2014-09-12T11:28:21-05:00 2013-12-31 431594752 MUELLER PROST LC 7733 FORSYTH BLVD SUITE 1200 ST LOUIS MO 63105 990 2013-01-01 431114366 PINE VIEW MANOR INC PINE 6607832118 307 N PINEVIEW STREET STANBERRY MO 64489 PAMELA HAILEY ADMINISTRATOR 6607832118 2014-09-11 1 JEANETTE BAX-KURTZ P00096490 3148622070 2014-09-08 2013 2015-11-30 17:44:51Z KENT PETERSON 307 N PINEVIEW STREET STANBERRY MO 64489 2639191 0 X WWW.PINEVIEWSTANBERRY.COM X 1978 MO DEDICATION TO HIGHEST QUALITY OF CARE AND SERVICE TO OUR RESIDENTS DELIVERED WITH SPIRITUAL COMPASSION, PERSONAL PRIDE, AND PROFESSIONALISM. 9 9 90 54 0 0 20609 4562 2700552 2630601 670 724 13381 2366 2735212 2638253 0 0 0 0 1584869 1483259 0 0 0 1058712 976126 2643581 2459385 91631 178868 1065898 1189772 533800 478806 532098 710966 THE MISSION OF PINE VIEW MANOR, INC. IS DEDICATION TO THE HIGHEST QUALITY OF TOTAL CARE AND SERVICE TO OUR RESIDENTS DELIVERED WITH SPIRITUAL COMPASSION, PERSONAL PRIDE, AND PROFESSIONALISM. 0 0 2255776 2633226 PINE VIEW MANOR PROVIDED 24 HOUR SKILLED NURSING CARE TO RESIDENTS. THE TOTAL SKILLED NURSING FACILITY CENSUS FOR 2013 WAS 15,160. PINE VIEW MANOR ALSO PROVIDED 24 HOUR CARE TO RESIDENTS IN THE ASSISTED LIVING UNIT. THE TOTAL ASSISTED LIVING FACILITY CENSUS DAYS FOR 2013 WAS 1,656. IN ADDITION, PINE VIEW MANOR PROVIDED IN-PATIENT AND OUT-PATIENT REHABILITATION SERVICES. 2255776 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 6 0 90 1 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X PAMELA HAILEY 6607832118 307 N PINEVIEW ST STANBERRY MO 64489 BARB SHUPE FORMER PRESIDENT 0.50 X X 0 0 0 KENT PETERSON PRESIDENT 1.50 X X 0 0 0 SANDY JOHNSON BOARD MEMBER 0.50 X 0 0 0 MIKE MCQUINN BOARD MEMBER 1.30 X 0 0 0 ELDON LONG FORMER BOARD MEMBER 0.30 X 0 0 0 LATON ALLISON BOARD MEMBER 0.50 X 0 0 0 JIM STRUEBY BOARD MEMBER 0.50 X 0 0 0 KATIE DIAS BOARD MEMBER 0.50 X 0 0 0 TONY JENNINGS BOARD MEMBER 0.50 X 0 0 0 DAVE HIBBS FORMER VICE PRESIDENT 0.30 X X 0 0 0 NORMA HILL VICE PRESIDENT 0.50 X X 0 0 0 TERESA STUART SECRETARY/TREASURER 40.00 X 32974 0 0 PAM HALEY ADMINISTRATOR 40.00 X 50655 0 0 83629 0 0 0 0 0 0 0 938 3624 4562 RESIDENT SERVICE REVEN 623000 2598349 2598349 RESIDENT TRANSPORTATIO 480000 13518 13518 RESIDENT CAFETERIA 722210 10165 10165 RESIDENT BEAUTY SHOP 446199 4892 4892 OTHER RESIDENT CARE RE 623000 3677 3677 2630601 724 724 2625 0 2625 2625 2625 679 938 938 -259 -259 2638253 2633226 0 465 83629 25328 58301 1156232 1093602 62630 151265 135447 15818 92133 83147 8986 2350 1175 1175 14600 14600 6066 3033 3033 4125 4125 32976 16488 16488 179278 176298 2980 19738 17813 1925 71664 70500 1164 71409 68565 2844 PURCHASED SERVICES 265355 265355 DIETARY EXPENSE 132754 132754 PHARMACY EXPENSE 42798 42798 REPAIRS & MAINTENANCE 30993 29219 1774 102020 94254 7766 2459385 2255776 203609 0 60996 227897 255771 301349 16523 15032 48771 23294 3310246 2690252 682111 619994 1726 2206 1065898 1189772 285823 279297 158468 140345 89509 59164 533800 478806 X 532098 710966 532098 710966 1065898 1189772 178868 0 X X 1 X 0 1 0 X 1192 1722 1276 20609 4562 29361 2491442 2533122 2531530 2700552 2630601 12887247 2492634 2534844 2532806 2721161 2635163 12916608 63839 49357 81727 194923 165291 223754 260157 306775 955977 165291 223754 323996 356132 81727 1150900 11765708 10531 7537 5766 