2018-11-15T16:08:59-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2017-01-01 910743702 THE LUTHERAN RETIREMENT HOME OF GREATER SEATTLE LUTH 2065259666 6720 EAST GREEN LAKE WAY NORTH SEATTLE WA 98103 BART BROSTEN CFO 2065259666 2018-11-15 1 KURT BENNION P01469618 4252506100 2018-11-15 67.137.57.251 2018-11-15 11:10:02 PS P 92EDA96F2591B15C33D80D338693BB85F692AD13 9C3E08EBF53FA5FA3C7B2B5BD0B3E335DF999A73 2017 2019-02-21 02:37:17Z THE HEARTHSTONE JAMES MERTZ 6720 EAST GREEN LAKE WAY NORTH SEATTLE WA 98103 20627219 0 9386 X WWW.HEARTHSTONE.ORG X 1961 WA PROMOTE INDEPENDENCE, HEALTH, SECURITY, PURPOSE AND BELONGING IN LIFE FOR ADULTS AGE 62 PLUS. 13 13 257 34 0 0 104288 179768 15559819 16531740 225756 1112423 76191 220977 15966054 18044908 104723 101272 0 0 10691137 10188061 0 0 142682 7094020 8160572 17889880 18449905 -1923826 -404997 55803231 62555781 45261292 50902875 10541939 11652906 X SEE SCHEDULE OTHE HEARTHSTONE, A LIFE PLAN COMMUNITY, A SEATTLE LANDMARK SINCE 1966, IS WELL REGARDED FOR COMFORT, HEALTH AND SENIOR WELLNESS. OUR GOAL IS TO PROVIDE A FULL RANGE OF OPTIONS WITH 118 INDEPENDENT LIVING APARTMENTS, 37 ASSISTED LIVING APARTMENTS, 12 MEMORY CARE APARTMENTS, AND CAN ACCOMODATE 40 RESIDENTS IN OUR HEALTH CARE CENTER WITH 24-HOUR NURSING CARE. THE HEARTHSTONE ALSO PROVIDES DAILY ACTIVITIES, THREE MEALS A DAY, REHABILITATION SERVICES FOR WELLNESS TO RECOVERY, AND HOSPICE SERVICES. THE CHAPEL IS OPEN FOR WEEKLY VESPER SERVICES, MUSIC RECITALS BY LOCAL STUDENTS, AND BOARD MEETINGS FOR OTHER NOT-FOR-PROFIT BUSINESSES. THROUGH DONATIONS, THE HEARTHSTONE PROVIDES FINANCIAL ASSISTANCE TO RESIDENTS WHO HAVE OUTLIVED THEIR ASSETS WHILE LIVING INDEPENDENTLY OR IN ASSISTED LIVING. THE HEARTHSTONE'S HEALTH CARE CENTER IS ALSO AVAILABLE FOR NON-HEARTHSTONE RESIDENTS AGE 62 AND OVER NEEDING SHORT-TERM REHABILITATION SERVICES. 0 0 14834951 101272 16531740 THE HEARTHSTONE OWNS AND OPERATES A LIFE PLAN COMMUNITY LOCATED IN SEATTLE, WASHINGTON, THAT INCLUDES 118 INDEPENDENT LIVING APARTMENTS, A SEPARATE INDEPENDENT LIVING BUILDING WITH 28 APARTMENTS, A 40-BED NURSING CARE FACILITY, A 37-UNIT ASSISTED LIVING AREA, AND 12 MEMORY CARE APARTMENTS.THE HEARTHSTONE IS INVOLVED WITH THE MEDICAL EDUCATION COMMUNITY BY PROVIDING A LEARNING EXPERIENCE TO STUDENTS FROM SHORELINE COMMUNITY COLLEGE SCHOOL OF NURSING AND UW SCHOOL OF PHARMACY TO LEARN PATIENT COMMUNICATION SKILLS AND DISCUSS MEDICATIONS. 14834951 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 82 0 257 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X BART BROSTEN CFO 2065172212 6720 EAST GREEN LAKE WAY NORTH SEATTLE WA 98103 JOHN ENGBER CHAIR 1.00 X X 0 0 0 REV DEANNA WILDERMUTH VICE CHAIR 1.00 X X 0 0 0 DAVID ASHCOM SECRETARY 1.00 X X 0 0 0 NANCY WARD PAST CHAIR 1.00 X 0 0 0 JAMES ABBOTT TRUSTEE (THROUGH FEB 2017) 1.00 X 0 0 0 JOHN BYRNE TRUSTEE 1.00 X 0 0 0 JUDITH CHANEY TRUSTEE 1.00 X 0 0 0 TERI HIGBY TRUSTEE 1.00 X 0 0 0 MARK JOHNSON TRUSTEE 1.00 X 0 0 0 KATHLEEN JONES TRUSTEE 1.00 X 0 0 0 REV ERNIE LASSMAN TRUSTEE 1.00 X 0 0 0 REV TIM OLESON TRUSTEE 1.00 X 0 0 0 BEATRICE PRIEST TRUSTEE 1.00 X 0 0 0 CAROL REDFIELD TRUSTEE 1.00 X 0 0 0 JAMES MERTZ CEO 40.00 X 220688 0 0 BART BROSTEN MBA CFO 40.00 X 125700 0 13918 R KEVIN MCFEELY COO (THROUGH MARCH 2017) 40.00 X 32884 0 3174 HAMADI SISAWO DNS 40.00 X 112675 0 12784 JOHN PAULSON CHRO 40.00 