2014-08-12T13:31:50-05:00 2013-09-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192303 990 2012-10-01 930557803 CASCADE MANOR INC CASC 8887246424 65 WEST 30TH AVE EUGENE OR 974059931 BRIAN YOUNG 8887246424 2014-08-09 1 TRACY S PAGLIA P00366884 2099556100 2012 2015-11-30 17:44:51Z JOHN THOMAS 965 ELLENDALE DRIVE MEDFORD OR 97504 8361917 0 X WWW.RETIREMENT.ORG X 1967 OR CASCADE MANOR INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. 8 8 140 15 0 0 88218 123068 7900822 7773321 134372 331220 79729 84588 8203141 8312197 0 0 0 0 3296519 3435025 0 0 0 4880668 5093635 8177187 8528660 25954 -216463 30452036 30818758 33158584 33727257 -2706548 -2908499 CASCADE MANOR INC.'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE CARE AND HOUSING FOR THE ELDERLY. 0 0 6930970 7773321 CASCADE MANOR IS A CONTINUING CARE RETIREMENT COMMUNITY, DEDICATED TO ENHANCING OUR RESIDENTS QUALITY OF LIFE IN A STIMULATING, SECURE ENVIRONMENT. WE PROVIDE HIGH-QUALITY SERVICES INCLUDING HOUSING, NUTRITIOUS MEALS, NURSING, HOUSEKEEPING, MAINTENANCE, AND OTHER SUPPORT TO THOSE WE SERVE. OUR LEVELS OF SERVICE INCLUDE INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING. 6930970 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 41 0 1 140 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 OR X SHERI LOYA 5418577644 965 ELLENDALE DRIVE MEDFORD OR 97504 X ROBERT BURKE 1.00 X X 0 0 0 MICHAEL DRENNAN 1.00 X X 0 0 0 JAMON KENT 1.00 X X 0 0 0 JOHN THOMAS 1.00 X X 0 0 0 MARTHA TIECH 1.00 1.00 X 0 0 0 BILL VAN VACTOR 1.00 3.00 X X 0 0 0 DON HIRST 1.00 X 0 0 0 JOAN LOOMIS 1.00 X 0 0 0 LAURIE BULLARD 1.00 X X 0 0 0 BRIAN YOUNG 40.00 X 145259 0 33397 145259 0 33397 1 0 1 0 PACIFIC RETIREMENT SERVICES 965 ELLENDALE DRIVE MEDFORD OR 97504 MANAGEMENT SERVICES 471652 LEE CONSTRUCTION COMPANY P O BOX 10367 EUGENE OR 97440 CONSTRUCTION 399559 JOHNSON CONTROLS INC P O BOX 730068 DALLAS TX 75373 SECURITY UPGRADE 125995 3 123068 123068 SERVICE FEES 623000 4281940 4281940 ENTRANCE FEES 623000 1693866 1693866 HEALTH CENTER REVENUE 623000 1510654 1510654 HOME CARE/PRIVATE DUTY 623000 86726 86726 LEVEL OF CARE 623000 68810 68810 131325 131325 7773321 146898 146898 93449 8861 84588 84588 84588 225181 40859 184322 184322 184322 8312197 7773321 0 415808 2720218 2260646 459572 20043 20043 512953 436102 76851 181811 151759 30052 524817 524817 284 284 53905 53905 5004 5004 225867 176424 49443 150839 150839 168023 111407 56616 34176 34176 692781 692681 100 28318 6822 21496 22703 7899 14804 573897 573897 1916664 1916664 73571 34625 38946 DIETARY EXPENSE 299656 299656 FACILITY SERVICE EXPENS 147763 87021 60742 HEALTH CENTER EXPENSE 147741 147741 ASSET DISPOSAL 27626 27626 8528660 6930970 1597690 0 835599 1771034 555936 524779 83295 262894 45426 49542 172608 181834 36745578 14954046 22686140 21791532 4752030 4898996 1321002 1338147 30452036 30818758 880040 1971932 15155415 14738829 16360000 16020000 763129 996496 33158584 33727257 X -3198569 -3357273 492021 448774 -2706548 -2908499 30452036 30818758 X -216463 -210407 224919 X 0 1 X 1 0 X 4329 47452 88218 123068 263067 7148768 7029226 7384982 7900822 7773321 37237119 7153097 7076678 7384982 7989040 7896389 37500186 115821 161592 136647 94274 90728 599062 308223 287573 253652 274198 111929 1235575 424044 449165 390299 368472 202657 1834637 35665549 126637 165158 201355 242153 240347 975650 126637 165158 201355 242153 240347 975650 7279734 7241836 7586337 8231193 8136736 38475836 0.92700 0.91770 0.02540 0.02680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 8528660 8528660 576433 144108 0 0 549980 558859 576433 1685272 2527908 137495 139715 144108 421318 631977 1200627 1200627 33468033 13716985 19751048 1765579 1237061 528518 311339 311339 21791532 REFUNDABLE ENTRANCE FEES 343525 DUE TO AFFILIATES 141937 ASSET RETIREMENT OBLIGATION 146074 INTEREST RATE SWAP AGREEMENT 364960 996496 X 8321705 -210407 224919 14512 8307193 5004 5004 8312197 8523656 0 8523656 5004 5004 8528660 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CORPORATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE CORPORATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2013 AND 2012, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF CASCADE MANOR FOUNDATION, INC. 45,811. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 179,108. 0 0 0 0 0 0 0 0 0 BRIAN YOUNG 126131 0 16000 0 3128 0 16322 0 17075 0 178656 0 0 0 PART I, LINE 3 COMPENSATION WAS RECOMMENDED BY PACIFIC RETIREMENT SERVICES, INC. AND APPROVED BY CASCADE MANOR, INC. BOARD AS PART OF THE ANNUAL BUDGET PROCESS. A HOSPITAL FACILITIES AUTHORITY OF THE CITY OF MEDFORD OREGON 521378932 584283EJ0 2010-12-30 16822838 REFUND ISSUER'S SERIES 2006 VARIABLE RATE DEMAND REVENUE BONDS 0 0 0 A 845000 16822838 16822838 2010 1 0 1 1 A 0 1 1 1 0 0.00600 0.00000 0.00600 0 0 1 A 0 0 1 0 1 1 WELLS FARGO BANK NA 4.920000000000 0 0 0 0 1 A 1 DELIVERY DATE OF REFUNDED BONDS REDEEMED BY BOND ISSUE IN "A" WAS 07/13/06. SCHEDULE K, PART III, LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K, PART IV, LINE 2C THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION TO REBATE. NO REBATE CALCULATION HAS BEEN OR WILL EVER BE MADE, BEFORE OR AFTER THE DUE DATE OF AN 8038-T. FORM 990, PART VI, SECTION A, LINE 3 CASCADE MANOR DELEGATES MANAGEMENT TO PACIFIC RETIREMENT SERVICES. FORM 990, PART VI, SECTION A, LINE 6 CASCADE MANOR, INC. HAS ONE MEMBER, PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A PACIFIC RETIREMENT SERVICES, INC. HAS THE AUTHORITY TO ELECT ALL DIRECTORS FROM NOMINEES SELECTED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B SOME DECISIONS OF THE BOARD ARE SUBJECT TO APPROVAL BY PACIFIC RETIREMENT SERVICES, AS OUTLINED IN ARTICLE III OF THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS CURRENTLY BEING REVIEWED BY THE CFO, ASSISTANT CONTROLLER AND THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE ARE SENT TO ALL BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY. THERE ARE TWO POLICIES RELATED TO CONFLICTS OF INTEREST: 1) BOARD OF DIRECTORS; 2) KEY EMPLOYEES, WHICH IDENTIFY THE PURPOSE, DEFINITIONS, AND PROCEDURES. IF A CONFLICT IS SELF-IDENTIFIED BY A BOARD MEMBER OR KEY EMPLOYEE IN THE QUESTIONNAIRE AND/OR MEETING, PROCEDURES ARE FOLLOWED AND DOCUMENTED ACCORDING TO THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A A COMPENSATION COMMITTEE OF THE PRS BOARD EXISTS TO DETERMINE COMPENSATION FOR THE EXECUTIVE DIRECTOR OF EACH COMMUNITY. THIS COMMITTEE IS COMPRISED OF THE OFFICERS OF THE PRS BOARD OF DIRECTORS. THE COMMITTEE HAS A CHARTER THAT OUTLINES ITS DUTIES AND RESPONSIBILITIES. IT ALSO HAS AGENDA ELEMENTS THAT DESCRIBE THE ACTIVITIES THAT THE COMMITTEE UNDERTAKES DURING THE YEAR. THE VP OF HUMAN RESOURCES PROVIDED SALARY STUDIES FROM THE FOLLOWING RESOURCES TO THE COMMITTEE RELATIVE TO EXECUTIVE DIRECTOR COMPENSATION: SALARY.COM, PAYSCALE.COM, 990 REVIEW (LIKE SIZE ORGANIZATIONS), CEMO (CHIEF EXECUTIVE OFFICERS OF MULTI-FACILITY ORGANIZATIONS) SALARY STUDY RESULTS, AND INDUSTRY STATE ASSOCIATION SALARY STUDY RESULTS BASED ON GEOGRAPHICAL LOCATION. THE RECOMMENDATION FOR BASE COMPENSATION AND BONUS ARE PROVIDED BY THE ED'S DIRECT SUPERVISOR (COO OR VP OF OPERATIONS). FORM 990, PART VI, SECTION C, LINE 19 ALL REQUESTS GO THROUGH CORPORATE COUNSEL. FORM 990, PART VII, SECTION A: NOTE THAT BRIAN YOUNG IS AN EMPLOYEE OF RETIREMENT SERVICES, INC. AND PERFORMS SERVICES ON BEHALF OF CASCADE