FURP.ORG / PUBLIC DATA EXPLORER

SAMARITAN KEEP NURSING HOME INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
SAMARITAN KEEP NURSING HOME INC (EIN 16-0969838)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-14
IRS object ID
202313189349310881
Schema version
2022v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-14T14:00:17-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUSTCHARLES LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S WARREN STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN160969838EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAMARITAN-KEEP NURSING HOME INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSAMABusinessNameControlTxt
Phone3157855702PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PRATT STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMAXINE BRIGGSPersonNm
Person TitleCFOPersonTitleTxt
Phone3157853605PhoneNum
Signature2023-11-13SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMAXINEPersonFirstNm
Person LastBRIGGSPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPATRICK CAPELLAPreparerPersonNm
PTINP01359200PTIN
Phone3154463600PhoneNum
Preparation2023-11-13PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMAXINE BRIGGSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1830 WASHINGTON STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$20,499,909GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SAMARITANHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO PROVIDE HIGH QUALITY,COMPREHENSIVE, SAFE AND COMPASSIONATE HEALTHCARE SERVICES TO MEET THE NEEDS OF OUR CIVILIAN AND MILITARY COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee450TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,477,097PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$19,773,448PYProgramServiceRevenueAmt
CY Program Service Revenue$19,492,464CYProgramServiceRevenueAmt
PY Investment Income$1,344PYInvestmentIncomeAmt
CY Investment Income$4,416CYInvestmentIncomeAmt
PY Other Revenue$768,739PYOtherRevenueAmt
CY Other Revenue$1,003,029CYOtherRevenueAmt
PY Total Revenue$23,020,628PYTotalRevenueAmt
CY Total Revenue$20,499,909CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$17,234,129PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$15,227,481CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,885,800PYOtherExpensesAmt
CY Other Expenses$7,210,915CYOtherExpensesAmt
PY Total Expenses$25,119,929PYTotalExpensesAmt
CY Total Expenses$22,438,396CYTotalExpensesAmt
PY Revenues Less Expenses-$2,099,301PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,938,487CYRevenuesLessExpensesAmt
Total Assets BOY$10,674,459TotalAssetsBOYAmt
Total Assets EOY$10,080,145TotalAssetsEOYAmt
Total Liabilities BOY$7,148,205TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,111,370TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,526,254NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,968,775NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HIGH QUALITY,COMPREHENSIVE, SAFE AND COMPASSIONATE HEALTHCARE SERVICES TO MEET THE NEEDS OF OUR CIVILIAN AND MILITARY COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$20,779,006ExpenseAmt
Revenue$20,454,973RevenueAmt
DescPROFESSIONAL CARE OF RESIDENTS IN A 272-BED SKILLED NURSING FACILITY. 81,812 RESIDENT DAYS OF CARE WERE RENDERED DURING 2022.Desc
Total Program Service Expenses$20,779,006TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee450EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAXINE BRIGGSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3157853605PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1104 PADDOCK STREETAddressLine1Txt
CityWATERTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13601ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
THOMAS CARMAN
PRESIDENT & CEO1.0043.50Yes (X)Yes (X)$0$880,166$57,874
DANIEL VILLA
TRUSTEE0.50Yes (X)$0$0$0
MAXINE BRIGGS
CFO/TREASURER1.0042.50Yes (X)Yes (X)$0$453,847$46,030
JAN TURCOTTE MD
SMC CHAIR1.002.50Yes (X)$0$0$0
MELANIE PARKER-GEURTSEN
SMC BOARD CHAIR EX OFFICIO1.001.00Yes (X)$0$0$0
MARY WARDWELL-DONAHUE
FORMER VICE CHAIR/CURRENT CHAIR1.003.50Yes (X)Yes (X)$0$0$0
JORDAN JONES
FORMER SECRETARY/CURRENT VICE CHAIR1.000.50Yes (X)Yes (X)$0$0$0
SAMUEL PURINGTON
CHAIR/IMMEDIATE PAST CHAIR1.002.50Yes (X)Yes (X)$0$0$0
TRACY VALENTINE
TRUSTEE/CURRENT SECRETARY1.000.50Yes (X)Yes (X)$0$0$0
MELISSA SCHMITT
AUXILIARY REPRESENTATIVE/EX-OFFICIO1.000.50Yes (X)$0$0$0
ADDISON VARS III
IMMEDIATE PAST CHAIR/TRUSTEE1.002.50Yes (X)$0$0$0
JOAN TREADWELL-WOODS
TRUSTEE1.000.50Yes (X)$0$0$0
FRANCEE CALARCO
TRUSTEE1.000.50Yes (X)$0$0$0
PETER L WALTON
TRUSTEE1.000.50Yes (X)$0$0$0
BARRY ORMSBY
TRUSTEE1.000.50Yes (X)$0$0$0
LINDA O'CONNOR
TRUSTEE1.000.50Yes (X)$0$0$0
POLLY MATARESE
TRUSTEE1.000.50Yes (X)$0$0$0
CARL MCLAUGHLIN
TRUSTEE1.000.50Yes (X)$0$0$0
PATRICK CALLI
SKH ADMINISTRATOR40.00$207,263$0$140Yes (X)
CHRISTINE ROBINSON
NURSE AID EDUCATION COORDINATOR40.00$112,886$0$7,060Yes (X)
MEGAN LABODA
SKH NURSING ADMIN40.00$107,285$0$11,872Yes (X)
KATHLEEN RIVERS
SKH DIRECTOR OF NURSING40.00$105,182$0$12,162Yes (X)
KARA PHAROAH
LTC NURSE MANAGER40.00$100,868$0$9,370Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$633,484TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,334,013TotReportableCompRltdOrgAmt
Total Other Compensation$144,508TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MEDEFIS
PO BOX 5068NEW YORKNY100875068AGENCY STAFF$752,703
SERVICE EMPLOYEES BENEFIT FUND
PO BOX 1240SYRACUSENY13201BENEFITS$652,722
MOHAWK HEALTHCARE
PO BOX 27UTICANY13503PURCHASED SERVICES$323,444
WATERTOWN INTERNISTS PC
53-59 PUBLIC SQUAREWATERTOWNNY13601MEDICAL DIRECTOR$175,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRESIDENT SERVICE REVENUEDesc
Business623000BusinessCd
Total Revenue Column$19,492,464TotalRevenueColumnAmt
Related Or Exempt Func Income$19,492,464RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$19,492,464TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,416TotalRevenueColumnAmt
Exclusion$4,416ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$40,520RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$40,520RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,520TotalRevenueColumnAmt
Exclusion$40,520ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OTHER REVENUE623000$674,591$674,591
SOLD SERVICES623000$261,277$261,277
CAFETERIA623000$26,641$26,641
FieldValueIRS element (for citing)
Other Revenue Total$962,509OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,499,909TotalRevenueColumnAmt
Related Or Exempt Func Income$20,454,973RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$44,936ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,529,858TotalAmt
Program Services$12,269,366ProgramServicesAmt
Management And General$260,492ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$385,963TotalAmt
Program Services$379,206ProgramServicesAmt
Management And General$6,757ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,404,704TotalAmt
Program Services$1,375,501ProgramServicesAmt
Management And General$29,203ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$906,956TotalAmt
Program Services$888,101ProgramServicesAmt
Management And General$18,855ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,775TotalAmt
Management And General$2,775ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,412TotalAmt
Management And General$21,412ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$17,781TotalAmt
Program Services$13,714ProgramServicesAmt
Management And General$4,067ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,217TotalAmt
Program Services$294ProgramServicesAmt
Management And General$2,923ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,180TotalAmt
Program Services$200ProgramServicesAmt
Management And General$980ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$900TotalAmt
Management And General$900ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$527,384TotalAmt
