2012-12-20T13:11:24-06:00 2011-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2011-01-01 113109867 ST JOHNLAND NURSING CENTER INC STJO 6312695800 395 SUNKEN MEADOW ROAD KINGS PARK NY 11754 MARY JEAN WEBER 6312695800 2012-12-18 1 FREDERICK H ROTHMAN P01275277 2128674000 2011 2016-02-24 21:20:13Z MARY JEAN WEBER 395 SUNKEN MEADOW ROAD KINGS PARK NY 11754 37356486 0 X WWW.STJOHNLAND.ORG X 1991 NY TO CREATE A CARING AND SUPPORTIVE ENVIRONMENT COMMITTED TO THE HIGHEST STANDARDS OF QUALITY HEALTHCARE. IT SEEKS TO UPHOLD THE PRINCIPLES OF HUMAN DIGNITY AND WORTH, AND AFFIRMS THE RIGHT OF EVERY INDIVIDUAL TO MAINTAIN THE OPTIMUM QUALITY OF LIFE. 19 19 458 85 0 0 200000 200000 34650391 37092815 3894 6805 305058 56866 35159343 37356486 0 0 0 0 23515283 23901694 0 0 0 11183445 11825380 34698728 35727074 460615 1629412 21212504 19796756 25710390 23735154 -4497886 -3938398 TO CREATE A CARING AND SUPPORTIVE ENVIRONMENT COMMITTED TO THE HIGHEST STANDARDS OF QUALITY HEALTHCARE. IT SEEKS TO UPHOLD THE PRINCIPLES OF HUMAN DIGNITY AND WORTH, AND AFFIRMS THE RIGHT OF EVERY INDIVIDUAL TO MAINTAIN THE OPTIMUM QUALITY OF LIFE. 0 0 28985975 33349829 INPATIENT PROGRAM WITH 230 RESIDENT CARE BEDS. 2073264 ADULT DAY CARE PROGRAM FOR 100 REGISTRANTS. 1669722 LONG TERM HOME HEALTHCARE PROGRAM FOR 50 REGISTRANTS. 28985975 1 1 0 0 0 0 0 0 1 1 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 0 1 36 0 458 1 0 0 0 0 0 0 0 0 0 0 X 19 19 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X MICHAEL BARTOLOTTA 6312695800 395 SUNKEN MEADOW RD KINGS PARK NY 11754 X GORDON S HARGRAVES 0.50 X X 0 0 0 JOAN M HEANEY 0.50 X X 0 0 0 PETER FETTEROLF 0.50 X X 0 0 0 VIRGINIA P JACOBSEN 0.50 X X 0 0 0 WILLIAM D KEEN 0.50 X X 0 0 0 CARL H DOERGE JR 0.50 X X 0 0 0 JOHN M PERKINS 0.50 X X 0 0 0 STEPHEN VAN R ULMAN 0.50 X X 0 0 0 WILLIAM A BAUM III 0.50 X X 0 0 0 JOAN P SHEPARD 0.50 X X 0 0 0 SUSAN L WALKER 0.50 X X 0 0 0 TRUDY H CALABRESE 0.50 X X 0 0 0 PHILLIP D CALDERONE 0.50 X 0 0 0 SHARON FUENTES 0.50 X 0 0 0 FREDRIC LAMARCA 0.50 X 0 0 0 HEATHER LANE SPEHR 0.50 X 0 0 0 THOMAS J EKKERS MD 0.50 X 0 0 0 MARY ALICE KOLODNER 0.50 X 0 0 0 BRIAN SWIGGETT 0.50 X 0 0 0 MARY JEAN WEBER 30.00 X 244902 61225 42433 MICHAEL BARTOLOTTA 30.50 X 137072 31459 35240 DR MAUREEN ORSEN 37.50 X 253211 0 39788 LOU ANN RUTHINOSKI 37.50 X 153020 0 34436 DEANNA BAEZ 35.00 X 117702 8407 17236 BETH STEWART 35.00 X 112528 8359 16963 MAUREEN RIZZO 35.00 X 106439 7603 16567 1124874 117053 202663 10 0 1 0 SODEXO PO BOX 360170 PITTSBURGH PA 15251 FOOD SERVICE 629254 CARE & COMFORT 1580 OCEAN AVENUE BOHEMIA NY 11716 TRANSPORTATION 541233 UNITEX 161 SOUTH MACQUESTEN PKWY MT VERNON NY 10550 LAUNDRY SERVICE 170682 LOEB & TROPER LLP 655 3RD AVENUE NEW YORK NY 10017 ACCOUNTING 157973 PERSONAL TOUCH PO BOX 5248 NEW YORK NY 10087 NURSE AGENCY 128901 5 200000 200000 SKILLED NURSING FACILI 623000 33349829 33349829 ADULT DAY CARE 623000 2073264 2073264 LONG TERM HOME HEALTH 623000 1669722 1669722 37092815 6805 6805 OTHER REVENUES 623000 56866 56866 56866 37356486 37092815 0 63671 737582 737582 16485408 14038886 2446522 265204 243510 21694 5197539 4319904 877635 1215961 997088 218873 222708 222708 157973 157973 2793241 2290458 502783 10732 10732 1889383 1549294 340089 1386409 1143402 243007 545619 447408 98211 30651 25134 5517 154279 126509 27770 1459743 1196989 262754 310129 247760 62369 NYS CASH RECEIPT ASSESS 1714155 1405607 308548 BAD DEBT 600000 492000 108000 PRESCRIPTION DRUGS/SUPP 523208 429031 94177 27150 22263 4887 35727074 28985975 6741099 0 197887 165977 1065905 1458201 6011832 6313413 237883 64723 63668 357681 710683 35073332 24370929 11620252 10702403 669880 1224344 144528 21212504 19796756 4739813 3958507 89659 139761 7422425 6830639 3273319 3768861 10185174 9037386 25710390 23735154 X -4540386 -3980898 42500 42500 -4497886 -3938398 21212504 19796756 X 1629412 -1069924 X X 0 1 1 X 1 1 X 3395401 3160859 