2020-08-11T15:43:38-05:00 2019-09-30 431594752 MUELLER PROST LC 7733 FORSYTH BLVD SUITE 1200 ST LOUIS MO 63105 990 2018-10-01 941636507 ST JOHNS RETIREMENT VILLAGE STJO 5306621290 135 WOODLAND AVENUE WOODLAND CA 95695 SEAN BELOUD EXECUTIVE DIRECTOR 5306621290 2020-08-11 1 KARYN A NUNN P00096490 3148622070 2020-08-05 47.24.178.82 2020-08-11 13:38:13 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C07DD3AA4395365E7C35FA948EC7F31A8176C973 2018 2020-09-22 18:59:49Z SEAN BELOUD 135 WOODLAND AVENUE WOODLAND CA 95695 10862881 0 X WWW.SJRV.ORG X 1967 CA TO HONOR THE ORGANIZATION'S RESIDENTS' DIGNITY, INDEPENDENCE AND SPIRITUALITY BY PROVIDING THEM WITH A SAFE, SUPPORTIVE AND CARING ENVIRONMENT IN WHICH TO LIVE. THE ORGANIZATION'S MISSION IS TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS IN ITS MULTI-LEVEL ASSISTED LIVING FACILITIES AND ITS SKILLED NURSING FACILITY. 8 7 265 51 0 0 229314 114127 10473880 10722634 618 562 18143 11976 10721955 10849299 0 0 0 0 6487343 6775369 0 0 50797 3900318 4038717 10387661 10814086 334294 35213 6768426 6415471 3910641 3520109 2857785 2895362 X TO HONOR THE ORGANIZATION'S RESIDENTS' DIGNITY, INDEPENDENCE AND SPIRITUALITY BY PROVIDING THEM WITH A SAFE, SUPPORTIVE AND CARING ENVIRONMENT IN WHICH TO LIVE. THE ORGANIZATION'S MISSION IS TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS IN ITS MULTI-LEVEL ASSISTED LIVING FACILITIES AND ITS SKILLED NURSING FACILITY. 0 0 5176690 5859243 MULTI-LEVEL ASSISTED LIVING FACILITIES. ASSISTED LIVING FOR ACTIVE RESIDENTS WITH MINIMAL CARE NEEDS IN COTTAGES AND APARTMENTS CALLED THE VILLAGE. ASSISTED LIVING FOR RESIDENTS WITH MODERATE CARE NEEDS IN THE PERSONAL CARE UNIT (PCU). HIGH LEVEL OF CARE FOR RESIDENTS IN NEED OF COGNITIVE AND MEMORY SUPPORT IN THE MANORS. RESPITE CARE IS AVAILABLE FOR A MINIMUM OF TWO WEEKS PRO-RATED AT THE MONTHLY RATE. - TOTAL 33,918 RESIDENT/PATIENT DAYS 4297486 4863391 SKILLED NURSING FACILITY. LONG-TERM CARE FOR CHRONIC CONDITIONS AS WELL AS POST-SURGICAL REHABILITATION SERVICES AND WOUND CARE. HOSPICE CARE IS AVAILABLE. RESPITE CARE IS AVAILABLE FOR A MINIMUM OF TWO WEEKS PRO-RATED AT THE MONTHLY RATE. - TOTAL 14,956 PATIENT DAYS 9474176 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 30 0 1 265 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X THE ORGANIZATION 5306621290 135 WOODLAND AVENUE WOODLAND CA 95695 MARILYN MITCHELL PRESIDENT 8.00 X X 0 0 0 SUZANNE ANDERSON VICE PRESIDENT 2.00 X X 0 0 0 JENEE RAWLINGS TREASURER 2.00 X X 0 0 0 JANET CARRERE SECRETARY 2.00 X X 0 0 0 ERIC DOWDY MEMBER 1.00 X 0 0 0 JANE MARTIN MEMBER 1.00 X 0 0 0 LISA SMITH YOUNGS MEMBER 1.00 X 0 0 0 WENDY STARR EXECUTIVE DIRECTOR (THROUGH 07/2019) 40.00 X X 128750 0 33721 SEAN BELOUD EXECUTIVE DIRECTOR (STARTED 07/2019) 40.00 X X 0 0 0 128750 0 33721 1 0 1 0 SYSCO FOOD SERVICES OF SACRAMENTO PO BOX 138007 SACRAMENTO CA 958138007 FOOD & SUPPLIES FOR KITCHEN 342987 ESKATON PROPERTIES INC 5105 MANZANITA AVENUE CARMICHAEL CA 95608 ACCOUNTING & IT SERVICES 314097 DYNAMIC MEDICAL MANAGEMENT INC 4605 W IMPERIAL VIEW CT ROCKLIN CA 95677 PHYSICAL THERAPY FOR PATIENTS 313334 SACRAMENTO VALLEY NURSING SERVICES PO BOX 938 RIO LINDA CA 95673 NURSING SERVICES 149083 4 23735 90392 114127 ASSISTED LIVING REVENUE 623000 5816472 5816472 NET SKILLED NURSING REVENUE 623000 4827885 4827885 OTHER PROGRAM REVENUE 623000 78277 78277 10722634 562 562 17452 0 17452 17452 17452 8106 23735 13582 -5476 -5476 10849299 10722634 0 12538 144244 144244 5351600 5058940 256419 36241 846277 762376 76941 6960 433248 420714 9171 3363 308780 308780 4497 4497 59104 59104 739042 592920 146122 26457 26457 74489 16526 57948 15 3588 1435 2153 534733 481260 53473 11687 7777 3644 266 125130 112617 12513 433192 389873 43319 115449 103904 11545 FOOD SERVICES 515151 514699 181 271 SUPPLIES 481210 469024 11927 259 OTHER EXPENSE 221143 164358 55516 1269 QUALITY ASSURANCE FEE 218839 218839 166226 160349 5877 10814086 9474176 1289113 50797 748410 799107 639100 709547 110584 0 462933 482526 118458 64443 13655412 9312523 4674346 4342889 14595 16959 6768426 6415471 752932 623782 8775 42282 3137997 2846524 10937 7521 3910641 3520109 X 2719670 2871289 138115 24073 2857785 2895362 6768426 6415471 35213 2364 0 X X 0 1 X 1 0 X 156581 147638 370099 229314 114127 1017759 9779178 10032366 10312136 10473880 10722634 51320194 38785 74048 15035 8106 135974 9935759 10218789 10756283 10718229 10844867 52473927 11184 3272 14456 0 11184 3272 14456 52459471 1790 15717 15087 19681 18014 70289 1790 15717 15087 19681 18014 70289 9937549 10234506 10771370 10737910 10862881 52544216 0.99840 0.99870 0.00130 0.00110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 75430 75430 11396782 7650118 3746664 2183200 1662405 520795 4342889 RESIDENT TRUST 7521 7521 X 10851663 2364 2364 10849299 0 10849299 10814086 0 10814086 0 10814086 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL AND CALIFORNIA INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND THE CORRESPONDING PROVISIONS OF THE CALIFORNIA REVENUE AND TAXATION CODE, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME (UBTI) AS DEFINED BY THE IRC. THE ORGANIZATION EVALUATES UNCERTAIN TAX POSITIONS THROUGH ITS REVIEW OF THE SOURCES OF INCOME TO IDENTIFY UBTI AND CERTAIN OTHER MATTERS, INCLUDING THOSE WHICH MAY AFFECT ITS TAX-EXEMPT STATUS. THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF SEPTEMBER 30, 2019 AND 2018, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THE ORGANIZATION FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2015 FOR FEDERAL AND 2014 FOR CALIFORNIA TAX FILINGS. RHYTHM AND RIBS 31841 23735 8106 2200 1901 2241 7240 31841 23735 8106 2200 1901 2241 7240 13582 -5476 X 0 0 0 0 0 0 0 0 0 WENDY STARR EXECUTIVE DIRECTOR (THROUGH 07/2019) 128750 0 0 0 0 0 0 0 33721 0 162471 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT OF THE FORM 990 IS DISTRIBUTED TO THE BOARD MEMBERS TOGETHER WITH A COPY OF THE AUDITED FINANCIAL STATEMENTS AND TRIAL BALANCE FOR REVIEW AND COMPARISON. THE BOARD DESIGNATES AND ASSIGNS ONE OF ITS QUALIFIED MEMBERS TO REVIEW THE RETURN. UPON RESOLUTION OF QUESTIONS AND ISSUES, AND APPROVAL BY THAT DESIGNATED BOARD MEMBER, THE BOARD APPROVES THE RETURN FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C ONGOING CONSIDERATION OF ANY EXISTING OR POTENTIAL BOARD MEMBERS, EMPLOYEES, VENDORS, VOLUNTEERS AND OTHER BUSINESS CONNECTIONS WITH POSSIBLE CONFLICTS IN MIND BY ALL EXISTING BOARD MEMBERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS CAREFULLY CONSIDERS SELECTION AND SALARY FOR THE CHIEF EXECUTIVE OFFICER/EXECUTIVE DIRECTOR, INCLUDING COMPARING TO CURRENT MARKET QUALIFICATIONS AND COMPENSATION. THE CHIEF EXECUTIVE OFFICER IS NOT COMPENSATED FOR SERVICE ON THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 1023 AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND ANNUAL FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR SELECTION PROCESS.