2014-08-20T12:34:36-05:00 2013-12-31 264298079 EFP ROTENBERG LLP 280 KENNETH DRIVE ROCHESTER NY 14623 990 2013-01-01 160962256 GOOD SHEPHERD-FAIRVIEW HOME INC GOOD 6077242477 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 RYK HALL CFO 6077242477 2014-08-20 1 DARLA WHEATON P00060135 5854278900 2013 2015-11-30 17:44:51Z MICHAEL KEENAN 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 10644655 0 X WWW.GSFHOME.COM X 1969 NY THE GOOD SHEPHERD-FAIRVIEW HOME, INC. OPERATES A MULTI-LEVEL RETIREMENT COMMUNITY. ITS PURPOSE IS TO PROVIDE SUITABLE HOUSING AND HEALTH CARE FOR THE ELDERLY. 18 17 303 250 0 0 227422 219587 9498921 10196440 11594 18896 176123 208371 9914060 10643294 0 0 0 0 5477195 6125223 0 0 0 4626884 4383948 10104079 10509171 -190019 134123 6899660 7263181 2539621 2552689 4360039 4710492 X THE GOOD SHEPHERD-FAIRVIEW HOME, INC. OPERATES A MULTI-LEVEL RETIREMENT COMMUNITY. ITS PURPOSE IS TO PROVIDE SUITABLE HOUSING AND HEALTH CARE FOR THE ELDERLY. 0 0 4265770 5618598 SKILLED NURSING FACILITY AND REHAB. 1342927 1768818 LICENSED ASSISTED LIVING PROGRAM 1263932 1664770 ADULT CARE FACILITY 1026944 1352625 APARTMENTS, BEAUTY, CAFE, PHYSICAL THERAPY AND OCCUPATIONAL THERAPY 1026944 1352625 7899573 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 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 1 307 0 1 303 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 18 17 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X RYK HALL 6077242477 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 ELLEN RURY DIRECTOR 1.00 X 0 0 0 PAUL MOLLO DIRECTOR 1.00 X 0 0 0 KENNETH TOMKO RESIDENT CARE COMMITTEE CHAIR 1.00 X 0 0 0 JAMES CHAMBERS VICE CHAIR 1.00 X X 0 0 0 LINDA GLAJCH SECRETARY 1.00 X X 0 0 0 OLIVER RILEY JR DIRECTOR 1.00 X 0 0 0 MICHAEL HAAS DIRECTOR 1.00 X 0 0 0 DOUGLAS JOHNSON DIRECTOR 1.00 X 0 0 0 JOAN LACEY DIRECTOR 1.00 X 0 0 0 PAUL MARRA DIRECTOR 1.00 X 0 0 0 FR JOHN MARTINICHIO TREASURER 1.00 X X 0 0 0 RYAN MURPHY MEAD DIRECTOR 1.00 X 0 0 0 JOANN NAVARRO BUILDING & GROUNDS COMMITT 1.00 X 0 0 0 R MARK PATTERSON CHAIR 1.00 X X 0 0 0 PRESCOTT PERKINS JR DIRECTOR 1.00 X 0 0 0 JEFFREY SMITH BYLAWS & BOARD DEVELOPMENT 1.00 X 0 0 0 THOMAS SYLVESTER DIRECTOR 1.00 X 0 0 0 MICHAEL KEENAN PRESIDENT/CEO 12.00 X X 0 281995 37378 JOSEPH TIGUE CFO/ASSISTANT TREASURER 11.00 X 0 100002 12594 RYK HALL CFO 18.00 X 0 30502 1722 KATHY SWEZEY EXECUTIVE DIRECTOR 18.00 X 102003 0 16862 102003 412499 68556 1 0 1 0 SELECT REHABILITATION 550 FRONTAGE ROAD SUITE 2415 NORTHFIELD IL 60093 THERAPY 733799 MEDICINE SHOPPE 1179 VESTAL AVENUE SUITE 1 BINGHAMTON NY 13903 PHARMACY 228937 2 212625 6962 219587 RESIDENTIAL SERVICE REVENUE 623000 10196440 10196440 10196440 9963 9963 9025 1269 1361 0 7664 1269 8933 8933 SOLD SERVICES 623000 69438 69438 APARTMENT SERVICES 531390 47949 47949 BEAUTY SHOP 812900 38396 38396 52588 52588 208371 10643294 10404811 0 18896 4456801 4097997 358804 147727 147727 1204503 741651 462852 316192 289839 26353 6006 6006 1700 1700 84349 37938 46411 99771 3036 96735 323374 307373 16001 11841 6534 5307 93114 93114 415151 415151 65960 65960 PURCHASED SERVICES 1195441 1190549 4892 SUPPLIES 1016614 927830 88784 MANAGEMENT SERVICES 719947 719947 NYS ASSESSMENT 199372 199372 151308 97454 53854 10509171 7899573 2609598 0 175050 215934 800128 1044920 26205 72380 17549940 13915999 3924287 3633941 353824 410542 840407 1004872 779759 880592 6899660 7263181 812503 905481 158209 139686 1505689 1216750 63220 290772 2539621 2552689 X 3285275 3447636 706526 840988 368238 421868 4360039 4710492 6899660 7263181 X 134123 24488 191842 X X 0 1 X 1 0 X 71138 9629 1260 14797 6962 103786 71138 9629 1260 14797 6962 103786 103786 17969 15499 7804 11461 9963 62696 201813 264078 139961 