2013-11-14T18:17:39-06:00 2012-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2012-01-01 133623600 NORTHERN MANOR MULTICARE CENTER INC NORT 8456233904 199 NORTH MIDDLETOWN ROAD NANUET NY 10954 MORRIS KLEIN 8456233904 2013-11-14 1 FREDERICK H ROTHMAN P01275277 2128674000 2012 2016-02-25 16:41:14Z MORRIS KLEIN 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 41859502 0 X WWW.NORTHERNMANOR.COM X 1991 NY TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM 11 11 419 25 0 0 0 5477669 36626627 35539562 813 1173 71361 841098 36698801 41859502 0 4675585 0 0 18266296 18501542 0 0 0 14056938 13534127 32323234 36711254 4375567 5148248 22230145 18799707 22382321 18718048 -152176 81659 TO OPERATE A RESIDENTIAL HEALTH FACILITY & ADULT DAY CARE PROGRAM 0 0 28669003 4675585 27388729 HEALTH CARE SERVICES FOR THE ELDERLY 3624012 8991931 OUTPATIENT ADULT DAY CARE SERVICES 32293015 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 0 419 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 JILL WECHSLER 35.00 X 159159 0 16867 GELENA DEVERMAN 35.00 X 149236 0 3876 GENNADIY GOLDVEKHT 35.00 X 103880 0 0 584451 857433 222424 4 0 1 0 TOWNE NURSING STAFF 1413 38TH STREET BROOKLYN NY 11218 NURSING SERVICES 1321146 CENTERS FOR CARE 1601 BRONXDALE AVENUE STE 209 BRONX NY 10462 ADMINISTRATIVE SERVICES 532789 SENIOR CARE 855 BRUSH AVENUE BRONX NY 10465 TRANSPORTATION 473207 NORTHERN METROPOLITAN FOUNDATION 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 ADMINISTRATIVE SERVICES 436049 CLEAN TEX SERVICES 491 LYONS AVE IRVINGTON NJ 07111 MEDICAL SUPPLIES 168884 5 5477669 5477669 RESIDENT SERVICE REVENUE 623000 27388729 27388729 ADULT DAY CARE 623000 8150833 8150833 35539562 1173 1173 MISC INCOME 900099 579025 579025 FOOD REVENUE 900099 262073 262073 841098 41859502 36380660 0 1173 X 4675585 4675585 382776 337330 45446 13410219 11560731 1849488 748987 645690 103297 2744223 2358405 385818 1215337 1047722 167615 1404887 1211131 193756 81546 81546 21263 21263 894674 771284 123390 33780 29122 4658 1110331 732007 378324 1656066 1427668 228398 1720230 1559389 160841 243993 210342 33651 865607 746226 119381 445466 384029 61437 FOOD EXPENSE 1918238 1653681 264557 NYS ASSESSMENT 1721444 1721444 MEDICAL SUPPLIES 1416602 1221229 195373 36711254 32293015 4418239 0 385684 671442 901372 9840590 7562747 221984 446548 22224594 13431973 9071218 8792621 59964 2710669 365013 22230145 18799707 6682965 5935421 10273188 6550000 2814345 5426168 3418282 22382321 18718048 X -372449 81659 220273 0 -152176 81659 22230145 18799707 5148248 -4914413 0 X X 0 1 X 1 0 X 5477669 5477669 34441288 35966570 35941663 36626627 36380660 179356808 34441288 35966570 35941663 36626627 41858329 184834477 0 0 0 184834477 869 1123 540 813 1173 4518 869 1123 540 813 1173 4518 130872 22743 71361 224976 34573029 35990436 35942203 36698801 41859502 185063971 0.99880 0.99870 0.00000 0.00010 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 790000 790000 16458313 9337778 7120535 537059 471887 65172 3861921 3485142 376779 577301 137166 440135 8792621 ESTIMATED LIABILITIES TO THIRD-PARTY PAYORS 3105000 RESIDENT FUNDS HELD IN TRUST 313282 3418282 X 36381833 0 36381833 5477669 5477669 41859502 32470697 0 32470697 4240557 4240557 36711254 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: NORTHERN MANOR MULTICARE CENTER, 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 5,477,669. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO RELATED ENTITY 4,240,557. 0 CONGREGATION CHEVRA LIADY NUSACH HOARY 1580 53RD STREET BROOKLYN NY 11219 113133470 501(C) (3) 435028 0 TO SUPPORT THE RELIGIOUS MISSION OF CHEVRA LIADY NUSACH HOARY NORTHERN RIVERVIEW 87 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133832251 501(C) (3) 1979251 TO FORGIVE INTERCOMPNAY BALANCES FOUNTAINVIEW AT COLLEGE ROAD INC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 133935070 501(C) (3) 2071051 TO FORGIVE INTERCOMPNAY BALANCES ASSISTED LIVING AT NORTHERN RIVERVIEW INC 89 SOUTH ROUTE 9W HAVERSTRAW NY 10927 133976617 501(C) (3) 183748 TO FORGIVE INTERCOMPNAY BALANCES LIFESTYLE OPTIONS FOR SENIORS 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134133472 501(C) (3) 6507 TO FORGIVE INTERCOMPNAY BALANCES 5 0 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 JILL WECHSLER 159159 0 0 0 0 0 0 0 16867 0 176026 0 0 0 GELENA DEVERMAN 149236 0 0 0 0 0 0 0 3876 0 153112 0 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 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 COOPERS 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 MANOR MULTICARE, INC. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G HEALTHCARE CONSULTANTS: PROGRAM SERVICE EXPENSES 771,284. MANAGEMENT AND GENERAL EXPENSES 123,390. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 894,674. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. 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 11B, II NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 LIFESTYLE OPTIONS FOR SENIORS FOUNDATIONINC 2000 FOUNTAINVIEW DRIVE MONSEY NY 10952 134133472 CHARITABLE FOUNDATION NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 NORTHERN METROPOLITAN INC 225 MAPLE AVENUE MONSEY NY 10952 133070759 NURSING HOME NY 501 (C)(3) LINE 9 NORTHERN METROPOLITAN FOUNDATION FOR HEALTH CARE INC 0 CHEVRA LIADY NUSACH HOARY - 11-3133470 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