Program Services$527,384ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$325,334TotalAmt
Management And General$325,334ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED SERVICES$2,290,818$1,626,774$664,044
SUPPLIES/UTILITIES$2,288,916$1,967,268$321,648
NYS ASSESSMENT$1,193,934$1,193,934
PROVISION FOR BAD DEBT$537,264$537,264

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$22,438,396TotalAmt
Program Services$20,779,006ProgramServicesAmt
Management And General$1,659,390ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$545,692BOYAmt
EOY$351,430EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,090,415BOYAmt
EOY$3,093,895EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,409,483BOYAmt
EOY$2,447,839EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$74,949BOYAmt
EOY$70,363EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$86,499BOYAmt
EOY$98,660EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,526,055LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$28,007,573LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,986,652BOYAmt
EOY$2,518,482EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,045,784BOYAmt
EOY$1,047,341EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$434,985BOYAmt
EOY$452,135EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,674,459BOYAmt
EOY$10,080,145EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,185,231BOYAmt
EOY$3,749,092EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,962,974BOYAmt
EOY$4,362,278EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,148,205BOYAmt
EOY$8,111,370EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,343,756BOYAmt
EOY$1,786,277EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$182,498BOYAmt
EOY$182,498EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,526,254BOYAmt
EOY$1,968,775EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,674,459BOYAmt
EOY$10,080,145EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,938,487ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$381,008OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$182,498BeginningYearBalanceAmt
End Year Balance$182,498EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$182,498BeginningYearBalanceAmt
End Year Balance$182,498EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$182,498BeginningYearBalanceAmt
End Year Balance$182,498EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$182,498BeginningYearBalanceAmt
End Year Balance$182,498EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$182,498BeginningYearBalanceAmt
End Year Balance$182,498EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$110,000OtherCostOrOtherBasisAmt
Book Value$110,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,678,511OtherCostOrOtherBasisAmt
Depreciation$18,150,486DepreciationAmt
Book Value$1,528,025BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$181,306OtherCostOrOtherBasisAmt
Depreciation$181,306DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,375,629OtherCostOrOtherBasisAmt
Depreciation$9,613,265DepreciationAmt
Book Value$762,364BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$180,609OtherCostOrOtherBasisAmt
Depreciation$62,516DepreciationAmt
Book Value$118,093BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,518,482TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
DUE TO (FROM) AFFILIATES (RELATED PARTIES)$2,899,123
RETIREMENT PLAN OBLIGATIONS$228,059
ASSETS HELD FOR RESIDENTS$198,762
ESTIMATED THIRD PARTY$884,656
LONG TERM DEBT$125,922
MEDICARE ADVANCE$25,756
FieldValueIRS element (for citing)
Total Liability$4,362,278TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationSAMARITAN QUALIFIES AS A TAX-EXEMPT, NOT-FOR-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2022 AND 2021, SAMARITAN DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2019 THROUGH 2022.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
THOMAS CARMAN
PRESIDENT & CEO$0$699,733$0$174,933$0$5,500$0$11,200$0$46,674$0$938,040$0$0
