AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC (EIN 13-4034061)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-09
- IRS object ID
- 202213139349302836
- Schema version
- 2021v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-09T11:43:21-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271728945 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PKF O'CONNOR DAVIES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MAMARONECK AVENUE SUITE 301 | AddressLine1Txt |
| City | HARRISON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 105281633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 134034061 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM CONTINUING CARE HEALTH SYSTEM | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AMST | BusinessNameControlTxt |
| Phone | 2125753322 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10025 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK PANCIRER | PersonNm |
| Person Title | SENIOR VP/CFO | PersonTitleTxt |
| Phone | 2125753322 | PhoneNum |
| Signature | 2022-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARK | PersonFirstNm |
| Person Last | PANCIRER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EVA MRUK | PreparerPersonNm |
| PTIN | P00543254 | PTIN |
| Phone | 9143818900 | PhoneNum |
| Preparation | 2022-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES DAVIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $474,193 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE PURPOSES OF ACCHS INCLUDE THE PROVISION OF ADVISORY AND OTHER SUPPORT TO INDEPENDENT NOT-FOR-PROFIT ORGANIZATIONS DEVOTED TO THE PROVISION OF HEALTH CARE, HOUSING AND SERVICES TO THE ILL , THE IMPAIRED, THE DISABLED, AND THE ELDERLY. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 2 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $242,830 | PYContributionsGrantsAmt |
| CY Contributions Grants | $130,230 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $333,811 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $315,589 | CYProgramServiceRevenueAmt |
| PY Investment Income | $25,145 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,124 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,196 | PYOtherRevenueAmt |
| CY Other Revenue | -$4,658 | CYOtherRevenueAmt |
| PY Total Revenue | $602,982 | PYTotalRevenueAmt |
| CY Total Revenue | $443,285 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,347 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,365,187 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $143,747 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $145,529 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $76,739 | PYOtherExpensesAmt |
| CY Other Expenses | $259,983 | CYOtherExpensesAmt |
| PY Total Expenses | $230,833 | PYTotalExpensesAmt |
| CY Total Expenses | $3,770,699 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $372,149 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,327,414 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,776,766 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,457,362 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,267,600 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,275,958 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,509,166 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $181,404 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE PURPOSES OF ACCHS INCLUDE THE PROVISION OF ADVISORY AND OTHER SUPPORT TO INDEPENDENT NOT-FOR-PROFIT ORGANIZATIONS DEVOTED TO THE PROVISION OF HEALTH CARE, HOUSING AND SERVICES TO THE ILL, THE IMPAIRED, THE DISABLED, AND THE ELDERLY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,510,716 | ExpenseAmt |
| Grant | $3,365,187 | GrantAmt |
| Revenue | $315,589 | RevenueAmt |
| Desc | SUPPORT SERVICES TO RELATED FACILITY-BASED LONG-TERM CARE SERVICE PROVIDERS | Desc |
| Total Program Service Expenses | $3,510,716 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 2 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK PANCIRER | PersonNm |
| Phone | 2125753322 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10025 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| JOSEPH C HOOPES JR | |||||||
| CHAIRMAN & TREASURER | 1.00 | 4.25 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| FRANCES R OLIVIERI | |||||||
| VICE CHAIRMAN | 0.30 | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GEORGE L VAN AMSON | |||||||
| VICE CHAIRMAN | 0.30 | 1.75 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOSE V TORRES | |||||||
| SECRETARY | 0.30 | 0.80 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| REV CANON JAMES CALLAWAY JR | |||||||
| DIRECTOR | 0.30 | 1.10 | Yes (X) | $0 | $0 | $0 | |
| JAMES C CAMPBELL | |||||||
| DIRECTOR | 0.30 | 1.10 | Yes (X) | $0 | $0 | $0 | |
| ISABEL M CARDEN | |||||||
| DIRECTOR | 0.30 | 1.10 | Yes (X) | $0 | $0 | $0 | |
| R SCOTT EDMONDS | |||||||
| DIRECTOR | 0.30 | 1.10 | Yes (X) | $0 | $0 | $0 | |
| DR KAREN M HOPKINS | |||||||
| DIRECTOR | 0.30 | 1.10 | Yes (X) | $0 | $0 | $0 | |
| JAY H MCDOWELL | |||||||
| DIRECTOR | 0.30 | 1.35 | Yes (X) | $0 | $0 | $0 | |
| LANGDON VAN NORDEN | |||||||
| DIRECTOR | 0.30 | 1.10 | Yes (X) | $0 | $0 | $0 | |
| JAMES DAVIS | |||||||
| PRESIDENT/ CEO | 2.00 | 58.00 | Yes (X) | $106,750 | $843,415 | $51,032 | |
