2013-08-15T19:04:49-05:00 2012-09-30 910189318 MOSS ADAMS LLP 3121 WEST MARCH LANE SUITE 100 STOCKTON CA 952192303 990 2011-10-01 931067253 PACIFIC RETIREMENT SERVICES INC PACI 8887246424 965 ELLENDALE DRIVE MEDFORD OR 97504 LYN HENNION 8887246424 2013-08-15 TRACY S PAGLIA P00366884 2099556100 2011 2016-02-24 21:20:13Z CAROLYN HENNION 965 ELLENDALE DRIVE MEDFORD OR 97504 11099422 0 X WWW.RETIREMENT.ORG X 1990 OR PACIFIC RETIREMENT SERVICES PROVIDES PROVIDES EXCEPTIONAL LEADERSHIP TO OUR FAMILY OF ORGANIZATIONS, WORKING TOGETHER TO ENHANCE THE AGING EXPERIENCE. 12 12 129 2 0 0 0 0 10990560 11038149 440843 46466 0 14807 11431403 11099422 0 0 0 0 6001595 6485957 0 0 0 2225834 2235372 8227429 8721329 3203974 2378093 45001490 46922982 5512232 5050225 39489258 41872757 PACIFIC RETIREMENT SERVICES PROVIDES PROVIDES EXCEPTIONAL LEADERSHIP TO OUR FAMILY OF ORGANIZATIONS, WORKING TOGETHER TO ENHANCE THE AGING EXPERIENCE. 0 0 8361771 0 11038149 PACIFIC RETIREMENT SERVICES, INC. PROVIDES STRATEGIES, FINANCIAL PLANNING AND ADMINISTRATIVE SERVICES FOR SEVERAL RELATED 501(C)(3) ORGANIZATIONS, INCLUDING SEVERAL THAT PROVIDE HOUSING FOR SENIOR CITIZENS. 8361771 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 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 1 1 1 1 0 0 1 60 0 1 129 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA OR WI X SHERI DRESSLER 5418577644 965 ELLENDALE DRIVE MEDFORD OR 97504 X WILLIAM THORNDIKE JR 1.00 X 4000 0 0 WILLIAM L LEEVER 1.00 X X 4000 0 0 EDWARD JOLLY 1.00 X X 4000 0 0 LYNN C JOHNSON 1.00 X X 0 0 0 MARC BAYLISS 1.00 X 4000 0 0 TODD MARTIN 1.00 X 3000 0 0 DOUG SCHMOR 1.00 X 5000 0 0 CAROLYN HENNION 1.00 X X 4000 0 0 DOUG SPANI 1.00 X 1000 0 0 LARRY BOECK 1.00 X 1000 0 0 JOHN A HUBBARD 1.00 X 1000 0 0 DOUG WILSON 1.00 X 1000 0 0 BILL VAN VACTOR 1.00 X 0 0 0 BRIAN MCLEMORE 50.00 X 307951 0 87624 MARY SCHOEGGL 50.00 X 149929 0 52895 JILL COLLINS 50.00 X 315408 0 64528 MICHAEL MORRIS 40.00 X 0 175752 46604 THOMAS BROWN 50.00 X 177036 0 1410 PAUL RIEPMA III 50.00 X 192394 0 21498 DEBBIE RAYBURN 50.00 X 191646 0 32542 STEVEN RINKLE 50.00 X 169466 0 31202 STEPHEN L EICHEN 50.00 X 170260 0 28230 THOMAS R BECKER 50.00 X 352116 0 0 2058206 175752 366533 31 1 1 0 ERNST & YOUNG LLP 950 MAIN AVE SUITE 1800 CLEVELAND OH 441137214 AUDITING/ACCOUNTING SERVICES 405783 ADVANCED ANSWERS ON DEMAND INC 11575 HERON BAY BLVD CORAL SPRINGS FL 33076 SOFTWARE SERVICES 174583 HAMILTON STEPHENS STEELE & MARTIN PLLC 201 S COLLEGE ST SUITE 2020 CHARLOTTE NC 28244 LEGAL SERVICES 170000 EN POINTE TECHNOLOGIES SALES INC PO BOX 514429 LOS ANGELES CA 900514429 IT SERVICES 155361 MICROSOFT LICENSING GP 1950 N STEMMONS FWY STE 2010 DALLAS TX 75207 SOFTWARE SERVICES 110934 7 MANAGEMENT FEE REVENUE 561000 8774757 8774757 ACCOUNTING FEES 561000 1109113 1109113 INFO TECH SVC FEES 561000 902828 902828 REIMBURSEMENT INCOME 561000 173000 173000 MEDIA & ADVERTISING 541800 77253 77253 1198 1198 11038149 