2020-11-13T14:00:13-06:00 2019-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2019-01-01 222291346 GENESEE VALLEY PRESBYTERIAN NURSING CENTER GENE 5854611991 254 ALEXANDER STREET ROCHESTER NY 14607 SCOTT MAAR CONTROLLER 5854611991 2020-11-13 1 KELLEY DEMONTE P01382609 5853811000 4.14.157.197 2020-11-13 13:16:47 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EEB0F1D07ECCEF90BDF2AB918C22792D9EBD0503 2019 2021-01-29 14:40:06Z KIRKHAVEN SCOTT MAAR 254 ALEXANDER STREET ROCHESTER NY 14607 14265314 0 X WWW.KIRKHAVEN.COM X 1980 NY ORGANIZATION IS A 147 LICENSED-BED SKILLED NURSING HOME, WHICH PROVIDES LONG-TERM AND SHORT-TERM SKILLED NURSING AND REHABILITATIVE CARE TO SENIORS INCLUDING A HIGH PERCENTAGE OF INDIGENT AND MINORITY SENIORS. ALL INCOME RECEIVED IS USED IN THE PROVISION OF CARE AND SUPPORT SERVICES. 15 15 323 15 0 0 159163 119008 13664661 14008868 1485 613 129804 136825 13955113 14265314 0 0 0 0 8212757 8554225 0 0 0 5986671 6566483 14199428 15120708 -244315 -855394 10467156 10632816 10943120 12963256 -475964 -2330440 NURSING HOME THAT PROVIDES SKILLED LONG-TERM CARE, REHABILITATIVE AND ALZHEIMERS/DEMENTIA CARE FOR SENIORS IN A MANNER THAT EMBRACES A PHILOSOPHY OF PERSON-CENTERED CARE, QUALITY OF CARE AND FAITH-BASED MISSION. 0 0 13458656 14008868 NURSING HOME THAT PROVIDES SKILLED LONG-TERM CARE, REHABILITATION AND ALZHEIMERS/DEMENTIA CARE FOR SENIORS IN A MANNER THAT EMBRACES A PHILOSOPHY OF PERSON-CENTERED CARE QUALITY OF CARE AND FAITH-BASED MISSION (147 BEDS). 13458656 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 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 2 0 1 323 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X SCOTT MAAR 5854611991 254 ALEXANDER STREET ROCHESTER NY 14607 JAMES BEIKIRCH DIRECTOR 0.50 0.25 X 0 0 0 SUSAN CARLSON DIRECTOR 0.50 0.25 X 0 0 0 TERRY W COTTON DIRECTOR 0.50 0.25 X 0 0 0 LETICIA FORNATARO VICE CHAIRPERSON 0.50 0.25 X X 0 0 0 DUANE GIRDNER DIRECTOR 0.50 0.25 X 0 0 0 MARY-JO LIPARI DIRECTOR 0.50 0.25 X X 0 0 0 ANGIE KETTELL DIRECTOR 0.50 0.25 X 0 0 0 NATALIE MASCO DIXON DIRECTOR 0.50 0.25 X 0 0 0 KELLY O'CONNELL DIRECTOR 0.50 0.25 X 0 0 0 RICHARD POTTS SECRETARY/TREASURER 0.50 0.25 X X 0 0 0 JOHN WARD CHAIRPERSON 0.50 0.25 X X 0 0 0 REV GORDON V WEBSTER DIRECTOR 0.50 0.25 X 0 0 0 DESIRAE DAVIS DIRECTOR 0.50 0.25 X 0 0 0 JILLIAN FARRAR DIRECTOR 0.50 0.25 X 0 0 0 ELAINE HISCOCK DIRECTOR 0.50 0.25 X 0 0 0 MARK MUTHIG DIRECTOR 0.50 0.25 X 0 0 0 ANNE GALLESE EXECUTIVE DIRECTOR/ADMINIS 40.00 X 162579 0 20093 JAMES DEVOE FORMER DEVELOPMENT DIRECTO 5.00 15.00 X 218449 0 25000 381028 0 45093 2 1 1 0 PHYSICAL AND OCCUPATIONAL REHABILITATION 7733 FORSYTH BLVD STE 1700 ST LOUIS MO 63105 THERAPY CONTRACTOR 169568 1 119008 119008 SKILLED NURSING HOME SERVICES 623000 14008868 14008868 14008868 613 613 38012 0 38012 38012 38012 STAFF CAFETERIA, VENDING, & GUEST 722210 42851 42851 ALL OTHER REVENUE 900099 42054 42054 PARKING FEES 812900 9632 9632 4276 4276 98813 14265314 14008868 0 137438 182672 182672 6826252 6469095 357157 368482 359678 8804 655880 607104 48776 520939 482199 38740 252349 252349 58960 58960 23203 23203 1499362 1420351 79011 205911 171570 34341 11938 2826 9112 187211 155989 31222 664766 548070 116696 141443 117854 23589 BAD DEBT EXPENSE 1020151 1020151 SUPPLIES & MATERIALS 996607 986340 10267 NYS CASH RECEIPTS ASSES 684158 684158 PURCHASED & CONTRACTED 544293 329733 214560 276131 103538 172593 15120708 13458656 1662052 0 10670 0 838855 864977 1604951 2228948 73078 89536 17300604 12273822 5557198 5026782 2382404 2422573 10467156 10632816 1202361 1740725 3304 2290 4338209 4424813 5399246 6795428 10943120 12963256 X -2414482 -4540389 1938518 