2011-11-11T14:56:40-06:00 2010-12-31 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2010-01-01 113711764 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC AMST 2125753322 1060 AMSTERDAM AVENUE NEW YORK NY 10025 MARK PANCIRER 2125753322 2011-11-11 1 BERNARD GROTELL 2128674000 2010 2016-03-07 17:11:31Z MARK PANCIRER 1060 AMSTERDAM AVENUE NEW YORK NY 10025 813530 0 X WWW.AMSTERDAMCARES.COM X 2004 NY TO PROVIDE INDEPENDENT LIVING, ENRICHED HOUSING AND SKILLED NURSING CARE 10 10 55 0 0 0 0 0 0 396438 0 413872 0 3220 0 813530 0 0 0 0 0 738725 0 0 0 0 10437127 0 11175852 0 -10362322 337254946 360406785 338308010 371822171 -1053064 -11415386 X AHCCRC, INC. HAS UNDERTAKEN A PROJECT INVOLVING ACQUISITION, CONSTRUCTION, FURNISHING, AND EQUIPPING OF A NEW CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE AMSTERDAM AT HARBORSIDE, LOCATED IN PORT WASHINGTON, NEW YORK, WHICH INCLUDES: 226 INDEPENDENT LIVING APARTMENTS (THE RESIDENTIAL UNITS), 26 ENRICHED HOUSING UNITS AND 18 ENRICHED HOUSING WITH DEMENTIA UNITS (THE ENRICHED HOUSING CENTER), 56 SKILLED NURSING BEDS (THE NURSING CENTER) AND RELATED COMMON AREAS AND AMENITIES AND RELATED INFRASTRUCTURE (COLLECTIVELY, THE COMMUNITY). CONSTRUCTION BEGAN IN JANUARY 2008 AND WAS COMPLETED IN JANUARY 2011. AHCCRC, INC. PLANS TO ADD THREE INDEPENDENT LIVING APARTMENTS, PENDING APPROVAL. INITIAL OCCUPANCY OCCURRED IN AUGUST 2010. 0 0 7436764 396438 TO PROVIDE INDEPENDENT LIVING, ENRICHED HOUSING AND SKILLED NURSING CARE 7436764 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 8 0 1 55 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X MARK PANCIRER 2125753322 570 7TH AVENUE 6TH FLOOR NEW YORK NY 10018 X LAWRENCE B THOMPSON JR 2.00 X X 0 0 0 GEORGE L VAN AMSON 0.50 X X 0 0 0 JOSEPH C HOOPES JR 1.00 X X 0 0 0 THE REVEREND JAMES G CALLAWAY JR 0.30 X 0 0 0 ISABEL M CARDEN 0.50 X 0 0 0 JAY H MCDOWELL 0.30 X X 0 0 0 REV DEACON FRANK L PETERSON JR 0.30 X 0 0 0 JAMES J CAMPBELL 0.30 X 0 0 0 DR KAREN M HOPKINS 0.30 X 0 0 0 FRANCES R OLIVIERI 0.30 X 0 0 0 MARGARET MARY MINICHINI 37.50 X 55956 0 7030 JAMES DAVIS 1.00 X 0 527629 139732 MARK PANCIRER 1.00 X 0 230457 53717 55956 758086 200479 0 0 1 0 GREYSTONE MANAGEMENT SERVICES COMPANY LL 222 LAS COLINAS BLVD SUITE 2100 IRVING TX 75039 MANAGEMENT ADVISORY SERVICES 113119 1 PRIVATE AND OTHER 623000 201011 201011 ENTRANCE FEES 623000 191804 191804 MEAL 623000 3623 3623 396438 413872 413872 GUEST APARTMENTAL RENT 623000 3120 3120 BISTRO 623000 75 75 MAINTENANCE SERVICE 623000 25 25 3220 813530 396438 0 417092 55956 55956 515019 434313 80706 114497 5715 108782 53253 53253 331920 331920 333 333 50000 50000 724428 83776 640652 6853 6853 28016 28016 6668 6668 747240 747240 24820 51 24769 4247373 4035004 212369 2699086 1937304 761782 45414 45414 PREOPENING EXPENSES 1377029 1377029 DINING SERVICES 116169 116169 TRANSPORTATION 25834 25834 RESIDENT SERVICES 5944 5944 11175852 7436764 3739088 0 17181927 19856576 94730987 66846809 4734 4734 147308 11823 52380 322339 249511918 2039267 200938261 247472651 24346657 25744545 337254946 360406785 7374379 3381100 296131267 296137851 17044754 58559569 17757610 13743651 338308010 371822171 X -1053064 -11415386 -1053064 -11415386 337254946 360406785 -10362322 0 X X 0 1 1 X 0 X X 0 0 0 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 113711764 1 1 1 1 0 1 0 OTHER INCOME 0 0 22353895 22353895 215605085 1786082 213819003 1047813 44372 1003441 10505125 208813 10296312 247472651 ADVERTISING AND MARKETING COSTS 10580820 DEFERRED FINANCING COSTS 15163725 25744545 SUBORDINATE NOTE-ACCHS, INC 3000000 RETAINAGE PAYABLE 3101145 ACCRUED INTEREST PAYABLE 7642506 13743651 813530 11175852 -10362322 0 -10362322 813530 0 813530 0 813530 11175852 0 11175852 0 11175852 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: AHCCRC, INC. HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2007 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. 0 0 0 0 0 0 0 0 0 JAMES DAVIS 0 417629 0 110000 0 0 0 0 0 139732 0 667361 0 0 MARK PANCIRER 0 230457 0 0 0 0 0 0 0 53717 0 284174 0 0 NASSAU COUNTY INDUSTRIAL DEV AGENCY 112559657 2007-12-20 271231266 ACQUISITION AND CONSTRUCTION OF FACILITY 0 0 0 286925405 50336498 43616233 5316248 964288 3033443 208478534 6876399 0 0 0 1 0 1 1 LEHMAN BROTHERS 2.700000000000 0 0 1 SEE PART V 1 1 0 SCHEDULE K SUPPLENTAL INFORMATION PART I, LINE A, COLUMN C: SERIES A-63166UAF8, SERIES B-63166UAA9, SERIES C-63166UAB7 PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 4B: PROJECT FUND-AEGON, CAPITALIZED INTEREST FUND-EAGON, RESERVE FUND-RBC CAPITAL MARKETS PART IV, COLUMN A, LINE 4C:PROJECT FUND-2.6 YEARS, CAPITALIZED INTEREST FUND-3 YEARS, RESERVE FUND-19.9 YEARS FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 AS PREPARED BY LOEB & TROPER LLP, ACCOUNTING FIRM, IS PROVIDED TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENTS AND TO THE FULL BOARD FORM 990, PART VI, SECTION B, LINE 12C ANY POTENTIAL CONFLICTS OF INTERESTS ARE DISCUSSED WITH BOARD MEMBERS. IF A CONFLICT EXISTS THE PERSON IS RECUSED FROM VOTING ON SAID MATTER. ANNUALLY, SENIOR MANAGEMENT SIGNS A DOCUMENT REQUIRING THEM TO IDENTIFY ANY POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A FORM 990, PART VI, LINE 15: THE ORGANIZATION HAS A PROCESS TO DETERMINE COMPENSATION FOR THE CEO WHICH INCLUDES A REVIEW BY A COMPENSATION AND BENEFITS CONSULTANT, THE USE OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN THE DELIBERATION AND THE FINAL DECISION. THIS PROCESS WAS LAST UNDERTAKEN IN 2010. COMPENSATION OF OTHER KEY EMPLOYEES IS BASED ON AN INFORMAL REVIEW OF COMPARABLE DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. COMPENSATION FROM RELATED ENTITIES FORM 990, PART VII, SECTION A, JAMES DAVIS AND MARK PANCIRER DEVOTED TIME TO RELATED ORGANIZATIONS. EACH DEVOTED 50 HOURS TO RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AMSTERDAM CONSULTING LLC 1060 AMSTERDAM AVENUE NEW YORK NY 10025 134034061 ADMINISTRATIVE AND CONSULTING SERVICES TO OTHER FACILITIES NY 540285 784706 N/A AMSTERDAM SERVICES CORP 1060 AMSTERDAM AVENUE NEW YORK NY 10025 133902473 PROVIDING ADMINISTRATIVE AND CONSULTING SERVICES TO HEALTHCARE FACILITIES NY 501(C)(3) 9 AMSTERDAM CONTINUING CARE HEALTH SYSTEM 0 AMSTERDAM CONTINUING CARE HEALTH SYSTEMS 1060 AMSTERDAM AVENUE NEW YORK NY 10025 134034061 PROVIDING ADVICE, INFORMATION & MONETARY CONTRIBUTIONS TO ELDERLY & DISABLED NY 501(C)(3) 9 N/A 0 AMSTERDAM NURSING HOME CORP (1992) 1060 AMSTERDAM AVENUE NEW YORK NY 10025 133834710 PROVIDING SKILLED NURSING HOME BEDS AND ADULT DAY CARE SERVICES FOR SENIORS NY 501(C)(3) 9 N/A 0 AMSTERDAM SERVICES CORP 2001 1060 AMSTERDAM AVENUE NEW YORK NY 10025 134184082 PROVIDING NURSING HOME CONSULTING AND ADMIN. OVERSITE. NY N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0