2020-11-13T13:51:01-06:00 2019-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2019-01-01 161449543 GENEVA NURSING HOME II INC GENE 3157874000 64 MASON ST GENEVA NY 14456 JEFFREY MORGAN CFO & TREASURER 3157874000 2020-11-12 1 AIMEE J JOZIC P01346943 5853811000 72.225.21.229 2020-11-12 19:12:32 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 5C704B3FF464E54C4CE4AB9B8A5F0120FA67052E 2019 2021-01-29 14:40:06Z LIVING CENTER AT GENEVA NORTH JOSE ACEVEDO MD MBA 64 MASON ST GENEVA NY 14456 6387279 0 X WWW.FLHEALTH.ORG X 1995 NY GENEVA NURSING HOME II, INC. IS A COMMUNITY BASED, NOT-FOR-PROFIT SKILLED NURSING FACILITY DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF ALL PEOPLE IN THE CENTRAL FINGER LAKES REGION. WE ARE COMMITTED TO SAFE, HIGH QUALITY, COMPASSIONATE SERVICES THAT ARE CONVENIENT, ACCESSIBLE AND AT REASONABLE COST, THROUGH THE EFFORTS OF OUR EMPLOYEES, MEDICAL STAFF AND VOLUNTEERS. WE ARE A CENTER FOR HEALTH EDUCATION THAT LIVES ITS LEADERSHIP COMMITMENTS THROUGH PARTICIPATION IN AND SPONSORSHIP OF PROFESSIONAL, ALLIED HEALTH AND COMMUNITY HEALTH EDUCATION PROGRAMS. 16 13 88 41 0 0 121314 84456 5745752 6225244 75345 77376 41228 203 5983639 6387279 0 0 0 0 2730811 2655273 0 0 0 3043567 3223453 5774378 5878726 209261 508553 7458893 7744694 8009172 6443796 -550279 1300898 X GENEVA NURSING HOME II, INC. IS A COMMUNITY BASED, NOT-FOR-PROFIT SKILLED NURSING FACILITY DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF ALL PEOPLE IN THE CENTRAL FINGER LAKES REGION. WE ARE COMMITTED TO SAFE, HIGH QUALITY, COMPASSIONATE SERVICES THAT ARE CONVENIENT, ACCESSIBLE AND AT REASONABLE COST, THROUGH THE EFFORTS OF OUR EMPLOYEES, MEDICAL STAFF AND VOLUNTEERS. WE ARE A CENTER FOR HEALTH EDUCATION THAT LIVES ITS LEADERSHIP COMMITMENTS THROUGH PARTICIPATION IN AND SPONSORSHIP OF PROFESSIONAL, ALLIED HEALTH AND COMMUNITY HEALTH EDUCATION PROGRAMS. 0 0 4024892 6264321 GENEVA NURSING HOME, II, INC, D/B/A LIVING CENTER GENEVA NORTH (LCN) IS AN 80-BED SKILLED NURSING FACILITY WITH A REPUTATION FOR OUTSTANDING MEDICAL, NURSING, AND REHABILITATIVE CARE. LOCATED IN GENEVA, NY, LCN CONSISTS OF TWO NURSING UNITS AND A RESPITE SERVICE WITH TWO BEDS. LCN OFFERS A BROAD RANGE OF SKILLED NURSING AND REHABILITATIVE SERVICES. OUR MULTIDISCIPLINARY TEAM, CONSISTING OF PHYSICIANS, NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, SOCIAL WORK, ACTIVITIES AND NUTRITIONAL SERVICES STAFF, WORKS DIRECTLY WITH THE RESIDENT AND FAMILY MEMBERS TO DEVISE AND CARRY OUT THE BEST POSSIBLE PLAN OF CARE. WE ARE ABLE TO OFFER A CONTINUUM OF CARE UNMATCHED IN OUR REGION, WITH A WIDE VARIETY OF MEDICAL SPECIALISTS AND OUTSTANDING ACUTE CARE AS NEEDED. 4024892 1 1 0 1 0 0 0 0 1 0 1 1 0 1 1 0 1 1 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 88 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 13 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X JEFFREY MORGAN 3157874000 196 NORTH STREET GENEVA NY 14456 KYLENE ABRAHAM DNP DIRECTOR 1.00 4.00 X 0 0 0 JOSE ACEVEDO MD MBA ASST SECRETARY 6.00 34.00 X X 0 692132 71978 REV JAMES ADAMS DIRECTOR 1.00 4.00 X 0 0 0 ROBERT ANDERSON MD DIRECTOR 1.00 39.00 X 0 237100 28837 PHIL BECKLEY VICE CHAIR 1.00 4.00 X X 0 0 0 TOM BURRALL DIRECTOR 1.00 4.00 X 0 0 0 JAMES CHENEY DIRECTOR 1.00 4.00 X 0 0 0 CRAIG DENSMORE DIRECTOR 1.00 4.00 X 0 0 0 CHEVANNE DEVANEY DIRECTOR 1.00 4.00 X 0 0 0 SUSAN STORK DIRECTOR 1.00 4.00 X 0 0 0 JOHN HICKS DIRECTOR 1.00 4.00 X 0 0 0 RYAN HALLINGS DIRECTOR 1.00 