PINE VIEW MANOR INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: PINE VIEW MANOR INC (EIN 43-1114366)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-08
IRS object ID: 201323129349302227
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-08T16:09:49-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	431594752	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MUELLER PROST PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	7733 FORSYTH BLVD SUITE 1200	AddressLine1
City	ST LOUIS	City
State	MO	State
ZIP Code	63105	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	431114366	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	PINE VIEW MANOR INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	PINE	NameControl
Phone	6607832118	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	307 N PINEVIEW STREET	AddressLine1
City	STANBERRY	City
State	MO	State
ZIP Code	64489	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	PAMELA HAILEY	Name
Title	ADMINISTRATOR	Title
Phone	6607832118	Phone
Date Signed	2013-11-07	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JEANETTE BAX-KURTZ	Name
PTIN	P00096490	PTIN
Phone	3148622070	Phone
Date Prepared	2013-11-03	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	BARB SHUPE	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	307 N PINEVIEW STREET	AddressLine1
City	STANBERRY	City
State	MO	State
ZIP Code	64489	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	2735212	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.PINEVIEWSTANBERRY.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1978	YearFormation
State Legal Domicile	MO	StateLegalDomicile
Activity Or Mission Description	DEDICATION TO HIGHEST QUALITY OF CARE AND SERVICE TO OUR RESIDENTS DELIVERED WITH SPIRITUAL COMPASSION, PERSONAL PRIDE, AND PROFESSIONALISM.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	114	TotalNbrEmployees
Total Nbr Volunteers	24	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1276	ContributionsGrantsPriorYear
Contributions Grants Current Year	20609	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	2531530	ProgramServiceRevenuePriorYear
Program Service Revenue CY	2700552	ProgramServiceRevenueCY
Investment Income Prior Year	1641	InvestmentIncomePriorYear
Investment Income Current Year	670	InvestmentIncomeCurrentYear
Other Revenue Prior Year	4125	OtherRevenuePriorYear
Other Revenue Current Year	13381	OtherRevenueCurrentYear
Total Revenue Prior Year	2538572	TotalRevenuePriorYear
Total Revenue Current Year	2735212	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	1534973	SalariesEtcPriorYear
Salaries Etc Current Year	1584869	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	959823	OtherExpensePriorYear
Other Expenses Current Year	1058712	OtherExpensesCurrentYear
Total Expenses Prior Year	2494796	TotalExpensesPriorYear
Total Expenses Current Year	2643581	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	43776	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	91631	RevenuesLessExpensesCY
Total Assets BOY	1106843	TotalAssetsBOY
Total Assets EOY	1065898	TotalAssetsEOY
Total Liabilities BOY	666376	TotalLiabilitiesBOY
Total Liabilities EOY	533800	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	440467	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	532098	NetAssetsOrFundBalancesEOY
Mission Description	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.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	2431015	Expense
Revenue	2713933	Revenue
Description	PINE VIEW MANOR PROVIDED 24 HOUR SKILLED NURSING CARE TO RESIDENTS. THE TOTAL SKILLED NURSING FACILITY CENSUS FOR 2012 WAS 15,106. PINE VIEW MANOR ALSO PROVIDED 24 HOUR CARE TO RESIDENTS IN THE ASSISTED LIVING UNIT. THE TOTAL ASSISTED LIVING FACILITY CENSUS DAYS FOR 2012 WAS 2,096. IN ADDITION, PINE VIEW MANOR PROVIDED IN-PATIENT AND OUT-PATIENT REHABILITATION SERVICES.	Description
Total Program Service Expense	2431015	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	9	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	114	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	0	CompensationProcessCEO
Compensation Process Other	0	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	PAMELA HAILEY	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6607832118	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	307 N PINEVIEW ST	AddressLine1
City	STANBERRY	City
State	MO	State
ZIP Code	64489	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
BARB SHUPE
PRESIDENT	1.00	X	X	0	0	0
KENT PETERSON
SECRETARY/TREASURER	1.00	X	X	0	0	0
SANDY JOHNSON
BOARD MEMBER	0.50	X		0	0	0
MIKE MCQUINN
BOARD MEMBER	1.00	X		0	0	0
BRUCE JOHNSON
FORMER BOARD MEMBER	0.00	X		0	0	0
LATON ALLISON
BOARD MEMBER	1.00	X		0	0	0
ELDON LONG
BOARD MEMBER	0.50	X		0	0	0
KATIE DIAS
BOARD MEMBER	0.50	X		0	0	0
DAVE HIBBS
VICE PRESIDENT	0.50	X	X	0	0	0
NORMA HILL
BOARD MEMBER	0.50	X		0	0	0
JERRY DOERHOFF
ADMINISTRATOR (PREVIOUS)	40.00		X	43846	0	0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	43846	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
All Other Contributions	20609	AllOtherContributions
Noncash Contributions	16103	NoncashContributions
Total Contributions	20609	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENT SERVICE REVEN	623000	2634347	2634347
OTHER RESIDENT CARE RE	623000	35691	35691
RESIDENT TRANSPORTATIO	480000	14354	14354
RESIDENT CAFETERIA	722210	9470	9470
RESIDENT BEAUTY SHOP	446199	6690	6690

