JENNIE B RICHMOND CHAFFEE NURSING HOME CO: Form 990, tax year 2023
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- Organization
- JENNIE B RICHMOND CHAFFEE NURSING HOME CO (EIN 23-7259920)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-15
- IRS object ID
- 202413209349303721
- 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 | 2024-11-15T08:16:20-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 454051133 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREED MAXICK CPAS PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 424 MAIN STREET SUITE 800 | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 142023508 | 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 | 237259920 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNIE B RICHMOND CHAFFEE NURSING HOME | BusinessNameLine1Txt |
| Business Name Line2 | COMPANY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JENN | BusinessNameControlTxt |
| Phone | 7165922871 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 EAST MAIN STREET | AddressLine1Txt |
| City | SPRINGVILLE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14141 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CAROLE FRANCIS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7165922871 | PhoneNum |
| Signature | 2024-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARY MADONIA | PreparerPersonNm |
| PTIN | P00405803 | PTIN |
| Phone | 7168472651 | PhoneNum |
| Preparation | 2024-11-13 | 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 | TERESA DONOHUE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 EAST MAIN STREET | AddressLine1Txt |
| City | SPRINGVILLE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,954,420 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | BERTRANDCHAFFEE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE LONG-TERM CARE AND REHABILITATIVE SERVICES TO THE RESIDENTS OF SPRINGVILLE AND THE SURROUNDING REGION TO ENHANCE THE HEALTH STATUS OF RESIDENTS AND RESPOND TO COMMUNITY HEALTH NEEDS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 115 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,675 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,571 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,265,691 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,939,179 | CYProgramServiceRevenueAmt |
| PY Investment Income | $788 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,670 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,268,154 | PYTotalRevenueAmt |
| CY Total Revenue | $5,954,420 | 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 | $4,562,416 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,107,285 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,672,708 | PYOtherExpensesAmt |
| CY Other Expenses | $2,621,417 | CYOtherExpensesAmt |
| PY Total Expenses | $7,235,124 | PYTotalExpensesAmt |
| CY Total Expenses | $6,728,702 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,966,970 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$774,282 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,281,582 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,121,225 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,105,151 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,719,076 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $176,431 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$597,851 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE LONG-TERM CARE AND REHABILITATIVE SERVICES TO THE RESIDENTS OF SPRINGVILLE AND THE SURROUNDING REGION TO ENHANCE THE HEALTH STATUS OF RESIDENTS AND RESPOND TO COMMUNITY HEALTH NEEDS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,868,029 | ExpenseAmt |
| Revenue | $5,939,179 | RevenueAmt |
| Desc | PROFESSIONAL CARE OF PATIENTS - FACILITY PROVIDED 80 NURSING BEDS, NURSING SERVICES, AND OTHER RELATED SERVICES AND SUPPLIES. | Desc |
| Total Program Service Expenses | $5,868,029 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | 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 | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 115 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | 0 | 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 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7165922871 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | JB RICHMOND CHAFFEE NURSING HOME | AddressLine1Txt |
| City | SPRINGVILLE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14141 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 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 |
|---|---|---|---|---|---|---|---|
| MICHAEL BOZA | |||||||
| BOARD MEMBER/TREASURER | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GARY EPPOLITO | |||||||
| BOARD MEMBER/PRESIDENT | 3.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| STAN HANDZLIK | |||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ROBBIN HANSEN | |||||||
| BOARD MEMBER/VICE PRESIDENT | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CLAUDIA MILLER | |||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| KAREN STANFORD | |||||||
| BOARD MEMBER/SECRETARY (TO 5/18/23) | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| PETER SWALES | |||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT ROGGIE | |||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JOHANNA HEALY | |||||||
| BOARD MEMBER/SECRETARY | 3.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ASHLEY LOWRY | |||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LIZ MELOCK | |||||||
