2013-08-14T16:26:11-05:00 2012-12-31 233022325 ZELENKOFSKE AXELROD LLC 2370 YORK ROAD SUITE A-5 JAMISON PA 18929 990 2012-01-01 251313958 SUSQUE-VIEW HOME INC SUSQ 5707481784 22 CREE DRIVE LOCK HAVEN PA 17745 DENNIS STAUFFER 5707481784 2013-08-14 1 ZELENKOFSKE AXELROD LLC P00671750 2159182277 2012 2016-02-24 21:20:13Z DENNIS STAUFFER 22 CREE DRIVE LOCK HAVEN PA 17745 10580119 0 X WWW.SUSQUEVIEWHOME.COM X 1976 PA SUSQUE-VIEW HOME IS DEDICATED TO MEETING THE NEEDS OF OUR COMMUNITY AS A LEADING REGIONAL RESOURCE FOR COMPREHENSIVE PROGRESSIVE HEALTHCARE. BY PROVIDING EXCELLENT QUALITY CARE IN A VIBRANT HEALTHY ENVIRONMENT, WE SEEK TO HELP OUR CITIZENS LIVE TO THEIR HIGHEST POTENTIAL. SUSQUE-VIEW HOME WILL USE RESOURCES IN A COST EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER, WORKING WITH PHYSICIANS, STAFF, VOLUNTEERS AND OTHER HEALTH PROFESSIONALS. WE WILL CONTINUE TO EXPLORE NEW PROGRAMS AND OPPORTUNITIES IN RESPONSE TO THE NEEDS OF OUR COMMUNITY. 3 3 221 25 0 0 0 0 10462486 10293295 1856 85443 17746 18652 10482088 10397390 0 0 0 0 6476654 6534124 0 0 0 3868777 3828905 10345431 10363029 136657 34361 8451414 8648233 2114439 2276897 6336975 6371336 X SUSQUE-VIEW HOME, INC. IS DEDICATED TO MEETING THE NEEDS OF OUR COMMUNITY AS A LEADING REGIONAL RESOURCE FOR COMPREHENSIVE PROGRESSIVE HEALTHCARE. BY PROVIDING EXCELLENT QUALITY CARE IN A VIBRANT HEALTHY ENVIRONMENT, WE SEEK TO HELP OUR CITIZENS LIVE TO THEIR HIGHEST POTENTIAL. SUSQUE-VIEW HOME WILL USE RESOURCES IN A COST-EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER. WORKING WITH PHYSICIANS, STAFF, VOLUNTEERS AND OTHER HEALTH PROFESSIONALS, WE WILL CONTINUE TO EXPLORE NEW PROGRAMS AND OPPORTUNITIES IN RESPONSE TO THE NEEDS OF OUR COMMUNITY. 0 0 9169667 10368530 THE SUSQUE-VIEW HOME, INC. PROVIDES SKILLED NURSING AND REHABILITATION SERVICES TO RESIDENTS OF CLINTON COUNTY AND SURROUNDING AREAS. THE HOME SERVES PRIVATE PAY AND INSURED PATIENTS AS WELL AS BENEFICIARIES OF THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS. 9169667 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 1 221 1 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 PA X DENNIS STAUFFER CONTROLLER 5707481784 22 CREE DRIVE LOCK HAVEN PA 17745 JOEL LONG 2.00 X 0 0 0 PETE SMELTZ 2.00 X 0 0 0 JEFF SNYDER 2.00 X 0 0 0 VIRGINIA CREVELING 50.00 X 84153 0 0 DENNIS STAUFFER 45.00 X 72322 0 0 156475 0 0 0 0 0 0 SIGNIFICA ISURANCE GROUP 1871 SANTA BARBARA DR LANCASTER PA 17764 HEALTH INSURANCE 1187488 SODEXO INC 4880 PAYSHERE CIRCLE CHICAGO IL 60674 DIETARY 1093562 ADVANTAGE CARE REHABILITATIONINC 5035 CLAIRTON BLVD PITTSBURGH PA 15236 THERAPY SERVICES 480184 PREMIERE HEALTHCARE RESOURCES 2009 RENAISSANCE BLVD STE 300 KING OF PRUSSIA PA 19406 MANAGEMENT CONSULTANT 243959 MILLENIUM PHARMACY SYSTEM 100 E KENSINGER DR 500 CRANBERRY TWP PA 16066 PHARMACY 223913 8 PROGRAM SERVICE