176123 208371 990346 1156828 47320398 0.08970 0.63460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 368238 53630 421868 362238 6000 368238 269434 92804 362238 264409 5025 269434 251283 13126 264409 1.00000 0 0 456317 456317 8011421 5735172 2276249 6066554 5527802 538752 3015648 2653025 362623 3633941 RESTRICT NET ASSETS-FOUNDATION 1004872 F 1004872 APARTMENT ESCROW 66422 DEFERRED FINANCING FEE 26720 DUE FROM FOUNDATION AND VILLAGE 787450 880592 DUE TO THIRD PARTY PAYERS 35589 RESIDENT DEPOSITS 66422 WORKERS' COMPENSATION INSURANCE LIABILITY 188761 290772 X 10841095 24488 191842 216330 10624765 18529 18529 10643294 10490642 0 10490642 18529 18529 10509171 PART V, LINE 4: TO SUPPORT THE HOME'S ACTIVITIES. PART X, LINE 2: THE HOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE HOME'S TAX-EXEMPT PURPOSE MAY BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. IN ACCORDANCE WITH ASC 740-10-50, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE HOME RECOGNIZES THE TAX BENEFITS FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES. MANAGEMENT BELIEVES THAT THE HOME IS CURRENTLY OPERATING IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS HAS BEEN INCLUDED ON THE HOME'S FINANCIAL STATEMENTS. THE EXEMPT HOME'S INFORMATIONAL RETURNS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES AND ITS OPEN AUDIT PERIODS ARE 2010 THROUGH 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 164,465. CHANGES IN VALUE OF FUNDS HELD IN TRUST BY OTHERS 27,377. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE PER ASU 2011-07 18,529. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE PER ASU 2011-07 18,529. 0 0 0 0 0 1 1 0 0 MICHAEL KEENAN PRESIDENT/CEO 0 250359 0 31636 0 0 0 0 0 37378 0 319373 0 0 PART I, LINE 3 THE ORGANIZATION IS A SUBSIDIARY OF FGS, INC. AND HAS RELIED ON FGS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO. PART I, LINE 6 MICHAEL KEENAN RECEIVED BONUSES PER HIS CONTRACT. FORM 990, PART VI, SECTION B, LINE 11 THE CFO REVIEWS FORM 990 AND COMPARES IT TO THE AUDIT FOR COMPLETENESS AND SUPPLEMENTARY DATA COMPARISONS. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH CONFLICT OF INTEREST POLICY IS MONITORED BASED ON FILED REPORTS, FACTS AND DETAILS REGARDING ITEMS FOR ACTION BY BOARD, AND THE HONOR AND CREDIBILITY OF MEMBERS TO NOTE ANY NEW POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 CEO COMPENSATION IS DETERMINED BY THE BOD EXECUTIVE COMMITTEE WITH VP OF HR PROVIDING MARKET SURVEY DATA. AN OUTSIDE CONSULTANT IS USED AS WELL. CEO IS UNDER MULTIPLE YEAR WRITTEN CONTRACT. CEO DETERMINES COMPENSATION OF ALL SENIOR MANAGEMENT POSITIONS WITH MARKET SURVEY DATA PROVIDED BY VP OF HR. FORM 990, PART VI, SECTION C, LINE 18 FORM 990 IS AVAILABLE BY REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, ETC. ARE AVAILABLE BY REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 164,465. CHANGE IN VALUE OF FUNDS HELD BY OTHERS 27,377. FORM 990, PART XII, LINE 2(C): NO CHANGE FROM PRIOR YEAR. GOOD SHEPHERD-FAIRVIEW FOUNDATION INC 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 133386383 TO PROVIDE FINANCIAL SUPPORT FOR AFFILIATED COMPANIES NY 501(C)(3) 170(B)(1)(A)(VI) FGS DBA GOOD SHEPHERD COMMUNITIES 0 GOOD SHEPHERD VILLAGE AT ENDWELL INC 32 VILLAGE DRIVE ENDWELL NY 13760 205580506 TO PROVIDE A CONTINUING CARE RETIREMENT COMMUNITY FOR THE ELDERY NY 501(C)(3) 509(A)(2) FGS DBA GOOD SHEPHERD COMMUNITIES 0 FGS DBA GOOD SHEPHERD COMMUNITIES 80 FAIRVIEW AVENUE BINGHAMTON NY 13904 161256975 TO PROVIDE SUITABLE HOUSING TO THE ELDERLY NY 501(C)(3) 509(A)(2) N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 GOOD SHEPHERD FAIRVIEW FOUNDATION C 212625 GRANT VALUE GOOD SHEPHERD COMMUNITIES O 719947 COST STUDIES AND/OR ACTUAL CHARGE