SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
MAUNALANI NURSING AND
REHABILITATION CENTER
Employer identification number

99-0249327
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11B 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 15 THE SALARY AND PREREQUISITES OF THE EXECUTIVE DIRECTOR WILL BE BASED ON HIS/HER PERFORMANCE AND REVIEWED ANNUALLY. IN APPROVING OR RECOMMENDING ANY SALARY OR PREREQUISITE 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 THE IRS. THE SALARY AND PREREQUISITES OF SENIOR MANAGEMENT STAFF WILL BE BASED ON HIS/HER PERFORMANCE AND REVIEWED ANNUALLY. IN APPROVING OR RECOMMENDING ANY SALARY OR PREREQUISITE 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 THE 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 XII, LINE 2C: THE BOARD COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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