2018-10-22T14:24:22-07:00 2017-12-31 990 2017-01-01 111633518 NORWEGIAN CHRISTIAN HOME AND HEALTH CENTER NORW 7182322322 1250 67th Street Brooklyn NY 11219 William Van Lew CFO 7183065621 2018-10-25 72.43.132.98 2017 2018-06-14 16:35:46Z George A Jensen 1250 67th Street Brooklyn NY 11219 23698317 0 X www.nchhc.org X 1903 NY Motivated by Faith in God, the Belief that Redemption can only be found in Jesus Christ, and his Love extends to all Mankind, the Norwegian Christian Home and Health Center exists to provide exceptional physical, social, and spiritual care services to its residents in a pleasant environment where human dignity is preserved. 15 15 338 52 0 0 28802 381294 22688511 23143738 45221 26343 169081 146942 22931615 23698317 0 0 0 0 13723408 13900036 0 0 0 8964040 9603082 22687448 23503118 244167 195199 30393133 30243321 25062196 25233384 5330937 5009937 Motivated by faith in God, the Belief that Redemption can only be found in Jesus Christ, and His Love extends to all mankind, the Norwegian Christian Home and Health Center exists to provide exceptional physical, social, and spiritual care services to its residents in a pleasant environment where human dignity is preserved. 0 0 16068385 0 18229123 Skilled Nursing and Respite Care provided in a full service, state of the art 135 bed facility with 2 respite beds and 24/7 medical care to attend to the complete needs of every resident. Sub-acute care provides intensive restorative rehabilitation designed to improve the physical state of the resident. An interdisciplinary team is comprised of physicians, nurses, therapists, social workers and more. The goal is to attain measurable progress with every resident, as well as to be able to affect a safe discharge. All rooms are equipped with satellite television, telephones, security, and safety devices. Services include housekeeping, laundry service, 3 nutritional meals daily (tailored to individual dietary needs), pastoral care and elective group activities. In 2017, the Home provided 46,329 days of skilled nursing care and 35 days of respite care. There were a total of 483 admissions and 472 discharges during 2017. 4561348 0 4808658 Assisted Living for when a helping hand is needed. Program services include 88 beds in semi-private accomodations providing residents with uncompromised and accurate attention. Residents enjoy delicious meals, and social programs that keep their minds and bodies active. Independent Living studio and suites provide 28 residents a secure environment while maintaining their independence. Luxury apartments include full functioning kitchens, walk in closets, cable and internet access. Public areas include a bright atrium with a fireplace, outdoor garden with pond and gazebo, as well as a comfortable environment to relax. In 2017, the Home provided 33,521 days of assisted living and independent living care. 103667 0 105957 Outpatient Therapy program provides physical, occupational, and speech therapy. Our goal with our outpatient therapy program is to restore mobility, endurance, strength, and functional abilities to individuals with orthopedic, neurological, and other conditions. A coordinated and comprehensive treatment plan is individually designed for each patient. Flexible hours and parking are available. In 2017, the Home provided 2,778 billable treatments. 0 0 0 20733400 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 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 1 1 0 0 1 15 0 1 338 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X William Van Lew 7183065621 1250 67th Street Brooklyn NY 11219 George A Jensen Chairman 2.0 1.0 X X 0 0 0 Stanley Ramsdal Member 1.0 0.0 X 0 0 0 Ralph Aavik Treasurer 2.0 0.00 X X 0 0 0 Arthur J Goyena Asst Treasurer 2.0 0.0 X X 0 0 0 Arlene Rutuelo Vice Chairman 2.0 1.0 X X 0 0 0 Lori Aavik Secretary 2.0 0 X X 0 0 0 Torry Berntsen Member 1.0 1.00 X 0 0 0 Eleanor Bensen Member 1.0 0.0 X 0 0 0 Rebecca E Daniel Assistant Secretary 2.0 0.0 X X 0 0 0 Richard C Thompson Jr Member 1.0 0.0 X 0 0 0 Roy Swensen Member 1.0 0.0 X 0 0 0 Edward Johannesen Member 2.0 0.0 X 0 0 0 Bill Dietrich Member 1.0 0 X 0 0 0 Arnold Oftedal Member 1.0 0 X 0 0 0 Reverend Paul Knudsen Member 1.0 0 X 0 0 0 Earnest K Ragin Executive Director 37.50 1.0 X 236239 0 73352 William