2024-11-15T08:23:46-06:00 2023-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 1000 COMMERCE PARK DR WILLIAMSPORT PA 17701 990 2023-01-01 240795507 THE WILLIAMSPORT HOME WILL 5703238781 1900 RAVINE ROAD WILLIAMSPORT PA 17701 JENNIFER CISNEROS NURSING HOME ADMINISTRATOR 5703238781 2024-11-11 1 0 JAIME L KUNTZ CPA P01272711 5703236023 2024-11-11 2023 2024-10-15 13:58:12Z JENNIFER CISNEROS 1900 RAVINE ROAD WILLIAMSPORT PA 17701 19805972 0 X THEWILLIAMSPORTHOME.COM X 1873 PA PROVIDE NURSING SERVICES IN A 129 BED SKILLED NURSING FACILITY AND HOUSING FOR THE ELDERLY. 14 14 299 5 0 0 574574 69657 15014547 18107963 -209600 579405 96853 140836 15476374 18897861 0 0 0 0 9362854 9067999 0 0 0 8375365 11007320 17738219 20075319 -2261845 -1177458 18816006 18847273 4388522 5163381 14427484 13683892 X TO PROVIDE THE HIGHEST QUALITY OF CARE TO OUR RESIDENTS WHILE HONORING THEIR INDEPENDENCE AND DIGNITY. 0 0 18005670 18107963 THE WILLIAMSPORT HOME (THE HOME) OPERATES A 129-BED SKILLED NURSING AND REHABILITATION CENTER, 2 LICENSED PERSONAL CARE PROGRAMS AND 185 INDEPENDENT LIVING APARTMENTS WHICH SERVE MEN AND WOMEN. THE HOME ALSO OPERATES A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) PROVIDING HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO ELDERLY RESIDENTS. THE HOME WAS APPROVED TO PROVIDE CONGREGATE MEALS, TRANSPORTATION AND ASSISTANCE TO APARTMENT RESIDENTS BY THE DEPARTMENT OF HEALTH AS A HOME CARE PROVIDER ON APRIL 1, 2011.CONTINUED ON SCHEDULE ODURING 2023, THE HOME PROVIDED 43,361 DAYS OF NURSING SERVICES TO RESIDENTS; 45,576 DAYS OF HOUSING TO RESIDENTS IN INDEPENDENT APARTMENTS; AND 7,599 DAYS IN OUR DHS LICENSED PERSONAL CARE PROGRAMS. OUR PROGRAMS ARE DESIGNED TO HELP MAINTAIN OUR RESIDENT'S HEALTH, SECURITY AND INDEPENDENCE.THE HOME PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOME DOES NOT PURSUE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS REVENUES. THE HOME PROVIDED APPROXIMATELY $11,226 OF CHARITY CARE DURING 2023. ADDITIONALLY, THE HOME PROVIDES SERVICES TO MEDICAL ASSISTANCE BENEFICIARIES AND IS REIMBURSED AT RATES DIFFERENT FROM STANDARD ROOM CHARGES. THE TOTAL DIFFERENCES RELATED TO THESE SERVICES WERE APPROXIMATELY $1,900,000 IN 2023.VOLUNTEERING:5 COMMUNITY VOLUNTEERS PROVIDED 777.80 HOURS IN SKILLED NURSING CENTER 24 APARTMENT RESIDENTS VOLUNTEERED 1,187.75 HOURS IN THE APARTMENTS DINING ROOM AND STORES. 14 BOARD MEMBERS VOLUNTEERED OVER 300 HOURS TO TWH CAMPUS 18005670 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 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 0 0 0 0 0 0 1 20 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X NICHOLAS MEALE 5703238781 1900 RAVINE ROAD WILLIAMSPORT PA 17701 CANDACE DEWAR PRESIDENT 1.00 X X 0 0 0 SUSAN EVANS VICE-PRESIDENT 1.00 X X 0 0 0 BRETTE CONFAIR SECRETARY 1.00 X X 0 0 0 RENEE LAYCHUR TREASURER 1.00 X X 0 0 0 SHARON ATHERHOLT DIRECTOR 1.00 X 0 0 0 MAUREEN CAREY DIRECTOR 1.00 X 0 0 0 WINONA KREMSER DIRECTOR 1.00 X 0 0 0 PATRICIA SHIPMAN DIRECTOR 1.00 X 0 0 0 BETH STUBLER DIRECTOR 1.00 X 0 0 0 LAURIE BARCLAY DIRECTOR 1.00 X 0 0 0 CATHERINE PICCOLO DIRECTOR 1.00 X 0 0 0 KATHLEEN PAGANA DIRECTOR 1.00 X 0 0 0 HIEN CONNOLLY DIRECTOR 1.00 X 0 0 0 PAMELA LUNDY DIRECTOR 1.00 X 0 0 0 DONALD S POTE RETIRED 43024 