2018-11-14T20:41:03-06:00 2017-12-31 990 2017-01-01 261231096 HERITAGE VILLAGE REHAB & SKILLED NURSING INC HERI 7169856820 4570 ROUTE 60 PO BOX 351 GERRY NY 14740 DAVID SMELTZER PRESIDENT & CEO 7169856820 2018-11-14 74.84.229.67 2018-11-14 21:32:18 ES P 29CF61E69A343F0F9E92979F662C591A3D406F2C 29CF61E69A343F0F9E92979F662C591A3D406F2C 2017 2019-02-21 02:37:17Z DAVID SMELTZER 4570 ROUTE 60 PO BOX 351 GERRY NY 14740 15347875 0 X HERITAGE1886.ORG X 2007 NY TO SERVE OTHERS THROUGH CHRIST-CENTERED MINISTRIES WHICH PROVIDE HOPE, DIGNITY AND PURPOSEFUL LIVING. 7 7 322 25 0 0 11405 2720 14993304 15084667 0 -3998 2917 260488 15007626 15343877 0 0 0 0 7197644 7280659 0 0 0 6853419 8023417 14051063 15304076 956563 39801 6077664 5941121 4797269 4620925 1280395 1320196 TO SERVE OTHERS THROUGH CHRIST-CENTERED MINISTRIES WHICH PROVIDE HOPE, DIGNITY AND PURPOSEFUL LIVING. 0 0 12831468 15341157 TO ESTABLISH, MAINTAIN AND OPERATE A NURSING HOME FOR THE ELDERLY WHICH INCLUDES FULL TIME MEDICAL CARE AND SUPERVISION. THE FACILITY HAS 120 AVAILABLE BEDS. 12831468 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 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 28 0 1 322 1 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X JAMES TANTALO 7164876800 4600 ROUTE 60 GERRY NY 14740 BURTON JONES CHAIR 1.00 X 0 0 0 SUSAN WILSTON VICE CHAIR 1.00 X 0 0 0 DAVID RISHELL SECRETARY/TREASURER 1.00 X 0 0 0 EDWIN ROORDA DIRECTOR 1.00 X 0 0 0 JOHN KELLEY DIRECTOR 1.00 X 0 0 0 JANET SNYDER DIRECTOR 1.00 X 0 0 0 SUSANNE MOHNKERN DIRECTOR 1.00 X 0 0 0 RANDAL GERIG CHIEF FINANCIAL OFFICER 1.00 37.50 X 0 0 0 DAVID SMELTZER PRESIDENT & CEO 1.00 37.50 X 0 331589 4520 JEFFREY ONDREY VP OF SKILLED NURSING SERVICES 1.00 37.50 X 0 127340 1795 RICHARD WHITVER PHARMACIST 37.50 X 135956 0 1429 ASHLEY BAILEY PHARMACIST 37.50 X 124342 0 1930 LAURA BLAKE VP OF HUMAN RESOURCES 1.00 37.50 X 0 102216 2091 260298 561145 11765 2 0 1 0 MCKESSON DRUG PO BOX 848442 DALLAS TX 75284 PRESCRIPTION DRUGS 2863946 SELECT REHABILITATION LLC 2600 COMPASS ROAD GLENVIEW IL 60026 REHABILITATION SERVICES 738552 CENTIMARK ROOF SYSTEMS PO BOX 536254 PITTSBURGH PA 15253 ROOFING 387344 MAPLEVALE FARMS 2063 ALLEN ST EXT FALCONER NY 14733 DIETARY 253757 BUFFALO HOSPITAL SUPPLY 4039 GENESEE STREET BUFFALO NY 14225 SUPPLIES 149182 5 2720 2720 RESIDENT SERVICE 623000 10757796 10757796 PHARMACY 623000 4190754 4190754 MEAL INCOME 623000 136117 136117 15084667 3998 -3998 -3998 -3998 SHARED SAVINGS 623000 197930 197930 REBATES AND REFUNDS 623000 38972 38972 OTHER 623000 22403 22403 1183 1183 260488 15343877 15341157 0 0 5794087 5495705 298382 53979 51199 2780 1012358 960224 52134 420235 398594 21641 1177073 1177073 13067 13067 36650 36650 4931 4931 37596 32011 5585 10734 10734 203290 203290 12064 7821 4243 163031 163031 381690 381690 67420 66183 1237 SUPPLIES/PRESCRIPTION D 4082744 4067260 15484 PURCHASED SERVICES 979711 962511 