BETHANY NURSING HOME AND HEALTH RELATED FACILITY INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- BETHANY NURSING HOME AND HEALTH RELATED FACILITY INC (EIN 51-0191763)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-02
- IRS object ID
- 201813069349301851
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-02T14:23:40-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161092347 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MENGEL METZGER BARR & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 EAST WATER ST STE 200 | AddressLine1Txt |
| City | ELMIRA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510191763 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETHANY NURSING HOME AND HEALTH RELATED | BusinessNameLine1Txt |
| Business Name Line2 | FACILITY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BETH | BusinessNameControlTxt |
| Phone | 6077398711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3005 WATKINS ROAD | AddressLine1Txt |
| City | HORSEHEADS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14845 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS SANTOBIANCO | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6077398711 | PhoneNum |
| Signature | 2018-10-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KRISTA L NILES-UPDYKE | PreparerPersonNm |
| PTIN | P00958947 | PTIN |
| Phone | 6077344183 | PhoneNum |
| Preparation | 2018-10-22 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 98.159.217.67 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-10-22 | IPDt |
| IP Tm | 10:52:38 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DE8F756557E6DC067C8E4F7CC1E5D7199762286C | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3879453E6F550BA2EC23F67EA1C8C4C18DF08C34 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | THOMAS SANTOBIANCO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3005 WATKINS ROAD | AddressLine1Txt |
| City | HORSEHEADS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14845 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,727,939 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BETHANY-VILLAGE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE REGIONAL LEADERSHIP, SERVICES, ADVOCACY, AND EDUCATION FOR QUALITY SENIOR LIVING, WHILE OPERATING A VIBRANT, LIFE-AFFIRMING RESIDENTIAL COMMUNITY THAT CELEBRATES SPIRITUAL WELL-BEING, ENHANCES INDEPENDENCE AND PROMOTES WELLNESS AS ITS RESIDENTS EVOLVE TOWARD THEIR FULL POTENTIAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 313 | TotalEmployeeCnt |
| Total Volunteers | 27 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,076 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,258 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,390,909 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,298,067 | CYProgramServiceRevenueAmt |
| PY Investment Income | $176 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,061 | CYInvestmentIncomeAmt |
| PY Other Revenue | $214,993 | PYOtherRevenueAmt |
| CY Other Revenue | $419,553 | CYOtherRevenueAmt |
| PY Total Revenue | $11,608,154 | PYTotalRevenueAmt |
| CY Total Revenue | $11,727,939 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,353,631 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,648,099 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,221,099 | PYOtherExpensesAmt |
| CY Other Expenses | $4,943,578 | CYOtherExpensesAmt |
| PY Total Expenses | $11,574,730 | PYTotalExpensesAmt |
| CY Total Expenses | $11,591,677 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $33,424 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $136,262 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,776,306 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,399,854 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,218,269 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,705,555 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $558,037 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $694,299 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF BETHANY VILLAGE IS TO PROVIDE REGIONAL LEADERSHIP, SERVICES, ADVOCACY, AND EDUCATION FOR QUALITY SENIOR LIVING, WHILE OPERATING A VIBRANT, LIFE-AFFIRMING RESIDENTIAL COMMUNITY THAT CELEBRATES SPIRITUAL WELL-BEING, ENHANCES INDEPENDENCE AND PROMOTES WELLNESS AS ITS RESIDENTS EVOLVE TOWARD THEIR FULL POTENTIAL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,302,294 | ExpenseAmt |
| Revenue | $11,724,681 | RevenueAmt |
| Desc | OPERATES A SKILLED NURSING FACILITY WHICH PROVIDES HEALTH CARE SERVICES TO THE ELDERLY. | Desc |
| Total Program Service Expenses | $10,302,294 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 313 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL KISER CPA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6077398711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3005 WATKINS ROAD | AddressLine1Txt |
