2014-11-17T18:09:14-06:00 2013-12-31 271728945 O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990 2013-01-01 160985052 ST JOSEPH NURSING HOME CO OF UTICA STJO 3157971230 2535 GENESEE ST UTICA NY 135016251 DAVID HARTNETT CFO 3157971230 2014-07-10 1 GARRETT M HIGGINS P00543209 9143818900 2014-07-10 2013 2015-11-30 17:44:51Z FREDERICK DECK 2535 GENESEE ST UTICA NY 135016251 8363478 0 X WWW.STJOSEPHNH.ORG X 1970 NY THE MISSION OF THE HOME IS TO PROVIDE CARE AND SERVICES TO THE COMMUNITY IN CONFORMANCE WITH THE THEOLOGY; PHILOSOPHY; TEACHINGS AND DOCTRINES OF THE ROMAN CATHOLIC CHURCH, RESPECTING AND BUILDING ON THE MISSION; PHILOSOPHY AND VALUES OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM. 13 13 259 41 0 0 72500 333335 8176533 7882451 17475 16291 80394 129602 8346902 8361679 0 0 0 0 5697537 5903952 0 0 0 3086516 2873123 8784053 8777075 -437151 -415396 3970192 4315238 3301632 3648286 668560 666952 X THIS MISSION OF THE HOME IS TO PROVIDE CARE AND SERVICES TO THE ELDERLY IN OUR COMMUNITY IN CONFORMANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND THE PHILOSOPHY AND VALUES OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM. THE HOME OPERATES A 120-BED, LICENSED, NURSING HOME IN UTICA, NY. IT PROVIDES PROFESSIONAL AND PERSONAL SERVICES IN A COMPASSIONATE AND CARING MANNER TO THE ELDERLY OF THE CITY OF UTICA, SURROUNDING COMMUNITIES, AND OTHER LOCATIONS THAT SEEK OUR SERVICES. 0 0 7337227 7882451 ST. JOSEPH NURSING HOME PROVIDES 24-HOUR, SKILLED-NURSING FOR AGED AND INFIRM RESIDENTS. THE CARING AND COMPASSIONATE STAFF WORKS DILIGENTLY TO FULFILL OUR MISSION BY OFFERING SHORT AND LONG TERM REHABILITATION, ENGAGING ACTIVITIES AND SOCIAL EVENTS, PAIN MANAGEMENT, COMPUTER INTERACTION AND DELICIOUS MEALS TO THE RESIDENTS. A CORNERSTONE OF OUR MISSION IS THE NURTURING OF THE SPIRITUAL LIFE OF OUR RESIDENTS AND THIS IS ACCOMPLISHED THROUGH THE SERVICES OF THE SIX CARMELITE SISTERS FOR THE AGED AND INFIRM ON OUR STAFF AND THROUGH DAILY MASS. IN 2013, THE ORGANIZATION PROVIDED 41,161 DAYS OF CARE TO APPROXIMATELY 206 PATIENTS, WITHOUT REGARD TO THEIR GENDER, ETHNIC BACKGROUND, RELIGION, OR FINANCIAL CIRCUMSTANCES. 7337227 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 11 0 259 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X X DAVID HARTNETT 3157971230 2535 GENESEE STREET UTICA NY 13501 WILLIAM F LOCKE TREASURER 1.00 X X 0 0 0 DAVID R DIODATI ESQ SECRETARY 1.00 X X 0 0 0 ELIZABETH GILROY-KEARNS SECOND VICE PRESIDENT 1.00 X X 0 0 0 P MICHAEL CALOGERO PRESIDENT 1.00 X X 0 0 0 SR PATRICIA RAWDON OCARM FIRST VICE-PRESIDENT 1.00 X X 0 0 0 MR RICHARD KETCHAM DIRECTOR - THRU 2013 1.00 X 0 0 0 MRS MARCIA E MARTIN DIRECTOR 1.00 X 0 0 0 MSGR CHARLES J FAHEY DIRECTOR 1.00 X 0 0 0 REV CAROL JUBENVILLE DIRECTOR 1.00 X 0 0 0 REV JOHN A BUEHLER DIRECTOR 1.00 X 0 0 0 SR ANTHONY DE LOURDES OCARM DIRECTOR 1.00 X 0 0 0 SR CYRIL METHODIUS OCARM DIRECTOR 1.00 X 0 0 0 SR FIDELIS M REGAN OCARM DIRECTOR 1.00 X 0 0 0 MRS SANDRA CORNEY DIRECTOR 1.00 X 0 0 0 DAVID HARTNETT CHIEF FINANCIAL OFFICER 40.00 X 73726 0 0 FREDERICK DECK CHIEF EXECUTIVE OFFICER 40.00 X 105193 0 11162 178919 0 11162 1 0 0 0 REHAB CARE INC 3041 AVENUE U BROOKLYN NY 11229 THERAPY SERVICES 467999 US FOOD 1051 AMBOY AVENUE PERTH AMBOY NJ 08861 FOOD SERVICES 292104 2 333335 333335 MEDICAID 621610 4692792 4692792 MEDICARE 621610 2038818 2038818 PRIVATE PAY 621610 1150841 1150841 7882451 16291 16291 17715 0 17715 17715 17715 2570 1799 771 771 INSURANCE PROCEEDS 900099 48755 48755 REFUNDS 900099 26870 26870 BEAUTY SHOP SALES 900099 25888 25888 9603 9603 111116 8361679 7882451 0 145893 190081 157459 32622 4225492 3508419 717073 169039 140028 29011 615283 509688 105595 704057 583226 120831 34115 34115 20400 20400 69233 41519 27714 6199 6199 714502 538889 175613 229893 229893 11282 6832 4450 2270 1320 950 52740 52740 193163 193163 83461 83461 CONTRACTED SERVICES 927344 838635 88709 NYS CASH RECEIPTS ASSES 363973 363973 MEDICAL SUPPLIES 94044 94044 DIRECT OPERATING EXPENS 35403 11577 23826 35101 35101 8777075 7337227 1439848 0 275343 464496 324870 81126 1231104 1392306 66083 89039 35196 38664 7220092 5549921 1358027 1670171 634003 539066 45566 40370 3970192 4315238 822990 1271308 45566 40370 675000 975000 1758076 1361608 3301632 3648286 X 668560 666952 668560 666952 3970192 4315238 X -415396 70792 342996 X X 0 1 X 1 0 X 28544 267088 91405 72500 333335 792872 8070321 7866984 8305115 8176533 7882451 40301404 1892 2021 2570 6483 8098865 8134072 8398412 8251054 8218356 41100759 0 0 0 41100759 20698 10827 12785 17475 34006 95791 20698 10827 12785 17475 34006 95791 59543 52360 46409 79614 111115 349041 8179106 8197259 8457606 8348143 8363477 41545591 0.98930 0.99250 0.00230 0.00170 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2009 AMOUNT: $ 27,225. 2010 AMOUNT: $ 2,390. 2011 AMOUNT: $ 10,100. 2012 AMOUNT: $ 14,175. BEAUTY AND BARBER SHOP - 2009 AMOUNT: $ 28,996. 2010 AMOUNT: $ 34,324. 2011 AMOUNT: $ 31,313. 2013 AMOUNT: $ 25,888. GIFT SHOP - 2009 AMOUNT: $ 1,763. VENDING MACHINES - 2009 AMOUNT: $ 1,224. 2010 AMOUNT: $ 706. 2011 AMOUNT: $ 966. 2012 AMOUNT: $ 955. 2013 AMOUNT: $ 1,134. MEDICAL RECORDS FEE - 2010 AMOUNT: $ 91. CASH DISCOUNTS ON PURCHASES - 2009 AMOUNT: $ 335. 2010 AMOUNT: $ 1,457. 2011 AMOUNT: $ 4,030. 2012 AMOUNT: $ 4,032. 2013 AMOUNT: $ 2,772. CAFETERIA INCOME - 2010 AMOUNT: $ 13,392. REIMBURSEMENT-CARMELITE SISTERS - 2012 AMOUNT: $ 34,565. 2013 AMOUNT: $ 5,696. BAD DEBT - 2012 AMOUNT: $ 8,000. INSURANCE PROCEEDS - 2012 AMOUNT: $ 17,887. 2013 AMOUNT: $ 48,755. REIMBURSEMENT - 2013 AMOUNT: $ 26,870. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 222500 222500 3283298 2656711 626587 903235 596157 307078 2811059 2297053 514006 1670171 DUE TO THIRD PARTY PAYORS 129 PENSION LIABILITY 1361479 1361608 X 8401134 70792 70792 8330342 31337 31337 8361679 8745738 0 8745738 31337 31337 8777075 PART IV, LINE 2B: RESIDENTS' FUNDS ARE HELD BY THE HOME ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE HOME FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE HOME AT THE REQUEST OF, OR ON BEHALF OF, RESIDENTS FOR THEIR PERSONAL USE. PART X, LINE 2: THE HOME RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY WHEN THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE HOME HAS NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION. THE HOME IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2010. PART XI, LINE 2D - OTHER ADJUSTMENTS: BEAUTY PARLOR EXPENSES NETTED AGAINST REVENUE PART XI, LINE 4B - OTHER ADJUSTMENTS: BEAUTY PARLOR EXPENSES NETTED AGAINST REVENUE 31,337. PART XII, LINE 4B - OTHER ADJUSTMENTS: BEAUTY PARLOR EXPENSES NETTED AGAINST REVENUE 31,337. MERRITTE LOCKE ATTORNEY- SAUNDER K WILLIAM LOCKE, BOARD MEMBER 34115 LEGAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 6 THERE SHALL BE FIVE MEMBERS OF THE CORPORATION. THE MEMBERS OF THIS CORPORATION SHALL BE THE SUPERIOR GENERAL AND THE VICAR GENERAL OF THE CARMELITE ORDER FOR THE AGED AND INFIRM, AND THREE MEMBERS TO BE APPOINTED BY THE EXISTING MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS ARE ELECTED BY THE MAJORITY VOTE OF THE MEMBERS OF THE CORPORATION AT THEIR ANNUAL MEETING. THE TERM OF OFFICE OF THE DIRECTOR SHALL BE FOR ONE YEAR OR UNTIL THEIR SUCCESSOR ARE DULY ELECTED AND QUALIFIED. ELECTED DIRECTORS SHALL BE SUBJECT TO REMOVAL WITHOUT ANY CAUSE AT ANY TIME BY THE AFFIRMATIVE VOTE OF THE MAJORITY OF THE MEMBERS OF THE CORPORATION. THE CORPORATE MEMBERS RETAIN THE RIGHT TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBERS OF THE CORPORATION: - TO FORMULATE AND CHANGE FROM TIME TO TIME, THE PHILOSOPHY, OBJECTIVES, AND PURPOSES OF THE CORPORATION FOR WHICH IT WAS AND IS FORMED AND EXISTS. - TO ELECT THE MEMBERS AND DIRECTORS, AND TO REMOVE THE SAME WITH OR WITHOUT CAUSE. - TO APPOINT AND REMOVE THE ADMINISTRATOR OF ANY FACILITY OWNED OR OPERATED BY THE CORPORATION. - TO AMEND, REVISE, ALTER, REPEAL OR OTHERWISE MODIFY THE CERTIFICATE OF INCORPORATION OR THE BY-LAWS OF THIS CORPORATION. - TO APPROVE ANY BORROWING OF FUNDS IN EXCESS OF THE BORROWING AUTHORITY TO BE GRANTED FROM TIME TO TIME BY THE MEMBERS TO THE BOARD OF DIRECTORS. - TO ACQUIRE, PURCHASE, SELL, LEASE, MORTGAGE, TRANSFER, OR ENCUMBER REAL ESTATE AND TO CONSTRUCT OR UNDERTAKE THE DESTRUCTION OF BUILDINGS OWNED BY THE CORPORATION. - TO MERGE, CONSOLIDATE, OR AFFILIATE THIS CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION OR PROGRAM. - TO REQUIRE A CERTIFIED AUDIT OF CORPORATE FUNDS AT ANY TIME AND TO NAME THE CERTIFIED PUBLIC ACCOUNTANT WHO IS TO PERFORM THE AUDIT. - TO LIQUIDATE, DISSOLVE OR TERMINATE THE