2012-04-27T18:05:06-05:00 2011-06-30 EIDE BAILLY LLP 1850 N CENTRAL AVE SUITE 400 PHOENIX AZ 850044527 990 2010-07-01 860411904 FSL PROGRAMS FSLP 6022851800 1201 E THOMAS ROAD PHOENIX AZ 85014 GUY MIKKELSEN 6022851800 2012-04-19 1 JOSHUA P HAYES 6022645844 2012-04-10 2010 2016-02-24 21:20:13Z GUY MIKKELSEN 1201 E THOMAS ROAD PHOENIX AZ 85014 11720536 0 0928 X WWW.FSL.ORG X 1980 AZ PROVIDE PROGRAMS AND SERVICES FOR SENIOR ADULTS, PERSONS WITH DISABILITIES, AND THEIR FAMILIES. 5 0 325 293 0 0 1107573 1317919 10445831 10370442 7685 28511 -52 -26 11561037 11716846 0 0 0 0 6907492 6698389 0 0 0 5874625 5184543 12782117 11882932 -1221080 -166086 3426968 3527250 3249006 3515374 177962 11876 X NONE 0 0 5416832 4767412 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 321,184 HOURS, OVER 252 DAYS, TO 717 UNDUPLICATED PERSONS, THE MAJORITY OF WHICH ARE ON A FIXED INCOME. ADHS ALSO CONSOLIDATED OUR TOLLESON LOCATION INTO GLENDALE, AND SANTA MARIA MERGED INTO THE NEWLY OPENED SCOTTSDALE LOCATION DURING THIS PAST FISCAL YEAR. 1899751 2089561 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 RESIDENTS2010-2011 BUDGET: $2,102,302TOTAL NUMBER OF CONTRACTED ALF'S FOR THREE ALTCS HEALTH PLANS: 745ADULT FOSTER CARE (AFC) - 69ASSISTED LIVING HOMES (ALH) - 594ASSISTED LIVING CENTERS (ALC) - 82 SERVICE COMPONENTS AND DATA FOR FY 2011 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 REQUESTS HAS DECLINED, AND ONLY REQUESTS HAVE BEEN FROM MERCY CARE AND EVERCARE (SCAN IS PERFORMING THEIR OWN INVESTIGATION). TOTAL NUMBER OF MONITORING VISITS - 771TOTAL NUMBER OF INVESTIGATIVE VISITS - 14ASSISTED LIVING TRAINING IS A CERTIFIED TRAINING PROGRAM APPROVED BY ADHS AND LICENSED BY ARIZONA STATE BOARD FOR PRIVATE POSTSECONDARY EDUCATION TO TRAIN CARTIFIED CAREGIVERS AND MANAGERS OF ASSISTED LIVING FACILITIES. THE CERTIFIED CAREGIVER/MANAGER TRAINING PROGRAM IS OFFERED ONCE PER MONTH FOR 74 CLOCK HOURS. TOTAL NUMBER OF STUDENTS WHO ATTENDED TRAININGS DURING FY 2011 - 214.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 - 19. 2517782 2832849 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 JANUARY WE HAVE PROVIDED 3,344 HOURS OF NURSING SERVICES TO THIS FRAGILE POPULATION.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 21,154 HOME CARE UNITS TO 375 CLIENTS AND 17,263 NURSING, THERAPY AND HOME HEALTH AIDE UNITS TO 746 CLIENTS. 991459 676956 OTHER SERVICES TO SUPPORT AND FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION ARE NUTRITION CENTERS, COMMUNITY SOCIAL SERVICES AND CAREGIVER SERVICES. 