| City | HORSEHEADS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14845 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| RICHARD G CARR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RANDI HEWIT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RC IKE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| J CAROL LINCOLN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH PONZI | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON PARMENTER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID SCHULTZ | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAWN BURLEW | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALISON HUNT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID HELSING | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WALTER HERBST | |||||||
| BOARD CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JACK BENJAMIN | |||||||
| BOARD VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JAMES BATTERSBY | |||||||
| TREASURER / SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| THOMAS SANTOBIANCO | |||||||
| CEO | 40.00 | $203,162 | $0 | $28,457 | Yes (X) | ||
| MICHAEL KISER | |||||||
| CFO | 40.00 | $128,065 | $0 | $6,396 | Yes (X) | ||
| JAMES MARK | |||||||
| ADMINISTRATOR | 40.00 | $135,977 | $0 | $14,695 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $467,204 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $49,548 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SELECT REHABILITATION INC | |||||
| PO BOX 809056 | CHICAGO | IL | 606809056 | MANAGES AND STAFFS PT/OT/SLP THERAPY PRO | $1,159,181 |
| FIRST CALL PHYSICIAN ASSISTANT SERVICES | |||||
| 378 BANNISTER ROAD | BREESPORT | NY | 14816 | PHYSICIAN ASSISTANT | $529,510 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $3,258 | AllOtherContributionsAmt |
| Total Contributions | $3,258 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE AND MEDICAID | 623000 | $9,465,406 | $9,465,406 |
| PRIVATE PAY | 623000 | $1,773,529 | $1,773,529 |
| ANCILLARY SERVICES | 623000 | $59,132 | $59,132 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,298,067 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,061 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,061 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| SHARED SERVICES/MGMT FEE | 623000 | $343,812 | $343,812 |
| SUNDRY | 623000 | $70,881 | $70,881 |
| OFFICE RENTAL | 623000 | $4,860 | $4,860 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $419,553 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,727,939 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,724,681 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $516,752 | TotalAmt |
| Program Services | $150,672 | ProgramServicesAmt |
| Management And General | $366,080 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,882,815 | TotalAmt |
| Program Services | $4,554,114 | ProgramServicesAmt |
| Management And General | $328,701 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,215 | TotalAmt |
| Program Services | $68,218 | ProgramServicesAmt |
| Management And General | $5,997 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,905 | TotalAmt |
| Program Services | $695,654 | ProgramServicesAmt |
| Management And General | $47,251 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,412 | TotalAmt |
| Program Services | $367,232 | ProgramServicesAmt |
| Management And General | $64,180 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,183 | TotalAmt |
| Management And General | $23,183 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,138 | TotalAmt |
| Program Services | $41,032 | ProgramServicesAmt |
| Management And General | $35,106 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,183,719 | TotalAmt |
| Program Services | $1,183,719 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,599 | TotalAmt |
| Program Services | $7,779 | ProgramServicesAmt |
| Management And General | $30,820 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,425 | TotalAmt |
| Program Services | $27,305 | ProgramServicesAmt |
| Management And General | $90,120 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,424 | TotalAmt |
| Program Services | $150,936 | ProgramServicesAmt |
| Management And General | $26,488 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,085 | TotalAmt |
| Program Services | $16,099 | ProgramServicesAmt |
| Management And General | $11,986 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,073 | TotalAmt |
| Program Services | $245,073 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,939 | TotalAmt |
| Program Services | $381,939 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,507 | TotalAmt |
| Program Services | $89,507 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTED SERVICES | $774,713 | $649,363 | $125,350 |
| MEDICAL SUPPLIES AND DR | $478,286 | $478,286 | |
| CASH RECEIPTS ASSESSMEN | $441,952 | $441,952 | $0 |
| FOOD | $364,168 | $364,168 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $523,367 | TotalAmt |
| Program Services | $389,246 | ProgramServicesAmt |
| Management And General | $134,121 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,591,677 | TotalAmt |
| Program Services | $10,302,294 | ProgramServicesAmt |