Van Lew CFO 35.00 2.50 X 173407 0 53843 Elaine Williams Director of Nursing 37.50 0 X 142781 0 44333 552427 0 171528 4 0 1 0 FJC Security Services 275 Jericho Turnpike Floral Park NY 11001 Security 133180 Senior Rehab Solutions 600 N Pearl Street Suite 1050 Dallas TX 75201 Therapy Services 1775526 Allied Universal Security Services PO Box 828854 Philadelphia PA 19182 Security Staff 163119 3 0 0 0 300000 0 81294 0 381294 Medicaid Revenue 623000 10358555 10358555 0 0 Medicare Revenue 623000 8450067 8450067 0 0 Other Patient Service Revenue 623000 4335116 4335116 0 0 0 0 0 0 23143738 26343 26343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cafeteria Gift Shop Income 900099 102782 102782 0 0 EQUAL Funds 921190 32087 32087 0 0 Miscellaneous 900099 8433 8433 0 0 3640 3640 0 0 146942 23698317 23317023 0 0 0 0 0 0 0 0 0 0 536841 0 536841 0 0 0 0 0 9890256 9212780 677476 0 663921 593811 70110 0 2068367 1849947 218420 0 740651 663438 77213 0 0 0 0 0 16674 0 16674 0 86100 0 86100 0 0 0 0 0 0 0 0 0 0 0 2095495 2078359 17136 0 1655 0 1655 0 41567 19049 22518 0 162628 0 162628 0 0 0 0 0 1646403 1461701 184702 0 0 0 0 0 0 0 0 0 8390 1433 6957 0 14906 0 14906 0 0 0 0 0 1559426 1398182 161244 0 432662 0 432662 0 NYS Assessment 725139 725139 0 0 Foods and Dietary Supplements 687302 604826 82476 0 Medical Supplies and Prescription Drugs 701751 701751 0 0 Bad Debt Expense 273206 273206 0 0 1149778 1149778 0 0 23503118 20733400 2769718 0 592398 948225 0 0 0 0 3040914 2899168 0 0 0 0 0 0 0 0 268947 191729 39398977 24653750 15870513 14745227 0 0 0 0 10620361 11458972 30393133 30243321 2780141 2681886 0 0 0 0 17690182 16073278 635430 601733 0 0 0 0 0 0 3956443 5876487 25062196 25233384 X 3440350 2738033 1299359 1607813 591228 664091 5330937 5009937 30393133 30243321 X 195199 0 0 0 0 -516199 X 0 1 X 1 1 1 X 14544 386919 38713 28802 81294 550272 20575393 20638971 21876791 22688511 23143738 108923404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20589937 21025890 21915504 22717313 23225032 109473676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109473676 74332 56214 57629 45221 26343 259739 0 0 0 0 0 0 74332 56214 57629 45221 26343 259739 0 0 0 0 0 0 132664 227429 159755 169081 446942 1135871 20796933 21309533 22132888 22931615 23698317 110869286 0.98741 0.98819 0.00234 0.00261 X Schedule A, Part III, Line 12 Contribution from Norwegian Christian Home Foundation, Income from Cafeteria and Gift Shop, Television and Phone charges, and Miscellaneous. 0 1 X 591228 0 72863 0 0 0 664091 589018 0 2210 0 0 0 591228 632857 0 -43839 0 0 0 589018 646390 0 -13533 0 0 0 632857 589930 0 56460 0 0 0 646390 0 1 0 0 0 938541 0 938541 35585894 0 22277227 13308667 0 0 0 0 2874542 0 2376523 498019 0 0 0 0 14745227 Assets Limited As to Use 7214044 Intrest in net assets of Norwegian Christian Home Foundation 1607813 Restrixcted Cash - Resident's Funds 601733 Beneficial Interest in Trusts 664091 Due from Foundation,net 83615 Insurance Recovery Receivable 1264578 Other Receivables 23098 11458972 0 Pension Liability 3426139 Professional and similiar liabilities 1264578 Due to third party payors 800816 Workers Compensation Payable 384954 5876487 X 23698317 0 0 0 0 0 23698317 0 0 0 23698317 23503118 0 0 0 0 0 23503118 0 0 0 23503118 Schedule D, Part IV, Line 2b Resident's Funds are held by the Home on behalf of the residents. Such funds represent living allowances received by residents as well as other funds deposited with the Home for safekeeping. The funds are disbursed at the request of, or on behalf of resident's for their personal use. Schedule D, Part V, Line 4 The Konrad W. Frederiksen charitable trust was established in 1958 consisting of 4661.7 units of the Massachusetts Life Fund. The trust agreement stipulates that net income is to be paid quarterly to the Home. In 2001, the Home recorded its beneficiary interest in the Vera J. Clark trust. The trust agreement states that the net income from the trust is to be paid quarterly to the Home and several other charitable organizations. Schedule D, Part X, Line 2 The Home recognizes the effect of income tax positions only if those positions are more likely than not to be sustained. Management has determined that the Home had no uncertain tax positions that would require financial statement recognition or