2015-11-12T15:47:20-06:00 2014-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2014-01-01 133623600 NORTHERN MANOR MULTICARE CENTER INC NORT 8456233904 199 NORTH MIDDLETOWN ROAD NANUET NY 10954 MORRIS KLEIN EXECUTIVE DIRECTOR 8456233904 2015-11-12 1 AARON SHAPIRO P01333816 2128674000 2014 2016-02-25 16:41:14Z MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 32173116 0 X WWW.NORTHERNMANOR.COM X 1991 NY TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 9 9 427 25 0 0 177541 131129 35037654 31946040 8679 5218 0 90729 35223874 32173116 1785128 435078 0 0 18109860 17941569 0 0 0 13515547 12676051 33410535 31052698 1813339 1120418 18628519 18215806 23233521 21700390 -4605002 -3484584 TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM. 0 0 22210719 27514469 HEALTH CARE SERVICES FOR THE ELDERLY. 4412432 4431571 OUTPATIENT ADULT DAY CARE SERVICES. 435078 435078 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. 27058229 1 1 0 0 0 0 0 0 0 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 70 0 427 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 0 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 4000 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 1250 0 ABRAHAM ZACHARIASH BOARD MEMBER 0.10 0.90 X 0 4000 0 RABBI HERSHEL HAGER BOARD MEMBER 0.10 0.90 X 0 250 0 ISRAEL ORZEL BOARD MEMBER 0.10 0.90 X 0 2750 0 MORRIS KLEIN EXECUTIVE DIRECTOR 6.00 29.00 X 135192 653425 183314 GEDALIA KLEIN CHIEF OPERATING OFFICER 3.00 14.50 X 22556 109021 18329 MICHAEL NOWICKI COMPLIANCE OFFICER 6.00 29.00 X 32193 155600 0 AKIVA FOGEL ADMINISTRATOR 35.00 X 223027 0 8322 GELENA DEVERMAN ADC DIRECTOR 35.00 X 137723 0 4397 GENNADIY GOLDVEKHT REGISTERED NURSE 35.00 X 103231 0 0 CAROL P SCHIAVONE NURSE MANAGER 35.00 X 114270 0 0 ELIZABETH GEROSA DIRECTOR OF NURSING 35.00 X 133156 0 12414 LAURENCE KAMER MANAGER 35.00 X 100218 0 0 1001566 939296 226776 8 0 1 0 TOWNE NURSING STAFF 1413 38TH STREET BROOKLYN NY 11218 NURSING SERVICES 1881239 SENIOR CARE 855 BRUSH AVENUE BRONX NY 10465 TRANSPORTATION 317403 CENTERS FOR CARE 4770 WHITE PLAINS ROAD BRONX NY 10470 ADMINISTRATIVE SERVICES 296721 CLEAN TEX SERVICES 491 LYONS AVE IRVINGTON NJ 07111 LAUNDRY AND LINEN SERVICE 182738 4 131129 131129 RESIDENT SERVICE REVENUE 623000 27514469 27514469 ADULT DAY CARE 623000 4431571 4431571 31946040 5218 5218 MISC INCOME 900099 90729 0 90729 90729 32173116 31946040 0 95947 435078 435078 456195 393303 62892 12825280 11057321 1767959 895122 771718 123404 2852291 2459065 393226 912681 786856 125825 1620965 1410198 210767 398436 398436 38950 38950 395263 340771 54492 19931 17183 2748 1353193 1166638 186555 1894813 1626799 268014 1439703 1241221 198482 296604 255713 40891 757977 653480 104497 174959 157628 17331 FOOD EXPENSE 1999198 1999198 NYS ASSESSMENT 1204801 1204801 MEDICAL SUPPLIES 1081258 1081258 31052698 27058229 3994469 0 635068 1542562 759324 675151 7803350 6798754 456555 476095 23085268 14758811 8533206 8326457 59964 50775 381052 346012 18628519 18215806 4728522 4477246 5935000 5000000 5875217 5839711 6694782 6383433 23233521 21700390 X -4605002 -3484584 -4605002 -3484584 18628519 18215806 1120418 0 X X 0 1 X 1 0 X 5477669 177541 131129 5786339 35941663 36626627 36380660 35037654 31946040 175932644 35941663 36626627 41858329 35215195 32077169 181718983 0 0 0 181718983 540 813 1173 8679 5218 16423 540 813 1173 8679 5218 16423 71361 90729 162090 35942203 36698801 41859502 35223874 32173116 181897496 0.99900 0.99940 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 790000 790000 17231834 10416957 6814877 592629 500183 92446 4007265 3691009 316256 463540 150662 312878 8326457 ESTIMATED LIABILITIES TO THIRD-PARTY PAYORS 941000 RESIDENT FUNDS HELD IN TRUST 233895 DUE TO RELATED PARTIES 5208538 6383433 X 32173116 0 32173116 0 32173116 30617620 0 30617620 435078 435078 31052698 PART X, LINE 2: NORTHERN MANOR MULTICARE CENTER, INC. HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2011 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO RELATED ENTITY 435,078. 0 CONGREGATION CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501(C) (3) 435078 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 108058 522278 18613 89962 8521 41185 24009 116043 7754 35508 166955 804976 0 0 MICHAEL NOWICKI COMPLIANCE OFFICER 32193 155600 0 0 0 0 0 0 0 0 32193 155600 0 0 AKIVA FOGEL ADMINISTRATOR 223027 0 0 0 0 0 0 0 8322 0 231349 0 0 0 PART I, LINE 3 THE STUDY WAS CONDUCTED BY THE SOLE CORPORATE MEMBER "NORTHERN METROPOLITAN FOUNDATION" ON BEHALF OF NORTHERN MANOR MULTICARE, INC. 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 ASSISTED LIVING AT NORTHERN RIVERVIEW, INC. 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. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FINAL FORM 990 WAS REVIEWED BY THE BOARD PRIOR TO BEING FILED. 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 15 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" ON BEHALF OF NORTHERN MANOR MULTICARE, INC. 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 0 0 0 0 0