2014-07-02T09:11:31-07:00 2013-12-31 990 2013-01-01 222291346 GENESEE VALLEY PRESBYTERIAN NURSING CENTER GENE 5854611991 254 Alexander Street Rochester NY 14607 James DeVoe President 5854611991 2014-06-30 2013 2015-11-30 17:44:51Z Kirkhaven James E DeVoe 254 Alexander Street Rochester NY 14607 11815966 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. 12 12 317 15 0 0 82033 140827 11810738 11595747 1767 1113 74248 78279 11968786 11815966 0 0 0 0 8326562 8328135 0 0 0 4156929 4198777 12483491 12526912 -514705 -710946 10556588 11422806 10115490 9454241 441098 1968565 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 11358974 0 11595747 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 11358974 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 9 0 1 317 1 0 0 0 0 0 0 X 12 12 0 0 0 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 0.5 X 0 0 0 Thomas Lockwood Director/Officer 0.5 0.25 X 0 0 0 Ronald Wright Jr Director 0 0 X 0 0 0 Sharon Boyd Director/Officer 0.5 0.5 X 0 0 0 Ann Marie Cook Director/Officer 0.5 0.25 X X 0 0 0 Reverend Steve Becker Director 0.5 0.25 X 0 0 0 Nick Bhatia Director 0.5 0.25 X 0 0 0 Tom D'Antonio Director 0.5 0.25 X 0 0 0 Roger Roth Director 0.5 0.25 X 0 0 0 Marisa Geitner Director 0.5 0.25 X 0 0 0 James E DeVoe President/CEO 28 12 X X X 119788 51338 52146 Amanda Brown VP/Administrator 40 0 X 107700 0 19601 Cassandra Tilliman VP of Human Resources 31 9 X 79985 23892 18906 Scott Maar VP of Finance 28 12 X 63720 27309 16567 JoAnne Ryan Director 0.5 0.25 X 0 0 0 Erane Allen Director 0.5 0.25 X 0 0 0 371193 102539 107220 2 0 1 0 Freedom Therapy 304 East Avenue Rochester NY 14607 Therapy Services 643246 1 0 0 0 140827 0 0 0 140827 Skilled Nursing Home Services 623110 11595747 11595747 0 0 0 0 0 0 11595747 1113 0 0 1113 0 0 0 0 0 0 0 0 22454 0 0 0 22454 0 22454 0 0 22454 0 0 0 Staff Cafeteria 722210 24511 0 0 24511 Barber & Beauty Service 812112 14939 0 0 14939 Telephone & Newspaper 812900 7426 0 0 7426 8949 0 0 8949 55825 11815966 11595747 0 79392 503520 126243 377277 0 6217450 5973347 244103 0 380445 365227 15218 0 721724 692855 28869 0 504996 484796 20200 0 14563 0 14563 0 22245 0 22245 0 793346 779236 14110 0 7110 7110 0 0 35181 452 34729 0 59267 59267 0 0 621241 559117 62124 0 16336 6335 10001 0 22202 22202 0 527074 474366 52708 0 89911 0 89911 0 Supplies 984458 963785 20673 0 NYS Cash Receipts Assessment 630253 630253 0 0 Purchased Services/Repairs & Maintenance 253923 205525 48398 0 Other 121667 31060 90607 0 12526912 11358974 1167938 0 81380 80949 1057128 1569672 1220123 1158307 78251 109084 16016981 9869553 5953184 6147428 2166522 2357366 10556588 11422806 1263929 1040686 23181 33829 4994218 6256124 3834162 2123602 10115490 9454241 X -1488483 -239970 974466 1252124 955115 956411 441098 1968565 10556588 11422806 X -710946 0 0 0 0 2238413 X 0 1 X 1 0 X 22029 120496 108103 82033 140827 473488 11910584 11691414 12641176 11810738 11595747 59649659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11932613 11811910 12749279 11892771 11736574 60123147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60123147 8878 3752 2245 1767 1113 17755 0 0 0 0 0 0 8878 3752 2245 1767 1113 17755 0 0 0 0 0 0 82686 51651 71388 74248 78279 358252 12024177 11867313 12822912 11968786 11815966 60499154 0.99378 0.99379 0.00029 0.00066 X Schedule A, Part III, Line 12 Staff cafeteria, vending, guest meals, telephone, newspaper, hair care, misc. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 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 937839 7757 206424 0 206424 0 945596 0 1 0 0 1 1 0 438016 438016 0 13180188 8194060 4986128 0 0 0 0 0 2115550 1498021 617529 0 283227 177472 105755 6147428 Beneficial Interest in Foundation 2208535 Mortgage Acquisition Costs 98875 Resident Funds Held in Trust 49805 Due From Affiliated Parties 151 2357366 Due to Third Party Payors 510552 Pension Liability 997221 Workers Compensation Trust Liability 501716 Resident Funds Held in Trust 49805 Deferred Compensation Liability 62811 Due to Affiliated Parties 1497 2123602 11815966 0 0 0 0 0 11815966 0 0 0 11815966 13006058 0 0 0 479146 479146 12526912 0 0 0 12526912 Schedule D, Part V, Line 4 Endowment funds are to be held in perpetuity with the income to be recognized and transferred to temporary 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. Schedule D, Part XII, Line 2d Loss on extinguishment of debt=$59,146 and Workers Compensation Trust change in deficit estimate=$420,000. X X X X 0 1 0 0 0 0 0 1 0 James E DeVoe President/CEO 112252 48108 7536 3230 0 0 22127 9483 14375 6161 156290 66982 144542 72926 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 and related 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 approval by Executive Committee and board. Total aggragate bonus payments equaled $18,194. Form 990, Part VI, Section A, Line 6 The organization is a membership corporation with Presbyterian Homes & Services of Genesee Valley (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 & Finance Committee of the board of directors 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 meeting, 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. 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=$2,438,605;Change in beneficial interest in Foundation=$278,954;Loss on extinguishment of debt=$(59146); Workers Compensation Trust change in deficit estimate=$(420,000). 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 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 Seniorsfirst Foundation Inc c 140827 Actual dollar value Prebyterian Homes & Services of Genesee Valley dba Seniorsfirst o 710424 % of time spent Seniorsfirst Foundation Inc m 45142 Actual cost