2011-11-14T09:02:58-06:00 2010-12-31 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2010-01-01 141756230 Seton Health at Schuyler Ridge Residential Healthcare SETO 5183711400 One Abele Blvd Clifton Park NY 120652951 Daniel Kochie 5182685520 2011-11-11 1 Alicia Janisch 5137847100 2010 2016-03-07 17:11:31Z Scott St George 1300 Massachusetts Avenue Troy NY 12180 13005345 0 0928 X N/A X 1993 NY To provide skilled nursing care, physical rehabilitation, and adult medical day health services. 15 12 312 67 0 0 44368 3044 11592531 12036705 739167 935748 21948 25811 12398014 13001308 0 0 0 0 7150093 7233801 0 0 0 3894022 4294485 11044115 11528286 1353899 1473022 15141822 16920360 12267882 12565900 2873940 4354460 To provide skilled nursing and rehabilitative care to the aged and infirm residents, as well as medical day care to elderly citizens in the community and to subsidize the cost of providing this care for persons receiving public assistance. 0 0 10333693 12036705 During 2010 Seton Health at Schuyler Ridge provided more than 42,700 days of skilled nursing care to 275 aged and infirm residents and more than 3,900 days of medical day health care services to 74 aged and infirm participants. 10333693 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 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 1 1 0 0 1 33 0 1 312 1 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X Daniel Kochie CFO 5182685520 1300 Massachusetts Avenue Troy NY 12180 X Beverly Karpiak 0.50 X 0 0 0 Neil Weiner 0.50 X 0 0 0 Sr Clarisse Correia 0.50 X 0 0 0 R William Casey 0.50 X 0 0 0 Lynda Walowit 0.50 X 0 0 0 Dr Constance Glasgow 0.50 X 0 0 0 Edward Wixted 0.50 X 0 0 0 Richard Bennett 0.50 X 0 0 0 Thomas Ryan 0.50 X 0 0 0 Robert Paliwodzinski 0.50 X 0 0 0 Dr Donald Schneider 0.50 X 0 0 0 Anne Franti 0.50 X 0 0 0 Eugene Kelenski 0.50 X 0 0 0 Scott St George Sch O 37.50 X X 0 254687 66651 Daniel Kochie Sch O 37.50 X X 0 98151 16144 Gino Pazzaglini Sch O 37.50 X X 0 700146 65281 Sandra Sullivan-Smith 37.50 X 117498 0 28538 Christine Urbano 37.50 X 102196 0 17403 Leslie Duell 37.50 X 74461 0 10377 Ellen Barrett 37.50 X 71700 0 19902 Dianne Pingelski 37.50 X 73776 0 11373 219694 1052984 194017 2 0 1 0 Favorite Healthcare Staffing Inc PO Box 803356 Kansas City MO 641803356 Nurse Agency 227652 Plaza Linen Service Plank Road Plaza Clifton Park NY 12065 Linen Services 203016 ChemRx 750 Park place Long Beach NY 11561 Pharmacy Services 131640 Medical Staffing Netwotk PO Box 840416 Dallas TX 752840416 Nurse Agency 108034 4 3044 3044 Skilled Nursing 623000 6235278 6235278 Medicare/Medicaid 623000 5801427 5801427 12036705 939785 939785 4037 -4037 -4037 -4037 Cafeteria & Gift Shop 722210 21394 21394 Other Revenue 900099 4417 4417 25811 13001308 12036705 0 961559 5839610 5226959 612651 334708 306179 28529 629651 575982 53669 429832 393195 36637 58122 25876 32246 5005 5005 16321 16321 23862 18177 5685 919532 876370 43162 73480 73480 215386 202097 13289 9797 7226 2571 312118 292860 19258 427385 401015 26370 41264 41264 Purchased Svcs. 1258382 1106810 151572 0 NYS Assessment 584606 584606 0 0 Bad Debt 161000 161000 0 0 Dues 97277 5593 91684 0 Loss on Mgmt Contract 2677 0 2677 0 88271 35004 53267 11528286 10333693 1194593 0 500 500 6237994 8282566 1049692 1103510 15065 17239 33074 21039 11081732 3983101 7472156 7098631 333341 396875 15141822 16920360 2083572 2535249 95386 190792 9885229 9566314 203695 273545 12267882 12565900 X 2863953 4344473 9987 9987 2873940 4354460 15141822 16920360 X 1473022 7498 X 0 1 1 X 0 X 21940 10295 4862 44438 3044 84579 10697461 10658533 11662381 11592531 12036706 56647612 10719401 10668828 11667243 11636969 12039750 56732191 0 3382 3382 3382 3382 56728809 565554 302745 -609865 739167 939785 1937386 565554 302745 -609865 739167 939785 1937386 26224 36107 36146 21948 25811 146236 11311179 11007680 11093524 12398084 13005346 58815813 0.96450 0.97650 0.03290 0.02070 X 650000 650000 8856780 2632239 6224541 1410159 1243570 166589 164793 107292 57501 7098631 Resident Trust and Resident Security Deposits 273545 273545 1 1 0 0 0 0 0 0 0 Scott St George Sch O 0 240098 0 7000 0 7589 0 58293 0 8358 0 321338 0 6717 Gino Pazzaglini Sch O 0 266024 0 228203 0 205919 0 53093 0 12188 0 765427 0 0 Part I, Lines 4a-b Gino J. Pazzaglini received severance payments totaling $60,189 during the 2010 calendar year. Part I, Line 4b: Gino Pazzaglini received a payment of $82,015 during the 2010 