2019-10-04T10:59:59-05:00 2018-12-31 311543240 CBIZ MHM LLC 401 PLYMOUTH ROAD SUITE 200 PLYMOUTH MEETING PA 19462 990 2018-01-01 231945075 ELK HAVEN NURSING HOME ASSOCIATION ELKH 8148342618 785 JOHNSONBURG ROAD ST MARYS PA 15857 JUNE SORG PRESIDENT 8148342618 2019-09-20 1 JOSEPH G SULLIVAN P00360476 6108622249 96.90.32.117 2019-09-20 09:49:08 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 56971691821012DDD9905C946DE3CC28305BB2C4 2018 2020-01-14 16:20:31Z JUNE SORG 785 JOHNSONBURG ROAD ST MARYS PA 15857 13982161 0 X WWW.ELKHAVENNURSINGHOME.COM X 1967 PA PROVIDING LONG TERM NURSING CARE THROUGH A SKILLED NURSING FACILITY AND PERSONAL CARE UNIT. 5 5 230 48 0 0 7285 18208 10808697 10464934 438801 541181 49811 51574 11304594 11075897 0 0 0 0 7333629 7247688 0 0 0 3453451 3840412 10787080 11088100 517514 -12203 27388276 26944697 844048 771198 26544228 26173499 X OUR MISSION IS TO BE THE LEADING PROVIDER OF SPECIALIZED HEALTH CARE PROGRAMS, PRODUCTS AND SERVICES IN THE AREA. WE ARE COMMITTED TO QUALITY, DIGNITY, RESPECT AND HOSPITALITY IN OUR CUSTOMER SERVICE AND ACTIVE PARTICIPATION IN THE COMMUNITIES WE SERVE. EMPOWERED EMPLOYEES DRIVE OUR CUSTOMER RELATIONS AND CREATE AN ATMOSPHERE WHICH ENHANCES PERSONAL GROWTH, EXPANDS RESPONSIBILITY, MAXIMIZES CREATIVITY AND INSTILLS TRUST. WE BELIEVE IN CREATING VALUE FOR OUR CUSTOMERS. MEETING THEIR INDIVIDUAL AND COLLECTIVE NEEDS IS A SHARED RESPONSIBILITY AND THE STANDARD OF CONDUCT BY WHICH EACH OF US IS MEASURED. 0 0 9966154 10464934 ASSOCIATION OPERATES A 120-BED NURSING FACILITY AND A 40-UNIT PERSONAL CARE CENTER, PROVIDING HOUSING, HEALTH CARE AND OTHER RELATED SERVICES FOR THE RESIDENTS OF ELK COUNTY, PENNSYLVANIA. 9966154 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 32 0 1 230 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X COMPLETE HEALTHCARE RESOURCES-EASTERN INC 2153285723 200 DRYDEN ROAD SUITE 2000 DRESHER PA 19025 X ROBERT SCHRIEBER BOARD MEMBER 2.00 X 0 0 0 JUNE SORG PRESIDENT 2.00 X X 0 0 0 SANDRA SCHWABENBAUER SECRETARY/TREASURER 2.00 X X 0 0 0 CHARLETTE GERG VICE PRESIDENT 2.00 X X 0 0 0 LOU RADKOWSKI BOARD MEMBER 2.00 X 0 0 0 MARK JACOB SOLICITOR 2.00 X 0 0 0 ARLENE ANDERSON ADMINISTRATOR, START DATE 1/1/18 40.00 X 0 0 0 0 0 0 0 0 0 0 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 REHABILIATION SERVICES 924218 COMPLETE HEALTHCARE RESOURCES-EASTERN I 200 DRYDEN ROAD SUITE 3100 DRESHER PA 19025 MANAGEMENT SERVICES 501552 ST MARY'S PHARMACY 4 RAILROAD ST ST MARYS PA 15857 PHARMACY 289557 GORDON FOOD SERVICE PO BOX 88029 CHICAGO IL 60680 FOOD SERVICES 114896 4 18208 18208 RESIDENT SERVICE REVENUE 623000 10464934 10464934 10464934 632287 632287 2815158 2906264 -91106 -91106 -91106 FOOD REVENUE 900099 35670 35670 OTHER REVENUE 900099 15904 15904 51574 11075897 10464934 0 592755 26210 2621 23589 5286649 5164935 121714 25086 25086 1496984 1471385 25599 412759 400340 12419 439559 439559 16177 16177 37950 37950 1073134 1030473 42661 8274 84 8190 131872 23930 107942 34386 34386 226108 226108 6936 3438 3498 35 35 435420 435420 115985 115985 OTHER EXPENSES 946004 854823 91181 SUPPLIES 181093 166622 14471 FOOD 107402 105898 1504 BAD DEBT EXPENSE 80077 80077 0 11088100 9966154 1121946 0 1594922 1457682 3059114 2672232 1030344 931347 209267 112944 14383154 9277721 5356466 5105433 15982035 16380961 156128 284098 27388276 26944697 719741 652384 1248 1695 123059 117119 844048 771198 X 26544228 26173499 26544228 26173499 27388276 26944697 -12203 -358526 0 X 0 1 X 1 0 X 3145 12277 9558 7287 18208 50475 10956455 11317160 10953140 10808697 10464934 54500386 10959600 11329437 10962698 10815984 10483142 54550861 0 0 0 54550861 482583 463728 483353 474819 632287 2536770 482583 463728 483353 474819 632287 2536770 75615 80641 57833 49811 51574 315474 11517798 11873806 11503884 11340614 11167003 57403105 0.95030 0.95310 0.04420 0.04120 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2014 AMOUNT: $ 23,154. 2015 AMOUNT: $ 25,576. 2016 AMOUNT: $ 15,658. 2017 AMOUNT: $ 12,370. 2018 AMOUNT: $ 15,904. FOOD REVENUE - 2014 AMOUNT: $ 52,461. 2015 AMOUNT: $ 55,065. 2016 AMOUNT: $ 42,175. 2017 AMOUNT: $ 37,441. 2018 AMOUNT: $ 35,670. 44000 44000 11213043 6719138 4493905 255185 207680 47505 2626871 2143139 483732 244055 207764 36291 5105433 THIRD PARTY SETTLEMENTS 117119 117119 X 11075897 0 11075897 0 11075897 11446626 358526 358526 11088100 0 11088100 PART X, LINE 2: THE ASSOCIATION IS A NOT-FOR-PROFIT CORPORATION AND IS RECOGNIZED AS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THE COMMONWEALTH ACT OF MAY 5, 1933, KNOWN AS THE NONPROFIT ORGANIZATION LAW AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. THE ASSOCIATION ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON A "MORE LIKELY THAN NOT" THRESHOLD APPLIED TO THE RECOGNITION OF THE TAX POSITIONS BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE UNRECOGNIZED TAX BENEFIT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILITY ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR ALL UNCERTAIN TAX POSITIONS. INTEREST AND PENALTIES ASSESSED, IF ANY, ARE ACCRUED AS INCOME TAX EXPENSE. THE ASSOCIATION HAS IDENTIFIED ITS TAX STATUS AS TAX-EXEMPT ENTITY AS A TAX POSITION; HOWEVER, THE ASSOCIATION HAS DETERMINED THAT SUCH TAX POSITION DOES NOT RESULT IN AN UNCERTAINTY REQUIRING RECOGNITION. THE ASSOCIATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2015. PART XII, LINE 2C THE ASSOCIATION HAD AN UNREALIZED LOSS OF $358,526 FOR THE YEAR ENDED 2018. FORM 990, PART VI, SECTION A, LINE 3 ELK HAVEN ENTERED INTO A MANAGEMENT AGREEMENT WITH COMPLETE HEALTHCARE RESOURCES - EASTERN, (CHRE) INC. TO PROVIDE FINANCIAL AND ACCOUNTING SERVICES AND SUPERVISE THE DAY-TO-DAY OPERATIONS. ARLENE ANDERSON, ADMINISTRATOR OF THE FACILITY, IS AN EMPLOYEE OF CHRE. HER COMPENSATION FOR HER WORK AT ELK HAVEN DURING 2018 WAS $95,220. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS SENT TO THE BOARD MEMBERS FOR REVIEW AND SIGNATURE PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE DISCLOSURES ARE REVIEWED ANNUALLY BY THE BOARD AND AS NEW CONFLICTS ARISE. FORM 990, PART VI, SECTION B, LINE 15 MARKET STUDIES ARE PERFORMED IN THE REGION TO DETERMINE THE APPROPRIATE LEVEL OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC BASED UPON REQUEST.