PARK RIDGE NURSING HOME INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PARK RIDGE NURSING HOME INC (EIN 16-0978184)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201743189349307264
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-14T14:20:49-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161226221 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160978184 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARK RIDGE NURSING HOME INC | BusinessNameLine1Txt |
| Business Name Line2 | DBA PARK RIDGE LIVING CENTER | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PARK | BusinessNameControlTxt |
| Phone | 5859921032 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1555 LONG POND RD | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14626 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS R CRILLY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5859921032 | PhoneNum |
| Signature | 2017-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA M FRANCO | PreparerPersonNm |
| PTIN | P00589741 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Preparation | 2017-11-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 24.39.85.114 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-13 | IPDt |
| IP Tm | 20:10:10 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 517AEBE328CBAAA90E396C2FD1060AA56161F780 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 517AEBE328CBAAA90E396C2FD1060AA56161F780 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ERIC BIEBER MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1555 LONG POND RD | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14626 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,937,502 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ROCHESTERREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | AS AN AFFILIATE OF THE SYSTEM AND THE CENTER OF AGING AND CONTINUING CARE SERVICES, PARK RIDGE NURSING HOME (DBA PARK RIDGE LIVING CENTER) IS DEDICATED TO PROVIDING QUALITY CARE, INDEPENDENCE AND A POSITIVE LIVING EXPERIENCE FOR THE PATIENTS AND RESIDENTS IN OUR FACILITY. THE MISSION IS ACHIEVED THROUGH THE CORE VALUES OF THE SYSTEM WHICH INCLUDE PEOPLE, EXCELLENCE, LEARNING AND RESULTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 26 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 24 | VotingMembersIndependentCnt |
| Total Employee | 346 | TotalEmployeeCnt |
| Total Volunteers | 102 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,162,031 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,556,048 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,045,596 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,363,391 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,269 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,441 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,892 | PYOtherRevenueAmt |
| CY Other Revenue | $13,622 | CYOtherRevenueAmt |
| PY Total Revenue | $26,221,788 | PYTotalRevenueAmt |
| CY Total Revenue | $26,937,502 | 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 | $16,532,070 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,519,281 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,621,129 | PYOtherExpensesAmt |
| CY Other Expenses | $8,749,204 | CYOtherExpensesAmt |
| PY Total Expenses | $26,153,199 | PYTotalExpensesAmt |
| CY Total Expenses | $26,268,485 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $68,589 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $669,017 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,459,278 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,173,574 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,678,689 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $25,718,583 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,780,589 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,454,991 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS AN AFFILIATE OF THE SYSTEM AND THE CENTER OF AGING AND CONTINUING CARE SERVICES, PARK RIDGE NURSING HOME (DBA PARK RIDGE LIVING CENTER) IS DEDICATED TO PROVIDING QUALITY CARE, INDEPENDENCE AND A POSITIVE LIVING EXPERIENCE FOR THE PATIENTS AND RESIDENTS IN OUR FACILITY. THE MISSION IS ACHIEVED THROUGH THE CORE VALUES OF THE SYSTEM WHICH INCLUDE PEOPLE, EXCELLENCE, LEARNING AND RESULTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,510,786 | ExpenseAmt |
| Revenue | $16,454,258 | RevenueAmt |
| Desc | 120-BED NURSING FACILITY PROVIDING 43,208 PATIENT CARE DAYS. PARK RIDGE NURSING HOME PROVIDES A MODEL OF CARE FOR RESIDENTS WHERE THEY ARE ENCOURAGED TO MAKE THEIR OWN CHOICES AND PROVIDES A HOME ENVIRONMENT IN WHICH THEY WILL LIVE AND SHARE LIFE'S JOURNEY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,205,750 | ExpenseAmt |
| Revenue | $6,329,014 | RevenueAmt |