| MARK PANCIRER | |||||||
| SR. VP. / CFO | 2.00 | 58.00 | Yes (X) | $30,888 | $250,569 | $48,178 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $137,638 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,093,984 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $99,210 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORITT HOCK & HAMROFF LLP | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1407 BROADWAY 39TH FLOOR | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10018 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | LEGAL SERVICES | ServicesDesc |
| Compensation | $118,364 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $103,450 | FundraisingAmt |
| Related Organizations | $26,780 | RelatedOrganizationsAmt |
| Noncash Contributions | $25,000 | NoncashContributionsAmt |
| Total Contributions | $130,230 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MANAGEMENT SERVICES | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $315,589 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $315,589 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $315,589 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,124 | TotalRevenueColumnAmt |
| Exclusion | $2,124 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $26,250 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $103,450 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $30,908 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,658 | TotalRevenueColumnAmt |
| Exclusion | -$4,658 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $443,285 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $315,589 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$2,534 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,359,285 | TotalAmt |
| Program Services | $3,359,285 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,902 | TotalAmt |
| Program Services | $5,902 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,000 | TotalAmt |
| Program Services | $135,000 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,529 | TotalAmt |
| Program Services | $10,529 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,561 | TotalAmt |
| Management And General | $144,561 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,000 | TotalAmt |
| Management And General | $18,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,000 | TotalAmt |
| Management And General | $68,000 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,803 | TotalAmt |
| Management And General | $4,803 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,399 | TotalAmt |
| Management And General | $7,399 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,924 | TotalAmt |
| Management And General | $11,924 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,296 | TotalAmt |
| Management And General | $5,296 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,770,699 | TotalAmt |
| Program Services | $3,510,716 | ProgramServicesAmt |
| Management And General | $259,983 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,262 | BOYAmt |
| EOY | $159,553 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,983,785 | BOYAmt |
| EOY | $2,094,267 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140 | BOYAmt |
| EOY | $705 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $53,721 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,924 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $41,797 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,594 | BOYAmt |
| EOY | $121,594 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $472,985 | BOYAmt |
| EOY | $39,446 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,776,766 | BOYAmt |
| EOY | $2,457,362 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $8,358 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,267,600 | BOYAmt |
| EOY | $2,267,600 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,267,600 | BOYAmt |
| EOY | $2,275,958 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,509,166 | BOYAmt |
| EOY | $181,404 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,509,166 | BOYAmt |
| EOY | $181,404 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,776,766 | BOYAmt |
| EOY | $2,457,362 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,327,414 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$347 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$1 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $330,261 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $295,590 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $323,748 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $242,830 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,230 | CurrentTaxYearAmt |
| Total | $1,322,659 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $330,261 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $295,590 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $323,748 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $242,830 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,230 | CurrentTaxYearAmt |
| Total | $1,322,659 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $561,277 | SubstantialContributorsTotAmt |
| Public Support Total170 | $761,382 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $65,922 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $78,385 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $92,710 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25,145 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,124 | CurrentTaxYearAmt |
| Total | $264,286 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,196 | CurrentTaxYearMinus1YearAmt |
| Total | $1,196 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,588,141 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $1,702,971 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.47940 | PublicSupportCY170Pct |
| Public Support PY170 | 0.47120 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,721 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,924 | DepreciationAmt |
| Book Value | $41,797 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $41,797 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SUBVENTION - SUBORDINATE NOTE | Desc |
| Amt | $2,267,600 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,267,600 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $110,258,010 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$347 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $113,489,946 | OtherRevenueAmt |
| Revenue Not Reported | $113,489,599 | RevenueNotReportedAmt |
| Revenue Subtotal | -$3,231,589 | RevenueSubtotalAmt |
| Other Revenues Not Included | $3,674,874 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $3,674,874 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $443,285 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $34,867,111 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $35,000,073 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $35,000,073 | ExpensesNotReportedAmt |
| Expenses Subtotal | -$132,962 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,903,661 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,903,661 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,770,699 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HEALTH SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE ENTITY HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE HEALTH SYSTEM IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2018. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | REVENUE FROM RELATED ORGANIZATIONS 113,489,946. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | ELIMINATIONS 3,674,874. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES FROM RELATED ORGANIZATIONS 35,000,073. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | ELIMINATIONS 3,903,661. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNUAL GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $129,700 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $103,450 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $26,250 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $24,295 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $6,613 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $129,700 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $103,450 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $26,250 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $24,295 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $6,613 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $30,908 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$4,658 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 E OVERLOOK | AddressLine1Txt |
| City | PORT WASHINGTON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11050 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 113711764 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $3,359,285 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | CHILDREN'S SUMMER PROGRAM FUNDING AWARDS | GrantTypeTxt |
| Recipient | 6 | RecipientCnt |
| Cash Grant | $5,902 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS TO ORGANIZATIONS: THE HEALTH SYSTEM GAVE A CONTRIBUTION TO A RELATED ORGANIZATION, AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY, INC. THE ORGANIZATIONS HAVE OVERLAPPING MANAGEMENT AND BOARD MEMBERS, WHICH IS HOW THE HEALTH SYSTEM ENSURES THAT THE ORGANIZATION WILL USE THE FUNDS FOR THE INTENDED PURPOSE. THE HEALTH SYSTEM ALSO REQUIRES SUFFICIENT DOCUMENTATION FROM THE GRANTEE PRIOR TO REIMBURSEMENT OF EXPENDITURES. CHILDREN'S SUMMER PROGRAM FUNDING AWARDS: THE DR. AND MRS. F. LANDMAN SUMMER SCHOLARSHIP FUND IS AVAILABLE TO THE BIOLOGICAL, ADOPTED, OR FOSTER CHILDREN AND STEPCHILDREN OF EMPLOYEES OF AMSTERDAM NURSING HOME AND THE AMSTERDAM AT HARBORSIDE, WHO HAVE WORKED FOR AMSTERDAM FOR A MINIMUM OF THREE YEARS. CHILDREN MUST BE 25 YEARS OLD OR YOUNGER AND MUST USE THE FUNDING TO SUPPORT SUMMER LEARNING EXPERIENCES, INCLUDING EDUCATIONAL, TRAINING, AND RECREATIONAL SUMMER PROGRAMS, CAMPS, AND OTHER DEVELOPMENTAL OPPORTUNITIES. GRANTEES WILL BE REQUIRED TO SUBMIT EVIDENCE OF THE USE OF THE FUNDS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES DAVIS | ||||||||||||||
| PRESIDENT/ CEO | $105,000 | $830,915 | $0 | $0 | $1,750 | $12,500 | $0 | $12,969 | $0 | $38,063 | $106,750 | $894,447 | $0 | $0 |
| MARK PANCIRER | ||||||||||||||
| SR. VP. / CFO | $30,000 | $250,569 | $0 | $0 | $888 | $0 | $0 | $12,969 | $0 | $35,209 | $30,888 | $298,747 | $0 | $0 |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | RESTRUCTURING CASH GRANT | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2021-09-08 | DistributionDt |