| Management And General | $1,289,383 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $564,274 | BOYAmt |
| EOY | $1,100 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $573,514 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,884,744 | BOYAmt |
| EOY | $1,872,915 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $579,890 | BOYAmt |
| EOY | $105,074 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,784,630 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,513,386 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,548,028 | BOYAmt |
| EOY | $2,271,244 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $199,370 | BOYAmt |
| EOY | $1,576,007 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,776,306 | BOYAmt |
| EOY | $6,399,854 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,391,540 | BOYAmt |
| EOY | $1,364,084 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,224 | BOYAmt |
| EOY | $62,389 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $289,528 | BOYAmt |
| EOY | $940,546 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,496,977 | BOYAmt |
| EOY | $3,338,536 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,218,269 | BOYAmt |
| EOY | $5,705,555 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,037 | BOYAmt |
| EOY | $694,299 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,037 | BOYAmt |
| EOY | $694,299 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,776,306 | BOYAmt |
| EOY | $6,399,854 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $136,262 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,230 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,033 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,163 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,541 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,258 | CurrentTaxYearAmt |
| Total | $32,225 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,242,476 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,749,768 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,906,310 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,390,909 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,298,067 | CurrentTaxYearAmt |
| Total | $54,587,530 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,261,706 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,754,801 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,909,473 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,392,450 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,301,325 | CurrentTaxYearAmt |
| Total | $54,619,755 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $54,619,755 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $338 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $320 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $254 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $176 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,061 | CurrentTaxYearAmt |
| Total | $8,149 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $338 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $320 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $254 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $176 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,061 | CurrentTaxYearAmt |
| Total | $8,149 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $156,961 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $76,327 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $173,176 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $215,528 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $419,553 | CurrentTaxYearAmt |
| Total | $1,041,545 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,419,005 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,831,448 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,082,903 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,608,154 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,727,939 | CurrentTaxYearAmt |
| Total | $55,669,449 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98110 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97820 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,400 | OtherCostOrOtherBasisAmt |
| Book Value | $24,400 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,298,081 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,806,266 | DepreciationAmt |
| Book Value | $1,491,815 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,177,044 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,518,345 | DepreciationAmt |
| Book Value | $658,699 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $285,105 | OtherCostOrOtherBasisAmt |
| Depreciation | $188,775 | DepreciationAmt |
| Book Value | $96,330 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,271,244 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM MEDICAID | $153,726 |
| DUE FROM AFFILIATED ENTITY | $1,002,525 |
| RESTRICTED CASH - RESIDENT DEPOSITS | $50,745 |
| RESTRICTED CASH - PROJECT FUNDS | $369,011 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,576,007 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTIES | $113,335 |