| Desc | CERTIFIED HOME HEALTH AGENCY PROVIDING 3,290 EPISODES OF CARE. THE PROGRAM PROVIDES SHORT-TERM, AT-HOME SERVICES AFTER A HOSPITAL STAY, SURGERY OR A NEW HEALTH DIAGNOSIS. SERVICES ARE CUSTOMIZED FOR EACH INDIVIDUAL AND RANGE FROM SKILLED MEDICAL CARE TO ASSISTANCE WITH HOUSEHOLD TASKS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,546,624 | ExpenseAmt |
| Revenue | $2,593,741 | RevenueAmt |
| Desc | THREE SOCIAL DAYCARES CENTERS PROVIDING 22,718 CLIENT CARE DAYS. AN ADULT DAY SERVICES PROGRAM WHICH PROVIDES A CARING, SUPPORTIVE AND THERAPEUTIC ENVIRONMENT FOR PEOPLE WHO NEED CARE OR SUPERVISION DURING DAY-TIME HOURS. AN EMERGENCY RESPONSE SYSTEM PROVIDING 640 CUSTOMERS. A MULTIPLE SCLEROSIS ACHIEVEMENT CENTER PROVIDING 4,492 CLIENT CARE DAYS. THIS PROGRAM SERVES MID-TO-LATE STAGE M.S. PATIENTS AS WELL AS INDIVIDUALS WITH OTHER NEUROLOGICAL DIAGNOSES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $22,263,160 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| 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 | 346 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 26 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 24 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | CHRIS PETERSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5859220089 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 KINGS HIGHWAY | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14617 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| LINDA BECKER | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ERIC BIEBER MD | |||||||||
| CEO | 1.00 | 54.00 | Yes (X) | $63,942 | $3,452,878 | $1,064,908 | Yes (X) | ||
| ROBERT DOBIES | |||||||||
| CHAIR OF THE BOARD | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL NUCCITELLI | |||||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FAHEEM MASOOD | |||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL MEYERS | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS PENN MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM DESTLER PHD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RACHEL ADONIS | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT S SANDS | |||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RALPH DESTEPHANO | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT HAVRILLA | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAGAT MEHTA MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH PATTON PHD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS RILEY | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NANCY FERRIS PHD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN GENIER MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TARUN KOTHARI MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANNA LYNCH | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LEONARD OLIVIERI | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| EFRAIN RIVERA | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LEON T SAWYKO | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JUSTIN SMITH | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN M GALLINA | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY C MAPSTONE | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS HOUSEKNECHT | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS R CRILLY | |||||||||
| CFO | 1.00 | 54.00 | Yes (X) | $18,412 | $994,204 | $427,250 | Yes (X) | ||
| MARK KLYCZEK | |||||||||
| VICE PRESIDENT, LTC | 20.00 | 35.00 | Yes (X) | $126,711 | $221,742 | $109,799 | Yes (X) | ||
| ROBERT NESSELBUSH | |||||||||
| COO | 0.00 | 55.00 | $0 | $1,608,627 | $676,261 | Yes (X) | |||
| HUGH THOMAS | |||||||||
| CAO | 1.00 | 54.00 | $22,380 | $1,208,560 | $512,645 | Yes (X) | |||
| AMANDA BROWN | |||||||||
| ADMINISTRATOR | 36.00 | 4.00 | $124,988 | $12,499 | $8,264 | Yes (X) | |||
| ELIZABETH LANDER | |||||||||
| COMMUNITY HEALTH NURSE | 40.00 | $106,574 | $0 | $19,896 | Yes (X) | ||||
| CAMILLA MINER | |||||||||
| DIRECTOR, CLINICAL SERVICES | 40.00 | $115,703 | $0 | $18,489 | Yes (X) | ||||
| PATTI MURPHY | |||||||||
| DIRECTOR OF NURSING | 40.00 | $103,459 | $0 | $18,303 | Yes (X) | ||||
| MARK CLEMENT | |||||||||
| FORMER CEO | 0.00 | $0 | $1,373,284 | $30,715 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $682,169 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,871,794 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,886,530 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NURSEFINDERS | |||||
| PO BOX 910738 | DALLAS | TX | 75391 | TEMPORARY STAFFING SERVICES | $303,012 |
| CORNERSTONE CENTRE LLC | |||||
| 460 WHITE SPRUCE BLVD | ROCHESTER | NY | 14623 | RENTAL | $133,155 |
| MEDICAL STAFFING NETWORK | |||||
| 6551 PARK OF COMMERCE BLVD | BOCA RATON | FL | 33487 | TEMPORARY STAFFING SERVICES | $116,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,492,968 | RelatedOrganizationsAmt |
| Government Grants | $63,080 | GovernmentGrantsAmt |
