2022-02-10T10:18:19-06:00 2021-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-07-01 522327829 ST MARY'S NURSING CENTER INC STMA 3014758000 21585 PEABODY STREET LEONARDTOWN MD 20650 TRACY L KUBINEC TREASURER 3014758000 2022-01-26 1 TRACY KUBINEC XXX-XX-XXXX KERRI N BOGDA CPA P00760402 7177404863 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ANNETTE HODGES 21585 PEABODY STREET LEONARDTOWN MD 20650 14756004 0 X WWW.SMNCI.ORG X 2001 MD TO PROVIDE LONG AND SHORT TERM NURSING AND REHABILITATIVE CARE TO SENIORS. 9 9 236 158 0 0 788589 1975341 14233446 12640892 50223 93951 102962 41575 15175220 14751759 0 0 0 0 9363383 7954055 0 0 0 4912175 5500294 14275558 13454349 899662 1297410 19684621 21161426 6798245 6977640 12886376 14183786 TO PROVIDE QUALITY OF LIFE SERVICES IN SOUTHERN MARYLAND TO THE ADULT POPULATION IN A DIGNIFIED AND COMPASSIONATE MANNER. 0 0 11319708 0 12640892 ST. MARY'S NURSING CENTER IS THE 5 STAR PROVIDER OF CHOICE FOR LONG-TERM NURSING CARE AND REHABILITATIVE SERVICES IN ST. MARY'S COUNTY, MARYLAND. CARE IS PROVIDED IN A COMFORTABLE, CLEAN, HOME-LIKE SETTING OF 160 LICENSED BEDS BY A PROFESSIONAL AND ATTENTIVE STAFF OF CARING EMPLOYEES. DURING THE YEAR ENDED JUNE 30, 2021, THE CENTER PROVIDED 40,146 DAYS OF CARE TO AN AVERAGE OF 110 RESIDENTS PER DAY. AS A PARTICIPATING PROVIDER IN THE MARYLAND MEDICAL ASSISTANCE PROGRAM, THE CENTER IS COMMITTED TO PROVIDING CARE TO THE INDIGENT IN THE COMMUNITY. 11319708 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 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 0 0 1 0 0 0 1 6 0 236 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X TRACE A HALL CFO 3014758000 21585 PEABODY STREET LEONARDTOWN MD 20650 W DAVID VIAR JR PRESIDENT 5.00 X X 0 0 0 JUDITH H STERLING VICE PRESIDENT 1.00 X X 0 0 0 JOSEPH R DENSFORD SECRETARY 1.00 X X 0 0 0 TRACY L KUBINEC TREASURER 1.00 X X 0 0 0 DENISE A MORTENSEN TRUSTEE 1.00 X 0 0 0 GEORGE C MATISICK TRUSTEE 1.00 X 0 0 0 ROSE M MILLER TRUSTEE 1.00 X 0 0 0 JAMES FARRELL TRUSTEE 1.00 X 0 0 0 ALLEN BURTON TRUSTEE 1.00 X 0 0 0 JENNIFER RILEY KNODE TRUSTEE (RESIGNED FEB. '21) 1.00 X 0 0 0 ANNE HAYES TRUSTEE (UNTIL JUNE '21) 1.00 X 0 0 0 ANNETTE HODGES ADMINISTRATOR 40.00 X 127958 0 8083 TRACE HALL CFO 40.00 X 104377 0 3544 KIMBERLY WOOD DIRECTOR OF NURSING 40.00 X 110633 0 12324 LORENA SMITH RN CHARGE NURSE 40.00 X 112818 0 897 RICHARD MCKELVEY LPN 40.00 X 115096 0 11155 ANA LIZA FASCIA RN CHARGE NURSE 40.00 X 111913 0 25237 MELISSA KNIGHT LPN CHARGE NURSE 40.00 X 117743 0 3468 800538 0 64708 9 0 0 0 FLAGSHIP REHAB 157 BALTIMORE STREET CUMBERLAND MD 21502 PHYSICAL THERAPY SERVICES 1505876 DIAMOND MEDICAL LAB 66 PAINTERS MILL ROAD SUITE 200 OWINGS MILLS MD 21117 DIAGNOSTIC SERVICES 278325 MAXIM HEALTHCARE STAFFING SERVICES 1007 N ORANGE ST 4TH FLOOR WILMINGTON DE 19801 STAFFING SERVICES 185425 REMEDI SENIORCARE 9006 YELLOW BRICK ROAD ROSEDALE MD 21237 PHARMACY BROKER SERVICES 168136 NOELKER & HULL ASSOCIATES 30 W KING STREET CHAMBERSBURG PA 17201 ARCHITECTURAL DESIGN SERVICES 122480 5 1951729 23612 1975341 PROGRAM SERVICE REVENUE 623000 12640892 12640892 12640892 93951 93951 2095 4245 -2150 -2150 -2150 BEAUTY AND BARBERSHOP INCOME 623000 13463 13463 REBATES 623000 9467 9467 TV/TELEPHONE SERVICE 623000 7397 7397 13398 13398 43725 14751759 12640892 0 135526 X 333804 