2018-11-15T14:31:21-06:00 2017-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2017-01-01 133832251 NORTHERN RIVERVIEW HEALTH CARE CENTER INC NORT 8454295381 87 SOUTH ROUTE 9W HAVERSTRAW NY 10927 MORRIS KLEIN EXECUTIVE DIRECTOR 8454295381 2018-11-13 1 AARON SHAPIRO P01333816 2128674000 64.22.227.161 2018-11-15 11:55:00 ES P 4275C7E7C8129915C35F764424C97B97C01C68F2 988419C5643A1C0877F6823E03E3852E0B43B763 2017 2019-02-21 02:37:17Z MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 20398612 0 X WWW.NORTHERNRIVERVIEW.COM X 1995 NY TO PROVIDE SKILLED NURSING CARE TO THE ELDERLY. 9 9 274 19 0 0 0 0 20809681 20375246 1892 4501 219112 18865 21030685 20398612 338984 341634 0 0 9114307 10837793 0 0 0 7398308 7480614 16851599 18660041 4179086 1738571 28689659 32202384 5810733 7584887 22878926 24617497 TO PROVIDE SKILLED NURSING CARE TO THE ELDERLY. 0 0 14933932 20375246 LONG TERM AND SHORT TERM INPATIENT HEALTH SERVICES FOR THE ELDERLY, IN 2017 NORTHERN RIVERVIEW HEALTH CARE CENTER, INC. (NORTHERN RIVERVIEW) PROVIDED 79,640 DAYS OF CARE. 341634 341634 BENEFITING, PROMOTING, AND SUPPORTING QUALIFYING RELIGIOUS CHARITABLE AND EDUCATIONAL ACTIVITIES CONDUCTED BY OR IN CONNECTION WITH CHEVRA LIADY NUSACH HOARY, A RELIGIOUS ORGANIZATION AND THE SOLE MEMBER OF NORTHERN METROPOLITAN FOUNDATION. 15275566 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 22 0 274 1 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 0 1 0 0 NY X MICHAEL ITZKOWITZ 8453569880 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 STUART MEYERS CHAIRMAN 0.10 0.90 X X 0 4750 0 RABBI SIMON LAUBER SECRETARY 0.10 0.90 X X 0 3250 0 LEON STEINMETZ BOARD MEMBER 0.10 0.90 X 0 3000 0 HINDI GINSBERG BOARD MEMBER 0.10 0.90 X 0 500 0 CHARLES F KENNY ESQ BOARD MEMBER 0.10 0.90 X 0 1000 0 ABRAHAM ZACHARIASH BOARD MEMBER 0.10 0.90 X 0 0 0 RABBI HERSHAL HAGER BOARD MEMBER 0.10 0.90 X 0 500 0 ISRAEL ORZEL BOARD MEMBER 0.10 0.90 X 0 2500 0 RAFI KLEIN BOARD MEMBER 0.10 0.90 X 0 2000 0 MORRIS KLEIN EXECUTIVE DIRECTOR 6.00 29.00 X 116578 563463 171444 MICHAEL NOWICKI COMPLIANCE OFFICER 6.00 29.00 X 33491 161874 0 GEDALIA KLEIN CHIEF OPERATING OFFICER 3.00 14.50 X 22651 109480 28054 DAVID BRACHFELD ADMINISTRATOR 35.00 X 161848 0 0 JESSICA CHARDONNETTE ADMISSIONS DIRECTOR 35.00 X 102196 0 8322 DONNA Y BOLANTE MANAGER 35.00 X 107433 0 0 VICTORIA DAPAAH DNS 35.00 X 145482 0 0 689679 852317 207820 5 0 1 0 TOWNE NURSING STAFF 1413 38TH STREET BROOKLYN NY 11218 NURSING SERVICES 463663 CENTERS FOR CARE 4770 WHITE PLAINS ROAD BRONX NY 10470 CONSULTING SERVICES 426603 CHEVRA LIADY NUSACH 1578 53RD STREET BROOKLYN NY 11219 ADMINISTRATIVE SERVICES 287380 3 PATIENT SERVICES 623000 20375246 20375246 20375246 4501 4501 MISCELLANEOUS 900099 18865 18865 18865 20398612 20375246 0 23366 341634 341634 368767 368767 7151154 6126284 1024870 355148 310909 44239 2314443 1918207 396236 648281 531590 116691 306275 36000 270275 119206 119206 44365 44365 1023267 768278 254989 29677 647 29030 1268823 970487 298336 745014 610911 134103 4730 4730 8 8 689100 565062 124038 858843 704251 154592 FOOD 949619 949619 MEDICAL SUPPLIES 772091 772091 NYS CASH RECEIPTS ASSES 669596 669596 18660041 15275566 3384475 0 4669622 4237667 636953 654351 3962194 4302013 1198022 1350787 16709502 12502286 4796863 4207216 13426005 17450350 28689659 32202384 3221943 3878788 266249 312490 2322541 2010505 0 1383104 5810733 7584887 X 22878926 24617497 22878926 24617497 28689659 32202384 1738571 0 X X 0 1 X 1 0 X 18648221 19508599 20276172 20809681 20375246 99617919 18648221 19508599 20276172 20809681 20375246 99617919 0 0 0 99617919 1425 1451 1631 1892 4501 10900 1425 1451 1631 1892 4501 10900 28980 208 37 219112 18865 267202 18678626 19510258 20277840 21030685 20398612 99896021 0.99720 0.99770 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME 0 1 X 309421 309421 12058956 8342661 3716295 3601833 3468858 132975 739292 690767 48525 4207216 ESTIMATED AMOUNTS DUE FROM THIRD PARTY PAYORS 259000 OTHER RECEIVABLES 1231321 DUE FROM RELATED PARTIES 15901654 SECURITY DEPOSITS 58375 17450350 ESTIMATED LIABILITIES TO THIRD-PARTY PAYORS 1383104 1383104 X 20398612 0 20398612 0 20398612 18318407 0 18318407 341634 341634 18660041 PART IV, LINE 2B: RESIDENT FUNDS ARE MAINTAINED IN ACCOUNTS SEPARATE FROM NORTHERN RIVERVIEW'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS' ACCOUNTS. PART X, LINE 2: NORTHERN RIVERVIEW HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2014 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO RELATED ENTITY 341,634. 