| Noncash Contributions | $22,968 | NoncashContributionsAmt |
| Total Contributions | $1,556,048 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT/RESIDENT SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $25,363,391 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,363,391 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,363,391 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,441 | TotalRevenueColumnAmt |
| Exclusion | $4,441 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,622 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,622 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,622 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,937,502 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,377,013 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,441 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,822 | TotalAmt |
| Program Services | $264,544 | ProgramServicesAmt |
| Management And General | $43,278 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,896,665 | TotalAmt |
| Program Services | $11,667,225 | ProgramServicesAmt |
| Management And General | $2,229,440 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $926,225 | TotalAmt |
| Program Services | $778,029 | ProgramServicesAmt |
| Management And General | $148,196 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,548,154 | TotalAmt |
| Program Services | $1,300,449 | ProgramServicesAmt |
| Management And General | $247,705 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $840,415 | TotalAmt |
| Program Services | $705,949 | ProgramServicesAmt |
| Management And General | $134,466 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,129,712 | TotalAmt |
| Program Services | $1,788,959 | ProgramServicesAmt |
| Management And General | $340,753 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,089 | TotalAmt |
| Management And General | $1,089 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,506 | TotalAmt |
| Program Services | $63,269 | ProgramServicesAmt |
| Management And General | $61,237 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,289 | TotalAmt |
| Program Services | $560,523 | ProgramServicesAmt |
| Management And General | $106,766 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,887 | TotalAmt |
| Program Services | $167,065 | ProgramServicesAmt |
| Management And General | $31,822 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $690,666 | TotalAmt |
| Program Services | $580,159 | ProgramServicesAmt |
| Management And General | $110,507 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,036,788 | TotalAmt |
| Program Services | $870,902 | ProgramServicesAmt |
| Management And General | $165,886 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL AND FOOD SUPPLI | $1,349,461 | $1,133,547 | $215,914 |
| NYS REVENUE & RECEIPTS | $821,676 | $821,676 | |
| ALLOWANCE FOR DOUBTFUL | $677,447 | $677,447 | |
| SERVICE CONTRACTS | $205,141 | $172,319 | $32,822 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $846,542 | TotalAmt |
| Program Services | $711,098 | ProgramServicesAmt |
| Management And General | $135,444 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,268,485 | TotalAmt |
| Program Services | $22,263,160 | ProgramServicesAmt |
| Management And General | $4,005,325 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,972 | BOYAmt |
| EOY | $2,863,996 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,580 | BOYAmt |
| EOY | $23,629 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,791 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,952,666 | BOYAmt |
| EOY | $2,981,437 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,056 | BOYAmt |
| EOY | $89,975 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,481 | BOYAmt |
| EOY | $14,457 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $25,866,135 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,444,312 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,280,141 | BOYAmt |
| EOY | $18,421,823 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,517,287 | BOYAmt |
| EOY | $1,521,032 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,621,304 | BOYAmt |
| EOY | $2,257,225 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,459,278 | BOYAmt |
| EOY | $28,173,574 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,245,065 | BOYAmt |
| EOY | $1,459,153 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$12,594 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,180,000 | BOYAmt |
| EOY | $16,206,486 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,851 | BOYAmt |
| EOY | $22,292 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,247,367 | BOYAmt |
| EOY | $8,030,652 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,678,689 | BOYAmt |
| EOY | $25,718,583 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,780,589 | BOYAmt |
