2013-01-11T13:56:46-06:00 2011-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2011-01-01 112388200 COBBLE HILL HEALTH CENTER INC COBB 7188556789 380 HENRY STREET BROOKLYN NY 11201 ANTHONY LEWIS 7188556789 2013-01-07 1 FREDERICK H ROTHMAN P01275277 2128674000 2011 2016-03-07 17:11:31Z ANTHONY LEWIS 380 HENRY STREET BROOKLYN NY 11201 62098806 0 X WWW.COBBLEHILL.ORG X 1977 NY TO MAINTAIN A NURSING FACILITY AND PROVIDE ADULT DAY CARE & LONG TERM HOME HEALTH SERVICES ON AN OUTPATIENT BASIS. 11 11 534 11 0 0 9071542 5217463 45356278 46767783 383191 535700 -38299 -46858 54772712 52474088 0 0 0 0 26984660 27535568 0 0 0 17427745 18051299 44412405 45586867 10360307 6887221 103196036 108791153 63865780 69610566 39330256 39180587 X COBBLE HILL HEALTH CENTER, INC. OPERATES A 364 BED NURSING FACILITY. THE CENTER PROVIDES NURSING CARE TO PATIENTS AND IS LICENSED TO PROVIDE ADULT DAY CARE SERVICES. IN ADDITION, THE CENTER PROVIDES A LONG-TERM HOME HEALTH CARE PROGRAM. 0 0 33338781 38223847 SEE SCHEDULE O.THE CENTER HAS BEEN PROVIDING RESIDENTIAL AND COMMUNITY BASED SERVICES TO THE DISABLED AND ELDERLY FOR OVER 30 YEARS. THE CENTER OFFERS A COMPLETE RANGE OF MEDICAL, NURSING AND REHABILITATION SERVICES. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:>SUBACUTE CARE MEDICAL CARE, THE GOAL OF WHICH IS TO ENSURE A QUICK AND COMPLETE RECOVERY THEREBY RESTORING OUR RESIDENTS INDEPENDENCE AND HELP THEM RETURN TO COMMUNITY LIVING; >LONG TERM CARE, WHICH OFFERS A HOME-LIKE ALTERNATIVE THAT PROVIDES EACH INDIVIDUAL WITH HIS OR HER SPECIFIC NEEDS, BE IT PHYSICAL, PSYCHOLOGICAL OR EMOTIONAL, IN AN OPTIMUM ENVIRONMENT ENSURING THAT QUALITY OF LIFE IS MAINTAINED;>REHABILITATION, WHOSE GOAL IS TO RESTORE RESIDENTS FUNCTION AND THE ABILITIES THEY HAD PRIOR TO THE ONSET OF ILLNESS, INJURY OR TRAUMA; >A DIALYSIS CENTER, WHERE TREATMENT IS CONVENIENT BECAUSE IT IS ADMINISTERED ON-SITE AND PROVIDES MINIMAL DISRUPTION OF THEIR REGULAR SCHEDULES AND LIVES; >ALZHEIMERS SPECIAL CARE, WHICH, FOR OVER A DECADE, HAS LED THE WAY IN CARING FOR INDIVIDUALS WITH ALZHEIMERS DISEASE. THROUGH PROGRAM DEVELOPMENT, RESEARCH AND TRAINING,OUR ALZHEIMERS UNIT HAS RECEIVED THE BEST PRACTICES AWARD.THE CENTER PROVIDED 121,430 DAYS OF SKILLED NURSING CARE IN 2011. 2261650 3264501 THE CENTER ALSO OPERATES AN ADULT DAY CARE PROGRAM BY A BI-LINGUAL STAFF (ENGLISH AND SPANISH)WITH DOOR-TO-DOOR AMBULETTE TRANSPORTATION. SOME OF THE SERVICES THE PROGRAM PROVIDES INCLUDE THE FOLLOWING:>MEDICAL AND NURSING SUPERVISION AND MONITORING;>INDIVIDUAL NEEDS ASSESSMENT TO HELP IMPROVE AND MAINTAIN INDEPENDENCE;>ON-SITE REGISTERED NURSES WHO OBSERVE AND MONITOR HEALTH STATUS AND ADMINISTER AND MONITOR MEDICATIONS AND PERFORM CATHETERIZATION, DRESSING CHANGES, ETC. THE CENTER PROVIDED 19,855 DAY CARE VISITS DURING 2011. 4892263 5279435 REFERRED TO AS THE NURSING HOME WITHOUT WALLS, THE CENTER'S LONG TERM HOME HEALTH CARE PROGRAM INCLUDES NURSING CARE, REHABILITATION THERAPY AND OTHER HEALTH SERVICES DELIVERED IN THE COMFORT OF HOME ON A LONG-TERM BASIS. THE GOAL IS TO PRMOTE OUR PATIENTS INDEPENDENCE AND ABILITY TO REMAIN AT HOME. THESE SERVICES MAY INCLUDE HEART AND BLOOD PRESSURE MONITORING, WOUND CARE, MEDICATION ADMINISTRATION, AS WELL AS HELP WITH SPEECH AND SIMPLE MOVEMENTS. THE CARE YOUR LOVED ONE RECEIVES IS PERSONALIZED AND CAN BE MODIFIED AS HIS OR HER NEEDS CHANGE. DURING 2011, THE CENTER PROVIDED 245,065 HOURS OF HOME HEALTH CARE SERVICES. 40492694 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 39 0 534 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X ALAN GROSS 7188556789 380 HENRY STREET BROOKLYN NY 11201 DEMETRA POLIMEROS 1.00 X X 0 0 0 THOMAS SPATH 1.00 X 0 0 0 PATRICK OWEN BURNS 1.00 X 0 0 0 MARK DONOVAN 1.00 X 0 0 0 JOSEPH BROADWIN 1.00 X 0 0 0 PAUL SAYEGH 1.00 X 0 0 0 DR CIRIL GODEC 1.00 X 0 0 0 CHARLIE CARAMES 1.00 X 0 0 0 GREG O'CONNEL 1.00 X 0 0 0 FRANCES MCPARTLAND 1.00 X 0 0 0 JUDITH FRANCES 1.00 X 0 0 0 ANTHONY LEWIS 35.00 X 326938 0 34546 OLGA LIPSCHITZ 21.00 X 293622 0 47861 ALAN GROSS 35.00 X 360330 0 48330 DANIEL TUCHMAN 35.00 X 242278 0 46721 LOUIS MUDANNAYAKE 35.00 X 164976 0 46481 JOAN SKYERS 35.00 X 199172 0 33075 ARTHUR ZOLOTAREVSKY 35.00 X 137709 0 26657 ALLA IMAS 35.00 X 151266 0 44472 SHIRLEY WITHERSPOON 35.00 X 126365 0 33241 SOMMER ESPINO 35.00 X 146396 0 34327 2149052 0 395711 16 0 1 0 SENIOR CARE 1991 FLATBUSH AVENUE BROOKLYN NY 11234 NURSING AGENCY 513996 NURSING PERSONNEL HOME CARE 175 SOUTH 9TH STREET BROOKLYN NY 11211 NURSING AGENCY 440107 ATTENTIVE HOME CARE 85-06 QUEENS BLVD ELMHURST NY 11373 NURSING AGENCY 398236 SAMARITAN SERVICE INC 24 COUNTRY ROAD TENAFLY NJ 07670 NURSING AGENCY 332773 LIFE CARE SERVICE 1723 AVENUE M BROOKLYN NY 11230 NURSING AGENCY 236213 17 111000 5092768 13695 5217463 SKILLED NURS. FACILITY 623000 38223847 38223847 LONG TERM HOME HEALTH 621610 5279435 5279435 ADULT DAY CARE PROGRAM 621990 3264501 3264501 46767783 424804 424804 40000 110351 -70351 -70351 -70351 9625263 9514367 110896 110896 110896 MISCELLANEOUS 900099 23493 23493 23493 52474088 46767783 0 488842 1612083 1612083 18555187 17520677 1034510 1447888 1367164 80724 4234565 3998474 236091 1685845 1591854 93991 245844 245844 150477 150477 713 713 53983 53983 6842620 6461083 381537 31967 30185 1782 3685132 3479674 205458 210549 198810 11739 2022457 1903546 118911 33913 32022 1891 1344829 1269851 74978 682885 644812 38073 CASH RECEIPTS ASSESSMEN 1958235 1958235 BAD DEBT EXPENSE 750000 750000 MISCELLANEOUS EXPENSES 37695 35594 2101 45586867 40492694 5094173 0 5227634 6110894 831661 792604 8448287 9670793 76341 57390 296007 103160 88794546 17067671 60319258 71726875 12074253 12350452 15922595 7978985 103196036 108791153 8191797 8938673 47125000 46280000 8548983 14391893 63865780 69610566 X 39199793 39044834 130463 135753 39330256 39180587 103196036 108791153 X 6887221 -7036890 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 713 713 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: $713 IS AN ALLOCATION OF ASSOCIATION DUES TO LOBBYING EXPENSES. 