2011-11-12T23:04:37-06:00 2010-12-31 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2010-01-01 133834710 AMSTERDAM NURSING HOME CORP (1992) AMST 2125753322 1060 AMSTERDAM AVE NEW YORK NY 10025 MARK PANCIRER 2125753322 2011-11-10 1 BERNARD GROTELL 2128674000 2010 2016-03-07 17:11:31Z AMSTERDAM NURSING HOME MARK PANCIRER 1060 AMSTERDAM AVE NEW YORK NY 10025 62229456 0 X AMSTERDAMCARES.ORG X 1995 NY AMSTERDAM NURSING HOME PROVIDES ROOM AND BOARD AND MEDICAL CARE FOR THE ELDERLY. 12 12 628 5 0 0 2857 88503 54305948 57503099 113402 90827 317090 287028 54739297 57969457 0 0 0 0 30967441 32933047 0 0 0 23677311 25225127 54644752 58158174 94545 -188717 53525543 51931386 47011684 45340171 6513859 6591215 X TO OPERATE A NOT FOR PROFIT NURSING HOME FACILITY WITH 409 SKILLED NURSING HOME BEDS AND AN ADULT DAY CARE PROGRAM FOR 40 PARTICIPANTS. 0 0 51365075 57503099 THE HOME PROVIDES ROOM AND BOARD AND MEDICAL CARE FOR THE ELDERLY. THE HOME HAS A CAPACITY OF 409 BEDS ALONG WITH AN ADULT DAY CARE PROGRAM WITH A CAPACITY OF 40 REGISTRANTS. IN 2010, THE NURSING HOME HAD 632 ADMISSIONS AND PROVIDED 13,809 ADULT DAY CARE VISITS. THE NURSING HOME HAD AN OCCUPANCY RATE OF 98.53 PERCENT. 51365075 1 1 0 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 79 0 1 628 1 0 0 0 0 0 0 0 0 0 0 X 12 12 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 LAWRENCE B THOMPSON 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 JOSE V TORRES 0.30 X X 0 0 0 REV 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 0 0 0 REV DEACON FRANK L PETERSON JR 0.30 X 0 0 0 DYER S WADSWORTH 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 JAMES DAVIS 30.50 X 353877 268756 44728 GAIL M MEEHAN 35.00 X 101701 0 14883 MARK PANCIRER 32.00 X 200457 42500 41217 STEPHEN LANSEY 35.00 X 158683 0 21879 FLORECITA NEBRES 35.00 X 148410 0 29768 MICHAEL WHITE 30.00 X 125882 0 27506 DR XIAOSHUANG YIN 35.00 X 101562 0 28172 ANTONELLA VALENTINI 35.00 X 108266 0 23669 SALLY NUNEZ 35.00 X 117515 0 14870 JUDITH FENSTER 35.00 X 160734 33077 6304 DR EDWARD WILLIAM DUTTON COLT 0.30 X 0 0 0 1577087 344333 252996 12 0 1 0 UNITED HOME CARE 77-04 BROADWAY ELMHURST NY 11373 NURSING AGENCY 3086352 SECURITAS SECURITY SERVICES 200 WEST 50TH ST NEW YORK NY 10019 SECURITY 433787 HOSPITAL FOR SPECIAL SURGERY 535 EAST 70TH STREET NEW YORK NY 10021 REHAB. SERVICES 425037 WESTCHESTER AMBULETTE SERVICE 193 SO BROADWAY YONKERS NY 10701 AMBULETTE SERVICE 409344 LOEB AND TROPER LLP 655 THIRD AVE NEW YORK NY 10017 ACCOUNTING AND CONSULTING 402823 11 64 88439 88503 MEDICARE/MEDICAID 623000 45288762 45288762 PRIVATE PAY PATIENT CA 623000 9610666 9610666 ADULT DAY CARE 623000 2603671 2603671 57503099 74656 74656 4276170 4259999 16171 16171 16171 ADM. FEE REL. ORG. 623000 151792 151792 GIFT CART & MILLER INN 623000 68552 68552 DIRECT TV FEES 623000 33705 33705 32979 32979 287028 57969457 57503099 0 377855 1115603 1115603 21742463 20256699 1485764 1309220 1289960 19260 7072864 6712896 359968 1692897 1587430 105467 173095 173095 43057 43057 28477 28477 5630174 4800328 829846 10489 2413 8076 6398618 4992918 1405700 1198275 887511 310764 59043 44935 14108 3191009 2808088 382921 2842075 2501026 341049 706214 621468 84746 ASSESSMENT FUND 2522502 2522502 BAD DEBT EXPENSE 2072872 2072872 MISCELLANEOUS 349227 264029 85198 58158174 51365075 6793099 0 1400 1400 16008828 15993128 8834810 7804661 77246 84352 695884 548489 70048558 45311854 26605741 24736704 1301634 2762652 53525543 51931386 5120723 5435304 38741981 37905518 3148980 1999349 47011684 45340171 X 6204296 6290684 309563 300531 6513859 6591215 53525543 51931386 X -188717 266073 X X 0 1 1 X 0 X 31198 37265 158939 2857 88503 318762 49084721 49996515 55666730 54305948 57503099 266557013 49115919 50033780 55825669 54308805 57591602 266875775 0 0 0 266875775 184102 338914 118412 113402 74656 829486 184102 338914 118412 113402 74656 829486 232962 843735 804202 317090 287028 2485017 49532983 51216429 56748283 54739297 57953286 270190278 0.98770 0.98730 0.00310 0.00380 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: GIFT CART & MILLERINN RECOVERY OF EXPENSE PHONE & VENDING MACHINE DISCOUNT ON PURCHASES GENERAL ADMINISTRATION STAR PROGRAM DIRECT TV FEES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 28477 28477 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: DUES PAID TO THE FOLLOWING ORGANIZATIONS THAT HAD LOBBYING EXPENSES: 1199, NYAHSA, CCLC AND NY PRESBYTERIAN. 1432917 1432917 49958287 31110331 18847956 210625 114001 96624 17427057 14087522 3339535 1019672 1019672 24736704 OTHER RECEIVABLES 222431 OTHER ASSETS 110930 DUE FORM THIRD PARTY PAYOR 2429288 SUBVENTION CERTIFICATE FROM ACCHS, INC, 3 2762652 PATIENT FUNDS 413493 DUE TO THIRD PARTIES 1322633 ACCRUED INTEREST PAYABLE 263223 1999349 57969457 58158174 -188717 -23451 289524 266073 77356 58235530 -23451 289524 266073 57969457 0 57969457 58158174 0 58158174 0 58158174 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: UNCERTAINTY IN INCOME TAXES - THE HOME 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 XI, LINE 8 - OTHER ADJUSTMENTS: DISCOUNT ON PURCHASES 289,524. PART XII, LINE 2D - OTHER ADJUSTMENTS: DISCOUNT ON PURCHASES 289,524. PART XIII, LINE 2D - OTHER ADJUSTMENTS: DISCOUNT ON PURCHASES X X X X X X 1 0 0 0 0 0 0 1 0 JAMES DAVIS 243877 268756 110000 0 0 0 17778 0 26950 0 398605 268756 0 0 MARK PANCIRER 200457 42500 0 0 0 0 11985 0 29232 0 241674 42500 0 0 STEPHEN LANSEY 158683 0 0 0 0 0 14974 0 6905 0 180562 0 0 0 FLORECITA NEBRES 148410 0 0 0 0 0 8347 0 21421 0 178178 0 0 0 MICHAEL WHITE 125882 0 0 0 0 0 8701 0 18805 0 153388 0 0 0 JUDITH FENSTER 160734 33077 0 0 0 0 0 0 6304 0 167038 33077 0 0 PART I, LINE 4A GAIL M. MEEHAN RECEIVED $58,758 SEVERANCE PAYMENT PART I, LINE 7 EXECUTIVE COMMITTEE GATHERS COMPARABLE INFORMATION, EVALUATES AND APPROVES A BONUS FOR THE ORGANIZATION'S CEO. 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/ 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 C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -23,451. DISCOUNT ON PURCHASES 289,524. TOTAL TO FORM 990, PART XI, LINE 5: 266,073. FORM 990, PART XI, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. FORM 990, PART VII, SECTION A, COLUMN B: JAMES DAVIS AND MARK PANCIRER DEVOTED THEIR TIME TO A RELATED ORGANIZATION. JAMES DAVIS DEVOTED 19.5 HOURS. MARK PANCIRER DEVOTED 18 HOURS. AMSTERDAM CONSULTING LLC 1060 AMSTERDAM AVENUE NEW YORK NY 10025 134034061 PROVIDING ADMINISTRATIVE AND CONSULTING SERVICES NY 564285 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 SYSTEMS 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) 7 N/A 0 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 1060 AMSTERDAM AVENUE NEW YORK NY 10025 113711764 INDEPENDENT LIVING, ENRICHED HOUSING AND SKILLED NURSING CARE NY 501(C)(3) 9 AMSTERDAM CONTINUING CARE HEALTH SYSTEMS 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