EXEC. DIRECTOR 40.00 X 0 0 0 TAMMY SHEEHAN UNTIL 11323 NURSING HOME ADMINISTRATOR 40.00 X 0 0 0 NICHOLAS MEALE DIRECTOR OF FINANCE 40.00 X 27000 0 0 JENNIFER CISNEROS AS OF 52923 NURSING HOME ADMINISTRATOR 40.00 X 0 0 0 DENISE STAYER 11423 - 52623 NURSING HOME ADMINISTRATOR 40.00 X 0 0 0 SUSAN R HOOKER REGISTERED NURSE 65.50 X 126014 0 16918 SUSAN ECKER QA NURSE 40.00 X 101859 0 0 JILL MEREDITH INFECTION CONTROL NURSE 40.00 X 101493 0 14552 356366 0 31470 3 0 0 0 THE STAFFING FIRM PO BOX 628328 ORLANDO FL 32862 STAFFING 1190550 FUNCTIONAL PATHWAYS 10133 SHERRIL BLVD STE 200 KNOXVILLE TN 37932 THERAPY SERVICES 1012897 SODEXO INC & AFFILIATES BOX 360170 PITTSBURGH PA 15251 FOOD SERVICES 842475 STAFFQUEST INC PO BOX 75359 CHICAGO IL 60675 STAFFING 797906 AFFINITY HEALTH SERVICES 942 PHILADELPHIA ST INDIANA PA 15701 MANAGEMENT SERVICES 774919 18 38483 31174 69657 PATIENT SERVICE REVENUE 623000 14778124 14778124 APARTMENT REVENUE 623000 3329839 3329839 18107963 200365 200365 1287151 908111 379040 379040 379040 CABLE TV SERVICES FOR RESIDENTS 517000 50191 50191 BEAUTY/BARBER SHOP REVENUE 812900 29375 29375 TRANSPORTATION FOR RESIDENTS 480000 14443 14443 46827 46827 140836 18897861 18107963 0 720241 X 7646622 7240763 405859 73936 55182 18754 809094 762155 46939 538347 509030 29317 410423 32463 377960 14596 14596 52521 507 52014 4833053 4438395 394658 97370 97370 1898023 1567463 330560 622015 622015 103464 86071 17393 123292 123292 1247746 1247746 390723 127926 262797 NURSING HOME ASSESSMENT 312331 312331 REPAIRS & MAINTENANCE 290156 177479 112677 BAD DEBT EXPENSE 243196 243196 MEDICAL SUPPLIES 180010 180010 188401 182276 6125 20075319 18005670 2069649 0 500 500 625618 376381 1098870 2435809 26152 26774 59038 68676 37297665 28070394 9849185 9227271 6625301 6274001 531342 437861 18816006 18847273 1698014 2119483 10811 9358 2118363 1868998 400049 999891 161285 165651 4388522 5163381 X 14302578 13212205 124906 471687 14427484 13683892 18816006 18847273 X -1177458 383881 49985 X 0 1 X 1 0 X 52157 1273900 2124768 574574 69657 4095056 17599559 16918039 15938015 15014547 18107963 83578123 17651716 18191939 18062783 15589121 18177620 87673179 0 0 0 87673179 185653 115653 140442 187483 200365 829596 185653 115653 140442 187483 200365 829596 137193 82791 96478 96853 140836 554151 17974562 18390383 18299703 15873457 18518821 89056926 0.98450 0.98540 0.00930 0.00870 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: EMPLOYEE AND GUEST MEALS - 2019 AMOUNT: $ 6,151. 2020 AMOUNT: $ 1,888. 2021 AMOUNT: $ 735. 2022 AMOUNT: $ 973. 2023 AMOUNT: $ 2,040. BEAUTY/BARBER SHOP REVENUE - 2019 AMOUNT: $ 29,949. 2020 AMOUNT: $ 6,432. 2021 AMOUNT: $ 6,933. 2022 AMOUNT: $ 15,686. 2023 AMOUNT: $ 29,375. CABLE TV SERVICES FOR RESIDENTS - 2019 AMOUNT: $ 57,646. 2020 AMOUNT: $ 60,620. 2021 AMOUNT: $ 57,400. 2022 AMOUNT: $ 55,638. 2023 AMOUNT: $ 50,191. CONCESSION/VENDING - 2019 AMOUNT: $ 7. 2020 AMOUNT: $ -5,485. 2021 AMOUNT: $ 1,355. 2022 AMOUNT: $ 8,746. 2023 AMOUNT: $ 7,788. TRANSPORTATION FOR RESIDENTS - 2019 AMOUNT: $ 2,298. 2020 AMOUNT: $ 4,444. 2021 AMOUNT: $ 5,727. 2022 AMOUNT: $ 3,568. 2023 AMOUNT: $ 14,443. OTHER INCOME - 2019 AMOUNT: $ 38,164. 2020 AMOUNT: $ 14,549. 2021 AMOUNT: $ 24,328. 2022 AMOUNT: $ 11,804. 