2016-09-26T10:18:07-05:00 2015-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2015-01-01 113109867 ST JOHNLAND NURSING CENTER INC STJO 6312695800 395 SUNKEN MEADOW ROAD KINGS PARK NY 11754 MARY JEAN WEBER CEO 6312695800 2016-09-21 1 AARON SHAPIRO P01333816 2128674000 2015 2017-02-10 21:41:12Z MARY JEAN WEBER 395 SUNKEN MEADOW ROAD KINGS PARK NY 11754 35801075 0 X WWW.STJOHNLAND.ORG X 1991 NY TO CREATE A CARING AND SUPPORTIVE ENVIRONMENT COMMITTED TO THE HIGHEST STANDARDS OF QUALITY HEALTHCARE. 8 8 501 17 0 0 566439 200000 33593781 35217294 529 461 622068 383320 34782817 35801075 0 0 0 0 24149387 24917402 0 0 0 10520527 10147339 34669914 35064741 112903 736334 17351972 17100732 22835413 20408764 -5483441 -3308032 TO CREATE A CARING AND SUPPORTIVE ENVIRONMENT COMMITTED TO THE HIGHEST STANDARDS OF QUALITY HEALTHCARE. IT SEEKS TO UPHOLD THE PRINCIPLES OF HUMAN DIGNITY AND WORTH, AND AFFIRMS THE RIGHT OF EVERY INDIVIDUAL TO MAINTAIN THE OPTIMUM QUALITY OF LIFE. 0 0 26109477 33148827 INPATIENT PROGRAM WITH 230 RESIDENT CARE BEDS. 1875109 1955881 ADULT DAY CARE PROGRAM FOR 100 REGISTRANTS. 426162 112586 LONG TERM HOME HEALTHCARE PROGRAM FOR 50 REGISTRANTS. 28410748 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 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 1 0 0 0 1 28 0 501 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X MICHAEL BARTOLOTTA 6312695800 395 SUNKEN MEADOW RD KINGS PARK NY 11754 TRUDY H CALABRESE PRESIDENT 0.50 1.00 X X 0 0 0 CARL H DOERGE JR VICE PRESIDENT 0.50 1.00 X X 0 0 0 SHARON FUENTES VICE PRESIDENT 0.50 1.00 X X 0 0 0 DAVID H DEMING VICE PRESIDENT 0.50 1.00 X X 0 0 0 PETER FETTEROLF SECRETARY 0.50 1.00 X X 0 0 0 JOAN M HEANEY ASSISTANT SECRETARY 0.50 1.00 X X 0 0 0 WILLIAM D KEEN TREASURER 0.50 1.00 X X 0 0 0 FREDRIC R LAMARCA ASSISTANT TREASURER 0.50 1.00 X X 0 0 0 MARY JEAN WEBER CEO 30.00 7.50 X 254964 63741 41835 MICHAEL BARTOLOTTA FISCAL DIRECTOR 30.50 7.00 X 154549 35470 37931 DR MAUREEN ORSEN MEDICAL DIRECTOR 37.50 X 258821 0 39920 DEANNA BAEZ ASSISTANT ADMINISTRATOR 35.00 2.50 X 127574 9113 17005 DR ALEX CZIRA PHYSICIAN 37.50 X 113679 0 34638 EILEEN GIORDANO CASE MANAGER 37.50 X 116935 0 15784 MICHELLE RANDAZZO DIRECTOR OF NURSING 37.50 X 142546 0 22211 JOHN DUFFY DIRECTOR OF SUPPORT SERVIC 37.50 X 104428 0 35038 KAREN VITTORIA DIRECTOR OF REHAB 37.50 X 104952 0 33994 1378448 108324 278356 9 0 1 0 MORRISON MANAGEMENT PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 1674952 CARE & COMFORT 1580 OCEAN AVENUE BOHEMIA NY 11716 TRANSPORTATION 554020 MEDLINE INDUSTRIES PO BOX 382075 PITTSBURGH PA 15251 MEDICAL SUPPLIES 481747 SHORE PHARMACEUTICAL PO BOX 78000 DETROIT MI 48278 PHARMACEUTICAL 383390 MDE CONTRACTING 474 HAWKINS AVE RONKONKOMA NY 11779 CONTRACTING 281953 20 200000 200000 SKILLED NURSING FACILITY 623000 33148827 33148827 ADULT DAY CARE 623000 1955881 1955881 LONG TERM HOME HEALTH CARE 623000 112586 112586 35217294 461 461 PENSION CREDIT 900099 271354 271354 OTHER 900099 111966 111966 383320 35801075 35217294 0 383781 772562 633501 139061 16536045 13559558 2976487 380019 311616 68403 5963158 4889790 1073368 1265618 1037807 227811 206053 206053 212336 212336 1987335 1629614 357721 4107 4107 1114056 512122 601934 1045240 857097 188143 508978 417362 91616 15376 12608 2768 81609 66919 14690 1350842 1107690 243152 383266 314278 68988 NYS CASH RECEIPT ASSESS 1685555 1685555 FOOD & KITCHEN 870093 713476 156617 PRESCRIPTION DRUGS/SUPP 544463 544463 MISCELLANEOUS 138030 113185 24845 35064741 28410748 6653993 0 233725 516032 1450671 1390563 4956747 4418771 490287 1168262 109283 105765 588725 566918 38508753 29903561 9045054 8605192 477480 329229 17351972 17100732 5278670 6336533 101119 142114 150172 4847355 4156316 1538076 798652 11029198 8865972 22835413 20408764 X -5525941 -3350532 42500 42500 -5483441 -3308032 17351972 17100732 X 736334 1439075 X X 0 1 X 1 1 1 X 200000 200000 533147 566439 200000 1699586 37092815 35438542 34286331 33593781 35217294 175628763 37292815 35638542 34819478 34160220 35417294 177328349 0 0 0 177328349 6805 95360 63898 529 461 167053 6805 95360 63898 529 461 167053 56866 461318 344003 622068 383320 1867575 37356486 36195220 35227379 34782817 35801075 179362977 0.98870 0.98900 0.00090 0.00100 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUES AMNESTY PROGRAM INCOME PENSION REFUND OTHER INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 42500 42500 42500 42500 42500 42500 42500 42500 42500 42500 1.00000 0 0 452043 452043 19835798 15447617 4388181 16460951 12947065 3513886 1759961 1508879 251082 8605192 LINE OF CREDIT 700000 SECURITY DEPOSITS 68566 ACCRUED PENSION 8017996 CAPITAL LEASE PAYABLE 34087 DUE TO THE SOCIETY OF ST. JOHNLAND 45323 8865972 X 35801075 0 35801075 0 35801075 35064741 0 35064741 0 35064741 PART IV, LINE 2B: AMOUNTS HELD IN TRUST FOR RESIDENTS. PART V, LINE 4: THE CENTER HAS ONE INDIVIDUAL DONOR-RESTRICTED ENDOWMENT FUND ESTABLISHED FOR SUPPORT FOR THE ELDERLY. PART X, LINE 2: THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2012 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPPLICABLE TAXING AUTHORITIES. X X X X X 0 0 0 0 0 0 0 0 0 MARY JEAN WEBER CEO 253697 63741 0 0 1267 0 7649 1912 25819 6455 288432 72108 0 0 MICHAEL BARTOLOTTA FISCAL DIRECTOR 154256 35470 0 0 293 0 4636 1066 26204 6025 185389 42561 0 0 DR MAUREEN ORSEN MEDICAL DIRECTOR 255773 0 0 0 3048 0 7765 0 32155 0 298741 0 0 0 DEANNA BAEZ ASSISTANT ADMINISTRATOR 127408 9113 0 0 166 0 3827 273 12045 860 143446 10246 0 0 MICHELLE RANDAZZO DIRECTOR OF NURSING 142023 0 0 0 523 0 4276 0 17935 0 164757 0 0 0 PART I, LINE 3 THE ORGANIZATION RELIES ON THE BOARD OF DIRECTORS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. THIS PROCESS WAS LAST DONE IN DECEMBER 2012. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD ELECT THE DIRECTORS OF EACH PROGRAM EACH SPRING AT THE ANNUAL MEETING OF EACH CORPORATION. IF A VACANCY OCCURS ON THE BOARD IN THE INTERIM, THE REMAINING DIRECTORS MAY ELECT A SUCCESSOR TO SERVE UNTIL THE NEXT ANNUAL MEETING OF MEMBERS. AT THE NEXT ANNUAL MEETING, THE MEMBERS ELECT DIRECTORS FOR SPECIFIC TERMS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS HAVE THE RIGHTS AND DUTIES PROVIDED BY STATUTE UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW WHICH ARE NOT UNLIKE THOSE OF STOCKHOLDERS IN A TRADITIONAL "FOR PROFIT" CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING WITH THE IRS, COPIES HAVE BEEN PROVIDED TO ALL BOARD MEMBERS FOR REVIEW. QUESTIONS AND COMMENTS HAVE BEEN FOWARDED TO THE CEO, WHO HAS DISCUSSED WITH THE PREPARER ANY CHANGES THAT MAY NEED TO BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF ST. JOHNLAND NURSING CENTER, INC. THAT ALL DIRECTORS, OFFICERS, EMPLOYEES, AGENTS AND CONTRACTORS AVOID ANY ALL ACTIVITIES THAT CONFLICT WITH OR APPEAR TO CONFLICT WITH THEIR RESPONSIBILITIES AND OBLIGATIONS TO ST. JOHNLAND. CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE REQUIRED TO BE SIGNED BY EMPLOYEES. WHEN A CONFLICT ARISES, IT IS BROUGHT TO THE BOARD'S ATTENTION TO BE DISCUSSED. THE BOARD MEMBER WHO HAS THIS CONFLICT MUST RECUSE THEMSELVES FROM PARTICIPATING IN ANY DISCUSSION RELATED TO THE MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION RELIES ON THE BOARD OF DIRECTORS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. THIS PROCESS WAS LAST DONE IN DECEMBER 2012. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: ADJUSTMENT TO REFLECT PENSION FUNDED STATUS 1,439,075. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SOCIETY OF ST JOHNLAND 395 SUNKEN MEADOW RD KINGS PARK NY 11758 111890580 FUND RAISING NY 501(C)(3) LINE 7 N/A 0 ST JOHNLAND RESIDENCES II INC 395 SUNKEN MEADOW RD KINGS PARK NY 11758 200316499 TO ESTABLISH, OPERATE AND MAINTAIN AN ADULT RESIDENTIAL FACILITY NY 501(C)(3) LINE 11A, I N/A 0 0 0 1 0 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0