REVENU 623000 10293295 10293295 10293295 28860 28860 239312 182729 56583 56583 56583 BEAUTY SHOP REVENUE 900099 12643 12643 BEAUTY SHOP RENT 900099 6009 6009 18652 10397390 10368530 0 28860 156475 156475 4534562 4098448 436114 80701 72940 7761 1425977 1288833 137144 336409 304055 32354 159597 159597 22988 15093 7895 18250 18250 8480 8480 1860510 1858153 2357 7363 7363 261798 236480 25318 48676 6840 41836 24000 24000 6961 5461 1500 422065 422065 83218 83218 PURCHASED SERVICES 596914 445996 150918 RESIDENT MEDICATIONS 157549 157549 BAD DEBT EXPENSE 78000 78000 OXYGEN 72536 72536 10363029 9169667 1193362 0 1978212 1499803 1059780 1456939 87049 103816 11569204 8623205 2865267 2945999 2461106 2641676 8451414 8648233 1225588 1397052 44230 47539 844621 832306 2114439 2276897 X 6336975 6371336 6336975 6371336 8451414 8648233 34361 0 X 0 1 X 1 0 X 2040 2273 10579 14892 9692435 9812564 10328120 10480232 10311947 50625298 9694475 9814837 10338699 10480232 10311947 50640190 0 0 0 50640190 29755 17712 20341 28144 28860 124812 29755 17712 20341 28144 28860 124812 9724230 9832549 10359040 10508376 10340807 50765002 0.99750 0.99710 0.00250 0.00290 X 0 1 X 4214208 3056669 1157539 247030 187627 59403 6827957 5230469 1597488 280009 148440 131569 2945999 WC FUND BALANCE AND RESERVE FOR MEDICAL LIABILITY 832306 832306 10657565 304555 304555 10353010 44380 44380 10397390 10667584 304555 304555 10363029 0 10363029 PART IV, LINE 2B: SUSQUE-VIEW HOME HAS CUSTODY OF SOME OF THE RESIDENTS' PERSONAL FUNDS PART XI, LINE 2D - OTHER ADJUSTMENTS: REFUNDING OF COUNTY'S MEDICAL ASSISTANCE FUNDING PART XI, LINE 4B - OTHER ADJUSTMENTS: NET UNREALIZED GAIN ON INVESTMENTS PART XII, LINE 2D - OTHER ADJUSTMENTS: REFUNDING OF COUNTY'S MEDICAL ASSISTANCE FUNDING PART X - LIABILITY UNDER FIN 48 FOOTNOTE INCOME TAXES - THE HOME IS NON-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES. FASB CLARIFIES THE ACCOUNTING OF UNCERTAINTY IN INCOMES TAXES BY PRESCRIBING THE RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. THIS WAS EFFECTIVE FOR FISCAL YEARS BEGINNING AFTER DECEMBER 15 ,2008 AND WAS ADOPTED BY THE HOME FOR THE YEAR ENDING DECEMBER 31, 2009. PART XII LINE 2D - RECONCILIATION OF CHANGES - OTHER COUNTY MEDICAL ASSISTANCE FUNDING REFUND PART XIII LINE 2D - RECONCILIATION OF CHANGES - OTHER COUNTY MEDICAL ASSISTANCE FUNDING REFUND FORM 990, PART VI, SECTION A, LINE 3 SUSQUE-VIEW HOME IS MANAGED BY PREMIER HEALTHCARE RESOURCES, INC., WHICH PROVIDES MANAGEMENT AND ADMINISTRATIVE SERVICES TO SUSQUE-VIEW HOME. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATIONS CFO REVIEWS THE FORM 990 WITH THE BOARD OF DIRECTORS AT THE MONTHLY BOARD MEETINGS PRIOR TO FILING FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS AND UPDATES THE POLICY ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST,EITHER HAND DELIVERED OR MAILED (CERTIFIED)