2018-10-10T18:34:54-05:00 2017-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL SUITE 201 PITTSFORD NY 14534 990 2017-01-01 160743146 ST ANN'S HOME FOR THE AGED STAN 5856976000 1500 PORTLAND AVENUE ROCHESTER NY 14621 DENNIS KANT SENIOR VICE PRESIDENT & CFO 5856976307 2018-10-08 1 JENNIFER ARBORE P00893012 5853811000 2017 2022-09-23 18:48:47Z DENNIS KANT 1500 PORTLAND AVENUE ROCHESTER NY 14621 69010813 0 X WWW.STANNSCOMMUNITY.COM X 1874 NY PROMOTE INDEPENDENCE, PHYSICAL & SPIRITUAL WELL-BEING OF OLDER ADULTS IN A SKILLED NURSING FACILITY. 21 15 1639 400 11420 10420 2596554 651673 60673684 61047013 724938 763506 1173167 1508267 65168343 63970459 61540 63528 0 0 44314070 41671723 0 0 0 20391497 20747626 64767107 62482877 401236 1487582 85679292 87936821 59010161 60426812 26669131 27510009 X SINCE OUR FOUNDING IN 1874, OUR MISSION HAS BEEN TO PROMOTE THE HIGHEST LEVELS OF INDEPENDENCE, PHYSICAL AND SPIRITUAL WELL-BEING OF OLDER ADULTS IN THE CATHOLIC TRADITION OF EXCELLENCE IN CARE AND SERVICES. ST. ANN'S COMMUNITY, OTHERWISE KNOWN AS ST. ANN'S OF GREATER ROCHESTER, INC., OFFERS A CONTINUUM OF SERVICES FOR SENIORS IN THE GREATER ROCHESTER AREA THROUGH THESE AFFILIATED ORGANIZATIONS: ST. ANN'S HOME FOR THE AGED, ST. ANN'S NURSING HOME COMPANY, INC., CHAPEL OAKS, INC., ST. ANN'S FOUNDATION, INC., AND ST. ANN'S SENIOR HOUSING, INC. ST. ANN'S HOME FOR THE AGED (ST. ANN'S HOME) IS A 388 BED LICENSED SKILLED NURSING FACILITY. SPECIALIZED CARE OFFERED IN THIS FACILITY INCLUDES 60 UNITS DEDICATED TO PROVIDING SHORT-TERM POST-ACUTE REHABILITATION AND COMPLEX MEDICAL SERVICES, AND 36 UNITS PROVIDING DEMENTIA CARE. ST. ANN'S HOME ALSO OPERATES HOME CONNECTION, A 30 SLOT MEDICAL ADULT DAY PROGRAM AND HOME & HEART, A SOCIAL ADULT DAY PROGRAM AT TWO SATELLITE CENTERS SERVING 27 PEOPLE. 0 0 52816958 63528 61282721 ST. ANN'S HOME FOR THE AGED (ST. ANN'S HOME) IS A 470 BED LICENSED SKILLED NURSING FACILITY THAT INCLUDED THESE SERVICES DURING THE 2017 FISCAL YEAR: SKILLED NURSING CARE PROVIDED A TOTAL OF 136,873 DAYS OF CARE. INCLUDED IN THESE NUMBERS ARE BED DAYS FOR THE SPECIAL CARE UNIT, A 36 BED DEMENTIA CARE UNIT.THE WEGMANS TRANSITIONAL CARE CENTER PROVIDES 72 BEDS DEDICATED TO PROVIDING SHORT TERM POST ACUTE REHABILITATION. OUR TCC PROGRAM PROVIDED A TOTAL OF 21,946 DAYS OF CARE. THE LEO CENTER FOR CARING IS A 10-BED HOSPICE UNIT AND PROVIDED 1,737 DAYS OF CARE. THE HOME CONNECTION PROGRAM PROVIDED 30 SLOTS FOR MEDICAL ADULT DAY SERVICES AND THE HOME & HEART PROGRAM OFFERED SOCIAL ADULT DAY CARE AT TWO SATELLITE CENTERS SERVING 48 PEOPLE. DURING 2017, 51,219 HOURS OF CARE WERE PROVIDED TO PARTICIPANTS OF BOTH PROGRAMS. 