2017-04-28T17:26:44-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2016-01-01 990290103 KAHALA SENIOR LIVING COMMUNITY INC KAHA 8082187000 4389 MALIA STREET HONOLULU HI 96821 PATRICK DUARTE CEO/PRESIDENT 8082187000 2017-04-26 1 KURT BENNION CPA P01469618 4252506100 67.137.57.251 2017-04-26 15:33:23 PD P 9C59EE6D3CCD21689CFBADFF7A4DB800BA897A92 3A69748B60C5562FF1572AE4C29EA0C331661B82 2016 2021-01-29 14:40:06Z PATRICK DUARTE 4389 MALIA STREET HONOLULU HI 96821 65190004 0 X WWW.KAHALANUI.COM X 1989 HI TO PROVIDE A CONTINUUM OF HIGH QUALITY RESIDENTIAL AND HEALTH CARE SERVICES TO RESIDENTS. 13 13 432 130 0 0 684852 864117 26181240 27256848 2941275 2051901 6145195 5530219 35952562 35703085 281874 301017 0 0 13028264 13847765 0 0 15837 16918330 17969281 30228468 32118063 5724094 3585022 196320043 195472981 278114416 271491140 -81794373 -76018159 X IN THE SPIRIT OF OHANA, KAHALA SENIOR LIVING COMMUNITY AND ITS ASSOCIATES ARE DEDICATED TO SERVING THE UNMET CARE NEEDS OF SENIORS IN HAWAII. WE ARE A NOT-FOR-PROFIT ORGANIZATION THAT PROVIDES A CONTINUUM OF HIGH QUALITY RESIDENTIAL AND HEALTH CARE SERVICES ENABLING OUR RESIDENTS TO LIVE A GRACIOUS HAWAIIAN LIFESTYLE IN AN ENVIRONMENT OF DIGNITY, RESPECT, TRUST, AND FRIENDSHIP. 0 0 27861294 301017 27256848 KAHALA NUI IS A SENIOR LIVING COMMUNITY LOCATED IN HONOLULU, HAWAII THAT PROVIDES A CONTINUUM OF RESIDENTIAL AND HEALTHCARE SERVICES TO SENIORS. FOUR DISTINCT LEVELS OF CARE ARE OFFERED: INDEPENDENT LIVING, ASSISTED LIVING, MEMORY SUPPORT, AND SKILLED NURSING. KAHALA NUI HAS 270 INDEPENDENT LIVING UNITS FOR SENIORS WHO DON'T REQUIRE ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. HI'OLANI IS KAHALA NUI'S HEALTHCARE CENTER THAT PROVIDES ASSISTED LIVING SERVICES, MEMORY SUPPORT, AND SKILLED NURSING TO RESIDENTS WHO TRANSFER FROM INDEPENDENT LIVING AND TO INDIVIDUALS FROM THE COMMUNITY. HI'OLANI IS LICENSED FOR 67 ASSISTED LIVING BEDS (INCLUDING MEMORY SUPPORT) AND 60 SKILLED NURSING BEDS. IN ADDITION TO HEALTHCARE SERVICES, KAHALA NUI OFFERS A VARIETY OF SERVICES THAT INCLUDE CASUAL AND FORMAL IN-HOUSE DINING, WELLNESS PROGRAMS, RECREATIONAL EVENTS, HOUSEKEEPING AND LINEN SERVICES, SCHEDULED TRANSPORTATION TO ALL MAJOR SHOPPING MALLS AND VARIOUS RELIGIOUS AND MEDICAL FACILITIES, BUILDING AND GROUNDS MAINTENANCE, 24-HOUR SECURITY, AND BUSINESS SERVICES. IN OCTOBER 2015, KAHALA NUI OPENED AN ADULT WELLNESS CENTER THAT CAN SERVE UP TO 50 INDIVIDUALS. 27861294 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 74 0 432 1 0 1 CJ 0 0 0 0 0 0 0 1 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 HI X HUILAN KAMITA 8082187022 4389 MALIA STREET HONOLULU HI 96821 PHILIP CHING CHAIR 10.00 0.00 X X 0 0 0 STEVE ROBERTSON VICE CHAIR 5.00 0.00 X X 0 0 0 FRANK TOKIOHA II SECRETARY 5.00 0.00 X X 0 0 0 ROY KING JR SECRETARY 5.00 0.00 X X 0 0 0 LISA SAKAMOTO CPA TREASURER 5.00 0.00 X X 0 0 0 WENDELL