EMPIRE HOME INFUSION SERVICE INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
EMPIRE HOME INFUSION SERVICE INC (EIN 14-1795732)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-08-10
IRS object ID
201122239349300502
Schema version
2010v3.2
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

FieldValueIRS element (for citing)
Timestamp2011-08-10T11:16:56-07:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141795732EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Empire Home Infusion Services IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlEMPINameControl
Phone5182746200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Blacksmith DriveAddressLine1
CityMaltaCity
StateNYState
ZIP Code12020ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRichard PettersonName
TitleCFOTitle
Date Signed2011-08-10DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts8044434GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.NEHEALTH.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionEmpire Home Infusion Services, Inc. provides infusion therapy service, respiratory therapy services and home medical services and equipment to its patients.ActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7664115ProgramServiceRevenuePriorYear
Program Service Revenue CY8015185ProgramServiceRevenueCY
Investment Income Prior Year-2975InvestmentIncomePriorYear
Investment Income Current Year-5842InvestmentIncomeCurrentYear
Other Revenue Prior Year31547OtherRevenuePriorYear
Other Revenue Current Year35091OtherRevenueCurrentYear
Total Revenue Prior Year7692687TotalRevenuePriorYear
Total Revenue Current Year8044434TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2631982SalariesEtcPriorYear
Salaries Etc Current Year2930213SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4855713OtherExpensePriorYear
Other Expenses Current Year4903415OtherExpensesCurrentYear
Total Expenses Prior Year7487695TotalExpensesPriorYear
Total Expenses Current Year7833628TotalExpensesCurrentYear
Revenues Less Expenses Prior Year204992RevenuesLessExpensesPriorYear
Revenues Less Expenses CY210806RevenuesLessExpensesCY
Total Assets BOY1775063TotalAssetsBOY
Total Assets EOY2859742TotalAssetsEOY
Total Liabilities BOY393484TotalLiabilitiesBOY
Total Liabilities EOY1267357TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1381579NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1592385NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide a high-quality, accessible continuum of healthcare, supportive housing and community services.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense6990299Expense
Revenue8015185Revenue
DescriptionProvide infusion therapy services, respiratory therapy services and home medical services and equipment to its patients. Infusion therapy is a group of medical therapies involving prolonged and repeated administrations of medications, usually intravenously but sometimes subcutaneously or epidurally. Respiratory therapy includes a full range of home respiratory therapy services and equipment (such as respiratory therapist visits, oxygen concentrators and tanks, sleep apnea, nebulizers). Home medical equipment includes hospital beds, wheelchairs, walkers, canes, crutches, commodes and air mattresses.Description
Total Program Service Expense6990299TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLynette G TuroNamePerson
Telephone Number5182746200TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1433 River St Suite 3000AddressLine1
CityTroyCity
StateNYState
ZIP Code121802260ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
William J Foley PhD
Board Member2.00X000
Thomas Nowak
Treasurer2.00X000X
Theresa Faul
Pharmacist40.0001075715004X
Stephen Berkley
Pharmacist40.0001066297020X
Russell Oster
Board Member2.00X000
Ronald L Guzior
Board Member4.00X000
Robert W Johnson III Esq
Chairman4.00X000X
Robert J Bylancik CHE
Board Member2.00X0500000
Robert Fortune
Board Member2.00X000
Robert C Davenport MD
0.0001072727300X
Richard Petterson
CFO0.00020984426700X
Michelle Mazzacco
Officer4.0001491817977X
Mark Cartwright
Board Member2.00X000
Lisa Thorn MD
EX Officio2.00X0250000
Kelly Ringler
Pharmacist40.00010823110111X
John Lang
Board Member2.00X000
Jo-Ann Costantino
EX Officio0.50034292818369X
Jane Altes PhD
Board Member2.00X000
James V Puleo MD
Board Member2.00X0250000
James Slavin MD
Board Member2.00X000
James K Reed MD
EX Officio0.00X050807328508
James HPuleo MD
Board Member2.00X000
James E Prout Esq
EX Officio2.00X000
Harry L Robinson Esq
Board Member2.00X000
Harold Gordon Esq
Vice Chair4.00X000X
Diana Boschi
Director40.00011597514634X
Craig Duncan
0.0004026370X
Chester Opalka
Board Member2.00X000
Anthony P Tartaglia MD
Secretary2.00X000X
Ann DiSarro
Board Member4.00X000
Alan Goldberg
Board Member2.00X000
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs2258341TotalReportableCompFrmRltdOrgs
Total Other Compensation125623TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Mediware
PO box 414228Kansas CityMO641414228Medical Supplies276045
Healthcare Management Solutions Inc
750 Chestnut Ridge RoadChestnut RidgeNY10977AR Billing Service278405
Eddy Visiting Nurse Association
433 River Street Suite 3000TroyNY12180Nursing/IV164407
Cardinal Dist-Syracuse
Lock Box 5303 Collection Center DriChicagoIL60693Medical Supplies773392
Airsep Corporation
290 Creekside DriveBuffaloNY14228Medical Supplies172131
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHome Infusion & DMEDescription
Total Revenue Column8015185TotalRevenueColumn
Exclusion$8,015,185ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue8015185TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column-5842TotalRevenueColumn
Exclusion-$5,842ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMisc RevDescription
Total Revenue Column35091TotalRevenueColumn
Exclusion$35,091ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue35091TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column8044434TotalRevenueColumn
Exclusion$8,044,434ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2397328Total
Program Services2191330ProgramServices
Management And General205998ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total55269Total
Program Services50520ProgramServices
Management And General4749ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total303720Total
Program Services277622ProgramServices
Management And General26098ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total173896Total
Program Services158953ProgramServices
Management And General14943ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total99418Total
Management And General99418ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total17812Total
Management And General17812ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total49135Total
Management And General49135ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total32384Total
Management And General32384ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total167713Total
Management And General167713ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total53164Total
Program Services38962ProgramServices
Management And General14202ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total7666Total
Management And General7666ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total487416Total
Program Services396561ProgramServices
Management And General90855ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total46243Total
Management And General46243ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Phone7840678406
Medical Supplies23378002337800
Equipment rental and maint.203683203683
Contract Services10008061000806
Bad Debt212223212223

