2022-11-15T13:04:41-06:00 2021-12-31 271728945 PKF O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE SUITE 301 HARRISON NY 105281633 990 2021-01-01 113188802 NEW YORK CONGREGATIONAL NURSING CENTER NEWY 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 KENDALL CHRISTIANSEN CHAIRPERSON 7185767000 2022-11-15 1 KENDALL CHRISTIANSEN XXX-XX-XXXX GARRETT M HIGGINS P00543209 9143818900 2022-11-11 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z KENDALL CHRISTIANSEN 135 LINDEN BOULEVARD BROOKLYN NY 11226 59714920 0 X WWW.NYCNC.ORG X 1994 NY THE CENTER IS A 200-BED SKILLED NURSING FACILITY THAT WAS SOLD EFFECTIVE JUNE 30, 2021. X 5 5 258 6 0 0 1781909 3577402 17975567 10178336 10613 15010330 57540 5958847 19825629 34724915 0 15000000 0 0 14626839 6532569 0 0 0 9437399 7988861 24064238 29521430 -4238609 5203485 13214603 0 20418088 0 -7203485 0 X THE MISSION OF NEW YORK CONGREGATIONAL NURSING CENTER ("THE CENTER") IS TO PROVIDE SKILLED NURSING CARE AND REHABILITATION THERAPY SERVICES FOR 200 RESIDENTS. 0 1 26570168 15000000 10178336 THE CENTER OFFERED A WIDE RANGE OF SERVICES ADDRESSING THE NEEDS OF PEOPLE RECOVERING FROM POST SURGICAL CONDITIONS, ACUTE MEDICAL EVENTS AND OTHER SITUATIONS REQUIRING INTENSIVE NURSING CARE AND REHABILITATION. THESE SERVICES FOR THE MOST PART WERE PROVIDED ON-SITE OR DIRECTLY THROUGH CONSULTATION. THE OPERATIONS OF THE CENTER WERE SOLD AS OF JUNE 30, 2021. 26570168 1 1 0 1 0 0 0 0 1 0 0 0 0 0 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 1 0 0 0 1 17 0 258 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 NY X X DINA GABBAY 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 KENDALL CHRISTIANSEN CHAIRPERSON 0.20 0.80 X X 0 0 0 DR ESTHER SIEGEL VICE CHAIRPERSON 0.20 0.00 X X 0 0 0 MICHAEL ROBINSON SECRETARY/TREASURER 0.20 0.00 X X 0 0 0 MICHAEL SHARP DIRECTOR 0.20 0.40 X 0 0 0 DR MARGARET L MCCLURE DIRECTOR, THRU 8/13/21 0.20 0.00 X 0 0 0 THOMAS BETTRIDGE DIRECTOR 0.20 0.80 X 0 0 0 WINSOME MCLEAN-DAVIS PRESIDENT & CEO 33.90 1.10 X 125000 0 0 125000 0 0 1 0 0 0 LANDMARK ABSTRACT AGENCY LLC 207 ROCKAWAY TURNPIKE LAWRENCE NY 11559 TITLE INSURANCE SERVICES 1946208 THERADYNAMICS REHAB MANAGEMENT LLC 225 CROSSWAYS PARK DRIVE WOODBURY NY 11797 OCCUPATIONAL THERAPISTS 1117954 COHNREZNICK LLP 1301 6TH AVENUE NEW YORK NY 20022 BUSINESS ADVISORY SERVICES 637214 CONGREGATIONAL CONSULTING LLC 3839 FLATLANDS AVENUE BROOKLYN NY 11234 ADMINISTRATIVE SERVICES 450000 HISTOPATHOLOGY SERVICES 535 EAST CRESCENT AVENUE RAMSEY NJ 07446 NURSING SERVICES 236232 13 3577402 3577402 MEDICAID 623000 5761933 5761933 MEDICARE 623000 4070660 4070660 OTHER NET PATIENT REVENUE 623000 296906 296906 PRIVATE PAY REVENUE 623000 48837 48837 10178336 335 335 40000000 24990005 15009995 15009995 15009995 FORGIVENESS OF DEBT 900099 5933573 5933573 MISCELLANEOUS REVENUE 900099 23985 23985 MEDICAL RECORDS FEES 900099 1289 1289 5958847 34724915 10178336 0 20969177 15000000 15000000 125000 117773 7227 4793190 4518434 274756 993809 753680 240129 189454 114209 75245 431116 304255 126861 246172 246172 63990 63990 1450 1450 2733677 1277274 1456403 64119 64119 596553 534343 62210 95716 51669 44047 624166 575521 48645 2848 2039 809 389 389 696801 696801 1754387 1524716 229671 NYS CASH RECEIPT ASSMNT 380114 380114 BAD DEBT EXPENSE 347698 347698 MEDICATIONS 171820 171820 REPAIRS & MAINTENANCE 125095 125095 83866 74727 9139 29521430 26570168 2951262 0 3116888 0 389412 0 262637 0 2428232 0 86786 0 56567 0 0 