2017-11-21T13:30:58-06:00 2016-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2016-01-01 133623600 NORTHERN MANOR MULTICARE CENTER INC NORT 8456233904 199 NORTH MIDDLETOWN ROAD NANUET NY 10954 MORRIS KLEIN EXECUTIVE DIRECTOR 8456233904 2017-11-21 1 AARON SHAPIRO P01333816 2128674000 38.98.118.70 2017-11-21 10:58:40 ES 2633872017314034ae65 2017-11-10 P 225B73B148284D6C629F7CBF4AC09CDDFD7CF9F8 73A2BDB4DEE3E1301F7FB9DCBA9193E2BC5F7900 2016 2017-02-10 21:41:12Z X MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 29500870 0 X WWW.NORTHERNMANOR.COM X 1991 NY TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 8 8 422 25 0 0 0 0 28599051 29249047 1369 4399 8140 247424 28608560 29500870 435278 435278 0 0 17152759 17311377 0 0 0 11442965 11214139 29031002 28960794 -422442 540076 17140808 18541968 21047835 21908919 -3907027 -3366951 TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 0 0 23139196 28153387 HEALTH CARE SERVICES FOR THE ELDERLY. NORTHERN MANOR MULTICARE CENTER, INC. (NORTHERN MANOR) OPERATES A 231-BED SKILLED NURSING FACILITY IN NANUET, NEW YORK. 2347488 1095660 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. 435278 435278 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. 25921962 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 92 0 422 1 0 0 0 0 0 0 0 0 0 0 X 8 8 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 3250 0 LEON STEINMETZ BOARD MEMBER 0.10 0.90 X 0 4000 0 RABBI SIMON LAUBER 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 0 500 0 ABRAHAM ZACHARIASH BOARD MEMBER 0.10 0.90 X 0 0 0 RABBI HERSHEL HAGER BOARD MEMBER 0.10 0.90 X 0 0 0 ISRAEL ORZEL BOARD MEMBER 0.10 0.90 X 0 3000 0 MORRIS KLEIN EXECUTIVE DIRECTOR 6.00 29.00 X 116579 563462 172276 GEDALIA KLEIN CHIEF OPERATING OFFICER 3.00 14.50 X 22639 109423 23060 MICHAEL NOWICKI COMPLIANCE OFFICER 6.00 29.00 X 33392 161392 0 SHLOMO KATZ ADMINISTRATOR 35.00 X 253862 0 21396 LAURENCE KAMER MANAGER 35.00 X 102198 0 0 ANNETTE FEARON DIRECTOR OF NURSING 35.00 X 143493 0 11224 672163 848527 227956 4 0 1 0 TOWNE NURSING STAFF 1413 38TH STREET BROOKLYN NY 11218 MEDICAL/HEALTH SERVICES 1351753 CHEVRA LIADY NUSACH HOARY 1578 53RD STREET BROOKLYN NY 11219 ADMINISTRATIVE SERVICES 547215 CENTERS FOR CARE 4770 WHITE PLAINS ROAD BRONX NY 10470 CONSULTING SERVICES 435028 CFC AGENCY LLC 1601 BRONXDALE AVENUE BRONX NY 10462 ADMINISTRATIVE SERVICES 241642 ARI & SONS CATERING INC 904 KINGS HIGHWAY BROOKLYN NY 11223 FOOD SERVICES 159421 6 RESIDENT SERVICE REVENUE 623000 28153387 28153387 ADULT DAY CARE 623000 1095660 1095660 29249047 4399 4399 MISCELLANEOUS 900099 247424 247424 247424 29500870 29249047 0 251823 435278 435278 481354 262844 218510 12823864 11438243 1385621 825677 759169 66508 2154585 1955941 198644 1025897 916608 109289 1168027 1043597 124430 132468 132468 41500 41500 1311789 1172432 139357 59074 6125 52949 2094000 1866753 227247 1146156 1024056 122100 698019 623659 74360 334452 298823 35629 842401 752660 89741 192240 171761 20479 NYS ASSESSMENT 1139100 1139100 MEDICAL SUPPLIES 1058452 1058452 FOOD 996461 996461 28960794 25921962 3038832 0 351399 381450 747906 509193 7092258 7595261 437763 1387427 24860579 16287670 8152798 8572909 47712 44649 310972 51079 17140808 18541968 4001179 3952701 4135000 2755147 234602 296337 5811087 5788548 43478 6865967 9072708 21047835 21908919 X -3907027 -3366951 -3907027 -3366951 17140808 18541968 540076 0 X X 0 1 X 1 0 X 5477669 177541 131129 5786339 36380660 35037654 31946040 28599051 29249047 161212452 41858329 35215195 32077169 28599051 29249047 166998791 0 0 0 166998791 1173 8679 5218 1369 4399 20838 1173 8679 5218 1369 4399 20838 90729 8140 247424 346293 41859502 35223874 32173116 28608560 29500870 167365922 0.99780 0.99890 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME 0 1 X 790000 790000 18539992 11721318 6818674 618165 534386 83779 4270400 3861794 408606 642022 170172 471850 8572909 DUE TO RELATED PARTIES 9072708 9072708 X 29500870 0 29500870 0 29500870 28525516 0 28525516 435278 435278 28960794 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, 2013 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS TO RELATED ENTITY 435,278. 1 CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501(C) (3) 435278 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 105162 508280 0 0 11417 55182 24009 116043 5524 26700 146112 706205 0 0 GEDALIA KLEIN CHIEF OPERATING OFFICER 21405 103457 0 0 1234 5966 0 0 3953 19107 26592 128530 0 0 MICHAEL NOWICKI COMPLIANCE OFFICER 32296 156096 0 0 1096 5296 0 0 0 0 33392 161392 0 0 SHLOMO KATZ ADMINISTRATOR 253862 0 0 0 0 0 0 0 21396 0 275258 0 0 0 ANNETTE FEARON DIRECTOR OF NURSING 143493 0 0 0 0 0 0 0 11224 0 154717 0 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. 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. FORM 990, PAGE ONE, BOX B, AMENDED RETURN: THE DECEMBER 31, 2016 FORM 990 WAS AMENDED DUE TO AN ADDITION TO PART VII, SECTION B. 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