2013-11-13T17:20:28-06:00 2012-12-31 271728945 O'CONNOR DAVIES LLP 500 MAMARONECK AVENUE HARRISON NY 105281633 990 2012-01-01 113188802 NEW YORK CONGREGATIONAL NURSING CENTER NEWY 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 FRANK CIANCIOTTO 7185767000 2013-11-09 1 GARRETT M HIGGINS P00543209 9143818900 2013-11-06 2012 2016-03-07 17:11:31Z CECELIA C ZUCKERMAN 135 LINDEN BOULEVARD BROOKLYN NY 11226 28576413 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. 6 6 362 7 0 0 35175 26648 26256038 28423994 9671 8054 98926 117717 26399810 28576413 2700 5550 0 0 15165237 16054687 0 0 0 11805982 12908536 26973919 28968773 -574109 -392360 23190134 21331599 22945284 21546573 244850 -214974 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 19687119 5550 21566810 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 72,714 DAYS OF CARE TO APPROXIMATELY 447 PATIENTS IN 2012. 6053459 6857184 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 67,540 DAYS OF CARE IN 2012. 25740578 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 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 260 0 362 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X X FRANK CIANCIOTTO 7185767000 135 LINDEN BOULEVARD BROOKLYN NY 11226 KENDALL CHRISTIANSEN 0.50 0.50 X X 0 0 0 DR ESTHER SIEGEL 0.50 X X 0 0 0 MICHAEL ROBINSON 0.50 X X 0 0 0 ROBERT R GAINER 0.50 X 0 0 0 JOSE MALDONADO 0.50 X 0 0 0 DR MARGARET L MCCLURE 0.50 X 0 0 0 JAMES WAECHTER 0.50 X 0 0 0 CECELIA C ZUCKERMAN 35.00 0.50 X 413840 0 40137 FLORENCE KATZ 35.00 0.50 X 202599 0 32987 FRANK CIANCIOTTO 35.00 0.50 X 241819 0 41930 DAVETH FORBES-THOMAS 35.00 X 170629 0 8515 ROBERT MUNFA 35.00 X 163722 0 18447 MOHAMMAD CHOWDHURY 35.00 X 152708 0 37397 ROUANDY PASCAL 35.00 X 161380 0 13088 ADRIAN COX 35.00 X 134874 0 6888 1641571 0 199389 11 0 1 0 FRIENDLY HOME CARE 2002 CONEY ISLAND AVE BROOKLYN NY 11223 HOME HEALTHCARE AGENCY 680768 CARING PROFESSIONS 70-20 AUSTIN STREET SUITE 135 FOREST HILL NY 11375 HOME HEALTHCARE AGENCY 656071 ATTENTIVE HOME CARE 2774 CONEY ISLAND AVE BROOKLYN NY 11235 HOME HEALTHCARE AGENCY 442386 S&A UNIFIED HOME 424 KINGS HIGHWAY BROOKLYN NY 11223 HOME HEALTHCARE AGENCY 266973 BESTCARE INC PO BOX 9010 LEVITTOWN NY 11756 HOME HEALTHCARE AGENCY 265155 13 26648 26648 MEDICAID 623000 23292561 23292561 MEDICARE 623000 4170005 4170005 OTHER NET PATIENT REVENUE 623000 928753 928753 PRIVATE PAY REVENUE 623000 32675 32675 28423994 8054 8054 CASH DISCOUNTS 900099 75593 75593 MISCELLANEOUS REVENUE 900099 27465 27465 VENDING MACHINE REVENUE 900099 10909 10909 3750 3750 117717 28576413 28423994 0 125771 X 5550 5550 973312 973312 11111199 10534910 576289 639256 600752 38504 1908303 1715506 192797 1422617 1237562 185055 139958 139958 89304 89304 7593 7593 4710521 4686728 23793 11011 7813 3198 1237884 1093792 144092 58671 58671 1543884 1511648 32236 24908 4702 20206 14191 2532 11659 1452941 1408638 44303 455823 455823 NYS CASH RECEIPTS ASSES 1083694 1083694 PURCHASED AND CONTRACTE 843827 684531 159296 BAD DEBT EXPENSE 720000 720000 MEDICAL SUPPLIES 219877 219877 294449 222343 72106 28968773 25740578 3228195 0 469461 152470 2791744 2173652 6156579 5928590 62819 76441 239214 214886 34086857 25161069 9964951 8925788 3505366 3859772 23190134 21331599 3384179 4206741 14575000 13840000 184523 164478 49014 49877 4752568 3285477 22945284 21546573 X 244850 -214974 244850 -214974 23190134 21331599 X -392360 2475 -69939 X X 0 1 X 1 0 X 30704 16118 11533 35175 26648 120178 25755931 24838777 25266978 26256038 28423994 130541718 25786635 24854895 25278511 26291213 28450642 130661896 0 0 0 130661896 69328 35066 14064 9671 8054 136183 69328 35066 14064 9671 8054 136183 28298 14955 90209 98926 117717 350105 25884261 24904916 25382784 26399810 28576413 131148184 0.99630 0.99490 0.00100 0.00260 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2008 AMOUNT: $ 28,298. 2009 AMOUNT: $ 14,955. 2010 AMOUNT: $ 90,209. 2011 AMOUNT: $ 15. 2012 AMOUNT: $ 27,465. CASH DISCOUNTS - 2011 AMOUNT: $ 84,515. 2012 AMOUNT: $ 75,593. VENDING MACHINE INCOME - 2011 AMOUNT: $ 12,208. 2012 AMOUNT: $ 10,909. MEDICAL RECORDS FEE - 2011 AMOUNT: $ 2,188. 2012 AMOUNT: $ 3,750. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7593 7593 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 X 44462 44462 28666953 20771251 7895702 5375442 4389818 985624 8925788 DUE FROM RELATED PARTIES 1437035 RESIDENT'S FUNDS 164478 DEFERRED MORTGAGE COSTS 723270 DUE FROM MEDICAID 1534989 3859772 DEFERRED COMPENSATION PAYABLE 126454 DUE TO THIRD PARTIES 307470 INTEREST RATE SWAP LIABILITY 2851553 3285477 X 28578888 2475 2475 28576413 0 28576413 28968773 0 28968773 0 28968773 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, LINE 2: 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 2009. 1 X X X X X X 0 0 0 0 0 0 0 1 0 CECELIA C ZUCKERMAN 360797 0 35000 0 18043 0 29000 0 11137 0 453977 0 0 0 FLORENCE KATZ 182599 0 20000 0 0 0 10164 0 22823 0 235586 0 0 0 FRANK CIANCIOTTO 226819 0 15000 0 0 0 12164 0 29766 0 283749 0 0 0 DAVETH FORBES-THOMAS 170629 0 0 0 0 0 8515 0 0 0 179144 0 0 0 ROBERT MUNFA 143722 0 20000 0 0 0 8219 0 10228 0 182169 0 0 0 MOHAMMAD CHOWDHURY 147708 0 5000 0 0 0 7631 0 29766 0 190105 0 0 0 ROUANDY PASCAL 156380 0 5000 0 0 0 0 0 13088 0 174468 0 0 0 PART I, LINE 7 THE ORGANIZATION AWARDED THE FOLLOWING INDIVIDUALS A BONUS THAT WAS SUBJECT TO BOARD DISCRETION AND APPROVAL. THE BONUSES WERE INCLUDED IN THEIR 2012 W-2S. - CECILIA ZUCKERMAN, $35,000 - FRANK CIANCIOTTO, $15,000 - FLORENCE KATZ, $20,000 - ROBERT MUNFA, $20,000 - ROUANDY PASCAL, $ 5,000 - MOHAMMAD CHOWDHURY, $ 5,000 A 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 A 2085000 17103440 324425 275697 780630 15722688 2006 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 1 0 0 0 0 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 15A 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 AND APPROVED BY THE BOARD, 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 AND FORM 1023 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, 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. OTHER FEES FORM 990, PART IX, LINE 11G THERAPISTS: PROGRAM SERVICE EXPENSES 379,262. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 379,262. CONSULTANT: PROGRAM SERVICE EXPENSES 83,572. MANAGEMENT AND GENERAL EXPENSES 23,793. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 107,365. MEDICAL RECORD FEES: PROGRAM SERVICE EXPENSES 1,243. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,243. NURSING STAFF: PROGRAM SERVICE EXPENSES 15,077. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,077. HOME HEALTH AIDES: PROGRAM SERVICE EXPENSES 176,541. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 176,541. PERSONAL CARE AIDES: PROGRAM SERVICE EXPENSES 3,972,333. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,972,333. SOCIAL SERVICES: PROGRAM SERVICE EXPENSES 17,700. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,700. DENTAL FEES: PROGRAM SERVICE EXPENSES 41,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,000. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY -69,939. 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 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0