2016-05-13T07:59:48-05:00 2015-06-30 274573546 STILLWAGGON & MCGILL LLC 10 WOODLAND CENTER DRIVE GROVE CITY PA 16127 990 2014-07-01 990249327 MAUNALANI NURSING AND REHABILITATION CENTER MAUN 8087320771 5113 MAUNALANI CIRCLE HONOLULU HI 96816 SAI CHANTAVY EXECUTIVE DIRECTOR 8087320771 2016-04-28 1 JOHN C STILLWAGGON CPA P00158206 7244587490 2016-04-28 2014 2016-08-17 19:52:53Z SAI CHANTAVY 5113 MAUNALANI CIRCLE HONOLULU HI 96816 14128705 0 X N/A X 1950 HI COMMITTED TO PROVIDING EXCELLENCE IN NURSING CARE AND REHABILITATION SERVICES BY BEING READY TO MEET THE CHANGING NEEDS OF THE COMMUNITY. MAUNALANI NURSING AND REHABILITATION CENTER IS THE PROVIDER AND EMPLOYER OF CHOICE IN THE INDUSTRY. RESIDENTS AND GUESTS WILL EXPERIENCE A CULTURE OF CARING THAT IS LIFE AFFIRMING, SATISFYING AND MEANINGFUL. 9 8 170 15 0 0 159446 2077603 12280743 12037013 -103874 5866 0 8223 12336315 14128705 0 0 0 0 7086100 7265846 0 0 0 6354604 5660423 13440704 12926269 -1104389 1202436 31912066 33571127 3018834 3409054 28893232 30162073 MAUNALANI NURSING AND REHABILITATION CENTER IS A PRIVATE NONPROFIT HEALTH CARE ORGANIZATION FOUNDED IN 1950. THE ORGANIZATION IS COMMITTED TO PROVIDING EXCELLENCE IN NURSING CARE AND REHABILITATION SERVICES BY BEING READY TO MEET THE CHANGING NEEDS OF THE COMMUNITY. 0 0 11838084 12045236 MAUNALANI NURSING & REHABILITATION CENTER IS A 100-BED FACILITY LICENSED TO PROVIDE SKILLED, INTERMEDIATE, AND REHABILITATIVE CARE SERVICES. DAILY OCCUPANCY RATE FOR 2014/2015 IS 97.80% WITH AN AVERAGE PER DIEM RATE OF $325.22. 11838084 1 1 0 0 0 0 0 1 1 0 1 0 0 1 1 1 1 1 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 1 0 0 0 1 27 0 1 170 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X THE ORGANIZATION 8087320771 5113 MAUNALANI CIRCLE HONOLULU HI 968164019 HOWARD H HAMAMOTO PRESIDENT 1.00 1.00 X X 0 0 0 JOSEPH H GOLDCAMP VP & TREASURER 1.00 1.00 X X 0 0 0 SAI CHANTAVY SECRETARY & EXEC. DIRECTOR 60.00 10.00 X X 176553 0 14416 DAVID DEVENOT DIRECTOR 0.50 X 0 0 0 A JAMES WRISTON JR DIRECTOR 0.50 0.50 X 0 0 0 SUSAN KOSASA DIRECTOR 0.50 X 0 0 0 JAMES PIETSCH DIRECTOR 0.50 0.50 X 0 0 0 RODERICK J PEROFF DIRECTOR 0.50 X 0 0 0 BARBARA K STANTON DIRECTOR 0.50 X 0 0 0 ROBERT HIDANO FINANCE DIRECTOR 45.00 5.00 X 114489 0 7781 291042 0 22197 2 0 1 0 GENESIS ELDERCARE REHAB SERVICES PO BOX 7247-6524 PHILADELPHIA PA 19170 THERAPY SERVICES 561255 STATE DIRECTOR OF FINANCE 1001 KAMOKILA BLVD RM 317 KAPOLEI HI 96707 PROVIDER FEES 420912 AEGIS THERAPIES INC PO BOX 8103 FORT SMITH AR 72902 THERAPY SERVICES 111804 3 1826000 251603 2077603 NET PATIENT REVENUE 623000 11965818 11965818 MISCELLANEOUS PATIENT CHARGES 623000 71195 71195 12037013 5866 5866 OTHER INCOME 623000 8223 8223 8223 14128705 12045236 0 5866 192882 96441 96441 5919005 5441450 477555 206642 187235 19407 491305 445165 46140 456012 413186 42826 11033 11033 45000 45000 677668 625337 52331 75111 70494 4617 77047 73195 3852 518511 492585 25926 8534 8534 1700000 1700000 250129 237623 12506 252115 228438 23677 FOOD AND SUPPLIES 926298 923055 3243 GENERAL ADMINISTRATION 698065 522498 175567 SUSTAINABILITY FEE EXPE 420912 381382 39530 12926269 11838084 1088185 0 1000 1000 1941696 1791730 2944858 2631058 63569 57949 334542 312831 4240226 2800633 1639289 1439593 24987112 27336966 31912066 33571127 2491188 1021821 523379 554734 4267 6499 0 1826000 3018834 3409054 X 28893232 30162073 28893232 30162073 31912066 33571127 X 1202436 66405 X X 0 1 X 1 0 X 278082 8738 156286 159446 251603 854155 10882784 11560416 12177012 12280743 12045236 58946191 11160866 11569154 12333298 12440189 12296839 59800346 0 0 0 59800346 7744 3334 2415 6109 5866 25468 7744 3334 2415 6109 5866 25468 8223 8223 11168610 11572488 12335713 12446298 12310928 59834037 0.99940 0.99960 0.00040 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X DECORATIONS 0 1 4267 62698 60466 6499 1 X 1257665 649764 607901 2899893 2077478 822415 82668 73391 9277 1439593 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 25322512 DUE FROM MAUNALANI FOUNDATION 1826000 OVERFUNDED PENSION PLAN 188454 27336966 ACCRUED CONTRIBUTION TO PENSION PLAN 1826000 1826000 X 14128705 0 14128705 0 14128705 12926269 0 12926269 0 12926269 PART III, LINE 4: ALL THE ARTWORKS ARE USED AS DECORATIONS IN THE ORGANIZATION. PART IV, LINE 1B: THE COMPANY IS TRUSTEE FOR THE RESIDENTS' PERSONAL FUNDS. THE FUNDS ARE RECEIVED FROM THE RESIDENTS FROM VARIOUS SOURCES AND DISBURSED AS THE RESIDENTS' NEEDS WARRANT. THESE FUNDS ARE RESTRICTED AND ARE NOT AVAILABLE FOR OPERATIONS. PART IV, LINE 2B: THE ORGANIZATION MAINTAINS RESIDENTS' PERSONAL FUNDS WHEN REQUESTED BY THE RESIDENTS. AT 6/30/15, THREE RESIDENTS HAD THEIR PERSONAL FUNDS ON ACCOUNT. THE RESIDENT TRUST FUNDS IS IN A SEPARATE BANK ACCOUNT AT AMERICAN SAVINGS BANK. PART X, LINE 2: IN ACCORDANCE WITH ASC NO. 740 AS IT RELATES TO UNCERTAIN TAX POSITIONS FOR THE YEAR ENDED JUNE 30, 2015, THE COMPANY HAS EVALUATED ITS TAX POSITIONS TAKEN FOR ALL OPEN YEARS. CURRENTLY, 2011, 2012, AND 2013 TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. HOWEVER, THE COMPANY IS NOT CURRENTLY UNDER AUDIT NOR HAS THE COMPANY BEEN CONTACTED BY THE INTERNAL REVENUE SERVICE. BASED ON THE EVALUATION OF THE COMPANY'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER EXAMINATION. THEREFORE, NO ASSET OR LIABILITY FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED IN THE FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2015. X X X 0 0 0 0 0 0 0 0 0 SAI CHANTAVY SECRETARY & EXEC. DIRECTOR 165365 0 10000 0 1188 0 5326 0 9090 0 190969 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED, READ AND UNDERSTANDS, AND AGREED TO COMPLY WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE SALARY AND PERQUISITES OF THE EXECUTIVE DIRECTOR AND SENIOR MANAGEMENT STAFF WILL BE BASED ON HIS/HER PERFORMANCE AND REVIEWED ANNUALLY. IN APPROVING OR RECOMMENDING ANY SALARY OR PERQUISITE ADJUSTMENT, THE COMMITTEE WILL CONSIDER THE RESPONSIBILITY, QUALIFICATIONS, EXPERIENCE, PERFORMANCE RECORD OF THE INDIVIDUAL, AND THE SALARY RANGES PAID TO A SIMILAR POSITION IN THE MARKETPLACE. THE COMPENSATION WILL BE REASONABLE AND IN ACCORDANCE WITH THE RULES OF IRS. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST FOR A PERIOD OF THREE YEARS FROM THE DATE FILED.IT IS AVAILABLE IN THE ADMINISTRATIVE OFFICE OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 A PERSON MUST SUBMIT A REQUEST IN WRITING TO THE EXECUTIVE DIRECTOR. COPYING FEES MAY APPLY. FINANCIAL STATEMENTS ARE FOR INTERNAL USE ONLY. FORM 990, PART XI, LINE 9: GAIN ON ITEMS NOT YET RECOGNIZED AS A COMPONENT OF NET 335,400. PERIODIC PENSION COST. -268,995. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF MAUNALANI FOUNDATION. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. MAUNALANI FOUNDATION 5113 MAUNALANI CIRCLE HONOLULU HI 96816 990075234 NON-HEALTHCARE ACTIVITIES WHICH INCLUDE LEASING LAND AND A BUILDING HI 501(C)(3) 509(A)(3) MAUNALANI NURSING AND REHABILITATION CENTER 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 MAUNALANI FOUNDATION K 550000 COST MAUNALANI FOUNDATION O 27555 SEE SCHEDULE R, PART VII MAUNALANI FOUNDATION O 11856 SEE SCHEDULE R, PART VII MAUNALANI FOUNDATION C 1826000 FAIR VALUE MAUNALANI FOUNDATION B 1700000 FAIR VALUE SCHEDULE R, PART V, LINE 2(2)(D) SAI CHANTAVY WORKS 70 HOURS A WEEK. SHE IS CONSIDERED AN EMPLOYEE OF THE MAUNALANI NURSING AND REHABILITATION CENTER. APPROXIMATELY 60 HOURS PER WEEK ARE SPENT PERFORMING HER DUTIES AS THE ADMINISTRATOR OF THE CENTER. FOR THE REMAINING 10 HOURS PER WEEK, SHE ASSISTS THE MAUNALANI FOUNDATION PRIMARILY IN REGARDS TO OVERSIGHT AND MANAGEMENT OF THE INVESTMENTS HELD BY THE FOUNDATION. $27,555 IS 1/7 OF HER 2014-2015 SALARY ALLOCATED TO THE FOUNDATION. SCHEDULE R, PART V, LINE 2(3)(D) ROBERT HIDANO WORKS 50 HOURS A WEEK. HE IS CONSIDERED AN EMPLOYEE OF THE MAUNALANI NURSING AND REHABILITATION CENTER. APPROXIMATELY 45 HOURS PER WEEK ARE SPENT PERFORMING HIS DUTIES AS THE FINANCE DIRECTOR OF THE CENTER. FOR THE REMAINING 5 HOURS PER WEEK, HE ASSISTS THE MAUNALANI FOUNDATION. $11,856 IS 1/10 OF HIS 2014-2015 SALARY ALLOCATED TO THE FOUNDATION.