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 112150953 LUTHERAN AUGUSTANA CENTER FOR EXTENDED CARE AND REHABILITATION INC LUTH 7186306000 5434 SECOND AVENUE BROOKLYN NY 11220 DAVID ROSE 7186306000 2011-11-04 1 FREDERICK H ROTHMAN 2128674000 2010 2016-03-07 17:11:31Z DAVID ROSE 5434 SECOND AVENUE BROOKLYN NY 11220 34431529 0 9386 X WWW.LUTHERANAUGUSTANACENTER.COM X 1968 NY TO PROVIDE SKILLED NURSING HOME CARE FOR THE ELDERLY AND DISABLED,RESTORATIVE REHABILITATION AND SUB ACUTE CARE IN A 240-BED NURSING HOME FACILITY. 13 12 467 0 0 0 91720 69457 33675056 34017467 62791 28048 302770 311256 34132337 34426228 0 0 0 0 20896095 21237331 0 0 0 13442821 13657124 34338916 34894455 -206579 -468227 37314834 38389038 31712896 33240396 5601938 5148642 SEE SCHEDULE O LUTHERAN AUGUSTANA CENTER FOR EXTENDED CARE AND REHABILITATION, A NOT FOR PROFIT ORGANIZATION, EXISTS AS A SOCIAL MINISTRY ORGANIZATION OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA, DEDICATED TO PROVIDING A FULL RANGE OF SERVICES FOCUSING UPON THE ENCHANCEMENT OF AN INDIVIDUALS PHYSICAL, SOCIAL, EMOTIONAL AND SPIRITUAL WELL BEING. TO FULFILL ITS MISSION, LUTHERAN AUGUSTANA CENTER FOR EXTENDED CARE AND REHABILITATION PLEDGES TO: - SERVE THE DIVERSE NEEDS OF OUR RESIDENTS, THEIR FAMILIES AND THE COMMUNITY AT LARGE. -SUPPORT INDIVIDUALS IN REALIZING THEIR MAXIMUM POTENTIAL AND INDEPNDENCE WHILE ENRICHING THEIR LIVES WITH DIGNITY AND HONOR. 0 0 27378166 29206342 IN 2010, LUTHERAN AUGUSTANA CENTER CONTINUED TO INCREASE THE CAPACITY OF ITS SHORT TERM RESTORATIVE REHABILITATION AND MEDICALLY COMPLEX SUBACUTE CARE PROGRAMS. AS A RESULT, DISCHARGES BACK TO THE COMMUNITY INCREASED BY 23% IN 2010. AUGUSTANA'S PROGRESSIVE WOUND CARE PREVENTION AND TREATMENT PROTOCOLS, UTILIZING EVIDENCE BASED PRACTICE TREATMENTS INCORPORATING THE USE OF APPROPRIATE SUPPORT SURFACES AND NEGATIVE PRESSURE THERAPY, HAS RESULTED IN SIGNIFICANT POSITIVE OUTCOMES FOR THOSE WE PROVIDED CARE AND TREATMENT TO. AUGUSTANA'S IN-HOUSE PRESSURE ULCER OCCURRENCES ARE CURRENTLY AND HAVE ROUTINELY BEEN BELOW THE NATIONAL AVERAGE. THE CENTER PROVIDED 79,877 DAYS OF SKILLED NURSING CARE FOR THE YEAR ENDED DECEMBER 31,2010. 4261583 4811125 LUTHERAN AUGUSTANA CENTER FOR EXTENDED CARE AND REHABILITATION LONG TERM HOME HEALTHCARE PROGRAM ATTAINED 100% OCCUPANCY IN 2009. THE PROGRAM COMMENCED OPERATIONS IN SEPTEMBER 2007. DURING 2010, 25 ADDITIONAL SLOTSWERE APPROVED BY DOH, RAISING THE CAPACITY TO 125 SLOTS 31639749 1 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 45 0 1 467 1 0 0 0 0 0 0 0 0 0 0 X 13 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL PAGANO 7186306014 5434 2ND AVENUE BROOKLYN NY 11220 REVDAVID H ROMMEREIM 1.00 X X 0 0 0 REV KHADER EL'YATEEM 1.00 X 0 0 0 BRENDA A GRANDELL 1.00 X 0 0 0 REV RICHARD A MILLER 1.00 X 0 0 0 CHRISTINE HAUGE 1.00 X 0 0 0 PETER CLAVIN 1.00 X 0 0 0 FLORENCE SULLIVAN ESQ 1.00 X 0 0 0 DONALD ENG ESQ 1.00 X 0 0 0 ROBERT KASSENBROCK 1.00 X 0 0 0 WENDY Z GOLDSTEIN 1.00 X X 0 963111 302656 RITA RASMUSSEN 1.00 X X 0 0 0 FREDERICK HADAD 1.00 X X 0 0 0 REV CRAIG MILLER 1.00 X X 0 0 0 DAVID ROSE 35.00 X 271720 0 32797 MICHAEL PAGANO 35.00 X 180460 0 26661 ELENA N LOPEZ 35.00 X 136117 0 8084 ELIZABETH A WALSH 35.00 X 150996 0 22523 HILDA GRIER 35.00 X 123338 0 3323 ANGELA R PEZZA 35.00 X 117781 0 11700 ERIC SILBERMAN 35.00 X 104430 0 23070 DEBRA CAVAN 35.00 X 96014 0 22927 JACQUELINE M ARTHURS 35.00 X 0 98224 22065 1084842 963111 430814 9 0 1 0 GREATCARE INC 407 PARK AVENUE SOUTH NEW YORK NY 10016 HOME HEALTH AIDE SERVICES 1189488 S & A UNIFIED HOME CARE INC 424 KINGS HIGHWAY BROOKLYN NY 11223 HOME HEALTH AIDE SERVICES 600894 LUTHERAN MEDICAL CENTER 150 55TH STREET BROOKLYN NY 11220 MANAGEMENT AND ANCILLARY SERVICES 285162 NES ENERGY INC 2221-7 FIFTH AVE RONKONKOMA NY 11779 CONSTRUCTION 282652 UNITEX TEXTILE RENTAL SERVICES 401 SOUTH MACQUESTEN PARKWAY MT VERNON NY 10550 LAUNDRY AND LINEN SERVICES 216706 12 36962 32495 69457 NET PATIENT SERVICE RE 623000 34017467 34017467 34017467 28048 28048 5301 36962 5301 0 PARKING GARAGE 812930 219270 219270 REBATES 900099 56493 56493 TELEPHONE 221000 31351 31351 4142 4142 311256 34426228 34017467 0 339304 511638 511638 15177699 14220097 957602 890581 835631 54950 2887739 2628159 259580 1769674 1657365 112309 124215 124215 61202 61202 93038 93038 4242930 3992884 250046 6428 326 6102 1458996 1114354 344642 184282 15596 168686 2376631 2137333 239298 17706 15279 2427 1485719 1347142 138577 575634 524227 51407 PHARMACEUTICALS 1025518 1025518 ASSESMENT FEES 995164 995164 BAD DEBTS 606708 606708 FOOD 402953 399751 3202 34894455 31639749 3254706 0 57344 21897 5154509 2954212 5779614 9643653 13581 13620 478416 548223 41451026 25737191 16203883 15713835 9627487 9493598 37314834 38389038 6027524 6922648 86454 32000 25258836 24909571 340082 1376177 31712896 33240396 X 5373747 4909710 44857 40667 183334 198265 5601938 5148642 37314834 38389038 X -468227 14931 X X 1 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 154000 154000 36806380 23080161 13726219 177548 116825 60723 4023532 2540205 1483327 289566 289566 15713835 ESCROW DEPOSITS 8329572 BENEFICIAL INTEREST IN PERPETUAL TRUST 152533 DUE FROM THIRD PARTY 1011493 9493598 DUE TO THIRD PARTIES 1150391 RESIDENT FUNDS 225786 1376177 34426228 34894455 -468227 14931 14931 -453296 34441159 14931 14931 34426228 0 34426228 34894455 0 34894455 0 34894455 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER 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 REVIEW BY TAXING AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: GAIN ON BENEFICIAL INTEREST IN PERPETUAL TRUST 14,931. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON BENEFICIAL INTEREST IN PERPETUAL TRUST 14,931. WALK-A-THON 42263 36962 5301 460 4841 42263 36962 5301 460 4841 5301 0 X X X X 0 0 0 0 0 0 0 0 0 WENDY Z GOLDSTEIN 0 888111 0 75000 0 0 0 269600 0 33056 0 1265767 0 0 DAVID ROSE 260988 0 0 0 10732 0 17863 0 14934 0 304517 0 0 0 MICHAEL PAGANO 179565 0 0 0 895 0 10034 0 16627 0 207121 0 0 0 ELIZABETH A WALSH 150468 0 0 0 528 0 8967 0 13556 0 173519 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 REV. CRAIG MILLER IS THE SON OF REV. RICHARD MILLER. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 HAS BEEN REVIEWED WITH THE ORGANIZATION'S FINANCE COMMITTEE, AND THE BOARD OF DIRECTORS PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C LUTHERAN AUGUSTANA CENTER REQUIRES ALL MEMBERS OF THE BOARD OF DIRECTORS TO COMPLETE AN ANNUAL CONFLICT OF INTEREST AND RELATED MATTERS DISCLOSURE STATEMENT PRIOR TO SERVING ON THE BOARD FOR THE CURRENT YEAR. THIS DISCLOSURE STATEMENT IS MONITORED AND REVIEWED BY AUGUSTANA'S EXECUTIVE DIRECTOR. IN 2009, AUGUSTANA SUPPLEMENTED ITS ORIGINAL DISCLOSURE STATEMENT WITH AN ADDITIONAL QUESTIONAIRE INTENDED TO COVER ISSUES RAISED BY THE NEW FORM 990, BUT NOT ADDRESSED IN THE ORIGINAL DISCLOSURE STATEMENT. THIS QUESTIONAIRE WAS COMPLETED BY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES PRIOR TO THE FILING OF THE FORM 990. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING THE DISCLOSURE STATEMENTS AND, IF ANY SUSPECTED CONFLICTS ARE IDENTIFIED, REFERRING THE MATTER TO THE EXECUTIVE DIRECTOR TO DETERMINE WHETHER FURTHER INQUIRY IS REQUIRED. IF REQUIRED, THE MATTER IS REFERRED TO GENERAL COUNSEL FOR RESOLUTION. IF THERE IS A CONFLICT THE EXECUTIVE DIRECTOR WILL TAKE THE APPROPRIATE ACTION. AT NO TIME DURING THE PROCESS WILL THE PERSON WITH A CONFLICT OR POSSIBLE CONFLICT PARTICIPATE IN THE PROCEEDINGS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES OF LUTHERAN MEDICAL CENTER ENGAGES SULLIVAN COTTER AND ASSOCIATES, INC. TO PROVIDE LUTHERAN MEDICAL CENTER'S BOARD OF TRUSTEES WITH A REPORT THAT CONTAINS: A) A MARKET ANALYSIS OF THE TOTAL COMPENSATION LEVELS OF SENIOR EXECUTIVES IN RELATION TO THEIR PEERS IN THE MARKET PLACE, B) A REVIEW OF CURRENT COMPENSATION AND BENEFIT PLAN DESIGNS TO ENSURE THEIR COMPETITIVENESS TO THE MARKET PLACE, AND C) TO ENSURE COMPLIANCE WITH ANY STATE OR FEDERAL REGULATIONS. THE BOARD RELIES UPON THE DATA AND RECOMMENDATIONS PROVIDED BY SULLIVAN COTTER TO DETERMINE THE COMPENSATION LEVEL OF THE CEO.FOR OTHER KEY POSITIONS, THE COST OF LIVING ADJUSTMENTS IS THE SAME PERCENTAGE AS THOSE RECEIVED BY THE NON UNION STAFF BASED ON THE CURRENT BUDGET. THE BOARD CONDUCTS THIS PROCESS ANNUALLY. IN 2010, THERE WERE NO COST OF LIVING ADJUSTMENTS GIVEN TO KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: GAIN ON BENEFICIAL INTEREST IN PERPETUAL TRUST 14,931. TOTAL TO FORM 990, PART XI, LINE 5: 14,931. PART XII, LINE 2C IN PRIOR YEARS, THE ORGANIZATION HAS HAD A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT PUBLIC ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. FORM 990, PART VII, COLUMN (B) WENDY GOLDSTEIN WORKS 35 HOURS FOR A RELATED ORGANIZATION. LUTHERAN MEDICAL CENTER 150 55TH STREET BROOKLYN NY 11220 111839567 MEDICAL CENTER NY 501(C)(3) 3 N/A 0 COMMUNITY CARE ORGANIZATION INC 246 55TH STREET BROOKLYN NY 11220 113001682 LICENSED HOME HEALTH CARE NY 501(C)(3) 9 N/A 0 LUTHERAN FAMILY HEALTH CENTERS 150 55TH STREET BROOKLYN NY 11220 202508411 MEDICAL AND DENTAL CLINICS NY 501(C)(3) 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 LUTHERAN MEDICAL CENTER O 285162 VALUE OF SERVICES PROVIDED COMMUNITY CARE ORGANIZATION O 154928 VALUE OF SERVICES PROVIDED