52816958 1 1 0 0 0 0 0 0 0 1 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 1 0 0 0 0 0 1 0 0 0 1 89 0 1 1639 1 1 1 0 0 0 0 0 0 0 0 0 X 21 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X DENNIS KANT SENIOR VICE PRESIDENT & CFO 5856976000 1500 PORTLAND AVENUE ROCHESTER NY 14621 X MARGARET BRINGEWATT IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 JOSEPH STANKAITIS MD CHAIR 1.00 X X 0 0 0 PATRICK BURKE DIRECTOR 1.00 X 0 0 0 CHERYL RYAN DIRECTOR 1.00 X 0 0 0 CRAIG BURTON DIRECTOR 1.00 X 0 0 0 THOMAS COMBS DIRECTOR 1.00 X 0 0 0 MARK CRONIN DIRECTOR 1.00 X 0 0 0 RONALD SALLUZZO DIRECTOR 1.00 X 0 0 0 KENT GARDNER CHAIR ELECT 1.00 X X 0 0 0 JAMES LEO TREASURER 1.00 X X 0 0 0 REV KEVIN MCKENNA DIRECTOR 1.00 X 0 0 0 SISTER MARLENE PAPE DIRECTOR 1.00 X 0 0 0 MICHAEL PINCH DIRECTOR 1.00 X 0 0 0 MAURICIO RIVEROS DIRECTOR 1.00 X 0 0 0 MARK BELFER DIRECTOR 1.00 X 0 0 0 JILL WYNN DIRECTOR 1.00 X 0 0 0 MICHAEL MCRAE PRESIDENT/CEO 34.00 6.00 X X 405812 0 64609 MICHELLE ASHBY DIRECTOR 1.00 X 0 0 0 ANNA LYNCH DIRECTOR 1.00 X 0 0 0 DEB SCHAUSEIL DIRECTOR 1.00 X 0 0 0 CARMEN INDIANO DIRECTOR 1.00 X 0 0 0 DENNIS KANT SENIOR VP/CFO 20.00 20.00 X 235421 0 16903 ROBERT BOURG SENIOR VP OF ORGANIZATIONAL TRAIN 31.00 9.00 X 190388 0 5613 STEVEN SMITH VP OF FOUNDATION & RESOURC 6.00 34.00 X 177717 0 10746 SUSAN MURTY VP ADMINISTRATOR 35.00 5.00 X 218008 0 17858 DIANE KANE MD CHIEF MEDICAL DIRECTOR 7.00 33.00 X 331322 0 34785 KIMBERLY PETRONE ASSOCIATE MEDICAL DIRECTOR 36.00 4.00 X 299838 0 32042 JOHN JURIK MD ASSOCIATE MEDICAL DIRECTOR 36.00 4.00 X 216162 0 17833 JARVIS SANCHEZ-RIVERA MD STAFF ATTENDING PHYSICIAN 36.00 4.00 X 210487 0 17739 ELIZABETH TOMASZCZUK CHIEF NURSING EXECUTIVE 36.00 4.00 X 145019 0 17517 2430174 0 235645 10 0 1 0 CARDINAL HEALTH PHARMACY 110 SCIENCE PKWY ROCHESTER NY 14620 PHARMACY SERVICES 2026180 US FOODSERVICE INC 9399 WEST HIGGINS ROAD SUITE 500 ROSEMONT IL 60018 FOOD SERVICE 1245655 KEY INSURANCE & BENEFITS 777 CANAL VIEW BOULEVARD SUITE 100 ROCHESTER NY 14623 INSURANCE 910896 BUFFALO HOSPITAL SUPPLY 4039 GENESEE ST 100 BUFFALO NY 14225 MEDICAL EQUIPMENT SUPPLIER 622112 HIGHFALLS TECHNOLOGIES GROUP 309 N AUTUMN DR ROCHESTER NY 14626 COMPUTER SUPPLIER 469030 36 514006 137667 651673 NET RESIDENT SERVICE REVENUE 623000 58303638 58303638 SUPPORT SERVICES 623000 2743375 2743375 61047013 681466 681466 117457 34583 82874 82874 82874 5047099 4965059 82040 82040 82040 70160 40712 29448 29448 MISCELLANEOUS 900099 677700 235708 441992 MEAL REVENUE 900099 537717 537717 PANDION/RAHSA 900099 238822 11420 227402 -58294 -58294 1395945 63970459 61282721 11420 2024645 63528 63528 1343075 1343075 33055516 29718039 3337477 1264816 1092715 172101 3524161 3021521 502640 2484155 2146141 338014 157272 157272 28550 28550 76386 76386 2147049 1065938 1081111 80604 80604 714597 476455 238142 824350 824350 1207229 1003098 204131 194485 87482 107003 861543 861543 4898769 4898769 518662 12973 505689 MEDICAL SUPPLIES 2941599 2941599 NYS ASSESSMENT 2885734 2885734 FOOD 1827374 1747644 79730 OTHER EXPENSES 925984 610189 315795 457439 183590 273849 62482877 52816958 9665919 0 5392197 5903513 2190381 229195 5952088 6840863 467844 445941 669433 2198667 69803993 28583276 43332390 41220717 16247706 20846015 1117158 1403574 10310095 8848336 85679292 87936821 29613993 32080892 444 372438 27598969 26863708 1796755 1109774 59010161 60426812 X 18307197 17927864 7410115 8546115 951819 1036030 26669131 27510009 85679292 87936821 X 1487582 1968048 -2614752 X X 0 1 X 1 0 X 487370 2048746 1988742 2596554 514006 7635418 57051061 59870406 63397519 60760823 61117173 302196982 57538431 61919152 65386261 63357377 61631179 309832400 0 0 0 309832400 465895 774852 800934 635578 798923 3476182 465895 774852 800934 635578 798923 3476182 863280 669879 807955 1051564 1395945 4788623 58867606 63363883 66995150 65044519 63826047 318097205 0.97400 0.97660 0.01090 0.01010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6576241 1080937 7657178 5863168 713073 6576241 6028846 -165678 5863168 5705040 323806 6028846 4779686 925354 5705040 0.00000 0.08070 0.91930 0 0 122823 122823 42069718 16323412 25746306 26027942 11319490 14708452 1583510 940374 643136 41220717 BENEFICIAL INTEREST IN NET ASSETS OF ST. ANN'S FOUNDATION, INC. 631962 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 417963 BENEFICIAL INTEREST IN REMAINDER TRUSTS 875042 DUE FROM AFFILIATES 5451807 DUE FROM AFFILIATES, PENSION CONTRIBUTIONS 759068 DUE FROM THIRD PARTY PAYORS 712494 8848336 DEFERRED COMPENSATION 671769 ESTIMATED THIRD PARTY PAYOR SETTLEMENT 9094 FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENTS 428911 1109774 X 60579289 1968048 -2614752 -646704 61225993 76386 2668080 2744466 63970459 59738411 -2668080 -2668080 62406491 76386 76386 62482877 PART V, LINE 4: INCOME FROM ENDOWMENT FUNDS ARE TO BE USED FOR IT'S CORPORATE PURPOSE. PART X, LINE 2: THE HOME IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON ITS EXEMPT INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE HOME'S TAX-EXEMPT PURPOSE MAY BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENTS 176,784. PENSION LIABILITY ADJUSTMENT -3,217,226. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS -495,139. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 35,850. CHANGE IN INTEREST IN NET ASSETS OF ST. ANN'S FOUNDATION, INC. 598,563. CHANGE IN JOINT VENTURE INVESTMENT 286,416. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -34,583. GIFT SHOP EXPENSES -40,712. SUPPORT SERVICES 2,743,375. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 34,583. GIFT SHOP EXPENSES 40,712. SUPPORT SERVICES -2,743,375. 1 ST ANN'S OF GREATER ROCHESTER INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161494042 501(C)(3) 63528 CASH FINANCIAL SUPPORT 1 0 SCHEDULE I, PART I, LINE 2: THE ORGANIZATION PROVIDES PERIODIC REPORTS DETAILING THE USE OF THE GRANT FUNDS TO THE BOARD OF DIRECTORS. X X X 1 1 X X X X X 0 0 0 0 0 0 0 1 0 MICHAEL MCRAE PRESIDENT/CEO 405812 0 0 0 0 0 21160 0 43449 0 470421 0 0 0 DENNIS KANT SENIOR VP/CFO 235421 0 0 0 0 0 4264 0 12639 0 252324 0 0 0 ROBERT BOURG SENIOR VP OF ORGANIZATIONAL TRAIN 190388 0 0 0 0 0 3352 0 2261 0 196001 0 0 0 STEVEN SMITH VP OF FOUNDATION & RESOURC 177717 0 0 0 0 0 3328 0 7418 0 188463 0 0 0 SUSAN MURTY VP ADMINISTRATOR 218008 0 0 0 0 0 3796 0 14062 0 235866 0 0 0 DIANE KANE MD CHIEF MEDICAL DIRECTOR 331322 0 0 0 0 0 20728 0 14057 0 366107 0 0 0 KIMBERLY PETRONE ASSOCIATE MEDICAL DIRECTOR 299838 0 0 0 0 0 17980 0 14062 0 331880 0 0 0 JOHN JURIK MD ASSOCIATE MEDICAL DIRECTOR 216162 0 0 0 0 0 4209 0 13624 0 233995 0 0 0 JARVIS SANCHEZ-RIVERA MD STAFF ATTENDING PHYSICIAN 210487 0 0 0 0 0 3077 0 14662 0 228226 0 0 0 ELIZABETH TOMASZCZUK CHIEF NURSING EXECUTIVE 145019 0 0 0 0 0 3028 0 14489 0 162536 0 0 0 PART I, LINE 1A ST. ANN'S COMMUNITY PROVIDED THE FOLLOWING BENEFITS FOR THE PRESIDENT/CEO: PERSONAL CAR ALLOWANCE OF $3,095; AND REIMBURSEMENT OF PROFESSIONAL COACHING FEES OF $24,464. ALL OF THESE ITEMS WERE CONSIDERED TAXABLE BENEFITS FOR THE PRESIDENT/CEO AND WERE INCLUDED AS WAGE COMPENSATIONON ON THE FORM W-2. PART I, LINE 7 80% IS TIED TO KEY ORGANIZATIONAL GOALS. 20% IS TIED TO INDIVIDUAL PERFORMANCE VS. ORGANIZATIONAL GOALS. PATRICK BURKE BOARD MEMBER OF ST. ANN'S COMMUNITY 67600 PATRICK BURKE IS A CURRENT BOARD MEMBER AND MANAGING PRINCIPLE OF BURKE GROUP. ST. ANN'S ENGAGES BURKE GROUP AS ADMINISTRATOR OF IT'S RETIREMENT PLANS AND FOR ACTUARIAL SERVICES RELATED TO THESE PLANS. 0 ANNA LYNCH BOARD MEMBER OF ST. ANN'S COMMUNITY 101188 ANNA LYNCH IS A CURRENT BOARD MEMBER AND MANAGING PARTNER OF UNDERBERG & KESSLER LLP. ST. ANN'S ENGAGES UNDERBERG & KESSLER FOR LEGAL SERVICES. 0 REV KEVIN MCKENNA BOARD MEMBER OF ST. ANN'S COMMUNITY 11131 REV. KEVIN MCKENNA IS A CURRENT BOARD MEMBER AND REVEREND OF SACRED HEART CATHEDRAL. ST. ANN'S RENTS SPACE AT SACRED HEART CATHEDRAL FOR ITS ADS PROGRAM. 0 MICHELLE ASHBY BOARD MEMBER OF ST. ANN'S COMMUNITY 149835 MICHELLE ASHBY IS A CURRENT BOARD MEMBER AND PRESIDENT/CEO OF TIPPING POINT MEDIA. ST. ANN'S ENGAGES TIPPING POINT MEDIA FOR MARKETING CONSULTING. 0 MAURICIO RIVEROS BOARD MEMBER OF ST. ANN'S COMMUNITY 56167 MAURICIO RIVEROS IS A CURRENT BOARD MEMBER AND VICE PRESIDENT OF THE PIKE COMPANY. THE PIKE COMPANY OWNS LECESSE CONSTRUCTION. ST. ANN'S ENGAGES LECESSE CONSTRUCTION FOR CONSTRUCTION PROJECTS. 