BROOKS JR DIRECTOR 3.00 0.00 X 0 0 0 EVELYN CHAR RN MS DIRECTOR 3.00 0.00 X 0 0 0 CHARLES KELLEY MD DIRECTOR 3.00 0.00 X 0 0 0 SHARI KOGAN MD DIRECTOR 3.00 0.00 X 0 0 0 KAMAL MASAKI MD DIRECTOR 3.00 0.00 X 0 0 0 JON MCKENNA DIRECTOR 3.00 0.00 X 0 0 0 KENNETH MILLER CFA DIRECTOR 3.00 0.00 X 0 0 0 ADRIENNE YOSHIHARA DIRECTOR 3.00 0.00 X 0 0 0 PATRICK DAURTE CEO/PRESIDENT 50.00 0.00 X 316731 0 5688 WENDY WONG EXECUTIVE DIRECTOR 50.00 0.00 X 236132 0 6240 HUILAN KAMITA CFO 50.00 0.00 X 147882 0 3859 JAY DUQUETTE ADMINISTRATOR 50.00 0.00 X 132277 0 15646 DARLENE CANTO DIRECTOR OF MARKETING 50.00 0.00 X 139733 0 10389 DANA MATLIN DIRECTOR OF HUMAN RESOURCES 50.00 0.00 X 110773 0 3411 DARYN MURAI SENIOR LIVING COUNSELOR 40.00 0.00 X 110786 0 21112 1194314 0 66345 7 0 1 0 UNITED LAUNDRY SERVICES INC 2291 ALAHAO PLACE HONOLULU HI 96819 LAUNDRY 239635 HEIDE & COOK LTD 1714 KANAKANUI STREET HONOLULU HI 96819 EQUIPMENT MAINTENANCE 204773 ZIEGLER LOTSOFF CAPITAL MANAGEMENT 20 N CLARK ST 34TH FL CHICAGO IL 60602 ASSET MANAGEMENT 141109 TAM N BRUMBACK 4389 MALIA ST HONOLULU HI 96819 LICENSED MASSAGE THERAPIST 113360 4 864117 23011 864117 MONTHLY SERVICE FEES 623000 23643179 23643179 SKILLED NURSING ANCILLARY & THERA 623000 1954175 1954175 ENTRANCE FEES 623000 1659494 1659494 27256848 2004002 2004002 33349 0 33349 33349 33349 29534818 29486919 47899 47899 47899 FUTURE SERVICE OBLIGATIONS 900099 4879477 4879477 MISCELLANEOUS REVENUE 900099 617393 617393 5496870 35703085 27256848 0 7582120 258117 258117 42900 42900 553457 118527 419093 15837 10263018 8942777 1320241 205015 178642 26373 2020729 1760781 259948 805546 701920 103626 2277 2277 33225 300 32925 57815 5065 52750 259570 259570 1289886 1273646 16240 251083 55431 195652 1279762 1100018 179744 70777 18816 51961 3341629 3341629 425 425 1771 1771 3283075 3283075 4914492 3735014 1179478 397966 397966 FOOD COSTS 2251769 2234655 17114 REPAIRS AND MAINTENANCE 433063 395126 37937 RESIDENTS AND COMMUNITY 82627 82627 EXCISE TAX EXPENSE 16889 16889 1180 1180 32118063 27861294 4240932 15837 3928132 2660294 7719171 3725172 975473 685724 143186 260714 47920 35740 447362 625210 159613037 50614540 112332361 108998497 63752477 71629974 6973961 6851656 196320043 195472981 1613466 1770146 5701661 5979601 68242327 55773740 1194309 1270000 201362653 206697653 278114416 271491140 X -83853240 -78729130 358226 519085 1700641 2191886 -81794373 -76018159 196320043 195472981 3585022 2191192 0 X 0 1 X 1 0 X 206589 1192117 510905 684852 864117 3458580 28690570 26091793 25845141 26181240 27256848 134065592 28897159 27283910 26356046 26866092 28120965 137524172 0 0 0 137524172 1053576 1396709 1816234 2623963 2037351 8927833 1053576 1396709 1816234 2623963 2037351 8927833 398896 421675 431270 396389 617393 2265623 30349631 29102294 28603550 29886444 30775709 148717628 0.92470 0.93510 0.06000 0.05430 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1070 1070 0 PART II-B, LINE 1: A PORTION OF THE MEMBERSHIP DUES PAID TO THE HEALTHCARE ASSOCIATION OF HAWAII WAS USED BY THE ASSOCIATION TO LOBBY ON BEHALF OF KAHALA NUI AND OTHER HEALTHCARE PROVIDERS IN HAWAII. 0 1 X 1788018 491245 155983 2435246 1475192 335660 -22834 1788018 1059178 356736 59278 1475192 1008245 50933 1059178 0.00000 0.90010 0.09990 0 0 148494763 44048049 104446714 4744154 2166700 2577454 5927505 4399791 1527714 446615 446615 108998497 ENTRANCE FEE LIABILITY 205199048 ACCRUED BOND INTEREST EXPENSE 354306 RESIDENT LIABILITY 1144299 206697653 X 28275586 355698 355698 27919888 256070 7527127 7783197 35703085 31861993 0 31861993 256070 256070 32118063 PART IV, LINE 2B: ESCROW ACCOUNTS ARE RELATED TO A $5,000 DEPOSIT RECEIVED FROM INTERESTED INDIVIDUALS WHO HAVE DEPOSITED MONEY IN ORDER TO HOLD A SPOT ON THE CCRC WAIT LIST. PART V, LINE 4: THE ENDOWEMENT FUNDS SUPPORT VARIOUS PROGRAMS INCLUDING: 1. SUPPORTING RESIDENTS THAT HAVE EXHAUSTED THEIR FINANCIAL RESOURCES 2. TRAINING OF PERSONNEL 3. GENERAL SUPPORT 4. SCHOLARSHIPS 5. SUPPORTING PROGRAMS AND SERVICES IN THE HEALTH CENTER 6. SUPPORTING VARIOUS PROGRAMS IN INDEPENDENT LIVING, TRAINING IN THE HEALTH CENTER, COMMUNITY OUTREACH, AND GENERAL SUPPORT PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION, EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES IN THE FINANCIAL STATMENTS. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION FOR OPERATIONS 355,698. PART XI, LINE 4B - OTHER ADJUSTMENTS: TEMPORARILY RESTRICTED CONTRIBUTIONS 360,574. PERMANENTLY RESTRICTED CONTRIBUTIONS 491,245. EARNING ON ENDOWMENTS 155,983. INVESTMENT INCOME 1,591,949. DECREASE IN OBLIGATION TO PROVIDE FUTURE SERVICES 4,879,477. REALIZED GAIN ON SALE OF INVESTMENTS 47,899. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS 0 0 INVESTMENTS 1488244 0 0 0 0 0 0 1488244 0 1488244 0 0 0 0 0 0 PART I, LINE 2 KAHALA USES A SWEEP ACCOUNT AT A BANK IN THE CAYMAN ISLANDS TO DECREASE THE BALANCE IN THEIR U.S. BANK ACCOUNT TO $25,000 ON A NIGHTLY BASIS. THAT MONEY IS INVESTED BY THE CAYMAN ISLANDS BANK UNTIL KAHALA WITHDRAWS THE FUNDS. 0 ALZHEIMER'S ASSOCIATION 1050 ALA MOANA BLVD 2610 HONOLULU HI 96814 990212360 501(C)(3) 32054 763 FAIR MARKET VALUE FOOD AND CLOTHING TO SUPPORT EDUCATION AND AWARENESS CATHOLIC CHARITIES HAWAII 1822 KEEAUMOKU ST HONOLULU HI 96822 990073547 501(C)(3) 37130 SENIOR HOUSING ASSISTANCE KOKUA KALIHI VALLEY 2239 N SCHOOL ST HONOLULU HI 96819 990149797 501(C)(3) 21380 SENIOR HEALTH PROGRAM ASSISTANCE PALAMA SETTLEMENT 810 N VINEYARD BLVD HONOLULU HI 96817 990074140 501(C)(3) 12300 FAIR MARKET VALUE GIFT BAGS, WHEELCHAIR AND WALKER PROVIDE FOOD AND TOILETRIES FOR HOMEBOUND SENIOR CITIZENS IN THE KALIHI-PALAMA DISTRICT PROJECT DANA 2720 NAKOOKOO ST HONOLULU HI 96826 990143990 501(C)(3) 30855 SUPPORT SENIOR PROGRAMS KAPIOLANI COMMUNITY COLLEGE 4303 