2020-11-12T16:12:20-06:00 2019-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2019-01-01 160743146 ST ANN'S HOME FOR THE AGED STAN 5856976000 1500 PORTLAND AVENUE ROCHESTER NY 14621 DENNIS KANT SENIOR VICE PRESIDENT & CFO 5856976307 2020-11-09 1 JENNIFER ARBORE P00893012 5853811000 4.14.157.197 2020-11-09 16:26:03 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 829852D3FE1B4BD6D88CB1F1483A018BA4D8437D 2019 2021-01-29 14:40:06Z DENNIS KANT 1500 PORTLAND AVENUE ROCHESTER NY 14621 66576024 0 X WWW.STANNSCOMMUNITY.COM X 1874 NY PROMOTE INDEPENDENCE, PHYSICAL & SPIRITUAL WELL-BEING OF OLDER ADULTS IN A SKILLED NURSING FACILITY. 23 19 1615 150 5659 4659 1817457 4656884 55234899 53674414 716614 1584764 1668287 1383973 59437257 61300035 69036 91992 0 0 44258051 43189713 0 0 0 17953708 17630276 62280795 60911981 -2843538 388054 81685764 126169381 57243726 107519096 24442038 18650285 X SINCE OUR FOUNDING IN 1874, OUR MISSION HAS BEEN TO PROMOTE THE HIGHEST LEVELS OF INDEPENDENCE, PHYSICAL AND SPIRITUAL WELL-BEING OF OLDER ADULTS IN THE CATHOLIC TRADITION OF EXCELLENCE IN CARE AND SERVICES. ST. ANN'S COMMUNITY, OTHERWISE KNOWN AS ST. ANN'S OF GREATER ROCHESTER, INC., OFFERS A CONTINUUM OF SERVICES FOR SENIORS IN THE GREATER ROCHESTER AREA THROUGH THESE AFFILIATED ORGANIZATIONS: ST. ANN'S HOME FOR THE AGED, ST. ANN'S NURSING HOME COMPANY, INC., CHAPEL OAKS, INC., ST. ANN'S FOUNDATION, INC., AND ST. ANN'S SENIOR HOUSING, INC. ST. ANN'S HOME FOR THE AGED (ST. ANN'S HOME) IS A 470 BED LICENSED SKILLED NURSING FACILITY. SPECIALIZED CARE OFFERED IN THIS FACILITY INCLUDES 34 UNITS DEDICATED TO PROVIDING SHORT-TERM POST-ACUTE REHABILITATION AND COMPLEX MEDICAL SERVICES, AND 36 UNITS PROVIDING DEMENTIA CARE. ST. ANN'S HOME ALSO OPERATES HOME CONNECTION, A 30 SLOT MEDICAL ADULT DAY PROGRAM AND HOME & HEART, A SOCIAL ADULT DAY PROGRAM AT TWO SATELLITE CENTERS SERVING 27 PEOPLE. 0 0 51117061 91992 53830137 ST. ANN'S HOME FOR THE AGED (ST. ANN'S HOME) IS A 470 BED LICENSED SKILLED NURSING FACILITY THAT INCLUDED THESE SERVICES DURING THE 2019 FISCAL YEAR: SKILLED NURSING CARE PROVIDED A TOTAL OF 135,535 DAYS OF CARE. INCLUDED IN THESE NUMBERS ARE BED DAYS FOR THE SPECIAL CARE UNIT, A 36 BED DEMENTIA CARE UNIT.THE WEGMANS TRANSITIONAL CARE CENTER PROVIDES 72 BEDS DEDICATED TO PROVIDING SHORT TERM POST ACUTE REHABILITATION. OUR TCC PROGRAM PROVIDED A TOTAL OF 13,476 DAYS OF CARE. THE LEO CENTER FOR CARING IS A 10-BED HOSPICE UNIT AND PROVIDED 3,218 DAYS OF CARE. THE HOME CONNECTION PROGRAM PROVIDED 30 SLOTS FOR MEDICAL ADULT DAY SERVICES AND THE HOME & HEART PROGRAM OFFERED SOCIAL ADULT DAY CARE AT TWO SATELLITE CENTERS SERVING 48 PEOPLE. DURING 2019, 6,925 DAYS OF CARE WERE PROVIDED TO PARTICIPANTS OF BOTH PROGRAMS. 51117061 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 121 0 1615 0 1 1 0 0 0 0 0 0 0 0 0 X 23 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X DENNIS KANT SENIOR VICE PRESIDENT & CFO 5856976000 1500 PORTLAND AVENUE ROCHESTER NY 14621 X DAN ADAMS DIRECTOR 1.00 X 0 0 0 EDMOND AKUBUIRO DIRECTOR 1.00 X 0 0 0 MICHELLE ASHBY DIRECTOR 1.00 X 0 0 0 CRAIG BURTON DIRECTOR 1.00 X 0 0 0 THOMAS COMBS DIRECTOR 1.00 X 0 0 0 MARK CRONIN DIRECTOR 1.00 X 0 0 0 KENT GARDNER CHAIR 1.00 X X 0 0 0 JOHN HAYES SECRETARY 1.00 X X 0 0 0 CARMEN INDIANO DIRECTOR 1.00 X 0 0 0 JAMES LEO TREASURER 1.00 X X 0 0 0 CANDICE LUCAS DIRECTOR 1.00 X 0 0 0 ANNA LYNCH DIRECTOR 1.00 X 0 0 0 SR MARLENE PAPE DIRECTOR 1.00 X 0 0 0 MICHAEL PINCH DIRECTOR 1.00 X 0 0 0 PATRICIA RISSONE DIRECTOR 1.00 X 0 0 0 MAURICIO RIVEROS DIRECTOR 1.00 X 0 0 0 CHERYL RYAN DIRECTOR 1.00 X 0 0 0 RONALD SALLUZZO BOARD CHAIR ELECT 1.00 X X 0 0 0 DEB SCHAUSEIL DIRECTOR 1.00 X 0 0 0 REV ROBERT SCHRADER DIRECTOR 1.00 X 0 0 0 SAMANTHA SINGHAL DIRECTOR 1.00 X 0 0 0 JOSEPH STANKAITIS IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 MICHAEL MCRAE PRESIDENT/CEO 34.00 6.00 X X 494916 0 31256 DENNIS KANT SVP/CFO 20.00 20.00 X 275546 0 30439 ELIZABETH TOMASZCZUK CHIEF NURSING EXECUTIVE 36.00 4.00 X 182026 0 27897 EILEEN RYAN-MARUKE VP OF MARKETING AND COMM RELATIONS 32.00 8.00 X 187532 0 28049 STEVEN SMITH VP OF FOUNDATION AND RESOURCE DEVELOPMENT 6.00 34.00 X 215155 0 27824 ROBERT BOURG VP OF ORGANIZATIONAL TRAINING AND DEVELOPMENT 31.00 9.00 X 234972 0 12391 SUSAN MURTY VP ADMINISTRATOR 34.00 6.00 X 238531 0 31222 KIM PETRONE MEDICAL DIRECTOR 36.00 4.00 X 381640 0 30877 JENNIFER BLACKCHIEF VP SENIOR HOUSING OPERATIONS AND DEVELOPMENT 0.00 40.00 X 0 221803 9401 JOHN JURIK ASSOCIATE MEDICAL DIRECTOR 36.00 4.00 X 245475 0 27875 JARVIS SANCHEZ-RIVERA ASSOCIATE MEDICAL DIRECTOR 36.00 4.00 X 259416 0 31003 MICHAEL LARCHE CHIEF INFORMATION OFFICER 31.00 9.00 X 205529 0 10983 BRIAN DAY STAFF ATTENDING PHYSICIAN 40.00 0.00 X 217767 0 11700 SHARON OSBORNE EXECUTIVE DIRECTOR 36.00 4.00 X 187531 0 17793 3326036 221803 328710 13 0 1 0 LECESSE CONSTRUCTION CO 75 THRUWAY PARK DRIVE WEST HENRIETTA NY 14586 CONSTRUCTION CONTRACTOR 4353432 SWBR ARCHITECTS 387 EAST MAIN STREET ROCHESTER NY 14604 ARCHITECTURAL SERVICES FOR RENOVATION PR 796179 ADP INC POBOX 842875 BOSTON MA 02284 PAYROLL PROCESSING 331844 RANSTAD TECHNOLOGIES PO BOX 847872 DALLAS TX 75284 TEMP HELP IT/HELP DESK 290532 MEDICAB 1449 HUDSON AVENUE ROCHESTER NY 14621 TRANSPORTATION SERVICES 158896 9 4656884 4656884 NET RESIDENT SERVICE REVENUE 623000 50931039 50931039 SUPPORT SERVICES 623000 2743375 2743375 53674414 618996 618996 102108 34181 67927 67927 67927 6178905 5016 5218153 0 960752 5016 965768 965768 51500 23655 27845 27845 MISCELLANEOUS 900099 577667 155723 421944 MEAL REVENUE 900099 481885 481885 PANDION/RAHSA 900099 228649 5659 222990 1288201 61300035 53830137 5659 2807355 91992 91992 1207665 1207665 33718288 29537115 4181173 5859353 4778772 1080581 2404407 1960987 443420 137464 137464 17650 17650 83771 83771 2046745 976917 1069828 81805 