2013-11-14T18:12:28-06:00 2012-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2012-01-01 133070759 NORTHERN METROPOLITAN INC NORT 8453529000 225 MAPLE AVENUE MONSEY NY 10952 MORRIS KLEIN 8453529000 2013-11-14 1 FREDERICK H ROTHMAN P01275277 2128674000 2012 2016-03-07 17:11:31Z MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 19554429 0 X WWW.NORTHERNMET.COM X 1981 NY TO PROVIDE SKILLED CARE FOR THE ELDERLY 11 11 253 42 0 0 0 3252603 16697427 16301691 130 135 4004 0 16701561 19554429 0 1194629 0 0 8730352 8729248 0 0 0 6179943 5581843 14910295 15505720 1791266 4048709 5863410 5296792 9368529 5974233 -3505119 -677441 TO PROVIDE SKILLED CARE FOR THE ELDERLY 0 0 11990438 1194629 11659985 NURSING HOME: PROVIDE SKILLED NURSING CARE TO THE ELDERLY 1031260 4505928 ADULT DAYCARE PROGRAM: PROVIDE OUTPATIENT CARE TO THE ELDERLY 160000 135778 SNAP PROGRAM: DISTRIBUTIONS OF FOOD TO THE NEEDY 13181698 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 51 0 253 1 0 0 0 0 0 0 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 0 0 NY X MICHAEL ITZKOWITZ 8453569880 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 STUART MEYERS 0.10 0.90 X 0 4000 0 MARTIN HAUBENSTOCK 0.10 0.90 X 0 5250 0 LEON STEINMETZ 0.10 0.90 X 0 2750 0 RABBI SIMON LAUBER 0.10 0.90 X 0 0 0 REGINA AUSLANDER 0.10 0.90 X 0 750 0 BENJAMIN KLEIN 0.10 0.90 X 0 750 0 HINDI GINSBERG 0.10 0.90 X 0 500 0 CHARLES F KENNY 0.10 0.90 X 0 2000 0 ABRAHAM ZACHARIASH 0.10 0.90 X 0 3000 0 RABBI HERSHAL HAGER 0.10 0.90 X 0 750 0 ISRAEL ORZEL 0.10 0.90 X 0 5500 0 MORRIS KLEIN 6.00 29.00 X 131805 637057 185820 GEDALIA KLEIN 3.00 14.50 X 18480 89320 15861 MICHAEL NOWICKI 6.00 29.00 X 21891 105806 0 AHRON STEINBERG 35.00 X 105494 0 0 SHARON STOLBACH 35.00 X 101459 0 10498 JOCELYN PALMA 35.00 X 115424 0 0 BARBARA ULLMAN 35.00 X 102463 0 17591 LINDA SCHULMAN 35.00 X 112285 0 0 709301 857433 229770 6 0 1 0 CENTERS FOR CARE 1601 BRONXDALE AVENUE BRONX NY 10462 ADMINISTRATIVE SERVICES 301387 NORTHERN METROPOLITAN FOUNDATION 2000 FOUNTAINVIEW ROAD MONSEY NY 10952 ADMINISTRATIVE SERVICES 196663 2 3252603 3252603 NURSING FACILITY 623000 11659985 11659985 ADULT DAY CARE PROGRAM 623000 4505928 4505928 SNAP REVENUE 623000 135778 135778 16301691 135 135 19554429 16301691 0 135 X 1194629 1194629 215270 180312 34958 6848977 5743887 1105090 175186 146737 28449 834361 691730 142631 655454 549013 106441 897884 793081 104803 18866 18866 20759 20759 185903 163797 22106 61496 51509 9987 512651 413415 99236 1042276 873102 169174 10131 8486 1645 282506 236629 45877 211600 177238 34362 MEDICAL SUPPLIES 730275 611683 118592 NYS CASH RECEIPTS ASSES 714784 598708 116076 FOOD EXPENSE 539859 452190 87669 LAUNDRY 120194 100675 19519 232659 194877 37782 15505720 13181698 2324022 0 918093 226742 3010 230320 3747166 3345289 133700 219622 5439658 4293339 1017685 1146319 43756 128500 5863410 5296792 3440311 3044111 262997 239584 5665221 2690538 9368529 5974233 X -3505119 -677441 -3505119 -677441 5863410 5296792 4048709 -1221031 0 X X 0 1 X 1 0 X 3252603 3252603 16266942 16621156 15292922 16697427 16301691 81180138 16266942 16621156 15292922 16697427 19554294 84432741 0 0 0 84432741 38524 4004 135 42663 38524 4004 135 42663 3399 1522 1580 130 6631 16270341 16622678 15333026 16701561 19554429 84482035 0.99940 0.99930 0.00050 0.00050 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3231537 2382179 849358 2189516 1911160 278356 18605 18605 1146319 RESIDENT FUNDS HELD IN TRUST 75538 ESTIMATED LIABILITIES TO THIRD-PARTY PAYORS 2615000 2690538 X 16301826 0 16301826 3252603 3252603 19554429 14537079 0 14537079 968641 968641 15505720 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: NORTHERN METROPOLITAN INC. HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2009 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANT FROM RELATED ENTITY 3,252,603. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO RELATED ENTITY 968,641. 0 CONGREGATION CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501 (C) 3 225988 TO SUPPORT THE RELIGIOUS MISSION OF CHEVRA LIADY NUSACH HOARY NORTHERN MANOR MULTICARE CENTER INC 199 MIDDLETOWN ROAD NANUET NY 10954 133623600 501 (C) 3 730120 TO FORGIVE INTERCOMPANY BALANCES NORTHERN RIVERVIEW HEALTH CARE CENTER INC 87 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133832251 501 (C) 3 168985 TO FORGIVE INTERCOMPANY BALANCES FOUNTAINVIEW AT COLLEGE ROAD INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 133935070 501 (C) 3 20582 TO FORGIVE INTERCOMPANY BALANCES ASSISTED LIVING AT NORTHERN RIVERVIEW INC 89 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133976617 501 (C) 3 26734 TO FORGIVE INTERCOMPANY BALANCES LIFESTYLE OPTIONS FOR SENIORS FOUNDATIONINC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134133472 501 (C) 3 22220 TO FORGIVE INTERCOMPANY BALANCES 6 X 0 1 0 0 0 0 0 0 0 MORRIS KLEIN 105637 510577 17647 85296 8521 41184 24009 116043 7846 37922 163660 791022 0 0 PART I, LINE 4B MORRIS KLEIN, $140,052 FORM 990, PART VI, SECTION A, LINE 2 CHIEF OPERATING OFFICER GEDALIA KLEIN IS RELATED TO EXECUTIVE DIRECTOR, MORRIS KLEIN. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FINAL FORM 990 WILL BE REVIEWED BY THE DIRECTOR OF FINANCE AND CHAIRMAN OF THE BOARD PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER, DIRECTOR, AND OFFICER IS PROVIDED WITH THE CONFLICT OF INTEREST POLICY, AND IS REQUIRED TO FILL OUT A FORM WHICH WILL DISCLOSE ANY CONFLICT OF INTEREST. IF THERE IS A CONFLICT, THE BOARD MEMBER WILL RECUSE HIM/HERSELF FROM VOTING ON ANY ISSUE THAT CREATES THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A A PRICE WATERHOUSE COOPER STUDY REVIEWED AND SUBSTANTIATED THE TOP MANAGEMENT COMPENSATION. THE LAST SALARY DETERMINATION FOR TOP MANAGEMENT COMPENSATION TOOK PLACE IN JUNE 2011. THE STUDY WAS CONDUCTED BY THE SOLE CORPORATE MEMBER "NORTHERN METROPOLITAN FOUNDATION" ON BEHALF OF NORTHERN METROPLITAN INC. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G PHYSICAL THERAPY CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 81,139. MANAGEMENT AND GENERAL EXPENSES 15,731. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,870. OCCUPATIONAL THERAPY CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 32,882. MANAGEMENT AND GENERAL EXPENSES 6,375. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,257. HEALTHCARE CONSULTANTS : PROGRAM SERVICE EXPENSES 49,776. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,776. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. NORTHERN MANOR MULTICARE CENTER INC 199 MIDDLETOWN ROAD NANUET NY 10954 133623600 NURSING HOME NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN RIVERVIEW HEALTH CARE CENTER INC 87 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133832251 NURSING HOME NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 ASSISTED LIVING AT NORTHERN RIVERVIEW INC 89 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133976617 ASSISTED LIVING FOUNDATION NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 FOUNTAINVIEW AT COLLEGE ROAD INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 133935070 INDEPENDANT LIVING FACILITY NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 113354023 CHARITABLE FOUNDATION NY 501 (C)(3) LINE 11A, I CHEVRA LIADY NUSACH 0 NORTHERN SERVICES GROUP INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134120014 ADMINISTRATIVE SUPPORT ORGANIZATION NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 LIFESTYLE OPTIONS FOR SENIORS FOUNDATION INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134133472 CHARITABLE FOUNDATION NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 RELIGOUS ENTITY NY 501 (C)(3) LINE 1 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0