X 118841 0 13622 ANN VEY DIRECTOR OF MARKETING 40.00 X 112149 0 7892 722937 0 51390 5 0 1 0 ANDERSON CONSTRUCTION GROUP 1900 AIRPORT WAY S 102 SEATTLE WA 98134 CONSTRUCTION 1373024 CONSONUS REHAB UNIT 12 PO BOX 4800 PORTLAND OR 97208 THERAPY SERVICES 812398 CONSONUS PHARMACY SERVICES WA LLC PO BOX 34663 SEATTLE WA 98124 PHARMACY SERVICES 251923 PERFORMANCE SYSTEMS INTEGRATION LLC 19310 N CREEK PKWY STE 109 BOTHELL WA 98011 FIRE SYSTEMS 222253 UNIDINE CORPORATION PO BOX 360639 PITTSBURGH PA 15251 DINING MANAGEMENT 121381 9 179768 179768 RESIDENTS' MONTHLY FEES 623000 8941371 8941371 HEALTH CARE SERVICES 623000 4958063 4958063 ENTRANCE FEE AMORTIZATION 623000 2632306 2632306 16531740 913008 913008 2781726 2582311 199415 199415 199415 MEAL REVENUES 722210 171885 171885 MISCELLANEOUS INCOME 900099 49092 49092 220977 18044908 16531740 0 1333400 101272 101272 396365 396365 7779315 6378978 1284894 115443 292485 236275 50472 5738 926993 807204 112712 7077 792903 667148 125105 650 114084 114084 47230 47230 105975 105975 1565182 1355469 209713 152900 152663 237 34113 27477 6636 815834 648704 167130 18971 3990 14019 962 2209 1877 332 719139 719139 2032877 1974852 55975 2050 105013 105013 SUPPLIES 821029 758037 61680 1312 FOOD 781744 781744 MISCELLANEOUS EXPENSES 309078 33670 274111 1297 EQUIPMENT MAINTENANCE 117389 106347 11042 417805 157109 259748 948 18449905 14834951 3472272 142682 187379 1422773 1021944 849212 79563 51693 191022 145325 63848220 22985927 39200109 40862293 14664928 18821749 458286 402736 55803231 62555781 1589108 1534078 15087908 18817327 22684818 18301035 3054079 9476201 178938 2666441 2774234 45261292 50902875 X 10474284 11516288 67655 136618 10541939 11652906 55803231 62555781 X -404997 1418728 1624 95612 X 0 1 X 1 0 X 264677 115513 80120 104288 179768 744366 13731067 14116189 15127753 15559819 16531740 75066568 59194 65179 60860 71301 171885 428419 14054938 14296881 15268733 15735408 16883393 76239353 0 0 0 76239353 654715 894370 849493 669882 913008 3981468 654715 894370 849493 669882 913008 3981468 49092 49092 14709653 15191251 16118226 16405290 17845493 80269913 0.94980 0.95600 0.04960 0.04400 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME 0 0 0 0 0 0 0 0 1 432 432 0 PART II-B, LINE 1: THE HEARTHSTONE PAYS MEMBERSHIP DUES TO LEADINGAGE NATIONAL AND LEADINGAGE WASHINGTON. LEADINGAGE NATIONAL ESTIMATES 3.6% OF MEMBERSHIP DUES ARE USED FOR LOBBYING ACTIVITIES. LEADINGAGE WASHINGTON ESTIMATES 1.9% OF MEMBERSHIP DUES ARE USED FOR LOBBYING. 0 1 X 4477419 4477419 45679190 15379568 30299622 8024917 7606359 418558 5666694 5666694 40862293 LAND PAYABLE - REMEDIATION OBLIGATION 2486762 INTEREST RATE SWAP AGREEMENT 287472 2774234 17768698 0 17768698 105975 170235 276210 18044908 18343930 0 18343930 105975 105975 18449905 PART IV, LINE 2B: THE ORGANIZATION HOLDS WAIT LIST DEPOSITS FOR INDIVIDUALS WHO WANT TO ACCESS FUTURE ENTRANCE TO THE FACILITY. THE DEPOSITS ARE RETURNED TO INDIVIDUALS WHO WISH TO REMOVE THEMSELVES FROM THE WAIT LIST. WHILE BEING HELD, THE FUNDS ARE INVESTED. THE ORGANIZATION HOLDS PARTIALLY REFUNDABLE DEPOSITS FOR RESIDENTS LIVING IN OUR FACILITY. AN INDIVIDUAL CAN RECEIVE A PARTIAL REFUND OF THEIR DEPOSIT IF THEY LEAVE THE FACILITY WITHIN FOUR YEARS OF ENTRANCE. WHILE BEING HELD, FUNDS ARE INVESTED. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS 170,235. 