2016-11-14T09:30:20-06:00 2015-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2015-01-01 133623600 NORTHERN MANOR MULTICARE CENTER INC NORT 8456233904 199 NORTH MIDDLETOWN ROAD NANUET NY 10954 MORRIS KLEIN EXECUTIVE DIRECTOR 8456233904 2016-11-13 1 AARON SHAPIRO P01333816 2128674000 2015 2017-02-10 21:41:12Z MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 28608560 0 X WWW.NORTHERNMANOR.COM X 1991 NY TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 9 9 415 25 0 0 131129 0 31946040 28599051 5218 1369 90729 8140 32173116 28608560 435078 435278 0 0 17941569 17152759 0 0 0 12676051 11442965 31052698 29031002 1120418 -422442 18215806 17140808 21700390 21047835 -3484584 -3907027 TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 0 0 22746061 27202025 HEALTH CARE SERVICES FOR THE ELDERLY. NORTHERN MANOR MULTICARE CENTER, INC. (NORTHERN MANOR) OPERATES A 231-BED SKILLED NURSING FACILITY IN NANUET, NEW YORK. 2580780 1397026 OUTPATIENT ADULT DAY CARE SERVICES. NORTHERN MANOR OPERATES AN ADULT DAY CARE CENTER WITH TWO DAILY PROGRAMS OF 100 SLOTS EACH IN BROOKLYN, NEW YORK. 435278 435278 BENEFITING, PROMOTING, AND SUPPORTING QUALIFYING RELIGIOUS CHARITABLE AND EDUCATIONAL ACTIVITIES CONDUCTED BY OR IN CONNECTION WITH CHEVRA LIADY NUSACH HOARY, A RELIGIOUS ORGANIZATION AND THE SOLE MEMBER OF NORTHERN FOUNDATION FOR HEALTH CARE, INC. 25762119 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 63 0 415 1 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 0 1 0 0 NY X MICHAEL ITZKOWITZ 8453569880 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 STUART MEYERS CHAIRMAN 0.10 0.90 X X 0 4250 0 LEON STEINMETZ BOARD MEMBER 0.10 0.90 X 0 4250 0 RABBI SIMON LAUBER BOARD MEMBER 0.10 0.90 X 0 0 0 REGINA AUSLANDER BOARD MEMBER 0.10 0.90 X 0 0 0 HINDI GINSBERG BOARD MEMBER 0.10 0.90 X 0 500 0 CHARLES F KENNY ESQ BOARD MEMBER 0.10 0.90 X 0 1000 0 ABRAHAM ZACHARIASH BOARD MEMBER 0.10 0.90 X 0 4000 0 RABBI HERSHEL HAGER BOARD MEMBER 0.10 0.90 X 0 0 0 ISRAEL ORZEL BOARD MEMBER 0.10 0.90 X 0 3250 0 MORRIS KLEIN EXECUTIVE DIRECTOR 6.00 29.00 X 135361 654245 188651 GEDALIA KLEIN CHIEF OPERATING OFFICER 3.00 14.50 X 23099 111643 28044 MICHAEL NOWICKI COMPLIANCE OFFICER 6.00 29.00 X 34212 165357 12293 SHLOMO KATZ ADMINISTRATOR 35.00 X 243749 0 6370 GENNADIY GOLDVEKHT REGISTERED NURSE 35.00 X 101616 0 0 LAURENCE KAMER MANAGER 35.00 X 103249 0 0 ANNETTE FEARON DIRECTOR OF NURSING 35.00 X 101888 0 0 CHRISTINE LI MDS COORDINATOR 35.00 X 114491 0 4159 857665 948495 239517 6 0 1 0 TOWNE NURSING STAFF 1413 38TH STREET BROOKLYN NY 11218 MEDICAL/HEALTH SERVICES 1025552 CENTERS FOR CARE 4770 WHITE PLAINS ROAD BRONX NY 10470 ADMINISTRATIVE SERVICES 280670 CFC AGENCY LLC 1601 BRONXDALE AVENUE BRONX NY 10462 ADMINISTRATIVE SERVICES 244848 LEON S HARRIS MD PC 4 FIELDSTONE COURT NEW CITY NY 10956 MEDICAL/HEALTH SERVICES 105060 GRANDISON MANAGEMENT 1413 38TH STREET BROOKLYN NY 11218 MEDICAL/HEALTH SERVICES 102035 5 RESIDENT SERVICE REVENUE 623000 27202025 27202025 ADULT DAY CARE 623000 1397026 1397026 28599051 1369 1369 MISCELLANEOUS 900099 8140 8140 8140 28608560 28599051 0 9509 435278 435278 482045 424026 58019 12433312 10941472 1491840 876270 770802 105468 2297755 2021195 276560 1063377 935388 127989 1556533 1369188 187345 144049 144049 39925 39925 583366 513151 70215 24615 4592 20023 1412610 1191528 221082 2587793 2276355 311438 657031 577951 79080 192368 169184 23184 758190 666934 91256 177887 156477 21410 NYS ASSESSMENT 1156938 1156938 MEDICAL SUPPLIES 1139575 1139575 FOOD 1012085 1012085 29031002 25762119 3268883 0 1542562 351399 675151 747906 6798754 7092258 476095 437763 23631696 15478898 8326457 8152798 50775 47712 346012 310972 18215806 17140808 4477246 4001179 5000000 4135000 233895 234602 5839711 5811087 6149538 6865967 21700390 21047835 X -3484584 -3907027 -3484584 -3907027 18215806 17140808 -422442 0 X X 0 1 X 1 0 X 5477669 177541 131129 5786339 36626627 36380660 35037654 31946040 28599051 168590032 36626627 41858329 35215195 32077169 28599051 174376371 0 0 0 174376371 813 1173 