2011-08-14T13:11:13-05:00 2010-09-30 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2009-10-01 910666887 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST PRES 2068262110 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 TAMERYN CAMPBELL 2068262110 2011-08-12 1 Sara Elizabeth J Hyre 4254544919 2009 2016-02-24 21:20:13Z TAMERYN CAMPBELL 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 27754048 0 X WWW.PRCN.NET X 1956 WA CREATE RESIDENTIAL COMMUNITIES THAT PROVIDE EXCELLENT SERVICES AND ENRICH THE LIVES OF SENIORS. 16 16 467 16 75473 -48145 14701 0 16384810 21983719 547664 738905 186819 191622 17133994 22914246 1250 0 9312774 13067562 0 0 6694834 29325616 16007608 42394428 1126386 -19480182 284858176 279527548 272871303 285292345 11986873 -5764797 PROVIDE CONTINUING CARE AND SENIOR HOUSING IN THE SEATTLE AREA ACROSS THREE CONTINUING CARE RETIREMENT COMMUNITIES. OUR VISION IS TO CREATE THRIVING RESIDENTIAL HOMES THAT PROVIDE EXCELLENT SERVICES AND ENRICH THE LIVES OF SENIORS. 0 0 35558390 1250 22080501 PROVIDE NURSING CARE, ASSISTED AND INDEPENDENT LIVING FOR THE ELDERLY, SERVING APPROXIMATELY 413 RESIDENTS. 35558390 1 0 0 1 0 0 0 0 0 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 0 0 0 1 104 0 1 467 1 1 1 0 0 0 0 0 0 0 0 16 16 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 1 0 WA X JIM YAMAMOTO 2068262110 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 ROB MITCHELL 3.00 X X 0 0 0 GREG ROBINSON 4.00 X X 0 0 0 BONNIE BRIAN CALDWELL 3.00 X 0 0 0 LUCILLE KELLEY 1.00 X 0 0 0 JOHN ESHELMAN 3.00 X 0 0 0 CAROLE CONGER 3.00 X 0 0 0 RICHARD MATHEWS 3.00 X 0 0 0 JAMES MELHORN 3.00 X 0 0 0 GARY HOULAHAN 3.00 X 0 0 0 PAUL COLLINS 2.00 X 0 0 0 HEATHER JAMES 3.00 X 0 0 0 TOM JOHNSTON 3.00 X 0 0 0 DOUG DIEKEMA 3.00 X 0 0 0 TOM VALSILATOS 3.00 X 0 0 0 KAY BROWELEIT 3.00 X 0 0 0 REV SCOTT LUMSDE 0.10 X 0 0 0 TAMERYN CAMPBELL 40.00 X 0 0 0 MARSH KELLEGREW 40.00 X 82354 0 0 RACHEL RUGGERI 40.00 X 151748 0 6598 JEFF CRANDALL 40.00 X 120615 0 8698 ALAN FLETCHER 40.00 X 158495 0 12700 SALLY NAFZIGER 40.00 X 113040 0 8134 THOM HOWSON 40.00 X 108820 0 8966 JANET NAHLIN 40.00 X 107361 0 10759 WES BARD 40.00 X 103693 0 5061 DAVE GIELCZYK 40.00 X 101376 0 4565 BRIAN ENGLUND 40.00 X 154099 0 9767 1201601 0 75248 9 1 1 1 SELLEN CONSTRUCTION 227 WESTLAKE AVE N SEATTLE WA 98109 CONTRACTOR 7404354 GREYSTONE DEVELOPMENT 222 W LAS COLINAS BLVD IRVING TX 75039 CONSULTING 2783520 STUDIOSIX5 336 SOUTH CONGRESS SUITE 165 AUSTIN TX 78707 INTERIOR DESIGN 1134659 PERKINS WILL 10100 B CENTRAL EXPRESSWAY DALLAS TX 75231 ARCHITECT 503911 RICE FERGUSEN 262 4TH STREET BREMERTON WA 98337 ARCHITECT 436330 17 RESIDENCY FEES 623990 12067188 12067188 MEDICAL SERVICES 623000 6435052 6435052 ASSISTED LIVING 623990 3475663 3475663 OTHER 900099 5816 5816 21983719 1066106 1066106 80887 80887 80887 80887 4512601 4376066 463736 136535 -463736 -327201 -327201 GARAGE INCOME 900099 91368 15895 75473 ASSISTED LIVING 900099 7474 7474 TRANSPORTATION 900099 7242 7242 4651 4651 110735 22914246 22080501 75473 758272 1250 1250 701539 554216 147323 9977989 7889851 2088138 121650 91238 30412 1011160 695327 315833 1255224 1012109 243115 302563 302563 218956 4302 214654 113990 39078 74912 69216 69216 1306645 1137104 169541 109525 109525 464793 177182 287611 210474 96818 113656 15170317 14183543 986774 125338 8458 116880 31336 9221 22115 8274381 7736163 538218 638326 638326 RAW FOOD & KITCHEN 1062047 1062047 PURCHASED SERVICES 914024 733298 180726 BAD DEBT 128291 128291 DUES/PERMITS/LICENSE 87827 45865 41962 UBI TAXES 1961 1961 95606 81320 14286 42394428 35558390 6836038 0 502107 2846711 18846857 3115829 688686 7277555 3000000 235721 397653 244644465 30338865 218108443 214305600 23071097 34850754 4470197 12142128 15935068 4591318 284858176 279527548 14512339 3743671 16438942 89627787 224485000 186690000 17435022 5230887 272871303 285292345 X 11904277 -5764797 82596 0 0 11986873 -5764797 284858176 279527548 X 0 1 1 X 0 X 37649 126671 13000 14701 192021 14461812 16252820 16063743 16481882 22080501 85340758 14499461 16379491 16076743 16496583 22080501 85532779 0 0 0 85532779 601572 528264 523801 519253 1066106 3238996 601572 528264 523801 519253 1066106 3238996 36468 19367 55835 15101033 16907755 16600544 17052304 23165974 88827610 0.96290 0.96180 0.03650 0.03780 X 0 0 0 0 0 1 1774 0 0 0 1774 0 13218689 13218689 197280061 23436593 173843468 11216655 6032857 5183798 22929060 869415 22059645 214305600 DEPOSITS 2571841 SWAP AGREEMENTS 206046 ACCRUED MARKETING FEES 2453000 5230887 22914246 42394428 -19480182 1728516 -4 1728512 -17751670 24709893 1728516 67131 1795647 22914246 0 22914246 42519502 125074 125074 42394428 0 42394428 Part XI, Line 8 - Other Adjustments: ROUNDING: -4. Part XII, Line 2d - Other Adjustments: REVENUE FROM AFFILIATES: 66212. RENTAL REVENUE BETWEEN AFFILIATES: 919. Part XIII, Line 2d - Other Adjustments: EXPENSE FROM AFFILIATES: 124155. RENTAL REVENUE BETWEEN AFFILIATES: 919. X 1 0 X X X X 0 0 0 0 0 0 0 0 0 RACHEL RUGGERI 151748 0 0 0 0 0 2100 0 4498 0 158346 0 0 0 ALAN FLETCHER 158495 0 0 0 0 0 4658 0 8042 0 171195 0 0 0 BRIAN ENGLUND 154099 0 0 0 0 0 3561 0 6206 0 163866 0 0 0 Part I, Line 1a TAMERYN CAMPBELL (PRESIDENT & CEO) TEMPORARILY STAYED IN ONE OF THE VACANT APARTMENTS FOR APPROXIMATELY 2 MONTHS TO FACILITATE HER RELOCATION INTO THE AREA UPON EMPLOYMENT. ESTIMATED BENEFIT WAS $3,000. Supplemental Information Part III ALAN FLETCHER WAS COMPENSATED BY GREYSTONE COMMUNITIES, AN UNRELATED ORGANIZATION, IN THE AMOUNT OF $171,195 IN WAGES AND OTHER COMPENSATION. FORMER CEO BRIAN ENGLAND WAS COMPENSATED DURING THE 2009 CALENDAR YEAR, BUT HIS EMPLOYMENT ENDED PRIOR TO THE BEGINNING OF THE FISCAL YEAR STARTING OCTOBER 1, 2009. WASHINGTON STATE HOUSING FINANCE COMMISSION- Series A 911874730 93978LDE3 2007-02-28 204865405 CONSTRUCT A CONTINUING CARE RETIREMENT COMMUNITY 0 0 204865405 26888820 3869728 169068115 2009 0 0 1 1 0 0 1 0 1 1 0 1 1 SOVEREIGN BANK 5.000000000000 0 0 0 Form 990, Part VI, Section B, line 11 THE CONTROLLER REVIEWS THE 990 PRIOR TO SUBMISSION. Form 990, Part VI, Section B, line 12c ANNUALLY, A CONFLICT OF INTEREST FORM IS DISTRIBUTED TO THE BOARD OF DIRECTORS AND OFFICERS. THE CEO TYPICALLY REVIEWS THE FORMS AND IDENTIFIES ANY CONFLICTS. IF A CONFLICT IS FOUND, THAT BOARD MEMBER REMOVES HIMSELF OR HERSELF FROM VOTING ON OR DISCUSSING THAT MATTER. Form 990, Part VI, Section B, line 15 THE BOARD USES AN INDEPENDENT COMPENSATION CONSULTANT AND COMPENSATION SURVEY TO ANNUALLY DETERMINE THE CEO AND CFO'S COMPENSATION. THE CEO IS RESPONSIBLE FOR CONDUCTING THE REVIEW OF OTHER OFFICERS' COMPENSATION (EXECUTIVE DIRECTORS). Form 990, Part VI, Section C, line 19 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART I, LINE 6: THERE WERE 16 VOLUNTEER MEMBERS ON THE BOARD OF DIRECTORS. FH LLC 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 910666887 OPERATE RETIREMENT COMMUNITY WA -18378880 240395984 N/A PRESBYTERIAN RETIREMENT NORTHWEST FOUNDATION 715 9TH AVENUE SUITE 400 SEATTLE WA 98104 911586491 BENEFIT RESIDENTS AND EMPLOYEES WA 501(C)(3) 11-TYPE 1 PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0