2020-11-16T21:45:30-06:00 2019-12-31 271728945 PKF O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990 2019-01-01 134034061 AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC AMST 2125753322 1060 AMSTERDAM AVENUE NEW YORK NY 10025 MARK PANCIRER SENIOR VP/CFO 2125753322 2020-11-16 1 GARRETT M HIGGINS P00543209 9143818900 2020-11-16 24.190.81.120 2020-11-16 21:45:25 ES P F6241A67CEA968FA82FDD3F36018BF333AFB8C14 9616F4B14A694591D1E716C270910E6FA5556DA3 2019 2021-01-29 14:40:06Z JAMES DAVIS 1060 AMSTERDAM AVENUE NEW YORK NY 10025 741607 0 X WWW.AMSTERDAMCARES.ORG X 1997 NY THE PURPOSES OF ACCHS INCLUDE THE PROVISION OF ADVISORY AND OTHER SUPPORT TO INDEPENDENT NOT-FOR-PROFIT ORGANIZATIONS DEVOTED TO THE PROVISION OF HEALTH CARE, HOUSING AND SERVICES TO THE ILL , THE IMPAIRED, THE DISABLED, AND THE ELDERLY. 11 11 2 12 0 0 295590 323748 323733 291360 78385 92710 0 -6844 697708 700974 19072 11103 0 0 164167 220416 0 0 0 8368 7036 191607 238555 506101 462419 4928272 5427661 2267648 2289315 2660624 3138346 THE PURPOSES OF ACCHS INCLUDE THE PROVISION OF ADVISORY AND OTHER SUPPORT TO INDEPENDENT NOT-FOR-PROFIT ORGANIZATIONS DEVOTED TO THE PROVISION OF HEALTH CARE, HOUSING AND SERVICES TO THE ILL, THE IMPAIRED, THE DISABLED, AND THE ELDERLY. 0 0 154852 11103 291360 SUPPORT OF SERVICES FOR THE ELDERLY 154852 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 2 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X MARK PANCIRER 2125753322 1060 AMSTERDAM AVENUE NEW YORK NY 10025 JAMES DAVIS PRESIDENT/ CEO 2.00 48.00 X 102999 889822 50108 MARK PANCIRER SR. VP. / CFO 0.50 49.50 X 30000 314196 52315 LAWERNCE B THOMPSON CHAIRMAN (THRU SEPT. 2019) 1.00 4.00 X X 0 0 0 JOSEPH C HOOPES JR CHAIRMAN & TREASURER 0.50 2.00 X X 0 0 0 GEORGE L VAN AMSON VICE CHAIRMAN 0.30 1.00 X X 0 0 0 JOSE V TORRES SECRETARY 0.30 0.30 X X 0 0 0 REV CANON JAMES CALLAWAY JR BOARD MEMBER 0.30 0.50 X 0 0 0 ISABEL M CARDEN BOARD MEMBER 0.30 0.70 X 0 0 0 JAY H MCDOWELL BOARD MEMBER 0.30 0.60 X 0 0 0 REV DEACON FRANK PETERSON JR BOARD MEMBER 0.30 0.50 X 0 0 0 JAMES C CAMPBELL BOARD MEMBER 0.30 0.50 X 0 0 0 DR KAREN M HOPKINS BOARD MEMBER 0.30 0.50 X 0 0 0 FRANCES R OLIVIERI BOARD MEMBER 0.30 0.50 X 0 0 0 R SCOTT EDMONDS BOARD MEMBER 0.30 0.50 X 0 0 0 132999 1204018 102423 1 0 1 0 0 156906 126000 40842 323748 MANAGEMENT SERVICES 561000 291360 291360 291360 92710 92710 33789 156906 40633 -6844 -6844 700974 291360 0 85866 11103 11103 132999 132999 68569 68569 2556 2556 16292 10750 5542 1355 1355 4222 4222 290 290 1169 1169 238555 154852 83703 0 880883 247732 3863648 4886562 148 146 121594 121594 61999 171627 4928272 5427661 48 21715 2267600 2267600 2267648 2289315 X 2660624 3138346 2660624 3138346 4928272 5427661 462419 15303 0 X 0 0 0 X 313370 216825 330261 295590 323748 1479794 313370 216825 330261 295590 323748 1479794 513742 966052 35234 83121 65922 78385 92710 355372 1835166 1930527 0.52640 0.59120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 SUBVENTION - SUBORDINATE NOTE 2267600 2267600 ANNUAL GOLF OUTING 190695 156906 33789 630 33789 6214 190695 156906 33789 630 33789 6214 40633 -6844 1 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 1060 AMSTERDAM AVENUE NEW YORK NY 10025 113711764 501(C)(3) 11103 RELATED ORGANIZATION EXPENSES 1 0 PART I, LINE 2: THE HEALTH SYSTEM GAVE A CONTRIBUTION TO A RELATED ORGANIZATION, AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY, INC. THE ORGANIZATIONS HAVE THE SAME MANAGEMENT AND SIMILAR BOARDS, WHICH IS HOW THE HEALTH SYSTEM ENSURES THAT THE ORGANIZATION WILL USE THE FUNDS FOR THE INTENDED PURPOSE. THE HEALTH SYSTEM ALSO REQUIRES SUFFICIENT DOCUMENTATION FROM THE GRANTEE PRIOR TO REIMBURSEMENT OF EXPENDITURES. X X X 0 0 0 0 0 0 0 0 0 JAMES DAVIS PRESIDENT/ CEO 102999 620350 0 250000 0 19472 0 19614 0 30494 102999 939930 0 0 MARK PANCIRER SR. VP. / CFO 30000 263567 0 50000 0 629 0 19614 0 32701 30000 366511 0 0 FORM 990, PART VI, SECTION A, LINE 2 LAWRENCE B. THOMPSON AND R. SCOTT EDMONDS HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B AMSTERDAM CONTINUING CARE HEALTH SYSTEM, INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, A COPY OF THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE AUDIT COMMITTEE. ANY ISSUES ARE REVIEWED AND CORRECTED. THE CFO THEN MAKES THE FULL 990 AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. ONCE THE BOARD HAS APPROVED THE RETURN IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS, AND KEY PERSONS MUST COMPLETE AN ANNUAL DISCLOSURE AND AFFIRMATION FORM IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. AN INTERESTED DIRECTOR MEANS ANY AMSTERDAM DIRECTOR WHO HAS AN INTEREST AS A PRINCIPAL, PARTNER, DIRECTOR, OFFICER, EMPLOYEE, AGENT, OR STOCKHOLDER (OTHER THAN A STOCKHOLDER OF A PUBLICLY TRADED CORPORATION WHOSE STOCK IS WIDELY HELD) OF ANY ENTITY WITH WHICH AMSTERDAM HAS OR CONTEMPLATES TRANSACTING BUSINESS. AN INTERESTED DIRECTOR MUST DISCLOSE THE RELATIONSHIP OR INTEREST IN THE TRANSACTION TO THE BOARD OF DIRECTORS OF THE APPLICABLE AMSTERDAM ENTITY. DISCLOSURE SHALL BE MADE TO THE CHAIRMAN OF THE BOARD AS SOON AS THE INTERESTED DIRECTOR BECOMES AWARE OF THE POTENTIAL FOR A CONFLICT IN CONNECTION WITH THE TRANSACTION, WHO THEN SHALL INFORM THE APPLICABLE BOARD. IF THE CHAIRMAN IS INVOLVED IN THE TRANSACTION, THE CHAIRMAN SHALL ADVISE THE SECRETARY OF THE APPLICABLE AMSTERDAM ENTITY WHO SHALL ARRANGE FOR BOARD DISCLOSURE. NO INTERESTED DIRECTOR SHALL PARTICIPATE IN THE DISCUSSION, DELIBERATIONS AND VOTING REGARDING A TRANSACTION. THE AFFIRMATIVE VOTE OF THE MAJORITY OF ALL THE DIRECTORS OF THE APPLICABLE AMSTERDAM ENTITY SHALL BE REQUIRED BEFORE ENTERING INTO THE TRANSACTION (EXCLUDED IN SUCH COUNTS IS THE INTERESTED DIRECTOR). NO TRANSACTION SHALL BE INVALIDATED OR AFFECTED IN ANY WAY IF THIS POLICY IS FOLLOWED. ALL OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. SAID CONFLICTS ARE ADDRESSED BY MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 AMSTERDAM HAS A PROCESS TO DETERMINE COMPENSATION FOR THE PRESIDENT/CEO WHICH INCLUDES A REVIEW BY A COMPENSATION AND OUTSIDE BENEFITS CONSULTANT. THE USE OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN THE DELIBERATION AND THE FINAL DECISION. THIS PROCESS WAS UNDERTAKEN IN DECEMBER 2018 FOR THE YEAR 2019. THIS PROCESS INCLUDES A REVIEW OF TOTAL COMPENSATION INCLUDING BONUS CONSIDERATION BY THE BOARD. AMSTERDAM HAS A PROCESS TO DETERMINE COMPENSATION FOR OFFICERS, WHICH INCLUDES A REVIEW BY A COMPENSATION AND BENEFITS CONSULTANT, THE USE OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN THE DELIBERATION, AND THE FINAL DECISION. COMPENSATION OF KEY EMPLOYEES IS BASED ON AN INFORMAL REVIEW BY THE PRESIDENT/CEO OF COMPARABLE DATA. THIS WAS LAST DONE IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS ALSO POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FORM 1023, FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. AMSTERDAM CONSULTING LLC 1060 AMSTERDAM AVE NEW YORK NY 10025 134034061 ADMIN & CONSULTING NY 373757 3648084 AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC AMSTERDAM SERVICES CORP 1060 AMSTERDAM AVE NEW YORK NY 10025 133902473 ADMIN & CONSULTING NY 501(C)(3) PF AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 AMSTERDAM NURSING HOME CORPORATION (1992) 1060 AMSTERDAM AVE NEW YORK NY 10025 133834710 NURSING HOME NY 501(C)(3) LINE 10 AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 300 EAST OVERLOOK PORT WASHINGTON NY 11050 113711764 ASSIST ELDERLY NY 501(C)(3) LINE 12A, I AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 ANH FOUNDATION 1060 AMSTERDAM AVE NEW YORK NY 10025 117099598 GRANTMAKING NY 501(C)(3) PF AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 AMSTERDAM 2012 INC 1060 AMSTERDAM AVE NEW YORK NY 10025 461715083 DEV RENT PROP NY 501(C)(3) LINE 10 AMSTERDAM NURSING HOME CORPORATION (1992) 0 AMSTERDAM SERVICES CORP (2001) 1060 AMSTERDAM AVE NEW YORK NY 10025 134184082 ADMIN & CONSULTING NY AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC C 14430 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 ANH FOUNDATION C 126000 COST AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC Q 147860 COST