333804 6555805 6087384 468421 88001 78764 9237 352737 350065 2672 623708 558218 65490 7024 7024 37000 37000 1401 1401 2674372 1862476 811896 34954 34954 348401 206344 142057 22632 22632 456630 431918 24712 2003 1919 84 1356 819 537 681942 681942 152329 152329 MEDICAL SUPPLIES 665571 665571 FOOD 276760 276760 BAD DEBT EXPENSE 113450 113450 LICENSES & FEES 15501 2137 13364 8968 1941 7027 13454349 11319708 2134641 0 3738865 2518020 401786 2438829 1120663 919635 72663 83407 152432 235795 16363915 5822498 10941525 10541417 3239755 4083768 16932 340555 19684621 21161426 1190851 1186948 3983844 3802541 1623550 1988151 6798245 6977640 X 12883589 14183786 2787 0 12886376 14183786 19684621 21161426 1297410 0 X 0 1 X 1 0 X 29032 36217 37993 788589 1975341 2867172 13895338 14402329 14678827 14233446 12640892 69850832 13924370 14438546 14716820 15022035 14616233 72718004 0 0 0 72718004 10698 26797 55605 50223 96046 239369 10698 26797 55605 50223 96046 239369 76191 71695 76820 102962 43725 371393 14011259 14537038 14849245 15175220 14756004 73328766 0.99170 0.99270 0.00330 0.00210 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: TV/TELEPHONE SERVICE - 2016 AMOUNT: $ 37,357. 2017 AMOUNT: $ 34,439. 2018 AMOUNT: $ 18,763. 2019 AMOUNT: $ 6,895. 2020 AMOUNT: $ 7,397. MISCELLANEOUS - 2016 AMOUNT: $ 1,878. 2017 AMOUNT: $ 1,567. 2018 AMOUNT: $ 9,384. 2019 AMOUNT: $ 25,662. 2020 AMOUNT: $ 4,251. BEAUTY/BARBERSHOP INCOME - 2016 AMOUNT: $ 34,343. 2017 AMOUNT: $ 34,065. 2018 AMOUNT: $ 32,226. 2019 AMOUNT: $ 33,773. 2020 AMOUNT: $ 13,463. TRANSPORTATION REVENUE - 2016 AMOUNT: $ 2,613. 2017 AMOUNT: $ 1,624. 2018 AMOUNT: $ 5,786. 2019 AMOUNT: $ 14,389. 2020 AMOUNT: $ 5,547. REBATES - 2018 AMOUNT: $ 6,878. 2019 AMOUNT: $ 18,593. 2020 AMOUNT: $ 9,467. ACTIVITIES REVENUE - 2018 AMOUNT: $ 3,783. 2019 AMOUNT: $ 3,650. 2020 AMOUNT: $ 3,600. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1401 1401 0 PART II-B, LINE 1: ST. MARY'S NURSING CENTER, INC. IS A MEMBER OF LIFESPAN, A SENIOR CITIZEN ADVOCACY ORGANIZATION. A PORTION OF THE DUES PAID IS ALLOCATED TO LOBBYING EXPENSES. 1 93097 843723 825795 111025 0 1037025 1037025 9231376 2538628 6692748 3923254 1867319 2055935 2172260 1416551 755709 10541417 14712180 -43824 -43824 14756004 -4245 -4245 14751759 13414770 4245 4245 13410525 43824 43824 13454349 PART IV, LINE 1B: FOR RESIDENTS WHOSE PRIMARY PAYOR FOR LONG-TERM CARE IS MARYLAND MEDICAL ASSISTANCE, THE RESIDENT CAN ELECT TO HAVE THE CENTER MANAGE THEIR FUNDS. IN SUCH CASES, THE CENTER HOLDS RESIDENTS' FUNDS IN ESCROW AND DISBURSES THEM IN ACCORDANCE WITH THE REQUIREMENTS AND REGULATIONS OF THE MARYLAND MEDICAL ASSISTANCE PROGRAM. PART XI, LINE 2D - OTHER ADJUSTMENTS: NEGATIVE INCOME RECLASSED TO EXPENSES -43,824. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -4,245. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 4,245. PART XII, LINE 4B - OTHER ADJUSTMENTS: NEGATIVE INCOME RECLASSED TO EXPENSES 43,824. A MARYLAND HEALTH AND HIGHER EDUCATIONAL FACILITIES AUTHORITY 520936091 2012-06-19 5350000 RE-FI PRIOR CONVENTIONAL BANK LOAN, CAPITAL PROJECTS 0 0 0 A 1482010 5350000 92267 1871522 3386212 2013 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 0 A 1 PART IV, LINE 7: BOND ISSUE FUNDS WERE INITIALLY RELEASED TO REFUND A PRIOR ISSUE AND TO MEET COST OF ISSUANCE EXPENSES. FUNDS RELEASED