2016-09-15T09:05:01-05:00 2015-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 46 PUBLIC SQUARE SUITE 400 WILKESBARRE PA 18701 990 2015-01-01 221500539 THE HOUSE OF THE GOOD SHEPHERD HOUS 9086845900 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 DEBORAH S BEARDS EXECUTIVE DIRECTOR 9086845900 2016-09-13 1 BARBARA LAPUTKA CPA P00782769 5708200100 2015 2017-02-10 21:41:12Z DEBORAH S BEARDS 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 11869817 0 X WWW.HOTGS.ORG X 1884 NJ TO PROVIDE CARE, NURTURANCE AND HOUSING FOR THE ELDERLY THROUGH OPERATION OF VARIOUS FACILITIES. 14 14 181 50 0 0 45331 42741 11804787 11697648 67151 77722 17408 17052 11934677 11835163 0 0 0 0 5776572 6081857 0 0 0 5675391 5761060 11451963 11842917 482714 -7754 20005657 19381571 15030025 14524790 4975632 4856781 X THE HOUSE OF THE GOOD SHEPHERD IS A NON-SECTARIAN, NON-PROFIT RETIREMENT COMMUNITY AFFILIATED WITH THE EPISCOPAL DIOCESE OF NEWARK. IT IS LED BY A BOARD OF TRUSTEES WHO VOLUNTEER THEIR TIME WITHOUT REMUNERATION. THE TRUSTEES FOCUS ON FULFILLING THE ORGANIZATION'S MISSION.THE MISSION OF THE HOUSE OF THE GOOD SHEPHERD IS TO SERVE THE PHYSICAL, MENTAL, AND SPIRITUAL NEEDS OF OLDER PERSONS WITHOUT REGARD TO RELIGION, RACE, COLOR, CREED, AGE, SEX, OR NATIONAL ORIGIN. THIS MISSION IS TO BE CARRIED OUT WITHIN ITS FINANCIAL RESOURCES BY PROVIDING:(1) RESIDENTIAL AND HEALTH CARE ACCOMMODATIONS AND SERVICES, (2) OUTREACH SERVICES TO NON-RESIDENTS, AND (3) RESOURCE INFORMATION AND CONSULTATION WITH OTHERS PROVIDING SERVICES TO THE AGED. 0 0 9319001 11699661 OPERATED A CONTINUING CARE RETIREMENT COMMUNITY PROVIDING HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO ELDERLY RESIDENTS THROUGH THE OPERATION OF A NURSING FACILITY, ASSISTED LIVING, COMPREHENSIVE PERSONAL CARE AND INDEPENDENT LIVING UNITS. DURING 2015, THERE WERE 21,300 NURSING FACILITY PATIENT DAYS, 8,880 PERSONAL CARE DAYS AND 10,567 ASSISTED LIVING DAYS.FIVE EPISCOPAL CONGREGATIONS IN THE ORANGES FOUNDED THE HOUSE OF THE GOOD SHEPHERD IN 1882. IN THOSE DAYS ITS FOCUS WAS TO PROVIDE CARE AND SERVICES TO THE POOR AND DISABLED. A 20-ROOM RENTAL HOME LAUNCHED OUR HUMBLE BEGINNINGS. BY 1890, A NEW HOME WAS BUILT ON HENRY STREET. IN THE EARLY 1960'S A WOODED, 15-ACRE SITE WAS PURCHASED IN HACKETTSTOWN. THE GOAL WAS TO DEVELOP A RETIREMENT COMMUNITY FOR THE EVER-GROWING POPULATION OF SENIORS IN NORTHERN NEW JERSEY. FOUR LEVELS OF SERVICES ARE PROVIDED:THERE ARE 48 UNITS OF INDEPENDENT LIVING ARE LOCATED IN OUR MAIN BUILDING AND ON THE GROUNDS. COTTAGES, APARTMENTS AND DUPLEXES SERVE SENIORS WHO ARE INDEPENDENT YET VALUE THE SECURITY OF 24/7 EMERGENCY ASSISTANCE AND A WIDE VARIETY OF SERVICES AND PROGRAMS.IN 61 UNITS OF ASSISTED LIVING AND COMPREHENSIVE PERSONAL CARE, STAFF IS AVAILABLE TO ASSIST WITH MEDICATION ADMINISTRATION AND PROVIDE WATCHFUL OVERSIGHT TO SENIORS WHO ARE NO LONGER ABLE TO BE TOTALLY INDEPENDENT.A 62-BED SKILLED NURSING UNIT SERVES SENIORS WHO REQUIRE TOTAL CARE.POST-HOSPITAL, SUBACUTE CARE IS PROVIDED ON THE SKILLED NURSING UNIT TO SENIORS SEEKING A TEMPORARY STAY TO REHABILITATE AFTER A HOSPITAL STAY.SECURITY: IN ADDITION TO SEEKING A SECURE ENVIRONMENT IN WHICH TO LIVE, RESIDENTS COME TO THE HOUSE WITH THE KNOWLEDGE THAT, WHEN THEIR ASSETS ARE DEPLETED, THE HOUSE WILL, WITHIN ITS FINANCIAL CAPACITY, UTILIZE ITS AVAILABLE RESOURCES TO PROVIDE LIFELONG CARE AND SERVICES. IN ADDITION TO SUBSIDIZING RESIDENTS WITHOUT ASSETS IN INDEPENDENT LIVING, THE HOUSE SUBSIDIZES RESIDENTS OF COMPREHENSIVE PERSONAL CARE AND SKILLED CARE WHO ARE RECIPIENTS OF MEDICAID.LICENSES: THE HOUSE OF THE GOOD SHEPHERD IS LICENSED BY THE STATE OF NEW JERSEY AS A: (1) CONTINUING CARE RETIREMENT COMMUNITY, (2) SKILLED NURSING FACILITY, (3) ASSISTED NURSING FACILITY, AND (4) COMPREHENSIVE PERSONAL CARE FACILITY. 9319001 1 0 0 1 0 0 0 0 1 1 1 0 0 0 1 1 0 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 1 0 0 0 1 64 0 1 181 1 0 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X HOLLIE DRISCOLL 9086845734 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 DAVID SULLIVAN CHAIR/TRUSTEE 0.30 0.30 X X 0 0 0 CLAUDIA CONWAY VICE CHAIR/ TRUSTEE 0.30 0.30 X X 0 0 0 JUDY KILGORE TREASURER/TRUSTEE 0.30 0.30 X X 0 0 0 REV PAUL OLSSON SECRETARY/TRUSTEE 0.30 0.30 X X 0 0 0 REV DAVID RUDE TRUSTEE 0.20 0.20 X 0 0 0 ROBERT BARTKUS ESQ TRUSTEE 0.20 0.20 X 0 0 0 REV BIRDA FERGUSON TRUSTEE 0.20 0.20 X 0 0 0 CARL BANNISTER TRUSTEE 0.20 0.20 X 0 0 0 ROBYN JENSEN TRUSTEE 0.20 0.20 X 0 0 0 PHILLIP GUIDONE ESQ TRUSTEE 0.20 0.20 X 0 0 0 REV TOM MATHEWS TRUSTEE 0.20 0.20 X 0 0 0 ELVA SCHAFER RESIDENT TRUSTEE 0.20 0.20 X 0 0 0 LINDA PUGLIESE RESIGNED 2015 TRUSTEE 0.20 0.20 X 0 0 0 SR SUZANNE ELIZABETH TRUSTEE 0.20 0.20 X 0 0 0 REV SHEILA SHUFORD TRUSTEE 0.20 0.20 X 0 0 0 DEBORAH S BEARDS EXECUTIVE DIRECTOR 40.00 2.00 X 160886 0 32805 HOLLIE DRISCOLL CHIEF FINANCIAL OFFICER 40.00 2.00 X 96408 0 14292 257294 0 47097 1 0 1 0 REHABCARE GROUP INC 680 SOUTH FOURTH STREET LOUISVILLE KY 40202 CONTRACT THERAPY 734786 SODEXO INC & AFFILIATES 6145 PARK SQUARE DRIVE UNIT 1-6 LORAIN OH 44053 FOOD SERVICE MANAGEMENT 453640 OMNICARE INC 121 ALGONQUIN PARKWAY WHIPPANY NJ 07981 PHARMACY SERVICES PROVIDER 200558 MCKESSON MEDICAL 8121 TENTH AVENUE NORTH GOLDEN VALLEY MN 55427 MEDICAL SUPPLIES 128130 DEMPSEY UNIFORM & LINEN 1200 MID VALLEY DRIVE JESSUP PA 18434 LAUNDRY SERVICE 124926 5 23111 19630 42741 NET RESIDENT SVC REV 623000 11697648 11697648 11697648 78198 78198 32940 17203 15737 15737 15737 476 -476 -476 -476 10632 23111 16975 -6343 -6343 GUEST MEALS 900099 3376 3376 SHARED SERVICES REVENUE 623000 2013 2013 2269 2269 7658 11835163 11699661 0 92761 304391 304391 4400261 3931349 468912 286699 264506 22193 740745 642492 98253 349761 295226 54535 107114 107114 31119 31119 318 318 1133095 1083522 49573 76626 76626 825069 680200 144869 548374 548374 35474 35474 338059 338059 1124914 1124914 358825 358825 FOOD 475495 475495 BAD DEBTS 293084 293084 PHARMACY 189604 189604 LICENSES & FEES 73835 73835 150055 83319 66736 11842917 9319001 2523916 0 15054 19083 111947 241687 1492989 1383766 209902 209165 29680671 17567079 12688636 12113592 5261778 5211311 225351 202967 20005657 19381571 683035 742307 305927 344582 13640000 12990000 6813 9651 394250 438250 15030025 14524790 X 4529935 4407123 23023 26984 422674 422674 4975632 4856781 20005657 19381571 X -7754 -109027 -2070 X X 0 1 X 1 0 X 562926 39623 72188 45331 42741 762809 10464313 11083525 11067103 11804787 11697648 56117376 11027239 11123148 11139291 11850118 11740389 56880185 540791 540791 0 540791 540791 56339394 104462 96587 103299 98951 111138 514437 104462 96587 103299 98951 111138 514437 21452 25354 13186 13875 18290 92157 11153153 11245089 11255776 11962944 11869817 57486779 0.98000 0.97860 0.00890 0.00900 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2011 AMOUNT: $ 9,288. 2012 AMOUNT: $ 8,341. 2013 AMOUNT: $ 8,401. 2014 AMOUNT: $ 8,572. 2015 AMOUNT: $ 5,645. FUNDRAISING GAMING - 2011 AMOUNT: $ 12,164. 2012 AMOUNT: $ 17,013. 2013 AMOUNT: $ 4,785. 2014 AMOUNT: $ 5,303. 2015 AMOUNT: $ 10,632. SHARED SERVICES REVENUE - 2015 AMOUNT: $ 2,013. 0 0 0 0 0 0 0 0 1 318 318 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO THE STATE (LEADINGAGE, NJ) AND NATIONAL (LEADINGAGE) ASSOCIATION OF HOMES AND SERVICES FOR THE AGING. A PORTION OF THE DUES ARE USED FOR LOBBYING PURPOSES. THE $318 REPORTED AS LOBBYING EXPENDITURES IS THE PORTION OF DUES THAT WERE USED FOR LOBBYING PURPOSES BY LEADINGAGE, NJ AND LEADINGAGE. 0 1 X 549806 -1114 2264 546428 508239 43745 2178 549806 526565 4591 22917 508239 0.23000 0.77000 0.00000 0 0 328328 328328 26224082 15212870 11011212 3121761 2354209 767552 6500 6500 12113592 REFUNDABLE FEES AND DEPOSITS 438250 438250 X 11735524 -109027 -5745 -114772 11850296 -15133 -15133 11835163 11854375 17203 17203 11837172 5745 5745 11842917 PART IV, LINE 2B: CURRENT ASSETS REPORTED ON THE ORGANIZATION'S BALANCE SHEET AS OF 12/31/15 INCLUDE THE AMOUNT OF THE PNA TRUST FUND (I.E. RESIDENT TRUST FUNDS) HELD WITH FULTON BANK AS WELL AS THE PETTY CASH FUND HELD ONSITE. THE LIABILITIES RELATED TO THESE ACCOUNTS ARE REPORTED ON LINE 21 OF PART X OF THE 990. THESE ACCOUNTS ARE FUNDS HELD FOR THE RESIDENTS. PART V, LINE 4: THE INCOME FROM THE ENDOWMENT FUNDS ARE DESIGNATED TO SUBSIDIZE RESIDENTS THAT HAVE OUTLIVED THEIR FUNDS. PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2015 AND 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: WRITE OFF EXPENSES INCLUDED IN REVENUE ON FINANCIAL STATEMENTS -5,745. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -17,203. SHARED SERVICES REVENUE 2,013. ADDITIONAL INVESTMENT INCOME 57. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 17,203. PART XII, LINE 4B - OTHER ADJUSTMENTS: WRITE OFF EXPENSES INCLUDED IN REVENUE ON FINANCIAL STATEMENTS 5,745. CELEBRATE THE HOUSE WINE AND DINE 20508 17158 3350 454 9180 GOLF OUTING 13235 5953 7282 4900 2441 33743 23111 10632 454 4900 11621 16975 -6343 X X X X 0 0 0 0 0 0 0 0 0 DEBORAH S BEARDS EXECUTIVE DIRECTOR 160886 0 0 0 0 0 22125 0 10680 0 193691 0 0 0 A NEW JERSEY HEALTH CARE FACILITIES FINANCING AUTHORITY SERIES 2012-1 221987084 2012-11-27 14645000 REFUNDING OF 2001 BOND ISSUE 0 0 0 A 1655000 14645000 227814 14417186 2012 1 0 1 1 A 0 1 0 0 1 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS THE AMOUNT REPORTED ON PART II, LINE 11, REPRESENTS PROCEEDS OF THE BOND ISSUE USED TO CURRENTLY REFUND THE 2001 BOND ISSUE. FORM 990, PART VI, SECTION B, LINE 11 THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER CONDUCT A DETAILED REVIEW OF THE FORM 990. AFTER THEIR REVIEW, THE TREASURER OF THE BOARD REVIEWS THE FORM 990 IN DETAIL. A COPY OF THE ORGANIZATION'S FINAL FORM 990 IS PROVIDED TO THE GOVERNING BODY MEMBERS AT THE NEXT MEETING OF THE BOARD OF TRUSTEES FOLLOWING COMPLETION OF THE FORM BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE POLICY IS GIVEN TO AND SIGNED BY EACH BOARD MEMBER AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. ANY CONFLICTS OF INTEREST MUST BE DISCLOSED AND BOARD MEMBERS MUST ABSTAIN FROM VOTING IF SUCH CONFLICTS ARISE AT MEETINGS. THE EXECUTIVE DIRECTOR REVIEWS THE CONFLICT FORMS FOR THE BOARD OF DIRECTORS. IF A CONFLICT ARISES, THE ACTIONS TAKEN AND RESULTS ARE DOCUMENTED IN THE BOARD MINUTES. THE CONFLICT OF INTEREST STATEMENTS FOR SENIOR MANAGEMENT ARE SUBMITTED TO THE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THE PERSONNEL COMMITTEE REFERS TO COMPENSATION STUDIES DONE BY TRADE ORGANIZATIONS EACH YEAR FOR COMPARATIVE INFORMATION ON SALARY/WAGE DATA. THEY ALSO LOOK AT SURROUNDING RETIREMENT COMMUNITIES TO ENSURE THEIR TOP MANAGEMENT OFFICIALS' PAY IS COMMENSURATE WITH SIMILAR POSITIONS AT THOSE ORGANIZATIONS. AFTER THE PERSONNEL COMMITTEE ESTABLISHES COMPENSATION AMOUNTS FOR THE EXECUTIVE DIRECTOR, THE PAYROLL BUDGET FOR OTHER PERSONNEL IS REVIEWED BY THE PERSONNEL COMMITTEE AND APPROVED BY THE BOARD OF TRUSTEES. THIS PROCESS AND FINAL DETERMINATIONS ARE DOCUMENTED IN THE MINUTES. 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. FORM 990, PART XI, LINE 9: SHARED SERVICES REVENUE -2,013. ADDITIONAL INVESTMENT INCOME -57. PART XII, LINE 2C THE PROCESS USED BY THE COMMITTEE THAT ASSUMES RESPONSIBLITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. THE HOUSE OF THE GOOD SHEPHERD FOUNDATION INC 798 WILLOW GROVE STREET HACKETTSTOWN NJ 07840 223692108 SUPPORTING ORGANIZATION FOR THE HOUSE OF THE GOOD SHEPHERD NJ 501(C)(3) LINE 11A, I THE HOUSE OF THE GOOD SHEPHERD 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 HOUSE OF THE GOOD SHEPHERD FOUNDATION Q 17397 CASH TRANSFER