2015-11-16T11:43:29-06:00 2014-12-31 264298079 EFP ROTENBERG LLP 280 KENNETH DRIVE ROCHESTER NY 14623 990 2014-01-01 237098164 ST ANN'S NURSING HOME COMPANY INC D/B/A THE HERITAGE STAN 5856976000 1500 PORTLAND AVENUE ROCHESTER NY 14621 DENNIS KANT SENIOR VICE PRESIDENT & CFO 5856976307 2015-11-12 1 JENNIFER ARBORE P00893012 5854278900 2014 2016-02-25 16:41:14Z DENNIS KANT 1500 PORTLAND AVENUE ROCHESTER NY 14621 12132302 0 X WWW.STANNSCOMMUNITY.COM X 1971 NY PROMOTE INDEPENDENCE, PHYSICAL & SPIRITUAL WELL-BEING OF OLDER ADULTS IN A SKILLED NURSING FACILITY. 20 18 0 19 0 0 3800 43344 8105250 9160101 964964 742884 44885 16226 9118899 9962555 89046 94530 0 0 5300546 4980885 0 0 0 5799999 6216985 11189591 11292400 -2070692 -1329845 40419339 36266967 20392764 18655573 20026575 17611394 X SINCE OUR FOUNDING IN 1874, OUR MISSION HAS BEEN TO PROMOTE THE HIGHEST LEVELS OF INDEPENDENCE, PHYSICAL AND SPIRITUAL WELL-BEING OF OLDER ADULTS IN THE CATHOLIC TRADITION OF EXCELLENCE IN CARE AND SERVICES. TO FULFILL THIS MISSION, ST. ANN'S COMMUNITY OFFERS A CONTINUUM OF SERVICES FOR SENIORS IN THE GREATER ROCHESTER AREA. ST. ANN'S COMMUNITY OTHERWISE KNOWN AS ST. ANN'S OF GREATER ROCHESTER INC. DELIVERS THESE SERVICES THROUGH THESE AFFILIATED ORGANIZATIONS: ST.ANN'S HOME FOR THE AGED, ST. ANN'S NURSING HOME COMPANY, INC., CHAPEL OAKS, INC., ST. ANN'S FOUNDATION, INC. AND ST. ANN'S SENIOR HOUSING INC.ST. ANN'S NURSING HOME COMPANY, INC. (THE HERITAGE) IS A NOT-FOR-PROFIT CORPORATION THAT OPERATES ST. ANN'S CARE CENTER AT CHERRY RIDGE, A 72-BED RESIDENTIAL HEALTH CARE FACILITY, PROVIDING INPATIENT POST-ACUTE REHABILITATION CARE AND PALLIATIVE CARE. 0 0 10335912 94530 9160101 ST. ANN'S NURSING HOME COMPANY, INC. (THE HERITAGE) IS A LICENSED SKILLED NURSING FACILITY THAT CURRENTLY OPERATES AS ST. ANN'S CARE CENTER AT CHERRY RIDGE. IT IS A 72-BED LICENSED FACILITY WHICH INCLUDES 60 SKILLED NURSING BEDS AND 12 INPATIENT POST-ACUTE REHABILITATION CARE BEDS. DURING 2014, 21,718 DAYS OF CARE FOR SKILLED NURSING AND 3,801 DAYS OF CARE FOR POST-ACUTE REHABILITATION WERE PROVIDED. 10335912 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 20 18 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X DENNIS KANT SENIOR VICE PRESIDENT & CFO 5856976000 1500 PORTLAND AVENUE ROCHESTER NY 14621 MARGARET BRINGEWATT CHAIR 1.00 X X 0 0 0 JOSEPH STANKAITIS MD CHAIR ELECT 1.00 X X 0 0 0 PATRICK BURKE IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 TIMOTHY WHITE SECRETARY 1.00 X X 0 0 0 MARIE CASTAGNARO TREASURER 1.00 X X 0 0 0 ROBERT BERGIN DIRECTOR 1.00 X 0 0 0 CRAIG BURTON DIRECTOR 1.00 X 0 0 0 THOMAS COMBS DIRECTOR 1.00 X 0 0 0 MARK CRONIN DIRECTOR 1.00 X 0 0 0 PAULA DOLAN DIRECTOR 1.00 X 0 0 0 KENT GARDNER DIRECTOR 1.00 X 0 0 0 RICHARD GANGEMI MD DIRECTOR 1.00 X 0 0 0 REV KEVIN MCKENNA DIRECTOR 1.00 X 0 0 0 SISTER MARLENE PAPE DIRECTOR 1.00 X 0 0 0 MICHAEL PINCH DIRECTOR 1.00 X 0 0 0 MAURICIO RIVEROS DIRECTOR 1.00 X 0 0 0 ANN MCCORMICK DIRECTOR 1.00 X 0 0 0 JUDY TOYER DIRECTOR 1.00 X 0 0 0 JILL WYNN DIRECTOR 1.00 X 0 0 0 MICHAEL MCRAE PRESIDENT/CEO 5.00 35.00 X X 0 348950 14465 DENNIS KANT SENIOR VP/CFO 3.00 37.00 X 0 227700 15191 ROBERT BOURG