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total109546Total
Program Services43433ProgramServices
Management And General66113ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7833628Total
Program Services6990299ProgramServices
Management And General843329ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY126692BOY
EOY253272EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY917240BOY
EOY978819EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY131531BOY
EOY137132EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY33962BOY
EOY45091EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2683970LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1238542LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1143103BOY
EOY1445428EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY-577465BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1775063BOY
EOY2859742EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY317115BOY
EOY375127EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY76369BOY
EOY892230EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY393484BOY
EOY1267357EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1381579BOY
EOY1592385EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1381579BOY
EOY1592385EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1775063BOY
EOY2859742EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses210806ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Total0Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6070489CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6989552CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7507592CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7664115CurrentTaxYearMinus1Year
Current Tax Year8015185CurrentTaxYear
Total36246933Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6070489CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6989552CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7507592CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7664115CurrentTaxYearMinus1Year
Current Tax Year8015185CurrentTaxYear
Total36246933Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50936246933PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10480CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12373CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2418CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year-2975CurrentTaxYearMinus1Year
Current Tax Year-5842CurrentTaxYear
Total16454Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10480CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12373CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2418CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year-2975CurrentTaxYearMinus1Year
Current Tax Year-5842CurrentTaxYear
Total16454Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7843CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14894CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years46304CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year31547CurrentTaxYearMinus1Year
Current Tax Year35091CurrentTaxYear
Total135679Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6088812CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7016819CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7556314CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7692687CurrentTaxYearMinus1Year
Current Tax Year8044434CurrentTaxYear
Total36399066Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99580PublicSupportPercentage509
Prior Year Support Percentage0.99600PriorYearSupportPercentage
Investment Income Percentage0.00050InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00090PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
Facts And Circumstances TestPart III, Line 12--Misc Rev IV 9,353.00Misc Rev DME 25,738.00 Total 35,091.00FactsAndCircumstancesTest

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis46495OtherCostOrOtherBasis
Depreciation38193Depreciation
Book Value8302BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2509140OtherCostOrOtherBasis
Depreciation1161029Depreciation
Book Value1348111BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis128335OtherCostOrOtherBasis
Depreciation39320Depreciation
Book Value89015BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1445428TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$911,575
Current Liabilities-$19,345
FieldValueIRS element (for citing)
Total Of Amounts892230TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XIdentifier
Return ReferencePart X : FIN48 FootnoteReturnReference
ExplanationNortheast Health is classified for tax purposes as an organization under 501 (c) (3) of the Internal Revenue Code (the Code), and as such it is generally exempt from income taxes under the provisions of Section 501(a) of the Code.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
Robert C Davenport MD
96364934997442783022114572
Richard Petterson
2062003230414872317977236544
Michelle Mazzacco
144336484557882189157158
Jo-Ann Costantino
312858776522305116726697361297
James K Reed MD
46079714190330861482713681536581
Craig Duncan
402637402637

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 7Identifier
Return ReferencePart I, Line 7: Non-Fixed payments not listed aboveReturnReference

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VII, Section A, Line 1aHours of Officers, Directors, Key Employees and Highest Compensated Employees:The following officers, directors, key employees and highest compensated employees devote the indicated average number of weekly hours to related organizations:Rich Petterson 40.0 hours per weekJames Reed 40 hours per weekJo-Ann Costantino 39.5 hours per weekMichelle Mazzacco 36 hours per week.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableIn 2010, Northeast Health and its affiliates did not make the above-named documents available to the public, although certificates of incorporation were available from the NYS Secretary of State.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe executive compensation policy described in the note for Line 15a also applies to other officers and key employees of the organization.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsNortheast Health, the health system to which Empire Home Infusion Service belongs, has two system-wide conflict of interest policies, one applicable to the board of directors of each system affiliate and one applicable to administrative staff and select employees and medical staff. Together, the two policies require annual disclosure of conflicts of interest by all directors, officers and key employees, and prescribe responses to such conflicts applying customary conflicts of interest principles. Employee disclosure forms are reviewed annually by the system compliance officer for a determination of any conflict's impact on the integrity of the disclosing individual's acts and decisions. Violation of the policy subjects an employee to potential disciplinary action. Board of directors conflict of interest disclosure forms are reviewed and summarized by the system compliance officer, and the summary is reviewed by the board corporate compliance and audit committe and any necessary action taken by such committee. Customary procedures are followed, including nonparticipation by affected individuals in the deliberation and vote on any matters that potentially conflict with the individual's outside interest. Appropriate corrective action is taken by the Board in the event of a director's failure to disclose a conflict of interest or other violation of the policy.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessFirst, Form 990 was presented to the Board Audit/Compliance Committee for review at a special meeting, to which all other Board members were invited to attend. The 990 was then made available on the Board website for all Board members to review.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyNortheast Health elects the members of the organization's governing bodyForm 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderHome Aide Service of Eastern New YorkForm 990, Part VI, Line 6
Form 990, Part VI, Line 4: Description of Significant Changes to Organizational DocumentsThe organization amended its bylaws to extend the date until which the number of directors is set at no less than 17 nor more than 27, to January 2012, and to provide that directors whose final term expires in January 2011 may be re-elected and serve for an additional year, until January 2012.Form 990, Part VI, Line 4
Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyThe organization delegated control over certain duties of key employees to a related exempt organization.Form 990, Part VI, Line 3
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtDirectors Robert Johnson and James Prout have a business relationship. Directors James H. Puleo, M.D. and James V. Puleo, M.D. have a family relationship.Form 990, Part VI, Line 2

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Home Aide Service of Eastern New York
433 River Street Suite 3000TroyNY12180141514867Home CareNY501(c)(3)Line 9N/Afalse
Northeast Health Inc
2212 Burdett AvenueTroyNY12180042450756Health SystemNY501(c)(3)11, IIfalseNA
Shaker Properties Inc
2212 Burdett AveTroyNY12180223119822Real Estate HoldingNY501(c)(3)N/AfalseNA
Beechwood Inc
2218 Burdett AvenueTroyNY12180141649089Real Estate HoldingNY501(c)(3)N/AfalseNA
Glen Eddy Inc
1 Glen Eddy DriveNiskayunaNY12309141794150Independent/Assisted LifingNY501(c)(3)Line 9falseNA
Beverwyck Inc
10 Autumn DriveSlingerlandsNY12159141717028Independent/Assisted LivingNY501(c)(3)Line 9falseNA
Hawthorne Ridge Inc
30 Community WayEast GreenbushNY12061800102840Independent/Assisted LivingNY501(c)(3)Line 9falseNA
The Majorie Doyle Rockwell Cntr Inc
421 West Columbia StreetCohoesNY12047141793885Adult Home/AlzheimerNY501(c)(3)Line 9falseNA
Senior Care Connection Inc
504 State StSchenectadyNY12305141708754PACE ProgramNY501(c)(3)Line 9falseNA
The Capital Region Geriatric Cntr Inc
421 West Columbia StreetCohoesNY12047141701597Nursing HomeNY501(c)(3)Line 9falseNA
Heritage House Nursing Center Inc
2920 Tibbits AvenueTroyNY12180141725101Nursing HomeNY501(c)(3)Line 9falseNA
The James AEddy Memorial Geriatric Cntr
2256 Burdett AveTroyNY12180222570478Nursing HomeNY501(c)(3)Line 9falseNA
Sunnyview Hospital and Rehab Center
1270 Belmont AveSchenectadyNY12308141338386Rehabilitation HospitalNY501(c)(3)Line 3falseNA
Samaritan Hospital of Troy New York
2215 Burdett AveTroyNY12180141338544General HospitalNY501(c)(3)Line 3falseNA
Memorial Hospital Albany NY
600 Northern BlvdAlbanyNY12204141338457General HospitalNY501(c)(3)Line 3falseNA
LTC Eddy Inc
2212 Burdett AvenueTroyNY12180222564710Elderly Health/HousingNY501(c)(3)11, IIfalseNA

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Samaritan Medical Office Building IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12231 Burdett AveAddressLine1
CityTroyCity
StateNYState
ZIP Code12180ZIPCode
FieldValueIRS element (for citing)
EIN141607244EIN
Primary ActivityReal EstatePrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC corpTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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