| EOY | $2,413,903 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $26,129 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $14,959 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,780,589 | BOYAmt |
| EOY | $2,454,991 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,459,278 | BOYAmt |
| EOY | $28,173,574 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $669,017 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$6,788 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $12,173 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $2,210,432 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,999,549 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,647,132 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,162,031 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,556,048 | CurrentTaxYearAmt |
| Total | $11,575,192 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,166,079 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,079,143 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,367,663 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,045,596 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $25,363,391 | CurrentTaxYearAmt |
| Total | $115,021,872 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,376,511 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,078,692 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,014,795 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,207,627 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $26,919,439 | CurrentTaxYearAmt |
| Total | $126,597,064 | 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 | $126,597,064 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,277 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,262 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,265 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,269 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,441 | CurrentTaxYearAmt |
| Total | $13,514 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,277 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,262 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,265 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,269 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,441 | CurrentTaxYearAmt |
| Total | $13,514 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,371 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,890 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,394 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,892 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,622 | CurrentTaxYearAmt |
| Total | $30,169 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,380,159 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,082,844 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,018,454 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,221,788 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $26,937,502 | CurrentTaxYearAmt |
| Total | $126,640,747 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99970 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99970 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00010 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Beginning Balance | $18,851 | BeginningBalanceAmt |
| Additions During Year | $50,659 | AdditionsDuringYearAmt |
| Distributions During Year | $47,218 | DistributionsDuringYearAmt |
| Ending Balance | $22,292 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $130,417 | BeginningYearBalanceAmt |
| Contributions | $9,201 | ContributionsAmt |
| Investment Earnings Or Losses | $443 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $113,932 | GrantsOrScholarshipsAmt |
| End Year Balance | $26,129 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $123,358 | BeginningYearBalanceAmt |
| Contributions | $34,198 | ContributionsAmt |
| Investment Earnings Or Losses | $2,126 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $29,265 | GrantsOrScholarshipsAmt |
| End Year Balance | $130,417 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $165,880 | BeginningYearBalanceAmt |
| Contributions | $16,345 | ContributionsAmt |
| Investment Earnings Or Losses | $356 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $59,223 | GrantsOrScholarshipsAmt |
| End Year Balance | $123,358 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $216,788 | BeginningYearBalanceAmt |
| Contributions | $30,201 | ContributionsAmt |
| Investment Earnings Or Losses | $268 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $81,377 | GrantsOrScholarshipsAmt |
| End Year Balance | $165,880 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $440,300 | BeginningYearBalanceAmt |
| Contributions | $24,652 | ContributionsAmt |
| Investment Earnings Or Losses | $276 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $248,440 | GrantsOrScholarshipsAmt |
| End Year Balance | $216,788 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.36410 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.63590 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,736 | OtherCostOrOtherBasisAmt |
| Book Value | $4,736 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,841,021 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,880,826 | DepreciationAmt |
| Book Value | $16,960,195 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,391 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,312 | DepreciationAmt |
| Book Value | $31,079 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,973,339 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,551,174 | DepreciationAmt |
| Book Value | $1,422,165 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,648 | OtherCostOrOtherBasisAmt |
| Book Value | $3,648 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,421,823 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| THIRD PARTY SETTLEMENTS | $2,215,949 |
| DUE FROM UNITY HOSPITAL | $41,088 |
| OTHER RECEIVABLES | $188 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,257,225 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED PENSION | $5,890,248 |
| LIBOR INTEREST RATE SWAP VALUATION | $481,956 |
| DUE TO AFFILIATES | $354,501 |
| SELF INSURANCE | $274,947 |
| THIRD PARTY PAYABLE | $1,029,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,030,652 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $26,937,502 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,937,502 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $26,937,502 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $26,268,485 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $26,268,485 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $26,268,485 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | ENDOWMENT FUNDS HELD FOR INTENDED USE BY PARK RIDGE NURSING HOME, INC. ARE IN THE POSSESSION OF THE UNITY HEALTH SYSTEM FOUNDATION. WHEN THE TERMS OF THE ENDOWMENT ARE MET, THE FOUNDATION GRANTS THE FUNDS OVER TO PARK RIDGE NURSING HOME, INC. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ERIC BIEBER MD | ||||||||||||||
| CEO | $20,291 | $1,095,724 | $43,651 | $2,357,154 | $0 | $0 | $18,397 | $993,449 | $965 | $52,097 | $83,304 | $4,498,424 | $19,460 | $1,050,857 |
| THOMAS R CRILLY | ||||||||||||||
| CFO | $7,915 | $427,392 | $10,497 | $566,812 | $0 | $0 | $6,828 | $368,708 | $940 | $50,774 | $26,180 | $1,413,686 | $6,778 | $365,989 |
| MARK KLYCZEK | ||||||||||||||
| VICE PRESIDENT, LTC | $87,975 | $153,955 | $38,736 | $67,787 | $0 | $0 | $36,265 | $63,465 | $3,661 | $6,408 | $166,637 | $291,615 | $25,568 | $44,745 |
| ROBERT NESSELBUSH | ||||||||||||||
| COO | $0 | $747,958 | $0 | $860,669 | $0 | $0 | $0 | $624,284 | $0 | $51,977 | $0 | $2,284,888 | $0 | $556,513 |
| HUGH THOMAS | ||||||||||||||
| CAO | $9,950 | $537,324 | $12,430 | $671,236 | $0 | $0 | $8,479 | $457,869 | $842 | $45,455 | $31,701 | $1,711,884 | $8,040 | $434,181 |
| MARK CLEMENT | ||||||||||||||
| FORMER CEO | $0 | $0 | $0 | $0 | $0 | $1,373,284 | $0 | $26,618 | $0 | $4,097 | $0 | $1,403,999 | $0 | $1,373,284 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS INCLUDING: - ERIC BIEBER, M.D. (PRESIDENT & CEO) - THOMAS CRILLY (CFO) - MARK CLEMENT (CEO UNTIL 11/30/14) - HUGH THOMAS (CAO) - ROBERT NESSELBUSH (COO) USED THE FOLLOWING TO ESTABLISH THEIR COMPENSATION AND BENEFITS: - COMPENSATION COMMITTEE, - INDEPENDENT COMPENSATION CONSULTANT, - FORM 990 OF OTHER ORGANIZATIONS, - COMPENSATION SURVEYS AND STUDIES; - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE ORGANIZATION USES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE SALARIES FOR ALL EXECUTIVES TO ENSURE SUCH SALARIES ARE CONSISTENT WITH MARKET SALARIES PAID TO SIMILARLY SITUATED EXECUTIVES. IN ADDITION, A COMPENSATION COMMITTEE REVIEWS THIS INFORMATION ANNUALLY AND IT IS THEN APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. FINALLY, EXECUTIVES RECEIVE A WRITTEN LETTER OUTLINING THE SPECIFICS OF THE COMPENSATION AGREEMENT AND THEIR EXPECTED PERFORMANCE. |
| PART I, LINES 4A-B | SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS PROVIDE BENEFITS TO CERTAIN KEY EXECUTIVE EMPLOYEES OF PARK RIDGE NURSING HOME, INC. D/B/A PARK RIDGE LIVING CENTER. THE ORGANIZATION MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THERE WERE NO DISTRIBUTIONS PAID IN 2016. IN 2014 AND PRIOR YEARS, THE TOTAL COMPENSATION OF THE FORMER CEO'S WAS DISCLOSED AS A COMBINATION OF CASH PAID BY THE ORGANIZATION AND DEFERRED COMPENSATION. THE CASH PAYMENTS TO THE FORMER CEO'S SHOWN ON THE 2016 TAX RETURNS REPRESENTS PAYMENT OF COMPENSATION WHICH WAS RECOGNIZED IN PREVIOUS TAX RETURNS. THERE WAS NO INCREMENTAL EXPENSE RECOGNIZED BY THE ORGANIZATION IN 2016 FOR PAYMENTS MADE TO FORMER CEO'S. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VILLAGE OF EAST ROCHESTER HOUSING AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 161497561 | BondIssuerEIN |
| CUSIP | 274722DX2 | CUSIPNum |
| Bond Issued | 2008-12-11 | BondIssuedDt |
| Issue Price | $18,750,000 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,920,000 | RetiredAmt |
| Total Proceeds | $19,177,030 | TotalProceedsAmt |
| Capital Expenditures | $19,177,030 | CapitalExpendituresAmt |
| Substantial Completion | 2010 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN STANLEY CA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 10.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: | DATE THE REBATE COMPUTATION WAS PERFORMED: 12/01/2010 NOTE REGARDING THE REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. PART IV, LINE 4B - MORGAN STANLEY CAPITAL SERVICES, INC. |
| SCHEDULE K, PART I, LINE A(F), DESCRIPTION OF PURPOSE: | CONSTRUCTING AND EQUIPPING 23,280 SQUARE FOOT SINGLE STORY BUILING HOUSING 40 SHORT-STAY SKILLED NURSING FACILITY BEDS PROVIDING RESTORATIVE REHABILITION AND POST ACCUTE CARE AND RELATED DINING, ACTIVITY AND LIVING AREAS AND FOUR 11,000 SQUARE FOOT (APPROXIMATELY), SINGLE STORY RANCH-STYLE HOUSING 80 HEALTHCARE BEDS AND LIVING AREAS LOCATED ON APPROXIMATELY 5.5 ACRES OF LAND. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANNA LYNCH | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | DIRECTOR | RelationshipDescriptionTxt |
| Transaction | $235,588 | TransactionAmt |
| Transaction | ANNA LYNCH IS A MANAGING PARTNER AT UNDERBERG & KESSLER. UNDERBERG & KESSLER PROVIDES LEGAL SERVICES TO VARIOUS AFFILIATES OF THE HEALTH SYSTEM. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | EACH BOARD HAS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD PLUS THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND SUCH OTHER DIRECTORS AS THE CHAIR MAY NOMINATE FROM TIME TO TIME FOR APPOINTMENT BY A MAJORITY VOTE OF THE ENTIRE BOARD. BETWEEN MEETINGS OF THE BOARD, AND TO THE EXTENT PERMITTED BY LAW, THE EXECUTIVE COMMITTEE SHALL POSSESS THE POWERS OF THE BOARD WITH RESPECT TO MANAGING AND CONDUCTING THE AFFAIRS OF THE CORPORATION, EXCEPT AS OTHERWISE PROVIDED BY LAW OR WITHIN CERTAIN BY-LAWS. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | ROCHESTER REGIONAL HEALTH, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, INCLUDING AMENDMENT OF BYLAWS AND CHARTERS, REMOVAL OF MEMBERS OF THE GOVERNING BODY, AND THE DECISION TO DISSOLVE THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE. THIS REVIEW IS PERFORMED IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND OTHER RELEVANT INFORMATION FOR THE APPROPRIATE TIME PERIOD. |
| FORM 990, PART VI, SECTION B, LINE 12C | UPON EMPLOYMENT, ALL EMPLOYEES RECEIVE THE ETHICAL STANDARD OF CONDUCT BOOKLET FOR WHICH THEY SIGN A RECEIPT OF ACKNOWLEDGEMENT. CONFLICT OF INTEREST IS DEFINED, AS IS MANAGEMENT OF A CONFLICT OF INTEREST. EMPLOYEES ARE REQUIRED TO DISCLOSE AND SEEK RESOLUTION TO ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST BEFORE TAKING A POTENTIALLY IMPROPER ACTION AND THEREAFTER, ANNUALLY, EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM, PROVIDING MANAGEMENT WITH SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THAT MANAGEMENT CAN (1) DETERMINE WHETHER ANY ACTUAL OR PERCEIVED CONFLICT OF INTEREST EXISTS, AND (2) MONITOR WORK ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE OR OFFICER IN A POSITION WHERE THERE MAY BE A QUESTION AS TO HIS/HER OBJECTIVITY AS WELL AS TO AVOID ANY APPEARANCE OF IMPROPRIETY. THROUGHOUT THE YEAR, KEY EMPLOYEES AND OFFICERS OF THE ORGANIZATION ARE ALSO REQUIRED TO NOTIFY MANAGEMENT PROMPTLY IF ANY CHANGE TO THEIR DISCLOSURES OCCURS. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST. IN ADDITION, EACH MEMBER OF THE BOARD OF DIRECTORS MUST ALSO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, WHICH MUST BE SUBMITTED TO THE GENERAL COUNSEL. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S OFFICER AND KEY EMPLOYEE COMPENSATION ARRANGEMENTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. INFORMATION REVIEWED FOR THE OFFICER/KEY EMPLOYEE INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX EXEMPT ORGANIZATIONS IN THE WESTERN/CENTRAL NY COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM AT 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617 AND ADMINISTRATIVE OFFICES OF THE FILING ORGANIZATION. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. |
| FORM 990, PART XI, LINE 9: | PENSION ACTUARIAL VALUATION -83,049. FMV ADJUSTMENT ON DERIVATIVE INSTRUMENT 54,134. BENEFICIAL INTEREST IN FOUNDATION 41,088. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| FORM 5471 FILED ON BEHALF STATEMENT | STATEMENT PURSUANT TO TREAS REG SEC 1 6038-2(J)(3) THE FOLLOWING INFORMATION IS SUBMITTED WITH RESPECT TO PARK RIDGE NURSING HOME, INC. FORM 5471 (INFORMATION RETURN OF U S PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS) FILING REQUIREMENT FOR THE ENTITY BELOW NAME OF FOREIGN CORPORATION HEALTH CARE CASUALTY INSURANCE LIMITED BEGINNING TAX YEAR OF FOREIGN CORPORATION JANUARY 1, 2016 ENDING TAX YEAR OF FOREIGN CORPORATION DECEMBER 31, 2016 THE FORM 5471 FILING REQUIREMENT FOR THIS FOREIGN CORPORATION FOR CATEGORIES 4 AND 5 HAVE BEEN SATISFIED BY INCLUSION IN THE FOLLOWING US FILER'S TAX RETURN NAME OF US FILER UNITY HEALTH SYSTEM, INC. ADDRESS OF US FILER 1555 LONG POND ROAD ROCHESTER, NY 14626 EIN OR SSN 22-2572873 ENDING TAX YEAR OF US FILER DECEMBER 31, 2016 TYPE OF RETURN FILED 990 IRS CENTER WHERE RETURN FILED OGDEN, UTAH 84201-0027. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (34 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THE ROCHESTER GENERAL HOSPITAL | |||||||||||
| 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 160743134 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| GRHS FOUNDATION | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 223378111 | R/E INV MGMT | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| THE ROCHESTER GENERAL HOSPITAL FOUNDATION | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 222229425 | FUNDRAISING | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| DRIVING PARK AVENUE | NEWARK | NY | 14513 | 222963015 | FUNDRAISING | NY | 501(C)(3) | LINE 12A, I | NWCH | Yes (1) | |
| NEWARK WAYNE COMMUNITY HOSPITAL | |||||||||||
| DRIVING PARK AVENUE | NEWARK | NY | 14513 | 150584188 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| RGHS WORKERS' COMPENSATION TRUST | |||||||||||
| 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 166429300 | SEE PART VII | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| CONTINUING CARE NETWORK INC (CCN) | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 222963016 | SUPPORT RGH | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER GENERAL HUDSON HOUSING | |||||||||||
| 2066 HUDSON AVENUE | ROCHESTER | NY | 14621 | 223210351 | LOW INC HOUSING | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| VIA HEALTH HOME CARE I | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 161504370 | HOME HEALTH | NY | 501(C)(3) | LINE 10 | CCN | Yes (1) | |
| VIA HEALTH HOMECARE II | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 161538727 | HOME HEALTH | NY | 501(C)(3) | LINE 10 | CCN | Yes (1) | |
| INDEPENDENT LIVING FOR SENIORS | |||||||||||
| 2066 HUDSON AVENUE | ROCHESTER | NY | 14617 | 161491059 | ADULT DAY HC | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER GENERAL LONG TERM CARE | |||||||||||
| 1550 EMPIRE BLVD | WEBSTER | NY | 14580 | 223187140 | NH & REHAB | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| WESTERN NEW YORK MEDICAL PRACTICE PC | |||||||||||
| 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 611654232 | PHYS PRAC | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| THE UNITY HOSPITAL OF ROCHESTER | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 237221763 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| NORTH PARK NURSING HOME INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 223159644 | LONG TERM CARE FACILITY | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY HEALTH SYSTEM FOUNDATION | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 119627400 | FOUNDATION | NY | 501(C)(3) | LINE 7 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER GENERAL HEALTH SYSTEM | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 222551509 | SYSTEM SUPPORT | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARK RIDGE CHILD CARE CENTER INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 222918126 | CHILD DAY CARE SERVICES | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARK RIDGE HOUSING DEVELOPMENT FUND | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 222608311 | LOW INCOME HOUSING PROJECT FOR ELDERLY | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARK RIDGE HOUSING INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 222570457 | SENIOR APARTMENT COMPLEX | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARKWAY COMMONS HOUSING DEVELOPMENT | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 223130818 | LOW INCOME HOUSING FOR ELDERLY/HANDICAPPED | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| STBERNARD'S HOUSING DEVELOPMENT FU | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 161492955 | LOW INCOME HOUSING PROJECT | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY AGING SERVICES INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 841684195 | MANAGEMENT AND DEVELOPMENT CO | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY HOUSING DEVELOPMENT FUND CORP | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 300068596 | RECEIPT AND DISBURSEMENTS OF SUBSIDIES | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| WOODLAND VILLAGE INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 161588242 | SENIOR APARTMENT COMPLEX | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY AMBULATORY SURGERY CENTER INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 383871383 | OUTPATIENT SURGERY | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY HEALTH SYSTEM INC | |||||||||||
