2016-05-16T13:05:58-05:00 2015-06-30 GARY MCGEE & CO LLP 808 SW THIRD AVENUE SUITE 700 PORTLAND OR 97204 990 2014-07-01 930386852 ROBISON JEWISH HOME ROBI 5035354300 6125 SW BOUNDARY PORTLAND OR 97221 BOBBIE JENKINS CHIEF FINANCIAL OFFICER 5035354300 2016-05-16 YEE LEE MCGEE P01294356 5032222515 2014 2016-08-17 19:52:53Z CEDAR SINAI PARK SANDRA SIMON 6125 SW BOUNDARY PORTLAND OR 97221 22592773 0 X WWW.CSPARK.COM X 1920 OR TO PROVIDE RESIDENTIAL AND COMMUNITY-BASED CARE TO OUR ELDERS AND INFIRM WITH SERVICES THAT ALLOW THEM TO LIVE WITH COMFORT, INDEPENDENCE AND DIGNITY IN A MANNER AND IN AN ENVIRONMENT BASED ON JEWISH VALUES. 26 26 377 220 0 0 2445999 4881615 18067135 17502562 167401 34187 -19810 147708 20660725 22566072 588750 160099 0 0 12178321 12695346 0 0 432339 6957225 7108073 19724296 19963518 936429 2602554 33215404 34821411 10463620 9487726 22751784 25333685 TO PROVIDE RESIDENTIAL AND COMMUNITY-BASED CARE TO OUR ELDERS AND INFIRM WITH SERVICES THAT ALLOW THEM TO LIVE WITH COMFORT, INDEPENDENCE AND DIGNITY IN A MANNER AND IN AN ENVIRONMENT BASED ON JEWISH VALUES. 0 0 16065733 160099 17502562 PROVIDING A HIGH LEVEL OF NURSING CARE AND HOUSING TO PRIVATE, MEDICARE, AND WELFARE RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY. 16065733 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 48 0 377 1 0 0 0 0 0 0 0 0 0 0 X 26 26 1 0 1 0 1 1 0 1 1 0 0 0 1 1 0 1 0 0 0 0 OR X ROBISON JEWISH HOME 5035354300 6125 SW BOUNDARY PORTLAND OR 97221 RACHAEL DUKE TRUSTEE 1.00 X 0 0 0 MICHELLE EASTERN-GRADOW TRUSTEE 1.00 X 0 0 0 MICHAEL FEVES TRUSTEE 1.00 X 0 0 0 DEANNE FROEHLICH TRUSTEE 1.00 X 0 0 0 LESLIE GELLER TRUSTEE 1.00 X 0 0 0 CAROL KORANDA TRUSTEE 1.00 X 0 0 0 PAUL LABBY TRUSTEE 1.00 X 0 0 0 SUSIE MARCUS TRUSTEE 1.00 X 0 0 0 ALBERT MENASHE TRUSTEE 1.00 X 0 0 0 JACK MENASHE TRUSTEE 1.00 X 0 0 0 JOANNE VAN NESS MENASHE TRUSTEE 1.00 X 0 0 0 SHARON MORELL TRUSTEE 1.00 X 0 0 0 JEFF REINGOLD TRUSTEE 1.00 X 0 0 0 EDDY SHULDMAN TRUSTEE 1.00 X 0 0 0 DR RODGER SLEVEN TRUSTEE 1.00 X 0 0 0 MARTHA SOLTESZ TRUSTEE 1.00 X 0 0 0 BEVERLY STEIN TRUSTEE 1.00 X 0 0 0 SHARON WEIL TRUSTEE 1.00 X 0 0 0 JIM WINKLER TRUSTEE 1.00 X 0 0 0 LINDA VELTMAN TRUSTEE 1.00 X 0 0 0 LANCE STEINBERG PRESIDENT 2.00 X X 0 0 0 ELISE BRICKNER-SCHULZ VICE PRESIDENT OF DEVELOPMENT 2.00 X X 0 0 0 ANDREW ROSENGARTEN VICE PRESIDENT OF FINANCE 2.00 X X 0 0 0 IVAN GOLD VICE PRESIDENT OF PROGRAMS 2.00 X X 0 0 0 LIZ RABINER LIPPOFF SECRETARY 2.00 X X 0 0 0 PAUL R FRISCH IMMEDIATE PAST PRESIDENT 2.00 X X 0 0 0 DAVID FUKS CEO (RETIRED 9/15) 40.00 X 218785 0 21554 RICHARD HORSFORD CFO/CONTROLLER 40.00 X 118897 0 21554 SANDRA SIMON COO (THRU 9/15, CEO EFF. 9/15) 40.00 X 102355 0 5977 DAVID KOHNSTAMM RSM ADMINISTRATOR 40.00 X 103797 0 21554 543834 0 70639 4 0 1 0 0 218742 