2011-11-15T18:32:23-06:00 2010-12-31 JH COHN LLP 1212 6TH AVENUE NEW YORK NY 10036 990 2010-01-01 237216197 JAMAICA HOSPITAL NURSING HOME COMPANY INC JAMA 7182065101 89-40 135TH STREET JAMAICA NY 114182898 MOUNIR F DOSS 7182065101 2011-11-15 1 THOMAS LANNING 2122970400 2010 2016-03-07 17:11:31Z X TRUMP PAVILION MOUNIR F DOSS 89-40 135TH STREET JAMAICA NY 114182898 29293057 0 X WWW.TRUMPPAVILION.ORG X 1972 NY THE JAMAICA HOSPITAL NURSING HOME CO INC (THE NURSING HOME) IS A 224 BED, NOT FOR PROFIT INSTITUTION PROVIDING SKILLED NURSING CARE TO THE COMMUNITY. 6 5 287 25 0 0 0 0 25161182 29237176 -347864 6377 54424 49504 24867742 29293057 0 0 0 0 15506294 16475366 0 0 0 13507354 19703442 29013648 36178808 -4145906 -6885751 57389129 54676348 63132141 67259825 -5743012 -12583477 THE JAMAICA HOSPITAL NURSING HOME CO INC (THE NURSING HOME) IS A 224 BED, NOT FOR PROFIT INSTITUTION PROVIDING SKILLED NURSING CARE TO THE COMMUNITY. 0 0 32234375 29237176 224 BEDS PROVIDING SKILLED NURSING CARE AND REHABILITATION TO THE COMMUNITY. 32234375 1 0 0 0 0 0 0 0 0 1 0 0 0 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 1 120 0 1 287 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X MANZAR SASSANI 7182066291 89-40 135TH STREET JAMAICA NY 11418 NEIL FOSTER PHILLIPS 1.00 X X 0 0 0 ROBERT KOOP 1.00 X X 0 0 0 KATHRINE MASSELL 1.00 X 0 0 0 WALTER J COOK 1.00 X 0 0 0 MARK A RICCA 1.00 X X 0 0 0 DAVID ROSEN 80.00 X X 0 1737965 71372 GREGORY BRADLEY 35.00 X 292375 0 57685 TERESA FLORES RN 35.00 X 163470 0 46748 ANTHONY DIMARIA MD 17.50 X 220753 0 49521 VARANO KHALIKAPRASAD RN 37.50 X 133619 0 17082 CHRISTINE PENNINGTON 35.00 X 139350 0 17284 949567 1737965 259692 8 0 1 0 SODEXHO 500 ROSS STREET PITTSBURGH PA 15265 FOOD SERVICES 903135 OCEANSIDE 2525 LONG BEACH ROAD OCEANSIDE NY 11572 LAUNDRY SERVICES 322169 HEALTHPRO MANAGEMENT SERVICES 10600 YORK ROAD COCKEYSVILLE MD 21030 REHAB SERVICES 264424 ARAMARK MANAGEMENT SERVICES 2300 WARRENVILLE ROAD DOWNERS GROVE IL 60515 HOUSEKEEPING SERVICES 236682 METROPOLITAN THERAPY SERVICES 8900 VAN WYCK EXPRESSWAY JAMAICA MN 11418 THERAPY SERVICES 189958 8 SKILLED NURSING FACIL. 623000 29237176 29237176 29237176 6377 6377 TELEPHONE INCOME 900099 17772 17772 MISCELLANEOUS REV. 900099 17652 17652 PARKING FACILITIES REV 900099 14080 14080 49504 29293057 29254828 0 38229 11755975 10840131 915844 1086705 1032370 54335 2727881 2591487 136394 904805 859565 45240 69405 69405 121952 121952 8624843 7101800 1523043 51028 51028 52213 326 51887 534582 534582 629 114 515 7672 4140 3532 2159206 1943285 215921 2774712 2635976 138736 406573 365054 41519 MEDICAL SUPPLIES 1622035 1476379 145656 CASH ASSESSMENT 1245551 1245551 BAD DEBTS 1024040 1024040 ASSESS. AND PENALTIES 458904 458904 THERAPIST FEES 279352 279291 61 270745 249256 21489 36178808 32234375 3944433 0 2432037 1117145 1525103 1843954 4097321 4206863 579284 580792 48724460 4032463 47069028 44691997 700000 450000 986356 1785597 57389129 54676348 5812370 2810769 38662550 42168392 18657221 22280664 63132141 67259825 X -5743012 -12583477 -5743012 -12583477 57389129 54676348 X -6885751 45286 X X 0 1 1 X 1 1 X 683297 683297 45030408 3482451 41547957 3010755 550012 2460743 44691997 FUNDS IN TRUST FOR RESIDENTS 93769 DUE TO JAMAICA HOSPITAL 22025137 DUE TO MEDISYS HEALTH NETWORK 161758 22280664 29293057 36178808 -6885751 45286 45286 -6840465 29293057 0 29293057 0 29293057 36178808 0 36178808 0 36178808 PART XI, LINE 8 - OTHER ADJUSTMENTS: CUMULATIVE EFFECT OF ACCOUNTING CHANGE 45,286. 0 0 0 0 0 0 0 0 0 DAVID ROSEN 0 1378292 0 0 0 359673 0 57756 0 13616 0 1809337 0 0 GREGORY BRADLEY 278874 0 0 0 13501 0 45114 0 12571 0 350060 0 0 0 TERESA FLORES RN 161284 0 0 0 2186 0 35090 0 11658 0 210218 0 0 0 ANTHONY DIMARIA MD 209192 0 0 0 11561 0 38765 0 10756 0 270274 0 0 0 VARANO KHALIKAPRASAD RN 133619 0 0 0 0 0 5524 0 11558 0 150701 0 0 0 CHRISTINE PENNINGTON 139303 0 0 0 47 0 5707 0 11577 0 156634 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 MEDISYS HEALTH NETWORK IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MEDISYS HEALTH NETWORK, AS SOLE MEMBER CAN APPOINT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS PREPARED BY OUTSIDE ACCOUNTANT AND REVIEWED INTERNALLY BY MANAGEMENT, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE TRUSTEES VIA EMAIL AND OR A BOARD MEETING. ONCE THE REVIEW OF THE FORM 990 HAS BEEN COMPLETED TO THE BOARD'S SATISFACTION AND THE BOARD IS COMFORTABLE WITH ITS CONTENTS, THE FORM 990 IS THEN MAILED TO ALL BOARD MEMBERS AS READY TO FILE, SUBSEQUENTLY IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISFY THE CRITERIA TO BE CONSIDERED AN "INTERESTED PERSON" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE AUDIT & COMPLIANCE COMMITTEE REVIEWS THE SUBMISSIONS FOR CONFLICTS AND THE DEPARTMENT OF INTERNAL AUDIT MONITORS COMPLIANCE. EXECUTIVE COMPENSATION POLICY - THE BOARD OF MEDISYS HEALTH NETWORK HAS CREATED AN INDEPENDENT COMPENSATION COMMITTEE WHOSE CHARGE IS TO REVIEW AND APPROVE THE COMPENSATION OF ALL INDIVIDUALS WHO MEET THE REQUIREMENTS OF A DISQUALIFIED PERSON FOR INTERMEDIATE SANCTION. THIS COMMITTEE IS EMPOWERED TO APPROVE COMPENSATION FOR ALL ENTITIES WITHIN THE MEDISYS HEALTH NETWORK SYSTEM. THE COMMITTEE HAS RETAINED AN INDEPENDENT COMPENSATION CONSULTANT TO APPLY ITS STANDARD METHODOLOGY FOR DETERMINATION OF APPROPRIATE EXECUTIVE COMPENSATION AND BENEFIT LEVELS FOR EXECUTIVES. IT IS POLICY TO TARGET THE TOTAL COMPENSATION (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) OF EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES IN CONSULTATION WITH AN INDEPENDENT COMPENSATION CONSULTANT IN A MANNER THAT COMPLIES WITH THE INTERMEDIATE SANCTION REGULATIONS AND OTHER FEDERAL AND STATE LAWS AND REGULATIONS. THE COMMITTEE SHALL APPROVE BASE SALARIES FOR EXECUTIVES AND ANY DISQUALIFIED INDIVIDUALS BASED UPON THE AMOUNTS PAID TO SIMILARLY SITUATED EXECUTIVES WITHIN THE RELEVANT MARKETPLACE, WITH POSSIBLE ADJUSTMENTS MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. THE CEO SHALL RECOMMEND TO THE COMPENSATION COMMITTEE ANY ADJUSTMENTS TO THE BASE SALARIES OF EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CUMULATIVE EFFECT OF ACCOUNTING CHANGE 45,286. TOTAL TO FORM 990, PART XI, LINE 5: 45,286. FORM 990, PART XI, LINE 2C: THE OVERSIGHT AND SELECTION PROCESSES DID NOT CHANGE FROM THE PRIOR YEAR. FORM 990, PART VII, SECTION A, LINE 1B: FOR DAVID ROSEN, PRESIDENT & CEO, THE HOURS REPORTED REFLECT TOTAL TIME WORKED AS OFFICERS FOR ALL OF THE RELATED ORGANIZATIONS SHOWN ON SCHEDULE R. TOTAL COMPENSATION IS REPORTED ON EACH ENTITY'S FORM 990. COST ALLOCATION AMONG THE ENTITIES IS PERFORMED CONSISTENT WITH ACCOUNTING RULES AND APPLICABLE COST ALLOCATION METHODOLOGIES. FORM 990, PART VII, COLUMN C: MANAGEMENT HAS IN THE PREPARATION OF ITS FORM 990 REVIEWED PERSONNEL IN THE INSTITUTION TO SEE IF ANYONE MEETS THE CRITERIA ESTABLISHED TO BE CONSIDERED A "KEY EMPLOYEE" FOR IRS PURPOSES. IT IS THE CONTENTION OF MANAGEMENT THAT NO EMPLOYEE FULFILLS ANY OF THE SITUATIONS UNDER THE RESPONSIBILITY TEST ESTABLISHED BY THE IRS TO MEET TITLE OF KEY EMPLOYEE. THEREFORE, PART VII OF FORM 990 DOES NOT HAVE ANY INDIVIDUALS WHO WOULD BE CONSIDERED A "KEY EMPLOYEE". FORM 990, PART IV, LINE 20: THE ORGANIZATION RECEIVED ITS PUBLIC EXEMPTION STATUS UNDER A HOSPITAL SECTION 170(B)(1)(A)(III), HOWEVER, ITS OPERATING CERTIFICATE DOES NOT CLASSIFY THEM AS A HOSPITAL FOR PURPOSES OF FILING SCHEDULE H. 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