2023-11-15T14:18:03-06:00 2022-12-31 460475780 GROSSMAN ST AMOUR CPAS PLLC 110 WEST FAYETTE STREET SUITE 900 SYRACUSE NY 13202 990 2022-01-01 161364582 IROQUOIS NURSING HOME INC IROQ 3154391300 4600 SOUTHWOOD HEIGHTS DRIVE JAMESVILLE NY 13078 CASSANDRA BULAK CHIEF FINANCIAL OFFICER 3154391300 2023-11-15 1 CASSANDRA BULAK 999009999 0 MICHAEL G LISSON CPA P01254506 3154241120 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CASSANDRA BULAK 4600 SOUTHWOOD HEIGHTS DRIVE JAMESVILLE NY 13078 16126684 0 X WWW.IROQUOISNH.ORG X 1990 NY IROQUOIS NURSING HOME, INC. OPERATES A 160 BED SKILLED NURSING FACILITY, PROVIDING NURSING_HOME ACCOMODATIONS FOR THE SICK, INVALID, INFIRMED AND DISABLED OF THE CENTRAL NEW YORK COMMUNITY. 8 8 285 8 0 0 465906 0 16754769 14619625 945207 760800 1008019 746259 19173901 16126684 0 0 0 0 8098248 8501465 0 0 0 7082417 8178254 15180665 16679719 3993236 -553035 51719402 46711483 1679123 2717383 50040279 43994100 IROQUOIS NURSING HOME, INC. OPERATES A 160 BED SKILLED NURSING FACILITY, PROVIDING NURSING HOME ACCOMMODATIONS FOR THE SICK, INVALID, INFIRMED AND DISABLED OF THE CENTRAL NEW YORK COMMUNITY. 0 0 13701349 16126684 SKILLED NURSING SERVICES AND ELDER CARE TO RESIDENTS. 13701349 1 0 0 0 0 0 0 0 1 1 1 0 0 0 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 1 0 0 0 1 0 0 285 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X CASSANDRA BULAK 3154691300 4600 SOUTHWOOD HEIGHTS DRIVE JAMESVILLE NY 13078 JULIE EDMUNDS SMITH CHAIRMAN 0.50 X 0 0 0 JORDAN JENNINGS QUALITY CHAIR 0.50 X 0 0 0 JUIANNE HIMES DIRECTOR 0.50 X 0 0 0 KRISTEN HEATH DIRECTOR 0.50 X 0 0 0 JOHN BERGEMANN SECRETARY 0.50 X 0 0 0 BRANDY HARVEY DIRECTOR 0.50 X 0 0 0 KAREN DABROWSKI DIRECTOR 0.50 X 0 0 0 KEVIN RANDALL FINANCE CHAIR 0.50 X 0 0 0 MAGGIE CALLI PRESIDENT 40.00 X 132823 0 15186 CASSANDRA BULAK CFO 40.00 X 95533 0 0 228356 0 15186 1 1 0 0 DR AMECHI ADIFE MD 6412 WINDING CREEKWAY VICTOR NY 14564 PROFESSIONAL 141300 1 SKILLED NURSING SERVICES AND ELDE 623000 14619625 14619625 14619625 760800 760800 ADMINISTRATIVE FEE INCOME 623000 438000 438000 NONOPERATING REVENUE INTEREST ON 623000 209367 209367 OTHER INCOME 623000 98892 98892 746259 16126684 16126684 0 0 6958820 5610911 1347909 997163 801998 195165 545482 441840 103642 281119 281119 32954 32954 109101 109101 10849 9764 1085 147517 132765 14752 101250 91125 10125 196584 176926 19658 391 391 2444 2444 719584 684094 35490 257721 231949 25772 OUTSIDE SERVICES 4278653 3922956 355697 SUPPLIES 1224797 1021577 203220 MEDICAID CASH ASSESSMEN 451720 451720 BAD DEBT 363570 123724 239846 16679719 13701349 2978370 0 4042337 1171596 1728246 2081179 5776596 6371847 134660 121539 342053 685006 22814517 16479990 6967913 6334527 32564121 29831881 163476 113908 51719402 46711483 1217883 2217744 79804 30341 381436 469298 1679123 2717383 X 49956607 43910533 83672 83567 50040279 43994100 51719402 46711483 -553035 -5493144 0 X 0 1 X 1 1 1 X 4328 3499 1123451 465906 0 1597184 18478384 18901513 18311966 