2015-05-12T07:53:48-07:00 2014-12-31 990 2014-01-01 222291346 GENESEE VALLEY PRESBYTERIAN NURSING CENTER GENE 5854611991 254 Alexander Street Rochester NY 14607 James DeVoe President 5854611991 2015-05-15 2014 2016-04-25 22:37:26Z Kirkhaven James e DeVoe 254 Alexander Street Rochester NY 14607 12137469 0 X www.Kirkhaven.com X 1980 NY Organization is a 147 licensed-bed skilled nursing home, which provides long-term and short-term skilled nursing and rehabilitative care to seniors including a high percentage of indigent and minority seniors. All income received is used in the provision of care and support services. 15 15 343 10 0 0 140827 263942 11595747 11795793 1113 974 78279 76760 11815966 12137469 0 0 0 0 8328135 7494424 0 0 0 4198777 4564786 12526912 12059210 -710946 78259 11422806 11402637 9454241 12036700 1968565 -634063 Nursing home that provides skilled long-term care, rehabilitative and Alzheimers/Dementia care for seniors in a manner that embraces a philosophy of person-centered care, quality of care and faith-based mission. 0 0 10904561 0 11795793 Nursing home that provides skilled long-term care, rehabilitation and Alzheimers/Dementia care for seniors in a manner that embraces a philosophy of person-centeredcare, quality of care and faith-based mission. 0 0 0 10904561 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 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 11 0 1 343 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NY X Kirkhaven 5854611991 254 Alexander Street Rochester NY 14607 David Irish Director 0.5 0.25 X 0 0 0 Thomas Lockwood Director 0.5 0.25 X 0 0 0 Sharon Boyd Director 0.5 0.25 X 0 0 0 Ann Marie Cook Director 0.5 0.25 X 0 0 0 Tom D'Antonio Director/Officer 0.5 0.25 X X 0 0 0 JoAnne Ryan Director 0.5 0.25 X 0 0 0 Erane Allen Director/Officer 0.5 0.25 X X 0 0 0 Matthew Cipro Director 0.5 0.25 X 0 0 0 Tom Gears Director 0.5 0.25 X 0 0 0 Alan Goodfellow Director/Officer 0.5 0.25 X X 0 0 0 Deborah Beardslee Director 0.5 0.25 X 0 0 0 John Ward Director 0.5 0.25 X 0 0 0 Carlo Jannotti Director 0.5 0.25 X 0 0 0 Marisa Geitner Director 0.5 0.25 X 0 0 0 Jann Packard Director 0.5 0.25 X 0 0 0 Gordon Webster Director 0.5 0.25 X 0 0 0 James E DeVoe President/CEO 26.25 11.25 X X X 118520 50794 43818 Amanda Brown VP/Administrator 40 0 X 105796 0 13013 Cassandra Tilliman VP of Human Resources 31 8 X 73990 22101 11819 Scott Maar VP of Finance 26.25 11.25 X 61402 26315 10789 359708 99210 79439 2 0 1 0 Freedom Therapy 2050 S Clinton Avenue Rochester NY 14618 Therapy Services 229315 PORT Rehab Care 7733 Forsyth Blvd Suite 1700 St Louis MO 63105 Therapy Services 575002 2 0 0 0 263942 0 0 0 263942 Skilled Nursing Home Services 623110 11795793 11795793 0 0 0 0 0 0 11795793 974 0 0 974 0 0 0 0 0 0 0 0 23128 0 0 0 23128 0 23128 0 0 23128 0 0 0 Staff Cafeteria & Vending 722210 28012 0 0 28012 Barber & Beauty Shop Service 812112 12335 0 0 12335 Telephone & Newspaper 812900 6550 0 0 6550 6735 0 0 6735 53632 12137469 11795793 0 77734 0 0 0 0 0 0 0 0 410577 120414 290163 0 0 0 0 0 5897577 5662504 235073 0 73566 70623 2943 0 641581 615918 25663 0 471123 452278 18845 0 0 0 0 0 14866 0 14866 0 23361 23361 0 0 0 0 0 0 0 0 0 0 0 1040269 1025366 14903 0 1212 1212 0 0 36448 2913 33535 0 72139 72139 0 0 0 0 0 0 590775 531697 59078 0 20969 11948 9021 0 0 0 0 0 0 0 0 0 33346 0 33346 0 0 0 0 0 549575 494618 54957 0 97215 0 97215 0 Supplies 1036380 1018496 17884 0 NYS Cash Receipts Assessment 586919 586919 0 0 Purchased Services/Repairs & Maintenance 261167 214275 46892 0 200145 23241 176904 0 12059210 10904561 1154649 0 80949 12863 1569672 1456064 0 1158307 1471514 109084 121442 16185976 10221486 6147428 5964490 2357366 2376264 11422806 11402637 1040686 981248 33829 13865 6256124 5956820 2123602 5084767 9454241 12036700 X -239970 -2863777 1252124 1272059 956411 957655 1968565 -634063 11422806 11402637 X 78259 0 0 0 0 -2680887 X 0 1 X 1 0 X 120496 108103 82033 140827 263942 715401 11691414 12641176 11810738 11595747 11795793 59534868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11811910 12749279 11892771 11736574 12059735 60250269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60250269 3752 2245 1767 1113 974 9851 0 0 0 0 0 0 3752 2245 1767 1113 974 9851 0 0 0 0 0 0 51651 71388 74248 78279 76760 352326 11867313 12822912 11968786 11815966 12137469 60612446 0.99402 0.99378 0.00016 0.00029 X Schedule A, Part III, Line 12 staff cafeteria, vending, guest meals, telephone, newspapers, hair care, misc. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 956411 1244 61729 0 61727 0 957657 955117 1294 157986 0 157986 0 956411 954101 1016 120662 0 120662 0 955117 952412 1689 8961 0 8961 0 954101 945596 6816 138650 0 138650 0 952412 0 1 0 0 1 1 0 438016 438016 0 13306078 8476067 4830011 0 0 0 0 0 2153329 1559861 593468 0 288553 185558 102995 5964490 Beneficial Interest in Foundation 2229714 Mortgage Acquisition Costs 92462 Resident Funds Held in Trust 54088 2376264 0 Due to Third Party Payers 655424 Pension Liability 3550905 Workers Compensation Trust Liability 501716 Deferred Compensation Liability 122485 Resident Funds Held in Trust 54088 Due to Affiliated Party 200149 5084767 12137469 0 0 0 0 0 12137469 0 0 0 12137469 12059210 0 0 0 0 0 12059210 0 0 0 12059210 Schedule D, Part V, Line 4 Endowment funds are to be held in perpetuity with the income to be recognized and transferred to temporarily restricted funds within the Foundation and transferred to Kirkhaven annually based on the board approved Total Return & Spend policy for use in subsidizing the organization's mission and operation. X X X X X 0 1 0 0 0 0 0 1 0 James E DeVoe President/CEO 110907 47531 7613 5034 0 0 16450 7050 14223 6095 149193 65710 156290 66982 Schedule J, Part I, Line 4 President/CEO is the sole participant in a 457(f) deferred compensation plan that is funded by the organization in the amount of $21,000 per year. Schedule J, Part I, Line 7 Executive Leadership staff were paid a bonus for specific goal performance results as per the Executive Bonus Program and approved by Executive Committee and board. Total bonus payments paid amounted to $15,910 for 2 executives. Form 990, Part VI, Section A, Line 4 The bylaws were revised to incorporate changes related to the restructuring of PRCC (dba Valley Manor) and the NYS Revitalization Act. Form 990, Part VI, Section A, Line 6 The organization is a membership corporation with Presbyterian Homes & Services of Genesee Valley (dba Seniorsfirst) the sole member. Form 990, Part VI, Section A, Line 7a The board of directors for the Member constitute in part the board of directors of the organization. Form 990, Part VI, Section A, Line 7b The organization's bylaws identify certain reserved powers that require approval by the Member. Form 990, Part VI, Section B, Line 11b The 990 is reviewed by the Audit Committee of the board on behalf of the organization's board. A copy of the 990 is available to all directors of the governing board. Form 990, Part VI, Section B, Line 12c Board members and key employees must complete and update conflict of interest forms annually and as needed. At all board meetings and committee meetings, a call for disclosure of any conflicts of interest related to the approved agenda is required and documented in the minutes. The Governance Committee of the parent board monitors and enforces compliance as needed. Form 990, Part VI, Section B, Line 15 The executive Committee of the parent board reviews, determines and approves (with full board approval) the CEO compensation. Periodic survey and comparable compensation data is used to ascertain reasonableness and competitiveness of compensation. In 2014, the board entered into an Employment Contract with the CEO through 12/31/2016. The HR Committee upon approval of the board, reviews and approves compensation pay scales and annual increase range for all other staff. Form 990, Part VI, Section C, Line 19 Information is available to the public upon request to administration. Form 990, Part XI, Line 9 Change in unrestricted net assets related to the pension plan-($2,702,066). Change in beneficial interest in Foundation - $21,179. Prebyterian Homes & Services of Genesee Valley dba Seniorsfirst 254 Alexander Street Rochester NY 14607 161592416 Parent Organization NY 501(C)(3) 11d N/A 0 Seniorsfirst Foundation Inc 254 Alexander Street Rochester NY 14607 161378080 Supporting Organization NY 501(c)(3) 11d PHSGV Seniorsfirst 0 Presbyterian Residence Center Corporation (PRCC) dba Valley Manor Apartments 1570 East Avenue Rochester NY 14610 160958326 Sister Organization NY 501(c)(3) 9 PHSGV Seniorsfirst 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 Seniorsfirst Foundation Inc c 263942 Actual dollar value Seniorsfirst Foundation Inc e 200149 Actual dollar value of loan Seniorsfirst Foundation Inc e 750000 Actual line of credit guarantee Seniorsfirst Foundation Inc m 51596 Actual cost Presbyterian Residence Center Corporation (PRCC) dba Valley Manor Apartments o 99210 Allocation of cost based on time study allocation percentage