2014-05-15T15:55:29-05:00 2013-06-30 274573546 STILLWAGGON & MCGILL LLC 10 WOODLAND CENTER DRIVE GROVE CITY PA 16127 990 2012-07-01 990249327 MAUNALANI NURSING AND REHABILITATION CENTER MAUN 8087320771 5113 MAUNALANI CIRCLE HONOLULU HI 96816 SAI CHANTAVY 8087320771 2014-05-15 1 JOHN C STILLWAGGON CPA P00158206 7244587490 2014-05-15 2012 2015-11-30 17:44:51Z SAI CHANTAVY 5113 MAUNALANI CIRCLE HONOLULU HI 96816 12335713 0 X N/A X 1950 HI COMMITTED TO PROVIDING EXCELLENCE IN NURSING CARE AND REHABILITATION SERVICES BY BEING READY TO MEET THE CHANGING NEEDS OF THE COMMUNITY. MAUNALANI NURSING AND REHABILITATION CENTER IS THE PROVIDER AND EMPLOYER OF CHOICE IN THE INDUSTRY. RESIDENTS AND GUESTS WILL EXPERIENCE A CULTURE OF CARING THAT IS LIFE AFFIRMING, SATISFYING AND MEANINGFUL. 8 7 158 15 0 0 8738 156286 11560416 12177012 3334 2415 0 0 11572488 12335713 0 0 0 0 6369052 6783352 0 0 0 3771903 4368026 10140955 11151378 1431533 1184335 26494023 28835374 4343374 3544725 22150649 25290649 MAUNALANI NURSING AND REHABILITATION CENTER IS A PRIVATE NON-PROFIT HEALTH CARE ORGANIZATION FOUNDED IN 1950. THE ORGANIZATION IS COMMITTED TO PROVIDING EXCELLENCE IN NURSING CARE AND REHABILITATION SERVICES BY BEING READY TO MEET THE CHANGING NEEDS OF THE COMMUNITY. 0 0 10057561 12177012 MAUNALANI NURSING & REHABILITATION CENTER IS A 100-BED FACILITY LICENSED TO PROVIDE SKILLED, INTERMEDIATE, AND REHABILITATIVE CARE SERVICES. DAILY OCCUPANCY RATE FOR 2012/2013 IS 95.52% WITH AN AVERAGE PER DIEM RATE OF $318.03. 10057561 1 1 0 0 0 0 0 1 1 0 1 0 0 1 1 1 1 1 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 1 0 0 0 1 26 0 1 158 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 X THE ORGANIZATION 8087320771 5113 MAUNALANI CIRCLE HONOLULU HI 968164019 HOWARD H HAMAMOTO 1.00 1.00 X X 0 0 0 JOSEPH H GOLDCAMP 1.00 1.00 X X 0 0 0 SAI CHANTAVY 60.00 10.00 X X 170857 0 13666 DAVID DEVENOT 0.50 X 0 0 0 A JAMES WRISTON JR 0.50 0.50 X 0 0 0 SUSAN KOSASA 0.50 X 0 0 0 JAMES PIETSCH 0.50 0.50 X 0 0 0 BARBARA K STANTON 0.50 X 0 0 0 ROBERT HIDANO 45.00 5.00 X 104747 0 7447 275604 0 21113 2 0 1 0 GENESIS REHAB SERVICES 6549 PAYSPHERE CIRCLE CHICAGO IL 60674 REHAB SERVICE 496945 PHARMERICA PO BOX 409251 ATLANTA GA 30384 MEDICATION 289256 HAWAII FLOUR MILL PO BOX 855 HONOLULU HI 96816 DIETARY SUPPLIES 260805 3 156286 156286 NET PATIENT REVENUE 623000 12104945 12104945 MISCELLANEOUS PATIENT CHARGES 623000 72067 72067 12177012 2415 2415 12335713 12177012 0 2415 166182 83091 83091 5408833 4881262 527571 326359 290611 35748 475250 423193 52057 406728 362177 44551 8384 8384 67158 67158 907836 886286 21550 174443 158359 16084 523743 497556 26187 13598 13598 315149 299392 15757 281895 251018 30877 FOOD AND SUPPLIES 1088246 1084703 3543 GENERAL ADMINISTRATION 566662 465106 101556 SUSTAINABILITY FEE EXPE 420912 374807 46105 11151378 10057561 1093817 0 1050 1000 3131154 3995478 2258825 2360834 55484 57898 131611 209260 4331763 2493475 1641362 1838288 19274537 20372616 26494023 28835374 3854390 3076021 440241 466381 1743 2323 47000 0 4343374 3544725 X 22150649 25290649 22150649 25290649 26494023 28835374 X 1184335 1955665 X X 0 1 X 1 0 X 484740 493740 278082 8738 156286 1421586 9525758 10407341 10882784 11560416 12177012 54553311 10010498 10901081 11160866 11569154 12333298 55974897 0 0 0 55974897 21465 2602 7744 3334 2415 37560 21465 2602 7744 3334 2415 37560 10031963 10903683 11168610 11572488 12335713 56012457 0.99930 0.99810 0.00070 0.00190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X DECORATIONS 0 1 1743 36121 35541 2323 1 X 1176102 567423 608679 2926610 1854812 1071798 229051 71240 157811 1838288 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 20372616 20372616 X 12335713 0 12335713 0 12335713 11151378 0 11151378 0 11151378 PART III, LINE 4: ALL THE ARTWORKS ARE USED AS DECORATIONS IN THE ORGANIZATION. PART IV, LINE 1B: THE COMPANY IS TRUSTEE FOR THE RESIDENTS' PERSONAL FUNDS. THE FUNDS ARE RECEIVED FROM THE RESIDENTS FROM VARIOUS SOURCES AND DISBURSED AS THE RESIDENTS' NEEDS WARRANT. THESE FUNDS ARE RESTRICTED AND ARE NOT AVAILABLE FOR OPERATIONS. PART IV, LINE 2B: THE ORGANIZATION MAINTAINS RESIDENTS' PERSONAL FUNDS WHEN REQUESTED BY THE RESIDENTS. AT 6/30/13, ONE RESIDENT HAD HIS PERSONAL FUNDS ON ACCOUNT. THE RESIDENT TRUST FUNDS IS IN A SEPARATE BANK ACCOUNT AT AMERICAN SAVINGS BANK. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ACCORDANCE WITH ASC NO. 740 AS IT RELATES TO UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED JUNE 30, 2013, THE COMPANY HAS EVALUATED ITS TAX POSITIONS TAKEN FOR ALL OPEN YEARS. CURRENTLY, 2010, 2011, AND 2012 TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. HOWEVER, THE COMPANY IS NOT CURRENTLY UNDER AUDIT NOR HAS THE COMPANY BEEN CONTACTED BY THE INTERNAL REVENUE SERVICE. BASED ON THE EVALUATION OF THE COMPANY'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER EXAMINATION. THEREFORE, NO ASSET OR LIABILITY FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED IN THE FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2013. X X X 0 0 0 0 0 0 0 0 0 SAI CHANTAVY 162857 0 8000 0 0 0 5254 0 8412 0 184523 0 88846 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED, READ AND UNDERSTANDS, AND AGREED TO COMPLY WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE SALARY AND PERQUISITES OF THE EXECUTIVE DIRECTOR AND SENIOR MANAGEMENT STAFF WILL BE BASED ON HIS/HER PERFORMANCE AND REVIEWED ANNUALLY. IN APPROVING OR RECOMMENDING ANY SALARY OR PERQUISITE ADJUSTMENT, THE COMMITTEE WILL CONSIDER THE RESPONSIBILITY, QUALIFICATIONS, EXPERIENCE, PERFORMANCE RECORD OF THE INDIVIDUAL, AND THE SALARY RANGES PAID TO A SIMILAR POSITION IN THE MARKETPLACE. THE COMPENSATION WILL BE REASONABLE AND IN ACCORDANCE WITH THE RULES OF IRS. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST FOR A PERIOD OF THREE YEARS FROM THE DATE FILED.IT IS AVAILABLE IN THE ADMINISTRATIVE OFFICE OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 A PERSON MUST SUBMIT A REQUEST IN WRITING TO THE EXECUTIVE DIRECTOR. COPYING FEES MAY APPLY. FINANCIAL STATEMENTS ARE FOR INTERNAL USE ONLY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: LOSS ON ITEMS NOT YET RECOGNIZED AS A COMPONENT OF NET PERIODIC PENSION COST. 673,821. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF MAUNALANI FOUNDATION. 1,098,079. REDUCTION OF ACCUMULATED DEPRECIATION BECAUSE DEPRECIATION WAS OVERSTATED IN PREVIOUS YEARS IN ASSOCIATION WITH BUILDING IMPROVEMENTS. 183,765. THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. MAUNALANI FOUNDATION 5113 MAUNALANI CIRCLE HONOLULU HI 96816 990075234 NON-HEALTHCARE ACTIVITIES WHICH INCLUDE LEASING LAND AND A BUILDING HI 501(C)(3) 509(A)(3) MAUNALANI NURSING AND REHABILITATION CENTER 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 MAUNALANI FOUNDATION K 480000 COST MAUNALANI FOUNDATION O 23740 SEE SCHEDULE R, PART VII MAUNALANI FOUNDATION O 10271 SEE SCHEDULE R, PART VII METHOD OF DETERMINING AMOUNT INVOLVED SCHEDULE R, PART V, LINE 2(2)(D) SAI CHANTAVY WORKS 70 HOURS A WEEK. SHE IS CONSIDERED AN EMPLOYEE OF THE MAUNALANI NURSING AND REHABILITATION CENTER. APPROXIMATELY, 60 HOURS PER WEEK ARE SPENT PERFORMING HER DUTIES AS THE ADMINISTRATOR OF THE CENTER. FOR THE REMAINING 10 HOURS PER WEEK, SHE ASSISTS THE MAUNALANI FOUNDATION PRIMARILY IN REGARDS TO OVERSIGHT AND MANAGEMENT OF THE INVESTMENTS HELD BY THE FOUNDATION. $23,740 IS 1/7 OF HER 2012-2013 SALARY ALLOCATED TO THE FOUNDATION. METHOD OF DETERMINING AMOUNT INVOLVED SCHEDULE R, PART V, LINE 2(3)(D) ROBERT HIDANO WORKS 50 HOURS A WEEK. HE IS CONSIDERED AN EMPLOYEE OF THE MAUNALANI NURSING AND REHABILITATION CENTER. APPROXIMATELY, 45 HOURS PER WEEK ARE SPENT PERFORMING HIS DUTIES AS THE FINANCE DIRECTOR OF THE CENTER. FOR THE REMAINING 5 HOURS PER WEEK, HE ASSISTS THE MAUNALANI FOUNDATION. $10,271 IS 1/10 OF HIS 2012-2013 SALARY ALLOCATED TO THE FOUNDATION.