2013-11-15T12:33:11-06:00 2012-12-31 954749365 STANISLAWSKI & HARRISON CPAS 301 N LAKE AVE SUITE 900 PASADENA CA 91101 990 2012-01-01 951708771 MARYCREST MANOR MARY 3108382778 10664 ST JAMES DRIVE CULVER CITY CA 90230 SR VERONICA DEL CARMEN MALDONADO 3108382778 2013-11-14 1 ALAN HARRISON P00157337 6267933600 2013-11-14 2012 2016-02-25 16:41:14Z SR VERONICA DEL CARMEN M 10664 ST JAMES DRIVE CULVER CITY CA 90230 5711708 0 X HTTP://WWW.MARYCRESTCULVERCITY.COM X 1956 CA SEE PART III LINE 1 3 3 90 25 0 0 158227 443079 5256290 5239366 2300 1355 4344 23751 5421161 5707551 0 1557090 0 0 1922067 1953690 0 0 37175 2900046 2697272 4822113 6208052 599048 -500501 5562876 6441509 439353 1816335 5123523 4625174 X SEE SCHEDULE O 0 0 5800028 1557090 5239366 MARYCREST PROVIDES SHORT-TERM AND LONG-TERM SKILLED NURSING CARE, CONVALESCENT CARE AND GENERAL HEALTH SERVICES FOR THE ELDER POPULATION, AS WELL AS ENHANCING ITS PASTORAL CARE SERVICES. MARYCREST OPERATES A 57-BED CONVALESCENT HOME IN CULVER CITY, CALIFORNIA. MARYCREST HAS PROVIDED 7,247 DAYS OF CARE TO PRIVATE PATIENTS, 10,561 DAYS OF CARE TO PATIENTS UNDER MEDI-CAL, AND 2,126 DAYS OF CARE TO PATIENTS UNDER MEDICARE.MARYCREST PROVIDED TRAINING AND CERTIFICATION OF ALL CURRENT CERTIFIED NURSING ASSISTANCE IN RESTORATIVE NURSING. 5800028 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 90 1 0 0 0 0 0 1 1 0 0 0 0 X 3 3 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 CA X SISTER MARGARET MARY WILSON 6262891353 920 EAST ALHAMBRA ROAD ALHAMBRA CA 91801 X SISTER NOELLA CHANCE OCD 40.00 X X 0 0 0 SISTER RITA THERESE HAYDEN OCD 2.00 X X 0 0 0 SISTER VERONICA DEL CARMEN MALDONAD 2.00 X X 0 0 0 SISTER VERONICA DEL CARMEN MALDONAD 40.00 X X 0 0 0 SISTER MARY MICHAEL RAY OCD 2.00 X X 0 0 0 SISTER FRANCIS MARIE FISHER OCD 2.00 X X 0 0 0 0 0 0 0 0 0 0 0 27630 415449 443079 PATIENT SERVICE REVENU 623000 5171843 5171843 OTHER RESIDENT REVENUE 623000 67523 67523 5239366 1355 1355 7771 27630 4157 3614 3614 OTHER REVENUE 900099 20137 20137 20137 5707551 5239366 0 25106 1557090 1557090 1612523 1588547 23976 189306 183813 5358 135 151861 149571 2290 5593 5593 8359 8359 33579 33579 3298 3298 44179 16608 24389 3182 17154 17154 179756 172988 6768 1717 1288 343 86 107 107 507848 256074 218304 33470 129201 124271 4930 60406 50769 9349 288 NURSING 472984 472984 DIETARY 435544 435544 TAXES AND LICENSES 325903 325903 471644 461280 10350 14 6208052 5800028 370849 37175 1807398 2455497 2449569 2450668 50000 12145 273688 287466 36703 117350 5943418 4846727 925781 1096691 19737 21692 5562876 6441509 390409 1778961 48944 37374 439353 1816335 X 4755026 4398792 338497 196382 30000 30000 5123523 4625174 5562876 6441509 -500501 2152 0 X 0 1 X 0 0 X 607353 234001 335178 158227 443079 1777838 607353 234001 335178 158227 443079 1777838 567246 1210592 31570 689 2199 2300 1355 38113 46659 16060 4478 55538 122735 1938686 24579339 0.62440 0.43860 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FUNDRAISING REVENUE - 2009 AMOUNT: $ 4,624. 