2024-11-15T14:26:10-06:00 2023-12-31 540504608 BROWN EDWARDS & COMPANY LLP 3906 ELECTRIC ROAD ROANOKE VA 24018 990 2023-01-01 900345214 KISSITO HEALTHCARE INC AND AFFILIATES KISS 5402650322 7500 SHADWELL DRIVE NO D ROANOKE VA 24019 THOMAS E CLARKE PRESIDENT 5402650322 2024-11-15 1 0 RICHARD HEDLEY P00936170 5403450936 2024-11-15 2023 2024-10-15 13:58:12Z X THOMAS E CLARKE 7500 SHADWELL DRIVE NO D ROANOKE VA 24019 71403814 1 1 9429 X WWW.KISSITO.ORG X 1988 IL KISSITO HEALTHCARE IS A NON-PROFIT ORGANIZATION THAT SEEKS TO SERVE THE WORLD'S MOST VERNERABLE POPULATIONS. KISSITO MANAGES AND COORDINATES THE OVERALL HEALTHCARE FOR THE FRAIL AND ELDERLY POPULATION IN SKILLED NURSING FACILITIES. X 3 2 1822 50 0 0 0 0 69156085 71386506 7522 17308 700 0 69164307 71403814 0 0 0 0 34351028 33964358 0 0 0 30556309 32576750 64907337 66541108 4256970 4862706 61263756 0 45133838 0 16129918 0 X KISSITO HEALTHCARE EXISTS FOR THE BETTERMENT AND CARE OF HUMAN LIFE. WE SEEK TO PROVIDE VULNERABLE POPULATIONS WITH LOW-COST, HIGH IMPACT HEALTHCARE SOLUTIONS THAT IMPROVE OUTCOMES AND SAVE LIVES. 0 1 63116128 71386506 PROVIDING LONG-TERM CARE FOR THE ELDERLY AND HANDICAPPED IN THE FORM OF MEDICAL SERVICES. 63116128 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 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 1 96 0 1 1822 1 0 0 0 0 0 0 0 0 0 0 X 3 2 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X KATIE M PERRY 5402650322 5228 VALLEYPOINT PARKWAY BLDG B STE ROANOKE VA 24019 THOMAS M CLARKE PRESIDENT 2.00 3.00 X X 0 230000 0 ANA VELASQUEZ CLARKE CHAIRMAN OF THE BOARD 2.00 3.00 X X 0 8765 0 TIMOTHY DIXON SECRETARY 2.00 3.00 X X 0 121063 11308 ROBERT MCCLINTIC CHIEF EXECUTIVE OFFICER 10.00 30.00 X 0 691904 38703 KATIE PERRY CHIEF FINANCIAL OFFICER 10.00 30.00 X 0 257833 14580 MARY FERRELL VICE PRESIDENT OF OPERATIONS 30.00 10.00 X 0 231537 0 ROBERT NELSON ADMINISTRATOR 40.00 X 184154 0 0 BLANCHE HAIRSTON LPN 40.00 X 171430 0 0 CHERYL RAMEY DIRECTOR OF NURSING 40.00 X 155974 0 0 CHARLES O'BRIANT FLYNN ADMINISTRATOR 40.00 X 148511 0 0 RAKISHA SPENCER LPN 40.00 X 143477 0 0 803546 1541102 64591 23 0 1 0 MEDLINE INDUSTRIES THREE LAKES DRIVE NORTHFIELD IL 60093 SUPPLIES 1392033 SYSCO FOOD SERVICE 5081 S VALLEY PIKE HARRISONBURG VA 22801 SUPPLIES 1364454 COMMONWEALTH HOME HEALTHCARE INC 1900 APPERSON DR SALEM VA 24153 STAFFING 1113911 OMNICARE INC PO BOX 9482 CINCINNATI OH 45202 SUPPLIES 954731 GALE HEALTHCARE SOLUTIONS LLC 3101 W DR MLK JR BOULEVARD SUITE TAMPA FL 33607 STAFFING 776187 5 NURSING CARE 623000 67434149 67434149 VALUE-BASED PURCHASING (VBP) PAYM 623000 3698159 3698159 OTHER RESERVE 623000 254198 254198 71386506 17308 17308 71403814 71386506 0 17308 31457419 31457419 458704 458704 2048235 2048235 3424980 3424980 10225751 10225751 9960940 9960940 57516 57516 31524 31524 828649 828649 DIETARY & NUTRITION EXP 4374241 4374241 PURCHASED SERVICES 1721294 1721294 ACTIVITES & SOCIAL SERV 1104059 1104059 LAUNDRY & LINEN 493464 493464 