2013-01-22T09:10:39-06:00 2011-12-31 271728945 O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990 2011-01-01 113188802 NEW YORK CONGREGATIONAL NURSING CENTER NEWY 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 FRANK CIANCIOTTO 7185767000 2013-01-21 1 GARRETT HIGGINS P00543209 9143818900 2013-01-21 2011 2016-02-25 16:41:14Z CECELIA C ZUCKERMAN 135 LINDEN BOULEVARD BROOKLYN NY 11226 26399810 0 X WWW.NYCNC.ORG X 1994 NY THE MISSION OF NEW YORK CONGREGATIONAL NURSING CENTER IS TO PROVIDE SKILLED NURSING CARE AND REHABILITATION THERAPY SERVICES FOR 200 RESIDENTS. ADDITIONALLY, THE CENTER HAS A LONG-TERM HOME HEALTH CARE PROGRAM WHICH PROVIDES NURSING, REHAB THERAPY, DIETARY, SOCIAL WORK AND HOME HEALTH AIDE/PERSONAL CARE SERVICES TO PERSONS LIVING IN THEIR OWN HOMES. 7 7 350 7 0 0 11533 35175 25266978 26256038 14064 9671 90209 98926 25382784 26399810 0 2700 0 0 16046431 15165237 0 0 0 11140583 11805982 27187014 26973919 -1804230 -574109 24835302 23190134 23143823 22945284 1691479 244850 X THE MISSION OF NEW YORK CONGREGATIONAL NURSING CENTER IS TO PROVIDE SKILLED NURSING CARE AND REHABILITATION THERAPY SERVICES FOR 200 RESIDENTS. ADDITIONALLY, THE CENTER HAS A LONG-TERM HOME HEALTH CARE PROGRAM WHICH PROVIDES NURSING, REHAB THERAPY, DIETARY, SOCIAL WORK AND HOME HEALTH AIDE/PERSONAL CARE SERVICES TO PERSONS LIVING IN THEIR OWN HOMES. 0 0 19798400 2700 22080649 NEW YORK CONGREGATIONAL NURSING CENTER OFFERS A WIDE RANGE OF SERVICES ADDRESSING THE NEEDS OF PEOPLE RECOVERING FROM POST SURGICAL CONDITIONS, ACUTE MEDICAL EVENTS AND OTHER SITUATIONS REQUIRING INTENSIVE NURSING CARE AND REHABILITATION. THESE SERVICES FOR THE MOST PART ARE PROVIDED ON-SITE OR DIRECTLY THROUGH CONSULTATION. TYPES OF SERVICES: - MEDICAL SERVICES INCLUDING: AUDIOLOGY, CARDIOLOGY, DENTAL, INFECTIOUS DISEASE, NEUROLOGY, ONCOLOGY, OPTOMETRY, PODIATRY, PSYCHIATRY, PHYSIATRY, PSYCHOLOGY, PULMONOLOGY, OPHTHALMOLOGY, SURGICAL, UROLOGY, AND VASCULAR - REHABILITATION THERAPY INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH, AND DYSPHAGIA- NURSING INCLUDING INTRAVENOUS THERAPY, TRACHEOTOMY CARE, OXYGEN THERAPY, WOUND CARE, ALTERNATIVE FEEDING DELIVERY SYSTEMS, AND MANAGEMENT OF COMPLEX CONDITIONS- PSYCHO-SOCIAL COUNSELING - THERAPEUTIC DIETS - NUTRITIONAL COUNSELING - BEAUTY PARLOR SERVICES - PASTORAL CARE - DISCHARGE PLANNING INCLUDING COMPREHENSIVE EDUCATION AND PREPARATION FOR DISCHARGE, AND A HOME VISIT BEFORE DISCHARGE THE ORGANIZATION PROVIDED 71,257 DAYS OF CARE TO APPROXIMATELY 453 PATIENTS IN 2011. 3714948 4175389 LONG TERM HOME HEALTH CARE PROGRAM PROVIDING QUALITY CARE (125 SLOTS) TO ENABLE THE ELDERLY TO REMAIN IN THEIR OWN RESIDENCE. IN-HOME SERVICES INCLUDE:- NURSING ASSESSMENT & MANAGEMENT- PHYSICAL THERAPY- OCCUPATIONAL THERAPY - SPEECH THERAPY - RESPIRATORY THERAPY - SOCIAL WORK- NUTRITIONAL COUNSELING- PERSONAL CARE- HOUSEKEEPING- MEDICAL SUPPLIES AND MEDICAL EQUIPMENT THERE WERE 39,518 DAYS OF CARE IN 2011. 