DIAMOND HEAD ROAD HONOLULU HI 96816 996000354 501(C)(3) 3772 17182 BOOK VALUE EVENT SUPPLIES AND GAS KETTLE OCCUPATIONAL THERAPIST TRAINING HAWAII MEALS ON WHEELS PO BOX 61194 HONOLULU HI 96839 990198132 501(C)(3) 34872 62809 FAIR MARKET VALUE FOOD HOT MEALS FOR COMMUNITY SENIORS 7 0 SCHOLARSHIP PROGRAM 15 42900 PART I, LINE 2: EACH GRANT TO AN UNRELATED ORGANIZATION IS APPROVED AND INCLUDED IN THE BUDGET; ALL EXPENDITURES ARE PRESENTED TO THE BOARD OF DIRECTORS. THE HAWAII COMMUNITY FOUNDATION MONITORS THE USE OF SCHOLARSHIP FUNDS ON BEHALF OF KAHALA SENIOR LIVING COMMUNITY. X 0 1 X X X X X 0 0 0 1 0 0 0 0 0 PATRICK DAURTE CEO/PRESIDENT 274231 0 42500 0 0 0 5688 0 0 0 322419 0 0 0 WENDY WONG EXECUTIVE DIRECTOR 201132 0 35000 0 0 0 5646 0 594 0 242372 0 0 0 HUILAN KAMITA CFO 129400 0 18482 0 0 0 3653 0 206 0 151741 0 0 0 DARLENE CANTO DIRECTOR OF MARKETING 91983 0 47750 0 0 0 4238 0 6151 0 150122 0 0 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PROVIDED FOR PATRICK J. DUARTE, CEO, AND ARE NOT INCLUDED IN THIS TAXABLE COMPENSATION. PART I, LINE 1B NO WRITTEN POLICY IS FOLLOWED; HOWEVER, THE SOCIAL CLUD MEMBERSHIP WAS APPROVED BY THE EXECUTIVE COMMITTEE AND THE ORGANIZATION REQUIRES SUBSTANTIATION PRIOR TO REIMBURSEMENT FOR SOCIAL CLUB EXPENSES. PART I, LINE 5 THE CEO/PRESIDENT AND EXECUTIVE DIRECTOR RECEIVE BONUSES THAT ARE BASED ON SEVERAL VARIABLES INCLUDING FINANCIAL PERFORMANCE, RESIDENT SATISFACTION, AND GROWTH. A STATE OF HAWAII DEPARTMENT OF BUDGET AND FINANCE 990266961 419800EU7 2003-01-23 140709368 SEE PART VI 1 0 0 B STATE OF HAWAII DEPARTMENT OF BUDGET AND FINANCE 990266961 41980SAY2 2012-08-15 73400000 SEE PART VI 0 0 0 A 68790000 140709368 6647561 17258643 2035015 3500000 125500054 2005 0 0 1 1 B 18220000 75450742 5188205 1437467 1 1 1 1 A 0 1 1 1 0 0.00150 0.00150 0 1 0.00020 0 0 B 0 1 1 1 0 0.00150 0.00150 0 0 0 A 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, BOND ISSUES: (F) DESCRIPTION OF PURPOSE: FUND THE CONSTRUCTION AND EQUIPPING OF KAHALA NUI (F) DESCRIPTION OF PURPOSE: I. ADVANCE REFUND THE OUTSTANDING PRINCIPLE AMOUNT OF THE DEPARTMENT'S $72,750,000 SPECIAL PURPOSE REVENUE BONDS SERIES 2003A, $68,790,000 OF WHICH WAS OUSTANDING. II. FUND A DEBT SERVICE RESERVE FUND III. PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE BONDS AND THE REFUNDING OF THE SERIES 2003A BONDS FORM 990, PART VI, SECTION A, LINE 1 KAHALA SENIOR LIVING COMMUNITY HAS AN EXECUTIVE COMMITTEE COMPRISED OF THE OFFICERS OF THE BOARD OF DIRECTORS AND THE CEO. THE EXECUTIVE COMMITTEE HAS AND EXERCISES THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE ORGANIZATION; PROVIDED, HOWEVER, THAT IT DOES NOT HAVE THE AUTHORITY TO (A) AMEND, ALTER OR REPEAL THE BYLAWS; (B) ELECT, APPOINT OR REMOVE ANY MEMBER OF THE EXECUTIVE COMMITTEE OR ANY DIRECTOR OR OFFICER OF THE ORGANIZATION; (C) AMEND OR RESTATE THE ARTICLES OF INCORPORATION; (D) ADOPT A PLAN OF MERGER; (E) ADOPT A PLAN OF CONSOLIDATION WITH ANOTHER ORGANIZATION; (F) AUTHORIZE THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE ORGANIZATION; (G) AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE ORGANIZATION OR ANY PETITION TO OR APPLICATION FOR RELIEF FROM ANY BANKRUPTCY COURT, OR REVOKE PROCEEDINGS THEREFOR; (H) ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE ORGANIZATION; (I) OR AMEND, ALTER OR REPEAL ANY RESOLUTION OF THE BOARD OF DIRECTORS WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY SUCH COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B A FORM 990 DRAFT WAS PROVIDED TO OFFICERS AND KEY MANAGEMENT PRIOR TO BOARD REVIEW. UPON THE APPROVAL OF OFFICERS AND KEY MANAGEMENT, THE FORM WAS SUBMITTED TO THE BOARD OF DIRECTORS. IF THE BOARD OF DIRECTORS HAD ANY COMMENTS, QUESTIONS, OR SUGGESTIONS, THESE WERE CONSIDERED PRIOR TO FILING. AFTER ALL ISSUES WERE ADDRESSED, THE DRAFT WAS FINALIZED AND FILED BY THE ORGANIZATION'S ACCOUNANTS. FORM 990, PART VI, SECTION B, LINE 12C BY SIGNING AN ANNUAL CONFLICT OF INTEREST STATEMENT, ALL OFFICERS, DIRECTORS, OR TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSURE WHETHER THEY HAVE CONFLICTS OF INTEREST IN REGARDS TO THE ORGANIZATION. NO MEMBER OF THE BOARD OF DIRECTORS SHALL PARTICIPATE IN ANY DISCUSSION OR VOTE ON ANY MATTER IN WHICH HE OR SHE OR MEMBER OF HIS OR HER IMMDIATE FAMILY HAS POTENTIAL CONFLICT OF INTEREST DUE TO HAVING MATERIAL ECONOMIC INVOLVEMENT REGARDING THE MATTER BEING DISCUSSED. WHEN SUCH A SITUATION PRESENTS ITSELF, THE DIRECTOR MUST ANNOUNCE HIS OR HER POTENTIAL CONFLICT, DISQUALIFY HIMSELF OR HERSELF, AND BE EXCUSED FROM THE MEETING UNTIL DISCUSSION IS OVER ON THE MATTER INVOLVED. FORM 990, PART VI, SECTION B, LINE 15A IN THE ORGANIZATION'S DETERMINATION OF THE CURRENT CEO/PRESIDENT'S COMPENSATION, ITS EXECUTIVE COMMITTEE REVIEWED THE QUALIFICATIONS OF THE EXISTING CEO/PRESIDENT, PATRICK DUARTE, ALONG WITH INDUSTRY-RELATED INFORMATION GATHERED FROM AN INDEPENDENT THIRD PARTY EXECUTIVE RECRUITER AND INTERNAL SALARIES MANAGEMENT PERSONNEL. IN 2016, THE PROCESS INCLUDED COMPARABILITY DATA, REVIEW AND APPROVAL BY INDEPENDENT PERSONS, AND CONTEPORANEOUS SUBSTANTIATION. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILALE TO THE PUBLIC THROUGH POSTING ON THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE. KAHALA NUI SENIOR LIVING INC 4389 MALIA STREET HONOLULU HI 96821 814797420 SUPPORT SUBSIDIARY ORGANIZATIONS HI 501(C)(3) LINE 12C, III-FI N/A 0 LIVE WELL INC 4389 MALIA STREET HONOLULU HI 96821 814868431 HOME- AND COMMUNITY-BASED PROGRAMS FOR THE ELDERLY HI 501(C)(3) LINE 10 KAHALA NUI SENIOR LIVING INC 0 KAHALA NUI SENIOR LIVING FOUNDATION INC 4389 MALIA STREET HONOLULU HI 96821 814851343 FUNDRAISING HI 501(C)(3) LINE 10 KAHALA NUI SENIOR LIVING INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0