2021-11-12T15:19:33-07:00 2020-12-31 990 2020-01-01 237155198 BROTHERS OF MERCY NURSING HOME COMPANY INC BROT 7167596985 10570 BERGTOLD ROAD CLARENCE NY 14031 Joseph Widmer CFO 7167597600 2021-11-12 0 11 0 AAL2 2020 2022-09-23 18:48:47Z BROTHERS OF MERCY NURSING AND REHABILITATION CENTER PETER EIMER 4520 RANSOM ROAD CLARENCE NY 14031 27911648 0 X BROTHERSOFMERCY.ORG X 1971 NY TO PROVIDE SKILLED NURSING CARE AND REHABILITATION SERVICES TO THE ELDERLY AND COMMUNITY 10 9 688 85 0 0 216500 4687716 24690083 22741587 68138 51121 477516 277396 25452237 27757820 0 0 0 0 13749655 17313301 0 0 0 10859947 8865488 24609602 26178789 842635 1579031 14898972 16967208 8490481 8924732 6408491 8042476 TO PROVIDE SKILLED NURSING CARE AND REHABILITATION SERVICES TO THE ELDERLY AND COMMUNITY 0 0 22476754 22887438 NURSING CARE AND REHABILITATION SERVICES FOR A 240 BED NYS LICENSED NURSING FACILITY 0 0 0 22476754 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 35 0 1 688 1 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X X Joseph Widmer 7167596985 10570 Bergtold Road Clarence NY 14031 Peter Eimer Board Member/Corp CEO 24.5 13 X X 141328 76100 18987 Teresa Dillsworth Administrator 37.5 0 X 188122 0 18419 Joseph Widmer CFO 22.5 15 X 105285 76085 18252 Valerie Kane Corp Compliance Officer 15 22.5 X 58056 98851 10253 Nicole Eckert De Santiago Director of Nursing 37.5 0 X 118099 0 17057 Lauren Grawe Outpatient Therapy Director 37.5 0 X 100207 0 14444 Brother Kenneth Thomas Board Member 6.25 31.25 X 0 0 0 Brother Matthias Moller Board Member 0.5 2.5 X 0 0 0 Michael Noe Board Member/Secretary 0.5 2.5 X X 0 0 0 Sister Patricia Burkard Board Member/Chairwomen 0.5 2.5 X X 0 0 0 Michael McRae Board Member 0.5 2.5 X 0 0 0 Thomas Fentner Board Member 0.5 2.5 X 0 0 0 Msgr David LiPuma Board Member 0.5 2.5 X 0 0 0 David Nasca Board Member/Treasurer 0.5 2.5 X X 0 0 0 David Rogers Board Member 0.5 2.50 X 0 0 0 711097 251036 97412 5 0 1 0 Paycom 7501 W Memorial Rd Oklahoma City OK 73142 consulting 100722 1 0 0 0 165855 4448860 73001 73001 4687716 Resident Service Revenue 623000 22741587 22741587 0 0 0 0 0 0 22741587 52344 0 0 52344 0 0 0 0 0 0 0 0 0 0 152605 0 159140 -5312 -6535 5312 -1223 0 0 -1223 0 Other Income 623000 9294 9294 0 0 Cafeteria Income 722210 124345 0 0 124345 Gift Shop Income 453220 89440 82240 0 7200 54317 54317 0 0 277396 27757820 22887438 0 182666 X 0 0 0 0 0 0 0 0 306221 118099 188122 0 0 0 0 0 14603511 13955219 648292 0 129451 98456 30995 0 904014 826219 77795 0 1370104 1310935 59169 0 1599645 0 1599645 0 74365 74365 0 0 237897 56359 181538 0 0 0 0 0 0 0 0 0 0 0 656963 656963 0 0 45617 45617 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360895 314903 45992 0 2662 545 2117 0 0 0 0 0 0 0 0 0 93611 93611 0 0 0 0 0 0 574343 545626 28717 0 778681 762329 16352 0 NYS ASSESSMENT FEES 1268226 1268226 0 0 MEDICAL SUPPLIES/EQUIPMENT 750945 750945 0 0 FOOD/DIETARY SUPPLIES 801844 801844 0 0 NON MEDICAL SUPPLIES 951535 457555 493980 0 668259 338938 329321 0 26178789 22476754 3702035 0 462246 260276 316437 302911 0 0 5339967 3674574 0 0 0 0 1696760 2819272 127798 108130 86765 101225 23517424 16728846 4906899 6788578 1758407 2776444 0 0 0 0 0 0 203693 135798 14898972 16967208 3896164 4315246 0 0 0 0 0 0 53788 80798 0 0 4514219 4276657 0 0 26310 252031 8490481 8924732 X 6350841 7987476 57650 55000 6408491 8042476 14898972 16967208 1579031 54954 0 0 0 0 X X 0 1 X 1 0 X 37800 152326 163935 216500 238856 809417 22046576 22639247 23157558 24991585 22887438 115722404 142656 164707 154874 176014 131545 769796 0 0 0 0 0 0 0 0 0 0 0 0 22227032 22956280 23476367 25384099 23257839 117301617 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117301617 20407 47754 51589 66332 52344 238426 0 0 0 0 0 0 20407 47754 51589 66332 52344 238426 0 0 0 0 0 0 0 0 0 0 4448860 4448860 22247439 23004034 23527956 25450431 27759043 121988903 0.96158 0.9982 0.00195 0.0018 X Schedule A, Part III, Line 12 Provider Relief Funds received from HHS - $1,847,871 PPP/SBA loan forgiveness - $2,600,989 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 0 16000 16000 0 15552274 12306259 3246015 0 77709 75435 2274 0 5662697 4347152 1315545 