FORT HUDSON NURSING CENTER INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
FORT HUDSON NURSING CENTER INC (EIN 20-0481583)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-09-10
IRS object ID
202022549349301507
Schema version
2019v5.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-09-10T14:23:14-05:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161131146PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BONADIO & CO LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line16 WEMBLEY CTAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12205ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200481583EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FORT HUDSON NURSING CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFORTBusinessNameControlTxt
Phone5187472811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1319 BROADWAYAddressLine1Txt
CityFORT EDWARDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12828ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN COBURNPersonNm
Person TitleCFOPersonTitleTxt
Phone5187472811PhoneNum
Signature2020-08-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonARIEL F AMMIRATOPreparerPersonNm
PTINP01346991PTIN
Phone5184644080PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address4.26.26.190IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-08-12IPDt
IP Tm14:26:23IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id83DCA7CB572579BC2F7670A58B2B8A6B85EBC27AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2020-11-19 02:30:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANDREW CRUIKSHANKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1319 BROADWAYAddressLine1Txt
CityFORT EDWARDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12828ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$23,915,529GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FORTHUDSON.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionSKILLED NURSING CARE AND SKILLED REHABILITATION SERVICES FOR THE ELDERLY AND CHRONICALLY ILL.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee708TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$416,351PYContributionsGrantsAmt
CY Contributions Grants$1,103,811CYContributionsGrantsAmt
PY Program Service Revenue$22,188,139PYProgramServiceRevenueAmt
CY Program Service Revenue$22,800,498CYProgramServiceRevenueAmt
PY Investment Income-$14,703PYInvestmentIncomeAmt
CY Investment Income$11,220CYInvestmentIncomeAmt
PY Other Revenue$443,890PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$23,033,677PYTotalRevenueAmt
CY Total Revenue$23,915,529CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,605,434PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,133,965CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,316,926PYOtherExpensesAmt
CY Other Expenses$8,704,356CYOtherExpensesAmt
PY Total Expenses$21,922,360PYTotalExpensesAmt
CY Total Expenses$22,838,321CYTotalExpensesAmt
PY Revenues Less Expenses$1,111,317PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,077,208CYRevenuesLessExpensesAmt
Total Assets BOY$11,496,186TotalAssetsBOYAmt
Total Assets EOY$16,265,131TotalAssetsEOYAmt
Total Liabilities BOY$7,488,474TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,180,211TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,007,712NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,084,920NetAssetsOrFundBalancesEOYAmt
MissionSKILLED NURSING CARE AND SKILLED REHABILITATION SERVICES FOR ELDERLY AND CHRONICALLY ILL INDIVIDUALS LIVING IN THE NURSING FACILITY OR SERVED IN THE ADULT DAY HEALTH CARE PROGRAM. CARE IS PROVIDED IN AN ENVIRONMENT WHICH MAXIMIZES DIGNITY AND INDEPENDENCE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$20,562,725ExpenseAmt
Revenue$22,764,506RevenueAmt
DescSKILLED NURSING CARE AND SKILLED REHABILITATION SERVICES FOR ELDERLY AND CHRONICALLY ILL INDIVIDUALS LIVING IN THE NURSING FACILITY OR SERVED IN THE ADULT DAY HEALTH CARE PROGRAM. CARE IS PROVIDED IN AN ENVIRONMENT WHICH MAXIMIZES DIGNITY AND INDEPENDENCE.Desc
Total Program Service Expenses$20,562,725TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document14IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee708EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN COBURNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5187472811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1319 BROADWAYAddressLine1Txt