81805 676754 488407 188347 970429 970429 1254061 1133571 120490 227859 150757 77102 888212 888212 -2743370 -1481203 -1262167 4675821 4675821 660919 15016 645903 NYS ASSESSMENT 2796001 2796001 MEDICAL SUPPLIES 2234400 2234400 FOOD 1783297 1678493 104804 OTHER EXPENSES 1042385 669140 373245 796073 522663 273410 60911981 51117061 9794920 0 1469774 1360740 212293 249359 6732891 7248558 372113 350866 1579249 1646590 78673680 32903391 41783941 45770289 19566012 16331422 1701292 2498892 8268199 50712665 81685764 126169381 29504092 32482743 407666 469052 25500929 64487574 600745 4582056 1230294 5497671 57243726 107519096 X 13556056 8967368 10885982 9682917 24442038 18650285 81685764 126169381 X 388054 1434866 -7614673 X X 0 1 X 1 0 X 1988742 2596554 514006 1817457 4656884 11573643 63397519 60760823 61117173 55276305 53725914 294277734 65386261 63357377 61631179 57093762 58382798 305851377 0 0 0 305851377 800934 635578 798923 701823 721104 3658362 800934 635578 798923 701823 721104 3658362 807955 1051564 1395945 1337105 1059552 5652121 66995150 65044519 63826047 59132690 60163454 315161860 0.97050 0.97180 0.01160 0.01170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7158271 1257610 8415881 7657178 -498907 7158271 6576241 1080937 7657178 5863168 713073 6576241 6028846 -165678 5863168 0.00000 0.07830 0.92170 0 0 1249675 1249675 44479168 19504826 24974342 22963047 12218319 10744728 9981790 1180246 8801544 45770289 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 408794 BENEFICIAL INTEREST IN REMAINDER TRUSTS 858242 DUE FROM AFFILIATES 2668315 DUE FROM AFFILIATES, PENSION CONTRIBUTIONS 380009 DUE FROM THIRD PARTY PAYORS 615855 LIMITED USE ASSETS 44650727 RIGHT OF USE ASSET 1130723 50712665 DEFERRED COMPENSATION 751454 DUE TO AFFILIATES 4447498 ESTIMATED THIRD PARTY PAYOR SETTLEMENT 298719 5497671 55345672 1434866 -4619919 -3185053 58530725 83771 2685539 2769310 61300035 60916082 23655 23655 60892427 83771 -64217 19554 60911981 PART V, LINE 4: INCOME FROM ENDOWMENT FUNDS ARE TO BE USED FOR IT'S CORPORATE PURPOSE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENTS -621,635. PENSION LIABILITY ADJUSTMENT -1,938,388. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS 149,369. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 35,926. CHANGE IN INTEREST IN NET ASSETS OF ST. ANN'S FOUNDATION, INC. -2,645,970. CHANGE IN JOINT VENTURE INVESTMENT 400,779. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -34,181. GIFT SHOP EXPENSES -23,655. SUPPORT SERVICES 2,743,375. PART XII, LINE 2D - OTHER ADJUSTMENTS: GIFT SHOP EXPENSES 23,655. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -34,181. SISTERS OF ST. JOSEPH CONTRIBUTION -30,036. 