126393 134049 109079 4293352 4881615 RESIDENT SERVICES 623000 17455168 17455168 DEVELOPER FEE 623000 47394 47394 17502562 34187 34187 23000 126393 26701 -3701 -3701 OTHER REVENUE 900099 151409 151409 151409 22566072 17502562 0 181895 112279 112279 47820 47820 408615 408615 9359777 7955810 1216771 187196 48972 30852 17630 490 2175660 1805798 326349 43513 702322 589951 98325 14046 314257 314257 25783 25783 741393 511561 207590 22242 140094 4203 131688 4203 149974 145475 4499 1096209 1052361 43848 70565 12702 57863 352084 352084 1018486 998116 20370 103965 83172 20793 FOOD COSTS 1124222 1124222 OTHER EXPENSES 716280 279350 286511 150419 SUPPLIES 573072 441265 126076 5731 MEDICAID BED TAX 535843 535843 145846 128344 17502 19963518 16065733 3465446 432339 2775550 9227923 2776653 2373073 3387535 2560562 1207740 911402 2832925 1267240 53755 61580 66173 85959 35557896 18157483 15923608 17400413 2570014 647770 1621451 285489 33215404 34821411 1250359 1201306 517110 144161 6851553 6511719 110545 105439 1589892 1669262 10463620 9487726 X 16911325 17023402 5840459 8310283 22751784 25333685 33215404 34821411 2602554 -20653 0 X 0 1 X 1 0 X 3802161 1865143 2998039 2445999 4881615 15992957 16308402 16047205 17518442 18067135 17502562 85443746 20110563 17912348 20516481 20513134 22384177 101436703 290177 360067 351222 355929 443492 1800887 0 290177 360067 351222 355929 443492 1800887 99635816 105961 103724 170245 138686 34187 552803 105961 103724 170245 138686 34187 552803 151409 151409 20216524 18016072 20686726 20651820 22569773 102140915 0.97550 0.99280 0.00540 0.00720 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME 151409 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 2325994 2325994 27373001 15525306 11847695 3730791 2632177 1098614 2128110 2128110 17400413 ACCRUED BOND INTEREST 86730 REFUNDABLE ADVANCE 1000000 DUE TO AFFILIATE 582532 1669262 PART IV, LINE 2B: TENANT SECURITY DEPOSITS AND RESIDENT FUNDS HELD IN TRUST. ANNUAL BENEFIT 149393 126393 23000 2827 15103 3060 5711 149393 126393 23000 2827 15103 3060 5711 26701 -3701 1 HOUSING WITH SERVICES LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 465768550 112279 TO COVER EXPENSES FOR SENIORS AND PEOPLE WITH DISABILITIES LIVING IN AFFORDABLE HOUSING. 1 RESIDENT ASSISTANCE 5 47820 FAIR MARKET VALUE PART I, LINE 2: RESTRICTED FUNDS ARE PLACED INTO ACCOUNTS AND MONITORED TO ENSURE THE MONIES ARE USED PER DONOR INTENT. OUR STAFF AND ADMINISTRATORS DETERMINE WHICH RESIDENTS ARE LOW INCOME AND QUALIFY FOR ASSISTANCE. ONCE DETERMINATION IS MADE, ASSISTANCE IS MADE AVAILABLE. X X X 0 0 0 0 0 0 0 0 0 DAVID FUKS CEO (RETIRED 9/15) 218785 0 0 0 0 0 21554 0 0 0 240339 0 0 0 A HOSPITAL FACILITY AUTHORITY 930847114 179027VH7 2005-12-16 9218214 CONSTRUCTION OF ASSISTED LIVING FACILITIY 0 0 0 A 3071495 9218214 9034150 184364 2005 0 1 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 2 ALBERT, JOANNE & JACK MENASHE HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS OF THE ORGANIZATION WERE RESTATED EFFECTIVE JANUARY 13, 2015. CHANGES INCLUDE DEFINITIONS AND DETAILS OF THE ORGANIZATION'S COMMITTEES, AS WELL AS MODERNIZING AND UPDATING THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 6 ANY PERSON MAY BECOME A MEMBER OF THE ROBISON JEWISH HOME BY PAYING THE DUES SET BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION WILL ELECT APPROXIMATLEY ONE THIRD OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS PREPARED BY AN INDEPENDENT CPA AND IS REVIEWED WITH THE FINANCE COMMITTEE PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15 COMPARATIVE AMOUNTS ARE BASED ON SIMILAR POSITIONS AND DUTIES IN SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CLAY TOWER GP LLC 1430 SW 12TH AVENUE PORTLAND OR 97201 020536507 TO OPERATE APARTMENT COMPLEX OR 0 359040 ROBISON JEWISH HOME CSP-1200 GP LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 454612993 TO ACQUIRE & REHABILITIATE PROPERTY OR 0 100 ROBISON JEWISH HOME CSP-PARK LEXINGTON GP LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 260526202 TO ACQUIRE & REHABILITIATE PROPERTY OR 0 100 ROBISON JEWISH HOME SINAI FAMILY HOME SERVICES INC 7412 SW BEAVERTON-HILLSDALE HWY 10 PORTLAND OR 97225 208504069 PROVIDE RESIDENTIAL AND COMMUNITY-BASED CARE TO ELDERS OR 501(C)(3) LINE 11A, I N/A 0 CEDAR SINAI PARK FOUNDATION 6125 SW BOUNDARY STREET PORTLAND OR 97221 043774565 SUPPORTING ROBISON JEWISH HOME OR 501(C)(3) LINE 11A, I ROBISON JEWISH HOME 1 CSP-O'BRIEN INC 6125 SW BOUNDARY STREET PORTLAND OR 97221 200235623 TO OWN REAL PROPERTY OR 501(C)(2) ROBISON JEWISH HOME 1 CSP KEHILLAH HOUSING 6000 SW BEAVERTON-HILLSDALE HWY PORTLAND OR 97221 454839314 CONSTRUCT AND OPERATE APARTMENT COMPLEX OR 501(C)(3) LINE 7 ROBISON JEWISH HOME 1 CEDAR SINAI PARK-CLAY TOWER APTS 6125 SW BOUNDARY STREET PORTLAND OR 97221 260536507 LOW INCOME HOUSING OR CLAY TOWER GP LLC RELATED -60 1094533 0 1 0.00010 HOUSING WITH SERVICES LLC 6125 SW BOUNDARY STREET PORTLAND OR 97221 465768550 COORDINATE HEALTH SERVICES OR N/A RELATED 1825 190395 0 1 0.51000 CSP-1200 LIMITED PARTNERSHIP 6125 SW BOUNDARY STREET PORTLAND OR 97221 320371089 LOW INCOME HOUSING OR CSP 1200 GP LLC RELATED -59 1660384 0 1 0.00010 CSP-PARK LEXINGTON LTD PARTNERSHIP 6125 SW BOUNDARY STREET PORTLAND OR 97221 900881617 LOW INCOME HOUSING OR CSP-PARK RELATED -75 8790331 0 1 0.00010 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 HOUSING WITH SERVICES LLC B 112279 FAIR MARKET VALUE CEDAR SINAI PARK FOUNDATION C 134049 FAIR MARKET VALUE CSP-KEHILLAH HOUSING D 506576 FAIR MARKET VALUE