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 133623600 NORTHERN MANOR MULTICARE CENTER INC NORT 8456233904 199 NORTH MIDDLETOWN ROAD NANUET NY 10954 MORRIS KLEIN EXECUTIVE DIRECTOR 8456233904 2018-11-13 1 AARON SHAPIRO P01333816 2128674000 64.22.227.161 2018-11-15 11:36:16 ES P 4275C7E7C8129915C35F764424C97B97C01C68F2 988419C5643A1C0877F6823E03E3852E0B43B763 2017 2019-02-21 02:37:17Z MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 29950219 0 X WWW.NORTHERNMANOR.COM X 1991 NY TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 9 9 419 25 0 0 0 0 29249047 28676694 4399 -82087 247424 1270481 29500870 29865088 435278 435028 0 0 17311377 17348112 0 0 0 11214139 11583059 28960794 29366199 540076 498889 18541968 21243993 21908919 24112055 -3366951 -2868062 TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 0 0 22786746 27958484 HEALTH CARE SERVICES FOR THE ELDERLY. NORTHERN MANOR MULTICARE CENTER, INC. (NORTHERN MANOR) OPERATES A 231-BED SKILLED NURSING FACILITY IN NANUET, NEW YORK. 2301669 718210 OUTPATIENT ADULT DAY CARE SERVICES. NORTHERN MANOR OPERATES AN ADULT DAY CARE CENTER WITH TWO DAILY PROGRAMS OF 100 SLOTS EACH IN BROOKLYN, NEW YORK. 435028 435028 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 FOUNDATION FOR HEALTH CARE, INC. 25523443 1 0 0 0 0 0 0 0 1 0 1 0 0 0 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 51 0 419 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 HERSHEL 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 GEDALIA KLEIN CHIEF OPERATING OFFICER 3.00 14.50 X 22651 109480 28054 MICHAEL NOWICKI COMPLIANCE OFFICER 6.00 29.00 X 33491 161874 0 ANNETTE FEARON DIRECTOR OF NURSING 35.00 X 146739 0 0 ROBERT KORNFELD ADMINISTRATOR 35.00 X 141137 0 0 STACEY BLOT ADNS 35.00 X 107231 0 6553 GENNADIY GOLDVEKHT REGISTERED NURSE 35.00 X 107769 0 0 675596 852317 206051 5 0 1 0 TOWNE NURSING STAFF 1413 38TH STREET BROOKLYN NY 11218 MEDICAL/HEALTH SERVICES 1141154 CENTERS FOR CARE 4770 WHITE PLAINS ROAD BRONX NY 10470 CONSULTING SERVICES 576865 CHEVRA LIADY NUSACH HOARY 1578 53RD STREET BROOKLYN NY 11219 ADMINISTRATIVE SERVICES 438458 CFSC AGENCY LLC 4770 WHITE PLAINS RD BRONX NY 10470 ADMINISTRATIVE CONTRACTED SERVICES 234740 ARI & SONS CATERING INC 904 KINGS HIGHWAY BROOKLYN NY 11223 FOOD SERVICES 118309 5 RESIDENT SERVICE REVENUE 623000 27958484 27958484 ADULT DAY CARE 623000 718210 718210 28676694 3044 3044 85131 -85131 -85131 -85131 EARLY LEASE TERMINATION 900099 1000000 1000000 MISCELLANEOUS 900099 270481 270481 1270481 29865088 28676694 0 1188394 435028 435028 206919 206919 12843212 11274404 1568808 828015 738855 89160 2374920 2120176 254744 1095046 910431 184615 1302498 1149433 153065 151665 151665 42300 42300 1557837 1346137 211700 32624 3350 29274 1612622 1133352 479270 1176144 1019924 156220 614686 533041 81645 348744 302422 46322 909638 788816 120822 498606 432379 66227 NYS ASSESSMENT 1149335 1149335 MEDICAL SUPPLIES 1133440 1133440 FOOD 1052920 1052920 29366199 25523443 3842756 0 381450 3971084 509193 625324 7595261 7664867 1387427 604754 24480777 16195478 8572909 8285299 44649 41586 51079 51079 18541968 21243993 3952701 4301842 2755147 2550187 296337 264093 5788548 5788548 43478 37874 9072708 11169511 21908919 24112055 X -3366951 -2868062 -3366951 -2868062 18541968 21243993 498889 0 X X 0 1 X 1 0 X 177541 131129 308670 35037654 31946040 28599051 29249047 28676694 153508486 35215195 32077169 28599051 29249047 28676694 153817156 0 0 0 153817156 8679 5218 1369 4399 3044 22709 8679 5218 1369 4399 3044 22709 90729 8140 247424 1270481 1616774 35223874 32173116 28608560 29500870 29950219 155456639 0.98950 0.99780 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME TERMINATION OF LEASE 0 1 X 790000 790000 11764906 7336383 4428523 7816848 5149538 2667310 3935420 3537704 397716 173603 171853 1750 8285299 DUE TO RELATED PARTIES 10207409 ESTIMATED LIABILITIES TO THIRD-PARTY PAYORS 962102 11169511 X 29865088 0 29865088 0 29865088 28931171 0 28931171 435028 435028 29366199 PART IV, LINE 2B: RESIDENT FUNDS ARE MAINTAINED IN ACCOUNTS SEPARATE FROM NORTHERN MANOR'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS' ACCOUNTS. PART X, LINE 2: NORTHERN MANOR 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: GRANTS TO RELATED ENTITY 435,028. 1 CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501(C) (3) 435028 TO SUPPORT THE RELIGIOUS MISSION OF CHEVRA LIADY NUSACH HOARY 1 0 PART I, LINE 2: NORTHERN MANOR MULTICARE 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 GEDALIA KLEIN CHIEF OPERATING OFFICER 21417 103514 0 0 1234 5966 0 0 4809 23245 27460 132725 0 0 MICHAEL NOWICKI COMPLIANCE OFFICER 31499 152244 0 0 1992 9630 0 0 0 0 33491 161874 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 MANOR MULTICARE CENTER, INC. (NORTHERN MANOR). 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 OF NORTHERN MANOR. 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. ANY QUESTIONS OR COMMENTS BY THE BOARD ARE BROUGHT TO THE AUDITOR'S ATTENTION AND ADDRESSED. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER 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 FOR HEALTH CARE, INC. ON BEHALF OF NORTHERN MANOR. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED SINCE PRIOR YEAR. NORTHERN RIVERVIEW HEALTH CARE CENTER INC 87 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133832251 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 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 - 11-3133470 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 1 0 0 0