991459 676956 10825824 1 1 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 1 1 0 0 1 X 38 0 1 325 1 0 0 0 0 0 0 0 0 0 0 X 5 0 1 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 X X 0 211022 20145 CAROLYN HILL 10.00 X X 0 112926 0 BLANCA RUIZ 5.00 X X 0 90108 6197 JOHN HANSEN 6.00 X X 0 78135 20088 DAVID PADDISON THROUGH 311 6.00 X X 0 132152 20823 RICHARD ARMSTRONG AS OF 411 2.00 X 0 124000 0 CARRIE A SMITH 20.00 X 108817 0 6701 LINDA MARTIN 19.00 X 0 139209 12700 JOSEPH SWITALSKI 0.50 X 0 104438 0 STEVE HASTINGS 1.00 X 0 134149 17170 108817 1126139 103824 1 0 1 0 FSL MANAGEMENT 1201 E THOMAS ROAD PHOENIX AZ 85014 MANAGEMENT FEES 995963 ST JOSEPHS HOSPITAL CATERING 350 W THOMAS RD PHOENIX AZ 85013 FOOD SUPPLY SERVICES 424369 SANDRA BAKER 6811 W VILLA THERESA GLENDALE AZ 85308 IN HOME CARE GIVING SERVICES 230887 MELVA CALVIN 22831 S RECKER RD GILBERT AZ 85298 IN HOME CARE GIVING SERVICES 155816 4 111565 716 1205638 1317919 GOVERNMENT CONTRACTS 623000 8329545 8329545 CLIENT FEES 623000 1979799 1979799 PROGRAM INCOME 623000 61098 61098 10370442 32175 32175 3664 -3664 -3664 -3664 0 716 26 -26 -26 11716846 10366778 0 32149 113380 57736 55644 5514448 5514448 93378 93378 477236 477236 499947 499947 995963 995963 5501 5501 1802427 1802427 16909 16909 597992 597992 656175 656175 425568 425568 9610 9610 15379 15379 227661 227661 88073 88073 FOOD & BEVERAGE 188922 188922 REPAIRS & MAINTENENCE 119421 119421 LICENSES, FEES, PERMITS 10820 10820 MISCELLANEOUS EXPENSE 8836 8836 CRAFT/RECREATIONAL 6655 6655 8631 8631 11882932 10825824 1057108 0 391907 604327 83589 11653 2203507 2364577 64826 63141 1219997 843542 349449 376455 333690 107097 3426968 3527250 880683 812157 723922 943225 30217 36072 1614184 1723920 3249006 3515374 X -201185 -421299 379147 433175 177962 11876 3426968 3527250 -166086 0 X 0 1 1 X 1 1 X 1886562 1577647 1375527 1107573 1317919 7265228 12011067 12920669 11672507 10445831 10370442 57420516 13897629 14498316 13048034 11553404 11688361 64685744 0 38491 231245 269736 38491 231245 269736 64416008 77628 7685 32175 117488 77628 7685 32175 117488 13897629 14498316 13125662 11561089 11720536 64803232 0.99400 0.99810 0.00180 0.00130 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 58500 5850 52650 264297 60416 203881 897200 777276 119924 376455 DUE TO AFFILIATES 802797 DUE TO COMBINED AFFILIATES 661704 NOTES PAYABLE AFFILIATES 259419 1723920 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: THE ENTITY HAS ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION TOPIC ASC 740-10 (PREVIOUSLY FINANCIAL INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES), ON JUNE 1, 2009. THE IMPLEMENTATION OF THIS STANDARD HAD NO IMPACT ON THE FINANCIAL STATEMENTS. AS OF BOTH THE DATE OF ADOPTION, AND AS OF JUNE 30, 2011 AND 2010, THE UNRECOGNIZED TAX BENEFIT ACCRUAL WAS ZERO. 0 0 0 0 0 0 0 0 0 GUY MIKKELSEN 0 179247 0 10000 0 21775 0 0 0 21113 0 232135 0 0 DAVID PADDISON THROUGH 311 0 127066 0 0 0 5086 0 0 0 22078 0 154230 0 0 LINDA MARTIN 0 113575 0 0 0 25634 0 0 0 13594 0 152803 0 0 STEVE HASTINGS 0 126745 0 0 0 7404 0 0 0 18318 0 152467 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, LINDA MARTIN, DAVID PADDISON AND STEVE HASTINGS ARE COMPENSATED BY A RELATED ORGANIZATION FOR SERVICES PROVIDED TO FSAL PROGRAMS, INC. AND RELATED ORGANIZATIONS. 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 2 DAVID PADDISON AND RICH ARMSTRONG HAVE A FAMILY RELATIONSHIP. 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 FOUNDATION FOR SENIOR LIVING. 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 CONTROLLER OF THE ORGANIZATION'S PARENT, 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, FSAL MANAGEMENT (FSAL), FOR HIS SERVICES PROVIDED TO FSAL AND ITS RELATED ORGANIZATIONS. HIS COMPENSATION IS APPROVED BY THE GOVERNING BOARD OF FSAL. 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. FORM 990, PART VII, SECTION A THE FOLLOWING OFFICERS, DIRECTORS AND HIGHEST COMPENSATED EMPLOYEES SERVE FOUNDATION FOR SENIOR LIVING AND ALL OTHER RELATED ORGANIZATIONS THE FOLLOWING HOURS PER WEEK. GUY MIKKELSEN - 38 HOURS CAROLYN HILL - 30 HOURS BLANCA RUIZ - 35 HOURS JOHN HANSEN - 34 HOURS DAVID PADDISON - 34 HOURS CARRIE SMITH - 20 HOURS LINDA MARTIN - 21 HOURS STEVE HASTINGS - 39 HOURS JOSEPH SWITALSKI - 39.5 HOURS RICHARD ARMSTRONG - 38 HOURS FOUNDATION FOR SENIOR LIVING 1201 E THOMAS ROAD PHOENIX AZ 85014 860298945 PROVIDE POLICY ADVICE AND GUIDANCE TO ITS SUBSIDIARIES AZ 501C3 7 N/A 0 FOUNDATION FOR SENIOR ADULT LIVING INC 1201 E THOMAS ROAD PHOENIX AZ 85014 860462784 LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY AZ 501C3 9 FOUNDATION FOR SENIOR LIVING 0 FSL PATHYWAYS 1201 E THOMAS ROAD PHOENIX AZ 85014 860748876 GROUP HOUSING AND BEHAVIORAL HEALTH SERVICES TO MENTALLY IMPAIRED ADULTS AZ 501C3 9 FOUNDATION FOR SENIOR LIVING 0 FSL HOME IMPROVEMENTS 1201 E THOMAS ROAD PHOENIX AZ 85014 383649930 REHABILITIATION OF HOMES FOR THE BENEFIT OF FSL FACILITIES AZ 501C3 9 FOUNDATION FOR SENIOR LIVING 0 FSL MANAGEMENT 1201 E THOMAS ROAD PHOENIX AZ 85014 860462786 MANAGEMENT SERVICES TO RELATED FOUNDATION FOR SENIOR LIVING ORGANIZATIONS AZ 501C3 11, TYPE 1 FOUNDATION FOR SENIOR LIVING 0 FSL REAL ESTATE SERVICES 1201 E THOMAS ROAD PHOENIX AZ 85014 861006866 REAL ESTATE DEVELOPMENT SERVICES TO FOUNDATION FOR SENIOR LIVING AZ 501C3 11, TYPE 1 FOUNDATION FOR SENIOR LIVING 0 PAYSON SENIOR LIVING INC 1201 E THOMAS ROAD PHOENIX AZ 85014 860458284 LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY AZ 501C3 9 FOUNDATION FOR SENIOR LIVING 0 FSL CHRISTOPHER PROPERTIES INC 1201 E THOMAS ROAD PHOENIX AZ 85014 300506152 LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY AZ 501C3 9 FOUNDATION FOR SENIOR LIVING 0 FSL RURAL DEVELOPMENT 1201 E THOMAS ROAD PHOENIX AZ 85014 860380470 LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY AZ 501C3 9 FOUNDATION FOR SENIOR LIVING 0 ST CLAIRE SENIOR LIVING 1201 E THOMAS ROAD PHOENIX AZ 85014 753021717 LOW-INCOME HOUSING AND RELATED SERVICES TO THE ELDERLY - 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