SAMARITAN SENIOR VILLAGE INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- SAMARITAN SENIOR VILLAGE INC (EIN 45-4913668)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-13
- IRS object ID
- 202403189349311380
- Schema version
- 2023v5.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-13T19:07:35-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161226221 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUSTCHARLES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S WARREN STREET | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454913668 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMARITAN SENIOR VILLAGE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMA | BusinessNameControlTxt |
| Phone | 3157855702 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22691 CAMPUS DRIVE | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MAXINE BRIGGS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3157853605 | PhoneNum |
| Signature | 2024-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PATRICK CAPELLA | PreparerPersonNm |
| PTIN | P01359200 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Preparation | 2024-11-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MAXINE BRIGGS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 830 WASHINGTON STREET | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,351,185 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SAMARITANHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY,COMPREHENSIVE,SAFE AND COMPASSIONATE HEALTH CARE SERVICES AT MULTIPLE LEVELS FOR THE LOCAL ELDERLY POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 444 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,000,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,428,909 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,022,456 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $205 | CYInvestmentIncomeAmt |
| PY Other Revenue | $188,922 | PYOtherRevenueAmt |
| CY Other Revenue | $328,524 | CYOtherRevenueAmt |
| PY Total Revenue | $19,617,831 | PYTotalRevenueAmt |
| CY Total Revenue | $30,351,185 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,425,395 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,969,299 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,510,937 | PYOtherExpensesAmt |
| CY Other Expenses | $10,471,632 | CYOtherExpensesAmt |
| PY Total Expenses | $22,936,332 | PYTotalExpensesAmt |
| CY Total Expenses | $24,440,931 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,318,501 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,910,254 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,373,530 | TotalAssetsBOYAmt |
| Total Assets EOY | $55,842,090 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,678,515 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,152,948 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,695,015 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $28,689,142 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HIGH QUALITY,COMPREHENSIVE,SAFE AND COMPASSIONATE HEALTH CARE SERVICES AT MULTIPLE LEVELS FOR THE LOCAL ELDERLY POPULATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,827,433 | ExpenseAmt |
| Revenue | $24,350,980 | RevenueAmt |
| Desc | PROFESSIONAL CARE OF RESIDENTS IN A 168 BED SKILLED NURSING FACILITY AND 120 BED ASSISTED LIVING FACILITY. 57,022 RESIDENT SKILLED NURSING DAYS AND 38,724 RESIDENT ASSISTED LIVING DAYS OF CARE WERE RENDERED DURING 2023. | Desc |
| Total Program Service Expenses | $22,827,433 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 444 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAXINE BRIGGS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3157853605 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 104 PADDOCK STREET | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| THOMAS CARMAN | |||||||||
| PRESIDENT/CEO | 1.00 | 43.50 | Yes (X) | Yes (X) | $0 | $1,043,591 | $59,072 | ||
| DENISE YOUNG | |||||||||
| SMC BOARD CHAIR EX OFFICIO | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CARL MCLAUGHLIN | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| LINDA O'CONNOR | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| JORDAN JONES | |||||||||
| VICE CHAIR | 1.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARY WARDWELL-DONAHUE | |||||||||
| CHAIR | 1.00 | 3.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BARRY ORMSBY | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| MELISSA SCHMITT | |||||||||
| AUXILLARY REPRESENTATIVE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| FRANCEE CALARCO | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| TRACY VALENTINE | |||||||||
| SECRETARY | 1.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARTIN YENAWINE | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| JOAN TREADWELL-WOODS | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| KI LACLAIR | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN KIEFF | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| SAMUEL PURINGTON | |||||||||