1 RESIDENT ASSISTANCE 3 101272 PART I, LINE 2: THE ORGANIZATION PROVIDES SERVICES TO RESIDENTS WHO HAVE EXHAUSTED THEIR FINANCIAL RESOURCES. ASSISTANCE IS PROVIDED TO HELP COVER ROOM AND BOARD, MEDICAL CARE, AND PRESCRIPTIONS. THE AMOUNT REPORTED AS GRANTS CONSTITUTES THE VALUE OF THESE SERVICES. X X 1 1 X X X X 0 0 0 0 0 0 0 0 0 JAMES MERTZ CEO 213739 0 0 0 6949 0 0 0 0 0 220688 0 0 0 PART I, LINE 1A ALL SALARIED EMPLOYEES RECEIVE A HOLIDAY BONUS FROM THE ORGANIZATION. THE ORGANIZATION GROSSES UP THE BONUS AMOUNTS BY 15%. UNTIL SEPTEMBER 2017, JAMES MERTZ USED AN APARTMENT OWNED BY THE ORGANIZATION WITHOUT PAYING RENT. THE VALUE OF THIS RENT WAS NOT INCLUDED IN HIS TAXABLE COMPENSATION. A WASHINGTON STATE HOUSING FINANCE COMMISSION 911874730 2013-07-03 25000000 REFUND 2004 BOND/BUILD BLDG 0 0 0 A 2219478 25000000 450097 14767300 9782603 2015 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 1 WELLS FARGO 20.000000000000 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S MEMBERSHIP IS MADE UP OF BETWEEN EIGHT AND FIFTEEN CONGREGATIONS FROM THE NORTHWEST WASHINGTON SYNOD OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA AND THE NORTHWEST DISTRICT, LUTHERAN CHURCH - MISSOURI SYNOD (COLLECTIVELY, THE "JURISDICTIONAL UNITS"). CONGREGATIONS, AT LEAST TWO OF WHICH SHALL COME FROM EACH OF THE JURISDICTIONAL UNITS, ARE ADMITTED TO MEMBERSHIP UPON APPLICATION APPROVED BY A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ELECT ALL FULL-TERM BOARD POSITIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE ACCOUNTING MANAGER AND CFO. IT WAS THEN REVIEWED BY THE AUDIT/INVESTMENT COMMITTEE. IT WAS THEN PRESENTED AT A BOARD MEETING FOR FINAL REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C KEY MANAGERS AND BOARD MEMBERS ARE REQUIRED TO SIGN STATEMENTS ANNUALLY. BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS IMMEDIATELY AS THEY ARISE. BOTH MANAGEMENT AND THE BOARD ARE SENSITIVE TO THIS ISSUE AND ARE EXPECTED TO CONTINUOUSLY MONITOR SITUATIONS FOR POSSIBLE CONFLICTS. AN INDIVIDUAL WITH A CONFLICT OF INTEREST IS ALLOWED TO ANSWER QUESTIONS BUT IS NOT PERMITTED TO VOTE ON THE MATTER. THE STATEMENTS ARE REVIEWED EACH YEAR AS PART OF CORPORATE COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15A THE CHIEF HUMAN RESOURCES OFFICER PROVIDES A REPORT TO THE CHAIR OF THE BOARD OF TRUSTEES USING DATA FROM COMPENSATION SURVEYS, AS WELL AS THE CPI FOR THE SEATTLE AREA, TO DETERMINE AN APPROPRIATE SALARY RANGE FOR THE CEO. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS THE REPORT AND MAKES A RECOMMENDATION TO THE FULL BOARD. THE BOARD COMPARES SALARIES WITH SIMILAR ORGANIZATIONS AND MAKES THE FINAL DECISION ON CEO COMPENSATION. ANNUAL INCREASES ARE DETERMINED BY THE BOARD BASED ON ANNUAL PERFORMANCE EVALUATIONS. THE CHIEF HUMAN RESOURCES OFFICER PROVIDES A REPORT USING DATA FROM COMPENSATION SURVEYS, AS WELL AS THE CPI FOR THE SEATTLE AREA, TO DETERMINE AN APPROPRIATE SALARY RANGE FOR THE OTHER OFFICERS AND KEY EMPLOYEES. THE REPORT IS REVIEWED AND DISCUSSED BY THE ADMINISTRATOR, CFO AND CEO. THE CEO MAKES THE FINAL DECISION FOR COMPENSATION AMOUNTS. ANNUAL INCREASES ARE BASED ON ANNUAL PERFORMANCE EVALUATIONS. THESE PROCESSES WERE LAST COMPLETED IN 2017. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S BUSINESS OFFICE. FORM 990, PART XI, LINE 9: UNREALIZED GAIN ON SWAP INVESTMENT 95,612.