2018-05-01T20:11:33-05:00 2017-09-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2016-10-01 930712867 ROGUE VALLEY MANOR FOUNDATION INC ROGU 8887246424 1200 MIRA MAR AVENUE MEDFORD OR 97504 GARY MILLER CHAIR 8887246424 2018-04-21 1 KURT BENNION CPA P01469618 4252506100 67.137.57.251 2018-04-21 17:14:36 PD P 34711CE866C7812F6419C49FC34AA771683A6B38 1C4AA1E388E3DC50B055405D9AA64341548DFCA7 2016 2021-01-29 14:40:06Z GARY MILLER 1 WEST MAIN SUITE 303 MEDFORD OR 97501 2285129 0 X WWW.RETIREMENT.ORG X 1977 OR ACQUIRE, HOLD, AND DISTRIBUTE GIFTS TO ROGUE VALLEY MANOR AND COMMUNITY ORGANIZATIONS. 12 12 0 250 0 0 1319100 1686265 0 0 288825 212216 -113383 -92372 1494542 1806109 1695496 741629 0 0 152345 197247 0 0 0 93629 325515 1941470 1264391 -446928 541718 12516186 14454195 135486 55142 12380700 14399053 THE MISSION OF THE ROGUE VALLEY MANOR FOUNDATION IS TO ENRICH THE QUALITY OF LIFE FOR MANOR RESIDENTS, FOR SENIORS SERVED BY AFFILIATE ORGANIZATIONS, AND FOR OTHERS IN THE COMMUNITY. 0 0 1003613 741629 0 GRANTS AND ALLOCATIONS / OUTLAYS ACCORDING TO DONORS' SPECIFIED PURPOSES. 1003613 1 1 0 0 0 0 0 1 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 12 12 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X SHERI LOYA 5418577644 1 WEST MAIN SUITE 303 MEDFORD OR 97501 X X GARY MILLER CHAIR 1.00 0.00 X X 0 0 0 WILL VAN ERT VICE CHAIR 1.00 0.00 X X 0 0 0 RON MCUNE SECRETARY 1.00 0.00 X X 0 0 0 LYN BOENING TREASURER 1.00 0.00 X X 0 0 0 MARC BAYLISS DIRECTOR 1.00 0.00 X 0 0 0 TIM BROPHY DIRECTOR 1.00 0.00 X 0 0 0 DIANE HEARTH DIRECTOR (THROUGH OCTOBER 2016) 1.00 0.00 X 0 0 0 DON HILDEBRAND DIRECTOR 1.00 1.00 X 0 0 0 CANDY MANARY DIRECTOR 1.00 0.00 X 0 0 0 MIKE MAYERLE DIRECTOR (THROUGH OCTOBER 2016) 1.00 0.00 X 0 0 0 MIKE MCCLAIN DIRECTOR 1.00 0.00 X 0 0 0 NILS NILSSON DIRECTOR 1.00 0.00 X 0 0 0 EARL NORGARD DIRECTOR 1.00 0.00 X 0 0 0 ELLEN WALDMAN DIRECTOR 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 191011 41196 1454058 11421 1686265 273348 273348 134505 195401 236 -60896 -236 -61132 -61132 191011 191011 283383 -92372 -92372 1806109 0 0 119844 633966 633966 107663 107663 162814 162814 849 849 21721 21721 11863 11863 252 252 7000 7000 27012 27012 2050 2050 525 525 11218 11218 4850 456 4394 653 653 2010 2010 4204 4204 PROGRAM FUND EXPENSES 244150 244150 OTHER FACILITY SERVICE 21591 11164 10427 1264391 1003613 260778 0 835382 362612 129900 138987 3169 7089 5930 2403 30962 26579 6393 4383 11281412 13684721 254000 254000 12516186 14454195 109509 32647 25977 22495 135486 55142 X 7740602 9253093 3287831 3793693 1352267 1352267 12380700 14399053 12516186 14454195 X 541718 1467548 9087 X 0 1 X 1 0 X 470020 1068697 946652 1319100 1686265 5490734 470020 1068697 946652 1319100 1686265 5490734 1344763 4145971 240248 284657 252228 265722 273348 1316203 6806937 1024185 0.60910 0.62910 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 254000 X 0 1352267 1352267 1366546 362 14641 1352267 1366819 -273 1366546 1364300 100 2419 1366819 1366702 1031 -3433 1364300 0.00000 1.00000 0.00000 1 0 30962 26579 4383 4383 DUE TO AFFILIATES 22495 22495 X PART III, LINE 4: SEVERAL PAINTINGS ARE ON DISPLAY THROUGHOUT THE CAMPUS TO ENRICH OUR RESIDENTS' LIVES. PART V, LINE 4: THE FOUNDATION'S ENDOWMENT CONSISTS OF VARIOUS INDIVIDUAL FUNDS ESTABLISHED FOR VARIOUS PURPOSE. PART X, LINE 2: THE FOUNDATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE FOUNDATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2017 AND 2016, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. BIG SALE 382022 191011 191011 283383 382022 191011 191011 283383 283383 -92372 1 ROGUE VALLEY MANOR INC 1200 MIRA MAR AVENUE MEDFORD OR 97504 930453216 501(C)(3) 593688 40278 FMV SIX VEHICLES; EXERCISE EQUIPMENT RESIDENT PROGRAM SUPPORT 1 0 SCHOLARSHIPS 64 107663 0 PART I, LINE 2: THE USE OF GRANT FUNDS IS MONITORED BY THE BOARD OF DIRECTORS AND IS REVIEWED QUARTERLY FOR PROPRIETY. FORM 990, PART VI, SECTION A, LINE 3 ROGUE VALLEY MANOR FOUNDATION, INC. DELEGATES MANAGEMENT TO ROGUE VALLEY MANOR. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE MEMBER, ROGUE VALLEY MANOR. FORM 990, PART VI, SECTION A, LINE 7A ROGUE VALLEY MANOR, INC. HAS THE RIGHT TO ELECT FOUNDATION DIRECTORS FROM NOMINEES SELECTED BY THE FOUNDATION BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS ARE RESERVED TO ROGUE VALLEY MANOR, THE SOLE MEMBER: (A) MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THE FOUNDATION; (B) SALE, LEASE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FOUNDATION; (C) THE CREATION OF ANY TAXABLE OR TAX-EXEMPT SUBSIDIARY ORGANIZATION TO THE FOUNDATION; (D) ANY ACQUISITIONS OF CONTROLLING INTERESTS IN ORGANIZATIONS OR BUSINESSES BY THE FOUNDATION; (E) APPROVAL OF BUDGETS AND LONG RANGE PLANS BEFORE AUTHORIZED EXPENDITURES MAY BE MADE THEREFROM; (F) APPROVAL OF AN INDIVIDUAL NON-BUDGETED CAPITAL EXPENDITURE UP TO $250,000 AND A CUMULATIVE TOTAL OF NON-BUDGETED CAPITAL EXPENDITURES IN A FISCAL YEAR NOT TO EXCEED $500,000; (G) ANY AMENDMENT TO THE MISSION STATEMENT IN ARTICLE I, SECTION 4 OF THE BYLAWS; AND (H) ELECT PERSONS TO BE DIRECTORS UNDER ARTICLE II OF THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO, ASSISTANT CONTROLLER AND THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE ARE SENT TO ALL BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY. THERE ARE TWO POLICIES RELATED TO CONFLICTS OF INTEREST: 1) BOARD OF DIRECTORS; 2)KEY EMPLOYEES, WHICH IDENTIFY THE PURPOSE, DEFINITIONS, AND PROCEDURES. IF A CONFLICT IS SELF-IDENTIFIED BY A BOARD MEMBER OR KEY EMPLOYEE IN THE QUESTIONNAIRE AND/OR MEETING, PROCEDURES ARE FOLLOWED AND DOCUMENTED ACCORDING TO THE POLICY. FORM 990, PART VI, SECTION C, LINE 19 ALL REQUESTS GO THROUGH CORPORATE COUNSEL. FORM 990, PART VII, SECTION A: MARC BAYLISS SERVED AS THE INTERIM ADMINISTRATOR FROM OCTOBER 2015 THROUGH JUNE 2016 WHILE THE ORGANIZATION SEARCHED FOR A NEW ADMINISTRATOR. DURING THIS TIME, HE WAS NOT A DIRECTOR. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF ANNUITY 9,087. PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931067253 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 12C, III-FI N/A 0 PACIFIC RETIREMENT SERVICES FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 472352652 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 ROGUE VALLEY MANOR 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930453216 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 THE CUMBERLAND REST INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 750891470 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 CASCADE MANOR INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930557803 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931179254 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930513697 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 CAPITOL LAKES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 391412320 SENIOR HOUSING WI 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 UNIVERSITY RETIREMENT COMMUNITY FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931301816 PUBLIC FOUNDATION CA 501(C)(3) LINE 7 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 0 TRINITY TERRACE FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 912162130 PUBLIC FOUNDATION TX 501(C)(3) LINE 7 THE CUMBERLAND REST INC 0 HOLLADAY PARK PLAZA FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 264529118 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 HOLLADAY PARK PLAZA 0 MIRABELLA WASHINGTON FOUNDATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 450574348 PUBLIC FOUNDATION WA 501(C)(3) LINE 7 MIRABELLA 0 CASCADE MANOR FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931330100 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 CASCADE MANOR INC 0 CAPITOL LAKES FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 383781089 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 CAPITOL LAKES INC 0 MIRABELLA 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 342030255 SENIOR HOUSING WA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 MIRABELLA PORTLAND FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 452508860 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 MIRABELLA AT SOUTH WATERFRONT 0 MIRABELLA AT SOUTH WATERFRONT 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 711016384 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 COMMUNITY VOLUNTEER NETWORK 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930892261 COMMUNITY SERVICES OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930864466 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ASHLAND HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930942933 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM GRANTS PASS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943136037 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ROSEBURG HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943179782 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MYRTLE CREEK HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943162074 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM BEND HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943163349 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM EAGLE POINT HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943191447 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM KLAMATH FALLS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943196455 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MEDFORD II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943212537 SENIOR 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FORT WORTH II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587415 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MEDFORD III HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587418 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ROSEBURG II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587420 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM GRANTS PASS II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311662259 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM DAVIS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311662208 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MYRTLE CREEK II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311715321 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM PORTLAND HOUSING CORPORATION 1 WEST MAIN ST SUITE 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