2024-07-11T10:52:41-05:00 2023-08-31 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2022-09-01 943382224 VALLEYCARE SENIOR HOUSING INC % NICOLE PEDIGO VALL 9258473000 1111 E STANLEY BOULEVARD LIVERMORE CA 94550 KYLE WICHELMANN CFO 9258473000 2024-07-10 true KYLE WICHELMANN 999009999 ROBERT W FRIZ P00438748 2673303000 2024-06-27 3 2022 2023-04-26 12:10:37Z RICHARD SHUMWAY 1111 E STANLEY BOULEVARD LIVERMORE CA 94550 0 false X WWW.VALLEYCARE.COM X 2001 CA VALLEYCARE SENIOR HOUSING WAS DEVELOPED TO OFFER INDEPENDENT AND ASSISTED HOUSING FOR SENIORS, OVER 62 YEARS OLD IN THE COMMUNITY WITH A PORTION BEING LOW INCOME. 3 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1084970 1084970 0 0 1084970 1084970 VALLEYCARE SENIOR HOUSING WAS DEVELOPED TO OFFER INDEPENDENT AND ASSISTED HOUSING FOR SENIORS, OVER 62 YEARS OLD IN THE COMMUNITY WITH A PORTION BEING LOW INCOME. false false 0 0 0 VALLEYCARE SENIOR HOUSING WAS DEVELOPED TO OFFER INDEPENDENT AND ASSISTED HOUSING FOR SENIORS, OVER 62 YEARS OLD IN THE COMMUNITY WITH A PORTION BEING LOW INCOME. 0 true false false false false false false false false false true false false false false true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 0 0 0 false false false false false false false false false false false false X 3 1 true false false false true true true true true false false true true true true true true false false false CA X NICOLE PEDIGO 9258473000 1111 E STANLEY BOULEVARD LIVERMORE CA 94550 DAVID ENTWISTLE DIRECTOR 0.2 56.45 X 0 4675833 438576 LINDA HOFF DIRECTOR 0.2 54.45 X 0 1850502 187068 RICHARD SHUMWAY PRESIDENT & CEO 0.2 70.2 X 0 1279934 294382 KYLE WICHELMANN CFO 0.2 50.2 X 0 517853 78781 DIANE GRUNSKY SECRETARY (UNTIL 11/22) 0.2 49.8 X 0 148585 21507 JACQUELINE STEIN FORMER SECRETARY 0.0 50.0 X 0 129018 7251 SOLEIL CANLAS SECRETARY (AS OF 11/22) 0.0 50.0 X 0 74400 14255 JOHN SENSIBA CHAIR 0.2 1.6 X 0 0 0 0 8676125 1041820 0 true true false 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1084970 1084970 1084970 0 0 0 0 0 0 0 0 0 0 1084970 1084970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 1084970 1084970 0 0 1084970 1084970 1084970 1084970 0 X false true X true false X X 1 STANFORD HEALTH CARE TRI-VALLEY 941429628 3 true 0 0 1 0 0 true false false false false false false false false false false false false false false true false 1084970 1084970 1084970 0 0 X PART X, LINE 2 FIN 48 SHC AND ITS SUBSIDIARIES HAVE NO UNCERTAIN TAX POSITIONS PERTAINING TO UNRELATED BUSINESS INCOME. false true false false false false false false false DAVID ENTWISTLE DIRECTOR 0 2007529 0 2071871 0 596433 0 382562 0 56014 0 5114409 0 335777 LINDA HOFF DIRECTOR 0 998588 0 689306 0 162608 0 152645 0 34423 0 2037570 0 113922 RICHARD SHUMWAY PRESIDENT & CEO 0 669463 0 536733 0 73738 0 254430 0 39952 0 1574316 0 125001 KYLE WICHELMANN CFO 0 395368 0 120484 0 2001 0 52671 0 26110 0 596634 0 0 DIANE GRUNSKY SECRETARY (UNTIL 11/22) 0 126991 0 1500 0 20094 0 7516 0 13991 0 170092 0 0 JACQUELINE STEIN FORMER SECRETARY 0 125258 0 3500 0 260 0 6263 0 988 0 136269 0 0 SCHEDULE J, PART I, LINE 3 A RELATED ORGANIZATION, STANFORD HEALTH CARE TRI-VALLEY ("SHC TRI-VALLEY"), COMPENSATES THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. SHC TRI-VALLEY USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OF GOVERNORS. SCHEDULE J, PART I, LINE 4B STANFORD HEALTH CARE ("SHC"), A RELATED ORGANIZATION, PROVIDES ALL SENIOR EXECUTIVES WITH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS. FOR EACH CALENDAR YEAR, A HYPOTHETICAL ACCOUNT IS ESTABLISHED FOR EACH PARTICIPANT AND CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION) AS OF THE LAST DAY OF EACH QUARTER. THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN EACH CALENDAR YEAR ACCOUNT ON THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE SECOND CALENDAR YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED (OR, IF LATER, THE DATE ON WHICH THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION). THE PARTICIPANT BECOMES FULLY VESTED IN HIS OR HER ACCOUNTS UNDER THE SERP UPON THE EARLIEST OF (A) DISCHARGE FROM EMPLOYMENT WITHOUT CAUSE; (B) ENTITLEMENT TO LONG-TERM DISABILITY INCOME BENEFITS; (C) ATTAINMENT OF AGE OF 60 WHILE EMPLOYED OR IF LATER, THE PARTICIPANT'S COMPLETION OF TWO FULL YEARS OF PARTICIPATION; (D) COMPLETION OF SEVEN YEARS AS AN ELIGIBLE EMPLOYEE; OR (E) DEATH. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING INDIVIDUALS IN CALENDAR YEAR 2022: DAVID ENTWISTLE $346,221 LINDA HOFF $117,466 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). AMOUNTS CREDITED AND DISCLOSED ON THE FORM 990 IN PRIOR YEARS THAT VESTED AND WERE PAID IN CALENDAR 2022 ARE REPORTED IN COLUMN (F). SHC TRI-VALLEY'S PRESIDENT PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT HIS RETIREMENT BENEFITS. UNDER THE PLAN, A HYPOTHETICAL ACCOUNT IS ESTABLISHED FOR THE PARTICIPANT AND CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY AS OF THE LAST DAY OF EACH QUARTER. THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. THE PARTICIPANT BECOMES VESTED IN EACH CALENDAR YEAR ACCOUNT ON THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE SECOND CALENDAR YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED (OR, IF LATER, THE DATE ON WHICH THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION). THE PARTICIPANT BECOMES FULLY VESTED IN HIS OR HER ACCOUNTS UNDER THE SERP UPON THE EARLIEST OF (A) DISCHARGE FROM EMPLOYMENT WITHOUT CAUSE; (B) ENTITLEMENT TO LONG-TERM DISABILITY INCOME BENEFITS; (C) ATTAINMENT OF AGE OF 60 WHILE EMPLOYED OR IF LATER, THE PARTICIPANT'S COMPLETION OF TWO FULL YEARS OF PARTICIPATION; (D) COMPLETION OF SEVEN YEARS AS AN ELIGIBLE EMPLOYEE; OR (E) DEATH. THE FOLLOWING AMOUNT BECAME VESTED AND WAS PAID TO RICHARD SHUMWAY IN CALENDAR YEAR 2022: $65,868. AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). SCHEDULE J, PART II, COLUMN B(III) OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN (III) INCLUDES ACCRUED VACATION PAY OUT, GROUP TERM LIFE, SERP DISTRIBUTION, IMPUTED INTEREST FOR MORTGAGE LOAN FORGIVENESS, AND ADDITIONAL PAY. SCHEDULE J, PART II DIRECTORS ARE NOT COMPENSATED IN THEIR CAPACITY AS DIRECTORS OF VALLEYCARE SENIOR HOUSING, INC. HOWEVER, THE INDIVIDUALS LISTED WERE ALSO EMPLOYEES OF RELATED ORGANIZATIONS, POSITIONS FOR WHICH THEY RECEIVED COMPENSATION AS REPORTED IN PART II. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF STANFORD HEALTH CARE: DAVID ENTWISTLE LINDA HOFF THE FOLLOWING INDIVIDUALS ARE BOARD MEMBERS AT STANFORD HEALTH CARE: DAVID ENTWISTLE THE FOLLOWING INDIVIDUALS ARE VOTING BOARD MEMBERS AT SUMIT HOLDING INTERNATIONAL, LLC: DAVID ENTWISTLE LINDA HOFF THE FOLLOWING INDIVIDUALS ARE VOTING BOARD MEMBERS AT SUMIT INSURANCE COMPANY, LTD.: DAVID ENTWISTLE LINDA HOFF THE FOLLOWING INDIVIDUALS ARE CLASS A SUBSCRIBER VOTING MEMBERS AT THE PROFESSIONAL EXCHANGE ASSURANCE COMPANY: (AS OF 9/1/2023) DAVID ENTWISTLE LINDA HOFF THE FOLLOWING INDIVIDUAL IS A MANAGER AT STANFORD PET-CT LLC: DAVID ENTWISTLE THE FOLLOWING INDIVIDUAL IS A DIRECTOR AT LUCILE SALTER PACKARD CHILDREN'S HOSPITAL: DAVID ENTWISTLE FORM 990, PART VI, SECTION A, LINE 6 STANFORD HEALTH CARE TRI-VALLEY ("SHC TRI-VALLEY") IS THE CORPORATE MEMBER OF VALLEYCARE SENIOR HOUSING, INC. FORM 990, PART VI, SECTION A, LINE 7A VALLEYCARE SENIOR HOUSING, INC. IS A TYPE I SUPPORTING ORGANIZATION. ITS BOARD MEMBERS ARE ELECTED BY MEMBERS OF ITS SUPPORTED ORGANIZATION, SHC TRI-VALLEY, EIN: 94-1429628. FORM 990, PART VI, SECTION A, LINE 7B VALLEYCARE SENIOR HOUSING, INC. IS A TYPE I SUPPORTING ORGANIZATION. APPROVAL BY ITS SUPPORTED ORGANIZATION, SHC TRI-VALLEY, EIN: 94-1429628, IS NEEDED FOR THE FOLLOWING: - ENACTMENT, AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION - ENACTMENT OR AMENDMENT OF THE BYLAWS OF THE CORPORATION - MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION - SALE, LEASE, CONVEYANCE EXCHANGE OR TRANSFER OF SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS - THE CORPORATION'S ANNUAL BUDGET - CORPORATION'S ASSUMPTION OF ANY INDEBTEDNESS OTHER THAN INDEBTEDNESS INCURRED IN THE NORMAL COURSE OF BUSINESS - PLAN FOR FUNDRAISING BY OR ON BEHALF OF THE CORPORATION - CORPORATION'S ENGAGEMENT IN ANY ACTIVITY OTHER THAN ACTIVITIES THAT SUPPORT THE CHARITABLE PURPOSE OF THE MEMBER - ANY OTHER ACTION REQUIRED TO BE APPROVED BY THE MEMBER UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE DEPARTMENT REVIEWS THE FORM 990 FOR ACCURACY. PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE, A COMPLETE COPY OF THE FORM 990 IS SENT ELECTRONICALLY TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW. THE CHIEF FINANCIAL OFFICER REVIEWED THE FORM 990 WITH THE AUDIT COMMITTEE AND INVITED QUESTIONS. FOLLOWING THIS REVIEW, A FULL COPY OF THE FINAL RETURN IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING. ONCE THESE STEPS ARE COMPLETE, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") WITHIN 30 DAYS OF BEGINNING SERVICE AT SHC-TV. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS. FURTHERMORE, OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO UPDATE THEIR DISCLOSURE STATEMENT WITHIN TEN (10) BUSINESS DAYS OF A MATERIAL CHANGE IN THEIR SITUATIONS THAT MAY CREATE AN ACTUAL OR PERCEIVED CONFLICT-OF-INTEREST. A DISCLOSURE THAT APPEARS TO BE A CONFLICT WILL BE RESOLVED BY A MUTUAL AGREEABLE PLAN WITH THE VICE PRESIDENT OF HUMAN RESOURCES THAT OUTLINES THE STEPS THE OFFICER, DIRECTOR OR KEY EMPLOYEE MUST TAKE TO RECTIFY THE CONFLICT. IN MATTERS THAT ARE UNCLEAR OR QUESTIONABLE, THE OFFICE OF CHIEF COMPLIANCE OFFICER WILL BE CONSULTED FOR A RULING. IF FURTHER INQUIRY IS NECESSARY THE OFFICE OF THE GENERAL COUNSEL WILL DETERMINE THE APPROPRIATE COURSE OF ACTION. FORM 990, PART VI, SECTION B, LINES 15A & 15B A RELATED ORGANIZATION, SHC TRI-VALLEY, PAYS THE TOP MANAGEMENT OFFICIAL. SHC TRI-VALLEY'S COMPENSATION PROCESS INCLUDED THE SERVICES OF WILLIS TOWERS WATSON FOR COMPENSATION BENCHMARKING, ANALYSIS, AND REPORTING. THE BOARD OF DIRECTORS HAS A COMPENSATION SUB-COMMITTEE WHO REVIEW THE RESULTS OF THE COMPENSATION REVIEW AND IS ASSURED THAT TOTAL COMPENSATION IS CONSISTENT WITH THE MARKET. THIS PROCESS WAS LAST PERFORMED IN NOVEMBER 2023. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING/ORGANIZING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VIII REVENUE: ACCORDING TO LAND LEASE AGREEMENT, VALLEYCARE SENIOR HOUSING WILL REPORT INCOME WHEN OPERATIONS BECOMES PROFITABLE. THE BRD OF TRUST LELAND STANF JR UNIV 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 941156365 EDUCATION CA 501(C)(3) 2 NA false FUNDACION STANFORD UNIVERSITY EN CHILE AV CONDELL 189 PROVIDENCIA SANTIAGO CI EDUCATION CI 501(C)(3) STANFORD true STANFORD HEALTH CARE TRI-VALLEY 1111 E STANLEY BLVD LIVERMORE CA 94550 941429628 HOSPITAL CA 501(C)(3) 3 SHC true JAEDAN BUPIN STANFORD CENTER IN THE REPU RESEARCH KS 501(C)(3) N/A STANFORD true LUCILE PACKARD FOUNDATION FOR CHILDREN'S 400 HAMILTON AVENUE SUITE 340 PALO ALTO CA 94301 770440090 HEALTHCARE CA 501(C)(3) 7 LPCH true LUCILE SALTER PACKARD CHILDRENS HOSPITAL 725 WELCH ROAD MC 5553 PALO ALTO CA 94304 770003859 HEALTHCARE CA 501(C)(3) 3 STANFORD true PACKARD CHILDREN'S HEALTH ALLIANCE 725 WELCH ROAD MC5551 PALO ALTO CA 94304 320359189 HEALTHCARE CA 501(C)(3) 3 LPCH true SHR HOLDINGS INC 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 943187167 REAL ESTATE CA 501(C)(25) N/A STANFORD true STANFORD FACULTY CLUB PO BOX 7229 STANFORD CA 94309 941187089 FAC INTERACT. CA 501(C)(7) N/A STANFORD true STANFORD FEDERAL CREDIT UNION 1860 EMBARCADERO RD PALO ALTO CA 94303 941492212 CREDIT UNION CA 501(C)(1) N/A STANFORD true STANFORD HABITAT CONSERVATION BOARD 415 BROADWAY REDWOOD CITY CA 94063 461882243 CONSERVATION CA 501(C)(3) 7 STANFORD true STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD CA 94305 946174066 HEALTHCARE CA 501(C)(3) 3 STANFORD true STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BLDG 11 CAPE TOWN SF EDUCATION SF 501(C)(3) N/A STANFORD true STANFORD UNIVERSITY BOOKSTORE 505 BROADWAY 6TH FLOOR MC 1065 REDWOOD CITY CA 94063 940894150 SUPPORT CA 501(C)(3) 12A, I STANFORD true SU EMP BEN TRUST POST RETEMPYNT BEN 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 943246199 BENEFITS CA 501(C)(9) N/A STANFORD true THE DUDLEY E CHAMBERS FOUNDATION JP MORGAN CHASE PO BOX 3038 MILWAUKEE WI 53201 386841793 SUPPORT NY 501(C)(3) 12D, III-O STANFORD true THE FREIDENRICH SUPPORT FOUNDATION 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 300519583 SUPPORT CA 501(C)(3) 12A, I STANFORD true THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD CAUSEWAY HK 986078093 SUPPORT HK 501(C)(3) N/A STANFORD true THE STANFORD TRUST 65 HIGH STREET OXFORD UK OX1 46L SUPPORT UK 501(C)(3) N/A STANFORD true UNIVERSITY HEALTHCARE ALLIANCE 7999 GATEWAY BLVD STE 300 NEWARK CA 94560 943192446 HEALTHCARE CA 501(C)(3) 3 SHC true VALLEYCARE MEDICAL FOUNDATION INC 1111 E STANLEY BLVD LIVERMORE CA 94550 262593526 SR. 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SCHEDULE R, PART IV CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. CHARITABLE LEAD UNITRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. OTHER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. POOLED INCOME FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, COLUMNS (F), (G), (H) AND (I) RESPONSE IS "N/A" FOR ALL ORGANIZATIONS.