CityFORT EDWARDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12828ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DEAN REALI
PRESIDENT0.40Yes (X)Yes (X)$0$0$0
KEVIN HAYES
VICE PRESIDENT0.40Yes (X)Yes (X)$0$0$0
GRETCHEN STEFFAN
SECRETARY0.40Yes (X)Yes (X)$0$0$0
ROBERT MILES
TREASURER0.40Yes (X)Yes (X)$0$0$0
SUZANNE BLOOD
DIRECTOR0.40Yes (X)$0$0$0
JOHN BRODT
DIRECTOR0.40Yes (X)$0$0$0
CARMEN DELLA BELLA
DIRECTOR0.40Yes (X)$0$0$0
JOAN GRISHKOT
DIRECTOR0.40Yes (X)$0$0$0
KEITH LAAKE
DIRECTOR0.40Yes (X)$0$0$0
CHRIS NELSON
DIRECTOR0.40Yes (X)$0$0$0
J LAWRENCE PALTROWITZ
DIRECTOR0.40Yes (X)$0$0$0
TORI J RILEY
DIRECTOR0.40Yes (X)$0$0$0
SARAH WRIGHT
DIRECTOR0.40Yes (X)$0$0$0
ANDREW CRUIKSHANK
CEO0.40Yes (X)$0$342,751$57,30840.00
JOHN COBURN
CFO0.40Yes (X)$0$193,811$32,40540.00
HOLLY VAUGHN
DIRECTOR OF NURSING40.00$102,223$0$17,092Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$102,223TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$536,562TotReportableCompRltdOrgAmt
Total Other Compensation$106,805TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$658,206RelatedOrganizationsAmt
Government Grants$44,403GovernmentGrantsAmt
All Other Contributions$401,202AllOtherContributionsAmt
Total Contributions$1,103,811TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
CARE OF CHRONICALLY ILL623000$19,316,730$19,316,730
OTHER OPERATING REVENUE623000$3,483,768$3,447,776$35,992
FieldValueIRS element (for citing)
Total Program Service Revenue$22,800,498TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,220TotalRevenueColumnAmt
Exclusion$11,220ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,915,529TotalRevenueColumnAmt
Related Or Exempt Func Income$22,764,506RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$47,212ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,415,642TotalAmt
Program Services$8,653,153ProgramServicesAmt
Management And General$762,489ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,718,323TotalAmt
Program Services$4,497,338ProgramServicesAmt
Management And General$220,985ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$343,120TotalAmt
Management And General$343,120ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$62,473TotalAmt
Management And General$62,473ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$79,875TotalAmt
Management And General$79,875ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$407,578TotalAmt
Program Services$407,578ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$128,543TotalAmt
Program Services$128,543ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$444,002TotalAmt
Program Services$444,002ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$203,356TotalAmt
Management And General$203,356ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
NYS CASH RECEIPTS ASSES$1,725,539$1,725,539
THERAPY SERVICES$1,310,479$1,310,479
DIETARY COSTS$1,238,615$1,238,615
REPAIR AND MAINTENANCE$694,958$694,958

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,065,818TotalAmt
Program Services$1,462,520ProgramServicesAmt
Management And General$603,298ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$22,838,321TotalAmt
Program Services$20,562,725ProgramServicesAmt
Management And General$2,275,596ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,008,954BOYAmt
EOY$1,837,289EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,515,782BOYAmt
EOY$2,469,585EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$99,371BOYAmt
EOY$86,291EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$229,147BOYAmt
EOY$209,051EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,512,364LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$12,414,757LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,688,181BOYAmt
EOY$8,097,607EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$108,000BOYAmt
EOY$108,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,846,751BOYAmt
EOY$3,457,308EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,496,186BOYAmt
EOY$16,265,131EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,654,204BOYAmt
EOY$1,782,318EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$50,503BOYAmt
EOY$106,967EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,635,615BOYAmt
