2016-05-12T13:31:53-05:00 2015-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2014-07-01 231700999 SAINT JOSEPH VILLA STJO 2158364179 110 WEST WISSAHICKON AVENUE FLOURTOWN PA 19031 SISTER DOROTHY APPRICH EXECUTIVE DIRECTOR 2158364179 2016-05-12 1 JULIUS C GREEN CPA JD P00350393 2159720701 2014 2016-08-17 19:52:53Z SISTER DOROTHY APPRICH 110 WEST WISSAHICKON AVENUE FLOURTOWN PA 19031 23864468 0 X WWW.STJOSEPHVILLA.ORG X 1968 PA SKILLED NURSING SERVICES PRIMARILY TO SISTERS OF ST. JOSEPH OF CHESTNUT HILL AND OTHERS. 5 5 418 0 0 0 8427086 10721814 13558984 13091336 2415 1259 153165 29521 22141650 23843930 2033 1832 0 0 15721370 15369725 0 0 0 5762276 5757392 21485679 21128949 655971 2714981 9993141 14407244 2043716 3425294 7949425 10981950 X THE MISSION OF SAINT JOSEPH VILLA IS ROOTED IN THE MISSION OF THE SISTERS OF ST. JOSEPH WHO FOUNDED AND SPONSOR THE VILLA. THE SISTERS' MISSION OF UNITING PEOPLE WITH GOD AND WITH ONE ANOTHER IS THE PRIMARY FOCUS OF THE STAFF AT THE VILLA. THEY REFLECT THE HEALING PRESENCE OF JESUS IN REVERENCING THE DIGNITY, UNIQUENESS AND BEAUTY OF EACH OF ITS RESIDENTS. THEY STRIVE TO MAKE GOD'S LOVE REAL FOR THE RESIDENTS, FOR ONE ANOTHER AND FOR ALL WHO VISIT THE VILLA. BY EMBRACING THE VALUES OF TEAMWORK, RESPECT, HOSPITALITY, COMPASSION, COMMUNICATION AND RESPONSIBILITY, THE VILLA COMMUNITY OFFERS CARE THAT IS PERSON-CENTERED AND RELATIONSHIP-BASED TO THE RESIDENTS. 0 0 18218068 1832 13110634 TO OPERATE A SKILLED NURSING HOME PRIMARILY FOR THE SISTERS OF SAINT JOSEPH OF CHESTNUT HILL AS WELL AS FOR LAY RESIDENTS AS ROOM IS AVAILABLE. INFIRMARY/CONVENT FACILITIES ARE AVAILABLE FOR THE RETIRED MEMBERS OF THE SISTERS OF SAINT JOSEPH OF CHESTNUT HILL ONLY. SAINT JOSEPH VILLA HAD A TOTAL OF 93,091 RESIDENT DAYS. THE COMPOSITION OF THE DAYS INCLUDE 20,800 MEDICAID DAYS, 63,090 SELF PAY DAYS, 7,555 MEDICARE DAYS, AND 1,646 OF OTHER PAYOR RESIDENT DAYS IN FISCAL YEAR 2015. 18218068 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 29 0 1 418 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X MICHAEL J RYBCZYNSKI OPERATIONS ADMINISTRATOR 2158363525 110 WEST WISSAHICKON AVENUE FLOURTOWN PA 19031 SISTER ANNE MYERS PRESIDENT 1.00 39.00 X X 6401 0 3912 SISTER EILEEN MARNIEN VICE PRESIDENT 1.00 39.00 X X 6401 0 10704 SISTER REGINA BELL GENERAL COUNCIL 1.00 39.00 X 6401 0 3912 SISTER MAUREEN ERDLIEN GENERAL COUNCIL 1.00 39.00 X 6401 0 4381 SISTER TERESA SHAW GENERAL COUNCIL 1.00 39.00 X 6401 0 10704 SISTER DOROTHY APPRICH EXECUTIVE DIRECTOR 40.00 X 6401 0 4320 SISTER MARIE O'BRIEN TREASURER 4.00 26.00 X 6401 0 10704 MICHAEL J RYBCZYNSKI OPERATIONS ADMINISTRATOR 40.00 X 100249 0 6241 145056 0 54878 1 0 0 0 SELECT REHABILITATION PO BOX 809056 CHICAGO IL 60680 REHABILITATION SERVICES 2748274 1 10721814 10721814 NET RESIDENT SVC REV 623000 13091336 13091336 13091336 1259 1259 30761 20538 10223 10223 DISCOUNTS/REFUNDS 900099 9852 9852 VENDING MACHINE INCOME 900099 1331 1331 FINANCE CHARGES 900099 190 190 7925 7925 19298 23843930 13110634 0 11482 1832 1832 93444 85138 8306 12945030 11794332 1150698 247937 225898 22039 1391452 1267764 123688 691862 630362 61500 42000 42000 15987 1500 14487 1349225 496000 853225 904574 843661 60913 636545 636545 73426 50326 23100 19629 15769 3860 607064 607064 165866 165866 MEDICAL SUPPLIES 593269 593269 RESIDENT CARE EXPENSE 463986 463986 BAD DEBT EXPENSE 314717 314717 OTHER DIRECT EXPENSE 278444 264538 13906 292660 198084 94576 21128949 18218068 2910881 0 1188 1188 1431026 639759 2797720 3803277 65144 71521 57683 165975 25933992 16208468 5640380 9725524 9993141 14407244 1987048 3334924 56668 90370 2043716 3425294 X 7949425 10981950 7949425 10981950 9993141 14407244 2714981 317544 0 X 1 X 0 1 0 X 8533559 8410343 10127743 8427086 10721814 46220545 9764482 10727095 12452625 13558984 13091336 59594522 18298041 19137438 22580368 21986070 23813150 105815067 0 0 0 105815067 972 779 1061 2415 1259 6486 972 779 1061 2415 1259 6486 50910 65032 65561 173467 50059 405029 18349923 19203249 22646990 22161952 23864468 106226582 0.99610 0.99580 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: SALE OF INVENTORY - 2010 AMOUNT: $ 32,419. 2011 AMOUNT: $ 33,994. 2012 AMOUNT: $ 52,183. 2013 AMOUNT: $ 46,311. 2014 AMOUNT: $ 30,761. DISCOUNTS/REFUND - 2010 AMOUNT: $ 14,051. 2011 AMOUNT: $ 26,350. 2012 AMOUNT: $ 4,337. 2013 AMOUNT: $ 13,904. 2014 AMOUNT: $ 9,852. OTHER MISC INCOME - 2010 AMOUNT: $ 4,440. 2011 AMOUNT: $ 4,688. 2012 AMOUNT: $ 9,041. 2013 AMOUNT: $ 113,252. 2014 AMOUNT: $ 9,446. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 6562069 3848549 2713520 13741821 11452952 2288869 5630102 906967 4723135 9725524 X PART IV, LINE 2B: THE ORGANIZATION PROVIDES SERVICES FOR RESIDENTS' PERSONAL FUNDS, WHICH ARE KEPT IN A BANK ACCOUNT AND THE DETAIL IS TRACKED ON SUPPORTING SCHEDULES. PART X, LINE 2: THE CONVENT ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING 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 IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2015 AND 2014. THE CONVENT'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS PRIOR TO 2012 ARE NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO THE CONGREGATION'S GOVERNING COUNCIL. THE EXECUTIVE DIRECTOR AND OPERATIONS ADMINISTRATOR REVIEW THE PREPARED FORM 990 BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. THE MEMBERS OF THE BOARD OF DIRECTORS ARE NOT REQUIRED TO SIGN AN ANNUAL STATEMENT, HOWEVER, THEY VERBALLY REVIEW AND DETERMINE ANY CONFLICTS ANNUALLY AT A BOARD MEETING. AT THE ANNUAL REVIEW OF THIS POLICY, THE PRESIDENT OF THE BOARD SIGNS THE POLICY TO INDICATE THAT ALL BOARD MEMBERS AND KEY EMPLOYEES ARE IN COMPLIANCE. IF THERE IS A CONFLICT OF INTEREST TO REPORT, THE INFORMATION IS PROVIDED TO THE BOARD PRESIDENT, WHO THEN PRESENTS THE CONFLICT INFORMATION TO THE BOARD OF DIRECTORS FOR DISCUSSION AND RESOLUTION. THE ORGANIZATION'S PRESIDENT AND TREASURER WILL MONITOR PROPOSED OR ONGOING TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PARTICIPATES IN AN ANNUAL SALARY AND BENEFITS SURVEY WITH THE LEADING AGE PA ORGANIZATION (FORMALLY PENNSYLVANIA ASSOCIATION OF NON PROFIT HOMES FOR THE AGING). THE SURVEY IS INTENDED TO MAKE SURE THE ORGANIZATION DOES NOT EXCEED FAIR MARKET VALUE FOR SALARIES AND BENEFITS. THE SURVEY PROVIDES THE FAIR MARKET VALUE OF SALARY AND BENEFIT INFORMATION GATHERED FROM ORGANIZATIONS IN THE SAME INDUSTRY AND WITHIN THE SAME GEOGRAPHICAL AREA AS SAINT JOSEPH VILLA. THE INFORMATION GATHERED IN THE SURVEY INCLUDES MOST OF THE POSITIONS IN THE FACILITY, INCLUDING BUT NOT LIMITED TO EXECUTIVE DIRECTOR, ADMINISTRATORS, DEPARTMENT DIRECTORS, ASSISTANTS, RN'S, LPN'S, CNA'S, NURSING SUPERVISORS, AND THERAPISTS. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE ANNUAL BUDGET, WHICH INCLUDES SALARY INFORMATION AND INCREASES FOR ALL EMPLOYEES. THE APPROVAL IS DOCUMENTED IN THE BOARD MINUTES. IN ADDITION, THE SALARY INFORMATION IS ALSO DOCUMENTED IN THE EMPLOYEE PERSONNEL FILES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE IN THE ADMINISTRATOR'S OFFICE UPON REQUEST. CONVENT OF THE SISTERS OF SAINT JOSEPH OF CHESTNUT HILL 9701 GERMANTOWN AVENUE PHILADELPHIA PA 19118 231352546 CONVENT PA 501(C)(3) 1 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0