2013-07-31T10:08:23-05:00 2012-12-31 161170608 TOSKI & CO CPAS PC 300 ESSJAY RD SUITE 115 WILLIAMSVILLE NY 14221 990 2012-01-01 237155198 BROTHERS OF MERCY NURSING HOME COMPANY INC BROT 7167596985 10570 BERGTOLD RD CLARENCE NY 14031 BROTHER JUDE HOLZFOERSTER 7167596985 2013-07-31 1 JOHN T O'BRIEN MBA MST P01253588 7166340700 2012 2016-02-24 21:20:13Z BROTHER JUDE HOLZFOERSTER 10570 BERGTOLD RD CLARENCE NY 14031 19669591 0 X N/A X 1971 NY TO PROVIDE REHABILITATION SERVICES AND SKILLED NURSING CARE. 8 4 637 150 0 0 27615 18543 19326906 19357123 14404 17717 304366 276208 19673291 19669591 0 0 0 0 13303650 13295388 0 0 0 5784554 5951837 19088204 19247225 585087 422366 9424228 9179607 4087700 3420713 5336528 5758894 TO PROVIDE REHABILITATION SERVICES AND SKILLED NURSING CARE. 0 0 18093999 19498298 NURSING CARE AND REHABILITATION SERVICE FOR A 240 BED N.Y.S. LICENSED NURSING FACILITY. 18093999 1 1 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 30 0 1 637 1 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X MARY BETH GOEHLE 7167596985 10570 BERGTOLD ROAD CLARENCE NY 14031 X BROTHER JUDE HOLZFOERSTER 37.50 X X 69180 0 7177 BROTHER KENNETH THOMAS 0.50 X X 0 0 0 BROTHER FIDELIS VERRALL 37.50 X X 23931 0 3697 BROTHER MATHIAS MOLLER 20.00 X 7669 0 860 BROTHER GABRIEL JOSEPH PARISI 0.50 X 0 0 0 PETER EIMER 10.00 30.00 X X 0 100780 0 JOSEPH DUNN 0.50 X 0 0 0 DAVID NASCA 0.50 X 0 0 0 VALERIE KANE 40.00 X 133546 0 22020 MARY BETH GOEHLE 40.00 X 72450 0 19193 306776 100780 52947 1 0 1 0 FAVORITE NURSESFAVORITE TEMPS P O BOX 803356 KANSAS CITY MO 641803356 LPN FEES 117063 FREED MAXICK CPA'S PC P O BOX 8000 DEPT 644 BUFFALO NY 14267 CONSULTING/MGMT/STRATEGIC PLANNING 106441 INFORMATION MANAGEMENT SOLUTIONS INC 109 CHATHAM AVENUE BUFFALO NY 14216 COMPUTER SERVICES 100354 3 18543 18543 RESIDENT SERVICES 623000 9927357 9927357 FEES & CONTRACTS - GOV'T AGENCIES 623000 9429766 9429766 19357123 11280 11280 6437 0 6437 6437 6437 CAFETERIA & COFFEE SHOP 722210 84325 84325 NURSE AIDE TRAINING INCOM 611430 39997 39997 DISCOUNTS EARNED 623000 36805 36805 115081 64373 50708 276208 19669591 19498298 0 152750 359723 78297 281426 11094049 10741484 352565 174714 166105 8609 806948 763232 43716 859954 816070 43884 35339 35339 46072 46072 204618 46420 158198 9485 9485 830934 719915 111019 103326 103326 349636 318295 31341 11440 8048 3392 57271 57271 535197 508437 26760 552484 524859 27625 NYS ASSESSMENT FEES 994574 994574 MEDICAL SUPPLIES & EQUI 937200 937200 FOOD & BEVERAGE 697458 697458 SUPPLIES 290215 266344 23871 296588 265253 31335 19247225 18093999 1153226 0 2765212 1951086 1678865 2431354 1312545 1115328 108584 84307 91436 94789 51527 40002 17790876 15062650 2675657 2728226 676994 686978 63408 47537 9424228 9179607 2966607 2336584 1057685 1036592 63408 47537 4087700 3420713 X 5336528 5758894 5336528 5758894 9424228 9179607 422366 0 X X 0 1 X 0 0 X 10916 24548 26301 27615 18543 107923 2010395 19233473 18761839 19326906 19357123 78689736 249529 83579 80726 141470 555304 2021311 19507550 18871719 19435247 19517136 79352963 0 0 0 79352963 51787 30759 20720 14404 11280 128950 51787 30759 20720 14404 11280 128950 317226 77137 238736 129330 141175 