EOY$5,702,179EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,148,152BOYAmt
EOY$3,588,747EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,488,474BOYAmt
EOY$11,180,211EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,007,712BOYAmt
EOY$5,084,920EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,007,712BOYAmt
EOY$5,084,920EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,496,186BOYAmt
EOY$16,265,131EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,077,208ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,301OtherCostOrOtherBasisAmt
Book Value$50,301BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,010,669OtherCostOrOtherBasisAmt
Depreciation$4,955,119DepreciationAmt
Book Value$2,055,550BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$277,097OtherCostOrOtherBasisAmt
Depreciation$234,478DepreciationAmt
Book Value$42,619BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,429,632OtherCostOrOtherBasisAmt
Depreciation$7,225,160DepreciationAmt
Book Value$1,204,472BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,744,665OtherCostOrOtherBasisAmt
Book Value$4,744,665BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,097,607TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$2,918,037
DUE FROM THIRD PARTIES$456,625
RESIDENT FUNDS$82,646
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,457,308TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO AFFILIATES$3,063,082
DUE TO PAYERS$443,019
DUE TO RESIDENTS$82,646
FieldValueIRS element (for citing)
Total Liability$3,588,747TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW CRUIKSHANK
CEO$0$342,751$0$0$0$0$0$0$0$57,308$0$400,059$0$0
JOHN COBURN
CFO$0$193,811$0$0$0$0$0$0$0$32,405$0$226,216$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationINDUSTRY DATA FROM TRADE ASSOCIATION IS USED BY BOARD TO SET PARAMETERS FOR SALARY AND BENEFIT LEVELS.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonSHAWNA CRUIKSHANKPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionWIFE OF CEORelationshipDescriptionTxt
Transaction$72,945TransactionAmt
TransactionANNUAL SALARYTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2SHAWNA CRUIKSHANK - WIFE OF CEO
FORM 990, PART VI, SECTION A, LINE 6FORT HUDSON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER AND PASSIVE PARENT OF FORT HUDSON NURSING CENTER, INC.
FORM 990, PART VI, SECTION A, LINE 7AFORT HUDSON HEALTH SYSTEM APPOINTS BOARD MEMBERS TO FORT HUDSON NURSING CENTER.
FORM 990, PART VI, SECTION B, LINE 11BRETURNS ARE PRESENTED TO THE FULL BOARD FOR COMMENT AND APPROVAL PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CANNUAL REVIEW OF DISCLOSURES AND REQUIREMENT TO INFORM OF NEW DEVELOPMENTS.
FORM 990, PART VI, SECTION B, LINE 15INDUSTRY DATA FROM TRADE ASSOCIATIONS IS USED TO SET PARAMETERS FOR SALARY AND BENEFIT LEVELS.
FORM 990, PART VI, SECTION C, LINE 18UPON WRITTEN REQUEST BASED ON STATUTORY AND REGULATORY REQUIREMENTS.
FORM 990, PART VI, SECTION C, LINE 19UPON WRITTEN REQUEST BASED ON STATUTORY AND REGULATORY REQUIREMENTS.
FORM 990, PART VII - COMPENSATION EXPLANATIONANDREW CRUIKSHANK NONTAXABLE FRINGE BENEFITS ORGANIZATIONAL AVERAGE 16.72% GROSS WAGES. JOHN COBURN NONTAXABLE FRINGE BENEFITS ORGANIZATIONAL AVERAGE 16.72% GROSS WAGES.
FORM 990, PART XII, LINE 2C:PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
FORT HUDSON RESIDENCES INC
319 BROADWAYFORT EDWARDNY12828311655779HOUSING FOR THE ELDERLYNY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INC0
FORT HUDSON HOME CARE INC
319 BROADWAYFORT EDWARDNY12828208166870HOMECARE AND SOCIAL DAYCARENY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INC0
FORT HUDSON PROPERTY MANAGEMENT CORP
319 BROADWAYFORT EDWARDNY12828141810104REAL ESTATE HOLDING COMPANYNY501(C)(2)FORT HUDSON HEALTH SYSTEM INC0
FORT HUDSON FOUNDATION CORPORATION
319 BROADWAYFORT EDWARDNY12828223368083FUNDRAISINGNY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INC0
FORT HUDSON HEALTH SYSTEM INC
319 BROADWAYFORT EDWARDNY12828200928661PASSIVE PARENT/SOLE MEMBER OF LISTED ORGNY501(C)(3)509(A)(3)0
FORT HUDSON CERTIFIED HOME HEALTH AGENCY
319 BROADWAYFORT EDWARDNY12828463241378HOME HEALTH CARENY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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