1 ST ANN'S OF GREATER ROCHESTER INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161494042 501(C)(3) 91992 CASH FINANCIAL SUPPORT 1 0 SCHEDULE I, PART I, LINE 2: THE ORGANIZATION PROVIDES PERIODIC REPORTS DETAILING THE USE OF THE GRANT FUNDS TO THE BOARD OF DIRECTORS. X X X 1 1 X X X X X 0 0 0 0 0 0 0 1 0 MICHAEL MCRAE PRESIDENT/CEO 387395 0 106209 0 1312 0 11938 0 19318 0 526172 0 0 0 DENNIS KANT SVP/CFO 229068 0 44117 0 2361 0 12517 0 17922 0 305985 0 0 0 ELIZABETH TOMASZCZUK CHIEF NURSING EXECUTIVE 162264 0 18751 0 1011 0 8615 0 19282 0 209923 0 0 0 EILEEN RYAN-MARUKE VP OF MARKETING AND COMM RELATIONS 158491 0 28085 0 956 0 8767 0 19282 0 215581 0 0 0 STEVEN SMITH VP OF FOUNDATION AND RESOURCE DEVELO 178983 0 34416 0 1756 0 9913 0 17911 0 242979 0 0 0 ROBERT BOURG VP OF ORGANIZATIONAL TRAINING AND DE 196464 0 37823 0 685 0 10883 0 1508 0 247363 0 0 0 SUSAN MURTY VP ADMINISTRATOR 199642 0 38433 0 456 0 11904 0 19318 0 269753 0 0 0 KIM PETRONE MEDICAL DIRECTOR 299281 0 80856 0 1503 0 12670 0 18207 0 412517 0 0 0 JENNIFER BLACKCHIEF VP SENIOR HOUSING OPERATIONS AND DEV 0 185784 0 35740 0 279 0 7893 0 1508 0 231204 0 0 JOHN JURIK ASSOCIATE MEDICAL DIRECTOR 229325 0 9857 0 6293 0 11608 0 16267 0 273350 0 0 0 JARVIS SANCHEZ-RIVERA ASSOCIATE MEDICAL DIRECTOR 236454 0 22454 0 508 0 11685 0 19318 0 290419 0 0 0 MICHAEL LARCHE CHIEF INFORMATION OFFICER 182315 0 21444 0 1770 0 9475 0 1508 0 216512 0 0 0 BRIAN DAY STAFF ATTENDING PHYSICIAN 205059 0 12345 0 363 0 10029 0 1671 0 229467 0 0 0 SHARON OSBORNE EXECUTIVE DIRECTOR 167588 0 19378 0 565 0 8579 0 9214 0 205324 0 0 0 PART I, LINE 1A ST. ANN'S COMMUNITY PROVIDED THE FOLLOWING BENEFITS FOR THE PRESIDENT/CEO: PERSONAL CAR ALLOWANCE OF $3,278; INSURANCE OF $1,228; AND MOVING EXPENSES OF $18,840. ALL OF THESE ITEMS WERE CONSIDERED TAXABLE BENEFITS FOR THE PRESIDENT/CEO AND WERE INCLUDED AS WAGE COMPENSATIONON ON THE FORM W-2. PART I, LINE 7 80% IS TIED TO KEY ORGANIZATIONAL GOALS. 20% IS TIED TO INDIVIDUAL PERFORMANCE VS. ORGANIZATIONAL GOALS. A MONROE COUNTY INDUSTRIAL DEV CORP 510188852 61075TUH9 2019-12-31 69470902 TO REFUND REV BOND, SERIES 2014 AND NEW FINANCING FOR CONSTRUCTION PROJECT 0 0 1 A 69470902 4237988 25454691 886704 38404616 486903 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 ANNA LYNCH BOARD MEMBER OF ST. ANN'S COMMUNITY 127101 ANNA LYNCH IS A CURRENT BOARD MEMBER AND MANAGING PARTNER OF UNDERBERG & KESSLER LLP. ST. ANN'S ENGAGES UNDERBERG & KESSLER FOR LEGAL SERVICES. 0 MICHELLE ASHBY BOARD MEMBER OF ST. ANN'S COMMUNITY 121876 MICHELLE ASHBY IS A CURRENT BOARD MEMBER AND PRESIDENT/CEO OF TIPPING POINT MEDIA. ST. ANN'S ENGAGES TIPPING POINT MEDIA FOR MARKETING CONSULTING. 0 MAURICIO RIVEROS BOARD MEMBER OF ST. ANN'S COMMUNITY 5934976 MAURICIO RIVEROS IS A CURRENT BOARD MEMBER AND PRESIDENT/CEO OF THE PIKE GROUP, WHO OWNS LECESSE CONSTRUCTION. ST. ANN'S ENGAGES LECESSE CONSTRUCTION FOR CONSTRUCTION PROJECTS. 0 FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION FOR THE REPORT IS PREPARED BY ST ANN'S STAFF, PROVIDED AND REVIEWED BY THE BONADIO GROUP. FINAL REPORTS ARE REVIEWED BY THE ST. ANN'S FINANCE TEAM, INCLUDING THE DIRECTOR OF FINANCE AND CFO, AND PROVIDED TO CEO AND BOARD MEMBERS PRIOR TO REVIEW AT THE BOARD MEETING. COPIES OF THE REPORTS ARE DISTRIBUTED AT A SUBSEQUENT BOARD MEETING AT WHICH TIME THE REPORTS ARE APPROVED. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS (INCLUDING THE PRESIDENT AND CEO) ARE REQUIRED TO ANNUALLY COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE FORMS ARE THEN REVIEWED BY THE VP OF ORGANIZATIONAL DEVELOPMENT AND ANY POTENTIAL CONFLICTS ARE DEALT WITH AS NEEDED INCLUDING ABSTAINING FROM VOTING ON MATTERS RELATED TO SUCH CONFLICTS. ANY PERSON COVERED BY THE POLICY SHALL NOT KNOWINGLY USE HIS OR HER POSITION FOR PERSONAL GAIN, TO COMPROMISE ST. ANN'S INTERESTS, OR TO ALLOW A CONFLICT TO ARISE BETWEEN ST. ANN'S INTEREST AND HIS OR HER PERSONAL INTEREST. FORM 990, PART VI, SECTION B, LINE 15 EACH YEAR AN INDEPENDENT WAGE STUDY IS CONDUCTED BY A CONSULTANT. DIRECTORS AND ABOVE, EXCEPT CEO, ARE REVIEWED BY VP OR HR AND CEO WITH ADJUSTMENTS MADE TO MAINTAIN COMPETITIVENESS. CEO DATA IS REVIEWED BY A COMMITTEE INCLUDING THE BOARD CHAIR, PAST BOARD CHAIR AND HR BOARD CHAIR. ADJUSTMENTS MADE AS NEEDED TO MAINTAIN MARKET COMPETITIVENESS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: ALL OFFICERS AND EMPLOYEES REPORTED ON PART VII ARE FULL TIME EMPLOYEES OF THE ST. ANN'S COMMUNITY (ST. ANN'S HOME FOR THE AGED ("SAH") AND RELATED ORGANIZATIONS) WORKING AN AVERAGE OF 40 HOURS PER WEEK. HOURS REPORTED IN COLUMN B OF PART VII ARE THE AVERAGE HOURS RELATED TO WORK PERFORMED FOR SAH. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENTS -621,635. PENSION LIABILITY ADJUSTMENT -1,938,388. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS 149,369. CHANGE IN VALUE OF BENEFICIAL INTEREST IN NET ASSETS OF ST. ANN'S FDN, INC. -2,645,970. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 35,926. CHANGE IN JOINT VENTURE INVESTMENT 400,779. PAYMENTS FROM AFFILIATES FOR SUPPORT SERVICES -2,743,375. LOSS ON EXTINGUISHMENT OF DEBT -221,343. NONOPERATING CONTRIBUTION -30,036. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. ST ANN'S FOUNDATION INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161379536 HEALTH CARE NY 501(C)(3) LINE 12A, I ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S NURSING HOME COMPANY INC DBA THE HERITAGE 1500 PORTLAND AVENUE ROCHESTER NY 14621 237098164 HEALTH CARE NY 501(C)(3) LINE 10 ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S OF GREATER ROCHESTER INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161494042 HEALTH CARE NY 501(C)(3) LINE 12B, II N/A 0 ST ANN'S SENIOR HOUSING INC DBA CHERRY RIDGE 1500 PORTLAND AVENUE ROCHESTER NY 14621 760705854 HEALTH CARE NY 501(C)(3) LINE 10 ST ANN'S OF GREATER ROCHESTER INC 0 CHAPEL OAKS INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161489340 HEALTH CARE NY 501(C)(3) LINE 10 ST ANN'S OF GREATER ROCHESTER INC 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1