Field	Value	IRS element (for citing)
Total Program Service Revenue	2700552	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	670	TotalRevenueColumn
Exclusion	$670	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Personal	13381	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Personal	0	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Personal	13381	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	13381	TotalRevenueColumn
Related Or Exempt Function Income	13381	RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2735212	TotalRevenueColumn
Related Or Exempt Function Income	2713933	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$670	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	43846	Total
Program Services	21923	ProgramServices
Management And General	21923	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1326341	Total
Program Services	1243328	ProgramServices
Management And General	83013	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	114732	Total
Program Services	106651	ProgramServices
Management And General	8081	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	99950	Total
Program Services	93694	ProgramServices
Management And General	6256	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	12380	Total
Management And General	12380	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	5203	Total
Program Services	2602	ProgramServices
Management And General	2601	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	4549	Total
Management And General	4549	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	32744	Total
Program Services	16372	ProgramServices
Management And General	16372	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	172826	Total
Program Services	169347	ProgramServices
Management And General	3479	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	8009	Total
Program Services	7508	ProgramServices
Management And General	501	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	73859	Total
Program Services	72404	ProgramServices
Management And General	1455	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	89836	Total
Program Services	86348	ProgramServices
Management And General	3488	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
PURCHASED SERVICES	255901	255901
DIETARY EXPENSE	133854	133854
PHARMACY EXPENSE	76052	76052
MEDICAL SUPPLIES EXPENS	40196	40196

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	153303	Total
Program Services	104835	ProgramServices
Management And General	48468	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	2643581	Total
Program Services	2431015	ProgramServices
Management And General	212566	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	83561	BOY
EOY	60996	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	243225	BOY
EOY	255771	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	12916	BOY
EOY	16523	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	44317	BOY
EOY	48771	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	3302336	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2620225	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	720486	BOY
EOY	682111	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	2338	BOY
EOY	1726	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	1106843	BOY
EOY	1065898	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	541124	BOY
EOY	285823	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	86555	BOY
EOY	158468	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	38697	BOY
EOY	89509	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	666376	BOY
EOY	533800	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	440467	BOY
EOY	532098	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	440467	BOY
EOY	532098	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1106843	BOY
EOY	1065898	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	91631	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	1	AccountantCompileOrReview

Accountant Compile Or Review Basis AccountantCompileOrReviewBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
FS Audited	0	FSAudited
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1140	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	1192	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1722	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1276	CurrentTaxYearMinus1Year
Current Tax Year	20609	CurrentTaxYear
Total	25939	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2196611	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2491442	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2533122	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2531530	CurrentTaxYearMinus1Year
Current Tax Year	2700552	CurrentTaxYear
Total	12453257	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2197751	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2492634	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2534844	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2532806	CurrentTaxYearMinus1Year
Current Tax Year	2721161	CurrentTaxYear
Total	12479196	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	63839	CurrentTaxYearMinus1Year
Current Tax Year	49357	CurrentTaxYear
Total	113196	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Current Tax Year Minus3 Years	165291	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	223754	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	260157	CurrentTaxYearMinus1Year
Current Tax Year	306775	CurrentTaxYear
Total	955977	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Current Tax Year Minus3 Years	165291	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	223754	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	323996	CurrentTaxYearMinus1Year
Current Tax Year	356132	CurrentTaxYear
Total	1069173	Total

Field	Value	IRS element (for citing)
Public Support Total509	11410023	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	15103	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	10531	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	7537	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5766	CurrentTaxYearMinus1Year
Current Tax Year	14051	CurrentTaxYear
Total	52988	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	15103	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	10531	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	7537	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5766	CurrentTaxYearMinus1Year
Current Tax Year	14051	CurrentTaxYear
Total	52988	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	27226	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	27940	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	34403	CurrentTaxYearMinus2Years
Total	89569	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2240080	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2531105	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2576784	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2538572	CurrentTaxYearMinus1Year
Current Tax Year	2735212	CurrentTaxYear
Total	12621753	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.90400	PublicSupportPercentage509
Prior Year Support Percentage	0.92710	PriorYearSupportPercentage
Investment Income Percentage	0.00420	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00420	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	51250	OtherCostOrOtherBasis
Book Value	51250	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2454002	OtherCostOrOtherBasis
Depreciation	1887047	Depreciation
Book Value	566955	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	387895	OtherCostOrOtherBasis
Depreciation	368803	Depreciation
Book Value	19092	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	409189	OtherCostOrOtherBasis
Depreciation	364375	Depreciation
Book Value	44814	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	682111	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
DUE TO RESIDENTS	$1,726
ASSET RETIREMENT OBLIGATION	$32,732
EMPLOYEE ASSISTANCE FUND	$5,186
PROVIDER TAX	$49,865

Field	Value	IRS element (for citing)
Total Of Amounts	89509	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	Identifier
Return Reference	PART X, LINE 2:	ReturnReference
Explanation	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, 2012 AND 2011. THE MANOR'S INFORMATION RETURNS, FOR THE YEARS ENDING 2012, 2011, 2010 AND 2009 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR 3 YEARS AFTER THEY WERE FILED.	Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
BARB SHUPE PRESIDENT OF PINE VIEW
BARB SHUPE IS A DIRECTOR OF GRAND RIVER AMBULANCE	245	PINE VIEW MANOR USES GRAND RIVER AMBULANCE TO TRANSPORT RESIDENTS TO AND FROM THE HOSPITALS.	0
MIKE MCQUINN BOARD MEMBER
MIKE MCQUINN OWNS FAMILY HEALTH PHARMACY	53227	PINE VIEW MANOR USES FAMILY HEALTH PHARMACY TO SUPPLY MEDICATIONS TO RESIDENTS AND ALSO TO SET UP BUBBLE PACKS FOR MED DISTRIBUTION.	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReference	ExplanationExplanation
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 C, LINE 19	THE ORGANIZATIONS GOVERNING DOCUMENTS AND ANNUAL FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
	THE ORGANIZATIONS FINANCIAL STATEMENT REVIEW OVERSIGHT PROCESS AND ACCOUNTING FIRM SELECTION PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.