2013-11-18T08:25:09-07:00 2012-12-31 990 2012-01-01 222291346 GENESEE VALLEY PRESBYTERIAN NURSING CENTER GENE 5854611991 254 Alexander Street Rochester NY 14607 James DeVoe 5854611991 2013-10-31 2012 2016-03-07 17:11:31Z Kirkhaven James E DeVoe 254 Alexander Street Rochester NY 14607 11968786 0 X www.Kirkhaven.com X 1980 NY Organization is a 147 licensed-bed skilled nursing home, which provides long-term and short-term skilled nursing and rehabilitative care to seniors. 12 12 330 20 0 0 108103 82033 12641176 11810738 2245 1767 71388 74248 12822912 11968786 0 0 0 0 8046831 8326562 0 0 0 4317754 4156929 12364585 12483491 458327 -514705 10886799 10556588 9828637 10115490 1058162 441098 Nursing home that provides skilled long-term care, rehabilitative and Alzheimers/Dementia care for seniors in a manner that embraces a philosophy of person-centered care, quality of care and faith-based mission. 0 0 11367121 0 11810738 Nursing home that provides skilled long-term care, rehabilitation and Alzheimers/Dementia care for seniors in a manner that embraces a philosophy of person-centeredcare, quality of care and faith-based mission. 0 0 0 11367121 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 12 0 1 330 1 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NY X Kirkhaven 5854611991 254 Alexander Street Rochester NY 14607 David Irish 0.5 X 0 0 0 Thomas Lockwood 0.5 X X 0 0 0 Ronald Wright Jr 0.5 X 0 0 0 Sharon Boyd 0.5 X X 0 0 0 Judy Bufano 0.5 X 0 0 0 Ann Marie Cook 0.5 X 0 0 0 Jann Packard 0.5 X X 0 0 0 Reverend Steve Becker 0.5 X 0 0 0 Nick Bhatia 0.5 X 0 0 0 Tom D'Antonio 0.5 X 0 0 0 Roger Roth 0.5 X 0 0 0 Marisa Geitner 0.5 X 0 0 0 James E DeVoe 28 12 X X X 110349 47292 49848 Amanda Brown 40 0 X 104612 0 19144 Cassandra Tilliman 31 9 X 77049 23014 18312 Scott Maar 28 12 X 61673 26431 16123 353683 96737 103427 1 0 1 0 Freedom Therapy 304 East Avenue Rochester NY 14607 Therapy Services 655520 1 0 0 0 82033 0 0 0 82033 Skilled Nursing Home Services 623110 11810738 11810738 0 0 11810738 1767 0 0 1767 0 0 0 0 0 0 0 0 21800 0 0 0 21800 0 21800 0 0 21800 0 0 0 Staff Cafeteria 722210 25330 0 0 25330 Vending & Guest Meals 722210 7296 0 0 7296 Telephone & Newspaper 812900 9640 0 0 9640 10182 0 0 10182 52448 11968786 11810738 0 76015 484346 124129 360217 6181121 5937270 243851 388807 373255 15552 771426 741770 29656 500862 480828 20034 4885 4885 22990 22990 785080 773540 11540 10784 10784 42889 11684 31205 68928 68928 635279 571751 63528 13170 4530 8640 23501 23501 508417 457575 50842 78677 0 78677 Supplies 1013088 991688 21400 Purchased Services/Repairs & Maintenance 245244 193105 52139 NYS Cash Receipt Assessment 617207 617207 0 Other 86790 9077 77713 12483491 11367121 1116370 0 916249 81380 1153797 1057128 1058560 1220123 83285 78251 15591405 9638221 5724604 5953184 1950304 2166522 10886799 10556588 1063802 1263929 31222 23181 5070687 4994218 3662926 3834162 9828637 10115490 X -688650 -1488483 792711 974466 954101 955115 1058162 441098 10886799 10556588 X -514705 0 0 0 0 -102359 X 0 1 X 1 0 X 153451 22029 120496 108103 82033 486112 11771508 11910584 11691414 12641176 11810738 59825420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11924959 11932613 11811910 12749279 11892771 60311532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60311532 23684 8878 3752 2245 1767 40326 0 0 0 0 0 0 23684 8878 3752 2245 1767 40326 0 0 0 0 0 0 56756 82686 51651 71388 74248 336729 12005399 12024177 11867313 12822912 11968786 60688587 0.99379 0.99375 0.00066 0.00118 X staff cafeteria, vending, guest meals, telephone, newspaper, misc. and other. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 954101 1016 120662 0 120662 0 955117 952412 1689 8961 0 8961 0 954101 945596 6816 138650 0 138650 0 952412 937839 7757 206424 0 206424 0 945596 931310 6529 -229158 0 -229158 0 937839 0 1 0 0 1 1 0 438016 438016 0 12166092 7805949 4360143 0 0 0 0 0 2257791 1671614 586177 0 729506 160658 568848 5953184 Beneficial Interest in Foundation 1929581 Mortgage Acquisition Costs 170560 Resident Funds Held in Trust 61249 Due From Affiliated Parties 5132 2166522 0 Due to Third Party Payors 402571 Pension Liability 3248384 Workers Compensation Trust Liability 121958 Resident Funds Held in Trust 61249 3834162 11968786 0 0 0 0 0 11968786 0 0 0 11968786 12483491 0 0 0 0 0 12483491 0 0 0 12483491 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Endowment funds are to be held in perpetuity with the income to be recognized and transferred to temporary restricted funds within the Foundation and transferred to Kirkhaven annually based on the board approved Total Return & Spend policy for use in subsidizing the organization's mission and operation. X X X X 0 1 0 0 0 0 0 1 0 James E DeVoe 103384 44308 6964 2985 0 0 20952 9979 13242 15654 144542 72926 139010 68469 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 President/CEO is the sole participant in a 457(f) deferred compensation plan that is funded by the organization and related organization in the amount of $21,000 per year. SchJ_P01_S00_L07 Schedule J, Part I, Line 7 Executive Leadership staff were paid a bonus for specific goal performance results as per the Executive Bonus Program and approval by Executive Committee and Board. Total aggragate bonus payments equaled $17,161. F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The organization is a membership corporation with Presbyterian Homes & Services of Genesee Valley (Seniorsfirst) the sole member. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a The board of directors of the Member, constitute in part the board of directors of the organization. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b The organization's bylaws identify certain reserved powers that require approval by the Member. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The 990 is reviewed by the Audit & Finance Committee of the board of directors on behalf of the organization's board. A copy of the 990 is available to all directors of the governing board. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c Board members and key employees must complete and update conflict of interest forms annually and as needed. The Governance Committee of the parent board monitors and enforces compliance as needed. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The Executive Committee of the parent board reviews, determines and approves (with full board approval) the CEO compensation. Periodic survey and comparable compensation data is used to ascertain reasonableness and competitiveness of compensation. The HR Committee upon approval of the board, reviews and approves compensation pay scales and annual increase range for all other staff. F990_P06_S0B_L16a Form 990, Part VI, Section B, Line 16a The organization participates in a taxable joint-venture for Group Purchasing of supplies and services. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Information is available to the public upon request to administration. F990_P11_S00_L09 Form 990, Part XI, Line 9 Change in unrestricted net assets related to the pension plan= ($285,128); Change in Beneficial Interest in Foundation= $182,769. Prebyterian Homes & Services of Genesee Valley dba Seniorsfirst 254 Alexander Street Rochester NY 14607 161592416 Parent Organization NY 501(C)(3) 11d N/A 0 Seniorsfirst Foundation Inc 254 Alexander Street Rochester NY 14607 161378080 Supporting Organization NY 501(c)(3) 11d PHSGV Seniorsfirst 0 Presbyterian Residence Center Corporation (PRCC) dba Valley Manor Apartments 1570 East Avenue Rochester NY 14610 160958326 Sister Organization NY 501(c)(3) 9 PHSGV Seniorsfirst 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 Seniorsfirst Foundation Inc c 82033 Actual dollar value computed using board approved Total Return & Spend policy Prebyterian Homes & Services of Genesee Valley dba Seniorsfirst o 700361 % of time spent Seniorsfirst Foundation Inc m 46142 Actual cost Financial statements were delayed in being issued by our CPAs due to complications. A filing extension was requested and approved.