EXISTENCE OF THIS CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH TERMINATION OR DISSOLUTION IN CONFORMITY WITH SECTION 501(C)3 OF THE INTERNAL REVENUE CODE OF 1986 AS AMENDED. - TO MAKE GIFTS AND DONATIONS OR LOANS TO OTHER CHARITIES INCLUDING BUT NOT LIMITED TO OTHER CORPORATIONS RELATED TO THE CARMELITE SISTERS FOR THE AGED AND INFIRM, PROVIDED SUCH GIFTS, DONATIONS OR LOANS ARE NOT CONTRARY TO THE GOVERNING STATE LAW OR DO NOT MATERIALLY ADVERSELY AFFECT ANY REIMBURSEMENT TO THE CORPORATION FOR THE PROVISION OF CARE. - TO MAKE AND PROMULGATE WRITTEN OR OTHER STATEMENTS OF POLICY AS MAY BE REQUIRED BY ANY GOVERNMENTAL REGULATORY AGENCY. FORM 990, PART VI, SECTION B, LINE 11 ST. JOSEPH NURSING HOME COMPANY OF UTICA HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. THE FINANCE COMMITTEE REPORTS TO THE BOARD OF DIRECTORS REGARDING THE REVIEW, AND A ELECTRONIC COPY OF FORM 990 IS PROVIDED TO THE BOARD. ANY COMMENTS AND RECOMMENDATIONS BY THE BOARD ARE INCLUDED IN THE FINAL COPY OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST DISCLOSURE POLICY REQUIRES ALL OFFICERS AND BOARD MEMBERS TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. THIS WAS LAST COMPLETED IN JUNE 2012 IN ADDITION, SHOULD AN OFFICER OR BOARD MEMBER ASSUME NEW EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER ROLE WITH THE ORGANIZATION, SUCH INDIVIDUAL IS REQUIRED TO DISCLOSE IN WRITING THE NATURE OF SUCH EXTERNAL INTERESTS. THE DISCLOSURE STATEMENT IS PROVIDED TO THE ADMINISTRATOR FOR REVIEW. CONFLICTS ARE RESOLVED BY MAKING A REQUIRED DISCLOSURE, AND MAY RESULT IN RESTRICTING THE OFFICER OR BOARD MEMBER IN ANY RELATED ACTIVITY OR PROCESS AS DETERMINED APPROPRIATE TO THE CIRCUMSTANCES OF THE CONFLICT. FAILURE TO DISCLOSE A CONFLICT OF INTEREST IS IN VIOLATION OF THE ADOPTED POLICY AND CAN RESULT IN DISCIPLINARY ACTION OR REMOVAL. FORM 990, PART VI, SECTION B, LINE 15 A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION FOR COVERED INDIVIDUALS BASED ON RELEVANT DATA INCLUDING COMPARABILITY COMPENSATION FOR SIMILARLY SITUATED ENTITIES AND INDEPENDENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS AS DEEMED NECESSARY. SALARIES WERE LASTED UPDATED IN OCTOBER 2012. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION, FORM 990, FORM 1023, AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. THE ORGANIZATION ALSO FILES AN ANNUAL COST REPORT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH CONTAINS FINANCIAL STATEMENTS AND RELATED NOTE DISCLOSURES. THIS COST REPORT IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 342,996. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. CARMELITE SISTERS FOR THE AGED AND INFIRM 600 WOODS ROAD GERMANTOWN NY 12572 141369151 LONG TERM HEALTH CARE MINISTRY IN CONFORMITY WITH ROMAN CATHOLIC DOCTRINE NY 501(C)3 1 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0