calendar year that represents amounts previously deferred under a nonqualified plan. Supplemental Information Part III Part I, Line 3: Seton Health at Schuyler Ridge Residential Healthcare relied on a related organization (Seton Health System, Inc.) that used one or more of the methods described below to establish the top management official's compensation: - Compensation Committee - Independent Compensation Consultant - Approval by the Board or Compensation Committee - Compensation Study or Survey Supplemental Information Part III Part II: Deferred Compensation amounts reported in Schedule J do not include amounts where the entitlement to future payment is contingent on satisfaction of specific performance criteria. Form 990, Part VI, Section A, line 6 Seton Health at Schuyler Ridge Residential Healthcare has a single corporate member, Seton Health System, Inc. Form 990, Part VI, Section A, line 7a Seton Health at Schuyler Ridge Residential Healthcare has a single corporate member, Seton Health System, who has the ability to elect members to the governing body. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Seton Health at Schuyler Ridge Residential Healthcare financial information or corporation as a whole are subject to approval by its sole corporate member, Seton Health System, Inc. Form 990, Part VI, Section B, line 11 Management, including certain Officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's top management official, the process performed by Seton Health System (a related organization who paid the top management official) included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The executive committee reviewed and approved the compensation. In the review of the compensation, the top management official was compared to other organizations in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the executive committee minutes. Individual was not present when his compensation was decided. In determining compensation of the other officers of the organization, the process performed by Seton Health System (a related organization who paid the other officers) included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The executive committee reviewed and approved the compensation. In the review of the compensation, the other officers of the organization were compared to other organizations' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the executive committee minutes. Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request. Form 990, Part VII: Officers (as noted with "Sch O") for Seton Health at Schuyler Ridge Residential Healthcare provide services to Seton Health System and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore officers' hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week for all Seton Health System entities. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net Pension Adjustments -12,876. On Time Quality Grant (NYS) Reimbursements 20,374. Total to Form 990, Part XI, Line 5: 7,498. Ascension Health PO Box 45998 St Louis MO 63134 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Seton Health System Inc 1300 Massachusetts Ave Troy NY 12180 141776186 Hospital NY Section 501(c)(3) Schedule A, Line 3 Ascension Health 0 Seton Auxiliary Inc 1300 Massachusetts Ave Troy NY 12180 141505031 Support of Seton Health System, Inc. NY Section 501(c)(3) Schedule A, Line 9 Seton Health System Inc 1 Seton Health Foundation Inc 1300 Massachusetts Ave Troy NY 12180 222345416 Support of Seton Health System, Inc. NY Section 501(c)(3) Schedule A, Line 11a Seton Health System Inc 1 Seton Licensed Home Care Inc 1300 Massachusetts Ave Troy NY 12180 141809134 Licensed Home Health Agency NY Section 501(c)(3) Schedule A, Line 3 Seton Health System Inc 1 St Mary's Woodland Village Inc 1300 Massachusetts Ave Troy NY 12180 141675183 Discontinued Operations NY Section 501(c)(3) Schedule A, Line 9 Seton Health System Inc 1 Vincentian Health Services Inc 1300 Massachusetts Ave Troy NY 12180 141685163 Discontinued Operations NY Section 501(c)(3) Schedule A, Line 11a Seton Health System Inc 1 Affiliated Management Services Corp 1300 Massachusetts Ave Troy NY 12180 141668024 Real Estate NY N/A C 1 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 Ascension Health A 939786 Interest Earnings/Gains Ascension Health E 9566314 Cost Ascension Health L 71628 Cost Seton Health System Inc L 112053 Cost Seton Health System Inc N 332848 Cost