| IMMEDIATE PAST CHAIR | 1.00 | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ADDISON F VARS III ESQ | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| MAXINE BRIGGS | |||||||||
| CFO/TREASURER | 1.00 | 42.50 | Yes (X) | Yes (X) | $0 | $559,897 | $48,174 | ||
| PETER WALTON | |||||||||
| TRUSTEE | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| MELANIE PARKER-GEUTSEN | |||||||||
| SMC BOARD CHAIR EX OFFICIO (2022-2023) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK CALLI | |||||||||
| SSV ADMINISTRATOR | 40.00 | $233,470 | $45,527 | $13,610 | Yes (X) | ||||
| VICKIE SMITHERS | |||||||||
| NURSE MANAGER | 40.00 | $164,441 | $0 | $31,523 | Yes (X) | ||||
| SUSAN GREER | |||||||||
| ASSISTANT DIRECTOR OF NURSING | 40.00 | 0.00 | $209,292 | $0 | $26,097 | Yes (X) | |||
| JEANETTE EMERY | |||||||||
| DIRECTOR OF NURSING | 40.00 | $179,908 | $0 | $14,885 | Yes (X) | ||||
| NEVA BOSSARD | |||||||||
| ASSISTED LIVING ADMINISTRATOR | 40.00 | $120,118 | $0 | $26,296 | Yes (X) | ||||
| SHAUNA CAMPANARO | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | $127,828 | $0 | $15,576 | Yes (X) | ||||
| STEPHANY JO WORTHINGTON | |||||||||
| STAFF RN | 40.00 | $123,284 | $0 | $25,313 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,158,341 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,649,015 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $260,546 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line1ContractorAddress/ForeignAddress/AddressLine1Txt | CityContractorAddress/ForeignAddress/CityNm | CountryContractorAddress/ForeignAddress/CountryCd |
|---|---|---|---|---|---|---|---|---|
| RENZI BROS INC | ||||||||
| 901 RAIL ST | WATERTOWN | NY | 13601 | FOOD SERVICE | $609,953 | |||
| MEDEFIS INC | ||||||||
| PO BOX 5608 | NEW YORK | NY | 100875068 | AGENCY STAFF | $392,191 | |||
| MOHAWK HEALTHCARE | ||||||||
| PO BOX 27 | UTICA | NY | 13503 | PURCHASED SERVICE | $223,738 | |||
| POINT CLICK CARE TECHNOLIGIES | ||||||||
| SOFTWARE | $189,417 | 5570 EXPLOYER DRIVE | MISSISSAUGA | CA | ||||
| US FOODS | ||||||||
| 901 RAIL ST | WATERTOWN | NY | 13601 | FOOD SERVICE | $141,326 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,000,000 | GovernmentGrantsAmt |
| Total Contributions | $6,000,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET RESIDENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $24,022,456 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,022,456 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,022,456 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $205 | TotalRevenueColumnAmt |
| Exclusion | $205 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| TELEVISION | 623000 | $42,938 | $42,938 |
| CAFETERIA | 623000 | $29,074 | $29,074 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $256,512 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $256,512 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $328,524 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,351,185 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,350,980 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $205 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $443,044 | TotalAmt |
| Program Services | $434,136 | ProgramServicesAmt |
| Management And General | $8,908 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,851,509 | TotalAmt |
| Program Services | $10,633,335 | ProgramServicesAmt |
| Management And General | $218,174 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,216 | TotalAmt |
| Program Services | $282,743 | ProgramServicesAmt |
| Management And General | $5,473 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,565,175 | TotalAmt |
| Program Services | $1,533,706 | ProgramServicesAmt |
| Management And General | $31,469 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $821,355 | TotalAmt |
| Program Services | $804,841 | ProgramServicesAmt |
| Management And General | $16,514 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,557 | TotalAmt |
| Management And General | $50,557 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,860 | TotalAmt |
| Management And General | $27,860 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,640,000 | TotalAmt |
| Program Services | $1,495,909 | ProgramServicesAmt |
| Management And General | $144,091 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,357 | TotalAmt |
| Program Services | $11,235 | ProgramServicesAmt |
| Management And General | $46,122 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,102 | TotalAmt |
| Management And General | $141,102 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,278 | TotalAmt |
| Program Services | $578,278 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,357 | TotalAmt |
| Program Services | $4,369 | ProgramServicesAmt |
| Management And General | $988 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,091 | TotalAmt |
| Program Services | $5,091 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,138 | TotalAmt |
| Program Services | $536,587 | ProgramServicesAmt |
| Management And General | $72,551 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,226,044 | TotalAmt |
