2013-11-07T14:02:35-06:00 2012-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2012-01-01 112388200 COBBLE HILL HEALTH CENTER INC COBB 7188556789 380 HENRY STREET BROOKLYN NY 11201 DANIEL TUCHMAN 7188556789 2013-11-05 1 FREDERICK H ROTHMAN P01275277 2128674000 2012 2016-02-25 16:41:14Z ANTHONY LEWIS 380 HENRY STREET BROOKLYN NY 11201 61458224 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 11 548 11 0 0 5217463 249662 46767783 53431118 535700 842283 -46858 -132187 52474088 54390876 0 0 0 0 27535568 29777106 0 0 0 18051299 22892804 45586867 52669910 6887221 1720966 108791153 105904618 69610566 65304581 39180587 40600037 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. 1 0 38467740 43635716 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 131,993 DAYS OF SKILLED NURSING CARE IN 2012. 2334479 3122561 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 19,889 DAY CARE VISITS DURING 2012. 6307898 6374051 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 2012, THE CENTER PROVIDED 317,903 HOURS OF HOME HEALTH CARE SERVICES. 404699 232802 CASE MANAGEMENT 114879 65988 COMMUNITY CARE TRANSITION PROJECT 519578 298790 47629695 1 1 0 1 0 0 0 0 0 0 1 0 0 0 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 1 1 0 0 0 1 23 0 548 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 1 1 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 347795 0 36918 ALAN GROSS 42.00 X 367700 0 50747 DANIEL TUCHMAN 35.00 X 286369 0 52360 JOAN SKYERS 35.00 X 215206 0 38231 ALLA IMAS 35.00 X 175948 0 48520 SOMMER ESPINO 35.00 X 155820 0 44727 ARTHUR ZOLOTAREVSKY 35.00 X 138667 0 27816 LEISA BRYANT 35.00 X 138950 0 27138 1826455 0 326457 20 0 1 0 NURSING PERSONNEL HOME CARE 175 SOUTH 9TH STREET BROOKLYN NY 11211 NURSING AGENCY 799280 HOME HEALTH CARE SERVICE 1650 CONEY ISLAND AVE BROOKLYN NY 11230 NURSING AGENCY 530783 ATTENTIVE HOME CARE 85-06 QUEENS BLVD ELMHURST NY 11373 NURSING AGENCY 510257 SENIOR CARE 1991 FLATBUSH AVENUE BROOKLYN NY 11234 NURSING AGENCY 476796 PELLACARE 1418 65TH STREET BROOKLYN NY 11219 NURSING AGENCY 362345 17 130700 113305 5657 249662 SKILLED NURS. FACILITY 623000 43635716 43635716 LONG TERM HOME HEALTH CARE 621610 6374051 6374051 ADULT DAY CARE PROGRAM 621990 3122561 3122561 CASE MANAGEMENT 624100 232802 232802 COMMUNITY CARE TRANSITION PROJECT 624200 65988 65988 53431118 402589 402589 40000 192960 -152960 -152960 -152960 7314082 6874388 439694 439694 439694 MISCELLANEOUS 900099 20773 20773 20773 54390876 53431118 0 710096 X 1141889 1141889 20410961 19077979 1332982 1621877 1515957 105920 4866012 4563406 302606 1736367 1622970 113397 370780 370780 183100 183100 56789 56789 7696321 7193696 502625 12934 12089 845 4072044 3806110 265934 219197 204882 14315 3666249 3303864 362385 35720 33387 2333 2989611 2794368 195243 625173 584345 40828 CASH RECEIPTS ASSESSMEN 2226166 2226166 LAUNDRY & LINEN 591613 552976 38637 147107 137500 9607 52669910 47629695 5040215 0 6110894 6168792 792604 1192773 9670793 13502073 57390 66797 103160 165404 89292444 20057282 71726875 69235162 12350452 12726860 7978985 2846757 108791153 105904618 8938673 5427473 46280000 45390000 14391893 14487108 69610566 65304581 X 39044834 40460748 135753 139289 39180587 40600037 108791153 105904618 X 1720966 -18069 -283447 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6646 6646 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: $6,646 IS AN ALLOCATION OF ASSOCIATION DUES TO LOBBYING EXPENSES. 