2018-11-09T15:11:08-06:00 2017-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2017-01-01 223032483 GAN KAVOD INC GANK 3157973114 2050 TILDEN AVE NEW HARTFORD NY 13413 CHRISTA SERAFIN CEO 3157973114 2018-10-23 1 DEBORAH STUCK P01281391 3154463600 2018-10-23 24.39.85.114 2018-10-23 13:46:19 ED P 7165BC8F883BFC7282D8DA0A25427F7F001F9809 843BD1CBF118E88B8E0E68794B0017FE904C4146 2017 2019-02-21 02:37:17Z CHRISTA SERAFIN 2050 TILDEN AVE NEW HARTFORD NY 13413 5472153 0 X WWW.SITRIN.COM X 1989 NY TO PROVIDE A COMMUNITY RESIDENCE FOR THE DEVELOPMENTALLY DISABLED. 11 10 191 0 0 0 0 420 5722379 5468724 1190 1649 2445 1360 5726014 5472153 0 0 0 0 3865139 3809704 0 0 0 1609769 1668922 5474908 5478626 251106 -6473 4030560 3742031 1719007 1436951 2311553 2305080 X THE SITRIN CORPORATIONS STRIVE TO MEET THE NEEDS OF OUR COMMUNITY, WITH PROGRAMS AND SERVICES TO ENHANCE THE QUALITY OF LIFE FOR PERSONS NEEDING ASSISTANCE. WE ARE DEDICATED TO PROVIDING COMPASSIONATE, PROFESSIONAL CARE TO OUTPATIENTS, INPATIENTS AND RESIDENTS, AND ARE COMMITTED TO OUR EMPLOYEES - THE STRENGTH OF OUR FAMILY. 0 0 4487914 5470084 THE INTERMEDIATE CARE FACILITY AND INDIVIDUALIZED RESIDENTIAL ALTERNATIVE ARE RESIDENTIAL PROGRAMS THAT PROVIDE COMMUNITY-LIKE SETTINGS FOR MENTALLY RETARDED AND DEVELOPMENTALLY DISABLED PERSONS THROUGH SMALL GROUP SETTINGS WITH CONTINUOUS SUPERVISION. IN 2017, GAN KAVOD'S TOTAL RESIDENT DAYS WERE 14,939 AND 47 ADULTS WERE SERVED. 4487914 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 1 191 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CHRISTA SERAFIN 3157973114 2050 TILDEN AVE NEW HARTFORD NY 13413 X ERNEST BERKOWITZ DIRECTOR 1.00 1.00 X 0 0 0 DR SUSAN BLATT DIRECTOR 1.00 4.50 X 0 25385 0 EDWARD KOWALSKY DIRECTOR 1.00 6.00 X 0 0 0 SHEILA BAMBERGER VICE CHAIRPERSON 2.00 2.50 X X 0 0 0 DAVID GOLDBAS TREASURER 2.00 5.00 X X 0 0 0 MICHAEL COMINSKY SECRETARY 2.00 9.00 X X 0 0 0 MICHAEL SILVERMAN CHAIRMAN 2.00 9.00 X X 0 0 0 RANDY ROCKFORD DIRECTOR 1.00 2.00 X 0 0 0 CHET COHEN DIRECTOR 1.00 2.50 X 0 0 0 MARK SMITH DIRECTOR 1.00 1.50 X 0 0 0 ADELE SOSSEN DIRECTOR 1.00 2.00 X 0 0 0 CHRISTA SERAFIN CHIEF EXECUTIVE OFFICER 1.00 36.50 X 0 209958 15600 RICHARD WILSON VP OF STRATEGIC PLANNING 1.00 36.50 X 0 71135 0 PATRICIA HAYS ADMINISTRATOR 22.50 15.00 X 0 140902 6600 0 447380 22200 0 0 1 0 0 420 420 MEDICAID 900099 4836484 4836484 PARTICIPANT FEES 531390 563047 563047 NEW YORK STATE OPWDD 900099 69193 69193 5468724 1649 1649 MISCELLANEOUS INCOME 900099 1360 1360 1360 5472153 5470084 0 1649 3250630 2740984 509646 20566 20566 339797 221582 118215 198711 193461 5250 20205 20205 22772 22772 139813 139813 146419 37563 108856 143215 75269 67946 41423 41423 160396 159463 933 109507 49939 59568 GENERAL PROGRAM EXPENSE 351497 274176 77321 CONTRACTED SERVICES 191748 191748 FOOD 149776 149776 FACILITY TAX ASSESSMENT 128050 128050 64101 64101 5478626 4487914 990712 0 2667 2661 1169354 911969 879618 654420 18357 23497 3700073 1909417 1942452 1790656 18112 358828 4030560 3742031 693880 277663 858908 729725 166219 429563 1719007 1436951 X 2311553 2305080 2311553 2305080 4030560 3742031 -6473 0 X 0 1 X 1 0 X 420 420 5071645 5061515 5577956 5722379 5468724 26902219 5071645 5061515 5577956 5722379 5469144 26902639 0 0 0 26902639 1250 1552 1293 1190 1649 6934 1250 1552 1293 1190 1649 6934 158 574 4768 2445 1360 9305 5073053 5063641 5584017 5726014 5472153 26918878 0.99940 0.99940 0.00030 0.00020 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2013 AMOUNT: $ 158. 2014 AMOUNT: $ 574. 2015 AMOUNT: $ 4,768. 2016 AMOUNT: $ 2,445. 2017 AMOUNT: $ 1,360. 80000 80000 2824716 1305472 1519244 795357 603945 191412 1790656 DUE FROM AFFILIATE 145375 CASH HELD IN TRUST FOR RESIDENTS 72119 RESERVE FOR REPLACEMENT ACCOUNT 80110 INSURANCE CLAIMS RECEIVABLE 61224 358828 CASH HELD IN TRUST FOR RESIDENTS 72119 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 296220 INSURANCE CLAIMS LIABILITY 61224 429563 X 5472153 0 5472153 0 5472153 5478626 0 5478626 0 5478626 PART X, LINE 2: GAN KAVOD IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS OF DECEMBER 31, 2017 AND 2016, GAN KAVOD DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2014 THROUGH 2017. GAN KAVOD DOES NOT ANTICIPATE ANY UNRECOGNIZED TAX BENEFITS TO CHANGE IN THE NEXT TWELVE MONTHS. X X 0 0 0 0 0 0 0 0 0 CHRISTA SERAFIN CHIEF EXECUTIVE OFFICER 0 209958 0 0 0 0 0 0 0 15600 0 225558 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE CHARLES T. SITRIN NETWORK OF HOMES & SERVICES, INC. IS THE SOLE MEMBER OF GAN KAVOD, INC. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER, THE CHARLES T. SITRIN NETWORK OF HOMES & SERVICES, INC. APPOINTS THE BOARD OF DIRECTORS OF GAN KAVOD, INC. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWED THE 990 AT THE OCTOBER 2018 BOARD MEETING PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS ARE REQUIRED TO UPDATE AND RE-SIGN THE CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS COLLECTIVELY REVIEWS AND APPROVES THE CEO'S SALARY AND BENEFITS. COMPARATIVE DATA FROM OTHER LIKE ORGANIZATIONS IS USED. THE MEETING IS DOCUMENTED THROUGH EXECUTIVE SESSION MINUTES OF THE BOARD MEETING. THE ADMINISTRATOR'S COMPENSATION IS REVIEWED AND APPROVED THROUGH THE ANNUAL REVIEW PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING BODY MAKE ALL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PAGE 7, PART VII THE FOLLOWING OFFICER IS ALSO AN OFFICER OF THE RELATED ENTITY, CHARLES T. SITRIN HEALTH CARE CENTER, INC. -CHRISTA SERAFIN CHARLES T SITRIN HEALTH CARE CENTER INC 2050 TILDEN AVE NEW HARTFORD NY 13413 223100745 SKILLED NURSING/OUTPATIENT REHABILIATION NY 501(C)(3) LINE 10 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 SITRIN CHILD DAY CARE FACILITY INC 3 KAVOD ROAD NEW HARTFORD NY 13413 161484534 CHILD DAY CARE CENTER NY 501(C)(3) LINE 10 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 2050 TILDEN AVE NEW HARTFORD NY 13413 150543936 SOLE MEMBER OF OTHER ENTITIES NY 501(C)(3) LINE 7 N/A 0 CEDARBROOK VILLAGE INCORPORATED 2050 TILDEN AVE NEW HARTFORD NY 13413 200670083 ASSISTED LIVING FACILITY NY 501(C)(3) LINE 10 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 SITRIN FOUNDATION INC 2050 TILDEN AVE NEW HARTFORD NY 13413 300098393 FOUNDATION NY 501(C)(3) LINE 12A, I CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 GEORGIAN COURT ESTATES SENIOR HOUSING CORPORATION 2050 TILDEN AVE NEW HARTFORD NY 13413 204288247 SENIOR HOUSING COMPLEX NY 501(C)(3) LINE 10 CHARLES T SITRIN NETWORK OF HOMES & SERVICES INC 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0