VP OF ORGANIZATIONAL TRAINING & DEVELOPMENT 4.00 36.00 X 0 164603 2861 STEVEN SMITH VP OF FOUNDATION & RESOURCE DEVELOPMENT 0.00 40.00 X 0 163235 7115 MICHAEL SEELIG CR VP 0.00 40.00 X 0 162186 13590 DIANE KANE MD CHIEF MEDICAL DIRECTOR 33.00 7.00 X 0 358806 16537 KIMBERLY PETRONE ASSOCIATE MEDICAL DIRECTOR 4.00 36.00 X 0 270924 14463 JOHN JURIK ASSOCIATE MEDICAL DIRECTOR 4.00 36.00 X 0 222321 12617 JARVIS SANCHEZ-RIVERA STAFF ATTENDING PHYSICIAN 4.00 36.00 X 0 203284 13482 MICHELE SINCLAIR CHIEF NURSING EXECUTIVE 4.00 36.00 X 0 197778 14055 ELIZABETH MULLIN-DIPROSA FORMER PRESIDENT/CEO 3.00 37.00 X 0 440535 9362 DAVID SONES FORMER VP ADMINISTRATOR 5.00 35.00 X 0 139264 4865 0 2899586 138603 0 1 1 0 0 43344 43344 NET RESIDENT SERVICE REVENUE 623000 9160101 9160101 9160101 301647 301647 805 0 805 805 805 2610984 2169747 441237 441237 441237 MISCELLANEOUS 900099 10665 10665 TELEPHONE REVENUE 900099 4756 4756 15421 9962555 9160101 0 759110 94530 94530 4117751 3921681 196070 564935 538035 26900 298199 284000 14199 14750 14750 44478 44478 77744 58745 18999 30229 30229 46557 41706 4851 136679 136679 11950 5547 6403 261815 261815 1526979 1526979 94181 94181 INTERCOMPANY SUPPORT AL 2406694 1819083 587611 BAD DEBT 602335 602335 NYS ASSESSMENT 450997 450997 LETTER OF CREDIT FEES 265010 265010 246587 234589 11998 11292400 10335912 956488 0 2000 2000 2293708 2799660 1128478 1090238 26683 32246 21864227 4316539 19019220 17547688 12234296 10063995 5714954 4731140 40419339 36266967 1334194 1000442 73198 31255 15739924 16536752 3245448 1087124 20392764 18655573 X 19877926 17427053 148649 184341 20026575 17611394 40419339 36266967 X -1329845 -82992 -1002344 X X 0 1 X 1 0 X 7547730 5076424 3242965 3800 43344 15914263 13626983 14483099 8168801 8105250 9160101 53544234 21174713 19559523 11411766 8109050 9203445 69458497 0 0 0 69458497 407175 302967 305615 328004 302522 1646283 407175 302967 305615 328004 302522 1646283 170203 188336 20166 378705 21752091 20050826 11737547 8437054 9505967 71483485 0.97170 0.97190 0.02300 0.02190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1126852 1126852 9998232 1672279 8325953 9575531 2225405 7350126 1163612 418855 744757 17547688 BENEFICIAL INTEREST IN REMAINDER TRUSTS 184341 DEFERRED FINANCING COSTS, NET 251037 DUE FROM AFFILIATES 1880745 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS, MEDICAID 2415017 4731140 DUE TO AFFILIATES 671342 FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENT 415782 1087124 X 8832741 -82992 -1002344 -1085336 9918077 44478 44478 9962555 11247922 0 11247922 44478 44478 11292400 PART X, LINE 2: THE CARE CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON ITS EXEMPT INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE CARE CENTER'S TAX-EXEMPT PURPOSE MAY BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. IN ACCORDANCE WITH ASC 740-10-50, THE CARE CENTER WILL RECOGNIZE THE TAX BENEFITS FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES. MANAGEMENT BELIEVES THAT THE CARE CENTER IS CURRENTLY OPERATING IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS HAS BEEN INCLUDED ON THE CARE CENTER'S FINANCIAL STATEMENTS. THE EXEMPT INFORMATIONAL RETURNS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES AND ITS OPEN AUDIT PERIODS ARE 2012 THROUGH 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENT -431,291. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS 56,419. LOSS ON REFINANCING -627,472. 0 ST ANN'S OF GREATER ROCHESTER INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161494042 501(C)(3) 94530 N/A PROVIDE FINANCIAL SUPPORT 1 0 PART I, LINE 2: THE ORGANIZATION PROVIDES PERIODIC REPORTS DETAILING THE USE OF THE GRANT FUNDS TO THE BOARD OF DIRECTORS. X X X 1 1 X X X X X 0 0 0 0 0 0 0 1 0 MICHAEL MCRAE PRESIDENT/CEO 0 323551 0 0 0 25399 0 0 0 14465 0 363415 0 0 DENNIS KANT SENIOR VP/CFO 0 215131 0 0 0 12569 0 0 0 15191 0 242891 0 0 ROBERT BOURG VP OF ORGANIZATIONAL TRAINING & DEVE 0 161500 0 0 0 3103 0 0 0 2861 0 167464 0 0 STEVEN SMITH VP OF FOUNDATION & RESOURCE DEVELOPM 0 156977 0 0 0 6258 0 0 0 7115 0 170350 0 0 MICHAEL SEELIG CR VP 0 151367 0 0 0 10819 0 0 0 13590 0 175776 0 0 DIANE KANE MD CHIEF MEDICAL DIRECTOR 0 327026 0 0 0 31780 0 0 0 16537 0 375343 0 0 KIMBERLY PETRONE ASSOCIATE MEDICAL DIRECTOR 0 261590 0 0 0 9334 0 0 0 14463 0 285387 0 0 JOHN JURIK ASSOCIATE MEDICAL DIRECTOR 0 209465 0 0 0 12856 0 0 0 12617 0 234938 0 0 JARVIS SANCHEZ-RIVERA STAFF ATTENDING PHYSICIAN 0 192478 0 0 0 10806 0 0 0 13482 0 216766 0 0 MICHELE SINCLAIR CHIEF NURSING EXECUTIVE 0 185538 0 0 0 12240 0 0 0 14055 0 211833 0 0 ELIZABETH MULLIN-DIPROSA FORMER PRESIDENT/CEO 0 427734 0 0 0 12801 0 0 0 9362 0 449897 0 0 DAVID SONES FORMER VP ADMINISTRATOR 0 137188 0 0 0 2076 0 0 0 4865 0 144129 0 0 PART I, LINE 1A ST. ANN'S COMMUNITY PROVIDED THE FOLLOWING BENEFITS FOR THE FORMER PRESIDENT/CEO: PERSONAL CAR ALLOWANCE OF $29,092; REIMBURSEMENT OF TAX PREPARATION FEES AND PROFESSIONAL ADVISORY SERVICE FEES OF $8,842; AND CLUB MEMBERSHIP OF $1,524. ALL OF THESE ITEMS WERE CONSIDERED TAXABLE BENEFITS FOR THE FORMER PRESIDENT/CEO AND WERE INCLUDED AS WAGE COMPENSATIONON ON THE FORM W-2. ST. ANN'S COMMUNITY PROVIDED THE FOLLOWING BENEFITS FOR THE PRESIDENT/CEO: PERSONAL CAR ALLOWANCE OF $9,438; REIMBURSEMENT OF PROFESSIONAL ADVISORY SERVICE FEES OF $16,000; AND REIMBURSEMENT OF MOVING EXPENSES OF $2,050. ALL OF THESE ITEMS WERE CONSIDERED TAXABLE BENEFITS FOR THE PRESIDENT/CEO AND WERE INCLUDED AS WAGE COMPENSATIONON ON THE FORM W-2. PART I, LINE 7 80 % IS TIED TO KEY ORGANIZATIONAL GOALS. 20% IS TIED TO INDIVIDUAL PERFORMANCE VS. ORGANIZATIONAL GOALS. PATRICK BURKE BOARD MEMBER OF ST. ANN'S COMMUNITY 55494 PATRICK BURKE IS A CURRENT BOARD MEMBER AND MANAGING PRINCIPLE OF BURKE GROUP. ST. ANN'S ENGAGES BURKE GROUP AS ADMINISTRATOR OF IT'S RETIREMENT PLANS AND FOR ACTUARIAL SERVICES RELATED TO THESE PLANS. 0 DR DIANE KANE KEY EMPLOYEE OF ST. ANN'S HOME FOR THE AGED 88176 ST. ANN'S COMMUNITY MEDICAL PRACTICE IS A FOR-PROFIT ENTITY OWNED BY DR. KANE. DR. KANE IS ALSO THE MEDICAL DIRECTOR FOR ST. ANN'S HOME FOR THE AGED. THE ST. ANN'S MEDICAL PRACTICE PURCHASES SERVICES FROM ST. ANN'S WHICH INCLUDES DR. KANE'S TIME AS WELL AS ADDITIONAL NURSING AND ADMINISTRATIVE SUPPORT, TIME AND SPACE. FEES PAID TO ST. ANN'S COMMUNITY (ST. ANN'S HOME AND RELATED ORGANIZATIONS) TOTAL $88,176 FOR 2014. 