2011-11-14T17:48:44-06:00 2010-12-31 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2010-01-01 161085780 ST CAMILLUS RESIDENTIAL HEALTH CARE FACILITY STCA 3154882951 813 FAY ROAD SYRACUSE NY 132193098 MICHAEL ZINGARO 3154882951 2011-11-04 1 JOSEPH J SCHLEGEL 3154463600 2010 2016-02-24 21:20:13Z MICHAEL ZINGARO 813 FAY ROAD SYRACUSE NY 132193098 33908395 0 X WWW.ST-CAMILLUS.ORG X 1969 NY ST. CAMILLUS IS A RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO CARING FOR LIFE THROUGH A BROAD RANGE OF HEALTHCARE SERVICES. THE ORGANIZATION OPERATES A 284 BED SKILLED NURSING FACILITY WHICH INCLUDES A 20 BED UNIT DEDICATED TO TRAUMATIC BRAIN INJURY, ALONG WITH AN ADULT DAY HEALTH CARE PROGRAM, A CERTIFIED HOME HEALTH CARE AGENCY, AND AN OUT PATIENT DIAGNOSTIC AND TREATMENT CENTER. THROUGH THESE SERVICES, ST. CAMILLUS HELPS TO ADDRESS THE LONG-TERM CARE, REHABILITATION AND HOME AND COMMUNITY BASED CARE NEEDS OF OUR COMMUNITY. 22 21 761 98 0 0 93884 325807 33585222 33093599 0 0 438809 488989 34117915 33908395 0 0 0 0 21997998 22291920 0 0 0 12007467 12990081 34005465 35282001 112450 -1373606 20055972 19821560 13962741 14974521 6093231 4847039 X ST. CAMILLUS IS A RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO CARING FOR LIFE THROUGH A BROAD RANGE OF HEALTHCARE SERVICES. THE ORGANIZATION OPERATES A 284 BED SKILLED NURSING FACILITY WHICH INCLUDES A 20 BED UNIT DEDICATED TO TRAUMATIC BRAIN INJURY, ALONG WITH AN ADULT DAY HEALTH CARE PROGRAM, A CERTIFIED HOME HEALTH CARE AGENCY, AND AN OUT PATIENT DIAGNOSTIC AND TREATMENT CENTER. THROUGH THESE SERVICES, ST. CAMILLUS HELPS TO ADDRESS THE LONG-TERM CARE, REHABILITATION AND HOME AND COMMUNITY BASED CARE NEEDS OF OUR COMMUNITY. 0 0 29883218 33582588 CARE AND TREATMENT OF PATIENTS IN A RESIDENTIAL HEALTH CARE FACILITY AND AN OUTPATIENT CLINIC. 29883218 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 30 0 1 761 1 0 0 0 0 0 0 0 0 0 0 X 22 21 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MARGARET FRIGON 3154882951 813 FAY ROAD SYRACUSE NY 132193098 REV LOUIS AIELLO 1.00 X 0 0 0 JOHN J CANNIZZARO 1.00 X X 0 0 0 PETER CAPPUCCILLI JR 1.00 X 0 0 0 JOHN F CATANZARITA 1.00 X 0 0 0 CHARLES P CONOLE 1.00 X 0 0 0 PATRICIA A CURTIN 1.00 X X 0 0 0 KATHY DUSCKAS 1.00 X 0 0 0 JAMES N JEROSE 1.00 X 0 0 0 RV MSGR RICHARD KOPP 1.00 X 0 0 0 WAYNE V LA FRANCE 1.00 X 0 0 0 MAUREEN DUNN MCGLYNN 1.00 X 0 0 0 PAUL MELLO 1.00 X 0 0 0 JAMES J MURPHY 1.00 X 0 0 0 MICHAEL R O'LEARY MD 1.00 X 0 0 0 BRENDA A RIGAS 1.00 X 0 0 0 JAMES D SPENCER 1.00 X 0 0 0 RONALD WSTAHL MD 1.00 X 0 0 0 DERRICK J SUEHS 1.00 X 0 0 0 MARY GRACE VANNORTWICK 1.00 X X 0 0 0 RICHARD J PRATT 1.00 X 0 0 0 WILLIAM LOEHR 1.00 X 0 0 0 DANIEL J ROSS 1.00 X 0 0 0 AILEEN BALITZ 40.00 X X 164743 0 392 DAVID DUBE 20.00 X 91810 0 0 MICHAEL ZINGARO 40.00 X 96759 0 1204 CHAD GOODMAN 40.00 X 92618 0 9299 DEBRA BOWERS 40.00 X 14215 0 398 KATHY BARBER 40.00 X 84433 0 9471 CHRISTINE KEARNEY 40.00 X 82236 0 8288 HELENA GLASSFORD 40.00 X 71642 0 9480 HEATHER KEMMIS 40.00 X 74285 0 13270 772741 0 51802 1 0 1 0 SODEXHO INC 1900 SELWYN AVENUE CHARLOTTE NC 28207 FOOD SERVICE 1399973 HAYNER HOYT CORPORATION 625 ERIE BOULEVARD WEST SYRACUSE NY 13204 BUILDING CONTRACTOR 816112 NURSECORE MANAGEMENT SERVICES 2201 BROOKHOLLOW ARLINGTON TX 76006 NURSING