354332 354332 66541108 63116128 3424980 0 1357102 0 0 0 6392625 0 0 0 0 0 137954 0 0 34752796 0 0 0 0 0 18623279 0 61263756 0 7313151 1868102 35952585 0 45133838 0 X 16129918 0 16129918 0 61263756 0 X 4862706 -20992624 X X 0 1 X 1 0 X 587783 6509800 0 7097583 48310574 66393063 66426420 69156085 71386506 321672648 48898357 72902863 66426420 69156085 71386506 328770231 0 0 0 328770231 52590 13169 16844 7522 17308 107433 52590 13169 16844 7522 17308 107433 295373 5881770 3084317 700 9262160 49246320 78797802 69527581 69164307 71403814 338139824 0.97230 0.97400 0.00030 0.00130 X 0 0 0 0 0 0 0 0 0 ROBERT MCCLINTIC CHIEF EXECUTIVE OFFICER 0 691904 0 0 0 0 0 26907 0 11796 0 730607 0 0 KATIE PERRY CHIEF FINANCIAL OFFICER 0 257833 0 0 0 0 0 6805 0 7775 0 272413 0 0 MARY FERRELL VICE PRESIDENT OF OPERATIONS 0 231537 0 0 0 0 0 0 0 0 0 231537 0 0 THOMAS M CLARKE PRESIDENT 0 230000 0 0 0 0 0 0 0 0 0 230000 0 0 ROBERT NELSON ADMINISTRATOR 184154 0 0 0 0 0 0 0 0 0 184154 0 0 0 BLANCHE HAIRSTON LPN 171430 0 0 0 0 0 0 0 0 0 171430 0 0 0 CHERYL RAMEY DIRECTOR OF NURSING 155974 0 0 0 0 0 0 0 0 0 155974 0 0 0 PART I, LINE 3 THE COMPENSATION FOR THE PRESIDENT AND CEO IS ESTABLISHED BY THE PARENT ORGANIZATION. THE PARENT ORGANIZATION DETERMINES THE PRESIDENT AND CEO'S COMPENSATION BY REFERENCE TO COMPARABILITY DATA THAT IS SUBJECT TO REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE PARENT'S BOARD AND TOP MANAGEMENT OF THE PARENT COMPANY. ROBERT MCCLINTIC CHIEF EXECUTIVE OFFICER 26309526 LIMITED LIABILITIES CONVERTED ULTIMATELY SOLD TO ENTITY THAT ROBERT MCCLINTIC OWNS 100% 0 AFS OF LOW MOOR, INC 2023-11-30 9214501 BOOK VALUE 932528022 RBM OF LOW MOOR LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF FINCASTLE, INC 2023-11-30 5394004 BOOK VALUE 932446605 RBM OF FINCASTLE LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF BASTIAN, INC 2023-11-30 3366531 BOOK VALUE 932424483 RBM OF BASTIAN LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF HOT SPRINGS, INC 2023-11-30 2058862 BOOK VALUE 932471463 RBM OF HOT SPRINGS LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF LEBANON, INC 2023-11-30 4195109 BOOK VALUE 932494259 RBM OF LEBANON LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF MARTINSVILLE, INC 2023-11-30 -390490 BOOK VALUE 834697614 RBM OPCO OF MARTINSVILLE LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF MARTINSVILLE ALF, INC 2023-11-30 -1224845 BOOK VALUE 834690750 RBM OPCO OF MARTINSVILLE ALF LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF WARSAW, INC 2023-11-30 3695854 BOOK VALUE 841744612 RBM OF WARSAW LLC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 AFS OF YUMA, INC - DISCONTINUED OPERATIONS 2023-11-30 0 BOOK VALUE 363666533 KISSITO HEALTHCARE INC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 501(C)(3) 1 0 1 0 1 1 1 1 0 PART I, LINE 2E: PERSON(S) INVOLVED: ROBERT MCCLINTIC PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: SOLE OWNER OF MCCLINTIC HOLDCO I & II. ALL