2013-08-05T14:54:26-07:00 2012-10-31 990 2011-11-01 954022185 KEIRO SERVICES KEIR 3239807555 325 SOUTH BOYLE AVENUE LOS ANGELES CA 90033 SHAWN MIYAKE 3239807500 2013-07-31 2011 2016-02-24 21:20:13Z KEIRO SENIOR HEALTHCARE SHAWN MIYAKE 325 SOUTH BOYLE AVENUE LOS ANGELES CA 90033 4522332 0 X www.keiro.org X 1961 CA TO ENHANCE THE QUALITY OF SENIOR LIFE IN OUR COMMUNITY 14 13 40 68 0 0 1644992 586136 0 0 522339 465811 2839756 3365230 5007087 4417177 0 0 0 0 2221850 2213029 0 0 434936 947279 1019531 3169129 3232560 1837958 1184617 27367856 30440144 261194 816454 27106662 29623690 X To enhance the quality of senior life in our community. 0 0 145765 0 0 KEIRO SENIOR HEALTHCARE (KEIRO SERVICES) PROVIDES A FULL CONTINUUM OF CARE THROUGH KEIRO NURSING HOME, SOUTH BAY KEIRO NURSING HOME, KEIRO INTERMEDIATE CARE FACILITY, KEIRO RETIREMENT HOME, AND THE INSTITUTE FOR HEALTHY AGING AT KEIRO (IHA). THE TOTAL OPERATING EXPENSES FOR THE IHA WERE $246,719 ALL OF WHICH WERE FOCUSED ON COMMUNITY BENEFIT ACTIVITES. 246719 0 The Instittute for Healthy Aging at Keiro (IHA) achievements are: 1) Partnered with community organizations to educate 2,264 people through evidence based seminars/conferences; 2) Provided case management/referral services to 55 people; 3) Provided nikkei community internship programs; community needs assessments and clinical observations site for 2 graduate gerontology students, 1 graduate MSW intern, 1 graduate medical student, three undergraduate students; 4) Provided health promotion/wellness, caregiving and consumer education to over 29,000 families through Keiro's website, blog and newsletters; 5) Provided Meeting space/parking/overhead to other NFP community Organizations; 6) Grant writing to support IHA; 7) Contributed $2,920 to other NFP organizations. 0 0 0 392484 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 13 0 1 40 1 0 0 0 0 0 1 1 0 0 0 0 1 0 X 14 13 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X DALE POSADAS 3239807503 325 SOUTH BOYLE AVENUE LOS ANGELES CA 90033 Ernest Doizaki 1 X 0 0 0 Jeff Folick 1 X 0 0 0 Gerald Fukui 1 X 0 0 0 Tom Haga 1 X 0 0 0 Thomas Iino CPA 1 X 0 0 0 Gary Kawaguchi 1 X 0 0 0 Frank Kawana 1 X X 0 0 0 Kiyoshi Maruyama CPA 1 X X 0 0 0 Lynn Miyamoto ESQ 1 X 0 0 0 Makoto Nakayama Pharm D 1 X 0 0 0 Stuart Tsujimoto 1 X 0 0 0 George Sugimoto 1 X 0 0 0 Ruth Watanabe 1 X X 0 0 0 Shawn Miyake 40 X X 240677 0 16408 John Ikegami 1 X 0 0 0 Dianne Belli 40 X 141360 0 11333 Audrey Lee-Sung 40 X 106055 0 6401 Gene Kanamori 40 X 100679 0 12151 Dale Posadas 40 X 103680 0 2810 692451 0 49103 5 0 1 0 Adams & Associaates 5318 East 2nd Street Number 486 Long Beach CA 908038674 Security Services 212034 1 0 0 25015 0 0 561121 76881 586136 0 465811 0 0 465811 0 0 0 0 0 0 0 0 0 0 0 0 565781 25015 105155 460626 0 460626 MANAGEMENT FEE REVENUE 900099 2899901 2899901 0 0 4703 4703 0 0 2904604 4417177 2904604 0 926437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1696379 139480 1345586 211313 56210 1611 46559 8040 331510 20846 277369 33295 128930 10835 100952 17143 0 0 0 0 50466 0 50466 0 13049 0 13049 0 0 0 0 0 0 0 125100 0 49651 75449 26091 2091 0 24000 0 0 0 0 209777 11019 156417 42341 0 0 0 0 0 0 0 0 31785 31785 0 0 30830 5309 20686 4835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99627 99627 0 0 76538 0 76538 0 PURCHASED SERVICES 285707 35866 239289 10552 DUES AND SUBSCRIPTIONS 10285 281 7502 2502 SEMINARS 14824 4906 9478 440 45452 28828 11598 5026 3232560 392484 2405140 434936 3257192 2725684 452028 962133 179352 50000 11186 -22622 0 0 0 0 0 0 3053 7002 43919 42997 1169713 580830 1487688 588883 12998854 15754629 0 0 0 0 0 0 8934584 10331438 27367856 30440144 261194 816454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261194 816454 X 13036480 14599125 3404693 5088328 10665489 9936237 27106662 29623690 27367856 30440144 X 1184617 1332411 X 0 1 1 X 0 X X 0 0 0 Keiro Nursing Home 953946299 7 1 1 1 0 Keiro Retirement Home 952916028 7 1 1 1 0 2 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10326218 417763 965000 0 150000 0 11558981 9924521 335176 66521 0 0 0 10326218 8087196 825341 1067249 0 55265 0 9924521 6719121 837361 1019257 0 488543 0 8087196 0 0.86 0.14 0 0 0 52475 52475 0 219784 67338 152446 0 0 0 0 0 845584 513492 332092 0 51870 0 51870 588883 INTEREST RECEIVABLES 8600 OTHER ASSETS 9524 LONG-TERM RECEIVABLE-CRT 3375942 DUE FROM/TO RELATED ORGANIZATIONS-NET 6937372 10331438 0 0 4417177 3232560 1184617 892288 0 0 0 440123 1332411 2517028 5779294 892288 0 0 545278 1437566 4341728 0 75449 75449 4417177 3262266 0 0 0 105155 105155 3157111 0 75449 75449 3232560 SchD_P05_S00_L04 Schedule D, Part V, Line 4 The KS endowment fund was established to ensure that the Organization is funded to continue to meet its mission to care for the elderly. Net assets associated with the endowment are classified and reported based on the donor-imposed restrictions. SchD_P10_S00_L02 Schedule D, Part X, Line 2 THE ORGANIZATION IS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(A) OF THE CODE AND CORRESPONDING SECTIONS OF THE CALIFORNIA REVENUE AND TAXATION CODE, THOUGH IT IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSES, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE CODE. ACCORDINGLY, NO PROVISION OR CREDIT FOR FEDERAL OR STATE INCOME TAXES IS RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE STATUTE OF LIMITATIONS FOR FEDERAL AND CALIFORNIA STATE PURPOSES IS GENERALLY THREE AND FOUR YEARS, RESPECTIVELY. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 UNREALIZED GAIN ON CHARITABLE REMAINDER TRUST SchD_P12_S00_L02d Schedule D, Part XII, Line 2d UNREALIZED GAIN ON CHARITABLE REMAINDER TRUST - $440,123 FUNDRAISING EXPENSES - $105,155 TOTAL $545,278 SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Investment Management Fees SchD_P13_S00_L02d Schedule D, Part XIII, Line 2d FUNDRAISING EXPENSES SchD_P13_S00_L04b Schedule D, Part XIII, Line 4b Investment Management Fees GOLF TOURNAMENT 81533 0 81533 1800 3604 10800 4411 0 2933 BENEFIT LUNCHEON 509263 25015 484248 0 0 11254 46128 0 24225 0 590796 25015 565781 1800 3604 22054 50539 0 27158 105155 460626 X X X 0 0 0 0 0 0 0 0 0 Shawn Miyake 234677 0 0 0 6000 0 7305 0 9103 0 257085 0 Dianne Belli 137760 0 0 0 3600 0 4406 0 6927 0 152693 0 X 170 68845 SELLING PRICE X 3 8036 SELLING PRICE 1 0 1 1 SchM_P01_S00_L00 Schedule M, Part I COLUMN (B) - REPORTED NUMBER IS THE NUMBER OF CONTRIBUTIONS. SchM_P01_S00_L32b Schedule M, Part I, Line 32b THIRD PARTIES ARE USED TO PROCESS AND SELL VEHICLE/VESSEL CONTRIBUTIONS, SECURITIES AND REAL ESTATES. F990_P01_S00_L01 Form 990, Part I, Line 1 FULFILL ITS MISSION TO ENHANCE THE QUALITY OF SENIOR LIFE IN OUR COMMUNITY. AS THE LARGEST HEALTHCARE PROVIDER SERVICING THE JAPANESE AMERICAN COMMUNITY, WE OFFER PEACE OF MIND TO OVER 125,000 FAMILIES AT OUR FACILITIES PROVIDING CARE IN A CULTURALLY-SENSITIVE ENVIRONMENT WITH FAMILIAR LANGUAGE, FOOD, ACTIVITIES AND VALUES. WE PROVIDE EDUCATION AND RESOURCES TO FAMILIES CARING FOR SENIORS AT HOME, ADULTS 50+, EMPLOYEES AND VOLUNTEERS THROUGH THE INSTITUTE FOR HEALTHY AGING AT KEIRO. F990_P03_S00_L04b Form 990, Part III, Line 4b ORGANIZATIONS EVENT SPONSORSHIPS/SUPPORT AND DONATIONS. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 ONE BOARD MEMBER AND THE CEO HAVE A BUSINESS RELATIONSHIP OUTSIDE OF THE ORGANIZATION. THE BOARD MEMBER RECUSES HIMSELF ON ANY MATTERS THAT PRESENT CLIENT CONFLICT. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a MEMBERS OF THE GOVERNING BODY ARE ELECTED BY THE EXECUTIVE BOARD. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b DECISIONS MADE BY THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE KEIRO SERVICES BOARD. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b THE 990 IS REVIEWED BY THE FINANCE COMMITTEE, CHAIRPERSONS AND TREASURES OF THE SUPPORTED ORGANIZATIONS. MEMBERS DISCUSS RELEVANT MATTERS AND ASK QUESTIONS OF STAFF. ONCE APPROVED, STAFF ARE DIRECTED TO PROVIDE COPIES TO ALL BOARD MEMBERS PRIOR TO SUBMISSION. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c A CHIEF COMPLIANCE OFFICER IS DESIGNATED BY THE CORPORATION TO OVERSEE COMPLIANCE TO POLICIES AND PROCEDURES. ANNUAL MANDATORY MEETINGS ARE HELD FOR ALL STAFF TO GO OVER COMPLIANCE ISSUES SPECIFIC TO OUR INDUSTRY. CCO ALSO PROVIDES EDUCATION TO THE BOARD OF DIRECTORS. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE CEO AND KEY EMPLOYEES OCCURS IN A TWO STEP PROCESS. THE FIRST STEP INCLUDES A MEETING OF THE PERSONNEL COMMITTEE WHICH IS MADE UP OF INDEPENDENT BOARD MEMBERS AS VERIFIED BY THE COMPLETION OF CONFLICT OF INTEREST DISCLOSURES. IN THIS MINUTED MEETING, THE COMMITTEE REVIEWS COMPARABILITY DATA FROM INDEPENDENT DATA SOURCES. THE COMMITTEE DELIBERATES OVER THE MATERIAL AND ITS COMPARABILITY WITH CURRENT COMPENSATION ARRANGEMENTS FOR KEY EMPLOYEES. ONCE A DECISION IS FINALIZED, A RECOMMENDATION IS MADE TO THE FULL BOARD ON WHETHER TO ACCEPT THE ARRANGEMENTS OR MODIFY THEM. THE FULL BOARD THEN VOTES TO ACCEPT THE RECOMMENDATION OR NOT. IN THE SECOND STEP, THE CEO'S COMPENSATION IS REVIEWED AT AN EXECUTIVE SESSION OF THE FULL BOARD. THE SAME INDEPENDENT DATA SOURCES ARE UTILIZED FOR COMPARABILITY PURPOSES. AFTER DELIBERATIONS, THE FULL BOARD MAKES A DETERMINATION ON THE CEO'S COMPENSATION ARRANGEMENT. THIS DISCUSSION AND ANY DECISIONS MADE ARE CONTEMPORANEOUSLY MINUTED. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 FINANCIAL STATEMENTS ARE BEING PUBLISHED IN THE ORGANIZATION'S ANNUAL REPORT. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. F990_P11_S00_L05 Form 990, Part XI, Line 5 NET UNREALIZED GAIN ON INVESTMENTS $892,288 NET UNREALIZED GAIN ON CHARITABLE REMAINDER TRUST $440,123 TOTAL TO FORM 990, PART XI, LINE 5 $1,332,411 KEIRO NURSING HOME 2221 LINCOLN PARK AVENUE LOS ANGELES CA 90031 953946299 SKILLED NURSING CARE CA 501 (C)(3) LINE 7 KEIRO SERVICES 0 KEIRO RETIREMENT HOME 325 SOUTH BOYLE AVENUE LOS ANGELES CA 90033 952916028 NURSING & RESIDENTIAL CARE CA 501 (c)(3) LINE 7 KEIRO SERVICES 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 KEIRO NURSING HOME o 28702976 ACTUAL COSTS KEIRO NURSING HOME p 30253889 ACTUAL COSTS KEIRO RETIREMENT HOME o 8153255 ACTUAL COSTS KEIRO RETIREMENT HOME p 7590852 ACTUAL COSTS