| Program Services | $793,717 | ProgramServicesAmt |
| Management And General | $432,327 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,740,519 | TotalAmt |
| Program Services | $1,740,519 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,833 | TotalAmt |
| Management And General | $297,833 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $1,249,265 | $1,249,265 | |
| DIETARY SUPPLIES | $952,701 | $946,407 | $6,294 |
| NYS ASSESSMENT | $873,419 | $873,419 | |
| MEDICAL SUPPLIES | $617,170 | $607,325 | $9,845 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $399,941 | TotalAmt |
| Program Services | $296,551 | ProgramServicesAmt |
| Management And General | $103,390 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,440,931 | TotalAmt |
| Program Services | $22,827,433 | ProgramServicesAmt |
| Management And General | $1,613,498 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500 | BOYAmt |
| EOY | $1,275 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $642,002 | BOYAmt |
| EOY | $2,159,202 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,000,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,157,973 | BOYAmt |
| EOY | $2,451,041 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,100 | BOYAmt |
| EOY | $41,240 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,689 | BOYAmt |
| EOY | $116,785 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $64,442,707 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,684,739 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,285,300 | BOYAmt |
| EOY | $44,757,968 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,966 | BOYAmt |
| EOY | $314,579 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,373,530 | BOYAmt |
| EOY | $55,842,090 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,089,589 | BOYAmt |
| EOY | $2,856,789 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,120,173 | BOYAmt |
| EOY | $20,334,222 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,468,753 | BOYAmt |
| EOY | $3,961,937 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,678,515 | BOYAmt |
| EOY | $27,152,948 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,507,854 | BOYAmt |
| EOY | $23,741,501 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,161 | BOYAmt |
| EOY | $4,947,641 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,695,015 | BOYAmt |
| EOY | $28,689,142 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,373,530 | BOYAmt |
| EOY | $55,842,090 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,910,254 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $83,873 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $187,161 | BeginningYearBalanceAmt |
| Contributions | $6,000,000 | ContributionsAmt |
| Other Expenditures | $1,239,520 | OtherExpendituresAmt |
| End Year Balance | $4,947,641 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $187,161 | BeginningYearBalanceAmt |
| End Year Balance | $187,161 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $187,161 | BeginningYearBalanceAmt |
| End Year Balance | $187,161 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $187,161 | BeginningYearBalanceAmt |
| End Year Balance | $187,161 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $187,161 | BeginningYearBalanceAmt |
| End Year Balance | $187,161 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $297,775 | OtherCostOrOtherBasisAmt |
| Book Value | $297,775 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,804,540 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,504,015 | DepreciationAmt |
| Book Value | $43,300,525 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,319,632 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,180,724 | DepreciationAmt |
| Book Value | $1,138,908 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,760 | OtherCostOrOtherBasisAmt |
| Book Value | $20,760 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $44,757,968 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILATES | $2,928,180 |
| DUE TO THIRD PARTY PAYORS | $312,326 |
| OTHER LIABILITIES | $250,744 |
| PENSION PLANS | $211,152 |
| RESIDENTS FUND | $259,535 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,961,937 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INTENDED PURPOSE OF THE ENDOWMENT FUNDS IS TO PROVIDE LONG-TERM SUPPORT FOR CHARITABLE PROGRAM. |
| PART X, LINE 2: | SAMARITAN SENIOR VILLAGE QUALIFIES AS A TAX-EXEMPT, NOT-FOR-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2023 AND 2022, SAMARITAN DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2020 THROUGH 2023. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS CARMAN | ||||||||||||||
| PRESIDENT/CEO | $0 | $735,218 | $0 | $306,133 | $0 | $2,240 | $0 | $11,200 | $0 | $47,872 | $0 | $1,102,663 | $0 | $0 |
| MAXINE BRIGGS | ||||||||||||||
| CFO/TREASURER | $0 | $494,062 | $0 | $43,335 | $0 | $22,500 | $0 | $17,800 | $0 | $30,374 | $0 | $608,071 | $0 | $0 |
| PATRICK CALLI | ||||||||||||||
| SSV ADMINISTRATOR | $200,751 | $43,364 | $22,701 | $0 | $10,018 | $2,163 | $12,187 | $1,213 | $169 | $41 | $245,826 | $46,781 | $0 | $0 |