8679 5218 1369 17252 813 1173 8679 5218 1369 17252 71361 90729 8140 170230 36698801 41859502 35223874 32173116 28608560 174563853 0.99890 0.99900 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME 0 1 X 790000 790000 17605513 11023400 6582113 595395 520327 75068 4123987 3767640 356347 516801 167531 349270 8152798 ESTIMATED LIABILITIES TO THIRD-PARTY PAYORS 289749 DUE TO RELATED PARTIES 6576218 6865967 X 28608560 0 28608560 0 28608560 28595725 0 28595725 435278 435278 29031003 PART IV, LINE 2B: RESIDENT FUNDS ARE MAINTAINED IN ACCOUNTS SEPARATE FROM NORTHERN MANOR'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS' ACCOUNTS. PART X, LINE 2: NORTHERN MANOR HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2012 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS TO RELATED ENTITY 435,278. 0 CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501(C) (3) 435278 TO SUPPORT THE RELIGIOUS MISSION OF CHEVRA LIADY NUSACH HOARY 1 0 0 1 0 0 0 0 0 1 0 MORRIS KLEIN EXECUTIVE DIRECTOR 110136 532322 16704 80738 8521 41185 24009 116043 8331 40268 167701 810556 0 0 GEDALIA KLEIN CHIEF OPERATING OFFICER 23099 111643 0 0 0 0 0 0 4808 23236 27907 134879 0 0 MICHAEL NOWICKI COMPLIANCE OFFICER 34212 165357 0 0 0 0 0 0 2107 10186 36319 175543 0 0 SHLOMO KATZ ADMINISTRATOR 243749 0 0 0 0 0 0 0 6370 0 250119 0 0 0 PART I, LINE 4B MORRIS KLEIN, $140,052 PART I, LINE 7 BONUSES ARE DETERMINED BY THE BOARD AND ARE BASED ON PERFORMANCE. FORM 990, PART VI, SECTION A, LINE 2 CHIEF OPERATING OFFICER, GEDALIA KLEIN, IS RELATED TO EXECUTIVE DIRECTOR, MORRIS KLEIN. FORM 990, PART VI, SECTION A, LINE 6 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF NORTHERN MANOR MULTICARE CENTER, INC. (NORTHERN MANOR). FORM 990, PART VI, SECTION A, LINE 7A NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY OF NORTHERN MANOR. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FINAL FORM 990 IS CIRCULATED TO THE ENTIRE BOARD AND REVIEWED BY MANAGEMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER IS PROVIDED WITH THE CONFLICT OF INTEREST POLICY, AND IS REQUIRED TO FILL OUT A FORM WHICH WILL DISCLOSE ANY CONFLICT OF INTEREST. IF THERE IS A CONFLICT, THE BOARD MEMBER WILL RECUSE HIM/HERSELF FROM VOTING ON ANY ISSUE THAT CREATES THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A A PRICEWATERHOUSECOOPERS STUDY REVIEWED AND SUBSTANTIATED THE TOP MANAGEMENT COMPENSATION. THE LAST SALARY DETERMINATION FOR TOP MANAGEMENT COMPENSATION TOOK PLACE IN JUNE 2011. THE STUDY WAS CONDUCTED BY THE SOLE CORPORATE MEMBER NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE, INC. ON BEHALF OF NORTHERN MANOR. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED SINCE PRIOR YEAR. NORTHERN RIVERVIEW HEALTH CARE CENTER INC 87 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133832251 NURSING HOME NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 ASSISTED LIVING AT NORTHERN RIVERVIEW INC 89 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133976617 ASSISTED LIVING FACILITY NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 FOUNTAINVIEW AT COLLEGE ROAD INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 133935070 INDEPENDENT LIVING FACILITY NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 113354023 CHARITABLE FOUNDATION AND ADMINISTRATIVE SUPPORT ORGANIZATION NY 501 (C)(3) LINE 11A, I CHEVRA LIADY NUSACH 0 NORTHERN SERVICES GROUP INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134120014 ADMINISTRATIVE SUPPORT ORGANIZATION NY 501 (C)(3) LINE 11B, II NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 LIFESTYLE OPTIONS FOR SENIORS FOUNDATIONINC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134133472 CHARITABLE ENTITY NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN INC 225 MAPLE AVENUE MONSEY NY 10952 133070759 NURSING HOME NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 CHEVRA LIADY NUSACH HOARY - 11-3133470 1580 53RD STREET BROOKLYN NY 11219 113133470 RELIGIOUS ENTITY NY 501 (C)(3) LINE 1 N/A 0 0 1 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0