2013-11-14T12:38:40-06:00 2012-12-31 910189318 MOSS ADAMS LLP 3121 WEST MARCH LANE SUITE 100 STOCKTON CA 952192303 990 2012-01-01 943358174 ESKATON VILLAGE GRASS VALLEY ESKA 9163340810 5105 MANZANITA AVENUE CARMICHAEL CA 95608 BILL PACE 9163340810 2013-11-11 1 TRACY S PAGLIA P00366884 2099556100 2012 2016-02-25 16:41:14Z TODD S MURCH 5105 MANZANITA AVENUE CARMICHAEL CA 95608 7419297 0 X WWW.ESKATON.ORG X 2002 CA TO ENHANCE THE QUALITY OF LIFE OF SENIORS THROUGH INNOVATIVE HEALTH, HOUSING AND SOCIAL SERVICES. 12 11 131 0 0 0 27500 0 6202388 6467836 -22 -12516 188120 0 6417986 6455320 0 0 0 0 2182305 2301678 0 0 0 3903576 3626092 6085881 5927770 332105 527550 12311507 12127044 27542267 26693262 -15230760 -14566218 ESKATON VILLAGE GRASS VALLEY'S PRIMARY MISSION IS TO ENHANCE THE QUALITY OF LIFE OF SENIORS THROUGH INNOVATIVE HEALTH, HOUSING AND SOCIAL SERVICES. 0 0 5114414 0 6467836 ESKATON VILLAGE GRASS VALLEY IS A MULTI-LEVEL RETIREMENT COMMUNITY THAT OFFERS INDEPENDENT LIVING APARTMENTS WITH SERVICES & ASSISTED LIVING APARTMENTS. ALL RESIDENTS HAVE AN EMERGENCY RESPONSE SYSTEM WITH 24-HOUR STAFFING, SHUTTLE SERVICE, ACCESS TO THE FITNESS CENTER, SERVICES OF A RECREATION COORDINATOR & ADVICE NURSE, ALSO A FULL RANGE OF RECREATIONAL ACTIVITIES THAT MAY INCLUDE GARDENING, ARTS & CRAFT PROJECTS, CURRENT EVENTS DISCUSSIONS & EXERCISE. ESKATON VILLAGE GRASS VALLEY OPERATING STATISTICS - RESIDENT DAYS: 42,362. PLEASE VISIT THE ESKATON WEBSITE (WWW.ESKATON.ORG) FOR THE ESKATON ANNUAL & SOCIAL ACCOUNTABILITY REPORT. 5114414 1 0 0 0 0 0 0 0 0 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 1 1 0 0 1 23 0 1 131 1 0 0 0 0 0 0 0 0 0 0 X 12 11 0 1 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X X EDUARD BOOGAARD 9163395688 5105 MANZANITA AVENUE CARMICHAEL CA 95608 TODD MURCH 2.00 52.00 X X 0 497237 268623 ANNE BURNS JOHNSON 0.30 1.80 X 0 0 0 CARL GERLACH 0.30 1.80 X X 0 0 0 CLARENCE WILLIAMS 0.30 1.80 X 0 0 0 DOUGLAS ELMETS 0.30 1.80 X 0 0 0 GAY MARIE BONE 0.30 1.80 X X 0 0 0 LEELAND S KING 0.30 1.80 X 0 0 0 LISA YATES 0.30 1.80 X 0 0 0 MARK A HYJEK 0.30 1.80 X 0 0 0 MARY HOPP 0.30 2.80 X 0 0 0 SAM PEREZ 0.30 1.80 X 0 0 0 VICTOR SIPOS 0.30 1.80 X 0 0 0 WES G JUSTYN 0.30 2.80 X 0 0 0 MARGARET DYER-CHAMBERLIN 0.30 1.80 X 0 0 0 BILL PACE 2.00 52.00 X 0 320523 23245 ELIZABETH DONOVAN 2.00 52.00 X 0 285000 28339 0 1102760 320207 0 0 1 0 ESKATON PROPERTIES INC 5105 MANZANITA AVE CARMICHAEL CA 95608 MANAGEMENT FEE 393558 STANLEY SECURITY SOLUTIONS DEPT CH 10504 PALATINE PALATINE IL 60055 SECURITY 168537 2 HEALTH CARE RELATED SE 623000 5578195 5578195 ESKATON PROPERTIES 623000 574606 574606 HOMEOWNER MGMT. & SVCS 623000 200550 200550 CATERING AND MEAL REVE 623000 46215 46215 APPLICANT FEES 623000 33300 33300 34970 34970 6467836 4200 4200 947261 951328 12649 -4067 -12649 -16716 -16716 6455320 6467836 0 -12516 1669249 1342017 327232 506213 406977 99236 126216 100798 25418 393558 316407 77151 332070 296333 35737 32285 32285 479864 448443 31421 330709 330709 12010 9519 2491 2022 1028 994 37370 37370 926063 