903604 2390324 19615446 19131175 19578981 19669591 80385517 0.98720 0.98770 0.00160 0.00280 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 16000 16000 11850042 10037180 1812862 377580 373867 3713 5171891 4651603 520288 375363 375363 2728226 RESIDENT FUNDS HELD IN TRUST 44720 RESIDENT ACTIVITY FUNDS 2817 47537 X 19669591 0 19669591 0 19669591 19247225 0 19247225 0 19247225 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOME IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; THEREFORE, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FINANCIAL STATEMENTS. THE HOME HAS BEEN CLASSIFIED AS A PUBLICLY SUPPORTED ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A) OF THE CODE. THE HOME PRESENTLY DISCLOSES OR RECOGNIZES INCOME TAX POSITIONS BASED ON MANAGEMENT'S ESTIMATE OF WHETHER IT IS REASONABLY POSSIBLE OR PROBABLE THAT A LIABILITY HAS BEEN INCURRED FOR UNRECOGNIZED INCOME TAXES. MANAGEMENT HAS CONCLUDED THAT THE HOME HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT IN IT FINANCIAL STATEMENTS. U.S. FORMS 990 FILED BY THE HOME ARE SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. THE HOME IS NO LONGER SUBJECT TO TAX EXAMINATION FOR THE YEARS ENDED DECEMBER 31, 2008 AND PRIOR. X X X 0 0 0 0 0 0 0 0 0 VALERIE KANE 133546 0 0 0 0 0 4323 0 17697 0 155566 0 5128 0 FORM 990, PART VI, SECTION B, LINE 11 LINE 11A EXPLANATION - FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS THEN REVIEWED BY THE ADMINISTRATOR AND OTHER OFFICERS. IT IS APPROVED BY THE BOARD PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C QUESTIONNAIRE IS SENT OUT ANNUALLY AND INFORMATION REGARDING POTENTIAL CONFLICTS OF INTEREST IS MAINTAINED BY ADMINISTRATION. COMPLETED QUESTIONNAIRES ARE KEPT ON FILE IN THE FINANCE OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS REVIEWS SALARIES FOR TOP MANAGEMENT OFFICIALS AND USES COMPARABILITY DATA FROM NYAHSA (NY ASSOCIATION FOR HOMES AND SERVICES FOR THE AGING) IN ORDER TO DETERMINE SALARIES. FORM 990, PART VI, SECTION C, LINE 19 DISCLOSURE IS BASED ON THE PURPOSE OF THE REQUEST. COMPENSATION OF OFFICER: FORM 990 PART VII DIRECTOR NO. 6: PETER C. EIMER, C.O.O., IS PAID BY BROTHERS OF MERCY SACRED HEART HOME, INC., A RELATED ORGANIZATION, BUT A PORTION OF HIS SALARY IS REIMBURSED BY BROTHERS OF MERCY NURSING HOME, INC. TO BROTHERS OF MERCY SACRED HEART HOME. THE AMOUNT REIMBURSED IN 2012 WAS $27,158. FORM 990 PART XII LINE 2C: NO CHANGES HAVE TAKEN PLACE DURING THE FISCAL YEAR ENDED DECEMBER 31, 2012. BROTHERS OF MERCY INC 4520 RANSOM ROAD CLARENCE NY 14031 160746852 HOUSING, LIVING EXPENSE, ETC FOR BROTHERS OF MERCY NY 501(C)(3) 170(B)1(A)I 0 BROTHERS OF MERCY SACRED HEART HOME 4520 RANSOM RD CLARENCE NY 14031 161082636 ADULT CARE FACILITY NY 501(C)(3) 170(B)1(A)III 0 BROTHERS OF MERCY HOUSING CO INC 10500 BERGTOLD ROAD CLARENCE NY 14031 237117107 HOUSING FOR ELDERLY NY 501(C)(3) 170(B)1(A)VI 0 BROTHERS OF MERCY FACILITIES FOUNDATION 10500 BERGTOLD ROAD CLARENCE NY 14031 161558645 SUPPORT CHARITABLE PURPOSES OF BROTHERS NY 501(C)(3) 170(B)1(A)VI 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 BROTHERS OF MERCY INC K 94525 FMV BROTHERS OF MERCY SACRED HEART HOME O 27158 FMV