2014-05-15T15:10:55-05:00 2013-06-30 450250958 EIDE BAILLY LLP 1850 N CENTRAL AVE SUITE 400 PHOENIX AZ 850044527 990 2012-07-01 860411904 FSL PROGRAMS FSLP 6022851800 1201 E THOMAS ROAD PHOENIX AZ 85014 GUY MIKKELSEN 6022851800 2014-05-15 1 BRENDA BLUNT P00075126 6022645844 2014-05-15 2012 2015-11-30 17:44:51Z GUY MIKKELSEN 1201 E THOMAS ROAD PHOENIX AZ 85014 11475501 0 0928 X WWW.FSL.ORG X 1980 AZ PROVIDE PROGRAMS AND SERVICES FOR SENIOR ADULTS, PERSONS WITH DISABILITIES, AND THEIR FAMILIES. 5 0 310 332 0 0 1191620 974722 11530313 10486877 24354 13772 0 130 12746287 11475501 0 0 0 0 6524018 6484666 0 0 0 5481186 5664028 12005204 12148694 741083 -673193 2629067 2444942 1876108 2322075 752959 122867 X PROVIDE PROGRAMS AND SERVICES FOR SENIOR ADULTS, PERSONS WITH DISABILITIES, AND THEIR FAMILIES. 0 1 4078598 3894913 ADULT DAY HEALTH SERVICES PROVIDES MEDICAL SERVICES, THERAPEUTIC RECREATION, AND SOCIAL SERVICES DURING THE DAY TO SENIORS AND ADULTS WITH PHYSICAL AND COGNITIVE IMPAIRMENTS, OR TO ANYONE WHO CANNOT BE LEFT HOME ALONE SAFELY DURING THE DAY. ADHS FOCUSES ON MAINTAINING OR IMPROVING AN INDIVIDUAL'S PHYSICAL AND/OR MENTAL FUNCTIONS TO ALLOW THEM TO REMAIN LIVING AT HOME FOR AS LONG AS POSSIBLE WHILE PROVIDING THE CAREGIVERS WITH THE NECESSARY SUPPORT SYSTEM FOR THEMSELVES. IN THIS FISCAL YEAR FSL'S ADHS PROGRAM SERVED A TOTAL OF 356,539 HOURS, OVER 252 DAYS, TO 625 UNDUPLICATED PERSONS, THE MAJORITY OF WHICH ARE ON A FIXED INCOME. 2612503 2613497 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. ON SCH O)2012-2013 BUDGET: $2,230,138TOTAL NUMBER OF CONTRACTED ALF'S FOR THREE ALTCS HEALTH PLANS: 832ADULT FOSTER CARE (AFC) - 63ASSISTED LIVING HOMES (ALH) - 703ASSISTED LIVING CENTERS (ALC) - 66 SERVICE COMPONENTS AND DATA FOR FY 2012/2013 INCLUDE THE FOLLOWING:MONITORING AND INVESTIGATIVE SERVICES PROVIDED ON A CONTRACTUAL BASIS FOR THREE ALTCS HEALTH PLANS TO ENSURE COMPLIANCE WITH ADHS LICENSURE REGULATIONS. EACH HOME IS MONITORED ONCE PER YEAR TO ENSURE COMPLIANCE OF ADHS REGULATIONS. INVESTIGATIONS ARE REFERRED BY CONTRACTED HEALTH PLANS AND ARE DEPENDENT UPON NUMBER OF REQUESTS. NUMBER OF INVESTIGATIVE REQUEST HAS DECLINED, AND THE ONLY REQUESTS HAVE BEEN FROM MERCY CARE AND EVERCARE (SCAN IS PERFORMING THEIR OWN INVESTIGATIONS). TOTAL NUMBER OF MONITORING VISITS - 930TOTAL NUMBER OF INVESTIGATIVE VISITS - 1ASSISTED LIVING TRAINING IS A CERTIFIED TRAINING PROGRAM APPROVED BY ADHS AND LICENSED BY ARIZONA STATE BOARD FOR PRIVATE POSTSECONDARY EDUCATION TO TRAIN CERTIFIED CAREGIVERS AND MANAGERS FOR ASSISTED LIVING FACILITIES. THE CERTIFIED CAREGIVER/MANAGER TRAINING PROGRAM IS OFFERED ONCE PER MONTH (OR BASED ON NUMBER OF STUDENT ENROLLMENTS, 8 OR MORE REQUIRED) FOR 74 CLOCK HOURS. TOTAL NUMBER OF STUDENTS ATTENDED TRAININGS DURING FY 2012/2013 - 60.ADULT 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 - 18. 