4.00 X 0 0 0 MATTHEW TALBOTT MD DIRECTOR 1.00 40.00 X 0 485799 24489 MENZO CASE SECRETARY 1.00 4.00 X X 0 0 0 TOM THOMPSON MD DIRECTOR 1.00 4.00 X 0 0 0 LANCE WARD CHAIR 1.00 4.00 X X 0 0 0 JEFFREY MORGAN TREASURER & CFO 6.00 34.00 X 0 206840 14407 BILL KING THROUGH 92019 INTERIM TREASURER 6.00 34.00 X 0 166214 21467 FRANK M KORICH SR VP OPERATIONS 5.00 35.00 X 0 297515 51319 PATRICK R BOYLE VP HUMAN RESOURCES 1.60 38.40 X 0 247450 46340 WILLIAM GARRITY VP LONG TERM CARE 8.00 32.00 X 0 162802 40645 MANUEL ENECILLA PHYSICIAN HOSPITALIST GGH 40.00 X 229646 0 8892 SARA DREW NP GGH DERMATOLOGY 40.00 X 165906 0 2784 KELLY BOWEN NP HOSPITALIST 40.00 X 126345 0 28289 521897 2495852 339447 3 0 1 0 0 63326 21130 84456 PATIENT SVC REVENUE 623000 6206523 6206523 18721 18721 6225244 38299 38299 39077 0 39077 39077 39077 OTHER REVENUE 900099 203 203 203 6387279 6264321 0 38502 1923467 1521948 401519 58318 28979 29339 524208 403273 120935 149280 114841 34439 41826 41826 4775 4775 15638 15638 18262 18262 9519 9519 21455 3050 18405 141937 92679 49258 715 715 114895 114895 236619 224788 11831 31022 31022 SHARED SERVICES 1748024 963751 784273 NYS ASSESSMENT TAX 368456 368456 PURCHASED SERVICES 223981 106969 117012 SUPPLIES 161030 111054 49976 85299 85104 195 5878726 4024892 1853834 0 216603 354569 17501 18718 758612 815460 15139 9649 9579782 7390064 2344457 2189718 1602863 1888856 2503718 2467724 7458893 7744694 607706 839304 1325191 615420 17501 18718 2981572 2661176 3077202 2309178 8009172 6443796 X -550279 1300898 -550279 1300898 7458893 7744694 X 508553 209179 665080 468365 X X 0 1 X 1 1 1 X 900 576 121314 84456 207246 5441393 5637303 5997125 5745752 6225244 29046817 5442293 5637303 5997701 5867066 6309700 29254063 0 0 0 29254063 15380 14323 38356 42884 38299 149242 15380 14323 38356 42884 38299 149242 41228 203 41431 5457673 5651626 6036057 5951178 6348202 29444736 0.99350 0.99370 0.00510 0.00490 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 392 392 0 PART II-B, LINE 1: PORTION OF ASSOCIATION DUES ATTRIBUTED TO LOBBYING EXPENSES. 0 1 X 81133 81133 7455261 6089188 1366073 78053 60502 17551 1926608 1240374 686234 38727 38727 2189718 INVESTMENT IN GGH POOLED INVESTMENTS 1888856 F 1888856 RESERVE FOR REPLACEMENT 673662 RESTRICTED HUD SINKING FUND 1794062 2467724 DUE TO AFFILIATES/OTHER FUNDS 1893979 LT DUE TO AFFILIATE PENSION 415199 2309178 7261538 209179 665080 874259 6387279 0 6387279 5878726 0 5878726 0 5878726 PART IV, LINE 2B: LCN HOLDS AGENCY FUNDS FOR THE CONVENIENCE OF ITS RESIDENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: PRIOR PERIOD REVENUE 665,080. 0 1 0 0 0 0 0 0 0 JOSE ACEVEDO MD MBA ASST SECRETARY 0 528331 0 138801 0 25000 0 38833 0 33145 0 764110 0 0 ROBERT ANDERSON MD DIRECTOR 0 209303 0 9000 0 18797 0 467 0 28370 0 265937 0 0 MATTHEW TALBOTT MD DIRECTOR 0 469406 0 0 0 16393 0 0 0 24489 0 510288 0 0 JEFFREY MORGAN TREASURER & CFO 0 179486 0 0 0 27354 0 0 0 14407 0 221247 0 0 BILL KING THROUGH 92019 INTERIM TREASURER 0 156096 0 0 0 10118 0 1261 0 20206 0 187681 0 0 FRANK M KORICH SR VP OPERATIONS 0 240140 0 32375 0 25000 0 28389 0 22930 0 348834 0 0 PATRICK R BOYLE VP HUMAN RESOURCES 0 190812 0 25038 0 31600 0 17774 0 28566 0 293790 0 0 WILLIAM GARRITY VP LONG TERM CARE 0 142078 0 9354 0 11370 0 11849 0 28796 0 203447 0 0 MANUEL ENECILLA PHYSICIAN HOSPITALIST GGH 219772 0 8125 0 1749 0 255 0 8637 0 238538 0 0 0 SARA DREW NP GGH DERMATOLOGY 146906 0 0 0 19000 0 0 0 2784 0 168690 0 0 0 KELLY