2017-08-08T08:34:58-05:00 2016-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2016-01-01 135596795 JOHN E ANDRUS MEMORIAL INC JOHN 9144783700 185 OLD BROADWAY HASTINGS ON HUDSON NY 10706 BETSY BIDDLE EXECUTIVE DIRECTOR 9144783700 2017-08-03 1 AARON SHAPIRO P01333816 2128674000 38.98.118.70 2017-08-07 13:00:20 ED P D7076C0EC39B17C3336BFEA465ABF20A32036F2A 73A2BDB4DEE3E1301F7FB9DCBA9193E2BC5F7900 2016 2021-01-29 14:40:06Z ANDRUS ON HUDSON BETSY BIDDLE 185 OLD BROADWAY HASTINGS ON HUDSON NY 10706 22099019 0 X WWW.ANDRUSONHUDSON.ORG X 1953 NY TO CREATE AND SUSTAIN A RESIDENTIAL CARE COMMUNITY WITH A STIMULATING AND SECURE ENVIRONMENT. 12 12 347 65 0 0 2362182 1229038 19787860 19962347 12968 25659 492774 830063 22655784 22047107 0 0 0 0 13808317 14363489 0 0 0 6375133 6407779 20183450 20771268 2472334 1275839 22726556 23861313 4981898 4834616 17744658 19026697 X SEE SCHEDULE O 0 0 18412090 19962347 ANDRUS ON HUDSON (AOH) IS A SKILLED NURSING FACILITY WHICH PROVIDES ROOM AND BOARD SERVICES TO RESIDENTS. AOH IS A NYS-LICENSED 197-BED FACILITY. REVENUES ARE DERIVED FROM PROVIDING HEALTH CARE SERVICES. A SIGNIFICANT PORTION OF THE FACILITY'S OPERATING REVENUES IS FUNDED THROUGH THE MEDICAID AND MEDICARE PROGRAMS, AS WELL AS SELF PAY INDIVIDUALS. THE NUMBER OF DAYS OF CARE PROVIDED DURING 2016 WAS 68,743. THE MAJORITY OF RESIDENTS COME FROM THE CITY OF YONKERS, NEW YORK. 18412090 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 47 0 347 1 0 0 0 0 0 0 0 0 0 0 X 12 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X NOVELLA KELLY 9144783700 185 OLD BROADWAY HASTINGS ON HUDSON NY 10706 MCCAIN MCMURAY PRESIDENT, CO-CHAIRMAN 4.00 X X 0 0 0 ELIZABETH SHOGREN VICE PRESIDENT, CO-CHAIRMAN 4.00 X X 0 0 0 ROBERT HEDLUND TREASURER 4.00 X X 0 0 0 ROBERT CADOUX BOARD DIRECTOR 4.00 X 0 0 0 DAVIS BENEDICT BOARD DIRECTOR 4.00 X 0 0 0 JOCELYN DOWNIE BOARD DIRECTOR 4.00 X 0 0 0 IRENE GUTHEIL BOARD DIRECTOR 4.00 X 0 0 0 COLEBERT ANDRUS BOARD DIRECTOR 4.00 X 0 0 0 ANDREW SHERMAN BOARD DIRECTOR 4.00 X 0 0 0 ALEXANDRA CARDON DURAN BOARD DIRECTOR 4.00 X 0 0 0 SUSAN COHN BOARD DIRECTOR 4.00 X 0 0 0 MARC DEVONGE BOARD DIRECTOR 4.00 X 0 0 0 BETSY BIDDLE EXECUTIVE DIRECTOR 37.50 X 225897 0 36405 NOVELLA KELLY DIRECTOR OF FINANCE 37.50 X 157071 0 8718 BARBARA FLEISCHER ADMINISTRATOR 37.50 X 165708 0 9594 SUSAN DEMPSEY DIRECTOR OF NURSING 37.50 X 125978 0 18351 RICHARD FELIPE DIRECTOR OF FACILITIES 37.50 X 110668 0 35651 785322 0 108719 5 0 1 0 AFFINITY REHABILITATION LLP 307 INTERNATIONAL CIRCLE ROAD SUIT COCKEYSVILLE MD 21030 THERAPY MANAGEMENT SERVICES 822797 JENNINGS CO 480 MAMARONECK AVENUE HARRISON NY 10528 BUILDING CONTRACTOR 434237 SWITCH INC 25 NORTH RIVERSIDE AVE CROTON ON HU NEW YORK NY 10520 ELECTRICAL CONTRACTOR 256602 PHARMSCRIPT LLC 150 PIERCE STREET SOMERSET NJ 08873 PHARMACY DRUGS AND SUPPLIES 224092 UNITEC VER-TECH ELEVATOR COMPANY PO BOX 33106 NEWARK NJ 071880130 ELEVATOR CONTRACTOR 185598 5 1229038 1229038 PATIENT SERVICE REVENUE 623990 19962347 19962347 19962347 25659 25659 389841 51912 337929 337929 337929 OTHER 900099 492134 492134 492134 22047107 19962347 0 855722 415886 375337 40549 10003694 9028334 975360 658927 594682 64245 2478504 2236850 241654 806478 727846 78632 87778 87778 42250 42250 1048 1048 1107398 882548 224850 4976 4976 1154400 804647 349753 689275 677222 12053 9963 1622 8341 149457 149457 1192694 1192694 227689 227689 NYS CASH RECEIPTS ASSMT 1086196 1086196 MEDICAL SUPPLIES 654655 654655 20771268 18412090 2359178 0 3351531 2076789 3442909 5283459 1522715 1756968 69996 60019 43012838 28522625 14151735 14490213 187670 193865 22726556 23861313 1655182 1625615 242896 259280 3053837 2949721 29983 0 4981898 4834616 X 16474152 18623891 867700 0 402806 402806 17744658 19026697 22726556 23861313 1275839 6200 0 X X 0 1 X 1 0 X 23831755 803479 1630142 2362182 1229038 29856596 15802096 18037187 18983873 19787860 19962347 92573363 39633851 18840666 20614015 22150042 21191385 122429959 0 0 0 122429959 399304 374971 373596 377516 415500 1940887 399304 374971 373596 377516 415500 1940887 178919 281616 277414 178458 492134 1408541 40212074 19497253 21265025 22706016 22099019 125779387 0.97340 0.96900 0.01540 0.01280 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUES INTEREST IN KIND RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 402806 7929 7929 402806 402806 7024 7024 402806 402806 6927 6927 402806 402806 6797 6797 402806 402806 6640 6640 402806 0 0 701675 701675 36703903 24114827 12589076 4744397 4272359 472038 862863 135439 727424 14490213 X 22104171 6200 51912 58112 22046059 1048 1048 22047107 20822132 51912 51912 20770220 1048 1048 20771268 PART IV, LINE 2B: RESIDENT FUNDS HELD IN TRUST ARE MAINTAINED IN BANK ACCOUNTS SEPARATE FROM JOHN E. ANDRUS MEMORIAL, INC.'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS' ACCOUNTS. PART V, LINE 4: THE ENDOWMENT CONSISTS OF A DONOR-RESTRICTED ENDOWMENT FUND ESTABLISHED FOR RESIDENT ACTIVITIES. THE OBJECTIVE OF THE ORGANIZATION IS TO MAINTAIN THE PRINCIPAL ENDOWMENT FUNDS AT THE ORIGINAL AMOUNT DESIGNATED BY THE DONOR AND TO EARN INCOME ON THE FUNDS. THE INVESTMENT POLICY TO ACHIEVE THIS OBJECTIVE IS TO INVEST IN LOW-RISK SECURITIES. INTEREST EARNED IN RELATION TO THE ENDOWMENT FUNDS IS RECORDED AS TEMPORARILY RESTRICTED INCOME AND RELEASED FROM RESTRICTION UPON EXPENDITURE FOR THE PROGRAM FOR WHICH THE ENDOWMENT FUND WAS ESTABLISHED. PART X, LINE 2: THE ORGANIZATION 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 XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 51,912. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 51,912. X X 0 0 0 0 0 0 0 1 0 BETSY BIDDLE EXECUTIVE DIRECTOR 190897 0 35000 0 0 0 14100 0 22305 0 262302 0 0 0 NOVELLA KELLY DIRECTOR OF FINANCE 157071 0 0 0 0 0 5914 0 2804 0 165789 0 0 0 BARBARA FLEISCHER ADMINISTRATOR 165708 0 0 0 0 0 0 0 9594 0 175302 0 0 0 PART I, LINE 7 A BONUS OF $35,000 WAS PAID TO THE EXECUTIVE DIRECTOR BASED ON PERFORMANCE. THIS WAS DETERMINED AND APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART III, LINE 1 ANDRUS ON HUDSON IS A NURTURING, FAMILY FOCUSED SENIOR CARE COMMUNITY FOSTERING DIGNITY, WELL BEING AND INDEPENDENCE FOR SENIORS. WE OFFER LONG TERM NURSING CARE, SHORT TERM REHABILITATION, PALLIATIVE CARE, HOSPICE AND RESPITE SERVICES IN OUR 197 BED NURSING HOME. ANDRUS ON HUDSON IS WESTCHESTER'S ONLY MEDICARE AND MEDICAID CERTIFIED SKILLED NURSING AND SHORT-TERM REHABILITATION RESOURCE OFFERING ALL PRIVATE ROOMS WITH BATH. WE RESPECT EACH RESIDENT'S INDIVIDUALITY AND RIGHT TO PRIVACY IN AN INVITING HOME-LIKE COMMUNITY WITH FEATURES AND AMENITIES SPECIFICALLY DESIGNED FOR SENIOR ADULTS. ANDRUS ON HUDSON GOES BEYOND PROVIDING MEDICAL AND PHYSICAL CARE WITH A VARIETY OF CULTURAL, EDUCATIONAL AND RECREATIONAL PROGRAMS AS WELL AS PET THERAPY, MUSIC THERAPY AND ART THERAPY. ANDRUS ON HUDSON HAS AN INCOMPARABLE INTERGENERATIONAL PROGRAM. LITTLE LEAF NURSERY SCHOOL, GREENBURGH NORTH CASTLE INTERNSHIP AND HUDSON LAB SCHOOL ALL HAVE CLASSROOMS IN OUR BUILDING. THESE CHILDREN, AGES 2 TO 19, INTERACT WITH OUR SENIORS THROUGH WORK, PLAY, ART, MUSIC, CONVERSATION AND LAUGHTER. SHARING THESE EXPERIENCES HELPS OUR SENIORS FEEL MORE VIBRANT. OUR SENIORS ALSO HAVE THE OPPORTUNITY TO INTERACT WITH OUR NEIGHBORS AS THEY ATTEND THEATER, CONCERTS, MOVIES, BINGO AND DANCE TOGETHER IN OUR AUDITORIUM. FORM 990, PART VI, SECTION A, LINE 2 MCCAIN MCMURRAY, COLBERT ANDRUS, DAVIS BENEDICT, ROBERT HEDLUND, ELIZABETH SHOGREN, AND JOCELYN DOWNIE ALL HAVE FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WAS REVIEWED BY THE EXECUTIVE DIRECTOR AND THE DIRECTOR OF FINANCE. THE COMPLETED IRS FORM 990 WAS E-MAILED TO ALL BOARD MEMBERS PRIOR TO BE BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBER AND ALL EMPLOYEES ARE INSTRUCTED, ON CONFLICT OF INTEREST POLICIES AND EACH RECEIVES A QUESTIONAIRE TO COMPLETE AND SIGN. ALL ISSUES ARE ADDRESSED AND RE-ADDRESSED AT THIS TIME. POSTERS AND NOTICES ARE PLACED IN THE FACILITY. IF A CONFLICT OF INTEREST EXISTS, THE AFFECTED MEMBER IS ASKED TO ABSTAIN FROM DECISION MAKING ON RELATED ISSUES. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE DIRECTOR'S COMPENSATION IS BASED ON A COMPENSATION STUDY AND WAS APPROVED BY THE BOARD IN JUNE 2015. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR