2015-11-12T15:47:20-06:00 2014-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2014-01-01 133832251 NORTHERN RIVERVIEW HEALTH CARE CENTER INC NORT 8454295381 87 SOUTH ROUTE 9W HAVERSTRAW NY 10927 MORRIS KLEIN EXECUTIVE DIRECTOR 8454295381 2015-11-12 1 AARON SHAPIRO P01333816 2128674000 2014 2016-04-25 22:37:26Z MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 19510258 0 X WWW.NORTHERNRIVERVIEW.COM X 1995 NY TO PROVIDE SKILLED NURSING CARE TO THE ELDERLY. 9 9 292 19 0 0 0 0 18648221 19508599 1425 1451 28980 208 18678626 19510258 338991 339109 0 0 8033678 8142250 0 0 0 6816314 7180292 15188983 15661651 3489643 3848607 17409370 21460904 5842748 6045675 11566622 15415229 TO PROVIDE SKILLED NURSING CARE TO THE ELDERLY. 0 0 12381713 339109 19508599 LONG TERM AND SHORT TERM INPATIENT HEALTH SERVICES FOR THE ELDERLY, IN 2014 NORTHERN RIVERVIEW PROVIDED 64,050 DAYS OF CARE. 12381713 1 0 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 0 0 0 0 0 0 1 0 0 0 1 25 0 292 1 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 0 0 0 0 NY X MICHAEL ITZKOWITZ 8453569880 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 STUART MEYERS CHAIRMAN 0.10 0.90 X X 0 4250 0 LEON STEINMETZ BOARD MEMBER 0.10 0.90 X 0 4250 0 RABBI SIMON LAUBER BOARD MEMBER 0.10 0.90 X 0 4000 0 REGINA AUSLANDER BOARD MEMBER 0.10 0.90 X 0 0 0 HINDI GINSBERG BOARD MEMBER 0.10 0.90 X 0 500 0 CHARLES F KENNY ESQ BOARD MEMBER 0.10 0.90 X 0 1250 0 ABRAHAM ZACHARIASH BOARD MEMBER 0.10 0.90 X 0 4000 0 RABBI HERSHAL HAGER BOARD MEMBER 0.10 0.90 X 0 250 0 ISRAEL ORZEL BOARD MEMBER 0.10 0.90 X 0 2750 0 MORRIS KLEIN EXECUTIVE DIRECTOR 6.00 29.00 X 135192 653425 183314 MICHAEL NOWICKI COMPLIANCE OFFICER 6.00 29.00 X 32193 155600 0 GEDALIA KLEIN CHIEF OPERATING OFFICER 3.00 14.50 X 22556 109021 18329 SHLOMO KATZ DIRECTOR 35.00 X 190980 0 12414 HELEN OKONKWO DIRECTOR OF NURSING 35.00 X 153523 0 12414 DONNA Y BOLANTE MANAGER 35.00 X 101076 0 1040 635520 939296 227511 4 0 1 0 TOWNE NURSING STAFF 1413 38TH STREET BROOKLYN NY 11218 NURSING SERVICES 581190 CENTERS FOR CARE 4770 WHITE PLAINS ROAD BRONX NY 10470 ADMINISTRATIVE SERVICES 408015 MEDICAL DIRECTOR SERVICES PC 5014 16TH AVENUE BROOKLYN NY 11204 MEDICAL DIRECTOR 101076 3 PATIENT SERVICES 623000 19508599 19508599 19508599 1451 1451 MISCELLANEOUS REVENUE 900099 208 208 208 19510258 19508599 0 1659 339109 339109 428239 336570 91669 6258980 4919186 1339794 182038 143071 38967 811577 637851 173726 461416 362645 98771 842734 662339 180395 117652 117652 38950 38950 570102 448067 122035 35217 27678 7539 677718 537624 140094 1332345 1047144 285201 465 366 99 2929 2302 627 843674 663076 180598 431776 339350 92426 NYS CASH RECEIPTS ASSES 910575 715658 194917 FOOD EXPENSE 824433 647955 176478 MEDICAL SUUPPLIES 551722 551722 15661651 12381713 3279938 0 4035730 2994343 675007 617950 3115417 2964078 256224 790177 16392612 10153898 6988870 6238714 2338122 7855642 17409370 21460904 1809136 2627067 3334263 2978115 699349 440493 5842748 6045675 X 11566622 15415229 11566622 15415229 17409370 21460904 3848607 0 X X 0 1 X 1 0 X 15568288 15568288 19964690 19245363 18665367 18648221 19508599 96032240 19964690 19245363 34233655 18648221 19508599 111600528 0 0 0 111600528 1201 275 8187 1425 1451 12539 1201 275 8187 1425 1451 12539 81667 28980 208 110855 19965891 19327305 34241842 18678626 19510258 111723922 0.99890 0.99890 0.00010 0.00010 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME 309421 309421 11916683 6934395 4982288 3450247 2621966 828281 716261 597537 118724 6238714 ESTIMATED AMOUNTS DUE FROM THIRD PARTY PAYORS 259000 OTHER RECEIVABLES 285773 DUE FROM RELATED PARTIES 7310869 7855642 RESIDENT FUNDS HELD IN TRUST 239493 CAPITAL LEASE PAYABLE 201000 440493 X 19510258 0 19510258 0 19510258 15322542 0 15322542 339109 339109 15661651 PART X, LINE 2: NORTHERN RIVERVIEW HEALTH CARE CENTER, INC. 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. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO RELATED ENTITY 339,109. 0 CONGREGATION CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501 (C)(3) 339109 TO SUPPORT THE RELIGIOUS MISSION OF CHEVRA LIADY NUSACH HOARY 1 0 0 1 0 0 0 0 0 1 0 MORRIS KLEIN EXECUTIVE DIRECTOR 108058 522278 18613 89962 8521 41185 24009 116043 7754 35508 166955 804976 0 0 MICHAEL NOWICKI COMPLIANCE OFFICER 32193 155600 0 0 0 0 0 0 0 0 32193 155600 0 0 SHLOMO KATZ DIRECTOR 190980 0 0 0 0 0 0 0 12414 0 203394 0 0 0 HELEN OKONKWO DIRECTOR OF NURSING 153523 0 0 0 0 0 0 0 12414 0 165937 0 0 0 PART I, LINE 3 THE STUDY WAS CONDUCTED BY THE SOLE CORPORATE MEMBER "NORTHERN METROPOLITAN FOUNDATION" ON BEHALF OF NORTHERN MANOR MULTICARE, INC. PART I, LINE 7 BONUSES ARE DETERMINED BY THE BOARD AND ARE BASED ON PERFORMANCE. PART 1, LINE 4B MORRIS KLEIN $140,052 FORM 990, PART VI, SECTION A, LINE 2 CHIEF OPERATING OFFICER GEDALIA KLEIN IS RELATED TO EXECUTIVE DIRECTOR, MORRIS KLEIN. FORM 990, PART VI, SECTION A, LINE 6 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF ASSISTED LIVING AT NORTHERN RIVERVIEW, INC.. FORM 990, PART VI, SECTION A, LINE 7A NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FINAL FORM 990 WAS REVIEWED BY THE BOARD PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER, DIRECTOR, AND OFFICER IS PROVIDED WITH THE CONFLICT OF INTEREST POLICY, AND IS REQUIRED TO FILL OUT A FORM WHICH WILL DISCLOSE ANY CONFLICT OF INTEREST. IF THERE IS A CONFLICT, THE BOARD MEMBER WILL RECUSE HIM/HERSELF FROM VOTING ON ANY ISSUE THAT CREATES THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 A PRICEWATERHOUSECOOPER STUDY REVIEWED AND SUBSTANTIATED THE TOP MANAGEMENT COMPENSATION. THE LAST SALARY DETERMINATION FOR TOP MANAGEMENT COMPENSATION TOOK PLACE IN JUNE 2011. THE STUDY WAS CONDUCTED BY THE SOLE CORPORATE MEMBER "NORTHERN METROPOLITAN FOUNDATION" ON BEHALF OF NORTHERN RIVERVIEW HEALTH CARE CENTER INC. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. NORTHERN MANOR MULTICARE CENTER INC 199 MIDDLETOWN ROAD NANUET NY 10954 133623600 NURSING HOME NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 ASSISTED LIVING AT NORTHERN RIVERVIEW INC 89 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133976617 ASSISTED LIVING FACILITY NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 FOUNTAINVIEW AT COLLEGE ROAD INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 133935070 INDEPENDENT LIVING FACILITY NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 113354023 CHARITABLE FOUNDATION AND ADMINISTRATIVE SUPPORT ORGANIZATION NY 501 (C)(3) LINE 11A, I CHEVRA LIADY NUSACH HOARY 0 NORTHERN SERVICES GROUP INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134120014 ADMINISTRATIVE SUPPORT ORGANIZATION NY 501 (C)(3) LINE 11B, II NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 LIFESTYLE OPTIONS FOR SENIORS FOUNDATIONINC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134133472 CHARITABLE ENTITY NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN INC 225 MAPLE AVENUE MONSEY NY 10952 133070759 NURSING HOME NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 RELIGIOUS ENTITY NY 501 (C)(3) LINE 1 N/A 0 0 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0