| BOARD MEMBER (BEGAN 6/1/2023) | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ALLISON DUWE | |||||||
| BOARD MEMBER (BEGAN 6/1/2023) | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| GEORGETTE WAY-MILLER | |||||||
| BOARD MEMBER/ADMINISTRATOR (MARCH-SEPT 2023) | 40.00 | Yes (X) | $42,832 | $0 | $15,444 | ||
| SHARON ZEAMER | |||||||
| BOARD MEMBER/ADMINISTRATOR (BEGAN NOV 2023) | 40.00 | Yes (X) | $20,000 | $0 | $64 | ||
| CAROLE M FRANCIS | |||||||
| CFO | 10.00 | 30.00 | Yes (X) | $0 | $0 | $136,060 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $62,832 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $151,568 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUSION WORKFORCE SOLUTIONS | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 30133 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 30133 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | TEMPORARY AGENCY STAFFING | ServicesDesc |
| Compensation | $392,304 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $13,571 | AllOtherContributionsAmt |
| Total Contributions | $13,571 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PROGRAM SERVICES | 623000 | $4,884,787 | $4,884,787 |
| GRANT REVENUE | 623000 | $1,054,392 | $1,054,392 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,939,179 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,670 | TotalRevenueColumnAmt |
| Exclusion | $1,670 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,954,420 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,939,179 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,670 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,832 | TotalAmt |
| Management And General | $62,832 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,359,013 | TotalAmt |
| Program Services | $3,134,460 | ProgramServicesAmt |
| Management And General | $224,553 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,420 | TotalAmt |
| Program Services | $83,999 | ProgramServicesAmt |
| Management And General | $4,421 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,836 | TotalAmt |
| Program Services | $365,594 | ProgramServicesAmt |
| Management And General | $19,242 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,184 | TotalAmt |
| Program Services | $197,968 | ProgramServicesAmt |
| Management And General | $14,216 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,576 | TotalAmt |
| Management And General | $38,576 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,852 | TotalAmt |
| Program Services | $55,397 | ProgramServicesAmt |
| Management And General | $92,455 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,800 | TotalAmt |
| Program Services | $4,800 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,056 | TotalAmt |
| Program Services | $335,899 | ProgramServicesAmt |
| Management And General | $24,157 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,052 | TotalAmt |
| Program Services | $105,052 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,541 | TotalAmt |
| Program Services | $5,541 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,686 | TotalAmt |
| Program Services | $72,852 | ProgramServicesAmt |
| Management And General | $3,834 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,269 | TotalAmt |
| Management And General | $65,269 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SHARED SERVICES | $1,315,416 | $1,056,096 | $259,320 |
| NYS ASSESSMENT FEE | $318,084 | $318,084 | |
| CONTRACTED SERVICES | $80,754 | $80,754 | |
| MISCELLANEOUS | $48,369 | $23,062 | $25,307 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,962 | TotalAmt |
| Program Services | $28,471 | ProgramServicesAmt |
| Management And General | $26,491 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,728,702 | TotalAmt |
| Program Services | $5,868,029 | ProgramServicesAmt |
| Management And General | $860,673 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,734 | BOYAmt |
| EOY | $1,035,932 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $571,999 | BOYAmt |
| EOY | $680,585 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,132 | BOYAmt |
| EOY | $10,435 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,723,555 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,442,638 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $357,603 | BOYAmt |
| EOY | $280,917 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,114 | BOYAmt |
| EOY | $113,356 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,281,582 | BOYAmt |
| EOY | $2,121,225 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $719,330 | BOYAmt |
| EOY | $2,432,383 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,894 | BOYAmt |
| EOY | $14,189 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $371,927 | BOYAmt |
| EOY | $272,504 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,105,151 | BOYAmt |
| EOY | $2,719,076 | 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 | $176,431 | BOYAmt |
| EOY | -$597,851 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,431 | BOYAmt |
| EOY | -$597,851 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,281,582 | BOYAmt |
| EOY | $2,121,225 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$774,282 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $200 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,472 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,426 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,675 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,571 | CurrentTaxYearAmt |