SUBORDINATE ENTITIES WERE CONVERTED TO LLCS. AFTER CONVERSION OF THE LLCS, THE PARENT, KISSITO HEALTHCARE, INC SOLD ALL OF THE MEMBERSHIP INTERESTS IN THE NEWLY CONVERTED LIMITED LIABILITY COMPANIES. THIS WAS DEEMED AN ASSET SALE AND RECOGNIZED ON THE KISSITO HEALTCARE INC. SEPARATE RETURN. ROBERT MCCLINTIC IS THE CEO OF KISSITO AND IS A BENEFICIAL OWNER IN THE NEW ENTITIES. SUPPLEMENTAL INFORMATION: NURSING & REHABILITATION SERVICES - 7 SKILLED NURSING FACILITIES, AND 1 ASSISTED LIVING FACILITY KISSITO OPERATES EIGHT FACILITIES THAT DELIVER EXCEPTIONAL SPECIAL NEEDS SERVICES LIKE VENTILATOR DEPENDENT CARE, COMPLEX WOUND CARE, ALZHEIMER/DEMENTIA CARE, POST-ACUTE REHABILITATION, ASSISTED LIVING, AND CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS. KISSITO CARES FOR ARE SHORT-TERM REHABILITATION PATIENTS WITH A PLAN TO RETURN TO HOME. PATIENTS ARE GETTING OLDER; THEY'RE WAITING LONGER TO SEEK HELP; AND DISEASES CONTINUE TO EVOLVE. AS A FORWARD-LOOKING NURSING HOME OPERATOR, WE STRIVE TO MEET THE NEEDS OF TODAY WHILE EVOLVING WITH THE CHANGES SHAPING TOMORROW. HIGH ACUITY SKILLED NURSING - RESPIRATORY CARE CENTER OF EXCELLENCE: AS MORE AND MORE SENIORS AGE IN PLACE, THE ROLE OF THE NURSING HOME IS CHANGING. KISSITO BELIEVES THAT THE ROLE OF A NURSING HOME WILL BE TO CARE FOR THOSE SENIORS WHO NEED EXTENSIVE HIGH-ACUITY SERVICES BOTH SHORT-TERM AND LONG-TERM. IN VIRGINIA, KISSITO HAS DEVELOPED TWO HIGH-ACUITY RESPIRATORY CENTERS OF EXCELLENCE. THE CENTERS ARE DESIGNED TO CARE FOR VENTILATOR AND TRACHEOTOMY DEPENDENT PATIENTS. AT THESE FACILITIES WE BOTH WEAN PATIENTS OFF OF THE VENTILATOR SO THEY MAY RETURN TO THEIR COMMUNITY AND WE CARE FOR THOSE ON A VENTILATOR LONG TERM AND PROVIDE A HIGH QUALITY OF LIFE WHILE DOING SO. FORM 990, PART III, LINE 3 THE PARENT, KISSITO HEALTHCARE, INC. SOLD IT'S ASSETS, INCLUDING THE CONVERTED SUBORDINATES, IN THE LONG-TERM HEALTHCARE SPACE TO ANOTHER FOR-PROFIT ENTITY ON NOVEMBER 30, 2023. THE PARENT, KISSITO HEALTHCARE, INC. FILED THE APPROPRIATE FORM 8594 WITH ITS SEPARATE RETURN. THE PARENT WILL USE THE PROCEEDS OF THE SALE TO CONTINUE AS A 501(C)(3) NOT-FOR-PROFIT TO SERVE OTHERS IN NEED. FORM 990, PART VI, SECTION A, LINE 2 THOMAS CLARKE, PRESIDENT AND DIRECTOR, IS RELATED BY MARRIGAGE TO ANA CLARKE, DIRECTOR. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED BY THE BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY COMPLETE A WRITTEN CONFLICT OF INTEREST DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY REFERENCE TO COMPARABILITY DATA AND IS SUBJECT TO REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE BOARD, AND TOP MANAGEMENT OF THE COMPANY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CONVERSION TO LLC -20,992,624. FORM 990, PART XII, LINE 2C NO CHANGES IN METHOD SINCE PRIOR YEAR. KISSITO HEALTHCARE INC 7500 SHADWELL DRIVE SUITE D ROANOKE VA 24019 363666533 MANAGEMENT SERVICES IL 501(C)(3) LINE 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1