2023 AMOUNT: $ 36,999. PROFESSIONAL WELLNESS - 2019 AMOUNT: $ 2,978. 2020 AMOUNT: $ 343. 2022 AMOUNT: $ 438. 2023 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 796206 796206 27002315 19953487 7048828 6547018 5690822 856196 2952126 2426085 526041 9227271 FINANCE LEASE OBLIGATIONS 165651 165651 X 19331727 383881 49985 433866 18897861 0 18897861 20075319 0 20075319 0 20075319 PART X, LINE 2: THE HOME ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2023 AND 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS HELD BY OTHERS 49,985. A LYCOMING COUNTY AUTHORITY HEALTHCARE REVENUE NOTE SERIES A OF 2013 236760375 2013-04-12 4400000 SEE PART VI 0 0 0 A 2497017 4400000 43739 4356261 2015 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 SCHEDULE K, PART 1, BOND ISSUES: (A) ISSUER NAME: LYCOMING COUNTY AUTHORITY HEALTHCARE REVENUE NOTE SERIES A OF 2013 (F) DESCRIPTION OF PURPOSE: DESIGN, CONSTRUCTION, AND EQUIPPING OF REHABILITATION UNIT FORM 990, PART VI, SECTION A, LINE 3 THE HOME UTILIZES THE MANAGEMENT SERVICES OF AFFINITY HEALTHCARE SERVICES. AFFINITY EMPLOYS DONALD S. POTE, EXECUTIVE DIRECTOR ($104,234) AND THE FOLLOWING NURSING HOME ADMINISTRATORS DURING THE YEAR: TAMMY SHEEHAN ($31,085) (UP TO 1/13/23) DENISE STAYER ($161,591) (1/14/23 - 5/26/23) JENNIFER CISNEROS ($74,853) (AS OF 5/29/23) FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PROVIDED TO AND REVIEWED BY ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS AND MEMBERS OF MANAGEMENT MUST COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. ALL QUESTIONNAIRES ARE REVIEWED BY THE EXECUTIVE DIRECTOR AND MAINTAINED ON FILE. BOARD DIRECTORS WITH POTENTIAL CONFLICTS ARE REQUIRED TO ABSTAIN FROM VOTING ON MATTERS RELATED TO THE CONFLICT AND COULD BE REMOVED FROM THE BOARD IF THE CONFLICT IS SIGNIFICANT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE EXECUTIVE DIRECTOR AND ALL EMPLOYEES IS CALCULATED BY MANAGEMENT AND THE MANAGEMENT COMPANY, AFFINITY HEALTH SERVICES. MANAGEMENT AND AFFINITY USE DATA FROM LEADING AGE PA AND WAGE/SALARY SURVEYS FROM THE REGION TO COMPARE ORGANIZATIONAL WAGES TO LOCAL AND REGIONAL COMPETITION AS WELL AS OTHER LOCAL MARKETS. THE BOARD OF MANAGERS APPROVES ALL STAFF COMPENSATION (INCLUDING THE EXECUTIVE DIRECTOR AND MANAGEMENT) AT THE TIME THE OPRATING BUDGET IS APROVED. MANAGEMENT DESCRIBES IN DETAIL THE SALARY INCREASES FOR ALL STAFF DURING THE OPERATING BUDGET REVIEW WITH THE BOARD AND THE BOARD APPROVES THE BUDGET AND INCLUDED INCREASES. THE REVIEW AND APPROVAL IS DOCUMENTED VIA BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART IX, LINE 11G THERAPY AND ANCILLARY SERVICES: PROGRAM SERVICE EXPENSES 1,056,890. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,056,890. NURSING: PROGRAM SERVICE EXPENSES 2,968,063. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,968,063. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 368,791. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 368,791. CONSULTANTS: PROGRAM SERVICE EXPENSES 44,651. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,651. CONTRACTORS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 394,658. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 394,658. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS HELD BY OTHERS 49,985.