BOWEN NP HOSPITALIST 117841 0 3250 0 5254 0 696 0 27593 0 154634 0 0 0 PART I, LINE 3 AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHODS DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION THESE QUESTIONS HAVE BEEN LEFT BLANK. REFER TO SCHEDULE O, DESCRIPTION OF COMPENSATION REVIEW AND APPROVAL PROCESS. PART I, LINE 4B CERTAIN OFFICERS AND DIRECTORS OF GENEVA NURSING HOME II, INC. D.B.A LIVING CENTER AT GENEVA NORTH PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PROVIDED BY GENEVA GENERAL HOSPITAL (GGH), A RELATED IRC SECTION 501(C)(3) ORGANIZATION. GGH DEPOSITED $50,000 INTO A 457(F) PLAN IN 2019 FOR JOSE ACEVEDO, MD, MBA, PRESIDENT & CEO. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE ADMINISTRATIVE COMMITTEE OF THE BOARD PRIOR TO BEING FILED. ANY COMMITTEE FINDINGS ARE REVIEWED AND IMPLEMENTED AS APPROPRIATE BY MANAGEMENT. CHANGES IN IRS REQUIREMENTS AND ORGANIZATION PRACTICES FROM THE PRIOR YEAR ARE HIGHLIGHTED FOR THE COMMITTEE BY MANAGEMENT. THE COMMITTEE REPORTS ON THIS DISCUSSION TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 12C LCN MAINTAINS A CONFLICT OF INTEREST POLICY WHICH BOARD MEMBERS ARE REQUIRED TO SIGN PRIOR TO TAKING OFFICE. STATEMENTS ARE UPDATED AND REVIEWED ANNUALLY BY AN ADMINISTRATIVE COMMITTEE. THE PROCESS FOR HANDLING ANY CONFLICT OF INTEREST WHICH MAY ARISE IS DETAILED IN THE CORPORATE BYLAWS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS REVIEWED BY A COMPENSATION COMMITTEE, AND COMPARABILITY DATA IS PART OF THE DECISION. FORM 990, PART VI, SECTION C, LINE 19 LCN MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC WHERE REQUIRED BY LAW AND UPON REQUEST. LCN'S FORM 990 IS PROVIDED TO ANY INDIVIDUAL WHO PROVIDED A REQUEST IN PERSON OR WHO SUBMITS A WRITTEN REQUEST. THERE IS NO CHARGE OTHER THAN A REASONABLE FEE FOR COPYING AND POSTAGE. COPIES ARE AVAILABLE AT THE FINANCE OFFICE. AN ELECTRONIC VERSION MAY BE FOUND AT WWW.GUIDESTAR.ORG. FORM 990, PART XI, LINE 9: ADDITIONAL PENSION LIABILITY 458,161. NET PERIODIC PENSION INCOME 10,204. PART XII, LINE 2C LCS HAS A BOARD COMMITTEE WHO ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. FINGER LAKES REGIONAL HEALTH SYSTEM INC 196 NORTH STREET GENEVA NY 14456 223193606 SOLE MEMBER OF LCN, GGH, FLHF, LCS, HLC, AND SSMH NY 501(C)(3) LINE 7 0 GENEVA GENERAL HOSPITAL 196 NORTH STREET GENEVA NY 14456 160743032 PROVIDER OF HEALTHCARE NY 501(C)(3) LINE 3 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 FINGER LAKES HEALTH FOUNDATION 196 NORTH STREET GENEVA NY 14456 150549310 COORDINATOR OF FUND RAISING ACTIVITIES NY 501(C)(3) LINE 11 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 LIVING CENTER AT GENEVA SOUTH 196 NORTH STREET GENEVA NY 14456 160957268 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 HUNTINGTON LIVING CENTER 369 EAST MAIN STREET WATERLOO NY 13165 510169552 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 GENEVA GENERAL HOUSING DEVELOPMENT CO 260 NORTH STREET GENEVA NY 14456 222816883 PROVIDE LOW INCOME HOUSING NY 501(C)(3) LINE 9 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 TAYLOR BROWN HOUSING DEVELOPMENT CO 371 EAST MAIN STREET WATERLOO NY 13165 222807734 DEVELOP AND PROVIDE SENIOR HOUSING COMPLEX NY 501(C)(3) LINE 9 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 SOLDIERS & SAILORS MEMORIAL HOSPITAL 418 NORTH MAIN STREET PENN YAN NY 14527 160743192 PROVIDER OF HEALTHCARE NY 501(C)(3) LINE 3 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0