2016-07-11T09:39:20-05:00 2015-12-31 431594752 MUELLER PROST LC 7733 FORSYTH BLVD SUITE 1200 ST LOUIS MO 63105 990 2015-01-01 431114366 PINE VIEW MANOR INC PINE 6607832118 307 N PINEVIEW STREET STANBERRY MO 64489 PAMELA HAILEY ADMINISTRATOR 6607832118 2016-06-28 1 JEANETTE BAX-KURTZ P00096490 3148622070 2016-06-28 2015 2016-09-27 15:27:22Z KENT PETERSON 307 N PINEVIEW STREET STANBERRY MO 64489 3781260 0 X WWW.PINEVIEWSTANBERRY.COM X 1978 MO DEDICATION TO HIGHEST QUALITY OF CARE AND SERVICE TO OUR RESIDENTS DELIVERED WITH SPIRITUAL COMPASSION, PERSONAL PRIDE, AND PROFESSIONALISM. 9 9 126 74 0 0 1854 3092 3617525 3770428 2119 2865 6375 4875 3627873 3781260 0 0 0 0 1888426 2210967 0 0 0 1112744 1174834 3001170 3385801 626703 395459 1872513 2045907 534844 312779 1337669 1733128 THE MISSION OF PINE VIEW MANOR, INC. IS DEDICATION TO THE HIGHEST QUALITY OF TOTAL CARE AND SERVICE TO OUR RESIDENTS DELIVERED WITH SPIRITUAL COMPASSION, PERSONAL PRIDE, AND PROFESSIONALISM. 0 0 3096296 3775303 PINE VIEW MANOR PROVIDED 24 HOUR SKILLED NURSING CARE TO RESIDENTS. THE TOTAL SKILLED NURSING FACILITY CENSUS FOR 2015 WAS 21,268. PINE VIEW MANOR ALSO PROVIDED 24 HOUR CARE TO RESIDENTS IN THE ASSISTED LIVING UNIT. THE TOTAL ASSISTED LIVING FACILITY CENSUS DAYS FOR 2015 WAS 3,201. IN ADDITION, PINE VIEW MANOR PROVIDED IN-PATIENT AND OUT-PATIENT REHABILITATION SERVICES. 3096296 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 12 0 1 126 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X PAMELA HAILEY 6607832118 307 N PINEVIEW ST STANBERRY MO 64489 KENT PETERSON VICE PRESIDENT 6.00 X X 0 0 0 SANDY JOHNSON FORMER BOARD MEMBER 2.00 X 0 0 0 MIKE MCQUINN BOARD MEMBER 6.00 X 0 0 0 LATON ALLISON BOARD MEMBER 4.00 X 0 0 0 JIM STRUEBY BOARD MEMBER 2.00 X 0 0 0 KATIE DIAS PRESIDENT 2.00 X X 0 0 0 TONY JENNINGS BOARD MEMBER 2.00 X 0 0 0 NORMA HILL FORMER VICE PRESIDENT 2.00 X X 0 0 0 BARB SHUPE BOARD MEMBER 2.00 X 0 0 0 JOHN GROOMER BOARD MEMBER 2.00 X 0 0 0 MIRANDA FLOYD VICE PRESIDENT 2.00 X X 0 0 0 TERESA STUART SECRETARY/TREASURER 40.00 X 42951 0 0 PAMELA HAILEY ADMINISTRATOR 40.00 X 104987 0 1191 147938 0 1191 1 0 0 0 0 3092 3092 RESIDENT SERVICE REVEN 623000 3716431 3716431 RESIDENT TRANSPORTATIO 480000 23384 23384 RESIDENT CAFETERIA 722210 18278 18278 RESIDENT BEAUTY SHOP 446199 7700 7700 OTHER RESIDENT CARE RE 623000 4635 4635 3770428 2865 2865 4875 0 4875 4875 4875 3781260 3775303 0 2865 149129 53089 96040 49094 49094 1659853 1582852 77001 202552 183712 18840 150339 135998 14341 160 80 80 20623 20623 10792 5396 5396 6421 6421 20682 10341 10341 187914 184201 3713 293 265 28 69664 68322 1342 90796 82135 8661 PURCHASED SERVICES 345720 345720 DIETARY EXPENSE 187364 187364 REPAIRS & MAINTENANCE 63280 60832 2448 MEDICAL SUPPLIES 37481 37481 133644 109414 24230 3385801 3096296 289505 0 50 50 736548 922166 428982 328662 20345 21626 24857 25671 3565336 2823377 655593 741959 6138 5773 1872513 2045907 469695 238509 65149 74270 534844 312779 X 1337669 1733128 1337669 1733128 1872513 2045907 395459 0 X X 1 X 0 1 0 X 1276 20609 4562 1854 3092 31393 2531530 2700552 2630601 3617525 3770428 15250636 2532806 2721161 2635163 3619379 3773520 15282029 63839 49357 81727 90599 75372 360894 260157 306775 114163 169908 851003 323996 356132 81727 204762 245280 1211897 14070132 5766 14051 3349 8494 7740 39400 5766 14051 3349 8494 7740 39400 2538572 2735212 2638512 3627873 3781260 15321429 0.91830 0.91050 0.00260 0.00280 X 51250 51250 2625576 2036187 589389 433049 388675 44374 455461 398515 56946 741959 DUE TO RESIDENTS 5773 ASSET RETIREMENT OBLIGATION 37805 EMPLOYEE ASSISTANCE FUND 6228 PROVIDER TAX 24464 74270 X PART X, LINE 2: THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THAT GUIDANCE, THE MANOR MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THE MANOR AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME ("UBIT"). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014. THE MANOR'S INFORMATION RETURNS, FOR THE YEARS ENDING 2015, 2014, 2013, AND 2012 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR 3 YEARS AFTER THEY WERE FILED. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS THAT CAN VOTE TO ELECT THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS THAT CAN VOTE TO ELECT THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS REVIEWED BY ALL PINE VIEW MANOR OFFICERS AND GOVERNING BOARD MEMBERS PRIOR TO FILING FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL DISCLOSURE STATEMENT IS CIRCULATED TO OFFICERS AND CERTAIN IDENTIFIED AGENTS AND EMPLOYEES TO ASSIST THEM IN CONSIDERING ANY CONFLICTS OF INTEREST, BUT DISCLOSURE IS APPROPRIATE AND REQUIRED WHENEVER CONFLICTS OF INTEREST MAY OCCUR. THE WRITTEN NOTICES OF DISCLOSURES ARE THEN FILED WITH THE ADMINISTRATOR OR SUCH OTHER PERSON DESIGNATED BY THE ADMINISTRATOR TO RECEIVE SUCH NOTIFICATIONS. AT THE MEETING OF THE BOARD OF DIRECTORS, ALL DISCLOSURES OF REAL OR APPARENT CONFLICTS OF INTEREST ARE NOTED FOR THE RECORD IN THE MINUTES. FORM 990, PART VI, SECTION B, LINE 15A THE ADMINISTRATOR'S COMPENSATION IS DELIBERATED AND DECIDED UPON BY THE BOARD OF DIRECTORS ANNUALLY. COMPARABILITY DATA AND COMPENSATION REPORTS ARE UTILITIZED IN THE COMPENSATION DELIBERATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS AND ANNUAL FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S ACCOUNTING FIRM SELECTION PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. THE ORGANIZATION UNDERWENT AN AUDIT IN 2014. IN 2015 THE ORGANIZATION UNDERWENT A REVIEW, SO THE FINANCIAL STATEMENT REVIEW OVERSIGHT PROCESS WAS NEW IN 2015.