TO PROVIDE FOR CAPITAL IMPROVEMENTS ARE ONLY UPON RECEIPT OF DOCUMENTED PROOF THAT EXPENSES HAD BEEN INCURRED. THE ORGANIZATION DOES NOT HOLD ANY FUNDS IN ESCROW OR OTHER ACCOUNTS AND THEREBY HAS NO EXPOSURE TO ARBITRAGE. AS SUCH, THE ORGANIZATION DOES NOT HAVE A WRITTEN POLICY FOR MONITORING. SHOULD THE TERMS OF ANY BOND ISSUE CHANGE, THE ORGANIZATION WOULD PROVIDE FOR ANY POLICIES NECESSARY TO MEET ALL BOND COMPLIANCE REGULATIONS. FORM 990, PART VI, SECTION A, LINE 1 THE FINANCE COMMITTEE IS AUTHORIZED TO APPROVE BAD DEBT WRITE-OFFS UNDER $6,000 PER MONTH. WRITE-OFFS IN EXCESS OF $6,000 MUST BE APPROVED BY THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS FIRST REVIEWED BY THE CFO WHO NOTES ANY CHANGES FROM THE PRIOR YEAR. THE CFO THEN GOES OVER THE FORM WITH THE ADMINISTRATOR. BEFORE THE FORM IS FILED IT IS GIVEN TO THE FINANCE COMMITTEE AND THE BOARD OF TRUSTEES FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD CONFLICT OF INTEREST POLICY STATES THAT BOARD MEMBERS MUST DISCLOSE POSSIBLE CONFLICTS AT THE TIME ANY CONTRACT OR OTHER ITEMS ARE CONSIDERED. BOARD MEMBERS ARE REQUIRED TO SIGN AN ANNUAL STATEMENT REGARDING ANY POSSIBLE CONFLICTS. POTENTIAL CONFLICTS WOULD INCLUDE BUSINESSES THAT PROVIDE SERVICES TO THE ORGANIZATION OR FOR ANYONE WHO RECEIVES SERVICES FROM THE ORGANIZATION. IF ANY BOARD MEMBER DECLARES A POTENTIAL CONFLICT OF INTEREST, THE BOARD MEMBER ABSTAINS FROM ANY VOTES WHERE THEY, THEIR BUSINESS, OR ANY CONFLICT WOULD HAVE BEEN AFFECTED. THE FULL BOARD MONITORS THE CONFLICT OF INTEREST POLICY. OFFICERS AND KEY EMPLOYEES ARE EXPECTED TO FOLLOW THE CONFLICT OF INTEREST POLICY AS STATED AS PART OF THE EMPLOYEE CONFLICT OF INTEREST POLICY. ALL POTENTIAL CONFLICTS ARE EXPECTED TO BE REPORTED AND ANY RESOLUTIONS WILL BE DECIDED BY SUPERIORS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE REVIEWS BROAD COMPARATIVE SALARY DATA IN SETTING THE ADMINISTRATOR'S SALARY. IN ADDITION, CONSIDERATION IS GIVEN TO THE ADMINISTRATOR'S HISTORICAL COMPENSATION AND THE RELATIVE COMPENSATION OF THE ADMINISTRATOR'S SUBORDINATES. SALARY DISCUSSIONS BY THE FULL BOARD OCCUR IN EXECUTIVE SESSIONS AFTER STAFF HAVE BEEN EXCUSED FROM THE BOARD MEETING. THE BOARD MAINTAINS THEIR OWN MINUTES FOR EXECUTIVE SESSIONS. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 304,155. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 304,155. CONSULTING: PROGRAM SERVICE EXPENSES 8,511. MANAGEMENT AND GENERAL EXPENSES 421,648. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 430,159. OUTPATIENT SERVICES: PROGRAM SERVICE EXPENSES 10,789. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,789. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 133,371. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 133,371. ADMIN PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 303. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 303. ADMIN PROFESSIONAL FEES OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 389,945. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 389,945. THERAPY: PROGRAM SERVICE EXPENSES 1,405,650. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,405,650. ST MARY'S NURSING CENTER FOUNDATION INC PO BOX 904 LEONARDTOWN MD 20650 521648341 FUNDRAISING MD 501(C)(3) LINE 12A, I N/A 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0