2014-02-04T12:16:48-06:00 2013-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2012-07-01 941156579 MERCY RETIREMENT AND CARE CENTER % JANICE WASHBURN MERC 5107692700 1301 MARINA VILLAGE PARKWAY Suite 210 ALAMEDA CA 94501 JANICE WASHBURN 5107692727 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 25303460 false X WWW.MERCYRETIREMENTCENTER.COM X 1872 CA MERCY RETIREMENT & CARE CENTER SERVES AND ENRICHES THE LIVES OF OLDER ADULTS BY PROVIDING HOUSING AND SERVICES THROUGH ITS RETIREMENT & CARE CENTER, ASSISTED LIVING AND MEMORY CARE UNITS. 10 10 206 566 0 1357534 10240211 12920007 13504863 232571 599001 590820 25486 15100932 24369561 3086 825 0 0 7661163 7584546 0 0 186658 6146898 6043630 13811147 13629001 1289785 10740560 18634039 28230715 1924273 1573315 16709766 26657400 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 7907702 7417993 MERCY RETIREMENT & CARE CENTER IS LICENSED FOR 59 SKILLED NURSING RESIDENTS. THE CARE CENTER PROVIDES SKILLED NURSING CARE TO 53 OLDER ADULT RESIDENTS IN AN AVERAGE MONTH FOR AN ANNUAL TOTAL OF OVER 19,225 RESIDENT DAYS. 44% OF RESIDENTS ARE PRIVATE PAY, WHILE 36% HAVE MEDI-CAL, 18% HAVE MEDICARE AND 2% HAVE OTHER INSURANCE COVERAGE. 2003284 4340495 MERCY'S ASSISTED LIVING UNIT PROVIDES HOUSING AND SERVICES FOR UP TO 84 OLDER ADULT RESIDENTS THAT REQUIRE SOME ASSISTANCE WITH MEDICATION OR DAILY ACTIVITIES. THIS YEAR WE PROVIDED ASSISTED LIVING HOUSING FOR 73 RESIDENTS EACH MONTH ON AVERAGE, EXCLUDING SECOND PERSONS IN EACH UNIT, FOR AN ANNUAL TOTAL OF 26,579 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 MANY THAT REFLECT OUR FAITH-BASED MISSION. 632616 1534504 MERCY'S MEMORY CARE UNIT PROVIDES HOUSING AND SERVICES FOR UP TO 22 OLDER ADULT RESIDENTS WHO HAVE DEMENTIA OR MEMORY LOSS. THIS YEAR WE PROVIDED MEMORY CARE HOUSING FOR 20 RESIDENTS EACH MONTH ON AVERAGE FOR A TOTAL OF 7,156 RESIDENT DAYS. THE MEMORY CARE UNIT HAS MANY DAILY ACTIVITIES DESIGNED FOR DEMENTIA OR MEMORY LOSS RESIDENTS. 316308 825 211871 10859910 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 62 0 true 206 true false false false false false false 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 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 VERN STIGGE 1.0 9.0 X X 0 0 0 CHRISTINE WHELAN 1.0 8.0 X X 0 0 0 REV NOREEN MEGINNESS 1.0 3.0 X 0 0 0 JESSE BEAN 1.0 3.0 X 0 0 0 LYNNE KATZMANN 1.0 3.0 X 0 0 0 RAHUL JOGLEKAR 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 SISTER PATTY CREEDON 40.0 X 173510 0 15782 SHAYE STARKEY 40.0 X 107653 0 2709 ELIZABETH PACIS 40.0 X 104014 0 6170 385177 743626 58259 3 false true false REHABCARE GROUP INC MEDICAL SERVICES 794765 FLORES SAUL PROPERTY MAINTENANCE 256293 SISTER OF MERCY NURSING SERVICES 173726 QUEZADA JUAN LUIS PROPERTY MAINTENANCE 365048 SIU ANDY REMODEL SERVICES 132825 5 26208 10214003 10240211 NET PATIENT SERVICE REVENUE 623000 7348221 7348221 RESIDENT SERVICES 623000 5861188 5861188 OTHER PROGRAM SERVICE REVENUE 623000 295454 295454 13504863 215395 215395 0 0 25486 25486 0 25486 25486 1317505 933899 383606 383606 383606 0 0 0 0 24369561 13504863 624487 825 825 0 0 0 250360 250360 0 5947302 5424535 393216 129551 164293 134416 25758 4119 788981 769743 8576 10662 433610 382596 41023 9991 992617 992617 51738 51738 45357 45357 0 0 58849 58849 1236478 1216898 19580 127836 4149 94513 29174 1218297 1084362 131169 2766 3520 3455 65 0 469505 413484 56021 43084 25409 17675 0 30977 11112 19670 195 0 0 1042693 847833 194860 119506 96458 23048 BAD DEBT 3465 3465 MEDICAL SUPPLIES & DRUGS 345398 345398 LICENSES, DUES, SUBSCRIPTIONS 64062 16787 47275 RECRUITING & RETENTION 121169 9906 111063 200 69079 69079 13629001 10859910 2582433 186658 616842 1064703 425831 805110 0 0 727754 10125424 0 0 0 0 0 0 0 0 60847 86166 19353348 13693552 6046174 5659796 10756591 10489516 0 0 0 0 0 0 0 0 18634039 28230715 1271849 964248 0 0 0 0 0 0 26598 26485 0 0 0 0 0 0 625826 582582 1924273 1573315 X 12620480 22359885 1747003 1955232 2342283 2342283 16709766 26657400 18634039 28230715 X 10740560 513074 -1306000 X false true X true false X 1004557 713930 654702 1357534 10240211 13970934 10825687 11396695 12268031 12920007 13504863 60915283 0 0 0 11830244 12110625 12922733 14277541 23745074 74886217 0 194813 130548 84071 10527 0 419959 194813 130548 84071 10527 0 419959 74466258 13507 171171 262901 281627 24081 753287 0 13507 171171 262901 281627 24081 753287 0 0 11843751 12281796 13185634 14559168 23769155 75639504 0.98449 0.97793 0.00996 0.01333 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 