| Total | $25,344 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,832,103 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,639,117 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,210,678 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,265,691 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,939,179 | CurrentTaxYearAmt |
| Total | $31,886,768 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,832,303 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,642,589 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,217,104 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,267,366 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,952,750 | CurrentTaxYearAmt |
| Total | $31,912,112 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $31,912,112 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $571 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $164 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $486 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $788 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,670 | CurrentTaxYearAmt |
| Total | $3,679 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $571 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $164 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $486 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $788 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,670 | CurrentTaxYearAmt |
| Total | $3,679 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,832,874 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,642,753 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,217,590 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,268,154 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,954,420 | CurrentTaxYearAmt |
| Total | $31,915,791 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99990 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99990 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00010 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,000 | OtherCostOrOtherBasisAmt |
| Book Value | $16,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,729,536 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,571,233 | DepreciationAmt |
| Book Value | $158,303 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,816,952 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,738,251 | DepreciationAmt |
| Book Value | $78,701 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $161,067 | OtherCostOrOtherBasisAmt |
| Depreciation | $133,154 | DepreciationAmt |
| Book Value | $27,913 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $280,917 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM THIRD PARTIES | $44,710 |
| PATIENT TRUST ACCOUNTS | $14,189 |
| ESCROW ACCOUNTS | $54,457 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $113,356 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO 3RD PARTIES | Desc |
| Amt | $272,504 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $272,504 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE HOME ACTS AS CUSTODIAN FOR RESIDENT PERSONAL FUNDS. |
| PART X, LINE 2: | THE HOSPITAL AND HOME ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND, ACCORDINGLY, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL AND HOME ACCOUNT FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH U.S. GAAP, WHICH REQUIRES THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS THAT THE HOSPITAL AND HOME HAVE TAKEN OR EXPECTS TO TAKE ON THEIR TAX RETURNS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN OUTSIDE, INDEPENDENT ACCOUNTING FIRM. THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE 990 PRIOR TO FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST QUESTIONNAIRE FORMS ARE COMPLETED BY DIRECTORS AND MANAGERS ANNUALLY. THEY ARE REVIEWED BY THE COMPLIANCE OFFICER AND ADDRESSED AS NEEDED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION FORMED AN INDEPENDENT SEARCH COMMITTEE THAT WAS INVOLVED IN NEGOTIATING THE CONTRACT OF THE CURRENT CEO. OTHER OFFICER AND KEY EMPLOYEE SALARIES ARE REVIEWED BY THE BOARD OF DIRECTORS AND SALARIES ARE COMPARED TO PEERS IN THE SURROUNDING AREA TO DETERMINE AN APPROPRIATE PAY SCALE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION PROVIDES COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: AUDIT OVERSIGHT | THE AUDIT OVERSIGHT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| FORM 990, PART IV, LINE 34: RELATED PARTIES | THE BERTRAND CHAFFEE HOSPITAL FOUNDATION, INC. (THE FOUNDATION) WAS ORGANIZED TO RECEIVE AND ADMINISTER FUNDS AND BEQUESTS TO BENEFIT THE COMMUNITY. WHILE THE FOUNDATION MAY, AT TIMES, MAKE DONATIONS TO JENNIE B. RICHMOND CHAFFEE NURSING HOME COMPANY ("JBR") OR BERTRAND CHAFFEE HOSPITAL ("BCH"), THERE IS NO OBLIGATION TO DO SO. THE FOUNDATION WAS NOT ORGANIZED SOLELY TO BENEFIT EITHER OF THESE ENTITIES. THE RELATIONSHIP BETWEEN THE FOUNDATION, JBR AND BCH DOES NOT MEET ANY "RELATED PARTY OR "CONTROL" DEFINITIONS STATED IN THE FORM 990 INSTRUCTIONS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERTRAND CHAFFEE HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 EAST MAIN STREET | AddressLine1Txt |
| City | SPRINGVILLE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14141 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160743921 | EIN |
| Primary Activities | HOSPITAL/HEALTH CARE | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 3 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |