2013-11-13T14:23:05-06:00 2012-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2012-01-01 161085780 ST CAMILLUS RESIDENTIAL HEALTH CARE FACILITY STCA 3154882951 813 FAY ROAD SYRACUSE NY 132193098 MICHAEL ZINGARO 3154882951 2013-11-12 1 JOSEPH J SCHLEGEL P00301329 3154463600 2012 2016-02-24 21:20:13Z MICHAEL ZINGARO 813 FAY ROAD SYRACUSE NY 132193098 37030229 0 X WWW.ST-CAMILLUS.ORG X 1969 NY ST. CAMILLUS IS A RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO CARING FOR LIFE THROUGH A BROAD RANGE OF HEALTHCARE SERVICES. THE ORGANIZATION OPERATES A 284 BED SKILLED NURSING FACILITY WHICH INCLUDES A 20 BED UNIT DEDICATED TO TRAUMATIC BRAIN INJURY, ALONG WITH AN ADULT DAY HEALTH CARE PROGRAM, A CERTIFIED HOME HEALTH CARE AGENCY, AND AN OUT PATIENT DIAGNOSTIC AND TREATMENT CENTER. THROUGH THESE SERVICES, ST. CAMILLUS HELPS TO ADDRESS THE LONG-TERM CARE, REHABILITATION AND HOME AND COMMUNITY BASED CARE NEEDS OF OUR COMMUNITY. 21 21 712 116 0 0 384452 189333 35260482 36483740 40118 14295 320231 342861 36005283 37030229 0 0 0 0 23364751 24092973 0 0 0 13082314 12681465 36447065 36774438 -441782 255791 19290265 18834902 14979759 14289610 4310506 4545292 X ST. CAMILLUS IS A RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO CARING FOR LIFE THROUGH A BROAD RANGE OF HEALTHCARE SERVICES. THE ORGANIZATION OPERATES A 284 BED SKILLED NURSING FACILITY WHICH INCLUDES A 20 BED UNIT DEDICATED TO TRAUMATIC BRAIN INJURY, ALONG WITH AN ADULT DAY HEALTH CARE PROGRAM, A CERTIFIED HOME HEALTH CARE AGENCY, AND AN OUT PATIENT DIAGNOSTIC AND TREATMENT CENTER. THROUGH THESE SERVICES, ST. CAMILLUS HELPS TO ADDRESS THE LONG-TERM CARE, REHABILITATION AND HOME AND COMMUNITY BASED CARE NEEDS OF OUR COMMUNITY. 0 0 30957208 36808815 CARE AND TREATMENT OF PATIENTS IN A RESIDENTIAL HEALTH CARE FACILITY AND AN OUTPATIENT CLINIC. 30957208 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 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 29 0 1 712 1 0 0 0 0 0 0 0 0 0 0 X 21 21 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MARGARET FRIGON 3154882951 813 FAY ROAD SYRACUSE NY 132193098 DOUGLAS J REICHER 1.00 X 0 0 0 REV LOUIS AIELLO 1.00 X 0 0 0 JOHN J CANNIZZARO 1.00 X X 0 0 0 PETER CAPPUCCILLI JR 1.00 X 0 0 0 JOHN F CATANZARITA 1.00 X 0 0 0 CHARLES P CONOLE 1.00 X 0 0 0 PATRICIA A CURTIN 1.00 X X 0 0 0 JEANNE E BISHOP MD 1.00 X 0 0 0 JAMES N JEROSE 1.00 X 0 0 0 RV MSGR RICHARD KOPP 1.00 X 0 0 0 WAYNE V LA FRANCE 1.00 X 0 0 0 PAUL MELLO 1.00 X 0 0 0 SHEILA LEMKE MD 1.00 X 0 0 0 DAVID J MOYNIHAN 1.00 X 0 0 0 BRENDA A RIGAS 1.00 X 0 0 0 JAMES D SPENCER 1.00 X X 0 0 0 DERRICK J SUEHS 1.00 X 0 0 0 MARY GRACE VANNORTWICK 1.00 X X 0 0 0 WILLIAM LOEHR 1.00 X 0 0 0 DANIEL J ROSS 1.00 X 0 0 0 ANNE MARIE MULLEN 1.00 X 0 0 0 AILEEN BALITZ 32.00 8.00 X 186308 0 444 MICHAEL ZINGARO 32.00 8.00 X 109099 0 5369 MICHAEL SCHAFER 40.00 X 114123 0 5369 KATHY BARBER 32.00 8.00 X 88305 0 10743 CHRISTINE KEARNEY 39.00 1.00 X 94543 0 10774 HELENA GLASSFORD 32.00 8.00 X 76725 0 10590 HEATHER KEMMIS 24.00 16.00 X 84726 0 15189 MARY ELLEN KAIER 34.00 6.00 X 102801 0 10788 DAVID DUBE 40.00 X 111450 0 0 968080 0 69266 5 0 1 0 SODEXHO INC 1900 SELWYN AVENUE CHARLOTTE NC 28207 FOOD SERVICE 1410318 NURSECORE MANAGEMENT SERVICES 2201 BROOKHOLLOW ARLINGTON TX 76006 NURSING STAFF 907593 NURSEFINDERS 7421 OSWEGO ROAD LIVERPOOL NY 13090 NURSING STAFF 309312 ADECCO EMPLOYMENT AGENCY 225 GREENFIELD PARKWAY LIVERPOOL NY 13088 NURSING STAFF 307142 ATLAS HEALTHCARE LINEN 414 W TAYLOR STREET SYRACUSE NY 13202 LINEN SERVICES 267118 8 43885 145448 189333 PROGRAM SERVICE REVENUE 623000 36483740 36483740 36483740 11875 11875 17786 0 17786 17786 17786 2420 0 2420 2420 2420 OTHER REVENUE 623000 148071 148071 MANAGEMENT FEE INCOME 623000 107436 107436 BEAUTY SHOP REVENUE 623000 69568 69568 325075 37030229 36808815 0 32081 925896 925896 17647319 15068578 2578741 4154601 3363154 791447 1365157 1151564 213593 57007 57007 39326 39326 205021 137364 67657 155887 51752 104135 48847 48847 458425 412582 45843 107775 107113 662 12810 4194 8616 471020 380541 90479 998881 898993 99888 392856 331955 60901 SUPPLIES 2583348 2431448 151900 CONTRACT LABOR 2482052 2482052 MANAGEMENT CONTRACT 1603826 1583902 19924 NYS ASSESSMENT 1500290 1500290 1564094 1051726 512368 36774438 30957208 5817230 0 52880 68293 50195 16024 7074870 6772335 210902 228094 63233 64111 289704 307044 27133957 18726770 9011628 8407187 2536853 2971814 19290265 18834902 4523068 4509126 7794854 6947130 2661837 2833354 14979759 14289610 X 4139654 4390445 170852 154847 4310506 4545292 19290265 18834902 X 255791 -21005 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 170852 5000 -21005 0 154847 376258 -94751 110655 170852 437275 110655 127414 299086 376258 1628216 88747 1279688 437275 1561368 309288 242440 1628216 0.00000 0.00000 1.00000 0 1 1 153315 153315 19193483 11959173 7234310 1229934 1137738 92196 6277419 5629859 647560 279806 279806 8407187 MORTGAGE REFINANCING COST, NET OF AMORTIZATION 207614 PATIENT FUNDS 47816 RESERVE FOR REPLACEMENTS 907145 CASH WORKING CAPITAL ESCROW 371664 INTEREST IN NET ASSETS OF ST. CAMILLUS FOUNDATION 149847 OTHER RECEIVABLES 1001728 LONG TERM RECEIVABLES 286000 2971814 PATIENTS' FUNDS 47816 ESTIMATED THIRD PARTY SETTLEMENTS 442705 ESTIMATED WORKER'S COMPENSATION TRUST LIABILITY 1692065 LINE OF CREDIT 308948 OTHER LIABILITIES 341820 2833354 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE ORGANIZATION HAS BEEN LIMITED BY DONORS OR GRANTORS TO A SPECIFIC TIME PERIOD OR PURPOSE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ST. CAMILLUS AND INTEGRITY ARE TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AS OF DECEMBER 31, 2012, THE ORGANIZATION DOES NOT HAVE ANY SIGNIFICANT UNRECOGNIZED TAX BENEFIT OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2009 THROUGH 2012. X X 0 0 0 0 0 0 0 0 0 AILEEN BALITZ 186308 0 0 0 0 0 0 0 444 0 186752 0 0 0 PART I, LINE 3 THE FACILITY'S SALARY RANGES ARE BASED ON AN INCORPORATION OF A STUDY PERFORMED BY AN INDEPENDENT ACCOUNTING FIRM DURING THE 1990'S, TRENDED FORWARD, AND TWO SEPARATE INDEPENDENT SURVEYS OF SALARY PACKAGES OF SIMILAR POSITIONS RECEIVED DURING 2009. FORM 990, PART VI, SECTION A, LINE 4 THE FACILITY'S BOARD APPROVED THE AMENDMENT OF THE BYLAWS TO REFLECT A CHANGE TO INCREASE THE NUMBER OF TRUSTEES FROM 25 TO 30. THE FACILITY'S BOARD APPROVED THE AMENDMENT OF THE CERTIFICATE OF INCORPORATION TO ADD AN ADDITIONAL CORPORATE PURPOSE; FUNDRAISING AND FUND DEVELOPMENT. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION VOTE TO ELECT TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE OPERATING DECISIONS MADE BY THE GOVERNING BODY (BOARD OF TRUSTEES) ARE DONE SO BY A MAJORITY VOTE OF THE TRUSTEES AND CAN NOT BE OVERRIDDEN. HOWEVER, ANY BY LAW CHANGES OR NEW TRUSTEE APPOINTMENTS REQUIRE A MAJORITY VOTE OF THE MEMBERS, IF PERSONALLY IN ATTENDANCE AT THE MEETING OR 100% WRITTEN APPROVAL. FORM 990, PART VI, SECTION B, LINE 11 BEFORE THIS FORM 990 WAS FILED WITH THE IRS, ALL OF THE FOLLOWING REVIEWS TOOK PLACE: THE PREPARED FORM 990 WAS REVIEWED BY THE CONTROLLER, CHIEF FINANCIAL OFFICER, AND CORPORATE COMPLIANCE OFFICER, IN CONSULTATION WITH ADMINISTRATIVE STAFF MEMBERS, EXECUTIVE MANAGEMENT, AND ADVISORS TO THE ORGANIZATION. THE PREPARED FORM 990 WAS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES AND WAS MADE AVAILABLE TO ALL CURRENT VOTING MEMBERS OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES WRITTEN DISCLOSURES BY ALL TRUSTEES, OFFICERS, KEY EMPLOYEES, AND OTHER MANAGEMENT OR SUPERVISORY EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE DECISION MAKING FOR THE ORGANIZATION. SUCH INDIVIDUALS ARE REQUIRED TO DISCLOSE ACTUAL AND POTENTIAL CONFLICTS OF INTEREST UPON INITIAL AFFILIATION WITH THE ORGANIZATION, ON AN ANNUAL BASIS, AND WHENEVER REPORTABLE INTERESTS ARISE. THE COMPLIANCE OFFICER, IN COLLABORATION WITH THE PRESIDENT AND/OR THE BOARD CHAIRMAN, REVIEWS WRITTEN DISCLOSURES, OBTAINS FURTHER INFORMATION AS NEEDED, AND EVALUATES ACTUAL AND POTENTIAL CONFLICTS. AS WARRANTED, THE PRESIDENT AND/OR BOARD CHAIRMAN IMPLEMENTS MEASURES TO ENSURE THAT DECISIONS RELATING TO THE ORGANIZATION ARE MADE SOLELY ON THE BASIS OF THE BEST INTERESTS OF THE ORGANIZATION AND IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSES. ANY TRUSTEE WHO HAS A DUALITY OF INTEREST OR A POTENTIAL CONFLICT OF INTEREST AS TO A MATTER COMING BEFORE THE BOARD IS PROHIBITED FROM VOTING OR USING PERSONAL INFLUENCE AS TO BOARD ACTION ON SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE FACILITY'S SALARY RANGES ARE BASED ON AN INCORPORATION OF A STUDY PERFORMED BY AN INDEPENDENT ACCOUNTING FIRM DURING THE 1990'S AND TRENDED FORWARD AND TWO SEPARATE INDEPENDENT SURVEYS OF SALARY PACKAGES OF SIMILAR POSITIONS RECEIVED DURING 2009. AT THE TIME OF HIRE THE FACILITY'S CEO REVIEWS THE SALARY REQUIREMENTS FOR KEY EMPLOYEES IN RELATION TO CURRENT MARKET CONDITIONS AND SALARY PAYSCALES PREVIOUSLY APPROVED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION. ANY SALARY RECOMMENDATIONS PROPOSED THAT ARE NOT COMMENSURATE WITH PREVIOUSLY APPROVED PAYSCALES REQUIRE CONSULTATION WITH AND AGREEMENT FROM THE BOARD CHAIRPERSON. ANNUALLY, OR WHEN CIRCUMSTANCES WARRANT, THE CEO PRESENTS TO THE EXECUTIVE COMMITTEE FOR THEIR REVIEW AND APPROVAL HER RECOMMENDATIONS FOR COMPENSATION OF KEY EMPLOYEES BASED ON PERFORMANCE EVALUATIONS. FORM 990, PART VI, SECTION C, LINE 18 THE FACILITY MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF ST. CAMILLUS FOUNDATION -21,005. FORM 990, PART XII, LINE 2C THE FACILITY HAS AN AUDIT COMMITTEE MADE UP OF TRUSTEES. THE AUDIT COMMITTEE MEETS TWICE ANNUALLY; THE FIRST MEETING TO REVIEW THE DRAFT FINANCIAL STATEMENTS AND PRELIMINARY FINDINGS; THE SECOND MEETING TO REVIEW THE FINAL FINANCIAL STATEMENTS AND FINDINGS. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR. ST CAMILLUS FOUNDATION 813 FAY ROAD SYRACUSE NY 13219 222429858 PROVIDE FINANCIAL SUPPORT NY 501 (C) (3) 9 ST CAMILLUS RESIDENTAL HEALTH CARE FACILITY 0 INTEGRITY HOME CARE SERVICES INC 813 FAY ROAD SYRACUSE NY 13219 161500579 HOME HEALTH SERVICES NY 501 (C) (3) 9 ST CAMILLUS RESIDENTAL HEALTH CARE FACILITY 0 1 0 1 1 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0