2024-05-10T17:46:29-05:00 2023-06-30 430765316 RUBINBROWN LLP 7676 FORSYTH BLVD SUITE 2100 SAINT LOUIS MO 63105 990 2022-07-01 430679177 MANOR GROVE INC MANO 3149650864 711 SOUTH KIRKWOOD ROAD ST LOUIS MO 63122 GEORGE ROLBY VICE PRESIDENT 3149650864 2024-05-09 1 GEORGE ROLBY 999009999 1 KIMBERLY A RYAN P00829977 3142903300 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z JENNIFER MCCALLON 711 SOUTH KIRKWOOD ROAD ST LOUIS MO 63122 12949233 0 X WWW.MANORGROVE.COM X 1907 MO TO PRESERVE THE QUALITY OF LIFE & PROVIDE EXPERT CARE FROM A HIGHLY SKILLED MULTIDISCIPLINARY TEAM. 11 11 166 11 0 0 1902048 11161 8042713 9726869 554992 171306 48128 9185 10547881 9918521 0 0 0 0 5826014 6316514 0 0 0 4336472 5176181 10162486 11492695 385395 -1574174 11020752 9707634 899375 1054765 10121377 8652869 X TO PRESERVE THE QUALITY OF LIFE THROUGH COMPASSIONATE, EXPERT CARE FROM A HIGHLY SKILLED MULTIDISCIPLINARY TEAM. WE RECOGNIZE THAT GOOD PEOPLE MAKE THE DIFFERENCE AND ARE THE KEY TO PROVIDING QUALITY CARE TO RESIDENTS WHO COME TO US FOR LONG-TERM CARE. WE ASSIST RESIDENTS IN ACHIEVING THEIR HIGHEST POSSIBLE LEVEL OF PHYSICAL, PSYCHOSOCIAL AND SPIRITUAL POTENTIAL, ALWAYS WORKING TO PROTECT AND ENHANCE THEIR DIGNITY. WE SEEK TO CONTINUALLY IMPROVE THE SERVICES WE PROVIDE TO STAY CURRENT WITH THE CHANGING ENVIRONMENT AND TO MAINTAIN A HOME-LIKE ATMOSPHERE FOR OUR FAMILY OF RESIDENTS. 0 0 10215187 9726869 OWNING AND OPERATING A LICENSED 117-BED SKILLED NURSING FACILITY LOCATED IN ST. LOUIS, MISSOURI. RENOVATIONS FROM FISCAL YEAR 2008 ADDED A THERAPY ROOM AND MODIFIED 14 ROOMS FOR MEDICARE RESIDENTS. MANOR GROVE'S HOME-LIKE ENVIRONMENT ASSURES PEACE OF MIND FOR RESIDENTS AND THEIR FAMILIES. IN 2015, A NEW PARKING LOT WAS ADDED ON THE NORTH-WEST SIDE OF THE MAIN BUILDING TO ACCOMODATE PARKING NEEDS OF FAMILY MEMBERS AND EMPLOYEES. IN 2017, THE RENOVATION OF THE SECOND FLOOR TOOK PLACE WHICH MADE THE SECOND FLOOR MUCH MORE ATTRACTIVE AND COMFORTABLE TO THE CURRENT AND PROSPECTIVE RESIDENTS. IN 2018, A NEW NURSES CALL SYSTEM WAS INSTALLED ON THE SECOND FLOOR. IN 2019-2020, A NEW GENERATOR WAS PUT IN PLACE. IN 2020-2021, THE ELEVATOR SYSTEM WAS UPGRADED. IN THE CHANGING LANDSCAPE OF COVID, WE HAVE PUT ESSENTIAL EFFORTS AND RESOURCES INTO KEEPING STAFF, VISITORS AND RESIDENTS AS SAFE AS POSSIBLE. WITH PURCHASES OF STATE OF THE ART EQUIPMENT WE HAVE BEEN ABLE TO KEEP OUR INFECTION RATES LOW AND PRODUCTIVITY HIGH. WE PLAN TO CONTINUE THESE EFFORTS THROUGH THE PANDEMIC, ALWAYS LOOKING FOR NEW OPPORTUNITIES TO BETTER OUR VACCINATION, TESTING AND TREATMENT METHODS. 