| CAP LEASE OBLIG WITH AFFILIATE | $3,102,173 |
| DUE TO AFFILIATED ENTITIES | $123,028 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,338,536 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $11,727,939 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,727,939 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,727,939 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,591,677 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,591,677 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,591,677 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | RESIDENT DEPOSITS REPRESENT CASH HELD ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT LIVING ALLOWANCES RECEIVED FROM THE STATE OF NEW YORK, AS WELL AS OTHER RESIDENT FUNDS DEPOSITED WITH THE FACILITY FOR SAFE KEEPING. |
| PART X, LINE 2: | THE FACILITY IS A NON-PROFIT ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE REGULATIONS. THE FACILITY HAS FILED FOR AND RECEIVED INCOME TAX EXEMPTIONS IN THE VARIOUS JURISDICTIONS WHERE THEY ARE REQUIRED TO DO SO. THE FACILITY FILES FORM 990 TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND IN NEW YORK STATE. WITH FEW EXCEPTIONS, AS OF DECEMBER 31, 2017, THE FACILITY IS NO LONGER SUBJECT TO U.S. FEDERAL OR STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2014. THE TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2014 THROUGH DECEMBER 31, 2017 ARE STILL SUBJECT TO POTENTIAL AUDIT BY THE IRS AND THE TAXING AUTHORITIES IN NEW YORK STATE. MANAGEMENT OF THE FACILITY BELIEVES IT HAS NO MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, IT HAS NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS SANTOBIANCO | ||||||||||||||
| CEO | $203,162 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $28,457 | $0 | $231,619 | $0 | $0 | $0 |
| MICHAEL KISER | ||||||||||||||
| CFO | $128,065 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,396 | $0 | $134,461 | $0 | $0 | $0 |
| JAMES MARK | ||||||||||||||
| ADMINISTRATOR | $135,977 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,695 | $0 | $150,672 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1B | FormAndLineReferenceDesc |
| Explanation | THE GOVERNING BOARD REVIEWS AND APPROVES ALL WAGE AND SALARY INCREASES THROUGH THE BUDGET PROCESS FOR THE CEO AND CFO. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE COMMITTEE MEETS WITH A DESIGNATED BOARD MEMBER WHO HAS BEEN ASSIGNED BY THE OTHER BOARD MEMBERS TO REVIEW THE FORM 990. THE FORM 990 IS PRESENTED TO THE DESIGNATED BOARD MEMBER AND THE FULL EXTENT OF THE FORM AND ITS PREPARATION IS EXPLAINED AT THAT TIME. THE DESIGNATED BOARD EMMBER THEN REVIEWS AND APPROVES THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS WRITTEN CONFLICT OF INTEREST POLICY AT QUARTERLY MEETINGS AND QUALITY ASSURANCE AUDITS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD REVIEWS AND APPROVES ALL WAGE AND SALARY INCREASES THROUGH THE BUDGET PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHYSICIANS AND THERAPISTS: PROGRAM SERVICE EXPENSES 1,183,719. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,183,719. |
| FORM 990, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BETHANY RETIREMENT HOME INC | |||||||||||
| 3005 WATKINS ROAD | HORSEHEADS | NY | 14845 | 160988865 | HOUSING ELDERLY | NY | 501(C)(3) | LINE 10 | N/A | 0 | |
| ORCHARD HOMES AT BETHANY VILLAGE INC | |||||||||||
| 3005 WATKINS ROAD | HORSEHEADS | NY | 14845 | 202019814 | HOUSING ELDERLY | NY | 501(C)(3) | LINE 10 | N/A | 0 | |
| BETHANY SENIOR CITIZENS' HOUSING INC | |||||||||||
| 3005 WATKINS ROAD | HORSEHEADS | NY | 14845 | 222238087 | HOUSING ELDERLY | NY | 501(C)(3) | LINE 10 | N/A | 0 | |
| BETHANY VILLAGE PRIMARY CARE NETWORK INC | |||||||||||
| 2977 WESTINGHOUSE ROAD | HORSEHEADS | NY | 14845 | 814217677 | HEALTH CLINIC | NY | 501(C)(3) | LINE 10 | 0 | BETHANY NURSING HOME AND HEALTH RELATED FACILITIES INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETHANY VILLAGE DEVELOPMENT CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3005 WATKINS ROAD | AddressLine1Txt |
| City | HORSEHEADS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14845 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 813458789 | EIN |
| Primary Activities | PROPERTY INVESTMENTS | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETHANY NURSING HOME AND HEALTH RELATED FACILITY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| BETHANY VILLAGE PRIMARY CARE NETWORK INC | ||
| D | $150,000 | LOAN AMOUNT |
| BETHANY SENIOR CITIZEN'S HOUSING INC | ||
| L | $106,242 | MANAGEMENT AGREEMENT (CONTRACT) |
| BETHANY VILLAGE PRIMARY CARE NETWORK INC | ||
| L | $237,570 | MANAGEMENT AGREEMENT |
| BETHANY RETIREMENT HOME INC | ||
| Q | $1,149,538 | SHARED SERVICE ALLOCATION |
| ORCHARD HOMES AT BETHANY VILLAGE INC | ||
| Q | $103,518 | SHARED SERVICE ALLOCATION |
| BETHANY RETIREMENT HOME INC | ||
| K | $232,254 | DIRECT FINANCE LEASE AGREEMENT |
| BETHANY RETIREMENT HOME INC | ||
| E | $694,082 | LOAN AMOUNT |
| ORCHARD HOMES AT BETHANY VILLAGE INC | ||
| S | $195,000 | REVIEW OF TRANSFERS |
Comments