23513348 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 9 0 1 350 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X FRANK CIANCIOTTO 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 X KENDALL CHRISTIANSEN 1.00 X X 0 0 0 DR ESTHER SIEGEL 1.00 X X 0 0 0 MICHAEL ROBINSON 1.00 X X 0 0 0 ROBERT R GAINER 1.00 X 0 0 0 JOSE MALDONADO 1.00 X 0 0 0 DR MARGARET L MCCLURE 1.00 X 0 0 0 JAMES WAECHTER 1.00 X 0 0 0 CECELIA C ZUCKERMAN 35.00 X 375023 0 46625 FLORENCE KATZ 35.00 X 168584 0 31328 FRANK CIANCIOTTO 35.00 X 212746 0 40592 DAVETH FORBES-THOMAS 35.00 X 168814 0 8474 DELORIS HERRY 35.00 X 151739 0 20110 MOHAMMAD CHOWDHURY 35.00 X 137699 0 36828 ADRIAN COX 35.00 X 135610 0 6829 MODUPE ADEDEJI-FAJOBI 35.00 X 112823 0 22614 1463038 0 213400 9 0 1 0 FRIENDLY HOME CARE 2002 CONEY ISLAND AVE BROOKLYN NY 11223 HOME HEALTHCARE AGENCY 520099 LOVING HOME CARE 21 SNYDER AVE 2ND FLOOR BROOKLYN NY 11226 HOME HEALTHCARE AGENCY 278392 OMEGA HOME HEALTH SERVICE 445 HAMILTON AVE 10TH FLOOR WHITE PLAINS NY 10601 HOME HEALTHCARE AGENCY 222661 BESTCARE INC PO BOX 9010 LEVITTOWN NY 11756 HOME HEALTHCARE AGENCY 203668 CITI HEALTH HOME CARE 1137 FLATBUSH AVE BROOKLYN NY 11226 HOME HEALTHCARE AGENCY 195148 12 35175 35175 MEDICAID 623000 20517591 20517591 MEDICARE 623000 5586278 5586278 PRIVATE PAY REVENUE 623000 152169 152169 26256038 9671 9671 CASH DISCOUNTS 900099 84515 84515 VENDING MACHINE REVENU 900099 12208 12208 MEDICAL RECORDS FEES 900099 2188 2188 15 15 98926 26399810 26256038 0 108597 2700 2700 865537 865537 10534096 9649718 884378 514133 486552 27581 1858336 1638075 220261 1393135 1191672 201463 40430 40430 95869 95869 5669 5669 3026087 2998867 27220 5976 2086 3890 1360231 1160358 199873 59598 59598 1588064 1554303 33761 13890 1379 12511 4095 168 3927 1513793 1462543 51250 497620 497620 BAD DEBT EXPENSE 1182000 1182000 NYS CASH RECEIPTS ASSES 1095322 1095322 PURCHASED AND CONTRACTE 785167 637376 147791 MEDICAL SUPPLIES 211791 211791 320380 238438 81942 26973919 23513348 3460571 0 985519 469461 3116665 2791744 5486716 6156579 191962 62819 335633 239214 33729673 23764722 11050735 9964951 3668072 3505366 24835302 23190134 3572681 3384179 15270000 14575000 184857 184523 63316 49014 4052969 4752568 23143823 22945284 X 1691479 244850 1691479 244850 24835302 23190134 X -574109 -872520 X X 0 1 1 X 0 X 29774 30704 16118 11533 35175 123304 23657148 25755931 24838777 25266978 26256038 125774872 23686922 25786635 24854895 25278511 26291213 125898176 0 0 0 125898176 197602 69328 35066 14064 9671 325731 197602 69328 35066 14064 9671 325731 85794 28298 14955 90209 98926 318182 23970318 25884261 24904916 25382784 26399810 126542089 0.99490 0.99010 0.00260 0.00390 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME CASH DISCOUNTS VENDING MACHINE INCOME MEDICAL RECORDS FEE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5669 5669 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: COSTS ARE INCURRED AS PART OF DUES PAID TO NURSING HOME INDUSTRY ORGANIZATIONS. 0 1 44462 44462 28403118 19771712 8631406 5282093 3993010 1289083 9964951 DUE FROM RELATED PARTIES 1420923 RESIDENT'S FUNDS 184523 DEFERRED MORTGAGE COSTS 779865 DUE FROM MEDICAID 1120055 3505366 DEFERRED COMPENSATION PAYABLE 98064 DUE TO THIRD PARTIES 1872890 INTEREST RATE SWAP LIABILITY 2781614 4752568 26399810 26973919 -574109 -1434 -871086 -872520 -1446629 26398376 -1434 -1434 26399810 0 26399810 26973919 0 26973919 0 26973919 PART IV, LINE 2B: RESIDENTS' FUNDS ARE HELD BY THE CENTER ON BEHALF OF THE RESIDENTS. SUCH FUNDS REPRESENT ALLOWANCES RECEIVED BY RESIDENTS AS WELL AS OTHER RESIDENTS' FUNDS DEPOSITED WITH THE CENTER FOR SAFEKEEPING. THE FUNDS ARE DISBURSED BY THE CENTER AT THE REQUEST OF, OR ON BEHALF OF RESIDENTS FOR THEIR PERSONAL USE. RESIDENT PERSONAL FUNDS ARE MAINTAINED IN BANK ACCOUNTS AND INVESTMENTS SEPARATE FROM THE CENTER'S ACCOUNTS. INTEREST EARNED ON RESIDENT FUNDS IS CREDITED TO THE RESIDENTS' ACCOUNTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE CENTER HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE CENTER IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR TAX YEARS PRIOR TO 2008. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY -928,136. NET ASSET TRANSFER 57,050. TOTAL TO SCHEDULE D, PART XI, LINE 8: -871,086. X X X X X X 0 0 0 0 0 0 0 0 0 CECELIA C ZUCKERMAN 341220 0 20000 0 13803 0 35456 0 11169 0 421648 0 0 0 FLORENCE KATZ 168584 0 0 0 0 0 8474 0 22854 0 199912 0 0 0 FRANK CIANCIOTTO 212746 0 0 0 0 0 10745 0 29847 0 253338 0 0 0 DAVETH FORBES-THOMAS 168814 0 0 0 0 0 8474 0 0 0 177288 0 0 0 DELORIS HERRY 151739 0 0 0 0 0 7731 0 12379 0 171849 0 0 0 MOHAMMAD CHOWDHURY 137699 0 0 0 0 0 6981 0 29847 0 174527 0 0 0 NEW YORK CITY INDUSTRIAL DEVELOPMENT AGENCY CIVIC FACILITY REVENUE SERIES 2 132906040 649438BE7 2006-07-27 17075000 REFUND FOR PRIOR ISSUE (8/17/95) AND RENOVATIONS FOR FACILITY 0 0 0 2085000 17103440 324425 275697 780630 15722688 2006 1 0 1 1 0 0 0 0 1 0 1 0 0 0 1 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS NEW YORK CONGREGATIONAL COMMUNITY SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION APPOINTS THE BOARD OF DIRECTORS AT ITS ANNUAL MEETING. A VACANCY ON THE BOARD ARISING AT ANY TIME AND FROM ANY CAUSE MAY BE FILLED FOR THE UNEXPIRED TERM BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B ANY DIRECTOR MAY BE REMOVED WITH OR WITHOUT CAUSE BY THE SOLE MEMBER. IN ADDITION, THE SOLE MEMBER SHALL HAVE THE POWER TO MAKE, ALTER, AMEND, AND REPEAL THE BY-LAWS AND CERTIFICATE OF INCORPORATION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 NEW YORK CONGREGATIONAL NURSING CENTER HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE FINANCE COMMITTEE FOR ANY COMMENTS. A MEETING WOULD BE CALLED AFTER RECEIPT AND WOULD DEPEND ON THE MEMBERS OF THE COMMITTEE'S SCHEDULES. MINUTES OF THIS MEETING AND REVIEW WOULD BE KEPT WITH THE BOARD MEETING MINUTES. ANY COMMENTS OR QUESTIONS FROM THE FINANCE COMMITTEE ARE THEN GROUPED, SUMMARIZED AND PROVIDED TO THE OUTSIDE ACCOUNTANTS. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, DEPARTMENT DIRECTORS, MANAGEMENT STAFF, AND KEY EMPLOYEES UPON HIRING AND ANNUALLY THEREAFTER ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT. THIS DISCLOSURE STATES THAT THE INDIVIDUAL RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, UNDERSTANDS IT, WILL COMPLY WITH THE RULES, AND THAT THEY COMPLETED THE CORPORATE COMPLIANCE PROGRAM IN-SERVICE. ADDITIONALLY, THEY MUST MAKE FULL DISCLOSURE OF ANY ACTIVITIES THAT COULD RESULT IN A POSSIBLE CONFLICT OF INTEREST. IF A CONFLICT IS DEEMED TO EXIST, THE PRESIDENT MUST BE MADE AWARE AND POSSIBLE DISCIPLINARY ACTION OR EVEN TERMINATION IS POSSIBLE UPON REVIEW WITH THE HR DIRECTOR AND OUR RISK MANAGEMENT COUNCIL. THERE IS ALSO A COMPLIANCE HELPLINE WHICH IS A TOTAL-FREE AND COMPLETELY CONFIDENTIAL SERVE WHERE AN INDIVIDUAL CAN REPORT POSSIBLE VIOLATIONS TO THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO COMPENSATION IS BASED ON A 2004 STUDY BY JAMES ROCCO ASSOCIATES WHICH INCLUDED SIMILAR COMPENSATION FOR CEO'S IN SIMILAR SIZED NURSING HOMES. BASED ON THEIR RECOMMENDATION, A TEN YEAR CONTRACT WAS FORMALIZED WHICH INCLUDES ANNUAL SALARY