14051 3349 41234 10531 7537 5766 14051 3349 41234 27940 34403 62343 2531105 2576784 2538572 2735212 2638512 13020185 0.90370 0.90400 0.00320 0.00420 X 51250 51250 2460704 1939055 521649 389103 374634 14469 409189 376563 32626 619994 DUE TO RESIDENTS 2206 ASSET RETIREMENT OBLIGATION 34369 EMPLOYEE ASSISTANCE FUND 6208 PROVIDER TAX 16381 59164 X PART X, LINE 2: THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THAT GUIDANCE, THE MANOR MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THE MANOR AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME ("UBIT"). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012. THE MANOR'S INFORMATION RETURNS, FOR THE YEARS ENDING 2013, 2012, 2011 AND 2010 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR 3 YEARS AFTER THEY WERE FILED. 0 MIKE MCQUINN BOARD MEMBER MIKE MCQUINN OWNS FAMILY HEALTH PHARMACY 32115 PINE VIEW MANOR USES FAMILY HEALTH PHARMACY TO SUPPLY MEDICATIONS TO RESIDENTS. 0 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS WERE AMENDED AND RESTATED DURING THE YEAR TO BETTER REPRESENT THE PURPOSE, POLICIES, AND PROCEDURES OF THE ORGANIZAITON. AMONG OTHER NON-SIGNIFICANT ITEMS, THE ARTICLES WERE AMENDED TO MAKE THE FOLLOWING CHANGES: 1) ADDED: DIRECTORS MAY RECEIVE REASONABLE COMPENSATION FOR SERVICES RENDERED OTHER THAN AS A DIRECTOR, AND MAY RECEIVE REIMBURSEMENT FOR ACTUAL AND REASONABLE EXPENSES INCURRED ON BEHALF OF THE ORGANIZATION 2) ADDED: ANY DIRECTOR MAY RESIGN AT ANY TIME BY GIVING WRITTEN NOTICE TO THE BOARD PRESIDENT. SUCH RESIGNATION, WHICH MAY OR MAY NOT BE MADE CONTINGENT ON FORMAL ACCEPTANCE, SHALL TAKE EFFECT ON THE DATE GIVEN OR AT ANY LATER TIME SPECIFIED THEREIN. 3) ADDED: SECRETARY/TREASURER DOES NOT NEED TO BE A VOTING MEMBER OF THE BOARD. 4) REMOVED: PRESIDENT SHALL BE THE PRINCIPAL EXECUTIVE OFFICER OF THE CORPORATION AND SHALL IN GENERAL SUPERVISE AND CONTROL ALL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION. REPLACED WITH: THE PRESIDENT SHALL BE THE CUSTODIAN OF THE SEAL OF THE CORPORATION AND SEE THAT THE SEAL OF THE CORPORATION IS AFFIXED TO ALL DOCUMENTS, THE EXECUTION OF WHICH, ON BEHALF OF THE CORPORATION IS DULY AUTHORIZED. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS THAT CAN VOTE TO ELECT THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS THAT CAN VOTE TO ELECT THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS REVIEWED BY ALL PINE VIEW MANOR OFFICERS AND GOVERNING BOARD MEMBERS PRIOR TO FILING FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL DISCLOSURE STATEMENT IS CIRCULATED TO OFFICERS AND CERTAIN IDENTIFIED AGENTS AND EMPLOYEES TO ASSIST THEM IN CONSIDERING ANY CONFLICTS OF INTEREST, BUT DISCLOSURE IS APPROPRIATE AND REQUIRED WHENEVER CONFLICTS OF INTEREST MAY OCCUR. THE WRITTEN NOTICES OF DISCLOSURES ARE THEN FILED WITH THE ADMINISTRATOR OR SUCH OTHER PERSON DESIGNATED BY THE ADMINISTRATOR TO RECEIVE SUCH NOTIFICATIONS. AT THE MEETING OF THE BOARD OF DIRECTORS, ALL DISCLOSURES OF REAL OR APPARENT CONFLICTS OF INTEREST ARE NOTED FOR THE RECORD IN THE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS AND ANNUAL FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S FINANCIAL STATEMENT REVIEW OVERSIGHT PROCESS AND ACCOUNTING FIRM SELECTION PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.