0 3884765 0 2989316 0 13214603 0 4477682 0 968675 0 98168 0 14873563 0 20418088 0 X -7203485 0 -7203485 0 13214603 0 X 5203485 2000000 X 0 0 0 X 37034 217635 1100 1781909 3577402 5615080 22166046 22472500 24829808 17975567 10178336 97622257 22203080 22690135 24830908 19757476 13755738 103237337 0 0 0 103237337 16737 5712 25486 10613 335 58883 16737 5712 25486 10613 335 58883 232532 195794 58650 57540 5958847 6503363 22452349 22891641 24915044 19825629 19714920 109799583 0.94020 0.99280 0.00050 0.00060 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2017 AMOUNT: $ 86,986. 2018 AMOUNT: $ 44,978. 2019 AMOUNT: $ 38,289. 2020 AMOUNT: $ 56,634. 2021 AMOUNT: $ 23,985. CASH DISCOUNTS - 2017 AMOUNT: $ 133,496. 2018 AMOUNT: $ 135,439. 2019 AMOUNT: $ 11,106. VENDING MACHINE INCOME - 2017 AMOUNT: $ 4,645. 2018 AMOUNT: $ 5,157. 2019 AMOUNT: $ 4,485. 2020 AMOUNT: $ 772. MEDICAL RECORDS FEE - 2017 AMOUNT: $ 7,405. 2018 AMOUNT: $ 10,220. 2019 AMOUNT: $ 4,770. 2020 AMOUNT: $ 134. 2021 AMOUNT: $ 1,289. FORGIVENESS OF DEBT - 2021 AMOUNT: $ 5,933,573. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1450 1450 0 PART II-B, LINE 1: AMOUNTS REPORTED ON LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES PAID BY THE ORGANIZATION TO PROFESSIONAL ASSOCIATIONS AND SIMILAR ORGANIZATIONS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 0 1 X 0 PART IV, LINE 2B: RESIDENTS' FUNDS WERE HELD BY THE CENTER ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENTED ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE CENTER FOR SAFEKEEPING. THE FUNDS WERE DISBURSED BY THE CENTER AT THE REQUEST OF, OR ON BEHALF OF RESIDENTS FOR THEIR PERSONAL USE. RESIDENT PERSONAL FUNDS WERE MAINTAINED IN BANK ACCOUNTS AND INVESTMENTS SEPARATE FROM THE CENTER'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS WAS CREDITED TO THE RESIDENTS' ACCOUNTS. 1 BROOKLYN COMMUNITY FOUNDATION 1000 DEAN STREET SUITE 307 BOOKLYN NY 11238 113422729 501(C)(3) 15000000 0 TO ESTABLISH A PARTIALLY-ENDOWED DONOR-ADVISED FUND CALLED THE NYCNC ADVISED FUND 1 0 PART I, LINE 2: PURSUANT TO A GIFT AGREEMENT BETWEEN THE CENTER AND BROOKLYN COMMUNITY FOUNDATION, THE CENTER AGREES TO MAKE AN IRREVOCABLE GIFT TO THE FOUNDATION IN ORDER TO ESTABLISH A DONOR-ADVISED FUND IN ITS NAME UPON CLOSING THE SALE OF ITS FACILITY. A RELATED ORGANIZATION, NEW YORK CONGREGATIONAL COMMUNITY SERVICES, INTENDS TO BE ACTIVELY ENGAGED IN THE DEVELOPMENT OF A GRANTMAKING STRATEGY AND PROCESS THAT WILL INFORM ITS GRANT RECOMMENDATIONS WITH RESPECT TO THE DONOR-ADVISED FUND IN ORDER TO MAXIMIZE THE IMPACT OF THE CENTER'S GIFT. OPERATIONAL ASSETS AND BUSINESS OPERATIONS 2021-06-30 1800000 OPINION OF EXPERTS 844841748 CONGREGATIONAL SNF LLC 135 LINDEN BOULEVARD BROOKLYN NY 11226 LLC REAL PROPERTY ASSETS 2021-06-30 37200000 OPINION OF EXPERTS 863754336 135 LINDEN BLVD LLC 2071 FLATBUSH AVENUE SUITE 22 BROOKLYN NY 11234 LLC CASH 2021-06-30 15000000 BOOK VALUE 113422729 BROOKLYN COMMUNITY FOUNDATION 1000 DEAN STREET SUITE 307 BROOKLYN NY 11238 501(C)(3) 0 1 0 0 PART II, LINE 2E: PERSON(S) INVOLVED: WINSOME MCLEAN-DAVIS PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: WINSOME MCLEAN-DAVIS IS ALSO THE EXECUTIVE DIRECTOR OF THE TRANSFEREE ORGANIZATION, CONGREGATIONAL SNF LLC. FORM 990, PART III, LINE 3 AS OF JUNE 30, 2021, THE CENTER FINALIZED THE SALE OF ITS ASSETS AND OPERATIONS. THE OPERATIONS OF THE CENTER WILL BE CARRIED OUT BY THE PURCHASER. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS NEW YORK CONGREGATIONAL COMMUNITY SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION APPOINTS THE BOARD OF DIRECTORS AT ITS ANNUAL MEETING. A VACANCY ON THE BOARD ARISING AT ANY TIME AND FROM ANY CAUSE MAY BE FILLED FOR THE UNEXPIRED TERM BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B ANY DIRECTOR MAY BE REMOVED WITH OR WITHOUT CAUSE BY THE SOLE MEMBER. IN ADDITION, THE SOLE MEMBER HAS THE POWER TO MAKE, ALTER, AMEND, AND REPEAL THE BY-LAWS AND CERTIFICATE OF INCORPORATION OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE CENTER HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE FINANCE COMMITTEE FOR ANY COMMENTS AT THE NEXT MEETING OF THE COMMITTEE. MINUTES OF THIS MEETING AND REVIEW WOULD BE KEPT WITH THE COMMITTEE MEETING MINUTES. ANY COMMENTS OR QUESTIONS FROM THE FINANCE COMMITTEE ARE PROVIDED TO THE OUTSIDE ACCOUNTANTS. ONCE THE COMMENTS ARE ADDRESSED, THE COMMITTEE APPROVES THE RETURN, AT WHICH POINT IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, DEPARTMENT DIRECTORS, MANAGEMENT STAFF, AND KEY EMPLOYEES UPON HIRING AND ANNUALLY THEREAFTER ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT. THIS DISCLOSURE STATES THAT THE INDIVIDUAL RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, UNDERSTANDS IT, WILL COMPLY WITH THE RULES, AND THAT THEY COMPLETED THE CORPORATE COMPLIANCE PROGRAM IN-SERVICE. ADDITIONALLY, THEY MUST MAKE FULL DISCLOSURE OF ANY ACTIVITIES THAT COULD RESULT IN A POSSIBLE CONFLICT OF INTEREST. IF A CONFLICT IS DEEMED TO EXIST, THE PRESIDENT MUST BE MADE AWARE AND POSSIBLE DISCIPLINARY ACTION OR EVEN TERMINATION IS POSSIBLE UPON REVIEW WITH THE HR DIRECTOR AND THE CENTER'S RISK MANAGEMENT COUNCIL. THERE IS ALSO A COMPLIANCE HELPLINE WHICH IS A TOTAL-FREE AND COMPLETELY CONFIDENTIAL SERVE WHERE AN INDIVIDUAL CAN REPORT POTENTIAL VIOLATIONS OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS AS WELL AS THE CFO. THE BOARD ALSO RECEIVED GUIDANCE REGARDING TOP EXECUTIVE SALARIES BASED ON COMPARABLE POSITIONS FROM CCLC NY. THE DETERMINATION AND APPROVAL OF THE COMPENSATION IS DOCUMENTED IN THE BOARD MINUTES. THE CFO'S COMPENSATION IS RECOMMENDED BY THE CEO TO THE FINANCE COMMITTEE OF THE BOARD WHO SUBSEQUENTLY REVIEWS AND APPROVES IT. THE COMPENSATION REVIEW PROCESS WAS LAST UNDERTAKEN IN 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FORM 990 AND FORM 1023 IS AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, ARTICLES OF INCORPORATION, AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. FORM 990, PART XI, LINE 9: TRANSFER OF PAYCHECK PROTECTION PROGRAM LOAN LIABILITY 2,000,000. NEW YORK CONGREGATIONAL CENTER FOR COMMUNITY LIFE 135 LINDEN BLVD BROOKLYN NY 11226 200483447 OPERATE A COMMUNITY CENTER AND PROVIDE SOCIAL SUPPORT SERVICES NY 501(C)(3) LINE 10 NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL HOME FOR THE AGED 135 LINDEN BLVD BROOKLYN NY 11226 111631799 SUPPORT THE ACTIVITIES OF THE NY CONGREGATIONAL NURSING CENTER NY 501(C)(3) PF NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL HOME FOR THE AGED FOUNDATION 135 LINDEN BLVD BROOKLYN NY 11226 200276760 SUPPORT THE ACTIVITIES OF THE NY CONGREGATIONAL NURSING CENTER DE 501(C)(3) LINE 12B, II NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL COMMUNITY SERVICES 135 LINDEN BLVD BROOKLYN NY 11226 113519798 SUPPORT THE NY CONGREGATIONAL NURSING CENTER NY 501(C)(3) LINE 12B, II N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0