2016-06-28T14:13:33-05:00 2015-12-31 371106622 Ginoli & Company LtdCPA's 7625 N University Ste A Peoria IL 616148303 990 2015-01-01 431710785 SJL HEALTH SYSTEMS INC SJLH 3096918113 830 WEST TRAILCREEK DRIVE PEORIA IL 61614 BECKY STOKES TREASURER 3096918113 2016-06-22 1 MICHAEL REMMELECPA P00444163 3096712350 2016-06-17 2015 2016-09-27 15:27:22Z BECKY STOKES 830 W TRAILCREEK DR PEORIA IL 61614 3676870 0 X N/A X 2000 IL OPERATION OF A SKILLED NURSING CENTER 4 4 131 0 0 0 0 0 4042996 3676483 1341 387 5868105 0 9912442 3676870 0 0 0 0 2122400 1685184 0 0 0 2153417 1701489 4275817 3386673 5636625 290197 2487661 2458611 5468005 5148758 -2980344 -2690147 TO PROVIDE CARE FOR THE ELDERLY. 0 0 2857586 3676870 OPERATION OF A SKILLED NURSING CENTER 2857586 1 0 0 0 0 0 0 0 0 0 1 0 0 1 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 0 0 0 1 12 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 IL X MARK B PETERSEN 3096918113 830 W TRAILCREEK DR PEORIA IL 61614 X MICHAEL KUHL PRESIDENT 1.00 X 0 0 0 THOMAS HAMMERTON SECRETARY 1.00 X 0 0 0 BECKY STOKES TREASURER 1.00 X 0 0 0 MICHAEL A AHEARN DIRECTOR AT LARGE 1.00 X 0 0 0 0 0 0 0 0 0 0 MARTIN BROS 406 VIKING ROAD CEDAR FALLS IA 50613 FOOD SUPPLY VENDOR 171043 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 150455 OMNICARE PO BOX 78000 DETROIT MI 48278 PHARMACY 147173 3 PATIENT SERVICE 623000 3215413 3215413 RESIDENT SERVICES 623000 461070 461070 3676483 387 387 3676870 3676870 0 0 X 1560957 1530533 30424 124227 124227 10445 10445 2560 2560 2118 2118 7213 7213 283 283 182762 182762 165366 165366 MANAGEMENT FEE 249600 249600 NURSING SERVICES 185693 185693 PROVIDER BED TAX 165011 165011 OPERATIONS & MAINTENANC 149206 149206 581232 503994 77238 3386673 2857586 529087 0 82139 25747 554945 651393 13727 13727 4621244 3521491 1023430 1099753 813420 667991 2487661 2458611 1340755 613158 3001068 2924471 1126182 1611129 5468005 5148758 X -2980344 -2690147 -2980344 -2690147 2487661 2458611 290197 0 X 0 1 X 0 0 X 8366881 9129464 7815968 4042996 3676483 33031792 8366881 9129464 7815968 4042996 3676483 33031792 0 0 0 33031792 351 868 38374 1341 387 41321 351 868 38374 1341 387 41321 8367232 9130332 7854342 4044337 3676870 33073113 0.99880 0.99890 0.00120 0.00110 X 13500 13500 3352141 2336365 1015776 1202030 1146333 55697 53573 38793 14780 1099753 DEFERRED FINANCING COSTS 252581 ASSETS LIMITED AS TO USE 375757 PREPAID EXPENSES 39653 667991 ACCRUED PAYROLL 267685 INTEREST PAYABLE 15061 DUE TO AFFILIATES 351000 OTHER LIABILITIES 977383 1611129 3676870 0 3676870 0 3676870 3386673 0 3386673 0 3386673 Form 990, Part VI, Section A, line 3 Management company operates the nursing home facility. Form 990, Part VI, Section A, line 8a No official meetings were held and no written actions were needed by the governing body. Form 990, Part VI, Section A, line 8b There were no committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11 A draft copy of the Form 990 along with a copy of the audited financial statements are given to management to review. These are compared and any changes, if any, that are needed will be done at their request. Form 990, Part VI, Section B, line 15 The top management official is the Administrator of the nursing home. They are compensated at the same level of various other nursing home admistrators with the same responsibilites. All key employee salaries are set at the comparable rates with other nursing homes. Form 990, Part VI, Section C, line 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. Form 990, Part IX, line 24e FOOD: Program service expenses 139,218. Management and general expenses 0. Fundraising expenses 0. Total expenses 139,218. PURCHASED SERVICES: Program service expenses 131,042. Management and general expenses 0. Fundraising expenses 0. Total expenses 131,042. SUPPLIES: Program service expenses 116,314. Management and general expenses 0. Fundraising expenses 0. Total expenses 116,314. MISC. ADMIN. EXPENSES: Program service expenses 0. Management and general expenses 77,238. Fundraising expenses 0. Total expenses 77,238. WORKMEN'S COMPENSATION: Program service expenses 58,411. Management and general expenses 0. Fundraising expenses 0. Total expenses 58,411. PROPERTY & LIABILITY INSURANCE: Program service expenses 46,173. Management and general expenses 0. Fundraising expenses 0. Total expenses 46,173. OTHER DIETARY: Program service expenses 7,209. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,209. EQUIPMENT RENTAL: Program service expenses 5,027. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,027. TRAINING: Program service expenses 600. Management and general expenses 0. Fundraising expenses 0. Total expenses 600.