STAFF 509132 NURSEFINDERS 7421 OSWEGO ROAD LIVERPOOL NY 13090 NURSING STAFF 286590 ADECCO EMPLOYMENT AGENCY 225 GREENFIELD PARKWAY LIVERPOOL NY 13088 NURSING STAFF 279819 5 110655 215152 325807 PROGRAM SERVICE REVENU 623000 33093599 33093599 33093599 OTHER REVENUE 623000 488989 488989 488989 33908395 33582588 0 0 706100 706100 17500762 14786992 2713770 2767851 2242111 525740 1317207 1131205 186002 66897 66897 46200 46200 239694 159796 79898 144069 34057 110012 64378 64378 1110890 999801 111089 138971 134179 4792 34480 11457 23023 8018 8018 1020990 918891 102099 352748 296735 56013 SUPPLIES 3032897 2889803 143094 CONTRACT LABOR 2365250 2365250 MANAGEMENT CONTRACT 1565427 1545043 20384 NYS ASSESSMENT 1089282 1089282 EQUIPMENT RENTAL AND MA 308067 248091 59976 1401823 1030525 371298 35282001 29883218 5398783 0 310849 12782 1225551 232779 6178245 7058383 307345 529277 82177 75765 273095 277414 26575868 17145366 9765488 9430502 1913222 2204658 20055972 19821560 3174442 3351086 8834855 8597024 1953444 3026411 13962741 14974521 X 5655956 4470781 437275 376258 6093231 4847039 20055972 19821560 X -1373606 127414 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 437275 110655 127414 299086 376258 1628216 88747 1279688 437275 1561368 309288 242440 1628216 1.00000 0 1 1 153315 153315 18938950 10602782 8336168 6126887 5455231 671656 1356716 1087353 269363 9430502 MORTGAGE REFINANCING COST, NET OF AMORTIZATION 254366 PATIENT FUNDS 43083 RESERVE FOR REPLACEMENTS 841997 FUNDED DEPRECIATION ACCOUNT 464058 CASH WORKING CAPITAL ESCROW 311664 INTEREST IN NET ASSETS OF ST. CAMILLUS FOUNDATION 265603 OTHER RECEIVABLES 23887 2204658 PATIENTS' FUNDS 43083 ESTIMATED THIRD PARTY SETTLEMENTS 1706719 ESTIMATED WORKER'S COMPENSATION TRUST LIABILITY 846609 LINE OF CREDIT 430000 3026411 33908395 35282001 -1373606 127414 127414 -1246192 33908395 0 33908395 0 33908395 35249583 0 35249583 32418 32418 35282001 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ST. CAMILLUS AND INTEGRITY ARE TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION DOES NOT HAVE ANY SIGNIFICANT UNRECOGNIZED TAX BENEFIT OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2007 THROUGH 2010. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF ST. CAMILLUS FOUNDATION 127,414. PART XIII, LINE 4B - OTHER ADJUSTMENTS: FORFEITED GRANTS 32,418. X X 0 0 0 0 0 0 0 0 0 AILEEN BALITZ 164743 0 0 0 0 0 0 0 392 0 165135 0 0 0 DR MICHAEL O'LEARY CEO OF LABORAT LABORATORY ALLIANCE OF CNY DOES LAB WORK FOR THE FACILITY. 228953 INDEPENDENT CONTRACTOR 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION VOTE TO ELECT TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE OPERATING DECISIONS MADE BY THE GOVERNING BODY (BOARD OF TRUSTEES) ARE DONE SO BY A MAJORITY VOTE OF THE TRUSTEES AND CAN NOT BE OVERRIDDEN. HOWEVER, ANY BY LAW CHANGES OR NEW TRUSTEE APPOINTMENTS REQUIRE A MAJORITY VOTE OF THE MEMBERS, IF PERSONALLY IN ATTENDANCE AT THE MEETING OR 100% WRITTEN APPROVAL. FORM 990, PART VI, SECTION B, LINE 11 BEFORE THIS FORM 990 WAS FILED WITH THE IRS, ALL OF THE FOLLOWING REVIEWS TOOK PLACE: THE PREPARED FORM 990 WAS REVIEWED BY THE CONTROLLER, CHIEF FINANCIAL OFFICER, AND CORPORATE COMPLIANCE OFFICER, IN CONSULTATION WITH ADMINISTRATIVE STAFF MEMBERS, EXECUTIVE MANAGEMENT, AND