17200 NYS CASH RECEIPT ASSESS 527270 527270 BAD DEBT AND OTHER EXPE 299166 38630 260536 26980 3319 23661 15304076 12831468 2472608 0 181522 380067 1353405 1861360 476403 419507 87811 109916 10189134 7799813 2287963 2389321 1690560 780950 6077664 5941121 992586 780468 73202 25192 2791579 3010989 939902 804276 4797269 4620925 X 1280100 1318901 295 1295 1280395 1320196 6077664 5941121 39801 0 X X 0 1 X 1 0 X 2964 130 1035 11405 2720 18254 11733481 13352791 13886386 14993304 15084667 69050629 11736445 13352921 13887421 15004709 15087387 69068883 0 0 0 69068883 352 260488 260840 11736445 13352921 13887773 15004709 15347875 69329723 0.99620 1.00000 0.00000 X 12778 12778 4686132 3905014 781118 567258 275377 291881 4785985 3619422 1166563 136981 136981 2389321 DUE FROM RELATED COMPANIES 632367 RESIDENT FUNDS 57129 OTHER RECEIVABLES 91454 780950 DUE TO THIRD PARTY PAYORS 428679 CAPITAL LEASE 91892 RESIDENT FUNDS 57129 WORKERS COMPENSATION ASSESSMENT 226576 804276 X PART X, LINE 2: THE ORGANIZATION AND ITS COMPONENTS ARE NOT-FOR-PROFIT CORPORATIONS AND ARE EXEMPT FROM INCOME TAXES AS ORGANIZATIONS QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO CLASSIFIED THE ORGANIZATION AND ITS COMPONENTS AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS. 0 0 0 0 0 0 0 0 0 DAVID SMELTZER PRESIDENT & CEO 0 331589 0 0 0 0 0 4053 0 467 0 336109 0 0 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 WAS PROVIDED TO MEMBERS OF THE GOVERNING BODY FOR REVIEW AND COMMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FINANCE COMMITTEE REVIEWS DISCLOSURES BY OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15A HERITAGE VILLAGE REHAB & SKILLED NURSING INC BOARD OF DIRECTORS CONTRACTS WITH HERITAGE MINISTRIES MANAGEMENT COMPANY TO PROVIDE ADMINISTRATIVE SUPPORT, WHICH INCLUDES REVIEW OF PERFORMANCE AND COMPENSATION OF OFFICERS OR TOP MANAGEMENT. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE MAILED OR SENT ELECTRONICALLY UPON REQUEST. FORM 990, PART XII, LINE 2C: NO CHANGES IN OVERSIGHT PROCESS IN CURRENT YEAR. HERITAGE MINISTRIES CHARITABLE CARE NETWORK INC 4600 ROUTE 60 GERRY NY 14740 261454957 PASSIVE PARENT ORGANIZATION NY 501(C)(3) LINE 12A, I N/A 0 HERITAGE MINISTRIES MANAGEMENT COMPANY INC 4600 ROUTE 60 GERRY NY 14740 261590078 SUPPORTING ORGANIZATION NY 501(C)(3) LINE 12A, I N/A 0 GERRY HOMES INC 4600 ROUTE 60 GERRY NY 14740 160755780 HEALTH CARE FOR THE ELDERLY NY 501(C)(3) LINE 10 N/A 0 WESTERN NEW YORK MENNONITE RETIREMENT COMMUNITY INC 4945 VINECROFT DRIVE CLARENCE CENTER NY 14032 161560655 HOUSING FOR SENIORS NY 501(C)(3) LINE 10 N/A 0 HEARTHSTONE AT SERENITY CREEK 920 N SEMINARY AVENUE WOODSTOCK IL 60098 463825098 HEALTH CARE FOR THE ELDERLY IL 501(C)(3) LINE 10 N/A 0 WOODSTOCK CHRISTIAN LIFE SERVICES INC 920 N SEMINARY AVENUE WOODSTOCK IL 60098 363186415 HEALTH CARE FOR THE ELDERLY IL 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0