2011-02-15T16:54:55-06:00 2010-06-30 EIDE BAILLY LLP 1850 N CENTRAL AVENUE SUITE 400 PHOENIX AZ 850044527 990 2009-07-01 860411904 FSAL Programs Inc FSAL 6022851800 1201 E THOMAS ROAD PHOENIX AZ 85014 DAVID PADDISON 6022851800 2011-02-15 1 Dan DiPomazio CPA 6022645844 2011-02-15 2009 2016-02-24 21:20:13Z Guy Mikkelsen 1201 E THOMAS ROAD PHOENIX AZ 85014 11561089 0 0928 X WWW.FSL.ORG X 1980 AZ PROVIDE PROGRAMS AND SERVICES FOR SENIOR ADULTS, PERSONS WITH DISABILITIES, AND THEIR FAMILIES. 5 0 322 378 0 0 1375527 1107573 11658642 10445831 77628 7685 3343 -52 13115140 11561037 0 0 7396458 6907492 0 0 5924523 5874625 13320981 12782117 -205841 -1221080 3174409 3426968 2211638 3249006 962771 177962 0 0 4804575 4766991 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 295,255 hours, over 252 days, to 760 unduplicated persons, the majority of which are on a fixed income. 1743332 1905300 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. 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) - 4Assisted Living Homes (ALH) - 10 Assisted Living Centers (ALC) - 10+2009-2010 Budget: $2,182,597Total number of contracted ALF's for three ALTCS Health Plans: 706Adult Foster Care - 80Assisted Living Homes - 558Assisted Living Homes - 68 Service components and data for FY 2010 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. Average number of Investigations per month is five. Total number of Monitoring Visits - 724Total number of Investigative Visits - 24Assisted Living Training is a certified training program approved by ADHS and Licensed by Arizona State Board for Private Postsecondary Education for caregivers and managers of Assisted Living Facilities. The Certified Caregiver training program is offered once per month for 74 hours. Total number of students who attended trainings during FY 2010 - 206.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, for residents who do not have a family member or POA and who reside in contracted AFC homes. Total number of PAYEE clients served - 20. 1632384 1630922 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. The FSL Programs, 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 20,280 home care units to 377 clients and 12,687 nursing and home health aide units to 534 clients. 2788898 2149698 Other services to support and further the exempt purpose of the organization including home care agencies, nutrition centers and community social services. 2788898 2149698 10969189 1 1 0 0 0 0 0 1 0 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 0 0 1 9 0 1 322 1 0 0 0 0 0 0 0 0 0 5 0 1 1 0 0 1 1 0 1 0 0 0 1 1 1 0 1 1 0 0 0 AZ X DAVID PADDISON 6022851800 1201 E THOMAS ROAD PHOENIX AZ 85014 Guy Mikkelsen 2.00 X X 0 196667 19484 Carolyn Hill 10.00 X X 0 111815 11495 Blanca Ruiz 5.00 X X 0 90220 7363 John Hansen 6.00 X X 0 80046 15430 David Paddison 6.00 X X 0 115421 11382 Carrie A Smith 20.00 X 99960 0 8227 Linda Martin 19.00 X 0 158641 13062 Joseph Switalski 0.50 X 0 105384 0 STEVE HASTINGS 0.50 X 0 124061 16869 99960 982255 103312 0 0 1 0 FSL Management 1201 E Thomas Road Phoenix AZ 85014 Management Fees 979249 St Josephs Hospital Catering 350 W Thomas Rd Phoenix AZ 85013 Food Supply Services 452625 Sandra Baker 6811 W Villa Theresa Glendale AZ 85308 In home care giving services 232631 Melva Calvin 22831 S Recker Rd Gilbert AZ 85298 In home care giving services 111022 4 1447 1106126 1107573 Government Contracts 623000 8367293 8367293 CLIENT FEES 623000 2007998 2007998 PROGRAM INCOME 623000 70540 70540 10445831 605 605 7080 7080 7080 7080 0 1447 52 -52 -52 11561037 10452911 0 553 111004 99904 11100 5606074 4933345 672729 135640 119363 16277 560362 493119 67243 494412 435083 59329 979249 979249 7001 7001 1953085 1953085 49399 49399 785282 785282 952885 952885 514182 514182 17370 17370 25713 25713 169546 169546 84359 84359 FOOD & BEVERAGE 163899 163899 REPAIRS & MAINTENENCE 107208 107208 Miscellaneous Expense 24487 24487 BAD DEBTS 20399 20399 Licenses, Fees, Permits 7831 7831 12730 12730 12782117 10969189 1812928 0 496144 391907 74540 83589 2014745 2203507 47711 64826 1349172 999723 443297 349449 97972 333690 3174409 3426968 654961 880683 393551 723922 37465 30217 1125661 1614184 2211638 3249006 X 575639 -201185 387132 379147 962771 177962 3174409 3426968 X 0 1 1 X 0 X 1379504 1886562 1577647 1375527 1107573 7326813 10745281 12011067 12920669 11672507 10445831 57795355 12124785 13897629 14498316 13048034 11553404 65122168 0 38491 38491 38491 38491 65083677 77628 7685 85313 77628 7685 85313 12124785 13897629 14498316 13125662 11561089 65207481 0.99810 0.99880 0.00130 0.00120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 58500 3900 54600 109087 106303 2784 1181585 889520 292065 349449 Due from Affiliate 78346 Due from Combined Affiliate 255344 333690 Due to Affiliates 721576 Due to Combined Affiliates 628918 Notes Payable Affiliates 263690 1614184 11561037 12782117 -1221080 436271 436271 -784809 11990279 436271 436271 11554008 7029 7029 11561037 12775088 52 52 12775036 7081 7081 12782117 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. Part X: Description of Uncertain Tax Positions Under FIN 48: The Entities are non-profit, Arizona corporations which have been granted certificates of exemption from the payment of federal and state income taxes under provisions of Section 501(c)(3) of the Internal Revenue Code. The Entities have adopted the provisions of FASB Accounting Standards Codifcation 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, 2010, the unrecognized tax benefit accrual was zero. The Entities will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. The Entities are no longer subject to Federal tax examinations by tax authorities for years before 2006 and state examinations for years before 2005. Part XII, Line 4b - Other Adjustments: Gain on Sale of Assets not included in revenue on Financial Statements: 7081. FUNDRAISING EXPENSES: -52. Part XIII, Line 2d - Other Adjustments: FUNDRAISING EXPENSES: 52. Part XIII, Line 4b - Other Adjustments: Gain on sale af assets reducing expenses on financial statements: 7081. X X X 0 0 0 0 0 0 0 0 0 Guy Mikkelsen 0 157033 0 17958 0 21676 0 9594 0 9890 0 216151 0 0 Linda Martin 0 112130 0 20736 0 25775 0 6925 0 6464 0 172030 0 0 Supplemental Information Part III Schedule J, Part II: Guy Mikkelsen is compensated by a related organization, Foundation for Senior Living, Inc., for services provided to Foundation for Senior Living, Inc. and related organizations as President and CEO. Schedule J, Part I, Question 3: Linda Martin and Carolyn Hill also serve in the role of providing oversight to FSL Programs. They are compensated by a related organization for their services provided to FSL Programs, Inc. and other related entities. FSL Programs, Inc. relied on the related organization for determining their compensation. 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 Guy Mikkelsen, Linda Martin, Blanca Ruiz, David Paddison, John Hanson, Carrie Smith and Carolyn Hill have a business relationship. They serve as officers and directors for other related organizations. Form 990, Part VI, Section A, line 3 FSL Programs pays FSL Management, an affiliate, a management fee. These services include 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, Inc. Form 990, Part VI, Section A, line 7a The directors shall be appointed by the member of the organization. Directors may be removed at any time without cause by the Member. 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 CFO of Foundation for Senior Living, Inc. (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, parent organization. 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: The Top Management Official's compensation is approved by Guy Mikkelsen, President and CEO. Compensation studies are done to determine appropriate compensation for her level and role. Guy Mikkelsen is compensated by a related organization, Foundation for Senior Living, Inc. (FSL) for his services provided to FSL and its related organizations. His compensation is approved by the governing board of FSL. 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 the governing board, provided to that entity and other related organizations. Their compensation is approved by Guy Mikkelsen, President and CEO. The organization is expanding the review by independent persons for the upcoming 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 and directors serve Foundation for Senior Living, Inc. 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 Foundation for Senior Living Inc 1201 E Thomas Road Phoenix AZ 85014 860298945 Provide policy advice and guidance to its subsidiaries AZ 501c3 7 N/A 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 N/A FSL Pathyways 1201 E Thomas Road Phoenix AZ 85014 860748876 Group Housing and behavioral health services to mentally impaired adults AZ 501c3 9 N/A FSL Home Improvements Inc 1201 E Thomas Road Phoenix AZ 85014 383649930 Rehabilitiation of homes for the benefit of FSL Facilities AZ 501c3 9 N/A FSL Management 1201 E Thomas Road Phoenix AZ 85014 860462786 Management services to related Foundation for Senior Living organizations AZ 501c3 11, Type 1 N/A 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 N/A Payson Senior Living Inc 1201 E Thomas Road Phoenix AZ 85014 860458284 Low-income housing and related services to the elderly AZ 501c3 9 N/A FSL Christopher Properties Inc 1201 E Thomas Road Phoenix AZ 85014 300506152 Low-income housing and related services to the elderly AZ 501c3 9 N/A FSL Rural Development Inc 1201 E Thomas Road Phoenix AZ 85014 860380470 Low-income housing and related services to the elderly AZ 501c3 9 N/A St Claire Senior Living Inc 1201 E Thomas Road Phoenix AZ 85014 753021717 Low-income housing and related services to the elderly - in active AZ 501c3 9 N/A FSL Holding Properties LLC 1201 E Thomas Road Phoenix AZ 85014 020605634 Real Estate Rental AZ N/A FSL White Mountain Villas LP 1201 E Thomas Road Phoenix AZ 85014 753233168 Real Estate Rental AZ N/A FSL Ruby Heights Village LP 1201 E Thomas Road Phoenix AZ 85014 753233177 Real Estate Rental AZ N/A FSL Becket House Apartments LP 1201 E Thomas Road Phoenix AZ 85014 205096899 Real Estate Rental AZ N/A Roeser Senior Residences LLC 1201 E Thomas Road Phoenix AZ 85014 861005141 Real Estate Rental AZ N/A Mountain Village Seniors LLC 1201 E Thomas Road Phoenix AZ 85014 830403683 Real Estate Rental AZ N/A FSL Yuma Senior Terraces LP 1201 E Thomas Road Phoenix AZ 85014 200844505 Real Estate Rental AZ N/A FSL Esperanza Village LP 1201 E Thomas Road Phoenix AZ 85014 200844462 Real Estate Rental AZ N/A FSL Collins Court LP 1201 E Thomas Road Phoenix AZ 85014 900646418 Real Estate Rental AZ N/A FSL Gibson Garden Villas LP 1201 E Thomas Road Phoenix AZ 85014 800439718 Real Estate Rental AZ N/A FSL Seton VIllage LP 1201 E Thomas Road Phoenix AZ 85014 800673263 Real Estate Rental AZ N/A FSL Solar ONe LP 1201 E Thomas Road Phoenix AZ 85014 800587023 Real Estate Rental AZ N/A FSL Solar Three LP 1201 E Thomas Road Phoenix AZ 85014 800673255 real Estate Rental AZ N/A FSL Solar Two LP 1201 E Thomas Road Phoenix AZ 85014 800673259 real Estate Rental AZ N/A FSL St Francis Villas LP 1201 E Thomas Road Phoenix AZ 85014 800439708 real Estate Rental AZ N/A FSL St Peter PLace LP 1201 E Thomas Road Phoenix AZ 85014 800559418 real Estate Rental AZ N/A Affordable Services for Seniors Inc 1201 E Thomas Road Phoenix AZ 85014 710869419 Rental Real Estate AZ N/A C FSL White Mountain Inc 1201 E Thomas Road Phoenix AZ 85014 870796482 Rental Real Estate AZ N/A C FSL Ruby Heights Inc 1201 E Thomas Road Phoenix AZ 85014 870796484 Rental Real Estate AZ N/A C FSL Mountain Village Inc 1201 E Thomas Road Phoenix AZ 85014 201094637 Rental Real Estate AZ N/A C FSL Roeser Village Inc 1201 E Thomas Road Phoenix AZ 85014 860462785 Management residential rental AZ N/A C FSL Yuma Senior Terraces I Inc 1201 E Thomas Road Phoenix AZ 85014 870796479 Management residential rental AZ N/A C FSL Collins Inc 1201 E Thomas Road Phoenix AZ 85014 300506152 Rental Real Estate AZ N/A C FSL Gibson Garden Inc 1201 E Thomas Road Phoenix AZ 85014 800439678 Rental Real Estate AZ N/A C FSL Seton Inc 1201 E Thomas Road Phoenix AZ 85014 900646416 Rental Real Estate AZ N/A C FSL Solar 1 Inc 1201 E Thomas Road Phoenix AZ 85014 800587030 rental Real Estate AZ N/A C FSL Solar 2 Inc 1201 E Thomas Road Phoenix AZ 85014 900646941 rental Real Estate AZ N/A C FSL Solar 3 Inc 1201 E Thomas Road Phoenix AZ 85014 900646403 rental Real Estate AZ N/A C FSL St Francis Inc 1201 E Thomas Road Phoenix AZ 85014 800439674 rental Real Estate AZ N/A C FSL St Peter Inc 1201 E Thomas Road Phoenix AZ 85014 800559415 rental Real Estate AZ N/A C 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 1 1 foundation for Senior Living O 957437 Foundation for Senior Living Q 3110000 Foundation for Senior Living R 4494543 FSL Home Improvements N 57671 FSL Home Improvements Q 69915 FSL Management L 955177 FSL Management Q 65000 FSL Pathways K 354907 FSL HOLDING PROPERTIES J 119056