2014-07-15T15:00:28-05:00 2013-09-30 273256712 STARBUCK WALSH LLP 16057 KAMANA ROAD APPLE VALLEY CA 92307 990 2012-10-01 951660824 ST JOHN OF GOD RETIREMENT & CARE CENTER STJO 3237310641 2468 S ST ANDREWS PLACE LOS ANGELES CA 90018 SANTIAGO LOPEZ 3237310641 2014-07-08 1 JENNIFER STARBUCK P00401364 7602429222 2014-07-08 2012 2015-11-30 17:44:51Z SANTIAGO LOPEZ 2468 SSTANDREWS PLACE LOS ANGELES CA 90018 18286897 0 X WWW.STJOHNOFGODSENIORS.ORG X 1942 CA THE ST. JOHN OF GOD RETIREMENT AND CARE CENTER (THE CENTER) IS A CALIFORNIA NOT-FOR-PROFIT CORPORATION WHICH OPERATES 156 BED SKILLED NURSING, 60 UNIT ASSISTED LIVING AND RESIDENTIAL CARE, AND 51 UNIT INDEPENDENT LIVING FACILITIES, AND 31 UNITS FOR ALZHEIMER'S OR RELATED DISEASES. 9 8 411 0 0 0 239384 257568 17669885 18018227 9311 11102 0 0 17918580 18286897 0 0 0 0 9488609 10676061 0 0 0 8159566 8247175 17648175 18923236 270405 -636339 32468926 31702493 1370626 1189996 31098300 30512497 THE HOSPITALLER BROTHERS ARE COMMITTED TO COMPASSIONATE CARE BY RESPONDING TO THE NEEDS OF THE WHOLE PERSON, WHILE ENCOURAGING TEAMWORK/COLLABORATION. BY DOING SO, THEY PROMOTE THE VALUES OF HOSPITALITY, RESPECT AND HEALING. 0 0 14291272 18018227 OPERATED A SKILLED NURSING, LONG TERM CARE, INDEPENDENT LIVING, AND RESIDENTIAL CARE FACILITY AND PROVIDED ANCILLARY SERVICES TO RESIDENTS. 14291272 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 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 1 0 0 0 1 39 0 0 411 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 0 1 1 0 CA X X X WILLY ATIENZA 3237310641 2468 SSTANDREWS PLACE LOS ANGELES CA 90018 BROTHER STEPHEN DE LA ROSA OH 30.00 20.00 X X 0 0 0 BROTHER GEORGE TECKU OH 1.00 X 0 0 0 BROTHER THADDEUS BUI OH 1.00 X 0 0 0 DR LESLIE PAUL MD 1.00 X 0 0 0 DONNA BENTON PHD 1.00 X 0 0 0 PHIL DEVIN PHD 1.00 X 0 0 0 SANTIAGO LOPEZ 30.00 20.00 X 155043 0 0 155043 0 0 3 0 1 0 REHAB ALLIANCE 22995 MILL CREEK DR SUTIE A LAGUNA HILLS CA 92653 THERAPY SERVICES 579707 REHAB UNLIMITED 3545 WILSHIRE BLVD SUITE 250 LOS ANGELES CA 90010 THERAPY SERVICES 445305 PROCARE MEDICAL STAFFING 127 S BRAND BLVD SUITE 100G GLENDALE CA 91204 NURSING REGISTRY 325123 CALIFORNIA UNIQUE SECURITY PO BOX 455 NORCO CA 92860 SECURITY SERVICES 127774 4 256148 1420 257568 MEDICARE/MEDI-CAL PAYMENTS 623000 11256811 11256811 PATIENT & RESIDENTIAL 623000 6034005 6034005 HOSPICE & ANCILLARY SERVICES 623000 727411 727411 18018227 11102 11102 18286897 18018227 0 11102 381000 76200 304800 8584826 6867875 1716951 827024 661619 165405 883211 706569 176642 36400 36400 31167 31167 28262 28262 35676 35676 237665 237665 19537 19537 20018 11000 9018 3136 3136 2748 2748 1380765 1297919 82846 783567 626854 156713 PURCHASED SERVICES 2033974 1742574 291400 SUPPLIES 1808816 1550676 258140 ASSURANCE FEES 849637 849637 UTILITIES 767791 721724 46067 208016 208016 18923236 14291272 4631964 0 2825928 2817301 815805 818681 779765 1016290 256106 205349 50129844 23903381 27266139 26226463 178894 182120 346289 436289 32468926 31702493 1117852 1098692 183505 38769 69269 52535 1370626 1189996 X 31098300 30512497 31098300 30512497 32468926 31702493 -636339 50536 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 507991 507991 44515505 19522986 24992519 413084 372075 41009 2548728 2036695 512033 2144536 1971625 172911 26226463 SECURITY DEPOSITS 35772 PATIENT TRUST 16763 52535 18286897 0 18286897 0 18286897 18923236 0 18923236 0 18923236 0 0 0 0 0 0 0 0 0 SANTIAGO LOPEZ 155043 0 0 0 0 0 0 0 0 0 155043 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE EXECUTIVE COMMITTEE AND THEN APPROVED BY THE BOARD AT LARGE. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO DOCUMENT PERSONAL AND BUSINESS INTERESTS. EMPLOYEES RESPONSIBLE FOR FINANCIAL TRANSACTIONS ARE AWARE OF THOSE INTERESTS AND CONSIDER THEM WHEN MAKING DECISIONS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION REVIEWS AND APPROVES COMPENSATION OF EMPLOYEES AND DIRECTORS THROUGH REVIEW BY THE BOARD AND COMPARES SALARIES BASED UPON INSPECTION OF VARIOUS NON PROFIT ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DISCLOSES GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS UPON REQUEST. IN ADDITION, THE FORM 990 IS MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A FINANCE COMMITTEE WHO MEETS TO REVIEW THE AUDIT AND RECOMMEND THAT THE BOARD EITHER ACCEPT OR REJECT THE AUDIT. THE HOSPITALLER FOUNDATION OF CA 2468 S ST ANDREWS PLACE LOS ANGELES CA 90018 953299706 RELIGIOUS ORGANIZATION CA CHARITABLE LINE 1 0 HOSPITALLER BROTHERS HEALTH CARE SERVICE 2425 S WESTERN AVE LOS ANGELES CA 90018 954334552 HEALTH INSURANCE CA CHARITABLE LINE 1 0 ST JOHN OF GOD HEALTH CARE SERVICE PO BOX 2457 VICTORVILLE CA 92392 953806996 SUBSTANCE ABUSE TREATMENT AND PREVENTION CA CHARITABLE LINE 1 0 ST JOSEPH'S HEALTH AND RETIREMENT CENTER 2464 E OJAI AVE OJAI CA 93024 953265311 SKILLED NURSING FACILITY CA CHARITABLE LINE 1 0 BROTHERS OF ST JOHN OF GOD 2425 S WESTERN AVE LOS ANGELES CA 90018 952399225 RELIGIOUS ORGANIZATION CA CHARITABLE LINE 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 ST JOSEPH'S HEALTH AND RETIREMENT CENTER B 2748 CASH THE HOSPITALLER FOUNDATION OF CA C 256148 CASH ST JOSEPH'S HEALTH AND RETIREMENT CENTER D 90000 CASH BROTHERS OF ST JOHN OF GOD M 291000 CASH