2018-11-06T17:17:14-06:00 2017-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2017-01-01 112388200 COBBLE HILL HEALTH CENTER INC COBB 7188556789 380 HENRY STREET BROOKLYN NY 11201 ANTHONY LEWIS PRESIDENT/CEO 7188556789 2018-11-06 1 AARON SHAPIRO P01333816 2128674000 64.22.227.161 2018-11-06 14:00:39 ES P 4275C7E7C8129915C35F764424C97B97C01C68F2 82FF71277CCFCE0526AA11C39E3CDADE20CEB2CB 2017 2019-02-21 02:37:17Z ANTHONY LEWIS 380 HENRY STREET BROOKLYN NY 11201 48068603 0 X WWW.COBBLEHILL.ORG X 1977 NY TO MAINTAIN A NURSING FACILITY AND PROVIDE ADULT DAY CARE AND LONG TERM HOME HEALTH SERVICES ON AN OUTPATIENT BASIS. 9 9 520 236 0 0 172497 245442 47446683 45818622 266797 418488 -113101 81841 47772876 46564393 32569 1200000 0 0 29406844 29015841 0 0 0 18777003 19415812 48216416 49631653 -443540 -3067260 92424849 90684311 48354848 47318526 44070001 43365785 X COBBLE HILL HEALTH CENTER, INC. (CENTER)OPERATES A 364 BED NURSING FACILITY. THE CENTER PROVIDES NURSING CARE TO PATIENTS AND IS LICENSED TO PROVIDE ADULT DAY CARE SERVICES. IN ADDITION, THE CENTER PROVIDES A LONG-TERM HOME HEALTH CARE PROGRAM. 0 0 42632511 1200000 43473422 SEE SCHEDULE O.THE CENTER HAS BEEN PROVIDING RESIDENTIAL AND COMMUNITY BASED SERVICES TO THE DISABLED AND ELDERLY FOR OVER 30 YEARS. THE CENTER OFFERS A COMPLETE RANGE OF MEDICAL, NURSING AND REHABILITATION SERVICES. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:>SUBACUTE CARE MEDICAL CARE, THE GOAL OF WHICH IS TO ENSURE A QUICK AND COMPLETE RECOVERY THEREBY RESTORING OUR RESIDENTS INDEPENDENCE AND HELP THEM RETURN TO COMMUNITY LIVING; >LONG TERM CARE, WHICH OFFERS A HOME-LIKE ALTERNATIVE THAT PROVIDES EACH INDIVIDUAL WITH HIS OR HER SPECIFIC NEEDS, BE IT PHYSICAL, PSYCHOLOGICAL OR EMOTIONAL, IN AN OPTIMUM ENVIRONMENT ENSURING THAT QUALITY OF LIFE IS MAINTAINED;>REHABILITATION, WHOSE GOAL IS TO RESTORE RESIDENTS FUNCTION AND THE ABILITIES THEY HAD PRIOR TO THE ONSET OF ILLNESS, INJURY OR TRAUMA; >A DIALYSIS CENTER, WHERE TREATMENT IS CONVENIENT BECAUSE IT IS ADMINISTERED ON-SITE AND PROVIDES MINIMAL DISRUPTION OF THEIR REGULAR SCHEDULES AND LIVES; >ALZHEIMERS SPECIAL CARE, WHICH, FOR OVER A DECADE, HAS LED THE WAY IN CARING FOR INDIVIDUALS WITH ALZHEIMERS DISEASE. THROUGH PROGRAM DEVELOPMENT, RESEARCH AND TRAINING,OUR ALZHEIMERS UNIT HAS RECEIVED THE BEST PRACTICES AWARD.THE CENTER PROVIDED 125,144 DAYS OF SKILLED NURSING CARE IN 2017. 2027316 2345200 THE CENTER, THOUGH ITS WHOLLY OWNED SUBSIDIARY COBBLE HILL LIFECARE PLUS, LLC (CHLCP), PROVIDES CARE MANAGEMENT SERVICES TO AETNA BETTER HEALTH MEDICAID MANAGED LONG TERM CARE PLAN (MLTC). A STAFF OF APPROXIMATELY THIRTY MULTILINGUAL NURSES, SOCIAL WORKERS AND CLERICAL SUPPORT STAFF PROVIDE TELEPHONIC CARE MANAGEMENT TO APPROXIMATELY 11,000 AETNA MEMBERS IN BROOKLYN, MANHATTAN AND QUEENS IN 2017. 44659827 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 57 0 520 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NY X NEIL SCHLISSEL 7188556789 380 HENRY STREET BROOKLYN NY 11201 THOMAS SPATH CHAIR 1.00 1.25 X X 0 0 0 PAUL SAYEGH TREASURER 1.00 1.25 X X 0 0 0 W RUDY KAMUF SECRETARY 1.00 1.75 X X 0 0 0 CHARLIE CARAMES BOARD MEMBER 1.00 0.25 X 0 0 0 GREG O'CONNELL BOARD MEMBER 1.00 0.25 X 0 0 0 LEONARD T JORDAN BOARD MEMBER 1.00 0.25 X 0 0 0 JOAN MILLMAN BOARD MEMBER 1.00 0.25 X 0 0 0 PETER D YATRAKIS BOARD MEMBER 1.00 0.25 X 0 0 0 OLGA LIPSCHITZ BOARD MEMBER 1.00 0.25 X 0 0 0 ANTHONY LEWIS PRESIDENT / CEO 30.00 8.00 X 306713 34079 52981 DANIEL TUCHMAN ADMINISTRATOR / COO 30.00 8.00 X 298557 110235 61863 ALAN GROSS CFO UNTIL 8/2017 30.00 6.00 X 345775 97526 52981 NEIL SCHLISSEL CFO FROM 9/2017 30.00 6.00 X 129265 50272 39698 RAISA FORKOSH ADMISSIONS DIRECTOR 35.00 X 155239 0 40895 SOMMER ESPINO DIRECTOR OF NURSING 35.00 X 284441 0 52783 MENUCHA ACKERMAN MDS DIRECTOR 35.00 X 201067 0 25851 MAMERTO ALVAREZ MAINTENANCE SUPERVISOR 35.00 X 157451 0 41002 VIRGINIA COHEN CHLCP DIRECTOR 35.00 X 120852 0 13492 PAT SLINGER-HARVEY DIR. OF FOOD & NUTRITION 35.00 X 140356 0 29759 LYDIA CELLA ASSOCIATE DIRECTOR OF NURSING 35.00 X 133791 0 24022 ROBERT HEREL DIRECTOR OF SOCIAL WORK 35.00 X 128671 0 37460 2402178 292112 472787 23 0 1 0 THERADYNAMICS REHAB 225 CROSSWAYS PARK DRIVE WOODBURY NY 11797 NURSING AGENCY 1816178 WHITE GLOVE PLACEMENT 85 BARTLETT STREET BROOKLYN NY 11206 NURSING AGENCY 621824 UNITEX TEXTILE 401 SO MACQUESTEN PKWY MT VERNON NY 10550 LAUNDRY AGENCY 432033 LOEB AND TROPER 655 THIRD AVENUE NEW YORK NY 10017 ACCOUNTING SERVICES 155975 UNIVERSAL MEDICAL RECORDS 22 THE CROSS ROAD COARTLANT MANOR NY 10567 NURSING AGENCY 135878 12 235000 10442 245442 SKILLED NURSING FACILITY 623000 43473422 43473422 CASE MANAGEMENT 624100 2345200 2345200 45818622 382605 382605 40000 74011 -34011 -34011 -34011 1466082 1430199 35883 35883 35883 PURCHASE DISCOUNT 900099 87314 87314 MEDICAL RECORDS 900099 14248 14248 PARKING INCOME 900099 3644 3644 10646 10646 115852 46564393 45818622 0 500329 1200000 1200000 2013169 2013169 19316346 18105740 1210606 1713590 1619129 94461 4135710 3936163 199547 1837026 1744690 92336 133300 133300 332373 332373 168806 168806 6334 6334 74809 74809 3184985 3173548 11437 81405 79612 1793 4480717 4253201 227516 240923 228813 12110 4107528 3897348 210180 15687 14899 788 2650422 2517202 133220 966864 918266 48598 CASH RECEIPTS ASSESSMEN 2962869 2962869 8790 8347 443 49631653 44659827 4971826 0 5344527 7847541 2584252 5139968 9772821 8303512 50332 45328 111651 455075 81296783 31807287 51421162 49489496 12389767 16966046 10750337 2437345 92424849 90684311 4043787 4344814 33337189 32434535 342151 322730 10631721 10216447 48354848 47318526 X 43969583 43168463 100418 197322 44070001 43365785 92424849 90684311 X -3067260 1813357 549687 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 6334 6334 0 PART II-B, LINE 1: THE $6,334 IS AN ALLOCATION OF TRADE ASSOCIATION DUES FOR LOBBYING EXPENSES. 0 1 X 237000 237000 73992657 26237595 47755062 4737178 3399776 1337402 2329948 2169916 160032 49489496 ESTIMATED AMOUNTS DUE TO THIRD PARTIES 167082 SWAP AGREEMENTS 10049365 10216447 X 48376952 1813357 74011 1887368 46489584 74809 74809 46564393 49630855 74011 74011 49556844 74809 74809 49631653 PART IV, LINE 2B: RESIDENT PERSONAL FUNDS ARE MAINTAINED IN BANK ACCOUNTS SEPARATE FROM THE CENTER'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS' ACCOUNTS. PART X, LINE 2: THE CENTER 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 XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 74,011. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 74,011. 1 COBBLE HILL FOUNDATION 380 HENRY STREET BROOKLYN NY 11201 113122301 501(C)(3) 1200000 HEALTH CARE 1 0 PART I, LINE 2: THE GRANTS ARE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO THE FUNDS BEING TRANSFERRED. THE APPROVAL IS BASED ON DOCUMENTS SUBMITTED BY THE GRANTEES IN REQUEST OF THE GRANTS. MANAGEMENT PERFORMS A SUBSEQUENT REVIEW TO ENSURE THE FUNDS WERE USED AS INTENDED. THIS INCLUDES REVIEW OF REPORTS OF THE USE OF THE FUNDS SUBMITTED BY THE GRANTEES. X X X 0 0 0 0 0 0 0 1 0 ANTHONY LEWIS PRESIDENT / CEO 294038 32860 10972 1219 1703 0 28156 3128 19527 2170 354396 39377 0 0 DANIEL TUCHMAN ADMINISTRATOR / COO 237508 87750 10950 4050 50099 18435 22837 8447 22323 8256 343717 126938 0 0 ALAN GROSS CFO UNTIL 8/2017 174869 50092 11700 3300 159206 44134 24402 6883 16923 4773 387100 109182 0 0 NEIL SCHLISSEL CFO FROM 9/2017 127431 49829 1137 443 697 0 6701 2606 21882 8509 157848 61387 0 0 RAISA FORKOSH ADMISSIONS DIRECTOR 136605 0 10000 0 8634 0 17078 0 23817 0 196134 0 0 0 SOMMER ESPINO DIRECTOR OF NURSING 168426 0 10000 0 106015 0 22945 0 29838 0 337224 0 0 0 MENUCHA ACKERMAN MDS DIRECTOR 133781 0 3000 0 64286 0 1883 0 23968 0 226918 0 0 0 MAMERTO ALVAREZ MAINTENANCE SUPERVISOR 131142 0 10000 0 16309 0 17180 0 23822 0 198453 0 0 0 PAT SLINGER-HARVEY DIR. OF FOOD & NUTRITION 125413 0 1000 0 13943 0 14988 0 14771 0 170115 0 0 0 LYDIA CELLA ASSOCIATE DIRECTOR OF NURSING 116105 0 1000 0 16686 0 13871 0 10151 0 157813 0 0 0 ROBERT HEREL DIRECTOR OF SOCIAL WORK 124951 0 2000 0 1720 0 13650 0 23810 0 166131 0 0 0 PART I, LINE 7 THE BOARD APPROVES MERIT BASED BONUSES FOR ITS OFFICERS AND TOP EMPLOYEES FOR THEIR DEDICATION TO THE CENTER DURING THE YEAR. THESE BONUSES ARE APPROVED TOWARDS THE END OF THE YEAR. A NYC CAPITAL RESOURCE CORP 204099098 649437AEO 2008-01-30 35920000 RENOVATION 0 0 0 B NYC CAPITAL RESOURCE CORP 204099098 649437AF7 2008-01-30 4420000 REFINANCING 1 0 0 C NYC CAPITAL RESOURCE CORP 204099098 649437AG5 2008-01-30 7850000 CONSTRUCTION 0 0 0 A 35920000 12137676 1331784 22448875 2011 1 0 0 1 B 4420000 4261307 158691 2008 1 0 0 1 C 7850000 286416 7438143 2009 1 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 B 0 0 0 0 1 0 0 0 0 C 0 0 0 0 1 0 0 0 0 A 0 B 0 C 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO AND PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. ANY QUESTIONS THAT ARISE ARE DISCUSSED AND RESOLVED PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CENTER REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICT. THIS INFORMATION IS REVIEWED BY THE AUDIT AND CORPORATE COMPLIANCE COMMITTEES. THE AUDIT COMMITTEE IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST WHICH OCCUR, AND WILL ENSURE SUCH INDIVIDUALS DO NOT PARTICIPATE IN DISCUSSIONS OR DECISIONS INVOLVING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY A RECOMMENDATION BY THE PRESIDENT/CEO AND APPROVAL OF THE BOARD. THE PRESIDENT/CEO'S COMPENSATION IS DETERMINED BY THE GOVERNING BOARD. THIS PROCESS WAS LAST DONE IN 2016. THE PROCESS INCLUDES A BOARD REVIEW OF COMPENSATION OF SIMILAR POSITIONS AT OTHER HEALTH CARE FACILITIES OBTAINED FROM IRS FORM 990S FILED ON GUIDESTAR OR CANVASSING OF THOSE FACILITES. FORM 990, PART VI, SECTION C, LINE 19 THE CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SWAP AGREEMENT 549,687. FORM 990, PART XII, QUESTION 12C: THE PROCESS DID NOT CHANGE FROM PRIOR YEAR COBBLE HILL LIFECARE PLUS LLC 380 HENRY STREET BROOKLYN NY 11201 461226428 PROVIDES CARE MANAGEMENT SERVICES FOR THE ELDERLY LIVING AT HOME NY 2345200 COBBLE HILL HEALTH CENTER INC COBBLE HILL FOUNDATION INC 380 HENRY STREET BROOKLYN NY 11201 113122301 FUNDRAISING NY 501(C)(3) PF N/A 0 YOUR CHOICE AT HOME INC 380 HENRY STREET BROOKLYN NY 11201 461256502 HOME HEALTH CARE NY 501(C)(3) LINE 10 N/A 0 COBBLE HILL LIFECARE INC 380 HENRY STREET BROOKLYN NY 11201 461388106 SUPPORTING ORGANIZATION NY 501(C)(3) LINE 12C, III-FI N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0