2018-08-15T10:29:32-05:00 2017-09-30 431594752 MUELLER PROST LC 7733 FORSYTH BLVD SUITE 1200 ST LOUIS MO 63105 990 2016-10-01 941636507 ST JOHN'S RETIREMENT VILLAGE STJO 5306621290 135 WOODLAND AVENUE WOODLAND CA 95695 WENDY STARR EXECUTIVE DIRECTOR 5306621290 2018-08-10 1 WM GUY CROUCH P00643576 3148622070 2018-08-10 2016 2022-09-23 18:48:47Z WENDY STARR 135 WOODLAND AVENUE WOODLAND CA 95695 10771370 0 X WWW.SJRV.ORG X 1967 CA TO HONOR THE ORGANIZATION'S RESIDENTS' DIGNITY, INDEPENDENCE AND SPIRITUALITY BY PROVIDING THEM WITH A SAFE, SUPPORTIVE AND CARING ENVIRONMENT IN WHICH TO LIVE. THE ORGANIZATION'S MISSION IS TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS IN ITS MULTI-LEVEL ASSISTED LIVING FACILITIES AND ITS SKILLED NURSING FACILITY. 8 7 228 0 0 0 147638 370099 10032366 10312136 1158 702 31344 53783 10212506 10736720 0 0 0 0 5862978 6560889 0 0 107252 4284796 3996230 10147774 10557119 64732 179601 6699584 6615086 4360773 4096101 2338811 2518985 X TO HONOR THE ORGANIZATION'S RESIDENTS' DIGNITY, INDEPENDENCE AND SPIRITUALITY BY PROVIDING THEM WITH A SAFE, SUPPORTIVE AND CARING ENVIRONMENT IN WHICH TO LIVE. THE ORGANIZATION'S MISSION IS TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS IN ITS MULTI-LEVEL ASSISTED LIVING FACILITIES AND ITS SKILLED NURSING FACILITY. 0 0 4880443 5520329 MULTI-LEVEL ASSISTED LIVING FACILITIES. ASSISTED LIVING FOR ACTIVE RESIDENTS WITH MINIMAL CARE NEEDS IN COTTAGES AND APARTMENTS CALLED THE VILLAGE. ASSISTED LIVING FOR RESIDENTS WITH MODERATE CARE NEEDS IN THE PERSONAL CARE UNIT (PCU). HIGH LEVEL OF CARE FOR RESIDENTS IN NEED OF COGNITIVE AND MEMORY SUPPORT IN THE MANORS. RESPITE CARE IS AVAILABLE FOR A MINIMUM OF TWO WEEKS PRO-RATED AT THE MONTHLY RATE. - TOTAL 34,118 RESIDENT/PATIENT DAYS 4236768 4791807 SKILLED NURSING FACILITY. LONG-TERM CARE FOR CHRONIC CONDITIONS AS WELL AS POST-SURGICAL REHABILITATION SERVICES AND WOUND CARE. HOSPICE CARE IS AVAILABLE. RESPITE CARE IS AVAILABLE FOR A MINIMUM OF TWO WEEKS PRO-RATED AT THE MONTHLY RATE. - TOTAL 15,628 PATIENT DAYS 9117211 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 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 0 0 1 29 0 1 228 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 1 1 1 1 0 CA X THE ORGANIZATION 5306621290 135 WOODLAND AVENUE WOODLAND CA 95695 MARILYN MITCHELL PRESIDENT 15.00 X X 0 0 0 CHUCK SANTONI VICE PRESIDENT 4.00 X X 0 0 0 JENEE RAWLINGS SECRETARY 4.00 X X 0 0 0 JANET CARRERE MEMBER 4.00 X 0 0 0 SUZANNE ANDERSON MEMBER 2.00 X 0 0 0 ERIC DOWDY MEMBER 2.00 X 0 0 0 JANE MARTIN MEMBER 2.00 X 0 0 0 WENDY STARR CEO 40.00 X X 115773 0 0 M THERESE BROWN FORMER CEO 40.00 X X 145803 0 3911 261576 0 3911 2 0 0 0 SYSCO FOODS SERVICES PO BOX 138007 SACRAMENTO CA 95813 FOOD SERVICES 376375 DYNAMIC MEDICAL MANAGEMENT INC 4605 W IMPERIAL VIEW CT ROCKLIN CA 95677 PHYSICAL THERAPY 332285 SACRAMENTO VALLEY NURSING SERVICE PO BOX 938 RIO LINDA CA 95673 STAFFING SERVICES 170767 ESKATON PROPERTIES INC 5105 MANZANITA AVENUE CARMICHAEL CA 95608 ACCOUNTING & IT SERVICES 110227 4 370099 370099 ASSISTED LIVING REVENUE 623000 5510676 5510676 NET SKILLED NURSING REVENUE 623000 4783427 4783427 OTHER PROGRAM