2023-10-31T12:49:39-05:00 2022-12-31 912011386 JACOBSON JARVIS & CO PLLC 200 1ST AVE W SUITE 200 SEATTLE WA 98119 990 2022-01-01 911154904 KLINE GALLAND CENTER KLIN 2067258800 7500 SEWARD PARK AVENUE SOUTH SEATTLE WA 98118 JEFFREY COHEN CEO 2067258800 2023-10-25 1 JEFFREY COHEN 999009999 0 JACOB J DEHNE CPA P02534988 2066288990 2023-10-25 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z JEFFREY COHEN 7500 SEWARD PARK AVENUE SOUTH SEATTLE WA 98118 7268806 0 X WWW.KLINEGALLAND.ORG X 1982 WA PROVIDES FINANCIAL SUPPORT TO THREE NON-PROFIT AFFILIATED ORGANIZATIONS THAT PROVIDE SERVICES TO THE ELDERLY. 36 33 0 36 0 0 7415565 5064559 0 0 4659608 1576666 212115 225338 12287288 6866563 2686337 1322459 0 0 949424 848416 0 0 936351 814318 1013292 4450079 3184167 7837209 3682396 59836658 57329189 5093357 6747000 54743301 50582189 THE KLINE GALLAND CENTER PROVIDES FINANCIAL SUPPORT TO THREE NON-PROFIT AFFILIATED ORGANIZATIONS THAT PROVIDE SERVICES TO THE ELDERLY. 0 0 1324383 1322459 TO PROVIDE FINANCIAL SUPPORT FOR 3 RELATED NON-PROFIT ORGANIZATIONS - CAROLINE KLINE GALLAND HOME, POLACK ADULT DAY CENTER, AND THE SUMMIT AT FIRST HILL. 1324383 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 1 1 1 0 0 0 0 0 1 1 1 0 0 1 13 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 36 33 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA CA FL NJ NY OR X TRACEY GROSCOST 2067258800 7500 SEWARD PARK AVENUE SOUTH SEATTLE WA 98118 JEFF COHEN CHIEF EXECUTIVE OFFICER 4.80 35.20 X 0 752083 58292 TRACEY GROSCOST CHIEF FINANCIAL OFFICER 4.84 35.47 X 0 312151 9481 NATHAN NUSBAUM CHIEF DEVELOPMENT OFFICER 40.00 0.00 X 0 302637 39778 ERIN SHERIDAN CHIEF COMPLIANCE OFFICER AND GENERAL COUNSEL 4.20 30.80 X 0 157740 6546 IRENE FISHER CHAIRMAN 0.50 3.00 X X 0 0 0 ROBERT SIMON VICE CHAIRMAN 0.50 3.00 X X 0 0 0 JAY RIFFKIN TREASURER 0.50 3.00 X X 0 0 0 BARBARA SULMAN SECRETARY 0.50 3.00 X X 0 0 0 JACK ALMO PAST CHAIRMAN 0.50 3.00 X X 0 0 0 JEANIE ALHADEFF DIRECTOR 0.50 1.50 X 0 0 0 BECKY BENAROYA DIRECTOR 0.50 0.00 X 0 0 0 DAVID BENOLIEL DIRECTOR 0.50 0.00 X 0 0 0 MARC BRIDGE DIRECTOR 0.50 1.50 X 0 0 0 MARLENE BURNS DIRECTOR 0.50 0.00 X 0 0 0 MICHAEL COHEN DIRECTOR 0.50 1.50 X 0 0 0 LILLY DEJAEN DIRECTOR 0.50 0.00 X 0 0 0 LYNN DUBEY DIRECTOR 0.50 1.50 X 0 0 0 DAVID FAIN DIRECTOR 0.50 1.50 X 0 0 0 STEVEN FRIEDMAN DIRECTOR 0.50 0.00 X 0 0 0 LAUREN JASSNY DIRECTOR 0.50 0.00 X 0 0 0 MARK KANE DIRECTOR 0.50 1.50 X 0 0 0 IRVIN KARL DIRECTOR 0.50 0.00 X 0 0 0 THOMAS LEAVITT DIRECTOR 0.50 0.00 X 0 0 0 ALVIN MARTIN DIRECTOR 0.50 0.00 X 0 0 0 RABBI JAMES MIREL DIRECTOR 0.50 1.50 X 0 0 0 MICHAEL MORGAN DIRECTOR 0.50 1.50 X 0 0 0 SALLY NARODICK DIRECTOR 0.50 0.00 X 0 0 0 JEFF PIHA DIRECTOR 0.50 1.50 X 0 0 0 BRIAN QUINT DIRECTOR 0.50 1.50 X 0 0 0 ARI ROBICSEK DIRECTOR 0.50 1.50 X 0 0 0 DOUGLAS ROSEN DIRECTOR 0.50 1.50 X 0 0 0 ARTHUR RUBINFELD DIRECTOR 0.50 0.00 X 0 0 0 GARY SCHWARTZ DIRECTOR 0.50 1.50 X 0 0 0 STEVEN SCHWARTZ DIRECTOR 0.50 1.50 X 0 0 0 DAVID SHAPIRO DIRECTOR 0.50 1.50 X 0 0 0 IANTHA SIDELL DIRECTOR 0.50 1.50 X 0 0 0 ALLAN STEINMAN DIRECTOR 0.50 1.50 X 0 0 0 DORIS STIEFEL DIRECTOR 0.50 0.00 X 0 0 0 DOUG WIVIOTT DIRECTOR 0.50 1.50 X 0 0 0 ELANA ZANA DIRECTOR 0.50 1.50 X 0 0 0 0 1524611 114097 0 0 1 0 GOLDMAN SACHS 719 2ND AVE 1300 SEATTLE WA 98104 INVESTMENT MANAGEMENT 229085 CC INC 1011 WESTERN AVE STE 702 SEATTLE WA 98104 PUBLIC RELATIONS 102900 2 5064559 5064559 1576053 1576053 225338 0 225338 225338 225338 402856 402243 613 613 613 6866563 0 0 1802004 1322459 1322459 522600 180185 342415 209658 88799 120859 17724 10565 7159 54337 11817 42520 44097 18175 25922 28639 28639 53508 53508 229085 229085 142855 1924 140931 161227 55398 105829 47869 4222 43647 69800 69800 142032 142032 7707 4339 3368 1300 1300 10433 10433 5667 5667 6655 6655 OTHER EXPENSES 106515 2814 103701 3184167 1324383 923433 936351 2189006 1839537 38374 42872 104200 61700 39521 11395 750000 750000 9185 11768 2174038 870548 1309157 1303490 49663800 47789611 3776046 3617560 1957369 1901256 59836658 57329189 120988 109512 4972369 6637488 5093357 6747000 X 53856465 49816755 886836 765434 54743301 50582189 59836658 57329189 3682396 -7843508 0 X 0 1 X 1 1 1 X X 3 POLACK ADULT DAY CENTER 911154902 10 1 39000 0 THE SUMMIT AT FIRST HILL 911973348 10 1 608459 0 CAROLINE KLINE GALLAND HOME 910950710 10 1 675000 0 3 1322459 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1299715 1299715 768125 768125 0 106198 102423 3775 1303490 HEDGE FUNDS AND PRIVATE EQUITY 3617560 F 3617560 LIFE INSURANCE LIABILITY 1248862 DUE TO AFFILIATES 5237505 CHARITABLE GIFT ANNUITY LIABILITY 151121 6637488 1 THE SUMMIT AT FIRST HILL 7500 SEWARD PARK AVE S SEATTLE WA 98118 911973348 501(C)(3) 608459 0 FINANCIAL SUPPORT CAROLINE KLINE GALLAND HOME 7500 SEWARD PARK AVE S SEATTLE WA 98118 910950710 501(C)(3) 675000 0 FINANCIAL SUPPORT POLACK ADULT DAY CENTER 7500 SEWARD PARK AVE S SEATTLE WA 98118 911154902 501(C)(3) 39000 0 FINANCIAL SUPPORT 3 PART I, LINE 2: GRANTS MADE BY THE ORGANIZATION ARE EITHER TO RELATED ORGANIZATIONS OR TO EMPLOYEES OF RELATED ORGANIZATIONS FOLLOWING GRANT-MAKING LINE 2 PROCEDURES FOR GRANTS TO INDIVIDUALS. AS SUCH, THE GRANTS ARE MONITORED ON A CONTINUAL BASIS. 