ADVISORS TO THE ORGANIZATION. THE PREPARED FORM 990 WAS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES. UPON RECOMMENDATION BY THE FINANCE COMMITTEE, THE PREPARED FORM 990 WAS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, ACTING ON BEHALF OF THE ENTIRE BOARD, FOR FINAL APPROVAL. COMPLETED FORM 990 WAS MADE AVAILABLE TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES WRITTEN DISCLOSURES BY ALL TRUSTEES, OFFICERS, KEY EMPLOYEES, AND OTHER MANAGEMENT OR SUPERVISORY EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE DECISION MAKING FOR THE ORGANIZATION. SUCH INDIVIDUALS ARE REQUIRED TO DISCLOSE ACTUAL AND POTENTIAL CONFLICTS OF INTEREST UPON INITIAL AFFILIATION WITH THE ORGANIZATION, ON AN ANNUAL BASIS, AND WHENEVER REPORTABLE INTERESTS ARISE. THE COMPLIANCE OFFICER, IN COLLABORATION WITH THE PRESIDENT AND/OR THE BOARD CHAIRMAN, REVIEWS WRITTEN DISCLOSURES, OBTAINS FURTHER INFORMATION AS NEEDED, AND EVALUATES ACTUAL AND POTENTIAL CONFLICTS. AS WARRANTED, THE PRESIDENT AND/OR BOARD CHAIRMAN IMPLEMENTS MEASURES TO ENSURE THAT DECISIONS RELATING TO THE ORGANIZATION ARE MADE SOLELY ON THE BASIS OF THE BEST INTERESTS OF THE ORGANIZATION AND IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSES. ANY TRUSTEE WHO HAS A DUALITY OF INTEREST OR A POTENTIAL CONFLICT OF INTEREST AS TO A MATTER COMING BEFORE THE BOARD IS PROHIBITED FROM VOTING OR USING PERSONAL INFLUENCE AS TO BOARD ACTION ON SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE FACILITY'S SALARY RANGES ARE BASED ON AN INCORPORATION OF A STUDY PERFORMED BY AN INDEPENDENT ACCOUNTING FIRM DURING THE 1990'S AND TRENDED FORWARD AND TWO SEPARATE INDEPENDENT SURVEYS OF SALARY PACKAGES OF SIMILAR POSITIONS RECEIVED DURING 2009. AT THE TIME OF HIRE THE FACILITY'S CEO REVIEWS THE SALARY REQUIREMENTS FOR KEY EMPLOYEES IN RELATION TO CURRENT MARKET CONDITIONS AND SALARY PAYSCALES PREVIOUSLY APPROVED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION. ANY SALARY RECOMMENDATIONS PROPOSED THAT ARE NOT COMMENSURATE WITH PREVIOUSLY APPROVED PAYSCALES REQUIRE CONSULTATION WITH AND AGREEMENT FROM THE BOARD CHAIRPERSON. ANNUALLY, OR WHEN CIRCUMSTANCES WARRANT, THE CEO PRESENTS TO THE EXECUTIVE COMMITTEE FOR THEIR REVIEW AND APPROVAL HER RECOMMENDATIONS FOR COMPENSATION OF KEY EMPLOYEES BASED ON PERFORMANCE EVALUATIONS. FORM 990, PART VI, SECTION C, LINE 18 THE FACILITY MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE 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: CHANGE IN INTEREST IN NET ASSETS OF ST. CAMILLUS FOUNDATION 127,414. TOTAL TO FORM 990, PART XI, LINE 5: 127,414. FORM 990, PART XI, LINE 2C: THE FACILITY HAS AN AUDIT COMMITTEE MADE UP OF TRUSTEES. THE AUDIT COMMITTEE MEETS TWICE ANNUALLY; THE FIRST MEETING TO REVIEW THE DRAFT FINANCIAL STATEMENTS AND PRELIMINARY FINDINGS; THE SECOND MEETING TO REVIEW THE FINAL FINANCIAL STATEMENTS AND FINDINGS. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR. ST CAMILLUS FOUNDATION 813 FAY ROAD SYRACUSE NY 13219 222429858 PROVIDE FINANCIAL SUPPORT NY 501 (C) (3) 9 ST CAMILLUS RESIDENTAL HEALTH CARE FACILITY 0 INTEGRITY HOME CARE SERVICES INC 813 FAY ROAD SYRACUSE NY 13219 161500579 HOME HEALTH SERVICES NY 501 (C) (3) 9 ST CAMILLUS RESIDENTAL HEALTH CARE FACILITY 0 1 0 1 1 0 0 0 0 1 0 1 0 0 0 0 1 0 0