| Fair Market Value Of Asset | $3,359,285 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | BOOK VALUE | MethodOfFMVDeterminationTxt |
| EIN | 113711764 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 E OVERLOOK | AddressLine1Txt |
| City | PORT WASHINGTON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11050 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (1) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (1) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, LINE 2E: | PERSON(S) INVOLVED: (A) GEORGE L. VAN AMSON, JOSEPH C HOOPES, JR., REV. CANON JAMES G. CALLAWAY, JR., ISABEL M. CARDEN, JAY H. MCDOWELL, JAMES C. CAMPBELL, DR. KAREN M. HOPKINS, FRANCES R. OLIVIERI, R. SCOTT EDMONDS, LAGDON VAN NORDEN(B) JAMES DAVIS AND MARK PANCIRER |
| PART II, LINE 2E: | EXPLANATION OF INVOLVEMENT: (A) THE ABOVE BOARD MEMBERS ARE ALSO BOARD MEMBERS OF THE TRANSFEREE ORGANIZATION.(B) THE ABOVE OFFICERS AND EMPLOYEES ARE ALSO OFFICERS AND EMPLOYEES OF THE TRANSFEREE ORGANIZATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | AMSTERDAM CONTINUING CARE HEALTH SYSTEM, INC. 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, A COPY OF THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE AUDIT COMMITTEE. ANY ISSUES ARE REVIEWED AND CORRECTED. THE CFO THEN MAKES THE FULL 990 AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. ONCE THE BOARD HAS APPROVED THE RETURN IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS, OFFICERS, AND KEY PERSONS MUST COMPLETE AN ANNUAL DISCLOSURE AND AFFIRMATION FORM IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. AN INTERESTED DIRECTOR MEANS ANY AMSTERDAM DIRECTOR WHO HAS AN INTEREST AS A PRINCIPAL, PARTNER, DIRECTOR, OFFICER, EMPLOYEE, AGENT, OR STOCKHOLDER (OTHER THAN A STOCKHOLDER OF A PUBLICLY TRADED CORPORATION WHOSE STOCK IS WIDELY HELD) OF ANY ENTITY WITH WHICH AMSTERDAM HAS OR CONTEMPLATES TRANSACTING BUSINESS. AN INTERESTED DIRECTOR MUST DISCLOSE THE RELATIONSHIP OR INTEREST IN THE TRANSACTION TO THE BOARD OF DIRECTORS. DISCLOSURE SHALL BE MADE TO THE CHAIRMAN OF THE BOARD AS SOON AS THE INTERESTED DIRECTOR BECOMES AWARE OF THE POTENTIAL FOR A CONFLICT IN CONNECTION WITH THE TRANSACTION, WHO THEN SHALL INFORM THE BOARD. IF THE CHAIRMAN IS INVOLVED IN THE TRANSACTION, THE CHAIRMAN SHALL ADVISE THE SECRETARY, WHO SHALL ARRANGE FOR BOARD DISCLOSURE. NO INTERESTED DIRECTOR SHALL PARTICIPATE IN THE DISCUSSION, DELIBERATIONS AND VOTING REGARDING A TRANSACTION. THE AFFIRMATIVE VOTE OF THE MAJORITY OF ALL THE DIRECTORS SHALL BE REQUIRED BEFORE ENTERING INTO THE TRANSACTION (EXCLUDED IN SUCH COUNTS IS THE INTERESTED DIRECTOR). NO TRANSACTION SHALL BE INVALIDATED OR AFFECTED IN ANY WAY IF THIS POLICY IS FOLLOWED. ALL OFFICERS AND PERSONS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR SOONER IF A POTENTIAL CONFLICT OR ACTUAL CONFLICT SHOULD ARISE. POTENTIAL CONFLICTS OR ACTUAL CONFLICTS ARE REVIEWED BY THE COMPLIANCE OFFICER. EXECUTIVE EMPLOYEES ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR SOONER IF A POTENTIAL CONFLICT OR ACTUAL CONFLICT SHOULD ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 |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|
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS ALSO POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS A COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM CONSULTING LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262979244 | EIN |
| Primary Activities | ADMIN & CONSULTING | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Total Income | $317,326 | TotalIncomeAmt |
| End Of Year Assets | $1,422,898 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| AMSTERDAM SERVICES CORP | ||||||||||
| 1060 AMSTERDAM AVE | NEW YORK | NY | 10025 | 133902473 | ADMIN & CONSULTING | NY | 501(C)(3) | PF | AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC | Yes (1) |
| AMSTERDAM NURSING HOME CORPORATION (1992) | ||||||||||
| 1060 AMSTERDAM AVE | NEW YORK | NY | 10025 | 133834710 | NURSING HOME | NY | 501(C)(3) | LINE 10 | AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC | Yes (1) |
| AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC | ||||||||||
| 300 EAST OVERLOOK | PORT WASHINGTON | NY | 11050 | 113711764 | ASSIST ELDERLY | NY | 501(C)(3) | LINE 12A, I | AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC | Yes (1) |
| ANH FOUNDATION | ||||||||||
| 1060 AMSTERDAM AVE | NEW YORK | NY | 10025 | 137099598 | GRANTMAKING | NY | 501(C)(3) | PF | AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC | Yes (1) |
| AMSTERDAM 2012 INC | ||||||||||
| 1060 AMSTERDAM AVE | NEW YORK | NY | 10025 | 461715083 | DEV RENT PROP | NY | 501(C)(3) | LINE 10 | AMSTERDAM NURSING HOME CORPORATION (1992) | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM SERVICES CORP (2001) | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10025 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 134184082 | EIN |
| Primary Activities | ADMIN & CONSULTING | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of EOY Assets | $14,119 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC | ||
| B | $3,359,285 | COST |
| AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC | ||
| Q | $316,142 | COST |
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