AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC (EIN 13-4034061)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-12
- IRS object ID
- 201103179349300800
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-12T23:04:37-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOEB & TROPER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 THIRD AVENUE 12TH FLOOR | AddressLine1 |
| City | NEW YORK | City |
| State | NY | State |
| ZIP Code | 10017 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 134034061 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | AMST | NameControl |
| Phone | 2125753322 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVENUE | AddressLine1 |
| City | NEW YORK | City |
| State | NY | State |
| ZIP Code | 10025 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES DAVIS | Name |
| Title | SENIOR VICE PRESIDENT/CFO | Title |
| Phone | 2125753322 | Phone |
| Date Signed | 2011-11-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BERNARD GROTELL | Name |
| Phone | 2128674000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARK PANCIRER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVENUE | AddressLine1 |
| City | NEW YORK | City |
| State | NY | State |
| ZIP Code | 10025 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 790867 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.AMSTERDAMCARES.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | AMSTERDAM CONTINUING CARE HEALTH SYSTEM, INC. (HEALTH SYSTEM) IS THE SOLE CORPORATE MEMBER OF AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY, INC. (RETIREMENT COMMUNITY), WHICH WAS ESTABLISHED AS A NOT-FOR-PROFIT CORPORATION ON JANUARY 30, 2004. THE RETIREMENT COMMUNITY IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 263457 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 208147 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 540000 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 19430 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9344 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2694 | OtherRevenuePriorYear |
| Other Revenue Current Year | 9154 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 285581 | TotalRevenuePriorYear |
| Total Revenue Current Year | 766645 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 4569 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 693 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 169622 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 215795 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 40650 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9577 | OtherExpensePriorYear |
| Other Expenses Current Year | 5156 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 183768 | TotalExpensesPriorYear |
| Total Expenses Current Year | 221644 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 101813 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 545001 | RevenuesLessExpensesCY |
| Total Assets BOY | 1283807 | TotalAssetsBOY |
| Total Assets EOY | 1835076 | TotalAssetsEOY |
| Total Liabilities BOY | 2272827 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2281654 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -989020 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -446578 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PRIMARY PURPOSE OF THE ORGANIZATION IS TO OBTAIN CONTRIBUTIONS, GRANTS AND HOLD SPECIAL EVENTS TO SUPPORT THE AMSTERDAM NURSING HOME. ANNUALLY, THE ORGANIZATION HOLDS A GOLF OUTING EVENT. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 173628 | Expense |
| Grants | 693 | Grants |
| Revenue | 540000 | Revenue |
| Description | SUPPORT OF SERVICES FOR THE ELDERLY | Description |
| Total Program Service Expense | 173628 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 2 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARK PANCIRER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2125753322 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 570 SEVENTH AVENUE 6TH FLOOR | AddressLine1 |
| City | NEW YORK | City |
| State | NY | State |
| ZIP Code | 10018 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| LAWRENCE B THOMPSON | ||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |
| GEORGE L VAN AMSON | ||||||
| VICE CHAIRMAN | 0.30 | X | 0 | 0 | 0 | |
| JOSEPH C HOOPES JR | ||||||
| TREASURER | 0.50 | X | 0 | 0 | 0 | |
| JOSE V TORRES | ||||||
| SECRETARY | 0.30 | X | 0 | 0 | 0 | |
| THE REVEREND JAMES G CALLAWAY JR | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| ISABEL M CARDEN | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| KAREN M HOPKINS MD | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| JAY H MCDOWELL | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| THE REVEREND DEACON FRANK L PETERSO | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| JAMES J CAMPBELL | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| DYER S WADSWORTH | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| FRANCES R OLIVIERI | ||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |
| JAMES DAVIS | ||||||
| PRESIDENT/CHIEF EXECUTIVE OFFICER | 15.50 | 173752 | 448881 | 44728 | X | |
| MARK PANCIRER | ||||||
| SENIOR VICE PRES./ CFO | 10.00 | 30000 | 212957 | 41218 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 203752 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 661838 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 85946 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 79500 | FundraisingEvents |
| All Other Contributions | 128647 | AllOtherContributions |
| Total Contributions | 208147 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MANAGEMENT SERVICES TO | Description |
| Business Code | 561000 | BusinessCode |
| Total Revenue Column | 540000 | TotalRevenueColumn |
| Related Or Exempt Function Income | 540000 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 540000 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9344 | TotalRevenueColumn |
| Exclusion | $9,344 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 32000 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 79500 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 24222 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7778 | TotalRevenueColumn |
| Exclusion | $7,778 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 1376 | TotalRevenueColumn |
| Exclusion | $1,376 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1376 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 766645 | TotalRevenueColumn |
| Related Or Exempt Function Income | 540000 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $18,498 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 693 | Total |
| Program Services | 693 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 203752 | Total |
| Program Services | 163000 | ProgramServices |
| Management And General | 6955 | ManagementAndGeneral |
| Fundraising | 33797 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12043 | Total |
| Program Services | 9634 | ProgramServices |
| Management And General | 411 | ManagementAndGeneral |
| Fundraising | 1998 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1500 | Total |
| Fundraising | 1500 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1529 | Total |
| Program Services | 301 | ProgramServices |
| Fundraising | 1228 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1827 | Total |
| Fundraising | 1827 | Fundraising |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS | Description |
| Total | 300 | Total |
| Fundraising | 300 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221644 | Total |
| Program Services | 173628 | ProgramServices |
| Management And General | 7366 | ManagementAndGeneral |
| Fundraising | 40650 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1093975 | BOY |
| EOY | 1064721 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1827 | BOY |
| EOY | 6044 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121594 | BOY |
| EOY | 121594 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66411 | BOY |
| EOY | 642717 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1283807 | BOY |
| EOY | 1835076 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 14054 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2272827 | BOY |
| EOY | 2267600 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2272827 | BOY |
| EOY | 2281654 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -989020 | BOY |
| EOY | -446578 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -989020 | BOY |
| EOY | -446578 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1283807 | BOY |
| EOY | 1835076 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 545001 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2559 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 252516 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 247461 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 189305 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 263457 | CurrentTaxYearMinus1Year |
| Current Tax Year | 208147 | CurrentTaxYear |
| Total | 1160886 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 252516 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 247461 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 189305 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 263457 | CurrentTaxYearMinus1Year |
| Current Tax Year | 208147 | CurrentTaxYear |
| Total | 1160886 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 479964 | AmountsSubstContributorsTotal |
| Public Support Total170 | 680922 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9432 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 15512 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 18955 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 19430 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9344 | CurrentTaxYear |
| Total | 72673 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 46000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 24684 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 279000 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 33963 | CurrentTaxYearMinus1Year |
| Current Tax Year | 33376 | CurrentTaxYear |
| Total | 417023 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 1650582 | TotalSupport |
| Gross Receipts From Admissions Etc | 540000 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.41250 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.36850 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISC. INCOME SPECIAL EVENT MANAGEMENT SERVICE INCOME | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INVESTMENT IN AMSTERDAM SERVICES CORP. (2001) | Description |
| Book Value | 121594 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 121594 | TotalOfBookValueProgramRelated |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| SUBVENTION | 1 |
| OTHER RECEIVABLES | 550706 |
| CONSTRUCTION IN PROGRESS | 85390 |
| DUE FROM GERMAN MASONIC HOME CORPORATION | 6620 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 642717 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SUBVENTION -SUBORDINATE NOTE-ACCHS, INC | Description |
| Amount | $2,267,600 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2267600 | TotalOfAmounts |
| Total Revenue | 766645 | TotalRevenue |
| Total Expenses | 221644 | TotalExpenses |
| Excess Or Deficit For Year | 545001 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -2559 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -2559 | TotalAdjustments |
| Excess Or Deficit Per FS | 542442 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1819003 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 1076358 | OtherRevenues |
| Revenue Not Rptd F990 | 1076358 | RevenueNotRptdF990 |
| Revenue Subtotal | 742645 | RevenueSubtotal |
| Other Revenues Not Included | 24000 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 24000 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 766645 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11573030 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 11351386 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 11351386 | ExpensesNotRptdF990 |
| Expenses Subtotal | 221644 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 221644 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | UNCERTAINTY IN INCOME TAXES - HEALTH SYSTEM 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. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | DIRECT COST OF SPECIAL EVENT 24,222. UNREALIZED LOSS -2,559. RELATED ENTITY REVENUE 1,054,695. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | TRANSFER FROM AMSTERDAM SERVICE CORP. 24,000. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | DIRECT COST OF SPECIAL EVENT 24,222. RELATED ENTITY EXPENSES 11,327,164. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | ANNUAL GOLF OUTING | NameOfEvent1 |
| Gross Receipts Event1 | 111500 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 79500 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 32000 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 13099 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 9303 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 1820 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 111500 | GrossReceiptsTotal |
| Charitable Contributions Total | 79500 | CharitableContributionsTotal |
| Gross Revenue Total Events | 32000 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 13099 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 9303 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 1820 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 24222 | DirectExpenseSummaryEvents |
| Net Income Summary | 7778 | NetIncomeSummary |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES DAVIS | |||||||||||||
| 173752 | 315482 | 0 | 110000 | 0 | 23399 | 0 | 17778 | 0 | 26950 | 173752 | 493609 | 0 | 0 |
| MARK PANCIRER | |||||||||||||
| 30000 | 202719 | 0 | 0 | 0 | 10238 | 0 | 11985 | 0 | 29233 | 30000 | 254175 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| 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. | |
| 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 12C | |
| FORM 990, PART VI, LINE 15: THE ORGANIZATION HAS A PROCESS TO DETERMINE COMPENSATION FOR THE CEO/ EXECUTIVE DIRECTOR 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. THIS PROCESS INCLUDES A REVIEW OF TOTAL COMPENSATION INCLUDING BONUS CONSIDERATION. COMPENSATION OF OTHER KEY EMPLOYEES IS BASED ON AN INFORMAL REVIEW OF COMPARABLE DATA. | FORM 990, PART VI, SECTION B, LINE 15A | |
| THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| JAMES DAVIS AND MARK PANCIRER DEVOTED THEIR TIME TO A RELATED ORGANIZATION. JAMES DAVIS DEVOTED 19 HOURS AND MARK PANCIRER 30 HOURS. | FORM 990, PART VII, SECTION A, COLUMN B: | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -2,559. | FORM 990, PART XI, LINE 5: |
| THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C: | |
| FORM 990, PART VI, LINE 10A, 12, 13,AND 14: THE ORGANIZATION DOES NOT HAVE WRITTEN POLICIES AND PROCEDURES GOVERNING THE ACTIVITIES. HOWEVER, AMSTERDAM CONTINUING CARE HEALTH SYSTEM FOLLOWS THE POLICIES OF RELATED ORGANIZATION OF AMSTERDAM NURSING HOME CORP (1992). |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| AMSTERDAM HOUSE CCRC LLC | |||||||||
| 1060 AMSTERDAM AVENUE | NEW YORK | NY | 10025 | 412126554 | PROVIDING SKILLED NURSING HOME CARE AND LIVING PROGRAMS TO ELDERLY | NY | 813530 | 360406785 | N/A |
| AMSTERDAM CONSULTING LLC | |||||||||
| 1060 AMSTERDAM AVENUE | NEW YORK | NY | 10025 | 134034061 | ADMINISTRATIVE AND CONSULTING SERVICES TO OTHER FACILITIES | NY | 540285 | 784706 | N/A |
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| AMSTERDAM SERVICE CORP(S) | ||||||||||
| 1060 AMSTERDAM AVENUE | NEW YORK | NY | 10025 | 133902473 | PROVIDING ADMINISTRATIVE AND CONSULTING SERVICES TO HEALTHCARE FACILITIES | NY | 9 | 501(C)(3) | 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 | 9 | 501(C)(3) | N/A | 0 |
| AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC | ||||||||||
| 1060 AMSTERDAM AVENUE | NEW YORK | NY | 10025 | 113711764 | PROVIDING SKILLED NURSING HOME, HOME FOR INDEPENDENT LIVING FOR SENIORS | NY | 9 | 501(C)(3) | N/A | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMSTERDAM SERVICES CORP 2001 | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1060 AMSTERDAM AVENUE | AddressLine1 |
| City | NEW YORK | City |
| State | NY | State |
| ZIP Code | 10025 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 134184082 | EIN |
| Primary Activity | ADMINISTRATIVE AND CONSULTING SERVICES TO OTHER FACILITIES | PrimaryActivity |
| Legal Domicile State | NY | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 241165 | ShareOfTotalIncome |
| Share Of EOY Assets | 144879 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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