INCREMENTS. THE CFO COMPENSATION IS RECOMMENDED BY THE CEO TO THE FINANCE COMMITTEE OF THE BOARD WHO SUBSEQUENTLY REVIEWS IT FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION, FORM 990, FORM 1023, AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. THE ORGANIZATION ALSO FILES AN ANNUAL COST REPORT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH CONTAINS FINANCIAL STATEMENTS AND RELATED NOTE DISCLOSURES. THIS COST REPORT IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: CERTAIN MEMBERS OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ALSO SERVE ON THE BOARDS OF THE RELATED ENTITIES. EACH MEMBER SPENDS AN AVERAGE OF .50 HOURS PER WEEK SERVING ON THE FILING ORGANIZATION'S BOARD AND THE RELATED ENTITIES BOARD'S. KENDALL CHRISTIANSEN SERVES ON THE FOLLOWING BOARDS: NEW YORK CONGREGATIONAL CENTER FOR COMMUNITY LIFE, NEW YORK CONGREGATIONAL COMMUNITY SERVICES, NEW YORK CONGREGATIONAL HOME FOR THE AGED FOUNDATION, NEW YORK CONGREGATIONAL COMMUNITY PROPERTIES, AND NEW YORK CONGREGATIONAL HOME FOR THE AGED. JAMES WAECHTER SERVES ON THE FOLLOWING BOARDS: NEW YORK CONGREGATIONAL COMMUNITY SERVICES, NEW YORK CONGREGATIONAL HOME FOR THE AGED FOUNDATION, AND NEW YORK CONGREGATIONAL HOME FOR THE AGED. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY NEW YORK CONGREGATIONAL NURSING CENTER: CECELIA ZUCKERMAN, AND FRANK CIANCIOTTO. THEY EACH SPEND AN AVERAGE OF 35 HOURS PER WEEK WORKING FOR THIS ENTITY, AS WELL AS .50 HOURS WORKING FOR THE FILING ORGANIZATION AS WELL AS THE OTHER RELATED ENTITIES: NEW YORK CONGREGATIONAL COMMUNITY SERVICES, NEW YORK CONGREGATIONAL HOME FOR THE AGED FOUNDATION, NEW YORK CONGREGATIONAL COMMUNITY PROPERTIES, AND NEW YORK CONGREGATIONAL HOME FOR THE AGED. FLORENCE KATZ IS ALSO EMPLOYED BY NEW YORK CONGREGATIONAL NURSING CENTER. SHE SPENDS AN AVERAGE OF 35 HOURS PER WEEK WORKING FOR THIS ENTITY, AS WELL AS .50 HOURS WORKING FOR THE FILING ORGANIZATION AS WELL AS THE OTHER RELATED ENTITIES: NEW YORK CONGREGATIONAL COMMUNITY SERVICES, AND NEW YORK CONGREGATIONAL HOME FOR THE AGED FOUNDATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,434. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY -928,136. NET ASSET TRANSFER 57,050. TOTAL TO FORM 990, PART XI, LINE 5: -872,520. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. NEW YORK CONGREGATIONAL CENTER FOR COMMUNITY LIFE 135 LINDEN BLVD BROOKLYN NY 11226 200483447 OPERATE A COMMUNITY CENTER AND PROVIDE SOCIAL SUPPORT SERVICES NY 501(C)3 9 NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL HOME FOR THE AGED 135 LINDEN BLVD BROOKLYN NY 11226 111631799 SUPPORT THE ACTIVITIES OF THE NY CONGREGATIONAL NURSING CENTER NY 501(C)3 PF NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL HOME FOR THE AGED FOUNDATION 135 LINDEN BLVD BROOKLYN NY 11226 200276760 SUPPORT THE ACTIVITIES OF THE NY CONGREGATIONAL NURSING CENTER DE 501(C)3 TYPE I NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 NEW YORK CONGREGATIONAL COMMUNITY SERVICES 135 LINDEN BLVD BROOKLYN NY 11226 113519798 SUPPORT THE NY CONGREGATIONAL NURSING CENTER AND ITS AFFILIATES NY 501(C)3 TYPE II N/A 0 NEW YORK CONGREGATIONAL COMMUNITY PROPERTIES 135 LINDEN BLVD BROOKLYN NY 11226 550791344 MANAGE REAL PROPERTY FOR THE NY CONGREGATIONAL COMMUNITY SERVICES NY 501(C)3 PF NEW YORK CONGREGATIONAL COMMUNITY SERVICES 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1