2017-11-14T12:57:13-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 300 CROWN COLONY DRIVE SUITE 310 QUINCY MA 02169 990 2016-01-01 112167809 OZANAM HALL OF QUEENS NURSING HOME INC OZAN 7182247598 42-41 201ST STREET BAYSIDE NY 11361 SR MARY ROSE HEERY CHAIRPERSON 7182247598 2017-11-14 1 JUDY DALEY P01294075 6179848100 2017-11-14 67.137.57.251 2017-11-14 12:05:14 ES P 499B49BEE9E95068E93680D69C996EB6A62D8814 BDBF5572340FAAE6A27F900DDE1A70A54F7FF7ED 2016 2021-01-29 14:40:06Z SR M JOSEPH CATHERINE R 42-41 201ST STREET BAYSIDE NY 11361 63718623 0 0928 X WWW.OZANAMHALL.ORG X 1969 NY OZANAM HALL OF QUEENS NURSING HOME, INC. MISSION IS TO PROVIDE HOLISTIC CARE TO THE AGED AND INFIRM IN AN ATMOSPHERE OF CHRISTIAN UNDERSTANDING AND FAITH. WE HOLD IN REVERENTIAL ESTEEM THE SANCTITY OF LIFE ALTHOUGH MENTAL AND/OR PHYSICAL LIMITATIONS MAY EXIST, THE LIFE OF EVERY HUMAN BEING IS CONSIDERED SACRED. EACH ONE HAS, THEREFORE A MORAL RESPONSIBILITY TO RESPECT AND PROTECT THAT BASIC RIGHT TO LIFE. 14 13 697 220 0 0 93592 707785 53448539 52139872 323237 230403 412540 249447 54277908 53327507 0 0 0 0 38336431 37066572 0 0 0 18037821 18282899 56374252 55349471 -2096344 -2021964 85209814 81177100 37414405 35323236 47795409 45853864 X OZANAM HALL OF QUEENS NURSING HOME, INC. MISSION IS TO PROVIDE HOLISTIC CARE TO THE AGED AND INFIRM IN AN ATMOSPHERE OF CHRISTIAN UNDERSTANDING AND FAITH. WE HOLD IN REVERENTIAL ESTEEM THE SANCTITY OF LIFE ALTHOUGH MENTAL AND/OR PHYSICAL LIMITATIONS MAY EXIST, THE LIFE OF EVERY HUMAN BEING IS CONSIDERED SACRED. EACH ONE HAS, THEREFORE A MORAL RESPONSIBILITY TO RESPECT AND PROTECT THAT BASIC RIGHT TO LIFE. 0 0 47093686 52432563 OZANAM HALL IS A 432-BED SKILLED NURSING FACILITY THAT PROVIDED 138,958 NURSING DAYS TO VARIOUS RESIDENTS AS FOLLOWS, 21,148 MEDICARE DAYS, 99,129 MEDICAID DAYS, 18,591 PRIVATE DAYS, AND 90 OTHER PROVIDER DAYS. THE REHAB CENTER REHABILITATED AND RETURNED 462 RESIDENTS TO THE COMMUNITY. OUR "LOVE MADE VISIBLE" INITIATIVE IMPACTED 225 ALZHEIMER'S RESIDENTS. THE INITIATIVE EXTENDS TO WEEKENDS. OUR ANNUAL "MEMORY SCREENING" ALZHEIMER MEMORIAL CANDLE LIGHTING CEREMONY AND "BLOOD DRIVE" CONTINUES. WE CONTINUE TO PROVIDE DEMENTIA TRAINING TO THE PUBLIC. OZANAM HALL ALSO PARTICIPATES IN THE AMERICAN CANCER SOCIETY'S MAKING STRIDES AGAINST BREAST CANCER FUNDRAISER. 47093686 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 76 0 1 697 1 0 0 0 0 0 1 1 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 0 NY X X HARRY C ITOKA 7184232000 42-41 201ST STREET BAYSIDE NY 11361 REV MSGR AUSTIN F BENNETT CHAIRMAN 0.50 0.00 X X 0 0 0 SR MARY ROSE HEERY PRESIDENT 0.50 0.00 X X 0 0 0 REV ROBERT J WHELAN VICE PRESIDENT 0.50 0.00 X X 0 0 0 REV MSGR ALFRED P LOPINTO TREASURER 0.50 0.00 X X 0 0 0 SR JOSEPH CATHERINE RAYMOND CEO & SECRETARY 37.50 0.00 X X 0 0 0 JOAN MARREN MEMBER 0.50 0.00 X 0 0 0 KEITH M POWERS MEMBER 0.50 0.00 X 0 0 0 LESLEE A DEVLIN MEMBER 0.50 0.00 X 0 0 0 MARY P GIORDANO ESQ MEMBER 0.50 0.00 X 0 0 0 SR BERNADETTE THERESE REILLY MEMBER 0.50 0.00 X 0 0 0 SR M KEVIN PATRICIA MEMBER 0.50 0.00 X 0 0 0 SR M SEAN WILLIAM O'BRIEN MEMBER 0.50 0.00 X 0 0 0 SR MAUREEN MURRAY MEMBER 0.50 0.00 X 0 0 0 SR PHILIP ANN MEMBER 0.50 0.00 X 0 0 0 JAMES M KONIARSKI CPA CFO 37.50 0.00 X 165287 0 48428 MARGARET WHITE DIRECTOR OF REHABILITATION 37.50 0.00 X 138289 0 48428 HARRY ITOKA CONTROLLER 37.50 0.00 X 130120 0 36319 MADELENE SUPRENA RN 37.50 0.00 X 136859 0 42715 CLAUDIA WATSON DIRECTOR OF NURSING 37.50 0.00 X 114915 0 19480 685470 0 195370 5 0 1 0 BOND SCHOENECK & KING PLLC 22 CORPORATE WOODS BOULEVARD STE 5 ALBANY NY 12211 LEGAL 319740 CLIFTON BUDD & DEMARIA 350 FIFTH AVENUE 61ST FLR NEW YORK NY 10118 LEGAL 259480 TR PHYSICAL OCCUPATIONAL SERVICE 36-36 33RD STREET LONG ISLAND NY 11106 STAFFING SERVICES 192136 HORIZON HEALTHCARE STAFFING 20 JERUSALEM AVENUE HICKSVILLE NY 11801 STAFFING SERVICES 162365 EMERGE TECHNOLOGIES INC 44 P JEFRYN BOULEVARD WEST DEER PARK NY 11729 TECHNOLOGIES 119170 5 382709 325076 707785 NET RESIDENT SERVICES REVENUE 623000 52139872 52139872 52139872 22629 22629 28380 0 28380 28380 28380 10498462 10290688 207774 207774 207774 28804 382709 100428 -71624 -71624 OTHER OPERATING INCOME 900099 292691 292691 292691 53327507 52432563 0 187159 213715 213715 23847416 16759403 7088013 1381269 1284886 96383 9895237 9170336 724901 1728935 1596162 132773 499298 499298 189620 189620 1388677 1388677 19882 19882 496140 496140 1396428 1396428 2027 2027 19161 19161 1759569 1759569 4111915 4111915 570613 570613 SUPPLIES 2605417 2605417 BED TAX/ASSESSMENT 2527796 2527796 FOOD 1313416 1313416 BAD DEBT 751454 751454 631486 631486 55349471 47093686 8255785 0 1062315 1458300 3547906 7865847 6313183 6961469 278813 399428 93869404 47471230 50132908 46398174 7532166 4040720 16342523 14053162 85209814 81177100 3143599 3296171 32044 438412 1219716 994501 31951174 29323879 1067872 1270273 37414405 35323236 X 47290495 45025277 504914 828587 47795409 45853864 85209814 81177100 -2021964 80419 0 X X 0 1 X 1 0 X 294813 217538 578539 93592 707785 1892267 51081690 49869262 51995434 53616486 52168676 258731548 51376503 50086800 52573973 53710078 52876461 260623815 0 0 0 260623815 39790 72566 100588 109197 51009 373150 30614 29444 79497 139555 70404 102010 180085 109197 51009 512705 653086 716186 693335 315827 292691 2671125 52099993 50904996 53447393 54135102 53220161 263807645 0.98790 0.98700 0.00190 0.00210 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1092991 1092991 81753149 39544039 42209110 11023264 7927191 3096073 46398174 OTHER ASSETS 654467 DEPOSITS 2000000 DUE FROM THIRD PARTY PAYORS 9460747 UNIVERSAL SETTLEMENT RECEIVABLE 1937948 14053162 OTHER CURRENT LIABILITIES 633377 DUE TO THIRD PARTY PAYORS 582611 DUE TO RELATED PARTY 54285 1270273 X 53327507 0 53327507 0 53327507 55349471 0 55349471 0 55349471 PART IV, LINE 2B: RESIDENTS' FUNDS ARE HELD BY THE HOME ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT LIVING ALLOWANCES RECEIVED BY RESIDENTS AND OTHER RESIDENTS' FUNDS DEPOSITED WITH THE HOME FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE HOME AT THE REQUEST OF, OR ON BEHALF OF, RESIDENTS FOR THEIR PERSONAL USE. PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE 2013 THROUGH 2016 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. GOLF OUTING 28804 0 28804 100428 3 382709 382709 411513 382709 28804 100428 100428 -71624 X X X X X 0 0 0 0 0 0 0 0 0 JAMES M KONIARSKI CPA CFO 165287 0 0 0 0 0 10500 0 37928 0 213715 0 0 0 MARGARET WHITE DIRECTOR OF REHABILITATION 138289 0 0 0 0 0 10500 0 37928 0 186717 0 0 0 HARRY ITOKA CONTROLLER 130120 0 0 0 0 0 9743 0 26576 0 166439 0 0 0 MADELENE SUPRENA RN 136859 0 0 0 0 0 9621 0 33094 0 179574 0 0 0 PART I, LINE 3: A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS THE COMMITTEE MEETS YEARLY AND RECOMMENDS TO THE BOARD THE COMPENSATION FOR COVERED INDIVIDUALS BASED ON RELEVANT DATA INCLUDING COMPARABILITY COMPENSATION FOR SIMILARLY SITUATED ENTITIES AND INDEPENDENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS AS DEEMED NECESSARY. A DORMITORY AUTHORITY OF THE STATE OF NEW YORK 166000293 64983Q7J2 2006-12-19 41443072 TO FUND THE HOME'S CAPITAL RENOVATION PROJECT 0 0 0 A 41443072 3980435 2053732 35408905 2010 0 0 0 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE CORPORATION SHALL BE THE SPONSOR MEMBERS AND THE SYSTEM MEMBER. THE SPONSOR MEMBERS OF THE CORPORATION (THE "SPONSOR MEMBERS") SHALL CONSIST OF THE FOLLOWING INDIVIDUALS: THE SUPERIOR GENERAL OF THE COMMUNITY OF CARMELITE SISTERS FOR THE AGED AND INFIRM; THE ORDINARY OF THE ROMAN CATHOLIC DIOCESE OF BROOKLYN, NEW YORK; TWO (2) MEMBERS OF THE GENERAL COUNCIL OF CARMELITE SISTERS TO BE SELECTED BY THE SUPERIOR GENERAL OF THE COMMUNITY; AND TWO (2) MEMBER PRIESTS OF THE BROOKLYN DIOCESE TO BE SELECTED BY THE ORDINARY OF THE DIOCESE OF BROOKLYN. ANY ACTION BY THE SPONSOR MEMBERS SHALL BE AUTHORIZED BY THE AFFIRMATIVE VOTE OF AT LEAST FOUR (4) SPONSOR MEMBERS. THE SOLE SYSTEM MEMBER OF THE CORPORATION SHALL BE THE CARMELITE SYSTEM, INC., A NEW YORK NOT-FOR-PROFIT CORPORATION (THE "SYSTEM MEMBER"). ANY ACTION BY THE SYSTEM MEMBER SHALL BE TAKEN IN ACCORDANCE WITH THE BY-LAWS OF THE CARMELITE SYSTEM, INC. THE SUPERIOR GENERAL AND THE GENERAL COUNCIL OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM SHALL SERVE AS THE MEMBERS OF THE CARMELITE SYSTEM, INC. WITH SPECIFIED RESERVED POWERS. FORM 990, PART VI, SECTION A, LINE 7A THE COMMUNITY OF CARMELITE SISTERS AND THE ORDINARY OF THE ROMAN CATHOLIC DIOCESE OF BROOKLYN MAY EACH APPOINT TWO MEMBERS OF THE CORPORATION TO BE DIRECTORS OF THE CORPORATION (MEMBERS-DIRECTORS). EXCEPT AS OTHERWISE EXPRESSLY PROVIDED HEREIN, ALL STANDARDS APPLICABLE TO DIRECTORS IN THE BY LAWS SHALL ALSO APPLY TO MEMBERS-DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBERS OF THE CORPORATION: ANY AMENDMENT OF THE BY-LAWS; AMENDMENTS OF THE CORPORATION'S CERTIFICATE OF INCORPORATION; APPROVAL OR APPOINTMENT OF THE ADMINISTRATOR; THE APPROVAL OF INDIVIDUALS ELIGIBLE TO BE OFFICERS OF THE CORPORATION; THE APPROVAL OF INDIVIDUAL ELIGIBLE TO BE MEMBERS OF THE EXECUTIVE COMMITTEE; THE FORMULATION OR CHANGE FROM TIME TO TIME OF THE PHILOSOPHY, OBJECTIVE AND PURPOSES OF THE CORPORATION; THE PURCHASE, SALE, MORTGAGE OR LEASE OF REAL PROPERTY OF THE CORPORATION, OR THE SALE OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; CONSOLIDATION OF THE CORPORATION WITH ANOTHER NOT FOR PROFIT CORPORATION ORGANIZED FOR SIMILAR PURPOSES AND THE APPROVAL OF ANY PLAN FOR THE DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE REPORTS TO THE BOARD OF DIRECTORS REGARDING THE REVIEW OF THE FORM 990. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST DISCLOSURE POLICY REQUIRES ALL OFFICERS AND BOARD MEMBERS TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. IN ADDITION, SHOULD AN OFFICER OR BOARD MEMBER ASSUME NEW EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER ROLE WITH THE ORGANIZATION SUCH INDIVIDUALS IS REQUIRED TO DISCLOSE IN WRITING THE NATURE OF SUCH EXTERNAL INTERESTS. THE DISCLOSURE STATEMENT IS PROVIDED TO THE CHAIR OF THE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 15A A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION FOR A COVERED INDIVIDUAL BASED ON RELEVANT DATA INCLUDING COMPARABILITY OF COMPENSATION FOR SIMILARLY SITUATE ENTITIES AND COMPENSATION SURVEYS COMPLIED BY INDEPENDENT FIRMS AS REQUIRED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS HAS DESIGNED A COMMITTEE TO MANAGE THE PROCESS OF SELECTION AND OVERSIGHT OF THE AUDIT AND INDEPENDENT ACCOUNTANT, THE COMMITTEE MEETS WITH MANAGEMENT AND THE INDEPENDENT AUDITORS TO REVIEW THE ENGAGEMENT PROPOSAL, RESULTS OF THE AUDIT, DRAFT AUDIT REPORT, MANAGEMENT LETTER. THE COMMITTEE MAY MEET WITH THE INDEPENDENT AUDITORS IN EXECUTIVE SESSION BEFORE CONCLUDING ITS REVIEW AND ACCEPTANCE OF THE ANNUAL AUDIT REPORT. THE COMMITTEE REPORTS ITS FINDING AND MAKES RECOMMENDATION TO THE BOARD OF DIRECTORS. CARMELITE SISTERS FOR THE AGED AND INFIRM INC 600 WOODS ROAD GERMANTOWN NY 12526 141369151 TO SPONSOR NURSING HOMES NY 501(C)(3) LINE 10 N/A 0 ST PATRICK'S RESIDENCE 1400 BROOKDALE ROAD NAPERVILLE IL 60563 362527011 SKILLED NURSING FACILITY IL 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 ST PATRICK'S MANOR INC 863 CENTRAL STREET FRAMINGHAM MA 01701 042157057 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 ST PATRICK'S HOME FOR THE AGED AND INFIRM INC 66 VAN CORTLAND PARK SOUTH BRONX NY 10463 121740033 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 ST MARGARET HALL INC 1960 MADISON ROAD CINCINNATI OH 45206 310655031 SKILLED NURSING AND ASSISTED LIVING FACILITY OH 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 MOTHER ANGELINE MCCRORY MANOR INC 5199 EAST BROAD STREET COLUMBUS OH 43213 912134683 SKILLED NURSING FACILITY OH 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 MARIAN MANOR FOR THE AGED AND INFIRM INC 130 DORCHESTER STREET BOSTON MA 02127 042173054 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE INC 315 SOUTH FLAGLER DRIVE WEST PALM BEACH FL 33401 590879342 SKILLED, ASSISTED & INDEPENDENT LIVING FACILITY FL 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 KAHL HOME FOR THE AGED AND INFIRM 6701 JERSEY RIDGE ROAD DAVENPORT IA 52807 420760833 SKILLED NURSING FACILITY IA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 CARMEL TERRACE INC 933 CENTRAL STREET FRAMINGHAM MA 01701 043210051 ASSISTED LIVING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 CARMEL MANOR INC 100 CARMEL MANOR ROAD FT THOMAS KY 41075 610523290 SKILLED NURSING FACILITY KY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 VILLAS AT SAINT THERESE INC 5253 EAST BROAD STREET COLUMBUS OH 43213 472021696 INDEPENDENT LIVING FACILITY OH 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 THE CARMELITE SYSTEM INC 646 WOODS ROAD GERMANTOWN NY 12526 141810368 MANAGEMENT OF AFFILIATED FACILITIES NY 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 MOUNT CARMEL CARE CENTER INC 320 PITTSFIELD ROAD LENOX MA 01240 383902709 SKILLED NURSING FACILITY MA 501(C)(3) LINE 10 CARMELITE SISTERS FOR THE AGED AND INFIRM INC 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0