2012-06-15T14:44:24-05:00 2011-12-31 410746749 CLIFTONLARSONALLEN LLP 3000 NORTHUP WAY SUITE 200 BELLEVUE WA 980041446 990 2011-01-01 990290103 KAHALA SENIOR LIVING COMMUNITY INC KAHA 8082187000 4389 MALIA STREET HONOLULU HI 96821 PATRICK DUARTE 8082187000 2012-06-05 1 DANIEL M FREIN P00856532 4252506100 2012-06-05 2011 2016-02-24 21:20:13Z PATRICK DUARTE 4389 MALIA STREET HONOLULU HI 96821 50250667 0 X WWW.KAHALANUI.COM X 1989 HI TO PROVIDE A CONTINUUM OF HIGH QUALITY RESIDENTIAL AND HEALTH CARE SERVICES TO RESIDENTS. 9 9 382 240 411080 -113304 200565 137000 25949807 28245968 1048400 1316577 369104 359156 27567876 30058701 74212 58500 0 0 10561761 10922386 0 0 0 19551956 20067990 30187929 31048876 -2620053 -990175 184270211 181605397 219059288 217263270 -34789077 -35657873 X IN THE SPIRIT OF OHANA, KAHALA SENIOR LIVING COMMUNITY AND ITS ASSOCIATES ARE DEDICATED TO SERVING THE UNMET CARE NEEDS OF SENIORS IN HAWAII. WE ARE A NOT-FOR-PROFIT ORGANIZATION THAT PROVIDES A CONTINUUM OF HIGH QUALITY RESIDENTIAL AND HEALTH CARE SERVICES ENABLING OUR RESIDENTS TO LIVE A GRACIOUS HAWAIIAN LIFESTYLE IN AN ENVIRONMENT OF DIGNITY, RESPECT, TRUST, AND FRIENDSHIP. 0 0 27708666 58500 28276535 KAHALA NUI IS A SENIOR LIVING COMMUNITY LOCATED IN HONOLULU, HAWAII THAT PROVIDES A CONTINUUM OF RESIDENTIAL AND HEALTHCARE SERVICES TO SENIORS. FOUR DISTINCT LEVELS OF CARE ARE OFFERED: INDEPENDENT LIVING, ASSISTED LIVING, MEMORY SUPPORT, AND SKILLED NURSING. KAHALA NUI HAS 270 INDEPENDENT LIVING UNITS FOR SENIORS WHO DON'T REQUIRE ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. HI'OLANI IS KAHALA NUI'S HEALTHCARE CENTER WHICH PROVIDES ASSISTED LIVING SERVICES, MEMORY SUPPORT, AND SKILLED NURSING TO RESIDENTS WHO TRANSFER FROM INDEPENDENT LIVING AND TO INDIVIDUALS FROM THE COMMUNITY. HI'OLANI IS LICENSED FOR 63 ASSISTED LIVING BEDS (INCLUDING MEMORY SUPPORT) AND 60 SKILLED NURSING BEDS. IN ADDITION TO HEALTHCARE SERVICES, KAHALA NUI OFFERS A VARIETY OF SERVICES WHICH INCLUDE CASUAL AND FORMAL IN-HOUSE DINING, WELLNESS PROGRAMS, RECREATIONAL EVENTS, HOUSEKEEPING AND LINEN SERVICES, SCHEDULED TRANSPORTATION TO ALL MAJOR SHOPPING MALLS AND VARIOUS RELIGIOUS AND MEDICAL FACILITIES, BUILDING AND GROUNDS MAINTENANCE, 24-HOUR SECURITY, AND BUSINESS SERVICES. 27708666 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 20 0 382 1 1 1 0 0 0 0 0 0 0 0 1 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 HI X HUILAN KAMITA 8082187022 4389 MALIA STREET HONOLULU HI 96821 CHARLES O SWANSON 1.00 X 0 0 0 PHILIP H CHING 3.00 X X 0 0 0 EVELYN CHAR RN MS 1.00 X 0 0 0 CHARLES KELLY MD 3.00 X X 0 0 0 ROY KING 2.00 X X 0 0 0 TOBY MARTYN 2.00 X 0 0 0 LAURA THOMPSON 1.00 X 0 0 0 WENDELL BROOKS JR 3.00 X X 0 0 0 SHEILA CHONG 2.00 X 0 0 0 PATRICK DUARTE 50.00 X 211160 0 1200 WENDY WONG 50.00 X 174909 0 1200 DARLENE CANTO 50.00 X 125244 0 2271 511313 0 4671 3 0 1 0 HFM FOOD SERVICE PO BOX 855 HONOLULU HI 96808 FOOD VENDOR 491109 KING FOOD SERVICE PO BOX 971389 HONOLULU HI 96797 FOOD VENDOR 420592 UNITED LAUNDRY SERVICES INC 2291 ALAHOA PLACE HONOLULU HI 96819 LINEN SERVICE 273370 PALAMA HOLDINGS LLC 2029 LAUWILIWILI KAPOLEI HI 96707 FOOD VENDOR 216342 Y FUKUNAGA PRODUCTS LTD 5 SAND ISLAND ACCESS ROAD BLDG 906 HONOLULU HI 96819 FOOD VENDOR 128715 5 137000 4200 