2015-01-15T11:21:24-06:00 2014-02-28 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2013-03-01 941485533 CHANNING HOUSE CHAN 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 RHONDA BEKKEDAHL DIR FINANCE 6503270950 2015-01-15 1 RENIE M BURBANK P00159653 4159561500 2013 2016-04-25 22:37:26Z MELVIN MATSUMOTO 850 WEBSTER STREET PALO ALTO CA 94301 29909438 0 X WWW.CHANNINGHOUSE.ORG X 1961 CA PROVIDES HOUSING AND HEALTH CARE SERVICES WITHIN A LIFE CARE COMMUNITY. 14 14 108 70 0 0 280832 72368 13604814 14243756 711385 424952 54005 57657 14651036 14798733 40768 48624 0 0 4855828 4987765 8532 12100 37122 7083750 7722250 11988878 12770739 2662158 2027994 116074697 120246856 90837415 92841034 25237282 27405822 THE MISSION OF CHANNING HOUSE IS TO PROVIDE A CONTINUING CARE RESIDENTIAL COMMUNITY THAT ENHANCES EACH RESIDENT'S INDEPENDENCE, WELL BEING, NEEDED CARE, AND SECURITY. 0 0 10225938 48624 14243171 PROVIDE HOUSING, ASSISTED LIVING AND SKILLED NURSING SERVICES WHICH INCLUDE: FOOD SERVICES, HOUSEKEEPING, NURSING AND MEDICAL CARE. DURING FY 2014 WE SERVED AN AVERAGE OF 234 RESIDENTS WITH A TOTAL UTILIZATION OF 5,201 SERVICE DAYS OF SKILLED NURSING; 12,629 SERVICE DAYS OF ASSISTED LIVING; AND 63,145 DAYS OF RESIDENTIAL CARE SERVICES. CHANNING HOUSE ALSO HOSTED PUBLIC FUNCTIONS INCLUDING COMMUNITY MEETINGS, NEIGHBORHOOD POLLING PLACE, TUTORING PROGRAM FOR DISADVANTAGED YOUTHS, AND OTHER VOLUNTEER ACTIVITIES. 10225938 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 38 0 1 108 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X RHONDA BEKKEDAHL 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 DEXTER DAWES CHAIRMAN 8.00 X X 0 0 0 DAVID THORNTON VICE CHAIRMAN 8.00 X X 0 0 0 ED MILLER SECRETARY 4.00 X X 0 0 0 JOHN SCHNIEDWIND TREASURER 8.00 X X 0 0 0 RAYMOND BACCHETTI BOARD MEMBER 4.00 X 0 0 0 STEPHEN RELLER BOARD MEMBER 4.00 X 0 0 0 MICHAEL COUCH BOARD MEMBER 8.00 X 0 0 0 MARLENE PRENDERGAST BOARD MEMBER 4.00 X 0 0 0 GLORIA HOM BOARD MEMBER 4.00 X 0 0 0 JOHN BOGGS BOARD MEMBER 4.00 X 0 0 0 ROBERT HARRINGTON BOARD MEMBER 4.00 X 0 0 0 PAT IRISH BOARD MEMBER 4.00 X 0 0 0 JEAN MCCOWN BOARD MEMBER 4.00 X 0 0 0 ANDY COE BOARD MEMBER 4.00 X 0 0 0 MELVIN MATSUMOTO EXECUTIVE DIRECTOR 40.00 X 247377 0 1146 ARACELI ANTONIO DIRECTOR OF HEALTH SERVICES 40.00 X 139572 0 27255 JULIA JONES ADMINISTRATOR 40.00 X 131516 0 29666 RHONDA BEKKEDAHL DIRECTOR OF FINANCE/IT 40.00 X 113695 0 14491 JOY NAVA REGISTERED NURSE 40.00 X 101192 0 12046 733352 0 84604 5 0 1 0 NIBBI BROTHERS ASSOCIATES 180 HUBBELL ST SAN FRANCISCO CA 94107 CONSTRUCTION CONTRACTORS 3155186 MEDWEST JOHN GASTON 627 HILLCREST WAY EMERALD HILLS CA 94062 PROJECT MANAGER - HEALTH CENTER 421927 HARDISON KOMATSU IVELICH & TUCKER 538 NINTH ST 240 OAKLAND CA 94607 ARCHITECT 357726 HANSON BRIDGETT LLP 425 MARKET ST SAN FRANCISCO CA 94105 ATTORNEY 255198 SALIENT NETWORKS 5927 BALFOUR CT CARLSBAD CA 92008 RESIDENT SECURITY 231452 14 72368 72368 MONTHLY CARE FEES 623000 9955719 9955719 RESIDENT ENTRANCE FEES 623000 3968662 3968662 SPECIAL SERVICES 623000 307575 307575 PROCESSING FEES 623000 11800 11800 14243756 571512 571512 58242 0 58242 58242 58242 14941325 14914000 173885 27325 -173885 -146560 -146560 22235 22820 -585 -585 14798733 14243171 0 483194 X 48624 48624 100390 75368 25022 3495092 2244977 1250115 220339 188411 31928 878489 770248 108241 293455 235191 58264 301136 301136 46552 46552 12100 12100 2770813 2667077 103736 38421 38421 286043 63618 222425 81617 41080 40537 932138 863438 68700 16137 16137 15147 4495 10652 2840 2840 2245724 2245724 449528 316901 132627 MAINT./HOUSEKEEPING 310020 310020 AMORTIZATION OF DEBT 156585 156585 MEDICAL EXPENSES 69549 69549 12770739 10225938 2507679 37122 268320 748430 740038 759220 34839 8972 365485 0 3390 2625 184805 187258 101262335 25345033 67967094 75917302 42698504 38958787 61305 50573 3750917 3613689 116074697 120246856 3525946 3597451 24864723 27411243 62383769 61778125 62977 54215 90837415 92841034 X 24503281 26601625 734001 804197 25237282 27405822 116074697 120246856 X 2027994 91452 49094 X X 0 1 X 1 0 X 308680 206524 727269 280832 72368 1595673 12952616 12002924 15566131 13604814 14243756 68370241 20462 23357 22759 22914 22235 111727 13281758 12232805 16316159 13908560 14338359 70077641 5000 5000 5000 15000 2272707 3098212 3528792 3499758 3121718 15521187 2277707 3103212 3533792 3499758 3121718 15536187 54541454 550842 709420 1271142 1304110 629754 4465268 550842 709420 1271142 1304110 629754 4465268 13832600 12942225 17587301 15212670 14968113 74542909 0.73170 0.74960 0.05990 0.06360 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 500 0 0 1 500 0 0 1000 0 PART II-B, LINE 1: LETTERS TO LEGISLATORS AND/OR THEIR STAFFS REGARDING LEGISLATION RELATED TO LONG-TERM CARE, LICENSING AGENCIES, AND OTHER RELATED TOPICS. 974059 75004 21661 9649 1061075 138437 832847 2775 974059 133000 175 5262 138437 128932 4068 133000 122548 6384 128932 1.00000 0 0 873166 873166 52015465 21095038 30920427 8281635 4249995 4031640 40092069 40092069 75917302 LIABILITY FOR GIFT ANNUITIES 54215 54215 X 15027349 91452 137164 228616 14798733 0 14798733 12858809 0 12858809 -88070 -88070 12770739 PART V, LINE 4: ENHANCE THE WELL-BEING OF RESIDENTS. PROVIDE ON-GOING SUPPORT FOR THE CHARITABLE NEEDS OF RESIDENTS. PART X, LINE 2: CHANNING HOUSE HAS BEEN GRANTED TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. CHANNING HOUSE ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION ("ASC") 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON MARCH 1, 2008. THEY HAD NO UNRECOGNIZED TAX BENEFITS WHICH WOULD REQUIRE AN ADJUSTMENT TO THE MARCH 1, 2013 BEGINNING BALANCE OF NET ASSETS AND HAD NO UNRECOGNIZED TAX BENEFITS AT FEBRUARY 28, 2014. CHANNING HOUSE FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2006 FOR ITS FEDERAL AND 2005 FOR ITS STATE TAX FILINGS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN MINIMUM PENSION LIABLITY 51,064. CHANGE IN VALUE SPLIT INTEREST AGREEMENTS -1,970. RECLASSIFICATION OF OTHER REVENUE TO EXPENSES 88,070. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF OTHER REVENUE TO EXPENSES -88,070. 1 RESIDENT ASSISTANCE 2 48624 PART I, LINE 2: RESIDENCE ASSISTANCE: IF A RESIDENT BECOMES UNABLE TO AFFORD HIS/HER MONTHLY CARE FEES, HE/SHE MAY REQUEST FINANCIAL ASSISTANCE FROM CHANNING HOUSE. THE RESIDENT COMPLETES AN APPLICATION FOR ASSISTANCE AND MEETS WITH THE ADMINISTRATOR TO REVIEW HIS/HER FINANCIAL RESOURCES. THE ADMINISTRATOR AND EXECUTIVE DIRECTOR REVIW AND APPROVE ANY APPLICATIONS FOR ASSISTANCE. X X 0 0 0 0 0 0 0 0 0 MELVIN MATSUMOTO EXECUTIVE DIRECTOR 247377 0 0 0 0 0 999 0 147 0 248523 0 0 0 ARACELI ANTONIO DIRECTOR OF HEALTH SERVICES 139572 0 0 0 0 0 14026 0 13229 0 166827 0 0 0 JULIA JONES ADMINISTRATOR 131516 0 0 0 0 0 16127 0 13539 0 161182 0 0 0 A ABAG FINANCE AUTHORITY FOR NONPROFIT CORPORATIONS INSURED REVENUE BONDS 941485533 0037CQP80 2010-07-08 64066348 NEW HEALTH