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Nonprofiteer
← FOSS HOME & VILLIAGE

Form 990 for tax year 2022

Filed by FOSS HOME & VILLIAGE.

Totals

Total revenue
$17,968,264
Total expenses
$22,224,545
Contributions and grants received
$294,489
Grants paid
$0
Program service revenue
$17,502,492
Investment income
$11,807
Other revenue
$159,476
Total assets, end of year
$11,552,384
Total liabilities, end of year
$5,570,489
Net assets or fund balances, end of year
$5,981,895
Program services expenses (Part IX)
$16,978,553
Management and general expenses
$5,113,569
Fundraising expenses
$132,423
Program service expenses (Part III)
$16,978,553

Program services were 76.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1f · All other contributions, gifts and grants

    $294,489

  • 2a · Program service revenue: RESIDENT FEES

    total $17,502,492 · related or exempt $17,502,492

  • 3 · Investment income

    total $11,807 · excluded $11,807

  • 6a · Gross rents

    real property $269,875

  • 6b · Less rental expenses

    real property $195,503

  • 6c · Rental income or loss

    real property $74,372

  • 6d · Net rental income or loss

    total $74,372 · excluded $74,372

  • 10a · Gross sales of inventory

    $15,435

  • 10b · Cost of goods sold

    $4,902

  • 10c · Net income from sales of inventory

    total $10,533 · excluded $10,533

  • 11a · Other revenue: MISCELLANEOUS INCOME

    total $74,571 · excluded $74,571

  • 11e · Other revenue, total

    $74,571

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $222,668 · management and general $222,668

  • 7 · Other salaries and wages

    total $10,582,397 · program services $8,236,680 · management and general $2,288,482 · fundraising $57,235

  • 8 · Pension plan contributions

    total $308,901 · program services $235,475 · management and general $71,790 · fundraising $1,636

  • 9 · Other employee benefits

    total $1,126,389 · program services $858,644 · management and general $261,778 · fundraising $5,967

  • 10 · Payroll taxes

    total $966,263 · program services $736,581 · management and general $224,564 · fundraising $5,118

  • 11b · Fees: legal

    total $40,140 · management and general $40,140

  • 11c · Fees: accounting

    total $69,248 · management and general $69,248

  • 11g · Fees: other

    total $4,769,322 · program services $3,737,405 · management and general $1,022,766 · fundraising $9,151

  • 12 · Advertising and promotion

    total $81,623 · management and general $81,017 · fundraising $606

  • 13 · Office expenses

    total $405,868 · program services $216,261 · management and general $137,495 · fundraising $52,112

  • 14 · Information technology

    total $133,214 · program services $106,571 · management and general $26,643

  • 16 · Occupancy

    total $585,955 · program services $364,947 · management and general $221,008

  • 17 · Travel

    total $13,909 · management and general $13,909

  • 20 · Interest

    total $114,885 · management and general $114,885

  • 22 · Depreciation, depletion and amortization

    total $530,518 · program services $503,992 · management and general $26,526

  • 23 · Insurance

    total $356,905 · program services $285,524 · management and general $71,381

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $990,811 · program services $990,600 · management and general $211

  • 24b · Other expenses: FOOD

    total $642,880 · program services $642,880

  • 24c · Other expenses: TAXES & LICENSES

    total $123,529 · management and general $123,529

  • 24d · Other expenses: MISCELLANEOUS EXPENSES

    total $87,274 · program services $158 · management and general $86,518 · fundraising $598

  • 24e · All other expenses

    total $71,846 · program services $62,835 · management and general $9,011

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,639,674 · end of year $292,794

  • 4 · Accounts receivable

    beginning of year $1,512,058 · end of year $2,303,655

  • 8 · Inventories for sale or use

    beginning of year $122,885 · end of year $154,039

  • 9 · Prepaid expenses and deferred charges

    beginning of year $265,825 · end of year $305,489

  • 10a · Land, buildings and equipment: cost or other basis

    $25,289,974

  • 10b · Land, buildings and equipment: accumulated depreciation

    $16,806,970

  • 10c · Land, buildings and equipment, net

    beginning of year $8,791,425 · end of year $8,483,004

  • 11 · Investments: publicly traded securities

    beginning of year $2,140,355 · end of year $4,514

  • 15 · Other assets

    beginning of year $7,512 · end of year $8,889

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,392,087 · end of year $2,656,711

  • 19 · Deferred revenue

    beginning of year $125,678 · end of year $129,486

  • 21 · Escrow or custodial account liability

    beginning of year $7,512 · end of year $8,889

  • 23 · Secured mortgages and notes payable

    beginning of year $3,013,777 · end of year $2,775,403

  • 25 · Other liabilities

    beginning of year $530,868 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $9,836,579 · end of year $5,981,895

  • 28 · Net assets with donor restrictions

    beginning of year $573,233 · end of year $0

Mission and programs · 2022

Mission

NURSING HOME AND ASSISTED LIVING FACILITY.

  • SINCE 1929 FOSS HOME AND VILLAGE HAS PROVIDED CARE FOR THE COMMUNITY IN A NURSING HOME AND ASSISTED LIVING SETTING. FOSS SERVES A POPULATION WITH A SUBSTANTIAL NUMBER OF MEDICAID AND MEDICARE SUPPORTED RESIDENTS AND PATIENTS, WITH 70% OF ITS SERVICE REVENUE FROM MEDICAID/MEDICARE. IN ADDITION TO PROVIDING CARE, FOSS STRIVES TO BE ACTIVE IN THE COMMUNITY BY PARTNERING WITH THE UNIVERSITY OF WASHINGTON, SHORELINE COMMUNITY COLLEGE AND OTHER COLLEGES AND UNIVERSITIES. FOSS PROVIDES A LEARNING ENVIRONMENT FOR INTERNSHIPS BASED IN THE FIELDS OF DENTISTRY, PHARMACY, RESTORATIVE THERAPY, NURSING, AND NURSING ASSISTANT TRAINING. FOSS ALSO HAS AN ACTIVE VOLUNTEER PROGRAM THAT ENCOURAGES HIGH SCHOOL AND COLLEGE STUDENTS. FOSS SERVED 262 NURSING HOME CLIENTS AND 49 ASSISTED LIVING CLIENTS, (CONTINUED IN SCHEDULE O)WITH THE AVERAGE LENGTH OF STAY FOR SHORT-STAY RESIDENTS, DEFINED BY THOSE WHO STAYED 100 DAYS OR LESS, OF APPROXIMATELY 22 DAYS. RATES ARE SET BASED ON THE MARKET IN THE SEATTLE AREA, WHICH ARE NECESSARY TO MAKE THE ORGANIZATION VIABLE.

    Expenses $16,978,553 · Revenue $17,502,492

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Julie Yari

    CHAIR & DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • Jeff West RN

    VICE CHAIR & CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • Kris Chick

    TREASURER

    Total calculated
    $0
    Hours/week
    0.5

  • Judy Wildes

    TRUSTEE & VICE CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • Bev Roach

    TRUSTEE & SECRETARY

    Total calculated
    $0
    Hours/week
    0.5

  • John Rick Henry Jr

    PRESIDENT & CEO (THROUGH APRIL 2022)

    Total calculated
    $222,668
    From this org
    $222,668
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $222,668
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $222,668

  • R Kevin McFeely

    PRESIDENT/CEO

    Total calculated
    $449,782
    From this org
    $0
    From related orgs
    $414,994
    Other
    $34,788
    Hours/week
    20 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $414,994 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $34,788 related
    Filer's total
    $0 + $449,782 related

  • Nancy Mohrman

    ALU DIRECTOR

    Total calculated
    $284,074
    From this org
    $284,074
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $284,074
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $284,074

  • Laura Molzahn

    EXECUTIVE DIRECTOR

    Total calculated
    $216,141
    From this org
    $216,141
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $216,141
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $216,141

  • Solomon G-Kidane LPN

    NURSE

    Total calculated
    $187,087
    From this org
    $187,087
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $187,087
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $187,087

  • Banafsheh Baharloo RN

    NURSE

    Total calculated
    $185,647
    From this org
    $185,647
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $185,647
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $185,647

  • Milagros Almazan

    NURSE

    Total calculated
    $148,280
    From this org
    $148,280
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Form 990 of other organizations
  • 3 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4B
JOHN (RICK) HENRY, JR. PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2022, $0 WAS CONTRIBUTED TO THE PLAN, $0 ACCRUED WITHIN THE PLAN, AND $106,111 WAS PAID OUT OF THE PLAN. NANCY MOHRMAN PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2022, $0 WAS CONTRIBUTED TO THE PLAN, $0 ACCRUED WITHIN THE PLAN, AND $238,501 WAS PAID OUT OF THE PLAN. LAURA MOLZAHN PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2022, $0 WAS CONTRIBUTED TO THE PLAN, $0 ACCRUED WITHIN THE PLAN, AND $186,256 WAS PAID OUT OF THE PLAN.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
14 November 2023
IRS schema version
2022v5.0
Source object
202333199349310008

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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