REVENUE 623000 18033 18033 10312136 702 702 14385 0 14385 14385 14385 74048 34650 39398 39398 10736720 10312136 0 54485 162954 130363 32591 4891316 4458136 359565 73615 1097118 992706 87910 16502 409501 381516 21904 6081 307133 307133 1751 1751 59617 59617 789761 650333 139428 51976 17 51959 73515 8133 64505 877 2223 889 1334 487367 487367 13150 5558 7424 168 149226 149226 414648 414648 109111 29312 79799 FOOD SERVICES 470634 470322 125 187 SUPPLIES 442657 419290 22203 1164 QUALITY ASSURANCE FEE 271018 271018 REPAIRS & MAINTENANCE 128194 119186 9008 224249 130080 86845 7324 10557119 9117211 1332656 107252 348821 886435 326150 207143 623 623 612894 454053 196189 202293 13305579 8451129 5199645 4854450 9516 10089 5746 0 6699584 6615086 650613 638803 0 29519 3701469 3422607 8691 5172 4360773 4096101 X 2216650 2434875 122161 84110 2338811 2518985 6699584 6615086 179601 573 0 X X 0 1 X 1 0 X 176675 200913 156581 147638 370099 1051906 9325661 9626910 9779178 10032366 10312136 49076251 90795 121417 38785 74048 325045 9593131 9949240 9935759 10218789 10756283 50453202 0 0 0 50453202 2266 2010 1790 15717 15087 36870 2266 2010 1790 15717 15087 36870 9595397 9951250 9937549 10234506 10771370 50490072 0.99930 0.99950 0.00070 0.00050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 75430 75430 11330882 7005086 4325796 1899267 1446043 453224 4854450 RESIDENT TRUST 5172 5172 X 10737293 573 573 10736720 0 10736720 10557119 0 10557119 0 10557119 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL AND CALIFORNIA INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND THE CORRESPONDING PROVISIONS OF THE CALIFORNIA REVENUE AND TAXATION CODE, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME (UBTI) AS DEFINED BY THE IRC. THE ORGANIZATION EVALUATES UNCERTAIN TAX POSITIONS THROUGH ITS REVIEW OF THE SOURCES OF INCOME TO IDENTIFY UBTI AND CERTAIN OTHER MATTERS, INCLUDING THOSE WHICH MAY AFFECT ITS TAX EXEMPT STATUS. THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF SEPTEMBER 30, 2017, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THE ORGANIZATION FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2013 FOR THEIR FEDERAL AND 2012 FOR THEIR STATE TAX FILINGS. RHYTHM AND RIBS 74048 74048 34650 74048 74048 34650 34650 39398 FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT OF THE FORM 990 IS DISTRIBUTED TO THE BOARD MEMBERS TOGETHER WITH A COPY OF THE AUDITED FINANCIAL STATEMENTS AND TRIAL BALANCE FOR REVIEW AND COMPARISON. THE BOARD DESIGNATES AND ASSIGNS ONE OF ITS QUALIFIED MEMBERS TO REVIEW THE RETURN. UPON RESOLUTION OF QUESTIONS AND ISSUES, AND APPROVAL BY THE DESIGNATED BOARD MEMBER, THE BOARD APPROVES THE RETURN FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C EMPLOYEES MUST DISCLOSE TO THE CHIEF EXECUTIVE OFFICER ALL FINANCIAL OR EMPLOYMENT RELATIONSHIPS THEY HAVE WITH COMPETITORS, RESIDENTS, SUPPLIERS OR POTENTIAL SUPPLIERS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD CONDUCTS A MARKET SURVEY OF PAY RATES AND OTHER AVAILABLE DATA IN ORDER TO DETERMINE COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 1023 AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR SELECTION PROCESS.