2167158 2167158 17571697 5418816 12152881 64293911 7868076 56425835 2769759 2711381 58378 1992021 1069398 922623 71726875 DEPOSITS AND OTHER RECEIVABLES 136922 MORTGAGE COSTS 1798108 DUE FROM COBBLE HILL FOUNDATION, INC. 126482 CONSTRUCTION ESCROW 5917473 7978985 RESIDENT FUNDS HELD IN TRUST 282627 DUE TO THIRD PARTIES 995129 SWAP AGREEMENTS 13114137 14391893 52474088 45586867 6887221 -204313 -6832577 -7036890 -149669 52326143 -204313 110351 -93962 52420105 53983 53983 52474088 45643235 110351 110351 45532884 53983 53983 45586867 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2008 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SWAP AGREEMENT -6,832,577. PART XI, LINE 8, CHANGE IN VALUE OF SWAP AGREEMENT $773,510 PART XII, LINE 2D, RENTAL EXPENSES $101,924 PART XIII, LINE 2D, RENTAL EXPENSES $101,924 X 0 0 0 0 0 0 0 1 0 ANTHONY LEWIS 268000 0 17350 0 41588 0 28646 0 5900 0 361484 0 0 0 OLGA LIPSCHITZ 225000 0 29200 0 39422 0 28646 0 19215 0 341483 0 0 0 ALAN GROSS 268000 0 16300 0 76030 0 28646 0 19684 0 408660 0 0 0 DANIEL TUCHMAN 200000 0 15000 0 27278 0 28646 0 18075 0 288999 0 0 0 LOUIS MUDANNAYAKE 164498 0 0 0 478 0 18958 0 27523 0 211457 0 0 0 JOAN SKYERS 175336 0 0 0 23836 0 23413 0 9662 0 232247 0 0 0 ARTHUR ZOLOTAREVSKY 121058 0 0 0 16651 0 15417 0 11240 0 164366 0 0 0 ALLA IMAS 131127 0 0 0 20139 0 17098 0 27374 0 195738 0 0 0 SHIRLEY WITHERSPOON 121058 0 0 0 5307 0 14024 0 19217 0 159606 0 0 0 SOMMER ESPINO 137308 0 0 0 9088 0 16433 0 17894 0 180723 0 0 0 PART I, LINE 7 THE BOARD APPROVES MERIT BASED BONUSES FOR ITS OFFICERS AND KEY EMPLOYEES FOR THEIR DEDICATION TO THE CENTER DURIING THE YEAR. THESE BONUSES ARE APPROVED TOWARDS THE END OF THE YEAR BASED ON MERIT. NYC CAPITAL RESOURCE CORP 204099098 649437AEO 2008-01-30 35920000 RENOVATION 0 0 0 NYC CAPITAL RESOURCE CORP 204099098 649437AF7 2008-01-30 4420000 REFINANCING 1 0 0 NYC CAPITAL RESOURCE CORP 204099098 649437AG5 2008-01-30 7850000 CONSTRUCTION 0 0 0 35920000 12137676 1331784 22448875 2011 1 0 0 1 4420000 4261307 158691 2008 1 0 0 1 7850000 286416 7438143 2009 1 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE CFO REVIEWED THE 990 BEFORE IT WAS SUBMITTED. FORM 990, PART VI, SECTION B, LINE 12C COBBLE HILL REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICT. THIS INFORMATION IS REVIEWED BY THE AUDIT AND CORPORATE COMPLIANCE COMMITTEES. THE AUDIT COMMITTEE IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST WHICH OCCUR, AND WILL ENSURE SUCH INDIVIDUALS DO NOT PARTICIPATE IN DISCUSSIONS OR DECISIONS INVOLVING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION WAS DETERMINED BY A RECOMMENDATION BY THE CEO AND APPROVAL OF THE BOARD. THE CEO'S COMPENSATION IS DETERMINED BY THE GOVERNING BOARD.ALL OTHER KEY EMPLOYEES COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD. THIS PROCESS WAS LAST DONE IN 2011.THE PROCESS INCLUDED A REVIEW BY THE BOARD OF COMPENSATION OF SIMILAR POSITIONS AT OTHER HEALTH CARE FACILITIES OBTAINED FROM IRS FORM 990S FILED ON GUIDESTAR OR CANVASSING OF THOSE FACILITES. FORM 990, PART VI, SECTION C, LINE 19 COBBLE HILL MAKES ITS 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 5: NET UNREALIZED LOSSES ON INVESTMENTS: -204,313. CHANGE IN VALUE OF SWAP AGREEMENT -6,832,577. TOTAL TO FORM 990, PART XI, LINE 5: -7,036,890. FORM 990, PART XII, LINE 2C THE FINANCE COMMITTEE MEETS WITH THE AUDITORS TO REVIEW THE FINANCIAL STATEMENTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COBBLE HILL FOUNDATION INC 380 HENRY STREET BROOKLYN NY 11201 113122301 FUNDRAISING NY 501(C)(3) PF N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0