| SUSAN GREER | ||||||||||||||
| ASSISTANT DIRECTOR OF NURSING | $209,092 | $0 | $200 | $0 | $0 | $0 | $4,906 | $0 | $21,191 | $0 | $235,389 | $0 | $0 | $0 |
| VICKIE SMITHERS | ||||||||||||||
| NURSE MANAGER | $161,841 | $0 | $2,600 | $0 | $0 | $0 | $9,051 | $0 | $22,472 | $0 | $195,964 | $0 | $0 | $0 |
| JEANETTE EMERY | ||||||||||||||
| DIRECTOR OF NURSING | $179,158 | $0 | $750 | $0 | $0 | $0 | $6,369 | $0 | $8,516 | $0 | $194,793 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO AN IRC 457 (B) PLAN DURING 2023: MAXINE BRIGGS- $22,500 PATRICK CALLI- $12,182 THE FOLLOWING INDIVIDUALS RECEIVED COMPENSATION FROM SAMARITAN MEDICAL CENTER DURING 2023: THOMAS CARMAN: $1,102,663 MAXINE BRIGGS: $608,071 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERSON COUNTY CIVIC FACILITY DEVELOPMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issued | 2012-10-01 | BondIssuedDt |
| Issue Price | $28,145,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION OF SKILLED NURSING FACILITY | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $28,145,000 | TotalProceedsAmt |
| Capitalized Interest | $250,905 | CapitalizedInterestAmt |
| Capital Expenditures | $27,510,001 | CapitalExpendituresAmt |
| Other Spent Proceeds | $384,094 | OtherSpentProceedsAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF SAMARITAN SENIOR VILLAGE, INC. IS THE SAMARITAN MEDICAL CENTER. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S FORM 990 AND ACCOMPANYING SCHEDULES WERE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD, PRIOR TO FILING. FORM 990 WAS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL DISCLOSURE STATEMENTS ARE REQUIRED BY ALL BOARD MEMBERS AND KEY PERSONS. WE HAVE MET 100% COMPLIANCE WITH THIS REQUIREMENT EACH YEAR. RESPONSES ARE REVIEWED INITIALLY BY THE CHIEF EXECUTIVE OFFICER AND CHIEF COMPLIANCE OFFICER FOR ACCURACY AND COMPLETENESS. THIS INFORMATION IS DISCLOSED IN A FULL REPORT TO THE BOARD OF TRUSTEES FOR REVIEW AND CONSIDERATION FOR FUTURE DECISION MAKING. BOARD MEMBERS AND KEY PERSONS AFFIRM THEIR UNDERSTANDING OF THEIR DUTY TO REPORT ANY ADDITIONAL OR NEW POTENTIAL CONFLICTS THROUGHOUT THE YEAR. BOARD MEMBERS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATION IN VOTING AND DECISION MAKING IN RELATED TRANSACTIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION USES AN EXTERNAL CONSULTANT TO ANALYZE AND ESTABLISH COMPENSATION AND BENEFITS FOR ALL EXECUTIVE POSITIONS. AN EVALUATION IS PERFORMED ANNUALLY. THE ANALYSIS INCLUDES A REVIEW OF MARKET DATA BASED ON REGION, FACILITY SIZE, AND RESPECTIVE RESPONSIBILITIES. THIS INFORMATION IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND SUBSEQUENTLY PRESENTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE FILED AS PART OF THE ANNUAL NYS DEPARTMENT OF HEALTH INSTITUTIONAL COST REPORT, AND ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | PENSION AND OTHER POSTRETIREMENT LIABILITY ADJUSTMENTS 118,005. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -34,132. |
| FORM 990 PART XII LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| SCHEDULE A LINE 3 | SAMARITAN SENIOR VILLAGE, INC. IS A NURSING HOME WHICH HAS AS ITS MAIN PURPOSE THE PROVISION OF HEALTHCARE SERVICES, IT APPROPRIATELY NOTED ON FORM 1023 THAT IT IS A HOSPITAL. THE STATE OF NEW YORK DOES NOT REQUIRE NURSING HOMES TO BE LICENSED AS A HOSPITAL. AS A NURSING HOME, SAMARITAN SENIOR VILLAGE, INC. HAS AS ITS PRINCIPAL PURPOSE THE PROVISION OF HEALTH CARE. ACCORDINGLY, IT WAS (I) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 1023; (II) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 990 SCHEDULE A; AND (III) SHOULD NOT BE DESIGNATED AS A "HOSPITAL/HOSPITAL FACILITY" ON FORM 990 SCHEDULE H. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SAMARITAN MEDICAL CENTER | |||||||||||
| 830 WASHINGTON ST | WATERTOWN | NY | 13601 | 150533577 | HOSPITAL | NY | 501 (C) (3) | SCHED A,PART I,LN3 | N/A | 0 | |
| SAMARITAN KEEP NURSING HOME INC | |||||||||||
| 133 PRATT ST | WATERTOWN | NY | 13601 | 160969838 | SKILLED NURSING FACILITY | NY | 501 (C) (3) | SCHED A,PART I,LN3 | 0 | SAMARITAN MEDICAL CENTER | |
| THE SAMARITAN MEDICAL CENTER FDN OF NORTHERN NEW YORK INC | |||||||||||
| 830 WASHINGTON STREET | WATERTOWN | NY | 13601 | 161490523 | PROVIDES FUND FOR SAMARITAN MEDICAL CENTER AND AFFLIATES | NY | 501 (C) (3) | SCHED A,PART I,LN7 | 0 | SAMARITAN MEDICAL CENTER | |
| EDWARD J NOBLE HOSPITAL- SAMARITAN | |||||||||||
| 104 PADDOCK ST | WATERTOWN | NY | 13601 | 237227989 | HOSPITAL | NY | 501 (C) (3) | SCHED A,PART I,LN3 | 0 | SAMARITAN MEDICAL CENTER | |
| SAMARITAN MEDICAL PRACTICE PC | |||||||||||
| 830 WASHINGTON ST | WATERTOWN | NY | 13601 | 261528342 | PHYSICIAN MEDICAL PRACTICE | NY | 501 (C) (3) | SCHED A,PART I,LN3 | 0 | SAMARITAN MEDICAL CENTER | |
| SAMARITAN HOME HEALTH INC | |||||||||||
| 165 COLEMAN AVENUE | WATERTOWN | NY | 13601 | 461043637 | CERTIFIED HOME HEALTH AGENCY | NY | 501 (C) (3) | SCHED A,PART I,BOX 1 | 0 | SAMARITAN MEDICAL CENTER | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |