2015-11-09T14:42:38-06:00 2014-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2014-01-01 161085780 ST CAMILLUS RESIDENTIAL HEALTH CARE FACILITY STCA 3154882951 813 FAY ROAD SYRACUSE NY 132193098 MICHAEL ZINGARO VICE PRESIDENT - FINANCE 3154882951 2015-11-03 1 JOSEPH J SCHLEGEL P00301329 3154463600 2014 2016-04-25 22:37:26Z MICHAEL ZINGARO 813 FAY ROAD SYRACUSE NY 132193098 37526243 0 X WWW.ST-CAMILLUS.ORG X 1967 NY ST. CAMILLUS IS A RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO CARING FOR LIFE THROUGH A BROAD RANGE OF HEALTHCARE SERVICES. THE ORGANIZATION OPERATES A 284 BED SKILLED NURSING FACILITY WHICH INCLUDES A 20 BED UNIT DEDICATED TO TRAUMATIC BRAIN INJURY, ALONG WITH AN ADULT DAY HEALTH CARE PROGRAM, A SOCIAL ADULT DAY CARE PROGRAM, A CERTIFIED HOME HEALTH CARE AGENCY, AND AN OUT PATIENT DIAGNOSTIC AND TREATMENT CENTER. THROUGH THESE SERVICES, ST. CAMILLUS HELPS TO ADDRESS THE LONG-TERM CARE, REHABILITATION AND HOME AND COMMUNITY BASED CARE NEEDS OF OUR COMMUNITY. 27 27 743 83 0 0 430111 185672 36730165 36770334 17090 20443 370883 503839 37548249 37480288 0 0 0 0 23752099 25138706 0 0 0 12343087 12370367 36095186 37509073 1453063 -28785 19215924 19075016 13367416 13255293 5848508 5819723 X ST. CAMILLUS IS A RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO CARING FOR LIFE THROUGH A BROAD RANGE OF HEALTHCARE SERVICES. THE ORGANIZATION OPERATES A 284 BED SKILLED NURSING FACILITY WHICH INCLUDES A 20 BED UNIT DEDICATED TO TRAUMATIC BRAIN INJURY, ALONG WITH AN ADULT DAY HEALTH CARE PROGRAM, A SOCIAL ADULT DAY CARE PROGRAM, A CERTIFIED HOME HEALTH CARE AGENCY, AND AN OUT PATIENT DIAGNOSTIC AND TREATMENT CENTER. THROUGH THESE SERVICES, ST. CAMILLUS HELPS TO ADDRESS THE LONG-TERM CARE, REHABILITATION AND HOME AND COMMUNITY BASED CARE NEEDS OF OUR COMMUNITY. 0 0 31550583 37285859 CARE AND TREATMENT OF PATIENTS IN A RESIDENTIAL HEALTH CARE FACILITY AND AN OUTPATIENT CLINIC. 31550583 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 30 0 1 743 1 0 0 0 0 0 0 0 0 0 0 X 27 27 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MARIA WEIR 3154882951 813 FAY ROAD SYRACUSE NY 132193098 DR ROBERT ANDERSON TRUSTEE 1.00 X 0 0 0 REV LOUIS AIELLO MEMBER/TRUSTEE 1.00 X 0 0 0 JOHN J CANNIZZARO SECRETARY/MEMBER/TRUSTEE 1.00 X X 0 0 0 PETER CAPPUCCILLI JR TRUSTEE 1.00 X 0 0 0 JOHN F CATANZARITA TRUSTEE 1.00 X 0 0 0 CHARLES P CONOLE MEMBER/TRUSTEE 1.00 X 0 0 0 PATRICIA A CURTIN MEMBER/TRUSTEE 1.00 X 0 0 0 JEANNE E BISHOP MD TRUSTEE 1.00 X 0 0 0 JAMES N JEROSE TRUSTEE 1.00 X 0 0 0 RV MSGR RICHARD KOPP MEMBER/TRUSTEE 1.00 X 0 0 0 WAYNE V LA FRANCE TRUSTEE 1.00 X 0 0 0 PAUL MELLO TRUSTEE 1.00 X 0 0 0 SHEILA LEMKE MD TRUSTEE 1.00 X 0 0 0 DAVID J MOYNIHAN CPA TRUSTEE 1.00 X 0 0 0 BRENDA A RIGAS TRUSTEE 1.00 X 0 0 0 JAMES D SPENCER CHAIR/TRUSTEE/MEMBER 1.00 X X 0 0 0 DERRICK J SUEHS TRUSTEE 1.00 X 0 0 0 MARY GRACE VANNORTWICK VICE CHAIR/TRUSTEE/MEMBER 1.00 X X 0 0 0 WILLIAM LOEHR TRUSTEE 1.00 X 0 0 0 DANIEL J ROSS TRUSTEE 1.00 X 0 0 0 SHIRLEY CRUICKSHANK TRUSTEE 1.00 X 0 0 0 JOHN MAESTRI TRUSTEE 1.00 X 0 0 0 FRED MARTY TRUSTEE 1.00 X 0 0 0 SCOTT MCCLURG TRUSTEE 1.00 X 0 0 0 DOUGLAS J REICHER TRUSTEE 1.00 X 0 0 0 SCOTT WAKEMAN TRUSTEE 1.00 X 0 0 0 JOANN WALLACE TRUSTEE 1.00 X 0 0 0 MICHELLE KENNEDY TRUSTEE 1.00 X 0 0 0 AILEEN BALITZ PRESIDENT 36.00 4.00 X 198558 0 504 MICHAEL ZINGARO VP FINANCE 36.00 4.00 X 118921 0 5541 MICHAEL SCHAFER VP - NURSING 40.00 X 128142 0 5541 KATHY BARBER VP - QUALITY MANAGEMENT 34.00 6.00 X 96549 0 11044 CHRISTINE KEARNEY VP - REHABILITATION SVCS 39.00 1.00 X 104088 0 11084 HELENA GLASSFORD VP - HUMAN RESOURCES 32.00 8.00 X 82740 0 10880 HEATHER KEMMIS VP - HOME CARE 24.00 16.00 X 93540 0 15527 MARY ELLEN KAIER VP - LONG RANGE PLANNING 36.00 4.00 X 93909 0 10060 DAVID DUBE MEDICAL DIRECTOR 40.00 X 114575 0 0 1031022 0 70181 5 0 1 0 SODEXHO INC PO BOX 360170 PITTSBURGH PA 15251 FOOD SERVICE 1392482 ADECCO EMPLOYMENT AGENCY 225 GREENFIELD PARKWAY LIVERPOOL NY 13088 NURSING STAFF 581428 NURSECORE MANAGEMENT SERVICES 2201 BROOKHOLLOW ARLINGTON TX 76006 NURSING STAFF 528130 CLARUS LINEN SYSTEMS 60 GRINDER STREET BUFFALO NY 14215 LINEN SERVICES 259352 NURSEFINDERS 7421 OSWEGO ROAD LIVERPOOL NY 13090 NURSING STAFF 126170 6 64300 121372 7516 185672 PROGRAM SERVICE REVENUE 623000 36770334 36770334 36770334 20443 20443 8516 0 8516 8516 8516 25753 64300 45955 -20202 -20202 OTHER REVENUE 623000 183403 183403 FUND DEVELOPMENT REVENUE 623000 154157 154157 MANAGEMENT FEE INCOME 623000 107436 107436 70529 70529 515525 37480288 37285859 0 8757 986630 15450 971180 18971043 16287233 2683810 3728349 3042664 685685 1452684 1245973 206711 52165 52165 45743 45743 1460161 1396917 63244 255102 170918 84184 136817 49084 87733 5988 5988 888717 799845 88872 126766 124567 2199 27635 12106 15529 80334 80334 977690 879921 97769 542657 347749 194908 SUPPLIES 2616387 2462046 154341 CONTRACT LABOR 2166348 2166348 NYS ASSESSMENT 1551197 1551197 EQUIPMENT & MAINTENANCE 425377 343074 82303 1011283 655491 355792 37509073 31550583 5958490 0 153500 124933 6995246 7044813 189983 249462 54427 52939 248234 282582 28750826 20574175 8733959 8176651 2840575 3143636 19215924 19075016 4106618 4660037 7239303 7710353 2021495 884903 13367416 13255293 X 5775582 5767011 72926 52712 5848508 5819723 19215924 19075016 -28785 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 72926 22217 42431 52712 154847 73335 -149847 5409 72926 170852 5000 -21005 154847 376258 -94751 110655 170852 437275 110655 127414 299086 376258 0.00000 0.00000 1.00000 0 0 194602 194602 20721373 13353447 7367926 1262634 1172252 90382 6532854 6048476 484378 39363 39363 8176651 MORTGAGE REFINANCING COST, NET OF AMORTIZATION 232434 PATIENT FUNDS 32574 RESERVE FOR REPLACEMENTS 932403 CASH WORKING CAPITAL ESCROW 531246 OTHER RECEIVABLES 1324305 LONG TERM RECEIVABLES 50000 DONOR RESTRICTED FUNDS 40674 3143636 PATIENTS' FUNDS 32574 ESTIMATED THIRD PARTY SETTLEMENTS 312329 LINE OF CREDIT 490000 OTHER LIABILITIES 50000 884903 X PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE ORGANIZATION HAS BEEN LIMITED BY DONORS OR GRANTORS TO A SPECIFIC TIME PERIOD OR PURPOSE. PART X, LINE 2: ST. CAMILLUS AND INTEGRITY ARE TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS OF DECEMBER 31, 2014, THE ORGANIZATION DOES NOT HAVE ANY SIGNIFICANT UNRECOGNIZED TAX BENEFIT OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2011 THROUGH 2014. ANNUAL DINNER 34650 29650 5000 14216 SOCK HOP 20306 7700 12606 14570 8 35097 26950 8147 17169 90053 64300 25753 45955 45955 -20202 X X 0 0 0 0 0 0 0 0 0 AILEEN BALITZ PRESIDENT 198558 0 0 0 0 0 0 0 504 0 199062 0 0 0 PART I, LINE 3 THE FACILITY'S SALARY RANGES ARE BASED ON AN INCORPORATION OF A STUDY PERFORMED BY AN INDEPENDENT ACCOUNTING FIRM DURING THE 1990'S, TRENDED FORWARD, AND TWO SEPARATE INDEPENDENT SURVEYS OF SALARY PACKAGES OF SIMILAR POSITIONS RECEIVED DURING 2009. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION VOTE TO ELECT TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE OPERATING DECISIONS MADE BY THE GOVERNING BODY (BOARD OF TRUSTEES) ARE DONE SO BY A MAJORITY VOTE OF THE TRUSTEES AND CAN NOT BE OVERRIDDEN. HOWEVER, ANY BY LAW CHANGES OR NEW TRUSTEE APPOINTMENTS REQUIRE A MAJORITY VOTE OF THE MEMBERS, IF PERSONALLY IN ATTENDANCE AT THE MEETING OR 100% WRITTEN APPROVAL. FORM 990, PART VI, SECTION B, LINE 11 BEFORE THIS FORM 990 WAS FILED WITH THE IRS, ALL OF THE FOLLOWING REVIEWS TOOK PLACE: THE PREPARED FORM 990 WAS REVIEWED BY THE CONTROLLER, CHIEF FINANCIAL OFFICER, AND CORPORATE COMPLIANCE OFFICER, IN CONSULTATION WITH ADMINISTRATIVE STAFF MEMBERS, EXECUTIVE MANAGEMENT, AND ADVISORS TO THE ORGANIZATION. THE PREPARED FORM 990 WAS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES AND WAS MADE AVAILABLE TO ALL CURRENT VOTING MEMBERS OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES WRITTEN DISCLOSURES BY ALL TRUSTEES, OFFICERS, KEY EMPLOYEES, AND OTHER MANAGEMENT OR SUPERVISORY EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE DECISION MAKING FOR THE ORGANIZATION. SUCH INDIVIDUALS ARE REQUIRED TO DISCLOSE ACTUAL AND POTENTIAL CONFLICTS OF INTEREST UPON INITIAL AFFILIATION WITH THE ORGANIZATION, ON AN ANNUAL BASIS, AND WHENEVER REPORTABLE INTERESTS ARISE. THE COMPLIANCE OFFICER, IN COLLABORATION WITH THE CHAIR OF THE AUDIT COMMITTEE, IN CONSULTATION WITH THE PRESIDENT, REVIEWS WRITTEN DISCLOSURES, OBTAINS FURTHER INFORMATION AS NEEDED, AND EVALUATES ACTUAL AND POTENTIAL CONFLICTS. AS WARRANTED, THE PRESIDENT, THE CHAIR OF THE AUDIT COMMITTEE, AND/OR BOARD CHAIRMAN IMPLEMENTS MEASURES TO ENSURE THAT DECISIONS RELATING TO THE ORGANIZATION ARE MADE SOLELY ON THE BASIS OF THE BEST INTERESTS OF THE ORGANIZATION AND IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSES. ANY TRUSTEE WHO HAS A DUALITY OF INTEREST OR A POTENTIAL CONFLICT OF INTEREST AS TO A MATTER COMING BEFORE THE BOARD IS PROHIBITED FROM VOTING OR USING PERSONAL INFLUENCE AS TO BOARD ACTION ON SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE FACILITY'S SALARY RANGES ARE BASED ON AN INCORPORATION OF A STUDY PERFORMED BY AN INDEPENDENT ACCOUNTING FIRM DURING THE 1990'S AND TRENDED FORWARD AND TWO SEPARATE INDEPENDENT SURVEYS OF SALARY PACKAGES OF SIMILAR POSITIONS RECEIVED DURING 2009. AT THE TIME OF HIRE THE FACILITY'S CEO REVIEWS THE SALARY REQUIREMENTS FOR KEY EMPLOYEES IN RELATION TO CURRENT MARKET CONDITIONS AND SALARY PAYSCALES PREVIOUSLY APPROVED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION. ANY SALARY RECOMMENDATIONS PROPOSED THAT ARE NOT COMMENSURATE WITH PREVIOUSLY APPROVED PAYSCALES REQUIRE CONSULTATION WITH AND AGREEMENT FROM THE BOARD CHAIRPERSON. ANNUALLY, OR WHEN CIRCUMSTANCES WARRANT, THE CEO PRESENTS TO THE EXECUTIVE COMMITTEE FOR THEIR REVIEW AND APPROVAL HER RECOMMENDATIONS FOR COMPENSATION OF KEY EMPLOYEES BASED ON PERFORMANCE EVALUATIONS. FORM 990, PART VI, SECTION C, LINE 18 THE FACILITY MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE FACILITY HAS AN AUDIT COMMITTEE MADE UP OF TRUSTEES. THE AUDIT COMMITTEE MEETS TWICE ANNUALLY; THE FIRST MEETING TO REVIEW THE DRAFT FINANCIAL STATEMENTS AND PRELIMINARY FINDINGS; THE SECOND MEETING TO REVIEW THE FINAL FINANCIAL STATMENTS AND FINDINGS. THERE HAVE BEEN NO CHANGES TO THE PROCESSES FROM THE PRIOR YEAR. INTEGRITY HOME CARE SERVICES INC 813 FAY ROAD SYRACUSE NY 13219 161500579 HOME HEALTH SERVICES NY 501 (C) (3) 9 ST CAMILLUS RESIDENTAL HEALTH CARE FACILITY 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 1 1 1 0 0