2020-11-16T17:43:51-06:00 2019-12-31 271728945 PKF O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990 2019-01-01 113188802 NEW YORK CONGREGATIONAL NURSING CENTER NEWY 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 WINSOME MCLEAN-DAVIS PRESIDENT & CEO 7185767000 2020-11-16 1 GARRETT M HIGGINS P00543209 9143818900 2020-11-16 100.33.234.126 2020-11-16 17:43:47 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A6D13489680F7BF7A058155E65F3C61B5D8EE11D 2019 2021-01-29 14:40:06Z WINSOME MCLEAN-DAVIS 135 LINDEN BOULEVARD BROOKLYN NY 11226 24915044 0 X WWW.NYCNC.ORG X 1994 NY THE MISSION OF NEW YORK CONGREGATIONAL NURSING CENTER IS TO PROVIDE SKILLED NURSING CARE AND REHABILITATION THERAPY SERVICES FOR 200 RESIDENTS. ADDITIONALLY, THE CENTER HAS A CERTIFIED HOME HEALTH AGENCY WHICH PROVIDES NURSING, REHAB THERAPY, DIETARY, SOCIAL WORK AND HOME HEALTH AIDE/PERSONAL CARE SERVICES TO PERSONS LIVING IN THEIR OWN HOMES. 6 6 342 6 0 0 217635 1100 22472500 24829808 5712 25486 195794 58650 22891641 24915044 6000 0 0 0 16052746 15660149 0 0 0 9968786 9852910 26027532 25513059 -3135891 -598015 15903169 15130715 18374828 18156581 -2471659 -3025866 X THE MISSION OF NEW YORK CONGREGATIONAL NURSING CENTER IS TO PROVIDE SKILLED NURSING CARE AND REHABILITATION THERAPY SERVICES FOR 200 RESIDENTS. ADDITIONALLY, THE CENTER HAS A CERTIFIED HOME HEALTH AGENCY WHICH PROVIDES NURSING, REHAB THERAPY, DIETARY, SOCIAL WORK AND HOME HEALTH AIDE/PERSONAL CARE SERVICES TO PERSONS LIVING IN THEIR OWN HOMES. 0 0 21326345 24566595 NEW YORK CONGREGATIONAL NURSING CENTER OFFERS A WIDE RANGE OF SERVICES ADDRESSING THE NEEDS OF PEOPLE RECOVERING FROM POST SURGICAL CONDITIONS, ACUTE MEDICAL EVENTS AND OTHER SITUATIONS REQUIRING INTENSIVE NURSING CARE AND REHABILITATION. THESE SERVICES FOR THE MOST PART ARE PROVIDED ON-SITE OR DIRECTLY THROUGH CONSULTATION. TYPES OF SERVICES:- MEDICAL SERVICES INCLUDING: AUDIOLOGY, CARDIOLOGY, DENTAL, INFECTIOUS DISEASE, NEUROLOGY, ONCOLOGY, OPTOMETRY, PODIATRY, PSYCHIATRY, PHYSIATRY, PSYCHOLOGY, PULMONOLOGY, OPHTHALMOLOGY, SURGICAL, UROLOGY, AND VASCULAR - REHABILITATION THERAPY INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH, AND DYSPHAGIA- NURSING INCLUDING INTRAVENOUS THERAPY, TRACHEOTOMY CARE, OXYGEN THERAPY, WOUND CARE, ALTERNATIVE FEEDING DELIVERY SYSTEMS, AND MANAGEMENT OF COMPLEX CONDITIONS- PSYCHO-SOCIAL COUNSELING - THERAPEUTIC DIETS - NUTRITIONAL COUNSELING - BEAUTY PARLOR SERVICES - PASTORAL CARE - DISCHARGE PLANNING INCLUDING COMPREHENSIVE EDUCATION AND PREPARATION FOR DISCHARGE, AND A HOME VISIT BEFORE DISCHARGE THE ORGANIZATION PROVIDED 67,456 DAYS OF CARE TO APPROXIMATELY 596 PATIENTS IN 2019. 1100410 263213 THE ORGANIZATION'S CERTIFIED HOME HEALTH AGENCY PROVIDES QUALITY CARE TO ENABLE THE ELDERLY TO REMAIN IN THEIR OWN RESIDENCE. IN-HOME SERVICES INCLUDE:- NURSING ASSESSMENT & MANAGEMENT- PHYSICAL THERAPY- OCCUPATIONAL THERAPY - SPEECH THERAPY - SOCIAL WORK- HOME HEALTH AIDES- NUTRITIONAL COUNSELING- PERSONAL CARE- HOUSEKEEPING- MEDICAL SUPPLIES AND MEDICAL EQUIPMENT 22426755 1 0 0 1 0 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 342 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X X PATRICK CLUNE 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 FLORENCE KATZ PRESIDENT & CEO 33.90 1.10 X 258670 0 54442 FRANK CIANCIOTTO SENIOR VP/CFO 11.90 1.10 X 142646 0 44607 KIMBERLY JEFFERS DIRECTOR OF CHHA 35.00 X 146813 0 40078 SHARON ABRAMS ASSOCIATE DIRECTOR OF NURS 35.00 X 136962 0 36522 SOLOMON BERNSTEIN CONTROLLER 35.00 X 117869 0 55172 DAVETH FORBES-THOMAS VP OF NURSING 35.00 X 154259 0 13064 ALLA MEZHERITSKAYA MDS MANAGER 35.00 X 111876 0 51653 KENDALL CHRISTIANSEN CHAIRPERSON 0.20 0.80 X X 0 0 0 DR ESTHER SIEGEL VICE CHAIRPERSON 0.20 X X 0 0 0 MICHAEL ROBINSON SECRETARY/TREASURER 0.20 X X 0 0 0 MICHAEL SHARP DIRECTOR 0.20 0.40 X 0 0 0 DR MARGARET L MCCLURE DIRECTOR 0.20 X 0 0 0 THOMAS BETTRIDGE DIRECTOR 0.20 0.80 X 0 0 0 1069095 0 295538 10 0 1 0 THERADYNAMICS REHAB MANAGEMENT 225 CROSSWAYS PARK DRIVE WOODBURY NY 11797 OCCUPATIONAL THERAPISTS 1366245 CONGREGATIONAL CONSULTING 3839 FLATLANDS AVENUE BROOKLYN NY 11234 CONSULTING SERVICES 399000 EPIC SECURITY CORP 2067 BROADWAY NEW YORK NY 10023 SECURITY GUARDS 251367 APEX GLOBAL SOLUTIONS 400 RELLA BOULEVARD MONETEBLLO NY 10901 TECHNOLOGY SERVICES 157500 TEKCONN SERVICES 237 WEST 35TH STREET NEW YORK NY 10001 IT SERVICES 155416 7 1100 1100 MEDICAID 623000 17168226 17168226 MEDICARE 623000 6058557 6058557 OTHER NET PATIENT REVENUE 623000 1270225 1270225 PRIVATE PAY REVENUE 623000 332800 332800 24829808 23726 23726 1760 1760 MISCELLANEOUS REVENUE 900099 38289 38289 CASH DISCOUNTS 900099 11106 11106 MEDICAL RECORDS FEES 900099 4770 4770 4485 4485 58650 24915044 24829808 0 84136 500364 455777 44587 10873367 9915124 958243 933383 849363 84020 2171514 1976005 195509 1181521 1075184 106337 40885 40885 104990 15830 89160 42243 42243 1093 1093 2232706 2208932 23774 69428 50606 18822 1208458 1104285 104173 232382 65435 166947 675235 624813 50422 1182 482 700 5154 4577 577 1947 1947 648068 648068 551057 479420 71637 PURCHASED AND CONTRACTE 1464062 389396 1074666 NYS CASH RECEIPTS ASSES 1218243 1218243 BAD DEBT EXPENSE 750000 750000 MEDICATIONS 361257 361257 244520 232011 12509 25513059 22426755 3086304 0 1453495 943872 2142199 2501189 4563346 4129133 92785 86785 144939 188999 35668069 31295955 4674598 4372114 2831807 2908623 15903169 15130715 4232901 5748318 2623800 1820895 167057 176907 11351070 10410461 18374828 18156581 X -2471659 -3025866 -2471659 -3025866 15903169 15130715 X -598015 43808 X X 0 1 X 1 0 X 740681 84643 37034 217635 1100 1081093 24253151 23209041 22166046 22472500 24829808 116930546 24993832 23293684 22203080 22690135 24830908 118011639 0 0 0 118011639 7103 6406 16737 5712 25486 61444 7103 6406 16737 5712 25486 61444 161786 207686 232532 195794 58650 856448 25162721 23507776 22452349 22891641 24915044 118929531 0.99230 0.99210 0.00050 0.00030 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2015 AMOUNT: $ 86,260. 2016 AMOUNT: $ 37,248. 2017 AMOUNT: $ 86,986. 2018 AMOUNT: $ 44,978. 2019 AMOUNT: $ 38,289. CASH DISCOUNTS - 2015 AMOUNT: $ 61,917. 2016 AMOUNT: $ 156,671. 2017 AMOUNT: $ 133,496. 2018 AMOUNT: $ 135,439. 2019 AMOUNT: $ 11,106. VENDING MACHINE INCOME - 2015 AMOUNT: $ 4,641. 2016 AMOUNT: $ 6,455. 2017 AMOUNT: $ 4,645. 2018 AMOUNT: $ 5,157. 2019 AMOUNT: $ 4,485. MEDICAL RECORDS FEE - 2015 AMOUNT: $ 8,728. 2016 AMOUNT: $ 7,286. 2017 AMOUNT: $ 7,405. 2018 AMOUNT: $ 10,220. 2019 AMOUNT: $ 4,770. CAFETERIA MEAL CHARGE - 2015 AMOUNT: $ 50. PLANTS FLOWERS - 2015 AMOUNT: $ 190. 2016 AMOUNT: $ 26. 