2209949 -475964 -2330440 10467156 10632816 X -855394 -999082 X X 0 1 X 1 1 1 X 136768 293021 1203321 159163 119008 1911281 13048682 12935472 12633598 13664661 14008868 66291281 13185450 13228493 13836919 13823824 14127876 68202562 0 0 0 68202562 328 537 217 1485 613 3180 328 537 217 1485 613 3180 73287 75491 129213 86638 86699 451328 13259065 13304521 13966349 13911947 14215188 68657070 0.99340 0.99330 0.00000 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 966220 966220 964485 1735 966220 962814 1671 964485 958807 4007 962814 957657 1150 958807 1.00000 0 1 1 438016 438016 14374186 10300546 4073640 2159753 1748701 411052 328649 224575 104074 5026782 BENEFICIAL INTEREST IN FOUNDATION 2209949 RESIDENT DEPOSITS HELD IN TRUST 212624 2422573 DUE TO THIRD-PARTY PAYORS 538460 WORKERS COMPENSATION LIABILITY 501716 RESIDENT DEPOSITS HELD IN TRUST 212624 RETIREMENT BENEFIT LIABILITY 5142628 NOTE PAYABLE TO AFFILIATE, NET 400000 6795428 14265314 0 14265314 0 14265314 15120708 0 15120708 0 15120708 PART V, LINE 4: ENDOWMENT FUNDS ARE TO BE HELD IN PERPETUITY WITH THE INCOME TO BE RECOGNIZED AND TRANSFERRED TO TEMPORARILY RESTRICTED FUNDS WITHIN THE FOUNDATION AND TRANSFERRED TO KIRKHAVEN ANNUALLY BASED ON BOARD APPROVED TOTAL RETURN & SPEND POLICY FOR USE IN SUBSIDIZING THE ORGANIZATION'S MISSION AND OPERATIONS. X X X X X 1 1 0 0 0 0 0 0 0 ANNE GALLESE EXECUTIVE DIRECTOR/ADMINIS 162579 0 0 0 0 0 0 0 20093 0 182672 0 0 0 JAMES DEVOE FORMER DEVELOPMENT DIRECTO 218449 0 0 0 0 0 0 0 25000 0 243449 0 0 0 PART I, LINES 4A-B PRESIDENT EMERITUS JAMES E. DEVOE WAS PAID A SEVERANCE PREVIOUSLY APPROVED AS PART OF HIS COMPENSATION PACKAGE AND EMPLOYMENT AGREEMENT. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A MEMBERSHIP CORPORATION WITH PRESBYTERIAN HOMES & SERVICES OF GENESEE VALLEY (D/B/A SENIORSFIRST) THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS FOR THE MEMBER CONSTITUTE THE BOARD OF DIRECTORS FOR THE ORGANIZATION (MIRROR BOARD). FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S BYLAWS IDENTIFY CERTAIN RESERVED POWERS THAT REQUIRE APPROVAL BY THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD ON BEHALF OF THE ORGANIZATION'S BOARD. A COPY OF THE 990 IS AVAILABLE TO ALL THE GOVERNING DIRECTORS OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES MUST COMPLETE AND UPDATE CONFLICT OF INTEREST FORMS ANNUALLY AND AS NEEDED. AT ALL BOARD MEETINGS AND COMMITTEE MEETINGS, A CALL FOR DISCLOSURE OF ANY CONFLICTS OF INTEREST RELATED TO THE APPROVED AGENDA IS REQUIRED AND DOCUMENTED IN THE MINUTES. THE GOVERNANCE COMMITTEE OF THE PARENT BOARD MONITORS AND ENFORCES COMPLIANCE AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE PARENT BOARD REVIEWS, DETERMINES AND APPROVES (WITH FULL BOARD APPROVAL) THE EXECUTIVE DIRECTOR COMPENSATION. PERIODIC SURVEY AND COMPARABLE DATA IS USED TO ASCERTAIN REASONABLENESS AND COMPETITIVENESS OF COMPENSATION. THE HR COMMITTEE, UPON APPROVAL OF THE BOARD, REVIEWS AND APPROVES COMPENSATION SCALES AND ANNUAL INCREASE RANGE FOR ALL OTHER STAFF. FORM 990, PART VI, SECTION C, LINE 19 INFORMATION IS AVAILABLE TO THE PUBLIC UPON REQUEST TO ADMINISTRATION. FORM 990, PART XI, LINE 9: CHANGE IN FUNDED STATUS OF PENSION -1,270,513. CHANGE IN BENEFICIAL IN FOUNDATION 271,431. PART XII LINE 2C NO CHANGES FROM THE PRIOR YEAR. PRESBYTERIAN HOMES & SERVICES OF GENESEE VALLEY DBA SENIORFIRST 254 ALEXANDER STREET ROCHESTER NY 14607 161592416 PARENT ORGANIZATION NY 501(C) LINE 11 N/A 0 SENIORSFIRST FOUNDATION INC 254 ALEXANDER STREET ROCHESTER NY 14607 161378080 SUPPORTING ORGANIZATION NY 501(C) LINE 11 PHSGV DBA SENIORSFIRST 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1