16754769 14619625 87066257 18482712 18905012 19435417 17220675 14619625 88663441 0 0 0 88663441 635234 592654 294341 1166956 970162 3659347 635234 592654 294341 1166956 970162 3659347 761936 823096 778123 786266 536892 3686313 19879882 20320762 20507881 19173897 16126679 96009101 0.92350 0.92730 0.03810 0.03360 X 0 0 83672 100 5 210 83567 83668 4 83672 82537 1117 14 83668 79348 3499 8 318 82537 78978 4328 8 3966 79348 0 0 232637 232637 16132247 12015093 4117154 6430073 4464897 1965176 19560 19560 6334527 THIRD PARTY SETTLEMENTS 469298 469298 X 10633645 -5493039 -5493039 16126684 0 16126684 16679719 0 16679719 0 16679719 PART X, LINE 2: IROQUOIS IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS OF DECEMBER 31, 2021 IROQUOIS DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALITIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2020 THROUGH 2022. IROQUOIS DOES NOT ANTICIPATE ANY UNRECOGNIZED TAX BENEFITS TO CHANGE IN THE NEXT TWELEVE MONTHS. SCHEDULE D, PART IV, LINE 2B RESIDENT'S FUNDS REPRESENT AMOUNTS DEPOSITED WITH IROQUOIS ON BEHALF OF RESIDENTS FOR THEIR DISCRETIONARY USE. THESE FUNDS ARE ADMINISTERED BY IROQUOIS WITH THE CORRESPONDING LIABILITY TO THE RESIDENTS REFLECTED ON THE BALANCE SHEET. SCHEDUE D, PART V, LINE 4 RESTRICTED CASH IS USED FOR THE DONATED PURPOSE, WHICH MAY INCLUDE EDUCATIONAL FUND, RESIDENT'S HOLIDAY GIFTS, ACTIVITY PRIZES AND UNIT BASED ACTIVITIES. SCHEDULE D, PART XI, LINE 4B NONOPERATING REVENUE - INTEREST INCOME ON PROMISSORY NOTE WITH AFFILIATE - $209,367. DECREASE IN NET ASSETS WITH DONOR RESTRICTIONS $105. X X X 0 0 0 0 0 0 0 0 0 MAGGIE CALLI PRESIDENT 132823 0 0 0 0 0 0 0 15186 0 148009 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 PLAZA CORPORATION OF CENTRAL NEW YORK IS A MEMBER OF IROQUOIS NURSING HOMES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S BOARD OF DIRECTORS MEETS QUARTERLY. THEY ELECT THE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS MEETS QUARTERLY. THEY DISCUSS AND VOTE ON ISSUES REGARDING NEW MEMBERS AND OTHER BUSINESS RELATED ACTIONS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND REVIEWED BY CHIEF FINANCIAL OFFICER BEFORE SUBMISSION. A COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED BY THE BOARD OF DIRECTORS FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS DETERMINES COMPENSATION FOR THE ADMINISTRATOR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PLAZA CORPORATION OF CENTRAL NEW YORK 4600 SOUTHWOOD HEIGHTS DRIVE JAMESVILLE NY 13078 222800840 HOLDING COMPANY NY 501(C)(3) LINE 3 0 PLAZA NURSING HOME CO INC 5460 MELTZER COURT CICERO NY 13039 160955793 NURSING HOME SERVICES NY 501(C)(3) LINE 11 0 ENRICHED RESOURCES FOR INDEPENDENT ELDERLY 1207 ALMOND STREET SYRACUSE NY 13209 161163209 ENRICHED LIVING NY 501(C)(3) LINE 3 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 PLAZA CORPORATION OF CENTAL NEW YORK A 209367 INTEREST INCOME PROMISSORY NOTE PLAZA NURSING HOME CO INC O 438000 ADMINISTRATIVE SERVICES AGREEMENT