1 CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501 (C)(3) 341634 TO SUPPORT THE RELIGIOUS MISSION OF CHEVRA LIADY NUSACH HOARY 1 0 PART I, LINE 2: NORTHERN RIVERVIEW HEALTH CARE CENTER, INC. MAINTAINS RECORDS TO TRACK THE AMOUNT OF GRANTS AWARDED. THE ENTITY RECEIVING THE GRANT MUST BE A NON-PROFIT. 0 1 0 0 0 0 0 0 0 MORRIS KLEIN EXECUTIVE DIRECTOR 105161 508281 0 0 11417 55182 24009 116043 5381 26011 145968 705517 0 0 MICHAEL NOWICKI COMPLIANCE OFFICER 31499 152244 0 0 1992 9630 0 0 0 0 33491 161874 0 0 GEDALIA KLEIN CHIEF OPERATING OFFICER 21417 103514 0 0 1234 5966 0 0 4809 23245 27460 132725 0 0 DAVID BRACHFELD ADMINISTRATOR 161848 0 0 0 0 0 0 0 0 0 161848 0 0 0 PART I, LINE 4B MORRIS KLEIN, $140,052 FORM 990, PART VI, SECTION A, LINE 2 CHIEF OPERATING OFFICER, GEDALIA KLEIN, IS RELATED TO EXECUTIVE DIRECTOR, MORRIS KLEIN. FORM 990, PART VI, SECTION A, LINE 6 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF NORTHERN RIVERVIEW HEALTH CARE CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FINAL FORM 990 IS CIRCULATED TO THE ENTIRE BOARD AND REVIEWED BY MANAGEMENT PRIOR TO FILING. THE PREPARER IS AVAILABLE TO ADDRESS ANY QUESTIONS OR COMMENTS FROM THE BOARD AND WILL MAKE CHANGES ACCORDINGLY. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER, DIRECTOR, AND OFFICER IS PROVIDED WITH THE CONFLICT OF INTEREST POLICY, AND IS REQUIRED TO FILL OUT A FORM WHICH WILL DISCLOSE ANY CONFLICT OF INTEREST. IF THERE IS A CONFLICT, THE BOARD MEMBER WILL RECUSE HIM/HERSELF FROM VOTING ON ANY ISSUE THAT CREATES THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A A PRICE WATERHOUSE STUDY REVIEWED AND SUBSTANTIATED THE TOP MANAGEMENT COMPENSATION. THE LAST SALARY DETERMINATION FOR TOP MANAGEMENT COMPENSATION TOOK PLACE IN JUNE 2011. SUBSEQUENTLY ANOTHER STUDY WAS COMPLETED IN JUNE OF 2018. THE STUDY WAS CONDUCTED BY THE SOLE CORPORATE MEMBER NORTHERN METROPOLITAN FOUNDATION, INC. ON BEHALF OF NORTHERN RIVERVIEW. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. NORTHERN MANOR MULTICARE CENTER INC 199 MIDDLETOWN ROAD NANUET NY 10954 133623600 NURSING HOME NY 501 (C)(3) LINE 10 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 ASSISTED LIVING AT NORTHERN RIVERVIEW INC 89 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133976617 ASSISTED LIVING FACILITY NY 501 (C)(3) LINE 10 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 FOUNTAINVIEW AT COLLEGE ROAD INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 133935070 INDEPENDENT LIVING FACILITY NY 501 (C)(3) LINE 10 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 113354023 CHARITABLE FOUNDATION AND ADMINISTRATIVE SUPPORT ORGANIZATION NY 501 (C)(3) LINE 12A, I CHEVRA LIADY NUSACH HOARY 0 NORTHERN SERVICES GROUP INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134120014 ADMINISTRATIVE SUPPORT ORGANIZATION NY 501 (C)(3) LINE 12B, II NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 LIFESTYLE OPTIONS FOR SENIORS FOUNDATIONINC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134133472 CHARITABLE ENTITY NY 501 (C)(3) LINE 10 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN INC 225 MAPLE AVENUE MONSEY NY 10952 133070759 NURSING HOME NY 501 (C)(3) LINE 10 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 RELIGIOUS ENTITY NY 501 (C)(3) LINE 1 N/A 0 0 1 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0