0 0 0 0 0 0 0 0 1 1093 1093 0 PART II-B, LINE 1: COSTS ARE INCURRED AS PART OF DUES PAID TO NURSING HOME INDUSTRY ORGANIZATIONS. 0 1 X 44462 44462 29608323 25119584 4488739 6015284 6176371 -161087 4372114 DUE FROM RELATED PARTIES 134744 RESIDENT'S FUNDS 176907 DUE FROM THIRD PARTY PAYORS 1933345 INSURANCE RECOVERIES RECEIVABLE 663627 2908623 DUE TO THIRD PARTY PAYORS 2190852 INTEREST RATE SWAP LIABILITY 688920 INSURANCE CLAIMS PAYABLES 663627 DUE TO RELATED PARTIES 4867062 ADVANCE ON SALE 2000000 10410461 X 24208852 43808 43808 24165044 750000 750000 24915044 24763059 0 24763059 750000 750000 25513059 PART IV, LINE 2B: RESIDENTS' FUNDS ARE HELD BY THE CENTER ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE CENTER FOR SAFEKEEPING. THE FUNDS ARE DISBURSED BY THE CENTER AT THE REQUEST OF, OR ON BEHALF OF RESIDENTS FOR THEIR PERSONAL USE. RESIDENT PERSONAL FUNDS ARE MAINTAINED IN BANK ACCOUNTS AND INVESTMENTS SEPARATE FROM THE CENTER'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS' ACCOUNTS. PART X, LINE 2: THE CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE CENTER HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE CENTER IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR TAX YEARS PRIOR TO DECEMBER 31, 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY 12,204. CHANGE IN FAIR VALUE OF SPECULATIVE INTEREST RATE CONTRACT LIABILITY 31,604. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF BAD DEBT EXPENSE, PART XI LINE 24 750,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF BAD DEBT EXPENSE, PART XI LINE 24 750,000. X X 0 0 0 0 0 0 0 1 0 FLORENCE KATZ PRESIDENT & CEO 240350 0 0 0 18320 0 13068 0 41374 0 313112 0 0 0 FRANK CIANCIOTTO SENIOR VP/CFO 131783 0 10000 0 863 0 4357 0 40250 0 187253 0 0 0 KIMBERLY JEFFERS DIRECTOR OF CHHA 145497 0 0 0 1316 0 7617 0 32461 0 186891 0 0 0 SHARON ABRAMS ASSOCIATE DIRECTOR OF NURS 136366 0 0 0 596 0 7067 0 29455 0 173484 0 0 0 SOLOMON BERNSTEIN CONTROLLER 116105 0 0 0 1764 0 6356 0 48816 0 173041 0 0 0 DAVETH FORBES-THOMAS VP OF NURSING 153925 0 0 0 334 0 4663 0 8401 0 167323 0 0 0 ALLA MEZHERITSKAYA MDS MANAGER 111365 0 0 0 511 0 5921 0 45732 0 163529 0 0 0 PART I, LINE 7 THE ORGANIZATION AWARDED THE FOLLOWING INDIVIDUALS A BONUS THAT WAS SUBJECT TO BOARD DISCRETION AND APPROVAL. THE BONUSES WERE INCLUDED IN THEIR 2019 W-2S. - FRANK CIANCIOTTO - $10,000 A NEW YORK CITY INDUSTRIAL DEVELOPMENT AGENCY CIVIC FACILITY REVENUE SERIES 2 132906040 649438BE7 2006-07-27 17075000 REFUND FOR PRIOR ISSUE (8/17/95) AND RENOVATIONS FOR FACILITY 0 0 0 A 14930000 17078371 404974 16671637 2006 1 0 1 1 A 0 0 1 0 1 0 0 0 0 A 0 SCHEDULE K, PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART IV, LINE 2B: SPENDING EXEMPTION TO REBATE APPLIES. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS NEW YORK CONGREGATIONAL COMMUNITY SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION APPOINTS THE BOARD OF DIRECTORS AT ITS ANNUAL MEETING. A VACANCY ON THE BOARD ARISING AT ANY TIME AND FROM ANY CAUSE MAY BE FILLED FOR THE UNEXPIRED TERM BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B ANY DIRECTOR MAY BE REMOVED WITH OR WITHOUT CAUSE BY THE SOLE MEMBER. IN ADDITION, THE SOLE MEMBER SHALL HAVE THE POWER TO MAKE, ALTER, AMEND, AND REPEAL THE BY-LAWS AND CERTIFICATE OF INCORPORATION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B NEW YORK CONGREGATIONAL NURSING CENTER 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, IT IS ELECTRONICALLY SENT TO THE FINANCE COMMITTEE FOR ANY COMMENTS. A MEETING WOULD BE CALLED AFTER RECEIPT AND WOULD DEPEND ON THE MEMBERS OF THE COMMITTEE'S SCHEDULES. MINUTES OF THIS MEETING AND REVIEW WOULD BE KEPT WITH THE BOARD MEETING MINUTES. ANY COMMENTS OR QUESTIONS FROM THE FINANCE COMMITTEE ARE THEN GROUPED, SUMMARIZED AND PROVIDED TO THE OUTSIDE ACCOUNTANTS. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, DEPARTMENT DIRECTORS, MANAGEMENT STAFF, AND KEY EMPLOYEES UPON HIRING AND ANNUALLY THEREAFTER ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT. THIS DISCLOSURE STATES THAT THE INDIVIDUAL RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, UNDERSTANDS IT, WILL COMPLY WITH THE RULES, AND THAT THEY COMPLETED THE CORPORATE COMPLIANCE PROGRAM IN-SERVICE. ADDITIONALLY, THEY MUST MAKE FULL DISCLOSURE OF ANY ACTIVITIES THAT COULD RESULT IN A POSSIBLE CONFLICT OF INTEREST. IF A CONFLICT IS DEEMED TO EXIST, THE PRESIDENT MUST BE MADE AWARE AND POSSIBLE DISCIPLINARY ACTION OR EVEN TERMINATION IS POSSIBLE UPON REVIEW WITH THE HR DIRECTOR AND OUR RISK MANAGEMENT COUNCIL. THERE IS ALSO A COMPLIANCE HELPLINE WHICH IS A TOTAL-FREE AND COMPLETELY CONFIDENTIAL SERVE WHERE AN INDIVIDUAL CAN REPORT POSSIBLE VIOLATIONS TO THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION IS DETERMINED BY THE BOARD OF TRUSTEES AS WELL AS THE CFO. THE BOARD ALSO RECEIVED GUIDANCE REGARDING TOP EXECUTIVE SALARIES BASED ON COMPARABLE POSITIONS FROM CCLC NY. THE DETERMINATION AND APPROVAL OF THE COMPENSATION IS DOCUMENTED IN THE BOARD MINUTES. THE CFO'S COMPENSATION IS RECOMMENDED BY THE CEO TO THE FINANCE COMMITTEE OF THE BOARD WHO SUBSEQUENTLY REVIEWS IT FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FORM 990 AND FORM 1023 IS AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, ARTICLES OF INCORPORATION, FORM 990, FORM 1023, AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. THE ORGANIZATION ALSO FILES AN ANNUAL COST REPORT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH CONTAINS FINANCIAL STATEMENTS AND RELATED NOTE DISCLOSURES. THIS COST REPORT IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY 12,204. CHANGE IN FAIR VALUE OF SPECULATIVE INTEREST RATE CONTRACT LIABILITY 31,604. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. NEW YORK CONGREGATIONAL CENTER FOR COMMUNITY LIFE 135 LINDEN BLVD BROOKLYN NY 11226 200483447 OPERATE A COMMUNITY CENTER AND PROVIDE SOCIAL SUPPORT SERVICES NY 501(C)(3) LINE 10 NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL HOME FOR THE AGED 135 LINDEN BLVD BROOKLYN NY 11226 111631799 SUPPORT THE ACTIVITIES OF THE NY CONGREGATIONAL NURSING CENTER NY 501(C)(3) PF NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL HOME FOR THE AGED FOUNDATION 135 LINDEN BLVD BROOKLYN NY 11226 200276760 SUPPORT THE ACTIVITIES OF THE NY CONGREGATIONAL NURSING CENTER DE 501(C)(3) LINE 12B, II NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL COMMUNITY SERVICES 135 LINDEN BLVD BROOKLYN NY 11226 113519798 SUPPORT THE NY CONGREGATIONAL NURSING CENTER AND ITS AFFILIATES NY 501(C)(3) LINE 12B, II N/A 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0