926063 122694 122694 SWAP PAYMENTS 448342 448342 FINANCING FEES 413951 413951 ANCILLARY COST 25066 25066 SPECIAL EVENTS 15510 10385 5125 54578 1006 53572 5927770 5114414 813356 0 169552 111030 446222 447462 40983 290273 6551 7411 14488 50600 18513241 8454579 10438140 10058662 1046182 1078613 149389 82993 12311507 12127044 257408 278434 12469 12604 22190422 21647074 5081968 4755150 27542267 26693262 X -15230760 -14566218 -15230760 -14566218 12311507 12127044 527550 136992 0 X 0 1 X 1 0 X 5983 27500 33483 6058597 5557777 5917027 6202388 6467836 30203625 6058597 5557777 5923010 6229888 6467836 30237108 0 170723 163035 237531 388165 645716 1605170 170723 163035 237531 388165 645716 1605170 28631938 51262 2525 348 3660 4200 61995 51262 2525 348 3660 4200 61995 25000 188120 213120 6134859 5560302 5923358 6421668 6472036 30512223 0.93840 0.94770 0.00200 0.00800 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: ESCROW ACCOUNT REFUND - 2008 AMOUNT: $ 25,000. SWAP SETTLEMENT - 2011 AMOUNT: $ 188,120. 264818 264818 13853274 6287592 7565682 2710718 1120464 1590254 1499732 945048 554684 184699 101475 83224 10058662 INTEREST RATE SWAP AGREEMENT 4755150 4755150 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: FASB ASC TOPIC 740, INCOME TAXES, PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT DISCLOSURE OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. RECOGNITION OF A TAX POSITION IS DETERMINED WHEN IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES. A TAX POSITION THAT MEETS THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD IS MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE SETTLEMENT WITH A TAXING AUTHORITY. 0 1 0 0 0 0 0 0 0 TODD MURCH 0 435540 0 61667 0 30 0 254516 0 14107 0 765860 0 0 BILL PACE 0 277160 0 43333 0 30 0 16024 0 7221 0 343768 0 0 ELIZABETH DONOVAN 0 255000 0 30000 0 0 0 14250 0 14089 0 313339 0 0 PART I, LINE 4B THE PLAN IS LIMITED TO KEY EMPLOYEES WHO ARE DESIGNATED BY THE COMMITTEE. THE EMPLOYEE BECOMES FULLY VESTED UPON THE EARLIER OF HIS/HER TERMINATION OF EMPLOYMENT AT HIS/HER NORMAL RETIREMENT DATE OR HIS/HER COMPLETION OF 10 YEARS OF SENIOR EXECUTIVE MANAGEMENT SERVICE. FINAL AVERAGE PAY IS CALCULATED BY AVERAGING THE ANNUAL COMPENSATION FOR THE THREE CONSECUTIVE YEARS OUT OF THE LAST TEN YEARS OF SENIOR EXECUTIVE MANAGEMENT SERVICE THAT RESULTS IN THE HIGHEST AVERAGE. SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: COMPENSATION FOR THE PRESIDENT AND CEO WAS DETERMINED BY ESKATON PROPERTIES, INC., A RELATED ORGANIZATION, THAT USED ONE OR MORE OF THE METHODS DESCRIBED ON LINE 3 TO ESTABLISH COMPENSATION. FORM 990, PART VI, SECTION A, LINE 3 ESKATON PROPERTIES, INC. PERFORMS THE ORGANIZATION'S MANAGEMENT DUTIES THROUGH COMMON OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CORPORATE MEMBER WITH THE POWER TO APPOINT ALL DIRECTORS OTHER THAN THE PRESIDENT OF THE CORPORATION. AS A SUBSIDIARY CORPORATION TO THE CORPORATE MEMBER, ALL OF THE ASSETS OF THE ORGANIZATION WOULD BE RECEIVED BY THE CORPORATE MEMBER UPON DISSOLUTION. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE CORPORATE MEMBER HAS THE POWER TO APPOINT ALL DIRECTORS OTHER THAN THE PRESIDENT OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 DATA TO PREPARE THE 990 IS GATHERED BY THE LEAD ACCOUNTANT. THE RETURN IS PREPARED BY A PROFESSIONAL ACCOUNTING FIRM AND REVIEWED BY THE DIRECTOR OF FINANCE AND THE CFO. THE FINAL 990 IS SIGNED BY THE CFO. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY DISCLOSE THEIR POTENTIAL CONFLICTS OF INTEREST. DIRECTORS ABSTAIN FROM VOTING AND DO NOT PARTICIPATE IN DISCUSSION OF BOARD ACTIONS RELATED TO POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO IS DETERMINED BY A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE UTILIZES THE SERVICES OF A PROFESSIONAL COMPENSATION CONSULTANT THAT PROVIDES DATA FROM A WIDE RANGE OF COMPARABLE ORGANIZATIONS. FOR THE COO, CFO, AND OTHER HIGHLY COMPENSATED EMPLOYEES, COMPENSATION IS DETERMINED BY THE CEO BASED ON ANNUAL (COO AND CFO) OR PERIODIC (OTHER HIGHLY COMPENSATED EMPLOYEES) RECOMMENDATIONS FROM A PROFESSIONAL COMPENSATION CONSULTANT UTILIZING DATA FROM COMPARABLE ORGANIZATIONS. THIS PROCESS IS PERFORMED ANNUALLY. THE LAST REVIEW WAS NOVEMBER 2012. FORM 990, PART VI, SECTION C, LINE 19 ESKATON VILLAGE GRASS VALLEY'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT ROUTINELY AVAILABLE TO THE PUBLIC. THE ESKATON VILLAGE GRASS VALLEY FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH GUIDESTAR AND UPON REQUEST. FORM 990, PART X, LINE 20: TAX-EXEMPT BOND LIABILITY IS AN ALLOCATED PORTION OF A $48,600,000 BOND. THE REQUIRED SUPPLEMENTAL INFORMATION IS REPORTED ON ESKATON PROPERTIES, INC'S (94-2906316) FORM 990, SCHEDULE K. ESKATON FOUNDATION 5105 MANZANITA AVENUE CARMICHAEL CA 95608 680227233 FUNDRAISING CA 501(C)(3) LINE 7 ESKATON 1 ESKATON GOLD RIVER LODGE 5105 MANZANITA AVENUE CARMICHAEL CA 95608 941663809 SENIOR RESIDENCES & SERVICES CA 501(C)(3) LINE 9 ESKATON 1 ESKATON VILLAGE ROSEVILLE 5105 MANZANITA AVENUE CARMICHAEL CA 95608 680472230 SENIOR RESIDENCES & SERVICES CA 501(C)(3) LINE 9 ESKATON 1 ESKATON VILLAGE PLACERVILLE 5105 MANZANITA AVENUE CARMICHAEL CA 95608 270704516 SENIOR RESIDENCES & SERVICES CA 501(C)(3) LINE 9 ESKATON 1 ESKATON 5105 MANZANITA AVENUE CARMICHAEL CA 95608 942906307 SENIOR HOME-BASED SERVICES CA 501(C)(3) LINE 9 N/A 0 ESKATON PROPERTIES INC 5105 MANZANITA AVENUE CARMICHAEL CA 95608 942906316 SENIOR RESIDENCES & SERVICES CA 501(C )(3) LINE 9 ESKATON 1 ESKATON FOUNTAINWOOD LODGE 5105 MANZANITA AVENUE CARMICHAEL CA 95608 275246432 SENIOR RESIDENCES & SERVICES CA 501(C )(3) LINE 9 ESKATON 1 CALIFORNIA HEALTH CARE CONSULTANTS 5105 MANZANITA AVENUE CARMICHAEL CA 95608 942761402 LEASED EMPLOYEES FOR SENIOR RESIDENCES CA N/A C 0 LIVABLE DESIGN 5105 MANZANITA AVENUE CARMICHAEL CA 95608 942243808 PROVIDE RESEARCH & DESIGN PRINCIPALS TO HOME BUILDERS CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 ESKATON PROPERTIES INC M 393558 FMV ESKATON PROPERTIES INC P 616373 FMV ESKATON PROPERTIES INC Q 574606 FMV ESKATON PROPERTIES INC R 3126000 FMV