disclosure. The Home is no longer subject to examinations by the applicable taxing jurisdictions for periods prior to December 31, 2014. X X 0 0 0 0 0 0 0 0 0 Earnest K Ragin Executive Director 236239 0 0 0 0 0 16537 0 56815 0 309591 0 0 0 William Van Lew CFO 173407 0 0 0 0 0 10404 0 43439 0 227250 0 0 0 Elaine Williams Director of Nursing 142781 0 0 0 0 0 8567 0 35768 0 187116 0 0 0 Form 990, Part VI, Section A, Line 2 Board member Torry Berntsen is the son-in-law of Board Chair George A. Jensen. Secretary Lori Aavik is the daughter of Treasurer Ralph Aavik. Form 990, Part VI, Section B, Line 11b The Form 990 is completed by the CFO. Upon completion, the draft Form 990 is distributed to the Board of Directors for their review and comments. All questions and comments are forwarded to the CFO via email for research and any final edits will be made by the CFO to produce the final Form 990 that will be filed with the IRS. The Board of Directors documents its review and approval of the final report. Form 990, Part VI, Section B, Line 12c Annually all employees are provided with the Employee Attestation Notice reminding them of their responsibilities and rights as it relates to Corporate Compliance & Federal False Claims Act, and Federal Elderly Justice Act. The notice was last reviewed and revised in September 2018. Annually, a formal conflict of interest disclosure statement is distributed and signed by each Board member. The Board of Directors policy requires that any Board member who has a conflict of interest must disclose the conflict to the full Board and excuse themselves from any vote that involves a particular conflict of interest. Form 990, Part VI, Section B, Line 15 The compensation of the Executive Director / Administrator is decided by the Board of Directors which includes an annual review and approval by the Board. The Board utilizes data and / or benchmarks related to comparable compensation for similar qualified personal in comparable positions in similar facilities. His / her compensation is voted on during a Board meeting and documented in the Board minutes. The salaries of key employees and senior management staff are decided during the hiring process by the Executive Director / Administrator and Director of Human Resources jointly, which includes a review of comparable compensation for similar qualified persons in comparable positions at similar facilities. After initial hire, nominal salary increases may be granted taking into account cost of living increases and the facility's financial situation. Periodic salary reviews of key employees and top management may also be conducted taking into account employees performance and any additional responsibilities assigned including a review of comparable compensation for similar qualified persons in comparable positions in similar facilities. The Board authorizes the Executive Director / Administrator to increase all eligible non-union salaries by an approved percentage; each individual employee's salary increase is determined by the Executive Director / Administrator. The Board of Director's did approve a salary increase for non-union employees in 2016. Form 990, Part VI, Section C, Line 19 The organization makes it governing documents, conflict of interest policy, and audited financial statements available to the general public upon request. The organization files an annual cost report with the New York State Department of Health which contains the financial statements and related note disclosures. the cost report is available to the public upon request. Form 990, Part XI, Line 9 Pension liability adjustment ($897,516), Change in interest in net assets of Norwegian Christian Home Foundation $308,454, and Change in value of beneficial interest in trusts $72,863. Norwegian Christian Home Foundation 1270 67th Street Brooklyn NY 11219 743219871 Fundraising NY 501(c)3 9 Norwegian Christian Home and Health Center 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 Norwegian Christian Home Foundation p 5276 Miscellaneous donations / cash receipts for Foundation and miscellaneous expense paid by the NCHHC and charged to NCHF. Norwegian Christian Home Foundation q 88891 Salary and Benefits cost of Development Director, and cost of utilities, maintenance, and supplies.