2014-02-04T12:17:48-06:00 2013-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2012-07-01 940831870 SALEM LUTHERAN HOME ASSOCIATION OF THE BAY CITIES % JANICE WASHBURN SALE 5107692700 1301 MARINA VILLAGE PARKWAY Suite 210 ALAMEDA CA 94501 JANICE WASHBURN 5107692700 2014-01-27 true Brian D Todd 4178658701 2012 2015-11-30 17:44:51Z JESSE JANTZEN 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 13727536 false X WWW.SALEMLUTHERANHOME.ORG X 1924 CA SALEM LUTHERAN HOME ASSOCIATION SERVES AND ENRICHES THE LIVES OF OLDER ADULTS BY PROVIDING HOUSING AND SERVICES AT ITS CARE CENTER, AND ITS ASSISTED LIVING, MEMORY CARE, AND INDEPENDENT LIVING UNITS. 10 10 214 53 0 155161 500576 12552480 12962761 223606 88572 -1344 175627 12929903 13727536 0 0 0 0 7088468 7073036 0 0 17124 5547959 5818850 12636427 12891886 293476 835650 15194984 15533735 6441535 5703729 8753449 9830006 X A NONPROFIT ORGANIZATION COMMITTED TO SERVING AND ENRICHING THE PHYSICAL, EMOTIONAL, AND SPIRITUAL WELL-BEING OF OLDER ADULTS THROUGH A PROFESSIONAL, FAITH-CENTERED CARE COMMUNITY AND SERVICES. false false 7322788 5933140 SALEM'S CARE CENTER IS LICENSED FOR 48 SKILLED NURSING RESIDENTS. THE CARE CENTER PROVIDES SKILLED NURSING CARE TO 44 OLDER ADULT RESIDENTS IN AN AVERAGE MONTH, FOR AN ANNUAL TOTAL OF 15,865 RESIDENT DAYS. 45% OF RESIDENTS ARE PRIVATE PAY, WHILE 32% HAVE MEDI-CAL, 19% HAVE MEDICARE AND 5% HAVE OTHER INSURANCE COVERAGE AS PRIMARY PAYER SOURCE. 1379656 2260101 SALEM'S MEMORY CARE UNIT PROVIDES HOUSING AND SERVICES FOR UP 30 OLDER ADULT RESIDENTS WHO HAVE DEMENTIA OR MEMORY LOSS. THIS YEAR WE PROVIDED MEMORY CARE HOUSING FOR 29 RESIDENTS EACH MONTH ON AVERAGE FOR A TOTAL OF 10,571 RESIDENT DAYS. THE MEMORY CARE UNIT HAS MANY DAILY ACTIVITIES DESIGNED FOR DEMENTIA OR MEMORY LOSS RESIDENTS. 1273528 3040969 SALEM'S ASSISTED LIVING UNIT PROVIDES HOUSING AND SERVICES FOR UP TO 65 OLDER ADULT RESIDENTS THAT REQUIRE SOME ASSISTANCE WITH MEDICATION OR DAILY ACTIVITIES. THIS YEAR WE PROVIDED ASSISTED LIVING HOUSING FOR 61 RESIDENTS EACH MONTH ON AVERAGE, EXCLUDING SECOND PERSONS IN EACH UNIT, FOR AN ANNUAL TOTAL OF 22,265 RESIDENT DAYS. THE ASSISTED LIVING RESIDENTS ARE OFFERED FIVE LEVELS OF CARE IN ADDITION TO THE BASE LEVEL OF CARE SO THAT THEIR INDIVIDUAL NEEDS CAN BE MET. THERE ARE MANY ACTIVITIES PROVIDED FOR OUR ASSISTED LIVING RESIDENTS, INCLUDING SOME THAT REFLECT OUR FAITH-BASED MISSION. 636764 1728550 10612736 true true false true false false false false true true true false false false true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 74 0 true 214 true false false false false false true true false false false false X 10 10 false true false false true true true true true false false true true true true true true false false false CA X JANICE WASHBURN 5107692727 1301 MARINA VILLAGE PARKWAY SUITE ALAMEDA CA 94501 CHARLES RUTHROFF 1.0 4.0 X 0 0 0 CHRISTINE WHELAN 1.0 8.0 X X 0 0 0 SISTER LINDA ORRICK 1.0 6.0 X X 0 0 0 SISTER KATHLEEN KEARNEY 1.0 9.0 X X 0 0 0 JOAN RYAN 1.0 3.0 X 0 0 0 MICHAEL TELLEEN 1.0 3.0 X 0 0 0 REVEREND NOREEN MEGINNESS 1.0 3.0 X 0 0 0 JESSE BEAN 1.0 3.0 X 0 0 0 VERN STIGGE 1.0 9.0 X X 0 0 0 RAHUL JOGLEKAR 1.0 3.0 X 0 0 0 LYNNE KATZMAN 1.0 3.0 X 0 0 0 JESSE JANTZEN 1.0 45.0 X 0 374279 12127 JANICE WASHBURN 1.0 45.0 X 0 191227 12430 ADRIENE IVERSON 1.0 45.0 X 0 178120 9041 0 743626 33598 0 false true false REHABCARE GROUP INC PO BOX 50353 ST LOUIS MO 63150 SKILLED NURSING 533588 1 500576 500576 NET PATIENT SERVICE REVENUE 623000 5815364 5815364 RESIDENT SERVICES 623000 7040288 7040288 OTHER PROGRAM SERVICE REVENU 623000 107109 107109 12962761 88572 88572 0 0 7600 7600 0 7600 7600 0 0 0 0 GAIN ON INVESTMENT POOLS 900099 168027 168027 168027 13727536 12962761 264199 0 0 0 0 0 0 5681131 5248113 427527 5491 77956 66116 11840 868523 845485 22232 806 445426 406714 38690 22 956580 956580 40553 40553 45248 45248 0 0 25575 25575 1107008 1077543 23465 6000 107277 1584 100888 4805 1132221 1001982 130239 10590 3781 6809 0 606769 549397 57372 33348 19912 13436 0 21581 1662 19919 131952 106503 25449 0 808866 657350 151516 98658 79631 19027 BAD DEBT 81514 81514 MEDICAL SUPPLIES & DRUGS 336147 336147 LICENSES, DUES, SUBSCRIPTIONS 49081 4471 44610 RECRUITING & RETENTION 108860 7809 101051 117022 117022 12891886 10612736 2262026 17124 540125 1031147 42809 316929 0 0 952835 778900 0 0 0 0 5186 4736 0 0 61685 113334 25243633 16579968 9433283 8663665 4108608 4583977 0 0 0 0 0 0 50453 41047 15194984 15533735 1145044 766001 0 0 450844 341212 0 0 1119 1473 0 0 4360000 4142000 0 0 484528 453043 6441535 5703729 X 7213717 8035863 236681 491092 1303051 1303051 8753449 9830006 15194984 15533735 X 835650 240907 X false true X true false X 1159682 382092 276740 155161 500576 2474251 10697602 10798997 11546182 12552480 12962761 58558022 0 0 0 11857284 11181089 11822922 12707641 13463337 61032273 0 85534 165831 36767 51981 1428 341541 85534 165831 36767 51981 1428 341541 60690732 80780 94263 104924 109644 96172 485783 0 80780 94263 104924 109644 96172 485783 0 0 11938064 11275352 11927846 12817285 13559509 61518056 0.98655 0.98415 0.00790 0.00968 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1I THE ORGANIZATION IS A MEMBER OF SEVERAL ORGANIZATIONS WHOSE PURPOSE IS TO DIRECT, DEVELOP, OR AFFECT PUBLIC POLICY AND LEGISLATION WITH REGARD TO HEALTHCARE ISSUES. THE AMOUNT SPENT ON DUES ALLOCABLE TO LOBBYING ACTIVITIES IS NOT SPECIFICALLY KNOWN; HOWEVER, SUCH AMOUNTS ARE INSUBSTANTIAL. false true 2184513 302423 2486936 2283133 -98620 2184513 1857561 425572 2283133 1667030 190531 1857561 1942767 -275737 1667030 0.41180 0.58820 false false 191734 191734 18296692 11659476 6637216 3561709 3042147 519562 3193498 1878345 1315153 8663665 0 ASSET RETIREMENT OBLIGATION 410737 DUE TO RELATED PARTIES 42306 453043 13942868 240907 -25575 215332 13727536 13727536 12866311 12866311 25575 25575 12891886 ESCROW ACCOUNT LIABILITY SCHEDULE D, PART IV, LINE 2B THE ORGANIZATION HAS A SMALL SEPARATE TRUST BANK ACCOUNT AND CASH BOX HELD FOR RESIDENTS. ENDOWMENT PURPOSE SCHEDULE D, PART V, LINE 4 THERE ARE THREE ENDOWMENT FUNDS, ALL OF WHICH REQUIRE THE INCOME TO BE USED FOR CHARITABLE CARE OF RESIDENTS. UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 SCHEDULE D, PART XI, LINE 2D INVESTMENT FEES $(25,575) false false false false false true false false false JESSE JANTZEN 0 316156 0 56922 0 1201 0 1927 0 10200 0 386406 JANICE WASHBURN 0 169190 0 17045 0 4992 0 1210 0 11220 0 203657 ADRIENE IVERSON 0 162670 0 15000 0 450 0 2438 0 6603 0 187161 COMPENSATION OF THE TOP MANAGEMENT OFFICIAL SCHEDULE J, PART I, LINE 3 THE MANAGEMENT COMPANY AND RELATED ORGANIZATION, ELDER CARE ALLIANCE (ECA), USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. BONUS PAYMENTS SCHEDULE J, PART I, LINE 6A OFFICERS AND CERTAIN EMPLOYEES OF THE ORGANIZATION ARE ELIGIBLE TO RECEIVE BONUS PAYMENTS BASED ON AN INDIVIDUAL INCENTIVE COMPENSATION PLAN THAT IS MADE AT THE BEGINNING OF THE FISCAL YEAR. THE BONUSES ARE BASED ON FINANCIAL, PERSONAL, AND VARIOUS OTHER GOALS, AND TARGETS AND POTENTIAL BONUS PERCENTAGES ARE DETERMINED WHEN THE INCENTIVE PLAN IS DEVELOPED EACH YEAR. THE FINANCIAL GOALS FOR MANY OF THE INDIVIDUALS INCLUDE MEETING OR EXCEEDING A NET EARNINGS AMOUNT. OTHER PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES INCLUDE INDEPENDENT LIVING, WHICH CONSISTS OF 35 APARTMENT-STYLE UNITS AND 4 COTTAGES. DELEGATION OF MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 3 SALEM HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE, A NON-PROFIT PUBLIC BENEFIT CORPORATION THAT IS THE SOLE CORPORATE MEMBER OF SALEM, TO PROVIDE MANAGEMENT SERVICES INCLUDING, BUT NOT LIMITED TO, MARKETING, HUMAN RESOURCES, ACCOUNTING, INFORMATION TECHNOLOGY SERVICES, CLINICAL OVERSIGHT AND INSURANCE. MEMBERS FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ELDER CARE ALLIANCE. APPOINTMENT OF DIRECTORS: (A) THE BOARD OF DIRECTORS OF THE CORPORATION SHALL INCLUDE NO GREATER THAN THIRTEEN (13) INDIVIDUALS APPOINTED IN ACCORDANCE WITH THE FOLLOWING: (I) FIVE (5) INDIVIDUALS APPOINTED BY THE FACILITY AND PROGRAM SPONSOR, THE SIERRA PACIFIC SYNOD OF THE EVANGELICAL LUTHERAN CHURCH OF AMERICA; (II) FIVE (5) INDIVIDUALS APPOINTED BY THE CO-SPONSOR OF THE CORPORATE MEMBER, THE BURLINGAME REGIONAL COMMUNITY OF THE SISTERS OF MERCY OF THE AMERICAS, WEST MIDWEST COMMUNITY, INC., A DIVISION OF THE SISTERS OF MERCY OF THE AMERICAS, A RELIGIOUS INSTITUTE AND PUBLIC JURIDIC PERSON OF THE ROMAN CATHOLIC CHURCH; (III)A MAXIMUM OF TWO (2) INDIVIDUALS JOINTLY APPOINTED BY THE FACILITY AND PROGRAM SPONSOR AND BY THE CO-SPONSOR OF THE CORPORATE MEMBER; AND (IV) ONE (1) INDIVIDUAL NOMINATED BY THE RESIDENT