0 0 0 0 0 0 0 0 0 JEFF COHEN CHIEF EXECUTIVE OFFICER 0 703056 0 40557 0 8470 0 35750 0 22542 0 810375 0 0 TRACEY GROSCOST CHIEF FINANCIAL OFFICER 0 309410 0 2741 0 0 0 9150 0 331 0 321632 0 0 NATHAN NUSBAUM CHIEF DEVELOPMENT OFFICER 0 299935 0 2702 0 0 0 5353 0 34425 0 342415 0 0 ERIN SHERIDAN CHIEF COMPLIANCE OFFICER AND GENERAL 0 151508 0 6232 0 0 0 0 0 6546 0 164286 0 0 FORM 990, PART VII, SECTION A, LINE 4: THE COMPENSATION AMOUNTS REPORTED IN PART VII WERE PAID BY KLINE GALLAND PAYROLL COMPANY LLC, WHICH SERVES AS THE MASTER PAYROLL COMPANY FOR THIS ENTITY AND THOSE RELATED ENTITIES LISTED IN SCHEDULE R, PART II. JEFFREY COHEN CEO LIFE INSURANCE PREMIUMS X 150000 750000 0 1 1 750000 MICHAEL COHEN FAMILY 102900 PUBLIC RELATIONS 0 JAY RIFFKIN OWNER 20954 LEGAL SERVICES 0 SCHEDULE L, PART IV: THE ORGANIZATION CONTRACTS WITH COLEHOUR AND COHEN FOR PUBLIC RELATIONS SERVICES. THE SON OF MICHAEL COHEN, A BOARD MEMBER, IS AN OWNER OF COLEHOUR AND COHEN. AS SUCH, THE TRANSACTIONS HAVE BEEN DISCLOSED IN ACCORDANCE WITH IRS INSTRUCTIONS.THE ORGANIZATION CONTRACTS WITH DORSEY WHITNEY FOR LEGAL SERVICES. THE TREASURER, JAY RIFFKIN, IS AN OWNER OF DORSEY WHITNEY. AS SUCH, THE TRANSACTIONS HAVE BEEN DISCLOSED IN ACCORDANCE WITH IRS INSTRUCTIONS. FORM 990, PART VI, SECTION A, LINE 6 DONORS ARE MEMBERS AND HAVE THE RIGHT TO APPROVE SIGNIFICANT DECISIONS OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED FIRST BY THE CFO, AND THEN THE CEO AND ALL MEMBERS OF THE BOARD RECEIVE A DRAFT PRIOR TO THE FILING OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C DESIGNATED COMPLIANCE OFFICER REPORTS TO THE BOARD AND CEO THAT OVERSEES COMPLIANCE AND ADHERENCE TO APPLICABLE LAWS, RULES, AND REGULATIONS. FORM 990, PART VI, SECTION B, LINE 15 A COMMITTEE OF THE BOARD DETERMINES THE CEO'S COMPENSATION BY CONSULTING A NATIONAL SALARY SURVEY. COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE DETERMINED VIA LOCAL SALARY SURVEYS. 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 BY REQUEST. CAROLINE KLINE GALLAND HOME 7500 SEWARD PARK AVE S SEATTLE WA 98118 910950710 NURSING CARE WA 501(C)(3) LINE 10 KGC 1 THE SUMMIT AT FIRST HILL 7500 SEWARD PARK AVE S SEATTLE WA 98118 911973348 INDEPENDENT AND ASSISTED LIVING WA 501(C)(3) LINE 10 KGC 1 POLACK ADULT DAY CENTER 7500 SEWARD PARK AVE S SEATTLE WA 98118 911154092 ADULT DAY CARE WA 501(C)(3) LINE 10 KGC 1 POLACK FAMILY SUPPORTING FOUNDATION 7500 SEWARD PARK AVE S SEATTLE WA 98118 911289467 SUPPORT WA 501(C)(3) LINE 12A, I KGC 1 CAROLINE KLINE GALLAND TESTAMENTARY TRUST 7500 SEWARD PARK AVE S SEATTLE WA 98118 910567729 SUPPORT WA 501(C)(3) LINE 12A, I KGC 1 KLINE GALLAND CENTER FOUNDATION 7500 SEWARD PARK AVE S SEATTLE WA 98118 911973347 SUPPORT WA 501(C)(3) LINE 12A, I KGC 1 KLINE GALLAND PAYROLL COMPANY LLC 7500 SEWARD PARK AVE S SEATTLE WA 98118 912087012 COMMON PAYMASTER WA KGC C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 THE SUMMIT AT FIRST HILL B 608459 CASH CAROLINE KLINE GALLAND HOME B 675000 CASH POLACK ADULT DAY CENTER B 39000 CASH