2013-07-01T09:35:56-05:00 2012-12-31 371106622 Ginoli & Company LtdCPA's 7625 N University Ste A Peoria IL 616148303 990 2012-01-01 431710785 SJL HEALTH SYSTEMS INC D/B/A PRAIRIE ROSE HEALTH CARE CENTER SJLH 3096918113 830 WEST TRAILCREEK DRIVE PEORIA IL 61614 BRAD BARKLEY 3096918113 2013-06-25 1 MICHAEL REMMELECPA P00444163 3096712350 2013-06-25 2012 2016-02-24 21:20:13Z BRAD BARKLEY 830 W TRAILCREEK DR PEORIA IL 61614 9130332 0 X N/A X 2000 IL OPERATION OF A SKILLED NURSING CENTER 4 4 261 0 0 0 0 0 8366881 9129464 351 868 0 0 8367232 9130332 0 0 0 0 4990097 5174038 0 0 0 4912949 5488941 9903046 10662979 -1535814 -1532647 8486481 8401033 13164771 14611970 -4678290 -6210937 TO PROVIDE CARE FOR THE ELDERLY. 0 0 8141019 9130332 OPERATION OF A SKILLED NURSING CENTER 8141019 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 261 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 1.00 X 0 0 0 THOMAS HAMMERTON 1.00 X 0 0 0 BRAD BARKLEY 1.00 X 0 0 0 MICHAEL A AHEARN 1.00 X 0 0 0 0 0 0 0 0 0 0 MARTIN BROS 406 VIKING ROAD CEDER FALLS IA 50613 FOOD SUPPLY VENDOR 193593 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 166466 OMNICARE 100 EAST RIVER CENTER BLVD COVINGTON KY 41011 PHARMACEUTICAL SERVICES 107539 3 PATIENT SERVICE 623000 9114657 9114657 RESIDENT SERVICES 623000 14807 14807 9129464 868 868 9130332 9130332 0 0 X 4734122 4447602 286520 439916 439916 32214 32214 25265 25265 26359 26359 56952 56952 26123 26123 10467 10467 16056 16056 668341 668341 404471 404471 PROVIDER BED TAX 809009 809009 PURCHASED SERVICES 722349 722349 MANAGEMENT FEE 520700 520700 NURSING SERVICES 474066 474066 1696569 897614 798955 10662979 8141019 2521960 0 82502 79023 1812367 2112017 32153 32153 8734251 4003813 5052003 4730438 1507456 1447402 8486481 8401033 1989309 2356807 8123582 8064665 630000 630000 2421880 3560498 13164771 14611970 X -4678290 -6210937 -4678290 -6210937 8486481 8401033 -1532647 0 X 0 1 X 0 0 X 6381343 8514227 8721792 8366881 9129464 41113707 6381343 8514227 8721792 8366881 9129464 41113707 0 0 0 41113707 4094 2707 2015 351 868 10035 4094 2707 2015 351 868 10035 6385437 8516934 8723807 8367232 9130332 41123742 0.99980 0.99960 0.00020 0.00040 X 487408 487408 6595555 2673975 3921580 1651288 1329838 321450 4730438 DEFERRED FINANCING COSTS 717915 ASSETS LIMITED AS TO USE 662850 PREPAID EXPENSES 66637 1447402 ACCRUED PAYROLL 357389 INTEREST PAYABLE 867959 DUE TO AFFILIATES 351000 DUE TO TUTERA HEALTH CARE 458743 OTHER LIABILITES 1525407 3560498 9130332 0 9130332 0 9130332 10662979 0 10662979 0 10662979 A CITY OF GARY INDIANA SERIES A & B 356001040 582065598 2008-10-01 5100000 PURCHASE OF FACILITY 1 0 0 A 2008 0 0 1 1 A 1 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 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. All Other Functional Expenses Form 990, Part IX, line 24e OPERATIONS & MAINTENANCE: Program service expenses 0. Management and general expenses 430,964. Fundraising expenses 0. Total expenses 430,964. FOOD: Program service expenses 371,544. Management and general expenses 0. Fundraising expenses 0. Total expenses 371,544. SUPPLIES: Program service expenses 322,121. Management and general expenses 0. Fundraising expenses 0. Total expenses 322,121. MISC. ADMIN. EXPENSES: Program service expenses 0. Management and general expenses 243,924. Fundraising expenses 0. Total expenses 243,924. PROPERTY & LIABILITY INSURANCE: Program service expenses 97,277. Management and general expenses 0. Fundraising expenses 0. Total expenses 97,277. WORKMEN'S COMPENSATION: Program service expenses 74,471. Management and general expenses 0. Fundraising expenses 0. Total expenses 74,471. MISC. PAYROLL TAXES AND EMPLOYEE BENEFITS: Program service expenses 0. Management and general expenses 65,425. Fundraising expenses 0. Total expenses 65,425. BAD DEBT EXPENSE: Program service expenses 0. Management and general expenses 58,642. Fundraising expenses 0. Total expenses 58,642. MISC. EXPENSES: Program service expenses 10,011. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,011. OTHER DIETARY: Program service expenses 9,726. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,726. EQUIPMENT RENTAL: Program service expenses 9,559. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,559. TRAINING: Program service expenses 2,905. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,905.