2025-05-15T11:05:30-05:00 2024-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2023-07-01 941156579 MERCY RETIREMENT AND CARE CENTER MERC 5107692700 1301 MARINA VILLAGE PARKWAY 210 ALAMEDA CA 94501 MICHAEL CONNELL CFO AND TREASURER 5107692700 2025-05-13 1 1 KURT BENNION CPA P01469618 4252506100 2025-05-13 2023 2025-03-06 01:10:19Z ADRIENE IVERSON 1301 MARINA VILLAGE PARKWAY 210 ALAMEDA CA 94501 29362165 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. 11 10 236 50 0 0 8120923 9232914 16394348 18454462 130880 588617 63215 -361477 24709366 27914516 0 0 0 0 10334765 11003019 0 0 14965 17578504 16776857 27913269 27779876 -3203903 134640 59042185 61931031 28130510 29710343 30911675 32220688 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 9508311 0 9508339 MERCY RETIREMENT AND CARE CENTER IS LICENSED FOR 59 SKILLED NURSING RESIDENTS. THIS YEAR, THE CARE CENTER PROVIDED SKILLED NURSING CARE TO 51.6 OLDER ADULT RESIDENTS EACH MONTH (ON AVERAGE) FOR AN ANNUAL TOTAL OF OVER 18,835 RESIDENTS DAYS. OF OUR RESIDENTS, 3.7% WERE PRIVATE PAY, 80% HAD MEDI-CAL, 10.2% HAD MEDICARE, AND 6.1% HAD OTHER INSURANCE COVERAGE. 6753470 0 6058288 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 59.2 RESIDENTS EACH MONTH (ON AVERAGE), EXCLUDING SECOND PERSONS IN EACH APARTMENT, FOR AN ANNUAL TOTAL OF 21,595 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. 5039963 0 0 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. 2157465 0 2887835 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 7,877 RESIDENT DAYS. THE MEMORY CARE NEIGHBORHOOD HAS MANY DAILY ACTIVITIES DESIGNED FOR DEMENTIA OR MEMORY LOSS RESIDENTS. 2157465 0 2887835 23459209 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 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 32 0 236 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X MICHAEL CONNELL 4255596301 1980 112TH AVENUE SUITE 210 BELLEVUE WA 98004 X TORSTEN HIRCHE PRESIDENT (AS OF 1/1/24) 1.00 39.00 X X 0 1155028 29551 MICHAEL CONNELL TREASURER & CFO (AS OF MAY 2024) 1.00 39.00 X 0 645813 37634 ADRIENE IVERSON CEO 1.00 39.00 X 0 429431 9647 NICOLE FOREMAN HEALTH CARE ADMINISTRATOR 40.00 0.00 X 189417 0 11463 MICHAEL DAVIS DIRECTOR OF NURSING, CARE CENTER 40.00 0.00 X 144807 0 6886 MANDY DAVEY CARE CENTER ADMISSIONS MANAGER 40.00 0.00 X 130284 0 10366 JOSEPHINE DAVIS ASSISTANT EXECUTIVE DIRECTOR 40.00 0.00 X 124500 0 13722 TZGHEREDA BERHE LVN 40.00 0.00 X 115943 0 11728 MICHELLE LUKE SECRETARY (AS OF 1/1/24) 1.00 39.00 X 0 99416 9384 BING ISENBERG INTERIM CFO (THROUGH MAY 2024) 1.00 39.00 X 0 0 0 JOY MOORE CHAIR & DIRECTOR 1.00 5.00 X X 0 0 0 JESSE BOND CHAIR (AS OF 1/1/24) 0.10 2.20 X X 0 0 0 GREG RUSSELL VICE CHAIR (AS OF 1/1/24) 0.10 2.20 X X 0 0 0 GERALDINE MCGRATH VICE CHAIR (THROUGH 12/31/23) 1.00 5.00 X X 0 0 0 JACKIE EJUWA SECRETARY (THROUGH 12/31/23) 1.00 5.00 X X 0 0 0 MARY WAGNER IMMEDIATE PAST CHAIR (AS OF 1/1/24) 0.10 2.20 X X 0 0 0 BARB BENNETT DIRECTOR (AS OF 1/1/24) 0.10 2.20 X 0 0 0 SISTER PAULINE BORGHELLO DIRECTOR (THROUGH 12/31/23) 1.00 1.00 X 0 0 0 CATHY DANIGELIS DIRECTOR (AS OF 1/1/24) 0.10 2.20 X 0 0 0 STEVEN KIM DIRECTOR (THROUGH 12/31/23) 1.00 1.00 X 0 0 0 KATHI LENTZSCH DIRECTOR (AS OF 1/1/24) 0.10 2.20 X 0 0 0 SCOTT LUMSDEN DIRECTOR (AS OF 1/1/24) 0.10 2.20 X 0 0 0 SUE MALLEY DIRECTOR (THROUGH 12/31/23) 1.00 1.00 X 0 0 0 JIM MELHORN DIRECTOR (AS OF 1/1/24) 0.10 2.20 X 0 0 0 LISA NELSON DIRECTOR (AS OF 1/1/24) 0.10 2.20 X 0 0 0 ERICKA RYAN DIRECTOR (THROUGH 12/31/23) 1.00 1.00 X 0 0 0 704951 2329688 140381 10 0 1 0 ELDER CARE ALLIANCE 1301 MARINA VILLAGE PARKWAY SUITE ALAMEDA CA 94501 MANAGEMENT SERVICES 1196339 ROTO-ROOTER SERVICES COMPANY 5672 COLLECTIONS CENTER DR CHICAGO IL 60693 PLUMBING 794564 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 60694 OCCUPATIONAL & PHYSICAL THERAPY 564046 CLIPBOARD HEALTH PO BOX 103125 PASADENA CA 91189 TEMPORARY STAFFING 317194 FIRST CALL NURSING SERVICES 2300 MERCED STREET SAN LEANDRO CA 94577 TEMPORARY STAFFING 223104 10 1990211 7242703 3901624 9232914 HEALTH SERVICES REVENU 623000 12181998 12181998 RESIDENT SERVICES 623000 6272464 6272464 18454462 505395 505395 36067 0 36067 36067 36067 1193189 337682 1074567 373082 118622 -35400 83222 83222 MISCELLANEOUS INCOME 900099 -466 -466 DEBT EXTINGUISHMENT 900099 -397078 -397078 -397544 27914516 18454462 0 227140 9184380 9091066 93314 124922 123653 1269 945343 935738 9605 748374 740770 7604 1461234 79687 1381547 54596 54596 115607 115607 89900 89900 883739 881564 2175 270443 257853 12590 202646 202646 636916 636916 1362088 1362088 45334 45334 1520924 1520924 2064664 2064664 501740 501740 FOOD 3627784 3627784 ECA EXPENSE ALLOCATION 1022945 517137 505808 MEDICAL SUPPLIES 907652 907652 SUPPLIES 199789 199789 1808856 1283128 525528 200 27779876 23459209 4305702 14965 1328717 1728900 1075959 3853959 3275360 2307284 118858 196336 185405 48879532 10434617 40136171 38444915 10496306 11232793 2533336 4058917 59042185 61931031 2104019 1897605 29600 4270 4330 24245142 23811793 1777079 3967015 28130510 29710343 X 25558928 27170000 5352747 5050688 30911675 32220688 59042185 61931031 X 134640 572136 602237 X 0 1 X 1 1 1 X 5415953 8543656 7361002 8120923 9232914 38674448 15917233 14589990 13984050 16394348 18454462 79340083 21333186 23133646 21345052 24515271 27687376 118014531 851000 936500 713862 1278016 73659 3853037 0 851000 936500 713862 1278016 73659 3853037 