2015-05-22T18:40:14-05:00 2014-09-30 264677183 DZH PHILLIPS LLP 135 MAIN STREET 9TH FLOOR SAN FRANCISCO CA 941051815 990 2013-10-01 941156461 ALDERSLY ALDE 4154537425 326 MISSION AVENUE SAN RAFAEL CA 949013484 JOANNE MAXWELL EXECUTIVE DIRECTOR 4154537425 2015-05-13 1 P00176450 4157812500 X 2013 2016-03-07 17:11:31Z JOANNE MAXWELL 326 MISSION AVENUE SAN RAFAEL CA 949013484 17656740 0 X WWW.ALDERSLY.COM X 1921 CA PROVISION OF HOUSING AND NURSING SERVICES TO SENIOR CITIZENS. 12 12 111 120 0 0 1086165 850522 7532562 7884924 836130 594680 16684 -73673 9471541 9256453 0 0 0 0 3247488 3542877 50609 0 0 4371054 4304207 7669151 7847084 1802390 1409369 29931644 33072131 12491456 13220985 17440188 19851146 PROVISION OF HOUSING AND NURSING SERVICES TO SENIOR CITIZENS. 0 0 5094908 7884924 MAINTAINED RESIDENTIAL HEALTH CARE FACILITIES FOR SENIOR CITIZENS WHO HAVE ENTERED INTO A CONTINUING CARE AND LODGING AGREEMENT; MAINTAINED NURSING SERVICES INFIRMARY. APPROXIMATELY 100 SENIORS WERE SERVED. 5094908 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 63 0 1 111 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JOANNE MAXWELL 4154537425 326 MISSION AVENUE SAN RAFAEL CA 94901 PETER SCHAKOW PRESIDENT 8.00 X X 0 0 0 CYR MILLER SENIOR VICE PRESIDENT 8.00 X X 0 0 0 AL BORO VICE PRESIDENT 8.00 X X 0 0 0 W GRANT HELLAR III SECRETARY/TREASURER 8.00 X X 0 0 0 DR DAVID BERMAN DIRECTOR/MEDICAL DIRECTOR 8.00 X X 38208 0 0 TORBEN O BJORN DIRECTOR 8.00 X 0 0 0 KRUUSE CAROE DIRECTOR 8.00 X 0 0 0 TAGE HANSEN DIRECTOR 8.00 X 0 0 0 OLE MIKKELSEN DIRECTOR 8.00 X 0 0 0 KRISTIAN SORENSEN DIRECTOR 8.00 X 0 0 0 HERDIS VOGL DIRECTOR 8.00 X 0 0 0 BRIGIT JACOBSEN DIRECTOR 8.00 X 0 0 0 JOANNE MAXWELL EXECUTIVE DIRECTOR 40.00 X 188349 0 36033 CATALINA MADRID DIRECTOR OF NURSING 40.00 X 113841 0 0 340398 0 36033 2 0 1 0 SODEXHO INC & AFFILIATES DEPT 880328 LOS ANGELES CA 90088 DIETARY MANAGEMENT/SUPPLIES 676721 LIFE CARE SERVICES LLC 400 LOCUST ST STE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 594684 KAISER FOUNDATION HEALTH PO BOX 6000 SAN FRANCISCO CA 94160 HEALTH CARE SERVICES 262367 REHABCARE GROUP INC PO BOX 277365 ATLANTA GA 30384 REHAB SERVICE 185031 OLD TOWN GLASS INC 700 GRANT AVE NOVATO CA 94945 WINDOW CONTRACTOR 102205 5 30450 820072 6304 850522 RESIDENT CARE FEES 623000 2711685 2711685 HEALTH CARE CENTER FEES 623000 2449351 2449351 PERSONAL CARE FEES 623000 1838380 1838380 ACCOMODATION FEE AMORT. 623000 885508 885508 7884924 441147 441147 18868 0 18868 18868 18868 8525924 8372391 153533 153533 153533 0 30450 27896 -27896 -27896 LOSS ON DISPOSAL OF ASSETS 900099 -64645 -64645 -64645 9256453 7884924 0 521007 X 2893966 2627073 266893 50181 34832 15349 371644 342179 29465 227086 207142 19944 338819 338819 52597 52597 45123 45123 98980 98980 895187 561343 333844 154856 154856 191036 343 190693 354894 327668 27226 26881 5670 21211 292407 292407 629057 629057 166507 166507 FOOD 428159 428159 THERAPY 183044 183044 SUPPLIES 90250 90250 ACTIVITIES 89474 89474 266936 197731 69205 7847084 5094908 2752176 0 632686 348742 447434 466723 800000 225592 275303 194957 269874 20028638 10026222 10335953 10002416 15224170 18686375 1320738 1487739 1550114 734959 29931644 33072131 426557 395878 5806843 5593760 6258056 7231347 12491456 13220985 X 17359763 19770721 80425 80425 17440188 19851146 29931644 33072131 1409369 1001589 0 X X 0 1 X 1 0 X 56996 159729 61865 1086165 850522 2215277 7026957 7290804 7495043 7551722 7903792 37268318 7083953 7450533 7556908 8637887 8754314 39483595 632344 866004 800000 2298348 117938 117938 632344 983942 800000 2416286 37067309 306237 352486 346010 411818 441147 1857698 306237 352486 346010 411818 441147 1857698 4223 -5213 -12991 -64645 -78626 7394413 7797806 7889927 9049705 9130816 41262667 0.89830 0.95580 0.04500 0.04420 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2009 AMOUNT: $ 4,223. 2010 AMOUNT: $ -5,213. 2011 AMOUNT: $ -12,991. LOSS ON DISPOSAL - 2013 AMOUNT: $ -64,645. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4732894 6272 502967 5242133 4028256 123160 581478 4732894 3561674 9442 769060 -311920 4028256 3458347 218323 -20381 -94615 3561674 3202771 642454 266502 653380 3458347 1.00000 0 0 232822 232822 15566080 7699656 7866424 2205850 770540 1435310 2023886 1556026 467860 10002416 DEPOSITS RECEIVED 198991 UNEARNED PORTION OF ACCOMODATION FEES - EXHAUSTIBLE 2685072 UNEARNED PORTION OF ACCOMODATION FEES - NON-REFUNDABLE 2281192 GUARANTEED REFUNDS 1972865 UNEARNED VENDOR CREDIT 93227 7231347 X 10285938 1001589 27896 1029485 9256453 0 9256453 7874980 27896 27896 7847084 0 7847084 PART V, LINE 4: THE ORGANIZATION HAS A BOARD DESIGNATED ENDOWMENT FUND TO PROVIDE FOR GENERAL SUPPORT OF THE ORGANIZATION. THESE FUNDS ARE CLASSIFIED AS UNRESTRICTED NET ASSETS. PART X, LINE 2: MANAGEMENT HAS CONSIDERED POSSIBLE UNCERTAIN TAX POSITIONS AND CONCLUDED THAT THERE WERE NONE AS OF THE DATE THE FINANCIAL STATEMENTS WERE AVAILABLE FOR ISSUE. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 27,896. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 27,896. FORM 990, SCHEDULE D, PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701(D). ACCORDINGLY, IT HAS NOT PROVIDED FOR INCOME TAXES IN THESE FINANCIAL STATEMENTS. THE LLC'S NET EARNINGS ARE REPORTED ON THE FEDERAL AND STATE EXEMPT ORGANIZATION TAX RETURNS OF ITS PARENT COMPANY. THE LLC FILES A SEPARATE STATE TAX RETURN IN CALIFORNIA AND IS SUBJECT TO AN $800 MINIMUM TAX. EACH YEAR MANAGEMENT CONSIDERS WHETHER ANY MATERIAL TAX POSITION THE ORGANIZATION HAS TAKEN IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY. MANAGEMENT BELIEVES THAT ANY POSITIONS THE ORGANIZATION HAS TAKEN ARE SUPPORTED BY SUBSTANTIAL AUTHORITY AND, HENCE, DO NOT NEED TO BE MEASURED OR DISCLOSED IN THE FINANCIAL STATEMENTS. TAX RETURN FOR YEARS SUBSEQUENT TO SEPTEMBER 30, 2010 ARE SUBJECT TO EXAMINATION BY FEDERAL OR STATE TAX AUTHORITIES. TREE OF LIGHTS 8580 8580 TIVOLI 21870 21870 1250 3527 1950 21169 30450 30450 1250 3527 1950 21169 27896 -27896 0 0 0 0 0 0 0 0 0 JOANNE MAXWELL EXECUTIVE DIRECTOR 168645 0 19704 0 0 0 23640 0 12393 0 224382 0 0 0 ADDITIONAL INFORMATION LIFE CARE SERVICES, AN UNRELATED ORGANIZATION, PROVIDES MANAGEMENT SERVICES TO THE ORGANIZATION. THE ORGANIZATION'S EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES AND RECEIVES COMPENSATION ONLY FROM LIFE CARE SERVICES. DAVID BERMAN IS A DOCTOR ACTING AS AN INDEPENDENT CONTRACTOR AND PROVIDES MEDICAL EXPERTISE TO ALDERSLY IN THE ROLE OF MEDICAL DIRECTOR. JOANNE MAXWELL EXECUTIVE DIRECTOR (EMPLOYEE OF LIFE CARE SERVICES) 188349 LIFE CARE SERVICES, AN UNRELATED ORGANIZATION, PROVIDES MANAGEMENT SERVICES TO THE ORGANIZATION. THE ORGANIZATION'S EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES AND RECEIVES COMPENSATION ONLY FROM LIFE CARE SERVICES. 0 DAVID HAROLD BERMAN MD DIRECTOR/MEDICAL DIRECTOR 38208 DAVID BERMAN IS A DOCTOR ACTING AS AN INDEPENDENT CONTRACTOR AND PROVIDES MEDICAL EXPERTISE TO ALDERSLY IN THE ROLE OF MEDICAL DIRECTOR. 0 FORM 990, PART VI, SECTION A, LINE 3 LIFE CARE SERVICES (LCS), AN UNRELATED ORGANIZATION, PROVIDES MANAGEMENT SERVICES TO THE ORGANIZATION. ALDERSLY'S EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LCS, AND RECEIVES COMPENSATION ONLY FROM LCS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE GOVERNING BODY ARE ELECTED AND VOTED FOR AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN IS REVIEWED BY THE ACCOUNTANT OF THE ORGANIZATION'S MANAGEMENT COMPANY AND THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. A COPY OF THE 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY PREPARES AND FURNISHES EACH DIRECTOR A STATEMENT OF ANY TRANSACTION OR INDEMNIFICATION WITHIN ONE HUNDRED TWENTY (120) DAYS AFTER THE END OF THE ORGANIZATION'S FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 15 MANAGEMENT SERVICES ARE OUTSOURCED TO LIFE CARE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 135,163. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 135,163. OTHER FEES: PROGRAM SERVICE EXPENSES 561,343. MANAGEMENT AND GENERAL EXPENSES 198,681. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 760,024. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.