CENTER CONSTRUCTION & REMODEL 14 UNITS IN EXISTING BUILDING 1 0 0 A 17471427 64066348 4206409 4564688 1031002 3782180 22868167 18896889 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION B, LINE 11 THE AUDIT COMMITTEE REVIEWS A DRAFT OF IRS FORM 990 ON BEHALF OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. THE DRAFT AS REVIEWED BY THE AUDIT COMMITTEE IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF TRUSTEES. PROCESS INCLUDES RECORDING WHO CONDUCTED THE REVIEW, WHEN IT WAS CONDUCTED AND THE EXTENT (DETAIL OR SUMMARY) THE FORM WAS REVIEWED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, POLICY IS REVIEWED WITH BOARD MEMBERS AND KEY STAFF MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION GOES THROUGH AN ANNUAL REVIEW BY THE PERSONNEL COMMITTEE. THE PERSONNEL COMMITTEE IS RESPONSIBLE FOR THE PERFORMANCE APPRAISAL OF THE EXECUTIVE DIRECTOR. THE PERFORMANCE APPRAISAL IS ON AN ANNUAL BASIS. THE COMMITTEE IN ITS EVALUATION MAY SOLICIT INPUT FROM OTHER TRUSTEES, RESIDENTS AND STAFF OF CHANNING HOUSE. THE SALARY AND BENEFITS OF THE EXECUTIVE DIRECTOR ARE ALSO REVIEWED ON AN ANNUAL BASIS. THE PERSONNEL COMMITTEE SUBMITS ANY RECOMMENDED CHANGES TO THE EXECUTIVE DIRECTOR'S SALARY/BENEFITS TO THE BOARD OF TRUSTEES FOR APPROVAL. SUCH RECOMMENDATION WILL BE SUBMITTED FOR REVIEW AND APPROVAL TO THE BOARD AT THE REGULARLY SCHEDULED MEETING PRIOR TO THE EXECUTIVE DIRECTOR'S HIRE DATE ANNIVERSARY. ANY ACTION TAKEN BY THE BOARD ON PERSONNEL COMMITTEE RECOMMENDATIONS WILL BE RECORDED IN THE BOARD MINUTES. COMPENSATION ADJUSTMENTS FOR THE EXECUTIVE DIRECTOR WILL BE ESTABLISHED IN CONJUNCTION WITH A REVIEW OF COMPENSATION STUDIES AVAILABLE FROM BOTH NATIONWIDE AND STATEWIDE SOURCES, AS WELL AS OTHER SOURCES AS AVAILABLE (SUCH AS FROM A CONSULTANT). THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR ANNUAL EVALUATIONS AND IMPLEMENTING ANY SALARY ADJUSTMENTS FOR OTHER KEY MANAGEMENT STAFF. THESE EVALUATIONS MUST BE DONE IN CONJUNCTION WITH THE HIRE DATE ANNIVERSARIES FOR THE FOLLOWING: ADMINISTRATOR, DIRECTOR OF FINANCE, AND FACILITIES DIRECTOR. COMPENSATION ADJUSTMENTS FOR KEY MANAGEMENT STAFF WILL BE BASED ON BUDGETED AMOUNTS AVAILABLE, AS WELL AS STATEWIDE COMPENSATION STUDIES. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE POSTED IN THE RESIDENT LIBRARY; ATTACHED TO NEW RESIDENT CONTRACTS; AND AVAILABLE ON REQUEST FROM THE BUSINESS OFFICE. ALL BOARD MINUTES AND CHANGES TO BYLAWS ARE POSTED IN THE CHANNING HOUSE RESIDENT LIBRARY. COPIES OF MEETING MINUTES ARE AVAILABLE FOR A PRIOR THREE YEAR PERIOD. CONFLICT OF INTEREST POLICY IS AVAILABLE ON REQUEST FROM THE BUSINESS OFFICE. FORM 990, PART IX, LINE 11G FOOD SERVICES: PROGRAM SERVICE EXPENSES 2,521,347. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,521,347. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 112,088. MANAGEMENT AND GENERAL EXPENSES 1,179. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 113,267. ADMINISTRATION SERVICES: PROGRAM SERVICE EXPENSES 2,700. MANAGEMENT AND GENERAL EXPENSES 102,557. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,257. HOUSEKEEPING SERVICES: PROGRAM SERVICE EXPENSES 30,942. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,942. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF CHARITABLE GIFT ANNUITIES -1,970. CHANGE IN MINIMUM PENSION LIABILITY 51,064. 990, PART XII, LINE 2C AUDIT COMMITTEE AND OVERSIGHT: THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR.