2015-11-12T17:34:22-06:00 2014-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2014-01-01 112388200 COBBLE HILL HEALTH CENTER INC COBB 7188556789 380 HENRY STREET BROOKLYN NY 11201 ANTHONY LEWIS PRESIDENT/CEO 7188556789 2015-11-12 1 AARON SHAPIRO P01333816 2128674000 2014 2016-02-25 16:41:14Z ANTHONY LEWIS 380 HENRY STREET BROOKLYN NY 11201 50772502 0 X WWW.COBBLEHILL.ORG X 1977 NY TO MAINTAIN A NURSING FACILITY AND PROVIDE ADULT DAY CARE & LONG TERM HOME HEALTH SERVICES ON AN OUTPATIENT BASIS. 13 12 556 153 0 0 231190 235317 50035353 48025998 691187 637664 333776 -134929 51291506 48764050 1600000 0 0 0 30238588 29490947 0 0 0 20014740 18950213 51853328 48441160 -561822 322890 105029572 99429107 58280761 60247566 46748811 39181541 X COBBLE HILL HEALTH CENTER, INC. OPERATES A 364 BED NURSING FACILITY. THE CENTER PROVIDES NURSING CARE TO PATIENTS AND IS LICENSED TO PROVIDE ADULT DAY CARE SERVICES. IN ADDITION, THE CENTER PROVIDES A LONG-TERM HOME HEALTH CARE PROGRAM. 0 1 39363422 43954327 SEE SCHEDULE O.THE CENTER HAS BEEN PROVIDING RESIDENTIAL AND COMMUNITY BASED SERVICES TO THE DISABLED AND ELDERLY FOR OVER 30 YEARS. THE CENTER OFFERS A COMPLETE RANGE OF MEDICAL, NURSING AND REHABILITATION SERVICES. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:>SUBACUTE CARE MEDICAL CARE, THE GOAL OF WHICH IS TO ENSURE A QUICK AND COMPLETE RECOVERY THEREBY RESTORING OUR RESIDENTS INDEPENDENCE AND HELP THEM RETURN TO COMMUNITY LIVING; >LONG TERM CARE, WHICH OFFERS A HOME-LIKE ALTERNATIVE THAT PROVIDES EACH INDIVIDUAL WITH HIS OR HER SPECIFIC NEEDS, BE IT PHYSICAL, PSYCHOLOGICAL OR EMOTIONAL, IN AN OPTIMUM ENVIRONMENT ENSURING THAT QUALITY OF LIFE IS MAINTAINED;>REHABILITATION, WHOSE GOAL IS TO RESTORE RESIDENTS FUNCTION AND THE ABILITIES THEY HAD PRIOR TO THE ONSET OF ILLNESS, INJURY OR TRAUMA; >A DIALYSIS CENTER, WHERE TREATMENT IS CONVENIENT BECAUSE IT IS ADMINISTERED ON-SITE AND PROVIDES MINIMAL DISRUPTION OF THEIR REGULAR SCHEDULES AND LIVES; >ALZHEIMERS SPECIAL CARE, WHICH, FOR OVER A DECADE, HAS LED THE WAY IN CARING FOR INDIVIDUALS WITH ALZHEIMERS DISEASE. THROUGH PROGRAM DEVELOPMENT, RESEARCH AND TRAINING,OUR ALZHEIMERS UNIT HAS RECEIVED THE BEST PRACTICES AWARD.THE CENTER PROVIDED 129,454,DAYS OF SKILLED NURSING CARE IN 2014. 1549118 1313806 THE CENTER ALSO OPERATES AN ADULT DAY CARE PROGRAM BY A BI-LINGUAL STAFF (ENGLISH AND SPANISH)WITH DOOR-TO-DOOR AMBULETTE TRANSPORTATION. SOME OF THE SERVICES THE PROGRAM PROVIDES INCLUDE THE FOLLOWING:>MEDICAL AND NURSING SUPERVISION AND MONITORING;>INDIVIDUAL NEEDS ASSESSMENT TO HELP IMPROVE AND MAINTAIN INDEPENDENCE;>ON-SITE REGISTERED NURSES WHO OBSERVE AND MONITOR HEALTH STATUS AND ADMINISTER AND MONITOR MEDICATIONS AND PERFORM CATHETERIZATION, DRESSING CHANGES, ETC. THE CENTER PROVIDED 8,783 DAY CARE VISITS DURING 2014. 2328838 2757865 COBBLE HILL, THOUGH ITS WHOLLY OWNED SUBSIDIARY COBBLE HILL LIFECARE PLUS, LLC, PROVIDES CARE MANAGEMENT SERVICES. A STAFF OF APPROXIMATELY THIRTY MULTILINGUAL NURSES, SOCIAL WORKERS AND CLERICAL SUPPORT STAFF PROVIDE TELEPHONIC CARE MANAGEMENT TO 1,200 MEMBERS IN BROOKLYN, MANHATTAN AND QUEENS. 385924 385924 43627302 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 19 0 556 1 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NY X ALAN GROSS 7188556789 380 HENRY STREET BROOKLYN NY 11201 DEMETRA POLIMEROS CHAIR 1.00 0.80 X X 0 0 0 THOMAS SPATH SECRETARY 1.00 0.80 X X 0 0 0 PAUL SAYEGH TREASURER 1.00 0.30 X X 0 0 0 MARK DONOVAN BOARD MEMBER 1.00 0.30 X 0 0 0 JOSEPH BROADWIN BOARD MEMBER 1.00 0.30 X 0 0 0 PATRICK OWEN BURNS BOARD MEMBER 1.00 0.30 X 0 0 0 DR CIRIL GODEC BOARD MEMBER 1.00 0.30 X 0 0 0 CHARLES CARAMES BOARD MEMBER 1.00 0.30 X 0 0 0 GREG O'CONNELL BOARD MEMBER 1.00 0.30 X 0 0 0 PETER D YATRAKIS BOARD MEMBER 1.00 0.30 X 0 0 0 W RUDY KAMUF BOARD MEMBER 1.00 0.30 X 0 0 0 OLGA LIPSCHITZ BOARD MEMBER 1.00 0.30 X 125000 0 0 JUDI FRANCES BOARD MEMBER 1.00 0.80 X 0 0 0 ANTHONY LEWIS PRESIDENT / CEO 30.00 6.00 X 335276 0 39882 DANIEL TUCHMAN ADMINISTRATOR / COO 30.00 6.00 X 276218 36400 58780 ALAN GROSS CFO 30.00 6.00 X 298553 43950 49680 SHIRLEY WITHERSPOON DIRECTOR OF STAFF DEVELOPMENT 35.00 X 130645 0 25402 SOMMER ESPINO MDS DIRECTOR 35.00 X 218572 0 53953 RAISA FORKOSH ADMISSIONS DIRECTOR 35.00 X 151119 0 37715 MEVE SHAKESPEARE DIRECTOR OF NURSING 35.00 X 149002 0 30154 ARTHUR ZOLOTAREVSKY DIRECTOR OF REHAB 31.50 X 133273 0 31986 1817658 80350 327552 18 0 1 0 UNITEX TEXTILE RENTAL 401 SO MACQUESTEN PKWY MT VERNON NY 10550 LAUNDRY AND LINEN SERVICES 498245 WHITE GLOVE PLACEMENT 85 BARTLETT STREET BROOKLYN NY 11206 NURSING AGENCY 369541 THERADYNAMICS REHAB 225 CROSSWAYS PARK DRIVE WOODBURY NY 11797 REHAB/THERAPY SERVICES 365064 QUALITY HEALTHCARE 3512 QUENTIN ROAD BROOKLYN NY 11234 NURSING AGENCY 201193 SAMARITAN SERVICES INC 24 COUNTY ROAD TENAFLY NJ 07670 NURSING AGENCY 171777 15 138480 59726 37111 235317 SKILLED NURS. FACILITY 623000 43900576 43900576 CASE MANAGEMENT 624100 2757865 2757865 ADULT DAY CARE PROGRAM 621990 1313806 1313806 COMMUNITY CARE TRANSITION PROJECT 624200 53751 53751 48025998 237968 237968 40000 194763 -154763 -154763 -154763 2213385 1813689 399696 399696 399696 MEDICAL RECORDS INCOME 900099 12759 12759 VENDING MACHINE INCOME 900099 2985 2985 REBATES WEBSITE DONATIONS 900099 2461 2461 1629 1629 19834 48764050 48025998 0 502735 1152889 1152889 20217508 19211554 1005954 1575824 1498794 77030 4774812 4361714 413098 1769914 1608035 161879 391805 391805 190808 190808 3273 3273 63501 63501 3353358 3168284 185074 33264 30222 3042 4062740 3691156 371584 219208 199159 20049 3762677 3396724 365953 29016 26362 2654 2950918 2681023 269895 675483 617703 57780 CASH RECEIPTS ASSESSMEN 2365830 2365830 LAUNDRY AND LINEN 848332 770742 77590 48441160 43627302 4813858 0 2920278 1972532 2659795 2832760 6398 18230758 17804454 49120 57937 238350 296214 79089063 23952945 67023285 55136118 11717559 11949362 2184029 9379730 105029572 99429107 3984154 3867834 44455000 43470000 332840 324402 9508767 12585330 58280761 60247566 X 46666317 39087422 82494 94119 46748811 39181541 105029572 99429107 X 322890 -279170 -7610990 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3273 3273 0 PART II-B, LINE 1: $3,273 IS AN ALLOCATION OF ASSOCIATION DUES TO LOBBYING EXPENSES. 1 332840 324402 1 237000 237000 72567663 19281947 53285716 3707937 2576471 1131466 2576463 2094527 481936 55136118 MORTGAGE COSTS 1591006 DUE FROM COBBLE HILL FOUNDATION, INC. 251424 DUE FROM YOUR CHOICE AT HOME, INC. 320877 DEPOSITS AND OTHER RECEIVABLES 98879 ASSETS HELD FOR SALE 7117544 9379730 DUE TO THIRD PARTIES 1095951 SWAP AGREEMENTS 11489379 12585330 X 48616142 -279170 194763 -84407 48700549 63501 63501 48764050 48572422 194763 194763 48377659 63501 63501 48441160 PART IV, LINE 1B: FUNDS HELD ON BEHALF OF RESIDENTS. PART X, LINE 2: THE CENTER 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 XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 194,763. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 194,763. X X X 0 0 0 0 0 0 0 1 0 ANTHONY LEWIS PRESIDENT / CEO 306760 0 24439 0 4077 0 30290 0 9592 0 375158 0 0 0 DANIEL TUCHMAN ADMINISTRATOR / COO 213600 36400 27692 0 34926 0 21685 8605 20395 8095 318298 53100 0 0 ALAN GROSS CFO 252450 43950 30420 0 15683 0 21877 8413 14003 5387 334433 57750 0 0 SHIRLEY WITHERSPOON DIRECTOR OF STAFF DEVELOPMENT 130645 0 0 0 0 0 5246 0 20156 0 156047 0 0 0 SOMMER ESPINO MDS DIRECTOR 148500 0 14569 0 55503 0 25593 0 28360 0 272525 0 0 0 RAISA FORKOSH ADMISSIONS DIRECTOR 123900 0 13812 0 13407 0 16583 0 21132 0 188834 0 0 0 MEVE SHAKESPEARE DIRECTOR OF NURSING 130000 0 9000 0 10002 0 16201 0 13953 0 179156 0 0 0 ARTHUR ZOLOTAREVSKY DIRECTOR OF REHAB 115587 0 5452 0 12234 0 14409 0 17577 0 165259 0 0 0 PART I, LINE 7 THE BOARD APPROVES MERIT BASED BONUSES FOR ITS OFFICERS AND TOP EMPLOYEES FOR THEIR DEDICATION TO THE CENTER DURIING THE YEAR. THESE BONUSES ARE APPROVED TOWARDS THE END OF THE YEAR. A NYC CAPITAL RESOURCE CORP 204099098 649437AEO 2008-01-30 35920000 RENOVATION 0 0 0 B NYC CAPITAL RESOURCE CORP 204099098 649437AF7 2008-01-30 4420000 REFINANCING 1 0 0 C NYC CAPITAL RESOURCE CORP 204099098 649437AG5 2008-01-30 7850000 CONSTRUCTION 0 0 0 A 1190000 35920000 12137676 1331784 22448875 2011 1 0 0 1 B 500000 4420000 4261307 158691 2008 1 0 0 1 C 3030000 7850000 286416 7438143 2009 1 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 0 A 0 B 0 C 0 FORM 990, PART III, LINE 3 THE ADULT DAY CARE PROGRAM CLOSED AT THE END OF 2014. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS REVIEWED BY THE CFO AND PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. ANY QUESTIONS THAT ARISE ARE DISCUSSED AND RESOLVED PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C COBBLE HILL REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICT. THIS INFORMATION IS REVIEWED BY THE AUDIT AND CORPORATE COMPLIANCE COMMITTEES. THE AUDIT COMMITTEE IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST WHICH OCCUR, AND WILL ENSURE SUCH INDIVIDUALS DO NOT PARTICIPATE IN DISCUSSIONS OR DECISIONS INVOLVING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION WAS DETERMINED BY A RECOMMENDATION BY THE CEO AND APPROVAL OF THE BOARD. THE CEO'S COMPENSATION IS DETERMINED BY THE GOVERNING BOARD. ALL OTHER TOP EMPLOYEES' COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD. THIS PROCESS WAS LAST DONE IN 2014. THE PROCESS INCLUDED A REVIEW BY THE BOARD OF COMPENSATION OF SIMILAR POSITIONS AT OTHER HEALTH CARE FACILITIES OBTAINED FROM IRS FORM 990S FILED ON GUIDESTAR OR CANVASSING OF THOSE FACILITES. FORM 990, PART VI, SECTION C, LINE 19 COBBLE HILL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SWAP AGREEMENT -4,559,125. IMPAIRMENT LOSS -3,051,865. FORM 990 PART XII QUESTION 12C THE PROCESS DID NOT CHANGE FROM PRIOR YEAR. COBBLE HILL LIFECARE PLUS LLC 380 HENRY STREET BROOKLYN NY 11201 461226428 PROVIDES CARE MANAGEMENT SERVICES FOR THE ELDERLY LIVING AT HOME NY 2757865 5535 N/A COBBLE HILL FOUNDATION INC 380 HENRY STREET BROOKLYN NY 11201 113122301 FUNDRAISING NY 501(C)(3) PF N/A 0 YOUR CHOICE AT HOME INC 380 HENRY STREET BROOKLYN NY 11201 461256502 HOME HEALTH CARE NY 501(C)(3) N/A 0 COBBLE HILL LIFECARE INC 380 HENRY STREET BROOKLYN NY 11201 461388106 SUPPORTING ORGANIZATION NY 501(C)(3) N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0