0 FORM 990, PART VI, SECTION A, LINE 4 ADDITIONAL LANGUAGE WAS ADDED TO THE ORGANIZATIONAL DOCUMENTS TO REFLECT THE CHANGES REQUIRED BY THE NEW YORK NON-PROFIT REVITALIZATION ACT. FORM 990, PART VI, SECTION B, LINE 11 THE INFORMATION FOR THE REPORTS IS PREPARED BY ST. ANN'S STAFF, PROVIDED AND REVIEWED BY EFP ROTENBERG, LLP. FINAL REPORTS ARE REVIEWED BY THE ACCOUNTING TEAM, INCLUDING THE DIRECTOR OF FINANCE AND CFO, PROVIDED TO CEO AND SEVERAL EXECUTIVE COMMITTEE MEMBERS PRIOR TO REVIEW AT THE EXECUTIVE COMMITTEE MEETING. COPIES OF THE REPORTS ARE DISTRIBUTED AT THE SEPTEMBER BOARD MEETING AT WHICH TIME THE REPORTS ARE APPROVED. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS (INCLUDING THE PRESIDENT AND CEO) ARE REQUIRED TO ANNUALLY COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE FORMS ARE THEN REVIEWED BY THE VP OF ORGANIZATIONAL DEVELOPMENT AND ANY POTENTIAL CONFLICTS ARE DEALT WITH AS NEEDED INCLUDING ABSTAINING FROM VOTING ON MATTERS RELATED TO SUCH CONFLICTS. ANY PERSON COVERED BY THE POLICY SHALL NOT KNOWINGLY USE HIS OR HER POSITION FOR PERSONAL GAIN, TO COMPROMISE ST. ANN'S INTERESTS, OR TO ALLOW A CONFLICT TO ARISE BETWEEN ST. ANN'S INTEREST AND HIS OR HER PERSONAL INTEREST. FORM 990, PART VI, SECTION B, LINE 15 EACH YEAR AN INDEPENDENT WAGE STUDY IS CONDUCTED BY A CONSULTANT. DIRECTORS AND ABOVE, EXCEPT CEO, ARE REVIEWED BY VP OF HR AND CEO WITH ADJUSTMENTS MADE AS NEEDED TO MAINTAIN COMPETITIVENESS. CEO DATA IS REVIEWED BY A COMMITTEE INCLUDING THE BOARD CHAIR, PAST BOARD CHAIR, AND HR COMMITTEE CHAIR. ADJUSTMENTS MADE AS NEEDED TO MAINTAIN MARKET COMPETITIVENESS. 2013 VPS AND CEO DATA REVIEWED; 2013 DIRECTOR LEVEL DATA REVIEWED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENT -431,291. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS 56,419. LOSS ON REFINANCING -627,472. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. FORM 990, PART V, LINE 2A: ALL INDIVIDUALS WORKING AT ST. ANN'S NURSING HOME COMPANY, INC. D/B/A THE HERITAGE ("THE HERITAGE") ARE EMPLOYEES OF ST. ANN'S HOME FOR THE AGED ("SAH") AND ARE REPORTED ON ITS FORM 941 UNDER EIN 16-0743146. THE SALARY AND BENEFITS EXPENSES REPORTED ON FORM 990, PART IX ARE THE HERITAGE'S ALLOCATED PAYROLL COSTS BASED ON TIME SPENT BY THE SHARED EMPLOYEES. SAH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION. CHAPEL OAKS INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161489340 HEALTH CARE NY 501(C)(3) 9 ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S HOME FOR THE AGED 1500 PORTLAND AVENUE ROCHESTER NY 14621 160743146 HEALTH CARE NY 501(C)(3) 9 ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S FOUNDATION INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161379536 HEALTH CARE NY 501(C)(3) 11A ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S SENIOR HOUSING INC DBA CHERRY RIDGE 1500 PORTLAND AVENUE ROCHESTER NY 14621 760705854 HEALTH CARE NY 501(C)(3) 9 ST ANN'S OF GREATER ROCHESTER INC 0 ST ANN'S OF GREATER ROCHESTER INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161494042 HEALTH CARE NY 501(C)(3) 11B N/A 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1