2015-05-15T20:16:52-05:00 2014-06-30 450250958 EIDE BAILLY LLP 1850 N CENTRAL AVE SUITE 400 PHOENIX AZ 850044527 990 2013-07-01 860411904 FSL PROGRAMS INC FSLP 6022851800 1201 E THOMAS ROAD PHOENIX AZ 85014 CARRIE SMITH CHIEF OPERATING OFFICER 6022851800 2015-05-15 1 BRENDA BLUNT P00075126 6022645844 2015-05-15 2013 2016-02-25 16:41:14Z TOM EGAN 1201 E THOMAS ROAD PHOENIX AZ 85014 11378227 0 0928 X WWW.FSL.ORG X 1980 AZ PROVIDE PROGRAMS AND SERVICES FOR SENIOR ADULTS, PERSONS WITH DISABILITIES, AND THEIR FAMILIES. 5 0 271 209 0 0 974722 1128951 10486877 10204012 13772 -8548 130 146 11475501 11324561 0 105 0 0 6484666 5980786 0 0 0 5664028 5331615 12148694 11312506 -673193 12055 2444942 2529268 2322075 2383928 122867 145340 X PROVIDE PROGRAMS AND SERVICES FOR SENIOR ADULTS, PERSONS WITH DISABILITIES, AND THEIR FAMILIES. 0 1 3802851 105 3731148 ADULT DAY HEALTH SERVICES PROGRAMS MEET THE NEEDS OF SENIORS AND ADULTS WITH DISABILITIES IN A SUPPORTIVE, SAFE AND CARING ENVIRONMENT THAT PROVIDES THERAPEUTIC RECREATIONAL ACTIVITIES, DAILY EXERCISE PROGRAMS, PERSONAL/NURSING CARE, NUTRITIONAL MEALS, COMPANIONSHIP, SOCIAL SERVICES, COMMUNITY OUTINGS, AND LIMITED TRANSPORTATION SERVICES. THE CENTERS, LICENSED BY THE DEPARTMENT OF HEALTH SERVICES, ARE LOCATED IN TEMPE, PHOENIX AND GLENDALE, AND PROVIDE SPECIALIZED SENIOR AND SPECIALIZED YOUNG ADULT PROGRAMS AND SERVE MOST OF THE SURROUNDING COMMUNITIES OF THE CENTERS. THE PROGRAM ASSISTS THE PARTICIPANTS IN MAINTAINING THEIR INDIVIDUAL LEVEL OF INDEPENDENCE AND PROVIDES THE ABILITY FOR THE PARTICIPANTS TO REMAIN IN THE COMMUNITY RATHER THAN AN ALTERNATIVE INSTITUTIONAL PLACEMENT. (CONT'D ON SCHEDULE O) IN THIS FISCAL YEAR FSL'S ADHS CENTERS PROVIDED SERVICES FOR 252 DAYS, SERVING A TOTAL OF 293,261 HOURS TO THEIR 674 UNDUPLICATED CLIENTS, AND PROVIDED RESPITE SERVICES FOR OVER 900 CAREGIVERS. 2529171 2512929 COMMUNITY LIVING RESOURCES (CLR) IS A COMPILATION OF SERVICES DESIGNED TO HELP ENSURE THE PROVISION OF QUALITY CARE IN ASSISTED LIVING FACILITIES, AS DETERMINED BY ARIZONA LONG-TERM CARE SERVICES (ALTCS) HEALTH PLANS AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES (ADHS). THERE ARE THREE CLASSIFICATIONS OF LICENSED ASSISTED LIVING FACILITIES (ALF), EACH BASED ON A MAXIMUM NUMBER OF INDIVIDUALS LICENSED TO BE SERVED IN THE FACILITY: FOSTER CARE (AFC) - 1-4 RESIDENTSASSISTED LIVING HOMES (ALH) - 1-10 RESIDENTSASSISTED LIVING CENTERS (ALC) - 11 OR MORE RESIDENTS(CONT'D ON SCHEDULE O)TOTAL NUMBER OF CONTRACTED ALF'S FOR THREE ALTCS HEALTH PLANS: 893ADULT FOSTER CARE (AFC) - 55ASSISTED LIVING HOMES (ALH) - 744ASSISTED LIVING CENTERS (ALC) - 94 SERVICE COMPONENTS AND DATA FOR FY 2013/2014 INCLUDED THE FOLLOWING:QUALITY MONITORING AUDITS, AND OCCASIONAL INVESTIGATIVE AUDITS OF A SPECIFIC CONCERN, CONDUCTED ON A CONTRACTUAL BASIS FOR THREE ALTCS HEALTH PLANS (BRIDGEWAY, UNITED HEALTHCARE