2167158 2167158 17840074 6113820 11726254 64342948 9963576 54379372 2901862 2835774 66088 2040402 1144112 896290 69235162 RESIDENT FUNDS HELD IN TRUST 307797 DUE TO THIRD PARTIES 781727 SWAP AGREEMENTS 13397584 14487108 X 54508978 -18069 192960 174891 54334087 56789 56789 54390876 52806081 192960 192960 52613121 56789 56789 52669910 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: 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, 2009 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 192,960. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 192,960. PART XI, LINE 8, CHANGE IN VALUE OF SWAP AGREEMENT $283,447 X X 0 0 0 0 0 0 0 1 0 ANTHONY LEWIS 286760 0 18000 0 43035 0 29197 0 7721 0 384713 0 0 0 ALAN GROSS 281400 0 18000 0 68300 0 29197 0 21550 0 418447 0 0 0 DANIEL TUCHMAN 210000 0 50000 0 26369 0 29197 0 23163 0 338729 0 0 0 JOAN SKYERS 180596 0 10000 0 24610 0 25430 0 12801 0 253437 0 0 0 ALLA IMAS 150000 0 3000 0 22948 0 20241 0 28279 0 224468 0 0 0 SOMMER ESPINO 141427 0 6000 0 8393 0 17624 0 27103 0 200547 0 0 0 ARTHUR ZOLOTAREVSKY 124690 0 1500 0 12477 0 15093 0 12723 0 166483 0 0 0 LEISA BRYANT 115704 0 3500 0 19746 0 15052 0 12086 0 166088 0 0 0 PART I, LINE 7 THE BOARD APPROVES MERIT BASED BONUSES FOR ITS OFFICERS AND TOP EMPLOYEES FOR THEIR DEDICATION TO THE CENTER DURIING THE YEAR. THESE BONUSES ARE APPROVED TOWARDS THE END OF THE YEAR BASED ON MERIT. A NYC CAPITAL RESOURCE CORP 204099098 649437AEO 2008-01-30 35920000 RENOVATION 0 0 0 B NYC CAPITAL RESOURCE CORP 204099098 649437AF7 2008-01-30 4420000 REFINANCING 1 0 0 C NYC CAPITAL RESOURCE CORP 204099098 649437AG5 2008-01-30 7850000 CONSTRUCTION 0 0 0 A 35920000 12137676 1331784 22448875 2011 1 0 0 1 B 4420000 4261307 158691 2008 1 0 0 1 C 7850000 286416 7438143 2009 1 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 DURING 2012, COBBLE HILL LIFECARE PLUS LLC (CHLCP) WAS INCORPORATED AS A LIMITED LIABILITY COMPANY TO PROVIDE CARE MANAGEMENT SERVICES FOR THE ELDERLY LIVING AT HOME. CHLCP, A DISREGARDED ENTITY FOR INCOME TAX PURPOSES, IS A WHOLLY OWNED SUBSIDIARY OF CHHC. 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 TOP EMPLOYEES' COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD. THIS PROCESS WAS LAST DONE IN 2012.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. OTHER FEES FORM 990, PART IX, LINE 11G THERAPEUTIC, PHARMACY, AND RELATED SERVICES: PROGRAM SERVICE EXPENSES 1,412,820. MANAGEMENT AND GENERAL EXPENSES 98,714. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,511,534. STAFFING AGENCY FEES: PROGRAM SERVICE EXPENSES 687,915. MANAGEMENT AND GENERAL EXPENSES 48,065. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 735,980. SECURITY: PROGRAM SERVICE EXPENSES 126,613. MANAGEMENT AND GENERAL EXPENSES 8,846. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 135,459. CONSTRUCTION AGENCY FEES: PROGRAM SERVICE EXPENSES 129,666. MANAGEMENT AND GENERAL EXPENSES 9,060. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 138,726. LONG TERM PERSONAL CARE ASSISTANCE: PROGRAM SERVICE EXPENSES 4,124,574. MANAGEMENT AND GENERAL EXPENSES 288,185. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,412,759. AMBULETTE SERVICE: PROGRAM SERVICE EXPENSES 712,108. MANAGEMENT AND GENERAL EXPENSES 49,755. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 761,863. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SWAP AGREEMENT -283,447. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COBBLE HILL LIFECARE PLUS LLC 380 HENRY STREET BROOKLYN NY 11201 461226428 PROVIDES CARE MANAGEMENT SERVICES FOR THE ELDERLY LIVING AT HOME NY 232802 0 N/A 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 0