0 FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION FOR THE REPORT IS PREPARED BY ST. ANN'S STAFF, PROVIDED AND REVIEWED BY BONADIO & CO., LLP. FINAL REPORTS ARE REVIEWED BY THE ST. ANN'S ACCOUNTING TEAM, INCLUDING THE DIRECTOR OF FINANCE AND CFO, AND PROVIDED TO THE CEO AND BOARD MEMBERS FOR COMMENTS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS (INCLUDING THE PRESIDENT AND CEO) ARE REQUIRED TO ANNUALLY COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE FORMS ARE THEN REVIEWED BY THE VP OF ORGANIZATIONAL DEVELOPMENT AND ANY POTENTIAL CONFLICTS ARE DEALT WITH AS NEEDED INCLUDING ABSTAINING FROM VOTING ON MATTERS RELATED TO SUCH CONFLICTS. ANY PERSON COVERED BY THE POLICY SHALL NOT KNOWINGLY USE HIS OR HER POSITION FOR PERSONAL GAIN, TO COMPROMISE ST. ANN'S INTERESTS, OR TO ALLOW A CONFLICT TO ARISE BETWEEN ST. ANN'S INTEREST AND HIS OR HER PERSONAL INTEREST. FORM 990, PART VI, SECTION B, LINE 15 EACH YEAR AN INDEPENDENT WAGE STUDY IS CONDUCTED BY A CONSULTANT. DIRECTORS AND ABOVE, EXCEPT CEO, ARE REVIEWED BY THE VP OF HR AND CEO WITH ADJUSTMENTS MADE AS NEEDED TO MAINTAIN COMPETITIVENESS. CEO DATA IS REVIEWED BY A COMMITTEE INCLUDING THE BOARD CHAIR, PAST BOARD CHAIR, AND HR COMMITTEE CHAIR. ADJUSTMENTS MADE AS NEEDED TO MAINTAIN MARKET COMPETITIVENESS. 2017 VPS AND CEO DATA REVIEWED; 2017 DIRECTOR LEVEL DATA REVIEWED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: ALL OFFICERS AND EMPLOYEES REPORTED ON PART VII ARE FULL TIME EMPLOYEES OF THE ST. ANN'S COMMUNITY (ST. ANN'S HOME FOR THE AGED ("SAH") AND RELATED ORGANIZATIONS) WORKING AN AVERAGE OF 40 HOURS PER WEEK. HOURS REPORTED IN COLUMN B OF PART VII ARE THE AVERAGE HOURS RELATED TO WORK PERFORMED FOR SAH. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENTS 176,784. PENSION LIABILITY ADJUSTMENT -3,217,226. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS -495,139. CHANGE IN VALUE OF BENEFICIAL INTEREST IN NET ASSETS OF ST. ANN'S FDN, INC. 598,563. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 35,850. CHANGE IN JOINT VENTURE INVESTMENT 286,416. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. ST ANN'S FOUNDATION INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161379536 HEALTH CARE NY 501(C)(3) LINE 12A, I ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S NURSING HOME COMPANY INC DBA THE HERITAGE 1500 PORTLAND AVENUE ROCHESTER NY 14621 237098164 HEALTH CARE NY 501(C)(3) LINE 10 ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S OF GREATER ROCHESTER INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161494042 HEALTH CARE NY 501(C)(3) LINE 12B, II N/A 0 ST ANN'S SENIOR HOUSING INC DBA CHERRY RIDGE 1500 PORTLAND AVENUE ROCHESTER NY 14621 760705854 HEALTH CARE NY 501(C)(3) LINE 10 ST ANN'S OF GREATER ROCHESTER INC 0 CHAPEL OAKS INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161489340 HEALTH CARE NY 501(C)(3) LINE 10 ST ANN'S OF GREATER ROCHESTER INC 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1