MANOR, INC. PURSUANT TO A MANAGEMENT SERVICES AGREEMENT BETWEEN CASCADE MANOR, INC. AND PACIFIC RETIREMENT SERVICES. UNDER THE MANAGEMENT SERVICES AGREEMENT, HIS COMPENSATION IS REIMBURSED BY CASCADE MANOR, INC. HIS COMPENSATION IS REPORTED IN PART VII SECTION A IN ORDER TO HIGHLIGHT AMOUNTS PAID BY CASCADE MANOR, INC., NOTWITHSTANDING THAT HE IS EMPLOYED BY RETIREMENT SERVICES, INC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 179,108. CHANGE IN INTEREST IN NET ASSETS OF CASCADE MANOR FOUNDATION, INC. 45,811. PACIFIC RETIREMENT SERVICES INC 965 ELLENDALE DRIVE MEDFORD OR 97504 931067253 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 11C, III-FI N/A 0 ROGUE VALLEY MANOR 965 ELLENDALE DRIVE MEDFORD OR 97504 930453216 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 THE CUMBERLAND REST INC 965 ELLENDALE DRIVE MEDFORD OR 97504 750891470 SENIOR HOUSING TX 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 965 ELLENDALE DRIVE MEDFORD OR 97504 931179254 SENIOR HOUSING CA 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA 965 ELLENDALE DRIVE MEDFORD OR 97504 930513697 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 CAPITOL LAKES INC 965 ELLENDALE DRIVE MEDFORD OR 97504 391412320 SENIOR HOUSING WI 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 TRINITY TERRACE FOUNDATION INC 965 ELLENDALE DRIVE MEDFORD OR 97504 912162130 PUBLIC FOUNDATION TX 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA FOUNDATION 965 ELLENDALE DRIVE MEDFORD OR 97504 264529118 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 MIRABELLA WASHINGTON FOUNDATION 965 ELLENDALE DRIVE MEDFORD OR 97504 450574348 PUBLIC FOUNDATION WA 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 CASCADE MANOR FOUNDATION 965 ELLENDALE DRIVE MEDFORD OR 97504 931330100 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 PACIFIC RETIREMENT SERVICES INC 0 MIRABELLA 965 ELLENDALE DRIVE MEDFORD OR 97504 342030255 SENIOR HOUSING WA 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 MIRABELLA AT SOUTH WATERFRONT 965 ELLENDALE DRIVE MEDFORD OR 97504 711016384 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM COMMUNITY SERVICES INC 965 ELLENDALE DRIVE MEDFORD OR 97504 930892261 COMM SRVCS OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM EAGLE POINT HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943191447 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM KLAMATH FALLS HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943196455 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM MEDFORD II HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943212537 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM LIVELY OAKS HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943194409 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM REEDSPORT HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943212538 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM YREKA HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943212540 SENIOR HOUSING CA 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM EUGENE HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943247154 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM BEND II HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 943260016 SENIOR HOUSING OR 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 RVM MANSFIELD HOUSING CORPORATION 965 ELLENDALE DRIVE MEDFORD OR 97504 900292647 SENIOR HOUSING TX 501(C)(3) LINE 9 PACIFIC RETIREMENT SERVICES INC 0 CREST PARK INC 965 ELLENDALE DRIVE MEDFORD OR 97504 931169683 HOTEL OR N/A C 0 RETIREMENT SERVICES INC 965 ELLENDALE DRIVE MEDFORD OR 97504 931328250 MGMT COMPANY OR N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1