2019-03-22T10:17:18-05:00 2016-12-31 271728945 PKF O'Connor Davies LLP 500 Mamaroneck Avenue Harrison NY 105281633 990 2016-01-01 141370000 Hoosick Falls Health Center Inc HOOS 5186864371 21 Danforth Street Hoosick Falls NY 12090 Gregory Laurin President 5186864371 2019-03-22 1 Garrett M Higgins P00543209 9143818900 2019-03-04 65.51.112.58 2019-03-22 10:17:15 ED P 804F34CAD71154B6AB63CCDEAD416BA8AE38E5F8 9616F4B14A694591D1E716C270910E6FA5556DA3 2016 2019-02-21 02:37:17Z X Center for Nursing and Rehabilitation at Hoosick Falls Gregory Laurin 21 Danforth Street Hoosick Falls NY 12090 6317704 0 X nursingandrehab.org X 1914 NY The Centers mission is to provide rehabilitation and long-term care services to those in need. We strive to provide resident centered care in our 82 bed SNF so that each resident has the opportunity to reach their maximum potential. 9 9 220 24 0 0 168402 157528 6096278 6084001 114374 16366 8865 16924 6387919 6274819 0 0 0 0 4357002 4412470 0 0 0 2340956 2185386 6697958 6597856 -310039 -323037 3587262 3633166 2506223 2833015 1081039 800151 We are an 82 bed skilled nursing home facility providing 24 hr/7 days a week health care to those in need in a home like atmosphere. 0 0 6048427 6084001 Hoosick Falls Health Center focuses on developing, managing, and operating nursing home care in the Hoosick Falls, New York area and providing services to the community. The organization specializes in long-term care and rehabilitation services, and provides great nursing care, good food and friendly and helpful people, and a supporting and caring environment. The hoosick falls health center has 82 skilled nursing beds. During the year, the total patient/resident days were 25,094. 6048427 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 0 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 1 1 1 0 0 1 10 0 220 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X X Drew Lerman 8024474587 21 Danforth Street Hoosick Falls NY 12090 Gregory Laurin President 2.00 X X 0 0 0 William Koester Vice President 1.00 X X 0 0 0 William Johnston Treasurer 1.50 X X 0 0 0 Joyce Davis Secretary 1.00 X X 0 0 0 Edward J Gorman ESQ Board Member 1.00 X 0 0 0 Dennis Perry Board Member 1.00 X 0 0 0 Harold McClellan Board Member 1.00 X 0 0 0 Patty Ryan Board Member 1.00 X 0 0 0 Bill Cottrell Board Member 1.00 X 0 0 0 Laura Reynolds CEO 40.00 X 102170 0 0 102170 0 0 1 0 0 0 0 108474 49054 157528 Medicaid Revenue 623000 3382321 3382321 Medicare Revenue 623000 1875915 1875915 Private Patient Revenu 623000 672108 672108 Other Patient REvenue 623000 153657 153657 6084001 4689 4689 7800 0 7800 7800 7800 54562 42885 11677 11677 11677 Other Income 900099 9124 9124 9124 6274819 6084001 0 33290 102170 95067 7103 3520105 3275366 244739 14205 13217 988 378454 352142 26312 397536 369897 27639 1543 1543 24000 24000 809 809 1750 1750 425425 357875 67550 880 90 790 742578 692385 50193 138843 138843 12026 10164 1862 98440 69678 28762 260492 256136 4356 61033 61033 NYS Cash Receipts Asses 262311 262311 Bad Debt Expense 151979 151979 Special Activities 2879 2879 Repairs & Maintenance 398 398 6597856 6048427 549429 0 142858 64793 76496 729952 677490 53269 42861 23033 29436 7995729 5778086 2515378 2217643 132931 122772 391516 3587262 3633166 506460 496362 1282800 924400 28962 24989 132638 765756 555363 621508 2506223 2833015 X 1020129 738721 60910 61430 1081039 800151 3587262 3633166 X -323037 -2208 44357 X X 0 1 X 1 0 X 85335 105469 6657 168402 157528 523391 6048410 6336640 6234172 6096278 6084001 30799501 6133745 6442109 6240829 6264680 6241529 31322892 0 0 0 31322892 54708 42281 25986 17396 12489 152860 54708 42281 25986 17396 12489 152860 3702 2121 858 1065 9124 16870 6192155 6486511 6267673 6283141 6263142 31492622 0.99460 0.99400 0.00490 0.00570 X Schedule A, Part III, Line 12, Explanation of Other Income: Rebates Discounts - 2012 Amount: $ 469. 2013 Amount: $ 1,259. 2014 Amount: $ 231. 2015 Amount: $ 468. Miscellaneous - 2015 Amount: $ 155. Vending Machine Rebates - 2012 Amount: $ 655. 2013 Amount: $ 242. 2014 Amount: $ 561. 2015 Amount: $ 442. Services Sold - 2012 Amount: $ 662. 2013 Amount: $ 470. 2014 Amount: $ 66. Other Income - 2012 Amount: $ 1,916. 2013 Amount: $ 150. 2016 Amount: $ 9,124. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 809 809 0 Part II-B, Line 1: Costs are incurred as part of dues paid to nursing home industry organizations. 0 1 X 60499 60499 2799217 1628956 1170261 4556086 3703542 852544 579927 445588 134339 2217643 Due from Third-Party Payors 7840 Beneficial Interest in trust 61430 Other Long-Term Assets 322246 391516 Due to Third-Party Payors 171841 Due to Related Party 83664 Fair Market Value Swap Agreement 43757 Other Long-Term Liabilities 322246 621508 X 6181194 -2208 18807 16599 6164595 1750 108474 110224 6274819 6599398 111766 111766 6487632 1750 108474 110224 6597856 Part IV, Line 2b: Residents' funds are held by the Health Center on behalf of the residents. Such funds represent allowances received by residents as well as other residents' funds deposited with the Health Center for safekeeping. These funds are disbursed by the Health Center at the request of, or on behalf of, residents for their personal use. Part X, Line 2: The Organization recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Management has determined that the Organization had no uncertain tax positions that would require financial statement recognition or disclosure. The Organization is no longer subject to examinations by the applicable taxing jurisdictions for periods prior to December 31, 2013. Part XI, Line 2d - Other Adjustments: Revenue attributed to affiliate 18,807. Part XI, Line 4b - Other Adjustments: eliminations on consolidated financial statements 108,474. Part XII, Line 2d - Other Adjustments: Expenses Attributed to affiliate 111,766. Part XII, Line 4b - Other Adjustments: Eliminations on consolidated financial statements 108,474. Amended Form 990: The organization amended its 2016 Form 990 for the following reasons: 1. Part III, Line 4a: Updated its program narrative to include statistical information about the organization's programs. In addition, the program revenue and expenses were updated to agree with the changes in Part VIII, and Part IX. 2. Part IV: Lines 4, 11f, 35a, and 35b were all changed to yes to agree with the updated schedule presentation. 3. Part V: Lines 7g - 9b were left blank as the questions do not apply to the filing organization. 4. Part VI, Lines 15a/b were changed to "no" as the organization does not meet all of the rebuttable presumption criteria. In addition, only one officer is reported in Part VII with compensation, and therefore line 15b does not apply. 5. Part VI, Line 18: "Another's website" was checked off as the organization provides its Form 990 to the Attorney General, and it is posted on their website. 6. Part VII was updated to include all voting board members as of 12/31/2016. 7. Part VIII, Lines 2g and 11 were updated to agree with the reclass of program revenue. 8. Part IX: The total expense allocation was updated to agree with the organization's Medicaid cost report functional allocation. In addition, various reclasses of expenses were made in conformity with the IRS instructions. 9. Part X: Various reclasses of assets and liabilities were made in conformity with the IRS instructions. 10. Schedule A: The organization updated Part I to reflect their status per their IRS determination letter, which is under section 509(a)(2). Therefore, the organization is completing Part III of Schedule A, as required. 11. Schedule C: The organization is completing Schedule C to reflect its current year lobbying expenses. 12. Schedule D, Part IV: The organization updating lines 1c - 1f to remove the activity from its escrow funds as the funds are reported in Part X. 13. Schedule D, Part VI: The organization updated column (b) to report its building and equipment in this column instead of column (a) as the buildings and equipment are used to fulfill the organization's mission. 14. Schedule D, Parts IX and X: These sections were updated to agree with the changes reflected in Part X. 15. Schedule R: The organization updated Part II, and Part V, Line 2 to reflect the Foundation as a related controlled entity. Therefore, transactions over $50,000 are reported on Line 2. Form 990, Part VI, Section B, line 11b The organization 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 board for approval. Once the board has approved the return it is filed with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c Each employee and board member has a responsibility at all times to promote the best interests of the center for nursing and rehabilitation at Hoosick Falls. A conflict of interest occurs when an employee's judgment in acting for the facility is adversely affected. Examples of conflicts of interest include but are not limited to: - Accepting gratuities from other companies or individuals who do business with this facility or seek to do business with it. - Rendering services to competitors. - Using, facilitating, conveying, or permitting others to use facility documents, equipment, confidential information or trade secrets. - Benefiting personally from any purchases or sales by this facility. - Engaging in other employment to the detriment of the employee's work for the facility. Annually, all board members are required to complete and submit an annual conflict of interest disclosure form reporting any potential conflict of interests. If one believes a conflict of interest exists the individual must consult their supervisor, department manager, or administrator in which the determination of whether a conflict exists will be made and reviewed. Engagement in any business practices that compromise the facility in any way may result in the immediate termination of any and all employees involved in such activity, and may be grounds for legal action against those employees. Form 990, Part VI, Section B, line 15 The organization uses compensation surveys and comparable analysis of other similar size nursing homes to determine compensation of the CEO. 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 posted on guidestar.org and other similar types of websites. In addition, the financial statements, conflict of interest policy, articles of incorporation and by-laws are also available upon written request at 21 Danforth Street, Hoosick Falls, NY 12090 or by calling the organization directly at 518-686-4371. Form 990, Part XI, line 9: Change in Beneficial Interest in Trust 520. Change in Fair Value of Interest Rate Swap 43,837. Form 990, Part XII, Line 2c: The Organization has a committee that is responsible for the oversight of the audit of its financial statements and selection of an independent accountant. The process has not changed from the prior year. Hoosick Falls Health Center Foundation Inc 21 Danforth Street Hoosick Falls NY 12090 223186959 Support the operations of the Hoosick Falls Health Center, Inc. NY 501(c)(3) Line 7 Hoosick Falls Health Center Inc 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 Hoosick Falls Health Center Foundation Inc C 108474 Cost