2010 AMOUNT: $ 16,060. 2011 AMOUNT: $ 2,550. 2012 AMOUNT: $ 35,401. OTHER REVENUE - 2009 AMOUNT: $ 42,035. 2011 AMOUNT: $ 1,928. 2012 AMOUNT: $ 20,137. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 30000 30000 130000 100000 30000 30000 100000 130000 30000 100000 130000 30000 100000 130000 1.00000 0 0 29728 29728 4252231 3546206 706025 1329638 1219909 109729 331821 80612 251209 1096691 5713860 2152 2152 5711708 -4157 -4157 5707551 6212209 4157 4157 6208052 0 6208052 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S PERMANENTLY RESTRICTED ENDOWMENT FUND IS FOR GENERAL OPERATIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -4,157. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 4,157. LUNCHEON 35401 27630 7771 4157 35401 27630 7771 4157 4157 3614 1 CARMELITE SISTERS OF THE MOST SACRED HEART OF LOS ANGELES INC 920 E ALHAMBRA ROAD ALHAMBRA CA 91801 952561138 501(C)3 1557090 AMOUNT PAID TO ADVANCE THE CARMELITE MISSION. 1 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: RELATED ENTITIES WITH SURPLUS CASH AT THE END OF THE YEAR DONATE SUCH FUNDS TO CSMSHLA TO ADVANCE THE CARMELITE MISSION. ORGANIZATION MISSION STATEMENT FORM 990, PART III, LINE 1 MARYCREST MANOR OFFERS SHORT-TERM AND LONG-TERM SKILLED NURSING CARE TO OUR ELDERS, RESPECTING THE DIGNITY OF ALL PERSONS AND RECOGNIZING THE RICHNESS OF THE WISDOM AND THE EXPERIENCE THAT COMES WITH ADVANCED YEARS. WE ARE COMMITTED TO ADVANCING THE CULTURE OF LIFE FROM NATURAL CONCEPTION TO LIFE'S NATURAL END WITH A PROFOUND RESPECT FOR THE DIGNITY OF EACH PERSON AT EVERY STAGE OF THE HUMAN EXPERIENCE. MARYCREST MANOR STRIVES TO REFLECT THE COMPASSIONATE LOVE AND MERCY OF GOD, WHILE PROVIDING COMPREHENSIVE AND QUALITY SERVICES TO ALL RESIDENTS REGARDLESS OF RACE, COLOR, CREED, NATIONAL ORIGIN OR FINANCIAL STATUS. MARYCREST MANOR IS AT THE SERVICE OF THE FAMILY FOR LIFE. WE FURTHER DEFINE THIS MISSION TO INCLUDE THE FOLLOWING SPECIFIC GOALS: A) TO PROVIDE SHORT-TERM AND LONG-TERM SKILLED NURSING CARE WITH THE COMPASSIONATE HEART OF CHRIST; B) TO PROMOTE THE DIGNITY OF LIFE AT ALL STAGES IN THE CARE WE PROVIDE TO OUR RESIDENTS; C) TO MANAGE OUR FINANCIAL RESOURCES RESPONSIBLY AND PRUDENTLY IN ORDER TO PROVIDE HIGH QUALITY SKILLED NURSING CARE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MARYCREST MANOR, INC. IS MOUNT CARMEL HEALTH MINISTRIES, INC., A CALIFORNIA NONPROFIT PUBLIC BENEFIT RELIGIOUS CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ALL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION ARE MANAGED AND CONTROLLED BY THE BOARD OF DIRECTORS, EXCEPT THAT CERTAIN POWERS SHALL BE RESERVED TO THE MEMBER. THE