2015-11-05T08:35:53-06:00 2014-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2014-01-01 262006545 VILLAGE SENIOR SERVICES CORPORATION VILL 2123375600 120 BROADWAY SUITE 2840 NEW YORK NY 10271 RACHEL AMALFITANO CHIEF FINANCIAL OFFICER 2123375600 2015-11-04 1 AARON SHAPIRO P01333816 2128674000 2014 2016-03-07 17:11:31Z VILLAGECAREMAX RACHEL AMALFITANO 120 BROADWAY SUITE 2840 NEW YORK NY 10271 141590628 0 X WWW.VILLAGECARE.ORG X 2008 NY VILLAGE SENIOR SERVICES CORPORATION OPERATES A MEDICAID MANAGED LON-TERM CARE (MLTC) PLAN THAT COORDINATES HEATH CARE SERVICES FOR CHRONICALLY ILL ADULTS WHO WISH TO CONTINUE TO STAY AT HOME AND IN THEIR COMMUNITIES FOR AS LONG AS POSSIBLE. IT WORKS CLOSELY WITH MEMBERS' DOCTORS, HELP SET UP APPOINTMENTS, ARRANGE CARE, MONITOR MEDICATIONS AND PROVIDE GUIDANCE TOWARD THE BEST QUALITY HEALTH CARE OPTIONS AVAILABLE. 10 9 211 9 0 0 0 0 88749353 139655669 0 59252 0 0 88749353 139714921 0 0 0 0 5835177 13320001 0 0 0 75003703 121703453 80838880 135023454 7910473 4691467 25670764 43802223 13853907 27346460 11816857 16455763 X VILLAGE SENIOR SERVICES CORPORATION OPERATES A MEDICAID MANAGED LONG-TERM CARE (MLTC) PLAN THAT COORDINATES HEATH CARE SERVICES FOR CHRONICALLY ILL ADULTS WHO WISH TO CONTINUE TO STAY AT HOME AND IN THEIR COMMUNITIES FOR AS LONG AS POSSIBLE. IT WORKS CLOSELY WITH MEMBERS' DOCTORS, HELP SET UP APPOINTMENTS, ARRANGE CARE, MONITOR MEDICATIONS AND PROVIDE GUIDANCE TOWARD THE BEST QUALITY HEALTH CARE OPTIONS AVAILABLE. 0 0 117643066 139655669 VILLAGE SENIOR SERVICES CORPORATION OPERATES A MEDICAID MANAGEDLONG-TERM CARE (MLTC) PLAN THAT COORDINATES HEALTH CARE SERVICES FORCHRONICALLY ILL ADULTS WHO WISH TO REMAIN IN THEIR OWN HOME ANDCOMMUNITIES FOR AS LONG AS POSSIBLE. THE PLAN COVERS A WIDE RANGE OFLONG TERM CARE SERVICES INCLUDING A DEDICATED CARE TEAM. AT THE END OF2014, VSSC HAD OVER 2500 MEMBERS UNDER MANAGEMENT AND WAS APPROVEDTO ESTABLISH A FULLY INTEGRATED DUAL ADVANTAGE (FIDA) PLAN IN 2015. 117643066 1 0 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 24 0 211 1 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X RACHEL AMALFITANO 2123375600 120 BROADWAY SUITE 2840 NEW YORK NY 10271 EMMA DEVITO PRESIDENT & CEO 19.00 31.00 X X 290458 389482 45259 DANIEL M FOX VICE CHAIR/SECRETARY 1.00 7.00 X X 0 0 0 DAVID H SIDWELL CHAIR OF BOARD 1.00 8.00 X X 0 0 0 PATRICIA M OWENS DIRECTOR 1.00 6.00 X X 0 0 0 ELEANOR APPLEWHAITE DIRECTOR 1.00 5.00 X 0 0 0 JAMES J GARDINER DIRECTOR 1.00 5.00 X 0 0 0 FRANK J OLDHAM DIRECTOR 1.00 3.00 X 0 0 0 LEROY SHARER MD DIRECTOR 1.00 3.00 X 0 0 0 RICHARD WALLGREN DIRECTOR 1.00 3.00 X 0 0 0 JOHN BEHRE DIRECTOR 1.00 2.00 X 0 0 0 RACHEL AMALFITANO CHIEF FINANCIAL OFFICER 19.00 31.00 X 158078 211970 28376 ANTOINETTE CASSETTA EXECUTIVE VICE PRESIDENT 35.00 X 310017 0 35171 KARL DEHM VP OF VILLAGECAREMAX 35.00 X 251893 0 16961 MARGARET MAVRINAC