46466 46466 TAX REFUND 900099 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900292647 LINE 9 1 1 1 0 CORBINTON RETIREMENT 262987036 LINE 9 1 1 1 0 MIRABELLA AT MORRISON 271016196 LINE 9 1 1 1 0 MIDDLETON GLEN INC 911859494 LINE 9 1 1 1 0 SENIOR HOUSING OF MIDDLETON 470825736 LINE 9 1 1 1 0 46 884077 0 0 0 8721329 8721329 586066 146517 0 0 561371 586066 1147437 1721156 140343 146517 286860 430290 400000 400000 2233041 863372 1369669 24029 11729 12300 2210616 1883689 326927 360949 167336 193613 2302509 3722027 F 3722027 DUE FROM AFFILIATES 36498738 DEBT ISSUE COSTS & LOAN FEES 9551 OTHER NONCURRENT ASSETS 432732 36941021 OTHER LONG TERM LIABILITIES 430532 430532 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION 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 ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2012, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. X X X X 1 0 0 0 0 0 0 1 0 BRIAN MCLEMORE 281113 0 26838 0 0 0 70712 0 16912 0 395575 0 0 0 MARY SCHOEGGL 137276 0 12653 0 0 0 35983 0 16912 0 202824 0 0 0 JILL COLLINS 288570 0 26838 0 0 0 59802 0 4726 0 379936 0 0 0 MICHAEL MORRIS 0 147152 0 28600 0 0 0 29022 0 17582 0 222356 0 0 THOMAS BROWN 35466 0 0 0 141570 0 0 0 1410 0 178446 0 0 0 PAUL RIEPMA III 175340 0 17054 0 0 0 18375 0 3123 0 213892 0 0 0 DEBBIE RAYBURN 174667 0 16979 0 0 0 15280 0 17262 0 224188 0 0 0 STEVEN RINKLE 154465 0 15001 0 0 0 14290 0 16912 0 200668 0 0 0 STEPHEN L EICHEN 155259 0 15001 0 0 0 11318 0 16912 0 198490 0 0 0 THOMAS R BECKER 2116 0 0 0 350000 0 0 0 0 0 352116 0 0 0 PART I, LINE 4A THOMAS BROWN'S EMPLOYMENT ENDED 1/7/2011 AND HE RECEIVED A SEVERANCE PAYMENT. THOMAS BECKER'S EMPLOYMENT ENDED 7/5/10 AND HE RECEIVED A SEVERANCE PAYMENT. THE PARTIES ENTERED INTO SETTLEMENT AGREEMENTS AND MUTUAL GENERAL RELEASES (THE "AGREEMENTS"). THE AGREEMENTS PROVIDE FOR CERTAIN PAYMENTS TO MR. BROWN AND MR. BECKER, IMPOSES AND CLARIFIES CERTAIN OBLIGATIONS ON MR. BROWN AND MR. BECKER, CONTAINS MUTUAL RELEASES OF ALL CLAIMS BETWEEN THE PARTIES, AND IMPOSES MUTUAL CONFIDENTIALITY OBLIGATIONS. PART I, LINE 7 THE VP OF HUMAN RESOURCES PROVIDED SALARY STUDIES FROM THE FOLLOWING RESOURCES TO THE COMPENSATION COMMITTEE (A COMMITTEE OF THE PRS BOARD OF DIRECTORS) RELATIVE TO EXECUTIVE STAFF COMPENSATION: - SALARY.COM - PAYSCALE.COM - 990 REVIEW (LIKE SIZE ORGANIZATIONS) - CEMO (CHIEF EXECUTIVE OFFICERS OF MULTI-FACILITY ORGANIZATIONS) SALARY STUDY RESULTS RECOMMENDATION FOR BASE COMPENSATION AND INCENTIVE ARE PROVIDED BY THE IMMEDIATE SUPERVISOR, BASED ON STUDY FINDINGS AND PERFORMANCE FACTORS. THE HOSPITAL FACILITIES AUTHORITY OF THE CITY OF MEDFORD OR 521378932 2005-03-31 2094750 CONSTRUCTION OF OFFICE BUILDING 0 0 0 2094750 2094750 2006 0 0 1 1 1 0 0 0 0.00000 0.00000 0.00000 1 0 1 0 0 0 1 X FORM 990, PART VI, SECTION A, LINE 4 THE MAXIMUM NUMBER OF DIRECTORS WAS CHANGED FROM 11 TO 15. ONE (1) DIRECTOR FROM EACH SUPPORTED ORGANIZATION MUST SERVE ON THE BOARD OF DIRECTORS. REQUIREMENTS FOR NOTICE OF BOARD OF DIRECTORS MEETINGS WERE REVISED. DUTIES OF THE FOLLOWING COMMITTEES WERE ESTABLISHED: EXECUTIVE, GOVERNANCE, AUDIT, FINANCE AND THE INVESTMENT SUBCOMMITTEE. AMENDED AND RESTATED BYLAWS STATE THE BOARD SHALL EMPLOY A PRESIDENT AND GENERAL COUNSEL, AND TO APPOINT ASSISTANTS TO THE SECRETARY AND TREASURER. A NEW SECTION WAS ADDED PROHIBITING DISCRIMINATION IN PROVIDING SERVICES, HIRING EMPLOYEES, OR OTHERWISE, ON THE BASES OF GENDER, RACE, CREED, MARITAL STATUS, SEXUAL ORIENTATION, RELIGION, COLOR, AGE, NATIONAL ORIGIN, DISABILITY, OR FAMILIAL STATUS. NEW SECTIONS WERE ADDED REGARDING THE AMENDMENT OF BYLAWS, INSPECTION OF BOOKS AND RECORDS, CHECKS, DRAFTS ETC., DEPOSITS, LOANS OR GUARANTEES, EXECUTION OF DOCUMENTS, INSURANCE, AND INDEMNIFICATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS 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 15 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 STAFF COMPENSATION: SALARY.COM, PAYSCALE.COM, 990 REVIEW (LIKE SIZE ORGANIZATIONS), CEMO (CHIEF EXECUTIVE OFFICERS OF MULTI-FACILITY ORGANIZATIONS) SALARY STUDY RESULTS. RECOMMENDATION FOR BASE COMPENSATION AND INCENTIVE ARE PROVIDED BY IMMEDIATE SUPERVISOR, BASED ON STUDY FINDINGS AND PERFORMANCE FACTORS. FORM 990, PART VI, SECTION C, LINE 19 ALL REQUESTS GO THROUGH CORPORATE COUNSEL. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: PART VII, SECTION A: WILLIAM L. LEEVER DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: ROGUE VALLEY MANOR 1 HOUR UNIVERSITY RETIREMENT COMMUNITY AT DAVIS, INC. 1 HOUR EDWARD JOLLY DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: ROGUE VALLEY MANOR 1 HOUR MARC BAYLISS DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: ROGUE VALLEY MANOR MEMORIAL FOUNDATION 1 HOUR TODD MARTIN DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: MIRABELLA AT SOUTH WATERFRONT 1 HOUR MIRABELLA 1 HOUR MIRABELLA PORTLAND FOUNDATION 1 HOUR DOUG WILSON DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: CUMBERLAND REST, INC. 1 HOUR TRINITY TERRACE FOUNDATION 1 HOUR BILL VAN VACTOR DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: CASCADE MANOR FOUNDATION 1 HOUR CASCADE MANOR, INC. 1 HOUR JOHN A. HUBBARD DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: HOLLADAY PARK PLAZA, INC. 1 HOUR HOLLADAY PARK PLAZA FOUNDATION 1 HOUR HOLLADAY PARK PLAZA ENDOWMENT FUND 1 HOUR LARRY BOECK DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: CAPITOL LAKES, INC. 1 HOUR CAPITOL LAKES FOUNDATION 1 HOUR MIRABELLA AT SOUTH WATERFRONT 1 HOUR MIRABELLA 1 HOUR HUD ENTITIES 1 HOUR LYNN JOHNSON DEVOTES TIME TO RELATED ORGANIZATIONS AS FOLLOWS: MIRABELLA AT SOUTH WATERFRONT 1 HOUR MIRABELLA PORTLAND FOUNDATION 1 HOUR CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 5,406. 965 ELLENDALE DRIVE LLC 965 ELLENDALE DRIVE MEDFORD OR 97504 931067253 OFFICE BLDG. 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