3084339 3086861 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. IN JANUARY 2011, FSL HOME HEALTH AGENCY BEGAN A NEW PROGRAM FOR SKILLED HOURLY CARE FOR VENTILATOR DEPENDENT CLIENTS. THIS PROGRAM PROVIDES MUCH NEEDED SKILLED NURSING SERVICES TO CLIENTS AND FAMILIES IN THE HOME SETTING WITH MOST SHIFTS OF SERVICE LASTING WITHIN 8-12 HOURS. SINCE ITS INCEPTION HOURS OF NURSING SERVICES TO THIS FRAGILE POPULATION HAS CONTINUED TO GROW. (CONT. ON SCH O)FSL 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. CLIENTS ARE TYPICALLY ELDERLY OR PHYSICALLY CHALLENGED INDIVIDUALS WHO ARE ON A FIXED INCOME AND HAVE NO FINANCIAL RESOURCES TO ASSIST THEM IN PAYING FOR SERVICES. THE MARICOPA HOME CARE/HOME HEALTH PROGRAMS PROVIDED 13,953 HOME CARE UNITS TO 270 CLIENTS AND 15,605 SKILLED NURSING, THERAPY AND HOME HEALTH AIDE UNITS TO 523 CLIENTS. 1409878 893606 OTHER SERVICES TO SUPPORT AND FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION ARE NUTRITION CENTERS, COMMUNITY SOCIAL SERVICES AND CAREGIVER SERVICES. 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. 1409878 893606 11185318 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 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 20 0 1 310 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 RICHARD ARMSTRONG 6022851800 1201 E THOMAS ROAD PHOENIX AZ 85014 GUY MIKKELSEN 2.00 38.00 X X 0 201496 20147 STEVE HASTINGS 1.00 39.00 X X 0 149212 17779 BLANCA RUIZ 5.00 35.00 X X 0 77575 6464 JOHN HANSEN 6.00 34.00 X X 0 79045 8169 CARRIE SMITH 14.00 26.00 X X 106066 0 6539 RICHARD ARMSTRONG 2.00 38.00 X 0 124858 8563 LINDA MARTIN 20.00 20.00 X 0 132023 8265 CAROLYN HILL 10.00 30.00 X 0 107281 0 106066 871490 75926 1 0 1 0 FSL MANAGEMENT 1201 E THOMAS ROAD PHOENIX AZ 85014 MANAGEMENT FEES 1100293 ST JOSEPH'S HOSPITAL CATERING 350 W THOMAS RD PHOENIX AZ 85013 CATERED LUNCHES FOR ADHS CENTERS 329908 SANDRA BAKER 6811 W VILLA THERESA GLENDALE AZ 85308 INDIVIDUAL ON CALL NURSING 294001 MELVA CALVIN 22831 S RECKER RD GILBERT AZ 85298 INDIVIDUAL ON CALL NURSING 274003 MURIEL FENTON 6535 W SWEETWATER GLENDALE AZ 85304 INDIVIDUAL ON CALL NURSING 265850 5 84320 710000 180402 974722 GOVERNMENT CONTRACTS 623000 8950862 8950862 CLIENT FEES 623000 1479172 1479172 PROGRAM INCOME 623000 56843 56843 10486877 11772 11772 2000 0 2000 2000 2000 130 0 130 130 11475501 10488877 0 11902 X 104788 94309 10479 5280035 5280035 5467 5467 585909 585909 508467 508467 947478 947478 991 991 4000 4000 2404932 2404504 428 16749 16749 579908 579908 625550 625550 398764 398764 9386 9386 14847 14847 110490 110490 71985 71985 FOOD & BEVERAGE 189191 189191 BAD DEBTS 110634 110634 MISCELLANEOUS EXPENSE 86559 86559 REPAIRS & MAINTENENCE 73207 73207 19357 19357 12148694 11185318 963376 0 350414 368838 1938530 1866041 63141 36367 955897 813100 232559 142797 44423 30899 2629067 2444942 820517 739375 168693 90156 5927 3649 880971 1488895 1876108 2322075 X 421899 -123925 331060 246792 752959 122867 2629067 2444942 -673193 43101 0 X X 0 1 X 1 1 1 X 1375527 1107573 1317919 1191620 974722 5967361 11672507 10445831 10370442 11509437 10487007 54485224 13048034 11553404 11688361 12701057 11461729 60452585 0 38491 231245 4466 82296 356498 38491 231245 4466 82296 356498 60096087 77628 7685 32175 45230 11772 174490 77628 7685 32175 45230 11772 174490 13125662 11561089 11720536 12746287 11473501 60627075 0.99120 0.98290 0.00290 0.00260 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 955897 813100 142797 142797 DUE TO AFFILIATES 1488895 1488895 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 0 180017 0 10000 0 11479 0 0 0 20147 0 221643 0 0 STEVE HASTINGS 0 137740 0 0 0 11472 0 0 0 17779 0 166991 0 0 SUPPLEMENTAL INFORMATION PART III 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 AND STEVE HASTINGS ARE COMPENSATED BY A RELATED ORGANIZATION FOR SERVICES PROVIDED TO FSL PROGRAMS, INC. AND RELATED ORGANIZATIONS. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 THE CATHOLIC OUTREACH CENTER CLOSED ITS OPERATIONS EFFECTIVE MARCH 31, 2013. THE PROGRAM HAD BEEN IN OPERATION FOR 15 YEARS SINCE 1998, A COLLABORATION BETWEEN THE 5 SUN CITY PARISHES AND FSL ON BEHALF OF THE DIOCESE. 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 SHALL BE APPOINTED BY THE MEMBER OF THE ORGANIZATION. 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 CHIEF FINANCIAL OFFICER OF 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, LINE 15A: GUY MIKKELSEN IS COMPENSATED BY A RELATED ORGANIZATION, FSL MANAGEMENT (FSL), FOR HIS SERVICES PROVIDED TO FSL AND ITS RELATED ORGANIZATIONS. HIS COMPENSATION IS APPROVED BY THE GOVERNING BOARD OF FSL. 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. THE ORGANIZATION EXPANDED THE REVIEW BY INDEPENDENT PERSONS FOR THE FISCAL YEAR. DURING THE YEAR, FSL AND ITS RELATED ORGANIZATIONS USED AN INDEPENDENT CONSULTANT TO PERFORM A MARKET STUDY ANALYSIS ON COMPENSATION ACROSS SEVERAL INDUSTRIES. 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. OTHER FEES 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 20,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,230. SPONSOR PAYMENTS: PROGRAM SERVICE EXPENSES 2,231,805. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,231,805. NURSING: PROGRAM SERVICE EXPENSES 272. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 272. TEACHERS/PRESENTERS: PROGRAM SERVICE EXPENSES 33,372. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,372. MEDICAL TESTING: PROGRAM SERVICE EXPENSES 1,473. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,473. IN-HOUSE SUBCONTRACTING: PROGRAM SERVICE EXPENSES 29,054. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,054. EXTERMINATING: PROGRAM SERVICE EXPENSES 1,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,000. JANITORIAL SERVICES: PROGRAM SERVICE EXPENSES 46,520. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,520. SPECIFIC ASSISTANCE TO CLIENTS: PROGRAM SERVICE EXPENSES 28,895. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,895. MOVING AND OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 8,283. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,283. ENTERTAINERS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 428. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 428. PART XII LINE 2C FSL PROGRAMS & FSL HOME IMPROVEMENTS HAD A SINGLE AUDIT PERFORMED. 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