200000 200000 200000 7156260 33391743 35015994 34744044 34650391 37092815 174894987 36787144 38176853 34944044 34850391 37292815 182051247 0 0 0 182051247 30045 41935 91995 3894 6805 174674 30045 41935 91995 3894 6805 174674 69044 74722 66413 305058 56866 572103 36886233 38293510 35102452 35159343 37356486 182798024 0.99590 0.99560 0.00100 0.00110 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUES AMNESTY PROGRAM INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 42500 42500 42500 42500 42500 42500 1.00000 0 0 452043 452043 19070721 11995552 7075169 13890525 11057832 2832693 1660043 1317545 342498 10702403 LINE OF CREDIT 525000 SECURITY DEPOSITS 90286 ACCRUED PENSION 8422100 9037386 37356486 35727074 1629412 -1069924 -1069924 559488 37356486 0 37356486 0 37356486 35727074 0 35727074 0 35727074 PART IV, LINE 2B: AMOUNTS HELD IN TRUST FOR RESIDENTS. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE CENTER HAS ONE INDIVIDUAL DONOR-RESTRICTED ENDOWMENT FUND ESTABLISHED FOR SUPPORT FOR THE ELDERLY. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2008 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPPLICABLE TAXING AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: ADJUSTMENT TO REFLECT PENSION FUNDED STATUS -1,069,924. X X X X 0 0 0 0 0 0 0 0 0 MARY JEAN WEBER 239907 59977 0 0 4995 1248 12245 3061 21702 5425 278849 69711 0 0 MICHAEL BARTOLOTTA 136902 31420 0 0 170 39 6854 1573 21808 5005 165734 38037 0 0 DR MAUREEN ORSEN 244433 0 0 0 8778 0 12661 0 27127 0 292999 0 0 0 LOU ANN RUTHINOSKI 150659 0 0 0 2361 0 7651 0 26785 0 187456 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 LOU ANN RUTHINOSKY IS THE ADMINISTRATOR'S (MARY JEAN WEBER) SISTER FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT THE DIRECTORS EACH SPRING AT THE ANNUAL MEETING OF EACH CORPORATION. IF A VACANCY OCCURS ON THE BOARD IN THE INTERIM, THE REMAINING DIRECTORS MAY ELECT A SUCCESSOR TO SERVE UNTIL THE NEXT ANNUAL MEETING OF MEMBERS. AT THE NEXT ANNUAL MEETING, THE MEMBERS ELECT DIRECTORS FOR SPECIFIC TERMS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS HAVE THE RIGHTS AND DUTIES PROVIDED BY STATUTE UNDER THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW WHICH ARE NOT UNLIKE THOSE OF STOCKHOLDERS IN A TRADITIONAL FOR PROFIT CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING WITH THE IRS, COPIES WILL BE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW. QUESTIONS AND COMMENTS WILL BE FOWARDED TO THE CEO, WHO WILL THEN DISCUSS WITH THE PREPARER ANY CHANGES THAT MAY NEED TO BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF ST. JOHNLAND NURSING CENTER, INC. THAT ALL DIRECTORS, OFFICERS, EMPLOYEES, AGENTS AND CONTRACTORS AVOID ANY ALL ACTIVITIES THAT CONFLICT WITH OR APPEAR TO CONFLICT WITH THEIR RESPONSIBILITIES AND OBLIGATIONS TO ST. JOHNLAND. CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE REQUIRED TO BE SIGNED BY EMPLOYEES. WHEN A CONFLICT ARISES, IT IS BROUGHT TO THE BOARD'S ATTENTION TO BE DISCUSSED. THE BOARD MEMBER WHO HAS THIS CONFLICT MUST RECUSE THEMSELVES FROM PARTICIPATING IN ANY DISCUSSION RELATED TO THE MATTER. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. HOURS WORKED FOR RELATED ORGANIZATIONS: FORM 990, PART VII, LINE 1A: MARY JEAN WEBER - 7.5 HOURS MICHAEL BARTOLOTTA - 7 HOURS DEANNA BAEZ - 2.5 HOURS BETH STEWART - 2.6 HOURS MAUREEN RIZZO - 2.5 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: ADJUSTMENT TO REFLECT PENSION FUNDED STATUS -1,069,924. TOTAL TO FORM 990, PART XI, LINE 5: -1,069,924. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SOCIETY OF ST JOHNLAND 395 SUNKEN MEADOW RD KINGS PARK NY 11758 111890580 FUND RAISING NY 501(C)(3) LINE 7 N/A 0 ST JOHNLAND RESIDENCES II INC 395 SUNKEN MEADOW RD KINGS PARK NY 11758 200316499 TO ESTABLISH, OPERATE AND MAINTAIN AN ADULT RESIDENTIAL FACILITY NY 501(C)(3) LINE 11A, I N/A 0 0 0 1 0 1 0 0 0 0 0 1 1 0 1 0 0 0 0