137000 MONTHLY SERVICES FEES 623000 20602443 20602443 ENTRANCE FEES 623000 5299804 5299804 SKILLED NURSING ANCILL 623000 2343721 2343721 28245968 1076931 1076931 30567 30567 30567 30567 20431612 20191966 239646 239646 239646 GUEST MEALS 722100 411080 411080 ADJUSTMENTS TO REVENUE 900099 -82491 -82491 328589 30058701 28276535 411080 1234086 58500 58500 339875 339875 8466116 7615889 850227 158281 136944 21337 1291754 1120621 171133 666360 576531 89829 34276 34276 31945 31945 67018 67018 158673 158673 1376853 1279187 97666 207789 207789 1030388 898960 131428 34700 17093 17607 3652593 3652593 2098 2098 4081 4081 5498517 5498517 5512571 4189554 1323017 412834 412834 FOOD COSTS 1648708 1648708 REPAIRS AND MAINTENANCE 284321 284321 RESIDENT AND COMMUNITY 96834 96834 EXCISE TAX EXPENSE 11693 11693 2098 2098 31048876 27708666 3340210 0 711208 1163131 13552914 14039936 461004 455846 42979 34416 260051 193951 154276586 28324881 129598579 125951705 25655289 27378960 0 13988187 12387452 184270211 181605397 191736 1387263 69880000 68790000 993038 830613 147994514 146255394 219059288 217263270 X -34846691 -35698380 57614 40507 -34789077 -35657873 184270211 181605397 X -990175 121379 X 0 1 1 X 0 X 1200 32665 200565 137000 371430 23764722 24202124 26249513 25949807 28245968 128412134 23764722 24203324 26282178 26150372 28382968 128783564 0 0 0 128783564 1058301 867638 562364 1048652 1076931 4613886 1058301 867638 562364 1048652 1076931 4613886 -82491 -82491 24823023 25070962 26844542 27199024 29377408 133314959 0.96600 0.96570 0.03460 0.03430 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 150448946 26185781 124263165 3827640 2139100 1688540 125951705 ACCRUED INTEREST RECEIVABLE 178439 DEFERRED FINANCING COSTS 3301528 DEFERRED SALES AND MARKETING COSTS 1796053 PREPAID GROUND RENT 7111432 12387452 RESIDENT LIABILITIES 415868 ACCRUED PAYROLL 678970 ENTRANCE FEE LIABILITY 141755850 DEFERRED RENT 4253080 ORIGINAL DISCOUNT, NET -848374 146255394 30058701 31048876 -990175 54287 67092 121379 -868796 29898362 54287 37428 91715 29806647 137903 114151 252054 30058701 30910973 0 30910973 137903 137903 31048876 PART IV, LINE 2B: ESCROW ACCOUNTS ARE RELATED TO A 10% DEPOSIT RECEIVED FROM INTERESTED INDIVIDUALS WHO HAVE DEPOSITED MONEY IN ORDER TO HOLD A SPOT ON THE CCRC WAIT LIST. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION, EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES IN THE FINANCIAL STATEMENTS. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE YEARS 2007 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 37,428. PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS, GIFTS, AND BEQUESTS INCLUDED AS ADDITIONS TO NET ASSETS 114,151. 0 ALZHEIMER'S ASSOCIATION 1050 ALA MOANA BLVD 2610 HONOLULU HI 96814 990212360 501C(3) 8500 FAMILY SERVICES AND EDUCATIONSAL PROGRAMS ALOHA UNITED WAY 200 N VINEYARD BLVD HONOLULU HI 96817 990073494 501C(3) 45000 HOUSING ASSISTANCE PROGRAM FRANCISCAN VISTAS EWA 91-1471 MIULA ST EWA BEACH HI 96706 412270514 501C(3) 5000 PROMOTING SOCIAL INTERACTION AND EDUCATION ON HEALTH, WELLNESS, FITNESS, AND NUTRITION MEALS ON WHEELS PO BOX 61194 HONOLULU HI 96389 990198132 501C(3) 15000 FAIR MARKET VALUE MEALS PROVIDED ENABLING SENIORS TO STAY AT HOME DURING MEALTIME PALAMA SETTLEMENT 810 N VINEYARD BLVD HONOLULU HI 96817 990074140 501C(3) 6000 FAIR MARKET VALUE GIFT BAGS GIFT BAGS TO HOMEBOUND SENIORS DURING THE HOLIDAY SEASON. CATHOLIC CHARITIES (LANAKILA MULTI-PURPOSE SENIOR COMMUNITY CENTER) 1822 KEEAUMOKU ST HONOLULU HI 96822 990073547 501C(3) 10000 FAIR MARKET VALUE EXERCISE CLASSES ONE YEAR GIFT OF TAI-CHI, JAZZERCISE, CHAIR FITNESS, AND STRETCH AND BALANCE 4 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: EACH GRANT IS APPROVED AND INCLUDED IN THE BUDGET; ALL EXPENDITURES ARE PRESENTED TO THE BOARD OF DIRECTORS. X 0 1 X X X X X 0 0 0 1 0 0 0 0 0 PATRICK DUARTE 184960 0 25000 0 1200 0 0 0 1200 0 212360 0 0 0 WENDY WONG 158363 0 15346 0 1200 0 0 0 1200 0 176109 0 0 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PROVIDED FOR PATRICK J. DUARTE, CEO. PART I, LINE 1B NO WRITTEN POLICY IS FOLLOWED; HOWEVER, THE SOCIAL CLUB MEMBERSHIP WAS APPROVED BY THE EXECUTIVE COMMITTEE AND THE ORGANIZATION REQUIRES SUBSTANTIATION PRIOR TO REIMBURSEMENT FOR SOCIAL CLUB EXPENSES. STATE OF HAWAII DEPARTMENT OF BUDGET AND FINANCE 990266961 419800EU7 2003-01-23 140709368 TO FUND THE CONSTRUCTION OF BUIDING IMPROVEMENTS 0 0 0 72120000 140709368 9674299 2035015 3500000 125500054 2005 0 0 1 1 0 1 0 0 0.00200 0.00200 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 GREYSTONE MANAGEMENT COMPANY, LLC, WAS ENGAGED AS THE SOLE MANAGER OF THE KAHALA SENIOR LIVING COMMUNITY CONTINUING CARE RETIREMENT COMMUNITY. THE MANAGEMENT SERVICES CONTRACT ENDED ON FEBRUARY 15, 2011. FORM 990, PART VI, SECTION B, LINE 11 A FORM 990 DRAFT IS PROVIDED TO OFFICERS AND KEY MANAGEMENT PRIOR TO BOARD REVIEW. UPON THE APPROVAL OF OFFICERS AND KEY MANAGEMENT, THE FORM IS SUBMITTED TO THE BOARD OF DIRECTORS. IF THE BOARD OF DIRECTORS HAS ANY COMMENTS, QUESTIONS, OR SUGGESTIONS, THESE ARE CONSIDERED PRIOR TO FILING. AFTER ALL ISSUES ARE ADDRESSED, THE DRAFT IS FINALIZED AND FILED BY THE ORGANIZATION'S ACCOUNTANTS. FORM 990, PART VI, SECTION B, LINE 12C BY SIGNING AN ANNUAL CONFLICT OF INTEREST STATEMENT, ALL OFFICERS, DIRECTORS, OR TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE WHETHER THEY HAVE CONFLICTS OF INTEREST IN REGARDS TO THE ORGANIZATION. NO MEMBER OF THE BOARD OF DIRECTORS SHALL PARTICIPATE IN ANY DISCUSSION OR VOTE ON ANY MATTER IN WHICH HE OR SHE OR A MEMBER OF HIS OR HER IMMEDIATE FAMILY HAS POTENTIAL CONFLICT OF INTEREST DUE TO HAVING MATERIAL ECONOMIC INVOLVEMENT REGARDING THE MATTER BEING DISCUSSED. WHEN SUCH A SITUATION PRESENTS ITSELF, THE DIRECTOR MUST ANNOUNCE HIS OR HER POTENTIAL CONFLICT, DISQUALIFY HIMSELF OR HERSELF, AND BE EXCUSED FROM THE MEETING UNTIL DISCUSSION IS OVER ON THE MATTER INVOLVED. FORM 990, PART VI, SECTION B, LINE 15A IN THE ORGANIZATION'S DETERMINATION OF THE CURRENT CEO/PRESIDENT'S COMPENSATION, ITS EXECUTIVE COMMITTEE REVIEWED THE QUALIFICATIONS OF THE EXISTING CEO/PRESIDENT, PAT DUARTE ALONG WITH INDUSTRY-RELATED INFORMATION GATHERED FROM AN INDEPENDENT THIRD PARTY EXECUTIVE RECRUITER AND INTERNAL SALARIES FOR MANAGEMENT PERSONNEL. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH POSTING ON THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA)WEBSITE. FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES ARE AS FOLLOWS: UNREALIZED GAINS: 54,287 PRIOR PERIOD ADJUSTMENTS: 67,092