0 J THOMAS BRIODY DIRECTOR (THROUGH 11/22) 1.00 1.00 X 0 0 0 SISTER PHYLLIS HUGHES DIRECTOR (THROUGH 11/22) 1.00 1.00 X 0 0 0 SISTER PAULINE BORGHELLO DIRECTOR 1.00 1.00 X 0 0 0 STEVEN KIM DIRECTOR 1.00 1.00 X 0 0 0 SUE MALLEY DIRECTOR / VOTING RESIDENT REP 1.00 0.00 X 0 0 0 ADRIENE IVERSON CEO 1.00 44.00 X 0 390376 21128 ROBIN EVITTS CFO (THRU 4/23) 1.00 44.00 X 0 0 0 BING ISENBERG INTERIM CFO (AS OF 4/23) 1.00 44.00 X 0 0 0 NICOLE FOREMAN HEALTH CARE ADMINISTRATOR 40.00 0.00 X 154931 0 8932 NANCY BEECHAM DIRECTOR OF NURSING 40.00 0.00 X 125077 0 0 AARON LAWMAN STAFF DEVELOPMENT DIRECTOR 40.00 0.00 X 117399 0 9896 TZGHEREDA BERHE LVN 40.00 0.00 X 111956 0 10425 MANDY DAVEY CARE CENTER ADMINSSIONS MANAGER 40.00 0.00 X 107079 0 8932 616442 390376 59313 7 0 1 0 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 606941985 OCCUPATIONAL/PHYSICAL THERAPY 713963 STAHL COMPANIES INC 2998 DOUGLAS BLVD SUITE 325 ROSEVILLE CA 95661 CONSTRUCTION 348395 ROTO-ROOTER SERVICES COMPANY 5672 COLLECTIONS CENTER DR CHICAGO IL 60693 PLUMBING 227756 FIRST CALL NURSING SERVICES 2300 MERCED STREET SAN LEANDRO CA 94577 TEMPORARY STAFFING 198442 SIGNATURE STAFF RESOURCES LLC 1460 TL TOWNSEND DR 104 ROCKWALL TX 75032 TEMPORARY STAFFING 172254 7 978132 7142791 4909772 8120923 HEALTH SERVICES REVENU 623000 11401573 11401573 RESIDENT SERVICES 623000 4992775 4992775 16394348 316037 316037 63215 0 63215 63215 63215 1354119 1539276 -185157 -185157 -185157 24709366 16394348 0 194095 8700535 8600311 90388 9836 123269 123269 827036 827036 683925 683119 806 1383462 130385 1253077 130102 130102 98347 98347 102700 102700 1435497 1369572 65925 234704 203709 30995 303913 276001 27696 216 449582 449582 1910388 1910388 30548 30548 933358 933358 1991537 1991537 290520 290520 FOOD 5345299 5345299 MEDICAL SUPPLIES/DRUGS 1210873 1210873 ECA EXPENSE ALLOCATION 994609 439352 531237 24020 SUPPLIES 221668 221621 47 511397 510606 432 359 27913269 24613728 3167337 132204 1635540 1328717 559262 1075959 1983106 3275360 157978 196336 48808407 8672236 40203441 40136171 14061552 10496306 1573813 2533336 60174692 59042185 3542527 2108289 22438612 24245142 2303552 1777079 28284691 28130510 X 26417507 25558928 5472494 5352747 31890001 30911675 60174692 59042185 -3203903 2225577 0 X 0 1 X 1 1 1 X 1593395 5415953 8543656 7361002 8120923 31034929 16081297 15917233 14589990 13984050 16394348 76966918 17674692 21333186 23133646 21345052 24515271 108001847 45000 851000 936500 713862 1278016 3824378 0 45000 851000 936500 713862 1278016 3824378 104177469 425242 390693 1019282 500751 379252 2715220 425242 390693 1019282 500751 379252 2715220 18099934 21723879 24152928 21845803 24894523 110717067 0.94090 0.97400 0.02450 0.02580 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3252547 