ASST VP OF CLINOPS & UTIL MGT 35.00 X 190944 0 5051 NATALIYA AVERYANOVA ASSISTANT VPGOVERNMENT AFFAIRS 35.00 X 167188 0 8721 VANESSA FERNANDEZ AVP OF PLANS OPERATIONS 35.00 X 152301 0 18120 JANICE LEACOCK DIRECTOR OF CARE MANAGEMENT 35.00 X 148732 0 17905 EILEEN SCOTT AVP OF QUALITY MANAGEMENT 35.00 X 138727 0 10229 DEBORAH STRICOFF DIRECTOR OF PROVIDER RELATIONS 35.00 X 130109 0 5494 MARCELA ARZU ASST DIR OF QUALITY IMPROVEMENT 35.00 X 125573 0 16359 MEHRIBAN BRICKNER MANAGER OF DATA ANALYTICS 35.00 X 120797 0 1098 2184817 601452 208744 21 0 1 0 VILLAGE CARE OF NEW YORK 120 BROADWAY NEW YORK NY 10271 MANAGEMENT FEE 6283100 VILLAGE CARE PLUS 120 BROADWAY NEW YORK NY 10271 NURSING SERVICE 4958277 VILLAGE CENTER FOR CARE 120 BROADWAY NEW YORK NY 10271 NURSING HOME CARE 1534530 ROYAL HEALTH CARE OF LONG ISLAND LLC 521 5TH AVE NEW YORK NY 10175 HOMECARE VENDOR 1467938 RIVINGTON HOUSE HEALTH CARE FACILITY 120 BROADWAY NEW YORK NY 10271 ADULT DAY SERVICES 436163 8 MEDICAID CAPITATION 524114 139036799 139036799 SURPLUS INCOME 524114 618870 618870 139655669 58588 58588 1876371 1875707 664 664 664 139714921 139655669 0 59252 X 1636359 1472723 163636 9090120 4457540 4632580 108596 27034 81562 1084173 459178 624995 1400753 950584 450169 7913828 7913828 12828 12828 103000 103000 2693 2693 110865196 110198108 667088 337564 337564 470570 470570 2649 2649 1482156 77899 1404257 70233 70233 36250 36250 1983 1983 27690 27690 376813 376813 135023454 117643066 17380388 0 21037340 30221853 9934963 4289214 3175022 103179 150704 246610 37452 46315 209158 194716 110523 25670764 43802223 1027290 1625202 12826617 25721258 13853907 27346460 X 11816857 16455763 11816857 16455763 25670764 43802223 4691467 -52561 0 X X 0 1 X 1 0 X 9793876 88749353 139714921 238258150 9793876 88749353 139714921 238258150 0 0 0 238258150 9793876 88749353 139714921 238258150 1.00000 0.00000 X 246610 37452 209158 209158 CLAIMS RESERVE 15165075 DUE TO THIRD PARTIES 10556183 25721258 X 139659667 -52561 -52561 139712228 2693 2693 139714921 135023454 0 135023454 0 135023454 PART X, LINE 2: VSSC 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. 0 0 0 0 0 0 0 1 0 EMMA DEVITO PRESIDENT & CEO 275066 368842 14951 20049 441 591 11107 14893 8227 11032 309792 415407 0 0 RACHEL AMALFITANO CHIEF FINANCIAL OFFICER 149427 200370 8544 11456 107 144 11107 14893 1015 1361 170200 228224 0 0 ANTOINETTE CASSETTA EXECUTIVE VICE PRESIDENT 288974 0 20000 0 1043 0 20677 0 14494 0 345188 0 0 0 KARL DEHM VP OF VILLAGECAREMAX 225850 0 25000 0 1043 0 3231 0 13730 0 268854 0 0 0 MARGARET MAVRINAC ASST VP OF CLINOPS & UTIL MGT 189901 0 0 0 1043 0 5051 0 0 0 195995 0 0 0 NATALIYA AVERYANOVA ASSISTANT VPGOVERNMENT AFFAIRS 167188 0 0 0 0 0 8721 0 0 0 175909 0 0 0 VANESSA FERNANDEZ AVP OF PLANS OPERATIONS 152074 0 0 0 227 0 7847 0 10273 0 170421 0 0 0 JANICE LEACOCK DIRECTOR OF CARE MANAGEMENT 138505 0 10000 0 227 0 2941 0 14964 0 166637 0 0 0 PART I, LINE 7 NON-FIXED PAYMENT WAS USED TO ALIGN THE EXECUTIVES' CASH COMPENSATION TO THE CURRENT MARKET RATE. BASED ON 2014 COMPENSATION SURVEY COMPLETED AT THE END OF THE 2014, THE EXECUTIVES' CASH COMPENSATION WERE SIGNIFICANTLY BELOW THE 50% TILE OF THE MARKET COMPENSATION. THE NON-FIXED PAYMENT WAS INTENDED TO PARTIALLY BRIDGE THE GAP. FORM 990, PART VI, SECTION B, LINE 11 THE AUDIT AND FINANCE COMMITTEE REVIEW AND APPROVE THE COMPLETED 990. THE FORM 990 WILL BE DISTRIBUTED TO THE FULL BOARD PRIOR TO THE SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD DELEGATING POWER SHALL ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT. THE STATEMENT WOULD BE DISCLOSED TO VCNY AND SUBSIDIARIES' CORPORATE COMPLIANCE OFFICER WHOM WOULD REPORT THE FINDINGS TO THE VCNY BOARD EXECUTIVE COMMITTEE. IF A CONFLICT WERE TO BE FOUND THE CONFLICTED PERSON WOULD BE RECUSED FROM MATTERS RELATING TO HIS/HER POSSIBLE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 VCNY, A RELATED ORGANIZATION, HIRES ON AN ANNUAL BASIS AN INDEPENDENT CONTRACTOR THAT PROVIDES VCNY WITH A SALARY SURVEY WHICH IS REVIEWED AND APPROVED BY THE BOARD ON AN ANNUAL BASIS. THIS PROCESS WAS LAST PERFORMED IN 2014. FORM 990, PART VI, SECTION C, LINE 19 VSSC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIALS STATEMENTS AVAILABLE TO THE PUBLIC - UPON REQUEST. FORM 990, PART IX, LINE 11G NURSING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 196,588. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 196,588. CONSULTING & MGT FEES: PROGRAM SERVICE EXPENSES 2,790. MANAGEMENT AND GENERAL EXPENSES 124,350. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 127,140. OTHER FEES: PROGRAM SERVICE EXPENSES 1,038. MANAGEMENT AND GENERAL EXPENSES 330,526. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 331,564. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 15,624. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,624. PERSONAL EMERGENCY RESPONSE : PROGRAM SERVICE EXPENSES 207,360. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 207,360. DURABLE MEDICAL EQUIPMENT/PROS: PROGRAM SERVICE EXPENSES 2,006,061. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,006,061. SC-HOME HEALTH AIDE: PROGRAM SERVICE EXPENSES 2,305,562. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,305,562. SC-PERSONAL CARE AIDE: PROGRAM SERVICE EXPENSES 92,726,100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,726,100. ADULT DAY HEALTH CARE: PROGRAM SERVICE EXPENSES 1,907,350. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,907,350. SOCIAL DAY CARE: PROGRAM SERVICE EXPENSES 2,498,420. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,498,420. PODIATRY: PROGRAM SERVICE EXPENSES 20,393. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,393. HOME DELIVERED MEALS: PROGRAM SERVICE EXPENSES 121,785. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 121,785. NURSING FACILITY: PROGRAM SERVICE EXPENSES 3,052,167. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,052,167. OUTPATIENT REHAB/THERAPY: PROGRAM SERVICE EXPENSES 63,054. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 63,054. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 40,334. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,334. TRAVEL CLIENTS/EMPLOYEES: PROGRAM SERVICE EXPENSES 4,397,850. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,397,850. CARE MANAGEMENT: PROGRAM SERVICE EXPENSES 416,426. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 416,426. VISION: PROGRAM SERVICE EXPENSES 63,740. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 63,740. DENTAL: PROGRAM SERVICE EXPENSES 353,106. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 353,106. TRAINING AND EDUCATION: PROGRAM SERVICE EXPENSES 14,572. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,572. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. VILLAGE CARE OF NEW YORK 154 CHRISTOPHER STREET NEW YORK NY 10014 133854754 MANAGEMENT COMPANY NY 501(C)(3) 11 TYPE II N/A 0 VILLAGE CENTER FOR CARE 154 CHRISTOPHER STREET NEW YORK NY 10014 132911059 SNF, HOME CARE, DTP, CASE MGMT NY 501(C)(3) 9 VILLAGE CARE OF NEW YORK 0 RIVINGTON HOUSE HCF 154 CHRISTOPHER STREET NEW YORK NY 10014 133590465 SNF AND DTP NY 501(C)(3) 9 VILLAGE CARE OF NEW YORK 0 VILLAGE CENTER FOR CARE FUND 154 CHRISTOPHER STREET NEW YORK NY 10014 133471553 FUNDRAISING NY 501(C)(3) 7 VILLAGE CARE OF NEW YORK 0 MULTI TASKING SYSTEMS INC 154 CHRISTOPHER STREET NEW YORK NY 10014 133346371 TRAINING NY 501(C)(3) 9 VILLAGE CARE OF NEW YORK 0 VILLAGE DIAGNOSTICS & TREATMENT CENTER 154 CHRISTOPHER STREET NEW YORK NY 10014 134215186 PRIMARY HEALTH CARE NY 501(C)(3) 3 VILLAGE CARE OF NEW YORK 0 MOMENTUM PROJECT INC 154 CHRISTOPHER STREET NEW YORK NY 10014 133556768 NUTRITION AND SOCIAL SERVICES NY 501(C)(3) 9 VILLAGE CARE OF NEW YORK 0 VILLAGE SERVICES CORP 154 CHRISTOPHER STREET NEW YORK NY 10014 134188104 HEALTH CARE SERVICE NY 501(C)(3) PF VILLAGE CARE OF NEW YORK 0 VILLAGE HOUSING DEVELOPMENT FUND CORPORATION 154 CHRISTOPHER STREET NEW YORK NY 10014 131619096 SENIOR HOUSING NY 501(C)(3) 9 VILLAGE CARE OF NEW YORK 0 VILLAGE CARE HOLDING 154 CHRISTOPHER STREET NEW YORK NY 10014 134161623 HOLDING COMPANY NY N/A C 0 VILLAGE CARE NET INC 154 CHRISTOPHER STREET NEW YORK NY 10014 134161626 RETAIN OWNERSHIP OF 6N SYSTEMS NY N/A C 0 VILLAGE CARE PLUS INC 154 CHRISTOPHER STREET NEW YORK NY 10014 133959371 LIC HEALTH CARE SVC AGENCY NY N/A C 0 6N SYSTEMS INC 154 CHRISTOPHER STREET NEW YORK NY 10014 141833935 NURSING HOME SOFTWARE RETAILER NY N/A C 0 VILLAGE HOME AND COMMUNITY SERVICES 154 CHRISTOPHER STREET NEW YORK NY 10014 262534779 HOME CARE SERVICES NY N/A C 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 0