2012-07-03T12:38:14-07:00 2011-12-31 990 2011-01-01 222291346 GENESEE VALLEY PRESBYTERIAN NURSING CENTER GENE 5854611991 254 Alexander Street Rochester NY 14607 James DeVoe 5854611991 2012-07-03 2011 2016-02-24 21:20:13Z Kirkhaven James E DeVoe 254 Alexander Street Rochester NY 14607 12822912 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 12 314 30 0 0 120496 108103 11691414 12641176 3752 2245 51651 71388 11867313 12822912 0 0 0 0 7832189 8046831 0 0 0 4140603 4317754 11972792 12364585 -105479 458327 10749477 10886799 8126152 9828637 2623325 1058162 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 11459491 0 12641176 Organization is a 147 bed skilled nursing home, which provides long-term nursing and short-term rehabilitative care to elders including medical, nursing, therapy, meals, activities, counseling, housing and other support services. 0 0 0 11459491 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 0 1 13 0 1 314 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 Joseph Syta 0.5 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 James E DeVoe 27 X X X 101731 50106 55642 Amanda Brown 40 X 101700 0 16170 Cassandra Tilliman 30 X 74733 22323 15432 James Payne III 8 X 16237 64946 12908 Scott Maar 27 X 53745 26472 12754 348146 163847 112906 0 0 1 0 Freedom Therapy 304 East Avenue Rochester NY 14607 Therapy Services 621793 1 0 0 0 108103 0 0 0 108103 Skilled Nursing Home Services 623000 12641176 12641176 0 0 0 0 0 0 12641176 2245 0 0 2245 0 0 0 0 0 0 0 0 24675 0 0 0 24675 0 24675 0 0 24675 0 0 0 Staff Cafeteria 722210 26792 0 0 26792 Vending & Guest Meals 722210 7520 0 0 7520 Telephone & Newspaper 812900 9260 0 0 9260 3141 0 0 3141 46713 12822912 12641176 0 73633 481180 340921 140259 0 6065557 5829085 236472 0 173879 166924 6955 0 828128 796095 32033 0 498087 458240 39847 0 20997 0 20997 0 21665 0 21665 0 788209 783776 4433 0 5665 5665 0 0 37194 3173 34021 0 64131 64131 0 0 626610 563973 62637 0 19187 18592 595 0 14652 14652 0 515469 463922 51547 0 91099 0 91099 0 Supplies 1031135 998584 32551 0 NYS Cash Assessment 753638 753638 0 0 Purchased Services/Repairs & Maintenance 243875 197289 46586 0 Other 84228 15483 68745 0 12364585 11459491 905094 0 11351 916249 1315691 1153797 1268455 1058560 88566 83285 15074817 9350213 5759331 5724604 2306083 1950304 10749477 10886799 830185 1063802 77839 31222 5345427 5070687 1872701 3662926 8126152 9828637 X 870789 -688650 800124 792711 952412 954101 2623325 1058162 10749477 10886799 X 458327 -2023490 X 0 1 1 X 0 X 0 153451 22029 120496 108103 404079 10905563 11771508 11910584 11691414 12641176 58920245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10905563 11924959 11932613 11811910 12749279 59324324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59324324 31703 23684 8878 3752 2245 70262 0 0 0 0 0 0 31703 23684 8878 3752 2245 70262 0 0 0 0 0 0 40342 56756 82686 51651 71388 302823 10977608 12005399 12024177 11867313 12822912 59697409 0.99375 0.9937 0.00118 0.0016 X Part III (12)- staff cafeteria, vending, guest meals, telephone, newspaper, misc and other RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 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 12127056 7485657 4641399 0 0 0 0 0 2232069 1720327 511742 0 277676 144229 133447 5724604 Beneficial Interest in Foundation 1746812 Mortgage Net Acquisition Costs 145866 Resident funds Held in Trust 57626 1950304 0 Due to third Party Payors 588906 Due to Affiliated Parties 12988 Pension Liability 2831513 Resident Funds Held in Trust 57626 Workers Compensation Trust Liability 171893 3662926 12822912 12364585 458327 0 0 0 0 -2023490 -2023490 -1565163 12857783 0 0 0 34871 34871 12822912 0 0 0 12822912 12364585 0 0 0 0 0 12364585 0 0 0 12364585 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Endowment Funds are to be held in perpetuity with the income to be transferred annually to Kirkhaven based on the board approved Total Return & Spend policy for use in subsidizing the organization's mission and operation. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 Release of post retirement benefit obligation- $34,871 Change in net assets related to pension plan- $(2,052,638) Change in Benificial interest in Foundation- $ (5,723) SchD_P12_S00_L02d Schedule D, Part XII, Line 2d Release of post retirement benefit obligation-$ 34,871 X X X X 0 0 0 0 0 0 0 1 0 James E DeVoe 101731 50106 0 0 0 0 24054 11849 13225 6514 139010 68469 109938 54149 SchJ_P01_S00_L07 Schedule J, Part I, Line 7 Part I (7)- Bonus paid for performance results as per executive Bonus Program Plan and approval by Executive Committee and Board: Amanda Brown-$7,186 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 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 on the organization's board website. 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 competiveness 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_L05 Form 990, Part XI, Line 5 Release of post-retirement benefits= $34,872 Change in unrestricted net assets related to pension plan= ($ 2,052,638) Change in beneficial interest in Foundation= ($ 5,724) Total other changes= ($ 2,023,490) 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 1 1 1 1 1 0 0 Seniorsfirst Foundation Inc c 108103 Actual dollar value computed using board approved Total Return & Spend Policy Prebyterian Homes & Services of Genesee Valley dba Seniorsfirst n 388650 % of time Seniorsfirst Foundation Inc l 71607 Actual cost