2015-10-09T10:27:55-05:00 2014-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2014-01-01 221807020 OUR LADY'S RESIDENCE OURL 8563424100 1845 HADDON AVENUE CAMDEN NJ 08103 MARTIN IDLER EXECUTIVE DIRECTOR 8563424100 2015-10-05 1 JULIUS GREEN CPA P00350393 2159720701 2014 2016-02-25 16:41:14Z MARTIN B IDLER 1845 HADDON AVENUE CAMDEN NJ 08103 15874311 0 0928 X WWW.CAMDENDIOCESE.ORG X 1966 NJ A SKILLED NURSING FACILITY LICENSED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND HUMAN SERVICES. 8 6 313 85 0 0 23826 208515 15602122 15637199 2766 3926 82920 24671 15711634 15874311 0 600 0 0 10566900 10785213 0 0 0 6094675 6189183 16661575 16974996 -949941 -1100685 5157167 4696015 5301902 5941326 -144735 -1245311 X OUR MISSION IS TO OPERATE A NOT-FOR-PROFIT CATHOLIC BASED SKILLED NURSING FACILITY PROVIDING OUR RESIDENTS WITH THE BEST NURSING CARE AND REHABILITATION SERVICES, WHILE ENHANCING THE QUALITY OF LIFE IN A DIGNIFIED, SAFE ATMOSPHERE. WE SEEK TO PROVIDE APPROPRIATE SERVICE TO ALL WHO ASK FOR OUR ASSISTANCE. 0 0 15327256 600 15637199 OUR LADY'S RESIDENCE OPERATES A 214 BED SKILLED NURSING FACILITY IN PLEASANTVILLE, NEW JERSEY THAT IS LICENSED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND HUMAN SERVICES. OUR LADY'S RESIDENCE YEARLY CENSUS COUNT WAS 59,324 AND THE OCCUPANCY PERCENTAGE WAS 75.95%. THE HOME'S SOLE MEMBER IS CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN.RESIDENT PROGRAMS INCLUDE RESTORATIVE NURSING CARE BY LICENSED AND CERTIFIED NURSING STAFF, COMPREHENSIVE PLAN OF CARE, SOCIAL SERVICE, PHARMACY, CONGREGATED DINING, ACTIVITIES, SPECIAL DIETS, SPIRITUAL COUNSELING BY A CATHOLIC CHAPLAIN, HOUSEKEEPING, AND LAUNDRY.REHABILITATION SERVICES AND PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES ARE AVAILABLE FOR THOSE WHO ARE RECOVERING FROM FRACTURES, STROKES AND OTHER SHORT-TERM, POST HOSPITAL STAYS. IN ADDITION TO CORE THERAPIES AND TREATMENT MODALITIES, WE PROVIDE A WIDE RANGE OF COMPLEX CLINICAL CARE AND SPECIALIZED SERVICES, INCLUDING: GAIT AND BALANCE TRAINING, DYSPHASIA THERAPY, IV ANTIBIOTIC THERAPY, ENTERAL NUTRITION, WOUND CARE AND PAIN MANAGEMENT. 15327256 1 1 0 0 0 0 0 0 1 0 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 49 0 1 313 1 0 0 0 0 0 0 0 0 0 0 X 8 6 0 0 0 0 1 1 1 1 1 0 0 0 1 0 0 1 1 0 0 0 NJ X ROBERT WAITE CONTROLLER 8563424181 1845 HADDON AVENUE CAMDEN NJ 08103 DOROTHY POWELL PRESIDENT 5.00 0.00 X X 0 0 0 RICHARD MAXWELL VICE PRESIDENT 5.00 0.00 X X 0 0 0 MARTIN B IDLER EXECUTIVE DIRECTOR/SECRETARY 13.30 26.70 X X 0 167830 25667 LAWRENCE READER TREASURER 0.50 39.50 X X 0 114829 24200 MARY ANN MARCHETTI TRUSTEE 5.00 0.00 X 0 0 0 SISTER ELETA FELLI TRUSTEE 5.00 0.00 X 0 0 0 REV JOSEF A WAGENHOFFER TRUSTEE 5.00 0.00 X 0 0 0 REV JOHN VIGNONE TRUSTEE 5.00 0.00 X 0 0 0 ANNA TOSTI ADMINISTRATOR 40.00 0.00 X 103031 0 18453 103031 282659 68320 1 0 1 0 SELECT REHABILITATION PO BOX 809056 CHICAGO IL 606809056 PT, OT & ST THERAPY 1471111 SODEXO INC BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE 328983 CROTHALL HEALTHCARE 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 MAINTENANCE SERVICE 327174 FOX LONG TERM CARE 7 CARNEGIE PLAZA CHERRY HILL NJ 08003 PT, OT & ST THERAPY 243215 HOSPITALER SISTERS OF MERCY 1100 CLEMATIS AVENUE PLEASANTVILLE NJ 08232 NURSING SERVICES 152158 5 200000 8515 208515 NET RESIDENT SERVICE REV 623000 15637199 15637199 15637199 3926 3926 MEALS REVENUE 900099 12981 12981 RESIDENT TV REVENUE 900099 6300 6300 RESIDENT PHONE & VENDING REV 900099 4670 4670 720 720 24671 15874311 15637199 0 28597 X 600 600 7616141 6864225 751916 584733 527004 57729 2035375 1834429 200946 548964 523092 25872 32930 32930 30770 30770 2605075 2535482 69593 166039 1369 164670 331986 266377 65609 168898 168898 407833 407410 423 23950 15272 8678 5673 5223 450 119832 119832 123746 123746 41700 41700 NURSING HOME ASSESSMENT 634308 634308 FOOD 544041 544041 PHARMACY/DRUGS 346303 346303 BAD DEBT EXPENSE 223493 223493 382606 355050 27556 16974996 15327256 1647740 0 1000 1000 428145 724983 2519344 1929710 88 88 237539 263693 3421665 1773489 1751518 1648176 219533 128365 5157167 4696015 1634247 1170911 97476 14139 3570179 4756276 5301902 5941326 X -184549 -1285133 39814 39822 -144735 -1245311 5157167 4696015 X -1100685 109 X 0 1 X 1 0 X 178419 66120 45093 23826 208515 521973 15589048 16121322 15399193 15602121 15637199 78348883 15767467 16187442 15444286 15625947 15845714 78870856 0 0 0 78870856 31901 8744 6773 2766 3926 54110 31901 8744 6773 2766 3926 54110 26358 27812 50016 82920 24671 211777 15825726 16223998 15501075 15711633 15874311 79136743 0.99660 0.99600 0.00070 0.00120 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: 1 MISCELLANEOUS REVENUE - 2010 AMOUNT: $ 1,048. 2011 AMOUNT: $ 2,838. 2012 AMOUNT: $ 20,590. 2013 AMOUNT: $ 56,378. 2014 AMOUNT: $ 720. 2 RESIDENT TELEPHONE REV - 2010 AMOUNT: $ 5,954. 2011 AMOUNT: $ 4,865. 2012 AMOUNT: $ 10,151. 2013 AMOUNT: $ 5,774. 2014 AMOUNT: $ 4,670. 3 MEALS REVENUE - 2010 AMOUNT: $ 12,143. 2011 AMOUNT: $ 12,774. 2012 AMOUNT: $ 11,860. 2013 AMOUNT: $ 14,335. 2014 AMOUNT: $ 12,981. 4 RESIDENT TV REVENUE - 2010 AMOUNT: $ 7,213. 2011 AMOUNT: $ 7,335. 2012 AMOUNT: $ 7,415. 2013 AMOUNT: $ 6,433. 2014 AMOUNT: $ 6,300. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 90380 90380 2316613 1039188 1277425 1014672 734301 280371 1648176 RESIDENT PNA FUNDS 67804 DUE TO THIRD PARTY PAYORS 137300 DUE TO OTHER PARTIES 141369 DUE TO DIOCESE OF CAMDEN 4409803 4756276 X 16009866 135446 109 135555 15874311 0 15874311 17110442 135446 135446 16974996 0 16974996 PART IV, LINE 2B: PRIVATE PAY RESIDENTS HAVE ONE MONTH'S RENT DEPOSITED IN AN INTEREST-BEARING ACCOUNT AT PNC BANK. UPON DEATH, LEAVING THE FACILITY, OR APPLYING FOR MEDICAID, THE ESCROW BALANCE IS APPLIED TO THE RESIDENT'S OUTSTANDING ACCOUNT BALANCE AND ANY REMAINING MONIES ARE REFUNDED TO THE RESIDENT. PART X, LINE 2: THE HOME 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 2014 AND 2013. THE HOME'S FEDERAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX FOR THE YEARS PRIOR TO 2011 ARE NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 109. 0 0 0 0 0 0 0 0 0 MARTIN B IDLER EXECUTIVE DIRECTOR/SECRETARY 0 167830 0 0 0 0 0 13426 0 12241 0 193497 0 0 PART I, LINE 3 SALARY OF THE EXECUTIVE DIRECTOR IS PAID BY A RELATED ORGANIZATION AND IS REVIEWED ANNUALLY BY THE DIOCESE OF CAMDEN (RELATED PARTY) - RECEIVING THE SAME ANNUAL INCREASE PERCENTAGE AS ALL OTHER DIOCESAN EMPLOYEES. APPROVAL IS DETERMINED BY THE BOARD. THIS PAST JULY 1, THERE WAS A 2% DIOCESAN INCREASE. THERE IS NO PERFORMANCE BASED COMPENSATION. FORM 990, PART VI, SECTION A, LINE 6 CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN, INC. IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A AS SOLE MEMBER OF THE CORPORATION, CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN, INC. HAS THE POWER TO APPOINT THE TRUSTEES OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO THE POWER TO APPOINT THE TRUSTEES AS INDICATED ABOVE, CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN, INC HAS OTHER POWERS SET FORTH IN THE CORPORATION'S BY-LAWS WHICH INCLUDE THE FOLLOWING: - ADOPT OR AMEND THE CERTIFICATE OF INCORPORATION OR BY-LAWS OF THE CORPORATION; - ADOPT OR PERMIT ADOPTION OF ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGET OF THE CORPORATION AS WELL AS SIGNIFICANT CHANGES TO THE ORIGINAL BUDGET (5%); - AUTHORIZE OR PERMIT THE CORPORATION TO ENGAGE IN SIGNIFICANT TRANSACTIONS (AS FURTHER DEFINED IN THE BY-LAWS) IN EXCESS OF $100,000 AS WELL AS SUCH TRANSACTIONS RELATED TO THE ACQUISITION OR DISPOSITION OF LAND AND BUILDINGS OWNED BY THE CORPORATION; - APPROVE OR PERMIT THE APPROVAL OF ANY SECURED OR UNSECURED BORROWING OF MONEY BY THE CORPORATION; - APPROVE OR PERMIT THE APPROVAL OF ANY LONG-TERM STRATEGIC PLAN OF THE CORPORATION; - APPROVE A PLAN OF MERGER, CONSOLIDATION, AFFILIATION, OR DISSOLUTION OF THE CORPORATION; - ORGANIZE, ACQUIRE, AUTHORIZE OR PERMIT THE ORGANIZATION OR ACQUISITION OF ANY NEW SUBSIDIARY OF THE CORPORATION; AND, - APPROVE OR PERMIT THE APPROVAL OF CONTRIBUTIONS, GRANTS, OR LOANS IN EXCESS OF AN AGGREGATE OF $100,000. FORM 990, PART VI, SECTION B, LINE 11 THE CONTROLLER WILL REVIEW FORM 990 BEFORE IT IS SIGNED AND FILED. FORM 990, PART VI, SECTION B, LINE 15 SALARY OF THE EXECUTIVE DIRECTOR IS REVIEWED ANNUALLY BY THE DIOCESE OF CAMDEN (RELATED PARTY) - RECEIVING THE SAME ANNUAL INCREASE PERCENTAGE AS ALL OTHER DIOCESAN EMPLOYEES. THIS PAST JULY 1, THERE WAS A 2% DIOCESAN INCREASE. THERE IS NO PERFORMANCE BASED COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G TEMPORARY PERSONNEL: PROGRAM SERVICE EXPENSES 59,009. TOTAL EXPENSES 59,009. FOOD AND DIETICIAN COSTS: PROGRAM SERVICE EXPENSES 332,294. TOTAL EXPENSES 332,294. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 212,685. TOTAL EXPENSES 212,685. DIAPERS AND LINENS: PROGRAM SERVICE EXPENSES 85,153. TOTAL EXPENSES 85,153. GARBAGE DISPOSAL SERVICES: PROGRAM SERVICE EXPENSES 39,008. TOTAL EXPENSES 39,008. EXTERMINATION FEES: PROGRAM SERVICE EXPENSES 11,010. TOTAL EXPENSES 11,010. SECURITY: PROGRAM SERVICE EXPENSES 72,520. TOTAL EXPENSES 72,520. MAINTENANCE ADMIN FEES: PROGRAM SERVICE EXPENSES 115,297. TOTAL EXPENSES 115,297. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 50,000. TOTAL EXPENSES 50,000. PHARMACEUTICAL CONSULTANT: PROGRAM SERVICE EXPENSES 29,016. TOTAL EXPENSES 29,016. LAB FEES: PROGRAM SERVICE EXPENSES 43,471. TOTAL EXPENSES 43,471. PT, OT, AND SPEECH THERAPY: PROGRAM SERVICE EXPENSES 1,478,098. TOTAL EXPENSES 1,478,098. PAYROLL PROCESSING EXPENSE: MANAGEMENT AND GENERAL EXPENSES 20,896. TOTAL EXPENSES 20,896. CONSULTING EXPENSE: MANAGEMENT AND GENERAL EXPENSES 48,155. TOTAL EXPENSES 48,155. REGULATORY FEES: MANAGEMENT AND GENERAL EXPENSES 542. TOTAL EXPENSES 542. SNOW REMOVAL : PROGRAM SERVICE EXPENSES 7,921. TOTAL EXPENSES 7,921. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 109. BISHOP MCCARTHY RESIDENCE 1845 HADDON AVENUE CAMDEN NJ 08103 222051685 HEALTH CARE NJ 501(C)(3) LINE 9 CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN INC 0 SAINT MARY'S CATHOLIC HOME 1845 HADDON AVENUE CAMDEN NJ 08103 210634535 HEALTH CARE NJ 501(C)(3) LINE 9 CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN INC 0 MATER DEI NURSING HOME 1845 HADDON AVENUE CAMDEN NJ 08103 221840494 HEALTH CARE NJ 501(C)(3) LINE 9 CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN INC 0 DIOCESE OF CAMDEN 1845 HADDON AVENUE CAMDEN NJ 08103 RELIGIOUS SERVICES NJ 501(C)(3) LINE 1 CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN INC 0 CATHOLIC CHARITIES OF THE DIOCESE OF CAMDEN INC 1845 HADDON AVENUE CAMDEN NJ 08103 223759994 SOCIAL SERVICES NJ 501(C)(3) LINE 7 DIOCESE OF CAMDEN 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0