MAXINE BRIGGS
CFO/TREASURER$0$433,347$0$0$0$20,500$0$17,300$0$28,730$0$499,877$0$0
PATRICK CALLI
SKH ADMINISTRATOR$197,302$0$0$0$9,961$0$0$0$140$0$207,403$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationPART 1, LINE 4B: THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO AN IRC 457 (B) PLAN DURING 2022: MAXINE BRIGGS- $20,500ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF SAMARITAN-KEEP NURSING HOME, INC. IS THE SAMARITAN MEDICAL CENTER.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION'S FORM 990 AND ACCOMPANYING SCHEDULES WERE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD, PRIOR TO FILING. FORM 990 WAS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CANNUAL DISCLOSURE STATEMENTS ARE REQUIRED BY ALL BOARD MEMBERS AND KEY PERSONS. WE HAVE MET 100% COMPLIANCE WITH THIS REQUIREMENT EACH YEAR. RESPONSES ARE REVIEWED INITIALLY BY THE CHIEF EXECUTIVE OFFICER AND CHIEF COMPLIANCE OFFICER FOR ACCURACY AND COMPLETENESS. THIS INFORMATION IS DISCLOSED IN A FULL REPORT TO THE BOARD OF TRUSTEES FOR REVIEW AND CONSIDERATION FOR FUTURE DECISION MAKING. BOARD MEMBERS AND KEY PERSONS AFFIRM THEIR UNDERSTANDING OF THEIR DUTY TO REPORT ANY ADDITIONAL OR NEW POTENTIAL CONFLICTS THROUGOUT THE YEAR. BOARD MEMBERS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATION IN VOTING AND DECISION MAKING IN RELATED TRANSACTIONS.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION USES AN EXTERNAL CONSULTANT TO ANALYZE AND ESTABLISH COMPENSATION AND BENEFITS FOR ALL EXECUTIVE POSITIONS. AN EVALUATION IS PERFORMED ANNUALLY. THE ANALYSIS INCLUDES A REVIEW OF MARKET DATA BASED ON REGION, FACILITY SIZE, AND RESPECTIVE RESPONSIBILITIES. THIS INFORMATION IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND SUBSEQUENTLY PRESENTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE FILED AS PART OF THE ANNUAL NYS DEPARTMENT OF HEALTH INSTITUTIONAL COST REPORT, AND ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:PENSION AND OTHER POSTRETIREMENT LIABILITY ADJUSTMENTS 319,685. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST 61,323.
FORM 990 PART XII LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
SCHEDULE A LINE 3SAMARITAN KEEP NURSING HOME, INC. IS A NURSING HOME WHICH HAS AS ITS MAIN PURPOSE THE PROVISION OF HEALTHCARE SERVICES, IT APPROPRIATELY NOTED ON FORM 1023 THAT IT IS A HOSPITAL. THE STATE OF NEW YORK DOES NOT REQUIRE NURSING HOMES TO BE LICENSED AS A HOSPITAL. AS A NURSING HOME, SAMARITAN KEEP NURSING HOME, INC. HAS AS ITS PRINCIPAL PURPOSE THE PROVISION OF HEALTH CARE. ACCORDINGLY, IT WAS (I) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 1023; (II) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 990 SCHEDULE A; AND (III) SHOULD NOT BE DESIGNATED AS A "HOSPITAL/HOSPITAL FACILITY" ON FORM 990 SCHEDULE H.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SAMARITAN MEDICAL CENTER
830 WASHINGTON STREETWATERTOWNNY13601150533577HOSPITALNY501 (C) (3)SCHED A,PART I,LN3N/A0
THE SAMARITAN MEDICAL CENTER FDN OF NORTHERN NEW YORK INC
830 WASHINGTON STREETWATERTOWNNY13601161490523PROVIDES FUND FOR SAMARITAN MEDICAL CENTER AND AFFLIATESNY501 (C) (3)SCHED A,PART I,LN70SAMARITAN MEDICAL CENTER
EDWARD J NOBLE HOSPITAL- SAMARITAN
104 PADDOCK STREETWATERTOWNNY13601237227989HOSPITALNY501 (C) (3)SCHED A,PART I,LN30SAMARITAN MEDICAL CENTER
SAMARITAN SENIOR VILLAGE INC
22691 CAMPUS DRIVEWATERTOWNNY13601454913668SENIOR CITIZEN COMMUNITYNY501 (C) (3)SCHED A,PART I,LN30SAMARITAN MEDICAL CENTER
SAMARITAN MEDICAL PRACTICE PC
830 WASHINGTON STREETWATERTOWNNY13601261528342PHYSICIAN MEDICAL PRACTICENY501 (C) (3)SCHED A,PART I,LN30SAMARITAN MEDICAL CENTER
SAMARITAN HOME HEALTH
165 COLEMAN AVENUEWATERTOWNNY13601461043637CERTIFIED HOME HEALTH AGENCYNY501 (C) (3)SCHED A,PART I,BOX 10SAMARITAN MEDICAL CENTER
CLIFTON-FINE HEALTH CARE CORPORATION
1014 OSWEGATCHIE TRAILSTAR LAKENY13690900909506HOSPITALNY501 (C) (3)0SAMARITAN MEDICAL CENTER
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd