2011-06-30T09:38:31-05:00 2010-12-31 Ginoli & Company LtdCPA's 7625 N University Ste A Peoria IL 616148303 990 2010-01-01 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 2011-06-28 1 MICHAEL P REMMELE 3096712350 2011-06-27 2010 2016-02-24 21:20:13Z BRAD BARKLEY 830 W TRAILCREEK DR PEORIA IL 61614 8723807 0 X N/A X 2000 IL OPERATION OF A SKILLED NURSING CENTER 4 4 248 0 0 0 0 0 8514227 8721792 2707 2015 0 0 8516934 8723807 0 0 0 0 4735455 4801390 0 0 0 4709621 4596227 9445076 9397617 -928142 -673810 9343203 8630529 11811869 11773005 -2468666 -3142476 TO PROVIDE CARE FOR THE ELDERLY. 0 0 7248866 8723807 OPERATION OF A SKILLED NURSING CENTER 7248866 1 0 0 0 0 0 0 0 0 1 0 0 0 0 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 0 1 0 0 248 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 IL X LARRY TEMPLIN 3096918113 830 W TRAILCREEK DR PEORIA IL 61614 X MICHAEL KUHL 1.00 X 0 0 0 THOMAS HUMMERTON 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 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 441540 MARTIN BROS 406 VIKING ROAD CEDER FALLS IA 50613 FOOD SUPPLY VENDOR 344895 PETERSEN HEALTH CARE 830 WEST TRAILCREEK DR PEORIA IL 61614 MANAGEMENT SERVICES 318400 BLUE CROSSBLUE SHIELD PO BOX ZZ CHICAGO IL 60690 INSURANCE PROVIDER 308541 PETERSEN HEALTH CARE II 830 WEST TRAILCREEK DR PEORIA IL 61614 MANAGEMENT SERVICES 299000 5 PATIENT SERVICE 623000 8702784 8702784 RESIDENT SERVICES 623000 19008 19008 8721792 2015 2015 8723807 8723807 0 0 4466192 4211958 254234 335198 335198 37481 37481 60004 60004 19726 19726 14365 14365 4734 4734 679707 679707 407077 407077 MANAGEMENT FEE 617400 617400 NURSING SERVICES 516398 516398 OPERATIONS & MAINTENANC 364705 364705 PURCHASED SERVICES 357655 357655 PROVIDER BED TAX 339246 339246 1177729 759282 418447 9397617 7248866 2148751 0 186826 359597 1339244 894702 32153 32153 8640290 3242531 5671932 5397759 2113048 1946318 9343203 8630529 1222726 1197557 8316059 8178977 630000 630000 1643084 1766471 11811869 11773005 X -2468666 -3142476 -2468666 -3142476 9343203 8630529 -673810 X 0 1 1 X 1 1 X 3970529 3687087 6381343 8514227 8721792 31274978 3970529 3687087 6381343 8514227 8721792 31274978 0 0 0 31274978 9528 5976 4094 2707 2015 24320 9528 5976 4094 2707 2015 24320 3980057 3693063 6385437 8516934 8723807 31299298 0.99920 0.99900 0.00080 0.00100 X 487408 487408 6539640 2135588 4404052 1613242 1106943 506299 5397759 DEFERRED FINANCING COSTS 773223 ASSETS LIMITED AS TO USE 1122794 PREPAID EXPENSES 50301 1946318 ACCRUED PAYROLL 309037 INTEREST PAYABLE 319423 DUE TO AFFILIATES 351000 DUE TO TUTERA HEALTH CARE 458743 OTHER LIABILITES 328268 1766471 8723807 9397617 -673810 0 -673810 8723807 0 8723807 0 8723807 9397617 0 9397617 0 9397617 CITY OF GARY INDIANA SERIES A & B 356001040 582065598 2008-10-01 5100000 PURCHASE OF FACILITY 1 0 0 2008 0 0 1 1 1 0 0 0 0 1 0 0 0 0 0 0 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 X, line 24f FOOD: Program service expenses 331,356. Management and general expenses 0. Fundraising expenses 0. Total expenses 331,356. MISC. PAYROLL TAXES AND EMPLOYEE BENEFITS: Program service expenses 0. Management and general expenses 272,113. Fundraising expenses 0. Total expenses 272,113. SUPPLIES: Program service expenses 263,203. Management and general expenses 0. Fundraising expenses 0. Total expenses 263,203. MISC. ADMIN. EXPENSES: Program service expenses 0. Management and general expenses 122,620. Fundraising expenses 0. Total expenses 122,620. PROPERTY & LIABILITY INSURANCE: Program service expenses 83,989. Management and general expenses 0. Fundraising expenses 0. Total expenses 83,989. WORKMEN'S COMPENSATION: Program service expenses 68,069. Management and general expenses 0. Fundraising expenses 0. Total expenses 68,069. BAD DEBT EXPENSE: Program service expenses 0. Management and general expenses 23,714. Fundraising expenses 0. Total expenses 23,714. EQUIPMENT RENTAL: Program service expenses 7,534. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,534. OTHER DIETARY: Program service expenses 5,117. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,117. TRAINING: Program service expenses 277. Management and general expenses 0. Fundraising expenses 0. Total expenses 277. MISC. EXPENSES: Program service expenses -263. Management and general expenses 0. Fundraising expenses 0. Total expenses -263.