MEMBER OF THE CORPORATION IS MOUNT CARMEL HEALTH MINISTRIES, INC. THE POWERS RESERVED TO THE MEMBER MAY BE INITIATED AND EXERCISED BY THE MEMBER OR, IF INITIATED BY THE BOARD OF DIRECTORS OF THIS CORPORATION, MUST BE SUBMITTED TO AND RECEIVE THE APPROVAL OF THE MEMBER, AND THE ACTION OF THE MEMBER ON SUCH MATTERS SHALL BE FINAL. THE MEMBER HAS THE POWER, AMONG OTHER POWERS, TO APPROVE THE APPOINTMENT OF THE PRESIDENT, NEW MEMBERS AND BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION A, LINE 8B THERE WERE NO COMMITTEES AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS ARE PROVIDED THE FORM 990 VIA E-MAIL FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS COMPLETE CONFLICT OF INTEREST REPRESENTATIONS ANNUALLY FOR REVIEW. ALL OFFICERS AND KEY EMPLOYEES ARE RELIGIOUS PERSONNEL NOT RECEIVING COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CARMELITE SISTERS OF THE MOST SACRED HEART OF LOS ANGELES INC 920 E ALHAMBRA ROAD ALHAMBRA CA 91801 952561138 RELIGIOUS ORDER CA 501(C)3 LINE 1 N/A 0 SANTA TERESITA INC 819 BUENA VISTA STREET DUARTE CA 91010 951878859 SKILLED NURSING/ASSISTED LIVING CA 501(C)3 LINE 7 MOUNT CARMEL HEALTH MINISTRIES INC 0 LITTLE FLOWER CENTER INC 2434 GATES ST LOS ANGELES CA 90031 956122864 CHILD CARE CA 501(C)3 LINE 2 FLOS CARMELI FORMATION CENTERS INC 0 SACRED HEART RETREAT HOUSE INC 920 EAST ALHAMBRA ROAD ALHAMBRA CA 91801 113835568 SPIRITUAL AND EDUCATIONAL RESOURCE CENTERS CA 501(C)3 LINE 9 FLOS CARMELI FORMATION CENTERS INC 0 AVILA GARDENS INC 1171 ENCANTO PARKWAY DUARTE CA 91010 300468751 INDEPENDENT LIVING FACILITY CA 501(C)3 LINE 9 MOUNT CARMEL HEALTH MINISTRIES INC 0 MOUNT CARMEL HEALTH MINISTRIES INC 819 BUENA VISTA STREET DUARTE CA 91010 113835563 RELIGIOUS CA 501(C)3 LINE 1 CARMELITE SISTERS OF THE MOST SACRED HEART OF LOS ANGELES INC 0 MOUNT CARMEL IN THE DESERT INC 920 E ALHAMBRA ROAD ALHAMBRA CA 91801 113835661 OPERATE CHILDCARE, SCHOOLS, AND RELIGIOUS EDUCATION CA 501(C)3 LINE 9 FLOS CARMELI FORMATION CENTERS INC 0 FLOS CARMELI FORMATION CENTERS INC 920 E ALHAMBRA ROAD ALHAMBRA CA 91801 113835566 OPERATE CHILDCARE, SCHOOLS, AND RELIGIOUS EDUCATION CA 501(C)3 LINE 1 CARMELITE SISTERS OF THE MOST SACRED HEART OF LOS ANGELES INC 0 CARMELITE SISTERS OF THE SACRED HEART OF MONROVIA INC 1210 ROYAL OAKS DR DUARTE CA 91010 753253412 RELIGIOUS CA 501(C)3 LINE 1 CARMELITE SISTERS OF THE MOST SACRED HEART OF LOS ANGELES INC 0 CARMELITE EDUCATION CENTER INC 920 E ALHAMBRA ROAD DUARTE CA 91801 954712229 OPERATE CHILDCARE, SCHOOLS, AND RELIGIOUS EDUCATION CA 501(C)3 LINE 1 FLOS CARMELI FORMATION CENTERS INC 0 CARMELITE SISTERS FOUNDATION INC 920 E ALHAMBRA ROAD DUARTE CA 91801 392075616 RELIGIOUS CA 501(C)3 LINE 1 CARMELITE SISTERS OF THE MOST SACRED HEART OF LOS ANGELES INC 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0