COUNCIL OF SALEM LUTHERAN HOME, THE CONTINUING CARE RETIREMENT COMMUNITY OWNED AND OPERATED BY THE CORPORATION (THE "CCRC") AND APPOINTED BY THE APPOINTEES NAMED PURSUANT TO SUBPARAGRAPHS (I), (II) AND (III) ABOVE, WHICH NOMINEE MUST BE A RESIDENT OF THE CCRC AND WHO WILL NOT HAVE VOTING RIGHTS BUT SHALL HAVE THE SAME FIDUCIARY DUTIES, INCLUDING THE DUTIES OF LOYALTY, CARE AND CONFIDENTIALITY, TO THE CORPORATION IN THEIR ROLE OF RESIDENT REPRESENTATIVE. NOMINATION OF DIRECTORS: (A) SPONSOR AND CO-SPONSOR APPOINTEES. THE BOARD DEVELOPMENT COMMITTEE OF THE CORPORATE MEMBER SHALL IDENTIFY AND EVALUATE QUALIFIED INDIVIDUALS TO SERVE AS DIRECTORS OF THE CORPORATION AND SHALL RECOMMEND THEM TO THE FACILITY AND PROGRAM SPONSOR AND THE CO-SPONSOR OF THE CORPORATE MEMBER FOR APPOINTMENT OF THE SPONSOR AND CO-SPONSOR APPOINTEES. (B) RESIDENT REPRESENTATIVE. THE RESIDENT REPRESENTATIVE SHALL BE NOMINATED BY THE RESIDENT COUNCIL OF THE CCRC IN ANY MANNER DETERMINED BY THE RESIDENT COUNCIL THAT IS REASONABLY CALCULATED TO ENCOURAGE RESIDENT INVOLVEMENT IN SELECTING AND/OR SERVING AS THE RESIDENT REPRESENTATIVE, SO LONG AS THE RESIDENT COUNCIL CONVENES A MEETING FOR SUCH PURPOSE UPON NO LESS THAN THIRTY (30) DAYS' NOTICE. NOTICE OF THE MEETING SHALL BE POSTED IN A CONSPICUOUS PLACE WITHIN THE CCRC AND SHALL STATE THAT THE PURPOSE OF THE MEETING IS TO NOMINATE A RESIDENT TO THE BOARD OF THE CORPORATION. THE FOLLOWING ACTIONS REGARDING SALEM LUTHERAN HOME ("SALEM") SHALL NOT BE IMPLEMENTED WITHOUT THE SPECIFIC APPROVAL OF ELDER CARE ALLIANCE'S CORPORATE MEMBER, SIERRA PACIFIC SYNOD: (A) THE SALE, PURCHASE LEASE OR ENCUMBRANCE OF THE REAL PROPERTY OF SALEM; (B) ANY INCREMENT OR ADDITIONS TO THE CAPITAL DEBT LIMITATION OF SALEM OR ANY OTHER NEGOTIATION, MODIFICATION OR OTHER CHANGE IN THE EXISTING CAPITAL DEBT OF SALEM; (C) ANY ACTION SEEKING BANKRUPTCY OR OTHER DEBTOR PROTECTION FOR SALEM; AND (D) ANY OTHER MATTERS WHICH MAY BE REQUIRED BY CIVIL LAW TO BE NOMINATED BY THE RESIDENT COUNCIL OF THE CCRC IN ANY MANNER DETERMINED BY THE RESIDENT COUNCIL THAT IS REASONABLY CALCULATED TO ENCOURAGE RESIDENT INVOLVEMENT IN SELECTING AND/OR SERVING AS THE RESIDENT REPRESENTATIVE, SO LONG AS THE RESIDENT COUNCIL CONVENES A MEETING FOR SUCH PURPOSE UPON NO LESS THAN THIRTY (30) DAYS' NOTICE. NOTICE OF THE MEETING SHALL BE POSTED IN A CONSPICUOUS PLACE WITHIN THE CCRC AND SHALL STATE THAT THE PURPOSE OF THE MEETING IS TO NOMINATE A RESIDENT TO THE BOARD OF THE CORPORATION. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. ELDER CARE ALLIANCE, SALEM'S SOLE CORPORATE MEMBER AND MANAGEMENT COMPANY, HAS AN AUDIT COMMITTEE ON ITS BOARD OF DIRECTORS THAT REVIEWS THE FORM 990 BEFORE FILING. ALSO, THE EXECUTIVE DIRECTOR, CEO, AND CFO ALL REVIEW THE FORM 990 BEFORE FILING. THE FINAL FORM 990 IS THEN PROVIDED BY E-MAIL TO ALL MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING. CONFLICT OF INTEREST POLICY COMPLIANCE FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE ASSISTANT SECRETARY OF ELDER CARE ALLIANCE REQUESTS UPDATED CONFLICT OF INTEREST DISCLOSURE FORMS FROM THE BOARD OF DIRECTORS, OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED AUTHORITY. THE ASSISTANT SECRETARY PREPARES A TABLE SUMMARIZING THE DISCLOSURES MADE AND PRESENTS THE TABLE TO THE BOARD OF DIRECTORS FOR THEIR INFORMATION. IF AN APPARENT CONFLICT OF INTEREST IS IDENTIFIED, THE MATTER IS REVIEWED BY THE BOARD OR COMMITTEE AND ACTION TAKEN, IF DEEMED NECESSARY, SUCH AS REQUIRING AN INTERESTED DIRECTOR TO RECUSE HIMSELF OR HERSELF FROM A VOTE ON THE MATTER, OR TERMINATING A BUSINESS RELATIONSHIP ENTERED INTO IN VIOLATION OF THE POLICY. COMPENSATION DETERMINATION FORM 990, PART VI, SECTION B, LINES 15A & 15B SALEM HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE. INCLUDED IN THE SERVICES PROVIDED UNDER THIS MANAGEMENT CONTRACT ARE THE SERVICES OF THE CEO, CFO, AND EXECUTIVE DIRECTOR. THE COMPENSATION REVIEW OF THE EXECUTIVE DIRECTORS AND KEY EMPLOYEES WAS DONE FOR FY 2013 BY THE FINANCE COMMITTEE OF ELDER CARE ALLIANCE AS PART OF THE BUDGET REVIEW PROCESS. THE COMPENSATION FOR THE CEO AND CFO WAS REVIEWED AGAINST COMPARABLES PROVIDED FROM A COMPENSATION STUDY COMPILED BY FUTURESENSE, INC., A FIRM THAT SPECIALIZES IN COMPENSATION PROGRAMS. GOVERNING DOCUMENT AVAILABILITY FORM 990, PART VI, SECTION C, LINE 19 BECAUSE SALEM IS A CONTINUING CARE RETIREMENT COMMUNITY, AN ANNUAL REPORT MUST BE FILED WITH THE STATE OF CALIFORNIA CONTAINING THE ORGANIZATION'S FINANCIAL STATEMENTS. THERE IS A NON-VOTING MEMBER OF THE BOARD OF DIRECTORS THAT REPRESENTS THE SALEM RESIDENTS WHO HAS ACCESS TO ALL GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE CONFLICT OF INTEREST POLICY FOR SALEM. ALL REQUESTS MUST BE IN WRITING TO ELDER CARE ALLIANCE, SALEM'S MANAGEMENT COMPANY, AND WILL BE PROVIDED VIA EMAIL, US MAIL, OR BY FAX IF SO REQUESTED. ELDER CARE ALLIANCE 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 943260975 MANAGEMENT CA 501(C)(3) 11 B II NA false MERCY RETIREMENT AND CARE CENTER 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 941156579 ELDERLY CARE CA 501(C)(3) 9 ECA false ELDER CARE ALLIANCE OF CAMARILLO 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 943351613 ELDERLY CARE CA 501(C)(3) 9 ECA false ELDER CARE ALLIANCE OF SAN FRANCISCO 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 943351615 ELDERLY CARE CA 501(C)(3) 9 ECA false ELDER CARE ALLIANCE OF UNION CITY 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 943377985 ELDERLY CARE CA 510(C)(3) 9 ECA false ELDER CARE ALLIANCE OF SAN RAFAEL 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 760730971 ELDERLY CARE CA 501(C)(3) 9 ECA false false false false false false false false false false false false false true true true true false false false