2015-11-16T11:43:59-06:00 2014-12-31 264298079 EFP ROTENBERG LLP 280 KENNETH DRIVE ROCHESTER NY 14623 990 2014-01-01 161379536 ST ANN'S HOME FOUNDATION INC 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 12619974 0 X WWW.STANNSCOMMUNITY.COM X 1989 NY PROMOTES INDEPENDENCE, PHYSICAL AND SPIRITUAL WELL-BEING OF OLDER ADULTS IN THE CATHOLIC TRADITION 13 12 0 14 0 0 1351394 1792416 0 0 3116242 2616935 1231 28846 4468867 4438197 2309136 2397604 0 0 401639 391078 0 7744 34010 306181 293403 3016956 3089829 1451911 1348368 47335185 46405794 1543102 1136464 45792083 45269330 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 FOUNDATION, INC. EXISTS TO FOSTER FINANCIAL SUPPORT FOR ALL OF ST. ANN'S COMMUNITY. ESTABLISHED IN 1989, ST. ANN'S FOUNDATION WAS CREATED TO MATCH FINANCIAL SUPPORT WITH THE PROGRAMS AND INITIATIVES THROUGHOUT ST. ANN'S COMMUNITY THAT ARE PART OF THIS ORGANIZATION'S CONTINUUM OF HEALTH AND RESIDENTIAL SERVICES. 0 0 2453011 2397604 ST. ANN'S FOUNDATION, INC. EXISTS TO FOSTER FINANCIAL SUPPORT FOR ALL OF ST. ANN'S COMMUNITY. THROUGH FUNDRAISING EVENTS, GRANT WRITING, AND INDIVIDUAL GIVING, THE FOUNDATION SECURED CONTRIBUTIONS TO DIRECTLY SUPPORT PROGRAMS, EQUIPMENT AND SCHOLARSHIP PROGRAMS THAT DIRECTLY BENEFITED THE SENIORS SERVED BY ST. ANN'S COMMUNITY. 2453011 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 1 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 1 1 0 0 0 0 X 13 12 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 JAMES LEO CHAIR 1.00 X X 0 0 0 RONALD SALLUZZO IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 RACHEL BANDYCH CHAIR ELECT 1.00 X X 0 0 0 MARK CLEARY SECRETARY/TREASURER 1.00 X X 0 0 0 MICHAEL MCRAE PRESIDENT & CEO 0.00 40.00 X X 0 348950 14465 MARTIN BIRMINGHAM DIRECTOR 1.00 X 0 0 0 PATRICK BURKE DIRECTOR 1.00 X X 0 0 0 ANTHONY BARNABA DIRECTOR 1.00 X 0 0 0 JOHN HAYES DIRECTOR 1.00 X 0 0 0 KATHY KEOGH DIRECTOR 1.00 X 0 0 0 NICOLE MARRO DIRECTOR 1.00 X 0 0 0 SANDRA PARKER DIRECTOR 1.00 X 0 0 0 ROBERT RYAN DIRECTOR 1.00 X 0 0 0 DENNIS KANT SENIOR VP/CFO 0.00 40.00 X 0 227700 15191 ROBERT BOURG VP OF ORGANIZATIONAL TRAINING & DEVELOPMENT 0.00 40.00 X 0 164603 2861 STEVEN SMITH VP OF FOUNDATION & RESOURCE DEVELOPMENT 34.00 6.00 X 0 163235 7115 MICHAEL SEELIG CR VP 0.00 40.00 X 0 162186 13590 DIANE KANE MD CHIEF MEDICAL OFFICER 0.00 40.00 X 0 358806 16537 KIMBERLY PETRONE ASSOCIATE MEDICAL DIRECTOR 0.00 40.00 X 0 270924 14463 JOHN JURIK ASSOCIATE MEDICAL DIRECTOR 0.00 40.00 X 0 222321 12617 JARVIS SANCHEZ-RIVERA STAFF ATTENDING PHYSICIAN 0.00 40.00 X 0 203284 13482 MICHELE SINCLAIR CHIEF NURSING EXECUTIVE 0.00 40.00 X 0 197778 14055 ELIZABETH MULLIN-DIPROSA FORMER PRESIDENT & CEO 3.00 37.00 X 0 440535 9362 DAVID SONES FORMER VP ADMINISTRATOR 0.00 40.00 X 0 139264 4865 0 2899586 138603 0 1 1 0 0 30726 1761690 1792416 952611 952611 9827925 8163601 1664324 1664324 1664324 42856 18176 24680 24680 MISCELLANEOUS 900099 4166 4166 4166 4438197 4166 0 2641615 2338115 2338115 59489 59489 336931 336931 4646 4646 27405 27405 22096 22096 10500 10500 7744 7744 86502 86502 4775 4775 9448 9448 10744 327 2169 8248 3975 3975 3398 3398 OTHER EXPENSES 63680 -16308 71418 8570 RESIDENT FUND EXPENSE 39688 39688 INTERCOMPANY SUPPORT AL 36366 36366 PERSON CENTERED CARE EX 22423 22423 1904 1904 3089829 2453011 602808 34010 267931 3604 2004157 2095121 511236 875517 7965 11060 2193800 2089714 98077 93936 7539 4141 40124919 39071979 2217638 2254658 47335185 46405794 346030 78809 1197072 1057655 1543102 1136464 X 35883097 31296862 1666448 9240400 8242538 4732068 45792083 45269330 47335185 46405794 X 1348368 -367178 -1540963 37020 X X 0 1 X 1 0 X X 4 ST ANN'S HOME FOR THE AGED 160743146 9 1 1894039 0 CHAPEL OAKS INC 161489340 9 1 11035 0 ST ANN'S NURSING HOME COMPANY INC 237098164 9 1 43344 0 ST ANN'S SENIOR HOUSING INC 760705854 9 1 6325 0 4 1954743 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9049550 494815 9544365 7635456 1414094 9049550 4589712 533252 5122964 4689852 -100140 4589712 4218440 471412 4689852 0.00000 0.26690 0.73310 0 0 98077 93936 4141 4141 DUE TO AFFILIATES 1038621 SPLIT INTEREST OBLIGATION 19034 1057655 X 4039713 -367178 37020 -330158 4369871 86502 -18176 68326 4438197 3021503 18176 18176 3003327 86502 86502 3089829 PART V, LINE 4: INCOME FROM THE ENDOWMENT FUND IS TO BE USED FOR THE GENERAL PURPOSES OF THE FOUNDATION. PART X, LINE 2: THE FOUNDATION 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 FOUNDATION'S TAX-EXEMPT PURPOSE MAY BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. IN ACCORDANCE WITH ASC 740-10-50, THE FOUNDATION 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. MANAGAEMENT BELIEVES THAT THE FOUNDATION 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 FOUNDATION'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 VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 37,194. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUST -174. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENTS EXPENSE -18,176. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENTS EXPENSE 18,176. WINE TASTING 36695 36695 8963 4510 ANGEL BUS TRIP 6161 6161 825 2885 993 1 42856 42856 9788 2885 5503 18176 24680 1 ST ANN'S OF GREATER ROCHESTER INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 760705854 501(C)(3) 383372 CASH N/A SUPPORT FOR OPERATING EXPENSES ST ANN'S HOME FOR THE AGED 1500 PORTLAND AVENUE ROCHESTER NY 14621 160743146 501(C)(3) 1894039 CASH N/A SUBSTANTIAL SUPPORT TO CAPITAL IMPROVEMENTS, INCLUDING CONSTRUCTION OF NEW BUILDINGS; DIRECT SUPPORT TO RECREATION THERAPY; STAFF EDUCATION PROGRAMS; AND RESIDENT QUALITY LIFE PROGRAMS. ST ANN'S NURSING HOME COMPANY INC (THE HERITAGE) 1500 PORTLAND AVENUE ROCHESTER NY 14621 237098164 501(C)(3) 43344 CASH N/A SUBSTANTIAL SUPPORT TO CAPITAL IMPROVEMENTS, INCLUDING CONSTRUCTION OF NEW BUILDINGS; DIRECT SUPPORT TO RECREATION THERAPY; STAFF EDUCATION PROGRAMS; AND RESIDENT QUALITY LIFE PROGRAMS. CHAPEL OAKS INC 1500 PORTLAND AVENUE ROCHESTER NY 14621 161489340 501(C)(3) 11035 CASH N/A SUPPORT FOR EQUIPMENT PURCHASES AND CAPITAL IMPROVEMENTS ST ANN'S SENIOR HOUSING INC (CHERRY RIDGE) 1500 PORTLAND AVENUE ROCHESTER NY 14621 760705854 501(C)(3) 6325 CASH N/A SUPPORT FOR CAPITAL IMPROVEMENTS 5 0 NURSING SCHOLARSHIPS 16 34000 FMV N/A ANGEL FUND GRANTS FOR ST. ANN'S COMMUNITY RESIDENTS 571 23900 FMV N/A ADULT DAY CARE SCHOLARSHIPS 24 1589 FMV N/A PART I, LINE 2: FOUNDATION STAFF MONITOR GRANT AND PROJECT EXPENDITURES AGAINST BUDGET AND AS APPROPRIATE SECURE PROJECT EVALUATIONS ALL TO ENSURE THAT FUNDS PROVIDED FULFILL THE DONOR RESTRICTIONS AND OR OTHER REQUIREMENTS FOR THE GRANT. 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 OFFICER 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 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 PRESIDENT/CEO AND WERE INCLUDED AS WAGE COMPENSATIONON ON THE FORM W-2. ST. ANN'S COMMUNITY PROVIDED THE FOLLOWING BENEFITS FOR THE SENIOR VP/ADMINISTRATOR: 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 SENIOR VP/ADMINISTRATOR 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 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS MADE UP OF THE CHAIRS OF EACH BOARD COMMITTEE, ALONG WITH THE IMMEDIATE PAST BOARD CHAIR. ALL OF THE MEMBERS ARE ON THE BOARD. WHILE VIRTUALLY ALL DECISIONS GO TO THE BOARD FOR FINAL APPROVAL, THE EXECUTIVE COMMITTEE CAN ACT AS A DECISION-MAKING GROUP PER THE BYLAWS. 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 REPORT IS PREPARED BY ST. ANN'S STAFF, PROVIDED AND REVIEWED BY EFP ROTENBERG, LLP. FINAL REPORTS ARE REVIEWED BY THE ST. ANN'S ACCOUNTING TEAM, INCLUDING THE DIRECTOR OF FINANCE AND CFO, AND PROVIDED TO THE CEO AND BOARD MEMBERS FOR COMMENTS PRIOR TO FILING THE RETURN. 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. 2014 VPS AND CEO DATA REVIEWED; 2014 DIRECTOR LEVEL DATA REVIEWED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENT, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 37,194. CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUST -174. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. FORM 990, PART V, LINE 2A: ALL INDIVIDUALS WORKING AT ST. ANN'S FOUNDATION, INC. ("SAF") 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 SAF'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 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 NURSING HOME COMPANY INC DBA THE HERITAGE 1500 PORTLAND AVENUE ROCHESTER NY 14621 237098164 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 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 1 1