114161494 390693 1019282 500751 379252 541462 2831440 390693 1019282 500751 379252 541462 2831440 21723879 24152928 21845803 24894523 28228838 120845971 0.94470 0.94090 0.02340 0.02450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 3665920 394217 176927 3883210 3252547 465137 51764 3665920 3891430 -544366 94517 3252547 3032483 995911 136964 3891430 3481363 269242 718122 3032483 0.00000 0.75710 0.24290 0 1 1 201489 201489 41190380 7017481 34172899 2733429 475295 2258134 4753169 2941841 1811328 1065 1065 38444915 RESTRICTED COLLATERAL RESERVE ACCOUNT 4058917 4058917 DUE TO RELATED PARTIES 2070768 INTEREST RATE SWAP 321247 RELATED PARTY NOTE PAYABLE 1575000 3967015 24193166 572136 432478 1004614 23188552 89900 4636064 4725964 27914516 27453980 0 27453980 89900 235996 325896 27779876 PART IV, LINE 2B: THE ORGANIZATION HOLDS RESIDENT FUNDS IN TRUST. EACH RESIDENT MAY ACCESS THEIR FUNDS AT ANY TIME. RESIDENT FUNDS ARE HELD IN A SEPARATE BANK ACCOUNT FROM OTHER ORGANIZATIONAL ASSETS. 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF ASSETS 35,400. LOSS FROM EXTINGUISHMENT OF DEBT 397,078. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS REVENUE 3,341,079. NET INVESTMENT RETURN 1,106,253. BAD DEBT EXPENSE 188,732. PART XII, LINE 4B - OTHER ADJUSTMENTS: OTHER EXPENSES 47,264. BAD DEBT EXPENSE 188,732. 0 0 0 0 0 0 0 0 0 TORSTEN HIRCHE PRESIDENT (AS OF 1/1/24) 0 774419 0 380609 0 0 0 13200 0 16351 0 1184579 0 0 MICHAEL CONNELL TREASURER & CFO (AS OF MAY 2024) 0 464383 0 181430 0 0 0 16884 0 20750 0 683447 0 0 ADRIENE IVERSON CEO 0 396241 0 31900 0 1290 0 0 0 9647 0 439078 0 0 NICOLE FOREMAN HEALTH CARE ADMINISTRATOR 189177 0 0 0 240 0 1500 0 9963 0 200880 0 0 0 MICHAEL DAVIS DIRECTOR OF NURSING, CARE CENTER 134807 0 10000 0 0 0 0 0 6886 0 151693 0 0 0 PART I, LINE 3 THE MANAGEMENT COMPANY AND 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 2390926 3901624 FMV 0 0 0 0 PART I, COLUMN (B): THE AMOUNT REPORTED IN PART I, COLUMN B REPRESENTS THE POUNDS OF FOOD RECEIVED DURING THE FISCAL YEAR. 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 BING ISENBERG AS INTERIM CFO THROUGH KORN FERRY, A CONSULTING FIRM. AS ELDER CARE ALLIANCE'S INTERIM CFO, BING REPORTED TO THE CEO AND BOARD OF DIRECTORS AND HER RESPONSIBILITIES INCLUDED: 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; AND MANAGING INSURANCE STRATEGY AND BROKER PARTNERS. THE PROFESSIONAL SERVICES EXPENSE TO KORN FERRY WAS PAID BY ELDER CARE ALLIANCE DIRECTLY. THE TOTAL AMOUNT PAID TO KORN FERRY FOR CFO SERVICES WAS $475,773. THE ORGANIZATION WAS UNABLE TO OBTAIN ADDITIONAL INFORMATION REGARDING FUNDS PROVIDED DIRECTLY TO BING. BING LEFT THE ORGANIZATION IN MAY 2024. 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 THROUGH 12/31/23 ALL DIRECTORS WERE APPOINTED BY THE BOARD OF DIRECTORS OF ELDER CARE ALLIANCE, EXCEPT FOR THE EX-OFFICIO DIRECTOR AND THE INITIAL DIRECTORS APPOINTED BY THE INCORPORATOR. THE PRESIDENT/CHIEF EXECUTIVE OFFICER (OR ACTING PRESIDENT/CHIEF EXECUTIVE OFFICER) OF ELDER CARE ALLIANCE SERVED ON THE BOARD AS AN EX-OFFICIO DIRECTOR WITH FULL VOTING RIGHTS FOR AS LONG AS HE OR SHE HELD THE OFFICE OF PRESIDENT/CHIEF EXECUTIVE OFFICER OF ELDER CARE ALLIANCE. AS OF 1/1/24, AFTER THE AFFILIATION WITH TRANSFORMING AGE, IF NOT ALREADY SERVING ON THE BOARD OF DIRECTORS, THE CHAIR AND THE VICE-CHAIR OF TRANSFORMING AGE'S BOARD OF DIRECTORS ARE EX-OFFICIO VOTING MEMBERS OF THE BOARD OF DIRECTORS. TRANSFORMING AGE'S SECRETARY AND TREASURER ARE ALSO THE SECRETARY AND TREASURER, RESPECTIVELY, OF THIS ORGANIZATION. TRANSFORMING AGE HAS THE POWER TO REMOVE AND REPLACE ANY MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THROUGH 12/31/23, THE FOLLOWING ACTIONS REGARDING MERCY RETIREMENT AND CARE CENTER ("MRCC") REQUIRED 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: (A) 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 WAS NOT REQUIRED FOR COMMERCIAL TRANSACTIONS BETWEEN MRCC AND THE CORPORATION AND/OR ITS AFFILIATES, IF SUCH TRANSACTION WAS ENTERED INTO IN THE ORDINARY COURSE OF BUSINESS AND AT ARM'S LENGTH TERMS AND DID NOT EXCEED MONETARY LIMITS ESTABLISHED FROM TIME TO TIME BY ELDER CARE ALLIANCE AND APPROVED BY THE FACILITY AND PROGRAM SPONSOR; (B) FINAL APPROVAL OF ANY DEFICIT OPERATING AND/OR CAPITAL BUDGET OF MRCC; (C) 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; (D) APPROVAL OF THE MERGER OR REORGANIZATION OF MRCC; (E) APPROVAL OF THE 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 (F) APPROVAL OF ANY DEBT OR ENCUMBRANCE OF THE CORPORATE REAL ESTATE OF MRCC; (G) 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; (H) APPROVAL OF ANY CHANGES TO THE MISSION AND COMMON VALUES STATEMENT OF MRCC; (I) APPROVAL OF ANY REVISION OR AMENDMENT TO THE MRCC STATEMENT OF CATHOLIC IDENTITY; (J) 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; (K) ANY OTHER MATTERS WHICH MAY HAVE BEEN 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. AS OF 1/1/24, AFTER THE TRANSFORMING AGE AFFILIATION, TRANSFORMING AGE, AS THE SOLE MEMBER, HAS THE RIGHT TO (A) AMEND THE ARTICLES OF INCORPORATION AND BYLAWS; (B) ADOPT A PLAN OF MERGER OR CONSOLIDATION; (C) AUTHORIZE THE SALE, LEASE OR EXCHANGE OF SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS IF NOT IN THE ORDINARY COURSE OF BUSINESS; (D) AUTHORIZE THE ORGANIZATION'S VOLUNTARY DISSOLUTION OR REVOKE THE PROCEEDINGS THEREOF; (E) CONVERT THE ORGANIZATION INTO A FOR-PROFIT CORPORATION; AND (F) ADOPT A PLAN FOR THE DISTRIBUTION OF THE ORGANIZATION'S ASSETS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE DRAFT FORM 990 WAS REVIEWED BY THE CONTROLLER AND CFO. IT WAS THEN PROVIDED TO THE BOARD FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THROUGH 12/31/23, ANNUALLY, THE SECRETARY OF ELDER CARE ALLIANCE CAUSED 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 PREPARED A TABLE SUMMARIZING THE DISCLOSURES MADE AND PRESENTED THE TABLE TO THE BOARD OF DIRECTORS FOR THEIR INFORMATION. IF AN APPARENT CONFLICT OF INTEREST WAS IDENTIFIED, THE MATTER WAS REFERRED TO A COMMITTEE OF THE BOARD FOR REVIEW AND ACTION SUCH AS REQUIRING AN INTERESTED DIRECTOR TO RECUSE HIMSELF OR HERSELF FROM A VOTE ON THE MATTER OR TERMINATING A BUSINESS RELATIONSHIP ENTERED INTO IN VIOLATION OF THE POLICY. AS OF THE AFFILIATION WITH TRANSFORMING AGE ON 1/1/2024, THE CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS OF THE BOARD OF DIRECTORS AND EMPLOYEES. ANNUALLY, THE CONFLICT OF INTEREST FORM IS DISTRIBUTED TO THE BOARD OF DIRECTORS AND OFFICERS. THE PRESIDENT & CEO REVIEWS THE COMPLETED FORMS AND IDENTIFIES IF ANY CONFLICTS EXIST. ANY ACTUAL OR PERCEIVED CONFLICT OF INTEREST OF ANY GOVERNING BOARD MEMBER OR OFFICER SHALL BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD OR HIGHEST LEVEL OF MANAGEMENT (PRESIDENT & CEO) AND MADE A MATTER OF RECORD AT THE SOONEST POSSIBLE TIME. ANY GOVERNING BOARD MEMBER HAVING A POSSIBLE CONFLICT OF INTEREST SHALL NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER, AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM. 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 UPON REQUEST. FORM 990, PART VII, SECTION A: THE OFFICERS THAT HAVE COMPENSATION PRESENTED IN FORM 990, PART VII, SECTION A OF THE FORM 990 PROVIDE EXECUTIVE MANAGEMENT SUPPORT AND OVERALL GUIDANCE TO TRANSFORMING AGE AND ITS RELATED AND SUPPORTED AFFILIATES. THE ENTIRE TRANSFORMING AGE SYSTEM SERVES APPROXIMATELY 14,000 PEOPLE IN SENIOR AND AFFORDABLE HOUSING AND COMMUNITY-BASED SERVICES, EMPLOYS 2,300 EMPLOYEES, GENERATES $266 MILLION IN TOTAL ANNUAL OPERATING REVENUE AND HAS $1.055 BILLION IN TOTAL ASSETS. FORM 990, PART XI, LINE 9: UNREALIZED GAIN ON SWAPS 602,237. ELDER CARE ALLIANCE 1301 MARINA VILLAGE PARKWAY SUITE 2 ALAMEDA CA 94501 943260975 MANAGEMENT CA 501(C)(3) LINE 12B, II TRANSFORMING AGE 0 ELDER CARE ALLIANCE OF SAN RAFAEL 1301 MARINA VILLAGE PARKWAY SUITE 2 ALAMEDA CA 94501 760730971 SENIOR LIVING CA 501(C)(3) LINE 10 ELDER CARE ALLIANCE 0 ELDER CARE ALLIANCE OF SAN FRANCISCO 1301 MARINA VILLAGE PARKWAY SUITE 2 ALAMEDA CA 94501 943351615 SENIOR LIVING CA 501(C)(3) LINE 10 ELDER CARE ALLIANCE 0 ELDER CARE ALLIANCE OF CAMARILLO 1301 MARINA VILLAGE PARKWAY SUITE 2 ALAMEDA CA 94501 943351613 SENIOR LIVING CA 501(C)(3) LINE 10 ELDER CARE ALLIANCE 0 ELDER CARE ALLIANCE OF UNION CITY 1301 MARINA VILLAGE PARKWAY SUITE 2 ALAMEDA CA 94501 943377985 SENIOR LIVING CA 501(C)(3) LINE 10 ELDER CARE ALLIANCE 0 ELDER CARE ALLIANCE OF SAN MATEO 1301 MARINA VILLAGE PARKWAY SUITE 2 ALAMEDA CA 94501 940831870 AGE-RESTRICTED APARTMENTS CA 501(C)(3) LINE 10 ELDER CARE ALLIANCE 0 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST 915 118TH AVENUE SE 110 BELLEVUE WA 98005 910666887 PROVIDE CARE FOR SENIORS WA 501(C)(3) LINE 10 TRANSFORMING AGE 0 FRED LIND MANOR 915 118TH AVENUE SE 110 BELLEVUE WA 98005 910579225 PROVIDE SENIOR SERVICES WA 501(C)(3) LINE 10 TRANSFORMING AGE 0 VASHON ISLAND COMMUNITY CARE 1980 112TH AVENUE SUITE 210 BELLEVUE WA 98004 911703092 SENIOR LIVING WA 501(C)(3) LINE 10 PRESBYTERIAN RETIREMENT COMMUNITIES NW 0 FULL LIFE CARE 1980 112TH AVENUE SUITE 210 BELLEVUE WA 98004 911095588 SERVICES FOR THE ELDERLY WA 501(C)(3) LINE 7 TRANSFORMING AGE 0 CHRISTIAN RETIREMENT HOMES 6315 O STREET LINCOLN NE 68510 476041813 SENIOR LIVING NE 501(C)(3) LINE 10 TRANSFORMING AGE 0 EASTMONT TOWERS FOUNDATION 6315 O STREET LINCOLN NE 68510 911767080 BENEFIT RESIDENTS AND EMPLOYEES OF CHRISTIAN RETIREMENT HOMES NE 501(C)(3) LINE 10 TRANSFORMING AGE 0 GERMAN RETIREMENT HOME OF THE STATE OF WASHINGTON 11853 97TH AVE NE KIRKLAND WA 98034 910630507 SENIOR LIVING WA 501(C)(3) LINE 7 TRANSFORMING AGE 0 DOWNTOWN ACTION TO SAVE HOUSING 11018 NE 11TH STREET BELLEVUE WA 98004 943155152 HOUSING WA 501(C)(3) LINE 7 TRANSFORMING AGE 0 NORSE HOME 5311 PHINNEY AVENUE N SEATTLE WA 98103 910667588 ASSISTED LIVING WA 501(C)(3) LINE 10 TRANSFORMING AGE 0 SENIOR HOUSING ASSISTANCE GROUP 14400 TUKWILA INTL BLVD SUITE 100 TUKWILA WA 98168 943063455 SENIOR LIVING WA 501(C)(3) LINE 10 TRANSFORMING AGE 0 SHAG COMMUNITY LIFE FOUNDATION 14400 TUKWILA INTL BLVD SUITE 100 TUKWILA WA 98168 460779043 AFFORDABLE SENIOR LIVING WA 501(C)(3) LINE 10 TRANSFORMING AGE 0 TRANSFORMING AGE 1980 112TH AVENUE SUITE 210 BELLEVUE WA 98004 320672552 MANAGEMENT SERVICES WA 501(C)(3) LINE 12B, II N/A 0 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST FOUNDATION 1980 112TH AVENUE SUITE 210 BELLEVUE WA 98004 911586491 FUNDRAISING WA 501(C)(3) LINE 12A, I TRANSFORMING AGE 0 TRANSFORMING AGE VENTURES INC 715 NINTH AVENUE SUITE 400 SEATTLE WA 98104 471755666 FOR-PROFIT VENTURES AND ACTIVITIES WA N/A C 0 SENIOR HOUSING ASSISTANCE CORPORATION 1980 112TH AVENUE NE SUITE 210 BELLEVUE WA 98004 911923742 LOW-INCOME HOUSING WA N/A C 0 1 0 0 0 1 0 0 0 0 0 0 1 1 1 1 1 0 0 0