10215187 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 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 1 52 0 166 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 1 1 X ROZA KOYEN 3149650864 711 SOUTH KIRKWOOD ROAD ST LOUIS MO 63122 CAROL EILER PRESIDENT 3.00 X X 0 0 0 GEORGE ROLBY VICE PRESIDENT 1.00 X X 0 0 0 SHEILA EATON SECRETARY 3.00 X X 0 0 0 JIM WIRE CONTROLLER 4.00 X X 0 0 0 JASON APPEL MEMBER 1.00 X 0 0 0 CHRISTINA CAPIZZI MEMBER 2.00 X 0 0 0 DIANE KEEFE MEMBER 1.00 X 0 0 0 E LEE POTTS MEMBER 1.00 X 0 0 0 ANNE ROEHM MEMBER 3.00 X 0 0 0 PHIL ROUSH MEMBER 1.00 X 0 0 0 HARDY WASHINGTON MEMBER 1.00 X 0 0 0 JENNIFER MCCALLON ADMINISTRATOR 40.00 X 88851 0 10444 ROZA KOYEN ACCOUNTANT 40.00 X 63818 0 12518 EARNESTINE DECASUAL-SMITH NURSE 73.00 X 160515 0 17 RAYNA WALKER NURSE 63.00 X 105375 0 13545 JUDITH WHITE AIDE 90.00 X 109994 0 11438 FATIMA ZIADI AIDE 80.00 X 105345 0 11321 633898 0 59283 4 0 1 0 INTEGRITY HEALTH GROUP PO BOX 4729 WINTER PARK FL 327934729 NURSING STAFFING 1330699 ALLIANCE REHAB STL LLC DBA SYMBRIA 28100 TORCH PARKWAY SUITE 600 WARRENVILLE IL 60555 THERAPY 285507 KEVIN DEPEW DBA SILVERBACK VIDEO LLC 2342 CENTERLINE INSUSTRIAL DR ST LOUIS MO 63146 MARKETING 217707 GRAPE TREE MEDICAL STAFFING LLC PO BOX 5340 SIOUX FALLS SD 571175340 NURSING STAFFING 119239 FORVIS LLP FKA BKD LLP 910 E ST LOUIS ST STE 2 SPRINGFIELD MO 65806 MEDICARE BILLING 105701 5 11161 11161 ELDERLY CARE 623000 9726869 9726869 9726869 114024 114024 3087994 3030712 57282 57282 57282 TRANSPORTATION INCOME 480000 8078 8078 MISCELLANEOUS INCOME 621300 1107 1107 9185 9918521 9726869 0 180491 X 185434 32404 153030 5171688 4909122 262566 52482 18293 34189 510908 461206 49702 396002 366878 29124 4723 1922 2801 90255 90255 31999 31999 2123822 2123822 220147 220147 381915 352570 29345 275871 272285 3586 624 624 10588 5308 5280 770 770 427642 422083 5559 240002 230448 9554 SERVICE CONTRACTS 387808 50067 337741 FOOD SERVICE EXPENSES 361422 361422 MEDICAID NFRA TAX 336671 336671 PHARMACY AND SUPPLEMENT 111214 111214 170708 159472 11236 11492695 10215187 1277508 0 3966 7250 558267 677220 263715 516669 57390 70940 99284 72860 14297006 9109647 5302883 5187359 4371135 2769919 364112 405417 11020752 9707634 558355 614827 45101 25690 278199 290151 17720 124097 899375 1054765 X 10116287 8647889 5090 4980 10121377 8652869 11020752 9707634 -1574174 105666 0 X X 0 1 X 1 0 X 10111 416346 350919 1902048 11161 2690585 9453698 9143116 7970277 8042713 9726869 44336673 44453 46800 29200 10250 0 130703 9508262 9606262 8350396 9955011 9738030 47157961 7450 8323 6828 7332 9066 38999 0 7450 8323 6828 7332 9066 38999 47118962 180340 143339 147083 161744 114024 746530 180340 143339 147083 161744 114024 746530 28326 21316 9376 61382 9185 129585 9716928 9770917 8506855 10178137 9861239 48034076 0.98090 0.97910 0.01550 0.01680 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 28,326. 2019 AMOUNT: $ 21,316. 2020 AMOUNT: $ 9,376. 2021 AMOUNT: $ 61,382. 2022 AMOUNT: $ 9,185. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 347080 347080 11748859 7595995 4152864 1257315 828695 428620 943752 684957 258795 5187359 CAPITAL LEASE OBLIGATION 124097 124097 9991418 105666 -770 104896 9886522 31999 31999 9918521 11459926 0 11459926 31999 770 32769 11492695 PART IV, LINE 2B: SECURITY DEPOSITS HELD ON BEHALF OF RESIDENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: INTEREST EXPENSE -770. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE 770. X 0 0 0 0 0 0 0 0 0 EARNESTINE DECASUAL-SMITH NURSE 160515 0 0 0 0 0 0 0 17 0 160532 0 0 0 PART I, LINE 3 MANAGEMENT REVIEWS COMPENSATION TO VERIFY AMOUNTS ARE COMPARABLE TO OTHER ENTITIES IN THE SAME REGION AND SIZE AMONG OTHER FACTORS. BOARD OF DIRECTORS REVIEW AND APPROVE COMPENSATION FOR THE ADMINISTRATOR. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES THAT MAY ACT ON BEHALF OF THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE ADMINISTRATOR WILL REVIEW THE PREPARED FORM 990. THE BOARD WILL REVIEW AND APPROVE THE 990 DURING THEIR FIRST MEETING AFTER THE 990 HAS BEEN PREPARED. BOARD MEMBERS WILL BE ABLE TO VOICE ANY COMMENTS OR CONCERNS, AND DECIDE IF ANY CHANGES NEED TO BE MADE. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS OF THE BOARD ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. IF THE ADMINISTRATOR OR THE BOARD MEMBER SUSPECTS A CONFLICT OF INTEREST, IT IS DISCLOSED AT THE NEXT BOARD MEETING. THE BOARD MEMBERS DISCUSS THE ISSUES AND ACCEPT OR DENY THE TRANSACTION. THE DISCLOSURE, DISCUSSION, AND DECISION HAPPEN BEFORE THE TRANSACTION OCCURS. NO RESTRICTIONS HAVE BEEN IMPOSED SO FAR. FORM 990, PART VI, SECTION B, LINE 15A MANAGEMENT REVIEWS COMPENSATION TO VERIFY AMOUNTS ARE COMPARABLE TO OTHER ENTITIES IN THE SAME REGION AND SIZE AMONG OTHER FACTORS. BOARD OF DIRECTORS REVIEW AND APPROVE COMPENSATION FOR THE ADMINISTRATOR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION HAS MADE GOVERNING DOCUMENTS, THEIR CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 16B: INVESTMENT IN SCN, INC. THE ORGANIZATION ADOPTED A POLICY IN 2015 FOR THE MONITORING OF THIS INVESTMENT. DURING THE 2011 TAX YEAR SCN, INC. CONVERTED FROM A NON PROFIT ORGANIZATION TO A FOR PROFIT ORGANIZATION WITH FIVE MEMBERS, ALL OF WHICH ARE 501(C)(3) ORGANIZATIONS. SCN, INC. HAS BEEN ORGANIZED TO ENABLE ITS MEMBERS TO TAKE ADVANTAGE OF GROUP DISCOUNTS WHEN PURCHASING SUPPLIES AND SERVICES NEEDED FOR OPERATION OF THEIR NURSING HOME AND SKILLED-NURSING FACILITIES. FORM 990, PART IX, LINE 11G THERAPY SERVICES: PROGRAM SERVICE EXPENSES 279,873. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 279,873. PROFESSIONAL NURSING: PROGRAM SERVICE EXPENSES 1,843,949. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,843,949. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.