REGARDS TO HEALTHCARE ISSUES. THE AMOUNT SPENT ON DUES ALLOCABLE TO LOBBYING ACTIVITIES IS NOT SPECIFICALLY KNOWN; HOWEVER, SUCH AMOUNTS ARE INSUBSTANTIAL. false true 3333930 363960 3697890 3404078 -70148 3333930 2897352 506726 3404078 2626863 270489 2897352 2941907 -315044 2626863 0.36660 0.63340 false false 201489 201489 13590376 9667000 3923376 4545510 3311775 1233735 1015973 714777 301196 5659796 0 ASSET RETIREMENT OBLIGATION 571275 DUE TO RELATED PARTY 11307 582582 23517786 513074 -1364849 -851775 24369561 24369561 13570152 13570152 58849 58849 13629001 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 SIX ENDOWMENT FUNDS, ALL OF WHICH REQUIRE THE INCOME FROM THE FUNDS TO BE USED FOR CHARITY 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. OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 SCHEDULE D, PART XI, LINE 2D TRANSFER TO AFFILIATE $(1,306,000) INVESTMENT FEES $( 58,849) ------------ $(1,364,849) false false false false false true false false false JESSE JANTZEN 0 316156 0 56922 0 1201 0 1927 0 10200 0 386406 0 JANICE WASHBURN 0 168190 0 18045 0 4992 0 1210 0 11220 0 203657 0 0 SISTER PATTY CREEDON 157964 0 14220 0 1326 0 9179 0 6603 0 189292 0 ADRIENE IVERSON 0 161670 0 16000 0 450 0 2438 0 6603 0 187161 0 0 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, INDEPENDENT COMPENSATION CONSULTANT, 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, QUALITY, SAFETY, 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 THE BROWN BAG PROGRAM PROVIDES APPROXIMATELY 4,657 ELDERLY PERSONS WITH A BAG OF GROCERIES EVERY WEEK IN OAKLAND. APPROXIMATELY 400 VOLUNTEERS ASSISTED WITH THIS PROGRAM. DELEGATION OF MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 3 MERCY HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE, A NON-PROFIT PUBLIC BENEFIT CORPORATION THAT IS THE SOLE CORPORATE MEMBER OF MERCY, 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, LINE 6, 7A, & 7B THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ELDER CARE ALLIANCE. APPOINTED DIRECTORS: (A) THE BOARD OF DIRECTORS OF THE CORPORATION SHALL INCLUDE NO GREATER THAN TWELVE (12) INDIVIDUALS APPOINTED IN ACCORDANCE WITH THE FOLLOWING: (I) FIVE (5) INDIVIDUALS APPOINTED BY THE FACILITY AND PROGRAM SPONSOR, 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; (II) FIVE (5) INDIVIDUALS APPOINTED BY THE CO-SPONSOR OF THE CORPORATE MEMBER, THE SIERRA PACIFIC SYNOD OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA; (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 THE BOARD OF DIRECTORS SHALL FURTHER INCLUDE THE EX OFFICIO DIRECTOR. (IV) ONE (1) INDIVIDUAL NOMINATED BY THE RESIDENT COUNCIL OF MERCY RETIREMENT AND CARE CENTER, 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 MERCY RETIREMENT AND CARE CENTER ("MRCC") SHALL NOT BE IMPLEMENTED WITHOUT THE SPECIFIC APPROVAL OF ELDER CARE ALLIANCE'S CORPORATE MEMBER, 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: (A) THE SALE, PURCHASE LEASE OR ENCUMBRANCE OF THE REAL PROPERTY OF MRCC; (B) ANY INCREMENT OR ADDITIONS TO THE CAPITAL DEBT LIMITATION OF MRCC OR ANY OTHER NEGOTIATION, MODIFICATION OR OTHER CHANGE IN THE EXISTING CAPITAL DEBT OF MRCC; (C) ANY ACTION SEEKING BANKRUPTCY OR OTHER DEBTOR PROTECTION FOR MRCC; AND (D) ANY OTHER MATTERS WHICH MAY BE REQUIRED BY CIVIL OR ROMAN CATHOLIC CANON LAW TO BE SUBMITTED TO THE 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, OR WHICH THE BOARD OF DIRECTORS MAY REQUEST BE SUBMITTED. 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, MERCY'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 REFERRED TO A COMMITTEE OF THE BOARD FOR REVIEW AND ACTION, 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 MERCY HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE. INCLUDED IN THE SERVICES PROVIDED UNDER THIS MANAGEMENT CONTRACT ARE THE SERVICES OF THE CEO AND CFO. 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 MERCY BECAME A CONTINUING CARE RETIREMENT COMMUNITY IN DECEMBER 2011, THEREFORE 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 MERCY RESIDENTS WHO HAS ACCESS TO ALL GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE CONFLICT OF INTEREST POLICY FOR MERCY. ALL REQUESTS MUST BE IN WRITING TO ELDER CARE ALLIANCE, MERCY'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 SALEM LUTHERAN HOME ASSOC OF THE BAY CIT 1301 MARINA VILLAGE PKWY 210 ALAMEDA CA 94501 940831870 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 501(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 true false