AND MERCY CARE) TO ENSURE ALTCS MEMBERS' HEALTH AND WELL-BEING AS RESIDENTS IN ASSISTED LIVING FACILITIES. EACH ALTCS CONTRACTED ALF WHICH HAS MEMBERS IN RESIDENCE RECEIVES A QUALITY MONITORING VISIT ONCE A YEAR TO ENSURE THEIR MEMBERS' HEALTH AND WELL-BEING IN THESE FACILITIES. INVESTIGATIONS ARE REFERRED BY CONTRACTED HEALTH PLANS, AND ARE DEPENDENT UPON NUMBER OF REQUESTS. THE ONLY REQUESTS HAVE BEEN FROM MERCY CARE PLAN. QUALITY MONITORING AUDITS HAVE ALSO BEEN CONDUCTED TO A NUMBER OF SKILLED NURSING FACILITIES (SNF), PCP AND SPECIALISTS WITH ACTIVE BRIDGEWAY MEMBERS. ATTENDANT CARE AND DIRECT CARE WORKER (DCW) AUDITS HAVE ALSO BEEN ASSIGNED BY BRIDGEWAY AND UNITED HEALTH CARE. TOTAL NUMBER OF QUALITY MONITORING VISITS - 839 (INCLUDES SNF, PCP/SPECIALISTS AND ATTENDANT CARE/DCW AUDITS)TOTAL NUMBER OF INVESTIGATIVE VISITS - 3ADULT FOSTER CARE HOME (AFC) ALTCS CLIENT BILLING CLR PROCESSES SPONSOR PAYMENTS AND ACTS AS A PAYEE (SSI, SSA CHECKS), ON BEHALF OF TWO HEALTH PLANS (MERCY CARE AND SCAN), FOR RESIDENTS WHO DO NOT HAVE A FAMILY MEMBER OR POA, AND WHO RESIDE IN CONTRACTED AFC HOMES. TOTAL NUMBER OF PAYEE CLIENTS SERVED - 12. 2935348 3006023 FSL PROGRAMS HOME HEALTH AGENCY IS A MEDICARE CERTIFIED, STATE LICENSED PROGRAM THAT PROVIDES INTERMITTENT MEDICALLY NECESSARY SKILLED NURSING, THERAPY, SOCIAL SERVICES AND HOME HEALTH AIDE SERVICES THAT ALLOW PATIENTS THROUGHOUT THE PHOENIX METROPOLITAN AREA TO REMAIN SAFELY AND COMFORTABLY AT HOME. DURING THE PAST YEAR WE HAVE FOCUSED ON EXPANDING AND GROWING OUR MEDICARE BUSINESS AND HAVE A FULL TIME PHYSICAL THERAPIST WORKING FOR US. OUR TYPICAL DAILY CENSUS IS ABOUT 250 CLIENTS.FSL HOME HEALTH AGENCY'S SKILLED HOURLY CARE FOR VENTILATOR/ TRACK DEPENDENT CLIENTS CONTINUES TO GROW. THIS PROGRAM PROVIDES MUCH NEEDED SKILLED NURSING SERVICES TO CLIENTS (CONT'D ON SCHEDULE O)AND FAMILIES IN THE HOME SETTING WITH MOST SHIFTS OF SERVICE LASTING WITHIN 8-12 HOURS. DURING THE PAST FISCAL YEAR, WE SERVED 19 PATIENTS WITH 18,520 HOURS UNDER THIS PROGRAMFSL HOME CARE PROGRAM OFFERS A VARIETY OF NON-MEDICAL SERVICES TO INCLUDE HOUSEKEEPING, PERSONAL CARE ASSISTANCE AND CHORE SERVICES ALL DESIGNED TO INCREASE OR MAINTAIN ONE'S ABILITY TO LIVE SAFELY IN THE COMMUNITY. THE DAILY AVERAGE CENSUS IS 227. BETWEEN THE HOME HEALTH AND THE HOME CARE PROGRAMS FSL PROVIDED CARE TO OVER 1200 CLIENTS DURING THE PAST YEAR. 1046105 930246 OTHER SERVICES TO SUPPORT AND FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION ARE NUTRITION CENTERS, COMMUNITY SOCIAL SERVICES AND CAREGIVER SERVICE. FSL PROGRAMS LAUNCHED THE CATCH PROGRAM TO IMPROVE HEALTH OUTCOMES FOR UNINSURED PATIENTS OF THE INTERNAL MEDICINE CLINIC AT ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER. ALSO, IT EXPANDED THE ACTIVATE PROGRAM FOR TRANSITIONAL CARE WITH MERCY CARE AND DIGNITY HEALTH TO INCLUDE CHANDLER REGIONAL HOSPITAL. 1046105 930246 10313475 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 23 0 1 271 1 0 0 0 0 0 0 0 0 0 0 X 5 0 0 1 0 0 1 1 0 1 0 0 0 1 1 1 0 1 1 0 0 0 AZ X BLANCA RUIZ 6022851800 1201 E THOMAS ROAD PHOENIX AZ 85014 GUY MIKKELSEN PRESIDENT 2.00 38.00 X X 0 203173 15842 STEVE HASTINGS VICE PRESIDENT 1.00 39.00 X X 0 146692 13342 BLANCA RUIZ TREASURER 5.00 35.00 X X 0 82241 6111 JOHN HANSEN SECRETARY 6.00 34.00 X X 0 80380 2839 CARRIE SMITH CHIEF OPERATING OFFICER 12.00 28.00 X X 121394 0 5915 JOE SWITALSKI MEMBER 10.00 30.00 X 0 99112 1469 RICHARD ARMSTRONG CHIEF FINANCIAL OFFICER 2.00 38.00 X 0 128792 6646 LINDA MARTIN VICE PRESIDENT OF OPERATIO 20.00 20.00 X 0 145068 8078 121394 885458 60242 1 0 1 0 FSL MANAGEMENT 1201 E THOMAS ROAD PHOENIX AZ 85014 MANAGEMENT FEES 969025 MURIEL FENTON 6535 W SWEETWATER GLENDALE AZ 85304 ADULT FOSTER CARE 458595 ST JOSEPH'S HOSPITAL CATERING 350 W THOMAS RD PHOENIX AZ 85013 CATERED LUNCHED FOR ADHS CENTERS 342060 MELVA CALVIN 22831 S RECKER RD GILBERT AZ 85298 ADULT FOSTER CARE 306937 SANDRA BAKER 6811 W VILLA THERESA GLENDALE AZ 85308 ADULT FOSTER CARE 228558 5 40893 790000 298058 1128951 GOVERNMENT CONTRACTS 623000 8961999 8961999 CLIENT FEES 623000 1168596 1168596 PROGRAM INCOME 623000 73417 73417 10204012 15118 15118 30000 53666 -23666 -23666 -23666 146 0 146 146 11324561 10204012 0 -8402 X 105 105 104788 94309 10479 4822466 4822466 30874 30874 559321 559321 463337 463337 981593 981593 539 539 5750 5750 2287656 2286986 670 7960 7960 554103 554103 552813 552813 382429 382429 7810 7810 14557 14557 64000 64000 69175 69175 FOOD & BEVERAGE 183454 183454 MISCELLANEOUS EXPENSE 76526 76526 BAD DEBTS 72324 72324 REPAIRS & MAINTENENCE 53612 53612 17314 17314 11312506 10313475 999031 0 368838 532416 1866041 1806680 36367 36607 815406 662436 142797 152970 30899 595 2444942 2529268 739375 659611 90156 160640 3649 5451 1488895 1558226 2322075 2383928 X -123926 -121245 246793 266585 122867 145340 2444942 2529268 12055 65424 -55006 0 X 0 1 X 1 1 1 X 1107573 1317919 1191620 974722 1128951 5720785 10445831 10370442 11509437 10487007 10204158 53016875 11553404 11688361 12701057 11461729 11333109 58737660 0 38491 231245 4466 426501 208711 909414 38491 231245 4466 426501 208711 909414 57828246 7685 32175 45230 11772 15118 111980 7685 32175 45230 11772 15118 111980 146 146 11561089 11720536 12746287 11473501 11348373 58849786 0.98260 0.97790 0.00190 0.00330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 815406 662436 152970 152970 DUE TO AFFILIATES 1254920 DUE TO COMBINED AFFILIATES 58312 NOTES PAYABLE AFFILIATES 244994 1558226 X PART IV, LINE 2B: THE ORGANIZATION ACTS AS A REPRESENTATIVE FOR THEIR CLIENTS TO MAINTAIN SEPERATE ACCOUNTS FOR THEIR EXPENDITURES. A CORRESPONDING LIABILITY IS MAINTAINED FOR THE BALANCE OF THESE ACCOUNTS. PART X, LINE 2: EACH ENTITY BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE COMBINED FINANCIAL STATEMENTS. 0 0 0 0 0 0 0 0 0 GUY MIKKELSEN PRESIDENT 0 181666 0 10000 0 11507 0 0 0 15842 0 219015 0 0 STEVE HASTINGS VICE PRESIDENT 0 137966 0 0 0 8726 0 0 0 13342 0 160034 0 0 LINDA MARTIN VICE PRESIDENT OF OPERATIO 0 127112 0 6000 0 11956 0 0 0 8078 0 153146 0 0 SCHEDULE J, PART II: THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SCHEDULE J, PART I, QUESTION 3: GUY MIKKELSEN, LINDA MARTIN, AND STEVE HASTINGS ARE COMPENSATED BY A RELATED ORGANIZATION FOR SERVICES PROVIDED TO FSAL PROGRAMS, INC. AND RELATED ORGANIZATIONS. FORM 990, PART III, LINE 3 ADULT DAY HEALTH SERVICES CLOSED THEIR SCOTTSDALE ADULT DAY HEALTH SERVICES CENTER EFFECTIVE JUNE 27, 2014. OVER 90% OF THE SCOTTSDALE ADULT DAY HEALTH SERVICES CENTER CLIENTS TRANSFERRED TO EITHER THE PHOENIX OR TEMPE ADULT DAY HEALTH SERVICES CENTERS. FORM 990, PART VI, SECTION A, LINE 1B: THE BOARD MEMBERS ARE NOT INDEPENDENT AS THEY ARE COMPENSATED BY FOUNDATION FOR SENIOR LIVING (FSL) RELATED ORGANIZATIONS FOR THEIR SERVICES PROVIDED TO THE FSL ORGANIZATION AS A WHOLE. FOUNDATION FOR SENIOR LIVING HAS AN INDEPENDENT BOARD AND THEY ELECT THE BOARD MEMBERS FOR FSL PROGRAMS. FORM 990, PART VI, SECTION A, LINE 3 FSL PROGRAMS PAYS FSL MANAGEMENT, AN AFFILIATE, A MANAGEMENT FEE. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, FINANCIAL, HUMAN RESOURCES, AND RISK MANAGEMENT OVERSIGHT. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THIS ORGANIZATION IS FOUNDATION FOR SENIOR LIVING. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS ARE APPOINTED BY FOUNDATION FOR SENIOR LIVING. DIRECTORS MAY BE REMOVED AT ANY TIME WITHOUT CAUSE BY THE FOUNDATION FOR SENIOR LIVING. FORM 990, PART VI, SECTION A, LINE 8B FSL PROGRAMS DOES NOT HAVE A COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE TREASURY MANAGER FOR THE ORGANIZATION'S PARENT, FOUNDATION FOR SENIOR LIVING (FSL), WILL REVIEW THE RETURN PRIOR TO BEING SUBMITTED TO THE GOVERNING BOARD. THE RETURN WILL ALSO BE PROVIDED TO THE FSL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12 EVERYONE ON BOARDS OR WORKING FOR THE FOUNDATION AND ITS AFFILIATES ARE COVERED UNDER THE POLICY. FOR FOUNDATION, CONFLICTS ARE DETERMINED AT THE FSL BOARD LEVEL. FOR AFFILIATE CORPORATIONS, CONFLICTS ARE DETERMINED EITHER AT THE FSL LEADERSHIP COUNCIL LEVEL OR THE AFFILIATE BOARD LEVEL FOR BOTH THE LEVEL AT WHICH DETERMINATIONS OF WHETHER A CONFLICT EXISTS ARE MADE AND THE LEVEL AT WHICH ACTUAL CONFLICTS ARE REVIEWED. ALL POTENTIAL CONFLICTS OF INTEREST, REGARDLESS OF HOW SMALL OR INSIGNIFICANT, ARE TO BE REPORTED TO THE PRESIDENT OF THE BOARD OF DIRECTORS (OR COMMITTEE CHAIR) PRIOR TO ENGAGING IN A CONFLICT OF INTEREST BOARD OR COMMITTEE ACTION. THE PRESIDENT WILL ASK THE BOARD OF DIRECTORS TO MAKE A DECISION AS TO WHETHER THE RELATIONSHIP IS AN APPROPRIATE ONE FOR FSL. THE BOARD MEMBER DECLARING THE CONFLICT WILL HAVE NO VOTE ON THE MATTER. MOREOVER, THE PERSON HAVING A CONFLICT SHALL RETIRE FROM THE ROOM IN WHICH THE BOARD (OR ITS COMMITTEE) IS MEETING AND SHALL NOT PARTICIPATE IN THE FINAL DELIBERATION REGARDING THE MATTER UNDER CONSIDERATION. HOWEVER, THE PERSON SHALL BE PERMITTED TO PROVIDE THE BOARD OR COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION PRIOR TO LEAVING THE MEETING. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, LINE 15A: GUY MIKKELSEN IS COMPENSATED BY A RELATED ORGANIZATION, FSAL MANAGEMENT (FSAL), FOR HIS SERVICES PROVIDED TO FSAL AND ITS RELATED ORGANIZATIONS. HIS COMPENSATION IS APPROVED BY THE GOVERNING BOARD OF FSAL. ON AN ANNUAL BASIS, THEY ARE PROVIDED WITH COMPARABILITY DATA/COMPENSATION STUDIES TO DETERMINE HIS COMPENSATION. OTHER OFFICERS AND DIRECTORS ARE PROVIDED COMPENSATION FROM FSL AND OTHER RELATED ORGANIZATIONS FOR THEIR SERVICES, BEYOND BEING ON THE GOVERNING BOARD, PROVIDED TO THAT ENTITY AND OTHER RELATED ORGANIZATIONS. THEIR COMPENSATION IS APPROVED BY GUY MIKKELSEN, PRESIDENT AND CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL DIRECTOR V.A.: PROGRAM SERVICE EXPENSES 3,600. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,600. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 5,770. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,770. SPONSOR PAYMENTS: PROGRAM SERVICE EXPENSES 1,133,196. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,133,196. NURSING: PROGRAM SERVICE EXPENSES 1,804. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,804. TEACHERS/PRESENTERS: PROGRAM SERVICE EXPENSES 36,552. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,552. MEDICAL TESTING: PROGRAM SERVICE EXPENSES 2,356. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,356. IN-HOUSE SUBCONTRACTING: PROGRAM SERVICE EXPENSES 39,390. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,390. EXTERMINATING: PROGRAM SERVICE EXPENSES 1,630. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,630. JANITORIAL SERVICES: PROGRAM SERVICE EXPENSES 42,041. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,041. MOVING AND OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 2,118. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,118. ENTERTAINERS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 670. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 670. IN-HOUSE STAFFING: PROGRAM SERVICE EXPENSES 16,579. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,579. CARPET & UPHOLSTERY CLEANING: PROGRAM SERVICE EXPENSES 120. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120. OTHER CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 7,740. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,740. ADULT FOSTER CARE: PROGRAM SERVICE EXPENSES 994,090. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 994,090. 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