465137 51764 3665920 3891430 -544366 94517 3252547 3032483 995911 136964 3891430 3481363 269242 718122 3032483 3915778 456658 891073 3481363 0.00000 0.80200 0.19800 0 1 1 201489 201489 40372130 5703230 34668900 2946430 1951917 994513 5288358 1017089 4271269 40136171 DUE TO RELATED ORGANIZATION 1771986 LEASE LIABILITY 5093 1777079 26832243 2225577 2225577 24606666 102700 102700 24709366 27810569 0 27810569 102700 102700 27913269 PART V, LINE 4: THERE ARE SIX ENDOWMENT FUNDS, ALL OF WHICH REQUIRE THE INCOME FROM THE FUNDS TO BE USED FOR CHARITY CARE OF RESIDENTS. 0 0 0 0 0 0 0 0 0 ADRIENE IVERSON CEO 0 388736 0 350 0 1290 0 12196 0 8932 0 411504 0 0 NICOLE FOREMAN HEALTH CARE ADMINISTRATOR 154620 0 76 0 235 0 0 0 8932 0 163863 0 0 0 PART I, LINE 3 THE MANAGEMENT COMPANY RELATED ORGANIZATION, ELDER CARE ALLIANCE (ECA), USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. X 2 348720 FMV X 1 4561052 FMV 0 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED, DEFINED AS EACH SEPARATE GIFT, IN SCHEDULE M, PART I, COLUMN (B). FORM 990, PART VI, SECTION A, LINE 3 MERCY HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE, A NON-PROFIT PUBLIC BENEFIT CORPORATION THAT IS THE SOLE CORPORATE MEMBER OF MERCY, TO PROVIDE MANAGEMENT SERVICES INCLUDING, BUT NOT LIMITED TO, MARKETING, HUMAN RESOURCES, ACCOUNTING, INFORMATION TECHNOLOGY SERVICES, RISK MANAGEMENT, CLINICAL OVERSIGHT AND INSURANCE. ELDER CARE ALLIANCE HIRED ROBIN EVITTS AS CFO THROUGH REACH PARTNERS LLC, A MANAGEMENT CONSULTING FIRM. AS ELDER CARE ALLIANCE'S CFO, ROBIN REPORTS TO THE CEO AND BOARD OF DIRECTORS AND HER RESPONSIBILITIES INCLUDE: OVERSEEING ALL FINANCIAL AND ACCOUNTING FUNCTIONS INCLUDING FINANCIAL CLOSE, FINANCIAL PLANNING & ANALYSIS, CASH MANAGEMENT, FINANCING, TAX AND REGULATORY FINANCIAL COMPLIANCE, PAYROLL AND ACCOUNTS PAYABLE; LEADING THE INFORMATION TECHNOLOGY FUNCTION, RESPONSIBLE FOR STRATEGY AND DELIVERY, INCLUDING INFRASTRUCTURE AND APPLICATION SUPPORT OPERATIONS; MANAGING INSURANCE STRATEGY AND BROKER PARTNERS. THE PROFESSIONAL SERVICES EXPENSE TO REACH PARTNERS IS PAID BY ELDER CARE ALLIANCE DIRECTLY. ROBIN EVITTS LEFT THE ORGANIZATION ON 4/2023. BING ISENBERG WAS HIRED AS INTERIM CFO AT THE ORGANIZATION ON 4/2023. BING WAS COMPENSATED THROUGH KORN FERRY, A CONSULTING FIRM. AS ELDER CARE ALLIANCE'S INTERIM CFO, BING REPORTS TO THE CEO AND BOARD OF DIRECTORS AND HER RESPONSIBILITIES INCLUDE: OVERSEEING ALL FINANCIAL AND ACCOUNTING FUNCTIONS INCLUDING FINANCIAL CLOSE, FINANCIAL PLANNING & ANALYSIS, CASH MANAGEMENT, FINANCING, TAX AND REGULATORY FINANCIAL COMPLIANCE, PAYROLL AND ACCOUNTS PAYABLE; LEADING THE INFORMATION TECHNOLOGY FUNCTION, RESPONSIBLE FOR STRATEGY AND DELIVERY, INCLUDING INFRASTRUCTURE AND APPLICATION SUPPORT OPERATIONS; MANAGING INSURANCE STRATEGY AND BROKER PARTNERS. THE PROFESSIONAL SERVICES EXPENSE TO KORN FERRY IS PAID BY ELDER CARE ALLIANCE DIRECTLY. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ELDER CARE ALLIANCE. FORM 990, PART VI, SECTION A, LINE 7A FINAL APPROVAL OF THE APPOINTMENTS TO THE BOARD OF DIRECTORS OF MERCY RETIRMENT AND CARE CENTER ("MRCC") SHALL REQUIRE THE APPROVAL OF THE FACILITY AND PROGRAM SPONSOR, I.E. THE INDIVIDUALS IN THER CANONICAL CAPACITY (OR THEIR DESIGNEES), WHO CONSTITUTE THE INSTITUTE LEADERSHIP TEAM OF THE SISTERS OF MERCY OF THE AMERICANS, A PUBLIC JURIDIC PERSON ONF THE ROMAN CATHOLIC CHURCH. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS REGARDING MERCY RETIREMENT AND CARE CENTER ("MRCC") SHALL REQUIRE THE SPECIFIC APPROVAL OF THE FACILITY AND PROGRAM SPONSOR, I.E. THE INDIVIDUALS IN THEIR CANONICAL CAPACITY (OR THEIR DESIGNEES), WHO CONSTITUTE THE INSTITUTE LEADERSHIP TEAM OF THE SISTERS OF MERCY OF THE AMERICAS, A PUBLIC JURIDIC PERSON OF THE ROMAN CATHOLIC CHURCH: I) APPROVAL OF ANY MATERIAL CONFLICT-OF-INTEREST, AFFILIATE OR SIMILAR TRANSACTION BETWEEN MRCC, ON THE ONE HAND, AND THE CORPORATION AND/OR AN AFFILIATE OF THE CORPORATION, ON THE OTHER HAND; PROVIDED THAT APPROVAL OF THE FACILITY AND PROGRAM SPONSOR SHALL NOT BE REQUIRED FOR COMMERCIAL TRANSACTIONS BETWEEN MRCC AND THE CORPORATION AND/OR ITS AFFILIATES, IF SUCH TRANSACTION IS ENTERED INTO IN THE ORDINARY COURSE OF BUSINESS AND AT ARM'S LENGTH TERMS AND DOES NOT EXCEED MONETARY LIMITS ESTABLISHED FROM TIME TO TIME BY ELDER CARE ALLIANCE AND APPROVED BY THE FACILITY AND PROGRAM SPONSOR; II) FINAL APPROVAL OF ANY DEFICIT OPERATING AND/OR CAPITAL BUDGET OF MRCC; III) APPROVAL OF ALL UNBUDGETED OPERATING AND CAPITAL EXPENDITURES OF MRCC IN EXCESS OF MONETARY LIMITS ESTABLISHED FROM TIME TO TIME IN ACCORDANCE WITH THE POLICIES AND NORMS OF THE FACILITY AND PROGRAM SPONSOR; IV) APPROVAL OF THE MERGER OR REORGANIZATION OF MRCC; V) APPROVAL OF SALE, TRANSFER OR DISPOSITION OF ALL OR ANY ASSETS OF MRCC IN EXCESS OF MONETARY LIMITS ESTABLISHED FROM TIME TO TIME BY FACILITY AND PROGRAM SPONSOR AND IN ACCORDANCE WITH THE POLICIES AND NORMS OF THE FACILITY AND PROGRAM SPONSOR VI) APPROVAL OF ANY DEBT OR ENCUMBRANCE OF THE CORPORATE REAL ESTATE OF MRCC; VII) APPROVAL OF ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF MRCC THAT WOULD ALTER THE CORPORATE PURPOSE, AFFILIATION, RESERVED RIGHTS OR ANY SPONSOR RELATIONSHIP OF MRCC; VIII) APPROVAL OF ANY CHANGES TO THE MISSION AND COMMON VALUES STATEMENT OF MRCC; IX) APPROVAL OF ANY REVISION OR AMENDMENT TO THE MRCC STATEMENT OF CATHOLIC IDENTITY; X) APPROVAL OF ALL MATTERS OF MRCC IMPACTING THE CATHOLIC IDENTITY OF MRCC AND ITS PROGRAMS AND SERVICES, INCLUDING , BUT NOT LIMITED TO, ADHERENCE TO AND COMPLIANCE WITH THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE AND THE MRCC STATEMENT OF CATHOLIC IDENTITY; XI) ANY OTHER MATTERS WHICH MAY BE REQUIRED BY CIVIL OR ROMAN CATHOLIC CANON LAW REGARDING MRCC TO BE SUBMITTED TO THE INSTITUTE OF THE SISTERS OF MERCY OF THE AMERICAS, OR WHICH THE MRCC BOARD OF DIRECTORS MAY REQUEST BE SUBMITTED. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. BEFORE FILING, THE FORM 990 DRAFT RETURNS ARE REVIEWED BY THE CEO AND CFO, FOLLOWED BY THE AUDIT COMMITTEE OF THE BOARD. UPON THE AUDIT COMMITTEE'S RECOMMENDATION, THE FULL BOARD REVIEWS THE FORM 990'S TO PROVIDE THEIR APPROVAL, UPON WHICH THE TAX RETURNS ARE FILED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE SECRETARY OF ELDER CARE ALLIANCE CAUSES TO BE PREPARED UPDATED CONFLICT OF INTEREST DISCLOSURE FORMS FROM THE BOARD OF DIRECTORS, OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED AUTHORITY. THE SECRETARY PREPARES A TABLE SUMMARIZING THE DISCLOSURES MADE AND PRESENTS THE TABLE TO THE BOARD OF DIRECTORS FOR THEIR INFORMATION. IF AN APPARENT CONFLICT OF INTEREST IS IDENTIFIED, THE MATTER IS REFERRED TO A COMMITTEE OF THE BOARD FOR REVIEW AND ACTION. IF DEEMED NECESSARY, THE BOARD OR COMMITTEE MAY TAKE ACTION SUCH AS REQUIRING AN INTERESTED DIRECTOR TO RECUSE HIMSELF FROM A VOTE ON THE MATTER OR TERMINATING A BUSINESS RELATIONSHIP ENTERED INTO IN VIOLATION OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINES 15A AND 15B HAVE BOTH BEEN ANSWERED NO (AS MANDATED BY THE FORM 990 INSTRUCTIONS), AS THE CEO, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION ARE COMPENSATED BY A RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE ON WRITTEN REQUEST TO ELDER CARE ALLIANCE, MERCY'S MANAGEMENT COMPANY, AND WILL BE RESPONDED TO VIA EMAIL, US MAIL, OR BY FAX IF SO REQUESTED. ELDER CARE ALLIANCE 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943260975 MANAGEMENT CA 501(C)(3) LINE 12B, II N/A 0 ELDER CARE ALLIANCE OF CAMARILLO 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943351613 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF SAN FRANCISCO 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943351615 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF SAN RAFAEL 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 760730971 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF UNION CITY 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943377985 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF SAN MATEO 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 940831870 AGE-RESTRICTED APARTMENTS CA 501(C)(3) LINE 10 ECA 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0