| 1555 LONG POND ROAD | ROCHESTER | NY | 14626 | 222572873 | SYSTEM SUPPORT | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER REGIONAL HEALTH | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 471234999 | SYSTEM PARENT | NY | 501(C)(3) | LINE 12A, I | Yes (1) | N/A | |
| UNITED MEMORIAL MEDICAL CENTER | |||||||||||
| 127 NORTH STREET | BOTAVIA | NY | 14020 | 160743029 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| HENRY FOSTER ASSOCIATES DBA CORPORATE CARE OF FINGER LAKES | |||||||||||
| 4 COULTER ROAD | CLIFTON SPRINGS | NY | 14432 | 161282294 | EMPLOYEE ASSISTANCE PROGRAMS | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| CLIFTON SPRINGS HOSPITAL AND CLINIC | |||||||||||
| 2 COULTER ROAD | CLIFTON SPRINGS | NY | 14432 | 160743966 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| BEHAVIORAL HEALTH NETWORK INC | |||||||||||
| 490 EAST RIDGE ROAD | ROCHESTER | NY | 14621 | 166069131 | MENTAL HEALTH | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PRCD INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 161311581 | SUBSTANCE ABUSE TREATMENT & REHAB. | NY | 501(C)(3) | LINE 7 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| CLIFTON SPRINGS HOSPITAL AND CLINIC FOUNDATION | |||||||||||
| 2 COULTER ROAD | CLIFTON SPRINGS | NY | 14432 | 161560033 | FUNDRAISING | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NW ASSOCIATES LP | ||||||||||||
| PO BOX 111 DRIVING PARK AVENUE | NEWARK | NY | 14513 | 141674119 | R/E LEASING | NY | NWCH | RELATED | 0 | 0 | 0.52570 | |
| PARMA SENIOR HOUSING | ||||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 432082116 | HILTON PROJ | NY | 0 | 0 | N/A | |||
| UNITY SENIOR HOUSING ASSOCIATES LP | ||||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 061709927 | MOORE PK | NY | 0 | 0 | N/A | |||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREATER ROCHESTER ASSURANCE COMPANY LTD | |||||||||||||||
| GEORGE TOWN | GRAND CAYMAN | CJ | INSURANCE | CJ | N/A | C | 1.00000 | 0 | |||||||
| GRACO RISK RETENTION GROUP INC | |||||||||||||||
| INSURANCE | C | 1.00000 | 0 | 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 710933967 | SC | RGH | |||||
| NWA INC | |||||||||||||||
| R/E LEASING | C | 1.00000 | 0 | DRIVING PARK AVENUE | NEWARK | NY | 14513 | 141667339 | NY | NWCH | |||||
| GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC | |||||||||||||||
| INDEPENDENT PRACTICE ASSOCIATION | N/A | C | 0.50000 | 0 | 100 KINGS HWY S SUITE 2500 | ROCHESTER | NY | 14617 | 161507171 | NY | |||||
| ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC | |||||||||||||||
| DIALYSIS | C | 1.00000 | 0 | 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 383912199 | NY | RGHS | |||||
| ACM MEDICAL LABORATORY INC | |||||||||||||||
| CLINICAL LAB | C | 0 | 160 ELMGROVE PARK | ROCHESTER | NY | 14624 | 161059691 | NY | PRH INC | ||||||
| PRH INC | |||||||||||||||
| MEDICAL LAB | C | 0 | 1555 LONG POND ROAD | ROCHESTER | NY | 14626 | 161329632 | NY | ROCHESTER REGIONAL HEALTH | ||||||
| GREATER ROCHESTER IMMEDIATE MEDICAL CARE PLLC DBA ROCHESTER IMMEDIATE CARE | |||||||||||||||
| URGENT CARE CENTERS | C | 1.00000 | 0 | 265 BROOKVIEW CENTRE WAY SUITE 400 | KNOXVILLE | TN | 37919 | 271453784 | TN | WESTERN NEW YORK MEDICAL PC | |||||
| ROCHESTER MEDICINE PLLC | |||||||||||||||
| OCCUPATIONAL MEDICINE | C | 1.00000 | 0 | 265 BROOKVIEW CENTRE WAY SUITE 400 | KNOXVILLE | TN | 37919 | 812625325 | TN | WESTERN NEW YORK MEDICAL PC | |||||
| PARMA SENIOR HOUSING LLC | |||||||||||||||
| SENIOR HOUSING | C | 0 | 1555 LONG POND ROAD | ROCHESTER | NY | 14626 | 810671687 | NY | ROCHESTER REGIONAL HEALTH | ||||||
| UNITY SENIOR HOUSING CORP | |||||||||||||||
| SENIOR HOUSING | C | 0 | 1555 LONG POND ROAD | ROCHESTER | NY | 14624 | 061709925 | NY | ROCHESTER REGIONAL HEALTH | ||||||
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| THE UNITY HOSPITAL OF ROCHESTER | ||
| L | $1,470,000 | FMV |
| ROCHESTER REGIONAL HEALTH SYSTEM | ||
| P | $391,865 | FMV |
| ROCHESTER GENERAL HOSPITAL | ||
| P | $1,663,773 | FMV |
| THE UNITY HOSPITAL OF ROCHESTER | ||
| P | $3,331,763 | FMV |
| INDEPENDENT LIVING FOR SENIORS | ||
| L | $349,490 | FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | RELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITY: RGHS WORKERS' COMPENSATION TRUST SUPPORTS THE ROCHESTER GENERAL HOSPITAL, NEWARK WAYNE COMMUNITY HOSPITAL, ROCHESTER GENERAL LONG TERM CARE, INDEPENDENT LIVING FOR SENIORS, VIAHEALTH HOMECARE I, VIAHEALTH HOMECARE II, BEHAVIORAL HEALTH NETWORK, INC, CLIFTON SPRINGS HOSPITAL & CLINIC AND UNITED MEMORIAL MEDICAL CENTER. | ExplanationTxt |