0 2208744 0 2208744 6788578 0 Capital Lease Obligations 252031 252031 X 27812774 54954 0 0 0 54954 27757820 0 0 0 27757820 26178789 0 0 0 0 0 26178789 0 0 0 26178789 Schedule D, Part IV, Line 2b Resident Funds Held in Trust, Consisting of amounts deposited on behalf of residents and used for their personal care. Schedule D, Part X, Line 2 Income Taxes: The Home is a not-for-profit corporation as described in Section 509(a) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(c)(3) of the Code. Accordingly, no provision for federal income taxes is included in the financial statements. The Home files its Return of Organization Exempt from Income Tax in the U.S. federal jurisdiction and its Annual Filing of Charitable Organizations in New York State. X X X 0 0 0 0 0 0 0 0 0 Peter Eimer Board Member/Corp CEO 141328 76100 0 0 0 0 2833 1526 9509 5121 153670 82747 0 0 Joseph Widmer CFO 105285 76086 0 0 0 0 2103 1519 8493 6137 115881 83742 0 0 Valerie Kane Corp Compliance Officer 58056 98852 0 0 0 0 1140 1941 2653 4518 61849 105311 0 0 Teresa Dillsworth Administrator 188122 0 0 0 0 0 3629 0 14790 0 206541 0 0 0 Lauren Grawe Outpatient Therapy Director 100207 0 0 0 0 0 38 0 14405 0 114650 0 0 0 X 1 73001 receipt 0 1 0 Form 990, Part VI, Section B, Line 11b The Form 990 is reviewed by the CFO prior to filing. Form 990, Part VI, Section B, Line 12c Questionnaire is sent out annually and information regarding potential conflicts of interest is maintained by administration. Completed questionnaires are kept on file in the finance office. Form 990, Part VI, Section B, Line 15 The Board of Directors reviews salaries for top management officials and uses comparability data from Leading Age of NY in order to determine salaries. The process is documented in the Board Minutes. Form 990, Part VI, Section C, Line 18 The Form 1023 and Form 990 are available to the public upon request. Form 990, Part VI, Section C, Line 19 Disclosure of the organization's Governing documents, conflict of interest policy and financial statements is based on the purpose of the request. Form 990, Part IX, Line 11g Medical Services: Program Service Expense 243,683, Management & General Expense 0, Fundraising Expense 0, Total Expense 243,683 Other Purchased Services: Program Service Expense 328,370, Management & General Expense 0, Fundraising Expense 0, Total Expense 328,370 X-Ray Services: Program Service Expense 64,410, Management & General Expense 0, Fundraising Expense 0, Total Expense 64,410 Consulting: Program Service Expense 20,500, Management & General Expense 0, Fundraising Expense 0, Total Expense 20,500 Total Other Fees Col A 656,963 Form 990, Part XII, Line 2c There has been no change in the audit oversight process or the auditor selection process. Brothers of Mercy Holding Company Inc 4520 Ransom Road Clarence NY 14031 160746852 Holding Company NY 501 (C) (3) Line 12D N/A 0 Brothers of Mercy Sacred Heart Home 4526 Ransom Road Clarence NY 14031 161082636 Adult Care Facility NY 501 (C) (3) Line 10 N/A 0 Brothers of Mercy Housing Co Inc 10500 Bergtold Road Clarence NY 14031 237117107 Housing for Elderly NY 501 (C) (3) Line 7 N/A 0 Brothers of Mercy Facilities Foundation 4520 Ransom Road Clarence NY 14031 161558645 Support Charitable purposes of Brothers NY 501 (C) (3) Line 7 N/A 0 Brothers of Mercy of Montabaur Apartment Complex Inc 4530 Ransom Road Clarence NY 14031 464619699 Housing for Elderly NY 501 (C) (3) Line 10 N/A 0 Brothers of Mercy Management Company 4520 Ransom Road Clarence NY 14031 813966963 Support Services for Related Parties NY 501 (C) (3) Line 10 N/A 0 Brothers of Mercy of Mary Help of Christians Inc 4520 Ransom Road Clarence NY 14031 830592366 Religious Order of Brothers NY 501 (C) (3) Line 12D N/A 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 Brothers of Mercy of Mary Help of Christians Inc k 94525 Accounting Records Brothers of Mercy of Montabaur Apartment Complex Inc d 199525 End of Year Balance Brothers of Mercy Management Company d 1093937 End of Year Balance Brothers of Mercy Sacred Heart Home d 1519285 End of Year Balance Brothers of Mercy Facilities Foundation c 165855 Accounting Records